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  1. Neuropsychological Dysfunction among HIV Infected Drug Abusers

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    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

  2. Plasma proteomic profiling in HIV-1 infected methamphetamine abusers.

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    Gwenael Pottiez

    Full Text Available 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 itself. These proteins were involved in complement, coagulation pathways and oxidative stress. Continuous METH use is an unstable condition, altering levels of a number of plasma proteins.

  3. Interaction between Tat and Drugs of Abuse during HIV-1 Infection and Central Nervous System Disease

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    Monique E Maubert

    2016-01-01

    Full Text Available In many individuals, drug abuse is intimately linked with HIV-1 infection. In addition to being associated with one-third of all HIV-1 infections in the United States, drug abuse also plays a role in disease progression and severity in HIV-1-infected patients, including adverse effects on the central nervous system (CNS. Specific systems within the brain are known to be damaged in HIV-1-infected individuals and this damage is similar to that observed in drug abuse. Even in the era of anti-retroviral therapy (ART, CNS pathogenesis occurs with HIV-1 infection, with a broad range of cognitive impairment observed, collectively referred to as HIV-1-associated neurocognitive disorders (HAND. A number of HIV-1 proteins (Tat, gp120, Nef, Vpr have been implicated in the etiology of pathogenesis and disease as a result of the biologic activity of the extracellular form of each of the proteins in a number of tissues, including the CNS, even in ART-suppressed patients. In this review, we have made Tat the center of attention for a number of reasons. First, it has been shown to be synthesized and secreted by HIV-1-infected cells in the CNS, despite the most effective suppression therapies available to date. Second, Tat has been shown to alter the functions of several host factors, disrupting the molecular and biochemical balance of numerous pathways contributing to cellular toxicity, dysfunction, and death. In addition, the advantages and disadvantages of ART suppression with regard to controlling the genesis and progression of neurocognitive impairment are currently under debate in the field and are yet to be fully determined. In this review, we discuss the individual and concerted contributions of HIV-1 Tat, drug abuse, and ART with respect to damage in the CNS, and how these factors contribute to the development of HAND in HIV-1-infected patients.

  4. HIV infection among new synthetic drug abusers: a pilot study in Beijing

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    LI Ping; CHEN Xiao; XIE Pei-yan; CHU Ping; LI Dong-liang; LI Qian-qian; SHAO Yi-ming

    2013-01-01

    Background Following the increased human immunodeficiency virus (HIV) notification (infection) rates via sexual transmission and increased abuse of new synthetic drugs instead of heroin in China,a study on HIV infections and risk factors among synthetic drugs and heroin users in Beijing was conducted to provide a cue for further development of targets and strategies of HIV/AIDS control and prevention for different drug populations.Methods A total of 428 subjects including 224 heroin users and 204 new synthetic drug users was recruited from communities in Beijing by convenience sampling.A x2 test was used to compare HIV and syphilis infections between the two subpopulations.Logistic regression models were used to evaluate factors related to HIV,syphilis infections and abuse of synthetic drugs.Results Unbalanced distributions of demographics were detected between the two subpopulations.Compared with heroin users,most users of synthetic drugs were migrants,single and of younger age (age ≤30 years).Ten HIV infections and twenty-four syphilis infections were confirmed among 428 subjects.No significant difference in HIV infection was found between the two subpopulations (crude odds ratio (OR) =0.46,95% confidence interval (CI):0.07-15.80 and adjusted odds ratio (AOR) =1.26,95% CI:0.09-18.28) while four times as many syphilis infections were identified among users of synthetics drugs (AOR=3.92,95% CI:1.06-14.56).HIV and syphilis infections appeared to work synergistically.The migrants who were of Han ethnicity,single and who had stayed in Beijing for more than six months were more likely to abuse synthetics drugs.Conclusions The new synthetic drug users and heroin users are different subpopulations.We optimistically speculate that HIV has not yet been introduced into the former in Beijing,but considering higher syphilis infections in synthetic drug users and the role of syphilis in HIV infection,synthetic drug users,as a possible and important driver of the HIV

  5. Vitamin D Receptor (VDR and Epigenetics in HIV Infection and Drug Abuse

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    Nirupama eChandel

    2015-08-01

    Full Text Available Illicit drug abuse is highly prevalent and serves as a powerful co-factor for HIV exacerbation. Epigenetic alterations in drug abuse and HIV infection determine expression of several critical genes such as vitamin D receptor (VDR, which participates in proliferation, differentiation, cell death under both physiological and pathological conditions. On that account, active vitamin D, the ligand of VDR, is used as an adjuvant therapy to control infection, slow down progression of chronic kidney diseases, and cancer chemotherapy. Interestingly, vitamin D may not be able to augment VDR expression optimally in several instances where epigenetic contributes to down regulation of VDR; however, reversal of epigenetic corruption either by demethylating agents (DACs or histone deacetylase (HDAC inhibitors would be able to maximize expression of VDR in these instances.

  6. Drug abuse and weight loss in HIV-infected Hispanic men

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    Weight loss is an independent risk factor for mortality in HIV, but the role of drug use in HIV-related weight loss is not well described. We conducted this study to determine the role of drug abuse in HIV-related weight loss. Men (n=304), all of whom were Hispanic, were recruited into one of three ...

  7. Suicide risk and alcohol and drug abuse in outpatients with HIV infection and Chagas disease

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    Patrícia M. Guimarães

    2014-05-01

    Full Text Available Objective: To evaluate psychiatric comorbidities in outpatients receiving care for HIV and Chagas disease at Instituto de Pesquisa Clínica Evandro Chagas (IPEC, Fundação Oswaldo Cruz (Fiocruz, Rio de Janeiro, Brazil. Methods: Cross-sectional study with a consecutive sample of 125 patients referred to an outpatient psychiatric clinic from February to December 2010. The Mini International Neuropsychiatric Interview (MINI was used. Factors associated with more frequent mental disorders were estimated by odds ratios (OR with 95% confidence intervals (95%CI by multiple logistic regression. Results: Seventy-six (60.8% patients with HIV, 40 (32% patients with Chagas disease, and nine (7.2% patients with human T-lymphotropic virus were interviewed. The majority were women (64%, with up to 8 years of formal education (56%, and unemployed (81.6%. The median age was 49 years. Suicide risk (n=71 (56%, agoraphobia (n=65 (52%, major depressive episode (n=56 (44.8%, and alcohol/drug abuse (n=43 (34.4% predominated, the latter being directly associated with lower family income (OR = 2.64; 95%CI 1.03-6.75 and HIV infection (OR = 5.24; 95%CI 1.56-17.61. Suicide risk was associated with non-white skin color (OR = 2.21; 95%CI 1.03-4.75, unemployment (OR = 2.72; 95%CI 1.01-7.34, and diagnosis of major depression (OR = 3.34; 95%CI 1.54-7.44. Conclusion: Measures targeting adverse socioeconomic conditions and psychiatric and psychological monitoring and care should be encouraged in this population, considering the association with abuse of alcohol/other psychoactive drugs and suicide risk.

  8. [Influence of Opiate Abuse on Expression of Toll-like Receptor 9 in Peripheral Blood Mononuclear Cells of HIV-1-Infected Individuals].

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    Pan, Peijiang; Wei, Fumei; Jiang, Junjun; Liang, Bingyu; Huang, Jiegang; Liao, Yanyan; Su, Jinming; Li, Yu; Yang, Xiaoyi; Chen, Hui; Ye, Li; Liang, Hao

    2015-03-01

    The aim of this study was to investigate the influence of opiate abuse on the expression of Toll-like receptor 9 (TLR9) in the peripheral blood mononuclear cells (PBMCs) of HIV-1-infected patients and to elucidate possible mechanisms involved in the enhancement of HIV-1 replication by opiate abuse. A total of 200 participants were enrolled in the study by random selection from methadone treatment centers and voluntary HIV counseling and testing centers in the cities of Nanning, Liuzhou, and Qinzhou. These participants included 50 HIV-positive opiate abusers (Opiates HIV(+) group), 50 HIV-negative opiate abusers (Opiates HIV(-) group), 50 HIV-positive subjects who were not opiate abusers (Non-opiates HIV (+) group), and 50 HIV-negative subjects who were not opiate abusers (Control group). PBMCs were isolated from the peripheral blood samples from the subjects and the expression levels of TLR9 mRNA and protein were determined by q-PCR and western blot respectively. There was no significant difference among the four groups in age, gender, nationality, domicile, marital status, educational background or duration of drug abuse (P > 0.05). The median viral loads of the Opiates HIV(+) were significantly higher than those of the Non-Opiates HIV(+) groups (4.450 x 10(3) and 3.977 x 10(3) copies/mL respectively, P Opiates HIV(+), Non-Opiates HIV(+), Opiates HIV(-) and Control groups were (2.13 +/- 1.59) x 10(-3), (3.66 +/- 2.22) x 10(-3), (1.96 +/- 1.42) x 10(-3) and (7.66 +/- 4.87) x 10(-3), respectively. The expression of TLR9 mRNA was significantly lower in both HIV-1-infected and -uninfected groups of opiate abusers compared with groups of non-abusers (P Opiates HIV(+) group and the Opiates HIV(-) group (P > 0.05). However, in the non-opiate groups, the expression levels of TLR9 mRNA in the HIV(+) group were significantly lower than that of the control group (POpiates HIV(+), Non-Opiates HIV(+), and Opiates HIV(-) groups compared to the control group. These results

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

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    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.

  10. [Aorto pulmonary fistula: left-sided infective endocarditis in HIV and intravenous drugs abuser patient. Review of the literature].

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    Obón Azuara, B; Zalba Etayo, B; Gutiérrez Cía, I; Villanueva Anadón, B

    2007-11-01

    Infective endocarditis (IE) is the most severe complication in intravenous drug abusers (IVDAs). HIV infection increases the risk of IE in IVDAs too. IE in both population are special tendency to infect the right-sided heart, but unusual infective aortic valve. We report a case of HIV and IVDA patient admitted in hospital due to fever syndrome, with X-ray test normal and the first blood cultures negatives. CD4 count cell 90 mm3. It was impossible doing a transesophageal echocardiography (TEE) and transtoracic echocardiogramma (TTE) only showed a moderate aortic insufficiency with conserved systolic function. Despite using antibiotics, antifungals and highly active antiretroviral therapy, he developed ARDS, and mechanical ventilation should be performed. At that moment, TEE showed an aorto pulmonary fistula due to left-sided IE. Further cultures was undergone and only one blood culture was positive to Staphylococcus aureus. Cardiac surgery was not indicated. The patient died 3 weeks later.

  11. Transdiagnostic psychopathology mediates the relationship between childhood sexual abuse and HIV/AIDS and other sexually transmitted infections in adulthood.

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    Latack, Jessica A; Rodriguez-Seijas, Craig; Stohl, Malka; Blanco, Carlos; Hasin, Deborah S; Eaton, Nicholas R

    2015-10-01

    Exposure to childhood sexual abuse (CSA) is associated with elevated rates of mental disorders, sexual risk behavior, and sexually transmitted infections (STIs) in adulthood. Mental disorders themselves are associated with an increased risk for HIV/AIDs and STIs as well, and thus may mediate the association between CSA and HIV/AIDS and other STIs. The links among CSA, disorders, and STIs are unclear, however. The current study tested the hypothesis that the association of CSA with STIs is mediated by adult transdiagnostic psychopathology. We examined the potential mediating role of transdiagnostic psychopathology factors-internalizing (INT) and externalizing (EXT)-in the association between CSA and receiving a past-year diagnosis of HIV, AIDS, or another STI in a large, national probability sample of adults (N=34,653). Using indirect effects modeling, we found that 54.4% of the association between CSA and subsequent HIV/AIDS/STI diagnosis operated through transdiagnostic psychopathology. The proposed mediation model was supported, indicating that individuals reporting CSA had higher estimated levels of latent general liabilities for INT and EXT disorders, and it was largely these liabilities that accounted for the link between CSA and heightened risk of adult HIV, AIDS, and STI diagnoses.

  12. Escalating morphine exposures followed by withdrawal in feline immunodeficiency virus-infected cats: a model for HIV infection in chronic opiate abusers.

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    Barr, Margaret C; Huitron-Resendiz, Salvador; Sanchez-Alavez, Manuel; Henriksen, Steven J; Phillips, Tom R

    2003-11-24

    Opiate abuse is a risk factor for human immunodeficiency virus (HIV) infection. Because the direct effects of opiates on HIV infection are difficult to determine epidemiologically, animal models of lentivirus infection are relied upon to study the effects of opiates in the absence of confounding factors. Morphine, the predominant metabolite of heroin, is used in most experimental systems examining heroin abuse. In this study, morphine treatment of feline immunodeficiency virus (FIV)-infected cats modeled a typical pattern of escalating drug use interspersed with withdrawals. Plasma cortisol levels were measured for evidence of stress associated with morphine withdrawal. In the morphine-treated cats, cortisol levels peaked at time points corresponding to morphine withdrawal and returned to baseline levels during treatment and several weeks after the final withdrawal. Morphine-treated cats displayed clear behavioral and physical signs of opiate exposure and evidence of withdrawal when the drug was stopped. Morphine-exposed cats did not experience enhanced severity of FIV-related disease; in fact, morphine demonstrated a protective effect on FIV-associated changes in brainstem auditory evoked potentials. Our research suggests that opiate exposure is unlikely to adversely affect the progression of acute lentivirus infection and might be beneficial in controlling associated neurological disease.

  13. Distress tolerance and use of antiretroviral therapy among HIV-infected individuals in substance abuse treatment.

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    Magidson, Jessica F; Seitz-Brown, C J; Listhaus, Alyson; Lindberg, Briana; Anderson, Katelyn E; Daughters, Stacey B

    2013-09-01

    Despite recent clinical guidelines recommending early initiation and widespread use of antiretroviral therapy (ART), many HIV-infected individuals are not receiving ART-in particular low-income, minority substance users. Few studies have examined psychological, as opposed to structural, factors related to not receiving ART in this population. Perceived capacity to tolerate physical and psychological distress, known as distress tolerance (DT), may be a particularly relevant yet understudied factor. The current study tested the relationship between self-reported physical and psychological DT and ART receipt among predominantly low-income, minority HIV-infected substance users (n=77). Psychiatric disorders, biological indicators of health status, ART use, structural barriers to health care, and self-reported physical and psychological DT were assessed. 61% of participants were receiving ART. The only factors that distinguished individuals not on ART were greater avoidance of physical discomfort, higher psychological DT, and higher CD4 count. Both DT measures remained associated with ART use after controlling for CD4 count and were associated with almost a two-fold decrease in likelihood of ART receipt. Current findings suggest higher perceived capacity to tolerate psychological distress and greater avoidance of physical discomfort are important factors associated with lower ART use among substance users and may be important intervention targets.

  14. HIV/AIDS and Drug Abuse: Intertwined Epidemics

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    ... DrugFacts » HIV/AIDS and Drug Abuse: Intertwined Epidemics HIV/AIDS and Drug Abuse: Intertwined Epidemics Email Facebook ... to AIDS, greatly prolonging lives. What Exactly Is HIV/AIDS? HIV stands for human immunodeficiency virus. This ...

  15. 167例吸毒人员艾滋病病毒/梅毒感染状况及危险因素分析%HIV and syphilis infections among drug abusers in Tianjing

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    郭燕; 孙忠; 于茂河; 董笑月; 周宁; 柳忠泉; 柏建芸; 徐鹏; 程绍辉

    2011-01-01

    Objective To investigate the high risk behaviors of HIV and syphilis infections among drug abusers. Methods We conducted a cross-sectional survey of HIV and syphilis infections among drug abusers in drug rehabilitation centers in 2008. HIV and syphilis infections were confirmed with blood testing and behavior information was collected with a face to face interview. Results Three ( 1.80 % ) and seven (4. 19 % )drug abusers were positive for H IV and syphilis infection, respectively. Of 167 drug abusers, 74 (44.37 % )persons had HIV/AIDS knowledge. However, only 12 (7. 19%) persons realized the risk of HIV infection. The condom use rate was 21.56 % for drug abusers having intercourses with temporary sex partners. The HIV infection rate was 3.08% for injection drug users. Conclusion Drug abusers lack knowledge and awareness of HIV/AIDS and other sexually transmitted diseases. The prevention of HIV/STD infections should be strengthened among drug abusers.%目的 了解天津市吸毒人群艾滋病相关危险行为以及艾滋病病毒(HIV)、梅毒(SP)感染状况,为开展有效的预防、干预措施提供依据.方法 采用横断面调查,对2009年进入天津市戒毒所的人员进行问卷调查,同时抽取血样进行梅毒和HIV的实验室检测.结果 共收集到167例吸毒人员的问卷及血样,其中艾滋病知识知晓率为44.31%,仅有7.19%的调查对象意识到自己有感染艾滋病的危险,与临时性伴发生性关系时使用安全套的比例仅为21.56%.梅毒检出率为4.19%,HIV检出率为1.80%,其中注射吸毒者HIV检出率为3.08%.结论 天津市吸毒人群艾滋病知识知晓率较低,对艾滋病的危险因素认识不足,应加强这一人群的宣传教育,提高干预覆盖率.

  16. Drug Abuse, HIV, and HCV in Asian Countries.

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    Hser, Yih-Ing; Liang, Di; Lan, Yu-Ching; Vicknasingam, Balasingam Kasinather; Chakrabarti, Amit

    2016-09-01

    Drug abuse and co-occurring infections are associated with significant morbidity and mortality. Asian countries are particularly vulnerable to the deleterious consequences of these risks/problems, as they have some of the highest rates of these diseases. This review describes drug abuse, HIV, and hepatitis C (HCV) in Asian countries. The most commonly used illicit drugs include opioids, amphetamine-type stimulants (ATS), cannabis, and ketamine. Among people who inject drugs, HIV rates range from 6.3 % in China to 19 % in Malaysia, and HCV ranges from 41 % in India and Taiwan to 74 % in Vietnam. In the face of the HIV epidemics, drug policies in these countries are slowly changing from the traditional punitive approach (e.g., incarcerating drug users or requiring registration as a drug user) to embrace public health approaches, including, for example, community-based treatment options as well as harm reduction approaches to reduce needle sharing and thus HIV transmission. HIV and HCV molecular epidemiology indicates limited geographic diffusion. While the HIV prevalence is declining in all five countries, use of new drugs (e.g., ATS, ketamine) continues to increase, as well as high-risk sexual behaviors associated with drug use-increasing the risk of sexual transmission of HIV, particularly among men who have sex with men. Screening, early intervention, and continued scaling up of therapeutic options (drug treatment and recovery support, ART, long-term HIV and HCV care for drug users) are critical for effective control or continued reduction of drug abuse and co-infections.

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

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    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.

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

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    Pichili Vijaya Bhaskar Reddy

    2012-01-01

    Full Text Available 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.

  19. Association between childhood physical abuse, unprotected receptive anal intercourse and HIV infection among young men who have sex with men in Vancouver, Canada.

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    Arn J Schilder

    Full Text Available INTRODUCTION: The association between childhood sexual abuse and HIV risk among men who have sex with men (MSM is well established. However, no studies have examined the potential impact of other forms of childhood maltreatment on HIV incidence in this population. METHODS: We explored the impact of child physical abuse (CPA on HIV seroconversion in a cohort of gay/bisexual men aged 15 to 30 in Vancouver, Canada. Cox proportional hazard models were used, controlling for confounders. RESULTS: Among 287 participants, 211 (73.5% reported experiencing CPA before the age of 17, and 42 (14.6% reporting URAI in the past year. After a median of 6.6 years follow-up, 16 (5.8% participants HIV-seroconverted. In multivariate analysis, CPA was significantly associated with HIV seroconversion (adjusted hazard ratio [AHR] = 4.89, 95% confidence interval (CI: 1.65-14.48, after controlling for potential confounders. CONCLUSION: Our study uncovered a link between childhood physical violence and HIV incidence. Results highlight an urgent need for screening of young gay and bisexual men for histories of violence, and social and structural supports to prevent HIV transmission in this population.

  20. CTLA-4基因单倍型与吸毒合并HIV感染的相关性研究%Association between Cytotoxic T Lymphocyte-associated Antigen 4 Gene Haplotype and Drug Abuse with HIV Infection

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    刘莹; 刁波; 申元英; 周芳; 冯勇; 罗凡; 侯炜

    2011-01-01

    目的 研究细胞毒T淋巴细胞相关抗原4(cytotoxic T lymphocyte associated antigen-4,CTLA-4)基因外显子1的49位点和启动子-318位点单倍型与吸毒合并HIV感染的相关性.方法 采用序列特异性引物聚合酶链反应(polymeriase chain reaction with sequence-specific primers,PCR-SSP)方法,检测24例单纯吸毒者、41例吸毒合并HIV感染患者以及204例正常对照者CTLA-4基因外显子1的49位点启动子-318位点的单倍型.结果 吸毒者中CTLA-4A+ 49G和C-318T单倍型与正常对照组间差异无统计学意义(P>0.05).吸毒合并HIV感染组中CTLA-4单倍型1.1(C-318-A+ 49/C-318-A+ 49)显著低于对照组(2.4%vs 13.2%,P<0.05);CTLA-4单倍型3.3(T-318-A+ 49/T-318-A+49)明显高于对照组(12.2%vs2.9%,P<0.01).与吸毒组比较,吸毒合并HIV感染组中CTLA-4单倍型1.1(C-318-A十49/C-318-A+ 49)显著下降(2.4% vs 12.5%,P<0.05).结论 吸毒合并HIV感染与CTLA-4基因动态密切相关,单倍型1.1与吸毒合并HIV感染呈负相关,单倍型3.3与吸毒合并HIV感染呈正相关.%Objective To investigate the association between the haplotype of cytotoxic T lymphocyte-associated antigen 4 (CTLA-4) and drug abuse with HIV infection. Methods The A + 49G transition polymorphism at position 49 (exon 1) and C-318T transition polymorphism at position 318 in the promoter of the CTLA-4 gene were determined by polymerase chain reaction with sequence specific primers (PCR-SSP) method in 24 drug abusers, 41 drug abusers with HIV infection and 204 healthy controls. Results Compared with the control group, no significant difference in the distribution of haplotype was observed in A + 49G and C-318T gene polymorphisms in drug abusers (P>0. 05), the frequency of haplotype 1. 1 (C-318-A + 49/C-318-A + 49) in drug abusers with HIV infection was significantly lower (2. 4% vs 13. 2%, P<0. 05), and the frequency of haplotype 3. 3 (T-318-A + 49/T-318-A + 49) was significantly higher (12. 2% vs 2. 9%, P<0. 01

  1. Pregnancy and HIV infection

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    Mete Sucu

    2016-12-01

    Full Text Available The management of Human Immunodeficiency Virus (HIV infection is progressing rapidly. In developed countries, the perinatal transmission rates have decreased from 20-30% to 1-2% with the use of antiretroviral therapy and cesarean section. Interventions for the prevention of prenatal transmission has made the prenatal care of pregnant patients with HIV infection more complex. Rapid development of standard care and continuing increase in the distribution of HIV infection has required clinicians taking care of pregnants to have current information. Therefore, in our review we aimed to summarize the prenatal course, treatment and preventive methods for perinatal transmission of HIV. [Archives Medical Review Journal 2016; 25(4.000: 522-535

  2. Associations between Childhood Adversity and Depression, Substance Abuse and HIV and HSV2 Incident Infections in Rural South African Youth

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    Jewkes, Rachel K.; Dunkle, Kristin; Nduna, Mzikazi; Jama, P. Nwabisa; Puren, Adrian

    2010-01-01

    Objectives: To describe prevalence of childhood experiences of adversity in rural South African youth and their associations with health outcomes. Methods: We analyzed questionnaires and blood specimens collected during a baseline survey for a cluster randomized controlled trial of a behavioral intervention, and also tested blood HIV and herpes…

  3. HLA-associated susceptibility to HIV-1 infection.

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    Fabio, G; Scorza, R; Lazzarin, A; Marchini, M; Zarantonello, M; D'Arminio, A; Marchisio, P; Plebani, A; Luzzati, R; Costigliola, P

    1992-01-01

    We studied HLA antigen distribution of 50 heterosexual partners of HIV+ drug abusers with more than 1 year of sexual exposure to HIV, 36 children born to seropositive mothers and 61 haemophiliac patients exposed to presumably infectious clotting factor concentrates. B52 and B44 antigens were associated with HIV resistance while B51 was associated with HIV susceptibility. Forty-nine HIV+ drug abusers, spouses of heterosexual partners studied and 25 HIV+ mothers of the children were also typed. DR11 phenotype was associated with infectiousness of HIV+ subjects. Our data suggest that the HLA region controls susceptibility to infection with HIV and infectiousness of HIV+ subjects in different risk groups. PMID:1733633

  4. 天津市吸毒人群HIV和梅毒感染现状及影响因素%The rate of HIV/ syphilis infection and associated factors among drug abusers in Tianjin

    Institute of Scientific and Technical Information of China (English)

    郭燕; 王欣; 柏建芸; 程绍辉

    2012-01-01

    Objective To investigate the high risk behaviors related to HIV/syphilis infections among drug abusers in Tianjin and to provide evidence for controlling and preventing HIV/STD among them. Methods A cross-sectional survey with a face to face interview was conducted among drug abusers who entered the drug rehabilitation center between 2008 and 2009 and their blood samples were taken to test HIV/ syphilis. Results The rate of syphilis was 2. 9% among drug abusers in Tianjin and the HIV infection rate was 3. 8% . Multivariate logistic regression analysis showed that the factors associated with HIV infection among the drug abusers included floating population (OR=13. 222.95%CI:3. 66-47. 703),national minority (OR = 5. 046 ,95%CI: 1. 541- 16. 522) .injecting drug(OR = 9.151.95%CI,2. 301-36. 397).and high AIDS knowledge rate(OR = 0. 363,95%C7:0. 13-0. 969). Conclusion The rate of HIV infection among drug abusers in Tianjin is relatively high and risk behaviors related to HIV infection are common among them. There are urgent needs to carry out effective interventions to control local HIV transmission.%目的 通过对天津市吸毒人群艾滋病病毒(HIV)、梅毒(SP)感染状况及HIV危险因素的调查,为在该人群中开展相关控制措施提供依据.方法 采用横断面调查,对2008-2009年新进入戒毒所的821名吸毒人员进行问卷调查,同时抽取血样进行梅毒和HIV的实验室检测.结果 天津市吸毒人员梅毒感染率为2.9%(24/821),HIV感染率为3.8%(31/821).多因素分析表明,外省籍(OR=13.222,95% CI:3.665~47.703)、少数民族(OR=5.046,95%CI:1.541~16.522)、注射毒品(OR=9.151,95%CI:2.301~36.397)、艾滋病知识知晓率高(OR=0.363,95%CI:0.136~0.969)与HIV感染关系有统计学意义.结论 天津市吸毒人群HIV感染率较高,危险行为普遍存在,急需采取有效措施控制HIV的传播蔓延.

  5. MUCOCILIARY DYSFUNCTION IN HIV AND SMOKED SUBSTANCE ABUSE

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    Srinivasan eChinnapaiyan

    2015-10-01

    Full Text Available Impaired mucociliary clearance (MCC is a hallmark of acquired chronic airway diseases like chronic bronchitis associated with chronic obstructive pulmonary disease (COPD and asthma. This manifests as microbial colonization of the lung consequently leading to recurrent respiratory infections. People living with HIV demonstrate increased incidence of these chronic airway diseases. Bacterial pneumonia continues to be an important comorbidity in people living with HIV even though anti-retroviral therapy has succeeded in restoring CD4+ cell counts. People living with HIV demonstrate increased microbial colonization of the lower airways. The microbial flora is similar to that observed in diseases like cystic fibrosis and COPD suggesting that mucociliary dysfunction could be a contributing factor to the increased incidence of chronic airway diseases in people living with HIV. The three principal components of the MCC apparatus are, a mucus layer, ciliary beating and a periciliary airway surface liquid (ASL layer that facilitates ciliary beating. Cystic fibrosis transmembrane conductance regulator (CFTR plays a pivotal role in regulating the periciliary airway surface liquid. HIV proteins can suppress all the components of the MCC apparatus by increasing mucus secretion and suppressing CFTR function. This can decrease ASL height leading to suppressed ciliary beating. The effects of HIV on MCC are exacerbated when combined with other aggravating factors like smoking or inhaled substance abuse, which by themselves can suppress one or more components of the MCC system. This review discusses the pathophysiological mechanisms that lead to MCC suppression in people living with HIV who also smoke tobacco or abuse illicit drugs.

  6. Psychiatric context of acute/early HIV infection. The NIMH Multisite Acute HIV Infection Study: IV.

    Science.gov (United States)

    Atkinson, J Hampton; Higgins, Jenny A; Vigil, Ofilio; Dubrow, Robert; Remien, Robert H; Steward, Wayne T; Casey, Corinna Young; Sikkema, Kathleen J; Correale, Jackie; Ake, Chris; McCutchan, J Allen; Kerndt, Peter R; Morin, Stephen F; Grant, Igor

    2009-12-01

    Acute/early HIV infection is a period of high risk for HIV transmission. Better understanding of behavioral aspects during this period could improve interventions to limit further transmission. Thirty-four participants with acute/early HIV infection from six US cities were assessed with the Mini International Diagnostic Interview, Beck Depression Inventory II, State-Trait Anxiety Inventory, Brief COPE, and an in-depth interview. Most had a pre-HIV history of alcohol or substance use disorder (85%); a majority (53%) had a history of major depressive or bipolar disorder. However, post-diagnosis coping was predominantly adaptive, with only mild to moderate elevations of anxious or depressive mood. Respondents described challenges managing HIV in tandem with pre-existing substance abuse problems, depression, and anxiety. Integration into medical and community services was associated with adaptive coping. The psychiatric context of acute/early HIV infection may be a precursor to infection, but not necessarily a barrier to intervention to reduce forward transmission of HIV among persons newly infected.

  7. HIV infection in the elderly

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    Nancy Nguyen

    2008-09-01

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

  8. Leishmania / HIV co-infections.

    Science.gov (United States)

    Desjeux, P

    1995-11-01

    Visceral leishmaniasis (VL), which is transmitted by sandflies, is always present in at least 62 countries and is spreading to areas where it had not existed in the past. VL/HIV co-infections are becoming more and more common. In southern Europe, 25-70% of adult VL cases also have HIV infection. 1.5-9% of AIDS cases have newly acquired or reactivated VL. In the Mediterranean area, VL is the most common opportunistic parasitic infection among AIDS cases (i.e., 100 CD4/mcl). AIDS patients with VL have a much shorter survival period than other AIDS patients. VL can lie dormant for years but emerge clinically if an infected person has immunosuppression. Most VL/HIV co-infections in the western hemisphere are in Brazil. East African countries reporting VL/HIV co-infections include Ethiopia, Kenya, Malawi, and Sudan. Only one VL/HIV co-infected case has been found in Cameroon and in Guinea Bissau. VL/HIV co-infection cases tend to not have the usual VL clinical signs and symptoms (fever, weight loss, hepatosplenomegaly, polyadenopathies), making clinical diagnosis difficult. Since VL test sensitivity in HIV positive patients is reduced 20-40%, it is also difficult to make a serological diagnosis. In the first VL episode of HIV-infected patients, clinicians should use BMA, the safest and most sensitive test. Drug options for VL treatment include pentavalent antimonials, pentamidine, amphotericin B, and amphotericin B encapsulated in liposomes. Treatment failure is rather common in VL/HIV co-infected patients. Researchers from different centers need to conduct trials of various multi-therapy schedules. 70% of VL/HIV co-infected cases in southern Europe use intravenous drugs, suggesting that sharing of needles may account for the co-infection. The World Health Organization has mobilized against VL/HIV co-infections, including setting up a minimal surveillance system.

  9. Neurobiology of HIV, psychiatric and substance abuse comorbidity research: workshop report.

    Science.gov (United States)

    Kopnisky, Kathy L; Bao, Jing; Lin, Yu Woody

    2007-05-01

    Viral infections can cause persistent and progressive changes in emotional and cognitive functions. The viral-induced imbalances in neuronal network functioning may precipitate or accentuate psychiatric conditions in vulnerable individuals, in part, as a function of the host response to proinflammatory cytokines resulting from infection or brain injury. Research indicates that the mediators of psychiatric illnesses and HIV-neuropathogenesis utilize similar brain structures, neurocircuitry and receptor systems. The genetic, cellular and molecular mechanisms contributing to HIV neuropathogenesis and its late stage clinical correlate, HIV-associated-dementia (HAD), are active areas of neuroAIDS research. The study of HIV in the context of psychiatric comorbidities and comorbid pathogenesis is in a fledgling stage despite epidemiological studies suggesting that >60% of HIV infected individuals will suffer from at least one major psychiatric disorder during the course of infection. Depression is the primary comorbid disorder but anxiety and substance abuse disorders are also considerable in certain HIV(+) populations. Certain substances of abuse and the biological mediators of psychiatric illnesses reportedly interact in the brain and presumptively worsen HIV-related neuropathogenesis and survival measures. A panel of experts discussed approaches for studying the neuroscience of HIV and psychiatric comorbidity at a basic, mechanistic level since they co-exist in high proportion in the human population. Recommended approaches ranged from improving human consent forms and maximizing the value of repository resources to novel research designs and identifying human and animal endophenotypes.

  10. Cortisol Response Mediates HIV-1-Related Cognitive Deficits Among Injecting Drug Abusers

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    Raymond L. Ownby

    2006-01-01

    Full Text Available The cortisol response is an important measure of the endocrine activity to environmental challenges and has been related to cognitive function and mood. Previous studies have shown that the cortisol response to stress is dysregulated in persons with HIV-1 infection. Since cortisol is neurotoxic and its levels have been related to cognitive dysfunction in various disorders, it is possible that neuroendocrine dysregulation may also be related to cognitive dysfunction in individuals with HIV-1 infection. The purpose of this study was to test the hypothesis that the cortisol response to an alpha adrenergic challenge, cold pressor, is related to cognitive function in HIV-infected injecting drug abusers. We used growth curve modeling to study the relationship of cold pressor challenge stimulated cortisol response to scores on the modified HIV Dementia Scale (mHDS. To test this hypothesis, we assessed the effects of HIV-1 infection on the HDS score directly and indirectly via pattern of cortisol response. The analysis showed that HIV-1 infection was directly related to mHDS performance and that it also influenced scores on the mHDS by way of individuals’ pattern of cortisol response. Cortisol response to α-adrenergic challenge thus may mediate cognitive deficits in individuals with HIV-1 infection. These findings further emphasize the importance of understanding the role of stress in the cognitive problems associated with HIV-1 infection.

  11. INFECTIVE ENDOCARDITIS IN INTRAVENOUS DRUGS ABUSED PATIENT

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    E. Y. Ponomareva

    2011-01-01

    Full Text Available Three-year observation of acute tricuspid infective endocarditis in intravenous drug abused patient: diagnosis, clinical features, visceral lesions, the possibility of cardiac surgery and conservative treatment, outcome.

  12. Interaction of drugs of abuse and microRNA with HIV: a brief review

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    Sudheesh ePilakka-Kanthikeel

    2015-09-01

    Full Text Available MicroRNAs (miRNAs, the post-transcriptional regulators of gene expression, play key roles in modulating many cellular processes. The changes in the expression profiles of several specific miRNAs affect the interactions between miRNA and their targets in various illnesses, including addiction, HIV, cancer etc. The presence of anti-HIV-1 microRNAs (which regulate the level of infectivity of HIV-1 have been validated in the cells which are the primary targets of HIV infection. Drugs of abuse impair the intracellular innate anti-HIV mechanism(s in monocytes, contributing to cell susceptibility to HIV infection. Emerging evidence has implicated miRNAs are differentially expressed in response to chronic morphine treatment. Activation of mu opioid receptors (MOR by morphine is shown to down regulate the expression of anti-HIV miRNAs. In this review, we summarize the results which demonstrate that several drugs of abuse related miRNAs have roles in the mechanisms that define addiction, and how they interact with HIV.

  13. 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...

  14. Nutritional Alterations in Drug Abusers With and Without HIV

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    Janet E. Forrester

    2006-01-01

    Full Text Available Many studies have found that drug abusers have nutritional deficits, including weight deficits. The most plausible explanation for these deficits is dietary insufficiency. However, studies using objective measures of the dietary intake of drug abusers have failed to provide evidence of dietary insufficiency. Other mechanisms have rarely been examined. This article reviews the published literature on the nutritional status of drug abusers with and without HIV, with emphasis on dietary energy and macronutrient intake.

  15. β-Amyloid1-42, HIV-1Ba-L (clade B infection and drugs of abuse induced degeneration in human neuronal cells and protective effects of ashwagandha (Withania somnifera and its constituent Withanolide A.

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    Kesava Rao Venkata Kurapati

    Full Text Available Alzheimer's disease (AD is characterized by progressive dysfunction of memory and higher cognitive functions with abnormal accumulation of extracellular amyloid plaques and intracellular neurofibrillary tangles throughout cortical and limbic brain regions. Withania somnifera (WS also known as 'ashwagandha' (ASH is used widely in Ayurvedic medicine as a nerve tonic and memory enhancer. However, there is paucity of data on potential neuroprotective effects of ASH against β-Amyloid (1-42 (Aβ induced neuropathogenesis. In the present study, we have tested the neuroprotective effects of Methanol: Chloroform (3:1 extract of ASH and its constituent Withanolide A (WA against Aβ induced toxicity, HIV-1(Ba-L (clade B infection and the effects of drugs of abuse using a human neuronal SK-N-MC cell line. Aβ when tested individually, induced cytotoxic effects in SK-N-MC cells as shown by increased trypan blue stained cells. However, when ASH was added to Aβ treated cells the toxic effects were neutralized. This observation was supported by cellular localization of Aβ, MTT formazan exocytosis, and the levels of acetylcholinesterase activity, confirming the chemopreventive or protective effects of ASH against Aβ induced toxicity. Further, the levels of MAP2 were significantly increased in cells infected with HIV-1(Ba-L (clade B as well as in cells treated with Cocaine (COC and Methamphetamine (METH compared with control cells. In ASH treated cells the MAP2 levels were significantly less compared to controls. Similar results were observed in combination experiments. Also, WA, a purified constituent of ASH, showed same pattern using MTT assay as a parameter. These results suggests that neuroprotective properties of ASH observed in the present study may provide some explanation for the ethnopharmacological uses of ASH in traditional medicine for cognitive and other HIV associated neurodegenerative disorders and further ASH could be a potential novel drug to

  16. Autoimmune diseases and HIV infection

    Science.gov (United States)

    Virot, Emilie; Duclos, Antoine; Adelaide, Leopold; Miailhes, Patrick; Hot, Arnaud; Ferry, Tristan; Seve, Pascal

    2017-01-01

    Abstract To describe the clinical manifestations, treatments, prognosis, and prevalence of autoimmune diseases (ADs) in human immunodeficiency virus (HIV)-infected patients. All HIV-infected patients managed in the Infectious Diseases Department of the Lyon University Hospitals, France, between January 2003 and December 2013 and presenting an AD were retrospectively included. Thirty-six ADs were found among 5186 HIV-infected patients which represents a prevalence of 0.69% including immune thrombocytopenic purpura (n = 15), inflammatory myositis (IM) (n = 4), sarcoidosis (n = 4), Guillain–Barré syndrome (GBS) (n = 4), myasthenia gravis (n = 2), Graves’ disease (n = 2), and 1 case of each following conditions: systemic lupus erythematosus, rheumatoid arthritis, autoimmune hepatitis, Hashimoto thyroiditis and autoimmune hemolytic anemia. One patient presented 2 ADs. Thirty patients were known to be HIV-infected when they developed an AD. The AD preceded HIV infection in 2 patients. GBS and HIV infection were diagnosed simultaneously in 3 cases. At AD diagnosis, CD4 T lymphocytes count were higher than 350/mm3 in 63% of patients, between 200 and 350/mm3 in 19% and less than 200/mm3 in 19%. Twenty patients benefited from immunosuppressant treatments, with a good tolerance. ADs during HIV infection are uncommon in this large French cohort. Immune thrombocytopenic purpura, sarcoidosis, IM, and GBS appear to be more frequent than in the general population. Immunosuppressant treatments seem to be effective and well tolerated. PMID:28121924

  17. Identifying HIV-1 dual infections

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    Cornelissen Marion

    2007-09-01

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

  18. HIV stigma among substance abusing people living with HIV/AIDS: implications for HIV treatment.

    Science.gov (United States)

    Levi-Minzi, Maria A; Surratt, Hilary L

    2014-08-01

    HIV-related stigma has a major impact on quality of life and health among people living with HIV and AIDS (PLWHA). This study examines demographic, mental health, behavioral, contextual, and HIV care-related correlates of HIV stigma among 503 substance abusing PLWHA. Stigma was measured with the HIV Internalized Stigma Measure which has four subscales: stereotypes about HIV, self-acceptance, disclosure concerns, and social relationships. Severe substance dependence (55.3%) and depression (54.7%) were associated with higher HIV stigma across all domains. 49.9% of the sample reported antiretroviral (ARV) medication diversion (the unlawful sale and trading of ARV medications); diverters endorsed significantly higher stigma related to disclosure. 54.1% of the sample reported ≥95% ARV adherence; these individuals reported significantly lower stigma for self-acceptance, disclosure, and social relationships. Multivariate linear regression showed that depression and social support demonstrated significant main effects across stigma domains. Findings suggest that interventions to decrease HIV related stigma may be an important component of initiatives to increase engagement in HIV care.

  19. HIV-2 infection: Where are we today?

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    Nayana A Ingole

    2013-01-01

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

  20. HIV Infection and Adult Vaccination

    Science.gov (United States)

    ... Resources for Healthcare Professionals HIV Infection and Adult Vaccination Recommend on Facebook Tweet Share Compartir Vaccines are ... percentage is less than 15%. Learn about adult vaccination and other health conditions Asplenia Diabetes Type 1 ...

  1. 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.

  2. Common oral lesions associated with HIV infection.

    Science.gov (United States)

    Navazesh, M; Lucatorto, F

    1993-09-01

    More than 40 different lesions involving head and neck areas have been associated with HIV infection. The oral cavity may manifest the first sign of HIV infection. Early detection of these conditions can lead to early diagnosis of HIV infection and subsequent appropriate management. Signs, symptoms and management of the most common HIV-associated oral lesions are discussed.

  3. Cocaine enhances HIV-1-induced CD4(+) T-cell apoptosis: implications in disease progression in cocaine-abusing HIV-1 patients.

    Science.gov (United States)

    Pandhare, Jui; Addai, Amma B; Mantri, Chinmay K; Hager, Cynthia; Smith, Rita M; Barnett, Louis; Villalta, Fernando; Kalams, Spyros A; Dash, Chandravanu

    2014-04-01

    Substance abuse is a major barrier in eradication of the HIV epidemic because it serves as a powerful cofactor for viral transmission, disease progression, and AIDS-related mortality. Cocaine, one of the commonly abused drugs among HIV-1 patients, has been suggested to accelerate HIV disease progression. However, the underlying mechanism remains largely unknown. Therefore, we tested whether cocaine augments HIV-1-associated CD4(+) T-cell decline, a predictor of HIV disease progression. We examined apoptosis of resting CD4(+) T cells from HIV-1-negative and HIV-1-positive donors in our study, because decline of uninfected cells plays a major role in HIV-1 disease progression. Treatment of resting CD4(+) T cells with cocaine (up to 100 μmol/L concentrations) did not induce apoptosis, but 200 to 1000 μmol/L cocaine induced apoptosis in a dose-dependent manner. Notably, treatment of CD4(+) T cells isolated from healthy donors with both HIV-1 virions and cocaine significantly increased apoptosis compared with the apoptosis induced by cocaine or virions alone. Most important, our biochemical data suggest that cocaine induces CD4(+) T-cell apoptosis by increasing intracellular reactive oxygen species levels and inducing mitochondrial depolarization. Collectively, our results provide evidence of a synergy between cocaine and HIV-1 on CD4(+) T-cell apoptosis that may, in part, explain the accelerated disease observed in HIV-1-infected drug abusers.

  4. Bone disease and HIV infection.

    Science.gov (United States)

    Amorosa, Valerianna; Tebas, Pablo

    2006-01-01

    The high prevalence of bone demineralization among human immunodeficiency virus (HIV)-infected patients in the current therapeutic era has been described in multiple studies, sounding the alarm that we may expect an epidemic of fragility fractures in the future. However, despite noting high overall prevalences of osteopenia and osteoporosis, recent longitudinal studies that we review here have generally not observed accelerated bone loss during antiretroviral therapy beyond the initial period after treatment initiation. We discuss the continued progress toward understanding the mechanisms of HIV-associated bone loss, particularly the effects of HIV infection, antiretroviral therapy, and host immune factors on bone turnover. We summarize results of clinical trials published in the past year that studied the safety and efficacy of treatment of bone loss in HIV-infected patients and provide provisional opinions about who should be considered for bone disease screening and treatment.

