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Sample records for violence hiv infection

  1. A Syndemic Model of Substance Abuse, Intimate Partner Violence, HIV Infection, and Mental Health Among Hispanics

    OpenAIRE

    González-Guarda, Rosa M; Florom-Smith, Aubrey L.; Thomas, Tainayah

    2011-01-01

    Hispanics are disproportionately affected by substance abuse, HIV infection, intimate partner violence, and mental health conditions. To address health disparities among Hispanics and other vulnerable groups, it is necessary to understand the complex interactions between health conditions clustering together (e.g., substance abuse, intimate partner violence, and HIV) and the social ecology in which these conditions exist. A syndemic orientation, a consideration of clustering epidemics and com...

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

    OpenAIRE

    Osinde Michael O; Kaye Dan K; Kakaire Othman

    2011-01-01

    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 interview...

  3. Intimate partner violence and risk of HIV infection in Pakistan

    OpenAIRE

    Muazzam Nasrullah

    2011-01-01

    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.

  4. Exploring risk of experiencing intimate partner violence after HIV infection: a qualitative study among women with HIV attending postnatal services in Swaziland

    Science.gov (United States)

    Mulrenan, Claire; Colombini, Manuela; Kikuvi, Joshua; Mayhew, Susannah H

    2015-01-01

    Objective To explore risks of experiencing intimate partner violence (IPV) after HIV infection among women with HIV in a postnatal care setting in Swaziland. Design A qualitative semistructured in-depth interview study, using thematic analysis with deductive and inductive coding, of IPV experiences after HIV infection extracted from service-integration interview transcripts. Setting Swaziland. Participants 19 women with HIV, aged 18–44, were purposively sampled for an in-depth interview about their experiences of services, HIV and IPV from a quantitative postnatal cohort participating in an evaluation of HIV and reproductive health services integration in Swaziland. Results Results indicated that women were at risk of experiencing IPV after HIV infection, with 9 of 19 disclosing experiences of physical violence and/or coercive control post-HIV. IPV was initiated through two key pathways: (1) acute interpersonal triggers (eg, status disclosure, mother-to-child transmission of HIV) and (2) chronic normative tensions (eg, fertility intentions, initiating contraceptives). Conclusions The results highlight a need to mitigate the risk of IPV for women with HIV in shorter and longer terms in Swaziland. While broader changes are needed to resolve gender disparities, practical steps can be institutionalised within health facilities to reduce, or avoid increasing, IPV pathways for women with HIV. These might include mutual disclosure between partners, greater engagement of Swazi males with HIV services, and promoting positive masculinities that support and protect women. Trial registration number NCT01694862. PMID:25976760

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

    Directory of Open Access Journals (Sweden)

    Osinde Michael O

    2011-11-01

    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.

  6. Sexual violence and HIV/AIDS transmission

    OpenAIRE

    Jennifer Klot; Pam DeLargy

    2007-01-01

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

  7. Gender violence and HIV : reversing twin epidemics

    OpenAIRE

    Eghtessadi, R.

    2008-01-01

    The situation of women and girls in the context of the HIV and AIDS epidemic in many parts of the world and particularly sub-Saharan Africa continues to be a cause of major concern. With more than 30% of women in some countries reporting their first sexual encounter as forced, and the continued feminization of the HIV epidemic, violence remains both a cause and consequence of HIV infection. Once infected with HIV, women often face varied forms of violence, particularly driven by stigma and di...

  8. 77 FR 20277 - Establishing a Working Group on the Intersection of HIV/AIDS, Violence Against Women and Girls...

    Science.gov (United States)

    2012-04-03

    ...girls from seeking prevention, treatment, and...intersection of HIV/AIDS, violence against...their role in the prevention of violence against women and HIV/AIDS infection; (v...integration of HIV/AIDS prevention and [[Page...

  9. Impact of exposure to intimate partner violence on CD4+ and CD8+ T cell decay in HIV infected women: longitudinal study.

    Science.gov (United States)

    Jewkes, Rachel; Dunkle, Kristin; Jama-Shai, Nwabisa; Gray, Glenda

    2015-01-01

    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 pabuse at baseline or prior to the first HIV+ test (Coeff -178.4 95%CI -330.2, -26.5 p=0.02). In young ART-naive HIV positive women gender-based violence 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

  10. Crack cocaine use and its relationship with violence and HIV

    Scientific Electronic Library Online (English)

    Heraclito Barbosa de, Carvalho; Sergio Dario, Seibel.

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

  11. Crack cocaine use and its relationship with violence and HIV

    Directory of Open Access Journals (Sweden)

    Heraclito Barbosa de Carvalho

    2009-01-01

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

  12. Impact of Exposure to Intimate Partner Violence on CD4+ and CD8+ T Cell Decay in HIV Infected Women: Longitudinal Study

    Science.gov (United States)

    Jewkes, Rachel; Dunkle, Kristin; Jama-Shai, Nwabisa; Gray, Glenda

    2015-01-01

    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

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

    Scientific Electronic Library Online (English)

    Claudia, Barros; Lilia Blima, Schraiber; Ivan, França-Junior.

    2011-04-01

    Full Text Available OBJETIVO: Analisar a associação entre a violência por parceiro íntimo contra mulheres e a infecção ou suspeita de infecção pelo vírus da imunodeficiência humana (HIV). MÉTODOS: Estudo transversal com base em dados de questionários aplicados face-a-face e de prontuários médicos de 2.780 mulheres de 1 [...] 5 a 49 anos, atendidas em unidades do sistema único de saúde da Grande São Paulo, SP, em 2001-2002. As mulheres foram categorizadas em: usuárias em tratamento por serem "soropositivas para o HIV", com "suspeita de HIV" e aquelas que procuraram os serviços por outros motivos. A violência por parceiro íntimo contra mulheres na vida foi categorizada por gravidade e recorrência dos episódios de violência. A associação com o desfecho foi testada pelo modelo de Poisson com variância robusta e ajustada por variáveis sociodemográficas, sexuais e reprodutivas. RESULTADOS: A prevalência de violência foi de 59,8%. Sofrer violência reiterada e grave apresentou maior associação de infecção confirmada pelo HIV (RP = 1,91). A violência independente da gravidade e da recorrência dos episódios apresentou maior associação para a suspeita de infecção por HIV (RP = 1,29). CONCLUSÕES: A violência por parceiro íntimo contra mulheres tem papel relevante nas situações de suspeita e confirmação da infecção pelo HIV, sendo essencial incluir sua detecção, controle e prevenção como parte da atenção integral à saúde das mulheres. Abstract in spanish OBJETIVO: Analizar la asociación entre la violencia contra mujeres por pareja íntima y la infección o sospecha de infección por el virus de inmunodeficiencia humana (VIH). MÉTODOS: Estudio transversal con base en datos de cuestionarios aplicados cara-a cara y de prontuarios médicos de 2.780 mujeres [...] de 15 a 49 años, atendidas en unidades del sistema único de salud de la Gran Sao Paulo, Sureste de Brasil, en 2001-2002. Las mujeres fueron categorizadas en: usuarias en tratamiento por ser "seropositivas para el VIH", con "sospecha de VIH" y aquellas que buscaron los servicios por otros motivos. La violencia contra mujeres por pareja íntima en la vida fue categorizada por gravedad y recurrencia de los episodios de violencia. La asociación con la infección fue evaluada por el modelo de Poisson con variancia robusta y ajustada por variables sociodemográficas, sexuales y reproductivas. RESULTADOS: La prevalencia de violencia fue de 59,8%. Sufrir violencia reiterada y grave presentó mayor asociación de infección confirmada por el VIH (RP=1,91). La violencia independiente de la gravedad y de la recurrencia de los episodios presentó mayor asociación para la sospecha de infección por VIH (RP= 1,29). CONCLUSIONES: La violencia contra mujeres por pareja íntima tiene papel relevante en las situaciones de sospecha y confirmación de la infección por el HIV, siendo esencial incluir su detección, control y prevención como parte de la atención integral a la salud de las mujeres. Abstract in english OBJECTIVE: To analyze the association between intimate partner violence against women and infection or suspected infection by the human immunodeficiency virus (HIV). METHODS: A cross-sectional study was conducted, based on data from questionnaires applied face-to-face and medical records of 2,780 wo [...] men aged between 15 and 49 years, cared for in Sistema Único de Saúde (Unified Health System) units of the Greater São Paulo area, Southeastern Brazil, in 2001-2002. Women were categorized into: users in treatment because they are "HIV seropositive", those "suspected of having HIV" and others who sought health services for different reasons. Intimate partner violence against women throughout life was categorized according to the severity and recurrence of episodes of violence. The association with the outcome was tested using the Poisson model with robust and adjusted variance for sociodemographic, sexual and reproductive variables. RESULTS: The prevalence of violence was 59.8%. Suffering repeated and severe violence

  14. Pediatric HIV Infection

    Directory of Open Access Journals (Sweden)

    Pere Soler

    2004-11-01

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

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

    Directory of Open Access Journals (Sweden)

    Kerr Thomas

    2008-07-01

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

  16. Health promotion in the city: A structured review of the literature on interventions to prevent heart disease, substance abuse, violence and HIV infection in us metropolitan areas, 1980–1995

    OpenAIRE

    Freudenberg, Nicholas; Silver, Diana; Carmona, Jenniferm M.; Kass, Daniel; Lancaster, Brick; Speers, Marjorie

    2000-01-01

    To achieve its national public health goals, the US must improve the health of low-income urban populations. To contribute to this process, this study reviewed published reports of health promotion interventions designed to prevent heart disease, HIV infection, substance abuse, and violence in US cities. The study's objectives were to describe the target populations, settings, and program characteristics of these interventions and to assess the extent to which these programs followed accepted...

  17. Experience of sexual violence among women in HIV discordant unions after voluntary HIV counselling and testing: a qualitative critical incident study in Uganda

    OpenAIRE

    Emusu, Donath; Ivankova, Nataliya; Jolly, Pauline; Kirby, Russell; Foushee, Herman; Wabwire-mangen, Fred; Katongole, Drake; Ehiri, John

    2009-01-01

    HIV-serodiscordant relationships are those in which one partner is infected with HIV while the other is not. We investigated experiences of sexual violence among women in HIV discordant unions attending HIV post-test club services in Uganda. A volunteer sample of 26 women from three AIDS Information Centres in Uganda who reported having experienced sexual violence in a larger epidemiological study were interviewed, using the qualitative critical incident technique. Data were analysed using TE...

  18. Domestic violence screening: prevalence and outcomes in a Canadian HIV population.

    Science.gov (United States)

    Siemieniuk, Reed A C; Krentz, Hartmut B; Gish, Jessica A; Gill, M John

    2010-12-01

    There is a strong association between domestic violence victimization and HIV infection. This may lead to poor health outcomes including mental health disorders and reduced access to care. A standardized domestic violence screening interview was incorporated into ongoing care in the large and diverse population living with HIV in Southern Alberta, Canada. Results from May through December 2009 are reported, including the prevalence and outcomes of abuse. Thirty-four percent of 853 patients screened reported abuse. Of these, 16% reported abuse in their current relationship, 58% in a previous relationship, and 57% reported a history of childhood abuse. High-risk groups for abuse included females (43%), gay/bisexual males (35%), and Aboriginals (61%). We found an association between a history of domestic violence and delayed access to care (p Mental health conditions prior to HIV diagnosis, including depression (p < 0.0001), suicidal ideation (p < 0.0001), and anxiety disorder (p < 0.0001) were associated with abuse at any time, while a history of adjustment disorder was associated with childhood abuse (p < 0.05). A simple domestic violence screening tool was helpful for identifying patients experiencing abuse in our diverse HIV-infected population. This high prevalence of domestic violence among our HIV patients was associated with poor outcomes and an increased use of medical resources. HIV caregivers should be aware of domestic violence in order to optimize care and refer patients to appropriate support professionals as needed. PMID:21138382

  19. Intracellular Dynamics of HIV Infection

    OpenAIRE

    Petravic, Janka; Ellenberg, Paula; Chan, Ming-Liang; Paukovics, Geza; Smyth, Redmond P.; Mak, Johnson; Davenport, Miles P

    2014-01-01

    Early studies of HIV infection dynamics suggested that virus-producing HIV-infected cells had an average half-life of approximately 1 day. However, whether this average behavior is reflective of the dynamics of individual infected cells is unclear. Here, we use HIV-enhanced green fluorescent protein (EGFP) constructs and flow cytometry sorting to explore the dynamics of cell infection, viral protein production, and cell death in vitro. By following the numbers of productively infected cells e...

  20. Gender inequality and domestic violence: implications for human immunodeficiency virus (HIV) prevention

    OpenAIRE

    Kaye, Dan K.

    2004-01-01

    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...

  1. International travel and HIV infection.

    OpenAIRE

    von Reyn, C F; Mann, J.M.; Chin, J.

    1990-01-01

    Although human immunodeficiency virus (HIV) infection is a worldwide problem, its prevalence and pattern vary from country to country. Accordingly, the risk to international travellers of acquiring HIV infection also varies widely in different parts of the world, and depends principally on their behaviour. The risk of sexual acquisition of HIV infection can be virtually eliminated by avoiding penetrative sexual intercourse with intravenous drug users and persons who have had multiple sexual p...

  2. HIV/AIDS and Infections

    Science.gov (United States)

    ... pneumocystis carinii pneumonia (PCP) and histoplasmosis, and parasites cause crypto (cryptosporidiosis) and toxo (toxoplasmosis). Having HIV/AIDS can make any infection harder to treat. People ...

  3. Mucosal Immunology of HIV Infection

    OpenAIRE

    Xu, Huanbin; Wang, Xiaolei; Veazey, Ronald S.

    2013-01-01

    Recent advances in the immunology, pathogenesis, and prevention of human immunodeficiency virus (HIV) infection continue to reveal clues to the mechanisms involved in the progressive immunodeficiency attributed to infection but more importantly have shed light on the correlates of immunity to infection and disease progression. HIV selectively infects, eliminates, and/or dysregulates several key cells of the human immune system, thwarting multiple arms of the host immune response, and inflicti...

  4. HIV Infection and Cancer Risk

    Science.gov (United States)

    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.

  5. HIV infection of the penis

    OpenAIRE

    Anderson, Deborah; Politch, Joseph A.; Pudney, Jeffrey

    2011-01-01

    The penile foreskin, shaft, glans/corona, meatus and urethral introitus are all potential sites of HIV-1 acquisition in men. Circumcision decreases HIV infection in heterosexual men by 50–60%, indicating that the foreskin plays an important role, but that other sites are also involved. HIV target cells have been described throughout the male genital epithelium, but appear to be more accessible in the inner foreskin and urethral introitus, both of which are mucosal (wet) epithelia and infect...

  6. Selenium Deficiency and HIV Infection

    OpenAIRE

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

    2010-01-01

    Selenium is a non-metallic chemical element of great important to human health. Low selenium levels in humans are associated with several pathological conditions and are a common finding in HIV infected individuals. We conducted a review of the literature to assess if selenium deficiency or selenium supplementation could play a role in modifying the clinical course of HIV disease. Several studies investigated the role of selenium in disease progression, morbidity and mortality in HIV infected...

  7. History of Violence as a Predictor of HIV Risk among Multi-Ethnic, Urban Youth in the Southwest

    OpenAIRE

    Marsiglia, Flavio Francisco; Nieri, Tanya; Valdez, Elizabeth; Gurrola, Maria; Marrs, Catherine

    2009-01-01

    This community-based exploratory study examined the effects of a history of violence, ethnic identification, and acculturation status on HIV risk among a majority Latino sample of youth living in a large metropolitan area of the Southwest in the United States. The participants reported high rates of violence and attitudes that put them at risk for HIV/AIDS infection. They participated in 1 of 2 prevention interventions offered by a local non-governmental organization. The first intervention w...

  8. Haematological complications of HIV infection

    Scientific Electronic Library Online (English)

    Jessica, Opie.

    2012-06-01

    Full Text Available 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.

  9. Injection Drug Use, Sexual Risk, Violence, and STI/HIV among Moscow FSWs

    Science.gov (United States)

    Decker, Michele R.; Wirtz, Andrea L.; Baral, Stefan D.; Peryshkina, Alena; Mogilnyi, Vladmir; Weber, Rachel A.; Stachowiak, Julie; Go, Vivian; Beyrer, Chris

    2013-01-01

    Background/objectives The HIV prevalence in Eastern Europe and Central Asia continues to increase. While injection drug use (IDU) is leading factor, heterosexual transmission is on the rise. Little is known about female sex workers (FSWs) in the region despite the central role of commercial sex in heterosexual STI/HIV transmission globally. We evaluated the prevalence of STI/HIV among Moscow-based FSWs, and potential risk factors including IDU, sexual risks, and violence victimization. Methods Moscow-based FSWs (n=147) completed a clinic-based survey and STI/HIV testing over an eight month period in 2005. Results HIV prevalence was 4.8%, and 31.3% were infected with at least one STI including HIV. Sexual behaviors significantly associated with STI/HIV included anal sex (AOR 3.48), high client volume (three or more clients daily, AOR 2.71), recent subbotnik (sex demanded by police; AOR 2.50), and regularly being presented with more clients than initially agreed to (AOR 2.45). Past year experiences of physical violence from clients and threats of violence from pimps were associated with STI/HIV (AOR 3.14; AOR 3.65 respectively). IDU was not significantly associated with STI/HIV. Anal sex and high client volume partially mediated the associations of abuse with STI/HIV. Conclusion Findings illustrate substantial potential for heterosexual STI/HIV transmission in a setting better known for IDU-related risk. Many of the STI/HIV risks observed are not modifiable by FSWs alone. STI/HIV prevention efforts for this vulnerable population will benefit from reducing coercion and abuse perpetrated by pimps and clients. PMID:22287530

  10. Addressing the Intersection of HIV and Intimate Partner Violence Among Women with or at Risk for HIV in the United States.

    Science.gov (United States)

    McCree, Donna Hubbard; Koenig, Linda J; Basile, Kathleen C; Fowler, Dawnovise; Green, Yvonne

    2015-05-01

    In 2012, the White House established a working group in recognition of the need to understand and address the intersection of human immunodeficiency virus (HIV) infection and violence against women and girls. This report describes the Centers for Disease Control and Prevention (CDC)'s efforts for addressing intimate partner violence and HIV among women and provides suggestions for future prevention efforts. CDC's current efforts are focused on understanding these often co-occurring public health problems, identifying effective interventions, and ensuring that states and communities have the capacity and resources to implement prevention approaches based on the best available evidence. Additional research is needed on effective strategies for integrating violence prevention and HIV programming into health services targeting adolescent girls and women who experience intimate partner violence or are at risk for HIV. PMID:25973798

  11. Brucella Infection in HIV Infected Patients

    Directory of Open Access Journals (Sweden)

    SeyedAhmad SeyedAlinaghi

    2011-12-01

    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.

  12. Early thrombocytopenia in HIV infection.

    OpenAIRE

    1992-01-01

    Three children aged between 7 months and 2 years developed thrombocytopenia as an early feature of HIV infection. The prevalence of this condition, possible pathogenesis, and options for treatment are discussed. HIV testing should be considered in the investigation of a child with thrombocytopenia.

  13. Domestic Violence Shelters as Prevention Agents for HIV/AIDS?

    Science.gov (United States)

    Rountree, Michele A.; Pomeroy, Elizabeth C.; Marsiglia, Flavio F.

    2008-01-01

    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…

  14. Stages of HIV Infection

    Science.gov (United States)

    ... 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 ...

  15. Treatment of HIV Infection

    Science.gov (United States)

    ... drugs in order to maintain their health quality. HIV/AIDS Treatment Research NIAID is focused on finding new and ... is available to the public. Learn More About HIV/AIDS Treatments AZT and AIDS Classes of HIV/AIDS Antiretroviral ...

  16. HIV Infection and Cancer Risk

    Science.gov (United States)

    ... and head and neck cancer . Hepatitis B virus (HBV) and hepatitis C virus (HCV) both can cause liver cancer . Infection with most of these viruses is more common among people infected with HIV than among uninfected people. In addition, the prevalence of some traditional risk factors for cancer, especially ...

  17. [HIV infection in pregnant women in Chelyabinsk].

    Science.gov (United States)

    Orlova, O A; Karazhas, N V; Rusakova, E V

    2005-01-01

    Data on HIV infection in pregnant women in Chelyabinsk are presented. Starting from 1999, a considerable rise in the number of HIV-infected persons was registered in this city. The social and epidemiological characteristics of HIV-infected pregnant women, as well as the main routes and factors of the infective agent transmission, are given. Relationship between the spread of HIV-infection and drug addiction is revealed. The occurrence of different opportunistic infections in HIV-infected pregnant women is determined. PMID:15773407

  18. HIV/AIDS and Fungal Infections

    Science.gov (United States)

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

  19. Intersection of Intimate Partner Violence and HIV in Women

    Science.gov (United States)

    ... 20 as well as HIV infection,21 in adult women. Studies of HIV-Positive Women Several studies have examined ... transmission of HIV by roughly 63% in the study group overall. ... through the Rape Prevention and Education Program by supporting strategies to prevent first-time ...

  20. HIV infection among seafarers in Croatia.

    Science.gov (United States)

    Muli?, Rosanda; Vidan, Pero; Polak, Nikola Kolja

    2010-01-01

    The purpose of this study was to estimate the magnitude of the HIV problem among seafarers in Croatia. The study is based on data from the AIDS/HIV Registry of the Croatian National Institute of Public Health and data on the number of seafarers in Croatia, from the Croatian Seafarers' Union. All case records of HIV infection among seafarers and the type of their sexual contacts have been analysed retrospectively. During the period between 1985 and the end of October 2009, a total of 784 persons with diagnosed HIV infection were registered, of which 74 were seafarers (9.4%). Only 0.25% of Croatian seafarers are HIV infected. Considering the fact that seafarers are a "bridge" for HIV infection to the population, this article describes the epidemiological characteristics of HIV infection among Croatian seafarers and suggests measures in combating HIV infection in their population. PMID:21348014

  1. Psychosocial and cultural correlates of depression among Hispanic men with HIV infection: a pilot study.

    Science.gov (United States)

    De Santis, J P; Gonzalez-Guarda, R M; Vasquez, E P

    2012-12-01

    Depression is a common mental health condition among persons with human immunodeficiency virus (HIV) infection. Depression influences quality of life, social relationships and adherence to medication therapy. Little is known about depression among Hispanic men with HIV infection. The purpose of this pilot study was to describe the relationships of depression to other psychosocial factors (self-esteem, Hispanic stress, substance abuse and violence) and cultural factors (familism and Hispanic stress) among a sample of Hispanic men with HIV infection. Using a cross-sectional, descriptive research design a convenience sample of 46 Hispanic men with HIV infection was recruited and surveyed from the South Florida area of the USA. The majority of the participants (65%; n = 30) were depressed. In addition, the majority of participants reported high familism and self-esteem and low Hispanic stress. A history of substance abuse and childhood and adult violence were common. Significant relationships were noted between depression, and self-esteem, Hispanic stress, substance abuse, and adult physical violence. Healthcare providers need to be aware of the high rates of depression, substance abuse and violence that may occur among Hispanic men with HIV infection. More research is needed to further explore the relationship of these factors, as well as to determine the impact that these variables have on adherence to medication therapy among Hispanic men with HIV infection. PMID:22295937

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

    Scientific Electronic Library Online (English)

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

    1493-15-01

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

  3. Methamphetamine Enhances HIV Infection of Macrophages

    OpenAIRE

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

    2008-01-01

    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...

  4. Cancer Screening in Patients Infected with HIV

    OpenAIRE

    SIGEL, Keith; Dubrow, Robert; Silverberg, Michael; CROTHERS, Kristina; Braithwaite, Scott; Justice, Amy

    2011-01-01

    Non–AIDS-defining cancers are a rising health concern among HIV-infected patients. Cancer screening is now an important component of health maintenance in HIV clinical practice. The decision to screen an HIV-infected patient for cancer should include an assessment of individualized risk for the particular cancer, life expectancy, and the harms and benefits associated with the screening test and its potential outcome. HIV-infected patients are at enhanced risk of several cancers compared to th...

  5. Perceptions fuelling gender-based violence and HIV

    OpenAIRE

    Mandangu, G.

    2011-01-01

    The community of the Mudzi district, Zimbabwe is still mired in negative cultural practices, while stigma around HIV is high and gender-based violence (GBV) is commonplace, especially between intimate partners. This article sketches the situation and gives recommendations on how to improve the situation.

  6. Mucocutaneous manifestations of HIV infection

    Directory of Open Access Journals (Sweden)

    Shobhana A

    2004-03-01

    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.

  7. Human Immunodeficiency Virus (HIV) Primary Infection

    Science.gov (United States)

    newsletter | contact Share | Human Immunodeficiency Virus (HIV) Primary Infection Information for adults A A A When HIV is first contracted, there may be a ... 1–6 weeks following exposure to HIV (the human immunodeficiency virus). Chronic infection with this virus can cause ...

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

    OpenAIRE

    Tylleskar Thorkild; Tumwine James K; Karamagi Charles AS; Heggenhougen Kristian

    2006-01-01

    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...

  9. Western blot profile in HIV infection

    OpenAIRE

    Sudha T; Lakshmi V; Teja V

    2006-01-01

    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...

  10. Dyslipidemia in HIV-infected individuals

    Scientific Electronic Library Online (English)

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

    2010-12-01

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

  11. Epidemiology of HIV infection in women.

    Science.gov (United States)

    Johnson, A M

    1992-03-01

    In sub-Saharan Africa the highest rates of HIV infection are among sexually active young women ( 35 years old). In fact, 15-24 year old women in Africa are more likely to be HIV-infected than 15-24 year old men, indicating that women may have their first intercourse earlier and have older sexual partners than men. HIV risk factors in africa are number of partners, contact with prostitutes, being a prostitute, and a history of sexually transmitted diseases (STDs). The ratio of HIV-infected males is essentially the same as HIV-infected females in Africa. In Thailand and India, prostitutes have some of the highest rates of HIV infection. In the US, the mid-Atlantic, southeastern states and Puerto Rico have the highest rates among parturient women. HIV prevalence is higher among black and Hispanic women than white women and higher among urban women than rural women. 51% of HIV-infected women in the US acquired HIV via IV drug use and 33% via heterosexual intercourse. On the other hand, 55% of HIV-infected women in the UK and in Europe acquired HIV via heterosexual intercourse, while 23% in the UK and few in Europe acquired it via IV drug use. HIV infection among female prostitutes in the US and UK has largely occurred from IV drug use. Transmission of HIV from male to female is more efficient than it is from female to male. Cofactors for heterosexual transmission are vaginal intercourse, anal intercourse, presence of AIDS symptomatic disease, STDs (especially genital ulcers),and an uncircumcised penis. Mass education campaigns and counseling have increased people's knowledge about HIV/AIDS in developed and developing countries, but they do not always result in behavioral change. WHO believes that 3 million more women and children will die from AIDS during the 1990s. AIDS mortality will likely affect population growth in Africa and boost adult and infant mortality everywhere. PMID:1378779

  12. Arthritis associated with HIV infection: radiographic manifestations.

    Science.gov (United States)

    Rosenberg, Z S; Norman, A; Solomon, G

    1989-10-01

    Radiographs of symptomatic joints were retrospectively evaluated in 24 patients with inflammatory arthritis and human immunodeficiency virus (HIV) infection. Clinically, 20 patients had a seronegative arthritis including Reiter syndrome (54%), psoriatic arthritis (17%), and undifferentiated forms of spondyloarthropathy (13%). These patients were indistinguishable radiographically from patients with typical seronegative disorders except for the predominance of lower-extremity abnormalities. Four patients (17%) had a rheumatoidlike arthritis defined as acute symmetric polyarthritis (ASP). With the exception of extensive proliferative periostitis, ASP simulated classic rheumatoid arthritis. HIV-associated arthritis was manifest during various stages of HIV infection. It preceded acquired immunodeficiency syndrome in 64% of patients with stage IV HIV infection. Awareness of the coexistence of HIV infection in patients with the above-mentioned arthritides is important, since immunosuppressive therapy, commonly used in the treatment of arthritis, can have detrimental effects in patients with HIV infection. PMID:2781004

  13. Gendered violence and HIV in Burundi

    OpenAIRE

    Hakan Seckinelgin; Joseph Bigirumwami; Jill Morris

    2010-01-01

    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.

  14. Gendered violence and HIV in Burundi

    Directory of Open Access Journals (Sweden)

    Hakan Seckinelgin

    2010-10-01

    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.

  15. Psychiatric Disorders Among Patients with HIV Infection

    Directory of Open Access Journals (Sweden)

    Bahad?r Bak?m

    2005-01-01

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

  16. Stem Cell transplantation in HIV infected patients

    OpenAIRE

    Krishnan, Amrita

    2009-01-01

    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...

  17. Impact of HIV-1, HIV-2, and HIV-1+2 dual infection on the outcome of tuberculosis

    Directory of Open Access Journals (Sweden)

    C. Wejse

    2015-03-01

    Conclusion: The HIV type-associated risk of TB was much higher for HIV-1 patients and higher but less so for HIV-2 patients, compared with the HIV-uninfected. Clinical severity at presentation was also higher for HIV-infected patients, although less so for HIV-2-infected patients, and all HIV-infected patients had a poorer outcome than the uninfected; mortality was 4–5-fold higher for HIV-1 and dually infected patients and two-fold higher for HIV-2-infected patients. These differences between HIV types did not disappear after adjusting for CD4 count.

  18. Cancer screening in patients infected with HIV.

    Science.gov (United States)

    Sigel, Keith; Dubrow, Robert; Silverberg, Michael; Crothers, Kristina; Braithwaite, Scott; Justice, Amy

    2011-09-01

    Non-AIDS-defining cancers are a rising health concern among HIV-infected patients. Cancer screening is now an important component of health maintenance in HIV clinical practice. The decision to screen an HIV-infected patient for cancer should include an assessment of individualized risk for the particular cancer, life expectancy, and the harms and benefits associated with the screening test and its potential outcome. HIV-infected patients are at enhanced risk of several cancers compared to the general population; anal cancer, hepatocellular carcinoma, Hodgkin's lymphoma, and lung cancer all have good evidence demonstrating an enhanced risk in HIV-infected persons. A number of cancer screening interventions have shown benefit for specific cancers in the general population, but data on the application of these tests to HIV-infected persons are limited. Here we review the epidemiology and background literature relating to cancer screening interventions in HIV-infected persons. We then use these data to inform a conceptual model for evaluating HIV-infected patients for cancer screening. PMID:21695529

  19. Macrophage signaling in HIV-1 infection

    Directory of Open Access Journals (Sweden)

    Abbas Wasim

    2010-04-01

    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.

  20. HIV: Neuropsychiatric Aspects of Infection and Therapy

    Directory of Open Access Journals (Sweden)

    Rute Alves

    2013-12-01

    Full Text Available Since its recognition in the 80s, HIV infection has reached 65 million people worldwide. The presence of the virus in CNS occurs in most patients, increasingly being identified neuropsychiatric disorders associated with infection and / or treatment with ARV. This article intends to briefly review the neuro-pathogenesis and neuropsychiatric disorders associated with HIV infection and treatment with HAART, as well as its therapeutic approach.

  1. Women living with HIV: Disclosure, violence, and social support

    OpenAIRE

    Gielen, Andrea Carlson; Fogarty, Linda; O Campo, Patricia; Anderson, Jean; Keller, Jean; Faden, Ruth

    2000-01-01

    This paper describes the frequency of women's disclosure of their HIV status, examines the extent to which they experience adverse social and physical consequences when others learn they are infected, and analyzes correlates of these negative outcomes. There were 257 HIV-positive women between the ages of 18 and 44, recruited from HIV/AIDS primary care clinics and from community sites, who completed a face-to-face interview. Women in the sample were 33 years old on average; 92% were African-A...

  2. Epidemiology of HIV infection in Northern Pakistan

    International Nuclear Information System (INIS)

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

  3. Diagnosis of Acute HIV Infection in Connecticut

    Science.gov (United States)

    DUBROW, ROBERT; SIKKEMA, KATHLEEN J.; MAYER, KENNETH H.; BRUCE, R. DOUGLAS; JULIAN, PAMELA; RODRIGUEZ, IRMA; BECKWITH, CURT; ROOME, AARON; DUNNE, DANA; BOEVING, ALEXANDRA; KIDDER, THOMAS J.; JENKINS, HEIDI; DOBSON, MICHAEL; BECKER, JOSEPH; MERSON, MICHAEL H.

    2011-01-01

    Acute HIV infection (AHI) is the earliest stage of HIV disease, when plasma HIV viremia, but not HIV antibodies, can be detected. Acute HIV infection often presents as a nonspecific viral syndrome. However, its diagnosis, which enables linkage to early medical care and limits further HIV transmission, is seldom made. We describe the experience of Yale's Center for Interdisciplinary Research on AIDS with AHI diagnosis in Connecticut, as a participating center in the National Institute of Mental Health Multisite AHI Study. We sought to identify AHI cases by clinical referrals and by screening for AHI at two substance abuse care facilities and an STD clinic: We identified one case by referral and one through screening of 590 persons. Screening for AHI is feasible and probably cost effective. Primary care providers should include AHI in the differential diagnosis when patients present with a nonspecific viral syndrome. PMID:19637661

  4. Diagnosis of acute HIV infection in Connecticut.

    Science.gov (United States)

    Dubrow, Robert; Sikkema, Kathleen J; Mayer, Kenneth H; Bruce, R Douglas; Julian, Pamela; Rodriguez, Irma; Beckwith, Curt; Roome, Aaron; Dunne, Dana; Boeving, Alexandra; Kidder, Thomas J; Jenkins, Heidi; Dobson, Michael; Becker, Joseph; Merson, Michael H

    2009-01-01

    Acute HIV infection (AHI) is the earliest stage of HIV disease, when plasma HIV viremia, but not HIV antibodies, can be detected. Acute HIV infection often presents as a nonspecific viral syndrome. However, its diagnosis, which enables linkage to early medical care and limits further HIV transmission, is seldom made. We describe the experience of Yale's Center for Interdisciplinary Research on AIDS with AHI diagnosis in Connecticut, as a participating center in the National Institute of Mental Health Multisite AHI Study. We sought to identify AHI cases by clinical referrals and by screening for AHI at two substance abuse care facilities and an STD clinic. We identified one case by referral and one through screening of 590 persons. Screening for AHI is feasible and probably cost effective. Primary care providers should include AHI in the differential diagnosis when patients present with a nonspecific viral syndrome. PMID:19637661

  5. HIV infection and the kidneys, Part I

    Directory of Open Access Journals (Sweden)

    Basta-Jovanovi? Gordana

    2005-01-01

    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.

  6. Potential use of rapamycin in HIV infection

    DEFF Research Database (Denmark)

    Donia, Marco; McCubrey, James A

    2010-01-01

    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.

  7. Leprosy in an HIV-infected person

    Directory of Open Access Journals (Sweden)

    Chandra Gupta T

    2007-01-01

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

  8. The epidemiology of HIV infection in Zambia.

    Science.gov (United States)

    Kandala, N-B; Ji, C; Cappuccio, P F; Stones, R W

    2008-08-01

    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 Zambia Demographic and Health Survey (ZDHS) and made available in a separate data file in which HIV status was linked to a very limited set of demographic variables. We utilized this data set to examine associations between HIV prevalence, gender, age and geographical location. We applied the generalized geo-additive semi-parametric model as an alternative to the common linear model, in the context of analyzing the prevalence of HIV infection. This model enabled us to account for spatial auto-correlation, non-linear, location effects on the prevalence of HIV infection at the disaggregated provincial level (nine provinces) and assess temporal and geographical variation in the prevalence of HIV infection, while simultaneously controlling for important risk factors. Of the overall sample of 3950, 54% was female. The overall HIV-positivity rate was 565 (14.3%). The mean age at HIV diagnosis for male was 30.3 (SD=11.2) and 27.7 (SD=9.3) for female respectively. Lusaka and Copperbelt have the first and second highest prevalence of AIDS/HIV (marginal odds ratios of 3.24 and 2.88, respectively) but when the younger age of the urban population and the spatial auto-correlation was taken into account, Lusaka and Copperbelt were no longer among the areas with the highest prevalence. Non-linear effects of age at HIV diagnosis are also discussed and the importance of spatial residual effects and control of confounders on the prevalence of HIV infection. The study was conducted to assess the spatial pattern and the effect of confounding risk factors on AIDS/HIV prevalence and to develop a means of adjusting estimates of AIDS/HIV prevalence on the important risk factors. Controlling for important risk factors, such as geographical location (spatial auto-correlation), age structure of the population and gender, gave estimates of prevalence that are statistically robust. Researchers should be encouraged to use all available information in the data to account for important risk factors when reporting AIDS/HIV prevalence. Where this is not possible, correction factors should be applied, particularly where estimates of AIDS/HIV prevalence are pooled in systematic reviews. Our maps can be used for policy planning and management of AIDS/HIV in Zambia. PMID:18608086

  9. Depression in HIV infected patients: a review.

    Science.gov (United States)

    Nanni, Maria Giulia; Caruso, Rosangela; Mitchell, Alex J; Meggiolaro, Elena; Grassi, Luigi

    2015-01-01

    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

  10. AIDS/HIV infection and cerebrovascular disease

    OpenAIRE

    Pinto, A.

    2005-01-01

    The occurrence of cerebrovascular disease in patients with human immunodeficiency virus (HIV) infection has been reported mainly in advanced stages of the disease and was generally associated with nonbacterial thrombotic endocarditis, opportunistic infections, or tumors, although in recent series a large number of cryptogenic strokes were found, probably related to HIV vasculopathy. Recently a population-based study reported a strong association between acquired immunodeficiency syndrom...

  11. Cryptococcal meningitis among HIV infected patients

    OpenAIRE

    Manoharan G; Padmavathy B; Vasanthi S; Gopalte R

    2001-01-01

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

  12. Cryptococcal meningitis among HIV infected patients

    Directory of Open Access Journals (Sweden)

    Manoharan G

    2001-01-01

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

  13. The natural history of HIV infection

    DEFF Research Database (Denmark)

    Sabin, C.A.; Lundgren, J.D.

    2013-01-01

    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.

  14. Mental health, partner violence and HIV risk among women with protective orders against violent partners in Vhembe district, South Africa.

    Science.gov (United States)

    Pengpid, Supa; Peltzer, Karl

    2013-12-01

    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

  15. Dendritic cell dysregulation during HIV-1 infection.

    Science.gov (United States)

    Miller, Elizabeth; Bhardwaj, Nina

    2013-07-01

    Dendritic cells (DCs) are a diverse subset of innate immune cells that are key regulators of the host response to human immunodeficiency virus-1 (HIV-1) infection. HIV-1 directly and indirectly modulates DC function to hinder the formation of effective antiviral immunity and fuel immune activation. This review focuses upon the differential dysregulation of myeloid DCs (mDCs) and plasmacytoid DCs (pDCs) at various stages of HIV-1 infection providing insights into pathogenesis. HIV-1 evades innate immune sensing by mDCs resulting in suboptimal maturation, lending to poor generation of antiviral adaptive responses and contributing to T-regulatory cell (Treg) development. Dependent upon the stage of HIV-1 infection, mDC function is altered in response to Toll-like receptor ligands, which further hinders adaptive immunity and limits feasibility of therapeutic vaccine strategies. pDC interactions with HIV-1 are pleotropic, modulating immune responses on an axis between immunostimulatory and immunosuppressive. pDCs promote immune activation through an altered phenotype of persistent type I interferon secretion and weak antigen presentation capacity. Conversely, HIV-1 stimulates secretion of indolemine 2,3 dioxygenase (IDO) by pDCs resulting in Treg induction. An improved understanding of the roles and underlying mechanisms of DC dysfunction will be valuable to the development of therapeutics to enhance HIV-specific adaptive responses and to dampen immune activation. PMID:23772620

  16. Pulmonary infections in HIV-positive children

    International Nuclear Information System (INIS)

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

  17. Pulmonary infections in HIV-positive children

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-06-15

    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.)

  18. Interactive Effects of Morphine on HIV Infection: Role in HIV-Associated Neurocognitive Disorder

    OpenAIRE

    Nair, Madhavan P. N.; Zainulabedin Saiyed; Saxena, Shailendra K.; Sudheesh Pilakka-Kanthikeel; Pichili Vijaya Bhaskar Reddy

    2012-01-01

    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...

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

    Science.gov (United States)

    De Santis, Joseph P

    2009-01-01

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

  20. Neuropsychological Dysfunction among HIV Infected Drug Abusers

    Directory of Open Access Journals (Sweden)

    Ramani S. Durvasula

    2006-01-01

    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.

  1. JAMA Patient Page: Medications to Prevent HIV Infection

    Science.gov (United States)

    ... Medications to Prevent HIV Infection Human immunodeficiency virus (HIV) prevention (or prophylaxis ) includes both safe sex practices and ... through sexual contact. Therefore, an important part of HIV prevention is practicing “safe sex.” This involves using condoms ...

  2. Suicidal ideation, suicide attempts, and HIV infection.

    Science.gov (United States)

    Kelly, B; Raphael, B; Judd, F; Perdices, M; Kernutt, G; Burnett, P; Dunne, M; Burrows, G

    1998-01-01

    A cross-sectional study was performed to investigate the prevalence and predictors of suicidal ideation and past suicide attempt in an Australian sample of human immunodeficiency virus (HIV)-positive and HIV-negative homosexual and bisexual men. Sixty-five HIV-negative and 164 HIV-positive men participated. A suicidal ideation score was derived from using five items selected from the Beck Depression Inventory and the General Health Questionnaire (28-item version). Lifetime and current prevalence rates of psychiatric disorder were evaluated with the Diagnostic Interview Schedule Version-III-R. The HIV-positive (Centers for Disease Control and Prevention [CDC] Stage IV) men (n = 85) had significantly higher total suicidal ideation scores than the asymptomatic HIV-positive men (CDC Stage II/III) (n = 79) and the HIV-negative men. High rates of past suicide attempt were detected in the HIV-negative (29%) and HIV-positive men (21%). Factors associated with suicidal ideation included being HIV-positive, the presence of current psychiatric disorder, higher neuroticism scores, external locus of control, and current unemployment. In the HIV-positive group analyzed separately, higher suicidal ideation was discriminated by the adjustment to HIV diagnosis (greater hopelessness and lower fighting spirit), disease factors (greater number of current acquired immunodeficiency syndrome [AIDS]-related conditions), and background variables (neuroticism). Significant predictors of a past attempted suicide were a positive lifetime history of psychiatric disorder (particularly depression diagnoses), a lifetime history of infection drug use, and a family history of suicide attempts. The findings indicate increased levels of suicidal ideation in symptomatic HIV-positive men and highlight the role that multiple psychosocial factors associated with suicidal ideation and attempted suicide play in this population. PMID:9775697

  3. Stem-Cell-Based Gene Therapy for HIV Infection

    Directory of Open Access Journals (Sweden)

    Anjie Zhen

    2013-12-01

    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.

  4. How to turn the tide on gender-based violence, HIV and culture

    OpenAIRE

    Wangulu, E. F.

    2011-01-01

    Following presentations, discussions and debates, participants at the SAfAIDS Regional Summit: Turning the Tide on Gender-based Violence, HIV and Culture in Southern Africa, drafted recommendations, which they endorsed. This articled presents those recommendations.

  5. Women with HIV: gender violence and suicidal ideation / Mulheres com HIV: violência de gênero e ideação suicida

    Scientific Electronic Library Online (English)

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

    2014-10-01

    Full Text Available OBJETIVO Analisar a relação entre violência de gênero e ideação suicida em mulheres com HIV. MÉTODOS Estudo transversal com 161 usuárias de serviço de atenção especializada em HIV/aids. Investigou-se a presença de violência de gênero por meio da versão brasileira do instrumento World Health Org [...] anization Violence Against Women e a ideação suicida pelo Questionário de Ideação Suicida. A análise estatística foi realizada com o software SPSS utilizando o teste de Qui-quadrado e o modelo de regressão múltipla de Poisson. RESULTADOS Oitenta e duas mulheres com HIV referiram ideação suicida (50,0%), 78 (95,0%) das quais haviam sofrido violência de gênero. Idade da primeira relação sexual Abstract in english OBJECTIVE To analyze the relationship between gender violence and suicidal ideation in women with HIV. METHODS A cross-sectional study with 161 users of specialized HIV/AIDS care services. The study investigated the presence of gender violence through the Brazilian version of the World Health O [...] rganization Violence against Women instrument, and suicidal ideation through the Suicidal Ideation Questionnaire. Statistical analyses were performed with the SPSS software, using the Chi-square test and Poisson multiple regression model. RESULTS Eighty-two women with HIV reported suicidal ideation (50.0%), 78 (95.0%) of who had suffered gender violence. Age at first sexual intercourse

  6. Sexual Violence and HIV Transmission: Summary Proceedings of a Scientific Research Planning Meeting

    OpenAIRE

    Klot, Jennifer F.; Auerbach, Judith D.; Berry, Miranda R.

    2012-01-01

    This summarizes proceedings of a Scientific Research Planning Meeting on Sexual Violence and HIV transmission, convened by the Social Science Research Council on 19–20 March 2012 at the Greentree Foundation in New York. The Meeting brought together an interdisciplinary group of basic, clinical, epidemiological and social science researchers and policy makers with the aim of: (1) examining what is known about the physiology of sexual violence and its role in HIV transmission, acquisition and...

  7. [Comorbidities in HIV infection and aging with HIV ].