  5. Cocaine modulates HIV-1 integration in primary CD4+ T cells: implications in HIV-1 pathogenesis in drug-abusing patients.

    Science.gov (United States)

    Addai, Amma B; Pandhare, Jui; Paromov, Victor; Mantri, Chinmay K; Pratap, Siddharth; Dash, Chandravanu

    2015-04-01

    Epidemiologic studies suggest that cocaine abuse worsens HIV-1 disease progression. Increased viral load has been suggested to play a key role for the accelerated HIV disease among cocaine-abusing patients. The goal of this study was to investigate whether cocaine enhances proviral DNA integration as a mechanism to increase viral load. We infected CD4(+) T cells that are the primary targets of HIV-1 in vivo and treated the cells with physiologically relevant concentrations of cocaine (1 µM-100 µM). Proviral DNA integration in the host genome was measured by nested qPCR. Our results illustrated that cocaine from 1 µM through 50 µM increased HIV-1 integration in CD4(+) T cells in a dose-dependent manner. As integration can be modulated by several early postentry steps of HIV-1 infection, we examined the direct effects of cocaine on viral integration by in vitro integration assays by use of HIV-1 PICs. Our data illustrated that cocaine directly increases viral DNA integration. Furthermore, our MS analysis showed that cocaine is able to enter CD4(+) T cells and localize to the nucleus-. In summary, our data provide strong evidence that cocaine can increase HIV-1 integration in CD4(+) T cells. Therefore, we hypothesize that increased HIV-1 integration is a novel mechanism by which cocaine enhances viral load and worsens disease progression in drug-abusing HIV-1 patients.

  6. Injecting drugs of abuse and immunity: implications for HIV vaccine testing and efficacy.

    Science.gov (United States)

    Ugen, Kenneth E; Nyland, Susan B

    2006-11-01

    The recreational use of legal and illegal drugs has significant effects on immune responses and can potentially modulate susceptibility to infection by a number of pathogens. A number of agents including cannabinoids (marijuana), cocaine opiates, amphetamines, nicotine and alcohol were demonstrated to have potentially adverse effects on the susceptibility to infections, mediated most likely, by adverse effects on immunity. As such, these drugs of abuse could have significant and potentially adverse effects on the vaccination efficacy of a number of vaccines currently on the market and on potential experimental vaccines currently in the pipeline. This review will present an overview on how drugs of abuse potentially impacts immune responses and vaccination efficacy. The emphasis of this review will be the effects of opiate abuse, as exemplified by injecting/intravenous drug users (IDU), on HIV/AIDS and its potential impact on vaccine efficacy trials against this devastating infection/syndrome.

  7. Bloodstream infections in HIV-infected patients.

    Science.gov (United States)

    Taramasso, Lucia; Tatarelli, Paola; Di Biagio, Antonio

    2016-04-02

    In the combined antiretroviral therapy era, HIV-infected patients remain a vulnerable population for the onset of bloodstream infections (BSI). Worldwide, nontyphoid salmonellae, Streptococcus pneumoniae, Escherichia coli, Staphylococcus aureus and coagulase negative staphylococci are the most important pathogens. Intravenous catheter associated infection, skin-soft tissue infection and endocarditis are associated with Gram-positive bacteremia. Among the Gram-negative, nontyphoidal Salmonella have been previously correlated to sepsis. Other causes of BSI in HIV-infected patients are mycobacteria and fungi. Mycobacteria constitute a major cause of BSI in limited resource countries. Fungal BSI are not frequent and among them Cryptococcus neoformans is the most common life-threatening infection. The degree of immunosuppression remains the key prognostic factor leading to the development of BSI.

  8. Drug Use and Viral Infections (HIV, Hepatitis)

    Science.gov (United States)

    ... HIV, Hepatitis) Drug Use and Viral Infections (HIV, Hepatitis) Email Facebook Twitter Revised March 2017 What's the ... HIV and of worsening its consequences. What is hepatitis? Photo by ©iStock.com/ Skarie20 Hepatitis is an ...

  9. Pharmacotherapy of Pediatric HIV Infection

    OpenAIRE

    Rakhmanina, Natella; Phelps, Ryan

    2012-01-01

    With the ongoing epidemic of human immune deficiency virus (HIV) infections in the pediatric age group, the delivery of safe and effective antiretroviral therapy to children and adolescents is crucial to save the lives of millions of children worldwide. Antiretroviral drugs have been demonstrated to significantly decrease HIV-associated morbidity and mortality, assure normal growth and development, and improve survival and quality of life in children and adolescents. The immunologic response ...

  10. [Microbiological diagnosis of HIV infection].

    Science.gov (United States)

    López-Bernaldo de Quirós, Juan Carlos; Delgado, Rafael; García, Federico; Eiros, José M; Ortiz de Lejarazu, Raúl

    2007-12-01

    Currently, there are around 150,000 HIV-infected patients in Spain. This number, together with the fact that this disease is now a chronic condition since the introduction of antiretroviral therapy, has generated an increasing demand on the clinical microbiology laboratories in our hospitals. This increase has occurred not only in the diagnosis and treatment of opportunistic diseases, but also in tests related to the diagnosis and therapeutic management of HIV infection. To meet this demand, the Sociedad de Enfermedades Infecciosas y Microbiología Clinica (Spanish Society of Infectious Diseases and Clinical Microbiology) has updated its standard Procedure for the microbiological diagnosis of HIV infection. The main advances related to serological diagnosis, plasma viral load, and detection of resistance to antiretroviral drugs are reviewed in this version of the Procedure.

  11. HIV-associated opportunistic CNS infections: pathophysiology, diagnosis and treatment.

    Science.gov (United States)

    Bowen, Lauren N; Smith, Bryan; Reich, Daniel; Quezado, Martha; Nath, Avindra

    2016-10-27

    Nearly 30 years after the advent of antiretroviral therapy (ART), CNS opportunistic infections remain a major cause of morbidity and mortality in HIV-positive individuals. Unknown HIV-positive disease status, antiretroviral drug resistance, poor drug compliance, and recreational drug abuse are factors that continue to influence the morbidity and mortality of infections. The clinical and radiographic pattern of CNS opportunistic infections is unique in the setting of HIV infection: opportunistic infections in HIV-positive patients often have characteristic clinical and radiological presentations that can differ from the presentation of opportunistic infections in immunocompetent patients and are often sufficient to establish the diagnosis. ART in the setting of these opportunistic infections can lead to a paradoxical worsening caused by an immune reconstitution inflammatory syndrome (IRIS). In this Review, we discuss several of the most common CNS opportunistic infections: cerebral toxoplasmosis, progressive multifocal leukoencephalopathy (PML), tuberculous meningitis, cryptococcal meningitis and cytomegalovirus infection, with an emphasis on clinical pearls, pathological findings, MRI findings and treatment. Moreover, we discuss the risk factors, pathophysiology and management of IRIS. We also summarize the challenges that remain in management of CNS opportunistic infections, which includes the lack of phase II and III clinical trials, absence of antimicrobials for infections such as PML, and controversy regarding the use of corticosteroids for treatment of IRIS.

  12. 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.

  13. Renal issues in HIV infection.

    Science.gov (United States)

    Kalayjian, Robert C

    2011-09-01

    Kidney disease remains a prominent complication of HIV disease, despite beneficial effects of antiretroviral therapy on the natural history of HIV-associated nephropathy, and on kidney function in general populations of HIV infected patients. Persons of African descent continue to bear a disproportionate burden of severe kidney disease, as is true for the general population. Recently identified genetic variants in the apolipoprotein L1 gene may contribute to this burden. As is also true for the general population, markers of kidney disease, including microalbuminuria, are sensitive predictors of cardiovascular disease and mortality among persons living with HIV. The emerging experience with kidney transplantation also suggests this to be a viable option in selected patients.

  14. The Investigation of Infections of HIV, HCV and Syphilis among Active Drug Abusers in Beijing%北京市主动戒毒人群人类免疫缺陷病毒、丙型肝炎病毒和梅毒螺旋体感染状况调查

    Institute of Scientific and Technical Information of China (English)

    范丽霞; 李森林; 刘芳; 吴涛

    2011-01-01

    Objective To provide scientific basis on behavior interventions through investigating infections of human immunodeficiency virus(HIV) , hepatitis C virus( HCV ) and syphilis among active drug abusers. Methods 1136 actire drug abusers were investigated for drug abuse manner and their serum specimens were collected for detecting HIV,HCV and Syphilis antibody in Beijing. The relationship between different drug abuse manners and infection of mentioned disease was investigated. Results ①lnfection rate of HIV, HCV and Syphilis were 1.50%, 36.18% and 6.87 % respectively. The infection rates of HIV and HCV in intravenous injection drug users were higher than those in non-intravenous injection people ( P <0.01 ). The infection rate of HIV of the needle and syringe sharing people were higher than those of non needle and syringe sharing users(P <0.05). The coinfection rate of HIV/HCV, HCV/syphilis, HIV/syphilis and HIV/HCV/syphilis in drug abusers were 1.41%, 2.55%, 0.26% and 0.26% respectively. Conclusion Wide spreading and epidemic risks of blood transmitted diseases exist in the active drug abusers, and more effective intervention measures and monitoring should be taken to curb spreading of HIV, HCV and syphilis among active drug abusers.%目的 调查主动戒毒人群人类免疫缺陷病毒(HIV)、丙型肝炎病毒(HCV)和梅毒螺旋体(梅毒)感染状况,为其行为干预提供科学依据.方法 对北京市1136名主动戒毒人员进行HIV、HCV和梅毒抗体检测,并调查不同吸毒方式与上述各病毒感染的关系.结果 1136例中HIV、HCV、梅毒感染率分别为1.50%、36.18%及6.87%.静脉注射吸毒者HIV、HCV感染率明显高于非静脉注射吸毒者,差异有统计学意义(P<0.01).静脉吸毒者中共用针具者HIV感染率高于不共用针具者,差异有统计学意义(P<0.05).HIV、HCV重叠感染率1.41%,HCV、梅毒重叠感染率2.55%,HIV、梅毒重叠感染率0.26%,HIV、HCV、梅毒重叠感染率0

  15. [Cofactors in the course of HIV infection].

    Science.gov (United States)

    Meyer, L; Carré, N

    Cohorts of patients infected with the human immunodeficiency virus (HIV), and followed-up since their infection, have identified risk factors of progression to acquired immunodeficiency syndrome (AIDS). The risk of progression increases with the subject's age at contamination by 40% for each decade. Other host factors such as certain HLA subtypes would be related to progression. Virus-related factors have also been described. Sexual or transfusional transmission from a highly immunodepressed subject increases the risk of progression in the infected subject. Progression is more rapid in male homosexuals than in heterosexuals, even after exclusion of Kaposi's syndrome. There has been little success in isolating co-infections which might explain this finding. The more rapid progression in homosexuals could be due to infection with particularly virulent strains or particular subtypes. Finally, progresion is more rapid when signs of primary infection are major or prolonged, an observation which probably results from a complex host-virus interaction. Behavioral factors occurring after contamination (pregnancy, continued intravenous drug abuse, tobacco, alcohol) have not been demonstrated until now to play a role in progression.

  16. Treatment of primary HIV infection

    NARCIS (Netherlands)

    Grijsen, M.L.

    2013-01-01

    In this thesis we studied the treatment of PHI. Early cART transiently lowered the viral setpoint and deferred the need for restart of cART during chronic HIV infection, which was most likely caused by the effects of the CD4 gain during treatment and the transient lowering of the viral setpoint. Eve

  17. A Case of Seronegative HIV-1 Infection

    OpenAIRE

    Spivak, Adam M; Brennan, Tim; O'Connell, Karen; Sydnor, Emily; Thomas M Williams; Robert F. Siliciano; Gallant, Joel E.; Blankson, Joel N.

    2010-01-01

    Patients infected with HIV-1 typically seroconvert within weeks of primary infection. In rare cases, patients do not develop antibodies against HIV-1 despite demonstrable infection. We describe an HLA-B*5802 positive individual who presented with AIDS despite repeatedly negative HIV-1 antibody screening tests. Phylogenetic analysis of env clones revealed little sequence diversity, and weak HIV-1 specific CD8+ T cell responses were present to Gag epitopes. The patient seroconverted after immun...

  18. HIV Rapid Testing in Substance Abuse Treatment: Implementation Following a Clinical Trial

    Science.gov (United States)

    Haynes, L. F.; Korte, J. E.; Holmes, B. E.; Gooden, L.; Matheson, T.; Feaster, D. J.; Leff, J. A.; Wilson, L.; Metsch, L. R.; Schackman, B. R.

    2011-01-01

    The Substance Abuse Mental Health Services Administration has promoted HIV testing and counseling as an evidence-based practice. Nevertheless, adoption of HIV testing in substance abuse treatment programs has been slow. This article describes the experience of a substance abuse treatment agency where, following participation in a clinical trial,…

  19. 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.

  20. Substance abuse treatment in persons with HIV/AIDS: challenges in managing triple diagnosis.

    Science.gov (United States)

    Durvasula, Ramani; Miller, Theodore R

    2014-01-01

    Clinical management of HIV must account for the "triple diagnosis" of HIV, psychiatric diagnosis, and substance use disorders and requires integrated treatment services that focus beyond just mitigation of substance use and psychiatric and medical symptoms but also address other health behaviors. Because clinical management of HIV/AIDS has shifted significantly with the advent of highly active antiretroviral therapies (HAART) in the mid 1990s, a literature review focusing on literature published since 2000, and using relevant key words was conducted using a wide range of literature search databases. This literature review was complemented by studies to expand on specific treatment modalities for which there was a dearth of literature addressing HIV infected cohorts and to provide discussion of issues around substance abuse treatment as an HIV prevention tool. Existing models of substance abuse treatment including cognitive behavioral therapy and motivational interviewing have proven to be useful for enhancing adherence and reducing substance use in outpatient populations, while methadone maintenance and directly observed treatment have been useful with specific subgroups of users. Contextualization of services heightens the likelihood of successful outcomes and relapse prevention.

  1. National Institute on Drug Abuse symposium report: drugs of abuse, dopamine, and HIV-associated neurocognitive disorders/HIV-associated dementia.

    Science.gov (United States)

    Purohit, Vishnudutt; Rapaka, Rao; Frankenheim, Jerry; Avila, Albert; Sorensen, Roger; Rutter, Joni

    2013-04-01

    The National Institute on Drug Abuse organized a symposium on drugs of abuse, dopamine, and HIV-associated neurocognitive disorders (HAND)/HIV-associated dementia (HAD) in Rockville, Maryland, October 4, 2011. The purpose of this symposium was to evaluate the potential role of dopamine in the potentiation of HAND/HAD by drugs of abuse. A summary of the symposium has been presented in this report.

  2. Inflammation in HIV-Infected Patients

    DEFF Research Database (Denmark)

    Langkilde, Anne; Petersen, Janne; Klausen, Henrik Hedegaard;

    2012-01-01

    To examine mechanisms underlying the increased inflammatory state of HIV-infected patients, by investigating the association of HIV-related factors, demography, lifestyle, and body composition with the inflammatory marker soluble urokinase plasminogen activator receptor (suPAR)....

  3. HIV/AIDS and Fungal Infections

    Science.gov (United States)

    ... Environmental Diseases Mycotic Diseases Branch People living with HIV/AIDS Recommend on Facebook Tweet Share Compartir As ... Page Preventing fungal infections in people living with HIV/AIDS Fungi are difficult to avoid because they ...

  4. [Stroke in HIV-infected patients].

    Science.gov (United States)

    Lino, Ireneia; Sousa, António; Correia, José

    2007-01-01

    The spectrum of human immunodeficiency virus infection (HIV) is changing. New drug treatments have reduced morbidity and mortality of this disease, therefore it is necessary to start treating the HIV infection as a chronical disease. The association of the stroke with the HIV infection was inicially thought to be a result of other opportunistic infeccions and tumors. However, the vascular disease associated with HIV infection has been a subject of research and debate. New evidence shows that the vascular diseases could be a threat for the pacients doing highly active antirretroviral therapy (HAART). In this paper, we review the association between the HIV infection and stroke. Furthermore, we have done an analysis of the risk for the stroke on pacients with HIV infection considering the changes of the infection spectrum by the introduction of HAART.

  5. INVESTIGATION ON THE PSYCHOLOGICAL HEALTH STATUS OF 93 DRUG ABUSERS WITH HIV INFECTION UNDER CENTRALIZED COMPULSORY ISOLATION TREATMENT%93例集中强制隔离戒毒的HIV感染者心理健康状况调查

    Institute of Scientific and Technical Information of China (English)

    李梦桃

    2011-01-01

    目的:了解集中管理强制隔离戒毒的mV感染人员的心理健康状况.方法:对93例男性感染HIV(研究组)和113例男性非HIV感染(对照组)的强制隔离戒毒者分别进行SCL -90心理健康测评.将研究组的测评分值分别与对照组以及常模组进行统计学分析比较.结果:93例感染HIV戒毒者的SCL- 90的9项因子高于常模组分值,也高于非HⅣ感染的戒毒者,组间比较差异有显著性(P <0.05 -0.001).结论:集中管理强制隔离戒毒的HIV感染人员有明显的心理问题.积极开展场所内的心理辅导可以疏导和改善由于长期药物滥用和感染HIV产生的心理障碍,减少和避免不良事件的发生.%Objective:To understand the psychological health status of drug abuseis with HTV infection under centralized (put together) compulsory isolation detoxification treatment. Methods: Ninety -three male drug abusers with HIV infection who were doing detoxification in a centralized and isolated unit were selected as study group, and 113 male non - HIV infected drug abusers under compulsory isolation detoxification treatment at the same period with the study group were selected as control group. The two groups were tested with "SCL -90(Symptom Checklist 90) ". Statistical analysis was conducted based on the comparison between the scores of study group and those of the control group and normal control. Results:The study group obtained higher scores in all nine factors of SCL -90 compared with both the normal and the control group. The statistic results showed significant difference among groups (P < 0.01). Conclusion:Drug abusers with HIV infection under centralized compulsory isolation detoxification treatment have obvious psychological problems. Active psychological counselings should be conducted in centralized compulsory isolation detoxification treatment units,which is helpful to ease their psychological disorders caused by long - term drug abuse and HIV infection, and reduce

  6. The kidney in HIV infection: beyond HIV-associated nephropathy.

    Science.gov (United States)

    Wyatt, Christina M

    2012-01-01

    Acute kidney injury (AKI) and chronic kidney disease (CKD) are more common in HIV-infected persons than in the general population. AKI is associated with poor health outcomes, including increased risk of heart failure, cardiovascular events, end-stage renal disease (ESRD), and mortality. The most common causes of AKI in HIV-infected persons are systemic infections and adverse drug effects. The prevalence of CKD is rising in the HIV-infected population and CKD is increasingly likely to be caused by comorbid conditions, such as diabetes and hypertension, that frequently cause CKD in the general population. Guidelines for CKD screening in HIV-infected patients are being revised. It is currently recommended that all patients be screened for creatinine-based estimates of glomerular filtration rate and for urine protein at the time of HIV diagnosis. Annual screening is recommended for high-risk patients. Hemodialysis, peritoneal dialysis, and kidney transplantation are all options for treating ESRD in HIV-infected patients. Hemodialysis and peritoneal dialysis offer similar survival in HIV-infected patients with ESRD. In selected patients with well-controlled HIV infection, kidney transplantation is associated with survival intermediate between that in the overall transplant population and that among transplant recipients older than 65 years. This article summarizes a presentation by Christina M. Wyatt, MD, at the IAS-USA continuing medical education program held in Chicago in May 2012, describing AKI and CKD using case illustrations.

  7. Vaccination scars in HIV infected patients – does vaccinia vaccination confer protection against HIV?

    DEFF Research Database (Denmark)

    Jespersen, Sanne; Hønge, Bo Langhoff; Medina, Candida;

    Vaccination scars in HIV infected patients – does vaccinia vaccination confer protection against HIV?......Vaccination scars in HIV infected patients – does vaccinia vaccination confer protection against HIV?...

  8. 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; Kronborg, Gitte

    2014-01-01

    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...... 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...

  9. Use of non-antiretroviral drugs among individuals with and without HIV-infection

    DEFF Research Database (Denmark)

    Rasmussen, Line D; Kronborg, Gitte; Larsen, Carsten S

    2017-01-01

    no injection drug abuse or hepatitis C infection. Population controls were identified from The Danish Civil Registration System and matched on age and gender (5:1). We analyzed the proportion of individuals who redeemed 0-1, 2-4, 5-9, or 10 or more non-antiretroviral drugs. Data were analyzed according......AIM: We investigated the use of non-antiretroviral drugs in the HIV-infected compared to the general population. METHODS: From the Danish HIV Cohort Study, we identified all HIV-infected individuals older than 18 years at HIV diagnosis who received care in Denmark through 1995-2013 and reported...... to calendar time, age, time from initiation of combination antiretroviral therapy (cART) and stratified by gender, geographical origin and route of HIV transmission. We further analyzed the use of the 25 most used non-antiretroviral drug classes. RESULTS: We identified 4,928 HIV-infected individuals (median...

  10. Childhood sexual abuse and HIV-related risks among men who have sex with men in Washington, DC.

    Science.gov (United States)

    Phillips, Gregory; Magnus, Manya; Kuo, Irene; Rawls, Anthony; Peterson, James; Montanez, Luz; West-Ojo, Tiffany; Jia, Yujiang; Opoku, Jenevieve; Greenberg, Alan E

    2014-05-01

    Childhood sexual abuse (CSA) has been reported to be disproportionately higher among men who have sex with men (MSM) than among heterosexual men; it has also been found to be significantly positively associated with HIV status and HIV risk factors, including unprotected anal intercourse. The purpose of this study was to assess the correlates of CSA in a sample of community-recruited MSM, investigate race as a potential effect modifier, and describe the independent association between CSA and HIV infection in Washington, DC. A total of 500 MSM were recruited by venue-based sampling in 2008 as part of the National HIV Behavioral Surveillance. More than one-half of MSM identified as White, while one-third identified as Black. CSA was reported by 17.5 % of the 451 MSM, with the first instance of abuse occurring at a median age of 8.3 (interquartile range = 5.0, 11.0). In multivariable analysis, HIV-positive men were significantly more likely to report a history of CSA compared to HIV-negative men after adjusting for intimate partner violence in the last 12 months, having been arrested in the last 12 months, and depressive symptoms. HIV-positive MSM had more than four times the odds of reporting CSA after controlling for other correlates (aOR = 4.19; 95 % CI 2.26, 7.75). Despite hypothesizing that race modified the effect of CSA on HIV infection we found this was not the case in this sample. More research is needed to investigate the potential pathway between a history of CSA and HIV infection, and how this contributes to driving the HIV epidemic among MSM in Washington, DC.

  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. Frailty, HIV infection, and mortality in an aging cohort of injection drug users.

    Directory of Open Access Journals (Sweden)

    Damani A Piggott

    Full Text Available Frailty is associated with morbidity and premature mortality among elderly HIV-uninfected adults, but the determinants and consequences of frailty in HIV-infected populations remain unclear. We evaluated the correlates of frailty, and the impact of frailty on mortality in a cohort of aging injection drug users (IDUs.Frailty was assessed using standard criteria among HIV-infected and uninfected IDUs in 6-month intervals from 2005 to 2008. Generalized linear mixed-model analyses assessed correlates of frailty. Cox proportional hazards models estimated risk for all-cause mortality.Of 1230 participants at baseline, the median age was 48 years and 29% were HIV-infected; the frailty prevalence was 12.3%. In multivariable analysis of 3,365 frailty measures, HIV-infected IDUs had an increased likelihood of frailty (OR, 1.66; 95% CI, 1.24-2.21 compared to HIV-uninfected IDUs; the association was strongest (OR, 2.37; 95% CI, 1.62-3.48 among HIV-infected IDUs with advanced HIV disease (CD4<350 cells/mm3 and detectable HIV RNA. No significant association was seen with less advanced disease. Sociodemographic factors, comorbidity, depressive symptoms, and prescription drug abuse were also independently associated with frailty. Mortality risk was increased with frailty alone (HR 2.63, 95% CI, 1.23-5.66, HIV infection alone (HR 3.29, 95% CI, 1.85-5.88, and being both HIV-infected and frail (HR, 7.06; 95%CI 3.49-14.3.Frailty was strongly associated with advanced HIV disease, but IDUs with well-controlled HIV had a similar prevalence to HIV-uninfected IDUs. Frailty was independently associated with mortality, with a marked increase in mortality risk for IDUs with both frailty and HIV infection.

  13. Discrepant coagulation profile in HIV infection

    DEFF Research Database (Denmark)

    Haugaard, Anna Karen; Lund, Tamara T.; Birch, Carsten

    2013-01-01

    In HIV infection, cardiovascular disease (CVD) has emerged as a clinical problem, and elevated D-dimer has been reported. The pathophysiologic mechanisms underlying this remain unclear. We aimed to investigate whether untreated HIV-infected individuals display evidence of functional coagulopathy...

  14. Male reproduction and HIV-1 infection

    NARCIS (Netherlands)

    E. van Leeuwen

    2009-01-01

    From its initial presentation in the early nineteen eighties until 1996, HIV-1 infection almost inevitably led to AIDS, which was a death sentence. Because of the short life expectancy, patients were advised against pregnancy. The improved prognosis of patients with HIV-1 infection following the int

  15. Comorbidity and ageing in HIV infection

    NARCIS (Netherlands)

    Kooij, K.W.

    2017-01-01

    In the era of modern combination antiretroviral therapy (cART) the HIV-infected population is ageing. Studies have suggested that HIV-infected individuals, even if appropriately treated with cART, may be at increased risk for several age-related conditions. In this thesis a variety of age-related co

  16. Predicting risk of cancer during HIV infection

    DEFF Research Database (Denmark)

    Borges, Álvaro H; Silverberg, Michael J; Wentworth, Deborah

    2013-01-01

    To investigate the relationship between inflammatory [interleukin-6 (IL-6) and C-reactive protein (CRP)] and coagulation (D-dimer) biomarkers and cancer risk during HIV infection.......To investigate the relationship between inflammatory [interleukin-6 (IL-6) and C-reactive protein (CRP)] and coagulation (D-dimer) biomarkers and cancer risk during HIV infection....

  17. [Child sexual abuse and sexually transmitted infections in sub-saharan Africa].

    Science.gov (United States)

    Pitche, P

    2005-11-01

    Recently there has been increasing public concern regarding escalating child sexual abuse (CSA) in the sub-Saharan Africa. Medical consequences of child sexual abuse (CSA) include sexually transmitted infection (STI) and human immune virus (HIV) infection. The purpose of the study was to review literature on CSA and associated STI/HIV in the sub-Saharan Africa. The study covered the 23-year period from 1980 to 2003. The mean age of the child victims was 8 years. The incidence of penetrative sex in the studies ranged from 70 to 97%. Physical signs of CSA included genital or anal injuries, perineal trauma, and vesico-vaginal or recto-vaginal fistula. The incidence of STD varied according to whether the study was retrospective or prospective. Ten percent to 67% of children with STD had been sexually abused while 15 to 30% of sexual abuse incidents were associated with STD. The prevalence of HIV ranged from 3% in Togo to 37.5% in Cameroon. Most alleged child abusers were adult males known by the child, i.e., family members (30-60%), instructors or teachers, household personnel or neighbours. Some acts were motivated by traditional practices such as early, forced marriage and beliefs such as presumed benefits of sex with virgin children (cure for STI/HIV/STD, magic powers or wealth). This study shows that CSA is widespread throughout sub-Saharan Africa. Most problem involving CSA in sub-Saharan Afica have not been documented. Knowledge about the extent and special aspects of CSA in Africa can be useful for implementation of suitable management measures.

  18. Hormonal and Metabolic Disorders of Human Immunodeficiency Virus Infection and Substance Abuse

    Directory of Open Access Journals (Sweden)

    Jag H. Khalsa

    2006-01-01

    Full Text Available There are an estimated 200 million users of an illicit drug in the world today. In addition, an estimated 40 million people are infected with the human immunodeficiency virus (HIV and an estimated 180 million people are infected with the hepatitis C virus (HCV. Both the use of an illicit drug and the co-occurrence of infections are associated with a multitude of medical and health consequences including hormonal and metabolic disorders. Thus, the National Institute on Drug Abuse (NIDA, a part of the National Institutes of Health (NIH hosted a workshop on hormonal and metabolic disorders of HIV among substance abusers. A number of clinicians and scientists participated and discussed a wide range of issues concerning hormones, nutrition and metabolic complications in HIV and substance abuse. Their observations and the recommendations they made for future research are presented in these proceedings. The readers are encouraged to contact the NIH staff (JK, FV for technical guidance and programmatic priorities on the subject and directly contact the individual authors for collaborations.

  19. HIV infection is associated with reduced pulmonary diffusing capacity

    OpenAIRE

    2013-01-01

    INTRODUCTION: Prior studies comparing abnormalities in pulmonary function between HIV-infected and HIV-uninfected persons in the current era are limited. OBJECTIVES: To determine the pattern and severity of impairment in pulmonary function in HIV-infected compared with HIV-uninfected individuals. METHODS: Cross-sectional analysis of 300 HIV-infected men and 289 HIV-uninfected men enrolled from 2009 to 2011 in 2 clinical centers of the Lung HIV Study. Participants completed pre- and postbronch...

  20. Cerebrospinal fluid analysis in the HIV infection and compartmentalization of HIV in the central nervous system

    OpenAIRE

    Sérgio Monteiro Almeida

    2015-01-01

    The nervous system plays an important role in HIV infection. The purpose of this review is to discuss the indications for cerebrospinal fluid (CSF) analysis in HIV infection in clinical practice. CSF analysis in HIV infection is indicated for the diagnosis of opportunistic infections and co-infections, diagnosis of meningitis caused by HIV, quantification of HIV viral load, and analysis of CNS HIV compartmentalization. Although several CSF biomarkers have been investigated, none are clinicall...

  1. 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.

  2. Parasitic infections in HIV infected individuals: Diagnostic & therapeutic challenges

    OpenAIRE

    Nissapatorn, Veeranoot; Sawangjaroen, Nongyao

    2011-01-01

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

  3. HIV Infection Accelerates Hepatitis C-Related Liver Fibrosis

    Science.gov (United States)

    ... HIV Infection Accelerates Hepatitis C–Related Liver Fibrosis HIV Infection Accelerates Hepatitis C–Related Liver Fibrosis Email ... the progression of other chronic diseases as well. HIV and Fibrosis Dr. Kirk and his team tapped ...

  4. Cryptic Leishmania infantum infection in Italian HIV infected patients

    Directory of Open Access Journals (Sweden)

    Rubino Raffaella

    2009-12-01

    Full Text Available Abstract Background Visceral leishmaniasis (VL is a protozoan diseases caused in Europe by Leishmania (L. infantum. Asymptomatic Leishmania infection is more frequent than clinically apparent disease. Among HIV infected patients the risk of clinical VL is increased due to immunosuppression, which can reactivate a latent infection. The aims of our study were to assess the prevalence of asymptomatic L. infantum infection in HIV infected patients and to study a possible correlation between Leishmania parasitemia and HIV infection markers. Methods One hundred and forty-five HIV infected patients were screened for the presence of anti-Leishmania antibodies and L. infantum DNA in peripheral blood. Statistical analysis was carried out by using a univariate regression analysis. Results Antibodies to L. infantum were detected in 1.4% of patients. L. infantum DNA was detected in 16.5% of patients. Significant association for PCR-Leishmania levels with plasma viral load was documented (p = 0.0001. Conclusion In our area a considerable proportion of HIV infected patients are asymptomatic carriers of L. infantum infection. A relationship between high HIV viral load and high parasitemic burden, possibly related to a higher risk of developing symptomatic disease, is suggested. PCR could be used for periodic screening of HIV patients to individuate those with higher risk of reactivation of L. infantum infection.

  5. Cyclophilin B enhances HIV-1 infection

    Energy Technology Data Exchange (ETDEWEB)

    DeBoer, Jason; Madson, Christian J. [Department of Medical Microbiology and Immunology, Creighton University, Omaha, NE (United States); Belshan, Michael, E-mail: michaelbelshan@creighton.edu [Department of Medical Microbiology and Immunology, Creighton University, Omaha, NE (United States); The Nebraska Center for Virology, University of Nebraska, Lincoln, NE (United States)

    2016-02-15

    Cyclophilin B (CypB) is a member of the immunophilin family and intracellular chaperone. It predominantly localizes to the ER, but also contains a nuclear localization signal and is secreted from cells. CypB has been shown to interact with the Gag protein of human immunodeficiency type 1 (HIV-1). Several proteomic and genetic studies identified it as a potential factor involved in HIV replication. Herein, we show that over-expression of CypB enhances HIV infection by increasing nuclear import of viral DNA. This enhancement was unaffected by cyclosporine treatment and requires the N-terminus of the protein. The N-terminus contains an ER leader sequence, putative nuclear localization signal, and is required for secretion. Deletion of the N-terminus resulted in mislocalization from the ER and suppression of HIV infection. Passive transfer experiments showed that secreted CypB did not impact HIV infection. Combined, these experiments show that intracellular CypB modulates a pathway of HIV nuclear import. - Highlights: • CypB has been identified in several proteomic studies of HIV-1 infection. • CypB expression is upregulated in activated and infected T-cells. • Over-expression of CypB enhances HIV nuclear import and infection. • The N-terminus of CypB is necessary for these effects.

  6. [Travel medicine for HIV-infected patients].

    Science.gov (United States)

    Rossi, M; Furrer, H

    2001-06-01

    Many HIV-infected persons travel from temperate zones to (sub)tropical destinations. HIV-specific immigration issues, medical resources abroad and problems regarding travelling with multiple medications have to be anticipated. When prescribing immunizations and specific chemoprophylaxis, the stage of immunodeficiency as well as drug interactions with antiretrovirals and medicaments against opportunistic infections have to be taken into account. Live vaccines may be contraindicated. Immunocompromised HIV-infected travellers have a higher risk for serious courses of diseases by enteropathogens. Therefore a good information about food hygiene is important and a prescription of an antibiotic to take in case of severe diarrhea may be indicated. A new antiretroviral combination therapy should not be started immediately before travelling to the tropics. The possibility to continue an established HIV treatment during travel has to be evaluated cautiously. With good pre-travel advice the risk of severe health problems is low for most HIV-infected travellers.

  7. REPRESENTATION OF THE DISEASE, THE MOTIVATIONAL SPHERE AND MEDICAL COMMUNICATION AS AN OBJECTIVE FOR HIV PREVENTION AND THE TREATMENT OF HIV INFECTION IN SUBSTANCE USERS

    OpenAIRE

    Buzina, Tatiana

    2014-01-01

    The psychological aspect of treating HIV-infected substance users entails changing their behaviour, as their behaviour is what leads to the risk of them transmitting and spreading HIV. Psychological treatment must facilitate their adaptation so that they may be otherwise treated for substance abuse and HIV. We propose establishing the psychological objective of helping patients overcome substance addiction by addressing their internal representation of the disease (IRD), value-sense and motiv...

  8. Children Seeking Refuge: A Review of the Escalating Humanitarian Crisis of Child Sexual Abuse and HIV/AIDS in Latin America.

    Science.gov (United States)

    Thornton, Clifton P; Veenema, Tener Goodwin

    2015-01-01

    Early identification and intervention for victims of child sexual abuse (CSA) is essential to halting the spread of HIV in Latino populations because children who are sexually abused are at an increased risk of contracting HIV. The recent influx of unaccompanied children into the United States exposed histories of victimization, vulnerability to CSA, and suggested an epidemic of CSA in Latin America. CSA has been identified as a contributory event to HIV infection. The aim of our research was to identify factors associated with CSA and Latin Americans. A systematic review and a document search were conducted on factors associated with CSA in Latin America. Victimization was associated with lifelong risk factors for HIV. Males were consistently underrepresented in the published CSA literature and machismo attitudes may contribute to abuses of sexual power by males and contribute to males not reporting or under-reporting victimization.

  9. Current oral manifestations of HIV infection.

    Science.gov (United States)

    Navazesh, M

    2001-02-01

    The oral manifestations of human immunodeficiency virus infection have changed drastically since the introduction of the highly active anti-retroviral therapy (HAART) in developed countries. Recent studies have documented significant reductions in morbidity and mortality rates among HIV-infected patients on HAART. This article focuses on the latest information about the oral manifestations of HIV infection and will discuss the impact of HAART.

  10. 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.

  11. Association of drug abuse with inhibition of HIV-1 immune responses: studies with long-term of HIV-1 non-progressors.

    Science.gov (United States)

    Nair, Madhavan P N; Mahajan, S; Hewitt, R; Whitney, Z R B; Schwartz, S A

    2004-02-01

    Recreational drug use has been proposed to affect the course of human immunodeficiency virus (HIV) infections. To investigate the effects of substance abuse on HIV infections, we compared virus-specific cytotoxic T lymphocyte (CTL) responses and the expression of IL-16, TGF-beta1, and CXCR4 in three different cohorts of HIV-infected patients: (1) long-term nonprogressors (LT-NPs) of HIV infection who do not use recreational drugs; (2) nondrugs using normal progressors (NPs), and (3) drugs using NPs. Our results show that LT-NPs manifest increased CTL activity and IL-16 expression and decreased expression of TGF-beta1 and CXCR4 compared to NPs, regardless of recreational drug usage. Furthermore, drugs using NPs showed significantly lower levels of CTL and IL-16 expression and increased TGF-beta1 and CXCR4 expression compared to nondrugs using NPs. Our results suggest that recreational drug use may reduce CTL and IL-16 expression and increase the expression of TGF-beta1 and CXCR4, all of which may facilitate progression of HIV infections.

  12. Potential use of rapamycin in HIV infection

    DEFF Research Database (Denmark)

    Donia, Marco; McCubrey, James A; Bendtzen, Klaus

    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...

  13. HIV infection and the kidneys, Part I

    Directory of Open Access Journals (Sweden)

    Basta-Jovanović 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.

  14. 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...... 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...

  15. NKT cells in HIV-1 infection

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

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

  16. COURSE FEATURES EPIDEMIC PROCESS HIV INFECTION IN KHARKIV REGION

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    Nikolaeva LG

    2016-03-01

    . Taking effective preventive measures against drug abuse has led to the decrease in the incidence of HIV-infection among this group of risk and changes of transmission routes. In 2015 in the structure of the leading transmission routes there were (22.6 ± 1.8 % of parenteral and (56.9 ± 2.1 % of sexual cases (p<0.05. These data indicate that the implementation tract infection due to injecting drug use leads to a concentrated stage of the HIV epidemic. At the same time the increase in the proportion of sexual transmission increase in the number of infected women indicate a threat to the output of the epidemic risk groups to the general set of the population. Conclusions. 1. The incidence of HIV-infection in the region was in several times lower than on the whole in Ukraine (accordingly 2.4 - 23.7 and 10.6 - 47.1 per 100 000 population. 2. Carried out research in the region revealed the peculiarities of the epidemic process of HIV-infection. So the level of growth of newly registered cases of HIV-infection from 0.1 per 100 000 population in 1995 to 20.5 per 100 000 population in 2015 was set (the growth rate was +7.0 %; a gradual change in the sexual spectrum of HIV-infected people (women from 12.9 % to 41.0 % and men from 87.1 % to 59.0 % and the structure of the leading transmission routes (parenteral from 77.1 % to 22.6% and sexual from 5.7 % to 59.6 %; involvement in the epidemic process of all age groups with a predominance of the most working-age population 25 – 49 years. 3. The HIV epidemic is concentrated on the most vulnerable groups of population, but there is a risk of generalized spreading of HIV among the population. 4. Epidemiological surveillance of HIV infection must be adapted to the local epidemiological conditions, and preventive measures aimed at the timely detection of infection cases and the suspension of the epidemic.

  17. Substance Abuse Treatment in Persons with HIV/AIDS: Challenges in Managing Triple Diagnosis

    OpenAIRE

    Durvasula, Ramani; Miller, Theodore R.

    2014-01-01

    This paper provides a review of the current literature addressing substance abuse treatment in persons living with HIV/AIDS. Clinical management of HIV must account for the “triple diagnosis” of HIV, psychiatric diagnosis, and substance use disorders and requires integrated treatment services that focus beyond just mitigation of substance use and psychiatric and medical symptoms but also address other health behaviors. Because clinical management of HIV/AIDS has shifted significantly with the...

  18. Neuronal Stress and Injury Caused by HIV-1, cART and Drug Abuse: Converging Contributions to HAND

    Directory of Open Access Journals (Sweden)

    Ana B. Sanchez

    2017-02-01

    Full Text Available Multiple mechanisms appear to contribute to neuronal stress and injury underlying HIV-associated neurocognitive disorders (HAND, which occur despite the successful introduction of combination antiretroviral therapy (cART. Evidence is accumulating that components of cART can itself be neurotoxic upon long-term exposure. In addition, abuse of psychostimulants, such as methamphetamine (METH, seems to compromise antiretroviral therapy and aggravate HAND. However, the combined effect of virus and recreational and therapeutic drugs on the brain is still incompletely understood. However, several lines of evidence suggest a shared critical role of oxidative stress, compromised neuronal energy homeostasis and autophagy in promotion and prevention of neuronal dysfunction associated with HIV-1 infection, cART and psychostimulant use. In this review, we present a synopsis of recent work related to neuronal stress and injury induced by HIV infection, antiretrovirals (ARVs and the highly addictive psychostimulant METH.

  19. Neuronal Stress and Injury Caused by HIV-1, cART and Drug Abuse: Converging Contributions to HAND.

    Science.gov (United States)

    Sanchez, Ana B; Kaul, Marcus

    2017-02-23

    Multiple mechanisms appear to contribute to neuronal stress and injury underlying HIV-associated neurocognitive disorders (HAND), which occur despite the successful introduction of combination antiretroviral therapy (cART). Evidence is accumulating that components of cART can itself be neurotoxic upon long-term exposure. In addition, abuse of psychostimulants, such as methamphetamine (METH), seems to compromise antiretroviral therapy and aggravate HAND. However, the combined effect of virus and recreational and therapeutic drugs on the brain is still incompletely understood. However, several lines of evidence suggest a shared critical role of oxidative stress, compromised neuronal energy homeostasis and autophagy in promotion and prevention of neuronal dysfunction associated with HIV-1 infection, cART and psychostimulant use. In this review, we present a synopsis of recent work related to neuronal stress and injury induced by HIV infection, antiretrovirals (ARVs) and the highly addictive psychostimulant METH.

  20. Innate immunity in resistance to HIV infection.

    Science.gov (United States)

    Biasin, Mara; Clerici, Mario; Piacentini, Luca

    2010-11-01

    Resistance to human immunodeficiency virus (HIV) infection in subjects who do not seroconvert despite multiple exposures to the virus and to the progression to AIDS in HIV‐infected individuals depends on multiple factors involving both the innate and the adaptive immune system. The contribution of natural immunity in preventing HIV infection has so far received little attention, but many recently published articles suggest a key role for Toll‐like receptors, natural killer cells, interleukin‐22, acute‐phase amyloid A protein, and APOBEC3G in conferring resistance to HIV infection. The study of these factors will shed light on HIV pathogenesis and contribute to the development of new therapeutic approaches to this elusive disease.

  1. Psychotherapeutic strategies for coping with HIV infection.

    Science.gov (United States)

    Zilber, C

    2000-01-01

    Psychotherapy promotes adaptation to the medical, neuropsychiatric, and psychosocial challenges faced by people with HIV infection. This chapter describes a range of individual and group psychotherapy techniques with demonstrated efficacy in this population.

  2. Crystal methamphetamine, its analogues, and HIV infection: medical and psychiatric aspects of a new epidemic.

    Science.gov (United States)

    Urbina, Antonio; Jones, Kristina

    2004-03-15

    The use of the recreational drug crystal methamphetamine among younger homosexual men is expanding, and with it, unsafe sex behaviors that increase the transmission of human immunodeficiency virus (HIV). This article reviews available literature on the medical and psychiatric morbidities associated with methamphetamine abuse in HIV-infected patients. Medical complications include hypertension, hyperthermia, rhabdoymyolysis, and stroke. One fatal case of ingestion of methamphetamine with HIV medication has been documented. Two fatal cases of ingestion of HIV medication with the amphetamine analogue n-methyl-3,4 methylenedioxymethamphetamine (MDMA, or "ecstasy") have also been reported. Some molecular researchers suggest that dopaminergic systems are vulnerable to the combined neurotoxicity of HIV infection and methamphetamine. Population surveys indicate high rates of HIV infection among methamphetamine abusers and high rates of unprotected anal intercourse during drug intoxication. Intoxication can sometimes produce paranoia, auditory hallucinations, and, occasionally, violent behavior. Amphetamine withdrawal commonly results in symptoms of depression. Methamphetamine is a new challenge related to treatment and prevention of HIV infection.