    Science.gov (United States)

    Viard, Jean-Paul

    2014-10-01

    HIV infection has become a chronic condition with a life-long treatment. As AIDS-related mortality is decreasing, persons living with HIV are aging, their life expectancy tending to reach that of the general population. Aging with the virus and on antiretroviral drugs is raising new challenges: "non AIDS-defining" cancers, cardiovascular diseases, osteoporosis, and maybe neurocognitive disorders represent a new set of comorbidities in this setting, and some of them are now becoming significant causes of death. It is now clear that risk factors for these conditions include the classical risk factors known in the general population, but also risk factors specifically related to the history of HIV infection and its treatment. As a consequence, treating persons with HIV infection now follows two main objectives: controlling the virus and taking long-term comorbidities into account (prevention, testing and treatment). Specificitiesare linked to the existence of HIV-specific risk factors and to the problem of drug-drug interactions with antiretrovirals. PMID:25510131

  8. Virology, Immunology, and Clinical Course of HIV Infection.

    Science.gov (United States)

    McCutchan, J. Allen

    1990-01-01

    Presents overview of medical aspects of human immunodeficiency virus Type 1 (HIV-1) disease. Addresses structure and replication of virus, current methods for detecting HIV-1 in infected persons, effects of the virus on immune system, and clinical course of HIV-1 disease. Emphasizes variable causes of progression through HIV-1 infection stages;…

  9. Profile of Candidiasis in HIV Infected Patients

    OpenAIRE

    Parvaz Anwar Khan; Abida Malik; Haroon Subhan Khan

    2012-01-01

    Background and Objective: Candidiasis is a common opportunistic infection in HIV-infected patients. The spectrum of Candida infection is diverse, starting from asymptomatic colonization to pathogenicforms. The low absolute CD4+ T-lymphocyte count has traditionally been cited as the greatest risk factor for the development of Oropharyngeal Candidiasis and current guidelines suggest increased risk once CD4+ T lymphocyte counts fall below 200 cells/?L. Gradual emergence of non-albicans Candida ...

  10. Leprosy in an HIV-infected person

    OpenAIRE

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

    2007-01-01

    As per literature, very few case reports of leprosy ( M. leprae infection) in association with HIV are available till date. The cause for this rare coexistence when compared to Mycobacterium tuberculosis may be due to the fact that (a) M. leprae infection occurs due to affection of specific cell mediated immunity, (b) missing of signs and/or symptoms of leprosy both by physicians and patients as they are masked by overwhelming opportunistic infections and (c) long-time taken by M. lepra...

  11. Plasma Proteomic Profiling in HIV-1 Infected Methamphetamine Abusers

    OpenAIRE

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

    2012-01-01

    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...

  12. Voices from the Frontlines: The Epidemics of HIV/AIDS and Violence among Women and Girls

    OpenAIRE

    Teitelman, Anne M.; SELOILWE, ESTHER S.; CAMPBELL, JACQUELYN C.

    2009-01-01

    The papers in this special issue focus on the topic of violence against women. This group of scholarly works explores theoretical issues, context and health care interventions pertaining to violence in women’s lives. In conjunction with this special issue, this editorial provides a synopsis of presentations and discussions about the topic of the intersections of gender-based violence, HIV and the girl child that took place in July 2008 as part of the 17th conference of International Council...

  13. Enfuvirtide antiretroviral therapy in HIV-1 infection

    OpenAIRE

    Kitchen, Christina; Nun?o, Miriam; Kitchen, Scott G.; Krogstad, Paul

    2008-01-01

    It has been over 25 years since the first diagnosis of what would be known as AIDS. Although great strides in anti-HIV therapeutics have been made, there is still a great need for antiretrovirals that are effective against drug-resistant HIV. Enfuvirtide (ENF) is the first of a new class of fusion inhibitors to be approved by the US Food and Drug Administration for use in combination with other antiretroviral agents among HIV-1 infected patients with previous treatment experience. The inclusi...

  14. Tuberculosis-HIV Co-infection in Kiev City, Ukraine

    OpenAIRE

    Werf, Marieke J.; Yegorova, Olga B.; Chentsova, Nelly; Chechulin, Yuriy; Hasker, Epco; Petrenko, Vasyl I.; Veen, Jaap; Turchenko, Leonid V.

    2006-01-01

    In 2004, we tested all patients with newly diagnosed tuberculosis (TB) for HIV in Kiev City. The results were compared to information from medical records of 2002, when co-infection prevalence was 6.3%. Of 968 TB patients, 98 (10.1%) were HIV infected. TB-HIV co-infection is increasing, especially in injecting drug users.

  15. HIV INFECTION, ANTIRETROVIRAL THERAPY AND CARDIOVASCULAR RISK

    Directory of Open Access Journals (Sweden)

    Licia Iacoviello

    2010-08-01

    Full Text Available

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

  16. Towards targeted screening for acute HIV infections in British Columbia

    Directory of Open Access Journals (Sweden)

    Steinberg Malcolm

    2011-08-01

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

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

    Directory of Open Access Journals (Sweden)

    Andrea L Wirtz

    2013-12-01

    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.

  18. Legionellosis in patients with HIV infection

    DEFF Research Database (Denmark)

    Bangsborg, Jette Marie; Jensen, B N

    1990-01-01

    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.

  19. Intracranial Cryptococcal Infection in HIV Positive Patient

    Directory of Open Access Journals (Sweden)

    Nabil Moatassim Billah

    2014-02-01

    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.

  20. Interactive Effects of Morphine on HIV Infection: Role in HIV-Associated Neurocognitive Disorder

    Science.gov (United States)

    Reddy, Pichili Vijaya Bhaskar; Pilakka-Kanthikeel, Sudheesh; Saxena, Shailendra K.; Saiyed, Zainulabedin; Nair, Madhavan P. N.

    2012-01-01

    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 that opiate drug abuse is a risk factor in HIV infection, neural dysfunction and progression to AIDS. The information available on the role of morphine as a cofactor in the neuropathogenesis of HIV is scanty. This review summarizes the results that help in understanding the role of morphine use in HIV infection and neural dysfunction. Studies show that morphine enhances HIV-1 infection by suppressing IL-8, downregulating chemokines with reciprocal upregulation of HIV coreceptors. Morphine also activates MAPK signaling and downregulates cAMP response element-binding protein (CREB). Better understanding on the role of morphine in HIV infection and mechanisms through which morphine mediates its effects may help in devising novel therapeutic strategies against HIV-1 infection in opiate using HIV-infected population. PMID:22666564

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

    OpenAIRE

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

    2012-01-01

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

  2. Malignant syphilis in a HIV infected patient.

    Science.gov (United States)

    Jalili, Ahmad; Mosleh, Martin; Grabmeier-Pfistershammer, Katharina; Loewe, Robert; Stingl, Georg; Rieger, Armin

    2015-04-01

    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

  3. Mycobacterium tuberculosis infection interferes with HIV vaccination in mice.

    OpenAIRE

    Ignatowicz, Lech; Mazurek, Jolanta; Leepiyasakulchai, Chaniya; Sko?ld, Markus; Hinkula, Jorma; Ka?llenius, Gunilla; Pawlowski, Andrzej

    2012-01-01

    Tuberculosis (TB) has emerged as the most prominent bacterial disease found in human immunodeficiency virus (HIV)-positive individuals worldwide. Due to high prevalence of asymptomatic Mycobacterium tuberculosis (Mtb) infections, the future HIV vaccine in areas highly endemic for TB will often be administrated to individuals with an ongoing Mtb infection. The impact of concurrent Mtb infection on the immunogenicity of a HIV vaccine candidate, MultiHIV DNA/protein, was investigated in mice. We...

  4. Neuroimaging studies of the aging HIV-1-infected brain

    OpenAIRE

    Holt, John L.; Kraft-Terry, Stephanie D; Chang, Linda

    2012-01-01

    Highly active antiretroviral therapy (HAART) has increased life expectancy among HIV-infected individuals, and by 2015, at least half of all HIV-infected individuals will be over 50 years of age. Neurodegenerative processes associated with aging may be facilitated by HIV-1 infection, resulting in premature brain aging. This review will highlight brain abnormalities in HIV patients in the setting of aging, focusing on recent neuroimaging studies of the structural, physiological, functional and...

  5. Prevention of HIV-1 infection 2013: glimmers of hope

    OpenAIRE

    Cohen M

    2012-01-01

    The efficiency of transmission of HIV depends on the infectiousness of the index case and the susceptibility of those exposed. Infectiousness is dictated by the concentration of HIV-1 in relevant fluids (regardless of route of transmission) and the viral genotype and phenotype. People newly infected with HIV-1 (i.e. acute infection) and those with STI co-infections excrete such a large concentration of virus as to be “hyperinfectious.” The actual transmission of HIV likely occur...

  6. Successful cognitive aging in persons living with HIV infection

    OpenAIRE

    Malaspina, Lauren; Woods, Steven Paul; David J Moore; Depp, Colin; Letendre, Scott L.; Jeste, Dilip; Grant, Igor

    2010-01-01

    The number of older adults living with human immunodeficiency virus (HIV) infection is growing and this subpopulation of the epidemic is at heightened risk for a variety of poor health outcomes including HIV-associated neurocognitive disorders. The current study sought to examine the factors associated with freedom from neurocognitive impairment in older HIV-infected adults. Participants included 74 middle-aged and older (mean age 51 years), HIV-infected individuals with a mean estimated dura...

  7. Western blot profile in HIV infection

    Directory of Open Access Journals (Sweden)

    Sudha T

    2006-01-01

    Full Text Available 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 cases confirmed by WB test between January 2002 to July 2005, with the objective of mapping different band patterns of western blot results and determining whether the presence or absence of certain bands was associated with any specific stage of HIV infection. For the interpretation of the WB results in this study, the guidelines recommended by NACO, India were followed. Results: Reactivity with all the bands was the most commonly observed WB pattern, occurring in 92.91% (1363/1467 of cases, whereas the other 7.09% showed uncommon band patterns. Of all individual bands, p31 band was the most frequently missing one, absent in 7.09% cases. On classifying the WB reactive cases by the WHO clinical staging system, 38.45% (564/1467 were in Stage 1, 47.99% (704/1467 in stages 2 and 3 and 13.56% in stage 4. Correlation of CD4 cell counts with the various uncommon band patterns showed that only 5.56% (4/72 had counts in the 200-500 cells/µl range, whereas 45.83% and 48.61% had counts of < 200 and> 500 cells/µl respectively. Conclusion: Interpretation of the WB band pattern in combination with clinical features may be occasionally useful in predicting the stage of HIV infection.

  8. Toxoplasma gondii Infection and Self-directed Violence in Mothers

    DEFF Research Database (Denmark)

    Pedersen, Marianne G; Mortensen, Preben Bo

    2012-01-01

    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.

  9. Bloodstream Infections with Mycobacterium tuberculosis among HIV patients

    Centers for Disease Control (CDC) Podcasts

    2010-09-23

    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.

  10. Intestinal microbiota and HIV-1 infection

    Directory of Open Access Journals (Sweden)

    E. B. S. M. Trindade

    2007-01-01

    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.

  11. Innate immune sensing of HIV-1 infection

    DEFF Research Database (Denmark)

    Jakobsen, Martin Roelsgaard; Olagnier, David

    2014-01-01

    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.

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

    OpenAIRE

    Kim Hae-Young; Kasonde Prisca; Mwiya Mwiya; Thea Donald M; Kankasa Chipepo; Sinkala Moses; Aldrovandi Grace; Kuhn Louise

    2012-01-01

    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 infa...

  13. Clinical profile of HIV infection

    Directory of Open Access Journals (Sweden)

    Khopkar Uday

    1992-01-01

    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.

  14. Multicentric Castleman's disease & HIV infection.

    LENUS (Irish Health Repository)

    Cotter, A

    2009-10-01

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

  15. Family-of-Origin Factors and Partner Violence in the Intimate Relationships of Gay Men Who Are HIV Positive

    Science.gov (United States)

    Craft, Shonda M.; Serovich, Julianne M.

    2005-01-01

    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…

  16. Posttraumatic stress disorder in response to HIV infection.

    Science.gov (United States)

    Kelly, B; Raphael, B; Judd, F; Perdices, M; Kernutt, G; Burnett, P; Dunne, M; Burrows, G

    1998-11-01

    This study investigated the psychological impact of HIV infection through assessment of posttraumatic stress disorder in response to HIV infection. Sixty-one HIV-positive homosexual/bisexual men were assessed for posttraumatic stress disorder in response to HIV infection (PTSD-HIV) using a modified PTSD module of the DIS-III-R. Thirty percent met criteria for a syndrome of posttraumatic stress disorder in response to HIV diagnosis (PTSD-HIV). In over one-third of the PTSD cases, the disorder had an onset greater than 6 months after initial HIV infection diagnosis. PTSD-HIV was associated with other psychiatric diagnoses, particularly the development of first episodes of major depression after HIV infection diagnosis. PTSD-HIV was significantly associated with a pre-HIV history of PTSD from other causes, and other pre-HIV psychiatric disorders and neuroticism scores, indicating a similarity with findings in studies of PTSD from other causes. The findings from this preliminary study suggest that a PTSD response to HIV diagnosis has clinical validity and requires further investigation in this population and other medically ill groups. The results support the inclusion of the diagnosis of life-threatening illness as a traumatic incident that may lead to a posttraumatic stress disorder, which is consistent with the DSM-IV criteria. PMID:9854646

  17. Characteristics of tuberculous meningitis in HIV-infected patients

    Directory of Open Access Journals (Sweden)

    A Hristea

    2012-11-01

    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. [1] 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.

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

    Directory of Open Access Journals (Sweden)

    Ira Shah

    2004-10-01

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

  19. Euthanasia: from the perspective of HIV infected persons in Europe

    OpenAIRE

    Andraghetti, R.; Foran, S.; Colebunders, R.; Tomlinson, D.; Vyras, P.; Borleffs, C. J.; Fleerackers, Y.; Schrooten, W.; Borchert, M.

    2001-01-01

    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...

  20. Stem-Cell-Based Gene Therapy for HIV Infection

    OpenAIRE

    Anjie Zhen; Scott Kitchen

    2013-01-01

    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 t...

  1. Hispanic Women’s Experiences With Substance Abuse, Intimate Partner Violence, and Risk for HIV

    OpenAIRE

    Gonzalez-Guarda, Rosa Maria; Vasquez, Elias P.; Urrutia, Maria T.; Antonia M Villarruel; Peragallo, Nilda

    2011-01-01

    Hispanic females are disproportionately affected by substance abuse, intimate partner violence, and HIV. Despite these disparities, research describing the cultural and gender-specific experiences of Hispanic women with regard to these conditions is lacking. The purpose of this study is to describe the experiences that Hispanic community-dwelling women have with regard to substance abuse, violence, and risky sexual behaviors. Eight focus groups with 81 women were conducted. A bilingual, bicul...

  2. The Potential of the CNS as a Reservoir for HIV-1 Infection: Implications for HIV Eradication.

    Science.gov (United States)

    Fois, Alessandro F; Brew, Bruce J

    2015-06-01

    The ability of HIV-1 to establish latent infection is a key obstacle to its eradication despite the existence of effective antiretroviral drugs. The brain has been postulated as a reservoir for latent infection, but its role in HIV persistence remains unclear. In this review, we discuss the evidence surrounding the role of the central nervous system (CNS) as a viral reservoir and the potential challenges this might present in eradicating HIV. The strategies for eradication of HIV and their application to latent CNS infection are explored. Finally, we outline new developments in drug delivery and new therapeutic modalities designed to target HIV infection in the CNS. PMID:25869939

  3. Profile of Candidiasis in HIV Infected Patients

    Directory of Open Access Journals (Sweden)

    Parvaz Anwar Khan

    2012-12-01

    Full Text Available Background and Objective: Candidiasis is a common opportunistic infection in HIV-infected patients. The spectrum of Candida infection is diverse, starting from asymptomatic colonization to pathogenicforms. The low absolute CD4+ T-lymphocyte count has traditionally been cited as the greatest risk factor for the development of Oropharyngeal Candidiasis and current guidelines suggest increased risk once CD4+ T lymphocyte counts fall below 200 cells/?L. Gradual emergence of non-albicans Candida species as a cause of refractory mucosal and invasive Candidiasis, particularly in patients with advanced immunosuppression and problem of resistance to azoles and other antifungal agents in the Candida species is a point of concern.Materials and Methods: A prospective study was carried out over a period of 2 years (2010-2011 on patients suffering from AIDS for the presence of Candida infection. After thorough clinical examination relevant specimens were collected and processed specifically to ascertain Candida infection. Speciation of Candida isolates and antifungal sensitivity testing was also done. The CD4 cell counts of all the patients were estimated and correlated with the presence (or absence of candidiasis.Results: Out of a total of 165 HIV positive patients, a definitive diagnosis of candidiasis was made in 80 patients. Candida albicans was the most common yeast isolated. Patients with candidiasis had CD4 counts less than 200 cells/mm3. Maximum resistance was seen with fluconazole while no resistance was seen with voriconazole.Conclusion: The most common opportunistic fungal infection in HIV positive patients is candidiasis, affecting the mucocutaneous system mainly but the invasive form is also common. Resistance to azoles and other antifungal agents in the Candida species is a point of concern.

  4. Family-of-Origin Factors and Partner Violence in the Intimate Relationships of Gay Men Who Are HIV Positive

    OpenAIRE

    Craft, Shonda M.; Serovich, Julianne M.

    2005-01-01

    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 ...

  5. Occult hepatitis B virus infection in Moroccan HIV infected patients

    Directory of Open Access Journals (Sweden)

    Tahar Bajjou

    2015-06-01

    Full Text Available Background: The purpose of this study is to assess the prevalence of Occult hepatitis B virus Infection (OBI among antiretroviral treatment na and iuml;ve HIV-1 infected individuals in Morocco and to determine factors favouring its occurrence. Methods: The retrospective study was conducted in the Mohammed V military teaching hospital in Rabat between January 2010 and June 2011. It included patients with confirmed HIV infection, tested negative to serological detection of HBV surface antigen (HBsAg and did not received antiviral treatment or hepatitis B vaccine. All samples were tested for anti-HBc, anti-HBs and anti-HCV antibodies using enzyme immunoassay (ELISA. The detection of HBV DNA was performed by real-time PCR using two specific primers for a gene in the region C of the viral genome. The sensitivity of the technique was 20 copies/ml. Results: A total of 82 samples were analyzed, 19 (23 % were found to have isolated anti-HBc, 07 (8.5% with associated anti-HBc and Anti-HBs. No anti-HCV marker was detected on these screening samples. The HBV DNA was detected in 48 (58% samples, of which, males constituted 58% (28/48. The mean age of these patients was 38 +/- 8.2 (29-56, the median HIV-1 viral load and CD4 cell count HIV-1 infected patients were 127500 (54108-325325 copies/ml and 243 [80-385] cells/mm3 respectively and 27.1% (13/48 of these patients were found to have isolated anti-HBc. A significant correlations between DNA HBV and HIV viral load higher than 100000 copies/ml (P = 0.004, CD4 cell count lower than 400 cells/mm3 (P = 0.013, P = 0.006 and isolated anti-HBc samples (P <0.005 were founded. However there was no significant association with age, sex, transmission mode and clinical stage. Conclusion: The consequences of this high prevalence of OBI in Morocco need to be considered in laboratory diagnosis of HBV infection in HIV infected patients and the PCR seems to be inevitable for a better diagnosis and therapy. [Int J Res Med Sci 2015; 3(3.000: 617-621

  6. HPV in HIV-Infected Women: Implications for Primary Prevention

    OpenAIRE

    NathalieDauphinMckenzie; ErinKobetz; JamesHnatyszyn; A.Morishita

    2014-01-01

    Background: There is growing evidence that HIV-infected women might have a different HPV type distribution in cervical dysplasia specimens as compared to the general population. This has implications for primary prevention.Objective: We aimed to obtain preliminary data on the human papillomavirus (HPV) genotypes prevalent in histological samples of HIV-infected women with CIN 3/ CIS of the cervix in Miami, Florida. Method: Retrospective data were collected on HIV-infected women referred to t...

  7. Central nervous system manifestations of HIV infection in children

    International Nuclear Information System (INIS)

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

  8. Methamphetamine Enhances HIV-1 Infectivity in Monocyte Derived Dendritic Cells

    OpenAIRE

    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

    2008-01-01

    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 ...

  9. Impact of HIV-1, HIV-2 and HIV-1+2 dual infection on the outcome of tuberculosis

    DEFF Research Database (Denmark)

    Wejse, C; Patsche, C B

    2014-01-01

    Background: HIV1 infection has been shown to impact outcome in patients with tuberculosis (TB), but limited data on HIV2 impact on TB outcomes exist. The aim of this study was to assess the impact of HIV-types on mortality among TB patients in Guinea-Bissau and to examine the predictive ability of the TBscoreII a clinical score used to assess disease-severity. Methods: In a prospective follow-up study we examined the prevalence of HIV1, HIV2 and HIV1+2 dual co-infection in TB patients in Guinea Bissau and the impact on outcome at 12 months follow-up. We included all adult TB patients in an observational TB-cohort at the Bandim Health Project (BHP) in Guinea-Bissau from 2003-2013 and assessed survival status at 12 months after start of treatment. Results: We included 1312 patients, 499 (38%) were female (male/female ratio: 1.6). A total of 379 patients were HIV infected, 241 had HIV1, 93 had HIV2 and 45 were HIV1+2 dually infected. HIV type associated risk of TB was 6-fold higher for HIV-1, 7-fold higher for HIV1+2 dually infected and 2-fold higher for HIV2 single infected, compared with HIV uninfected. Of the included patients 144 (11%) died, 62 (12%) among females and 82 (9%) among males (Hazard Ratio (HR) 0.91 (95%CI 0.64-1.30), p=0.596). Female patients were younger (1 year younger (95%CI 0.5-2)) (p=0.04), reported a longer duration of symptoms than males (14 days longer (95%CI 4-25)) (p=0.003) and had a higher TBscoreII (0.5 points more (95%CI 0.3-0.7), p<0.001). More females than males were HIV-infected (36% vs 25%) (p<0.001) and more female had a Body mass index (BMI)<15 (11% vs 6%, p<0.001) and a Mid-upper-arm circumference (MUAC)<200 (13% vs 7%, p<0.001) HIV-infection increased mortality risk, with HIV1-infection displaying the highest HR (5.0 (95%CI 3.5-7.1)), followed by HIV1+2-infected (HR 4.2 (95%CI 2.2-7.8) and HIV2-infected (HR 2.1 (95%CI 1.2-3.8)). A TBscoreII?4 (HR 2.2 (95%CI 1.5-3.1)) was associated with increased mortality. Significantly increased HR's were found for signs of wasting; a BMI <18 was associated with a HR of 1.8 (95%CI 1.3-2.6)) and a MUAC <220 with a HR of 3.8 (95%CI 2.7-5.2). Conclusion: HIV type associated risk of TB was much higher for HIV-1 and less for HIV2 infected, compared with HIV uninfected. Clinical severity at presentation was also higher for HIV-infected, less for HIV2 infected and all HIV-infected had poorer outcome with 4-5 fold higher mortality for HIV1 and dually infected and two-fold higher for HIV-2 infected, these differences between HIV types did not disappear after adjusting for CD4 count.

  10. Survival of human immunodeficiency virus (HIV), HIV-infected lymphocytes, and poliovirus in water.

    OpenAIRE

    Moore, B. E.

    1993-01-01

    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...

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

    OpenAIRE

    Vanisri; SHIVAKUMAR S.CHENGTI

    2013-01-01

    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....

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

    Science.gov (United States)

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

    2010-01-01

    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…

  13. Comparative analysis of serum protein electrophoresis’ ?profiles of people infected with HIV and those not infected ?with HIV in Kinshasa

    OpenAIRE

    KAMANGU NTAMBWE ERICK; KALALA LUNGANZA RICHARD; MVUMBI LELO ?GEORGES; MESIA KAHUNU GAUTHIER

    2012-01-01

    Introduction: It is necessary to consider the analysis of electrophoresis’ profiles of serum ?proteins as an alternative and less expensive for the biological monitoring of patients infected by ?HIV in countries with limited resources.?Objective: The aim of the study was to establish a comparison between the electrophoresis’ ?profile of sera proteins of people infected by HIV naïve of treatment and people not infected by ?HIV. ?Method: A transversal study was conducted at AMO...

  14. Lung cancer in HIV-infected patients

    Directory of Open Access Journals (Sweden)

    R Palacios

    2012-11-01

    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.

  15. Beyond retrovirus infection: HIV meets gene therapy

    Directory of Open Access Journals (Sweden)

    Flávia Helena da Silva

    2006-01-01

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

  16. Beyond retrovirus infection: HIV meets gene therapy

    Scientific Electronic Library Online (English)

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

    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.

  17. Morphological aspects of liver CT in patients with HIV infections

    International Nuclear Information System (INIS)

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

  18. Progress toward curing HIV infections with hematopoietic stem cell transplantation.

    Science.gov (United States)

    Smiley, Stephen T; Singh, Anjali; Read, Sarah W; Sharma, Opendra K; Finzi, Diana; Lane, Clifford; Rice, Jeffrey S

    2015-01-15

    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

  19. Cohort Profile : The Bissau HIV Cohort-a cohort of HIV-1, HIV-2 and co-infected patients

    DEFF Research Database (Denmark)

    Jespersen, Sanne; HØnge, Bo Langhoff

    2014-01-01

    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: [wejse@dadlnet.dk].

  20. Somatic Symptoms and the Association between Hepatitis C Infection and Depression in HIV-infected Patients

    OpenAIRE

    Yoon, Jeanie C.; Crane, Paul K.; Ciechanowski, Paul S.; Harrington, Robert D.; Kitahata, Mari M.; Crane, Heidi M.

    2011-01-01

    Studies of depression and hepatitis C virus (HCV) infection in HIV-infected patients have been contradictory and often not addressed key differences between HCV-infected and uninfected individuals including substance use. This cross-sectional observational study from the University of Washington HIV Cohort examined associations between HCV, symptoms, and depression in HIV-infected patients in routine clinical care. Patients completed instruments measuring depression, symptoms, and substance u...

  1. Macrophage Infection via Selective Capture of HIV-1-Infected CD4+ T Cells

    OpenAIRE

    Baxter, Amy e; Russell, Rebecca a; Duncan, Christopher j A.; Moore, Michael d; Willberg, Christian b; Pablos, Jose l; Finzi, Andre?s; Kaufmann, Daniel e; Ochsenbauer, Christina; Kappes, John c; Groot, Fedde; Sattentau, Quentin j

    2014-01-01

    Macrophages contribute to HIV-1 pathogenesis by forming a viral reservoir and mediating neurological disorders. Cell-free HIV-1 infection of macrophages is inefficient, in part due to low plasma membrane expression of viral entry receptors. We find that macrophages selectively capture and engulf HIV-1-infected CD4+ T cells leading to efficient macrophage infection. Infected T cells, both healthy and dead or dying, were taken up through viral envelope glycoprotein-receptor-independent inter...

  2. Primary care for diabetes in HIV-infected patients

    Directory of Open Access Journals (Sweden)

    Viroj Wiwanitkit

    2007-11-01

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

  3. Anal Invasive Squamous Cell Cancer and Human Papillomavirus Distribution in HIV-Infected and Non-HIV-Infected Individuals

    Directory of Open Access Journals (Sweden)

    Laila Darwich

    2014-10-01

    Full Text Available Invasive-squamous-cell-cancer (ISCC of the anal canal is an uncommon disease. Human papillomavirus (HPV is the etiological agent of most of types of ISCC. The incidence of ISCC has been increasing in HIV-infected individuals, even after the introduction of highly active antiretroviral therapy. The aim of this study was to analyze biopsy specimens from patients diagnosed with ISCC at a tertiary hospital from 1983 to 2012 in order to detect HPV-DNA. Methods: Formaldehyde-fixed, paraffin-embedded specimens from patients with ISCC underwent HPV-DNA genotyping using multiplex PCR assay. Results: A total of 31 cases were collected; 10 were HIV-infected (9 men, 1 woman and 21 non-HIV-infected (11 men, 10 women. HPV infection was detected in 87.5% (7/8 of the HIV-infected patients (DNA from 2 biopsies was degraded and 76.2% (16/21 of non-HIV-infected individuals. Multiple-type infections were only found in 28.6% (2/7 of the HIV-infected patients (no multiple-type infections in non-HIV-infected individuals. The most prevalent type was HPV-16: 50% (4/8 in the HIV-infected group (57% [4/7] of the HPV-positive samples and 66.7% (14/21 in the non-HIV-infected group (87.5% (14/16 of the HPV-positive samples. Remarkably, 37.5% (3/8 of the HIV-infected group had high-risk HPV types not included in the vaccines (HPV-33, 51, 52, and 66 compared with 4.8% in the non-HIV-infected group (1/21, HPV-52. All cases of anal ISCC in HIV-infected patients were recorded in the highly active antiretroviral therapy era. Conclusion: HIV-infected patients presented anal ISCC with a higher proportion of high-risk HPV types not covered by the conventional vaccines than non-HIV-infected individuals.

  4. Pregnancy care in two adolescents perinatally infected with HIV.

    OpenAIRE

    Meloni, Alessandra; Tuveri, Milena; Floridia, Marco; Zucca, Francesca; Borghero, Grazia; Gariel, Donatella; Melis, Gian Benedetto

    2009-01-01

    Abstract We describe the main issues encountered in pregnancy care in two perinatally infected adolescents with HIV. Despite the young maternal age, both mothers complied well with visits and treatment during pregnancy and delivered at week 38 through elective caesarean section. Both, however, missed the regular gynaecological and the routine HIV visits scheduled after pregnancy. Both infants following HIV exposure were confirmed HIV negative at the end of tests performed in the fi...

  5. Current practices in laboratory monitoring of HIV infection

    OpenAIRE

    Vajpayee, Madhu; Mohan, Teena

    2011-01-01

    After a diagnosis of HIV infection is made, the patient needs to be monitored using both clinical assessment and laboratory markers. HIV/AIDS monitoring is essential in guiding when to recommend initiation of therapy. Clinical monitoring will include staging of the HIV/AIDS disease using either the presence or absence of HIV-related signs and symptoms using the WHO staging system. Various laboratory methods can be used to monitor the disease progression and to guide whether the patient will n...

  6. Methodologic approaches to surveillance of HIV infection among blood donors.

    OpenAIRE

    Petersen, L. R.; Dodd, R.; Dondero, T. J.

    1990-01-01

    Blood donors make up the largest group in the United States that is tested for human immunodeficiency virus, type 1 (HIV) antibody. The blood donor population is ideal for detecting and quantifying uncommon or unrecognized modes of HIV transmission in the general population because persons at known risk for HIV infection are excluded from donating blood. The national HIV surveillance program consists of a centralized computer database of information on all donations at selected American Red C...

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

    Science.gov (United States)

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

    2014-01-01

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

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

    Science.gov (United States)

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

    2014-04-01

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

  9. Recurrent thrombosis in an HIV-1 infected child

    OpenAIRE

    Shah, Ira

    2012-01-01

    Though thromboembolic complications in HIV infected patients have been described in literature, recurrent thrombosis is very rare. We present a six-year-old HIV infected boy who presented with recurrent thrombosis. He initially had renal artery thrombosis, then middle cerebral artery thrombosis and finally hepatic vein thrombosis that was fatal.

  10. RECURRENT HERPES ZOSTER DUPLEX SYMMETRICUS IN HIV INFECTION

    OpenAIRE

    Rajashekar T; Singh Gurcharan; Shivakumar V; Okade Rajendra

    2008-01-01

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

  11. Recurrent herpes zoster duplex symmetricus in HIV infection.

    Science.gov (United States)

    Rajashekar, T S; Singh, Gurcharan; Shivakumar, V; Okade, Rajendra

    2008-01-01

    A HIV infected patient with recurrent herpes zoster has been presented. Recurrence of herpes zoster contralaterally on the same dermatome and concomitant occurrence of three viral infections, viz. HIV, HPV and VZV in the same patient were the unusual and interesting observations in the present case report. PMID:19967018

  12. Recurrent herpes zoster duplex symmetricus in HIV infection

    Directory of Open Access Journals (Sweden)

    Rajashekar T

    2008-01-01

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

  13. Preventing Opportunistic Infections in HIV (Beyond the Basics)

    Science.gov (United States)

    ... and Infectious Diseases (NIAID) ( www.niaid.nih.gov ) ? HIV/AIDS Treatment Information Service Toll-free: (800) 448-0440 ( http:// ... infected patients Treatment of AIDS-related cytomegalovirus retinitis Treatment of Pneumocystis ... HIV/AIDS Opportunistic infection Patient information

  14. Glycoproteomic analysis identifies human glycoproteins secreted from HIV latently infected T cells and reveals their presence in HIV+ plasma

    OpenAIRE

    Yang, Weiming; Zhou, Jian-ying; Chen, Li; Ao, Minghui; Sun, Shisheng; Aiyetan, Paul; Simmons, Antoine; Zhang, Hui; Jackson, Jay Brooks

    2014-01-01

    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...

  15. HIV infection en route to endogenization: two cases.

    Science.gov (United States)

    Colson, P; Ravaux, I; Tamalet, C; Glazunova, O; Baptiste, E; Chabriere, E; Wiedemann, A; Lacabaratz, C; Chefrour, M; Picard, C; Stein, A; Levy, Y; Raoult, D

    2014-12-01

    The long-term spontaneous evolution of humans and the human immunodeficiency virus (HIV) is not well characterized; many vertebrate species, including humans, exhibit remnants of other retroviruses in their genomes that question such possible endogenization of HIV. We investigated two HIV-infected patients with no HIV-related disease and no detection with routine tests of plasma HIV RNA or cell-associated HIV DNA. We used Sanger and deep sequencing to retrieve HIV DNA sequences integrated in the human genome and tested the host humoral and cellular immune responses. We noticed that viruses from both patients were inactivated by the high prevalence of the transformation of tryptophan codons into stop codons (25% overall (3-100% per gene) and 24% overall (0-50% per gene)). In contrast, the humoral and/or cellular responses were strong for one patient and moderate for the other, indicating that a productive infection occurred at one stage of the infection. We speculate that the stimulation of APOBEC, the enzyme group that exchanges G for A in viral nucleic acids and is usually inhibited by the HIV protein Vif, has been amplified and made effective from the initial stage of the infection. Furthermore, we propose that a cure for HIV may occur through HIV endogenization in humans, as observed for many other retroviruses in mammals, rather than clearance of all traces of HIV from human cells, which defines viral eradication. PMID:25366539

  16. Substance abuse, violence, and HIV/AIDS (SAVA) syndemic effects on viral suppression among HIV positive women of color.

    Science.gov (United States)

    Sullivan, Kristen A; Messer, Lynne C; Quinlivan, E Byrd

    2015-01-01

    The combined epidemics of substance abuse, violence, and HIV/AIDS, known as the SAVA syndemic, contribute to the disproportionate burden of disease among people of color in the US. To examine the association between HIV viral load suppression and SAVA syndemic variables, we used baseline data from 563 HIV+ women of color treated at nine HIV medical and ancillary care sites participating in HRSA's Special Project of National Significance Women of Color (WOC) Initiative. Just under half the women (n=260) were virally suppressed. Five psychosocial factors contributing to the SAVA syndemic were examined in this study: substance abuse, binge drinking, intimate partner violence, poor mental health, and sexual risk taking. Associations among the psychosocial factors were assessed and clustering confirmed. A SAVA score was created by summing the dichotomous (present/absent) psychosocial measures. Using generalized estimating equation (GEE) models to account for site-level clustering and individual-covariates, a higher SAVA score (0 to 5) was associated with reduced viral suppression; OR (adjusted)=0.81, 95% CI: 0.66, 0.99. The syndemic approach represents a viable framework for understanding viral suppression among HIV positive WOC, and suggests the need for comprehensive interventions that address the social/environmental contexts of patients' lives. PMID:25397666

  17. Intestinal Parasitic Infections in HIV Infected and Non-Infected Patients in a Low HIV Prevalence Region, West-Cameroon

    OpenAIRE

    Nkenfou, Céline Nguefeu; Nana, Christelle Tafou; Payne, Vincent Khan

    2013-01-01

    The magnitude of intestinal parasitic infection in acquired immunodeficiency syndrome patients requires careful consideration in the developing world where poor nutrition is associated with poor hygiene and several tropical diseases. However, there have been very few studies addressing this issue in Cameroon. This study was conducted to determine the prevalence of intestinal parasitosis in HIV/AIDS patients in Dschang -Cameroon. Stool and blood specimens from HIV/AIDS patients and control gro...

  18. Elvitegravir for the treatment of HIV infection.

    Science.gov (United States)

    Reviriego, C

    2014-03-01

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

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

    Directory of Open Access Journals (Sweden)

    Devon D Brewer

    2012-07-01

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

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

    DEFF Research Database (Denmark)

    Knudsen, Andreas; Benfield, Thomas

    2009-01-01

    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.

  1. Factors Associated with Prevalent Hepatitis C Infection Among HIV-Infected Women with No Reported History of Injection Drug Use: The Women's Interagency HIV Study (WIHS)

    OpenAIRE

    Frederick, Toni; Burian, Pamela; Terrault, Norah; Cohen, Mardge; Augenbraun, Michael; YOUNG, MARY; Seaberg, Eric; Justman, Jessica; Levine, Alexandra M; Mack, Wendy J.; Kovacs, Andrea

    2009-01-01

    Although the primary mode of hepatitis C virus (HCV) transmission is exposure to blood products or injection drug use (IDU), studies have found varying independent risk factors for HCV infection among persons with no history of IDU or exposure to blood products. For HIV-infected women, sexual transmission may be another potential source of HCV infection. HIV-infected and HIV-negative women at risk for HIV enrolled in the Women's Interagency HIV Study (WIHS) during October 1994 to November 199...

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

    Directory of Open Access Journals (Sweden)

    Schadé Annemiek

    2013-01-01

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

  3. Genital chlamydial infection in STD patients: Its relation to HIV infection

    OpenAIRE

    Joyee A; Thyagarajan S; Reddy E; Venkatesan C; Ganapathy M

    2005-01-01

    In the present report, we have analysed C.trachomatis infection and HIV positivity among patients (n-143) who attended the STD clinic at the Institute of STDs, Government General Hospital, Chennai. HIV positivity rate was significantly high among those with chlamydial infection than in those without chlamydial infection (29.5% (13/44) vs. 11.1% (11/99); p

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

    OpenAIRE

    Elkington, Katherine S; Robbins, Reuben N.; Bauermeister, José A.; Abrams, Elaine J; McKay, Mary; Mellins, Claude A.

    2010-01-01

    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+ youth reported ...

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

    Directory of Open Access Journals (Sweden)

    P Reiss

    2012-11-01

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

  6. Changing Gender Norms and Reducing HIV and Violence Risk Among Workers and Students in China.

    Science.gov (United States)

    Pulerwitz, Julie; Hui, Wang; Arney, Jennifer; Scott, Lisa Mueller

    2015-08-01

    Global evidence demonstrates that inequitable gender norms negatively influence key health outcomes (e.g., violence, HIV/STI), and the importance of male involvement in prevention efforts. The China Family Planning Association and PATH partnered to develop and evaluate a gender-focused behavior change communication intervention for HIV and violence prevention. Eight participatory education sessions-adapted for the Chinese setting-were implemented in factories and schools. Baseline and endline surveys with participants (219 male factory workers and 496 male vocational students) were conducted. Support for (in)equitable norms was measured by the Gender Equitable Men Scale, as well as partner violence and communication. Focus groups with male and female workers/students, teachers, and factory managers were used to corroborate findings. At baseline, many workers and students supported inequitable gender norms, with workers generally being more inequitable. At endline, significant positive changes in gender-related views (e.g., reduction from 42% to 18% of workers agreeing that "a woman should tolerate violence in order to keep her family together") and behaviors (e.g., reduction from 15% to 7% of students reporting partner violence over the past 3 months) were reported. Results suggest that a relatively low intensity intervention can influence important gender norms and related behaviors. PMID:25950187

  7. Hispanic Women’s Experiences With Substance Abuse, Intimate Partner Violence, and Risk for HIV

    Science.gov (United States)

    Gonzalez-Guarda, Rosa Maria; Vasquez, Elias P.; Urrutia, Maria T.; Villarruel, Antonia M.; Peragallo, Nilda

    2011-01-01

    Hispanic females are disproportionately affected by substance abuse, intimate partner violence, and HIV. Despite these disparities, research describing the cultural and gender-specific experiences of Hispanic women with regard to these conditions is lacking. The purpose of this study is to describe the experiences that Hispanic community-dwelling women have with regard to substance abuse, violence, and risky sexual behaviors. Eight focus groups with 81 women were conducted. A bilingual, bicultural moderator asked women open-ended questions regarding the experiences that Hispanic women have with these conditions. Focus groups were audiotaped, transcribed, translated, verified, and then analyzed using qualitative content analysis. Participants discussed substance abuse, violence, and risky sexual behaviors interchangeably, often identifying common risk factors associated with these. Nevertheless, intimate partner violence was the most salient of conditions discussed. Three major themes emerged from the analysis: Transplantadas en otro mundo (Uprooted in another world), El criador de abuso (The breeding ground of abuse), and Rompiendo el silencio (Breaking the silence). This study supports the importance of addressing substance abuse, violence, and risk for HIV in an integrated manner and stresses the importance of addressing associated cultural factors (e.g., acculturation, machismo) in interventions targeting Hispanics. PMID:21191036

  8. Intestinal parasitic infections in Thai HIV-infected patients with different immunity status

    Directory of Open Access Journals (Sweden)

    Wiwanitkit Viroj

    2001-06-01

    Full Text Available Abstract Background One of the major health problems among HIV seropositive patients is superimposed infection due to the defect of immunity. Furthermore, intestinal parasite infection, which is also one of the basic health problems in tropical region, is common in these patients. In this study, a cross sectional study to document the prevalence of intestinal parasitic infection in Thai HIV-infected patients with different immune status was performed. Methods A study of stool samples from 60 Thai HIV-infected patients with different immune status was performed at King Chulalongkorn Memorial Hospital, Thailand. Each patient was examined for CD4 count and screened for diarrheal symptoms. Results The prevalence of intestinal parasitic infection among the HIV-infected patients in this study was 50 %. Non- opportunistic intestinal parasite infections such as hookworms, Opisthorchis viverrini and Ascaris lumbricoides were commonly found in HIV-infected people regardless of immune status with or without diarrheal symptoms. Opportunistic intestinal parasites such as Cryptosporidium, Isospora belli, Microsporidia and Strongyloides stercoralis infection were significantly more frequent in the low immunity group with diarrhea. Conclusion Therefore, opportunistic intestinal parasite infection should be suspected in any HIV infected patient with advanced disease presenting with diarrhea. The importance of tropical epidemic non-opportunistic intestinal parasite infections among HIV-infected patients should not be neglected.

  9. Amyloid and tau cerebrospinal fluid biomarkers in HIV infection

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    Rosengren Lars

    2009-12-01

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

  10. HIV/AIDS and Associated Conditions among HIV-Infected Refugees in Minnesota, 2000–2007

    OpenAIRE

    Kristina Krohn; Luisa Pessoa-Brandão; Ann O'Fallon; Brett Hendel-Paterson; Kailey Nelson; Blain Mamo; Glenise Johnson; Lowther, Sara A.; William Stauffer

    2012-01-01

    In 2010, the requirement for human immunodeficiency virus (HIV) testing of adult refugees prior to US resettlement was removed, thus leading to a potential for missed diagnosis. We reviewed refugee health assessment data and medical charts to evaluate the health status of HIV-infected refugees who arrived in Minnesota during 2000–2007, prior to this 2010 policy change. Among 19,292 resettled adults, 174 were HIV-infected; 169 (97%) were African (median age 26.4 (range: 17–...

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

    OpenAIRE

    Manners, R.

    2012-01-01

    Rates of sexual violence are high, and several studies have suggested that rates are particularly high among HIV-positive women. Experience of sexual violence can lead to numerous physical and psychological co-morbidities as well as a wide range of social problems. On both a Scottish Government and an international level it has been suggested that routine questioning about sexual violence in vulnerable populations can help to ensure access to appropriate services. This study aimed to assess t...

  12. Densitometric disorders in children infected with HIV

    Directory of Open Access Journals (Sweden)

    M Marczyñska

    2012-11-01

    Full Text Available The aim of study was to assess the prevalence of densitometric disorders and deficiencies of vitamin D3 in children vertically HIV-infected, treated with cART. In 34 children vertically HIV-infected aged 10–16 years (mean 13 years, receiving cART?5, bone densitometry and the titer of 25-OHD3 was done. We analyzed at the time of diagnosis of HIV infection and at the time of the study: age, clinical and immunological classification, the length, effectiveness of cART, the lowest immunological classification. 15/34 (44% children had abnormal dual-energy X-ray absorptiometry examination (DEXA of the lumbar aged-matched mean Z-score ?2.1 (range ?1.2 to ?3.5, of which 8 also had abnormal DEXA whole spine aged-matched mean Z-score ?1.6 (range ?1.1 to?2.2. Level of 25-OHD3 was abnormal (<20 ng/ml in 29/34 (85%, in 7 of them the level was very low (<4.0 ng /ml. 4/5 children with normal values of 25-OHD3 parallel had correct densitometry; 1/5 with a normal value of 25-OHD3 had significant abnormalities of bone density, visible in radiographs of the hand. Clinical classification at diagnosis was: N/A in 17, B in 12, C in 5 and immunological classification: 1 in 11, 2 in 9, 3 in 13 cases. The lowest classification was AIDS in 9 children, 15 had moderate signs of infection, and 10 mild signs; deep immune deficiency occurred in 17 children, 15 had moderate and 2 have never had immunodeficiency. The regimens based on PI received 9 children, NNTRI ?6, all 3 classes received 19. At the time of the study 31 children were successfully treated, 32 had no immunodeficiency, two had moderate deficiency. 32 children were qualified to N/A group, one was in the classification of B and one in C. All children unsuccessfully treated (3 had low levels of 25-OHD3. In a significant percentage of older children receiving antiretroviral treatment?5 years, had abnormal results of densytometry examination. There was no correlation between age, duration of the cART, the severity of the clinical, immunological classification, viral load and bone density disorders. Level of 25-OHD3 was abnormal in the majority of children. Disorders were also found in children successfully treated.

  13. Relationship of vitamin D, HIV, HIV treatment and lipid levels in the Women’s Interagency HIV study (WIHS) of HIV-infected and un-infected women in the US

    OpenAIRE

    Schwartz, Janice B.; Moore, Kelly L.; Yin, Michael; Sharma, Anjali; Merenstein, Dan; Islam, Talat; Golub, Elizabeth T.; Tien, Phyllis C.; Adeyemi, Oluwatoyin M.