  3. Risk of myocardial infarction in parents of HIV-infected individuals: a population-based cohort study

    DEFF Research Database (Denmark)

    Rasmussen, Line D; Omland, Lars H; Pedersen, Court;

    2010-01-01

    .08-1.60). The strongest association was seen in case the offspring was infected heterosexually (adjusted IRR, 1.59; 95% CI: 1.07-2.35) or by IV drug abuse (IVD) (adjusted IRR, 1.63; 95% CI: 1.02-2.60). In fathers of HIV patients the risk of MI was only increased if the offspring was infected by IVD (adjusted IRR, 1......ABSTRACT: BACKGROUND: Previous studies have indicated an increased risk of myocardial infarction (MI) in HIV infected individuals especially after start of highly active antiretroviral therapy (HAART). It is however controversial whether the increased risk of atherosclerotic disease is exclusively...... of MI in parents of HIV-infected individuals METHODS: From the Danish HIV Cohort Study and the Danish Civil Registration System we identified the parents of all HIV-infected patients born in Denmark after 1952 in whom a Danish born mother was identifiable. For each HIV patient, 4 matched population...

  4. Viral markers in HIV infection and AIDS.

    Science.gov (United States)

    Cunningham, A L; Dwyer, D E; Dowton, D N

    1993-01-01

    Viral and immune markers are used for monitoring either progression of human immunodeficiency virus (HIV) disease or response to antiviral therapy. Ideal properties of viral markers are that they are present in all HIV-infected persons at all stages of disease, that they are related to disease pathogenesis, that they can be easily quantitated, that this quantitation correlates rapidly and predictably with both disease stage and response to antivirals, and that they can be developed into rapid, reproducible automated tests. Currently available viral markers include HIV p24 antigenemia (after acid glycine dissociation), anti-p24 antibody titres, quantitative DNA and RNA polymerase chain reaction performed on cells and plasma, and HIV isolate phenotype. In Australia, these markers have been studied in acute HIV seroconversion, in neonatal infection, in body fluids other than blood, and in monitoring of response to antiviral drug therapy.

  5. Legionellosis in patients with HIV infection

    DEFF Research Database (Denmark)

    Bangsborg, Jette Marie; Jensen, B N; Friis-Møller, A

    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...... 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...

  6. Neuronal ferritin heavy chain and drug abuse affect HIV-associated cognitive dysfunction.

    Science.gov (United States)

    Pitcher, Jonathan; Abt, Anna; Myers, Jaclyn; Han, Rachel; Snyder, Melissa; Graziano, Alessandro; Festa, Lindsay; Kutzler, Michele; Garcia, Fernando; Gao, Wen-Jun; Fischer-Smith, Tracy; Rappaport, Jay; Meucci, Olimpia

    2014-02-01

    Interaction of the chemokine CXCL12 with its receptor CXCR4 promotes neuronal function and survival during embryonic development and throughout adulthood. Previous studies indicated that μ-opioid agonists specifically elevate neuronal levels of the protein ferritin heavy chain (FHC), which negatively regulates CXCR4 signaling and affects the neuroprotective function of the CXCL12/CXCR4 axis. Here, we determined that CXCL12/CXCR4 activity increased dendritic spine density, and also examined FHC expression and CXCR4 status in opiate abusers and patients with HIV-associated neurocognitive disorders (HAND), which is typically exacerbated by illicit drug use. Drug abusers and HIV patients with HAND had increased levels of FHC, which correlated with reduced CXCR4 activation, within cortical neurons. We confirmed these findings in a nonhuman primate model of SIV infection with morphine administration. Transfection of a CXCR4-expressing human cell line with an iron-deficient FHC mutant confirmed that increased FHC expression deregulated CXCR4 signaling and that this function of FHC was independent of iron binding. Furthermore, examination of morphine-treated rodents and isolated neurons expressing FHC shRNA revealed that FHC contributed to morphine-induced dendritic spine loss. Together, these data implicate FHC-dependent deregulation of CXCL12/CXCR4 as a contributing factor to cognitive dysfunction in neuroAIDS.

  7. Employment status in persons with and without HIV infection in Denmark

    DEFF Research Database (Denmark)

    Legarth, Rebecca; Omland, Lars Haukali; Kronborg, Gitte

    2014-01-01

    OBJECTIVE: To estimate annual employment rates and disability retirement rates (DRRs) among HIV-infected individuals and population controls during the period 1996-2011. DESIGN: A population-based cohort study including all HIV-infected individuals born in Denmark and not reporting intravenous (i.......v.) drug abuse as a route of HIV infection or diagnosed with hepatitis C infection (n = 2799) and 22,369 individually matched persons from the background population. Study inclusion was 1 January 1996 or HIV diagnosis, which ever came last. METHODS: Data on employment status and disability pension were...... extracted from Danish national registries. Employment rate and DRR were estimated in each calendar year after study inclusion for the cohorts included before 1996 (pre-1996), 1996-1999 and 2000-2011. RESULTS: Employment rate in the year of study inclusion increased from 54.8% [95% confidence interval (CI...

  8. Estudo da Adesão à Quimioprofilaxia Anti-retroviral para a Infecção por HIV em Mulheres Sexualmente Vitimadas Study of Adherence to Antiretroviral Chemoprophylaxis for HIV Infection in Sexually Abused Women

    Directory of Open Access Journals (Sweden)

    Jefferson Drezett

    1999-10-01

    Full Text Available Objetivos: embora não existam dados apropriados para estabelecer sua eficácia, alguns serviços tem utilizado, profilaticamente, a terapia anti-retroviral para o HIV nos casos de violência sexual. O objetivo deste estudo foi avaliar a aceitabilidade, tolerância e adesão a um esquema quimioprofilático para o HIV. Pacientes e método: foram avaliadas 62 mulheres vítimas de estupro e/ou atentado violento ao pudor com coito ectópico anal. Os agressores foram referidos como desconhecidos. A profilaxia foi iniciada dentro das primeiras 48 h da violência e mantida por 4 semanas, sendo administrados diariamente: zidovudina, 600 mg; indinavir, 2.400 mg e lamivudina, 300 mg. Resultados: a taxa de descontinuidade foi de 24,2%, sendo em 12 casos (80% decorrente de intolerância gástrica. Os efeitos colaterais estiveram presentes em 43 casos (69,4%, sendo as náuseas e vômitos os mais freqüentes. A complexidade posológica e o tempo de uso foram fatores possivelmente associados ao uso inadequado das drogas, ocorrendo em 10,6% dos casos. Conclusão: a taxa de descontinuidade da quimioprofilaxia foi semelhante à observada em outras indicações.Purpose: some medical institutions have been prophylactically ministrating anti-HIV therapy in cases of sexual violence, although there are no appropriate basic facts to establish its efficacy. The aim of the present study was to evaluate the acceptance, tolerance and adhesion of these women under a chemoprophylaxis plan for HIV. Methods: sixty-two women victims of rape and/or anal intercourse with unknown aggressors have been evaluated. Prophylaxis has been started within the first 48 h after violence and maintained for 4 weeks, with daily administration of zidovudine, 600 mg; indinavir, 2,400 mg and lamivudine, 300 mg. Results: the discontinuance rate was 24.2%, withe 12 cases (80% due to gastric intolerance. The side effects were present in 43 cases (69.4%, including nausea and vomitting as the most

  9. HIV infection in dialysis centers in Italy: a nationwide multicenter study.

    Science.gov (United States)

    Barbiano di Belgiojoso, G; Trezzi, M; Scorza, D; Barone, M T; Landriani, N; Genderini, A; Bertoli, S

    1998-01-01

    The prevalence of HIV infection in dialysis populations varies according to different countries and geographic areas. We performed a nationwide epidemiological study by means of a questionnaire in the period from January 1990 to December 1995. Questions were about whether and which HIV tests were performed and which preventive measures were adopted. A separate survey evaluated the data the HIV-positive patients. Only 62% of the centers responded to the questionnaire, corresponding to 21,500 dialysis patients in 1990 and 27,000 in 1995. The prevalence of HIV-positive subjects was 0,13% for 1995. A total of 48 patients with HIV infection were identified: risk factors were drug abuse in 16 cases, homosexuality in 9, heterosexual contact in 8, transfusion in 7, renal transplant in 3 and unknown cause in 5. Forty-five patients were on hemodialysis, and 3 were receiving peritoneal dialysis. At follow-up, 19 patients died: infection and malnutrition were the most frequent causes of death. The death rate of patients who were already HIV positive when dialysis was started (group 1, 29 cases) was 19.36 deaths/1,000 patient/month. The correlations, performed only for group 1, showed a significantly worse prognosis for patients with CD4 HIV infection in the dialysis population is low, and the outcome of HIV-positive patients in dialysis was found to be better than earlier literature reports. The use of chronic dialysis for HIV patients with uremia should not be discouraged.

  10. The stochastic dance of early HIV infection

    Science.gov (United States)

    Merrill, Stephen J.

    2005-12-01

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

  11. Programmatic Implications of Acute and Early HIV Infection.

    Science.gov (United States)

    Suthar, Amitabh B; Granich, Reuben M; Kato, Masaya; Nsanzimana, Sabin; Montaner, Julio S G; Williams, Brian G

    2015-11-01

    Human immunodeficiency virus (HIV) infection includes acute, early, chronic, and late stages. Acute HIV infection lasts approximately 3 weeks and early HIV infection, which includes acute HIV infection, lasts approximately 7 weeks. Many testing and blood screening algorithms detect HIV antibodies about 3 weeks after HIV infection. Incidence estimates are based on results of modeling, cohort studies, surveillance, and/or assays. Viral load is the key modifiable risk factor for HIV transmission and peaks during acute and early HIV infection. Empirical evidence characterizing the impact of acute and early HIV infection on the spread of the HIV epidemic are limited. Time trends of HIV prevalence collected from concentrated and generalized epidemics suggest that acute and early HIV infection may have a limited role in population HIV transmission. Collectively, these data suggest that acute and early HIV infection is relatively short and does not currently require fundamentally different programmatic approaches to manage the HIV/AIDS epidemic in most settings. Research and surveillance will inform which epidemic contexts and phases may require tailored strategies for these stages of HIV infection.

  12. Cerebrospinal fluid analysis in the HIV infection and compartmentalization of HIV in the central nervous system

    Directory of Open Access Journals (Sweden)

    Sérgio Monteiro de Almeida

    2015-07-01

    Full Text Available The nervous system plays an important role in HIV infection. The purpose of this review is to discuss the indications for cerebrospinal fluid (CSF analysis in HIV infection in clinical practice. CSF analysis in HIV infection is indicated for the diagnosis of opportunistic infections and co-infections, diagnosis of meningitis caused by HIV, quantification of HIV viral load, and analysis of CNS HIV compartmentalization. Although several CSF biomarkers have been investigated, none are clinically applicable. The capacity of HIV to generate genetic diversity, in association with the constitutional characteristics of the CNS, facilitates the generation of HIV quasispecies in the CNS that are distinct from HIV in the systemic circulation. CSF analysis has a well-defined and valuable role in the diagnosis of CNS infections in HIV/AIDS patients. Further research is necessary to establish a clinically applicable biomarker for the diagnosis of HIV-associated neurocognitive disorders.

  13. Encephalitis in primary HIV infection

    DEFF Research Database (Denmark)

    Helleberg, M; Kirk, O

    2013-01-01

    We report a case of primary HIV encephalitis, which initially presented as acute psychosis. Magnetic resonance imaging of the brain was suggestive of vasculitis and multiple infarctions, whereas a brain biopsy after six weeks of symptoms showed HIV encephalitis with microglial nodules, but no signs...... of vasculitis. We review previous reported cases and radiological findings in HIV encephalitis and discuss the role of antiretroviral therapy and steroids in its management....

  14. Epigenetic alterations in the brain associated with HIV-1 infection and methamphetamine dependence.

    Science.gov (United States)

    Desplats, Paula; Dumaop, Wilmar; Cronin, Peter; Gianella, Sara; Woods, Steven; Letendre, Scott; Smith, David; Masliah, Eliezer; Grant, Igor

    2014-01-01

    HIV involvement of the CNS continues to be a significant problem despite successful use of combination antiretroviral therapy (cART). Drugs of abuse can act in concert with HIV proteins to damage glia and neurons, worsening the neurotoxicity caused by HIV alone. Methamphetamine (METH) is a highly addictive psychostimulant drug, abuse of which has reached epidemic proportions and is associated with high-risk sexual behavior, increased HIV transmission, and development of drug resistance. HIV infection and METH dependence can have synergistic pathological effects, with preferential involvement of frontostriatal circuits. At the molecular level, epigenetic alterations have been reported for both HIV-1 infection and drug abuse, but the neuropathological pathways triggered by their combined effects are less known. We investigated epigenetic changes in the brain associated with HIV and METH. We analyzed postmortem frontal cortex tissue from 27 HIV seropositive individuals, 13 of which had a history of METH dependence, in comparison to 14 cases who never used METH. We detected changes in the expression of DNMT1, at mRNA and protein levels, that resulted in the increase of global DNA methylation. Genome-wide profiling of DNA methylation in a subset of cases, showed differential methylation on genes related to neurodegeneration; dopamine metabolism and transport; and oxidative phosphorylation. We provide evidence for the synergy of HIV and METH dependence on the patterns of DNA methylation on the host brain, which results in a distinctive landscape for the comorbid condition. Importantly, we identified new epigenetic targets that might aid in understanding the aggravated neurodegenerative, cognitive, motor and behavioral symptoms observed in persons living with HIV and addictions.

  15. Epigenetic alterations in the brain associated with HIV-1 infection and methamphetamine dependence.

    Directory of Open Access Journals (Sweden)

    Paula Desplats

    Full Text Available HIV involvement of the CNS continues to be a significant problem despite successful use of combination antiretroviral therapy (cART. Drugs of abuse can act in concert with HIV proteins to damage glia and neurons, worsening the neurotoxicity caused by HIV alone. Methamphetamine (METH is a highly addictive psychostimulant drug, abuse of which has reached epidemic proportions and is associated with high-risk sexual behavior, increased HIV transmission, and development of drug resistance. HIV infection and METH dependence can have synergistic pathological effects, with preferential involvement of frontostriatal circuits. At the molecular level, epigenetic alterations have been reported for both HIV-1 infection and drug abuse, but the neuropathological pathways triggered by their combined effects are less known. We investigated epigenetic changes in the brain associated with HIV and METH. We analyzed postmortem frontal cortex tissue from 27 HIV seropositive individuals, 13 of which had a history of METH dependence, in comparison to 14 cases who never used METH. We detected changes in the expression of DNMT1, at mRNA and protein levels, that resulted in the increase of global DNA methylation. Genome-wide profiling of DNA methylation in a subset of cases, showed differential methylation on genes related to neurodegeneration; dopamine metabolism and transport; and oxidative phosphorylation. We provide evidence for the synergy of HIV and METH dependence on the patterns of DNA methylation on the host brain, which results in a distinctive landscape for the comorbid condition. Importantly, we identified new epigenetic targets that might aid in understanding the aggravated neurodegenerative, cognitive, motor and behavioral symptoms observed in persons living with HIV and addictions.

  16. Prevalence and knowledge of sexual transmitted infections, drug abuse, and AIDS among male inmates in a Taiwan prison.

    Science.gov (United States)

    Feng, Ming-Chu; Feng, Jui-Ying; Chen, Yen-Hsu; Chang, Pi-Yen; Lu, Po-Liang

    2012-12-01

    This cross-sectional, descriptive, correlational study performed a structured questionnaire survey of a Taiwan population of male prison inmates to determine the prevalence of sexually transmitted infections (STIs), intravenous drug users (IDUs), and drug abuse and to assess their knowledge of HIV/AIDS. The objective was to obtain data needed to control the spread of HIV. Out of 1000 questionnaires distributed, 908 valid questionnaires were returned. Inmates were classified into three groups: IDUs with HIV (13.5%), IDUs without HIV (49.3%), and non-IDUs without HIV (37.2%). A total of 115 (12.7%) inmates had contracted STIs other than HIV. Compared with inmates without HIV, those with HIV were more likely to have a junior high school education level or lower and a history of the following: employment as a blue-collar laborer, STI, unprotected sexual activity, and needle sharing during intravenous drug use. The longer they have used intravenous drugs, the higher the probability that they shared needles, and the more likely they contracted with HIV. Taiwanese male inmates had a low level of knowledge about safe sex and HIV transmission routes, except for sharing needles. The three groups did not significantly differ in HIV-related knowledge. Given the high percentage of IDU and HIV infection in male prison inmates in Taiwan, interventions are needed to educate this population in the increased risk of contracting HIV/AIDS associated with unsafe sex and needle sharing during illicit drug use. Such interventions are crucial for limiting the spread of HIV as this population reintegrates with the community.

  17. Autophagy in Mycobacterium tuberculosis and HIV infections

    Directory of Open Access Journals (Sweden)

    Lucile eEspert

    2015-06-01

    Full Text Available Human Immunodeficiency Virus (HIV and Mycobacterium tuberculosis (M.tb are among the most lethal human pathogens worldwide, each being responsible for around 1.5 million deaths annually. Moreover, synergy between acquired immune deficiency syndrome (AIDS and tuberculosis (TB has turned HIV/M.tb co-infection into a major public health threat in developing countries. In the past decade, autophagy, a lysosomal catabolic process, has emerged as a major host immune defense mechanism against infectious agents like M.tb and HIV. Nevertheless, in some instances, autophagy machinery appears to be instrumental for HIV infection. Finally, there is mounting evidence that both pathogens deploy various countermeasures to thwart autophagy. This mini-review proposes an overview of the roles and regulations of autophagy in HIV and M.tb infections with an emphasis on microbial factors. We also discuss the role of autophagy manipulation in the context of HIV/M.tb co-infection. In future, a comprehensive understanding of autophagy interaction with these pathogens will be critical for development of autophagy-based prophylactic and therapeutic interventions for AIDS and TB.

  18. Increased risk of fragility fractures among HIV infected compared to uninfected male veterans.

    Directory of Open Access Journals (Sweden)

    Julie A Womack

    Full Text Available BACKGROUND: HIV infection has been associated with an increased risk of fragility fracture. We explored whether or not this increased risk persisted in HIV infected and uninfected men when controlling for traditional fragility fracture risk factors. METHODOLOGY/PRINCIPAL FINDINGS: Cox regression models were used to assess the association of HIV infection with the risk for incident hip, vertebral, or upper arm fracture in male Veterans enrolled in the Veterans Aging Cohort Study Virtual Cohort (VACS-VC. We calculated adjusted hazard ratios comparing HIV status and controlling for demographics and other established risk factors. The sample consisted of 119,318 men, 33% of whom were HIV infected (34% aged 50 years or older at baseline, and 55% black or Hispanic. Median body mass index (BMI was lower in HIV infected compared with uninfected men (25 vs. 28 kg/m²; p<0.0001. Unadjusted risk for fracture was higher among HIV infected compared with uninfected men [HR: 1.32 (95% CI: 1.20, 1.47]. After adjusting for demographics, comorbid disease, smoking and alcohol abuse, HIV infection remained associated with an increased fracture risk [HR: 1.24 (95% CI: 1.11, 1.39]. However, adjusting for BMI attenuated this association [HR: 1.10 (95% CI: 0.97, 1.25]. The only HIV-specific factor associated with fragility fracture was current protease inhibitor use [HR: 1.41 (95% CI: 1.16, 1.70]. CONCLUSIONS/SIGNIFICANCE: HIV infection is associated with fragility fracture risk. This risk is attenuated by BMI.

  19. HIV infection, aging and cardiovascular disease

    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...

  20. 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;…

  1. Maternal HIV infection influences the microbiome of HIV-uninfected infants.

    Science.gov (United States)

    Bender, Jeffrey M; Li, Fan; Martelly, Shoria; Byrt, Erin; Rouzier, Vanessa; Leo, Marguerite; Tobin, Nicole; Pannaraj, Pia S; Adisetiyo, Helty; Rollie, Adrienne; Santiskulvong, Chintda; Wang, Shaun; Autran, Chloe; Bode, Lars; Fitzgerald, Daniel; Kuhn, Louise; Aldrovandi, Grace M

    2016-07-27

    More than 1 million HIV-exposed, uninfected infants are born annually to HIV-positive mothers worldwide. This growing population of infants experiences twice the mortality of HIV-unexposed infants. We found that although there were very few differences seen in the microbiomes of mothers with and without HIV infection, maternal HIV infection was associated with changes in the microbiome of HIV-exposed, uninfected infants. Furthermore, we observed that human breast milk oligosaccharides were associated with bacterial species in the infant microbiome. The disruption of the infant's microbiome associated with maternal HIV infection may contribute to the increased morbidity and mortality of HIV-exposed, uninfected infants.

  2. [Kidney transplant in patients with HIV infection].

    Science.gov (United States)

    Bossini, Nicola; Sandrini, Silvio; Valerio, Francesca

    2012-01-01

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

  3. Trauma and Psychosocial Predictors of Substance Abuse in Women Impacted by HIV/AIDS

    OpenAIRE

    2008-01-01

    The purpose of this study was to estimate the relative contributions of trauma, chronic stress burden, depression, anxiety, social support, and social undermining in predicting alcohol and drug abuse, and whether ethnicity moderated these relationships. A multi-ethnic sample of 288 HIV-positive and HIV-negative women was recruited. Multiple group path analysis indicated that greater drug dependence was associated with being HIV+, more depression, and higher chronic burden. Trauma was related ...

  4. Parasitic infections in HIV infected individuals: Diagnostic & therapeutic challenges

    Science.gov (United States)

    Nissapatorn, Veeranoot; Sawangjaroen, Nongyao

    2011-01-01

    After 30 years of the human immunodeficiency virus (HIV) epidemic, parasites have been one of the most common opportunistic infections (OIs) and one of the most frequent causes of morbidity and mortality associated with HIV-infected patients. Due to severe immunosuppression, enteric parasitic pathogens in general are emerging and are OIs capable of causing diarrhoeal disease associated with HIV. Of these, Cryptosporidium parvum and Isospora belli are the two most common intestinal protozoan parasites and pose a public health problem in acquired immunodeficiency syndrome (AIDS) patients. These are the only two enteric protozoan parasites that remain in the case definition of AIDS till today. Leismaniasis, strongyloidiasis and toxoplasmosis are the three main opportunistic causes of systemic involvements reported in HIV-infected patients. Of these, toxoplasmosis is the most important parasitic infection associated with the central nervous system. Due to its complexity in nature, toxoplasmosis is the only parasitic disease capable of not only causing focal but also disseminated forms and it has been included in AIDS-defining illnesses (ADI) ever since. With the introduction of highly active anti-retroviral therapy (HAART), cryptosporidiosis, leishmaniasis, schistosomiasis, strongyloidiasis, and toxoplasmosis are among parasitic diseases reported in association with immune reconstitution inflammatory syndrome (IRIS). This review addresses various aspects of parasitic infections in term of clinical, diagnostic and therapeutic challenges associated with HIV-infection. PMID:22310820

  5. Completeness of HIV reporting on death certificates for Floridians reported with HIV infection, 2000-2011

    OpenAIRE

    Trepka, Mary Jo; Diana M. Sheehan; Fennie, Kristopher P.; Niyonsenga, Theophile; Lieb, Spencer; Maddox, Lorene

    2015-01-01

    HIV mortality is used as a key measure to monitor the impact of HIV throughout the world. It is important that HIV be correctly recorded on death certificates so that the burden of HIV mortality can be tracked accurately. The objective of this study was to determine the extent of failure to correctly report HIV on death certificates and examine patterns of incompleteness by demographic factors. Causes of death on death certificates of people infected with HIV reported to the Florida HIV surve...

  6. Alternate routes of administration and risk for HIV among prescription opioid abusers.

    Science.gov (United States)

    Surratt, Hilary; Kurtz, Steven P; Cicero, Theodore J

    2011-10-01

    Route of administration is an important contributor to the adverse health consequences of prescription medication abuse. The current study examines characteristics associated with non-oral routes of administration among a large sample of prescription opioid abusers and explores needle-related human immunodeficiency virus (HIV) risk behaviors as well. In the study, 791 opioid abusers completed a one-time structured interview, including complete histories of illicit and prescription drug abuse and route of drug administration. The most common method of pill use was oral (91%), followed by intranasal (53.1%), injection (23.8%), and smoking (14.5%). The youngest prescription opioid abusers, ages 18-24, displayed significantly higher odds of using alternate routes of administration and of reusing nonsterile needles for injection. HIV prevention programming should be developed for young prescription opioid injectors.

  7. Psychopharmacology in HIV-infected patients.

    Science.gov (United States)

    Repetto, Martin J; Petitto, John M

    2008-06-01

    Neuropsychiatric disorders and syndromes may be underdiagnosed and inadequately treated in individuals infected with HIV. Depression in particular is among the most prevalent diagnoses, and data from controlled clinical studies have shown that antidepressant medications are efficacious and safe for treating depression in HIV-infected persons. A significant shortcoming of this literature is that most of the available data are from studies conducted before the advent of highly active antiretroviral therapy. In addition, apart from antidepressant medications, controlled studies systematically assessing efficacy and safety issues for other classes of psychotropic drugs (e.g., antipsychotic and anxiolytic medications) in HIV-infected persons are lacking. This review summarizes essential findings pertaining to the use of psychotropic medications to treat depression and other neuropsychiatric disorders in the context of HIV. It includes a discussion of clinically relevant treatment considerations (e.g., side effects, drug-drug interactions) derived from the existing literature as well as judgments that clinicians face in the absence of research data. Despite some shortcomings of the existing literature, overall there is compelling evidence that the appropriate use of psychotropic medications (coupled with behavioral therapy) can improve the quality of life of mentally ill HIV-infected individuals.

  8. Occurence of pregnancies among HIV infected Indian women : Does knowledge about HIV status make a difference?

    NARCIS (Netherlands)

    Darak, Shrinivas; Hutter, Inge; Kulkarni, Sanjeevani; Kulkarni, Vinay; Janssen, Fanny

    2015-01-01

    This is the first study to examine the behavioural effect of HIV on fertility among HIV infected women in India. Retrospective calendar data from ever-married HIV infected women between 15 and 45 years of age, attending a specialized HIV clinic in Pune, Western India (N = 560), were analysed. Direct

  9. 42 CFR Appendix A to Part 130 - Definition of HIV Infection or HIV

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Definition of HIV Infection or HIV A Appendix A to... PAYMENTS RICKY RAY HEMOPHILIA RELIEF FUND PROGRAM Pt. 130, App. A Appendix A to Part 130—Definition of HIV Infection or HIV ER31MY00.000 ER31MY00.001...

  10. Occurrence of pregnancies among HIV infected Indian women: Does knowledge about HIV status make a difference?

    NARCIS (Netherlands)

    Darak, S.; Hutter, I.; Kulkarni, S.; Kulkarni, V.; Janssen, F.

    2015-01-01

    This is the first study to examine the behavioural effect of HIV on fertility among HIV infected women in India. Retrospective calendar data from ever-married HIV infected women between 15 and 45 years of age, attending a specialized HIV clinic in Pune, Western India , were analysed. Directly standa

  11. Occurrence of Pregnancies among HIV Infected Indian Women : Does Knowledge about HIV Status Make a Difference?

    NARCIS (Netherlands)

    S. Darak (Shrinivas); I. Hutter (Inge); S. Kulkarni (Sanjeevani); V. Kulkarni (Vinay); F. Janssen (Fanny)

    2015-01-01

    textabstractThis is the first study to examine the behavioural effect of HIV on fertility among HIV infected women in India. Retrospective calendar data from ever-married HIV infected women between 15 and 45 years of age, attending a specialized HIV clinic in Pune, Western India (N = 560), were anal

  12. Clinical profile of HIV infected patients attending a HIV referral clinic in Pune, India

    Directory of Open Access Journals (Sweden)

    Megha Antwal

    2014-01-01

    Interpretation & conclusions: Signs and symptoms associated with HIV positivity observed in this study can be used by health care providers to detect HIV infection early. Moreover, similar to HIV testing in patients with tuberculosis, strategies can be developed for considering Herpes zoster as a predictor of HIV infection.

  13. Prevalence of hepatitis C virus infection and its related risk factors in drug abuser prisoners in Hamedan - Iran

    Institute of Scientific and Technical Information of China (English)

    Amir Houshang Mohammad Alizadeh; Seyed Moayed Alavian; Khalil Jafari; Nastaran Yazdi

    2005-01-01

    AIM: Recent studies in Iran has shown that prevalence of hepatitis C virus (HCV) infection among Iranian prisoners is high, in spite of low HCV seroprevalence in general population.METHODS: This study was carried out in the central prison of Hamedan - Iran, in year 2002. Inmates were interviewed using a standard questionnaire including demographic,imprisonment history and HCV-related risk behaviors items. Thereafter, the sera drawn from the participants were tested for anti-HIV and anti-HCV antibodies.RESULTS: A total number of 427 drug abuser inmates participated in our study. Three hundred and ninety-seven (93%) were men and 30 (7%) were women. Total number of Ⅳ drug abusers (IDA) and non-Ⅳ drug abusers (NIDA)was 149 (34.9%) and 278 (65.1%), respectively. The overall rate of antibody positivity among inmates was 0.9% for HIV and 30% for HCV. Of all IDAs, 31.5% and of NIDAs, 29.1% had serological evidence of HCV infection.CONCLUSION: The seroprevalence of HCV infection among drug abuser prisoners in comparison with the general population in Iran, is very high (30% vs in italics 0.2%).Our results indicate the importance of policies to prevent transmission of HCV infection during and following incarceration.

  14. Drugs + HIV, Learn the Link

    Medline Plus

    Full Text Available ... the link between drug abuse and HIV infection. It contains information for young people, parents and teachers, ... present time. The virus (HIV) and the disease it causes (AIDS) are often linked and referred to ...

  15. Impact of childhood trauma on functionality and quality of life in HIV-infected women

    Directory of Open Access Journals (Sweden)

    Spottiswoode Bruce

    2011-09-01

    Full Text Available Abstract Background While there are many published studies on HIV and functional limitations, there are few in the context of early abuse and its impact on functionality and Quality of Life (QoL in HIV. Methods The present study focused on HIV in the context of childhood trauma and its impact on functionality and Quality of Life (QoL by evaluating 85 HIV-positive (48 with childhood trauma and 37 without and 52 HIV-negative (21 with childhood trauma and 31 without South African women infected with Clade C HIV. QoL was assessed using the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q, the Patient's Assessment of Own Functioning Inventory (PAOFI, the Activities of Daily Living (ADL scale and the Sheehan Disability Scale (SDS. Furthermore, participants were assessed using the Center for Epidemiologic Studies Depression Scale (CES-D and the Childhood Trauma Questionnaire (CTQ. Results Subjects had a mean age of 30.1 years. After controlling for age, level of education and CES-D scores, analysis of covariance (ANCOVA demonstrated significant individual effects of HIV status and childhood trauma on self-reported QoL. No significant interactional effects were evident. Functional limitation was, however, negatively correlated with CD4 lymphocyte count. Conclusions In assessing QoL in HIV-infected women, we were able to demonstrate the impact of childhood trauma on functional limitations in HIV.

  16. Gene Therapy for HIV Infections: Intracellular Immunization

    Directory of Open Access Journals (Sweden)

    Alain Piché

    1999-01-01

    Full Text Available Despite significant advances in the treatment of human immunodeficiency virus (HIV infection in the past 10 years, it remains an incurable disease. The inability of traditional drug-based therapies to inhibit HIV replication effectively for extended periods of time has stimulated intense research to develop novel approaches for this disease. Current understanding of HIV molecular biology and pathogenesis has opened the way for the development of gene therapy strategies for HIV infections. In this context, a number of intracellular immunization-based strategies have been evaluated, and some of them have reached the stage of phase I/II human clinical trials. These strategies include the use of single-chain antibodies, capsid-targeted viral inactivation, transdominant negative mutants, ribozymes, antisense oligonucleotides and RNA decoys. While a number of issues remain to be studied before intracellular immunization can be applied to the treatment of HIV infections, the significant progress already made in this field is likely to lead to clinical applications.

  17. Changes in HIV RNA and CD4 cell count after acute HCV infection in chronically HIV-infected individuals

    NARCIS (Netherlands)

    Gras, L.; Wolf, F. de; Smit, C.; Prins, M.; Meer, J.T. van der; Vanhommerig, J.W.; Zwinderman, A.H.; Schinkel, J.; Geskus, R.B.; Warris, A.

    2015-01-01

    OBJECTIVE: Little is known about the impact of acute hepatitis C virus (HCV) co-infection on HIV-1 disease progression. We investigated CD4 cell count and HIV RNA concentration changes after HCV infection in individuals chronically infected with HIV-1. METHODS: We selected individuals that had the l

  18. Cardiovascular manifestations of HIV infection in children

    NARCIS (Netherlands)

    Idris, Nikmah S; Grobbee, Diederick E; Burgner, David; Cheung, Michael M H; Kurniati, Nia; Sastroasmoro, Sudigdo; Uiterwaal, Cuno SPM

    2015-01-01

    BACKGROUND: HIV infection in children is now considered as a chronic condition, in which various non-infectious complications may occur, including those affecting the developing cardiovascular system. As children are expected to survive well into adulthood, understanding childhood as well as potenti

  19. Fosamprenavir calcium plus ritonavir for HIV infection.

    Science.gov (United States)

    Torres, Harrys A; Arduino, Roberto C

    2007-06-01

    Fosamprenavir is a protease inhibitor (PI) approved for the treatment of HIV-1 infection. Fosamprenavir is a prodrug of amprenavir developed to reduce the pill burden yet maintain the unique resistance pattern and efficacy associated with amprenavir. In a head-to-head, noninferiority trial in antiretroviral treatment-naive HIV-infected patients, the antiviral efficacy and tolerability of ritonavir-boosted fosamprenavir was not inferior to ritonavir-boosted lopinavir, when the PIs were combined with two other nucleoside reverse transcriptase inhibitors. There are fewer studies published about fosamprenavir use in antiretroviral treatment-experienced HIV-infected patients. The high genetic barrier to the development of resistance to fosamprenavir and the low level of cross-resistance between ritonavir-boosted fosamprenavir and other PI regimens are notable. As with amprenavir, gastrointestinal disturbance and rash are the most frequent short-term treatment-limiting events with fosamprenavir. Treatment with ritonavir-boosted fosamprenavir can produce a durable response. To date, fosamprenavir is one of the recommended preferred PI components for the treatment of antiretroviral-naive HIV-infected patients.

  20. Incomplete immune recovery in HIV infection

    DEFF Research Database (Denmark)

    Gaardbo, Julie C; Hartling, Hans J; Gerstoft, Jan

    2012-01-01

    tissue, perturbed frequencies of immune regulators such as regulatory T cells and Th17 cells, and increased immune activation, immunosenescence, and apoptosis. Importantly, INRs have an increased risk of morbidity and mortality compared to HIV-infected patients with an optimal immune reconstitution...

  1. HIV Risk Behavior Among Methamphetamine Users Entering Substance Abuse Treatment in Cape Town, South Africa.

    Science.gov (United States)

    Meade, Christina S; Lion, Ryan R; Cordero, Daniella M; Watt, Melissa H; Joska, John A; Gouse, Hetta; Burnhams, Warren

    2016-10-01

    South Africa is experiencing a growing methamphetamine problem, and there is concern that methamphetamine use may accelerate HIV transmission. There has been little research on the HIV prevention needs of methamphetamine users receiving substance abuse treatment in South Africa. This study assessed the prevalence and correlates of HIV risk behaviors among 269 methamphetamine users entering substance abuse treatment in two clinics in Cape Town. The prevalence of sexual risk behaviors was high among sexually active participants: 34 % multiple partners, 26 % unprotected intercourse with a casual partner, and 24 % sex trading for money/methamphetamine. The strongest predictor of all sexual risk behaviors was concurrent other drug use. Over half had not been HIV tested in the past year, and 25 % had never been tested, although attitudes toward HIV testing were overwhelmingly positive. This population of primarily heterosexual, non-injecting methamphetamine users is a high-risk group in need of targeted HIV prevention interventions. Substance abuse treatment is an ideal setting in which to reach methamphetamine users for HIV services.

  2. Post-traumatic stress is associated with verbal learning, memory, and psychomotor speed in HIV-infected and HIV-uninfected women.

    Science.gov (United States)

    Rubin, Leah H; Pyra, Maria; Cook, Judith A; Weber, Kathleen M; Cohen, Mardge H; Martin, Eileen; Valcour, Victor; Milam, Joel; Anastos, Kathryn; Young, Mary A; Alden, Christine; Gustafson, Deborah R; Maki, Pauline M

    2016-04-01

    The prevalence of post-traumatic stress disorder (PTSD) is higher among HIV-infected (HIV+) women compared with HIV-uninfected (HIV-) women, and deficits in episodic memory are a common feature of both PTSD and HIV infection. We investigated the association between a probable PTSD diagnosis using the PTSD Checklist-Civilian (PCL-C) version and verbal learning and memory using the Hopkins Verbal Learning Test in 1004 HIV+ and 496 at-risk HIV- women. HIV infection was not associated with a probable PTSD diagnosis (17% HIV+, 16% HIV-; p = 0.49) but was associated with lower verbal learning (p < 0.01) and memory scores (p < 0.01). Irrespective of HIV status, a probable PTSD diagnosis was associated with poorer performance in verbal learning (p < 0.01) and memory (p < 0.01) and psychomotor speed (p < 0.001). The particular pattern of cognitive correlates of probable PTSD varied depending on exposure to sexual abuse and/or violence, with exposure to either being associated with a greater number of cognitive domains and a worse cognitive profile. A statistical interaction between HIV serostatus and PTSD was observed on the fine motor skills domain (p = 0.03). Among women with probable PTSD, HIV- women performed worse than HIV+ women on fine motor skills (p = 0.01), but among women without probable PTSD, there was no significant difference in performance between the groups (p = 0.59). These findings underscore the importance of considering mental health factors as correlates to cognitive deficits in women with HIV.

  3. Co-factors in HIV neurobehavioural disturbances: substance abuse, hepatitis C and aging.

    Science.gov (United States)

    Gonzalez, Raul; Cherner, Mariana

    2008-02-01

    Neurocognitive disturbances associated with HIV infection may be modulated or confounded by coexisting and comorbid conditions that reflect the changing populations affected by the disease. HIV infection is often accompanied by substance dependence and/or hepatitis C co-infection. Both of these cofactors that may lead to brain dysfunction on their own, and therefore can affect the nature and course neurocognitive functioning in HIV. Improvements in antiretroviral therapies translate into greater longevity for people infected with HIV, many of whom are now entering their 6th and 7th decade of life and beyond. The increasing proportion of older persons with HIV is also the result of new infections in this age group. As aging confers additional metabolic, neurologic, and neuropsychiatric vulnerability, it is important to understand how this constellation of changes affects neurocognitive functioning in the context of HIV.

  4. Prevalence of selected sexually and blood-borne infections in Injecting drug abuser inmates of bandar abbas and roodan correction facilities, Iran, 2002

    Directory of Open Access Journals (Sweden)

    Parivash Davoodian

    2009-10-01

    Full Text Available Human Immunodeficiency Virus (HIV and other blood borne viral infections like hepatitis B virus (HBV and hepatitis C virus (HCV are major health issues especially in young and growing population of developing countries. All around the globe correctional facilities are known as potential source of spreading such disease. During summer 2002, HIV, HCV antibodies, hepatitis B surface (HBs antigen and rapid plasma reagin (RPR test were checked in venous blood samples of 252 injecting drug abuser prisoners from correctional facilities in southern Iran. Overall HIV, HCV and HBV infection rate was 15.1% (38/249, 64.8% (163/249, and 4.7% (12/249, respectively. HCV infection rate of HIV positive cases was 94% (35/38. All RPR results were negative. Duration of previous drug abuse and imprisonment were correlated with HIV and HCV infection (p value = 0.0003 and 0.015 & p value =0.02 and 0.02. Considering the higher prevalence of HIV and HCV infection in correctional facilities compared to general population of Iran, warrants immediate multidisciplinary approaches targeted at controlling further spread of these infections primarily among prisoners and secondarily preventing them to act as carrier to general population.

  5. Cause-specific excess mortality in siblings of patients co-infected with HIV and hepatitis C virus

    DEFF Research Database (Denmark)

    Hansen, Ann-Brit Eg; Lohse, Nicolai; Gerstoft, Jan;

    2007-01-01

    -years, compared with siblings of matched population controls. Substance abuse-related deaths contributed most to the elevated mortality among siblings [EMR = 2.25 (1.09-3.40)] followed by unnatural deaths [EMR = 0.67 (-0.05-1.39)]. No siblings of HIV/HCV co-infected patients had a liver-related diagnosis......BACKGROUND: Co-infection with hepatitis C in HIV-infected individuals is associated with 3- to 4-fold higher mortality among these patients' siblings, compared with siblings of mono-infected HIV-patients or population controls. This indicates that risk factors shared by family members partially...... account for the excess mortality of HIV/HCV-co-infected patients. We aimed to explore the causes of death contributing to the excess sibling mortality. METHODOLOGY AND PRINCIPAL FINDINGS: We retrieved causes of death from the Danish National Registry of Deaths and estimated cause-specific excess mortality...

  6. 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.

  7. Clinical profile of HIV infection

    OpenAIRE

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

    1992-01-01

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

  8. 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.

  9. HIV transmission rates from persons living with HIV who are aware and unaware of their infection.

    Science.gov (United States)

    Hall, H Irene; Holtgrave, David R; Maulsby, Catherine

    2012-04-24

    Transmission rate modeling estimated secondary infections from those aware and unaware of their HIV infection. An estimated 49% of transmissions were from the 20% of persons living with HIV unaware of their infection. About eight transmissions would be averted per 100 persons newly aware of their infection; with more infections averted the higher the percentage of persons with viral suppression who can be linked to care. Improving all stages of HIV care would substantially reduce transmission rates.

  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. New insights into complications and treatment of HIV-1 infection

    NARCIS (Netherlands)

    van Lelyveld, S.F.L.

    2013-01-01

    In this thesis the complications and treatment of HIV-1 infection in the current era was studied. Life expectancy of HIV-infected patients has increased enormously with the introduction of combination antiretroviral therapy (cART). In line with this observation, we found that the outcome of HIV-infe

  12. Prevalence of bipolar disorder in a HIV-infected outpatient population.

    Science.gov (United States)

    de Sousa Gurgel, Wagner; da Silva Carneiro, Alexandre Henrique; Barreto Rebouças, Diego; Negreiros de Matos, Karla Julianne; do Menino Jesus Silva Leitão, Terezinha; de Matos e Souza, Fábio Gomes

    2013-01-01

    This study assesses the prevalence of bipolar disorder (BD) among 196 HIV-infected adult outpatients attending in a specialized unit in Fortaleza, Brazil. Patients were interviewed with the Mood Disorder Questionnaire (MDQ), the Mini International Neuropsychiatric Interview (MINI), the Alcohol Use Disorders Identification Test (AUDIT), and a socio-demographic questionnaire based on WHO's behavioral surveillance surveys. Positive MDQ screening was found in 13.2% (N=26) and the BD diagnosis was confirmed in 8.1% (N=16) of the sample. There is an almost four times higher prevalence of BD among the HIV-infected patients of the sample (8.1%) than in the general population from the USA (2.1%). The prevalence of BD type I in the HIV patients was 5.6% (N=11) which is almost six times higher than the US general population (1%). The odds ratios of sexual behaviors and substance abuse variables correlated with BD were calculated. The variables associated with the diagnoses of BD were sex with commercial partners, sex outside the primary relationship, alcohol use disorders, and illicit drug abuse. The most common psychiatric comorbidity in the BD group was substance abuse (61.5%). A better understanding of psychiatric comorbidities and behavioral aspects of HIV-positive patients may help in improving long-term outcome of these patients.

  13. Prevalence of HIV infection and the correlates among homeless in Tehran, Iran

    Institute of Scientific and Technical Information of China (English)

    Abbas Ostad Taghi zadeh; SeyedAhmad SeyedAlinaghi; Farshad Fakhimi Hassanzad; Mehdi Hajizadeh; SeyedNajmeddin Mohamadi; Sahra Emamzadeh-Fard; Koosha Paydary; Mostafa Hosseini

    2014-01-01

    Objective:To determine the prevalence of HIV infection among homeless men and women and the related risk behaviors in Tehran, Iran. Methods: In 2007-2008, Tehran municipality stacked up 10 657 homeless men and women for assessment of HIV and began collaboration with Iranian Research Center for HIV/AIDS (IRCHA) departments to conduct HIV infection prevalence surveys in homeless populations. The results were analyzed for associations with demographic information, family support, status of drug abuse and relation with family and friends. Results:Overall HIV prevalence was 1.7%(95%confidence interval 1.4-1.9). Factors independently associated with HIV infection included history of using drugs [AOR 8.15 (4.86-13.67)], older age [AOR 1.80 (1.08-2.99) for 40- 55 yr], occupation [AOR 1.64 (1.19-2.24) for unemployed], and no relation with family [AOR 1.82 (1.30-2.54)]. Conclusions: This study supports the idea that injection drug use is contributing to the increased spread of HIV among Iranian homeless. Harm reduction programs should be expanded, particularly among homeless injection drug users.