    2014-01-01

    Relationships between vitamin D, lipids, HIV infection, and HIV treatment (±ART) were investigated with Women’s Interagency HIV Study data (n=1758 middle-aged women) using multivariable regression. 63 % had vitamin D deficiency. Median 25-OH vitamin D was highest in HIV-infected +ART-treated women (17 ng/mL, p

  14. SPECTRUM OF OPPORTUNISTIC INFECTIONS IN HIV-AIDS PATIENTS

    OpenAIRE

    Madkar, S. S.; Ashok Jaykumar Vankudre; Sl, Nilekar

    2012-01-01

    Aim: AIDS is characterized by a number of opportunistic infections which are responsible for high morbidity and mortality. The spectrum and distribution of opportunistic infections (OIs) in AIDS patients is ever-expanding. This spectrum varies from continent to continent. The aim of the present study was to document the spectrum of OIs in HIV-infected patients in Ambajogai. Material and Method: 178 HIV positive symptomatic patients, either hospitalized or coming to ART (Antiretroviral Therapy...

  15. Antiviral drug resistance in Cuban children infected with HIV-1

    OpenAIRE

    Y Alemán; Correa, C.; C Aragonés; I González; J Pérez; Alvarez, A; L Pérez; V Kourí; Vandamme, A; Van Laethem, K

    2012-01-01

    Between 1986 and 2011, 100 children have been diagnosed with HIV-1 in Cuba. 38 have acquired HIV-1 by vertical transmission, 6 by blood transfusion and 56 by sexual contacts (teenager). Currently, AZT/D4T +?3TC?+?NVP/KALETRA are available for the treatment of pediatric patients. The aim of the study was to monitor the subtype distribution and emergence of drug resistance in pediatric HIV-1 infections. Plasma from 46 HIV-1-infected children were collected from November 200...

  16. Clinical research in HIV-1 infected children

    OpenAIRE

    Fraaij, P. L. A.

    2005-01-01

    Acquired immune deficiency syndrome (AIDS) was described for the first time in 1981. Two years later the previously unknown human immunodeficiency virus (HIV) was identified as the causative agent. HIV has been included in the genus Lent/viruses of the Retroviridae family. Two types are recognized: HIV-1 and HIV-2. Of these, HIV-1 is the primary etiologic agent of the current pandemic. HIV probably originates from simian immunodeficiency virus (SIV) which is endemic in African ...

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

    International Nuclear Information System (INIS)

    Objectives: Enteric parasites are a major cause of diarrhoea in HIV/AIDS patients with low CD4 counts. Parasitic infections in HIV-infected individuals can reduce their quality of life and life span, especially those who are severely immunosuppressed with a CD4 T-lymphocyte count 0.05). 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)

  18. Interleukin-27 Is Differentially Associated with HIV Viral Load and CD4+ T Cell Counts in Therapy-Naïve HIV-Mono-Infected and HIV/HCV-Co-Infected Chinese

    OpenAIRE

    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

    2014-01-01

    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...

  19. Possible transmission of HIV Infection due to human bite

    Directory of Open Access Journals (Sweden)

    Bandivdekar Atmaram H

    2011-03-01

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

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

    Directory of Open Access Journals (Sweden)

    Nathan Shaffer

    2009-01-01

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

  1. Spectrum of motor neuron diseases with HIV-1 infection

    Directory of Open Access Journals (Sweden)

    Verma Ashok

    2006-01-01

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

  2. High prevalence of giardiasis and strongyloidiasis among HIV-infected patients in Bahia, Brazil

    OpenAIRE

    Giovana Feitosa; Bandeira, Anto?nio C.; Sampaio, Diana P.; Roberto Badaró; Carlos Brites

    2001-01-01

    Diarrhea due to intestinal microbial infections is a frequent manifestation among HIV-infected patients. It has been postulated that HIV-infected patients may have special types of intestinal infections, and that immune activation from such parasites may affect the progression of HIV disease. To evaluate these associations, the frequency of infections was examined in HIV-infected patients in Bahia, Brazil. To determine the potential impact of the presence of intestinal parasitic infections on...

  3. Disseminated tuberculosis in an AIDS/HIV-infected patient.

    Science.gov (United States)

    Abdi-Liae, Zahra; Moradnejad, Pardis; Alijani, Neda; Khazraiyan, Hamide; Mansoori, Sedigeh; Mohammadi, Naseh

    2013-01-01

    Disseminated tuberculosis (TB) is commonly seen in HIV-infected patients and is major cause of death in these patients. In HIV-infected patients disseminated tuberculosis is frequently undiagnosed or misdiagnosed. In this article we report a case of disseminated TB in a HIV-infected patient with a relatively long history of fever and other complaints without definite diagnosis. Diagnosis of disseminated TB was confirmed by bone marrow biopsy and polymerase chain reaction analysis (PCR) of the ascitic fluid. With anti-TB treatment signs and symptoms improved. PMID:24026999

  4. Positron emission tomography in patients suffering from HIV-1 infection

    International Nuclear Information System (INIS)

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

  5. Gender based violence as a risk factor for HIV-associated risk behaviors among female sex workers in Armenia.

    Science.gov (United States)

    Lang, Delia L; Salazar, Laura F; DiClemente, Ralph J; Markosyan, Karine

    2013-02-01

    This cross-sectional study identified the prevalence of gender based violence (GBV) and examined its association with sexual risk behavior among female sex workers (FSWs). Among 120 participants between ages 20 and 52, a total of 56.7 % reported lifetime GBV. Multivariate analyses revealed that GBV was significantly associated with inconsistent condom use, unprotected sex, condom misuse, fear of client reaction to requests of condom use, self-reported history of STIs, and earlier age of initiation of sex work. GBV must be considered an urgent public health priority among FSWs in Armenia. Interventions addressing FSWs, in addition to targeting skill-based, sexual risk reduction must also introduce a discourse among FSWs, sexual partners, clients and community members about the role of GBV in HIV-associated risk behaviors and infection. Structural level initiatives must address economic opportunities for women, health-sector policies and responses to FSWs' health needs, law enforcement training and societal norms toward women. PMID:22760740

  6. Increased Aldosterone Among HIV-Infected Women with Visceral Fat Accumulation

    OpenAIRE

    Lo, Janet; Looby, Sara E. Dolan; Wei, Jeffrey; Adler, Gail K.; Grinspoon, Steven K.

    2009-01-01

    Increased aldosterone has been associated with obesity and the metabolic syndrome in non HIV-infected patients, but aldosterone has not been investigated among HIV-infected patients with increased visceral adipose tissue (VAT). 24-hour urine aldosterone was assessed among age and BMI-matched HIV-infected women with increased VAT, HIV-infected women without increased VAT and healthy controls. 24-hour urine aldosterone was higher in HIV-infected women with increased VAT and was associated with ...

  7. [Treatment of HIV infection in 2006: highlights].

    Science.gov (United States)

    Schiffer, V; Hirschel, B

    2007-01-10

    In developed countries, drug therapy has turned HIV infection into a chronic disease. More is known about viral replication and new, easily tolerated drugs will enter the marketplace in 2007 and 2008. For the majority of patients who suffer neither resistance nor intolerance, older molecules are combined in the same pill. Very effective triple therapy, combining efavirenz, emtricitabine, and tenofovir in one pill (Atripla - Gilead) is already available in the United States and will become the standard of therapy in 2007. Since the eradication of the virus remains impossible even under effective antiretroviral therapy, the scheduled treatment interruptions as well as simplified maintenance therapies represent still a topic of interest for well selected patients, with an aim of reducing the costs and toxicities. PMID:17354665

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

    OpenAIRE

    A?sander, Ann-sofie

    2010-01-01

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

  9. HIV testing behaviors and perceptions of risk of HIV infection among MSM with main partners.

    Science.gov (United States)

    Stephenson, Rob; White, Darcy; Darbes, Lynae; Hoff, Colleen; Sullivan, Patrick

    2015-03-01

    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

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

    International Nuclear Information System (INIS)

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

  11. Condom distribution in jail to prevent HIV infection.

    Science.gov (United States)

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

    2013-10-01

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

  12. Greentree White Paper: Sexual Violence, Genitoanal Injury, and HIV: Priorities for Research, Policy, and Practice

    OpenAIRE

    Klot, Jennifer F.; Auerbach, Judith D.; Veronese, Fulvia; Brown, Gina; Pei, April; Charles R Wira; Hope, Thomas J; M'boup, Souleymane

    2012-01-01

    The links between sexual violence, genitoanal injury, and HIV are understudied but potentially significant for understanding the epidemic's disproportionate impacts on young women and girls, particularly in sub-Saharan Africa, other hyperendemic areas, and conflict-affected regions. A Scientific Research Planning Meeting was convened by the Social Science Research Council at the Greentree Foundation in New York, March 19–20, 2012, bringing together an interdisciplinary group of researchers,...

  13. Subclinical neurological and neuropsychological effect of infection with HIV.

    OpenAIRE

    Carne, C. A.; Stibe, C; Bronkhurst, A; Newman, S P; Weller, I V; Kendall, B E; Harrison, M. J.

    1989-01-01

    Thirty one homosexual men with antibody to human immunodeficiency virus (HIV) but without major neurological complaints were assessed in a cross sectional study of neurological and neuropsychological function. Eleven patients had AIDS, 10 had persistent generalised lymphadenopathy (PGL), and 10 had HIV infection without PGL (called "well"). Thirteen age matched homosexual men without antibody to HIV acted as controls. Significant abnormalities were found in six on clinical neurological examin...

  14. Cytotoxic T lymphocytes and viral adaptation in HIV infection.

    OpenAIRE

    Goulder, P.; Klenerman, P.

    2006-01-01

    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...

  15. Impact of HIV Infection on Medicare Beneficiaries with Lung Cancer

    OpenAIRE

    LEE, Jeannette Y.; Page C. Moore; Shelly Y. Lensing

    2012-01-01

    The incidence of lung cancer among individuals infected with the human immunodeficiency virus (HIV) is elevated compared to that among the general population. This study examines the prevalence of HIV and its impact on outcomes among Medicare beneficiaries who are 65 years of age or older and were diagnosed with nonsmall cell lung cancer (NSCLC) between 1997 and 2008. Prevalence of HIV was estimated using the Poisson point estimate and its 95% confidence interval. Relative risks for potential...

  16. Alcohol consumption trajectory patterns in adult women with HIV infection

    OpenAIRE

    Cook, Robert L; Zhu, Fang; Belnap, Bea Herbeck; Kathleen M. Weber; COLE, STEPHEN R.; VLAHOV, DAVID; Cook, Judith A.; Hessol, Nancy A.; Wilson, Tracey E; Plankey, Michael; Andrea A Howard; Sharp, Gerald B; Richardson, Jean L.; Cohen, Mardge H

    2013-01-01

    HIV-infected women with excessive alcohol consumption are at risk for adverse health outcomes, but little is known about their long-term drinking trajectories. This analysis included longitudinal data, obtained from 1996–2006, from 2791 women with HIV from the Women’s Interagency HIV Study. Among these women, the proportion in each of five distinct drinking trajectories was: continued heavy drinking (3%), reduction from heavy to non-heavy drinking (4%), increase from non-heavy to heavy dr...

  17. Transmitted drug resistance in nonsubtype B HIV-1 infection

    OpenAIRE

    Chan, Philip A.; KANTOR, RAMI

    2009-01-01

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

  18. Female streetworking prostitution and HIV infection in Glasgow.

    OpenAIRE

    McKeganey, N.; M Barnard; Leyland, A; Coote, I.; Follet, E.

    1992-01-01

    OBJECTIVES--To identify the extent of HIV infection and injecting drug use among female streetworking prostitutes in Glasgow; to estimate the size of the female streetworking prostitute population in the city; and to estimate the number of HIV positive women working as prostitutes on the streets in Glasgow. DESIGN--Observation and interviewing of female prostitutes over seven months in red light district; analysis of saliva samples for presence of antibodies to HIV; capture-recapture approach...

  19. Comparison of pregnancy characteristics and outcomes between HIV-infected and HIV-non-infected women in Brazil.

    Science.gov (United States)

    da Costa, T P; Leal, M C; Mota, J C; Machado, E S; Costa, E; Vianna, P; de Oliveira, R H; Abreu, T F; Nogueira, S A; Hofer, C B

    2013-01-01

    The aim of this study is to evaluate the characteristics of pregnant women whether they are HIV infected or not and their prenatal care. It is a cross-sectional study. HIV-infected women were derived from a cohort study of all HIV-infected pregnant women followed from 1995 to 2005, at the Instituto de Puericultura e Pediatria Martagão Gesteira - Rio de Janeiro. HIV-non-infected women were derived from a random sample of all pregnant women who gave birth at Rio de Janeiro municipality between 1999 and 2001. All relevant sociodemographic, clinical, and pregnancy outcomes data were retrieved from both studies. To evaluate the prenatal care, we calculated the Kotelchuck Modified Index (KMI). The index is based on the months of initiation of prenatal care and the proportion of visits observed in each trimester, according to gestational age at birth. Comparisons were performed using Student t- and chi-square tests. Variables with p-value < 0.25 were included in an unconditional logistic regression model. There were 713 HIV-infected women and 2145 HIV-non-infected women. Variables independently associated with HIV status were: inadequate KMI (OR=4.08, 95% CI=3.17-5.24); lower educational level (OR=1.32, 95% CI=1.04-1.68); does not live with a partner (OR=3.54, 95% CI=2.66-4.64); lower family income (OR=4.71, 95% CI=3.62-6.14); tobacco use (OR=2.17, 95% CI=1.63-2.88); and hypertension (OR=1.47, 95% CI=1.01-2.17). Prematurity was not independently associated with HIV status. Although in Brazil, the HIV care is free of charge, pregnant women are still having difficulty to reach the specialized care. Better access to care must be offered to this population and studies of prematurity in the HIV-infected women must evaluate their prenatal care. PMID:23394727

  20. SOCIO ECONOMIC ANALYSIS OF HIV INFECTED VICTIMS OF VINDHYA REGION

    OpenAIRE

    Hamendra Kumar Verma; Pandey, Devendra N.

    2014-01-01

    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.

  1. Exposure to Wild Primates among HIV-infected Persons

    OpenAIRE

    Lebreton, Matthew; Yang, Otto; Tamoufe, Ubald; Mpoudi-Ngole, Eitel; Torimiro, Judith N; Djoko, Cyrille F.; Carr, Jean K; Prosser, A. Tassy; Rimoin, Anne W.; Birx, Deborah L; Burke, Donald S.; Wolfe, Nathan D.

    2007-01-01

    HIV-1 is an immunosuppressive pathogen. Our behavioral data for 191 HIV-1–infected rural Cameroonians show frequent exposure to nonhuman primates through activities such as hunting and butchering. Immunosuppression among persons exposed to body fluids of wild nonhuman primates could favor the process of adaptation and subsequent emergence of zoonotic pathogens.

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

    Directory of Open Access Journals (Sweden)

    Xin-li LU

    2013-03-01

    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.

  3. The challenges of success: adolescents with perinatal HIV infection

    Directory of Open Access Journals (Sweden)

    Lynne M Mofenson

    2013-06-01

    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.

  4. A Comparative Analysis of Intestinal Parasitic Infections between HIV+/AIDS Patients and Non-HIV Infected Individuals

    OpenAIRE

    Eb, Kia; Hadighi, R.; Zahabian, F.; Mohraz, M.; Rezaian, M.; Ar, Meamar

    2007-01-01

    Background: The aim of this study was to verify the occurrence of intestinal parasitic infections in human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) patients in Iran in comparison with non-HIV individuals. Methods: A total of HIV+/AIDS patients (Group I) and 1220 clinically healthy individuals (Group II) were submitted to coproparasitological examination from 2003 to 2005. Results: The overall prevalence of intestinal parasites in group I and group II was 11.4% an...

  5. Progressive Multifocal Leukoencephalopathy Complicating HIV-1 Infection

    Science.gov (United States)

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

    2010-01-01

    Progressive multifocal leukoencephalopathy (PML) caused by the polyomavirus, JC virus (JCV), is one of the most dreaded complications of HIV-1 infection. Unlike other opportunistic infections, PML may present while blood CD4+ T cells remain above AIDS-defining levels and while patients receive combined antiretroviral therapy (cART), either shortly after starting or, more rarely, during chronic successful treatment. PML can be suspected by typical presentation with focal neurological deficits and corresponding demyelinating lesions at magnetic resonance imaging (MRI), while definitive diagnosis requires identification of JCV in cerebrospinal fluid (CSF) or brain tissue. While there is no specific treatment, reversal of immunosuppression by cART leads to clinical and MRI stabilization in 50-60% of PML patients and JCV clearance from CSF. A proportion of cART-treated patients develop inflammatory lesions, which may either accompany a favorable outcome or associate with clinical worsening. The reasons for variability in PML natural history and treatment responses are largely undefined, and more specific and rational approaches to management are sorely needed. PMID:19778765

  6. Polypharmacy in the HIV-infected older adult population

    OpenAIRE

    Gleason LJ; Luque AE; Shah K

    2013-01-01

    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...

  7. HIV infection of non-dividing cells: a divisive problem

    Directory of Open Access Journals (Sweden)

    Fassati Ariberto

    2006-10-01

    Full Text Available Abstract Understanding how lentiviruses can infect terminally differentiated, non-dividing cells has proven a very complex and controversial problem. It is, however, a problem worth investigating, for it is central to HIV-1 transmission and AIDS pathogenesis. Here I shall attempt to summarise what is our current understanding for HIV-1 infection of non-dividing cells. In some cases I shall also attempt to make sense of controversies in the field and advance one or two modest proposals.

  8. Treatment of depression in HIV-infected patients.

    OpenAIRE

    Cazzullo, C L; Bessone, E; Bertrando, P; Pedrazzoli, L; Cusini, M

    1998-01-01

    BACKGROUND: Pharmacological treatment of depression in HIV-infected patients has been found to be effective. This study assessed the efficacy and feasibility of treatment with fluoxetine and the best method of administering the drug to patients with HIV infection. METHODS: Sixteen seropositive and 16 seronegative patients, equally matched for age and sex, who had Hamilton Rating Scale for Depression scores of at least 16 and who received at least 20 mg/d of fluoxetine for 8 weeks were studied...

  9. Clinical and demographic features of HIV infection in El Salvador

    OpenAIRE

    García Vázquez Elisa; Cedillos Rolando A.; Wheeler David A.

    2003-01-01

    OBJECTIVE: To understand some of the clinical and demographic features of the epidemic of infection by HIV in El Salvador prior to the availability of antiretroviral therapy in that country. METHODS: We conducted a retrospective review of HIV-infected individuals who were admitted to Hospital Rosales, which is a large public teaching hospital in San Salvador, El Salvador, during the 5-year period of 1994 through 1998. Chart abstraction was done of 194 out of the 208 individuals admitted to th...

  10. Body composition and lipodystrophy in prepubertal HIV-infected children

    OpenAIRE

    Cecilia Zanin Palchetti; Rose Vega Patin; Aída de Fátima Thomé Barbosa Gouvêa; Vera Lúcia Szejnfeld; Regina Célia Menezes Succi; Fernanda Luisa Ceragioli Oliveira

    2013-01-01

    OBJECTIVE: To identify lipodystrophy in prepubertal HIV-infected children using anthropometric parameters and body composition assessment. METHODS: Cross-sectional study including 40 prepubertal HIV-infected children of both genders seen at the Care Center of the Division of Pediatric Infectious Diseases - Universidade Federal de São Paulo, São Paulo city, Brazil, was carried out from August to December 2008. Age, clinical and immunological status, prophylaxis, transmission and highly activ...

  11. Seroprevalence of hepatitis E in HIV infected patients in Greece.

    Science.gov (United States)

    Politou, Marianna; Boti, Sofia; Androutsakos, Theodoros; Valsami, Serena; Pittaras, Theodoros; Kapsimali, Violetta

    2015-09-01

    HEV infection is an emerging public health problem worldwide Data concerning HEV infection in HIV+ patients in Greece is scare. The aim of the study was to determine HEV seroprevalence in patients with HIV infection in Greece. We studied 243 HIV(+) patients 214 men (88%) and 29 women (12%) with a median age of 45 years (range 19-83) who attended the HIV unit of Pathophysiology Department of Laikon General Hospital in Athens for the presence of anti-HEV IgG antibodies with (EIA) (EIA HEV IgG, Adaltis, Rome, Italy Eighteen/243 patients (7.3%) were positive for HEV IgG antibodies, a seroprevalence that was not different from that described for the blood donors group from Greece There was no difference of the presence of HbsAg, hepatitis C and hepatitis A between the HEV(+) and HEV(-) patients. There was no statistically significant difference between the HEV(+) and HEV(-) group in terms of HIV acquisition, sexual orientation, median duration of HIV infection, ART treatment, or duration of ART. Only the median age of HEV(+) was 52years (35-78) while that of HEV(-) was 44years (19-83)(P?=?0.03). Only 2/18(11.1%) HEV(+) HIV(+) patients had abnormal ALT and AST values. The seroprevalence of hepatitis E in HIV(+) patients in Greece seems to be the same with that of the general population thus implying that HIV infection is not a risk factor for HEV infection and only age shows a positive correlation with seropositivity. J. Med. Virol. 87:1517-1520, 2015. © 2015 Wiley Periodicals, Inc. PMID:25965115

  12. Barriers and Facilitators of HIV Disclosure: Perspectives from HIV-Infected Men Who Have Sex with Men

    OpenAIRE

    Driskell, Jeffrey R.; Salomon, Elizabeth; Mayer, Kenneth; Capistrant, Benjamin; Safren, Steven

    2008-01-01

    HIV disclosure among sexually active HIV-infected men who have sex with men (MSM) is a complex phenomenon. To better understand factors that impact the decision-making process regarding HIV disclosure among HIV-infected MSM, the present study analyzed content from previously conducted counseling sessions where HIV disclosure was selected as the primary focus of the session. The counselor/participant dialogue was audio-recorded, transcribed, and analyzed qualitatively using content analysis. F...

  13. Prevention of HIV-1 infection 2013: glimmers of hope

    Directory of Open Access Journals (Sweden)

    Cohen M

    2012-11-01

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

  14. Case series of syphilis and HIV co-infections

    OpenAIRE

    Abdul Wahab, Asrul; Rahman, M. M.; Mohammad, Marlyn; Hussin, Salasawati

    2013-01-01

    Syphilis and HIV co-infection are indeed dangerous combinations. The present communication describes three different cases of syphilis and HIV co-infection in young men. The first case is a 25-year-old medical graduate with a primary and secondary syphilis lesions at time of presentation. The second case is a 24-year-old government officer with right eye posterior uveitis where the serology tests for syphilis were reactive. His HIV tests were also positive. The final case is a 25-year-old hom...

  15. HIV-2 infection with a long asymptomatic period.

    Science.gov (United States)

    Mota-Miranda, A; Gomes, H; Marques, R; Serrão, R; Lourenço, H; Santos-Ferreira, O; Lecour, H

    1995-09-01

    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

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

    Directory of Open Access Journals (Sweden)

    Kim Hae-Young

    2012-08-01

    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.

  17. Histone Deacetylase Inhibitor Romidepsin Inhibits de novo HIV-1 Infections

    DEFF Research Database (Denmark)

    JØnsson, Kasper L; Tolstrup, Martin

    2015-01-01

    Adjunct therapy with the histone deacetylase inhibitor (HDACi) romidepsin increases plasma viremia in HIV patients on combination antiretroviral therapy (cART). However, a potential concern is that reversing HIV latency with an HDACi may reactivate the virus in anatomical compartments with sub-optimal cART concentrations leading to de novo infection of susceptible cells in these sites. We tested physiologically relevant romidepsin concentrations known to reactivate latent HIV in order to definitively address this concern. We found that romidepsin significantly inhibited HIV infection in PBMCs and CD4+ T cells, but not in monocyte-derived-macrophages. In addition, romidepsin impaired HIV spreading in CD4+ T cell cultures. When we evaluated the impact of romidepsin on quantitative viral outgrowth assays with primary resting CD4+ T cells, we found that resting CD4+ T cells exposed to romidepsin exhibited reduced proliferation and viability. This significantly lowered assay sensitivity when measuring the efficacyof romidepsin as an HIV latency reversal agent. All together our data indicate that romidepsin-based HIV eradication strategies are unlikely to reseed a latent T cell reservoir, even under sub-optimal cART conditions, because romidepsin profoundly restricts de novo HIV infections.

  18. Histone Deacetylase Inhibitor Romidepsin Inhibits De Novo HIV-1 Infections.

    Science.gov (United States)

    Jønsson, Kasper L; Tolstrup, Martin; Vad-Nielsen, Johan; Kjær, Kathrine; Laustsen, Anders; Andersen, Morten N; Rasmussen, Thomas A; Søgaard, Ole S; Østergaard, Lars; Denton, Paul W; Jakobsen, Martin R

    2015-07-01

    Adjunct therapy with the histone deacetylase inhibitor (HDACi) romidepsin increases plasma viremia in HIV patients on combination antiretroviral therapy (cART). However, a potential concern is that reversing HIV latency with an HDACi may reactivate the virus in anatomical compartments with suboptimal cART concentrations, leading to de novo infection of susceptible cells in these sites. We tested physiologically relevant romidepsin concentrations known to reactivate latent HIV in order to definitively address this concern. We found that romidepsin significantly inhibited HIV infection in peripheral blood mononuclear cells and CD4(+) T cells but not in monocyte-derived macrophages. In addition, romidepsin impaired HIV spreading in CD4(+) T cell cultures. When we evaluated the impact of romidepsin on quantitative viral outgrowth assays with primary resting CD4(+) T cells, we found that resting CD4(+) T cells exposed to romidepsin exhibited reduced proliferation and viability. This significantly lowered assay sensitivity when measuring the efficacy of romidepsin as an HIV latency reversal agent. Altogether, our data indicate that romidepsin-based HIV eradication strategies are unlikely to reseed a latent T cell reservoir, even under suboptimal cART conditions, because romidepsin profoundly restricts de novo HIV infections. PMID:25896701

  19. [Cryptococcal infections in non-HIV infected patients: a new clinical problem in Chile].

    Science.gov (United States)

    Fica, Alberto; Soto, Andrés; Dabanch P, Jeannette; Pinilla, Jorge; Porte, Lorena

    2015-02-01

    Cryptococcal infections are classically associated to HIV/AIDS patients without therapy, but its presence among other immunosuppressed patients is less recognized. We report 3 lethal cases in non HIV-patients. Two of them presented with meningitis associated to renal transplant or corticosteroid use and, the third, with a necrotic skin infection in the context of progressive liver cirrhosis. In the former two patients, meningeal infection was suspected late, and in the latter, the diagnosis was established postmortem. Cryptococcal infections in non-HIV immunosupressed patients can affect different sites, are suspected late and have a high case-fatality ratio. PMID:25860049

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

    Science.gov (United States)

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

    2014-08-01

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

  1. Management of infertility in HIV infected couples: a review.

    Science.gov (United States)

    Agboghoroma, Chris O; Giwa-Osagie, Osato F

    2012-12-01

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

  2. Innate immune recognition and activation during HIV infection

    Directory of Open Access Journals (Sweden)

    Larsen Carsten S

    2010-06-01

    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.

  3. Innate immune recognition and activation during HIV infection

    DEFF Research Database (Denmark)

    Mogensen, Trine H; Melchjorsen, Jesper

    2010-01-01

    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.

  4. Erythema nodosum leprosum and HIV infection: A therapeutic experience.

    Science.gov (United States)

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

    2005-09-01

    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

  5. Combination effect on HIV infection in vitro of soluble CD4 and HIV-neutralizing antibodies.

    DEFF Research Database (Denmark)

    Hansen, J E; SØrensen, A M

    1994-01-01

    In combination with HIV gp120 V3-loop antibody, two carbohydrate specific neutralizing antibodies (83D4 and 2G12) had a synergistic neutralizing effect on HIV infection. However, sCD4 and an antibody which blocks gp 120/CD4 binding (1B1) both displayed antagonism.

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

    DEFF Research Database (Denmark)

    Legarth, Rebecca; Omland, Lars H

    2014-01-01

    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.

  7. Mortality of HIV-infected patients starting antiretroviral therapy in sub-Saharan Africa: comparison with HIV-unrelated mortality.

    OpenAIRE

    Brinkhof, Martin; Boulle, Andrew; Weigel, Ralf; Messou, Euge?ne; Mathers, Colin; Orrell, Catherine; Dabis, Franc?ois; Pascoe, Margaret; Egger, Matthias

    2009-01-01

    BACKGROUND: Mortality in HIV-infected patients who have access to highly active antiretroviral therapy (ART) has declined in sub-Saharan Africa, but it is unclear how mortality compares to the non-HIV-infected population. We compared mortality rates observed in HIV-1-infected patients starting ART with non-HIV-related background mortality in four countries in sub-Saharan Africa. METHODS AND FINDINGS: Patients enrolled in antiretroviral treatment programmes in Côte d'Ivoire, Malawi, South Afr...

  8. Mitochondrion-mediated apoptosis in HIV-1 infection.

    Science.gov (United States)

    Badley, Andrew D; Roumier, Thomas; Lum, Julian J; Kroemer, Guido

    2003-06-01

    Acquired immunodeficiency syndrome (AIDS), which is caused by human immunodeficiency virus (HIV-1), involves the apoptotic destruction of lymphocytes and, in the context of AIDS-associated pathologies, of neurons and myocytes. Several proteins encoded by HIV-1 trigger apoptosis by inducing permeabilization of the mitochondrial membrane. Several nucleoside analogs used clinically in the treatment of HIV-1 inhibit the replication of mitochondrial DNA (mtDNA) and/or increase the frequency of mtDNA mutations. These cause severe mitochondriopathy and might contribute to lipodystrophy, the complication associated with HIV-1 therapy. HIV-1 protease inhibitors can inhibit apoptosis at the mitochondrial level, which might help to alleviate lymphopenia. Thus, it appears that the pathogenesis of AIDS, and the pharmacological interventions and complications associated with this disease, affect the mitochondrial regulation of apoptosis, which, therefore, largely determines the outcome of HIV-1 infection. PMID:12823956

  9. Update on mental health issues in patients with HIV infection.

    Science.gov (United States)

    Vlassova, Natalia; Angelino, Andrew F; Treisman, Glenn J

    2009-03-01

    HIV infection remains a major world health problem more than 20 years after discovery of the virus. Mental disorders make individuals more vulnerable to behaviors that transmit HIV and interfere with HIV treatment adherence. The evidence supporting the need for optimal provision of mental health care in HIV clinics is mounting, along with evidence that these disorders can be treated successfully. Disorders of mental life include brain diseases (eg, depression, bipolar disorder, schizophrenia, and dementia), personality disorders, addictions, and psychologic disruptions, which contribute to the spread of the virus through their influence on behavior. However, although evidence exists that successful treatment of co-occurring mental disorders leads to improved HIV outcomes, integrated mental health care in HIV clinics remains grossly suboptimal. PMID:19239808

  10. Psychiatric Diagnoses among an HIV-Infected Outpatient Clinic Population.

    Science.gov (United States)

    Shacham, Enbal; Onen, Nur F; Donovan, Michael F; Rosenburg, Neal; Overton, E Turner

    2014-10-27

    As individuals with HIV infection are living longer, the management of psychiatric disorders has increasingly been incorporated into comprehensive care. Individuals were recruited from an outpatient HIV clinic to assess the prevalence and related associations of current psychiatric disorders and biomarkers. Of the 201 participants who completed the interviews, the median age was 43.5 years, and the majority was male and African American. Most were receiving HIV therapy and 78% of those had achieved virologic suppression. Prevalent psychiatric diagnoses included major depressive disorder, generalized anxiety, and agoraphobia. Alcohol and cocaine/crack abuse and dependence were common substance use disorders. Current receipt of HIV therapy was less common among those diagnosed with generalized anxiety disorder. Agoraphobia was the only disorder associated with unsuppressed viral load. Psychiatric and substance use disorders are highly prevalent among an urban HIV clinic population, although we identified few associations between psychiatric diagnoses and HIV diseases status. PMID:25348798

  11. Cryptosporidiosis Among HIV-infected Patients with Diarrhea in Edo State, Midwesten Nigeria

    Directory of Open Access Journals (Sweden)

    Akinbo, F. O.

    2010-01-01

    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.

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

    Directory of Open Access Journals (Sweden)

    Sanson-Le-Pors Marie-Jose

    2011-04-01

    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.

  13. Effects of methamphetamine dependence and HIV infection on cerebral morphology.

    DEFF Research Database (Denmark)

    Jernigan, Terry Lynne; Gamst, Abthony C

    2005-01-01

    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

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

    Directory of Open Access Journals (Sweden)

    Petropoulos Christos J

    2005-11-01

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

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

    Science.gov (United States)

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

    2012-03-01

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

  16. Changing Concepts of “Latent Tuberculosis Infection” in Patients Living with HIV Infection

    OpenAIRE

    Lawn, Stephen D.; Wood, Robin; Wilkinson, Robert J.

    2010-01-01

    One third of the world's population is estimated to be infected with Mycobacterium tuberculosis, representing a huge reservoir of potential tuberculosis (TB) disease. Risk of progression to active TB is highest in those with HIV coinfection. However, the nature of the host-pathogen relationship in those with “latent TB infection” and how this is affected by HIV coinfection are poorly understood. The traditional paradigm that distinguishes latent infection from active TB as distinct compar...

  17. Sexual risk behaviors and risk of HIV infection among adult male in Nepal

    OpenAIRE

    Khatiwada, Sudip Raj

    2013-01-01

    Background: The HIV infection among adult male is high in Nepal. The chances of HIV infection from heterosexual route and infecting close partners are high due to their risky sexual behaviors. This study aimed to assess the risk of HIV Infection and risk factors associated with high risk of HIV infection among adult male in Nepal. Methodology: An analytical cross-sectional study was conducted from the data of Nepal Demographic and Health Survey 2011. Out of 4121 adult men aged between (15-...

  18. Auditory impairments in HIV-infected individuals in Tanzania

    Science.gov (United States)

    Maro, Isaac I.; Moshi, Ndeserua; Clavier, Odile H.; MacKenzie, Todd A.; Kline-Schoder, Robert J.; Wilbur, Jed C.; Chambers, Robert D.; Fellows, Abigail M.; Jastrzembski, Benjamin G.; Mascari, John E.; Bakari, Muhammad; Matee, Mecky; Musiek, Frank E.; Waddell, Richard D.; von Reyn, C. Fordham; Buckey, Jay C.

    2014-01-01

    Objectives Abnormal hearing tests have been noted in HIV-infected patients in several studies, but the nature of the hearing deficit has not been clearly defined. We performed a cross-sectional study of both HIV+ and HIV? individuals in Tanzania using an audiological test battery. We hypothesized that HIV+ adults would have a higher prevalence of abnormal central and peripheral hearing test results compared to HIV? controls. Additionally, we anticipated that the prevalence of abnormal hearing assessments would increase with anti-retroviral therapy (ART) use, and treatment for tuberculosis (TB). Design Pure-tone thresholds, distortion product otoacoustic emissions (DPOAEs), tympanometry, and a gap detection test were performed using a laptop-based hearing testing system on 751 subjects (100 HIV? in the U.S., plus 651 in Dar es Salaam Tanzania including 449 HIV+ [130 ART? and 319 ART+], and 202 HIV?, subjects. No U.S. subjects had a history of TB treatment. In Tanzania, 204 of the HIV+, and 23 of the HIV?, subjects had a history of TB treatment. Subjects completed a video and audio questionnaire about their hearing as well as a health history questionnaire. Results HIV+ subjects had reduced DPOAE levels compared to HIV? subjects, but their hearing thresholds, tympanometry results, and gap detection thresholds were similar. Within the HIV+ group, those on ART reported significantly greater difficulties understanding speech-in-noise, and were significantly more likely to report that they had difficulty understanding speech than the ART? group. The ART+ group had a significantly higher mean gap detection threshold compared to the ART? group. No effects of TB treatment were seen. Conclusions The fact that the ART+/ART? groups did not differ in measures of peripheral hearing ability (DPOAEs, thresholds), or middle ear measures (tympanometry), but that the ART+ group had significantly more trouble understanding speech and higher gap detection thresholds, indicates a central processing deficit. These data suggest that: (a) hearing deficits in HIV+ individuals could be a central nervous system (CNS) side effect of HIV infection, (b) certain ART regimens might produce CNS side effects that manifest themselves as hearing difficulties, and/or (c) some ART regimens may treat CNS HIV inadequately, perhaps due to insufficient CNS drug levels, which is reflected as a central hearing deficit. Monitoring of central hearing parameters could be used to track central effects of either HIV or ART. PMID:24441742

  19. Risk factors for physical domestic violence in a high-prevalence HIV setting: findings from Project Accept baseline data (HPTN-043)

    OpenAIRE

    Sebastian Kevany; Godfrey Woelk; Shade, Starley B.; Michal Kulich; Turan, Janet M.; Alfred Chingono; Morin, Stephen F.

    2013-01-01

    Zimbabwe faces an acute generalized HIV/AIDS epidemic combined with rapidly deteriorating economic and political conditions, under which levels of domestic violence are on the rise. We aimed to determine possible demographic and behavioral factors associated with physical domestic violence in a rural setting in order to better inform both national and local domestic violence and HIV prevention policies. Using the Project Accept baseline data set, we selected demographic, socio-economic, and b...

  20. Nocardia osteomyelitis in the setting of previously unknown HIV infection

    International Nuclear Information System (INIS)

    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.)

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

    Scientific Electronic Library Online (English)

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

    2013-01-01

    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 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.

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

    Directory of Open Access Journals (Sweden)

    Busisiwe Ncama

    2013-01-01

    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.

  3. Care of HIV-infected patients in China.

    Science.gov (United States)

    Cao, Yun Zhen; Lu, Hong Zhou

    2005-01-01

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

  4. Observations on the problems of HIV infection in Malaysia.

    Science.gov (United States)

    Brettle, R P

    1992-01-01

    In order to control the spread of HIV infection, Malaysia will have to carry out systematic studies of at-risk populations, but doing so will also require legal and societal changes. Thailand's explosive HIV is already spreading from Thailand to neighboring countries, including Malaysia. By December 1990, 750 cases of HIV infection and 19 AIDS cases had been reported in Malaysia. Intravenous drug use accounted for 76% of transmissions. Despite the increasing problem of HIV, Malaysia has yet to conduct any systematic serological survey of at-risk populations. Furthermore, there is currently no easy way to obtain a fully confidential HIV test. Partly a result of Islam teachings, there is a reluctance to discuss sexual and drug-related matters, making it difficult for health personnel to be effective counsellors and educators. The government's policy of dealing with drug addicts -- strict nonvoluntary rehabilitation or detention -- also undermines efforts to control the spread of HIV, since it drives high risk group underground. Combating HIV infection will require research into high risk activities, especially drug and sexual habits. Such information can be used to devise education campaigns. Malaysia will ultimately have to develop a prevention and control strategy which is acceptable in an Islamic society, but the country must also consider the more pragmatic approaches that have been effective in the US and Europe. PMID:1548408

  5. Perceived barriers to HIV care among HIV-infected women in the Deep South.

    Science.gov (United States)

    Moneyham, Linda; McLeod, Jen; Boehme, Amelia; Wright, Laura; Mugavero, Michael; Seal, Paula; Norton, Wynne E; Kempf, Mirjam-Colette

    2010-01-01

    Despite the wide availability of effective treatments for HIV disease, many HIV-infected individuals are not in care, and HIV-infected women, particularly those residing in resource-poor areas, may have greater difficulty accessing HIV care than men. The purpose of this research was to explore perceived barriers to care experienced by HIV-infected women living in the Deep South region of the United States. Qualitative research methods were used to generate in-depth descriptions of women's experiences in accessing HIV care. Participants (N = 40) were recruited from 4 community-based HIV service organizations to participate in focus groups. Sessions lasted approximately 2 hours and were audio recorded. Verbatim transcripts, demographic data, and observational notes were subjected to content analysis strategies that coded the data into categories. Five categories of barriers to HIV care were identified as follows: personal, social, financial, geographic/transportation, and health system barriers. Implications of the findings for future research and practice are discussed in this study. PMID:20430653

  6. Travelling with HIV : a cross sectional analysis of Danish HIV-infected patients

    DEFF Research Database (Denmark)

    Nielsen, Ulla S; Jensen-Fangel, SØren

    2014-01-01

    BACKGROUND: We aimed to describe travel patterns, extent of professional pre-travel advice and health problems encountered during travel among HIV-infected individuals. METHODS: During a six-month period a questionnaire was handed out to 2821 adult HIV-infected individuals attending any of the eight Danish medical HIV care centers. RESULTS: A total of 763 individuals responded. During the previous two years 49% had travelled outside Europe; 18% had travelled less and 30% were more cautious when choosing travel destination than before the HIV diagnosis. Pre-travel advice was sought by only 38%, and travel insurance was taken out by 86%. However, 29%/74% did not inform the advisor/the insurance company about their HIV status. Nearly all patients on highly active antiretroviral therapy (HAART) were adherent, but 58% worried about carrying HIV-medicine and 19% tried to hide it. Only 19% experienced health problems during travel, 6% sought medical assistance and 0.5% was hospitalized. CONCLUSIONS: Danish HIV-infected patients travel frequently outside Denmark. Health and adherence to HAART were not major problems during travel. The main problems were failure to seek pre-travel advice, lack of disclosure of HIV status when seeking pre-travel advice or getting a travel insurance.

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

    DEFF Research Database (Denmark)

    Lohse, Nicolai; Hansen, Ann-Brit Eg

    2007-01-01

    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.

  8. Hypertension-an emerging cardiovascular risk factor in HIV infection.

    Science.gov (United States)

    Antonello, Vicente Sperb; Carlos Ferreira Antonello, Ivan; Grossmann, Thiago Kreutz; Tovo, Cristiane Valle; Brasil Dal Pupo, Bruna; de Quadros Winckler, Lisiane

    2015-05-01

    Patients with HIV may have an increased risk of hypertension and cardiovascular disease (CVD). The objective of this study was to determine the prevalence and risk factors for hypertension in a population of HIV-infected patients at an HIV/AIDS clinic in southern Brazil. We reviewed medical records of 1009 HIV-infected patients aged 18 years or more in an urban HIV/AIDS clinic based in Porto Alegre, southern Brazil. Hypertension was defined according to the Eighth Joint National Committee criteria. The prevalence of hypertension in this study cohort was 22.5% (95% confidence interval, 20%-25.2%). Individuals were significantly older in the hypertensive group (P < .001). After adjustment using a Poisson regression model of all variables that presented P < .2 in the univariate analysis, the variables that were significantly associated with hypertension were only age ?40 years and obesity. Also in this setting, dyslipidemia (P = .068) showed a tendency of association with hypertension. Compared with HIV-infected persons aged 18-39 years, those aged 40-59 years presented a 2-fold higher prevalence of hypertension (95% confidence interval, 1.2-3.3).The present study showed a high prevalence of hypertension among HIV-infected persons, similar to other studies, ranging from 13% to 45%, and also similar to the HIV-negative general population. Age and obesity were the factors associated with hypertension. Finally, the present study indicates a similar pattern of behavior and comorbidities for HIV-positive and -negative patients in relation to hypertension. PMID:25979413

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

    OpenAIRE

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

    2012-01-01

    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 effects o...

  10. Macrophage infection via selective capture of HIV-1-infected CD4+ T cells.

    Science.gov (United States)

    Baxter, Amy E; Russell, Rebecca A; Duncan, Christopher J A; Moore, Michael D; Willberg, Christian B; Pablos, Jose L; Finzi, Andrés; Kaufmann, Daniel E; Ochsenbauer, Christina; Kappes, John C; Groot, Fedde; Sattentau, Quentin J

    2014-12-10

    Macrophages contribute to HIV-1 pathogenesis by forming a viral reservoir and mediating neurological disorders. Cell-free HIV-1 infection of macrophages is inefficient, in part due to low plasma membrane expression of viral entry receptors. We find that macrophages selectively capture and engulf HIV-1-infected CD4+ T cells leading to efficient macrophage infection. Infected T cells, both healthy and dead or dying, were taken up through viral envelope glycoprotein-receptor-independent interactions, implying a mechanism distinct from conventional virological synapse formation. Macrophages infected by this cell-to-cell route were highly permissive for both CCR5-using macrophage-tropic and otherwise weakly macrophage-tropic transmitted/founder viruses but restrictive for nonmacrophage-tropic CXCR4-using virus. These results have implications for establishment of the macrophage reservoir and HIV-1 dissemination in vivo. PMID:25467409

  11. HIV Shedding from Male Circumcision Wounds in HIV-Infected Men: A Prospective Cohort Study

    Science.gov (United States)

    Tobian, Aaron A. R.; Kigozi, Godfrey; Manucci, Jordyn; Grabowski, Mary K.; Serwadda, David; Musoke, Richard; Redd, Andrew D.; Nalugoda, Fred; Reynolds, Steven J.; Kighoma, Nehemiah; Laeyendecker, Oliver; Lessler, Justin; Gray, Ronald H.; Quinn, Thomas C.; Wawer, Maria J.