  14. Alcohol and cannabinoids differentially affect HIV infection and function of human monocyte-derived dendritic cells (MDDC

    Directory of Open Access Journals (Sweden)

    Marisela eAgudelo

    2015-12-01

    Full Text Available During human immunodeficiency virus (HIV infection, alcohol has been known to induce inflammation while cannabinoids have been shown to have an anti-inflammatory role. For instance cannabinoids have been shown to reduce susceptibility to HIV-1 infection and attenuate HIV replication in macrophages. Recently, we demonstrated that alcohol induces cannabinoid receptors and regulates cytokine production by monocyte-derived dendritic cells (MDDC. However, the ability of alcohol and cannabinoids to alter MDDC function during HIV infection has not been clearly elucidated yet. In order to study the potential impact of alcohol and cannabinoids on differentiated MDDC infected with HIV, monocytes were cultured for 7 days with GM-CSF and IL-4, differentiated MDDC were infected with HIV-1Ba-L and treated with EtOH (0.1 and 0.2%, THC (5 and 10 uM, or JWH-015 (5 and 10 uM for 4-7 days. HIV infection of MDDC was confirmed by p24 and Long Terminal Repeats (LTR estimation. MDDC endocytosis assay and cytokine array profiles were measured to investigate the effects of HIV and substances of abuse on MDDC function. Our results show the HIV+EtOH treated MDDC had the highest levels of p24 production and expression when compared with the HIV positive controls and the cannabinoid treated cells. Although both cannabinoids, THC and JWH-015 had lower levels of p24 production and expression, the HIV+JWH-015 treated MDDC had the lowest levels of p24 when compared to the HIV+THC treated cells. In addition, MDDC endocytic function and cytokine production were also differentially altered after alcohol and cannabinoid treatments. Our results show a differential effect of alcohol and cannabinoids, which may provide insights into the divergent inflammatory role of alcohol and cannabinoids to modulate MDDC function in the context of HIV infection.

  15. Cognitive-Behavioral Stress Management Interventions for Ethnic-Minority HIV-Positive Alcohol/Drug Abusers in Resource Limited and Culturally Diverse Communities

    Directory of Open Access Journals (Sweden)

    Robert M. Malow

    2009-01-01

    Full Text Available The article reports our intervention work with Alcohol and Other Drug Abusing (AOD People Living With HIV (PLWH. Present research has involved adapting Cognitive Behavioral Stress Management (CBSM and other strategies to improve quality of life and health outcomes for PLWH. Historically, CBSM has used relaxation and coping skills training to reduce negative mood and improve coping behaviors. The efficacy of CBSM interventions to improve functioning has been demonstrated in many disease groups and, more recently, in ethnic-minority HIV+ samples in the US CBSM HIV risk reduction interventions are similar to other cognitive-behavioral therapies in emphasizing skills training and stress reduction. Among the most precarious and challenging clinical populations are HIV infected individuals with a history of alcohol and/or drug abuse. Compared to their counterparts with no history of alcohol or drug abuse, not only are they more likely to transmit the virus to others, but they are also at risk for problems in adhering to antiretroviral regimens. A main focus of this article is to report on our intervention work with very resource-limited, ethnic-minority PLWH with substance abuse problems, particularly our NIH funded projects in Miami and Haiti and the opportunities presented by the emerging science of biological vulnerability and genomic factors.

  16. Substance abuse in early adolescents and HIV preventive behaviors: findings from a school-based cross-sectional survey for the period from 2009 to 2013, Bangkok Thailand.

    Science.gov (United States)

    Thepthien, B; Altaf, L; Chuchareon, P; Srivanichakron, S

    2016-10-01

    This study is first of its kind in Bangkok, and is a five-year (2009-2013) cross-sectional web-based survey to examine HIV preventive behaviors related to substance abuse among adolescents (N = 16,913). The questionnaire was self-administered. Logistic regression was used to analyze the data. The relationship between different types of substance abuse with risky and preventive behaviors was assessed. Male participants reported more substance abuse as compared to females. The risk behaviors observed among the substance abusers include increased sexual experience, multiple sex partners, no use of condoms, and injection drug use. The preventive behaviors include having a high self-risk assessment, going for HIV testing (highest in methamphetamine users), and screening for sexually transmitted infection. Logistic regression suggests that risky behaviors (e.g., sexual experience, injection drug use) are more common in substance abusers. Adolescents are clearly at a high risk. Behavioral preventive measures are needed to reduce or delay premature substance exposure to prevent a wide range of health problems and risks such as HIV and AIDS, injection drug use and unprotected sex.

  17. The Oral Bacterial Communities of Children with Well-Controlled HIV Infection and without HIV Infection.

    Directory of Open Access Journals (Sweden)

    Brittany E Goldberg

    Full Text Available The oral microbial community (microbiota plays a critical role in human health and disease. Alterations in the oral microbiota may be associated with disorders such as gingivitis, periodontitis, childhood caries, alveolar osteitis, oral candidiasis and endodontic infections. In the immunosuppressed population, the spectrum of potential oral disease is even broader, encompassing candidiasis, necrotizing gingivitis, parotid gland enlargement, Kaposi's sarcoma, oral warts and other diseases. Here, we used 454 pyrosequencing of bacterial 16S rRNA genes to examine the oral microbiome of saliva, mucosal and tooth samples from HIV-positive and negative children. Patient demographics and clinical characteristics were collected from a cross-section of patients undergoing routine dental care. Multiple specimens from different sampling sites in the mouth were collected for each patient. The goal of the study was to observe the potential diversity of the oral microbiota among individual patients, sample locations, HIV status and various dental characteristics. We found that there were significant differences in the microbiome among the enrolled patients, and between sampling locations. The analysis was complicated by uneven enrollment in the patient cohorts, with only five HIV-negative patients enrolled in the study and by the rapid improvement in the health of HIV-infected children between the time the study was conceived and completed. The generally good oral health of the HIV-negative patients limited the number of dental plaque samples that could be collected. We did not identify significant differences between well-controlled HIV-positive patients and HIV-negative controls, suggesting that well-controlled HIV-positive patients essentially harbor similar oral flora compared to patients without HIV. Nor were significant differences in the oral microbiota identified between different teeth or with different dental characteristics. Additional studies are

  18. Sex differences in benzodiazepine use in the HIV-infected population.

    Science.gov (United States)

    Wixson, Sarah E; Brouwer, Emily S

    2014-01-01

    In the HIV-infected population there is a high prevalence of psychiatric disorders, conditions that often coexist with drug and alcohol dependence. Symptoms associated with psychiatric disorders are frequently managed with benzodiazepines, a class of medication often abused. We examined whether HIV-infected patients were more likely to fill a benzodiazepine prescription than their uninfected counterparts using a privately insured, nationally representative sample receiving clinical care between January 2007 and December 2009. Odds ratios (OR) and 95% confidence intervals (CI) to quantify the likelihood of receiving a benzodiazepine were calculated using multivariate logistic regression models. We examined the presence of interaction between HIV infection and sex using backwards elimination and by comparing stratum-specific OR to identify clinically meaningful differences. Overall, 323,796 beneficiaries were included in the sample, of which 723 were HIV infected. Bivariate analyses showed that compared to the uninfected sample, HIV-infected patients were more likely to have filled a benzodiazepine prescription (24% vs. 19%) during the study period. HIV-infected patients were also more likely to be male (80% vs. 44%), black (21% vs. 7%) and have a diagnosis of depression (12% vs. 8%) or insomnia (6% vs. 3%) than were uninfected patients. Adjusted for other covariates, HIV infection was associated with an increase (OR): 1.68, 95% CI: 1.39, 2.02) in the likelihood of filling a benzodiazepine prescription. When stratified by sex, HIV-infected males were more likely (OR: 1.68, 95% CI: 1.05, 2.67) than uninfected males to fill a benzodiazepine prescription while there was no observed difference in the likelihood of filling a benzodiazepine prescription between HIV-infected and uninfected females (OR: 1.12, 95% CI: 0.73, 1.70). Our findings suggest that HIV-infected patients, particularly HIV-infected males, are more likely to fill benzodiazepine prescriptions than their

  19. 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.

  20. HIGH PREVALENCE OF STIGMA-RELATED ABUSE AMONG A SAMPLE OF MEN WHO HAVE SEX WITH MEN IN TANZANIA: IMPLICATIONS FOR HIV PREVENTION

    Science.gov (United States)

    Anderson, Alexandra M.; Ross, Michael W.; Nyoni, Joyce E.; McCurdy, Sheryl A.

    2016-01-01

    In sub-Saharan Africa, the prevalence of stigma-related abuse and violence among men who have sex with men (MSM) and its potential impact on the HIV/AIDS epidemic is unknown. This study estimated the prevalence and source of violence and abuse among a sample of MSM in Tanzania and characterized the association between levels of violence and sexual and mental health variables. Data were taken from a larger study of 200 MSM in Tanzania. Frequency tabulations, bivariate analysis and logistic regression were performed to describe the prevalence and source of abuse and to determine the association between levels of violence and sexual demographics and mental health variables. The MSM sample for this study was young (median age 23), somewhat educated with the majority having attained secondary school (80%) and mostly employed (60%). Verbal (48.5%) and moral (32.5%) abuse were the most predominant types of abuse among the sample and were mostly from people in the street and neighbors. Sexual abuse (30%) was mostly from partners and physical violence (29.5%) was largely from people in the street. Participants in the high violence level group had a significantly greater number of sexual partners, depression scores and internalized homonegativity (IH) scores. IH predicted HIV infection, and verbal abuse predicted IH. There is a need for an increased awareness of violence and abuse faced by MSM in Tanzania, as well as effective programs to specifically target the issue of violence among MSM and its implication for mental health and for risky sexual behaviors and HIV transmission. PMID:25162483

  1. Cryptococcal meningitis associated with tuberculosis in HIV infected patients.

    Science.gov (United States)

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

    2013-07-01

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

  2. Trauma Symptoms, Sexual Behaviors, and Substance Abuse: Correlates of Childhood Sexual Abuse and HIV Risks among Men Who Have Sex with Men

    Science.gov (United States)

    Kalichman, Seth C.; Gore-Felton, Cheryl; Benotsch, Eric; Cage, Marjorie; Rompa, David

    2004-01-01

    Childhood sexual abuse is associated with high-risk sexual behavior in men who have sex with men. This study examined psychological and behavioral correlates of HIV risk behavior associated with childhood sexual abuse in a sample of men who have sex with men. Men attending a large gay pride event (N = 647) completed anonymous surveys that assessed…

  3. HIV Infection and Microbial Diversity in Saliva

    Science.gov (United States)

    Saxena, Deepak; Chen, Zhou; Liu, Gaoxia; Abrams, Willam R.; Phelan, Joan A.; Norman, Robert G.; Fisch, Gene S.; Corby, Patricia M.; Dewhirst, Floyd; Paster, Bruce J.; Kokaras, Alexis S.; Malamud, Daniel

    2014-01-01

    Limited information is available about the effects of HIV and subsequent antiretroviral treatment on host-microbe interactions. This study aimed to determine the salivary microbial composition for 10 HIV-seropositive subjects, before and 6 months after highly active antiretroviral therapy (HAART), compared with that for 10 HIV-seronegative subjects. A conventional culture and two culture-independent analyses were used and consistently demonstrated differences in microbial composition among the three sets of samples. HIV-positive subjects had higher levels of total cultivable microbes, including oral streptococci, lactobacilli, Streptococcus mutans, and Candida, in saliva than did HIV-negative subjects. The total cultivable microbial levels were significantly correlated with CD4+ T cell counts. Denaturing gradient gel electrophoresis (DGGE), which compared the overall microbial profiles, showed distinct fingerprinting profiles for each group. The human oral microbe identification microarray (HOMIM) assay, which compared the 16S rRNA genes, showed clear separation among the three sample groups. Veillonella, Synergistetes, and Streptococcus were present in all 30 saliva samples. Only minor changes or no changes in the prevalence of Neisseria, Haemophilus, Gemella, Leptotrichia, Solobacterium, Parvimonas, and Rothia were observed. Seven genera, Capnocytophaga, Slackia, Porphyromonas, Kingella, Peptostreptococcaceae, Lactobacillus, and Atopobium, were detected only in HIV-negative samples. The prevalences of Fusobacterium, Campylobacter, Prevotella, Capnocytophaga, Selenomonas, Actinomyces, Granulicatella, and Atopobium were increased after HAART. In contrast, the prevalence of Aggregatibacter was significantly decreased after HAART. The findings of this study suggest that HIV infection and HAART can have significant effects on salivary microbial colonization and composition. PMID:24523469

  4. Care of Patients With HIV Infection: Medical Complications and Comorbidities.

    Science.gov (United States)

    Bolduc, Philip; Roder, Navid; Colgate, Emily; Cheeseman, Sarah H

    2016-04-01

    Care of patients with HIV infection starts with diagnosis as soon as possible, preferably at or near the time of acute infection. Opportunistic infections, malignancies, and other conditions develop progressively over time, particularly in untreated patients. The AIDS-defining opportunistic infections most common in the United States include Pneumocystis jirovecii pneumonia, Candida esophagitis, toxoplasmic encephalitis, tuberculosis, disseminated Mycobacterium avium complex, cryptococcal meningitis, and cytomegalovirus retinitis. Specific prophylaxis regimens exist for several opportunistic infections, and effective antiretroviral therapy reduces the risk of most others. Other AIDS-defining conditions include wasting syndrome and HIV encephalopathy. AIDS-defining malignancies include Kaposi sarcoma, systemic non-Hodgkin lymphoma, primary central nervous system lymphoma, and invasive cervical cancer. Although not an AIDS-defining condition, anal cancer is common in patients with HIV infection. Other HIV-related conditions include thrombocytopenia, recurrent bacterial respiratory infections, HIV-associated nephropathy, and HIV-associated neurocognitive disorder.

  5. Longitudinal Characterization of Depression and Mood States Beginning in Primary HIV Infection

    OpenAIRE

    2014-01-01

    Though depression is known to frequently afflict those with chronic HIV, mood during the early course of HIV is not well characterized. In a prospective study we assessed mood during primary HIV infection [primary HIV infection (PHI),

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

    OpenAIRE

    Mofenson, Lynne M.; COTTON, Mark F.

    2013-01-01

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

  7. Screening for Neurocognitive Impairment in HIV-Infected Individuals at First Contact after HIV Diagnosis: The Experience of a Large Clinical Center in Northern Italy.

    Science.gov (United States)

    Focà, Emanuele; Magro, Paola; Motta, Davide; Compostella, Silvia; Casari, Salvatore; Bonito, Andrea; Brianese, Nigritella; Ferraresi, Alice; Rodari, Paola; Pezzoli, Maria Chiara; Quiros-Roldan, Eugenia; Castelli, Francesco

    2016-03-24

    Neurocognitive disorders are emerging, probably underestimated, complications in HIV-infected people. The aim of the study was to assess neurocognitive profiles of newly detected HIV-infected patients. We performed an observational retrospective single-cohort study. Illiterates and patients with neurologic symptoms or previous psychiatric diagnosis were excluded. Neuropsychological profiles were assessed using a validated battery of neuropsychological tests. We included 206 patients; with males representing the majority of them (85%). Risk factors for HIV acquisition were unprotected sexual intercourse (homo/bisexual in 39.8% and heterosexual in 60.2%). Thirty-nine patients (18.9%) were previous injection drug users, while 41 (19.9%) were alcohol abusers. Mean education was 11.1 years (SD--standard deviation--3.7). A high prevalence of HIV-associated neurocognitive disorders (HAND, 47.1%) was present in HIV-infected patients: particularly, asymptomatic neurocognitive impairment (ANI) was found in 30.6%, mild neurocognitive disorder (MND) in 15% and HIV-associated dementia (HAD) in 1.5%. Male gender, low degree of education, AIDS diagnosis and gepatitis B virus (HBV) co-infection were factors independently associated with HAND in a multivariable logistic regression model. Our data suggest that patient-specific factors and AIDS diagnosis have a certain kind of impact in HAND occurrence. A complete neuropsychological screening must be recommended in all patients at HIV-infection diagnosis.

  8. HIV testing among non-incarcerated substance-abusing juvenile offenders.

    Science.gov (United States)

    Tolou-Shams, Marina; Conrad, Selby; Louis, Alaina; Shuford, Sarah Hart; Brown, Larry K

    2015-11-01

    Juvenile offenders are a subgroup of adolescents at particular risk for HIV/STI infection. Although HIV prevalence among these youth is low (rates of other STIs, unprotected sexual activity, multiple partners, and incidents of substance use during sex are high compared with other adolescent populations. Many of these youth will enter the adult criminal justice system, which is known to have an extremely high rate of HIV infection. US constitutional mandates provide HIV/STI testing for incarcerated juveniles, but close to 80% of juvenile arrestees are never detained. Moreover, although they engage in similar HIV risk behaviors as those detained, they have limited access to available HIV/STI testing services. Thus, our study examined rates of lifetime HIV testing among a pilot sample of 60 court-involved, substance-using juveniles monitored in the community to explore rates of testing and the reasons related to lifetime testing among a high-risk, yet understudied US juvenile population.

  9. Longitudinal HIV Risk Behavior among the Drug Abuse Treatment Outcome Studies (DATOS) Adult Sample

    Science.gov (United States)

    Murphy, Debra A.; Brecht, Mary-Lynn; Herbeck, Diane; Evans, Elizabeth; Huang, David; Hser, Yih-Ing

    2008-01-01

    Longitudinal trajectories for HIV risk were examined over 5 years following treatment among 1,393 patients who participated in the nationwide Drug Abuse Treatment Outcome Studies. Both injection drug use and sexual risk behavior declined over time, with most of the decline occurring between intake and the first-year follow-up. However, results of…

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

    Science.gov (United States)

    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 group were screened respectively for intestinal parasites and for HIV antibodies. Intestinal parasites were identified using direct microscopy, formalin-ether concentration and Ziehl Neelsen methods. Out of 396 participants recruited among patients consulting at hospital, 42 (10.6%) were HIV positive, thirty of them treatment naïve. The overall prevalence of intestinal parasites was 14.64%. Out of 42 HIV/AIDS patients, 59.5% (25/42) were infected with intestinal parasites, while only 9.32% (33/354) of the HIV negative patients were infected with intestinal parasites. The parasites detected in our study population included Crystosporidium parvum (2.53%), Entamoeba histolytica (7.52%), Entamoeba coli (4.04%), Giardia lamblia (0.25%), Trichuris trichura (0.25%), Strongyloides stercoralis (0.25%) and Taenia spp. (0.25%). In the HIV infected group, Crystosporidium parvum (19.04%), Entamoeba histolytica (19.04%), Entamoeba coli (21.42%), Giardia lamblia (2.38%), Strongyloides stercoralis (0.25%) and Taenia spp. (0.25%) were found. Crystosporidium parvum was found to be significantly higher in HIV/AIDS patients than in controls (Pintestinal parasitosis. Routine examinations of stool samples for parasites would significantly benefit the HIV patients by contributing in reducing morbidity and improving the efficiency of antiretroviral treatment. Even after the introduction of free anti-retroviral drugs, opportunistic intestinal infections are still a threat. HIV patients should be screened

  11. Suppression of HIV-1 Infectivity by Human Glioma Cells.

    Science.gov (United States)

    Hoque, Sheikh Ariful; Tanaka, Atsushi; Islam, Salequl; Ahsan, Gias Uddin; Jinno-Oue, Atsushi; Hoshino, Hiroo

    2016-05-01

    HIV-1 infection to the central nervous system (CNS) is very common in AIDS patients. The predominant cell types infected in the brain are monocytes and macrophages, which are surrounded by several HIV-1-resistant cell types, such as astrocytes, oligodendrocytes, neurons, and microvascular cells. The effect of these HIV-1-resistant cells on HIV-1 infection is largely unknown. In this study, we examined the stability of HIV-1 cultured with several human glioblastoma cell lines, for example, NP-2, U87MG, T98G, and A172, to determine whether these HIV-1-resistant brain cells could enhance or suppress HIV-1 infection and thus modulate HIV-1 infection in the CNS. The HIV-1 titer was determined using the MAGIC-5A indicator cell line as well as naturally occurring CD4(+) T cells. We found that the stability of HIV-1 incubated with NP-2 or U87MG cells at 37°C was significantly shorter (half-life, 2.5-4 h) compared to that of HIV-1 incubated with T98G or A172 cells or in culture medium without cells (half-life, 8-18 h). The spent culture media (SCM) of NP-2 and U87MG cells had the ability to suppress both R5- and X4-HIV-1 infection by inhibiting HIV-1 attachment to target cells. This inhibitory effect was eliminated by the treatment of the SCM with chondroitinase ABC but not heparinase, suggesting that the inhibitory factor(s) secreted by NP-2 and U87MG cells was chiefly mediated by chondroitin sulfate (CS) or CS-like moiety. Thus, this study reveals that some but not all glioma cells secrete inhibitory molecules to HIV-1 infection that may contribute in lowering HIV-1 infection in the CNS in vivo.

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

    Directory of Open Access Journals (Sweden)

    Tahar Bajjou

    2015-03-01

    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

  13. HIV-2 infection and chemokine receptors usage - clues to reduced virulence of HIV-2.

    Science.gov (United States)

    Azevedo-Pereira, José Miguel; Santos-Costa, Quirina; Moniz-Pereira, José

    2005-01-01

    Human immunodeficiency virus type 1 (HIV-1) and type 2 (HIV-2) are the causative agents of Acquired Immunodeficiency Syndrome (AIDS). Without therapeutic intervention, HIV-1 or HIV-2 infections in humans are characterized by a gradual and irreversible immunologic failure that ultimately leads to the onset of a severe immunodeficiency that constitutes the hallmark of AIDS. In the last two decades AIDS has evolved into a global epidemic affecting millions of persons worldwide. Although sharing several identical properties, HIV-1 and HIV-2 have shown some important differences in vivo. In fact, a significant amount of epidemiologic, clinical and virologic data suggest that HIV-2 is in general less virulent than HIV-1. This reduced virulence is revealed by the longer asymptomatic period and the smaller transmission rate that characteristically are observed in HIV-2 infection. In this context, studies using HIV-2 as a model of a naturally less pathogenic infection could bring important new insights to HIV pathogenesis opening to new strategies to vaccines or therapeutic design. The reasons underlying the reduced pathogenicity of HIV-2 are still essentially unknown and surely are the outcome of a combination of distinct factors. In this review we will discuss the importance and the possible implications in HIV-2 pathogenesis, particularly during the asymptomatic period, of a less fitted interaction between viral envelope glycoproteins and cellular receptors that have been described in the way HIV-2 and HIV-1 use these receptors.

  14. Urban legends series: oral manifestations of HIV infection.

    Science.gov (United States)

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

    2013-09-01

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

  15. [Prevalence of HIV infection in dialysis patients: results of a national multicenter study].

    Science.gov (United States)

    Poignet, J L; Desassis, J F; Chanton, N; Litchinko, M B; Zins, B; Kolko, A; Patte, R; Sobel, A

    1999-01-01

    In order to determine the prevalence of HIV infection in french patients with end-stage renal disease (ESRD) on maintenance dialysis therapy, questionnaire forms were mailed out in february 1997 to the heads of the 260 dialysis facilities. We documented number of patients on maintenance dialysis therapy (hemo and peritoneal dialysis) and for HIV infected dialysis patients: age, gender, cause and duration of ESRD, known duration of HIV infection, risk factors for HIV infection, HBV and/or HCV infection, presence of clinical acquired immunodeficiency syndrome (AIDS), total CD4 count and treatment with antiretroviral agents. Questionnaire forms were returned from 98% of the dialysis facilities. As of february 1997 some 22,707 patients with ESRD were treated by renal replacement therapy, 19,947 by hemodialysis (HD) and 2760 by peritoneal dialysis (PD). 82 patients with ESRD and HIV infection were reported corresponding to 0.36% prevalence rate of all patients undergoing dialysis at the time specified. The 82 study subjects with ESRD and HIV infection received hemodialysis (79 patients) or peritoneal dialysis (3 patients) in 42 facilities. Forty seven patients were treated in Paris and suburbs and 9 in our own center. All 82 patients comprised 63% men and 47% women which included patients coming from Africa (37%), Caribbean and Oceania (28%), Europe (35%) of a mean age of 41.8 years. Modes of transmission were homobisexuals 15%, heterosexuals 31%, intravenous drug abusers 17%, blood transfusion 17% and unknown 20%. The mean duration of HIV infection was 96 months (range 12-168 months) and the mean duration of ESRD was 58 months (range 1-235 months). HIV associated nephropathy was established in 31%. AIDS was diagnosed in 25 patients. Seventy one percent of the patients were receiving an antiretroviral drug (tritherapy in 25% of cases). In conclusion HIV prevalence rate among French dialysis patients is low and focused in Paris and oversea. Sexual transmission is the

  16. Endocrine alterations in HIV-infected patients

    Directory of Open Access Journals (Sweden)

    Sujit Kumar Tripathy

    2015-01-01

    Full Text Available Aims and objectives: To study the frequency of thyroid, adrenal and gonadal dysfunction in newly diagnosed HIV-infected patients and to correlate them at different levels of CD4 cell counts. Materials and Methods: Forty-three HIV-positive cases were included in the study group. Cases were divided into three groups on the basis of CD4 cell count. Serum free T3, free T4, TSH, Cortisol, FSH, LH, testosterone and estradiol were estimated by the radioimmunoassay method. Hormone levels between cases were compared and their correlation with CD4 count was analyzed. Results: Prevalence of gonadal dysfunction (88.3% was the most common endocrine dysfunction followed by thyroid (60.4% and adrenal dysfunction (27.9%. Secondary hypogonadism (68.4% was more common than primary (31.6%. Low T3 syndrome, that is, isolated low free T3, was the most common (25.6% thyroid dysfunction followed by secondary hypothyroidism (16.2% and subclinical hypothyroidism (11.6%. Adrenal excess (16.3% was more common than adrenal insufficiency (11.6%. The difference in hormonal dysfunction between male and female was statistically insignificant (P > 0.05. 27.9% of patients had multiple hormone deficiency. There was negligible or no correlation between CD4 count and serum hormone level. Conclusion: In our study, endocrine dysfunction was quite common among HIV-infected patients but there was no correlation between hormone levels and CD4 count. Endocrine dysfunctions and role of hormone replacement therapy in HIV-infected patient needs to be substantiated by large longitudinal study, so that it will help to reduce morbidity, improve quality of life.

  17. 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

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

    OpenAIRE

    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 ...

  19. Epigenetic Alterations in the Brain Associated with HIV-1 Infection and Methamphetamine Dependence

    OpenAIRE

    Paula Desplats; Wilmar Dumaop; Peter Cronin; Sara Gianella; Steven Woods; Scott Letendre; David Smith; Eliezer Masliah; Igor Grant

    2014-01-01

    HIV involvement of the CNS continues to be a significant problem despite successful use of combination antiretroviral therapy (cART). Drugs of abuse can act in concert with HIV proteins to damage glia and neurons, worsening the neurotoxicity caused by HIV alone. Methamphetamine (METH) is a highly addictive psychostimulant drug, abuse of which has reached epidemic proportions and is associated with high-risk sexual behavior, increased HIV transmission, and development of drug resistance. HIV i...

  20. Care of Patients With HIV Infection: Antiretroviral Drug Regimens.

    Science.gov (United States)

    Bolduc, Philip; Roder, Navid; Colgate, Emily; Cheeseman, Sarah H

    2016-04-01

    The advent of combination antiretroviral drug regimens has transformed HIV infection from a fatal illness into a manageable chronic condition. All patients with HIV infection should be considered for antiretroviral therapy, regardless of CD4 count or HIV viral load, for individual benefit and to prevent HIV transmission. Antiretroviral drugs affect HIV in several ways: entry inhibitors block HIV entry into CD4 T cells; nucleotide and nucleoside reverse transcriptase inhibitors prevent reverse transcription from RNA to DNA via chain-terminating proteins; nonnucleoside reverse transcriptase inhibitors prevent reverse transcription through enzymatic inhibition; integrase strand transfer inhibitors block integration of viral DNA into cellular DNA; protease inhibitors block maturation and production of the virus. Current guidelines recommend six combination regimens for initial therapy. Five are based on tenofovir and emtricitabine; the other uses abacavir and lamivudine. Five include integrase strand transfer inhibitors. HIV specialists should assist with treating patients with complicated HIV infection, including patients with treatment-resistant HIV infection, coinfection with hepatitis B or C virus, pregnancy, childhood infections, severe opportunistic infections, complex drug interactions, significant drug toxicity, or comorbidities. Family physicians can treat most patients with HIV infection effectively by choosing appropriate treatment regimens, monitoring patients closely, and retaining patients in care.

  1. Purinergic Receptors: Key Mediators of HIV-1 infection and inflammation

    Directory of Open Access Journals (Sweden)

    Talia H Swartz

    2015-11-01

    Full Text Available Human immunodeficiency virus (HIV-1 causes a chronic infection that afflicts more than 38 million individuals worldwide. While the infection can be suppressed with potent anti-retroviral therapies, individuals infected with HIV have elevated levels of inflammation as indicated by increased T cell activation, soluble biomarkers, and associated morbidity and mortality. A single mechanism linking HIV pathogenesis to this inflammation has yet to be identified. Purinergic receptors are known to mediate inflammation and have been shown to be required for HIV-1 infection at the level of HIV-1 membrane fusion. Here we review the literature on the role of purinergic receptors in HIV-1 infection and associated inflammation and describe a role for these receptors as potential therapeutic targets.

  2. [Genetics in the study of HIV infection].

    Science.gov (United States)

    Amoroso, Antonio; Savoldi, Silvana

    2012-01-01

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

  3. HIV and Sexually Transmitted Infections in the Netherlands in 2005

    NARCIS (Netherlands)

    Boer IM de; Op de Coul ELM; Koedijk FDH; Veen MG van; Sighem AI van; Laar MJW van de; CIE

    2006-01-01

    The trend of increasing Sexually Transmitted Infections (STI) has partly stabilised in 2005 in the STI sentinel surveillance network. Among men having sex with men (MSM), the number of STI diagnoses remained high and the HIV positivity rate has increased. Moreover, in the national HIV registry (HIV

  4. HUMAN-IMMUNODEFICIENCY-VIRUS (HIV) TYPE-1 INFECTION STATUS AND IN-VITRO SUSCEPTIBILITY TO HIV-INFECTION AMONG HIGH-RISK HIV-1 SERONEGATIVE HEMOPHILIACS

    NARCIS (Netherlands)

    LEDERMAN, MM; JACKSON, JB; KRONER, BL; WHITE, GC; EYSTER, ME; ALEDORT, LM; HILGARTNER, MW; KESSLER, CM; COHEN, AR; KIGER, KP; GOEDERT, JJ

    1995-01-01

    Blood samples were obtained from 16 hemophiliacs who had a 50%-94% defined risk of human immunodeficiency virus (HIV type 1 infection on the basis of treatment history and from 14 controls not at risk for HIV infection. HIV-1 was not detected in any of 12 patient samples by cocultivation nor in 14 p

  5. Increasing rates of obesity among HIV-infected persons during the HIV epidemic.

    Directory of Open Access Journals (Sweden)

    Nancy Crum-Cianflone

    Full Text Available BACKGROUND: The prevalence and factors associated with overweight/obesity among human immunodeficiency virus (HIV-infected persons are unknown. METHODS: We evaluated prospective data from a U.S. Military HIV Natural History Study (1985-2004 consisting of early diagnosed patients. Statistics included multivariate linear regression and longitudinal linear mixed effects models. RESULTS: Of 1682 patients, 2% were underweight, 37% were overweight, and 9% were obese at HIV diagnosis. Multivariate predictors of a higher body mass index (BMI at diagnosis included more recent year of HIV diagnosis, older age, African American race, and earlier HIV stage (all p<0.05. The majority of patients (62% gained weight during HIV infection. Multivariate factors associated with a greater increase in BMI during HIV infection included more recent year of diagnosis, lower BMI at diagnosis, higher CD4 count, lower HIV RNA level, lack of AIDS diagnosis, and longer HIV duration (all p<0.05. Nucleoside agents were associated with less weight gain; other drug classes had no significant impact on weight change in the HAART era. CONCLUSIONS: HIV-infected patients are increasingly overweight/obese at diagnosis and during HIV infection. Weight gain appears to reflect improved health status and mirror trends in the general population. Weight management programs may be important components of HIV care.

  6. HIV-Associated Neuroretinal Disorder in Patients With Well-Suppressed HIV-Infection : A Comparative Cohort Study

    NARCIS (Netherlands)

    Demirkaya, Nazli; Wit, Ferdinand W N M; van Den Berg, Thomas J T P; Kooij, Katherine W; Prins, Maria; Schlingemann, Reinier O; Abramoff, Michael D; Reiss, Peter; Verbraak, Frank D

    2016-01-01

    PURPOSE: Loss of neuroretinal structure and function, ascribed to a 'HIV-associated Neuroretinal Disorder' (HIV-NRD), in the absence of ocular opportunistic infections, has been reported in HIV-infected individuals treated with combination antiretroviral therapy (cART). Whether HIV-infected individu

  7. 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.

  8. HIV risk behavior among HIV-infected men who have sex with men in Bangkok, Thailand.

    Science.gov (United States)

    Sirivongrangson, Pachara; Lolekha, Rangsima; Charoenwatanachokchai, Angkana; Siangphoe, Umaporn; Fox, Kimberley K; Jirarojwattana, Naiyana; Bollen, Liesbeth; Yenyarsan, Naruemon; Lokpichat, Somchai; Suksripanich, Orapin; McConnell, Michelle

    2012-04-01

    We assessed prevalence of sexually transmitted infection (STIs), sexual risk behaviors, and factors associated with risk behaviors among HIV-infected MSM attending a public STI clinic serving MSM in Bangkok, Thailand. Between October 2005-October 2007, 154 HIV-infected MSM attending the clinic were interviewed about sexual risk behaviors and evaluated for STIs. Patients were examined for genital ulcers and had serologic testing for syphilis and PCR testing for chlamydia and gonorrhea. Results showed that sexual intercourse in the last 3 months was reported by 131 men. Of these, 32% reported anal sex without a condom. STIs were diagnosed in 41%. Factors associated with having sex without a condom were having a steady male partner, having a female partner and awareness of HIV status <1 month. Sexual risk behaviors and STIs were common among HIV-infected MSM in this study. This highlights the need for increased HIV prevention strategies for HIV-infected MSM.

  9. Relationship of vitamin D, HIV, HIV treatment, and lipid levels in the Women's Interagency HIV Study of HIV-infected and uninfected women in the United States.

    Science.gov (United States)

    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 (±antiretroviral therapy [ART]) were investigated with Women's Interagency HIV Study data (n = 1758 middle-aged women) using multivariable regression. Sixty-three percent of women had vitamin D deficiency. Median 25-hydroxyvitamin D (25-OH vitamin D) was highest in HIV-infected + ART-treated women (17 ng/mL; P HIV treatment. Similarly, vitamin D levels were positively related to triglycerides only in ART-treated HIV-infected women and unrelated to cholesterol.

  10. 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

  11. Dengue in HIV infected patients:clinical profiles

    Institute of Scientific and Technical Information of China (English)

    Beuy Joob; Viroj Wiwanitkit

    2014-01-01

    Dengue is an important tropical viral infection. It can present with acute febrile illness with possible hemorrhagic complication. Since it is a common infection in the tropical world, concomitance with other diseases can be expected. An important consideration is the co-presentation of dengue with HIV infection. In this specific report, the authors summarize the clinical profiles of dengue patients with HIV infection. Based on the present study, it can be seen that clinical profiles of dengue in any group of HIV infection is not different.

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

    DEFF Research Database (Denmark)

    Jernigan, Terry Lynne; Gamst, Abthony C; Archibald, Sarah L.;

    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...

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

    Directory of Open Access Journals (Sweden)

    Sylvain Chawki

    2014-11-01

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

  14. Human rights abuses and vulnerability to HIV/AIDS: the experiences of Burmese women in Thailand.

    Science.gov (United States)

    Leiter, Karen; Suwanvanichkij, Voravit; Tamm, Ingrid; Iacopino, Vincent; Beyrer, Chris

    2006-01-01

    We investigated human rights concerns related to migration, living and working conditions, and access to HIV/AIDS services and reproductive health services for Burmese women in Thailand. Vulnerability to HIV/AIDS for Burmese women stemmed from abuses they experienced: gender and ethnic discrimination, including violence; unsafe migration and trafficking; labor and sexual exploitation; and denial of health care. Despite having bound itself to human rights laws, the Thai government is failing to fulfill its obligations to Burmese women, with particularly devastating impacts for their well-being, including the risk of HIV/AIDS. Moreover, as our documentation shows, this failure to incorporate human rights concerns into its national response to the epidemic virtually guarantees that HIV/AIDS will continue to be a problem in Thailand.

  15. HSV oropharyngeal shedding among HIV-infected children in Tanzania.

    Science.gov (United States)

    Zuckerman, Richard; Manji, Karim; Matee, Mecky; Naburi, Helga; Bisimba, Jema; Martinez, Raquel; Wieland-Alter, Wendy; Kim, Faith; von Reyn, C Fordham; Palumbo, Paul

    2015-06-01

    Herpes simplex virus (HSV) oral shedding has not been studied among HIV-positive children in Africa. We sought to evaluate longitudinal oral HSV reactivation in HIV-positive and -negative children. Twenty HIV-positive antiretroviral-naive and 10 HIV-negative children aged 3-12 years in Tanzania were followed prospectively for 14 days. Oral swabs were collected daily and submitted for HSV DNA PCR analysis. Clinical data were collected via chart review and daily diaries. HSV DNA was detected in 10 (50%) of HIV-positive and 4 (40%) of HIV-negative children. Children who shed HSV had virus detected in a median of 21.4% of samples; shedding was intermittent. Median CD4 count among HIV-infected children was 667 cells/µL in those with positive HSV DNA and 886 cells/µL in those who were negative (p = 0.6). Of the HIV-positive children reporting prior sores, five (83%) had positive HSV swabs, whereas the one HIV-negative child with prior sores did not have a PCR-positive swab. HSV is detected frequently in children with and without HIV. HIV-infected children reporting oral sores have a high rate of HSV detection. Given the proven strong interactions between HIV and HSV, further study of co-infection with these viruses is warranted in children.

  16. Gut Microbiota Linked to Sexual Preference and HIV Infection

    Directory of Open Access Journals (Sweden)

    Marc Noguera-Julian

    2016-03-01

    Full Text Available The precise effects of HIV-1 on the gut microbiome are unclear. Initial cross-sectional studies provided contradictory associations between microbial richness and HIV serostatus and suggested shifts from Bacteroides to Prevotella predominance following HIV-1 infection, which have not been found in animal models or in studies matched for HIV-1 transmission groups. In two independent cohorts of HIV-1-infected subjects and HIV-1-negative controls in Barcelona (n = 156 and Stockholm (n = 84, men who have sex with men (MSM predominantly belonged to the Prevotella-rich enterotype whereas most non-MSM subjects were enriched in Bacteroides, independently of HIV-1 status, and with only a limited contribution of diet effects. Moreover, MSM had a significantly richer and more diverse fecal microbiota than non-MSM individuals. After stratifying for sexual orientation, there was no solid evidence of an HIV-specific dysbiosis. However, HIV-1 infection remained consistently associated with reduced bacterial richness, the lowest bacterial richness being observed in subjects with a virological-immune discordant response to antiretroviral therapy. Our findings indicate that HIV gut microbiome studies must control for HIV risk factors and suggest interventions on gut bacterial richness as possible novel avenues to improve HIV-1-associated immune dysfunction.

  17. Gut Microbiota Linked to Sexual Preference and HIV Infection

    Science.gov (United States)

    Noguera-Julian, Marc; Rocafort, Muntsa; Guillén, Yolanda; Rivera, Javier; Casadellà, Maria; Nowak, Piotr; Hildebrand, Falk; Zeller, Georg; Parera, Mariona; Bellido, Rocío; Rodríguez, Cristina; Carrillo, Jorge; Mothe, Beatriz; Coll, Josep; Bravo, Isabel; Estany, Carla; Herrero, Cristina; Saz, Jorge; Sirera, Guillem; Torrela, Ariadna; Navarro, Jordi; Crespo, Manel; Brander, Christian; Negredo, Eugènia; Blanco, Julià; Guarner, Francisco; Calle, Maria Luz; Bork, Peer; Sönnerborg, Anders; Clotet, Bonaventura; Paredes, Roger

    2016-01-01

    The precise effects of HIV-1 on the gut microbiome are unclear. Initial cross-sectional studies provided contradictory associations between microbial richness and HIV serostatus and suggested shifts from Bacteroides to Prevotella predominance following HIV-1 infection, which have not been found in animal models or in studies matched for HIV-1 transmission groups. In two independent cohorts of HIV-1-infected subjects and HIV-1-negative controls in Barcelona (n = 156) and Stockholm (n = 84), men who have sex with men (MSM) predominantly belonged to the Prevotella-rich enterotype whereas most non-MSM subjects were enriched in Bacteroides, independently of HIV-1 status, and with only a limited contribution of diet effects. Moreover, MSM had a significantly richer and more diverse fecal microbiota than non-MSM individuals. After stratifying for sexual orientation, there was no solid evidence of an HIV-specific dysbiosis. However, HIV-1 infection remained consistently associated with reduced bacterial richness, the lowest bacterial richness being observed in subjects with a virological-immune discordant response to antiretroviral therapy. Our findings indicate that HIV gut microbiome studies must control for HIV risk factors and suggest interventions on gut bacterial richness as possible novel avenues to improve HIV-1-associated immune dysfunction. PMID:27077120

  18. Risk management information for HIV infection.

    Science.gov (United States)

    Edwards, A J

    1990-01-01

    This article discusses HIV infection in terms of the risk manager's information needs in the health care environment. The malpractice problem, increasing workman's compensation suits, the greater role of the ombudsman, implementation of the National Practitioner Data Bank, and the Joint Commission on Accreditation of Health Care Organizations' (JCAHO) emphasis on clinical excellence are conditions which have given greater importance to the risk manager's position. Included in this article are hedges to retrieve various components of risk management and a select bibliography from AIDSLINE.

  19. Nutritional status of persons with HIV infection, persons with HIV infection and tuberculosis, and HIV-negative individuals from southern India.

    Science.gov (United States)

    Swaminathan, Soumya; Padmapriyadarsini, C; Sukumar, B; Iliayas, Sheikh; Kumar, S Ramesh; Triveni, C; Gomathy, P; Thomas, Beena; Mathew, Minnie; Narayanan, P R

    2008-03-15

    We compared the nutritional status of individuals with human immunodeficiency virus (HIV) infection alone, individuals with HIV infection and tuberculosis (after completion of antituberculosis treatment), and HIV-negative individuals and found that malnutrition, anemia, and hypoalbuminemia were most pronounced among HIV-positive patients with tuberculosis. Weight loss was associated with loss of fat in female patients and with loss of body cell mass in male patients.

  20. 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.

  1. Primary Oral Tuberculosis as an Indicator of HIV Infection

    Directory of Open Access Journals (Sweden)

    R. A. G. Khammissa

    2011-01-01

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

  2. Varicella vaccination in HIV-1-infected children after immune reconstitution

    NARCIS (Netherlands)

    V. Bekker; G.H.A. Westerlaken; H. Scherpbier; S. Alders; H. Zaaijer; D. van Baarle; T. Kuijper

    2006-01-01

    Background: HIV-1-infected children have an increased risk of severe chickenpox. However, vaccination is not recommended in severely immunocompromised children. Objective: Can the live-attenuated varicella zoster virus (VZV) Oka strain be safely and effectively given to HIV-1-infected children despi

  3. Dialysis and renal transplantation in HIV-infected patients

    DEFF Research Database (Denmark)

    Trullas, Joan Carles; Mocroft, Amanda; Cofan, Federico;

    2010-01-01

    To determine prevalence and characteristics of end-stage renal diseases (ESRD) [dialysis and renal transplantation (RT)] among European HIV-infected patients.......To determine prevalence and characteristics of end-stage renal diseases (ESRD) [dialysis and renal transplantation (RT)] among European HIV-infected patients....