    2015-01-01

    Background A randomized trial of voluntary medical male circumcision (MC) of HIV—infected men reported increased HIV transmission to female partners among men who resumed sexual intercourse prior to wound healing. We conducted a prospective observational study to assess penile HIV shedding after MC. Methods and Findings HIV shedding was evaluated among 223 HIV—infected men (183 self—reported not receiving antiretroviral therapy [ART], 11 self—reported receiving ART and had a detectable plasma viral load [VL], and 29 self—reported receiving ART and had an undetectable plasma VL [HIV shedding and VL using a real—time quantitative PCR assay. Unadjusted prevalence risk ratios (PRRs) and adjusted PRRs (adjPRRs) of HIV shedding were estimated using modified Poisson regression with robust variance. HIV shedding was detected in 9.3% (17/183) of men not on ART prior to surgery and 39.3% (72/183) of these men during the entire study. Relative to baseline, the proportion shedding was significantly increased after MC at 1 wk (PRR = 1.87, 95% CI = 1.12–3.14, p = 0.012), 2 wk (PRR = 3.16, 95% CI = 1.94–5.13, p HIV shedding was decreased by 6 wk after MC (PRR = 0.27, 95% CI = 0.09–0.83, p = 0.023) and remained suppressed at 12 wk after MC (PRR = 0.19, 95% CI = 0.06–0.64, p = 0.008). Detectable HIV shedding from MC wounds occurred in more study visits among men with an HIV plasma VL > 50,000 copies/ml than among those with an HIV plasma VL HIV shedding was less common in visits from men with healed MC wounds compared to visits from men without healed wounds (adjPRR = 0.12, 95% CI = 0.07–0.23, p HIV shedding, the median log10 HIV copies/milliliter of lavage fluid was significantly lower in men with ART—induced undetectable plasma VL (1.93, interquartile range [IQR] = 1.83–2.14) than in men not on ART (2.63, IQR = 2.28–3.22, p HIV shedding is significantly reduced after healing of MC wounds. Lower plasma VL is associated with decreased frequency and quantity of HIV shedding from MC wounds. Starting ART prior to MC should be considered to reduce male-to-female HIV transmission risk. Research is needed to assess the time on ART required to decrease shedding, and the acceptability and feasibility of initiating ART at the time of MC. PMID:25919012

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

    Science.gov (United States)

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

    2014-09-01

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

  13. Modelling HIV and MTB Co-Infection Including Combined Treatment Strategies

    OpenAIRE

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

    2012-01-01

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

  14. Accelerated biological aging in HIV-infected individuals in South Africa: a case–control study

    OpenAIRE

    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.

    2013-01-01

    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...

  15. Screening and Assessing Violence and Mental Health Disorders in a Cohort of Inner City HIV-Positive Youth between 1998–2006

    OpenAIRE

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

    2009-01-01

    The focus of the primary care appointments for HIV-positive youth is often solely on medical concerns. However, these youth also present with mental health issues and histories of exposure to violence. To screen and assess for mental health disorders, HIV-positive youth between the ages of 13 to 24 consecutively enrolled in an adolescent and young adult HIV clinic between 1998–2006 (n?=?174), were screened for mental health disorders and violence, using the Client Diagnostic Questionnai...

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

    Directory of Open Access Journals (Sweden)

    Telfer Barbara

    2008-12-01

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

  17. Behcet's disease with HIV infection: response to antiretroviral therapy.

    Science.gov (United States)

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

    2005-01-01

    The differential diagnosis of oral ulcerations in a patient with AIDS/HIV infection is often challenging to the clinician. While old diseases have appeared in a new garb, many new ones are also being recognized. The association of Behetaet's disease and AIDS/HIV infection has been recently recognized. We present an HIV-positive patient having oro-genital aphthosis conforming to the diagnostic criteria for Behetaet's disease. Erythema nodosum, periphlebitis, erythematous papulopustular lesions, half and half nails, ocular congestion, raised ESR and dimorphic anemia were some other features present. He had low CD4+/CD8+ counts. He had no other HIV-related disease. He responded well to triple anti-retroviral treatment alone. The possible pathomechanism of the occurrence of both diseases is also discussed. PMID:16394440

  18. HIV co-infection accelerates decay of humoral responses in spontaneous resolvers of HCV infection

    OpenAIRE

    Y. LIU; T. Shen; Zhang, C.; Long, L; Duan, Z.; LU, F

    2014-01-01

    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...

  19. Incidence and Treatment Outcomes of Helicobacter pylori Infection in HIV-infected Patients

    OpenAIRE

    George PSEVDOS; Cristina BATOG; Victoria SHARP

    2013-01-01

    Helicobacter pylori is an established causative agent of pepticulcer disease throughout the world. There is paucity of informationregarding co-infection in HIV-infected individuals. We analyzed HIVinfectedpatients diagnosed with H. pylori infection in our institutionover a six year period.

  20. HBV and neurological impairment in HIV-infected patients

    Directory of Open Access Journals (Sweden)

    L Manolescu

    2012-11-01

    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.

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

    Scientific Electronic Library Online (English)

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

    2011-02-01

    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. 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.

  2. The spectrum of polyneuropathies in patients infected with HIV.

    OpenAIRE

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

    1989-01-01

    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...

  3. Diverse realities: sexually transmitted infections and HIV in India

    OpenAIRE

    Hawkes, S.; Santhya, K.

    2002-01-01

    There are many features that make India a vulnerable country as far as a sexually transmitted infection (STI)/HIV epidemic is concerned. These include the lack of a strong evidence base on which to formulate decision making, a pluralistic and often unregulated health sector, and a highly vulnerable population. Nonetheless, India has shown strong commitment to other areas of a comprehensive reproductive health care programme, and may be able to do so in the field of STI/HIV control. Vast numbe...

  4. CTL escape and viral fitness in HIV/SIV infection

    OpenAIRE

    SayuriSeki

    2012-01-01

    Cytotoxic T lymphocyte (CTL) responses exert a suppressive effect on HIV and simian immunodeficiency virus (SIV) replication. Under the CTL pressure, viral CTL escape mutations are frequently selected for with viral fitness costs. Viruses with such CTL escape mutations often need additional viral genome mutations for recovery of viral fitness. Persistent HIV/SIV infection sometimes shows replacement of a CTL escape mutation with an alternative escape mutation toward higher viral fitness. Thus...

  5. CTL Escape and Viral Fitness in HIV/SIV Infection

    OpenAIRE

    Seki, Sayuri; Matano, Tetsuro

    2012-01-01

    Cytotoxic T lymphocyte (CTL) responses exert a suppressive effect on HIV and simian immunodeficiency virus (SIV) replication. Under the CTL pressure, viral CTL escape mutations are frequently selected with viral fitness costs. Viruses with such CTL escape mutations often need additional viral genome mutations for recovery of viral fitness. Persistent HIV/SIV infection sometimes shows replacement of a CTL escape mutation with an alternative escape mutation toward higher viral fitness. Thus, mu...

  6. Context of risk for HIV and sexually transmitted infections among incarcerated women in the south: individual, interpersonal, and societal factors.

    Science.gov (United States)

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

    2014-01-01

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

  7. A community mobilisation intervention to prevent violence against women and reduce HIV/AIDS risk in Kampala, Uganda (the SASA! Study): study protocol for a cluster randomised controlled trial

    OpenAIRE

    Abramsky Tanya; Devries Karen; Kiss Ligia; Francisco Leilani; Nakuti Janet; Musuya Tina; Kyegombe Nambusi; Starmann Elizabeth; Kaye Dan; Michau Lori; Watts Charlotte

    2012-01-01

    Abstract Background Gender based violence, including violence by an intimate partner, is a major global human rights and public health problem, with important connections with HIV risk. Indeed, the elimination of sexual and gender based violence is a core pillar of HIV prevention for UNAIDS. Integrated strategies to address the gender norms, relations and inequities that underlie both violence against women and HIV/AIDS are needed. However there is limited evidence about the potential impact ...

  8. Condom Distribution in Jail to Prevent HIV Infection

    OpenAIRE

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

    2012-01-01

    To determine if a structural intervention of providing one condom a week to inmates in the Los Angeles County Men’s Central Jail MSM unit reduces HIV transmissions and net social cost, we estimated numbers of new HIV infections (1) when condoms are available; and (2) when they are not. Input data came from a 2007 survey of inmates, the literature and intervention program records. Base case estimates showed that condom distribution averted 1/4 of HIV transmissions. We predict .8 new infectio...

  9. Peptide inhibitors of HIV-1 protease and viral infection of peripheral blood lymphocytes based on HIV-1 Vif

    OpenAIRE

    Potash, Mary Jane; Bentsman, Galina; Muir, Tom; Krachmarov, Chavdar; Sova, Pavel; Volsky, David J.

    1998-01-01

    We recently reported that HIV-1 Vif (virion infectivity factor) inhibits HIV-1 protease in vitro and in bacteria, suggesting that it may serve as the basis for the design of new protease inhibitors and treatment for HIV-1 infection. To evaluate this possibility, we synthesized peptide derivatives from the region of Vif, which inhibits protease, and tested their activity on protease. In an assay of cleavage of virion-like particles composed of HIV-1 Gag precursor polyprotein, full-length recom...

  10. Deficient Antibody-Dependent Cellular Cytotoxicity against Human Immunodeficiency Virus (HIV)-Expressing Target Cells in Perinatal HIV Infection

    OpenAIRE

    Ziegner, Ulrike; Campbell, Donald; Weinhold, Kent; Frank, Ian; Rutstein, Richard; Starr, Stuart E.

    1999-01-01

    Peripheral blood mononuclear cells (PBMC) of human immunodeficiency virus (HIV)-infected children, age-matched HIV-seronegative controls, and HIV-infected asymptomatic and symptomatic adults were compared for their ability to mediate antibody-dependent cellular cytotoxicity (ADCC) and natural killer (NK) cell-mediated cytotoxicity against target cells expressing HIV or herpes simplex virus (HSV) antigens. Target cells consisted of CD4 lymphocytes purified from PBMC of ...

  11. Immunoglobulin genes and the acquisition of HIV infection in a randomized trial of recombinant adenovirus HIV vaccine

    OpenAIRE

    Pandey, Janardan P; Namboodiri, Aryan M; BU, SHIZHONG; Tapsoba, Jean De Dieu; Sato, Alicia; Dai, James Y.

    2013-01-01

    Our knowledge of the host genetic factors that contribute to the acquisition of HIV infection is limited. To identify the host genetic correlates of HIV1 acquisition, we genotyped 777 participants of a randomized trial of recombinant adenovirus HIV1 vaccine for Fc? receptor IIa (Fc?RIIa), Fc?RIIIa, and several GM and KM alleles—genetic markers of immunoglobulin ? and ? chains, respectively. None of the genotypes by itself was significantly associated with the acquisition of HIV1 infect...

  12. Evaluating anxiety and depression in HIV-infected patients.

    Science.gov (United States)

    Savard, J; Laberge, B; Gauthier, J G; Ivers, H; Bergeron, M G

    1998-12-01

    Because there is a large overlap between HIV manifestations and somatic symptoms of anxiety and depression, it is crucial to use measures that do not contain somatic items to validly and reliably assess these psychological states in HIV-infected patients. The purpose of this study was to assess the psychometric properties of the Hospital Anxiety and Depression Scale (HADS), a questionnaire that does not include any somatic items, in HIV-seropositive individuals. Because the study was conducted among French Canadian individuals, the quality of the translation was 1st subjectively and empirically assessed. Then, the psychometric properties of the HADS were evaluated in 162 HIV-seropositive patients, who, in addition to the HADS, also completed the Beck Depression Inventory (BDI) and the State-Trait Anxiety Inventory. The French Canadian version used was found to be subjectively and empirically equivalent to the original English version. Moreover, results of this study demonstrated a bifactorial structure with factors corresponding to the HADS subscales, an excellent internal consistency and test-retest reliability, a very good convergent validity, and an acceptable discriminant validity. Strikingly, in contrast to the BDI, HADS scores were found to be unconfounded by the presence of HIV symptomatology. The HADS appears to represent the best currently available self-report scale to reliably and validly assess anxiety and depression in HIV-infected patients. The HADS is simple and brief to administer (14 items) and may therefore be easily implemented in routine HIV care. PMID:9933941

  13. HIV infection and Periodontal disease a Hidden Truth

    Directory of Open Access Journals (Sweden)

    Hemachandra Babu C

    2011-12-01

    Full Text Available The association of periodontal disease in HIV-infected patients had been initially considered to be the first clinical expression or indication of profound immunodeficiency and stage of HIVdisease as expressed by CD4 –cells in the peripheral blood circulation. Three entities were majorly described and are strongly associated with HIV-infection include (aLinear gingival erythema(LGE, (bAcute necrotizing ulcerative gingivitis(ANUG and (cAcute necrotizing ulcerative periodontitis (ANUP. Many studies and case reports initially had reported higher prevalence of periodontal disease and also higher severity and rapid progression of existing gingivitis or periodontitis which was clinically assessed by measuring periodontal pockets and attachment loss. The prevalence and severity of periodontal disease in HIV-seropositve or AIDS patients is due to severe immune suppression expressed by rapid depletion of CD4-cells/ T- helper cells.HIVinfected patients are more prone to get periodontal disease when the CD4-cell count falls below 200 cells/ ?L or the stage of HIV-infection progresses to AIDS. In contrast, considerable variation has been observed in recent studies that there were less severity of progression and prevalence of periodontal disease in AIDS patients whose CD4-cell is below 200 cells/?L compared to HIV-infected patients whose CD4 cell count is above 200 cells/?L. The aim of this article is to review old and present concepts based on studies and case reports and also to encourage researchers to explore the changing face of disease progression in HIV-positive individuals

  14. Changes in Function of HIV-Specific T-Cell Responses with Increasing Time from Infection

    OpenAIRE

    Ndongala, Michel L.; Kamya, Philomena; Boulet, Salix; Peretz, Yoav; Rouleau, Danielle; Tremblay, Ce?cile; Leblanc, Roger; Co?te?, Pierre; Baril, Jean-guy; Thomas, Re?jean; Ve?zina, Sylvie; Boulassel, Mohamed R.; Routy, Jean-pierre; Se?kaly, Rafick P.; Bernard, Nicole F.

    2010-01-01

    Recently HIV-infected individuals have virus-specific responses characterized by IFN-?/IL-2 secretion and proliferation rarely seen in chronic infection. To investigate the timing of loss of HIV-specific T-cell function, we screened cells from 59 treatment-naïve HIV-infected individuals with known dates of infection for proteome-wide responses secreting IFN-?/IL-2 and IFN-? alone by ELISPOT. HIV peptide-specific proliferation was assessed by carboxyfluorescein diacetate succinimidyl ester...

  15. SPECTRUM OF OPPORTUNISTIC INFECTIONS IN HIV-AIDS PATIENTS

    Directory of Open Access Journals (Sweden)

    S S Madkar

    2012-10-01

    Full Text Available Aim: AIDS is characterized by a number of opportunistic infections which are responsible for high morbidity and mortality. The spectrum and distribution of opportunistic infections (OIs in AIDS patients is ever-expanding. This spectrum varies from continent to continent. The aim of the present study was to document the spectrum of OIs in HIV-infected patients in Ambajogai. Material and Method: 178 HIV positive symptomatic patients, either hospitalized or coming to ART (Antiretroviral Therapy centre in S.R.T.R. Medical College, Ambajogai, were included in the study for finding the spectrum of opportunistic infections. Result: The commonest opportunistic infection seen was tuberculosis (59% of patients, followed by oral candidiasis (37.6% of patients and parasitic diarrhea due to Cryptosporidium parvum(18 % of patients. It was observed that out of 178 patients, maximum 53.3% were in the age group of 29-38 years followed by 21% in the age group of 39-48 years. It was found that 77% were males and 23% were females, with male to female ratio is 3.3:1. Conclusion: This study demonstrates that tuberculosis is the commonest opportunistic infection seen in HIV patients. Clinicians should consider HIV in the differential diagnosis and management of all persons with tuberculosis.

  16. Intimate partner violence and HIV risk factors among African American and African Caribbean women in clinic-based settings

    OpenAIRE

    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.

    2012-01-01

    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...

  17. Genital chlamydial infection in STD patients: Its relation to HIV infection

    Directory of Open Access Journals (Sweden)

    Joyee A

    2005-01-01

    Full Text Available In the present report, we have analysed C.trachomatis infection and HIV positivity among patients (n-143 who attended the STD clinic at the Institute of STDs, Government General Hospital, Chennai. HIV positivity rate was significantly high among those with chlamydial infection than in those without chlamydial infection (29.5% (13/44 vs. 11.1% (11/99; p0.05. The results of the present study suggest the association between C.trachomatis and HIV infections and reinforce the need for routine screening for C.trachomatis as a necessary intervention to reduce the burden of chlamydial diseases and to reduce the risk of HIV and its spread in India.

  18. Skin conditions common to people with HIV infection or AIDS.

    Science.gov (United States)

    Kalibala, S

    1990-04-01

    The World Health Organization clinical criteria for AIDS diagnosis in Africa include Kaposi's sarcoma, Herpes zoster, Herpes simplex, and pruritic maculopapular rash, which have a predictive value for HIV seropositivity of 71-98%. Skin conditions may be classified as: 1) generalized dermatitis, 2) bacterial, fungal, viral, and parasitic infections, and 3) skin tumors. Pruritic maculopapular rash (prurigo) is often the first outward sign of HIV infection. Soothing preparations such as calamine lotion or E45 emollient cream can be applied. Occasionally antihistamine may be necessary, e.g., 10 mg of chlorpheniramine 8 hourly. Skin lesions may become secondarily infected with bacteria; usually Staphylococcus aureus and Streptococcus species. Persistent folliculitis or carbuncles should be treated with flucloxacillin 250 mg QDS for 7 days. In HIV/AIDS fungal infections often develop secondary infection. Candidiasis (thrush) is caused by yeasts, mainly Candida albicans and a small percentage by Tolurosis glabrata. Many HIV-infected patients suffer from seborrheic dermatitis. Fungal diseases more typically present as ringworms of the scalp (Tinea capitis). Whitfield's ointment is effective for ringworm. Antifungal creams such as miconazol or clotrimazole and systemic antifungal tablets such as ketoconazole, fluconazole, and itraconazole are also effective. Gentian violet lotion twice daily and Acyclovir tablets, 200 mg 5 times daily for 5 days, may help to reduce secondary Herpes simplex infection. HIV has been associated with an increased incidence of Herpes zoster (shingles). It is often necessary to give analgesics like aspirin or paracetamol to control the pain. Gentian violet paint may help to prevent secondary infection. When shingles affects the eye, Acyclovir tablets (800 mg 5 times daily) should be given. Kaposi's sarcoma affects wider age groups, and it is disseminated and more aggressive than the endemic type. Treatment options include radiotherapy and systemic cytotoxics such as vincristine. Intralesional injections of the drug interferon have also given successful results with some patients. PMID:12342834

  19. Polypharmacy in the HIV-infected older adult population

    Directory of Open Access Journals (Sweden)

    Gleason LJ

    2013-06-01

    Full Text Available 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 that require pharmacotherapy. Overall, there is not much known with respect to both the impact of aging on medication use in HIV-infected individuals, and the potential for interactions with highly active antiretroviral therapy (HAART and coadministered medications and its clinical consequences. In this review, we aim to provide an overview of polypharmacy with a focus on its impact on the HIV-infected older adult population and to also provide some clinical considerations in this high-risk population. Keywords: HIV, older adults, polypharmacy

  20. Modeling dynamics of HIV infected cells using stochastic cellular automaton

    Science.gov (United States)

    Precharattana, Monamorn; Triampo, Wannapong

    2014-08-01

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

  1. Prevalence and Long-Term Effects of Occult Hepatitis B Virus Infection in HIV-Infected Women

    OpenAIRE

    Tsui, Judith I.; French, Audrey L.; Seaberg, Eric C.; Augenbraun, Michael; Nowicki, Marek; Peters, Marion; Tien, Phyllis C.

    2007-01-01

    Occult hepatitis B virus (HBV) infection is of concern in human immunodeficiency virus (HIV)–infected persons. We observed that 2% of 400 HIV-infected women with antibodies to hepatitis B core antigen alone had occult HBV infection (i.e., detectable HBV DNA in the absence of HBV surface antigen). CD4 cell counts of

  2. Gender inequities in sexually transmitted infections: implications for HIV infection and control in Lagos State, Nigeria

    OpenAIRE

    Ezekiel Oluwagbemiga Adeyemi

    2011-01-01

    Beyond the statistics of sex-based differences in infection rates, there are profound differences in the underlying causes and consequences of HIV infections in male and female which need to be examined. The study therefore examines; the gender differences in the STI knowledge and gender-related potential risks of HIV heterosexual transmission. Quantitative and qualitative data were collected. A multi-stage random sampling procedure was employed in administration of 1358 questionnaires. For q...

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

    Science.gov (United States)

    Weidel, James J; Provencio-Vasquez, Elias; Watson, Susan D; Gonzalez-Guarda, Rosa

    2008-01-01

    Immigration from Latin America is changing the demographics of the United States. By the year 2050, one of every four persons in the United States will be of Hispanic ethnicity. As this segment of American society grows, interventions that improve health status for these individuals must be expanded and enhanced. HIV infection disproportionately affects people in the Hispanic community. Hispanics have unique cultural and social characteristics and norms that place them at risk for HIV exposure. The purpose of this report is to highlight culturally related issues that have been associated with HIV risk in Hispanics. Clinicians can broaden their knowledge of and appreciation for the complex cultural issues related to HIV research. Additionally, clinicians can steer interventions toward more culturally competent care for this rapidly growing segment of American society. PMID:18598900

  4. Serological diagnosis of Chagas disease in HIV-infected patients

    Scientific Electronic Library Online (English)

    Dulce, Stauffert; Mariângela Freitas da, Silveira; Marilia Arndt, Mesenburg; Thiago, Gaspar; Adriane Brod, Manta; Guilherme Lucas de Oliveira, Bicca; Marcos Marreiro, Villela.

    2015-06-01

    Full Text Available INTRODUCTION: This study assessed the rate of request for the serological diagnosis of Chagas disease among human immunodeficiency virus (HIV)-infected patients treated at the Specialized Care Service of Pelotas, Rio Grande do Sul, Brazil. METHODS: This cross-sectional study used secondary data obt [...] ained from the medical records of 252 patients aged between 18 and 75 years. RESULTS: The serological diagnosis of Chagas disease was requested only in 3.2% of cases. CONCLUSIONS: The results demonstrate poor adherence to protocols on the part of healthcare professionals, indicating the need to reevaluate the procedures applied to HIV-infected patients from endemic regions for both diseases.

  5. Renal transplantation in an HIV-infected patient: Pharmacokinetic aspects

    DEFF Research Database (Denmark)

    Alstrup, Karen; Kangas, Ida

    2011-01-01

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

  6. Cultured blood dendritic cells retain HIV-1 antigen-presenting capacity for memory CTL during progressive HIV-1 infection.

    Science.gov (United States)

    Fan, Z; Huang, X L; Zheng, L; Wilson, C; Borowski, L; Liebmann, J; Gupta, P; Margolick, J; Rinaldo, C

    1997-11-15

    Dendritic cells (DC) are potent APC that may be involved in the pathogenesis of HIV-1 infection. We studied the APC function of DC from HIV-1-infected subjects that were derived from monocyte-depleted PBMC by culture in human IL-4 and human granulocyte-macrophage CSF. The cultured cells from the HIV-1-infected subjects had similar morphology and phenotype of mature DC (CD80 = 41 +/- 8%, CD86 = 77 +/- 5%, CD40 = 87 +/- 6%, CD1a = 1 +/- 1%) to DC cultured from seronegative subjects. The yield of these DC was lower than from HIV-1-seronegative subjects (4 +/- 0% vs 11 +/- 2%, p vaccinia virus vectors expressing Gag, Pol, and Env and were able to stimulate equal or higher levels of MHC class I-restricted, anti-HIV-1 memory CTL (CTLm) than were similarly treated, autologous B lymphocyte cell lines. DC pulsed with peptides representing HIV-1 CTL epitopes stimulated higher levels of anti-HIV-1 CTLm responses than did DC infected with the vaccinia virus-HIV-1 constructs. Allogeneic, MHC class I-matched DC also stimulated anti-HIV-1 CTLm activity in cells from HIV-1-infected subjects. DC from early and late stages of HIV-1 infection had a similar ability to activate CTLm specific for targets expressing either HIV-1 genes via vaccinia virus vectors or HIV-1 immunodominant synthetic peptides. However, DC from either early or late stages of HIV-1 infection could not overcome the defect in anti-HIV-1 CTLm response in advanced infection. PMID:9366424

  7. Atopy in HIV-infected children in pretoria

    Scientific Electronic Library Online (English)

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

    2009-11-01

    Full Text Available 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.

  8. Evaluation of the Gen-Probe Aptima HIV-1 RNA Qualitative Assay as an Alternative to Western Blot Analysis for Confirmation of HIV Infection?

    OpenAIRE

    Pierce, Virginia M.; Neide, Brandy; Hodinka, Richard L.

    2011-01-01

    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.

  9. Evaluation of the Gen-Probe Aptima HIV-1 RNA Qualitative Assay as an Alternative to Western Blot Analysis for Confirmation of HIV Infection?

    Science.gov (United States)

    Pierce, Virginia M.; Neide, Brandy; Hodinka, Richard L.

    2011-01-01

    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

  10. [Detection of acute HIV infection by serum HIV-1 RNA quantification].

    Science.gov (United States)

    Negishi, Kumiko; Shitara, Minori; Sasaki, Yoshio; Ajisawa, Atushi; Obayashi, Taminori

    2006-04-01

    To assess the merit of serum HIV-1 RNA quantification in detecting acute HIV infection, we reviewed the results of HIV-1 RNA assay and antibody tests in all patients who received those tests at our hospital from August 1999 to December 2004. Of 3530 such patients, five were sero-negative and PCR-positive with more than 105 copies/ml at initial examination. Four of them had HAART and followed a favorable course; they were later confirmed to be sero-positive by Western blotting. The other one, positive only by CLEIA, was lost to follow-up. This reconfirms the importance of using PCR in the initial assessment of HIV infection in high-risk patients. PMID:16722451

  11. The treatment of chronic hepatitis C virus infection in HIV co-infection

    Directory of Open Access Journals (Sweden)

    Vogel Martin

    2009-12-01

    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.

  12. Sex, violence and HIV on the inside: cultures of violence, denial, gender inequality and homophobia negatively influence the health outcomes of those in closed settings.

    Science.gov (United States)

    Kelly-Hanku, Angela; Kawage, Thomas; Vallely, Andrew; Mek, Agnes; Mathers, Bradley

    2015-09-01

    To map the context of HIV in closed settings in Papua New Guinea (PNG), semi-structured interviews were undertaken with 56 prisoners and detainees and 60 key stakeholders. The nature of HIV-related risk differs for detained women and men, and reflects important gender-based issues present in PNG society more broadly. Women in detention are vulnerable to sexual violence and exploitation and at greatest risk of HIV while detained in police holding cells, where they are typically supervised by male officers, in contrast to prisons, where they have little contact with male staff. HIV risk for men in prison is associated with consensual and non-consensual sex; this risk is perpetuated by a pervasive culture of denial and institutionalised homophobia. The illegal nature of sodomy and male-to-male sex provides Correctional Services the legal grounds by which to refuse access to condoms for prisoners. Addressing HIV risk among detained men and women in PNG requires the reform of legislation, police and prison practices and an understanding of broader structural problems of gender-based violence and stigma and discrimination. PMID:25853184

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

    Science.gov (United States)

    Trøseid, Marius; Sönnerborg, Anders; Nowak, Piotr

    2011-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Kannangai R

    2010-01-01

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

  15. Flail arm-like syndrome associated with HIV-1 infection

    Directory of Open Access Journals (Sweden)

    Nalini A

    2009-01-01

    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.

  16. Disseminated fatal Talaromyces (Penicillium) marneffei infection in a returning HIV-infected traveller

    Scientific Electronic Library Online (English)

    N P, Govender; R E, Magobo; T G, Zulu; M, du Plooy; C, Corcoran.

    2014-12-01

    Full Text Available We report a case of disseminated fatal Talaromyces (Penicillium) marneffei infection in an HIV-infected, antiretroviral treatment-experienced South African woman who had travelled to mainland China. The 37-year-old woman was admitted to a private hospital in fulminant septic shock and died within 12 [...] h of admission. Intracellular yeast-like bodies were observed on the peripheral blood smear. A serum cryptococcal antigen test was negative. Blood cultures flagged positive after 2 days; on direct microscopy, yeast-like bodies were observed and a thermally dimorphic fungus, confirmed as T. marneffei, was cultured after 5 days. The clinical features of HIV-associated disseminated penicilliosis overlap with those of tuberculosis and endemic deep fungal infections. In the southern African context, where systemic opportunistic fungal infections such as cryptococcosis are more common among HIV-infected patients with a CD4+ count of

  17. Structured antiretroviral treatment interruptions in chronically HIV-1-infected subjects

    Science.gov (United States)

    Ortiz, Gabriel M.; Wellons, Melissa; Brancato, Jason; Vo, Ha T. T.; Zinn, Rebekah L.; Clarkson, Daniel E.; Van Loon, Katherine; Bonhoeffer, Sebastian; Miralles, G. Diego; Montefiori, David; Bartlett, John A.; Nixon, Douglas F.

    2001-01-01

    The risks and benefits of structured treatment interruption (STI) in HIV-1-infected subjects are not fully understood. A pilot study was performed to compare STI with continuous highly active antiretroviral therapy (HAART) in chronic HIV-1-infected subjects with HIV-1 plasma RNA levels (VL) 400 per ?l. CD4+ T cells, VL, HIV-1-specific neutralizing antibodies, and IFN-?-producing HIV-1-specific CD8+ and CD4+ T cells were measured in all subjects. STIs of 1-month duration separated by 1 month of HAART, before a final 3-month STI, resulted in augmented CD8+ T cell responses in all eight STI subjects (P = 0.003), maintained while on HAART up to 22 weeks after STI, and augmented neutralization titers to autologous HIV-1 isolate in one of eight subjects. However, significant decline of CD4+ T cell count from pre-STI level, and VL rebound to pre-HAART baseline, occurred during STI (P = 0.001 and 0.34, respectively). CD4+ T cell counts were regained on return to HAART. Control subjects (n = 4) maintained VL <400 copies per ml and stable CD4+ T cell counts, and showed no enhancement of antiviral CD8+ T cell responses. Despite increases in antiviral immunity, no control of VL was observed. Future studies of STI should proceed with caution. PMID:11687611

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

    OpenAIRE

    Okeoma Mmeje; Cohen, Craig R.; Deborah Cohan

    2012-01-01

    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.

  19. Coping With Stress Strategies in HIV-infected Iranian Patients.

    Science.gov (United States)

    Mahmoudi, Maryam; Dehdari, Tahereh; Shojaeezadeh, Davoud; Abbasian, Ladan

    2015-01-01

    Stress has significant adverse impacts on health outcomes of HIV-infected patients. Our study explored coping with stress strategies by HIV-infected Iranian patients. A qualitative content analysis study was conducted at the Consultation Clinic of HIV at the Imam Khomeini Hospital in Tehran, Iran in 2012. Twenty-six semi-structured in-depth interviews were done. Participants were asked about coping strategies for stress. After the first interview, continuous analysis of data was started and continued up to data saturation. Results showed that participants used two categories of strategies (emotion-based coping and problem-based coping) to cope with stress. Emotion-based coping had two sub-themes: adaptive and maladaptive. The problem-based coping category had three sub-themes: participation in education sessions, adherence to medication, and efforts to maintain a healthy lifestyle. Explanations of different strategies available to HIV-infected patients to cope with stress may help develop tailored interventions to improve the psychological conditions of people living with HIV. PMID:25769759

  20. Smart nanoparticles as targeting platforms for HIV infections

    Science.gov (United States)

    Adhikary, Rishi Rajat; More, Prachi; Banerjee, Rinti

    2015-04-01

    While Human Immunodeficiency Virus (HIV) infections are reducing in incidence with the advent of Highly Active Anti-retroviral Therapy (HAART), there remain a number of challenges including the existence of reservoirs, drug resistance and anatomical barriers to antiretroviral therapy. To overcome these, smart nanoparticles with stimuli responsive release are proposed for delivery of anti-retroviral agents. The paper highlights the strategic similarities between the design of smart antiretroviral nanocarriers and those optimized for cancer chemotherapy. This includes the development of nanoparticles capable of passive and active targeting as well as those that are responsive to various internal and external triggers. For antiretroviral therapy, the relevant triggers for stimuli responsive release of drugs include semen, enzymes, endosomal escape, temperature and magnetic field. Deriving from the experience of cancer chemotherapy, additional potential triggers are light and ultrasound which remain hitherto unexplored in HIV therapy. In addition, the roles of nanomicrobicides (nanogels) and virus mimetic nanoparticles are discussed from the point of view of prevention of HIV transmission. The challenges associated with translation of smart nanoparticles for HIV infections to realize the Millennium Development Goal of combating HIV infections are discussed.

  1. Postmortem findings and opportunistic infections in HIV-positive patients from a public hospital in Peru

    OpenAIRE

    Eza, Dominique; Cerrillo, Gustavo; Moore, David A. J.; Castro, Cecilia; Ticona, Eduardo; Morales, Domingo; Cabanillas, Jose; Barrantes, Fernando; Alfaro, Alejandro; Benavides, Alejandro; Rafael, Arturo; Valladares, Gilberto; Arevalo, Fernando; Evans, Carlton A.; Gilman, Robert H

    2006-01-01

    There is a paucity of HIV autopsy data from South America and none that document the postmortem findings in patients with HIV/AIDS in Peru. The purpose of this autopsy study was to determine the spectrum of opportunistic infections and the causes of mortality in HIV-positive patients at a public hospital in Lima. Clinico-epidemiological information regarding HIV infection in Peru is also reviewed. Sixteen HIV-related hospital postmortems, performed between 1999 and 2004, were included in this...

  2. Computational Inference Methods for Selective Sweeps Arising in Acute HIV Infection

    OpenAIRE

    Leviyang, Sivan

    2013-01-01

    During the first weeks of human immunodeficiency virus-1 (HIV-1) infection, cytotoxic T-lymphocytes (CTLs) select for multiple escape mutations in the infecting HIV population. In recent years, methods that use escape mutation data to estimate rates of HIV escape have been developed, thereby providing a quantitative framework for exploring HIV escape from CTL response. Current methods for escape-rate inference focus on a specific HIV mutant selected by a single CTL response. However, recent s...

  3. A randomized therapeutic vaccine trial of canarypox-HIV-pulsed dendritic cells vs. canarypox-HIV alone in HIV-1-infected patients on antiretroviral therapy?,??

    OpenAIRE

    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

    2009-01-01

    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...

  4. On the Dynamics of the Evolution of the HIV Infection

    CERN Document Server

    Zorenos dos Santos, R M; Zorzenon dos Santos, Rita M; Coutinho, Sergio

    2000-01-01

    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.

  5. HIV/HBV Co-Infections: Epidemiology, Natural History, and Treatment: A Review Article

    OpenAIRE

    Ranjbar, R.; Davari, A.; Izadi, M.; Jonaidi, N.; Alavian, S. M.

    2011-01-01

    Hepatitis B virus (HBV) infection, one of the major health priorities, accounts approximately for 350 million chronic cases and a global total of 33 million people were living with human immunodeficiency virus (HIV) in the world.Co-infection with HIV and the HBV presents a significant challenge to health care providers, with different prevalence rates in different parts of the world. It is important to screen all HIV infected individuals for HBV infection and reverse. Infection with HBV becom...

  6. Mycetoma in an HIV-infected patient Mycetoma em paciente HIV positivo

    Directory of Open Access Journals (Sweden)

    Luiz G. M. Castro

    1999-10-01

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

  7. Common mental disorders in TB/HIV co-infected patients in Ethiopia

    OpenAIRE

    Abebe Gemeda; Apers Ludwig; Hailmichael Yohannes; Tesfaye Markos; Deribew Amare; Duchateau Luc; Colebunders Robert

    2010-01-01

    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...

  8. HIV-2 infections in a rural Senegalese community.

    Science.gov (United States)

    Le Guenno, B; Pison, G; Enel, C; Lagarde, E; Seck, C

    1992-09-01

    In a community study in rural Senegal, 22 human immunodeficiency virus type-2 (HIV-2) seropositive cases and 64 matched controls were examined clinically and evaluated immunologically. The presence of clinical signs was highly correlated with HIV-2 seropositivity: 9 anti-HIV-2 positive patients and 5 controls presented with clinical signs (odd ratio [OR] = 8.2, confidence limits [CL] 2-35). The main symptom associated with HIV-2 seropositivity was a chronic cough (OR = 18.5, CL 1.8-899). The presence of diarrhoea was not significant (OR = 3.1, CL 0.3-3.5). The total number of CD8 cells, CD4/CD8 ratio, beta 2 microglobulin, and IgG level discriminated between seropositive and seronegative individuals (P less than 0.05). When the anti-HIV-2 positives were grouped as 13 healthy and 9 sick people, red blood cells, lymphocytes, T lymphocytes, CD4 cells, and beta 2 microglobulin differed significantly. Clinical symptoms were associated with immunodepression: 5 of 14 sick people had less than 500 CD4/microliters vs. 1 of 72 healthy persons. This study at the community level emphasizes the clinical and immunological impact of HIV-2 infection. Even if it presents with a longer incubation period than HIV-1, this virus is a major threat to public health. PMID:1402831

  9. Sensitivity of IFN-gamma release assay to detect latent tuberculosis infection is retained in HIV-infected patients but dependent on HIV/AIDS progression.

    OpenAIRE

    Karam, F.; Mbow, F.; Fletcher, H.; Senghor, Cs; Coulibaly, Kd; Lefevre, Am; Ngom Gueye, Nf; Dieye, T.; Sow, Ps; Mboup, S.; Lienhardt, C.

    2008-01-01

    BACKGROUND: Detection and treatment of latent TB infection (LTBI) in HIV infected individuals is strongly recommended to decrease morbidity and mortality in countries with high levels of HIV. OBJECTIVE: To assess the validity of a newly developed in-house ELISPOT interferon-gamma release assay (IGRA) for the detection of LTBI amongst HIV infected individuals, in comparison with the Tuberculin Skin Test (TST). METHODOLOGY/PRINCIPAL FINDINGS: ESAT6/CFP10 (EC) ELISPOT assays were performed, toge...

  10. Management of hepatitis C virus infection in HIV/HCV co-infected patients: clinical review.

    Science.gov (United States)

    Singal, Ashwani-K; Anand, Bhupinderjit S

    2009-08-14

    Nearly one fourth of individuals with human immunodeficiency virus (HIV) infection have hepatitis C virus (HCV) infection in the US and Western Europe. With the availability of highly active antiretroviral therapy and the consequent reduction in opportunistic infections, resulting in the prolongation of the life span of HIV-infected patients, HCV co-infection has emerged as a significant factor influencing the survival of HIV patients. Patients with HIV/HCV co-infection have a faster rate of fibrosis progression resulting in more frequent occurrences of cirrhosis, end-stage liver disease, and hepatocellular carcinoma. However, the mechanism of interaction between the two viruses is not completely understood. The treatment for HCV in co-infected patients is similar to that of HCV mono-infection; i.e., a combination of pegylated interferon and ribavirin. The presence of any barriers to anti-HCV therapy should be identified and eliminated in order to recruit all eligible patients. The response to treatment in co-infected patients is inferior compared to the response in patients with HCV mono-infection. The sustained virologic response rate is only 38% for genotype-1 and 75% for genotype-2 and -3 infections. Liver transplantation is no longer considered a contraindication for end-stage liver disease in co-infected patients. However, the 5 year survival rate is lower in co-infected patients compared to patients with HCV mono-infection (33% vs 72%, P = 0.07). A better understanding of liver disease in co-infected patients is needed to derive new strategies for improving outcome and survival. PMID:19673011

  11. Management of hepatitis C virus infection in HIV/HCV co-infected patients: Clinical review

    Directory of Open Access Journals (Sweden)

    Ashwani K Singal, Bhupinderjit S Anand

    2009-08-01

    Full Text Available Nearly one fourth of individuals with human immunodeficiency virus (HIV infection have hepatitis C virus (HCV infection in the US and Western Europe. With the availability of highly active antiretroviral therapy and the consequent reduction in opportunistic infections, resulting in the prolongation of the life span of HIV-infected patients, HCV co-infection has emerged as a significant factor influencing the survival of HIV patients. Patients with HIV/HCV co-infection have a faster rate of fibrosis progression resulting in more frequent occurrences of cirrhosis, end-stage liver disease, and hepatocellular carcinoma. However, the mechanism of interaction between the two viruses is not completely understood. The treatment for HCV in co-infected patients is similar to that of HCV mono-infection; i.e., a combination of pegylated interferon and ribavirin. The presence of any barriers to anti-HCV therapy should be identified and eliminated in order to recruit all eligible patients. The response to treatment in co-infected patients is inferior compared to the response in patients with HCV mono-infection. The sustained virologic response rate is only 38% for genotype-1 and 75% for genotype-2 and -3 infections. Liver transplantation is no longer considered a contraindication for end-stage liver disease in co-infected patients. However, the 5 year survival rate is lower in co-infected patients compared to patients with HCV mono-infection (33% vs 72%, P = 0.07. A better understanding of liver disease in co-infected patients is needed to derive new strategies for improving outcome and survival.

  12. The Challenges and Promise of HIV-Infected Donors for Solid Organ Transplantation.

    Science.gov (United States)

    Richterman, Aaron; Blumberg, Emily

    2015-04-01

    Solid organ transplantation is now the standard of care for many HIV-infected patients with end-stage kidney or liver disease. There is an overall organ shortage that affects all transplant candidates, including those with HIV. The use of HIV-infected donors could help alleviate this shortage. The precedent for this approach was set in South Africa, where promising short-term outcomes have been reported in a limited number of HIV-infected recipients of kidney transplants from HIV-infected donors. As a consequence, the HIV Organ Policy Equity (HOPE) Act was passed in the United States, legalizing research into HIV-infected organ donation. In this review, we discuss some of the key issues related to HIV-infected organ donation, including the need for transplant in HIV-infected populations, characterization of the potential donor pool in the USA, criteria for donor selection, concerns specific to the HIV-infected donor, the ethics of HIV-infected organ donation, and the next steps toward making HIV-infected donation a reality in the USA. PMID:25870139

  13. Adverse effects of antiretroviral therapy for HIV infection

    OpenAIRE

    Montessori, Valentina; Press, Natasha; Harris, Marianne; Akagi, Linda; Montaner, Julio S. G.

    2004-01-01

    LONG-TERM REMISSION OF HIV-1 DISEASE CAN BE READILY ACHIEVED by combinations of antiretroviral agents. The suppression of plasma viral loads to less than the limit of quantification of the most sensitive commercially available assays (i.e., less than 50 copies/mL) and the coincident improvement in CD4 T cell counts is associated with resolution of established opportunistic infections and a decrease in the risk of new opportunistic infections. However, prolonged treatment with combination regi...

  14. Neuropsychological function in asymptomatic HIV-1 infection: methodological issues.

    Science.gov (United States)

    Grunseit, A C; Perdices, M; Dunbar, N; Cooper, D A

    1994-12-01

    There have been conflicting reports as to whether significant neuropsychological deterioration occurs in asymptomatic HIV-1 infection. Comparisons among studies have been hindered by substantial variations in sample size, statistical methods, definitions of neuropsychological abnormality, and attention to potential confounding factors. In this study, the neuropsychological performance of 44 subjects with asymptomatic HIV-1 infection and 41 seronegative (SN) controls was compared using analysis of variance models. Rates of abnormality were also determined using commonly employed impairment criteria. The seropositive (SP) subjects performed comparably to SN controls once differences in full scale IQ were taken into account. Rates of abnormality for HIV-1 SP subjects were estimated at 10%, 17.5%, and 67.5% by three different criteria, and were not significantly different from the rates of the control group. The findings indicated that both premorbid characteristics, and the validity and biases of definitions of impairment should be examined and incorporated into the interpretation of study findings. PMID:7890823

  15. Recurrent pneumococcal meningitis in a splenectomised HIV-infected patient

    Directory of Open Access Journals (Sweden)

    Quesne Gilles

    2003-11-01

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

  16. Insomnia in HIV-infected patients: pathophysiologic implications.

    Science.gov (United States)

    Low, Yinghui; Goforth, Harold; Preud'homme, Xavier; Edinger, Jack; Krystal, Andrew

    2014-01-01

    The prevalence of insomnia in the HIV-seropositive population is estimated to be 29-97%, far greater than the 10% general population prevalence. We carried out a systematic review to assess whether the prevalence of insomnia is indeed higher in HIV-seropositive patients and to better understand the correlates of insomnia in order to attempt to explain the dramatically higher prevalence. Nineteen studies met our search criteria and were included in this review. We found that prior studies estimated the rate of disturbed sleep, but not a single study estimated the prevalence of insomnia using insomnia diagnostic criteria, which require that sleep disturbance occur frequently, persistently, and in association with impairment in quality of life or daytime function. We also found that in addition to correlates of sleep disturbance seen in the general population, there are also correlates specific to the HIV-seropositive population: stage and duration of HIV infection, and cognitive impairment. The most important conclusion of this review is that the prevalence of insomnia which meets diagnostic criteria has yet to be estimated in populations of HIV-seropositive patients and studies are needed to estimate this prevalence rate. The rate of sleep disturbance identified in HIV-infected patients (29-97%) should not be compared against the approximately 10% prevalence of clinically significant insomnia in the general population, which would suggest that HIV infection is associated with an alarming increase in sleep problems. Instead, this rate is best compared with the rate of sleep disturbance in the general population, which is roughly 33%. PMID:24522778

  17. HIV infection, aging and cardiovascular disease : epidemiology and prevention

    DEFF Research Database (Denmark)

    Petoumenos, Kathy; Worm, Signe W

    2011-01-01

    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.

  18. Primary HIV Infection Presenting as Non-traumatic Rhabdomyolysis with Acute Renal Failure

    Directory of Open Access Journals (Sweden)

    Prabahar Murugesan

    2008-01-01

    Full Text Available Renal disease is a relatively common complication in patients infected with the human immunodeficiency virus (HIV. A collapsing form of focal glomerulosclerosis has been considered as the primary form of HIV nephropathy. HIV infection is also associated with an increasing number of different forms of renal disease. Acute renal failure (ARF syndromes are frequently noted during the course of HIV infection. The most common include the following: acute and often reversible renal failure resulting from infection, hypotension, and administration of nephrotoxins used to treat opportunistic infections, and the use of highly active anti-retroviral therapy. ARF has been reported in up to 20% of hospitalized HIV infected patients compared to 3 to 5% of non-HIV infected patients. Primary HIV in-fection is usually symptomatic, and infected patients can present with a variety of symp-toms. Although ARF syndromes are frequently noted during the course of infection, it is an uncommon presentation of primary HIV infection. We describe a 42-year-old man who presented at our hospital with acute self-limited rhabdomyolysis and who was found to have primary HIV infection. Our case and other reports suggest that a diagnosis of primary HIV infection needs to be considered in patients who present with acute rhabdomyolysis.