  4. Primary cutaneous plasmablastic lymphoma revealing clinically unsuspected HIV infection*

    Science.gov (United States)

    Marques, Silvio Alencar; Abbade, Luciana P. Fernandes; Guiotoku, Marcelo Massaki; Marques, Mariangela Esther Alencar

    2016-01-01

    Plasmablastic lymphoma is a rare subtype of diffuse large B-cell lymphoma more frequently diagnosed in immunosuppressed patients, mainly HIV-infected. Primary cutaneous plasmablastic lymphoma is extremely rare, and in this patient it was the first clinical manifestation of unsuspected HIV-infection. PMID:27579749

  5. Interleukin-2 therapy in patients with HIV infection

    DEFF Research Database (Denmark)

    Abrams, D; Lévy, Y; Losso, M H;

    2009-01-01

    Interleukin-2 in HIV-Infected Patients with Low CD4+ Counts under Active Antiretroviral Therapy (SILCAAT) study and the Evaluation of Subcutaneous Proleukin in a Randomized International Trial (ESPRIT). In each, patients infected with the human immunodeficiency virus (HIV) who had CD4+ cell counts of either...

  6. [Tuberculosis and HIV infection in the Kaliningrad Region].

    Science.gov (United States)

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

    2005-01-01

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

  7. Etravirine pharmacokinetics in HIV-infected pregnant women

    NARCIS (Netherlands)

    N. Mulligan (Nikki); S. Schalkwijk (Stein); B.M. Best (Brookie); A. Colbers (Angela); J. Wang (Jiajia); E.V. Capparelli (Edmund V.); J. Moltó (José); A.M. Stek (Alice M.); G. Taylor (Graham); E. Smith (Elizabeth); C.H. Tenorio (Carmen Hidalgo); N. Chakhtoura (Nahida); M.E.E. van Kasteren (Marjo); C.V. Fletcher (Courtney V.); M. Mirochnick (Mark); D.M. Burger (David); A. Antinori (Andrea); I.E. van der Ende (Ineke); G. Faetkenheuer (Gerd); C. Giaquinto (Carlo); Y. Gilleece (Yvonne); A. Gingelmaier (Andrea); A. Haberl (Annette); D. Hawkins (David); J. Ivanovic (Jelena); K. Kabeya (Kabamba); J. Lambert (Julien); F. Lyons (Fyona); J.F.J.B. Nellen (Jeannine); E. Nicastri (Emanuelle); J. Rockstroh (Jürgen); C. Schwarze-zander; A. Ruiter (Annemiek de); T. Sadiq (Tariq); A. Ven (André van der); K. Weizsäcker (Katharina); C. Wood (Chris); C. Wyen (Christoph)

    2016-01-01

    markdownabstract__Background__ The study goal was to describe etravirine pharmacokinetics during pregnancy and postpartum in HIV-infected women. __Methods__ IMPAACT P1026s and PANNA are on-going, non-randomized, open-label, parallel-group, multi-center phase-IV prospective studies in HIV-infected

  8. Management of BU-HIV co-infection

    NARCIS (Netherlands)

    O'Brien, D. P.; Ford, N.; Vitoria, M.; Christinet, V.; Comte, E.; Calmy, A.; Stienstra, Y.; Eholie, S.; Asiedu, K.

    2014-01-01

    BACKGROUND Buruli Ulcer (BU)-HIV co-infection is an important emerging management challenge for BU disease. Limited by paucity of scientific studies, guidance for management of this co-infection has been lacking. METHODS Initiated by WHO, a panel of experts in BU and HIV management developed guidanc

  9. Platelets and HIV-1 infection: old and new aspects.

    Science.gov (United States)

    Torre, Donato; Pugliese, Agostino

    2008-09-01

    In this review we summarize the data on interaction of platelets with HIV-1 infection. Thrombocytopenia is a common finding among HIV-1 infected patients; several combined factors contribute to low peripheral platelet counts, which are present during all the stages of the disease. In addition, a relationship between platelet count, plasma viral load and disease progression has been reported, and this shows the potential influence platelets may have on the natural history of HIV-1 disease. Several lines of evidence have shown that platelets are an integral part of inflammation, and can be also potent effector cells of innate immune response as well as of adaptive immunity. Thus, we rewieved the role of inflammatory cytokines, and chemokines as activators of platelets during HIV-1 infection. Moreover, platelets show a direct interaction with HIV-1 itself, through different pathogenic mechanisms as binding, engulfment, internalisation of HIV-1, playing a role in host defence during HIV-1 infection, by limiting viral spread and probably by inactivating viral particles. Platelets may also play an intriguing role on endothelial dysfunction present in HIV-1 infection, and this topic begins to receive systematic study, inasmuch as interaction between platelets and endothelial cells is important in the pathogenesis of atherosclerosis in HIV-1 infected patients, especially in those patients treated with antiretroviral drugs. Finally, this review attempts to better define the state of this emerging issue, to focus areas of potential clinical relevance, and to suggest several directions for future research.

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

    OpenAIRE

    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...

  11. The Association of Physical and Sexual Abuse with HIV Risk Behaviors in Adolescence and Young Adulthood: Implications for Public Health.

    Science.gov (United States)

    Cunningham, Renee M.; And Others

    1994-01-01

    Interviews conducted with 602 youths at public health clinics revealed that a history of physical abuse, sexual abuse, or rape was related to engaging in a variety of human immunodeficiency virus (HIV) risk behaviors and to a continuation or increase in the number of these behaviors between adolescence and young adulthood. (Author/JDD)

  12. Hepatitis C and HIV co-infection: a review

    Institute of Scientific and Technical Information of China (English)

    Irena Maier; George Y. Wu

    2002-01-01

    Co-infection with hepatitis C virus and humanimmunodeficiency virus is common in certainpopulations. Among HCV(+) persons, 10 % are alsoHIV (+), and among HIV (+) persons, 25 % are alsoHCV(+). Many studies have shown that in intravenousdrug users, co-infection prevalence can be as high as90-95 %. There is increasing evidence supporting theconcept that people infected with HIV have a muchmore rapid course of their hepatitis C infection.Treatment of co-infection is often challenging becausehighly active anti-retroviral therapy (HAART) therapyis frequently hepatotoxic, especially in the presence ofHCV. The purpose of this review is to describe theeffects that HIV has on hepatitis C, the effects thathepatitis C has on HIV, and the treatment options inthis challenging population.

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

    Directory of Open Access Journals (Sweden)

    Céline Nguefeu Nkenfou

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

  14. Wound infection rates after invasive procedures in HIV-1 seropositive versus HIV-1 seronegative hemophiliacs.

    Science.gov (United States)

    Buehrer, J L; Weber, D J; Meyer, A A; Becherer, P R; Rutala, W A; Wilson, B; Smiley, M L; White, G C

    1990-01-01

    One-hundred and two patients with hemophilia A, hemophilia B, or acquired antibody to factor VIII who had undergone invasive procedures were cross referenced with patients participating in an ongoing prospective natural history study of HIV-1 infection in hemophiliacs. Matching revealed that HIV-1 status was known for 83 patients (83%) who had undergone 169 procedures between July 1979 and April 1988. Invasive procedures were classified as clean in 108 patients (63.9%), clean-contaminated in 45 (26.6%), contaminated in 2 (1.2%), and infected in 14 (8.3%). Wound infection rates by HIV-1 status were as follows (95% confidence intervals): HIV+ 1.4% (0% to 5%), HIV- 0% (0% to 9%), and procedure before testing HIV+ 1.5% (0% to 6%). There were no significant differences between the wound infection rates of HIV-positive and HIV-negative hemophiliacs nor in the wound infection rate among all three subgroups of patients (p greater than 0.5, Fisher's Exact Test). We conclude that surgery in HIV-1-infected patients who have not progressed to AIDS does not entail an increased risk of postoperative wound infections. PMID:2322041

  15. Risk factors associated with sexually transmitted infections among HIV infected men who have sex with men

    Science.gov (United States)

    Ma, Ping; Wei, Ye; Xia, Hongli; Jiang, Wenjie; Yang, Changqing; Meng, Xiaojun; Peng, Peng; Yang, Yue; Jiang, Liying; Chu, Minjie; Zhuang, Xun

    2017-01-01

    To investigate the factors associated with sexually transmitted infection and Human Immunodeficiency Virus (STI-HIV) co-infection among men who have sex with men (MSM). A total of 357 HIV-infected participants (84 STI-HIV co-infection and 273 HIV infections only) were recruited from Jiangsu, China. Logistic regression analyses were used to estimate the related factors associated with STI-HIV co-infection. Marginal structural models were adopted to estimate the effect of transmission drug resistance (TDR) on STI-HIV co-infection. For all participants, logistic regression analyses revealed that those who diagnosed with HIV-1 for longer duration (≥1.8 years) were significantly associated with reduced STI-HIV co-infection risk (OR = 0.55, 95%CI: 0.32–0.96, P = 0.036). In further stratification analysis by antiretroviral therapy (ART), individuals with longer duration showed consistent significant associations with STI-HIV co-infection risk (OR = 0.46, 95%CI: 0.26–0.83, P = 0.010) among MSM with ART-naïve status. In addition, significant reduced risk for STI-HIV co-infection (OR = 0.98, 95%CI: 0.96–0.99, P = 0.010) were observed in younger (under the average age of 31.03) MSM of the same group. Interestingly, we also found TDR was significantly associated with an increased risk of STI-HIV co-infection risk (OR = 3.84, 95%CI: 1.05–14.03, P = 0.042) in ART-naïve group. Our study highlights a pattern of STI-HIV co-infection among MSM in China and indicates that targeted interventions aimed at encouraging TDR monitoring in MSM with early HIV infection are warranted. PMID:28158317

  16. The Prevalence of Different Human Immunodeficiency Virus Transmission Routes and Knowledge about AIDS in Infected People with HIV in Sirjan

    Directory of Open Access Journals (Sweden)

    Mahin Behzadpour

    2012-06-01

    Full Text Available Background & Objective: The immune system of Patients with Acquired Immune Deficiency Syndrome (AIDS is weekend because of Human immunodeficiency virus (HIV infection, and they become vulnerable to several opportunistic and non-opportunistic pathogens and different carcinomas. IV drug abuse, sexual contact, occupational transmission, blood transfusion and maternal-fetal transmission are well known transmission routes for HIV infection. This study was under taken to investigate the prevalence of HIV transmission routs in the HIV infected population of Sirjan, and their knowledge about the disease, in order to plan better preventive strategies. Materials & Methods: A cross sectional study was planned. During a 6-month period in 2010, all of the HIV infected people in Sirjan (old and new cases who had a file at the consultation center for high risk behavior, completed a valid and reliable questionnaire. Results: The definite route of transmission was not clear in any of the patients because they had more than one suspicious route. Injected drug abusers were the most common (88.4% followed by those who got tattoos (79.1%, invasive therapeutic procedures, dentistry, surgery and endoscopy (56.1%, high risk sexual behavior (62.8%, bloodletting (9.3%, injuries in the barbershop (9.3% and blood transfusion (2.3%. Conclusion: All of the HIV infected cases in Sirjan were involved with several high risk behaviors, but the major route of transmission, similar to other parts of the country was injected drug abuse. Educational programs for prevention of AIDS should be followed seriously and special attention should be paid to groups with multiple high risk behaviors.

  17. PPAR and Liver Injury in HIV-Infected Patients

    Directory of Open Access Journals (Sweden)

    Maud Lemoine

    2009-01-01

    Full Text Available Due to the introduction of active HIV antiretroviral treatment, AIDS-related morbidity and mortality have markedly decreased and liver diseases are now a major cause of morbidity and mortality in HIV-infected patients. Chronic liver injury encompasses a wide spectrum of diseases due to HCV and HBV coinfection, drug-related toxicity, and NASH. HIV-infected patients who are receiving treatment present with a high prevalence of metabolic complications and lipodystrophy. Those patients are at high risk of nonalcoholic fatty liver disease, the liver feature of the metabolic syndrome. This review will focus on (1 the liver injuries in HIV-infected patients; (2 both the current experimental and human data regarding PPAR and liver diseases; (3 the interactions between HIV and PPAR; (4 the potential use of PPAR agonists for the management of HIV-related liver diseases.

  18. Broadly neutralizing antibodies: An approach to control HIV-1 infection.

    Science.gov (United States)

    Yaseen, Mahmoud Mohammad; Yaseen, Mohammad Mahmoud; Alqudah, Mohammad Ali

    2017-01-02

    Although available antiretroviral therapy (ART) has changed human immunodeficiency virus (HIV)-1 infection to a non-fatal chronic disease, the economic burden of lifelong therapy, severe adverse ART effects, daily ART adherence, and emergence of ART-resistant HIV-1 mutants require prospecting for alternative therapeutic modalities. Indeed, a growing body of evidence suggests that broadly neutralizing anti-HIV-1 antibodies (BNAbs) may offer one such feasible alternative. To evaluate their therapeutic potential in established HIV-1 infection, we sought to address recent advances in pre-clinical and clinical investigations in this area of HIV-1 research. In addition, we addressed the obstacles that may impede the success of such immunotherapeutic approach, suggested strategic solutions, and briefly compared this approach with the currently used ART to open new insights for potential future passive immunotherapy for HIV-1 infection.

  19. Increasing Rates of Obesity Among HIV-Infected Persons During the HIV Epidemic

    Science.gov (United States)

    2010-04-01

    overweight /obese at diagnosis and during HIV infection. Weight gain appears to reflect improved health status and mirror trends in the general...study results may be related to differences in timing of HIV diagnosis and treatment, socioeconomic status , and access to medical care. Of note, our...America Abstract Background: The prevalence and factors associated with overweight /obesity among human immunodeficiency virus (HIV)- infected persons are

  20. Renal and urologic emergencies in the HIV-infected patient.

    Science.gov (United States)

    Liang, Stephen Y; Overton, E Turner

    2010-05-01

    Antiretroviral therapy has revolutionized the care of individuals infected with the human immunodeficiency virus (HIV) and has fundamentally altered the scope of the disease. Acute renal failure and chronic kidney disease from medication toxicity and comorbid noninfectious illnesses are just as likely today as end-organ injury from the virus itself. Chronic immunosuppression renders HIV-infected patients vulnerable to any of several unique urological infections not frequently seen in immunocompetent patients. A deeper understanding of renal and urological emergencies in the context of the HIV-infected patient will better prepare the emergency physician to render optimal care to this rapidly expanding and aging patient population.

  1. Comorbidity acquired before HIV diagnosis and mortality in persons infected and uninfected with HIV: a Danish population-based cohort study

    DEFF Research Database (Denmark)

    Lohse, Nicolai; Gerstoft, Jan; Kronborg, Gitte;

    2011-01-01

    We aimed to estimate the impact of comorbidity acquired before HIV diagnosis on mortality in individuals infected with HIV.......We aimed to estimate the impact of comorbidity acquired before HIV diagnosis on mortality in individuals infected with HIV....

  2. Multi-micronutrient supplementation in HIV-infected South African children : effect on nutritional s tatus, diarrhoea and respiratory infections

    OpenAIRE

    Mda, S.

    2011-01-01

      Background: The nutritional status of HIV-infected children is reported to be poor. Diarrhoea and acute respiratory infections tend to be more common and severe in HIV-infected children than in uninfected ones. Deficiencies of micronutrients may result in poor growth and increased risk of diarrhoea and respiratory infections. Micronutrient deficiencies are common in HIV-infected children. The poor growth, diarrhoea and respiratory infections seen in HIV-infected children may be partly ...

  3. At Risk: The Relationship between Experiences of Child Sexual Abuse and Women's HIV Status in Papua New Guinea

    Science.gov (United States)

    Lewis, Ione R.

    2012-01-01

    Child sexual abuse in Papua New Guinea is a human rights issue as well as an indicator of HIV risk in women. This study aimed to develop knowledge about the link between violence experienced by women and their HIV status. The study used a mixed method approach to collect quantitative and qualitative data through structured interviews with a sample…

  4. Applications and limitations of inflammatory biomarkers for studies on neurocognitive impairment in HIV infection.

    Science.gov (United States)

    Cassol, Edana; Misra, Vikas; Morgello, Susan; Gabuzda, Dana

    2013-12-01

    Despite reduced prevalence of severe forms of HIV-associated neurocognitive disorders (HAND) on current antiretroviral therapy (ART) regimens, milder forms of neurocognitive impairment (NCI) remain prevalent in HIV-infected populations. These mild forms of HAND consist of subtypes, probably reflecting distinct, though possibly overlapping, pathophysiological mechanisms. Factors associated with HAND in HIV patients with prolonged viral suppression on ART include older age, low nadir CD4, active HCV co-infection, and cardiovascular risk factors, but underlying mechanisms and their relationship to innate immune activation, chronic inflammation, and other features of systemic disease are poorly understood. In this article, we discuss applications and limitations of plasma inflammatory biomarkers for studies on HAND in HIV patients on ART and describe an analysis pipeline to reduce common sources of noise and increase likelihood of identifying relevant inflammatory biomarkers. Clinical covariates and comorbidities that influence inflammatory biomarkers, such as aging, obesity, metabolic abnormalities, HCV co-infection, and substance abuse, are also reviewed. As an example for using this analytic pipeline, we present an exploratory study of 22 plasma inflammatory biomarkers (IFN-α 2b and -γ, 16 cytokines/chemokines, sIL-2R, sCD14, HA, and YKL-40) in a cohort of HIV-infected individuals with advanced disease, frequent HCV co-infection, and viral suppression on ART. The identification of inflammatory biomarkers associated with HAND in HIV+ patients on ART may be useful to distinguish between HAND subtypes with distinct pathophysiology, and is important for achieving a systems-level understanding of the biology of these disorders, developing effective therapies, and evaluating therapeutic outcomes.

  5. STI/HIV co-infections in UCH, Ibadan, Nigeria.

    Science.gov (United States)

    Kehinde, A O; Lawoyin, T O

    2005-04-01

    Sexually transmitted infections (STIs) are poorly recognised and inadequately treated in Nigeria in spite of the fact that it constitutes a major risk for HIV transmission. This study was carried out to ascertain STI/HIV co-infection rate and to obtain relevant socio-demographic and reproductive health data associated with STIs. This information is urgently needed for designing STI/HIV control strategies. All consenting patients with history suggestive of STI, who attended STI clinic at the University College Hospital, Ibadan, between March and November 2001 were enrolled in the study. Of the 210 patients seen, 98 (46.7%) were males while 112 (53.3%) were females (p > 0.05). One hundred and fifty six (74.3%) of them were aged 20-39 years while only 10 (5.1%) were adolescents. Twenty (9.5%) had laboratory diagnosis of STIs, out of which 6 (30%) were also HIV positive. Among those with STIs, 8 (40%) had gonorrhoea, 8 (40%) had candidiasis, while 4 (25%) were positive for Trichomonas vaginalis. None of the patients' sera was positive for Treponema palladium antibody HIV prevalence rate in the study was 21.9%. Highest rate was found in patients aged 20-29 years while no adolescent and no one over 50 years old was HIV positive. Five (62.5%) of the patients with gonorrhoea were also HIV positive, a lower percentage (25%) of those with trichomoniasis were positive for HIV, while none of those infected with candidiasis was HIV positive. STI/HIV co-infection rate was 30%. This study reveals a high STI/HIV co-infection rate, indicating that there is a need for proper management of STIs as a way of reducing the spread of HIV infection in Nigeria.

  6. Amyloid and tau cerebrospinal fluid biomarkers in HIV infection

    Directory of Open Access Journals (Sweden)

    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 (sAPPα and sAPPβ, amyloid beta fragment 1-42 (Aβ1-42, 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 sAPPα and sAPPβ 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 Aβ1-42 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 sAPPα and sAPPβ 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

  7. A case of polymicrobial infective endocarditis involving Neisseria mucosa occurring in an intravenous drug abuser.

    Science.gov (United States)

    Giles, M W; Andrew, J H; Tellus, M M

    1988-12-01

    The incidence of polymicrobial endocarditis has increased markedly in recent years, in association with the increasing level of abuse of intravenous drugs. Neisseria mucosa, an upper respiratory tract commensal, is a rare cause of infective endocarditis. We report the first case of polymicrobial infective endocarditis involving Neisseria mucosa occurring in an intravenous drug abuser.

  8. Poorer cognitive performance in perinatally HIV-infected children versus healthy socioeconomically matched controls

    NARCIS (Netherlands)

    Cohen, S.; ter Stege, J.A.; Geurtsen, G.J.; Scherpbier, H.J.; Kuijpers, T.W.; Reiss, P.; Schmand, B.; Pajkrt, D.

    2015-01-01

    Background: Despite the declining incidence of severe neurological complications such as HIV encephalopathy, human immunodeficiency virus (HIV) infection in children is still associated with a range of cognitive problems. Although most HIV-infected children in industrialized countries are immigrants

  9. Enhanced clearance of HIV-1-infected cells by broadly neutralizing antibodies against HIV-1 in vivo.

    Science.gov (United States)

    Lu, Ching-Lan; Murakowski, Dariusz K; Bournazos, Stylianos; Schoofs, Till; Sarkar, Debolina; Halper-Stromberg, Ariel; Horwitz, Joshua A; Nogueira, Lilian; Golijanin, Jovana; Gazumyan, Anna; Ravetch, Jeffrey V; Caskey, Marina; Chakraborty, Arup K; Nussenzweig, Michel C

    2016-05-20

    Antiretroviral drugs and antibodies limit HIV-1 infection by interfering with the viral life cycle. In addition, antibodies also have the potential to guide host immune effector cells to kill HIV-1-infected cells. Examination of the kinetics of HIV-1 suppression in infected individuals by passively administered 3BNC117, a broadly neutralizing antibody, suggested that the effects of the antibody are not limited to free viral clearance and blocking new infection but also include acceleration of infected cell clearance. Consistent with these observations, we find that broadly neutralizing antibodies can target CD4(+) T cells infected with patient viruses and can decrease their in vivo half-lives by a mechanism that requires Fcγ receptor engagement in a humanized mouse model. The results indicate that passive immunotherapy can accelerate elimination of HIV-1-infected cells.

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

    Directory of Open Access Journals (Sweden)

    Gabriel Somarriba

    2010-09-01

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

  11. Emergencies related to HIV infection and treatment (part 1

    Directory of Open Access Journals (Sweden)

    Amit Chandra

    2013-09-01

    Full Text Available HIV is a leading cause of mortality in resource limited settings and HIV associated medical emergencies are common emergency centre presentations in high-prevalence settings. HIV attacks the body’s immune system, making infected individuals susceptible to severe infections of multiple organ systems including the respiratory tract, ocular structures, and central nervous system. HIV infected individuals also suffer from unique patterns of cardiac disease, gastrointestinal disturbances, and haematologic and oncologic conditions. Anti-retroviral therapy itself is also associated with numerous side effects, many of which can be life-threatening. Diagnosis and management of HIV infected patients require knowledge of the disease’s pathology and the life threatening complications associated with it. Part 1 of this review discusses the pathophysiology of the disease and respiratory, cardiac, psychiatric, and neurologic complications.

  12. Utility of Pooled HIV RNA RT-PCR Assay in Diagnosing Acute HIV Infections

    Institute of Scientific and Technical Information of China (English)

    张麒; 蒋岩; 刘全忠

    2004-01-01

    Abstract: The P24 antigen test, HIV RNA PCR test,HIV isolation/culture and fourth-generation HIV uniform Ag/Ab assay are being utilized in diagnosing acute HIV infection in different labs. Many factors limit the use of screening for acute HIV in high-risk populations, in blood donors and during voluntary HIV testing, including, cost, technique, sensitivity and specificity. In this review we explore a new NAAT method which involves HIV RNA RT-PCR on pooled samples. This technique is able to screen for acute infections in a large testing volume and may he used as a screening method in high-risk populations and blood donors.

  13. SPECTRUM OF OPPORTUNISTIC INFECTIONS IN HIV-AIDS PATIENTS

    OpenAIRE

    S S Madkar; 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...

  14. Oral and airway microbiota in HIV-infected pneumonia patients

    OpenAIRE

    Iwai, S.; Fei, M; Huang, D.; Fong, S.; Subramanian, A.; Grieco, K; Lynch, SV; Huang, L

    2012-01-01

    Despite the increased frequency of recurrent pneumonia in HIV-infected patients and recent studies linking the airway bacterial community (microbiota) to acute and chronic respiratory infection, little is known of the oral and airway microbiota that exist in these individuals and their propensity to harbor pathogens despite antimicrobial treatment for acute pneumonia. This pilot study compared paired samples of the oral and airway microbiota from 15 hospitalized HIV-infected patients receivin...

  15. 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.

  16. Spiritual self-schema therapy, drug abuse, and HIV.

    Science.gov (United States)

    Marcotte, David; Avants, S Kelly; Margolin, Arthur

    2003-01-01

    This case report describes the use of Spiritual Self-Schema (3-S) therapy in the treatment of an HIV-positive inner-city drug user maintained on methadone and referred for additional treatment due to unremitting cocaine use. 3-S therapy is a manual-guided intervention based on cognitive self-schema theory. Its goal is to help the patient create, elaborate, and make accessible a cognitive schema--the "spiritual" self-schema-that is incompatible with drug use and other HIV risk behaviors. 3-S therapy facilitates a cognitive shift from the habitual activation of the "addict" self-schema, with its drug-related cognitions, scripts and action plans, to the "spiritual" self-schema, with its associated repertoire of harm reduction beliefs and behaviors.

  17. Impaired production of cytokines is an independent predictor of mortality in HIV-1-infected patients

    DEFF Research Database (Denmark)

    Ostrowski, Sisse R; Gerstoft, Jan; Pedersen, Bente K;

    2003-01-01

    With regard to the natural history of HIV-1 infection this study investigated whether whole-blood culture cytokine production was associated with mortality in HIV-1-infected patients.......With regard to the natural history of HIV-1 infection this study investigated whether whole-blood culture cytokine production was associated with mortality in HIV-1-infected patients....

  18. Mice chronically infected with chimeric HIV resist peripheral and brain superinfection: a model of protective immunity to HIV.

    Science.gov (United States)

    Kelschenbach, Jennifer L; Saini, Manisha; Hadas, Eran; Gu, Chao-Jiang; Chao, Wei; Bentsman, Galina; Hong, Jessie P; Hanke, Tomas; Sharer, Leroy R; Potash, Mary Jane; Volsky, David J

    2012-06-01

    Infection by some viruses induces immunity to reinfection, providing a means to identify protective epitopes. To investigate resistance to reinfection in an animal model of HIV disease and its control, we employed infection of mice with chimeric HIV, EcoHIV. When immunocompetent mice were infected by intraperitoneal (IP) injection of EcoHIV, they resisted subsequent secondary infection by IP injection, consistent with a systemic antiviral immune response. To investigate the potential role of these responses in restricting neurotropic HIV infection, we established a protocol for efficient EcoHIV expression in the brain following intracranial (IC) inoculation of virus. When mice were inoculated by IP injection and secondarily by IC injection, they also controlled EcoHIV replication in the brain. To investigate their role in EcoHIV antiviral responses, CD8+ T lymphocytes were isolated from spleens of EcoHIV infected and uninfected mice and adoptively transferred to isogenic recipients. Recipients of EcoHIV primed CD8+ cells resisted subsequent EcoHIV infection compared to recipients of cells from uninfected donors. CD8+ spleen cells from EcoHIV-infected mice also mounted modest but significant interferon-γ responses to two HIV Gag peptide pools. These findings suggest EcoHIV-infected mice may serve as a useful system to investigate the induction of anti-HIV protective immunity for eventual translation to human beings.

  19. Micro RNA in Exosomes from HIV-Infected Macrophages

    Directory of Open Access Journals (Sweden)

    William W. Roth

    2015-12-01

    Full Text Available Exosomes are small membrane-bound vesicles secreted by cells that function to shuttle RNA and proteins between cells. To examine the role of exosomal micro RNA (miRNA during the early stage of HIV-1 infection we characterized miRNA in exosomes from HIV-infected macrophages, compared with exosomes from non-infected macrophages. Primary human monocytes from uninfected donors were differentiated to macrophages (MDM which were either mock-infected or infected with the macrophage-tropic HIV-1 BaL strain. Exosomes were recovered from culture media and separated from virus particles by centrifugation on iodixanol density gradients. The low molecular weight RNA fraction was prepared from purified exosomes. After pre-amplification, RNA was hybridized to microarrays containing probes for 1200 miRNA species of known and unknown function. We observed 48 miRNA species in both infected and uninfected MDM exosomes. Additionally, 38 miRNAs were present in infected-cell exosomes but not uninfected-cell exosomes. Of these, 13 miRNAs were upregulated in exosomes from HIV-infected cells, including 4 miRNA species that were increased by more than 10-fold. Though numerous miRNA species have been identified in HIV-infected cells, relatively little is known about miRNA content in exosomes from these cells. In the future, we plan to investigate whether the upregulated miRNA species we identified are increased in exosomes from HIV-1-positive patients.

  20. Micro RNA in Exosomes from HIV-Infected Macrophages.

    Science.gov (United States)

    Roth, William W; Huang, Ming Bo; Addae Konadu, Kateena; Powell, Michael D; Bond, Vincent C

    2015-12-22

    Exosomes are small membrane-bound vesicles secreted by cells that function to shuttle RNA and proteins between cells. To examine the role of exosomal micro RNA (miRNA) during the early stage of HIV-1 infection we characterized miRNA in exosomes from HIV-infected macrophages, compared with exosomes from non-infected macrophages. Primary human monocytes from uninfected donors were differentiated to macrophages (MDM) which were either mock-infected or infected with the macrophage-tropic HIV-1 BaL strain. Exosomes were recovered from culture media and separated from virus particles by centrifugation on iodixanol density gradients. The low molecular weight RNA fraction was prepared from purified exosomes. After pre-amplification, RNA was hybridized to microarrays containing probes for 1200 miRNA species of known and unknown function. We observed 48 miRNA species in both infected and uninfected MDM exosomes. Additionally, 38 miRNAs were present in infected-cell exosomes but not uninfected-cell exosomes. Of these, 13 miRNAs were upregulated in exosomes from HIV-infected cells, including 4 miRNA species that were increased by more than 10-fold. Though numerous miRNA species have been identified in HIV-infected cells, relatively little is known about miRNA content in exosomes from these cells. In the future, we plan to investigate whether the upregulated miRNA species we identified are increased in exosomes from HIV-1-positive patients.

  1. Potential use of rapamycin in HIV infection

    DEFF Research Database (Denmark)

    Donia, Marco; McCubrey, James A; Bendtzen, Klaus;

    2010-01-01

    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...

  2. Risk Factors for Acquisition and Clearance of Oral Human Papillomavirus Infection Among HIV-Infected and HIV-Uninfected Adults

    Science.gov (United States)

    Beachler, Daniel C.; Sugar, Elizabeth A.; Margolick, Joseph B.; Weber, Kathleen M.; Strickler, Howard D.; Wiley, Dorothy J.; Cranston, Ross D.; Burk, Robert D.; Minkoff, Howard; Reddy, Susheel; Xiao, Weihong; Guo, Yingshi; Gillison, Maura L.; D'Souza, Gypsyamber

    2015-01-01

    Human papillomavirus (HPV) causes the majority of oropharyngeal cancers in the United States, yet the risk factors for and natural history of oral HPV infection are largely unknown. In 2010–2011, a US-based longitudinal cohort study of 761 human immunodeficiency virus (HIV)-infected and 469 at-risk HIV-uninfected participants from the Multicenter AIDS Cohort Study and the Women's Interagency HIV Study was initiated. Semiannually collected oral rinses were evaluated for 37 HPV genotypes using the Roche LINEAR ARRAY HPV Genotyping Test (Roche Molecular Systems, Pleasanton, California), and factors associated with oral HPV incidence and clearance were explored using adjusted Wei-Lin-Weissfeld modeling. Through 2013, the 2-year cumulative incidence of any type of oral HPV infection was 34% in HIV-infected persons and 19% in HIV-uninfected persons. However, many of these infections cleared. Seven percent of incident infections and 35% of prevalent infections persisted for at least 2 years. After adjustment for other risk factors, HIV infection (adjusted hazard ratio = 2.3, 95% confidence interval: 1.7, 3.2), reduced current CD4 cell count, and increased numbers of oral sex and “rimming” partners increased the risk of incident oral HPV infection, whereas male sex, older age, and current smoking increased the risk of oral HPV persistence (each P < 0.05). This helps explain the consistent associations observed between these factors and prevalent oral HPV infection in previous cross-sectional studies. PMID:25480823

  3. Examining the relationship between urogenital schistosomiasis and HIV infection.

    Directory of Open Access Journals (Sweden)

    Pamela Sabina Mbabazi

    2011-12-01

    Full Text Available BACKGROUND: Urogenital schistosomiasis, caused by infection with Schistosoma haematobium, is widespread and causes substantial morbidity on the African continent. The infection has been suggested as an unrecognized risk factor for incident HIV infection. Current guidelines recommend preventive chemotherapy, using praziquantel as a public health tool, to avert morbidity due to schistosomiasis. In individuals of reproductive age, urogenital schistosomiasis remains highly prevalent and, likely, underdiagnosed. This comprehensive literature review was undertaken to examine the evidence for a cause-effect relationship between urogenital schistosomiasis and HIV/AIDS. The review aims to support discussions of urogenital schistosomiasis as a neglected yet urgent public health challenge. METHODOLOGY/PRINCIPAL FINDINGS: We conducted a systematic search of the literature including online databases, clinical guidelines, and current medical textbooks. We describe plausible local and systemic mechanisms by which Schistosoma haematobium infection could increase the risk of HIV acquisition in both women and men. We also detail the effects of S. haematobium infection on the progression and transmissibility of HIV in co-infected individuals. We briefly summarize available evidence on the immunomodulatory effects of chronic schistosomiasis and the implications this might have for populations at high risk of both schistosomiasis and HIV. CONCLUSIONS/SIGNIFICANCE: Studies support the hypothesis that urogenital schistosomiasis in women and men constitutes a significant risk factor for HIV acquisition due both to local genital tract and global immunological effects. In those who become HIV-infected, schistosomal co-infection may accelerate HIV disease progression and facilitate viral transmission to sexual partners. Establishing effective prevention strategies using praziquantel, including better definition of treatment age, duration, and frequency of treatment for

  4. Renal transplantation in HIV-infected patients: 2010 update.

    Science.gov (United States)

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

    2011-04-01

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

  5. [Update on HIV infection in Mayotte].

    Science.gov (United States)

    Lartigau-Roussin, C; Receveur, M C; Hebert, J C; Giry, C; Pettinelli, M E; Malvy, D

    2007-04-01

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

  6. HIV-infected microglia mediate cathepsin B-induced neurotoxicity.

    Science.gov (United States)

    Zenón, Frances; Cantres-Rosario, Yisel; Adiga, Radhika; Gonzalez, Mariangeline; Rodriguez-Franco, Eillen; Langford, Dianne; Melendez, Loyda M

    2015-10-01

    HIV-1-infected mononuclear phagocytes release soluble factors that affect the homeostasis in tissue. HIV-1 can prompt metabolic encephalopathy with the addition of neuronal dysfunction and apoptosis. Recently, we reported that HIV-1 enhances the expression and secretion of bioactive cathepsin B in monocyte-derived macrophages, ultimately contributing to neuronal apoptosis. In this research, we asked if microglia respond to HIV infection similarly by modifying the expression, secretion, and neurotoxic potential of cathepsin B and determined the in vivo relevance of these findings. HIV-1ADA-infected human primary microglia and CHME-5 microglia cell line were assessed for expression and activity of cathepsin B, its inhibitors, cystatins B and C, and the neurotoxicity associated with these changes. Human primary neurons were exposed to supernatants from HIV-infected and uninfected microglia in the presence of cathepsin B inhibitors and apoptosis was assessed by TUNEL. Microglial expression of cathepsin B was validated in brain tissue from HIV encephalitis (HIVE) patients. HIV-infected microglia secreted significantly greater levels of cathepsin B, cystatin B, and cystatin C compared to uninfected cells. Increased apoptosis was observed in neurons exposed to supernatants from HIV-1 infected microglia at day 12 post-infection. The cathepsin B inhibitor CA-074 and cathepsin B antibody prevented neuronal apoptosis. Increased microglia-derived cathepsin B, cystatin B, and cystatin C and caspase-3+ neurons were detected in HIVE brains compared to controls. Our results suggest that HIV-1-induced cathepsin B production in microglia contributes to neuronal apoptosis and may be an important factor in neuronal death associated with HIVE.

  7. Syphilis and HIV co-infection (PhD-afhandling)

    DEFF Research Database (Denmark)

    Salado-Rasmussen, Kirsten

    2015-01-01

    The studies included in this PhD thesis examined the interactions of syphilis, which is caused by Treponema pallidum, and HIV. Syphilis reemerged worldwide in the late 1990s and hereafter increasing rates of early syphilis were also reported in Denmark. The proportion of patients with concurrent...... HIV has been substantial, ranging from one third to almost two thirds of patients diagnosed with syphilis some years. Given that syphilis facilitates transmission and acquisition of HIV the two sexually transmitted diseases are of major public health concern. Further, syphilis has a negative impact...... on HIV infection, resulting in increasing viral loads and decreasing CD4 cell counts during syphilis infection. Likewise, HIV has an impact on the clinical course of syphilis; patients with concurrent HIV are thought to be at increased risk of neurological complications and treatment failure. Almost ten...

  8. HIV Infection and TLR Signalling in the Liver

    Directory of Open Access Journals (Sweden)

    Megan Crane

    2012-01-01

    Full Text Available Despite the availability of effective combination antiretroviral therapy (cART, liver disease is one of the leading causes of morbidity and mortality in Human Immunodeficiency Virus (HIV-infected individuals, specifically, in the presence of viral hepatitis coinfection. HIV, a single stranded RNA virus, can bind to and activate both Toll-like receptor (TLR7 and TLR8 in circulating blood mononuclear cells, but little is known about the effect of HIV on TLRs expressed in the liver. HIV can directly infect cells of the liver and HIV-mediated depletion of CD4+ T-cells in the gastrointestinal tract (GI tract results in increased circulating lipopolysaccharide (LPS, both of which may impact on TLR signaling in the liver and subsequent liver disease progression. The potential direct and indirect effects of HIV on TLR signaling in the liver will be explored in this paper.

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

    DEFF Research Database (Denmark)

    Hansen, J E; Sørensen, A M; Olofsson, S;

    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.......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....

  10. Spatial working memory in asymptomatic HIV-infected subjects.

    Science.gov (United States)

    Grassi, B; Garghentini, G; Campana, A; Grassi, E; Bertelli, S; Cinque, P; Epifani, M; Lazzarin, A; Scarone, S

    1999-01-01

    Many clinical and research findings converge to indicate that frontal lobe, basal ganglia, and related neuronal connections are primarily involved in human immunodeficiency virus (HIV) infection; frontal lobe, mainly the prefrontal cortex, has a specialized role in working memory processes. This study focused on neuropsychological evaluation of the spatial component of working memory in a sample of 34 asymptomatic HIV-infected subjects as compared with 34 age- and sex-matched seronegative control subjects. A computer-administered test assessing spatial working memory was used for the neuropsychological evaluation. The findings did not show any spatial working memory impairment during the asymptomatic phase of HIV infection.

  11. A neglected epidemic: fungal infections in HIV/AIDS.

    Science.gov (United States)

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

    2014-03-01

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

  12. Management of HIV-hepatitis B co-infection

    Directory of Open Access Journals (Sweden)

    Marc Mendelson

    2011-04-01

    Full Text Available HIV-hepatitis B virus (HBV co-infected patients are at risk of increased morbidity and mortality. Early recognition of dual infection is a critical factor in directing appropriate therapy, and HBV screening should therefore be undertaken at the time of HIV diagnosis. Vaccination against HBV should be considered for all HIV patients who are not yet infected with HBV. Antiretroviral therapy containing two antiretrovirals active against HBV should be started if the patient either has symptomatic liver disease or is asymptomatic with a CD4 count of <350 cells/µl.

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

    Directory of Open Access Journals (Sweden)

    Denise J. Jamieson

    2008-01-01

    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.

  14. Determinants of Smoking and Quitting in HIV-Infected Individuals.

    Directory of Open Access Journals (Sweden)

    Susan Regan

    Full Text Available Cigarette smoking is widespread among HIV-infected patients, who confront increased risk of smoking-related co-morbidities. The effects of HIV infection and HIV-related variables on smoking and smoking cessation are incompletely understood. We investigated the correlates of smoking and quitting in an HIV-infected cohort using a validated natural language processor to determine smoking status.We developed and validated an algorithm using natural language processing (NLP to ascertain smoking status from electronic health record data. The algorithm was applied to records for a cohort of 3487 HIV-infected from a large health care system in Boston, USA, and 9446 uninfected control patients matched 3:1 on age, gender, race and clinical encounters. NLP was used to identify and classify smoking-related portions of free-text notes. These classifications were combined into patient-year smoking status and used to classify patients as ever versus never smokers and current smokers versus non-smokers. Generalized linear models were used to assess associations of HIV with 3 outcomes, ever smoking, current smoking, and current smoking in analyses limited to ever smokers (persistent smoking, while adjusting for demographics, cardiovascular risk factors, and psychiatric illness. Analyses were repeated within the HIV cohort, with the addition of CD4 cell count and HIV viral load to assess associations of these HIV-related factors with the smoking outcomes.Using the natural language processing algorithm to assign annual smoking status yielded sensitivity of 92.4, specificity of 86.2, and AUC of 0.89 (95% confidence interval [CI] 0.88-0.91. Ever and current smoking were more common in HIV-infected patients than controls (54% vs. 44% and 42% vs. 30%, respectively, both P<0.001. In multivariate models HIV was independently associated with ever smoking (adjusted rate ratio [ARR] 1.18, 95% CI 1.13-1.24, P <0.001, current smoking (ARR 1.33, 95% CI 1.25-1.40, P<0.001, and

  15. Management of HIV infected pregnant women in Chonburi Hospital.

    Science.gov (United States)

    Pinchun, P

    1994-04-01

    This study on birth control methods used, and HIV infection protection of the HIV infected pregnant women in the obstetrics-gynecology department of Chonburi Hospital from 1 January 1990 to 31 December 1993 revealed that there were 27 HIV infected women with less than 24 weeks gestational age, using birth control methods as such 12 women (44.44%) had tubal resection after abortion, 8 women (29.62%) oral contraceptive pills, 5 women (15.51%) injectable contraception, and 2 women (7.40%) norplants. The 106 HIV infected women with more than 24 weeks gestational age were allowed to deliver. The birth control methods were as follows: 19 women (17.92%) tubal resection, 38 women (35.84%) oral contraceptive pills, 49 women (46.22%) injectable contraception. They were all encouraged to use a condom while having sexual intercourse. Only 40 women of this group are still seen in the follow-up clinic and all are found to be healthy, the birth control is effective and HIV infection is in the early stage. The new born babies were not allowed to be breast fed and were followed-up periodically to 18 months old. Twenty five babies received HIV blood test; 7 babies (28%) were found to be HIV infected. The birth control and HIV infection protection used in this study demonstrate no adverse effects on the disease, and the unexpected problems of these women, as well as the health personnel concerned are reduced both economically and socially. This study provides the guidelines of good care for HIV infected pregnant women.

  16. 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

    DEFF Research Database (Denmark)

    Harboe, Zitta Barrella; Larsen, Mette Vang; Ladelund, Steen;

    2014-01-01

    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...

  17. Dynamics Analysis and Simulation of a Modified HIV Infection Model with a Saturated Infection Rate

    Directory of Open Access Journals (Sweden)

    Qilin Sun

    2014-01-01

    Full Text Available This paper studies a modified human immunodeficiency virus (HIV infection differential equation model with a saturated infection rate. It is proved that if the basic virus reproductive number R0 of the model is less than one, then the infection-free equilibrium point of the model is globally asymptotically stable; if R0 of the model is more than one, then the endemic infection equilibrium point of the model is globally asymptotically stable. Based on the clinical data from HIV drug resistance database of Stanford University, using the proposed model simulates the dynamics of the two groups of patients’ anti-HIV infection treatment. The numerical simulation results are in agreement with the evolutions of the patients’ HIV RNA levels. It can be assumed that if an HIV infected individual’s basic virus reproductive number R0<1 then this person will recover automatically; if an antiretroviral therapy makes an HIV infected individual’s R0<1, this person will be cured eventually; if an antiretroviral therapy fails to suppress an HIV infected individual’s HIV RNA load to be of unpredictable level, the time that the patient’s HIV RNA level has achieved the minimum value may be the starting time that drug resistance has appeared.

  18. HIV infection and specific mucosal immunity: workshop 4B.

    Science.gov (United States)

    Challacombe, S J; Fidel, P L; Tugizov, S; Tao, L; Wahl, S M

    2011-04-01

    Most HIV infections are transmitted across mucosal epithelium. An area of fundamental importance is understanding the role of innate and specific mucosal immunity in susceptibility or protection against HIV infection, as well as the effect of HIV infection on mucosal immunity, which leads to increased susceptibility to bacterial, fungal, and viral infections of oral and other mucosae. This workshop attempted to address 5 basic issues-namely, HIV acquisition across mucosal surfaces, innate and adaptive immunity in HIV resistance, antiviral activity of breast milk as a model mucosal fluid, neutralizing immunoglobulin A antibodies against HIV, and progress toward a mucosal vaccine against HIV. The workshop attendants agreed that progress had been made in each area covered, with much recent information. However, these advances revealed how little work had been performed on stratified squamous epithelium compared with columnar epithelium, and the attendants identified several important biological questions that had not been addressed. It is increasingly clear that innate immunity has an important biological role, although basic understanding of the mechanisms of normal homeostasis is still being investigated. Application of the emerging knowledge was lacking with regard to homeostatic mucosal immunity to HIV and its role in changing this homeostasis. With regard to breast milk, a series of studies have demonstrated the differences between transmitters and nontransmitters, although whether these findings could be generalized to other secretions such as saliva was less clear. Important progress toward an oral mucosal HIV vaccine has been made, demonstrating proof of principle for administering vaccine candidates into oral lymphoid tissues to trigger anti-HIV local and systemic immune responses. Similarly, experimental data emphasized the central role of neutralizing antibodies to prevent HIV infection via mucosal routes.

  19. Coordinated modulation of circulating miR-21 in HIV, HIV-associated pulmonary arterial hypertension, and HIV/HCV co-infection

    Science.gov (United States)

    Parikh, Victoria N.; Park, Joseph; Nikolic, Ivana; Channick, Richard; Yu, Paul B.; De Marco, Teresa; Hsue, Priscilla; Chan, Stephen Y.

    2015-01-01

    Dysregulation of microRNA-21 (miR-21) is independently associated with human immunodeficiency virus (HIV) infection, pulmonary arterial hypertension (PAH), and hepatitis C virus (HCV) infection. To assess expression of miR-21 in these overlapping comorbidities, we measured plasma miR-21 in HIV with and without PAH and then stratified by concomitant HCV infection. miR-21 was increased in HIV and HIV-PAH versus uninfected subjects, but did not differ between these groups. HIV/HCV co-infection correlated with even higher miR-21 levels within the HIV-infected population. These data reveal specific regulation of plasma miR-21 in HIV, HIV/HCV co-infection, and PAH and suggest that miR-21 may integrate complex disease-specific signaling in the setting of HIV infection. PMID:26473639

  20. The physical and psychological effects of HIV infection and its treatment on perinatally HIV-infected children

    Directory of Open Access Journals (Sweden)

    Rachel C Vreeman

    2015-12-01

    Full Text Available Introduction: As highly active antiretroviral therapy (HAART transforms human immunodeficiency virus (HIV into a manageable chronic disease, new challenges are emerging in treating children born with HIV, including a number of risks to their physical and psychological health due to HIV infection and its lifelong treatment. Methods: We conducted a literature review to evaluate the evidence on the physical and psychological effects of perinatal HIV (PHIV+ infection and its treatment in the era of HAART, including major chronic comorbidities. Results and discussion: Perinatally infected children face concerning levels of treatment failure and drug resistance, which may hamper their long-term treatment and result in more significant comorbidities. Physical complications from PHIV+ infection and treatment potentially affect all major organ systems. Although treatment with antiretroviral (ARV therapy has reduced incidence of severe neurocognitive diseases like HIV encephalopathy, perinatally infected children may experience less severe neurocognitive complications related to HIV disease and ARV neurotoxicity. Major metabolic complications include dyslipidaemia and insulin resistance, complications that are associated with both HIV infection and several ARV agents and may significantly affect cardiovascular disease risk with age. Bone abnormalities, particularly amongst children treated with tenofovir, are a concern for perinatally infected children who may be at higher risk for bone fractures and osteoporosis. In many studies, rates of anaemia are significantly higher for HIV-infected children. Renal failure is a significant complication and cause of death amongst perinatally infected children, while new data on sexual and reproductive health suggest that sexually transmitted infections and birth complications may be additional concerns for perinatally infected children in adolescence. Finally, perinatally infected children may face psychological

  1. Semen protects CD4+ target cells from HIV infection but promotes the preferential transmission of R5 tropic HIV.

    Science.gov (United States)

    Balandya, Emmanuel; Sheth, Siddharth; Sanders, Katherine; Wieland-Alter, Wendy; Lahey, Timothy

    2010-12-15

    Sexual intercourse is the major means of HIV transmission, yet the impact of semen on HIV infection of CD4(+) T cells remains unclear. To resolve this conundrum, we measured CD4(+) target cell infection with X4 tropic HIV IIIB and HC4 and R5 tropic HIV BaL and SF162 after incubation with centrifuged seminal plasma (SP) from HIV-negative donors and assessed the impact of SP on critical determinants of target cell susceptibility to HIV infection. We found that SP potently protects CD4(+) T cells from infection with X4 and R5 tropic HIV in a dose- and time-dependent manner. SP caused a diminution in CD4(+) T cell surface expression of the HIVR CD4 and enhanced surface expression of the HIV coreceptor CCR5. Consequently, SP protected CD4(+) T cells from infection with R5 tropic HIV less potently than it protected CD4(+) T cells from infection with X4 tropic HIV. SP also reduced CD4(+) T cell activation and proliferation, and the magnitude of SP-mediated suppression of target cell CD4 expression, activation, and proliferation correlated closely with the magnitude of the protection of CD4(+) T cells from infection with HIV. Taken together, these data show that semen protects CD4(+) T cells from HIV infection by restricting critical determinants of CD4(+) target cell susceptibility to HIV infection. Further, semen contributes to the selective transmission of R5 tropic HIV to CD4(+) target cells.

  2. Broadly Neutralizing Anti-HIV Antibodies Prevent HIV Infection of Mucosal Tissue Ex Vivo.

    Science.gov (United States)

    Scott, Yanille M; Park, Seo Young; Dezzutti, Charlene S

    2016-02-01

    Broadly neutralizing monoclonal antibodies (nAbs) specific for HIV are being investigated for use in HIV prevention. Due to their ability to inhibit HIV attachment to and entry into target cells, nAbs may be suitable for use as topical HIV microbicides. As such, they would present an alternative intervention for individuals who may not benefit from using antiretroviral-based products for HIV prevention. We theorize that nAbs can inhibit viral transmission through mucosal tissue, thus reducing the incidence of HIV infection. The efficacy of the PG9, PG16, VRC01, and 4E10 antibodies was evaluated in an ex vivo human model of mucosal HIV transmission. nAbs reduced HIV transmission, causing 1.5- to 2-log10 reductions in HIV replication in ectocervical tissues and ≈3-log10 reductions in HIV replication in colonic tissues over 21 days. These antibodies demonstrated greater potency in colonic tissues, with a 50-fold higher dose being required to reduce transmission in ectocervical tissues. Importantly, nAbs retained their potency and reduced viral transmission in the presence of whole semen. No changes in tissue viability or immune activation were observed in colonic or ectocervical tissue after nAb exposure. Our data suggest that topically applied nAbs are safe and effective against HIV infection of mucosal tissue and support further development of nAbs as a topical microbicide that could be used for anal as well as vaginal protection.

  3. Ethical Issues in a Stage 1 Cognitive-Behavioral Therapy Feasibility Study and Trial to Reduce Alcohol Use Among HIV-Infected Outpatients in Western Kenya

    OpenAIRE

    Papas, Rebecca K.; Gakinya, Benson N.; Baliddawa, Joyce B.; Martino, Steve; Bryant, Kendall J.; Meslin, Eric M.; Sidle, John E.

    2012-01-01

    Epidemics of both HIV/AIDS and alcohol abuse in sub-Saharan Africa have spurred the conduct of local behavioral therapy trials for these problems, but the ethical issues involved in these trials have not been fully examined. In this paper, we discuss ethical issues that emerged during the conduct of a behavioral intervention adaptation and trial using cognitive-behavioral therapy to reduce alcohol use among HIV-infected outpatients in Eldoret, Kenya. The study was performed within our multina...

  4. HIV infection in India: Epidemiology, molecular epidemiology and pathogenesis.

    Indian Academy of Sciences (India)

    Samir Lakhashe; Madhuri Thakar; Sheela Godbole; Srikanth Tripathy; Ramesh Paranjape

    2008-11-01

    The year 1986 saw first case of HIV infection as well as first report of AIDS case in India. Since then the epidemic has spread throughout the country. In the recent years there is evidence of epidemic being stabilized with decrease in new infections reported from some parts of the country. The absolute number of HIV infections in the country is expected to be close to 2.5 million and National AIDS Control Programme, phase III is geared to contain the epidemic. HIV viruses circulating in India predominantly belong to HIV-1 subtype C. However, there have been occasional reports of HIV-1 subtype A and B. Matter of concern is reports of A/C and B/C mosaic viruses that are being reported from different parts of the country. The data on HIV drug resistance from India is rather limited. Most of the studies have shown that the virus strains from drug naïve patients do not show significant level of drug resistance mutations. The few immunological studies in Indian patients show that the Indian HIV infected patients show both HIV-specific CTL responses as well as neutralizing antibody response. Mapping of CTL epitopes showed that while Indian patients identify same regions of Gag antigen as recognized by South African subtype C infected patients, some regions are uniquely recognized by Indian patients. There are very few studies on host genetic factors in India in context with HIV infection. However there are evidences reported of association of host genetic factors such as HLA types and haplotypes and HIV disease.

  5. Sexually transmitted infections among HIV-1-discordant couples.

    Directory of Open Access Journals (Sweden)

    Brandon L Guthrie

    Full Text Available INTRODUCTION: More new HIV-1 infections occur within stable HIV-1-discordant couples than in any other group in Africa, and sexually transmitted infections (STIs may increase transmission risk among discordant couples, accounting for a large proportion of new HIV-1 infections. Understanding correlates of STIs among discordant couples will aid in optimizing interventions to prevent HIV-1 transmission in these couples. METHODS: HIV-1-discordant couples in which HIV-1-infected partners were HSV-2-seropositive were tested for syphilis, chlamydia, gonorrhea, and trichomoniasis, and HIV-1-uninfected partners were tested for HSV-2. We assessed sociodemographic, behavioral, and biological correlates of a current STI. RESULTS: Of 416 couples enrolled, 16% were affected by a treatable STI, and among these both partners were infected in 17% of couples. A treatable STI was found in 46 (11% females and 30 (7% males. The most prevalent infections were trichomoniasis (5.9% and syphilis (2.6%. Participants were 5.9-fold more likely to have an STI if their partner had an STI (P<0.01, and STIs were more common among those reporting any unprotected sex (OR = 2.43; P<0.01 and those with low education (OR = 3.00; P<0.01. Among HIV-1-uninfected participants with an HSV-2-seropositive partner, females were significantly more likely to be HSV-2-seropositive than males (78% versus 50%, P<0.01. CONCLUSIONS: Treatable STIs were common among HIV-1-discordant couples and the majority of couples affected by an STI were discordant for the STI, with relatively high HSV-2 discordance. Awareness of STI correlates and treatment of both partners may reduce HIV-1 transmission. TRIAL REGISTRATION: ClinicalTrials.gov NCT00194519.

  6. Type and severity of intimate partner violence and its relationship with PTSD in HIV-infected women.

    Science.gov (United States)

    Hansrod, Fatima; Spies, Georgina; Seedat, Soraya

    2015-01-01

    HIV has an impact on the presence and severity of both intimate partner violence (IPV) and posttraumatic stress disorder (PTSD) in infected women. However, the relationship of type and severity of IPV with PTSD in this population has not been adequately explored. We focus on the association between the type and severity of IPV and HIV status and PTSD in a sample of South African women. One hundred and sixty-nine women (114 HIV-positive and 55 HIV-negative controls), matched for geographical area, education, and socio-economic status, were recruited from HIV clinics. Clinical and demographic data were collected, including data on childhood trauma, other traumatic life events, IPV, posttraumatic stress symptoms, problematic alcohol use, and depressive symptoms. HIV-positive women had significantly more depressive symptoms, alcohol abuse, and childhood trauma exposure as well as significantly higher rates of PTSD (25.4%) when compared with uninfected women (10.9%). No significant group differences in the rate, pattern, and severity of physical, sexual, psychological, injury, and negotiation IPV were found. In logistic regression analysis, the rate and severity category of IPV did not significantly predict PTSD in HIV-positive women when childhood trauma and life events were controlled for. Our results indicate the need for screening for alcohol abuse, PTSD and depressive symptoms at HIV wellness, and ARV clinics. The high rates of PTSD in HIV-positive women indicate the need for specialized programs to manage PTSD and minimize negative sequelae in this population. These results also highlight the need for improved screening and prevention of childhood trauma and IPV both in infected and uninfected women.

  7. Global human genetics of HIV-1 infection and China

    Institute of Scientific and Technical Information of China (English)

    Tuo Fu ZHU; Tie Jian FENG; Xin XIAO; Hui WANG; Bo Ping ZHOU

    2005-01-01

    Genetic polymorphisms in human genes can influence the risk for HIV-1 infection and disease progression, although the reported effects of these alleles have been inconsistent. This review highlights the recent discoveries on global and Chinese genetic polymorphisms and their association with HIV-1 transmission and disease progression.

  8. Care of Patients With HIV Infection: Diagnosis and Monitoring.

    Science.gov (United States)

    Bolduc, Philip; Roder, Navid; Colgate, Emily; Cheeseman, Sarah H

    2016-04-01

    Appropriate screening for HIV infection is the cornerstone of HIV-related care. There have been several recent changes in testing technology and screening recommendations. The US Preventive Services Task Force recommends universal HIV screening at least once for adolescents and adults ages 15 to 65 years, and additional screening for patients at higher risk, although evidence is insufficient to determine optimum rescreening intervals. All pregnant women should be screened for HIV infection in the first trimester, and pregnant women at high risk should be screened again in the third trimester. The Centers for Disease Control and Prevention recommends use of an algorithm using fourth-generation tests for screening; this decreases the window period between infection and detection to as few as 14 days, thereby reducing the number of false-negative results. Home HIV testing kits, which require follow-up confirmatory testing, also are available. Clinicians should be aware of HIV-specific laws in their states, including those criminalizing HIV exposure and transmission. Thorough medical and laboratory evaluations are essential at initiation of care for patients with HIV infection, along with appropriate follow-up monitoring, as recommended in various guidelines.

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

    DEFF Research Database (Denmark)

    Jernigan, Terry Lynne; Gamst, Abthony C; Archibald, Sarah L.;

    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- an...

  10. T-lymphocyte subsets in HIV-infected and high-risk HIV-uninfected adolescents - Retention of naive T lymphocytes in HIV-infected adolescents

    NARCIS (Netherlands)

    Douglas, SD; Rudy, B; Muenz, L; Starr, SE; Campbell, DE; Wilson, C; Holland, C; Crowley-Nowick, P; Vermund, SH

    2000-01-01

    Background: The capacity of the immune system of adolescents to generate and repopulate naive and memory cell populations under conditions of normal homeostasis and human immunodeficiency virus (HIV) infection is largely unknown. Objective: To assess lymphocyte subsets in HIV-infected and high-risk

  11. Interleukin-27 is differentially associated with HIV viral load and CD4+ T cell counts in therapy-naive HIV-mono-infected and HIV/HCV-co-infected Chinese.

    Directory of Open Access Journals (Sweden)

    Lai He

    Full Text Available 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 characterized. In this study, 155 antiretroviral therapy-naïve Chinese were recruited. Among them 80 were HIV- and HCV-negative healthy controls, 45 were HIV-mono-infected and 30 were HIV/HCV-co-infected. Plasma level HIV, HCV, IL-27 and CD4+ number were counted and their correlation, regression relationships were explored. We show that: plasma IL-27 level was significantly upregulated in HIV-mono-infected and HIV/HCV-co-infected Chinese; HIV viral load was negatively correlated with IL-27 titer in HIV-mono-infected subjects whereas the relationship was opposite in HIV/HCV-co-infected subjects; and the relationships between HIV viral loads, IL-27 titers and CD4+ T cell counts in the HIV mono-infection and HIV/HCV co-infection groups were dramatically different. Overall, our results suggest that IL-27 differs in treatment-naïve groups with HIV mono-infections and HIV/HCV co-infections, thereby providing critical information to be considered when caring and treating those with HIV mono-infection and HIV/HCV co-infection.

  12. Latent and Active Tuberculosis Infection Increase Immune Activation in Individuals Co-Infected with HIV

    Directory of Open Access Journals (Sweden)

    Zuri A. Sullivan

    2015-04-01

    Significance: Latent tuberculosis, which affects an estimated 1/3 of the world's population, has long been thought to be a relatively benign, quiescent state of M. tuberculosis infection. While HIV co-infection is known to exacerbate M. tuberculosis infection and increase the risk of developing active TB, little is known about the potential effect of latent TB infection on HIV disease. This study shows that HIV-infected individuals with both active and latent TB have elevated levels of inflammation and immune activation, biomarkers of HIV disease progression and elevated risk of mortality. These results suggest that, in the context of HIV, latent TB infection may be associated with increased risk of progression to AIDS and mortality.

  13. Examining the relationship between urogenital schistosomiasis and HIV infection.

    OpenAIRE

    Pamela Sabina Mbabazi; Olivia Andan; FITZGERALD, Daniel W.; Lester Chitsulo; Dirk Engels; Downs, Jennifer A

    2011-01-01

    BACKGROUND: Urogenital schistosomiasis, caused by infection with Schistosoma haematobium, is widespread and causes substantial morbidity on the African continent. The infection has been suggested as an unrecognized risk factor for incident HIV infection. Current guidelines recommend preventive chemotherapy, using praziquantel as a public health tool, to avert morbidity due to schistosomiasis. In individuals of reproductive age, urogenital schistosomiasis remains highly prevalent and, likely, ...

  14. Self-Reported HIV and HCV Screening Rates and Serostatus Among Substance Abuse Treatment Patients.

    Science.gov (United States)

    Hernández, Diana; Feaster, Daniel J; Gooden, Lauren; Douaihy, Antoine; Mandler, Raul; Erickson, Sarah J; Kyle, Tiffany; Haynes, Louise; Schwartz, Robert; Das, Moupali; Metsch, Lisa

    2016-01-01

    Substance users are at increased risk for HIV and HCV infection. Still, many substance use treatment programs (SUTP) fail to offer HIV/HCV testing. The present secondary analysis of screening data from a multi-site randomized trial of rapid HIV testing examines self-reported HIV/HCV testing patterns and serostatus of 2473 SUTP patients in 12 community-based sites that had not previously offered on-site testing. Results indicate that most respondents screened for the randomized trial tested more than a year prior to intake for HIV (52 %) and HCV (38 %). Prevalence rates were 3.6 and 30 % for HIV and HCV, respectively. The majority of participants that were HIV (52.2 %) and HCV-positive (40.5 %) reported having been diagnosed within the last 1-5 years. Multivariable logistic regression showed that members of high-risk groups were more likely to have tested. Bundled HIV/HCV testing and linkage to care issues are recommended for expanding testing in community-based SUTP settings.

  15. The split personality of regulatory T cells in HIV infection.

    Science.gov (United States)

    Chevalier, Mathieu F; Weiss, Laurence

    2013-01-03

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

  16. 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.

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

    Science.gov (United States)

    Mofenson, Lynne M; Cotton, Mark F

    2013-06-18

    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.

  18. Postpartum Sterilization Choices Made by HIV-Infected Women

    Directory of Open Access Journals (Sweden)

    Gretchen S. Stuart

    2005-01-01

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

  19. HIV/AIDS and Infections: MedlinePlus Health Topic

    Science.gov (United States)

    ... 8 in AIDS individuals without and with... HIV/AIDS and Infections -- see more articles Reference Desk AIDSinfo Glossary (AIDSinfo) Also in Spanish Find an Expert AIDS.gov AIDSinfo (Department of Health and Human Services) ...

  20. FEATURES OF PNEUMONIA IN HIV-INFECTED PATIENTS

    Directory of Open Access Journals (Sweden)

    M. T. Vatutin

    2016-01-01

    Full Text Available The article presents the clinical, diagnostic and treatment features of pneumocystis pneumonia in HIV-infected patients. The clinical case of diagnosis verification in a patient 58 years old with severe respiratory failure is described.

  1. An Epigenetic Clock Measures Accelerated Aging in Treated HIV Infection.

    Science.gov (United States)

    Boulias, Konstantinos; Lieberman, Judy; Greer, Eric Lieberman

    2016-04-21

    In this issue of Molecular Cell, Gross et al. (2016) find a CpG DNA methylation signature in blood cells of patients with chronic well-controlled HIV infection that correlates with accelerated aging.

  2. SOCIAL AND PSYCHOLOGICAL FEATURES OF HIV-INFECTED INDIVIDUALS

    Directory of Open Access Journals (Sweden)

    Liliya Anatolyevna Kudrich

    2016-02-01

    Full Text Available By 2020 the prevalence of HIV in the Russian Federation may increase by 250%, unless we provide appropriate treatment to as many HIV-infected people as possible (V.I. Skvortsova, 2015. Previous research in this field shows that the psychotraumatic character of the disease lowers the psychological resource of HIV-infected individuals. In most cases, they are not psychologically prepared for the negative life events, unable to find an optimal behavioral pattern when their life stereotypes are being destroyed. In fact, being HIV-infected is an example of an acute event (V.V. Pokrovsky, 1993. The ability to overcome the life crisis and effectiveness of using adaptation and compensatory mechanisms to fight the disease depend on the level of adaptation to the fact of being infected and resistance to stress. The aim of the current study was to determine social and psychological features of HIV-infected individuals and assess their influence on the stress resistance and adaptation abilities of HIV+ patients. We observed men and women aged 21-30 who had been HIV+ for 1-5 years. Investigation methods included the following diagnostic tools: The Cattel Sixteen Personality Factor Questionnaire (Form C, The State-Trait Anxiety Inventory (conducted by Spielberger, adapted for use in Russia by Hanin, The Social Readjustment Rating Scale (The Holmes-Rahe Stress Inventory, The Social and Psychological Adaptation Questionnaire (by C. Rogers and R. Diamond, methods of mathematical statistics. As a result of the study, we have developed comparative factor profiles of individual psychological features of HIV-infected individuals that show their dependence on the social environment and form certain behavioral patterns. We have revealed significant difference in state and trait anxiety between HIV-infected and non-HIV-infected individuals. Self-blame, inadequate self-esteem and level of aspiration indicate low cognitive assessment of the condition by the patients

  3. Involvement of extracellular signal-regulated kinase (ERK1/2)-p53-p21 axis in mediating neural stem/progenitor cell cycle arrest in co-morbid HIV-drug abuse exposure.

    Science.gov (United States)

    Malik, Shaily; Saha, Rinki; Seth, Pankaj

    2014-06-01

    Neurological complications in opioid abusing Human Immunodeficiency Virus-1 (HIV-1) patients suggest enhanced neurodegeneration as compared to non-drug abusing HIV-1 infected population. Neural precursor cells (NPCs), the multipotent cells of the mammalian brain, are susceptible to HIV-1 infection and as opiates also perturb their growth kinetics, detailed mechanistic studies for their co-morbid exposure are highly warranted. Using a well characterized in vitro model of human fetal brain-derived neural precursor cells, we investigated alterations in NPC properties at both acute and chronic durations. Chronic morphine and Tat treatment attenuated proliferation in NPCs, with cells stalled at G1-phase of the cell cycle. Furthermore HIV-Tat and morphine exposure increased activation of extracellular signal-regulated kinase-1/2 (ERK1/2), enhanced levels of p53 and p21, and decreased cyclin D1 and Akt levels in NPCs. Regulated by ERK1/2 and p53, p21 was found to be indispensible for Tat and morphine mediated cell cycle arrest. Our study elaborates on the cellular and molecular machinery in NPCs and provides significant mechanistic details into HIV-drug abuse co-morbidity that may have far reaching clinical consequences both in pediatric as well as adult neuroAIDS.

  4. Risk Factors for Anal HPV Infection and Anal Precancer in HIV-Infected Men Who Have Sex With Men

    OpenAIRE

    Schwartz, Lauren M.; Castle, Philip E.; Follansbee, Stephen; Borgonovo, Sylvia; Fetterman, Barbara; Tokugawa, Diane; Lorey, Thomas S.; Sahasrabuddhe, Vikrant V.; Luhn, Patricia; Gage, Julia C; Darragh, Teresa M.; Wentzensen, Nicolas

    2013-01-01

    Background. Carcinogenic human papillomaviruses (HPVs) cause a large proportion of anal cancers. Human immunodeficiency virus (HIV)–infected men who have sex with men (MSM) are at increased risk of HPV infection and anal cancer compared with HIV-negative men. We evaluated risk factors for HPV infection and anal precancer in a population of HIV-infected MSM.

  5. An initial screening for HIV-associated neurocognitive disorders of HIV-1 infected patients in China

    OpenAIRE

    Zhang, Yulin; Qiao, Luxin; Ding, Wei; Wei, Feili; Zhao, Qingxia; WANG, XICHENG; Shi, Ying; Li, Ning; Smith, Davey; Chen, Dexi

    2012-01-01

    HIV-associated neurocognitive disorders (HAND), characterized by cognitive, motor, and behavioral abnormalities, are common among people living with HIV and AIDS. In combined antiretroviral therapy era in Western countries, nearly 40% of HIV-infected patients continue to suffer from HAND, mainly with mild or asymptomatic cognitive impairment. However, the prevalence and the clinical features of HAND in China are still not well known. In this study, a multi-center cross-sectional study was per...

  6. Care of Patients With HIV Infection: Primary Care.

    Science.gov (United States)

    Bolduc, Philip; Roder, Navid; Colgate, Emily; Cheeseman, Sarah H

    2016-04-01

    With the advent of antiretroviral therapy and improved access to care, the average life expectancy of patients with HIV infection receiving optimal treatment approaches that of patients in the general population. AIDS-related opportunistic infections and malignancies are no longer the primary issues; instead, traditional age- and lifestyle-related conditions are a growing concern. Patients with HIV infection are at higher risk of cardiovascular disease, diabetes, hypertension, and some non-AIDS-related cancers than patients in the general population. Family physicians need to be knowledgeable about screening for and managing chronic comorbid conditions as this population ages. Health maintenance, including appropriate vaccinations, prophylaxis against opportunistic infections, and routine screening for sexually transmitted infections, remains an important part of care. As HIV infection becomes a chronic condition, emerging strategies in prevention, including preexposure prophylaxis, fall within the scope of practice of the family physician.

  7. Substance abuse treatment utilization among adults living with HIV/AIDS and alcohol or drug problems.

    Science.gov (United States)

    Orwat, John; Saitz, Richard; Tompkins, Christopher P; Cheng, Debbie M; Dentato, Michael P; Samet, Jeffrey H

    2011-10-01

    This is a prospective cohort study to identify factors associated with receipt of substance abuse treatment (SAT) among adults with alcohol problems and HIV/AIDS. Data from the HIV Longitudinal Interrelationships of Viruses and Ethanol study were analyzed. Generalized estimating equation logistic regression models were fit to identify factors associated with any service utilization. An alcohol dependence diagnosis had a negative association with SAT (adjusted odds ratio [AOR] = 0.36, 95% confidence interval [95% CI] = 0.19-0.67), as did identifying sexual orientation other than heterosexual (AOR = 0.46, CI = 0.29-0.72) and having social supports that use alcohol/drugs (AOR = 0.62, CI = 0.45-0.83). Positive associations with SAT include presence of hepatitis C antibody (AOR = 3.37, CI = 2.24-5.06), physical or sexual abuse (AOR = 2.12, CI = 1.22-3.69), social supports that help with sobriety (AOR = 1.92, CI = 1.28-2.87), homelessness (AOR = 2.40, CI = 1.60-3.62), drug dependence diagnosis (AOR = 2.64, CI = 1.88-3.70), and clinically important depressive symptoms (AOR = 1.52, CI = 1.08-2.15). While reassuring that factors indicating need for SAT among people with HIV and alcohol problems (e.g., drug dependence) are associated with receipt, nonneed factors (e.g., sexual orientation, age) that should not decrease likelihood of receipt of treatment were identified.

  8. Antisocial Psychopathy and HIV Risk among Alcohol and Other Drug (AOD Abusing Adolescent Offenders

    Directory of Open Access Journals (Sweden)

    Robert M. Malow

    2007-01-01

    Full Text Available While the consensus is that HIV prevalence has remained low among adolescent offenders, the prevalence of STDs and HIV transmission risk behaviors is alarming, particularly for those abusing alcohol and other drugs and those displaying antisocial or conduct disorder characteristics. In the current study, 269 male and 110 female inner city, culturally diverse alcohol and other drug (AOD abusing adolescent offenders completed measures of (a psychopathy, using the Millon Adolescent Clinical Inventory (MACI (b HIV transmission risk behavior, (c prevention skills and attitudes and (d social desirability. Results showed that those with high levels of psychopathy reported more AOD use, overall unprotected sex and more sexual activity when influenced by alcohol and/or marijuana. High psychopathy adolescent offenders also reported lower self-efficacy and sexual response-efficacy, less favorable safer sex and condom attitudes and less favorable intentions to engage in safer sex behaviors, when controlling for social desirability. Data suggest that adolescent offenders, who are either in court-ordered treatment or detention, should be assessed for psychopathy and provided with tailored risk reduction interventions, geared toward attitudinal and behavioral change. A discussion of integrating neurobiological measures to improve the next generation of tailored interventions for this risk group is offered in conclusion.

  9. HIV-1/HSV-2 co-infected adults in early HIV-1 infection have elevated CD4+ T cell counts.

    Directory of Open Access Journals (Sweden)

    Jason D Barbour

    Full Text Available INTRODUCTION: HIV-1 is often acquired in the presence of pre-existing co-infections, such as Herpes Simplex Virus 2 (HSV-2. We examined the impact of HSV-2 status at the time of HIV-1 acquisition for its impact on subsequent clinical course, and total CD4+ T cell phenotypes. METHODS: We assessed the relationship of HSV-1/HSV-2 co-infection status on CD4+ T cell counts and HIV-1 RNA levels over time prior in a cohort of 186 treatment naïve adults identified during early HIV-1 infection. We assessed the activation and differentiation state of total CD4+ T cells at study entry by HSV-2 status. RESULTS: Of 186 recently HIV-1 infected persons, 101 (54% were sero-positive for HSV-2. There was no difference in initial CD8+ T cell count, or differences between the groups for age, gender, or race based on HSV-2 status. Persons with HIV-1/HSV-2 co-infection sustained higher CD4+ T cell counts over time (+69 cells/ul greater (SD = 33.7, p = 0.04 than those with HIV-1 infection alone (Figure 1, after adjustment for HIV-1 RNA levels (-57 cells per 1 log(10 higher HIV-1 RNA, p<0.0001. We did not observe a relationship between HSV-2 infection status with plasma HIV-1 RNA levels over time. HSV-2 acquisition after HIV-1 acquisition had no impact on CD4+ count or viral load. We did not detect differences in CD4+ T cell activation or differentiation state by HSV-2+ status. DISCUSSION: We observed no effect of HSV-2 status on viral load. However, we did observe that treatment naïve, recently HIV-1 infected adults co-infected with HSV-2+ at the time of HIV-1 acquisition had higher CD4+ T cell counts over time. If verified in other cohorts, this result poses a striking paradox, and its public health implications are not immediately clear.

  10. Innate Immune Activation in Primary HIV-1 Infection

    OpenAIRE

    Chang, J. Judy; Altfeld, Marcus

    2010-01-01

    There is growing evidence highlighting the role of the immune response during acute HIV-1 infection on the control or development of disease. The adaptive immune responses do not appear until after the HIV-1 infection is already well established and as such the role of the earlier and faster responding innate immunity needs to be more closely scrutinized. In particular, two aspects of the innate immunity with growing developments will be examined in this review; type I IFNs and NK cells. Both...

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

    OpenAIRE

    Sherstiuk S.A.; Sorokina I.V

    2012-01-01

    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 acidophi...

  12. Psychometric properties of a short version of the HIV stigma scale, adapted for children with HIV infection

    OpenAIRE

    2013-01-01

    Background HIV is a stigmatizing medical condition. The concept of HIV stigma is multifaceted, with personalized stigma (perceived stigmatizing consequences of others knowing of their HIV status), disclosure concerns, negative self-image, and concerns with public attitudes described as core aspects of stigma for individuals with HIV infection. There is limited research on HIV stigma in children. The aim of this study was to test a short version of the 40-item HIV Stigma Scale (HSS-40), adapte...

  13. Psychometric properties of a short version of the HIV stigma scale, adapted for children with HIV infection

    OpenAIRE

    Wiklander, M.; Rydström, L.-L.; Ygge, B.-M.; Navér, L.; Wettergren, L.; Eriksson, L. E.

    2013-01-01

    Background: HIV is a stigmatizing medical condition. The concept of HIV stigma is multifaceted, with personalized stigma (perceived stigmatizing consequences of others knowing of their HIV status), disclosure concerns, negative self-image, and concerns with public attitudes described as core aspects of stigma for individuals with HIV infection. There is limited research on HIV stigma in children. The aim of this study was to test a short version of the 40-item HIV Stigma Scale (HSS-40), adapt...

  14. Sentinel surveillance of HIV-1 transmitted drug resistance, acute infection and recent infection.

    Directory of Open Access Journals (Sweden)

    Hong-Ha M Truong

    Full Text Available HIV-1 acute infection, recent infection and transmitted drug resistance screening was integrated into voluntary HIV counseling and testing (VCT services to enhance the existing surveillance program in San Francisco. This study describes newly-diagnosed HIV cases and characterizes correlates associated with infection.A consecutive sample of persons presenting for HIV VCT at the municipal sexually transmitted infections (STI clinic from 2004 to 2006 (N = 9,868 were evaluated by standard enzyme-linked immunoassays (EIA. HIV antibody-positive specimens were characterized as recent infections using a less-sensitive EIA. HIV-RNA pooled testing was performed on HIV antibody-negative specimens to identify acute infections. HIV antibody-positive and acute infection specimens were evaluated for drug resistance by sequence analysis. Multivariable logistic regression was performed to evaluate associations. The 380 newly-diagnosed HIV cases included 29 acute infections, 128 recent infections, and 47 drug-resistant cases, with no significant increases or decreases in prevalence over the three years studied. HIV-1 transmitted drug resistance prevalence was 11.0% in 2004, 13.4% in 2005 and 14.9% in 2006 (p = 0.36. Resistance to non-nucleoside reverse transcriptase inhibitors (NNRTI was the most common pattern detected, present in 28 cases of resistance (59.6%. Among MSM, recent infection was associated with amphetamine use (AOR = 2.67; p<0.001, unprotected anal intercourse (AOR = 2.27; p<0.001, sex with a known HIV-infected partner (AOR = 1.64; p = 0.02, and history of gonorrhea (AOR = 1.62; p = 0.03.New HIV diagnoses, recent infections, acute infections and transmitted drug resistance prevalence remained stable between 2004 and 2006. Resistance to NNRTI comprised more than half of the drug-resistant cases, a worrisome finding given its role as the backbone of first-line antiretroviral therapy in San Francisco as well as worldwide. The integration of HIV-1 drug

  15. Sentinel Surveillance of HIV-1 Transmitted Drug Resistance, Acute Infection and Recent Infection

    Science.gov (United States)

    Truong, Hong-Ha M.; Kellogg, Timothy A.; McFarland, Willi; Louie, Brian; Klausner, Jeffrey D.; Philip, Susan S.; Grant, Robert M.

    2011-01-01

    Background HIV-1 acute infection, recent infection and transmitted drug resistance screening was integrated into voluntary HIV counseling and testing (VCT) services to enhance the existing surveillance program in San Francisco. This study describes newly-diagnosed HIV cases and characterizes correlates associated with infection. Methodology/Principal Findings A consecutive sample of persons presenting for HIV VCT at the municipal sexually transmitted infections (STI) clinic from 2004 to 2006 (N = 9,868) were evaluated by standard enzyme-linked immunoassays (EIA). HIV antibody-positive specimens were characterized as recent infections using a less-sensitive EIA. HIV-RNA pooled testing was performed on HIV antibody-negative specimens to identify acute infections. HIV antibody-positive and acute infection specimens were evaluated for drug resistance by sequence analysis. Multivariable logistic regression was performed to evaluate associations. The 380 newly-diagnosed HIV cases included 29 acute infections, 128 recent infections, and 47 drug-resistant cases, with no significant increases or decreases in prevalence over the three years studied. HIV-1 transmitted drug resistance prevalence was 11.0% in 2004, 13.4% in 2005 and 14.9% in 2006 (p = 0.36). Resistance to non-nucleoside reverse transcriptase inhibitors (NNRTI) was the most common pattern detected, present in 28 cases of resistance (59.6%). Among MSM, recent infection was associated with amphetamine use (AOR = 2.67; p<0.001), unprotected anal intercourse (AOR = 2.27; p<0.001), sex with a known HIV-infected partner (AOR = 1.64; p = 0.02), and history of gonorrhea (AOR = 1.62; p = 0.03). Conclusions New HIV diagnoses, recent infections, acute infections and transmitted drug resistance prevalence remained stable between 2004 and 2006. Resistance to NNRTI comprised more than half of the drug-resistant cases, a worrisome finding given its role as the backbone of first

  16. The Impact of HIV Co-Infection on the Genomic Response to Sepsis

    NARCIS (Netherlands)

    Huson, Michaëla A M; Scicluna, Brendon P; van Vught, Lonneke A; Wiewel, Maryse A; Hoogendijk, Arie J; Cremer, Olaf L; Bonten, Marc J M; Schultz, Marcus J; Franitza, Marek; Toliat, Mohammad R; Nürnberg, Peter; Grobusch, Martin P; van der Poll, Tom

    2016-01-01

    HIV patients have an increased risk to develop sepsis and HIV infection affects several components of the immune system involved in sepsis pathogenesis. We hypothesized that HIV infection might aggrevate the aberrant immune response during sepsis, so we aimed to determine the impact of HIV infection

  17. HIV Infection and Children: A Medical Overview.

    Science.gov (United States)

    Anderson, Virginia

    1998-01-01

    Updates a 10-year medical overview on HIV/AIDS written for a Child Welfare League of America publication. Covers HIV transmission, diagnosis and treatment of HIV in infants, maternal treatment and testing, and advances and challenges, including new drug therapies. Concludes with recommendations on systems of care for affected families. (EV)

  18. 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

  19. Can HIV-1 infection be cured?%HIV-1感染能治愈吗?

    Institute of Scientific and Technical Information of China (English)

    张兴权

    2013-01-01

    A functional HIV-1 cure has been possible now.The ideal functional HIV-1 cure should get HIV-1 infected patients to the point where drugs are not needed after combination therapy and HIV-1 RNA cannot be detected in some patients.However,a functional HIV-1 cure is not equal to a cure for HIV-1,because HIV-1 RNA can still be detected in patients' latent infected cells and related symptoms have not been resolved completely.An era of eradication cure for HIV infection will be coming with further basic and clinical studies,especially when cleaning virus reservoirs by gene modifications successfully.%目前,HIV-1感染治疗已发展到“功能性治愈”阶段,即采用联合化疗一段时间后停止用药几年内,可以使部分患者体内的病毒达到检测不出的水平.然而,这还不是治愈,因为患者的静止淋巴细胞内仍可查到病毒痕迹,患者临床症状也并未完全消失.真正的治愈还须进行更深入的基础和临床研究,特别是通过基因修饰清除病毒的藏身之地.

  20. Correlation of mental illness and HIV/AIDS infection

    Directory of Open Access Journals (Sweden)

    Anousheh Safarcherati

    2016-01-01

    Full Text Available HIV/AIDS is among the leading causes of morbidity and mortality in world. There are more than 35 million people living with HIV/AIDS in the world. Although the annual incidence of HIV infection is decreasing globally, HIV prevalence is rising due to development of more effective treatment and higher survival. Iran suffers from concentrated HIV epidemics among injecting and non-injecting drug users. There are more than 27 thousand registered cases of HIV infection and it is estimated that there are above seventy eight thousand cases in the country. Regarding the burden of disease, it is projected that HIV/AIDS will have the highest growth during the next 10 years. The outcome of this epidemics will be determined by human behavior. HIV, psychiatric disorders and substance use disorders are closely correlated and are accompanied by similar risk factors. They also share common consequences such as stigma and discrimination. Correlation of psychiatric disorders, as one of the most influential determinants of our behavior, and HIV/AIDS infection is reviewed in this narrative article. Psychiatric disorders are associated with greater risk of HIV acquisition. Substance use disorders, both injecting and non-injecting, as well as severe mental illnesses put the individual at higher risk of acquiring HIV infection. Impaired judgment, diminished inhibition and control over behaviors, lack of insight and poor self-care have been proposed as the underlying mechanisms. On the other hand, HIV infection may put the individual at greater risk of developing a mental illness. Coping with a chronic and life-threatening illness, fear of stigma and discrimination, CNS invasion of the virus as well as the adverse neuropsychiatric side effects of anti-retroviral medications may all contribute to establishment of a psychiatric disorder. Although there exists a bi-directional correlation between mental health problems and HIV/AIDS infection, this reciprocity goes beyond

  1. Activation by malaria antigens renders mononuclear cells susceptible to HIV infection and re-activates replication of endogenous HIV in cells from HIV-infected adults.

    Science.gov (United States)

    Froebel, K; Howard, W; Schafer, J R; Howie, F; Whitworth, J; Kaleebu, P; Brown, A L; Riley, E

    2004-05-01

    We have tested the hypothesis that activation of T cells by exposure to malaria antigens facilitates both de novo HIV infection and viral reactivation and replication. PBMC from malaria-naive HIV-uninfected European donors could be productively infected with HIV following in vitro stimulation with a lysate of Plasmodium falciparum schizonts and PBMC from malaria-naive and malaria-exposed (semi-immune) HIV-positive adults were induced to produce higher levels of virus after stimulation with the same malaria extract. These findings suggest that effective malaria control measures might con-tribute to reducing the spread of HIV and extending the life span of HIV-infected individuals living in malaria endemic areas.

  2. Serologic validation of HIV infection in a tropical area.

    Science.gov (United States)

    Ribeiro, T T; Brites, C; Moreira, E D; Siller, K; Silva, N; Johnson, W D; Badaro, R

    1993-03-01

    We have defined human immunodeficiency virus type 1 (HIV-1) serologic reactivity in Brazilians living in an area endemic for tropical diseases. Enzyme-linked immunosorbent assay (ELISA) and Western blot (WB) analyses were performed on 342 patients with diseases including Chagas' disease, schistosomiasis, typhoid fever, helminthiasis, and cutaneous and visceral leishmaniasis. Nine percent of the visceral leishmaniasis patients' sera reacted in the HIV-1 ELISA but all were WB negative. All other sera from these patients were HIV negative. A total of 224 HIV-1 ELISA repeatedly positive sera also were HIV-1 WB tested. They were drawn from a total population of 19,230 individuals, including AIDS patients, blood donors, homosexual men, intravenous drug users, pregnant women, individuals with hemophiliac, and tuberculosis and sexually transmitted disease patients. The WB results were analyzed using five different interpretive criteria for WB positivity. The Centers for Disease Control (CDC) and the World Health Organization (WHO) criteria were the most sensitive and specific for identifying HIV-1-infected individuals. The WB pattern was similar to that seen in the United States. Envelope (ENV) protein antibodies were highly predictive of HIV-1 infection; none of the AIDS patients lacked ENV protein reactivity. We conclude that among the tropical diseases studied, only visceral leishmaniasis is associated with false-positive HIV-1 ELISA tests. Current CDC and WHO criteria for interpretation of HIV-1 WB tests are appropriate for Brazil.

  3. Myocardial infarction among Danish HIV-infected individuals

    DEFF Research Database (Denmark)

    Rasmussen, Line D; Helleberg, Marie; May, Margaret T

    2015-01-01

    BACKGROUND: Human immunodeficiency virus-infected individuals have increased risk of myocardial infarction (MI); however, the contribution from smoking and potentiating effects of HIV are controversial. METHODS: From the Danish HIV Cohort Study and the Copenhagen General Population Study, we...... identified 3251 HIV-infected individuals and 13 004 population controls matched on age and gender. Data on MI were obtained from the National Hospital Registry and the National Registry of Causes of Death. We calculated adjusted incidence rate ratios (aIRR) for risk of MI and population......-attributable fractions (PAF) of MI associated with smoking. RESULTS: In never smokers, HIV was not associated with an increased risk of MI (aIRR, 1.01; 95% confidence interval [CI], .41-2.54). In previous and current smokers, HIV was associated with a substantially increased risk of MI (aIRR, 1.78; 95% CI, .75...