  19. The ratio of hidden HIV infection in Cuba.

    Science.gov (United States)

    Atencia, Miguel; Garcia-Garaluz, Esther; Joya, Gonzalo

    2013-08-01

    In this work we propose the definition of the ratio of hidden infection of HIV/AIDS epidemics, as the division of the unknown infected population by the known one. The merit of the definition lies in allowing for an indirect estimation of the whole of the infected population. A dynamical model for the ratio is derived from a previous HIV/AIDS model, which was proposed for the Cuban case, where active search for infected individuals is carried out through a contact tracing program. The stability analysis proves that the model for the ratio possesses a single positive equilibrium, which turns out to be globally asymptotically stable. The sensitivity analysis provides an insight into the relative performance of various methods for detection of infected individuals. An exponential regression has been performed to fit the known infected population, owing to actual epidemiological data of HIV/AIDS epidemics in Cuba. The goodness of the obtained fit provides additional support to the proposed model. PMID:23906198

  20. Bone health in children and adolescents with perinatal HIV infection

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    George K Siberry

    2013-06-01

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

  1. Risk factors for concordant HIV infection in heterosexual couples in Trinidad.

    OpenAIRE

    de Gourville, EM; Mabey, D; Quigley, M.; Jack, N; Mahabir, B

    1998-01-01

    Risk factors for HIV infection in partners of HIV-seropositive index cases were investigated in a cross-sectional survey. Between September 1992 and April 1994 a total of 251 HIV-infected persons and 76 of their sexual partners were interviewed at the main sexually transmitted diseases (STDs) clinic in Trinidad. All participants gave signed consent and responded to a questionnaire. Sixty-four couples had risks for HIV infection through heterosexual intercourse only. However, many recruited se...

  2. Changing patterns of clinical events in perinatally HIV-1-infected children during the era of HAART

    OpenAIRE

    Tovo, Pierangelo

    2007-01-01

    BACKGROUND: The introduction of HAART has decreased mortality and progression to AIDS in perinatally HIV-1-infected children, but information on modification of the rate of specific clinical events is limited. METHOD: An observational population study on changes in HIV-1-related morbidity was conducted on 1402 perinatally HIV-1-infected children enrolled in the Italian Register for HIV Infection in Children and prospectively followed in the pre-HAART (1985-1995) and post-HAART periods (1996-2...

  3. Diabetes mellitus in HIV-infected patients receiving antiretroviral therapy

    Scientific Electronic Library Online (English)

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

    2014-01-01

    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.

  4. Bystander CD4+ T lymphocytes survive in HIV-infected human lymphoid tissue

    Science.gov (United States)

    Grivel, Jean-Charles; Biancotto, Angelique; Ito, Yoshinori; Lima, Rosangela G.; Margolis, Leonid B.

    2003-01-01

    HIV infection is associated with depletion of CD4(+) T cells. The mechanisms of this phenomenon remain to be understood. In particular, it remains controversial whether and to what extent uninfected ("bystander") CD4(+) T cells die in HIV-infected individuals. We address this question using a system of human lymphoid tissue ex vivo. Tissue blocks were inoculated with HIV-1. After productive infection was established, they were treated with the reverse transcriptase inhibitor nevirapine to protect from infection those CD4(+) T cells that had not yet been infected. These CD4(+) T cells residing in HIV-infected tissue are by definition bystanders. Our results demonstrate that after nevirapine application the number of bystander CD4(+) T cells is conserved. Thus, in the context of HIV-infected human lymphoid tissue, productive HIV infection kills infected cells but is not sufficient to cause the death of a significant number of uninfected CD4(+) T cells.

  5. Sero-prevalence of latent Toxoplasma gondii infection among HIV-infected and HIV-uninfected people in Addis Ababa, Ethiopia: A comparative cross-sectional study

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    Tegbaru Belete

    2009-10-01

    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.

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

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    Mathew Folaranmi OLANIYAN

    2010-03-01

    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.

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

    DEFF Research Database (Denmark)

    Katzenstein, TL; Oliveri, RS

    2002-01-01

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

  8. 'I think my future will be better than my past': examining support group influence on the mental health of HIV-infected Rwandan women.

    Science.gov (United States)

    Walstrom, Paige; Operario, Don; Zlotnick, Caron; Mutimura, Eugene; Benekigeri, Chantal; Cohen, Mardge H

    2013-01-01

    Urgent need exists for improved psychological services among HIV-infected women in post-genocide Rwanda. Psychological problems associated with trauma and sexual violence (i.e., depression, posttraumatic stress disorder [PTSD]) place women at increased risk for sexual risk behaviour, low health-seeking behaviour, delay of antiretroviral therapy (ART) and reduced ART adherence. We explored experiences of HIV-infected Rwandan women attending psychosocial support groups and their narratives about how participation affected their mental health and HIV treatment. Focus group discussions examined participants' reasons for support group attendance, perceived psychological benefit of support groups, influence on ART adherence, and other influences on health behaviors and attitudes. Rwandan women (aged 18-65) were randomly selected from 10 health clinic-facilitated support groups for HIV-infected trauma survivors in Kigali. Results identified positive psychological and physical changes as well as behaviour changes in relationships with men, which participants attributed to support group attendance. Data showed significant improvement in mental health, ART adherence and HIV serostatus disclosure resulting from group attendance. Participants acknowledged limitations of support groups with respect to addressing poverty and hunger. Implementing psychosocial support groups may leverage clinical outcomes and rejuvenate the well-being of HIV-infected women with interpersonal trauma and/or PTSD and depressive symptoms, particularly those from post-conflict countries. PMID:22812728

  9. CMV Arthritis in a HIV Infected Teenage Girl

    International Nuclear Information System (INIS)

    Full text: Introduction: The disease with Cytomegalovirus (CMV) in the immuno depressed patients is determined either by the reactivation of a latent infection or by the primary infection at a seronegative receptor from a seropositive blood donor. The CMV infection is an important co-factor of the progress of the HIV infection. Some clinical forms are mode frequently met: the CMV pneumonia, the CMV gastrointestinal infection, the CMV retinitis and the central nervous system condition as CMV meningitis. Other locations such as carditis, myositis, or arthritis are very seldom mentioned. Objectives: The presentation of a clinical case of CMV polyarthritis. Material And Method: A retrospective study of the medical record of an HIV infected teenage girl. Results: A teenage girl of 16 diagnosed with HIV for 10 years was hospitalized twice in 2 months. At the first hospitalization she presented abdominal pain, vomiting, pyrosis and severe asthenia. A gastro-duodenal radiography was performed which showed gastroduodenitis lesions. The serology for CMV IgG was positive, at a high titre and a diagnose of gastrointestinal infection was given. At the second episode of hospitalization the patient presented myalgia and polyarthralgia. A bone scintigraphy was performed which showed inflammations of the spinal column joints in the T6-L3 area, sacro-illiac joint (bilateral), scapulo-humeral joint and coxo-femural joint and also in the left knee joint area. Based on clinical and para 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)

  10. Tratamento de depressão em indivíduos infectados pelo HIV Treatment of depression in HIV-infected individuals

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    André Malbergier

    2001-09-01

    Full Text Available A infecção pelo HIV/Aids é freqüentemente associada a transtornos psiquiátricos. Dentre eles, a depressão é o mais comum. O diagnóstico e o tratamento dos transtornos depressivos são fundamentais para melhorar a qualidade de vida desses pacientes. Esta revisão tem como objetivo sintetizar e discutir os resultados mais importantes da literatura a respeito das particularidades do tratamento dos transtornos depressivos em indivíduos infectados pelo HIV. São discutidos a epidemiologia, o quadro clínico, a influência da depressão na evolução da infecção, o tratamento farmacológico com antidepressivos, testosterona e psicoestimulantes e a interação farmacológica entre os antidepressivos e benzodiazepínicos e as drogas antivirais. Conclui-se que o tratamento antidepressivo nessa população é eficaz, seguro e não promove imunossupressão nos indivíduos afetados.HIV/AIDS infection is frequently associated with psychiatric disorders, especially depression. The diagnosis and treatment of depression are essential to improve quality of life in these individuals. This review intends to summarize and discuss the most important results in the literature about the treatment of depression in HIV-infected individuals. The epidemiology, clinical presentation, contribution of depression on HIV infection, pharmacological treatment with antidepressants, testosterone, and psychostimulant drugs, and pharmacological interactions between antidepressants, benzodiazepines, and antiviral medications are discussed. The conclusion drawn from this study is that the treatment of depression in this population is effective, safe and does not promote immunosupression.

  11. Endothelial function and cardiovascular diseases in HIV infected patient

    Scientific Electronic Library Online (English)

    Ana Cristina O., Andrade; Bruno R., Cotter.

    2006-04-01

    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 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.

  12. Endothelial function and cardiovascular diseases in HIV infected patient

    Directory of Open Access Journals (Sweden)

    Ana Cristina O. Andrade

    2006-04-01

    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.

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

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    Edgardo G. Bottaro

    2004-08-01

    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.

  14. Dynamics of HIV Infection: A Cellular Automata Approach

    Science.gov (United States)

    Zorzenon Dos Santos, Rita Maria; Coutinho, Sérgio

    2001-10-01

    We use a cellular automata model to study the evolution of human immunodeficiency virus (HIV) infection and the onset of acquired innumodeficiency syndrome (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, which may occur in the lymph nodes. Our results reproduce 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. The dynamics of real experimental data is related to the transient behavior of our model and not to its steady state. We have also found that the infected cells organize themselves into spatial structures, which are responsible for the decrease on the concentration of uninfected cells, leading to AIDS.

  15. False negative HIV antibody test in HIV infected children who receive early antiretroviral treatment in a resource-limited setting

    OpenAIRE

    Raghuprakash Reddy; Manoranjan Midde; Gerardo Alvarez-Uria; Naik, Praveen K.; Shanmugamari Kannan

    2012-01-01

    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...

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

    Science.gov (United States)

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

    2014-10-01

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

  17. Prospective Antiretroviral Treatment of Asymptomatic, HIV-1 Infected Controllers

    Science.gov (United States)

    Hatano, Hiroyu; Yukl, Steven A.; Ferre, April L.; Graf, Erin H.; Somsouk, Ma; Sinclair, Elizabeth; Abdel-Mohsen, Mohamed; Liegler, Teri; Harvill, Kara; Hoh, Rebecca; Palmer, Sarah; Bacchetti, Peter; Hunt, Peter W.; Martin, Jeffrey N.; McCune, Joseph M.; Tracy, Russell P.; Busch, Michael P.; O'Doherty, Una; Shacklett, Barbara L.; Wong, Joseph K.; Deeks, Steven G.

    2013-01-01

    The study of HIV-infected “controllers” who are able to maintain low levels of plasma HIV RNA in the absence of antiretroviral therapy (ART) may provide insights for HIV cure and vaccine strategies. Despite maintaining very low levels of plasma viremia, controllers have elevated immune activation and accelerated atherosclerosis. However, the degree to which low-level replication contributes to these phenomena is not known. Sixteen asymptomatic controllers were prospectively treated with ART for 24 weeks. Controllers had a statistically significant decrease in ultrasensitive plasma and rectal HIV RNA levels with ART. Markers of T cell activation/dysfunction in blood and gut mucosa also decreased substantially with ART. Similar reductions were observed in the subset of “elite” controllers with pre-ART plasma HIV RNA levels below conventional assays (<40 copies/mL). These data confirm that HIV replication persists in controllers and contributes to a chronic inflammatory state. ART should be considered for these individuals (ClinicalTrials.gov NCT01025427). PMID:24130489

  18. Compromiso renal en pacientes HIV+ Renal abnormalities in HIV infected patients

    Directory of Open Access Journals (Sweden)

    María Marta Pernasetti

    2010-06-01

    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 pacientes 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.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.

  19. Compromiso renal en pacientes HIV+ / Renal abnormalities in HIV infected patients

    Scientific Electronic Library Online (English)

    María Marta, Pernasetti; Carlos, Chiurchiu; Jorge, de la Fuente; Javier, de Arteaga; Walter, Douthat; Cecilia, Bardosy; Abel, Zarate; Pablo U., Massari.

    2010-06-01

    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.

  20. Kaposi Sarcoma Incidence and Survival Among HIV-Infected Homosexual Men After HIV Seroconversion

    Science.gov (United States)

    Guiguet, Marguerite; Costagliola, Dominique; Fisher, Martin; de Luca, Andrea; Porter, Kholoud

    2010-01-01

    Background Despite the success of combination antiretroviral therapy (cART) in reducing the incidence of Kaposi sarcoma, HIV-infected individuals who have responded to treatment continue to be diagnosed with Kaposi sarcoma. We examine factors associated with the incidence of Kaposi sarcoma among cART-treated HIV-infected homosexual men and changes in their survival after its diagnosis over calendar time. Methods Data were from HIV-infected homosexual men with well-estimated dates of HIV seroconversion (ie, change in status from being HIV negative to having HIV antibodies detected). Incidence of Kaposi sarcoma was calculated. We used Kaplan–Meier methods to determine survival after Kaposi sarcoma diagnosis in three calendar periods: before 1996, 1996–2000, and 2001–2006. Poisson models were used to examine the effect of risk factors such as current and nadir CD4 cell count (ie, the lowest CD4 cell count ever recorded for a person), duration of infection, and age at diagnosis for Kaposi sarcoma incidence in cART-treated men. All statistical tests were two-sided. Results Among the 9473 men, 555 were diagnosed with Kaposi sarcoma in the period 1986–2006, of whom 319 died. The percentage surviving 24 months after Kaposi sarcoma diagnosis rose statistically significantly during the study period from 35% (95% confidence interval [CI] = 29% to 42%) before 1996 to 84% (95% CI = 76% to 90%) in 1996–2000 and to 81% (95% CI = 70% to 88%) in 2001–2006 (P < .001). Seventy men were diagnosed with Kaposi sarcoma after starting cART. Current (ie, within 6 months) CD4 cell count was associated with incidence of Kaposi sarcoma among cART-treated men (rate ratios [RRs] = 18.91, 95% CI = 8.50 to 42.09, for CD4 level category <200 cells per cubic millimeter; RR = 3.55, 95% CI = 1.40 to 9.00, for 200–349 cells per cubic millimeter; and RR = 4.11, 95% CI = 1.74 to 9.70, for 350–499 cells per cubic millimeter; all compared with ?500 cells per cubic millimeter). After adjustment for current CD4 cell count, HIV infection duration, age, or nadir CD4 cell count was not associated with Kaposi sarcoma incidence. Conclusions Among cART-treated HIV-infected homosexual men, current CD4 cell count was the factor most strongly associated with the incidence of Kaposi sarcoma. Survival estimates after Kaposi sarcoma diagnosis have improved over time. PMID:20442214

  1. Non-infective pulmonary disease in HIV-positive children

    International Nuclear Information System (INIS)

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

  2. Alcohol consumption trajectory patterns in adult women with HIV infection.

    Science.gov (United States)

    Cook, Robert L; Zhu, Fang; Belnap, Bea Herbeck; Weber, Kathleen M; Cole, Stephen R; Vlahov, David; Cook, Judith A; Hessol, Nancy A; Wilson, Tracey E; Plankey, Michael; Howard, Andrea A; Sharp, Gerald B; Richardson, Jean L; Cohen, Mardge H

    2013-06-01

    HIV-infected women with excessive alcohol consumption are at risk for adverse health outcomes, but little is known about their long-term drinking trajectories. This analysis included longitudinal data, obtained from 1996 to 2006, from 2,791 women with HIV from the Women's Interagency HIV Study. Among these women, the proportion in each of five distinct drinking trajectories was: continued heavy drinking (3 %), reduction from heavy to non-heavy drinking (4 %), increase from non-heavy to heavy drinking (8 %), continued non-heavy drinking (36 %), and continued non-drinking (49 %). Depressive symptoms, other substance use (crack/cocaine, marijuana, and tobacco), co-infection with hepatitis C virus (HCV), and heavy drinking prior to enrollment were associated with trajectories involving future heavy drinking. In conclusion, many women with HIV change their drinking patterns over time. Clinicians and those providing alcohol-related interventions might target those with depression, current use of tobacco or illicit drugs, HCV infection, or a previous history of drinking problems. PMID:22836592

  3. Avascular necrosis of the femoral head in HIV infected patients

    Directory of Open Access Journals (Sweden)

    Marcos Almeida Matos

    2007-02-01

    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.

  4. Non-infective pulmonary disease in HIV-positive children

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-06-15

    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.)

  5. Barriers to Antiretroviral Medication Adherence in Young HIV-Infected Children

    Science.gov (United States)

    Roberts, Kathleen Johnston

    2005-01-01

    The purpose of this exploratory study was to examine, from the perspectives of both HIV-infected children and such children's primary guardians, the barriers children face in adhering to combination antiretroviral therapies. Nine HIV-infected young children and 14 guardians of HIV-positive children were interviewed about what the children's lives…

  6. HCV/HIV co-infection: time to re-evaluate the role of HIV in the liver?

    OpenAIRE

    Blackard, J. T.; Sherman, K. E.

    2008-01-01

    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...

  7. Interventions to Address Chronic Disease and HIV: Strategies to Promote Exercise and Nutrition Among HIV-Infected Individuals

    OpenAIRE

    Botros, Diana; Somarriba, Gabriel; Neri, Daniela; Tracie L Miller

    2012-01-01

    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...

  8. The changing epidemiology of the global paediatric HIV epidemic: keeping track of perinatally HIV-infected adolescents

    OpenAIRE

    Sohn, Annette H.; Rohan Hazra

    2013-01-01

    The global paediatric HIV epidemic is shifting into a new phase as children on antiretroviral therapy (ART) move into adolescence and adulthood, and face new challenges of living with HIV. UNAIDS reports that 3.4 million children aged below 15 years and 2 million adolescents aged between 10 and 19 years have HIV. Although the vast majority of children were perinatally infected, older children are combined with behaviourally infected adolescents and youth in global reporting, making it difficu...

  9. Short Communication: Methicillin-Resistant Staphylococcus aureus Infections in Children and Young Adults Infected with HIV

    OpenAIRE

    Srinivasan, Ashok; Seifried, Steven; Zhu, Liang; Bitar, Wally; Srivastava, Deo K.; Shenep, Jerry L.; Bankowski, Matthew J.; Flynn, Patricia M.; Hayden, Randall T.

    2009-01-01

    The epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) infections, in particular with Panton-Valentine leukocidin (PVL)-positive strains, has not been well characterized in children and young adults with HIV infection. It is not known if PVL-positive strains of MRSA cause an increased morbidity in this population compared to PVL-negative strains. The purpose of this study was to retrospectively analyze the epidemiology of PVL-positive and PVL-negative MRSA infections in childr...

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

    DEFF Research Database (Denmark)

    Salado-Rasmussen, Kirsten; Knudsen, Andreas

    2014-01-01

    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.

  11. Knowledge about aids/HIV infection among female college students

    International Nuclear Information System (INIS)

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

  12. Outpatient Management of HIV Infection: Providing adequate care to HIV patients

    OpenAIRE

    Romanowski, Barbara

    1992-01-01

    The management of HIV and AIDS has changed dramatically over the past decade. Cases can now be managed adequately as outpatients and family physicians are assuming a greater role. Outpatient management involves regular follow up, including monitoring CD4 and CD8 levels, awareness and recognition of opportunistic infections, and early institution of zidovudine and primary preventive measures, including immunizations.

  13. High rate of seronegative HCV infection in HIV-positive patients

    OpenAIRE

    JUNIASTUTI,; Utsumi, Takako; NASRONUDIN,; ALIMSARDJONO, LINDAWATI; AMIN, MOCHAMAD; Adianti, Myrna; Yano, Yoshihiko; SOETJIPTO; HAYASHI, YOSHITAKE; HOTTA, HAK; LUSIDA, MARIA INGE

    2013-01-01

    Co-infection with human immunodeficiency virus (HIV) and hepatitis C virus (HCV) is a significant global health problem. The two viruses are transmitted with high efficacy via blood-to-blood contact, mainly intravenous drug use (IVDU), whereas HCV is less easily transmitted sexually. Antibody testing is the main screening method for HCV infection, although it may not be the optimal option for HIV infection. The aim of this study was to investigate HCV infection in HIV-positive patients, with ...

  14. HIV Infection among Civilian Applicants for Nigeria Military Service

    Directory of Open Access Journals (Sweden)

    Joshua A. Itsifinus

    2010-06-01

    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

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

    Directory of Open Access Journals (Sweden)

    Sharma Archana

    2009-01-01

    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.

  16. Anti-HIV-1 activity of flavonoid myricetin on HIV-1 infection in a dual-chamber in vitro model.

    Science.gov (United States)

    Pasetto, Silvana; Pardi, Vanessa; Murata, Ramiro Mendonça

    2014-01-01

    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

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

    Directory of Open Access Journals (Sweden)

    van Soolingen Dick

    2007-05-01

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

  18. Property grabbing and will writing in Lusaka, Zambia: an examination of wills of HIV-infected cohabiting couples.

    Science.gov (United States)

    Mendenhall, E; Muzizi, L; Stephenson, R; Chomba, E; Ahmed, Y; Haworth, A; Allen, S

    2007-03-01

    High rates of HIV and poverty place women in a precarious economic situation in Lusaka, Zambia. Mortality from HIV infection is high, leaving many households single headed and creating almost a half a million orphans. One of the most prevalent forms of gender violence that creates poverty in women is when the male's family claims the property of the deceased from the widow and the children. The Zambia-Emory HIV Research Project collected 184 wills from individuals in monogamous unions where one or both of the individuals were HIV-positive. Despite the fact that many wills specifically stated that their extended family was not allowed to tamper with their possessions in the event of death, property grabbing proved to be a prevalent and difficult issue in Lusaka. In order to improve the lives of widowed women in Lusaka, the government and other civic and non-governmental organisations must inform women of their rights to own and protect their land and other assets in the event of their husbands' death, an issue of increasing importance in the area of HIV/AIDS. PMID:17453571

  19. Macaques as model hosts for studies of HIV-1 infection

    Directory of Open Access Journals (Sweden)

    JasonTKimata

    2013-06-01

    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.

  20. Risk of Venous Thromboembolism in Patients Infected with HIV: A Cohort Study

    OpenAIRE

    Sule, Ashish Anil; Pandit, Nihar; Handa, Pankaj; Chadachan, Veerandra; Tan, Endean; Sum, Faith Nadine Choo Yun; Joyce, Er Hui Ling; Chin, Tay Jam

    2013-01-01

    Introduction Human immunodeficiency virus (HIV) patients are at risk of developing thrombosis than general population. There are several intersecting mechanisms associated with HIV infection and antiviral therapy that are emerging, which may lead to vasculopathy and hypercoagulability in these patients.

  1. Yoga lifestyle intervention reduces blood pressure in HIV-infected adults with cardiovascular disease risk factors

    OpenAIRE

    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

    2010-01-01

    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.

  2. Plasma levels of soluble CD14 independently predict mortality in HIV infection

    DEFF Research Database (Denmark)

    Sandler, Netanya G; Wand, Handan

    2011-01-01

    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.

  3. Risk of cancer among HIV-infected individuals compared to the background population : impact of smoking and HIV

    DEFF Research Database (Denmark)

    Helleberg, Marie; Gerstoft, Jan

    2014-01-01

    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.

  4. High levels of T lymphocyte activation in Leishmania-HIV-1 co-infected individuals despite low HIV viral load

    Directory of Open Access Journals (Sweden)

    Grinsztejn Beatriz

    2010-12-01

    Full Text Available Abstract Background Concomitant infections may influence HIV progression by causing chronic activation leading to decline in T-cell function. In the Americas, visceral (AVL and tegumentary leishmaniasis (ATL have emerged as important opportunistic infections in HIV-AIDS patients and both of those diseases have been implicated as potentially important co-factors in disease progression. We investigated whether leishmaniasis increases lymphocyte activation in HIV-1 co-infected patients. This might contribute to impaired cellular immune function. Methods To address this issue we analyzed CD4+ T absolute counts and the proportion of CD8+ T cells expressing CD38 in Leishmania/HIV co-infected patients that recovered after anti-leishmanial therapy. Results We found that, despite clinical remission of leishmaniasis, AVL co-infected patients presented a more severe immunossupression as suggested by CD4+ T cell counts under 200 cells/mm3, differing from ATL/HIV-AIDS cases that tends to show higher lymphocytes levels (over 350 cells/mm3. Furthermore, five out of nine, AVL/HIV-AIDS presented low CD4+ T cell counts in spite of low or undetectable viral load. Expression of CD38 on CD8+ T lymphocytes was significantly higher in AVL or ATL/HIV-AIDS cases compared to HIV/AIDS patients without leishmaniasis or healthy subjects. Conclusions Leishmania infection can increase the degree of immune system activation in individuals concomitantly infected with HIV. In addition, AVL/HIV-AIDS patients can present low CD4+ T cell counts and higher proportion of activated T lymphocytes even when HIV viral load is suppressed under HAART. This fact can cause a misinterpretation of these laboratorial markers in co-infected patients.

  5. Frequency of human immunodeficiency virus type-2 in hiv infected patients in Maputo City, Mozambique

    Directory of Open Access Journals (Sweden)

    Bhatt Nilesh

    2011-08-01

    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.

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

    OpenAIRE

    Wirtz, Andrea L.; Vincent Jumbe; Gift Trapence; Dunker Kamba; Eric Umar; Sosthenes Ketende; Mark Berry; Mdahl, Susanne Str X. F.; Chris Beyrer; Baral, Stefan D.

    2013-01-01

    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 Ap...

  7. Projected Lifetime Healthcare Costs Associated with HIV Infection

    Science.gov (United States)

    Nakagawa, Fumiyo; Miners, Alec; Smith, Colette J.; Simmons, Ruth; Lodwick, Rebecca K.; Cambiano, Valentina; Lundgren, Jens D.; Delpech, Valerie; Phillips, Andrew N.

    2015-01-01

    Objective Estimates of healthcare costs associated with HIV infection would provide valuable insight for evaluating the cost-effectiveness of possible prevention interventions. We evaluate the additional lifetime healthcare cost incurred due to living with HIV. Methods We used a stochastic computer simulation model to project the distribution of lifetime outcomes and costs of men-who-have-sex-with-men (MSM) infected with HIV in 2013 aged 30, over 10,000 simulations. We assumed a resource-rich setting with no loss to follow-up, and that standards and costs of healthcare management remain as now. Results Based on a median (interquartile range) life expectancy of 71.5 (45.0–81.5) years for MSM in such a setting, the estimated mean lifetime cost of treating one person was £360,800 ($567,000 or €480,000). With 3.5% discounting, it was £185,200 ($291,000 or €246,000). The largest proportion (68%) of these costs was attributed to antiretroviral drugs. If patented drugs are replaced by generic versions (at 20% cost of patented prices), estimated mean lifetime costs reduced to £179,000 ($281,000 or €238,000) and £101,200 ($158,900 or €134,600) discounted. Conclusions If 3,000 MSM had been infected in 2013, then future lifetime costs relating to HIV care is likely to be in excess of £1 billion. It is imperative for investment into prevention programmes to be continued or scaled-up in settings with good access to HIV care services. Costs would be reduced considerably with use of generic antiretroviral drugs. PMID:25901355

  8. Projected Lifetime Healthcare Costs Associated with HIV Infection

    DEFF Research Database (Denmark)

    Nakagawa, Fumiyo; Miners, Alec

    2015-01-01

    OBJECTIVE: Estimates of healthcare costs associated with HIV infection would provide valuable insight for evaluating the cost-effectiveness of possible prevention interventions. We evaluate the additional lifetime healthcare cost incurred due to living with HIV. METHODS: We used a stochastic computer simulation model to project the distribution of lifetime outcomes and costs of men-who-have-sex-with-men (MSM) infected with HIV in 2013 aged 30, over 10,000 simulations. We assumed a resource-rich setting with no loss to follow-up, and that standards and costs of healthcare management remain as now. RESULTS: Based on a median (interquartile range) life expectancy of 71.5 (45.0-81.5) years for MSM in such a setting, the estimated mean lifetime cost of treating one person was £ 360,800 ($567,000 or € 480,000). With 3.5% discounting, it was £ 185,200 ($291,000 or € 246,000). The largest proportion (68%) of these costs was attributed to antiretroviral drugs. If patented drugs are replaced by generic versions (at 20% cost of patented prices), estimated mean lifetime costs reduced to £ 179,000 ($ 281,000 or € 238,000) and £ 101,200 ($ 158,900 or € 134,600) discounted. CONCLUSIONS: If 3,000 MSM had been infected in 2013, then future lifetime costs relating to HIV care is likely to be in excess of £ 1 billion. It is imperative for investment into prevention programmes to be continued or scaled-up in settings with good access to HIV care services. Costs would be reduced considerably with use of generic antiretroviral drugs.

  9. The effects of Spiruline on the immune functions of HIV-infected undernourished children

    OpenAIRE

    Jacques Simpore, Salvatore Pignatelli

    2007-01-01

    Background: Malnutrition is a public health problem in the entire world, particularly in the developing countries. The effect of Spiruline supplement in the weight recovery of HIV-negative and HIV-infected undernourished children has been largely demonstrated. The aim of this study is to determine the effect of Spiruline on the immune status of 46 HIV-infected undernourished children, aged 15 ± 5 months, and of 23 undernourished HIV-negative children, aged 14 ± 6 months.Methodology: The dur...

  10. Nutrition Rehabilitation of the HIV-Infected and Negative Undernourished Children Utilizing Spiruline

    OpenAIRE

    Jacques Simpore; Frederic Zongo; Youssouf Ouattara; Fatoumata Kabore; Deleli Dansou; Augustin Bere; Jean-Baptiste Nikiema; Salvatore Musumeci

    2005-01-01

    The objective of the study was to assess the impact of an alimentary integrator composed by Spiruline (Spirulina platensis), produced at the Centre Medical St Camille (CMSC) of Ouagadougou, Burkina Faso, on the nutritional status of undernourished HIV-infected and HIV negative children. We compared two groups of children: 84 children HIV-infected and 86 HIV-negative. The duration of this study was eight weeks. Anthropometrics and haematological parameters allowed us to appreciate both the nut...

  11. The Neurocognitive Assessment of HIV-Infected School-Aged Nigerian Children

    OpenAIRE

    Boyede, Gbemisola O.; Lesi, Foluso E. A.; Ezeaka, Chinyere V.; Umeh, Charles S.

    2013-01-01

    Objective: Studies available on cognitive function among school-aged HIV-infected African and in particular Nigerian children are few. The purpose of the study was to assess the neurocognitive function of a group of HIV-infected schoolaged (6 - 15 years) children using the Raven’s Standard Progressive Matrices (RPM). Method: Cognitive assessments of 69 HIV positive children and 69 age- and sex-matched apparently healthy HIV negative control children were performed using the Raven’s Stand...

  12. Disbalance of the macro and micro elements in HIV infected patients

    OpenAIRE

    Institute of Immunology; Academy of Science; Uzbekistan

    2011-01-01

    Background: Microelemental content of the hair reflects the status of microelements in whole body andis an indicator of mineral metabolism. There is no sufficient literature on study of macro andmicroelements in HIV/AIDS. We study macro and micro elements in hair samples of HIV infectedpatients and healthy individuals.Materials and methods: We collected samples from 100 people aged 21 – 55. 40 persons were healthy,46 were HIV infected. HIV infected patients have been divided into 3 groups a...

  13. Mycoplasma genitalium infection among HIV-positive women: prevalence, risk factors and association with vaginal shedding

    OpenAIRE

    Gatski, M; Martin, D. H.; Theall, K; Amedee, A; Clark, R.A.; Dumestre, J; Chhabra, P; Schmidt, N.; Kissinger, P

    2011-01-01

    This study examined the prevalence and factors associated with Mycoplasma genitalium (MG) infection among HIV-positive women and the association between MG and vaginal HIV-1 RNA shedding. HIV-positive women attending an outpatient clinic in New Orleans, Louisiana, USA, from 2002 to 2005 were examined for a battery of sexually transmitted infections (STIs) and underwent a behavioural survey. A selected subset had a measurement of vaginal shedding analysed. Of the 324 HIV-positive women, 32 (9....

  14. HIV infection and tuberculosis in South Africa: an urgent need to escalate the public health response

    OpenAIRE

    Abdool Karim, Salim S.; Churchyard, Gavin J.; Abdool Karim, Quarraisha; Lawn, Stephen D.

    2009-01-01

    One of the greatest challenges facing post-apartheid South Africa is the control of the concomitant HIV and tuberculosis epidemics. HIV continues to spread relentlessly, and tuberculosis has been declared a national emergency. In 2007, South Africa, with 0·7% of the world’s population, had 17% of the global burden of HIV infection, and one of the world’s worst tuberculosis epidemics, compounded by rising drug resistance and HIV co-infection. Until recently, the South African Government?...

  15. Quality of life assessment in HIV-infection: validation of the European Portuguese version of WHOQOL-HIV.

    Science.gov (United States)

    Canavarro, Maria C; Pereira, Marco; Simoes, Mario R; Pintassilgo, Ana L

    2011-02-01

    The assessment of quality of life (QOL) in HIV infection has emerged as being vital to research and clinical practice. This assessment is also a challenge due to the specific characteristics of the infection, the increased availability of therapeutics, as well as the epidemiological variability inherent to HIV infection. The purpose of this study was to investigate the psychometric properties of the European Portuguese version of the World Health Organization's QOL Instrument in HIV Infection (WHOQOL-HIV) and to test its performance in a sample of HIV-infected patients. The European Portuguese version of WHOQOL-HIV was administered in a sample of 200 HIV-positive patients. The patients also completed the Portuguese versions of Beck Depression Inventory (BDI) and Brief Symptom Inventory (BSI). The WHOQOL-HIV showed quite an acceptable internal consistency (Cronbach's ? ranged from 0.86 to 0.95 across domains). Convergent validity with BDI and BSI was satisfactory for all domains (all r>0.50; pvalidity studies of the European Portuguese version of the WHOQOL-HIV revealed good psychometric characteristics, which allows for the use of this version of WHOQOL in our country, and cross-cultural comparability. PMID:21259131

  16. Candida species isolated from the vaginal mucosa of HIV-infected women in Salvador, Bahia, Brazil

    Directory of Open Access Journals (Sweden)

    Paula Matos Oliveira

    2011-06-01

    Full Text Available BACKGROUND: Vulvovaginal candidiasis (VVC is the second most common vaginal infection. HIV-infection is a risk factor for this infection. OBJECTIVE: To determine the frequency of VVC and to describe the main Candida species isolated and their susceptibility to antifungal drugs in HIV-infected patients, compared to HIV-uninfected women in Salvador, Brazil. METHODS: Cross-sectional study including a group of 64 HIV-infected women and 76 uninfected women, followed up at the AIDS reference center and at the Gynecological Clinic of Escola Bahiana de Medicina e Saúde Pública (Salvador, Bahia, Brazil. RESULTS: Frequency of Candida spp. was higher in HIV-infected women (29.7% than in HIV-uninfected controls (14.5% (p = 0.02. The odds ratio value for vulvovaginal candidiasis in HIV-infected patients was 2.6 (95% CI: 1.07 - 6.32 p = 0.03. Candida albicans was the most commonly isolated species in both HIV-infected (52.3% and uninfected women (85.7%, followed by C. parapsolis in 17.6% and 14.3%, respectively. In HIV-infected women, C. glabrata, C. parapsilosis, and a coinfection of C. albicans and C. glabrata were also identified. There was no significant difference between Candida species isolated from the vaginal mucosa of women with VVC and colonization of the vaginal mucosa of HIV-infected and HIV-uninfected women. One C. glabrata isolate from an HIV-infected patient was resistant to fluconazole and other two isolates exhibited a dose-dependent susceptibility. CONCLUSION: Our results confirm a higher frequency of Candida spp. isolated from the vaginal mucosa of HIV-infected women and a broader spectrum of species involved. Only Candida glabrata isolates showed decreased susceptibility to fluconazole.

  17. Candida species isolated from the vaginal mucosa of HIV-infected women in Salvador, Bahia, Brazil

    Scientific Electronic Library Online (English)

    Paula Matos, Oliveira; Rita Elizabeth, Mascarenhas; Claire, Lacroix; Suzana Ramos, Ferrer; Rone Peterson C, Oliveira; Elaine Andrade, Cravo; André P Ribeiro, Alves; Maria Fernanda Rios, Grassi.

    2011-06-01

    Full Text Available BACKGROUND: Vulvovaginal candidiasis (VVC) is the second most common vaginal infection. HIV-infection is a risk factor for this infection. OBJECTIVE: To determine the frequency of VVC and to describe the main Candida species isolated and their susceptibility to antifungal drugs in HIV-infected patie [...] nts, compared to HIV-uninfected women in Salvador, Brazil. METHODS: Cross-sectional study including a group of 64 HIV-infected women and 76 uninfected women, followed up at the AIDS reference center and at the Gynecological Clinic of Escola Bahiana de Medicina e Saúde Pública (Salvador, Bahia, Brazil). RESULTS: Frequency of Candida spp. was higher in HIV-infected women (29.7%) than in HIV-uninfected controls (14.5%) (p = 0.02). The odds ratio value for vulvovaginal candidiasis in HIV-infected patients was 2.6 (95% CI: 1.07 - 6.32 p = 0.03). Candida albicans was the most commonly isolated species in both HIV-infected (52.3%) and uninfected women (85.7%), followed by C. parapsolis in 17.6% and 14.3%, respectively. In HIV-infected women, C. glabrata, C. parapsilosis, and a coinfection of C. albicans and C. glabrata were also identified. There was no significant difference between Candida species isolated from the vaginal mucosa of women with VVC and colonization of the vaginal mucosa of HIV-infected and HIV-uninfected women. One C. glabrata isolate from an HIV-infected patient was resistant to fluconazole and other two isolates exhibited a dose-dependent susceptibility. CONCLUSION: Our results confirm a higher frequency of Candida spp. isolated from the vaginal mucosa of HIV-infected women and a broader spectrum of species involved. Only Candida glabrata isolates showed decreased susceptibility to fluconazole.

  18. Acute HIV infection with rapid progression to AIDS

    Scientific Electronic Library Online (English)

    Marcio de Oliveira, Silva; Milena, Bastos; Eduardo, Martins Netto; Nancy Alves de Lima, Gouvea; Alex Jose Leite, Torres; Esper, Kallas; David I, Watkins; Marcus, Altfeld; Carlos, Brites.

    2010-06-01

    Full Text Available Acute HIV infection is rarely recognized as the signs and symptoms are normally unspecific and can persist for days or weeks. The normal HIV course is characterized by a progressive loss of CD4+ cells, which normally leads to severe immunodeficiency after a variable time interval. The mean time from [...] initial infection to development of clinical AIDS is approximately 8-10 years, but it is variable among individuals and depends on a complex interaction between virus and host. Here we describe an extraordinary case of a man who developed Pneumocisits jiroveci pneumonia within one month after sexual exposure to HIV-1, and then presented with 3 consecutive CD4 counts bellow 200 cells/mm³ within 3 months, with no other opportunistic disease. Although antiretroviral therapy (AZT+3TC+ATZ/r) was started, with full adherence of the patient, and genotyping indicating no primary antiretroviral resistance mutations, he required more than six months to have a CD4 restoration to levels above 200 cells/mm³ and 10 months to HIV-RNA to become undetectable.

  19. Microbial translocation and cardiometabolic risk factors in HIV infection

    DEFF Research Database (Denmark)

    TrØseid, Marius; Manner, Ingjerd W

    2014-01-01

    The widespread access to antiretroviral treatment during the past decades has transformed HIV infection from a lethal disease to a chronic condition, in which the relative burden of non-AIDS-related chronic disorders such as cardiovascular disease, malignancy, renal, liver, and bone disease has increased. The adjusted relative risk for myocardial infarction is reported to be around 2-fold compared to that of the general population, which over time is likely to translate into increased absolute risk in an aging population. Thus, delineating potentially HIV-specific pathogenetic mechanisms is crucial in order to tailor novel strategies for prophylaxis and treatment. This review will focus on advances in the field that possibly link HIV-induced alterations of the gut mucosa and consequent microbial translocation to cardiometabolic risk factors in HIV infection. Recent work suggests that markers of microbial translocation are closely associated with several cardiovascular risk factors such as dyslipidemia, insulin resistance, hypertension, coagulation abnormalities, endothelial dysfunction, and carotid atherosclerosis. Future studies should investigate whether associations between microbial translocation and cardiovascular risk factors will translate into increased risk of acute events, and whether strategies to target gut microbiota and microbial translocation might reduce such a risk.

  20. IMMUNOLOGIC RESPONSE TO HIV INFECTION: MAIN IMMUNOPATHOLOGICAL ALTERATIONS

    Directory of Open Access Journals (Sweden)

    D. Geraldelli

    2015-02-01

    Full Text Available The intense degradation of defense cells caused by the human immunodeficiency virus (HIV in an organism and the speed at which the viral genome mutates to escape the initial immune response are the prime difficulties in combating opportunistic diseases and in creating an efficient vaccine for this virus. The common opportunistic diseases observed for HIV positive patients include tuberculosis, candidiasis and toxoplasmosis. One of the risk factors is the decrease in CD4+ T-lymphocyte count and the high plasmatic viral load, rendering the organism susceptible to these pathogens. Despite the effectiveness of antiretroviral therapy, this does not provide total elimination of the virus, only eliminating the virus present in the plasma. On treatment withdrawal, the infected latent CD4+ T-cells can re-establish the infection, conferring a large barrier to definitive HIV cure. Current studies have evaluated the inhibition of class I histone diacetylase (HDAC enzymes as a strategy to induce the viral gene expression and, consequently, the gradual emptying of latent reservoirs of the virus, improving the action of antiretroviral therapy. Thus, the monitoring of immune activation and counting of CD4+ T-lymphocytes are of fundamental importance to the prognosis of HIV patients, along with early diagnoses of opportunistic diseases, in order to avoid complications from these diseases.

  1. High prevalence of giardiasis and strongyloidiasis among HIV-infected patients in Bahia, Brazil

    Scientific Electronic Library Online (English)

    Giovana, Feitosa; Antônio C., Bandeira; Diana P., Sampaio; Roberto, Badaró; Carlos, Brites.

    2001-12-01

    Full Text Available Diarrhea due to intestinal microbial infections is a frequent manifestation among HIV-infected patients. It has been postulated that HIV-infected patients may have special types of intestinal infections, and that immune activation from such parasites may affect the progression of HIV disease. To eva [...] luate these associations, the frequency of infections was examined in HIV-infected patients in Bahia, Brazil. To determine the potential impact of the presence of intestinal parasitic infections on HIV disease progression, a retrospective study approach was used. The medical charts of 365 HIV-infected patients who had been treated at the AIDS Clinic of the Federal University of Bahia Hospital were reviewed, and the prevalence of parasites was compared with 5,243 HIV-negative patients who had attended the hospital during the same period of time. Among HIV-infected subjects, CD4 count, RNA plasma viral load (VL), and number of eosinophils were compared according to their stool examination results. The overall prevalence of each parasite was similar for HIV-positive and HIV-negative patients. However, the prevalence of S. stercoralis (p

  2. Activation of HIV Transcription with Short-Course Vorinostat in HIV-Infected Patients on Suppressive Antiretroviral Therapy

    Science.gov (United States)

    Solomon, Ajantha; Ghneim, Khader; Ahlers, Jeffrey; Cameron, Mark J.; Smith, Miranda Z.; Spelman, Tim; McMahon, James; Velayudham, Pushparaj; Brown, Gregor; Roney, Janine; Watson, Jo; Prince, Miles H.; Hoy, Jennifer F.; Chomont, Nicolas; Fromentin, Rémi; Procopio, Francesco A.; Zeidan, Joumana; Palmer, Sarah; Odevall, Lina; Johnstone, Ricky W.; Martin, Ben P.; Sinclair, Elizabeth; Deeks, Steven G.; Hazuda, Daria J.; Cameron, Paul U.; Sékaly, Rafick-Pierre; Lewin, Sharon R.

    2014-01-01

    Human immunodeficiency virus (HIV) persistence in latently infected resting memory CD4+ T-cells is the major barrier to HIV cure. Cellular histone deacetylases (HDACs) are important in maintaining HIV latency and histone deacetylase inhibitors (HDACi) may reverse latency by activating HIV transcription from latently infected CD4+ T-cells. We performed a single arm, open label, proof-of-concept study in which vorinostat, a pan-HDACi, was administered 400 mg orally once daily for 14 days to 20 HIV-infected individuals on suppressive antiretroviral therapy (ART). The primary endpoint was change in cell associated unspliced (CA-US) HIV RNA in total CD4+ T-cells from blood at day 14. The study is registered at ClinicalTrials.gov (NCT01365065). Vorinostat was safe and well tolerated and there were no dose modifications or study drug discontinuations. CA-US HIV RNA in blood increased significantly in 18/20 patients (90%) with a median fold change from baseline to peak value of 7.4 (IQR 3.4, 9.1). CA-US RNA was significantly elevated 8 hours post drug and remained elevated 70 days after last dose. Significant early changes in expression of genes associated with chromatin remodeling and activation of HIV transcription correlated with the magnitude of increased CA-US HIV RNA. There were no statistically significant changes in plasma HIV RNA, concentration of HIV DNA, integrated DNA, inducible virus in CD4+ T-cells or markers of T-cell activation. Vorinostat induced a significant and sustained increase in HIV transcription from latency in the majority of HIV-infected patients. However, additional interventions will be needed to efficiently induce virus production and ultimately eliminate latently infected cells. Trial Registration ClinicalTrials.gov NCT01365065 PMID:25393648

  3. A randomized therapeutic vaccine trial of canarypox-HIV-pulsed dendritic cells vs. canarypox-HIV alone in HIV-1-infected patients on antiretroviral therapy.