  4. Projected Lifetime Healthcare Costs Associated with HIV Infection

    DEFF Research Database (Denmark)

    Nakagawa, Fumiyo; Miners, Alec; Smith, Colette J

    2015-01-01

    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...... 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...

  5. Is phototherapy safe for HIV-infected individuals?

    Energy Technology Data Exchange (ETDEWEB)

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

    1996-08-01

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

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

    Directory of Open Access Journals (Sweden)

    Hélène C F Côté

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

  7. The Impact of HIV Co-Infection on the Genomic Response to Sepsis

    OpenAIRE

    Michaëla A M Huson; Brendon P Scicluna; van Vught, Lonneke A.; Wiewel, Maryse A.; Arie J Hoogendijk; Cremer, Olaf L; Bonten, Marc J M; Marcus J Schultz; Marek Franitza; Toliat, Mohammad R; Peter Nürnberg; Grobusch, Martin P.; Tom van der Poll

    2016-01-01

    HIV patients have an increased risk to develop sepsis and HIV infection affects several components of the immune system involved in sepsis pathogenesis. We hypothesized that HIV infection might aggrevate the aberrant immune response during sepsis, so we aimed to determine the impact of HIV infection on the genomic host response to sepsis. We compared whole blood leukocyte gene expression profiles among sepsis patients with or without HIV co-infection in the intensive care unit (ICU) and valid...

  8. 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.

  9. Analysis of HBV、 HCV、 HIV and Treponema pallidum infection in methamphetamine abuser%甲基苯丙胺滥用患者HBV、HCV、HIV及梅毒感染状况分析

    Institute of Scientific and Technical Information of China (English)

    李萍; 洪剑浩; 徐鹏; 刘学军; 尹啊娟

    2013-01-01

    目的 探讨目前国内甲基苯丙胺滥用患者(非静脉注射)乙型肝炎病毒(HBV)、丙型肝炎病毒(HCV)、人类免疫缺陷病毒(HIV)及梅毒螺旋体(Treponema pallidum,TP)的感染情况.方法 对132例甲基苯丙胺滥用患者和140例正常健康者的血清进行HBsAg、HCV抗体(IgM、IgG)、HIV抗体及梅毒抗体的检测,统计感染率.结果 132例甲基苯丙胺滥用患者的HBsAg阳性率为15.91%、HCV抗体阳性率为22.73%、梅毒抗体阳性率10.61%、HIV抗体为阴性.结论 甲基苯丙胺滥用患者的HBV、HCV、梅毒感染率均高于普通人群,检测其感染情况可为采取相应的预防措施和健康教育提供依据.

  10. Drugs + HIV, Learn the Link

    Medline Plus

    Full Text Available ... Research Training News & Events News Nora's Blog NIDA in the News NIDA Notes Podcasts E-Newsletters Public ... with drug abuse are among the main factors in the spread of HIV infection in the United ...

  11. Detection of Acute HIV-1 Infection by RT-LAMP.

    Directory of Open Access Journals (Sweden)

    Donna L Rudolph

    Full Text Available A rapid, cost-effective diagnostic test for the detection of acute HIV-1 infection is highly desired. Isothermal amplification techniques, such as reverse-transcription loop-mediated isothermal amplification (RT-LAMP, exhibit characteristics that are ideal for the development of a rapid nucleic acid amplification test (NAAT because they are quick, easy to perform and do not require complex, dedicated equipment and laboratory space. In this study, we assessed the ability of the HIV-1 RT-LAMP assay to detect acute HIV infection as compared to a representative rapid antibody test and several FDA-approved laboratory-based assays. The HIV-1 RT-LAMP assay detected seroconverting individuals one to three weeks earlier than a rapid HIV antibody test and up to two weeks earlier than a lab-based antigen/antibody (Ag/Ab combo enzyme immunoassay (EIA. RT-LAMP was not as sensitive as a lab-based qualitative RNA assay, which could be attributed to the significantly smaller nucleic acid input volume. To our knowledge, this is the first demonstration of detecting acute HIV infection using the RT-LAMP assay. The availability of a rapid NAAT, such as the HIV-1 RT-LAMP assay, at the point of care (POC or in laboratories that do not have access to large platform NAAT could increase the percentage of individuals who receive an acute HIV infection status or confirmation of their HIV status, while immediately linking them to counseling and medical care. In addition, early knowledge of HIV status could lead to reduced high-risk behavior at a time when individuals are at a higher risk for transmitting the virus.

  12. Acute HIV Infection among Pregnant Women in Malawi

    Science.gov (United States)

    Gay, Cynthia L.; Mwapasa, Victor; Murdoch, David M.; Kwiek, Jesse J.; Fiscus, Susan A.; Meshnick, Steven R.; Cohen, Myron S.

    2009-01-01

    Introduction There are limited data on acute HIV infection (AHI) prevalence during pregnancy. Methods Malawian pregnant women admitted in the third trimester and meeting eligibility criteria underwent dual HIV rapid antibody testing. AHI prevalence was retrospectively detected through HIV RNA pooling of seronegative plasma. Results Among 3825 pregnant women screened, dual HIV rapid testing indicated that 30.2% were HIV positive, 69.7% were HIV negative and 0.1% were indeterminate. Sensitivity and specificity of dual rapid testing was 99.0% and 98.7%, respectively. Of 2666 seronegative specimens, 2327 had samples available for HIV RNA pooling; 5 women (0.21%) (95% CI: 0.03, 0.40%) had AHI with a median peripartum viral load of 1,324,766 copies/mL. Discussion Pregnant women are at risk for AHI, warranting counseling of all women and their sexual partners about incident HIV during pregnancy. Dual HIV rapid tests have high sensitivity and specificity. HIV testing should be repeated in the third trimester and/or at delivery. PMID:20226326

  13. HIV infection early diagnosis experience in primary care

    Directory of Open Access Journals (Sweden)

    Francisco Jover Diaz

    2014-11-01

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

  14. Pleurisy in tuberculosis and HIV-infected patients

    Directory of Open Access Journals (Sweden)

    A. K. Ivanov

    2014-01-01

    Full Text Available A clinical and epidemiological study for 14 years was conducted. Among TB patients, the percentage of persons with mixed infection (TB+HIV infection increased during the observation period from 10 up to 64%. About one third of them had a pleura reaction with an accumulation of fluid between pleura’s petals. Pleuritis in patients with mixed infection were characterized by special features: pleurisy complicated another form of tuberculosis more often, in one-third of patients (29,8% pleural liquid had hemorrhagic type, Mycobacterium tuberculosis in the pleural fluid was detected six times more often. The level of activity of adenosine deaminase and neopterin in the exudate of patients with tuberculosis and HIV infection remained significantly higher than in the control group of persons. These data can be useful in the diagnostics of specific diseases in HIV-infected patients.

  15. Sexually transmitted infections and use of contraceptives in women living with HIV in Denmark - the SHADE cohort

    DEFF Research Database (Denmark)

    Thorsteinsson, Kristina; Ladelund, Steen; Storgaard, Merete

    2016-01-01

    BACKGROUND: No Danish guidelines for screening of sexually transmitted infections (STIs) in women living with HIV (WLWH) exist, except for annual syphilis testing. Drug-drug interaction between hormonal contraceptives and some types of highly active antiretroviral therapy (HAART) occurs. We...... criteria were HIV-1 infection and ≥ 18 years of age. Exclusion criteria were pregnancy, alcohol- or drug abuse impeding adherence to the protocol. At entry, participants were tested (and where appropriate, treated according to guidelines) for Chlamydia trachomatis, Neisseria gonorrhoeae, syphilis......, and herpes simplex (HSV-1 and HSV-2). At follow-up, predictors of condom use were estimated in sexually active WLWH. RESULTS: In total, 334 of the 1,392 eligible WLWH in Denmark were included (median age and HIV duration: 42.5 and 11.3 years). Chlamydia trachomatis was present in four individuals (1...

  16. HIV INFECTION STAGE, ANTIRETROVIRAL THERAPY SCHEME AND PATIENT IMMUNE STATUS INFLUENCE ON HIV/TB CO-INFECTION OUTCOME

    Directory of Open Access Journals (Sweden)

    A. V. Mordyk

    2016-01-01

    Full Text Available Retrospective research of 381 clinical records is conducted to study HIV infection influence on stationary stage of tuberculosis treatment outcome in HIV-TB co-infected patients. All cases were divided depending on a hospitalization outcome on favorable and adverse. At most of patients tuberculosis of respiratory organs met. Immunological researches were conducted, the stage of HIV infection was registered and the issue of purpose of anti-retroviral therapy was resolved. Besides, as indirect signs of an immunodeficiency at the patients with a combination of tuberculosis and HIV infection who were on hospitalization the indicators received when carrying out clinical laboratory trials were analyzed: absolute and relative quantity of lymphocytes according to the general blood test, the contents the globulin fractions and circulating immune complexes concentration according to the clinical chemistry blood test. At an assessment of results in both groups of research more than at a half of patients existence of HIV infection at late stages that speaks about late identification and neglect of an immunodeficiency was revealed. At patients with tuberculosis of lungs in combination with HIV infection at a failure statistically significant decrease in an immunoregulatory index is revealed. It is interesting that the level of CD4 lymphocytes and a stage of HIV infection had no impact on the co-infection’s outcome. However, existence of virus loa ding more than 100 000 copies/ml reduced probability favorable an outcome of treatment of tuberculosis at the patient with HIV infection. Timely purpose of anti-retroviral therapy at patients with co-infection increased chances of treatment of tuberculosis at patients with an immunodeficiency. Frequency of adverse side effect of antiviral therapy met equally often at patients in both groups. Thus, patients at any stages of HIV infection with any forms of tuberculosis, including generalized, had a

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-07-15

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

  18. The Surprising Role of Amyloid Fibrils in HIV Infection.

    Science.gov (United States)

    Castellano, Laura M; Shorter, James

    2012-01-01

    Despite its discovery over 30 years ago, human immunodeficiency virus (HIV) continues to threaten public health worldwide. Semen is the principal vehicle for the transmission of this retrovirus and several endogenous peptides in semen, including fragments of prostatic acid phosphatase (PAP248-286 and PAP85-120) and semenogelins (SEM1 and SEM2), assemble into amyloid fibrils that promote HIV infection. For example, PAP248-286 fibrils, termed SEVI (Semen derived Enhancer of Viral Infection), potentiate HIV infection by up to 105-fold. Fibrils enhance infectivity by facilitating virion attachment and fusion to target cells, whereas soluble peptides have no effect. Importantly, the stimulatory effect is greatest at low viral titers, which mimics mucosal transmission of HIV, where relatively few virions traverse the mucosal barrier. Devising a method to rapidly reverse fibril formation (rather than simply inhibit it) would provide an innovative and urgently needed preventative strategy for reducing HIV infection via the sexual route. Targeting a host-encoded protein conformer represents a departure from traditional microbicidal approaches that target the viral machinery, and could synergize with direct antiviral approaches. Here, we review the identification of these amyloidogenic peptides, their mechanism of action, and various strategies for inhibiting their HIV-enhancing effects.

  19. A systematic review of measures of HIV/AIDS stigma in paediatric HIV-infected and HIV-affected populations

    Science.gov (United States)

    McAteer, Carole Ian; Truong, Nhan-Ai Thi; Aluoch, Josephine; Deathe, Andrew Roland; Nyandiko, Winstone M; Marete, Irene; Vreeman, Rachel Christine

    2016-01-01

    Introduction HIV-related stigma impacts the quality of life and care management of HIV-infected and HIV-affected individuals, but how we measure stigma and its impact on children and adolescents has less often been described. Methods We conducted a systematic review of studies that measured HIV-related stigma with a quantitative tool in paediatric HIV-infected and HIV-affected populations. Results and discussion Varying measures have been used to assess stigma in paediatric populations, with most studies utilizing the full or variant form of the HIV Stigma Scale that has been validated in adult populations and utilized with paediatric populations in Africa, Asia and the United States. Other common measures included the Perceived Public Stigma Against Children Affected by HIV, primarily utilized and validated in China. Few studies implored item validation techniques with the population of interest, although scales were used in a different cultural context from the origin of the scale. Conclusions Many stigma measures have been used to assess HIV stigma in paediatric populations, globally, but few have implored methods for cultural adaptation and content validity. PMID:27717409

  20. Major Depletion of Plasmacytoid Dendritic Cells in HIV-2 Infection, an Attenuated Form of HIV Disease

    Science.gov (United States)

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

    2009-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Rita Cavaleiro

    2009-11-01

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

  2. 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.

  3. Sports behaviour among HIV-infected versus non-infected individuals in a Berlin cohort.

    Science.gov (United States)

    Stein, L; Hechler, D; Jessen, A B; Neumann, K; Jessen, H; Beneke, R

    2012-01-01

    Physical activity has been recommended based on beneficial effects described in HIV-infected patients. However, such guidelines do not take into account actual sport behaviours and general attitudes towards physical activity. To evaluate actual sport activity and attitudes towards sport in HIV-infected versus non-infected individuals we conducted an anonymous questionnaire investigating the prevalence, as well as possible changes, in sports engagement and the overall attitude to physical activity. A total of 283 patients of a general care facility specialized in the treatment of HIV/AIDS in Berlin, Germany, participated; 124 were HIV infected and 159 were non-infected, mostly men who have sex with men (MSM) (88%), with a median age of 35 years. The HIV-infected participants had a median CD4+ count of 554 cells/µL and 48.8% of them were using antiretroviral therapy (ART) at the time of survey. The proportion of patients actually performing physical activity was significantly lower (P = 0.028) within the HIV-infected group (61.3%) than within the non-infected group (74.2%). This difference remained significant after accounting for possible confounders such as age, gender, injecting drug use and sexual preferences. Previously reported sport activity prevalence was similar in both groups on leaving school. From our data we could not identify an association between the time of HIV diagnosis and changes in sports activity. In conclusion, fewer HIV-infected individuals report physical activity than non-infected individuals. Sociodemographic studies to evaluate potential differences in sports behaviour are required in order to inform exercise guidelines for HIV-infected patients.

  4. Abuse

    Science.gov (United States)

    ... basic needs like food, shelter, and love. Family violence can affect anyone. It can happen in any kind of family. Sometimes parents abuse each other, which can be hard for a child to witness. Some parents abuse their kids by using physical or verbal cruelty as a way of discipline. ...

  5. 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.

  6. [The lipid composition of bloodserum in patients with salmonella infection and suffering of alcohol abuse].

    Science.gov (United States)

    Makarov, V K; Leventsova, A E

    2012-10-01

    The impact of bacterial salmonella infection manifested in higher level of common lipids, increase of relative content of common phospholipids, free cholesterol, free fatty acids and phosphatidylcholine and decrease of content of cholesterol esters and total lysophospholipids. The patients with salmonella infection, suffering of alcohol abuse as opposed to non-abusing patients characterized by higher content of triglycerides, free cholesterol, total lysophospholipids, phosphatidylcholine and lower content of cholesterol esters and phosphatidylcholine.

  7. Care of HIV-infected patients in China

    Institute of Scientific and Technical Information of China (English)

    Yun; Zhen; CAO; Hong; Zhou; LU

    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.

  8. Targeted cytotoxic therapy kills persisting HIV infected cells during ART.

    Science.gov (United States)

    Denton, Paul W; Long, Julie M; Wietgrefe, Stephen W; Sykes, Craig; Spagnuolo, Rae Ann; Snyder, Olivia D; Perkey, Katherine; Archin, Nancie M; Choudhary, Shailesh K; Yang, Kuo; Hudgens, Michael G; Pastan, Ira; Haase, Ashley T; Kashuba, Angela D; Berger, Edward A; Margolis, David M; Garcia, J Victor

    2014-01-01

    Antiretroviral therapy (ART) can reduce HIV levels in plasma to undetectable levels, but rather little is known about the effects of ART outside of the peripheral blood regarding persistent virus production in tissue reservoirs. Understanding the dynamics of ART-induced reductions in viral RNA (vRNA) levels throughout the body is important for the development of strategies to eradicate infectious HIV from patients. Essential to a successful eradication therapy is a component capable of killing persisting HIV infected cells during ART. Therefore, we determined the in vivo efficacy of a targeted cytotoxic therapy to kill infected cells that persist despite long-term ART. For this purpose, we first characterized the impact of ART on HIV RNA levels in multiple organs of bone marrow-liver-thymus (BLT) humanized mice and found that antiretroviral drug penetration and activity was sufficient to reduce, but not eliminate, HIV production in each tissue tested. For targeted cytotoxic killing of these persistent vRNA(+) cells, we treated BLT mice undergoing ART with an HIV-specific immunotoxin. We found that compared to ART alone, this agent profoundly depleted productively infected cells systemically. These results offer proof-of-concept that targeted cytotoxic therapies can be effective components of HIV eradication strategies.

  9. The epidemiology of human papillomavirus in HIV-negative and HIV-infected men who have sex with men

    NARCIS (Netherlands)

    Mooij, S.H.

    2015-01-01

    This thesis studied the epidemiology and seroepidemiology of human papillomavirus (HPV) among HIV-negative and HIV-infected men who have sex with men (MSM) in Amsterdam, the Netherlands. Anal, penile, and oral HPV prevalence and incidence were high, in particular among HIV-infected MSM. Clearance of

  10. INCIDENCE OF LYMPHOMAS AND OTHER CANCERS IN HIV-INFECTED AND HIV-UNINFECTED PATIENTS WITH HEMOPHILIA

    NARCIS (Netherlands)

    RABKIN, CS; HILGARTNER, MW; HEDBERG, KW; ALEDORT, LM; HATZAKIS, A; EICHINGER, S; EYSTER, ME; WHITE, GC; KESSLER, CM; LEDERMAN, MM; DEMOERLOOSE, P; BRAY, GL; COHEN, AR; ANDES, WA; MANCOJOHNSON, M; SCHRAMM, W; KRONER, BL; BLATTNER, WA; GOEDERT, JJ

    1992-01-01

    Objective. - To determine the types and rates of cancers occurring in excess in the presence of infection with the human immunodeficiency virus type 1 (HIV-1). Design. - Cohort analytic study of HIV-infected and HIV-uninfected subjects followed for up to 12 years. Setting. - Fifteen hemophilia treat

  11. Relationships between humoral factors in HIV-1-infected mothers and the occurrence of HIV infection in their infants.

    Science.gov (United States)

    Mabondzo, A; Rouvier, P; Raoul, H; Le Naour, R; Courpotin, C; Hervé, F; Parnet-Mathieu, F; Lasfargues, G; Dormont, D

    1995-12-01

    Based on what is known about the biology of HIV-1 vertical transmission, the HIV burden of the mother, maternal immune factors and the integrity of the placental barrier are likely to play major roles. We therefore sought to determine whether the presence of antibodies in sera from 47 HIV-1-infected mothers, including 30 non-transmitting and 17 transmitting mothers, affected the risk of HIV-1 transmission to infants. Our findings showed no significant correlation between the capacity of antibodies to mediate antibody-dependent cell-mediated cytotoxicity (ADCC) and their capacity to induce protection of the child from HIV-1 infection (P = 0.14). Furthermore, no correlation was found between the capacity of maternal antibodies to neutralize in vitro lymphocyte or macrophage heterologous viral infection and the occurrence of in vivo HIV-1 infection in the infant. Sera recovered from five of 12 transmitting mothers and from five of 11 non-transmitting mothers were compared in their capacity to neutralize the viruses drawn from the same individuals. Four out of five maternal isolates from transmitting mothers and all maternal isolates from non-transmitting mothers were sensitive to enhancement of infection mediated by the maternal serum.

  12. Effect of Schistosoma mansoni Infection on Innate and HIV-1-Specific T-Cell Immune Responses in HIV-1-Infected Ugandan Fisher Folk.

    Science.gov (United States)

    Obuku, Andrew Ekii; Asiki, Gershim; Abaasa, Andrew; Ssonko, Isaac; Harari, Alexandre; van Dam, Govert J; Corstjens, Paul L; Joloba, Moses; Ding, Song; Mpendo, Juliet; Nielsen, Leslie; Kamali, Anatoli; Elliott, Alison M; Pantaleo, Giuseppe; Kaleebu, Pontiano; Pala, Pietro

    2016-07-01

    In Uganda, fisher folk have HIV prevalence rates, about four times higher than the national average, and are often coinfected with Schistosoma mansoni. We hypothesized that innate immune responses and HIV-specific Th1 immune responses might be downmodulated in HIV/S. mansoni-coinfected individuals compared with HIV+/S. mansoni-negative individuals. We stimulated whole blood with innate receptor agonists and analyzed supernatant cytokines by Luminex. We evaluated HIV-specific responses by intracellular cytokine staining for IFN-γ, IL-2, and TNF-α. We found that the plasma viral load and CD4 count were similar between the HIV+SM+ and HIV+SM- individuals. In addition, the TNF-α response to the imidazoquinoline compound CL097 and β-1, 3-glucan (curdlan), was significantly higher in HIV/S. mansoni-coinfected individuals compared with HIV only-infected individuals. The frequency of HIV-specific IFN-γ+IL-2-TNF-α- CD8 T cells and IFN-γ+IL-2-TNF-α+ CD4 T cells was significantly higher in HIV/S. mansoni-coinfected individuals compared with HIV only-infected individuals. These findings do not support the hypothesis that S. mansoni downmodulates innate or HIV-specific Th1 responses in HIV/S. mansoni-coinfected individuals.

  13. A Discrete Model for HIV Infection with Distributed Delay

    Directory of Open Access Journals (Sweden)

    Brahim EL Boukari

    2014-01-01

    Full Text Available We give a consistent discretization of a continuous model of HIV infection, with distributed time delays to express the lag between the times when the virus enters a cell and when the cell becomes infected. The global stability of the steady states of the model is determined and numerical simulations are presented to illustrate our theoretical results.

  14. Impairment of B-cell functions during HIV-1 infection.

    Science.gov (United States)

    Amu, Sylvie; Ruffin, Nicolas; Rethi, Bence; Chiodi, Francesca

    2013-09-24

    A variety of B-cell dysfunctions are manifested during HIV-1 infection, as reported early during the HIV-1 epidemic. It is not unusual that the pathogenic mechanisms presented to elucidate impairment of B-cell responses during HIV-1 infection focus on the impact of reduced T-cell numbers and functions, and lack of germinal center formation in lymphoid tissues. To our understanding, however, perturbation of B-cell phenotype and function during HIV-1 infection may begin at several different B-cell developmental stages. These impairments can be mediated by intrinsic B-cell defects as well as by the lack of proper T-cell help. In this review, we will highlight some of the pathways and molecular interactions leading to B-cell impairment prior to germinal center formation and B-cell activation mediated through the B-cell receptor in response to HIV-1 antigens. Recent studies indicate a regulatory role for B cells on T-cell biology and immune responses. We will discuss some of these novel findings and how these regulatory mechanisms could potentially be affected by the intrinsic defects of B cells taking place during HIV-1 infection.

  15. Candida infection in HIV positive patients 1985-2007.

    Science.gov (United States)

    Traeder, Christian; Kowoll, Susann; Arastéh, Keikawus

    2008-09-01

    Infection with Candida species remains a major problem in HIV infected patients. The analysis of over 15,000 hospitalisations (1985-2007) in the AVK cohort shows an increasing incidence of non-albicans species in candida esophagitis. Although our analysis shows a decreasing incidence of opportunistic infections like PCP, cerebral toxoplasmosis and others since the introduction of highly active antiretroviral therapy the incidence of candida esophagitis remains as high as in the years before the HAART era. This observation might reflect the development of resistance against fluconazole and the selection of non-albicans species as a consequence of a long-term prophylactic treatment of HIV+ patients over years.

  16. Zygomycosis Associated with HIV Infection and Liver Transplantation

    Directory of Open Access Journals (Sweden)

    Larry Nichols

    2011-01-01

    Full Text Available Zygomycosis is an increasing threat to patients with human immunodeficiency virus (HIV infection. Zygomycosis (formerly called mucormycosis is the fungal infection with Mucor, Rhizopus, or other species that share a common morphology of large empty pauciseptate hyphae with rare random-angle branching and a collapsed “twisted ribbon” appearance. Morphology allows a specific diagnosis on frozen section or smear prior to growth and identification of the fungi in culture which makes it improtant because treatment is different than that for more common mycoses such as candidiasis and aspergillosis. We present an informative and illustrative case of zygomycosis in a patient with HIV infection and liver transplantation.

  17. Human papillomavirus infection and disease in men: Impact of HIV

    Directory of Open Access Journals (Sweden)

    Sinead Delany-Moretlwe

    2013-12-01

    Full Text Available There is growing evidence of a significant burden of human papillomavirus (HPV infection and associated disease in men. High rates of HPV infection have been observed in men from sub-Saharan Africa where HIV prevalence is high. HIV infection increases HPV prevalence, incidence and persistence and is strongly associated with the development of anogenital warts and anal, penile and head and neck cancers in men. Despite increasing access to antiretroviral therapy, there appears to be little benefit in preventing the development of these cancers in HIV-positive men, making prevention of infection a priority. New prevention options that are being introduced in many African countries include male circumcision and HPV vaccination. However, more data are needed on the burden of HPV disease in men before boys are included in HPV vaccination programmes.

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

    DEFF Research Database (Denmark)

    Salado-Rasmussen, Kirsten; Knudsen, Andreas; Krarup, Henrik Bygum;

    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......-α), interferon gamma (IFN-γ), and IFN-γ-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...

  19. Governmental policies on HIV infection in China

    Institute of Scientific and Technical Information of China (English)

    Jie; SHEN; Dong; Bao; YU

    2005-01-01

    This article is a general review of the evolvement of HIV/AIDS-related public policies in China since 1980's. It tracks the important laws, regulations and other governmental documents in regard to HIV/AIDS prevention mainly at central level.

  20. A Hypereosinophilic Syndrome Associated with HIV Infection

    Science.gov (United States)

    1992-01-01

    syndrome and may be useful in HIV-associated cases in lieu of the already low levels of interferon - gamma in HIV patients and its negative effect on...response to recombinant interferon gamma . Br Med J 1987; 294: 1185 40. Wells JV, Ibister, Ries CA. Hematologic Diseases In: Stites DP, Sobo JD

  1. Stroke in a Patient With HIV Infection

    Directory of Open Access Journals (Sweden)

    Buse Rahime Hasırcı

    2015-08-01

    Full Text Available Stroke which is a common complication in Human immumodeficiency virus type 1 positive patients is seen between 1% and 5% in clinical series. Vasculopathy and atherogenesis in HIV are the main pathologic mechanisms of stroke. We report a 63 year old man with sudden onset of a right hemiplegia and who was diagnosed as HIV-related stroke.

  2. Triple trouble : tuberculosis, HIV infection and malnutrition

    NARCIS (Netherlands)

    Lettow, Monique Hendrika Elizabeth van

    2005-01-01

    Tuberculosis has emerged as the second commonest cause of death from infectious disease worldwide, after HIV/AIDS, killing nearly 2 million people each year. Most cases occur in less-developed countries. The human immunodeficiency virus (HIV) is the greatest single risk factor for the development of

  3. Highly active antiretroviral therapy and changing spectrum of liver diseases in HIV infected patients

    OpenAIRE

    Kavita S. Joshi; Rohit R. Shriwastav

    2016-01-01

    Background: HIV is now considered as chronic disease than a fatal disease. HIV infected individual is having normal life expectancy post highly active antiretroviral therapy (HAART) era. Liver disease is the major cause of morbidity and mortality in HIV infected patients. The objective was to study the prevalence, clinical profile of various liver diseases in HIV infected individuals on HAART and also to study aetiologies of liver involvement in HIV patients. Methods: It was a cross secti...

  4. Prevalence of psychological trauma and association with current health and functioning in a sample of HIV-infected and HIV-uninfected Tanzanian adults.

    Directory of Open Access Journals (Sweden)

    Brian W Pence

    Full Text Available In high income nations, traumatic life experiences such as childhood sexual abuse are much more common in people living with HIV/AIDS (PLWHA than the general population, and trauma is associated with worse current health and functioning. Virtually no data exist on the prevalence or consequences of trauma for PLWHA in low income nations.We recruited four cohorts of Tanzanian patients in established medical care for HIV infection (n = 228, individuals newly testing positive for HIV (n = 267, individuals testing negative for HIV at the same sites (n = 182, and a random sample of community-dwelling adults (n = 249. We assessed lifetime prevalence of traumatic experiences, recent stressful life events, and current mental health and health-related physical functioning. Those with established HIV infection reported a greater number of childhood and lifetime traumatic experiences (2.1 and 3.0 respectively than the community cohort (1.8 and 2.3. Those with established HIV infection reported greater post-traumatic stress disorder (PTSD symptomatology and worse current health-related physical functioning. Each additional lifetime traumatic experience was associated with increased PTSD symptomatology and worse functioning.This study is the first to our knowledge in an HIV population from a low income nation to report the prevalence of a range of potentially traumatic life experiences compared to a matched community sample and to show that trauma history is associated with poorer health-related physical functioning. Our findings underscore the importance of considering psychosocial characteristics when planning to meet the health needs of PLWHA in low income countries.

  5. STD Clinic Patients' Awareness of Non-AIDS Complications of HIV Infection

    Science.gov (United States)

    Castro, José Guillermo; Granovsky, Inna; Jones, Deborah; Weiss, Stephen M.

    2016-01-01

    Participants were recruited from a sexually transmitted disease (STD) clinic in Florida and were assessed regarding the knowledge and awareness of non-AIDS conditions associated with HIV infection. Questionnaires were administered before and after a brief information session on non-AIDS conditions associated with HIV infection. Participants included men (n = 46) and women (n = 51). Prior to the information session, at baseline, only 34% of the participants were worried about HIV infection. Most participants (82%) agreed that HIV could be treated with antiretroviral therapy (ART), while only 38% were aware that HIV-associated conditions cannot be easily treated with ART. After the information session, almost all participants reported they were concerned regarding the risk of HIV infection. High-risk patients may have limited knowledge about the consequences of HIV infection beyond the traditional AIDS-associated conditions. Increased awareness of these less known consequences of HIV infection may decrease the potential for complacency regarding acquiring HIV infection. PMID:25331221

  6. Determinants of IL-6 levels during HIV infection

    DEFF Research Database (Denmark)

    Borges, Alvaro H; O'Connor, Jemma L; Phillips, Andrew N

    2014-01-01

    INTRODUCTION: Elevated IL-6 levels have been linked to increased risk of cardiovascular disease (CVD), cancer and death. Compared to the general population, treated HIV+ persons have 50-100% higher IL-6 levels, but few data on the determinants of IL-6 levels during HIV infection currently exist....... MATERIAL AND METHODS: Participants in three international HIV trials (SMART, ESPRIT and SILCAAT) with IL-6 plasma levels measured at baseline were included (N=9864). Factors independently associated with log2-transformed IL-6 level were identified by multivariate linear regression; exponentiated estimates...... corresponding to fold differences (FDs) in IL-6 were calculated. Demographics (age, gender, race, BMI) and HIV-specific variables (nadir and entry CD4 counts, HIV-RNA, use of different ART regimens) were investigated in all three trials. In SMART (N=4498), smoking, comorbidities (CVD, diabetes, hepatitis B...

  7. Tubuloreticular inclusions in skin biopsies from patients with HIV infection

    DEFF Research Database (Denmark)

    Pedersen, C; Horn, T; Junge, Jette;

    1989-01-01

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

  8. Chemokine control of HIV-1 infection: Beyond a binding competition

    Directory of Open Access Journals (Sweden)

    Wu Yuntao

    2010-10-01

    Full Text Available Abstract A recent paper by Cameron et al. demonstrated that certain chemokines such as CCL19 activate cofilin and actin dynamics, promoting HIV nuclear localization and integration into resting CD4 T cells. Apparently, these chomokines synergize with the viral envelope protein, triggering cofilin and actin dynamics necessary for the establishment of viral latency. This study opens a new avenue for understanding chemokine interaction with HIV. Traditionally, chemokine control of HIV infection focuses on competitive binding and down-modulation of the corecptors, particularly CCR5. This new study suggests that a diverse group of chemokines may also affect HIV infection through synergistic or antagonistic interaction with the viral coreceptor signaling pathways.

  9. Neurological aspects at children with a perinatal HIV-infection

    Directory of Open Access Journals (Sweden)

    M. Yu. Fomina

    2010-01-01

    Full Text Available In the given research results of inspection of children with a HIV-infection are analyzed at perinatal ways. 550 children from a birth till 10 years are surveyed. The neurological status of patients, the data immunological and virologic inspection of plasma and cerebrospinal fluid is studied. It is spent neuroimaging and psychometric testing. It is shown that defeat of nervous system is HIV-infection display at children’s age. A HIV-induced defeat of the central and peripheral nervous system is presented, first of all, to specific HIV-encephalitis with sharp and sub acute a current. Are revealed clinical and immunological correlations at various stages of infectious process, influence antiretroviral therapies on dynamics of neurological infringements is analyzed.

  10. Thirty Years with HIV Infection-Nonprogression Is Still Puzzling

    DEFF Research Database (Denmark)

    Gaardbo, Julie C; Hartling, Hans J; Gerstoft, Jan;

    2012-01-01

    mechanisms. Understanding the lack of disease progression and the different interactions between HIV and the immune system could ideally teach us how to develop a functional cure for HIV infection. Here we review immunological features of controllers and LTNP, highlighting differences and clinical......In the early days of the HIV epidemic, it was observed that a minority of the infected patients did not progress to AIDS or death and maintained stable CD4+ cell counts. As the technique for measuring viral load became available it was evident that some of these nonprogressors in addition......, host differences in the immunological response have been proposed. Moreover, the immunological response can be divided into an immune homeostasis resistant to HIV and an immune response leading to viral control. Thus, non-progression in LTNP and controllers may be due to different immunological...

  11. Raltegravir with optimized background therapy for resistant HIV-1 infection

    DEFF Research Database (Denmark)

    Steigbigel, Roy T; Cooper, David A; Kumar, Princy N;

    2008-01-01

    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......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...

  12. Specific Elimination of Latently HIV-1 Infected Cells Using HIV-1 Protease-Sensitive Toxin Nanocapsules.

    Science.gov (United States)

    Wen, Jing; Yan, Ming; Liu, Yang; Li, Jie; Xie, Yiming; Lu, Yunfeng; Kamata, Masakazu; Chen, Irvin S Y

    2016-01-01

    Anti-retroviral drugs suppress HIV-1 plasma viremia to undetectable levels; however, latent HIV-1 persists in reservoirs within HIV-1-infected patients. The silent provirus can be activated through the use of drugs, including protein kinase C activators and histone deacetylase inhibitors. This "shock" approach is then followed by "kill" of the producing cells either through direct HIV-1-induced cell death or natural immune mechanisms. However, these mechanisms are relatively slow and effectiveness is unclear. Here, we develop an approach to specifically target and kill cells that are activated early in the process of virus production. We utilize a novel nanocapsule technology whereby the ricin A chain is encapsulated in an inactive form within a polymer shell. Specificity for release of the ricin A toxin is conferred by peptide crosslinkers that are sensitive to cleavage by HIV-1 protease. By using well-established latent infection models, J-Lat and U1 cells, we demonstrate that only within an HIV-1-producing cell expressing functional HIV-1 protease will the nanocapsule release its ricin A cargo, shutting down viral and cellular protein synthesis, and ultimately leading to rapid death of the producer cell. Thus, we provide proof of principle for a novel technology to kill HIV-1-producing cells without effects on non-target cells.

  13. [Organ transplants in HIV infected patients. Update and recommendations].

    Science.gov (United States)

    Barcan, Laura; Gadano, Adrian; Casetti, Isabel; Villamil, Federico

    2011-01-01

    Until few years ago, HIV infection was an absolute contraindication to consider organ transplants. Since HAART introduction, patient survival increased dramatically, but high mortality due to liver and kidney diseases became evident. For these reasons, this group of patients is now reconsidered for organ transplantation. In 2008, the Argentine Society of Transplants (SAT) and the Argentine Infectious Diseases Society (SADI), encouraged by the increasing published experience on kidney and liver transplants in this population, decided to form a Working Group, to prepare an update on this issue and elaborate practical recommendations for the better management of these patients. The first meeting was held on December 4th 2008. The most important conclusion was that HIV infection did not contraindicate a solid organ transplant. Later on, taking into account the accumulated experience and the available literature, the current document was prepared. HIV infected patients must fulfill certain clinical, immunological, virological and psychosocial criteria to be considered for solid organ transplants. HIV infected recipients of kidney and liver transplants currently show similar short and middle term survival to non HIV infected patients. There is not yet enough data on intrathoracic transplants in these patients in order to include them on a waiting list for these organs-transplants. Interactions between immunosupressors and antiretroviral drugs (specially protease inhibitors) are very important, and require a strict monitoring of immunosupressor levels.

  14. Stroke in a patient with tuberculous meningitis and HIV infection

    Directory of Open Access Journals (Sweden)

    Maria Bruna Pasticci

    2013-02-01

    Full Text Available Abstract. Tuberculous meningitis (TBM is a devastating disease. TBM occurs more commonly in HIV infected patients. The influence of HIV co-infection on clinical manifestations and outcome of TBM is not well defined. Yet, some differences have been observed and stroke has been recorded to occur more frequently. This study reports on an HIV infected Caucasian female with lung, meningeal tuberculosis and stroke due to a cortical sub-cortical ischemic lesion.TBM was documented in the absence of neurologic symptoms. At the same time, miliary lung TB caused by multi-susceptible Mycobacterium tuberculosis was diagnosed. Anti-TB therapy consisting of a combination of four drugs was administered. The patient improved and was discharged five weeks later. In conclusion, TBM and multiple underling pathologies including HIV infection, as well as other risk factors can lead to a greater risk of stroke. Moreover, drug interactions and their side effects add levels of complexity. TBM must be included in the differential diagnosis of HIV infected patients with stroke and TBM treatment needs be started as soon as possible before the onset of vasculopathy.

  15. Cardiovascular risk and dyslipidemia management in HIV-infected patients.

    Science.gov (United States)

    Stein, James H

    2012-01-01

    HIV infection and antiretroviral therapy each appear to increase cardiovascular disease risk. Increased risk may be attributable to the inflammatory effects of HIV infection and dyslipidemia associated with some antiretroviral agents. The prevalence of cardiovascular disease is increasing as patients live longer, age, and acquire traditional coronary heart disease (CHD) risk factors. In general, any additional cardiovascular risk posed by HIV infection or antiretroviral therapy is of potential concern for patients who are already at moderate or high risk for CHD. Long-term and well-designed studies are needed to more accurately ascertain to what degree HIV infection and antiretroviral therapy affect long-term cardiovascular disease risk. Management of dyslipidemia to reduce CHD risk in HIV-infected patients is much the same as in the general population, with the cornerstone consisting of statin therapy and lifestyle interventions. Smoking cessation is a major step in reducing CHD risk in those who smoke. This article summarizes a presentation by James H. Stein, MD, at the IAS-USA live continuing medical education activity held in New York City in March 2012.

  16. Abuse

    Science.gov (United States)

    ... indicate neglect. Belittling, threats or other uses of power by spouses, family members or others may indicate verbal or emotional abuse. Strained or tense relationships and frequent arguments between ...

  17. Twin pregnancy in a liver transplant recipient with HIV infection.

    Science.gov (United States)

    Van Schalkwyk, McI; Westbrook, R H; O'Beirne, J; Wright, A; Gonzalez, A; Johnson, M A; Kinloch-de Loës, S

    2016-10-05

    We are not aware of a report detailing the complex obstetrical and medical management of twin pregnancy in the context of HIV infection and early post-liver transplantation period. Here we describe the successful outcome of a twin pregnancy in a 28-year-old HIV-positive female receiving antiretroviral therapy and immunosuppressive therapy who was the recipient of a liver transplant for previous drug-induced liver failure.

  18. Profile of HIV-Infected Hispanics with Pancytopenia

    OpenAIRE

    2015-01-01

    Pancytopenia is seen in late HIV infection; it is associated with medical complications and with decreased survival. We determined the prevalence of pancytopenia at baseline in a cohort of HIV-positive Hispanics living in Puerto Rico, and compared their socio-demographic, immunological and clinical characteristics. A total of 1202 patients enrolled between 2000 and 2010 were included. They were grouped according to pancytopenia status, defined by having: platelets <150,000 μL, white cell c...

  19. Maternal Substance Use and HIV Status: Adolescent Risk and Resilience

    Science.gov (United States)

    Leonard, Noelle R.; Gwadz, Marya Viorst; Cleland, Charles M.; Vekaria, Pooja C.; Ferns, Bill

    2008-01-01

    We examined the risk and protective factors and mental health problems of 105 low SES, urban adolescents whose mothers were coping with alcohol abuse and other drug problems. Approximately half of the mothers were also HIV-infected. As hypothesized, there were few differences between adolescents of HIV-infected and HIV-uninfected mothers in…

  20. Tubuloreticular inclusions in skin biopsies from patients with HIV infection

    DEFF Research Database (Denmark)

    Pedersen, C; Horn, T; Junge, Jette;

    1989-01-01

    Skin biopsies obtained from apparently normal skin from 15 HIV infected patients and 6 anti-HIV negative patients were examined by electron microscopy. Tubuloreticular inclusions (TRI) were detected within the cytoplasm of capillary endothelial cells in 5/5 AIDS patients and in 2/5 patients...... with AIDS related conditions. Biopsies from 5 asymptomatic HIV positive patients and the 6 control subjects were without ultrastructural alterations. The occurrence of TRI was related to low numbers of CD 4+ lymphocytes. 5/7 patients with TRI had elevated serum interferon activity, and in all...

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

    Directory of Open Access Journals (Sweden)

    Zhang Lei

    2012-05-01

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

  2. CLINICAL SPECTRUM OF OPPORTUNISTIC INFECTIONS IN HIV POSITIVE PATIENTS

    Directory of Open Access Journals (Sweden)

    Usmani

    2015-03-01

    Full Text Available The human immunodeficiency virus (HIV infection leading to Acquired Immunodeficiency Syndrome (AIDS causes progressive decline in immunological response in people living with HIV/AIDS, making them susceptible to a variety opportunistic infections (OIs which are responsible for morbidity and mortality. Therefore early diagnosis and management of opportunistic infections reduce the mortality and morbidity in HIV positive patients. CONTEXT : AIMS : To study the demographic variables; spectrum of opportunist ic infections and its correlation with CD4 count in HIV patients. SETTING AND DESIGN : The study was conducted on 200 HIV patients either admitted to Sanjay Gandhi Memorial Hospital or attending ART Center, Sh y am Shah Medical College, Rewa (M.P from Januar y 2013 to October 2014. METHODS AND MATERIAL : A detailed history was recorded with emphasis on personal history, high risk behavior, history of migration, mode of transmission of infection and complete thorough clinical examination was done. Data analysis was done by calculating P value using Chi Square test. RESULTS : Out of 200 HIV patients, most of them (88% belonged to the age group 20 - 49 years, 66% were males and 34% were females. 45% were illiterates, 62% were from low socioeconomic class. Majority of patients were married (79% and 72.2% had seropositive spouse. Unprotected sexual route was the most common (85% mode of transmission; among which heterosexual route was the only mode of transmission. 59.4% of males contracted infection through unprotect ed sex with either commercial sex workers (44.8% or multiple sex partners (14.6%. 61% of patients had history of emigration. Tuberculosis was the most common opportunistic infection (51%, followed by oral candidiasis 30% and chronic diarrhea (9%.Pulmon ary Tuberculosis was the most common form of Tuberculosis (64.7%, followed by tubercular lymphadenopathy (15.7%. CONCLUSION : HIV/AIDS has no vaccine or cure, so prevention is the only

  3. Oral and airway microbiota in HIV-infected pneumonia patients.

    Science.gov (United States)

    Iwai, Shoko; Fei, Matthew; Huang, Delphine; Fong, Serena; Subramanian, Anuradha; Grieco, Katherine; Lynch, Susan V; Huang, Laurence

    2012-09-01

    Despite the increased frequency of recurrent pneumonia in HIV-infected patients and recent studies linking the airway bacterial community (microbiota) to acute and chronic respiratory infection, little is known of the oral and airway microbiota that exist in these individuals and their propensity to harbor pathogens despite antimicrobial treatment for acute pneumonia. This pilot study compared paired samples of the oral and airway microbiota from 15 hospitalized HIV-infected patients receiving antimicrobial treatment for acute pneumonia. Total DNA was extracted, bacterial burden was assessed by quantitative PCR, and amplified 16S rRNA was profiled for microbiome composition using a phylogenetic microarray (16S rRNA PhyloChip). Though the bacterial burden of the airway was significantly lower than that of the oral cavity, microbiota in both niches were comparably diverse. However, oral and airway microbiota exhibited niche specificity. Oral microbiota were characterized by significantly increased relative abundance of multiple species associated with the mouth, including members of the Bacteroides, Firmicutes, and TM7 phyla, while airway microbiota were primarily characterized by a relative expansion of the Proteobacteria. Twenty-two taxa were detected in both niches, including Streptococcus bovis and Chryseobacterium species, pathogens associated with HIV-infected populations. In addition, we compared the airway microbiota of five of these patients to those of five non-HIV-infected pneumonia patients from a previous study. Compared to the control population, HIV-infected patients exhibited relative increased abundance of a large number of phylogenetically distinct taxa, which included several known or suspected pathogenic organisms, suggesting that recurrent pneumonia in HIV-infected populations may be related to the presence of these species.