    Science.gov (United States)

    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; Schlesinger, Sarah J; Marovich, Mary A; Bhardwaj, Nina; Jacobson, Jeffrey M

    2009-10-01

    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 alone (arm B, n=15). The mean viral load (VL) setpoint during ATI did not differ between subjects in arms A and B. A higher percentage of subjects in the DC group had a VL setpoint control was transient. Subjects in arm A had a greater increase in KLH lymphoproliferative response than subjects in arm B; however, summed ELISPOT responses to HIV-1 antigens did not differ by treatment arm. We conclude that a DC-CP-HIV vaccine is well-tolerated in HIV-1-infected patients, but does not lower VL setpoint during ATI compared with CP-HIV alone. New methods to enhance the immunogenicity and antiviral efficacy of DC-based vaccines for HIV-1 infection are needed. PMID:19450647

  4. Characterization of the OSSN Microbiome in HIV-1 Infected Patients

    Directory of Open Access Journals (Sweden)

    Kenneth O Simbiri

    2012-04-01

    Full Text Available Purpose: Ocular surface squamous neoplasia (OSSN is a rare cancer previously seen in elderly men. In Botswana there is an increase in OSSN and pterygia among young HIV-1 infected patients. Factors that determine the course of this cancer have not been characterized. Recent studies identified HPV, EBV, KSHV, HSV-1/2, and CMV in patient samples. We now characterize the microbiome associated with the disease that may contribute to its course.Results: Pyrosequencing identified viruses, bacteria, fungus and parasites. Analysis of shotgun cloning sequences showed a majority of infectious agents identified by pyrosequencing.Conclusion: HIV patients with OSSN in Botswana are infected with a range of infectious agents which may represent a unique microbiome. The persistent expressions of gene products by these agents some of which are oncogenic are likely to contribute to the oncogenic process and suggest that treatment modalities of the cancer should involve the screening for endemic agents.

  5. Morphological features of adenohypophysis stillborn from HIV-infected mothers

    Directory of Open Access Journals (Sweden)

    Sherstiuk S.A.

    2012-01-01

    Full Text Available Adenohypophysis stillborn from HIV-infected mothers had a high functional stress for long periods of fetal devel-opment, leading to inhibition of its functional state, as evidenced by the decrease in the diameter of cells, reducing their se-cretory granules, and increased nuclear-cytoplasmic index. In the antenatal period of development in the adenohypophysis of stillbirths from HIV-infected mothers apparently failed embryo genesis, which appeared violation of a population growth of acidophilic cells. Inhibition of functional activ ity of the entire population of cells of the adenohypophysis indicate a failure of compensatory possibilities of the body, which in future may be the cause of severe endocrinopathies.

  6. Neuroradiological findings in perinatally HIV-infected children

    International Nuclear Information System (INIS)

    The neuroradiological studies (CT, MRI, angiography) in 21 children with perinatal HIV infection were reviewed retrospectively. No patient showed an intracranial mass lesion; after intravenous contrast medium application there was no case with disturbed blood-brain barrier. Common non-specific findings were atrophy and delayed myelination. In 7 cases atrophy was combined with multifocal nearly symmetric white matter lesions, which characteristically spared the U-fibres. Further findings included an intramedullary ring-shaped structure in the cervical cord, an AIDS-associated vasculopathy and symmetric calcifications in the basal ganglia. The spectrum of neuroradiological findings in paediatric AIDS patients differs from that in adults. Knowledge of these age-specific findings is important because the number of HIV-infected children is rising. (orig.)

  7. A Comparative Analysis of Intestinal Parasitic Infections between HIV+/AIDS Patients and Non-HIV Infected Individuals

    Directory of Open Access Journals (Sweden)

    EB Kia

    2007-04-01

    Full Text Available Background: The aim of this study was to verify the occurrence of intestinal parasitic infections in human immunodeficiency virus (HIV/acquired immunodeficiency syndrome (AIDS patients in Iran in comparison with non-HIV individuals. Methods: A total of HIV+/AIDS patients (Group I and 1220 clinically healthy individuals (Group II were submitted to coproparasitological examination from 2003 to 2005. Results: The overall prevalence of intestinal parasites in group I and group II was 11.4% and 11.6%, respectively, without significant difference between two groups. The prevalence of infection for each helminth and pathogenic protozoan, in every group, was as follows: Group I: Blastocystis hominis (6.1%; Giardia lamblia (4.2%; Cryptosporidium spp. (0.9%; Isospora belli (0.26%; Strongyloides stercoralis (0.26%; Hymenolepis nana (0.13%; and Rhabditis axei (0.13%. Group II: Blastocystis hominis (6.5%; Giardia lamblia (4.1%; Strongyloides stercoralis (0.33%; Hymenolepis nana (0.16%; and Trichostrongylus sp. (0.16%. Although the prevalence of infection for extracellular parasites was not statistically different between two groups, however, the infection rates for enteric coccidians including Cryptosporidium spp. and I. belli were significantly higher in patients at AIDS stage than Group II. Conclusion: The results emphasize the needs for especial consideration of enteropathogenic intracellular coccidians in immunocompromised patients.

  8. Role of atazanavir in the treatment of HIV infection

    OpenAIRE

    Pablo Rivas; Judit Morello; Carolina Garrido; Sonia Rodríguez-Nóvoa; Vincent Soriano

    2008-01-01

    Pablo Rivas1, Judit Morello2, Carolina Garrido1, Sonia Rodríguez-Nóvoa2, Vincent Soriano11Department of Infectious Diseases; 2Pharmacology Unit, Hospital Carlos III, Madrid, SpainAbstract: Atazanavir (ATV) is one of the latest protease inhibitors (PI) approved for the treatment of HIV infection. The drug has a relatively long-life (?7 h) and large inhibitory quotient which allows once daily administration. It is generally well tolerated and the main side effect i...

  9. T-cell receptor (TCR) usage in HIV-2 infection

    OpenAIRE

    Moysi, Eirini; Rowland-Jones, Sarah Louise; DONG, TAO; Stewart-Jones, Guillaume

    2012-01-01

    Long-term non-progressors (LTPNs) in HIV infection target the structural protein Gag more frequently than individuals who progress to disease. However, the targeting of Gag per se does not always distinguish these two groups. Various factors have been put forth as likely explanations for this discrepancy including differences in the breadth and magnitude of observed responses, the HLA type of the host, the nature of the individual epitopes targeted and the ability of the virus to mutate these...

  10. Vaginal Cleansing Practices in HIV Infected Zambian Women

    OpenAIRE

    Alcaide, Maria L.; Mumbi, Miriam; Chitalu, Ndashi; JONES, DEBORAH

    2013-01-01

    Vaginal practices are a variety of behavioral techniques that women use to manage their sexual life and personal hygiene. Women perceive vaginal practices as a beneficial practice. However, vaginal cleansing has been identified as one of the main risk factors for bacterial vaginosis and is potentially implicated in Human Immune Deficiency Virus (HIV) and sexually transmitted infection transmission. This study examined the prevalence of vaginal practices and the types of practices used among a...

  11. Profile of hematological abnormalities of Indian HIV infected individuals

    Directory of Open Access Journals (Sweden)

    Sharma Aman

    2009-08-01

    Full Text Available Abstract Background Hematological abnormalities are a common complication of HIV infection. These abnormalities increase as the disease advances. Bone marrow abnormalities occur in all stages of HIV infection. Methods Two hundred HIV infected individual were screened for hematological abnormalities from March 2007–March 2008. Absolute CD4 cell count analysis was carried out by flowcytometry. Depending on the results of the primary screening further investigations were performed, like iron studies, hemolytic work up, PNH work up and bone marrow evaluation. Other investigations included coagulation profile, urine analysis, blood culture (bacterial, fungal, mycobacterial, serology for Epstein Barr virus (EBV, Cytomegalovirus (CMV, Hepatitis B and C, and Parvo B19 infection. Results The most common hematological abnormality was anemia, seen in 65.5% (131/200 patients. Iron deficiency anemia was seen in 49.2% (/200 cases while anemia of chronic disease occurred in 50.7% (/200 cases. Bone marrow evaluation was carried out in 14 patients out of which staging marrow was performed in 2 cases of non-Hodgkin's lymphoma (NHL and did not show any bone marrow infiltration. In remaining12 cases bone marrow was done for evaluation of pancytopenia. Among patients with pancytopenia 50% (6/12 showed granulomas (4 were positive for AFB, 2 were positive for fungal cryptococci, 25% (3/12 showed hemophagocytosis. There was a strong negative correlation between anemia and CD4 counts in this study. Thrombocytopenia was seen in 7% (14/200 cases and had no significant correlation with CD4 counts. No patient had absolute neutrophil count (ANC Conclusion Anemia in HIV patients can be a good clinical indicator to predict and access the underlying immune status. Patients should be investigated for hematological manifestations and appropriate steps should be taken to identify and treat the reversible factors.

  12. Inflammation, coagulation and cardiovascular disease in HIV-infected individuals

    OpenAIRE

    Duprez, Daniel A.; Neuhaus, Jacqueline; Kuller, Lewis H.; Tracy, Russell; Belloso, Waldo; Wit, Stephane; Drummond, Fraser; Lane, H. Clifford; Ledergerber, Bruno; Lundgren, Jens; Nixon, Daniel; Paton, Nicholas I.; Prineas, Ronald J.; Neaton, James D.

    2012-01-01

    BACKGROUND: The SMART study was a trial of intermittent use of antiretroviral therapy (ART) (drug conservation [DC]) versus continuous use of ART (viral suppression [VS]) as a strategy to reduce toxicities, including cardiovascular disease (CVD) risk. We studied the predictive value of high sensitivity C-reactive protein (hsCRP), interleukin-6 (IL-6) and D-dimer with CVD morbidity and mortality in HIV-infected patients who were enrolled in SMART beyond other measured CVD risk factors. METHODS...

  13. Latent Toxoplasma gondii Infection and Associated Risk Factors among HIV-Infected Individuals at Arba Minch Hospital, South Ethiopia

    OpenAIRE

    Tsegaye Yohanes; Serkadis Debalke; Endalew Zemene

    2014-01-01

    Toxoplasmosis is a parasitic disease caused by Toxoplasma gondii (T. gondii). The parasite has cosmopolitan distribution, infecting almost all species of warm-blooded animals. Latent T. gondii infection in HIV/AIDS patients is a risk for development of cerebral toxoplasmosis (CT). The aim of this study is to determine seroprevalence of latent T. gondii infection and assess its associated factors among individuals infected with HIV in Arba Minch Hospital, south Ethiopia. A facility-based cross...

  14. An integrated structural intervention to reduce vulnerability to HIV and sexually transmitted infections among female sex workers in Karnataka state, south India

    Directory of Open Access Journals (Sweden)

    Isac Shajy

    2011-10-01

    Full Text Available Abstract Background Structural factors are known to affect individual risk and vulnerability to HIV. In the context of an HIV prevention programme for over 60,000 female sex workers (FSWs in south India, we developed structural interventions involving policy makers, secondary stakeholders (police, government officials, lawyers, media and primary stakeholders (FSWs themselves. The purpose of the interventions was to address context-specific factors (social inequity, violence and harassment, and stigma and discrimination contributing to HIV vulnerability. We advocated with government authorities for HIV/AIDS as an economic, social and developmental issue, and solicited political leadership to embed HIV/AIDS issues throughout governmental programmes. We mobilised FSWs and appraised them of their legal rights, and worked with FSWs and people with HIV/AIDS to implement sensitization and awareness training for more than 175 government officials, 13,500 police and 950 journalists. Methods Standardised, routine programme monitoring indicators on service provision, service uptake, and community activities were collected monthly from 18 districts in Karnataka between 2007 and 2009. Daily tracking of news articles concerning HIV/AIDS and FSWs was undertaken manually in selected districts between 2005 and 2008. Results The HIV prevention programme is now operating at scale, with over 60,000 FSWs regularly contacted by peer educators, and over 17,000 FSWs accessing project services for sexually transmitted infections monthly. FSW membership in community-based organisations has increased from 8,000 to 37,000, and over 46,000 FSWs have now been referred for government-sponsored social entitlements. FSWs were supported to redress > 90% of the 4,600 reported incidents of violence and harassment reported between 2007-2009, and monitoring of news stories has shown a 50% increase in the number of positive media reports on HIV/AIDS and FSWs. Conclusions Stigma, discrimination, violence, harassment and social equity issues are critical concerns of FSWs. This report demonstrates that it is possible to address these broader structural factors as part of large-scale HIV prevention programming. Although assessing the impact of the various components of a structural intervention on reducing HIV vulnerability is difficult, addressing the broader structural factors contributing to FSW vulnerability is critical to enable these vulnerable women to become sufficiently empowered to adopt the safer sexual behaviours which are required to respond effectively to the HIV epidemic.

  15. Uptake to HIV Post-Exposure Prophylaxis in Haiti: Opportunities to Align Sexual Violence, HIV PEP and Mental Health

    Science.gov (United States)

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

    2015-01-01

    Problem Sexual violence is a public health problem in Haiti, potentially augmenting HIV transmission. Reports from L’Hôpital de l’Université d’État d’Haiti (HUEH) suggest severe underutilization of antiretroviral post-exposure prophylaxis (ARV-PEP) amongst rape survivors. Method of Study Cross-sectional design using mixed methods. Informational-interviews were conducted with HUEH personnel to learn about post-rape service offerings. HUEH surveillance data was used to estimate the sexual assault reporting rate/100,000; and to examine the proportion of survivors receiving ARV-PEP within 72 hours, stratified by age (health services. Surveillance data show that 2,193 sexual assault survivors (adult and pediatric) reported a rape to HUEH personnel between 2004 through first quarter 2010. Annual estimates suggest a 2-fold increase comparing cases in 2004 versus 2009. Between 2008–2009, uptake to ARV-PEP within 72-hours was lower for pediatric (38.4%; N=131/341) compared to adult survivors (60.1%; N=83/138) (?2 = 18.8, p health are crucial to support the timely uptake to ARV-PEP. PMID:23278979

  16. Broad and Potent Neutralizing Antibody Responses Elicited in Natural HIV-2 Infection

    OpenAIRE

    Rui KONG; Li, Hui; Bibollet-Ruche, Frederic; Decker, Julie M.; Zheng, Natalie N.; Gottlieb, Geoffrey S.; KIVIAT, Nancy B.; Sow, Papa Salif; Georgiev, Ivelin; Hahn, Beatrice H.; Kwong, Peter D.; Robinson, James E; Shaw, George M.

    2012-01-01

    Compared with human immunodeficiency virus type 1 (HIV-1), little is known about the susceptibility of HIV-2 to antibody neutralization. We characterized the potency and breadth of neutralizing antibody (NAb) responses in 64 subjects chronically infected with HIV-2 against three primary HIV-2 strains: HIV-27312A, HIV-2ST, and HIV-2UC1. Surprisingly, we observed in a single-cycle JC53bl-13/TZM-bl virus entry assay median reciprocal 50% inhibitory concentration (IC50) NAb titers of 1.7 × 105, ...

  17. Sero-prevalence of latent Toxoplasma gondii infection among HIV-infected and HIV-uninfected people in Addis Ababa, Ethiopia: A comparative cross-sectional study

    OpenAIRE

    Tegbaru Belete; Tadesse Endale; Tebeje Mekashaw; Shimelis Techalew; Terefe Ashenafi

    2009-01-01

    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 ...

  18. Gender context of sexual violence and HIV sexual risk behaviors among married women in Iringa Region, Tanzania

    Directory of Open Access Journals (Sweden)

    Tumaini M. Nyamhanga

    2014-12-01

    Full Text Available 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.

  19. Neuroendocrine Abnormalities in Drug Abusers and HIV-Infected Individuals: Cortisol Response to Cold Pressor Challenge

    OpenAIRE

    Mahendra Kumar; Drenna Waldrop-Valverde; Adarsh M. Kumar; J. B. Fernandez; Louis Gonzalez; Ownby, Raymond L

    2006-01-01

    Although endocrine abnormalities have been reported in HIV-1 infection, the role of risk factors is not understood. Injecting drug use (IDU) is an important risk factor for contracting HIV-infection and studies suggest that substance use may also be associated with endocrine dysfunction. In order to investigate hypothalamic pituitary adrenal (HPA) axis activity in this population, this study investigated cortisol response to the cold pressor challenge in IDUs with and without HIV infection. A...

  20. Management of chronic diarrhea in HIV-infected patients: current treatment options, challenges and future directions

    OpenAIRE

    Lidia Elfstrand; Claes-Henrik Florén

    2010-01-01

    Lidia Elfstrand, Claes-Henrik FlorénDepartment of Medicine, Division of Clinical Sciences, Skåne University Hospital, Lund University, Lund, SwedenAbstract: Diarrhea is a common clinical manifestation of HIV infection regardless of whether the patients have AIDS. HIV and malnutrition tend to occur in the same populations, the underprivileged and resource-poor. Malnutrition increases severity and mortality of infection. Occurrence of chronic diarrhea in HIV-infected patien...

  1. Workshop on HIV Infection and Aging: What Is Known and Future Research Directions

    OpenAIRE

    Effros, Rita B; Fletcher, Courtney V.; Gebo, Kelly; Jeffrey B. Halter; Hazzard, william R.; Horne, Frances McFarland; Huebner, Robin E.; Janoff, Edward N.; Justice, Amy C.; Kuritzkes, Daniel; Nayfield, Susan G.; Plaeger, Susan F.; Schmader, Kenneth E.; Ashworth, John R.; Campanelli, Christine

    2008-01-01

    Highly active antiretroviral treatment has resulted in dramatically increased life expectancy among patients with HIV infection who are now aging while receiving treatment and are at risk of developing chronic diseases associated with advanced age. Similarities between aging and the courses of human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome suggest that HIV infection compresses the aging process, perhaps accelerating comorbidities and frailty. In a workshop...

  2. HIV Infection in the Etiology of Lung Cancer: Confounding, Causality, and Consequences

    OpenAIRE

    Kirk, Gregory D; MERLO, Christian A.

    2011-01-01

    Persons infected with HIV have an elevated risk of lung cancer, but whether the increase simply reflects a higher smoking prevalence continues to be debated. This review summarizes existing data on the association of HIV infection and lung cancer, with particular attention to study design and adjustment for cigarette smoking. Potential mechanisms by which HIV infection may lead to lung cancer are discussed. Finally, irrespective of causality and mechanisms, lung cancer represents an important...

  3. Immunosuppression and mycobacteria other than Mycobacterium tuberculosis: results from patients with and without HIV infection.

    OpenAIRE

    Peters, M.; Schu?rmann, D.; Mayr, A. C.; Heterzer, R.; Pohle, H. D.; Ruf, B.

    1989-01-01

    Infections caused by mycobacteria other than Mycobacterium tuberculosis (MOTT) have often been described as common in AIDS patients. To evaluate whether infections with MOTT are specific for HIV related immunosuppression or are also frequent in patients with immunosuppression of different aetiology, data on the frequency of isolation from immunosuppressed patients with HIV infection are important. Blood, stool and urine specimens from 134 patients with non-HIV related immunosuppression, and f...

  4. A stable latent reservoir for HIV-1 in resting CD4+ T lymphocytes in infected children

    OpenAIRE

    Persaud, Deborah; Pierson, Theodore; Ruff, Christian; Finzi, Diana; Chadwick, Karen R.; Margolick, Joseph B.; Ruff, Andrea; Hutton, Nancy; Ray, Stuart; Siliciano, Robert F.

    2000-01-01

    HIV-1 persists in a latent state in resting CD4+ T lymphocytes of infected adults despite prolonged highly active antiretroviral therapy (HAART). To determine whether a latent reservoir for HIV-1 exists in infected children, we performed a quantitative viral culture assay on highly purified resting CD4+ T cells from 21 children with perinatally acquired infection. Replication-competent HIV-1 was recovered from all 18 children from whom sufficient cells were obtained. The frequency of latently...

  5. Clinical Prediction and Diagnosis of Neurosyphilis in HIV-Infected Patients with Early Syphilis

    OpenAIRE

    Dumaresq, Jeannot; Langevin, Stéphanie; Gagnon, Simon; Serhir, Bouchra; Deligne, Benoît; Tremblay, Cécile; Tsang, Raymond S. W.; Fortin, Claude; Coutlée, François; Roger, Michel

    2013-01-01

    The diagnosis of neurosyphilis (NS) is a challenge, especially in HIV-infected patients, and the criteria for deciding when to perform a lumbar puncture (LP) in HIV-infected patients with syphilis are controversial. We retrospectively reviewed demographic, clinical, and laboratory data from 122 cases of HIV-infected patients with documented early syphilis who underwent an LP to rule out NS, and we evaluated 3 laboratory-developed validated real-time PCR assays, the Treponema pallidum particle...

  6. Paediatric HIV infection in Maputo, Mozambique : Horizontal transmission, treatment outcomes and drug resistance

    OpenAIRE

    Vaz, Paula

    2010-01-01

    This thesis describes observational studies performed at the main reference centre for paediatric HIV care and management in Mozambique, which is one of the countries most strongly affected by the AIDS pandemic. These studies focused on horizontal transmission, treatment outcomes and paediatric antiretroviral drug resistance in a cohort of HIV-1-infected children. The majority of children infected by HIV get the infection from their mothers during pregnancy, delivery or ...

  7. Chronic plasma cell endometritis in hysterectomy specimens of HIV-infected women: a retrospective analysis.

    OpenAIRE

    Kerr-layton, J. A.; Stamm, C. A.; Peterson, L. S.; Mcgregor, J. A.

    1998-01-01

    OBJECTIVE: Abnormal uterine bleeding is a common and troublesome problem in human immunodeficiency virus (HIV)-infected women. We sought to evaluate endometrial pathology among HIV-infected women requiring hysterectomy to explore if endometritis may be common among these patients. METHODS: We performed a retrospective analysis of uterine pathology specimens obtained from HIV-infected and control patients requiring hysterectomy in two urban hospitals between 1988 and 1997 matched for age, surg...

  8. Strategies for early detection of renal injury in HIV-infected patients : the new troponin

    OpenAIRE

    Brilha, Sara Sofia dos Santos, 1985-

    2011-01-01

    Background: HIV-infected patients have a known increased risk of kidney disease. For that reason, a biomarker that enables reliable detection of early and mild kidney dysfunction would be advantageous. Cystatin C is considered to be a better marker of kidney function than creatinine. Objectives: This study aimed to evaluate if serum cystatin C was a better marker than creatinine in a HIV-infected population. Material and Methods: This was an observational study of HIV-infected patients ...

  9. Physical and sexual violence, childhood sexual abuse and HIV/STI risk behaviour among alcohol-using women engaged in sex work in Mongolia.

    Science.gov (United States)

    Parcesepe, Angela M; Toivgoo, Aira; Chang, Mingway; Riedel, Marion; Carlson, Catherine; DiBennardo, Rebecca; Witte, Susan S

    2015-01-01

    Although the prevalence of human immunodeficiency virus (HIV) in Mongolia is low, it could increase without strategic prevention strategies. Female sex workers (FSWs) often experience barriers to prevention, including interpersonal violence. This study investigated if childhood sexual abuse (CSA) or recent physical or sexual violence was associated with HIV sexual risk behaviours and if CSA modified associations between recent violence and HIV sexual risk behaviours. Two-hundred twenty-two women who (1) were at least 18 years old and clients at the National AIDS Foundation; (2) reported vaginal or anal sex in the past 90 days in exchange for money or goods and (3) met criteria for harmful alcohol use in the past year were enrolled. In-person interviews assessed sexual risk behaviours and violence in childhood and adulthood. Negative binomial regression, ordinary least squares regression and modified Poisson regression were performed. Sexual risk with paying partners was associated with penetrative CSA and sexual violence by paying partners. CSA and recent violence were not associated with sexual risk behaviours with intimate partners. CSA modified the association between recent sexual violence and unprotected sex with intimate partners. Findings highlight the need for integrated violence and sexual risk reduction services to ensure safe and effective prevention for FSWs. PMID:25383593

  10. Neuroendocrine Abnormalities in Drug Abusers and HIV-Infected Individuals: Cortisol Response to Cold Pressor Challenge

    Directory of Open Access Journals (Sweden)

    Mahendra Kumar

    2006-01-01

    Full Text Available Although endocrine abnormalities have been reported in HIV-1 infection, the role of risk factors is not understood. Injecting drug use (IDU is an important risk factor for contracting HIV-infection and studies suggest that substance use may also be associated with endocrine dysfunction. In order to investigate hypothalamic pituitary adrenal (HPA axis activity in this population, this study investigated cortisol response to the cold pressor challenge in IDUs with and without HIV infection. After controlling for the effects of gender, duration of marijuana use and time since the last use of heroin, the findings show that the pattern of cortisol response depended upon HIV serostatus. Cortisol levels peaked later in HIV+ IDUs and recovered at a slower rate than HIV negative IDUs. These findings support our hypothesis that dysregulation in HPA axis activity occurs in HIV infected IDUs.

  11. Outcome of HIV-infected patients transferred to a specialist inpatient unit.

    Science.gov (United States)

    Whitehorn, J; Edwards, S G; Cartledge, J D; Miller, R F

    2011-04-01

    The British HIV Association (BHIVA) recommends that specialist clinical networks are involved in care of HIV-positive patients admitted to district general hospitals (DGHs) and that transfer to a specialist HIV treatment centre is considered for each patient. We audited our experience of 29 patients transferred to our specialist inpatient unit over a two year period. Fifteen (52%) patients were known to be HIV-infected before admission to the referring hospital. Ten (71%) of 14 patients with newly diagnosed HIV had an opportunistic infection at transfer. At the referring hospital the time taken to diagnose HIV infection ranged from one to 26 days (median = 3.5). Only five patients (17%) were transferred by 72 hours of admission to the referring hospital. The duration of stay at our centre was 1-212 days (median = 15): seven patients (24%) required admission to the intensive care unit. Seven patients died; of these, three had newly diagnosed HIV infection. This audit demonstrates that sick HIV-infected patients transferred to a specialist HIV unit had a poor outcome and lengthy hospital admissions. Our audit supports roll-out of HIV testing to avoid adverse outcomes associated with late diagnosis and development of clinical networks involving specialist HIV treatment centres in order to support provision of HIV care in DGHs. PMID:21515756

  12. CD3+CD8+CD161high Tc17 cells are depleted in HIV-infection

    DEFF Research Database (Denmark)

    Gaardbo, Julie Christine; Hartling, Hans Jakob

    2012-01-01

    CD8+ Tc17 cells with pro-inflammatory properties have only recently been acknowledged, and Tc17 cells in HIV-infection are undescribed. CD3+CD8+CD161 Tc17 cells and the production of Interleukin-17 were examined in untreated and treated HIV-infected patients, HIV-HCV co-infected patients and healthy controls. Depletion of CD3+CD8+CD161 Tc17 cells and diminished production of Interleukin-17 in HIV-infected patients was found. The level of Tc17 cells was associated with the level of the CD4+ count in treated patients.

  13. Conserved epitopes on HIV-1, FIV and SIV p24 proteins are recognized by HIV-1 infected subjects.

    Science.gov (United States)

    Roff, Shannon R; Sanou, Missa P; Rathore, Mobeen H; Levy, Jay A; Yamamoto, Janet K

    2015-06-01

    Cross-reactive peptides on HIV-1 and FIV p24 protein sequences were studied using peripheral blood mononuclear cells (PBMC) from untreated HIV-1-infected long-term survivors (LTS; >10 y of infection without antiretroviral therapy, ART), short-term HIV-1 infected subjects not on ART, and ART-treated HIV-1 infected subjects. IFN?-ELISpot and CFSE-proliferation analyses were performed with PBMC using overlapping HIV-1 and FIV p24 peptides. Over half of the HIV-1 infected subjects tested (22/31 or 71%) responded to one or more FIV p24 peptide pools by either IFN? or T-cell proliferation analysis. PBMC and T cells from infected subjects in all 3 HIV(+) groups predominantly recognized one FIV p24 peptide pool (Fp14) by IFN? production and one additional FIV p24 peptide pool (Fp9) by T-cell proliferation analysis. Furthermore, evaluation of overlapping SIV p24 peptide sequences identified conserved epitope(s) on the Fp14/Hp15-counterpart of SIV, Sp14, but none on Fp9-counterpart of SIV, Sp9. The responses to these FIV peptide pools were highly reproducible and persisted throughout 2-4 y of monitoring. Intracellular staining analysis for cytotoxins and phenotyping for CD107a determined that peptide epitopes from Fp9 and Fp14 pools induced cytotoxic T lymphocyte-associated molecules including perforin, granzyme B, granzyme A, and/or expression of CD107a. Selected FIV and corresponding SIV epitopes recognized by HIV-1 infected patients indicate that these protein sequences are evolutionarily conserved on both SIV and HIV-1 (e.g., Hp15:Fp14:Sp14). These studies demonstrate that comparative immunogenicity analysis of HIV-1, FIV, and SIV can identify evolutionarily-conserved T cell-associated lentiviral epitopes, which could be used as a vaccine for prophylaxis or immunotherapy. PMID:25844718

  14. Cutaneous histoplasmosis disclosing an HIV-infection / Histoplasmose cutanea reveladora de infeccao pelo HIV

    Scientific Electronic Library Online (English)

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

    2013-06-01

    Full Text Available Histoplasmose é infecção sistêmica endêmica em extensas áreas do continente Americano. Os autores relatam caso de paciente do sexo masculino, de zona urbana com lesões cutâneas e mucosas incomuns de histoplasmose. Investigação adicional posterior revelou [...] infecção subjacente pelo HIV com contagem de células CD4 de 7/mm3. O tratamento foi realizado com anfotericina B, dose total de 2065 mg, seguido por itraconazol 200 mg/dia associado à terapêutica antirretroviral com cura aparente do quadro. Histoplasmose é enfermidade oportunística definidora da síndrome de imunodeficiência adquirida, portanto, diagnóstico clinico de histoplasmose implica em investigação laboratorial de infecção subjacente pelo HIV. Abstract in english Histoplasmosis is a systemic mycosis endemic in extensive areas of the Americas. The authors report on an urban adult male patient with uncommon oral-cutaneous lesions proven to be histoplasmosis. Additional investigation revealed unnoticed HIV infection [...] with CD4+ cell count of 7/mm3. The treatment was performed with amphotericin B, a 2065 mg total dose followed by itraconazole 200mg/daily plus antiretroviral therapy with apparent cure. Histoplasmosis is an AIDS-defining opportunistic disease process; therefore, its clinical diagnosis must drive full laboratory investigation looking for unnoted HIV-infection.

  15. Cutaneous histoplasmosis disclosing an HIV-infection Histoplasmose cutânea reveladora de infecção pelo HIV

    Directory of Open Access Journals (Sweden)

    Silvio Alencar Marques

    2013-06-01

    Full Text Available Histoplasmosis is a systemic mycosis endemic in extensive areas of the Americas. The authors report on an urban adult male patient with uncommon oral-cutaneous lesions proven to be histoplasmosis. Additional investigation revealed unnoticed HIV infection with CD4+ cell count of 7/mm3. The treatment was performed with amphotericin B, a 2065 mg total dose followed by itraconazole 200mg/daily plus antiretroviral therapy with apparent cure. Histoplasmosis is an AIDS-defining opportunistic disease process; therefore, its clinical diagnosis must drive full laboratory investigation looking for unnoted HIV-infection.Histoplasmose é infecção sistêmica endêmica em extensas áreas do continente Americano. Os autores relatam caso de paciente do sexo masculino, de zona urbana com lesões cutâneas e mucosas incomuns de histoplasmose. Investigação adicional posterior revelou infecção subjacente pelo HIV com contagem de células CD4 de 7/mm3. O tratamento foi realizado com anfotericina B, dose total de 2065 mg, seguido por itraconazol 200 mg/dia associado à terapêutica antirretroviral com cura aparente do quadro. Histoplasmose é enfermidade oportunística definidora da síndrome de imunodeficiência adquirida, portanto, diagnóstico clinico de histoplasmose implica em investigação laboratorial de infecção subjacente pelo HIV.

  16. Nutrition Rehabilitation of the HIV-Infected and Negative Undernourished Children Utilizing Spiruline

    Directory of Open Access Journals (Sweden)

    Jacques Simpore

    2005-01-01

    Full Text Available The objective of the study was to assess the impact of an alimentary integrator composed by Spiruline (Spirulina platensis, produced at the Centre Medical St Camille (CMSC of Ouagadougou, Burkina Faso, on the nutritional status of undernourished HIV-infected and HIV negative children. We compared two groups of children: 84 children HIV-infected and 86 HIV-negative. The duration of this study was eight weeks. Anthropometrics and haematological parameters allowed us to appreciate both the nutritional and biological effects of Spiruline supplement to traditional meals. The rehabilitation with Spiruline shows on average a weight gain of 15 and 25 g/day in HIV-infected and in HIV negative children, respectively. The level of anaemia decreased during the study in all the children, but the recuperation was less efficient among the HIV-infected children, in fact, 81.8% of HIV negative undernourished children recuperated against 63.6% of HIV-infected children [Z: 1.70 (95% CI: -0.366, -0.002, p=0.088]. Present results allow to confirm that Spiruline is a good food supplement for undernourished children. In particular the rehabilitation by Spiruline seems to correct the anaemia and the weight loss also in HIV-infected, but more quickly in HIV negative undernourished children.

  17. Oxidative Imbalance in HIV-1 Infected Patients Treated with Antiretroviral Therapy

    Directory of Open Access Journals (Sweden)

    Antonella Mandas

    2009-01-01

    Full Text Available It is generally accepted that oxidative stress is involved in HIV infection. However, the role in oxidative balance of Highly Active Antiretroviral Therapy (HAART is still debated. In our study we assessed serum oxidant and antioxidant levels in an HIV-1-infected population treated with HAART, and compared them with those of untreated HIV-1 patients and HIV-1-negative subjects. The study included 116 HIV-1-infected patients (86 HAART-treated and 30 untreated, and 46 HIV-negative controls. Serum oxidant levels were significantly higher in the HIV-1 treated group as compared to untreated and control groups. In addition, a decrease of serum total antioxidant status was observed in the HIV-1 treated group. To be noted is that patients who rigorously follow antiretroviral therapy (optimal HAART adherence have significantly higher oxidative status than those who do not closely follow the therapy (poor HAART adherence. Analysis of variance revealed no significant further increase in oxidative status in HIV-1-infected patients taking antiretroviral and other drugs with the exception of psychiatric drugs (e.g. anxiolytics or antidepressants. Taken together, our results indicate that HAART may affect oxidative stress in HIV-1-infected patients and suggest that antiretroviral therapy plays an important role in the synergy of HIV infection and oxidative stress.

  18. Exercise and Human Immunodeficiency Virus (HIV-1) Infection

    Science.gov (United States)

    Lawless, DeSales; Jackson, Catherine G. R.; Greenleaf, John E.

    1995-01-01

    The human immune system is highly efficient and remarkably protective when functioning properly. Similar to other physiological systems, it functions best when the body is maintained with a balanced diet, sufficient rest and a moderately stress-free lifestyle. It can be disrupted by inappropriate drug use and extreme emotion or exertion. The functioning of normal or compromised immune systems can be enhanced by properly prescribed moderate exercise conditioning regimens in healthy people, and in some human immunodeficiency virus (HIV-1)-infected patients but not in others who unable to complete an interval training program. Regular exercise conditioning in healthy people reduces cardiovascular risk factors, increases stamina, facilitates bodyweight control, and reduces stress by engendering positive feelings of well-being. Certain types of cancer may also be suppressed by appropriate exercise conditioning. Various exercise regimens are being evaluated as adjunct treatments for medicated patients with the HIV-1 syndrome. Limited anecdotal evidence from patients suggests that moderate exercise conditioning is per se responsible for their survival well beyond expectancy. HIV-1-infected patients respond positively, both physiologically and psychologically, to moderate exercise conditioning. However, the effectiveness of any exercise treatment programme depends on its mode, frequency, intensity and duration when prescribed o complement the pathological condition of the patient. The effectiveness of exercise conditioning regimens in patients with HIV-1 infection is reviewed in this article. In addition, we discuss mechanisms and pathways, involving the interplay of psychological and physiological factors, through which the suppressed immune system can be enhanced. The immune modulators discussed are endogenous opioids, cytokines, neurotransmitters and other hormones. Exercise conditioning treatment appears to be more effective when combined with other stress management procedures.

  19. Prevalence of sexually transmitted infections among HIV-infected women in Brazil

    Scientific Electronic Library Online (English)

    Ana Gabriela Álvares, Travassos; Carlos, Brites; Eduardo M., Netto; Sheyla de Almeida, Fernandes; George W., Rutherford; Conceição Maria, Queiroz.

    2012-12-01

    Full Text Available This study aimed to evaluate the prevalence of sexually transmitted infections (STIs) and associated risk factors in HIV-infected pregnant women followed for prenatal care in Salvador, Bahia. This was a cross-sectional study of 63 women seeking prenatal care at a reference center. Participants were [...] interviewed regarding socio-epidemiological and clinical history, and were tested for HBsAg, anti-HCV, anti HTLV I/II, VDRL, Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma hominis, Ureaplasma urealyticum, CD4 count, and HIV plasma viral load. The main outcome variable was the presence of any STI. The mean age of patients was 28.2 years (16-40 years). 23 (36.5%) were diagnosed with at least one STI. The frequency of diagnoses was: HBV, 3.2%; HCV, 8.1%; HTLV I/II, 3.4%; syphilis, 9.5%; Chlamydia trachomatis, 11.1%; HPV, 15.0%; Mycoplasma hominis, 2.1%, and Ureaplasma urealyticum, 2.1%. No case of Neisseria gonorrhoeae was identified. No association was found between socio-epidemiological variables and the presence of an STI. CD4 T lymphocyte 1,000 copies (p = 0.027) were associated with the presence of sti. stis are frequent in pregnant women infected with hiv, and all hiv-infected pregnant women should be screened to decrease transmission of these pathogens and to protect their own health.

  20. HIV infection, bone metabolism, and fractures / Infecção pelo HIV, o metabolismo ósseo e fraturas

    Scientific Electronic Library Online (English)

    Robert, Güerri-Fernández; Judit, Villar-García; Adolfo, Díez-Pérez; Daniel, Prieto-Alhambra.

    2014-07-01

    Full Text Available Com o advento da terapia antirretroviral, houve uma melhora considerável na sobrevida dos indivíduos portadores do vírus HIV. Dessa forma, as alterações ósseas referentes ao HIV se tornaram um fator importante no cuidado desses indivíduos. O HIV altera o remodelamento ósseo causando fragilidade ósse [...] a. As alterações causadas por esse vírus nos linfócitos T afetam a produção de RANKL e de citocinas pró-inflamatórias levando à osteoclastogênese. Ademais, a terapia antirretroviral também pode afetar negativamente o metabolismo ósseo. Vários estudos descrevem aumento da incidência de fraturas nesses indivíduos quando comparados a controles sem a doença. Diretrizes da Sociedade Europeia de SIDA (EACS) têm orientado o manejo da osteoporose nesses sujeitos, enfatizando a identificação de pacientes com baixa massa óssea. A suplementação de cálcio e vitamina D e o uso de alendronato nesses indivíduos devem ser recomendados caso a caso. Abstract in english With the advent of high active antiretroviral therapy there was a significant improvement on HIV subjects survival. Thus, bone changes related to HIV became an important aspect of these individuals. HIV affects bone remodeling causing bone fragility. In addition, antiretroviral therapy may also nega [...] tively affect bone metabolism. Several studies describe an increased incidence of fractures in these patients when compared with controls without the disease. The European Society of AIDS (EACS), and other societies, have included guidance on management of osteoporosis in HIV-infected patients emphasizing the identification of patients with low bone mass. Supplementation of calcium and vitamin D and the use of alendronate in these individuals should be recommended on a case base.

  1. Carga viral vaginal de HIV em mulheres brasileiras infectadas pelo HIV / HIV vaginal viral load in Brazilian HIV-infected women

    Scientific Electronic Library Online (English)

    Angela, Campos; Eliana, Amaral; José Eduardo, Levi; Priscila, Portugal; Marina, Villarroel; Karina C., Bezerra; Marcos T. Nolasco da, Silva; Sirlei Siani, Morais.

    2008-02-01

    Full Text Available OBJETIVO: Avaliar os fatores associados à presença de RNA-HIV na vagina. MÉTODOS: Estudo de corte transversal, em mulheres infectadas por HIV, excluindo-se aquelas com antecedente de histerectomia, as em uso de medicações vaginais nas últimas 48 horas, as que se referiram à relação sexual desprotegi [...] da há menos de 72 horas, as gestantes e aquelas com sangramento genital. Após consentimento, coletou-se amostra sanguínea para contagem de linfócitos T CD4 e carga viral plasmática de HIV, além de lavado vaginal com 10mL de solução salina, que foi centrifugado, aliquotado e armazenado em freezer -70°C para posterior quantificação de RNA-HIV livre. A mensuração de carga viral de RNA-HIV livre plasmática e vaginal foi realizada utilizando-se o kit HIV Monitor v1.5 Cobas Amplicor®, Roche. Pesquisou-se a presença de HPV de alto e baixo risco, clamídia e gonococo por Captura Híbrida II®, Digene, em amostra endocervical. Colheu-se amostra vaginal para bacterioscopia com coloração de Gram, utilizando-se os critérios de Nugent. RESULTADOS: Entre as 200 mulheres estudadas, 73,5% usavam terapia anti-retroviral (TARV) com drogas múltiplas. O RNA-HIV foi detectável no lavado vaginal de 18 delas (9%), mas em apenas uma daquelas que tinham carga viral plasmática indetectável (0,5%). A prevalência de HIV vaginal foi 24 vezes maior naquelas em que HIV plasmático era detectável. Carga viral plasmática de HIV, não usar TARV, CD4 reduzido e vaginose bacteriana aumentaram a prevalência de RNA-HIV vaginal, mas apenas a carga viral plasmática se manteve significativa na análise ajustada. CONCLUSÃO: A prevalência de RNA-HIV vaginal foi baixa (9%). A carga viral acima de 1.500 cópias/mL foi a única variável que permaneceu como fator de risco para RNA-HIV vaginal livre. Abstract in english OBJECTIVE: To evaluate factors associated to presence of free RNA-HIV in the vagina. METHODS: Cross-sectional study with HIV-infected women, excluding those who had undergone histerectomy, had used vaginal medication within the last 48 hours, had had unprotected sex less than 72 hours before, were p [...] regnant, or had genital bleeding. After signing an informed consent, blood samples were obtained for T CD4 lymphocytes count and plasmatic viral load, in addition to cervico-vaginal lavage using 10mL of sterile normal saline, later centrifuged, aliquoted and stored at - 70°C to quantify free HIV-RNA. Plasmatic and vaginal viral load were measured using the kit HIV Monitor v1.5 Cobas Amplicor, Roche. Hybrid Capture test Digene was utilized for HPV (high and low risk), clamydia trachomatis and N. gonorrhoae detection from an endocervical sample. Vaginal swab for bacterioscopy by the Gram method, evaluated according to Nugent criteria was obtained. RESULTS: Among 200 women evaluated, 73.5% were using HAART. The RNA-HIV was detectable in the vaginal lavage of 18 (9%), but in only one of those who had undetectable plasma viral load (0.5%). The vaginal prevalence of HIV was 24 times higher among those with detectable plasmatic HIV. Plasma viral load > 1500 copies/mL, no HAART use, reduced CD4 and bacterial vaginosis had increased prevalence of vaginal HIV-RNA, but in the adjusted statistical analysis, only the former remained significant CONCLUSION: Prevalence of vaginal HIV-RNA was low (9%). Plasmatic viral load > 1500 copies/mL, was the only risk factor for free vaginal HIV-RNA.

  2. Vaccination against oncogenic human papillomavirus infection in HIV-infected populations : review of current status and future perspectives

    DEFF Research Database (Denmark)

    Nielsen, Lars Toft; Tolstrup, Martin

    2014-01-01

    UNLABELLED: Background Men and women with HIV infection are at increased risk of developing cancers associated with human papillomavirus (HPV). The two licensed prophylactic HPV vaccines protect against de novo infection with HPV-16 and HPV-18, which cause the majority of HPV-associated cancers. Currently, no vaccine efficacy data are available for persons with HIV infection. Nevertheless, some countries have implemented specific HPV vaccination recommendations for HIV-positive populations. To specifically recommend prophylactic HPV vaccination in people with HIV, the vaccines must be safe and immunogenic in immunosuppressed people at a high risk of HPV infection. This review aims to summarise the current knowledge from published HPV vaccine trials in HIV-infected populations, to compile scheduled and ongoing HPV vaccine trials with HIV-positive study populations and to extrapolate the relevant knowledge about HPV vaccine efficacy in HIV-negative populations to an HIV context. METHODS: The databases PubMed, Scopus and ClinicalTrials.gov were searched for peer-reviewed articles and scheduled or ongoing clinical HPV vaccine trials enrolling HIV-positive persons. RESULTS: Current data indicate that prophylactic HPV vaccines are safe and immunogenic in different HIV-positive populations (children, female adolescents, adults). Increased immunogenicity has been reported in persons on antiretroviral therapy compared with antiretroviral-naïve persons, whereas no clear association has been found between CD4(+) cell count at immunisation and vaccine response. Several scheduled and ongoing HPV vaccine trials aim to determine vaccine efficacy against disease endpoints in HIV-infected study populations. CONCLUSION: Prophylactic HPV vaccination appears safe, immunogenic and, by extrapolation, likely to reduce HPV-associated cancer development among persons with HIV infection.

  3. Interventions to address chronic disease and HIV: strategies to promote exercise and nutrition among HIV-infected individuals.

    Science.gov (United States)

    Botros, Diana; Somarriba, Gabriel; Neri, Daniela; Miller, Tracie L

    2012-12-01

    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 malnutrition and wasting. Multivitamin (vitamin B complex, vitamin C, and vitamin E) supplements and vitamin D may improve quality of life and decrease morbidity and mortality. Nutritional counseling and exercise interventions are effective for treating obesity, fat redistribution, and metabolic abnormalities. Physical activity interventions improve body composition, strength, and fitness in HIV-infected individuals. Taken collectively, the evidence suggests that a proactive approach to nutrition and physical activity guidance and interventions can improve outcomes and help abrogate the adverse metabolic, cardiovascular, and psychological consequences of HIV and its treatments. PMID:22933247

  4. Assessing Maladaptive Responses to the Stress of Being At-Risk of HIV Infection among HIV-Negative Gay Men in New York City

    OpenAIRE

    YI, HUSO; Shidlo, Ariel; Sandfort, Theo

    2011-01-01

    The aim of this study was to examine the psychometric properties and preliminary validity of a newly developed 16-item measure to assess maladaptive responses to the stress of being at risk for HIV infection among HIV-negative gay men. The measure consisted of three factors: (1) fatalistic beliefs about maintaining an HIV-negative serostatus; (2) reduced perceived severity of HIV infection due to advances in medical treatment of HIV/AIDS; and (3) negative affective states associated with the ...

  5. Microbial translocation and systemic inflammatory response in HIV-infection

    Directory of Open Access Journals (Sweden)

    Khasanova G.K.

    2013-09-01

    Full Text Available The purpose of the research was detection of markers of systemic inflammatory response syndrome together with levels of markers of gram-negative endotoxinemia in HIV-patients for evaluation of role of endotoxin in immune system hyperactivation and progression of disease. Material and methods. Evaluation of levels of endotoxin, sCD14, interleu-kin 1(3, TNF-a and C-reactive protein was done in 232 HIV-positive patients. LAL-test, ELISA and biochemical tests were used. Results. The statistically significant increase of levels of all markers of systemic inflammatory response which were investigated was detected in the group of HIV-positive patients, comparing to group of healthy individuals. Direct correlation of sCD14 level with most of markers of systemic inflammatory response was found. Increased level of sCD14 was associated with more prominent clinical and laboratory signs of immunosupression. Conclusion. These results confirm a role of endotoxin which is a marker of microbial translocation and highly active biological substance in pathogenesis of immune system hyperactivation and progression of HIV-infection.

  6. [Benign lymphoproliferative lesions of the parotid gland in HIV infection].

    Science.gov (United States)

    Cecconi, L; Busi Rizzi, E; Schininà, V; Mazzuoli, G

    1996-01-01

    The authors investigated the role of ultrasonography (US) as the method of choice in diagnosing parotid lesions in HIV+ patients. Bilateral parotid gland enlargement associated with laterocervical lymph node enlargement is a sign of HIV infection. This pathologic condition is observed in 2-10% of seropositive patients. Histology demonstrates benign lymphoproliferative lesions referrable to immune system activation. Our series consisted of 37 HIV+ patients monitored with US for a year, all patients had cytologic confirmation of their disease, with needle biopsy in 9 patients and with MR studies in 4 patients. US showed focal solid lesions, with cystic and mixed appearance in the 26 adult subjects and gross parenchymal inhomogeneity in the 11 children; laterocervical lymph node enlargement was associated in 31 cases. In the only two cases with unilateral parotid involvement, an abscess and a lymphoma were diagnosed. To conclude, US findings in HIV+ patients, although aspecific, can help make the correct diagnosis, if they are integrated with the patient's history and clinical findings. PMID:8966280

  7. Crack users, sexual behavior and risk of HIV infection / Usuários de crack, comportamento sexual e risco de infecção pelo HIV

    Scientific Electronic Library Online (English)

    Renata Cruz Soares de, Azevedo; Neury José, Botega; Liliana Andolpho Magalhães, Guimarães.

    2007-03-01

    Full Text Available OBJETIVO: Comparar uma amostra de usuários de cocaína injetável e usuários de crack avaliando comportamento sexual, risco para contaminação pelo HIV e sua soroprevalência. MÉTODO: Avaliou-se 109 usuários de cocaína injetável e 132 usuários de crack, utilizando o questionário da Organização Mundial d [...] e Saúde para o "Estudo Multicêntrico de Comportamentos e Soroprevalência de HIV entre Usuários de Droga Injetável" ampliado e sorologia para o HIV. Os dados foram avaliados pela Análise de Correspondências Múltiplas. RESULTADOS: Os usuários de crack apresentaram menor tempo gasto no consumo de drogas quando comparados com os usuários de cocaína injetável. Apesar disso, tiveram maiores taxas de atividade sexual de risco, diferenças no consumo de múltiplas drogas e maiores taxas de problemas com a justiça. A soroprevalência do HIV entre os usuários de crack, embora inferior aos usuários de cocaína injetável (7% x 33%), é elevada quando comparada à população geral nesta faixa etária. CONCLUSÕES: O comportamento sexual dos usuários de crack da amostra estudada pode ser considerado fator de risco para a contaminação pelo HIV. Os usuários de crack têm acesso à informações sobre HIV/AIDS, porém, não as utilizam para modificar comportamentos de risco que os expõem à possibilidade de contaminação e disseminação do HIV. A soroprevalência do HIV entre eles (7%) é um dado preocupante, o que torna necessário criar estratégias preventivas de contaminação e disseminação do HIV especificamente direcionadas a esta população. Abstract in english OBJECTIVE: To compare a sample of injecting cocaine users and crack users, assessing sexual behavior, risk for infection by HIV and its seroprevalence. METHOD: 109 injecting cocaine users and 132 crack users were assessed, using the World Health Organization questionnaire from the expanded "Cross-Si [...] te Study of Behaviors and HIV Seroprevalence among Injecting Drug Users" and HIV serology. Data were assessed by Multiple Correspondences Analysis. RESULTS: Crack users showed less time of drug consumption when compared to the injecting cocaine users. Despite this fact, they had higher rates of risky sexual activity, differences in poli-consumption of drugs, and higher rates of involvement in illegal issues. HIV seroprevalence among crack users, although lower than for injecting cocaine users (7% vs. 33%) is high when compared to the general population at the same age. CONCLUSIONS: Sexual behavior of crack users in the studied sample may be considered a risk factor for HIV infection. Crack users have access to information on HIV/ AIDS, but do not make use of it to change risk behaviors that may expose them to HIV infection and dissemination. HIV seroprevalence among crack users (7%) is concerning, which makes it necessary to create preventive strategies for HIV infection and dissemination that are specifically directed toward this population.

  8. Crack users, sexual behavior and risk of HIV infection Usuários de crack, comportamento sexual e risco de infecção pelo HIV

    OpenAIRE

    Renata Cruz Soares de Azevedo; Neury José Botega; Liliana Andolpho Magalhães Guimarães

    2007-01-01

    OBJECTIVE: To compare a sample of injecting cocaine users and crack users, assessing sexual behavior, risk for infection by HIV and its seroprevalence. METHOD: 109 injecting cocaine users and 132 crack users were assessed, using the World Health Organization questionnaire from the expanded "Cross-Site Study of Behaviors and HIV Seroprevalence among Injecting Drug Users" and HIV serology. Data were assessed by Multiple Correspondences Analysis. RESULTS: Crack users showed less time of drug con...

  9. Risk factors for physical domestic violence in a high-prevalence HIV setting: findings from Project Accept baseline data (HPTN-043

    Directory of Open Access Journals (Sweden)

    Sebastian Kevany

    2013-06-01

    Full Text Available Zimbabwe faces an acute generalized HIV/AIDS epidemic combined with rapidly deteriorating economic and political conditions, under which levels of domestic violence are on the rise. We aimed to determine possible demographic and behavioral factors associated with physical domestic violence in a rural setting in order to better inform both national and local domestic violence and HIV prevention policies. Using the Project Accept baseline data set, we selected demographic, socio-economic, and behavioral variables that might be associated with physical domestic violence based on a review of the literature. Univariate and multivariate analyses were carried out, and odds ratios (OR were computed using logistic regression. Women reporting physical domestic violence were significantly more likely to report (i a history of childhood domestic violence (OR=2.96, P<0.001, (ii two or more lifetime partners (OR=1.94, P<0.001, (iii some form of sexual abuse as a child (OR=1.82, not significant, and (iv low or medium socio-economic status as measured by type of homestead (OR=1.4, P=0.04 than women who reported no experience of physical domestic violence. Married women were less likely to experience physical domestic violence than unmarried women (OR=0.65, P=0.011. Women at greatest risk of domestic violence include those with a personal history of violence or sexual abuse, multiple lifetime partners, and low or medium socio-economic status. Risk assessments and joint interventions for both domestic violence reduction and HIV prevention should target these population groups, which are effective both on the public health and global heath diplomacy levels.

  10. Renal transplantation in HIV-infected patients: the Paris experience.

    Science.gov (United States)

    Touzot, M; Pillebout, E; Matignon, M; Tricot, L; Viard, J P; Rondeau, E; Legendre, C; Glotz, D; Delahousse, M; Lang, P; Peraldi, M N

    2010-10-01

    Kidney transplantation is now considered as a reasonable option for HIV-infected patients with end-stage renal disease. We describe here a retrospective study conducted in five transplantation centers in Paris. Twenty-seven patients were included. Immunosuppressive protocol associated an induction therapy and a long-term treatment combining mycophenolate mofetil, steroids and either tacrolimus or cyclosporine. All the patients had protocol biopsies at 3 months and 1 year. Patient's survival was 100% at 1 year and 98% at 2 years. Graft survival at 1 and 2 years is 98% and 96% at 1 and 2 years, respectively. The mean glomerular filteration rate values at 12 and 24 months were 60.6 mL/min/1.73 m² (range 23-98) and 65.4 mL/min/1.73 m² (range 24-110), respectively. Acute cellular rejection was diagnosed in four cases (15%). Because of high trough levels of calcineurin inhibitor, protease-inhibitor therapies were withdrawn in 11 cases. HIV disease progression was not observed. One patient developed B-cell lymphoma. In conclusion, our study confirms the safety of renal transplantation in HIV-infected patients with few adverse events and a low incidence of acute rejection. PMID:20840478

  11. Raltegravir in the management of HIV-infected patients

    Directory of Open Access Journals (Sweden)

    Hans-Jürgen Stellbrink

    2008-12-01

    Full Text Available Hans-Jürgen StellbrinkICH and IPM Study Center Hamburg, Hamburg, GermanyAbstract: Raltegravir has recently been licensed for the treatment of HIV-1 infection. Currently its use is limited to treatment-experienced patients and subjects with resistant virus. In addition to its activity in the setting of resistance and treatment failure, it appears to have great potential for first-line therapy and as a switch option for subjects with intolerance to other agents, as well. Overall tolerability in clinical trials was excellent, and the toxicity profile is non-overlapping with other agents, with no clear neuropsychiatric, gastrointestinal, or metabolic toxicity. Its metabolization occurs mainly via UGT1A1 rather than by the CYP450 system, resulting in a relatively unproblematic drug interaction profile. The independence of the compound from “boosting” of drug levels with ritonavir is an attractive feature for many patients suffering from ritonavir-associated side effects. However, it has to be dosed twice daily. The unique effect of raltegravir on the establishment of viral latency makes it a logical component of treatment attempts aiming at reducing and controlling this viral sanctuary. This review summarizes the clinical view on the role of this novel compound in HIV therapy.Keywords: raltegravir, MK-0518, integrase inhibitor, HIV infection, HAART

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

    Directory of Open Access Journals (Sweden)

    Banjoko S Olatunbosun

    2012-12-01

    Full Text Available Abstract Background There had been conflicting reports with levels of markers of iron metabolism in HIV infection. This study was therefore aimed at investigating iron status and its possible mediation of severity of HIV- 1 infection and pathogenesis. Method Eighty (80 anti-retroviral naive HIV-1 positive and 50 sero-negative controls were recruited for the study. Concentrations of serum total iron, transferrin, total iron binding capacity (TIBC, CD4+ T -lymphocytes, vitamin C, zinc, selenium and transferrin saturation were estimated. Results The mean CD4+ T-lymphocyte cell counts, serum iron, TIBC, transferrin saturation for the tests and controls were 319 ± 22, 952 ± 57 cells/?l (P 4+ T-lymphocyte cell count had a positive correlation with levels of vitamin C (r = 0.497, P Conclusion It could be inferred that derangement in iron metabolism, in addition to oxidative stress, might have contributed to the depletion of CD4+ T cell population in our subjects and this may result in poor prognosis of the disease.

  13. Depression in women infected with HIV / Depressão em mulheres infectadas pelo HIV

    Scientific Electronic Library Online (English)

    Valéria Antakly de, Mello; André, Malbergier.

    2006-03-01

    Full Text Available OBJETIVO: Devido ao aumento do número de mulheres infectadas pelo HIV, no Brasil e no mundo, torna-se necessária a realização de estudos que abordem os aspectos psiquiátricos dessa população. Esse estudo tem como objetivo avaliar a prevalência de depressão maior atual e outros transtornos depressivo [...] s em mulheres infectadas pelo HIV e comparar essa prevalência entre um grupo de pacientes sintomáticas e outro de assintomáticas. MÉTODO:Utilizou-se um desenho de estudo transversal que avaliou 120 mulheres portadoras do HIV divididas em dois grupos de 60 pacientes, de acordo com a presença, em algum momento da vida, de sintomas relacionados à AIDS (sintomáticas e assintomáticas). Foram avaliadas variáveis sociodemográficas e variáveis relacionadas aos transtornos depressivos. Foram utilizados na avaliação psiquiátrica dos transtornos depressivos o SCID-DSM-IV, escala de Hamilton-17, escala de Hamilton não somática e o inventário de Beck. RESULTADOS: Os resultados mostram uma prevalência de 25,8% de depressão maior atual, sendo maior nas pacientes sintomáticas em relação às assintomáticas (p = 0,002). CONCLUSÕES: Os resultados mostram uma alta prevalência de depressão nas mulheres infectadas pelo HIV. Abstract in english OBJETIVE:The number of women with HIV infection has been on the rise in recent years, making studies of the psychiatric aspects of this condition very important. The aim of this study was to evaluate the prevalence of major depression in women with HIV infection. METHOD: A total of 120 women were st [...] udied, 60 symptomatic (with AIDS symptoms) and 60 asymptomatic (without AIDS symptoms). Sociodemographic data were collected, and depressive disorders were identified. The instruments used to evaluate the depressive disorders were the SCID, DSM-IV, 17-item Hamilton depression scale, Hamilton depression scale for nonsomatic symptoms and the Beck depression scale. RESULTS: The prevalence of major depression was 25.8% and was higher in the symptomatic group than in the asymptomatic group (p = 0.002). CONCLUSIONS: The prevalence of major depressive episodes in women with HIV infection is high, and women with AIDS-related symptoms are more often depressed than are those who have never presented such symptoms.

  14. Prevalencia de trombocitopenia en niños con HIV/sida Prevalence of thrombocytopenia in HIV infected children

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    Graciela Barboni

    2010-10-01

    Full Text Available La trombocitopenia es una de las múltiples alteraciones hematológicas presentes en pacientes infectados con el virus de la inmunodeficiencia humana (HIV. Puede ser de curso crónico, en la cual la destrucción inmune, el secuestro esplénico o el daño en la producción son los mecanismos primariamente involucrados, o aguda, acompañando a otra intercurrencia. En este trabajo se evaluó la prevalencia de trombocitopenia en un lapso de 14 años, en una población pediátrica con HIV/sida, analizando las características clínicas y la relación con el estado inmuno-virológico. La prevalencia de trombocitopenia fue de 8.5%, (29 de los 339 niños en seguimiento. En 22 fue de curso crónico y en 7 aguda. Los pacientes evaluados presentaron niveles porcentuales de TCD4+ variables y la presencia de trombocitopenia no estuvo en relación con el compromiso inmunitario. Los pacientes trombocitopénicos tuvieron niveles de carga viral significativamente mayores que los que no la presentaron. En 10 de los 29 niños con recuentos plaquetarios disminuidos, la trombocitopenia fue la manifestación inicial de la infección por HIV. Las manifestaciones hemorrágicas de las trombocitopenias crónicas fueron leves, presentes en el 23% de los niños y no se asociaron al deterioro inmunológico, mientras que en las agudas fueron más graves y condicionadas a la evolución de la enfermedad coexistente. El desarrollo de trombocitopenias se ve favorecido por la continua actividad viral y la falla en la implementación del tratamiento antirretroviral adecuado.Thrombocytopenia is a common hematologic finding in patients infected with the human immunodeficiency virus. Multiple mechanisms may contribute to the development of chronic thrombocytopenia as immune-mediated platelet destruction, enhanced platelet splenic sequestration and impaired platelet production. Acute thrombocytopenia is frequently associated with coexisting disorders. In this study, the prevalence of thrombocytopenia was evaluated in a cohort of HIV infected children analyzing the clinical features and the association with the immunological and virological status of the disease in a 14 year-follow-up period. Thrombocytopenia prevalence was of 8.5% (29 out 339 children evaluated. Chronic and acute thrombocytopenia was observed in 22 and 7 children respectively. The percentages of CD4+ T cells were variable and not related with the presence of thrombocytopenia. Thrombocytopenic patients showed viral load levels significantly increased; being the thrombocytopenia the initial clinical manifestation of HIV infection in 10 out 29 children. Mild chronic thrombocytopenia bleeding found in 23% of children evaluated was not correlated with the immunologic status of the disease. In contrast, the severity of acute thrombocytopenia depended on the evolution of associated clinical conditions. Constant viral activity and failure in the use of antiretroviral agents might induce the development of thrombocytopenia in HIV-infected children.

  15. Prevalencia de trombocitopenia en niños con HIV/sida / Prevalence of thrombocytopenia in HIV infected children

    Scientific Electronic Library Online (English)

    Graciela, Barboni; Marcela, Candi; Mariela, Bayon; Jeannette, Balbaryski; Eduardo, Gaddi.

    2010-10-01

    Full Text Available La trombocitopenia es una de las múltiples alteraciones hematológicas presentes en pacientes infectados con el virus de la inmunodeficiencia humana (HIV). Puede ser de curso crónico, en la cual la destrucción inmune, el secuestro esplénico o el daño en la producción son los mecanismos primariamente [...] involucrados, o aguda, acompañando a otra intercurrencia. En este trabajo se evaluó la prevalencia de trombocitopenia en un lapso de 14 años, en una población pediátrica con HIV/sida, analizando las características clínicas y la relación con el estado inmuno-virológico. La prevalencia de trombocitopenia fue de 8.5%, (29 de los 339 niños en seguimiento). En 22 fue de curso crónico y en 7 aguda. Los pacientes evaluados presentaron niveles porcentuales de TCD4+ variables y la presencia de trombocitopenia no estuvo en relación con el compromiso inmunitario. Los pacientes trombocitopénicos tuvieron niveles de carga viral significativamente mayores que los que no la presentaron. En 10 de los 29 niños con recuentos plaquetarios disminuidos, la trombocitopenia fue la manifestación inicial de la infección por HIV. Las manifestaciones hemorrágicas de las trombocitopenias crónicas fueron leves, presentes en el 23% de los niños y no se asociaron al deterioro inmunológico, mientras que en las agudas fueron más graves y condicionadas a la evolución de la enfermedad coexistente. El desarrollo de trombocitopenias se ve favorecido por la continua actividad viral y la falla en la implementación del tratamiento antirretroviral adecuado. Abstract in english Thrombocytopenia is a common hematologic finding in patients infected with the human immunodeficiency virus. Multiple mechanisms may contribute to the development of chronic thrombocytopenia as immune-mediated platelet destruction, enhanced platelet splenic sequestration and impaired platelet produc [...] tion. Acute thrombocytopenia is frequently associated with coexisting disorders. In this study, the prevalence of thrombocytopenia was evaluated in a cohort of HIV infected children analyzing the clinical features and the association with the immunological and virological status of the disease in a 14 year-follow-up period. Thrombocytopenia prevalence was of 8.5% (29 out 339 children evaluated). Chronic and acute thrombocytopenia was observed in 22 and 7 children respectively. The percentages of CD4+ T cells were variable and not related with the presence of thrombocytopenia. Thrombocytopenic patients showed viral load levels significantly increased; being the thrombocytopenia the initial clinical manifestation of HIV infection in 10 out 29 children. Mild chronic thrombocytopenia bleeding found in 23% of children evaluated was not correlated with the immunologic status of the disease. In contrast, the severity of acute thrombocytopenia depended on the evolution of associated clinical conditions. Constant viral activity and failure in the use of antiretroviral agents might induce the development of thrombocytopenia in HIV-infected children.

  16. Robustness of a Cellular Automata Model for the HIV Infection

    CERN Document Server

    Figueirêdo, P H; Santos, R M Zorzenon dos

    2008-01-01

    An investigation was conducted to study the robustness of the results obtained from the cellular automata model which describes the spread of the HIV infection within lymphoid tissues [R. M. Zorzenon dos Santos and S. Coutinho, Phys. Rev. Lett. 87, 168102 (2001)]. The analysis focussed on the dynamic behavior of the model when defined in lattices with different symmetries and dimensionalities. The results illustrated that the three-phase dynamics of the planar models suffered minor changes in relation to lattice symmetry variations and, while differences were observed regarding dimensionality changes, qualitative behavior was preserved. A further investigation was conducted into primary infection and sensitiveness of the latency period to variations of the model's stochastic parameters over wide ranging values. The variables characterizing primary infection and the latency period exhibited power-law behavior when the stochastic parameters varied over a few orders of magnitude. The power-law exponents were app...

  17. Characterising B cell numbers and memory B cells in HIV infected and uninfected Malawian adults

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    Gordon Stephen

    2010-09-01

    Full Text Available Abstract Background Untreated human immunodeficiency virus (HIV disease disrupts B cell populations causing reduced memory and reduced naïve resting B cells leading to increases in specific co-infections and impaired responses to vaccines. To what extent antiretroviral treatment reverses these changes in an African population is uncertain. Methods A cross-sectional study was performed. We recruited HIV-uninfected and HIV-infected Malawian adults both on and off antiretroviral therapy attending the Queen Elizabeth Central hospital in Malawi. Using flow cytometry, we enumerated B cells and characterized memory B cells and compared these measurements by the different recruitment groups. Results Overall 64 participants were recruited - 20 HIV uninfected (HIV-, 30 HIV infected ART naïve (HIV+N and 14 HIV-infected ART treated (HIV+T. ART treatment had been taken for a median of 33 months (Range 12-60 months. Compared to HIV- the HIV+N adults had low absolute number of naïve resting B cells (111 vs. 180 cells/?l p = 0.008; reduced memory B cells (27 vs. 51 cells/?l p = 0.0008. The HIV+T adults had B-cell numbers similar to HIV- except for memory B cells that remained significantly lower (30 vs. 51 cells/?l p = 0.02. In the HIV+N group we did not find an association between CD4 count and B cell numbers. Conclusions HIV infected Malawian adults have abnormal B-cell numbers. Individuals treated with ART show a return to normal in B-cell numbers but a persistent deficit in the memory subset is noted. This has important implications for long term susceptibility to co-infections and should be evaluated further in a larger cohort study.

  18. Understanding HIV Transmission Risk Behavior Among HIV-Infected South Africans Receiving Antiretroviral Therapy: An Information—Motivation—Behavioral Skills Model Analysis

    OpenAIRE

    Kiene, Susan M; FISHER, William A.; Shuper, Paul A.; CORNMAN, Deborah H.; CHRISTIE, Sarah; Macdonald, Susan; PILLAY, Sandy; Mahlase, Gethwana; Fisher, Jeffrey D

    2013-01-01

    The current study applied the Information—Motivation—Behavioral Skills (IMB) model (J. D. Fisher & Fisher, 1992; W. A. Fisher & Fisher, 1993) to identify factors associated with HIV transmission risk behavior among HIV-infected South Africans receiving antiretroviral therapy (ART), a population of considerable significance for curtailing, or maintaining, South Africa’s generalized HIV epidemic. HIV prevention information, HIV prevention motivation, HIV prevention behavioral skills, and ...

  19. Role of HIV-1 Infection in Addictive Behavior: A Study of a HIV-1 Transgenic Rat Model

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    Sulie L. Chang

    2006-01-01

    Full Text Available Epidemiological research indicates that drug abuse is prevalent among individuals infected with HIV-1. Evidence from preclinical research also suggests that drugs of abuse exacerbate the progression of neuropathological changes in the HIV-1 infected brain probably through common mechanisms of neuronal injury. The effects of HIV-1 on the efficacy and abuse potential of controlled drugs such as morphine, however, has not been explored. The current study reports that the noninfectious HIV-1 transgenic (HIV-1 Tg rat shows up-regulated expression of the mu opioid receptor (MOR at the transcriptional level and functional supersensitivity to morphine, a MOR agonist. Compared to nontransgenic control rats, the HIV-1 Tg rats also show greater motivation to run in a wheel, a behavior that is known to be associated with increased drug self-administration. These results suggest the potential role of HIV-1 infection in enhancing vulnerability to addiction and this possibility warrants further investigation to better understand the link between HIV-1 infection and the abuse of drugs including opioids.

  20. HIV infection among U.S. Army and Air Force military personnel: sociodemographic and genotyping analysis.

    Science.gov (United States)

    Singer, Darrell E; Bautista, Christian T; O'Connell, Robert J; Sanders-Buell, Eric; Agan, Brian K; Kijak, Gustavo H; Hakre, Shilpa; Sanchez, Jose L; Sateren, Warren B; McCutchan, Francine E; Michael, Nelson L; Scott, Paul T

    2010-08-01

    Since 1985, the U.S. Department of Defense has periodically screened all military personnel for HIV allowing for the monitoring of the infection in this dynamic cohort population. A nested case-control study was performed to study sociodemographics, overseas assignment, and molecular analysis of HIV. Cases were newly identified HIV infections among U.S. Army and Air Force military personnel from 2000 to 2004. Controls were frequency matched to cases by gender and date of case first positive HIV screening test. Genotyping analysis was performed using high-throughput screening assays and partial genome sequencing. HIV was significantly associated with black race [odds ratio (OR) = 6.65], single marital status (OR = 4.45), and age (OR per year = 1.07). Ninety-seven percent were subtype B and 3% were non-B subtypes (A3, CRF01_AE, A/C recombinant, G, CRF02_AG). Among cases, overseas assignment in the period at risk prior to their first HIV-positive test was associated with non-B HIV subtype infection (OR = 8.44). Black and single military personnel remain disproportionately affected by HIV infection. Most non-B HIV subtypes were associated with overseas assignment. Given the increased frequency and length of assignments, and the expanding HIV genetic diversity observed in this population, there is a need for active HIV genotyping surveillance and a need to reinforce primary HIV prevention efforts. PMID:20673143

  1. The effects of untreated and treated HIV infection on bone disease.

    LENUS (Irish Health Repository)

    Cotter, Aoife G

    2013-11-20

    Low bone mineral density (BMD) is common in those with HIV, associated with higher bone turnover and a higher prevalence of fractures. This review explores low BMD in HIV, focusing on underlying mechanisms and relationships between low BMD and HIV infection, immune dysfunction, and antiretroviral therapy (ART).

  2. Modeling the Impact of Breast-Feeding by HIV-Infected Women on Child Survival.

    Science.gov (United States)

    Heymann, Sally Jody

    1990-01-01

    Models the survival outcomes of children in developing countries born to women infected with human immunodeficiency virus (HIV) who are breast-fed, bottle-fed, and wet-nursed. Uses decision analysis to assess the relative risk of child mortality from HIV transmission and non-HIV causes associated with different methods of feeding. (FMW)

  3. Sexual Behavior and Risk Practices of HIV Positive and HIV Negative Rwandan Women.

    Science.gov (United States)

    Adedimeji, Adebola A; Hoover, Donald R; Shi, Qiuhu; Gard, Tracy; Mutimura, Eugene; Sinayobye, Jean d'Amour; Cohen, Mardge H; Anastos, Kathryn

    2015-07-01

    It is not well understood how infection with HIV and prior experience of sexual violence affects sexual behavior in African women. We describe factors influencing current sexual practices of Rwandan women living with or without HIV/AIDS. By design, 75 % of participants were HIV positive and ~50 % reported having experienced genocidal rape. Univariate and multivariate logistic regression models were fit to describe demographic and clinical characteristics that influenced sexual behavior in the previous 6 months, condom use, history of transactional sex, and prior infection with a non-HIV sexually transmitted disease. Respondents' age, where they lived, whether or not they lived with a husband or partner, experience of sexual trauma, CD4 count, CES-D and PTSD scores were strongly associated with risky sexual behavior and infection with non-HIV STI. HIV positive women with a history of sexual violence in the contexts of war and conflict may be susceptible to some high-risk sexual behaviors. PMID:25488169

  4. SEROPREVALENCE OF HEPATITIS ‘B’ CO-INFECTION AMONG HIV INFECTED PATIENTS IN GOVERNMENT MEDICAL COLLEGE, KOTA AND ASSOCIATED HOSPITALS

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    Vandana Meena, Anita E Chand, Harshad Singh Naruka

    2015-01-01

    Full Text Available Introduction Human immunodeficiency virus (HIV shares routes of transmission with Hepatitis B virus (HBV, so HIV patients have more chance to get co-infected with HBV and this type of concurrent infection with both viruses may alter the disease progression, natural history and treatment response. Material & Method The study was carried out at the Integrated Counselling and Testing Centre (ICTC of Department of Microbiology, MBS Hospital, Government Medical College, Kota. The present study included 100 patients, diagnosed as HIV positive. Results Among the 100 HIV positive patients we found 35 patients co-infected with HBV. Among the 100 cases of HIV, 65 (65% were male, 34 (34% were female and 1 (1% was intersexual. In HIV +HBV co-infected cases 22 (62.8% were male and 13 (37.1% were female. Of the 100 HIV patients most were married 73 (73% followed by unmarried 16 (16%, widow 7 (7%, separate 4 (4%. Among HIV+HBV co-infection most was married 28 (80% as compared to separate 3 (8.5%, unmarried, 2 (5.7% and widow 2 (5.7%. Among the HIV patients route of transmission was mainly sexual 69 (69%.

  5. Six-Month Incidence and Persistence of Oral HPV Infection in HIV-Negative and HIV-Infected Men Who Have Sex with Men

    Science.gov (United States)

    Mooij, Sofie H.; Speksnijder, Arjen G. C. L.; Meijer, Chris J. L. M.; King, Audrey J.; Verhagen, Dominique W. M.; de Vries, Henry J. C.; Quint, Wim G. V.; Molijn, Anco; de Koning, Maurits N. C.; van der Sande, Marianne A. B.; van der Loeff, Maarten F. Schim

    2014-01-01

    Objectives Our aim was to assess incidence and persistence of oral HPV infection in HIV-negative and HIV-infected men who have sex with men (MSM). Methods MSM aged ?18 years were included in Amsterdam (the Netherlands) in 2010–2011, and followed up 6 months later. Participants completed risk factor questionnaires. HPV DNA was analyzed in oral-rinse and gargle specimens using the SPF10-PCR DEIA/LiPA25 system (version 1). A subset of oral samples was subjected to SPF10 sequencing to identify additional HPV types. Multivariable logistic regression analyses using generalized estimating equations (GEE) were performed to assess determinants for oral high-risk HPV incidence and persistence. Results 689/795 participant MSM provided both baseline and 6-month data. Baseline prevalence of high-risk HPV was 9.4% in HIV-negative and 23.9% in HIV-infected MSM (P<0.001). 56/689 MSM acquired ?1 high-risk HPV infection (6-month incidence 8.1%; 95%CI 6.2–10.4%); incidence was 4.1% in HIV-negative and 14.1% in HIV-infected MSM (P<0.001). HIV infection and recent use of cannabis were both independently associated with high-risk HPV incidence. Persistent high-risk HPV was observed in 48/130 (36.9%) infections. Conclusion Incidence of oral high-risk HPV infection in MSM is substantial, and is associated with HIV infection. Over a third of HPV infections persisted over a 6-month period. PMID:24896848

  6. The Effect of GBV-C Infection on CD4 Count and Viral Loads in Patients Infected With HIV

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    Hossein Keyvani

    2012-01-01

    Full Text Available Background: The picture that has emerged from studies investigating HIV infected people with GBV-C viremia is that they have lower plasma HIV viral loads in comparison with HIV-positive people who did not have the GBV-C viremia.Objectives: Since GBV-C HIV coinfection has not been studied in Iran, we have designed a survey to study the outcomes of GBV-C infection on HIV infected individuals.Patients and Methods: We analyzed 78 serum samples from HIV-positive patients in Tehran. The HIV positive statue was confirmed by Western blot in our laboratory. Next we detected GBV-C RNA by RT nested-PCR and divided our patient into GBV-C positive and GBV-C negative groups. The final step was measuring the CD4 count and HIV viral load and comparing the means of the CD4 count and HIV viral load in HIV-infected individuals in the GBV-C positive and GBV-C negative groups.Results: We detected GBV-C RNA in 15 patients out of 78. The mean CD4 count was 607.13 compared to 415.87 in the GBV-C negative group and the difference was significant (P = 0.005. In contrast to the CD4 count there was no significant difference in HIV viral loads between HIV infected individuals in the GBV-C positive and GBV-C negative groups.Conclusion: Although there was no significant difference in the mean of the HIV viral load between the GBV-C positive and GBV-C negative groups, the significantly higher CD4 mean in the GBV-C positive group compared with the GBV-C negative group suggests a beneficial effect of this coinfection.

  7. [Initial antiretroviral therapy in HIV-infected patients].

    Science.gov (United States)

    Cormier, Hélène; Hoen, Bruno

    2014-10-01

    In 2014 an antiretroviral treatment should be initiated in any HIV-infected patient, whatever his/her CD4 lymphocyte count. The objectives of antiretroviral treatment are both individual (restoration or preservation of immune functions, decreased morbidity and mortality, decreased chronic systemic inflammation) and collective (decreased risk of HIV sexual transmission). Preferred initial regimens include two nucleoside reverse transcriptase inhibitors (tenofovir/emtricitabine or abacavir/lamivudine) plus a third agent, either a non-nucleoside reverse transcriptase inhibitor (rilpivirine or efavirenz), or a ritonavir-boosted protease inhibitor (atazanavir or darunavir). Alternatively, the third agent may be chosen among integrase inhibitors (raltegravir, dolutegravir, elvitegravir/cobicistat). Immunologic and virologic response to first-line antiretroviral therapy should be monitored closely according to specific criteria and objectives. PMID:25510130

  8. [Structured treatment interruption in HIV-infected adolescents].

    Science.gov (United States)

    Vidal, P; Lalande, M; Rodiere, M

    2009-07-01

    Structured treatment interruption in HIV is now being debated. There are 2 cases in which it may be discussed: when the initial treatment was started early and when there is no compliance to treatment [Yeni P, et al. Les nouvelles recommandations de prise en charge des personnes infectées par le VIH 2006. Paris: Flammarion médecine-sciences; 2006]. Noncompliant behavior is one of the characteristics of chronic illness during adolescence. In HIV infection, however, the prognosis is negatively influenced because the resulting resistance to the antiretroviral therapy can further reduce therapeutic options. Therefore, it is important in such a critical period to consider both what is consciously and unconsciously at stake and what responsible action could be taken when a specialist is faced with spontaneous (unplanned) treatment interruption. We report here examples of follow-up care, interruption, and resumption of treatment in 4 female adolescents. PMID:19369045

  9. Mesenchymal stem cell derived hematopoietic cells are permissive to HIV-1 infection

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    Mondal Debasis

    2011-01-01

    Full Text Available Abstract Background Tissue resident mesenchymal stem cells (MSCs are multipotent, self-renewing cells known for their differentiation potential into cells of mesenchymal lineage. The ability of single cell clones isolated from adipose tissue resident MSCs (ASCs to differentiate into cells of hematopoietic lineage has been previously demonstrated. In the present study, we investigated if the hematopoietic differentiated (HD cells derived from ASCs could productively be infected with HIV-1. Results HD cells were generated by differentiating clonally expanded cultures of adherent subsets of ASCs (CD90+, CD105+, CD45-, and CD34-. Transcriptome analysis revealed that HD cells acquire a number of elements that increase their susceptibility for HIV-1 infection, including HIV-1 receptor/co-receptor and other key cellular cofactors. HIV-1 infected HD cells (HD-HIV showed elevated p24 protein and gag and tat gene expression, implying a high and productive infection. HD-HIV cells showed decreased CD4, but significant increase in the expression of CCR5, CXCR4, Nef-associated factor HCK, and Vpu-associated factor BTRC. HIV-1 restricting factors like APOBEC3F and TRIM5 also showed up regulation. HIV-1 infection increased apoptosis and cell cycle regulatory genes in HD cells. Although undifferentiated ASCs failed to show productive infection, HIV-1 exposure increased the expression of several hematopoietic lineage associated genes such as c-Kit, MMD2, and IL-10. Conclusions Considering the presence of profuse amounts of ASCs in different tissues, these findings suggest the possible role that could be played by HD cells derived from ASCs in HIV-1 infection. The undifferentiated ASCs were non-permissive to HIV-1 infection; however, HIV-1 exposure increased the expression of some hematopoietic lineage related genes. The findings relate the importance of ASCs in HIV-1 research and facilitate the understanding of the disease process and management strategies.

  10. Genetic determinants of pediatric HIV-1 infection: vertical transmission and disease progression among children.

    Science.gov (United States)

    Matt, C.; Roger, M.

    2001-01-01

    It is very likely that perinatal human immunodeficiency virus type 1 (HIV-1) infection is influenced by a combination of virologic and host factors. A greater understanding of the role played by various risk factors for HIV-1 infection is crucial for the design of new preventive and therapeutic strategies. In recent years, a number of studies have suggested that host genetic factors are important determinants of both the susceptibility to perinatal HIV-1 infection and the subsequent pathogenesis of acquired immunodeficiency syndrome (AIDS). Control of HIV-1 infection involves the processing of specific viral peptides and their presentation to cells of the immune system by highly polymorphic human leukocyte antigen (HLA) alleles. The contribution of multiple HLA class I and II alleles in modulating pediatric HIV/AIDS outcomes has now been confirmed by several independent groups. Penetration of HIV-1 into cells is mediated by interaction between CD4 and chemokine receptors that serve as entry coreceptors. Genetic polymorphisms in chemokine ligand and chemokine receptor genes have recently been associated both with mother-to-child HIV-1 transmission and disease progression in children. These observations suggest a key role for genetic factors in pediatric HIV-1 infection. This article describes the current state of knowledge regarding host genetic influences on pediatric HIV-1 infection and discusses the role of these genes in HIV/AIDS pathogenesis. PMID:11778647

  11. Genetic determinants of pediatric HIV-1 infection: vertical transmission and disease progression among children.

    Science.gov (United States)

    Matt, C; Roger, M

    2001-09-01

    It is very likely that perinatal human immunodeficiency virus type 1 (HIV-1) infection is influenced by a combination of virologic and host factors. A greater understanding of the role played by various risk factors for HIV-1 infection is crucial for the design of new preventive and therapeutic strategies. In recent years, a number of studies have suggested that host genetic factors are important determinants of both the susceptibility to perinatal HIV-1 infection and the subsequent pathogenesis of acquired immunodeficiency syndrome (AIDS). Control of HIV-1 infection involves the processing of specific viral peptides and their presentation to cells of the immune system by highly polymorphic human leukocyte antigen (HLA) alleles. The contribution of multiple HLA class I and II alleles in modulating pediatric HIV/AIDS outcomes has now been confirmed by several independent groups. Penetration of HIV-1 into cells is mediated by interaction between CD4 and chemokine receptors that serve as entry coreceptors. Genetic polymorphisms in chemokine ligand and chemokine receptor genes have recently been associated both with mother-to-child HIV-1 transmission and disease progression in children. These observations suggest a key role for genetic factors in pediatric HIV-1 infection. This article describes the current state of knowledge regarding host genetic influences on pediatric HIV-1 infection and discusses the role of these genes in HIV/AIDS pathogenesis. PMID:11778647

  12. Findings in Asymptomatic HIV Infected Patients Undergoing Chest Computed Tomography Testing: Implications for Lung Cancer Screening

    Science.gov (United States)

    SIGEL, Keith; WISNIVESKY, Juan; SHAHRIR, Shahida; BROWN, Sheldon; JUSTICE, Amy; KIM, Joon; RODRIGUEZ-BARRADAS, Maria; AKGÜN, Kathleen; RIMLAND, David; SOO HOO, Guy; CROTHERS, Kristina

    2014-01-01

    Background HIV infected persons have a two to five-fold increased unadjusted risk of lung cancer. In the National Lung Screening Trial (NLST), computed tomography (CT) screening was associated with a reduction in lung cancer mortality among high-risk smokers. These results may not generalize to HIV infected persons, particularly if they are more likely to have false-positive chest CT findings. Methods We utilized data including standardized chest CT scans from 160 HIV infected and 138 uninfected Veterans enrolled between 2009-2012 in the multicenter Examinations of HIV Associated Lung Emphysema (EXHALE) Study. Abnormal CT findings were abstracted from clinical interpretations of the scans and classified as positive by NLST criteria vs. other findings. Clinical evaluations and diagnoses that ensued were abstracted from the medical record. Results There was no significant difference by HIV in the proportion of CT scans classified as positive by NLST criteria (29% of HIV infected and 24% of HIV uninfected, p=0.3). However, HIV infected participants with CD4 counts 0.05). Conclusion HIV status was not associated with an increased risk of abnormal findings on CT or increased rates of follow-up testing in clinically stable outpatients with CD4 cell count >200. These data reflect favorably on the balance of benefits and harms associated with lung cancer screening for HIV infected smokers with less severe immunodeficiency. PMID:24401647

  13. Prevalence of STI/HIV co-infections among special treatment clinic attendees in Ibadan, Nigeria.

    Science.gov (United States)

    Kehinde, Aderemi O; Lawoyin, Taiwo O

    2005-07-01

    Sexually transmitted infections (STIs) are poorly recognised and inadequately treated in Nigeria despite the fact that they constitute a major risk factor for sexual transmission of HIV infection. This study was carried out to ascertain STI/HIV co-infection rates and also to obtain relevant socio-demographic and reproductive health data associated with STI/HIV infections among special treatment clinic (STC) attendees. This information is urgently needed for designing STI/HIV control strategies. All consenting patients who attended the STC clinic from March to November 2001 were interviewed to obtain their socio-demographic and reproductive health data. Urethral, high vaginal and endocervical swabs and urine specimens were obtained and processed by standard methods. HIV screening was done by double ELISA tests. Of the 210 patients seen, 98 (46.7%) were male and 112 (53.3%) were female (p > 0.05). The majority, 171 (81.4%) were aged 20-39 years, while only ten (4.8%) were adolescents. One-hundred-and-eighty (85.7%) had an STI, of which 41 (22.8%) were co-infected with HIV. Thirty (16.7%) patients with nongonococcal urethritis/cervicitis and five (2.8%) with gonorrhoea were also positive for HIV. Five patients were HIV positive but had no other STI. Patients with gonorrhoea, non-gonococcal urethritis/cervicitis, trichomoniasis and bacterial vaginosis were more likely than those with warts, candidiasis and herpes to have co-infection (chi2 = 12.5, p = 0.04). The study's HIV prevalence rate was 21.9%. STI/HIV co-infection rate was significantly higher among unskilled and unemployed patients compared with professional and skilled workers (p < 0.05). This study shows a high STI/HIV co-infection rate indicating that there is need for proper management of STI, as this will help curb the spread of HIV infection in Nigeria. PMID:16094931

  14. Production of Interferons and β-Chemokines by Placental Trophoblasts of HIV-1-Infected Women

    Directory of Open Access Journals (Sweden)

    James M. Reuben

    2001-01-01

    Full Text Available Objective: The mechanism whereby the placental cells of a human immunodeficiency virus (HIV-1-infected mother protect the fetus from HIV-1 infection is unclear. Interferons (IFNs inhibit the replication of viruses by acting at various stages of the life cycle and may play a role in protecting against vertical transmission of HIV-1. In addition the β-chemokines RANTES (regulated on activation T cell expressed and secreted, macrophage inflammatory protein-1-α (MIP-1α, and MIP-1β can block HIV-1 entry into cells by preventing the binding of the macrophage-trophic HIV-1 strains to the coreceptorCCR5. In this study the production of IFNs and β-chemokines by placental trophoblasts of HIV-1-infected women who were HIV-1 non-transmitters was examined.

  15. Risk factors for HIV infection in Males who have Sex with Males (MSM in Bangladesh

    Directory of Open Access Journals (Sweden)

    Khan Omar A

    2007-07-01

    Full Text Available Abstract Background Recent surveillance data from Bangladesh indicate rising HIV infection among intravenous drug users (IDU in the country. We suggest a likely association between HIV risk factors in this group and other groups, such as males who have sex with males (MSM. Methods Data on MSM in Bangladesh was collected and analyzed from numerous primary and secondary sources, including government ministries, non-profit health organizations, and personal communications. Results The overall prevalence of HIV in Bangladesh is relatively low, but surveillance data indicate that infection has reached significant proportions in certain high-risk groups and may soon spread to other groups, specifically MSM. Conclusion The epidemiology of HIV infection in other countries suggests that increasing rates of HIV in higher-risk populations can precede an epidemic in the general population. We review the data concerning MSM, IDU and HIV in Bangladesh from a variety of sources and propose ways to prevent HIV transmission.

  16. Use of dental care by HIV-infected medical patients.

    Science.gov (United States)

    Coulter, I D; Marcus, M; Freed, J R; Der-Martirosian, C; Cunningham, W E; Andersen, R M; Maas, W R; Garcia, I; Schneider, D A; Genovese, B; Shapiro, M F; Bozzette, S A

    2000-06-01

    Although increasing attention has been paid to the use of dental care by HIV patients, the existing studies do not use probability samples, and no accurate population estimates of use can be made from this work. The intent of the present study was to establish accurate population estimates of the use of dental services by patients under medical care. The study, part of the HIV Cost and Services Utilization Study (HCSUS), created a representative national probability sample, the first of its kind, of HIV-infected adults in medical care. Both bivariate and logistic regressions were conducted, with use of dental care in the preceding 6 months as the dependent variable and demographic, social, behavioral, and disease characteristics as independent variables. Forty-two percent of the sample had seen a dental health professional in the preceding 6 months. The bivariate logits for use of dental care show that African-Americans, those whose exposure to HIV was caused by hemophilia or blood transfusions, persons with less education, and those who were employed were less likely to use dental care (p < 0.05). Sixty-five percent of those with a usual source of care had used dental care in the preceding 6 months. Use was greatest among those obtaining dental care from an AIDS clinic (74%) and lowest among those without a usual source of dental care (12%). We conclude that, in spite of the high rate of oral disease in persons with HIV, many do not use dental care regularly, and that use varies by patient characteristics and availability of a regular source of dental care. PMID:10890713

  17. Anti-HIV-1 Activity of Flavonoid Myricetin on HIV-1 Infection in a Dual-Chamber In Vitro Model

    OpenAIRE

    Pasetto, Silvana; Pardi, Vanessa; Murata, Ramiro Mendonc?a

    2014-01-01

    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 Pinoc...

  18. The Relationship between Cocaine Use and Human Papillomavirus Infections in HIV-Seropositive and HIV-Seronegative Women

    OpenAIRE

    MINKOFF, Howard; Zhong, Ye; Strickler, Howard D; Watts, D Heather; Joel M. Palefsky; Levine, Alexandra M; D'Souza, Gypsyamber; Andrea A Howard; Plankey, Michael; Massad, L. Stewart; Burk, Robert

    2008-01-01

    Objective. Animal data suggest that cocaine has an immunosuppressive effect, but no human studies have been conducted to assess the relation of cocaine use with human papillomavirus (HPV) infection, the viral cause of cervical cancer. Since both cocaine use and HPV infection are common among HIV-positive women, we sought to determine whether use of cocaine and/or crack influences the natural history of HPV among women with or at high risk of HIV. Methods. Women enrolled in the Women's Int...

  19. Forensic Considerations of HIV Infected and Those at Risk

    Directory of Open Access Journals (Sweden)

    B. R. Sharma

    2005-01-01

    Full Text Available 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 existence of a confidential patient-physician relationship, a health care provider has a duty to warn a clearly identifiable third party of possible serious harm. This reliance suggests that states may eventually extend provider liability to ?significant others? and individuals with whom the provider knows, or has reason to believe, the infected individual is engaged in activity which may spread this virus. The focus by the courts reinforces the need for health care providers to stay current with local reporting requirements and their legal obligations.

  20. Raltegravir with optimized background therapy for resistant HIV-1 infection

    DEFF Research Database (Denmark)

    Steigbigel, Roy T; Cooper, David A

    2008-01-01

    BACKGROUND: Raltegravir (MK-0518) is an inhibitor of human immunodeficiency virus type 1 (HIV-1) integrase active against HIV-1 susceptible or resistant to older antiretroviral drugs. METHODS: We conducted two identical trials in different geographic regions to evaluate the safety and efficacy of raltegravir, as compared with placebo, in combination with optimized background therapy, in patients infected with HIV-1 that has triple-class drug resistance in whom antiretroviral therapy had failed. Patients were randomly assigned to raltegravir or placebo in a 2:1 ratio. RESULTS: In the combined studies, 699 of 703 randomized patients (462 and 237 in the raltegravir and placebo groups, respectively) received the study drug. Seventeen of the 699 patients (2.4%) discontinued the study before week 16. Discontinuation was related to the study treatment in 13 of these 17 patients: 7 of the 462 raltegravir recipients (1.5%) and 6 of the 237 placebo recipients (2.5%). The results of the two studies were consistent. At week 16, counting noncompletion as treatment failure, 355 of 458 raltegravir recipients (77.5%) had HIV-1 RNA levels below 400 copies per milliliter, as compared with 99 of 236 placebo recipients (41.9%, P<0.001). Suppression of HIV-1 RNA to a level below 50 copies per milliliter was achieved at week 16 in 61.8% of the raltegravir recipients, as compared with 34.7% of placebo recipients, and at week 48 in 62.1% as compared with 32.9% (P<0.001 for both comparisons). Without adjustment for the length of follow-up, cancers were detected in 3.5% of raltegravir recipients and in 1.7% of placebo recipients. The overall frequencies of drug-related adverse events were similar in the raltegravir and placebo groups. CONCLUSIONS: In HIV-infected patients with limited treatment options, raltegravir plus optimized background therapy provided better viral suppression than optimized background therapy alone for at least 48 weeks. (ClinicalTrials.gov numbers, NCT00293267 and NCT00293254.)

  1. HIV-hepatitis C virus co-infection in the era of direct-acting antivirals.

    Science.gov (United States)

    Bichoupan, Kian; Dieterich, Douglas T; Martel-Laferrière, Valérie

    2014-09-01

    Approximately one-third of patients infected with human immunodeficiency virus (HIV) are concomitantly infected with hepatitis C virus (HCV). As a result, liver disease remains a major source of morbidity and mortality in HIV patients. Prior to 2011, treatments of HCV lacked efficacy in clinical trials in HIV/HCV co-infected patients. Fortunately, several direct-acting antivirals (DAAs) have now entered clinical practice and others have reached advanced stages of clinical development. These therapies offer significant benefits such as improved rates of sustained virologic response (SVR), shortened durations of treatment, and compatibility with HIV antiretroviral therapies. Treatments such as sofosbuvir (SOF) have received approval for HIV/HCV co-infected patients. Moreover, interferon-free options exist for HIV/HCV co-infected patients who may be ineligible or intolerant of interferon. Despite these improvements, physicians must be aware of the differences between these DAAs, the patient characteristics that play a role on the effectiveness of these medications, and the drug-drug interactions these DAAs may have with existing HIV antiretroviral therapies. The aim of this review is to discuss the prevalence and incidence of HIV/HCV co-infection, critical factors related to patient evaluation, current treatment options, and new developments in the management of HIV/HCV co-infected patients. PMID:24996617

  2. Seroprevalence of anti-HCV and hepatitis B surface antigen in HIV infected patients

    Directory of Open Access Journals (Sweden)

    Tankhiwale S

    2003-01-01

    Full Text Available Human immunodeficiency virus (HIV is known to influence the natural history of infections with certain hepatitis viruses and interactions between HIV and hepatitis viruses may potentiate HIV replication. There is high degree of epidemiological similarity between hepatitis B virus and HIV as regard to high-risk group and route of transmission. Transmission of hepatitis C virus (HCV through blood transfusion and intravenous drug abuse is well documented. Present study deals with the study of concurrent infection of HBV and HCV with HIV infection. In the study of 110 HIV seropositive patients, 34(30.4% were positive for HBV and 8(7.27% for HCV. The difference of concomitant infection was highly significant compared to controls. (p value < 0.0001. Heterosexual high risk behaviour was observed in 89(80.91% of 110 HIV positive patients, out of which 23(25.8% and 5(5.62% were HBsAg and anti-HCV positive respectively. History of transmission was unclear in remaining patients. Concomitant infection of HIV and HBV was found to be significantly more in the symptomatic group (40.68% compared to asymptomatic group (19.6%. As HIV infection is known to affect the natural history of both HBV and HCV infection, screening of their concurrent association is necessary.

  3. Predictors of disease progression in HIV infection: a review

    Directory of Open Access Journals (Sweden)

    Ananworanich Jintanat

    2007-05-01

    Full Text Available Abstract During the extended clinically latent period associated with Human Immunodeficiency Virus (HIV infection the virus itself is far from latent. This phase of infection generally comes to an end with the development of symptomatic illness. Understanding the factors affecting disease progression can aid treatment commencement and therapeutic monitoring decisions. An example of this is the clear utility of CD4+ T-cell count and HIV-RNA for disease stage and progression assessment. Elements of the immune response such as the diversity of HIV-specific cytotoxic lymphocyte responses and cell-surface CD38 expression correlate significantly with the control of viral replication. However, the relationship between soluble markers of immune activation and disease progression remains inconclusive. In patients on treatment, sustained virological rebound to >10 000 copies/mL is associated with poor clinical outcome. However, the same is not true of transient elevations of HIV RNA (blips. Another virological factor, drug resistance, is becoming a growing problem around the globe and monitoring must play a part in the surveillance and control of the epidemic worldwide. The links between chemokine receptor tropism and rate of disease progression remain uncertain and the clinical utility of monitoring viral strain is yet to be determined. The large number of confounding factors has made investigation of the roles of race and viral subtype difficult, and further research is needed to elucidate their significance. Host factors such as age, HLA and CYP polymorphisms and psychosocial factors remain important, though often unalterable, predictors of disease progression. Although gender and mode of transmission have a lesser role in disease progression, they may impact other markers such as viral load. Finally, readily measurable markers of disease such as total lymphocyte count, haemoglobin, body mass index and delayed type hypersensitivity may come into favour as ART becomes increasingly available in resource-limited parts of the world. The influence of these, and other factors, on the clinical progression of HIV infection are reviewed in detail, both preceding and following treatment initiation.

  4. From HIV infection to AIDS A dynamically induced percolation transition?

    CERN Document Server

    Kamp, C; Kamp, Christel; Bornholdt, Stefan

    2002-01-01

    The origin of the unusual incubation period distribution in the development of AIDS is largely unresolved. A key factor in understanding the observed distribution of latency periods, as well as the occurrence of infected individuals not developing AIDS at all, is the dynamics of the long lasting struggle between HIV and the immune system. Using a computer simulation, we study the diversification of viral genomes under mutation and the selective pressure of the immune system.In common infections vast spreading of viral genomes usually does not takes place. In the case of an HIV infection this may occur, as the virus successively weakens the immune system by depletion of CD4+ cells.In a sequence space framework, this leads to a dynamically induced percolation transition, corresponding to the onset of AIDS. As a result, we obtain the prolongated shape of the incubation period distribution, as well as a finite fraction of non-progressors that do not develop AIDS, comparing well with results from recent clinical r...

  5. Potential impact of infant feeding recommendations on mortality and HIV-infection in children born to HIV-infected mothers in Africa: a simulation

    Directory of Open Access Journals (Sweden)

    Seksaria Vidyunmala

    2008-05-01

    Full Text Available Abstract Background Although breast-feeding accounts for 15–20% of mother-to-child transmission (MTCT of HIV, it is not prohibited in some developing countries because of the higher mortality associated with not breast-feeding. We assessed the potential impact, on HIV infection and infant mortality, of a recommendation for shorter durations of exclusive breast-feeding (EBF and poor compliance to these recommendations. Methods We developed a deterministic mathematical model using primarily parameters from published studies conducted in Uganda or Kenya and took into account non-compliance resulting in mixed-feeding practices. Outcomes included the number of children HIV-infected and/or dead (cumulative mortality at 2 years following each of 6 scenarios of infant-feeding recommendations in children born to HIV-infected women: Exclusive replacement-feeding (ERF with 100% compliance, EBF for 6 months with 100% compliance, EBF for 4 months with 100% compliance, ERF with 70% compliance, EBF for 6 months with 85% compliance, EBF for 4 months with 85% compliance Results In the base model, reducing the duration of EBF from 6 to 4 months reduced HIV infection by 11.8% while increasing mortality by 0.4%. Mixed-feeding in 15% of the infants increased HIV infection and mortality respectively by 2.1% and 0.5% when EBF for 6 months was recommended; and by 1.7% and 0.3% when EBF for 4 months was recommended. In sensitivity analysis, recommending EBF resulted in the least cumulative mortality when the a mortality in replacement-fed infants was greater than 50 per 1000 person-years, b rate of infection in exclusively breast-fed infants was less than 2 per 1000 breast-fed infants per week, c rate of progression from HIV to AIDS was less than 15 per 1000 infected infants per week, or d mortality due to HIV/AIDS was less than 200 per 1000 infants with HIV/AIDS per year. Conclusion Recommending shorter durations of breast-feeding in infants born to HIV-infected women in these settings may substantially reduce infant HIV infection but not mortality. When EBF for shorter durations is recommended, lower mortality could be achieved by a simultaneous reduction in the rate of progression from HIV to AIDS and or HIV/AIDS mortality, achievable by the use of HAART in infants.

  6. Community Outbreak of HIV Infection Linked to Injection Drug Use of Oxymorphone - Indiana, 2015.

    Science.gov (United States)

    Conrad, Caitlin; Bradley, Heather M; Broz, Dita; Buddha, Swamy; Chapman, Erika L; Galang, Romeo R; Hillman, Daniel; Hon, John; Hoover, Karen W; Patel, Monita R; Perez, Andrea; Peters, Philip J; Pontones, Pam; Roseberry, Jeremy C; Sandoval, Michelle; Shields, Jessica; Walthall, Jennifer; Waterhouse, Dorothy; Weidle, Paul J; Wu, Hsiu; Duwve, Joan M

    2015-05-01

    On January 23, 2015, the Indiana State Department of Health (ISDH) began an ongoing investigation of an outbreak of human immunodeficiency virus (HIV) infection, after Indiana disease intervention specialists reported 11 confirmed HIV cases traced to a rural county in southeastern Indiana. Historically, fewer than five cases of HIV infection have been reported annually in this county. The majority of cases were in residents of the same community and were linked to syringe-sharing partners injecting the prescription opioid oxymorphone (a powerful oral semi-synthetic opioid analgesic). As of April 21, ISDH had diagnosed HIV infection in 135 persons (129 with confirmed HIV infection and six with preliminarily positive results from rapid HIV testing that were pending confirmatory testing) in a community of 4,200 persons. PMID:25928470

  7. Oral ulcer as primary manifestation of HIV infection in an 80-year-old man

    DEFF Research Database (Denmark)

    Ludvigsen, Lene Ugilt Pagter; SØgaard, Ole Schmeltz

    2014-01-01

    Oral lesions such as candidiasis, Kaposi's sarcoma, hairy leukoplakia, herpes simplex infection, and ulcerative periodontitis are associated with HIV infection and may be the primary presentation in persons with undiagnosed HIV. We report a clinical case in which an 80-year-old man presented with an oral ulcer with morphological signs of immuno-suppression. The patient was perceived to be at low risk of HIV infection and thus, diagnostic HIV testing was delayed until subsequent development of Kaposi's sarcoma on the skin.

  8. Perinatal acquisition of drug-resistant HIV-1 infection: mechanisms and long-term outcome

    OpenAIRE

    Dollfus Catherine; Cornet Dorine; Warszawski Josiane; Blanche Stephane; Chaix Marie-Laure; Delaugerre Constance; Schneider Veronique; Burgard Marianne; Faye Albert; Mandelbrot Laurent; Tubiana Roland; Rouzioux Christine

    2009-01-01

    Abstract Background Primary-HIV-1-infection in newborns that occurs under antiretroviral prophylaxis that is a high risk of drug-resistance acquisition. We examine the frequency and the mechanisms of resistance acquisition at the time of infection in newborns. Patients and Methods We studied HIV-1-infected infants born between 01 January 1997 and 31 December 2004 and enrolled in the ANRS-EPF cohort. HIV-1-RNA and HIV-1-DNA samples obtained perinatally from the newborn and mother were subjecte...

  9. Immunovirological parameters and cytokines in HIV infection / Parâmetros imunovirológicos e citocinas na infecção pelo HIV

    Scientific Electronic Library Online (English)

    Karen Ingrid, Tasca; Sueli Aparecida, Calvi; Lenice do Rosário de, Souza.

    2012-12-01

    Full Text Available Enquanto modernas terapias antirretrovirais (TARV) têm resultado em menores índices de morbidade e mortalidade e na melhora visível dos parâmetros clínicos e laboratoriais em infectados pelo HIV, sabe-se que seu uso em longo prazo contribui com aparecimento dos vários eventos não associados à aids c [...] omo doenças cardiovasculares, cânceres e osteoporose, comorbidades as quais têm sido propostas como algumas das mais importantes que privam a maioria dos infectados pelo vírus a apresentarem prognóstico ainda melhor. Isso ocorre porque, mesmo com diminuição da inflamação e ativação imune após intervenção medicamentosa ao paciente, tais parâmetros continuam maiores que os apresentados por indivíduos saudáveis e o desequilíbrio dos perfis de citocinas também persiste. Por isso, avaliações de outros biomarcadores na prática clínica são necessárias para complementar os exames já realizados rotineiramente e permitir o monitoramento mais eficaz dos portadores do HIV. Esta revisão tem o intuito de investigar o papel das citocinas como potenciais marcadores, relacionando estudos sobre o comportamento de várias delas em diversas fases da infecção por HIV, na presença ou não de TARV. Abstract in english Although modern combined antiretroviral therapies (cART) result in lower morbidity and mortality and a visible improvement of clinical and laboratory parameters in HIV-infected, it is known that their long-term use contributes to appearance of the many events unrelated to AIDS such as cardiovascular [...] diseases, cancer and osteoporosis, comorbidities which have been proposed as some of the most important that deprive the majority of infected to present an even better prognosis. This is because even with a decrease in inflammation and immune activation after drug intervention to the patient, these parameters remain higher than those shown by healthy individuals and the imbalance of cytokine profiles also persists. Therefore, evaluations of other biomarkers in clinical practice are needed to complement the exams already carried out routinely and allow more effective monitoring of HIV patients. This review aims to investigate the role of cytokines as potential markers showing studies on their behavior in various stages of HIV infection, with or without cART.

  10. HIV-1 infection and alcohol abuse: Neurocognitive impairment, mechanisms of neurodegeneration and therapeutic interventions

    OpenAIRE

    Persidsky, Yuri; Ho, Wenzhe; Ramirez, Servio H.; Potula, Raghava; Abood, Mary E.; Unterwald, Ellen; Tuma, Ronald

    2011-01-01

    Clinical studies indicate that alcohol dependence has an additive effect on cognitive deficits associated with HIV-1 infection. Findings in humans and animal models suggest that alcohol, similar to HIV-1, induces inflammatory processes in the brain leading to neurodegeneration. The causes of HIV-1-associated neurotoxicity are comparable to those mediating alcohol-induced neuronal injury. This review aims to present the mechanisms of the combined effects of HIV-1 and alcohol abuse in the brain...

  11. Seroprevalence of Human Herpesvirus-8 in HIV-1 Infected and Uninfected Individuals in Cameroon

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    Owen Wood

    2013-09-01

    Full Text Available We evaluated the prevalence of HHV-8 antibodies in 516 plasma samples collected from HIV positive and negative patients from blood banks and urban areas of Cameroon. Among HIV-1 positive samples, HHV-8 seropositivity rate was 61% based on combined reactivity using both ELISA and IFA techniques. HIV negative samples showed 62% seropositivity rate for HHV-8 antibodies. Our results indicate a high HHV-8 prevalence rate in both HIV infected and uninfected individuals in Cameroon.

  12. Incidence and risk factors for invasive pneumococcal disease in HIV-infected and non-HIV-infected individuals before and after the introduction of combination antiretroviral therapy : persistent high risk among HIV-infected injecting drug users

    DEFF Research Database (Denmark)

    Harboe, Zitta Barrella; Larsen, Mette

    2014-01-01

    BACKGROUND: Invasive pneumococcal disease (IPD) is an important cause of morbidity among individuals infected with human immunodeficiency virus (HIV). We described incidence and risk factors for IPD in HIV-infected and uninfected individuals. METHODS: Nationwide population-based cohort study of HIV-infected adults treated at all Danish HIV treatment centers during 1995-2012. Nineteen population-matched controls per HIV-infected individual were retrieved. The risk of IPD was assessed using Poisson regression. RESULTS: The incidence of IPD was 304.7 cases per 100 000 person-years of follow-up (PYFU) in HIV-infected and 12.8 per 100 000 PYFU in HIV-uninfected individuals. After adjusting for confounders, HIV infection (relative risk [RR], 24.4 [95% confidence interval [CI], 23.7-25.1]), male sex (RR, 1.20 [95% CI, 1.16-1.24]), increasing age (per year) (RR, 1.03 [95% CI, 1.03-1.04]), and calendar period (pre-cART RR, 2.80 [95% CI, 2.70-2.91] compared with late cART) were significantly associated with an increased risk of IPD. Among HIV-infected individuals, male sex (RR, 1.57 [95% CI, 1.49-1.66]), smoking (RR, 1.34 [95% CI, 1.26-1.42]), and injecting drug use (RR, 2.51 [95% CI, 2.26-2.67]) were associated with an increased risk of IPD. Detectable viral loads (RR, 1.88 [95% CI, 1.79-1.98]) and a relative fall in CD4 T-cell counts were also associated with an increased risk (?500 to 350-500 CD4 T cells/µL: RR, 1.29 [95% CI, 1.21-1.37] and <100 cells/µL: RR, 7.4 [95% CI, 6.87-8.02]). The risk of IPD declined over time, although this was not the case for IDUs where the risk remained unchanged. CONCLUSIONS: The incidence of IPD in HIV-infected individuals remained significantly higher than the incidence observed in non-HIV-infected subjects, despite the widespread use of cART. IDUs have a persistently high risk of IPD. Injecting drug use, smoking, and the receipt of cART are suitable targets for preventive measures in the future.

  13. Incidence and Risk Factors for Invasive Pneumococcal Disease in HIV-infected and non-HIV infected Individuals Before and After the Introduction of Combination Antiretroviral Therapy : Persisting High Risk among HIV-infected Injecting Drug Users

    DEFF Research Database (Denmark)

    Harboe, Zitta Barrella; Larsen, Mette Vang

    2014-01-01

    BACKGROUND: ?Invasive pneumococcal disease (IPD) is an important cause of morbidity among HIV-infected individuals. We described incidence and risk factors for IPD in HIV-infected and uninfected individuals. METHODS: ?Nationwide population-based cohort study of HIV-infected adults treated at all Danish HIV-treatment centers during 1995-2012. Nineteen population-matched controls per HIV-infected individual were retrieved. The risk of IPD (RR, [95% CI]) was assessed using Poisson regression. RESULTS: ?The incidence of IPD was 304.7 cases/100,000 PYFU in HIV-infected and 12.8/100,000 PYFU in HIV-uninfected individuals. After adjusting for confounders, HIV-infection (RR 24.4 [23.7-25.1]), male sex (RR 1.20 [1.16-1.24]), increasing age (per year) (RR 1.03 [1.03-1.04]) and calendar period (pre-cART [RR 2.80 [2.70-2.91] compared to late cART) were significantly associated with an increased risk of IPD. Among HIV-infected individuals, male sex (RR 1.57 [1.49-1.66]), smoking (RR 1.34 [1.26-1.42]), and intravenous drug use (RR 2.51 [2.26-2.67]) were associated with an increased risk of IPD. Detectable viral loads (RR 1.88 [1.79-1.98]) and a relative fall in CD4 T-cell counts were also associated with an increased risk (?500 to 350-<500 CD4 T-cells/µl RR 1.29 [1.21-1.37], and <100 cells/µl RR 7.4 [6.87-8.02]). The risk of IPD declined over time though this was not the case for IDUs where the risk remained unchanged. CONCLUSIONS: ?The incidence of IPD in HIV-infected individuals remained significantly higher than the incidence observed in non-HIV-infected, in spite of the widespread use of cART. IDUs have a persisting high risk of IPD. IDU, smoking, the receipt of cART are suitable targets for preventive measures in the future.

  14. Incidence and Risk Factors for Invasive Pneumococcal Disease in HIV-Infected and Non-HIV-Infected Individuals Before and After the Introduction of Combination Antiretroviral Therapy : Persistent High Risk Among HIV-Infected Injecting Drug Users

    DEFF Research Database (Denmark)

    Harboe, Zitta Barrella; Larsen, Mette Vang

    2014-01-01

    BACKGROUND: Invasive pneumococcal disease (IPD) is an important cause of morbidity among individuals infected with human immunodeficiency virus (HIV). We described incidence and risk factors for IPD in HIV-infected and uninfected individuals. METHODS: Nationwide population-based cohort study of HIV-infected adults treated at all Danish HIV treatment centers during 1995-2012. Nineteen population-matched controls per HIV-infected individual were retrieved. The risk of IPD was assessed using Poisson regression. RESULTS: The incidence of IPD was 304.7 cases per 100 000 person-years of follow-up (PYFU) in HIV-infected and 12.8 per 100 000 PYFU in HIV-uninfected individuals. After adjusting for confounders, HIV infection (relative risk [RR], 24.4 [95% confidence interval [CI], 23.7-25.1]), male sex (RR, 1.20 [95% CI, 1.16-1.24]), increasing age (per year) (RR, 1.03 [95% CI, 1.03-1.04]), and calendar period (pre-cART RR, 2.80 [95% CI, 2.70-2.91] compared with late cART) were significantly associated with an increased risk of IPD. Among HIV-infected individuals, male sex (RR, 1.57 [95% CI, 1.49-1.66]), smoking (RR, 1.34 [95% CI, 1.26-1.42]), and injecting drug use (RR, 2.51 [95% CI, 2.26-2.67]) were associated with an increased risk of IPD. Detectable viral loads (RR, 1.88 [95% CI, 1.79-1.98]) and a relative fall in CD4 T-cell counts were also associated with an increased risk (?500 to 350-500 CD4 T cells/µL: RR, 1.29 [95% CI, 1.21-1.37] and <100 cells/µL: RR, 7.4 [95% CI, 6.87-8.02]). The risk of IPD declined over time, although this was not the case for IDUs where the risk remained unchanged. CONCLUSIONS: The incidence of IPD in HIV-infected individuals remained significantly higher than the incidence observed in non-HIV-infected subjects, despite the widespread use of cART. IDUs have a persistently high risk of IPD. Injecting drug use, smoking, and the receipt of cART are suitable targets for preventive measures in the future.

  15. High level of HIV-1 drug resistance among patients with HIV-1 and HIV-1/2 dual infections in Guinea-Bissau

    DEFF Research Database (Denmark)

    Jespersen, Sanne; Tolstrup, Martin

    2015-01-01

    BACKGROUND: With the widespread use of antiretroviral treatment (ART) in Africa, the risk of drug resistance has increased. The aim of this study was to evaluate levels of HIV-1 resistance among patients with HIV-1 and HIV-1/2 dual infections, treated with ART, at a large HIV clinic in Guinea-Bissau. FINDINGS: Patients were selected from the Bissau HIV cohort. All patients had HIV-1 or HIV-1/2 dual infection, a CD4 cell count performed before and 3-12 months after starting ART, and a corresponding available plasma sample. We measured viral load in patients with HIV-1 (n?=?63) and HIV-1/2 dual (n?=?16) infections a median of 184 days after starting ART (IQR: 126-235 days). In patients with virological failure (defined as viral load >1000 copies/ml) and with sufficient plasma available, we performed an HIV-1 genotypic resistance test. Thirty-six patients (46%) had virological failure. The CD4 cell count did not predict treatment failure. Of the 36 patients with virological failure, we performed a resistance test in 15 patients (42%), and nine patients (9/15; 60%) had resistance mutations. The most common mutation was K103N, which confers high-level resistance to non-nucleoside reverse transcriptase inhibitors (NNRTI). No major mutations against protease inhibitors (PI) were found. CONCLUSIONS: Our results showed that patients with HIV-1 and HIV-1/2 dual infections in Guinea-Bissau had a high rate of virological failure and rapid development of NNRTI resistance. It remains to be determined whether a more robust, PI-based treatment regimen might benefit this population more than NNRTIs.

  16. Impaired glucose metabolism in HIV-infected pregnant women: a retrospective analysis.

    LENUS (Irish Health Repository)

    Moore, Rebecca

    2015-05-20

    Metabolic complications including diabetes mellitus have been increasingly recognised in HIV-infected individuals since the introduction of antiretroviral therapy, particularly protease inhibitors (PIs). Pregnancy is also a risk factor for impaired glucose metabolism, and previous studies have given conflicting results regarding the contribution of PIs to impaired glucose tolerance (IGT) and gestational diabetes mellitus (GDM) in pregnant HIV-infected women.

  17. Two cases of Saint Louis encephalitis in HIV-1 infected patients in Buenos Aires

    Scientific Electronic Library Online (English)

    Guillermo Alberto, Viloria; Mariana Angelica, Kundro; Javier Jose, Toibaro; Alfredo, Seijo; Marcelo Horacio, Losso.

    2011-12-01

    Full Text Available Saint Louis encephalitis virus (SLE) is a mosquito borne disease. Only a small proportion of cases progress to severe clinical forms. There have been few reports on HIV-infected patients and the relationship between immunodeficiency and the course of the disease remains unclear. Herein we describe t [...] wo cases of SLE in HIV-1-infected patients in Buenos Aires city.

  18. HIV infection connected to rising anal cancer rates in men in the U.S.

    Science.gov (United States)

    Human immunodeficiency virus (HIV) infection contributes substantially to the epidemic of anal cancer in men, but not women in the United States, according to new research from NCI. Chart shows overall incidence rates of anal cancers in general population with dashed line showing those with HIV infection.

  19. Syphilitic retinitis in a homosexual man with concurrent HIV infection: case report.

    OpenAIRE

    Joyce, P. W.; Haye, K R; Ellis, M. E.

    1989-01-01

    A case is reported of secondary syphilis with ocular signs in a patient who had antibodies to human immunodeficiency virus (HIV) and hepatitis B infections and from whose urine cytomegalovirus was cultivated. Treatment with penicillin resulted in rapid recovery from his retinitis and uveitis. The case highlights the importance of testing for syphilis in all patients with HIV infection.

  20. Acute renal failure as initial presentation of visceral leishmaniasis in an HIV-1-infected patient.

    Science.gov (United States)

    Clevenbergh, P; Okome, M Nkoumou; Benoit, S; Bendini, J C; De Salvador, F; Elbeze, M; Cassuto, E; Marty, P; Dellamonica, P

    2002-01-01

    We report the case of an HIV-infected patient who presented with acute renal failure due to visceral leishmaniasis (VL). Although renal failure is the leading cause of death in dogs, the natural reservoir of Leishmania infantum, renal involvement is usually absent in human VL. However, L. infantum can be considered a cause of renal failure in HIV-infected patients. PMID:12195888

  1. The Prevalence of Motor Delay among HIV Infected Children Living in Cape Town, South Africa

    Science.gov (United States)

    Ferguson, Gillian; Jelsma, Jennifer

    2009-01-01

    Children living with HIV often display delayed motor performance owing to HIV infection of the central nervous system, the effects of opportunistic infections and, indirectly, owing to their social environments. Although these problems have been well documented, the impact of the virus on the development of South African children is less well…

  2. Measles in children with HIV infection: report of five cases

    Directory of Open Access Journals (Sweden)

    Vânia de Carvalho

    2003-10-01

    Full Text Available Patients with AIDS have a high incidence of skin problems due to the immunosuppression and malnourishment that are inherent to the progression of this disease. Clinical manifestation of these skin lesions and their severity are different in AIDS patients. We made a prospective study of five cases of measles in children with HIV infection during a community outbreak, and there were typical as well as atypical forms of the disease, including one case with negative serology. There were pulmonary complications, but none of the patients died. The anti-retroviral treatment may have contributed to the decrease in measles morbidity in these pediatric AIDS patients.

  3. Preventing HIV infection: pre-exposure and postexposure prophylaxis.

    Science.gov (United States)

    Doblecki-Lewis, Susanne; Kolber, Michael A

    2014-07-01

    Data supporting the use of pre-exposure prophylaxis (PrEP) and nonoccupational postexposure prophylaxis (nPEP) in the prevention of HIV infection after a sexual encounter continue to grow. In this review, we describe some of the research driving the various recommendations for use of antiretrovirals in prevention. In addition, current research is described regarding the establishment of viral reservoirs that argues for rethinking the timing for nPEP treatment. We discuss the variables that impact on the choice of prevention antiretrovirals, including drug distribution, drug transporters, and potential impact of race and ethnicity on these variables. PMID:24975125

  4. Gender Inequity Norms Are Associated with Increased Male-Perpetrated Rape and Sexual Risks for HIV Infection in Botswana and Swaziland

    Science.gov (United States)

    Shannon, Kate; Leiter, Karen; Phaladze, Nthabiseng; Hlanze, Zakhe; Tsai, Alexander C.; Heisler, Michele; Iacopino, Vincent; Weiser, Sheri D.

    2012-01-01

    Background There is limited empirical research on the underlying gender inequity norms shaping gender-based violence, power, and HIV risks in sub-Saharan Africa, or how risk pathways may differ for men and women. This study is among the first to directly evaluate the adherence to gender inequity norms and epidemiological relationships with violence and sexual risks for HIV infection. Methods Data were derived from population-based cross-sectional samples recruited through two-stage probability sampling from the 5 highest HIV prevalence districts in Botswana and all districts in Swaziland (2004–5). Based on evidence of established risk factors for HIV infection, we aimed 1) to estimate the mean adherence to gender inequity norms for both men and women; and 2) to model the independent effects of higher adherence to gender inequity norms on a) male sexual dominance (male-controlled sexual decision making and rape (forced sex)); b) sexual risk practices (multiple/concurrent sex partners, transactional sex, unprotected sex with non-primary partner, intergenerational sex). Findings A total of 2049 individuals were included, n?=?1255 from Botswana and n?=?796 from Swaziland. In separate multivariate logistic regression analyses, higher gender inequity norms scores remained independently associated with increased male-controlled sexual decision making power (AORmen?=?1.90, 95%CI:1.09–2.35; AORwomen?=?2.05, 95%CI:1.32–2.49), perpetration of rape (AORmen?=?2.19 95%CI:1.22–3.51), unprotected sex with a non-primary partner (AORmen?=?1.90, 95%CI:1.14–2.31), intergenerational sex (AORwomen?=?1.36, 95%CI:1.08–1.79), and multiple/concurrent sex partners (AORmen?=?1.42, 95%CI:1.10–1.93). Interpretation These findings support the critical evidence-based need for gender-transformative HIV prevention efforts including legislation of women's rights in two of the most HIV affected countries in the world. PMID:22247761

  5. Acute HIV Infection in Pregnancy: The Case for Third Trimester Rescreening

    OpenAIRE

    Chi Dola; Sean Kim; Jennifer Sackrison; Jason Cesario; Jocelyn Wertz

    2011-01-01

    Combination testing with anti-HIV Elisa and Western blot is both sensitive and specific for diagnosis of established HIV-1 infection but could not detect acute HIV infection (AHI). AHI is a time of extremely high viral load, which may correlate to increased risk of horizontal or vertical transmission. Thus, early identification of AHI could allow for interventions to decrease transmission. However, recognition of AHI can be challenging as symptoms could be absent or nonspecific, therefore, AH...

  6. Spectrum of tuberculosis in patients with HIV infection in British Columbia: report of 40 cases.

    OpenAIRE

    Korzeniewska-Kosela, M.; Fitzgerald, J. M.; Vedal, S.; Allen, E. A.; Schechter, M.T.; Lawson, L; Phillips, P.; Black, W; Montaner, J S.

    1992-01-01

    OBJECTIVE: To review the clinical features, treatment and outcome of all known cases of tuberculosis in patients with human immunodeficiency virus (HIV) infection in British Columbia between 1984 and 1990. DESIGN: Retrospective case review. SETTING: Provincial tuberculosis registry and university-affiliated HIV clinic. PATIENTS: All people with HIV infection in whom active tuberculosis was diagnosed during the study period. RESULTS: All 40 patients identified were men; their mean age was 38 y...

  7. HIV infection disrupts the sympatric host-pathogen relationship in human tuberculosis

    OpenAIRE

    Fenner, Lukas; Egger, Matthias; Bodmer, Thomas; Furrer, Hansjakob; Ballif, Marie; Battegay, Manuel; Helbling, Peter; Fehr, Jan; GSPONER, Thomas; Rieder, Hans L.; Zwahlen, Marcel; Hoffmann, Matthias; Bernasconi, Enos; Cavassini, Matthias; Calmy, Alexandra

    2013-01-01

    The phylogeographic population structure of Mycobacterium tuberculosis suggests local adaptation to sympatric human populations. We hypothesized that HIV infection, which induces immunodeficiency, will alter the sympatric relationship between M. tuberculosis and its human host. To test this hypothesis, we performed a nine-year nation-wide molecular-epidemiological study of HIV-infected and HIV-negative patients with tuberculosis (TB) between 2000 and 2008 in Switzerland. We analyzed 518 TB pa...

  8. Beh?et?s disease with HIV infection: Response to antiretroviral therapy

    OpenAIRE

    Mahajan Vikram; Sharma Nand; Sharma Vikas; Sharma Ramesh; Sarin Sandip

    2005-01-01

    The differential diagnosis of oral ulcerations in a patient with AIDS/HIV infection is often challenging to the clinician. While old diseases have appeared in a new garb, many new ones are also being recognized. The association of Beh?et?s disease and AIDS/HIV infection has been recently recognized. We present an HIV-positive patient having oro-genital aphthosis conforming to the diagnostic criteria for Beh?et?s disease. Erythema nodosum, periphlebitis, erythematous pa...

  9. Drugs of abuse and HIV infection/replication: implications for mother-fetus transmission

    OpenAIRE

    Wang, Xu; Ho, Wen-zhe

    2010-01-01

    Human immunodeficiency virus (HIV) infection and progression of acquired immunodeficiency syndrome (AIDS) can be modulated by a number of cofactors, including drugs of abuse. Opioids, cocaine, cannabinoids, methamphetamine (METH), alcohol, and other substances of abuse have been implicated as risk factors for HIV infection, as they all have the potential to compromise host immunity and facilitate viral replication. Although epidemiologic evidence regarding the impact of drugs of abuse on HIV ...

  10. HIV-1 Nef Inhibits Ruffles, Induces Filopodia, and Modulates Migration of Infected Lymphocytes?

    OpenAIRE

    Nobile, Cinzia; Rudnicka, Dominika; Hasan, Milena; Aulner, Nathalie; Porrot, Françoise; Machu, Christophe; Renaud, Olivier; Prévost, Marie-Christine; Hivroz, Claire; Schwartz, Olivier; Sol-Foulon, Nathalie

    2009-01-01

    The HIV-1 Nef protein is a pathogenic factor modulating the behavior of infected cells. Nef induces actin cytoskeleton changes and impairs cell migration toward chemokines. We further characterized the morphology, cytoskeleton dynamics, and motility of HIV-1-infected lymphocytes. By using scanning electron microscopy, confocal immunofluorescence microscopy, and ImageStream technology, which combines flow cytometry and automated imaging, we report that HIV-1 induces a characteristic remodeling...

  11. HIV-1 induces phenotypic and functional perturbations of B cells in chronically infected individuals

    OpenAIRE

    Moir, Susan; Malaspina, Angela; Ogwaro, Kisani M.; Donoghue, Eileen T.; Hallahan, Claire W.; Ehler, Linda A.; Liu, Shuying; Adelsberger, Joseph; Lapointe, Re?jean; Hwu, Patrick; Baseler, Michael; Orenstein, Jan M.; Chun, Tae-wook; Mican, Jo Ann M.; Fauci, Anthony S.

    2001-01-01

    A number of perturbations of B cells has been described in the setting of HIV infection; however, most remain poorly understood. To directly address the effect of HIV replication on B cell function, we investigated the capacity of B cells isolated from HIV-infected patients to respond to a variety of stimuli before and after reduction of viremia by effective antiretroviral therapy. B cells taken from patients with high levels of plasma viremia were defective in their proliferative responses t...

  12. The synergy between TB and HIV co-infection on perceived stigma in Ethiopia

    OpenAIRE

    Desalegn Dejene; Tesfaye Markos; HaileMichael Yohannes; Deribew Amare; Wogi Ajeme; Daba Shallo

    2010-01-01

    Abstract Background The synergy between tuberculosis (TB) and human immunodeficiency virus (HIV) co-infection on perceived stigma is not well studied. The objective of this study was to assess the effect of TB/HIV co-infection on perceived stigma in selected hospitals of Oromiya region, Ethiopia. A cross sectional study was conducted from February to April, 2009 in Adama, Nekemet and Jimma Specialized hospitals. Data were collected by trained HIV counselors. A structured questionnaire which c...

  13. Pneumocystis carinii pneumonia in vertically acquired HIV infection in the British Isles.

    OpenAIRE

    Gibb, D. M.; Davison, C. F.; Holland, F. J.; Walters, S.; Novelli, V.; Mok, J.

    1994-01-01

    In order to review the clinical course, laboratory findings, and outcome of children with vertically acquired HIV infection and Pneumocystis carinii pneumonia, questionnaires were sent to paediatricians in the British Isles who had reported P carinii pneumonia and HIV infection through the British Paediatric Surveillance Unit (BPSU). Paediatric reports from the BPSU are linked to reports of pregnancies in HIV positive women and laboratory reports. P carinii pneumonia was the most frequently r...

  14. New Options in the Treatment of Lipid Disorders in HIV-Infected Patients

    OpenAIRE

    Da Silva, Erika Ferrari Rafael; Ba?rbaro, Giuseppe

    2009-01-01

    Since the introduction of HAART, there was a remarkably change in the natural history of HIV disease, leading to a notable extension of life expectancy, although prolonged metabolic imbalances could significantly act on the longterm prognosis and outcome of HIV-infected persons, and there is an increasing concern about the cardiovascular risk in this population. Current recommendations suggest that HIV-infected perons undergo evaluation and treatment on the basis of the Third National Cholest...

  15. Association of the Veterans Aging Cohort Study Index with Exercise Capacity in HIV-Infected Adults

    OpenAIRE

    Oursler, Krisann K.; Tate, Janet P.; Gill, Thomas M; Crothers, Kristina; Brown, Todd T; Crystal, Stephen; Womack, Julie; Leaf, David A.; Sorkin, John D.; Justice, Amy C.

    2013-01-01

    Physical disability is a major priority in aging, affecting morbidity, mortality, and quality of life. Despite the large number of adults aging with HIV, our understanding of the physiologic and clinical risk factors for disability is limited. Our goal is to determine whether the Veterans Aging Cohort Study (VACS) Index, based on routine clinical blood tests, could serve as a point of care screening tool to identify HIV-infected adults at high risk for physical disability. HIV-infected adults...

  16. Recidivism in HIV-Infected Incarcerated Adults: Influence of the Lack of a High School Education

    OpenAIRE

    Marlow, Elizabeth; White, Mary C.; Tulsky, Jacqueline P.; Estes, Milton; Menendez, Enrique

    2008-01-01

    Recidivism is a pervasive problem facing the incarcerated. Incarcerated persons who are human immunodeficiency virus (HIV)-infected often have multiple risk factors associated with initial incarceration and recidivism, in particular, injection drug use. Yet, some jails provide case management for HIV-infected inmates to provide continuity of health care, which might have positive effects on reentry into the community. We sought to measure recidivism and factors related to recidivism in an HIV...

  17. The British Columbia Positive Women's Survey: a detailed profile of 110 HIV-infected women

    OpenAIRE

    Kirkham, C. M.; Lobb, D J

    1998-01-01

    OBJECTIVE: To describe the health, social environment, medical care received and satisfaction with medical care of HIV-infected women in British Columbia. DESIGN: Self-administered 75-item questionnaire distributed by mail or in person between March 1994 and February 1996 through community AIDS organizations and physicians' offices. SETTING: British Columbia. PARTICIPANTS: A total of 110 HIV-positive women. OUTCOME MEASURES: Sociodemographic data, risk factors for HIV infection, details about...

  18. Signaling through Toll-like receptors triggers HIV-1 replication in latently infected mast cells.

    Science.gov (United States)

    Sundstrom, J Bruce; Little, Dawn M; Villinger, Francois; Ellis, Jane E; Ansari, Aftab A

    2004-04-01

    Evidence that human progenitor mast cells are susceptible to infection with CCR5-tropic strains of HIV-1 and that circulating HIV-1-infected FcepsilonRIalpha(+) cells with a similar progenitor phenotype have been isolated from AIDS patients has led to speculation that mast cells may serve as a potential reservoir for infectious HIV-1. In this study, progenitor mast cells, developed in vitro from CD34(+) cord blood stem cells, were experimentally infected with the CCR5-tropic strain HIV-1Bal after 28 days in culture as they reached their HIV-1-susceptible progenitor stage. HIV-1 p24 Ag levels were readily detectable by day 7 postinfection (PI), peaked at 2-3 wk PI as mature (tryptase/chymase-positive) HIV-1 infection-resistant mast cells emerged, and then steadily declined to below detectable limits by 10 wk PI, at which point integrated HIV-1 proviral DNA was confirmed by PCR quantitation in ( approximately 34% of) latently infected mast cells. Stimulation by ligands for Toll-like receptor (TLR) 2, TLR4, or TLR9 significantly enhanced viral replication in a dose- and time-dependent manner in both HIV-1-infected progenitor and latently infected mature mast cells, without promoting degranulation, apoptosis, cellular proliferation, or dysregulation of TLR agonist-induced cytokine production in infected mast cells. Limiting dilution analysis of TLR activated, latently infected mature mast cells indicated that one in four was capable of establishing productive infections in A301 sentinel cells. Taken together, these results indicate that mast cells may serve both as a viral reservoir and as a model for studying mechanisms of postintegration latency in HIV infection. PMID:15034054

  19. Vascular access-related infections in HIV patients undergoing hemodialysis: case description and literature review

    Directory of Open Access Journals (Sweden)

    Carlos E. Figueroa Castro

    2008-12-01

    Full Text Available Poor immune status, the use of a vascular access different from an AV fistula, and intravenous drug use (IDU may favor increased rates of vascular access infections among HIV infected patients on hemodialysis. Staphylococcus spp. and Streptococcus spp. are the main cause of these infections, but Gram-negative rods and fungi have been found as well. Using an AV fistula when possible, and eliciting a history of IVDU on every visit may prevent this type of infection. When infections are present, coverage for both Gram-positive and negative organisms is recommended. Additional studies specifically addressing the issue of vascular access infection in HIV infected patients are required.

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

    OpenAIRE

    Price, Ma; Wallis, Cl; Lakhi, S.; Karita, E.; Kamali, A.; Anzala, O.; Sanders, Ej; Bekker, Lg; Twesigye, R.; Hunter, E.; Kaleebu, P.; Kayitenkore, K.; Allen, S.; Ruzagira, E.; Mwangome, M.

    2011-01-01

    To characterize WHO-defined transmitted HIV drug resistance mutation (TDRM) data from recently HIV-infected African volunteers, we sequenced HIV (pol) and evaluated for TDRM the earliest available specimens from ARV-naive volunteers diagnosed within 1 year of their estimated date of infection at eight research centers in sub-Saharan Africa. TDRMs were detected in 19/408 (5%) volunteers. The prevalence of TDRMs varied by research center, from 5/26 (19%) in Entebbe, 6/78 (8%) in Kigali, 2/49 (4...