  4. Heterosexually Acquired HIV Infection in a Chinese Population in Malaysia-HIV/AIDS control policy recommendations

    Institute of Scientific and Technical Information of China (English)

    王京

    2001-01-01

    @@ Introduction HIV infection and AIDS has emerged as a major public health problem all over the world. In the1980s,the infection was first found to be transmitted through homosexual activity and blood product transfusion. Now it is spreading among heterosexuals and injection drug users, and can be transmitted from mothers to infants.

  5. Intrinsic network connectivity abnormalities in HIV-infected individuals over age 60.

    Science.gov (United States)

    Guha, Anika; Wang, Liang; Tanenbaum, Aaron; Esmaeili-Firidouni, Pardis; Wendelken, Lauren A; Busovaca, Edgar; Clifford, Katherine; Desai, Akash; Ances, Beau M; Valcour, Victor

    2016-02-01

    Individuals infected with HIV are living longer due to effective treatment with combination antiretroviral therapy (cART). Despite these advances, HIV-associated neurocognitive disorders (HAND) remain prevalent. In this study, we analyzed resting state functional connectivity (rs-fc) data from HIV-infected and matched HIV-uninfected adults aged 60 years and older to determine associations between HIV status, neuropsychological performance, and clinical variables. HIV-infected participants with detectable plasma HIV RNA exhibited decreased rs-fc within the salience (SAL) network compared to HIV-infected participants with suppressed plasma HIV RNA. We did not identify differences in rs-fc within HIV-infected individuals by HAND status. Our analysis identifies focal deficits in the SAL network that may be mitigated with suppression of plasma virus. However, these findings suggest that rs-fc may not be sensitive as a marker of HAND among individuals with suppressed plasma viral loads.

  6. AIDS impact special issue 2015: interpersonal factors associated with HIV partner disclosure among HIV-infected people in China.

    Science.gov (United States)

    Qiao, Shan; Li, Xiaoming; Zhou, Yuejiao; Shen, Zhiyong; Tang, Zhenzhu

    2016-01-01

    HIV partner disclosure may facilitate social support, improve psychological well-being among HIV-infected individuals, and promote HIV testing and HIV prevention among their sexual partners. A growing literature emphasizes the critical role of interpersonal factors may play in decision-making and practice regarding HIV partner disclosure. However, there is a dearth of empirical studies that investigate how interpersonal factors may be associated with HIV partner disclosure. Using cross-sectional data collected from 791 HIV-infected people in Guangxi China, we examined the associations between these two interpersonal factors (quality of relationship with partner and family communication) and HIV partner disclosure. Descriptive analysis, t-test analysis, and gender stratified GLM analysis were conducted. We find that disclosing HIV status to partners was significantly related to better quality of relationship with partners and open and effective family communication. Gender and partner HIV status might moderate the associations between interpersonal factors and HIV partner disclosure. Our findings suggest the importance of considering relationship quality and enhancing open and comfortable family communication in HIV disclosure interventions. Gender difference and partner HIV status should be also considered in HIV disclosure intervention to address the diverse needs of HIV-infected people.

  7. Cytotoxic T lymphocyte activity in children infected with HIV.

    Science.gov (United States)

    Froebel, K S; Aldhous, M C; Mok, J Y; Hayley, J; Arnott, M; Peutherer, J F

    1994-01-01

    Of the Edinburgh cohort of approximately 130 children born to HIV-infected women, 9 are infected and alive. This article describes results from the first 18 months of a natural history study of seven of these, and two adopted children, studying the CD8 T cell-mediated cytotoxicity against HIV proteins (Gag, Tat, Pol, and Env), over time, and relating it to clinical progression and viral activity. Autologous EBV cell lines infected with vaccinia-HIV constructs were used as target cells, and bulk-cultured peripheral blood mononuclear cells as effector cells. The children ranged in age from 0 to 93 months, with six of the nine showing CTL activity to one or more HIV proteins. The specificity of the response was directed against Tat in the younger children, switching to Pol, then Gag or Env. Preliminary analysis of virological data showed no association between CTL and virus activity. The children with CTLs tended to be well clinically, but the cohort needs to be studied longer before conclusions can be made about CTL activity and HIV disease progression. Cytotoxic T lymphocyte activity has also been observed in two children diagnosed as HIV uninfected. These results show the importance of looking at CTL specificity, and may have implications in vaccine design.

  8. 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

  9. Increased longevity in HIV: caring for older HIV-infected adults.

    Science.gov (United States)

    Ball, Susan C

    2014-01-01

    The demographics of the HIV-infected population in the United States have shifted in a way that few would have predicted 30 years ago when the tide of sick and dying patients largely consisted of young men. Effective ART has allowed those infected to live long, productive lives and to grow old with their disease. With the increase in life expectancy afforded by HIV treatment, the cause of death among HIV-infected individuals is far more likely to be from an HIV-associated non-AIDS condition. Nonetheless, HIV seems to accelerate the aging process, and care providers involved in the treatment of older patients with HIV need to be aware that their patients are at increased risk of developing various common disorders, compared to uninfected same-age patients. Clinicians need to remain vigilant to the possibility of a new diagnosis of HIV among their older patients. Awareness of current or distant risk, frank discussions of sexual practices, and willingness to offer routine testing are crucial to making this diagnosis, with the recognition that longevity for patients with HIV is directly linked to how soon they enter care. HIV infection adds another challenge to the management of older patients; geriatricians and HIV specialists need to coordinate their efforts to provide patients with comprehensive multidisciplinary care. Older patients with HIV also have social and psychological needs that extend beyond the medical office. Maintaining independence, acknowledging limitations, reducing risk of adverse events such as falls or medication errors, and supporting self-acceptance and awareness are only a few of the many areas where care providers outside the medical office can be important for patients' ongoing well-being. Accessing family support, community outreach, church affiliation, or other outpatient support networks can be useful for patients. The remarkable change in prognosis brought about by effective ART in the mid-1990s has meant that HIV is now, for many, a

  10. Sulforaphane Inhibits HIV Infection of Macrophages through Nrf2.

    Directory of Open Access Journals (Sweden)

    Andrea Kinga Marias Furuya

    2016-04-01

    Full Text Available Marburg virus, the Kaposi's sarcoma-associated herpesvirus (KSHV and Dengue virus all activate, and benefit from, expression of the transcription regulator nuclear erythroid 2-related factor 2 (Nrf2. The impact of Nrf2 activation on human immunodeficiency virus (HIV infection has not been tested. Sulforaphane (SFN, produced in cruciferous vegetables after mechanical damage, mobilizes Nrf2 to potently reprogram cellular gene expression. Here we show for the first time that SFN blocks HIV infection in primary macrophages but not in primary T cells. Similarly SFN blocks infection in PMA-differentiated promonocytic cell lines, but not in other cell lines tested. siRNA-mediated depletion of Nrf2 boosted HIV infectivity in primary macrophages and reduced the anti-viral effects of SFN treatment. This supports a model in which anti-viral activity is mediated through Nrf2 after it is mobilized by SFN. We further found that, like the type I interferon-induced cellular anti-viral proteins SAMHD1 and MX2, SFN treatment blocks infection after entry, but before formation of 2-LTR circles. Interestingly however, neither SAMHD1 nor MX2 were upregulated. This shows for the first time that Nrf2 action can potently block HIV infection and highlights a novel way to trigger this inhibition.

  11. 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.

  12. Assessment of nutritional status of HIV-infected patients at a tertiary centre in North India.

    Science.gov (United States)

    Malhotra, Sunita; Wanchu, Ajay; Khurana, Sudha

    2007-07-01

    Infection with HIV has an adverse effect on nutritional status, and can result in progressive involuntary weight loss. We assessed the nutritional status of our patients with HIV infection and found that HIV-infected patients had significantly low nutrient intake and body mass index as compared with controls. Involuntary weight loss, altered body composition and reduced nutritional status were present throughout the stages of HIV infection.

  13. Economic costs of HIV infection: an employer's perspective.

    Science.gov (United States)

    Liu, G G; Yin, D D; Lyu, R; Chaikledkaew, U; Louie, S

    2002-01-01

    The introduction of highly active antiretroviral therapy has proven highly effective in treating patients with HIV/AIDS. However, the high cost of the advanced antiretroviral therapy has led to increased financial constraints on both patients and payers. From business firms'perspective, especially those with operations in developing countries, it is crucial to determine the long-term economic cost implications of alternative employment and benefit policies for HIV-infected workers or those at high risk for the disease. A simulation model is developed to predict the comprehensive lifetime economic costs of HIV-infected workers to an employer. This model employs age,CD4(+) cell counts,and plasma HIV-1 RNA level as major predictors of the disease progression and patient survival in the determination of various cost functions. Major cost components considered include direct expenses on health insurance premium,life insurance premium, short-term disability benefits, long-term disability benefits, hiring/training expenses, and indirect costs resulting from reduced or lost productivity at work. An individual model and a group model are derived to estimate the costs of an individual and a group of HIV-infected patients, respectively. Over a 10-year period, following the nonadvanced antiretroviral treatment regimen, the group model predicts that the total lifetime cost of an HIV-infected worker can be as high as U.S. 90,000 dollars to his/her employer, of which 60,000 dollars would be various explicit costs and 30,000 dollars lost work productivity. Sensitivity analysis further demonstrated that changes in the initial level of age,CD4(+) cell count, HIV-1 RNA viral load,CD4(+) cell decline rate, and the costs of medical care influence the dynamics of the cost functions. HIV infection can result in sizable economic costs to an employer over the lifetime course of an infected employee if not treated with the advanced antiretroviral therapy. These cost estimates provide a

  14. 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.

  15. Clinical presentation and opportunistic infections in HIV-1, HIV-2 and HIV-1/2 dual seropositive patients in Guinea-Bissau

    DEFF Research Database (Denmark)

    Sørensen, Allan; Jespersen, Sanne; Katzenstein, Terese L;

    2016-01-01

    BACKGROUND: Better understanding of HIV-2 infection is likely to affect the patient care in areas where HIV-2 is prevalent. In this study, we aimed to characterize the clinical presentations among HIV-1, HIV-2 and HIV-1/2 dual seropositive patients. METHODS: In a cross-sectional study, newly...... diagnosed HIV patients attending the HIV outpatient clinic at Hospital Nacional Simão Mendes in Guinea-Bissau were enrolled. Demographical and clinical data were collected and compared between HIV-1, HIV-2 and HIV-1/2 dual seropositive patients. RESULTS: A total of 169 patients (76% HIV-1, 17% HIV-2 and 6......% HIV 1/2) were included in the study between 21 March 2012 and 14 December 2012. HIV-1 seropositive patients were younger than HIV-2 and HIV-1/2 seropositive patients, but no difference in sex was observed. Patients with HIV-1 and HIV-1/2 had a lower baseline CD4 cell count than HIV-2 seropositive...

  16. Urinary tract infections in special populations: diabetes, renal transplant, HIV infection, and spinal cord injury.

    Science.gov (United States)

    Nicolle, Lindsay E

    2014-03-01

    Some populations have unique considerations relevant to complicated urinary tract infection. For patients with diabetes, renal transplant, HIV infection, and spinal cord injuries, approaches to management, including diagnosis and treatment, are generally similar to other patients with complicated urinary tract infection. In addition, there is no evidence that treatment of asymptomatic bacteriuria leads to improved outcomes.

  17. Recreational drug use and T lymphocyte subpopulations in HIV-uninfected and HIV-infected men.

    Science.gov (United States)

    Chao, Chun; Jacobson, Lisa P; Tashkin, Donald; Martínez-Maza, Otoniel; Roth, Michael D; Margolick, Joseph B; Chmiel, Joan S; Rinaldo, Charles; Zhang, Zuo-Feng; Detels, Roger

    2008-04-01

    The effects of recreational drugs on CD4 and CD8 T cells in humans are not well understood. We conducted a longitudinal analysis of men who have sex with men (MSM) enrolled in the Multicenter AIDS Cohort Study (MACS) to define associations between self-reported use of marijuana, cocaine, poppers and amphetamines, and CD4 and CD8 T cell parameters in both HIV-uninfected and HIV-infected MSM. For the HIV-infected MSM, we used clinical and laboratory data collected semiannually before 1996 to avoid potential effects of antiretroviral treatment. A regression model that allowed random intercepts and slopes as well as autoregressive covariance structure for within subject errors was used. Potential confounders adjusted for included length of follow-up, demographics, tobacco smoking, alcohol use, risky sexual behaviors, history of sexually transmitted infections, and antiviral therapy. We found no clinically meaningful associations between use of marijuana, cocaine, poppers, or amphetamines and CD4 and CD8 T cell counts, percentages, or rates of change in either HIV-uninfected or -infected men. The regression coefficients were of minimum magnitude despite some reaching statistical significance. No threshold effect was detected for frequent (at least weekly) or continuous substance use in the previous year. These results indicate that use of these substances does not adversely affect the numbers and percentages of circulating CD4 or CD8 T cells in either HIV-uninfected or -infected MSM.

  18. Determinants of survival among HIV-infected chronic dialysis patients.

    Science.gov (United States)

    Rodriguez, Rudolph A; Mendelson, Michael; O'Hare, Ann M; Hsu, Ling Chin; Schoenfeld, Patricia

    2003-05-01

    Over 100 HIV-infected patients have initiated chronic dialysis at San Francisco General Hospital (SFGH) since 1985. This study employed retrospective analysis to identify determinants of and trends in survival among HIV-infected patients who have initiated chronic dialysis at SFGH from January 1, 1985 to November 1, 2002 (n = 115). Cohort patient survival was compared with survival after an AIDS-opportunistic illness in all HIV-infected patients in San Francisco during the study period. Higher CD4 count (hazard ratio [HR], 0.86 per 50 cells/mm(3) increase; 95% confidence interval [CI], 0.80 to 0.93) and serum albumin (HR, 0.53 per 1 g/dl increase; CI, 0.36 to 0.78) at initiation of dialysis were strongly associated with lower mortality. Survival for those initiating dialysis during the era of highly active antiretroviral therapy (HAART) was 16.1 mo versus 9.4 mo for those initiating dialysis before this time, but this difference was not statistically significant. In adjusted analysis, only a non-statistically significant trend toward improved survival during the HAART era was noted (HR, 0.59; CI, 0.34 to 1.04). By comparison, survival for all HIV-infected patients after an AIDS-opportunistic illness in San Francisco increased from 16 mo in 1994 to 81 mo in 1996. The dramatic improvement in survival that has occurred since the mid-1990s for patients with HIV appears to be greatly attenuated in the sub-group undergoing dialysis. Although this may partly reflect confounding by race, injection drug use and HCV co-infection, future attempts to improve survival among HIV-infected dialysis patients should focus on barriers to the effective use of HAART in this group.

  19. Ampelopsin, a Small Molecule Inhibitor of HIV-1 Infection Targeting HIV Entry

    Institute of Scientific and Technical Information of China (English)

    DE-YU LIU; JIAN-TAO YE; WEN-HUI YANG; JIN YAN; CHANG-HONG ZENG; SA ZENG

    2004-01-01

    Objective To investigate the anti-HIV effects of ampelopsin and its interaction with HIV-1 coreceptor CXCR4. Methods Through anti-virus experiments in vitro, the inhibitory effect of ampelopsin on HIV-1 infection was verified. Chemotaxis assay was performed to show the ability to induce PBMCs migration by ampelopsin, RANTES and SDF-1(. Fluorescence labelling monoclonal antibody was utilized to observe the interaction of ampelopsin and CXCR4. Mice immunosuppressant model was also established to detail the role ampelopsin played in regulating cellular immunological functions. Results Ampelopsin could protect sensitive cells against HIV-1 infection and dramatically reduce HIV-1 antigen P24 expression. HIV-1SF33 attaching to MT-4 cells was interfered by ampelopsin, and the EC50 was 0.175 mg/mL for cellular protection and 0.024 mg/mL for P24 inhibition. At co-cultivating phase, EC50 was 0.229 mg/mL and 0.197 mg/mL respectively. Furthermore, the EC50 was 0.179 mg/mL and 0.348 mg/mL in acute infection. Human PBMCs migration was induced after being challenged with ampelopsin or chemokines, and synergistic action was observed during co-treatment. Ampelopsin alone resulted in maximal chemotaxis at 1 mg/mL. HIV-1 co-receptor CXCR4 on the surface of PBMCs was decreased by internalization, which indicated the effect of ampelopsin on CXCR4. About 70% CXCR4 was reduced by ampelopsin at 1 mg/mL. Ampelopsin also augmented cellular immunological functions in immunosuppressive mice. Conclusion Ampelopsin displays a strong inhibitive role during HIV-1 absorption, incubation and acute infection. These results are coincident with its immune enhancement.

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

    Directory of Open Access Journals (Sweden)

    Okeoma Mmeje

    2012-01-01

    Full Text Available 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.

  1. Vitamin D and clinical disease progression in HIV infection

    DEFF Research Database (Denmark)

    Viard, Jean-Paul; Souberbielle, Jean-Claude; Kirk, Ole

    2011-01-01

    BACKGROUND:: We examined the association between vitamin D [25(OH)D] level and disease progression in HIV infection. METHODS:: Within the EuroSIDA study, 2000 persons were randomly selected for 25(OH)D measurement in stored plasma samples closest to study entry. 25(OH)D results were stratified......, persons of black ethnic origin, living outside Southern Europe/Argentina, sampled during winter, and infected with HIV through non-homosexual exposure were at higher odds of having low 25(OH)D levels, while persons receiving protease inhibitors were at lower odds. Compared to those in the lowest 25(OH...

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

    Lifescience Database Archive (English)

    Full Text Available 18178131 Is HIV infection a TNF receptor signalling-driven disease? Herbein G, Khan... KA. Trends Immunol. 2008 Feb;29(2):61-7. (.png) (.svg) (.html) (.csml) Show Is HIV infection a TNF receptor signalling-driven dise...ase? PubmedID 18178131 Title Is HIV infection a TNF receptor signalling-driven diseas

  3. The central role of the CD4 T-helper cell in HIV infection : Analysis of cell mediated responses and CCR-5 genotypes in HIV-1 infected individuals

    OpenAIRE

    2001-01-01

    Human immunodeficiency virus (HIV) infection is characterized by progressive immunologic dysregulation. The main target of HIV is the CD4 cell resulting in malfunction of the immune system, with a decline in CD4 cells and subsequent development of the acquired immunodeficiency syndrome (AIDS). HIV-infected individuals show impaired responses to antigenic stimulation, particularly to HIV proteins, even before a significant decline in the number of CD4 cells is observed. T...

  4. [Control of HCV, HBV and HIV Infections in Hemodialysis].

    Science.gov (United States)

    Fabrizi, Fabrizio; Martin, Paul; Messa, Piergiorgio

    2013-01-01

    Infections with blood-borne pathogens are still common among patients on maintenance dialysis all over the world. The control of infection due to blood-borne viruses (particularly HBV) within dialysis units has been a major goal in the management of patients with chronic kidney disease in the industrialized world. Standard precautions and specific procedures have been recommended to prevent infections with HBV, HCV and HIV within dialysis units. Isolation of HBsAg positive patients by dialysis rooms, staff and machines continues to be an important step to control HBV infection within dialysis units, according to the CDC and other regulatory agencies. Some prospective observational studies have reported the complete prevention of HCV transmission to hemodialysis patients in the absence of any isolation policy, and the use of dedicated dialysis machines for HCV-infected patients is not recommended by clinical guidelines. Isolation of HCV-infected patients should be considered in special circumstances only. Vaccination is an important tool against transmission of HBV among patients on long-term dialysis even if the immune response towards the hepatitis B vaccine remains unsatisfactory. Hemodialysis is considered a low risk setting for the transmission of human immunodeficiency virus (HIV) infection, providing that standard and specific procedures are carefully observed. HIV-infected patients do not have to be isolated from other patients or dialyzed separately on dedicated machines.

  5. 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.

  6. Potential health impacts of heavy metals on HIV-infected population in USA.

    Directory of Open Access Journals (Sweden)

    Xiaohui Xu

    Full Text Available PURPOSE: Noninfectious comorbidities such as cardiovascular diseases have become increasingly prevalent and occur earlier in life in persons with HIV infection. Despite the emerging body of literature linking environmental exposures to chronic disease outcomes in the general population, the impacts of environmental exposures have received little attention in HIV-infected population. The aim of this study is to investigate whether individuals living with HIV have elevated prevalence of heavy metals compared to non-HIV infected individuals in United States. METHODS: We used the National Health and Nutrition Examination Survey (NHANES 2003-2010 to compare exposures to heavy metals including cadmium, lead, and total mercury in HIV infected and non-HIV infected subjects. RESULTS: In this cross-sectional study, we found that HIV-infected individuals had higher concentrations of all heavy metals than the non-HIV infected group. In a multivariate linear regression model, HIV status was significantly associated with increased blood cadmium (p=0.03 after adjusting for age, sex, race, education, poverty income ratio, and smoking. However, HIV status was not statistically associated with lead or mercury levels after adjusting for the same covariates. CONCLUSIONS: Our findings suggest that HIV-infected patients might be significantly more exposed to cadmium compared to non-HIV infected individuals which could contribute to higher prevalence of chronic diseases among HIV-infected subjects. Further research is warranted to identify sources of exposure and to understand more about specific health outcomes.

  7. Stimulation of Liver X Receptor Has Potent Anti-HIV Effects in a Humanized Mouse Model of HIV Infection.

    Science.gov (United States)

    Ramezani, Ali; Dubrovsky, Larisa; Pushkarsky, Tatiana; Sviridov, Dmitri; Karandish, Sara; Raj, Dominic S; Fitzgerald, Michael L; Bukrinsky, Michael

    2015-09-01

    Previous studies demonstrated that liver X receptor (LXR) agonists inhibit human immunodeficiency virus (HIV) replication by upregulating cholesterol transporter ATP-binding cassette A1 (ABCA1), suppressing HIV production, and reducing infectivity of produced virions. In this study, we extended these observations by analyzing the effect of the LXR agonist T0901317 [N-[4-(1,1,1,3,3,3-hexafluoro-2-hydroxypropan-2-yl)phenyl]-N-(2,2,2-trifluoroethyl)benzenesulfonamide] on the ongoing HIV infection and investigating the possibility of using LXR agonist for pre-exposure prophylaxis of HIV infection in a humanized mouse model. Pre-exposure of monocyte-derived macrophages to T0901317 reduced susceptibility of these cells to HIV infection in vitro. This protective effect lasted for up to 4 days after treatment termination and correlated with upregulated expression of ABCA1, reduced abundance of lipid rafts, and reduced fusion of the cells with HIV. Pre-exposure of peripheral blood leukocytes to T0901317 provided only a short-term protection against HIV infection. Treatment of HIV-exposed humanized mice with LXR agonist starting 2 weeks postinfection substantially reduced viral load. When eight humanized mice were pretreated with LXR agonist prior to HIV infection, five animals were protected from infection, two had viral load at the limit of detection, and one had viral load significantly reduced relative to mock-treated controls. T0901317 pretreatment also reduced HIV-induced dyslipidemia in infected mice. In conclusion, these results reveal a novel link between LXR stimulation and cell resistance to HIV infection and suggest that LXR agonists may be good candidates for development as anti-HIV agents, in particular for pre-exposure prophylaxis of HIV infection.

  8. Major depression in patients with HIV/AIDS and substance abuse.

    Science.gov (United States)

    Berger-Greenstein, Jori A; Cuevas, Carlos A; Brady, Stephen M; Trezza, Glenn; Richardson, Mark A; Keane, Terence M

    2007-12-01

    Previous research has been inconsistent in documenting a strong relationship between depression and HIV/AIDS, although a recent meta-analysis of studies examining this issue indicates that rates of depression are modestly higher for this population. For the current study, conducted from 2001-2004, we sought to examine rates and types of depressive symptoms in a cohort of patients receiving HIV care at two urban medical centers. These patients were participants in an intervention study examining adherence and mental health in persons triply diagnosed with psychiatric disorders, substance use disorders, and HIV/AIDS. Nearly three quarters of these participants were people of color, two thirds described their sexual orientation as heterosexual, and the vast majority were unemployed. We sought to examine the relationship of depression to patients' adherence to antiretroviral medication regimens (highly active antiretroviral therapy [HAART]). Results obtained from structured clinical interviews and self-report questionnaires indicated that study participants experienced high rates of depressive symptoms, and that 72.9% of participants met criteria for major depressive disorder (MDD). The results of this study offer a detailed view of the incidence and nature of MDDs and depressive symptoms for an urban sample of substance-abusing adults with HIV/AIDS. Given the degree to which depressive symptoms and MDD appear to be prevalent for this group, as well as the observation that these symptoms are amenable to treatment, future research should focus on identifying helpful strategies and interventions for treating these symptoms, effective ways of providing linkages to care, and ways in which standardized assessment and treatment protocols might be adapted to better suit this population.

  9. Defective HIV-1 proviruses produce novel protein-coding RNA species in HIV-infected patients on combination antiretroviral therapy.

    Science.gov (United States)

    Imamichi, Hiromi; Dewar, Robin L; Adelsberger, Joseph W; Rehm, Catherine A; O'Doherty, Una; Paxinos, Ellen E; Fauci, Anthony S; Lane, H Clifford

    2016-08-02

    Despite years of plasma HIV-RNA levels <40 copies per milliliter during combination antiretroviral therapy (cART), the majority of HIV-infected patients exhibit persistent seropositivity to HIV-1 and evidence of immune activation. These patients also show persistence of proviruses of HIV-1 in circulating peripheral blood mononuclear cells. Many of these proviruses have been characterized as defective and thus thought to contribute little to HIV-1 pathogenesis. By combining 5'LTR-to-3'LTR single-genome amplification and direct amplicon sequencing, we have identified the presence of "defective" proviruses capable of transcribing novel unspliced HIV-RNA (usHIV-RNA) species in patients at all stages of HIV-1 infection. Although these novel usHIV-RNA transcripts had exon structures that were different from those of the known spliced HIV-RNA variants, they maintained translationally competent ORFs, involving elements of gag, pol, env, rev, and nef to encode a series of novel HIV-1 chimeric proteins. These novel usHIV-RNAs were detected in five of five patients, including four of four patients with prolonged viral suppression of HIV-RNA levels <40 copies per milliliter for more than 6 y. Our findings suggest that the persistent defective proviruses of HIV-1 are not "silent," but rather may contribute to HIV-1 pathogenesis by stimulating host-defense pathways that target foreign nucleic acids and proteins.

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

    DEFF Research Database (Denmark)

    Katzenstein, Terese L; Oliveri, Roberto S; Benfield, Thomas;

    2002-01-01

    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 HIV DNA load had prognostic value independent......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...... of serum HIV RNA (p 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

  11. 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.

  12. Risk Factors for the Spread of HIV and Other Sexually Transmitted Infections Among HIV-infected Men Who Have Sex with Men in Lima, Peru

    Science.gov (United States)

    Clark, JL; Konda, KA; Segura, ER; Salvatierra, HJ; Leon, SR; Hall, ER; Caceres, CF; Klausner, JD; Coates, TJ

    2008-01-01

    Objectives To assess the prevalence of sexually transmitted infections (STIs), frequency of sexual risk behaviors, and relationship between knowledge of HIV infection status and sexual risk behavior among HIV-infected men who have sex with men (MSM) attending an STI clinic in Peru. Methods We recruited a convenience sample of 559 MSM from a municipal STI clinic in Lima, Peru. Participants completed a survey and provided blood for HIV, Syphilis, and HSV-2 antibody testing, and urine for gonorrhea and chlamydia nucleic acid testing. Results Among 124 HIV-infected MSM, 72.6% were aware of their HIV-infected status. Active syphilis (RPR≥1:8) was diagnosed in 21.0% of HIV-infected participants, HSV-2 in 79.8%, urethral gonorrhea in 1.6%, and chlamydia in 1.6%. Among 41 participants reporting insertive anal intercourse with their last sex partner, 34.2% did not use a condom. Of 86 participants reporting receptive anal intercourse, 25.6% did not use a condom. At least one episode of insertive unprotected anal intercourse (UAI) with an HIV-uninfected partner during the previous six months was reported by 33.6% (35/104) of participants, and receptive UAI with an HIV-uninfected partner by 44.6% (45/101). No difference in frequency of UAI, with HIV-uninfected or HIV-infected partners, was observed between men who knew their serostatus compared with those who were previously undiagnosed (all p-values >0.05). Conclusions HIV-infected MSM in Peru engaged in high-risk behaviors for spreading HIV and STIs. Knowledge of HIV-infected status was not associated with a decreased frequency of unprotected anal intercourse. Additional efforts to reduce risk behavior after the diagnosis of HIV infection are necessary. PMID:19028945

  13. Treatment outcomes in undocumented Hispanic immigrants with HIV infection.

    Directory of Open Access Journals (Sweden)

    Kenneth K Poon

    Full Text Available OBJECTIVE: Little is known about the treatment outcomes of undocumented Hispanic immigrants with HIV infection. We sought to compare the treatment outcomes of undocumented and documented patients 12-months after entering HIV care. METHODS: We conducted a retrospective cohort study of antiretroviral-naive patients 18 years and older attending their first visit at Thomas Street Health Center in Houston, Texas, between 1/1/2003 and 6/30/2008. The study population of 1,620 HIV-infected adults included 186 undocumented Hispanic, 278 documented Hispanic, 986 Black, and 170 White patients. The main outcome measures were retention in care (quarter years with at least one completed HIV primary care provider visit and HIV suppression (HIV RNA <400 copies/mL, both measured 12-months after entering HIV care. RESULTS: Undocumented Hispanic patients had lower median initial CD4 cell count (132 cells/mm(3 than documented Hispanic patients (166 cells/mm(3; P = 0.186, Black patients (226 cells/mm(3; P<0.001, and White patients (264 cells/mm(3; P = 0.001. However, once in care, undocumented Hispanic patients did as well or better than their documented counterparts. One year after entering HIV care, undocumented Hispanics achieved similar rates of retention in care and HIV suppression as documented Hispanic and White patients. Of note, black patients were significantly less likely to have optimal retention in care (adjusted odds ratio [aOR] 0.65, CI = 0.45-0.94 or achieve HIV suppression (aOR 0.32, CI = 0.17-0.61 than undocumented Hispanics. CONCLUSIONS: Undocumented Hispanic persons with HIV infection enter care with more advanced disease than documented persons, suggesting testing and/or linkage to care efforts for this difficult-to-reach population need intensification. Once diagnosed, however, undocumented Hispanics have outcomes as good as or better than other racial/ethnic groups. Safety net providers for undocumented immigrants are vital for maintaining

  14. Role of darunavir in the management of HIV infection

    Directory of Open Access Journals (Sweden)

    R Monica Lascar

    2009-11-01

    Full Text Available R Monica Lascar, Paul BennThe Mortimer Market Centre, Camden PCT, London WC1E 6JBAbstract: There is an ongoing need for potent antiretroviral therapies to deal with the increasing pool of treatment-experienced patients with multiple drug resistance. The last few years have seen the arrival of 2 new and very potent protease inhibitors – darunavir and tipranavir – alongside 2 whole new classes of anti-HIV agents – the integrase inhibitors and chemokine receptor CCR5 antagonists. This review focuses on the role of darunavir in managing HIV infection, with an emphasis on darunavir’s exceptional resistance profile and related clinical effectiveness, pharmacokinetics, tolerability and toxicity data. Darunavir in combination with the pharmacokinetic booster ritonavir has proved to be very effective in the treatment of highly treatmentexperienced HIV patients with multiple drug resistance. The favorable tolerability and toxicity profile alongside the drug’s high genetic barrier to the development of resistance prompted approval of darunavir for HIV-treatment naïve patients. Furthermore, the paradigm of treating HIV with a combination of anti-HIV agents is currently being challenged by ongoing darunavir monotherapy trials and these preliminary data will be discussed.Keywords: HIV, antiretroviral therapy, darunavir

  15. 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.

  16. A study of mode of transmission, clinical presentations, WHO and immunological staging among HIV infected children

    OpenAIRE

    Durgesh Kumar; Mukesh V. Singh; Dinesh Kumar; K. M. Shukla; Singh, D. K.; Singh, Dharmendra K.

    2014-01-01

    Background: The clinical manifestations of HIV infection vary widely among infants, children, and adolescent. So there is a need to study the mode of transmission, clinical presentations, WHO and immunological staging among HIV infected children. Methods: Observational analytic cross sectional study. The children who were HIV positive (confirmed by ELISA for HIV-1 and HIV-2), and attending the OPD of ART Centre and SN Children Hospital, Allahabad during period of one year. The study popula...

  17. Tuberculous abdominal abscess in an HIV-infected man: Neither infection previously diagnosed

    Directory of Open Access Journals (Sweden)

    Kuo-Yao Kao

    2010-11-01

    Full Text Available A 38-year-old man had a 1-week history of right lower quadrant abdominal pain; the initial impression was that he had diverticulitis of the ascending colon with an intra-abdominal abscess. Signs of peritonitis mandated an immediate right hemicolectomy. The unusual location of the abscess and the patient’s unusual postoperative course suggested that he might also have a systemic disease. Testing for HIV infection was positive. After 2 weeks in hospital, he was treated as an outpatient for both tuberculosis and HIV with a favourable outcome. In Taiwan a pre-operative HIV test is not performed routinely, and the HIV seroprevalence in surgical patient populations is unknown. Surgeons should keep the possibility of HIV infection in mind in a patient with an unusual clinical course.

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

    Directory of Open Access Journals (Sweden)

    Sundar Isaac Kirubakaran

    2004-03-01

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

  19. Factors Associated with Recent HIV Testing among Heterosexuals at High-Risk for HIV Infection in New York City

    Directory of Open Access Journals (Sweden)

    Marya eGwadz

    2016-04-01

    Full Text Available Background. The CDC recommends persons at high-risk for HIV infection in the United States receive annual HIV testing to foster early HIV diagnosis and timely linkage to health care. Heterosexuals make up a significant proportion of incident HIV infections (>25%, but test for HIV less frequently than those in other risk categories. Yet factors that promote or impede annual HIV testing among heterosexuals are poorly understood. The present study examines individual/attitudinal-, social-, and structural-level factors associated with past-year HIV testing among heterosexuals at high-risk for HIV. Methods. Participants were African American/Black and Hispanic heterosexual adults (N=2307 residing in an urban area with both high poverty and HIV prevalence rates. Participants were recruited by respondent-driven sampling (RDS in 2012-2015 and completed a computerized structured assessment battery covering background factors, multi-level putative facilitators of HIV testing, and HIV testing history. Separate logistic regression analysis for males and females identified factors associated with past-year HIV testing.Results. Participants were mostly male (58%, African American/Black (75%, and 39 years old on average (SD = 12.06 years. Lifetime homelessness (54% and incarceration (62% were common. Half reported past-year HIV testing (50% and 37% engaged in regular, annual HIV testing. Facilitators of HIV testing common to both genders included sexually transmitted infection (STI testing or STI diagnosis, peer norms supporting HIV testing, and HIV testing access. Among women, access to general medical care and extreme poverty further predicted HIV testing, while recent drug use reduced the odds of past-year HIV testing. Among men, past-year HIV testing was also associated with lifetime incarceration and substance use treatment.Conclusions. The present study identified gaps in rates of HIV testing among heterosexuals at high-risk for HIV, and both common and

  20. Factors Associated With Plasma IL-6 Levels During HIV Infection

    DEFF Research Database (Denmark)

    Borges, Álvaro H; O'Connor, Jemma L; Phillips, Andrew N

    2015-01-01

    BACKGROUND: Elevated interleukin 6 (IL-6) levels have been linked to cardiovascular disease, cancer and death. Persons with human immunodeficiency virus (HIV) infection receiving treatment have higher IL-6 levels, but few data are available on factors associated with circulating IL-6. METHODS......: Participants in 3 trials with IL-6 measured at baseline were included (N = 9864). Factors associated with IL-6 were identified by linear regression. Demographic and HIV variables (nadir/entry CD4(+) cell count, HIV RNA level, antiretroviral therapy regimen) were investigated in all 3 trials. In the SMART...... education, whereas black race was associated with lower IL-6. Higher HIV RNA levels were associated with higher IL-6 levels, and higher nadir CD4(+) cell counts with lower IL-6 levels. Compared with efavirenz, protease inhibitors were associated with higher and nevirapine with lower IL-6 levels. Smoking...

  1. Raltegravir cerebrospinal fluid concentrations in HIV-1 infection.

    Directory of Open Access Journals (Sweden)

    Aylin Yilmaz

    Full Text Available INTRODUCTION: Raltegravir is an HIV-1 integrase inhibitor currently used in treatment-experienced HIV-1-infected patients resistant to other drug classes. In order to assess its central nervous system penetration, we measured raltegravir concentrations in cerebrospinal fluid (CSF and plasma in subjects receiving antiretroviral treatment regimens containing this drug. METHODS: Raltegravir concentrations were determined by liquid chromatography tandem mass spectrometry in 25 paired CSF and plasma samples from 16 HIV-1-infected individuals. The lower limit of quantitation was 2.0 ng/ml for CSF and 10 ng/ml for plasma. RESULTS: Twenty-four of the 25 CSF samples had detectable raltegravir concentrations with a median raltegravir concentration of 18.4 ng/ml (range, <2.0-126.0. The median plasma raltegravir concentration was 448 ng/ml (range, 37-5180. CSF raltegravir concentrations correlated with CSF:plasma albumin ratios and CSF albumin concentrations. CONCLUSIONS: Approximately 50% of the CSF specimens exceeded the IC(95 levels reported to inhibit HIV-1 strains without resistance to integrase inhibitors. In addition to contributing to control of systemic HIV-1 infection, raltegravir achieves local inhibitory concentrations in CSF in most, but not all, patients. Blood-brain and blood-CSF barriers likely restrict drug entry, while enhanced permeability of these barriers enhances drug entry.

  2. 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.

  3. 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.

  4. Clinical management considerations for dyslipidemia in HIV-infected individuals.

    Science.gov (United States)

    Kirchner, Jeffrey T

    2012-01-01

    Dyslipidemia is common in patients with human immunodeficiency virus (HIV) and may result in significant morbidity, including coronary heart disease (CHD). Treatment of dyslipidemia in these patients is generally based on the National Cholesterol Education Program Adult Treatment Panel III goals for individuals without HIV. For individuals with ≥ 2 cardiovascular risk factors, the risk of CHD should be evaluated using the Framingham risk calculator and managed accordingly. Switching to an antiretroviral regimen with a favorable lipid profile should be considered before pharmacologic management if virologic suppression can be maintained. Statins are the first-choice therapy for elevated low-density lipoprotein cholesterol, but in HIV-infected individuals, special consideration must be given to drug-drug interactions, specifically those between protease inhibitors and statins. Management of dyslipidemia in HIV-infected individuals is a challenging but important aspect of chronic disease management. Additional research, specifically related to the role of chronic inflammation, is needed to better define the relationship between HIV infection and cardiovascular disease.

  5. Clinical value of determination HIV viral load in the cerebrospinal fluid of HIV-infected patients

    Directory of Open Access Journals (Sweden)

    V. B. Musatov

    2015-01-01

    Full Text Available Aim. To analyze the concentration of HIV RNA in the cerebrospinal fluid and to evaluate its significance in the pathology of the central nervous system among HIV infected persons.Materials: We examined 36 patients with HIV infection with signs of pathology of the central nervous system. All patients was done completed a standard investigation of cerebrospinal fluid, cytological examination and detection viral load of HIV in the cerebrospinal fluid and serum.Results. A different of opportunistic and HIV-related disease was diagnosed in 29 patients. The most frequent pathology of the nervous system (12 cases is a diffuse HIV-associated brain damage occurring in 7 patients in the form of aseptic non purulent meningitis and in 5 patients in the form of encephalitis. The average value of the absolute and relative count of CD4-lymphocytes in patients amounted 147,0 cells/μl (40,0; 408,75 and 10.0% (4,00; 18,50. Pathological changes in cellular composition and protein concentration of cerebrospinal fluid detected in 19 cases. Replication of HIV in the cerebrospinal fluid are detected in 31 of 32 patients not receiving antiretroviral therapy, including 17 patients with normal values of cerebrospinal fluid. The average HIV viral load in the cerebrospinal fluid was 15 133,0 copies/ml (2501,0; 30624,0 or 4,18 (3,35; 4,48 lg HIV RNA, average HIV viral load in serum – 62 784,0 copies/ml (6027,5; 173869,0 or 4,80 4,80 (3,7; 5,2 lg HIV RNA. The concentration of HIV in the cerebrospinal fluid was significantly lower than in serum (4,18 and 4,80 lg HIV RNA, p=0.027. 4 patients with severe, multietiology damage of the central nervous system viral, microbial and fungal etiology, there was an inverse relationship between the concentration of HIV in the cerebrospinal fluid and in serum, the concentrations of HIV was higher in the cerebrospinal fluid.Conclusion: Among the majority of HIV-infected patients with signs of the central

  6. International Congress of Drug Therapy in HIV Infection 23-26 October 2016, Glasgow, UK

    OpenAIRE

    Fauci, Anthony; Bekker, Linda-Gail; Rojo, Pablo; Grønborg Laut, Kamilla; Karpov, Igor; Elinav, Hila; Blaxhult, Anders; Trofimora, Tatiana; Knysz, Brygida; Zilmer, Kai; Kuzovatova, Elena; Staub, Therese; Chinello, Pierangelo; Pin, Barbara Del; Mondi, Annalisa

    2016-01-01

    Scientific advances over the 35 years since AIDS was first recognized as a new disease, have put us on a clear path towards ending the HIV/AIDS pandemic. Scaling-up access to antiretroviral therapy (ART) and HIV prevention strategies, such as pre-exposure prophylaxis, could dramatically decrease HIV-related deaths and the rate of new HIV infections. Current and future scientific advances, notably in HIV vaccine and cure research, will accelerate this process. Two major directions in HIV vacci...

  7. Toll-Like Receptor 7 Agonist GS-9620 Induces HIV Expression and HIV-Specific Immunity in Cells from HIV-Infected Individuals on Suppressive Antiretroviral Therapy

    Science.gov (United States)

    Tsai, Angela; Irrinki, Alivelu; Kaur, Jasmine; Cihlar, Tomas; Kukolj, George

    2017-01-01

    ABSTRACT Antiretroviral therapy can suppress HIV replication to undetectable levels but does not eliminate latent HIV, thus necessitating lifelong therapy. Recent efforts to target this persistent reservoir have focused on inducing the expression of latent HIV so that infected cells may be recognized and eliminated by the immune system. Toll-like receptor (TLR) activation stimulates antiviral immunity and has been shown to induce HIV from latently infected cells. Activation of TLR7 leads to the production of several stimulatory cytokines, including type I interferons (IFNs). In this study, we show that the selective TLR7 agonist GS-9620 induced HIV in peripheral blood mononuclear cells (PBMCs) from HIV-infected individuals on suppressive antiretroviral therapy. GS-9620 increased extracellular HIV RNA 1.5- to 2-fold through a mechanism that required type I IFN signaling. GS-9620 also activated HIV-specific T cells and enhanced antibody-mediated clearance of HIV-infected cells. Activation by GS-9620 in combination with HIV peptide stimulation increased CD8 T cell degranulation, production of intracellular cytokines, and cytolytic activity. T cell activation was again dependent on type I IFNs produced by plasmacytoid dendritic cells. GS-9620 induced phagocytic cell maturation and improved effector-mediated killing of HIV-infected CD4 T cells by the HIV envelope-specific broadly neutralizing antibody PGT121. Collectively, these data show that GS-9620 can activate HIV production and improve the effector functions that target latently infected cells. GS-9620 may effectively complement orthogonal therapies designed to stimulate antiviral immunity, such as therapeutic vaccines or broadly neutralizing antibodies. Clinical studies are under way to determine if GS-9620 can target HIV reservoirs. IMPORTANCE Though antiretroviral therapies effectively suppress viral replication, they do not eliminate integrated proviral DNA. This stable intermediate of viral infection is

  8. Acute hepatitis C: changing epidemiology and association with HIV infection.

    Science.gov (United States)

    Brejt, Nick; Gilleece, Yvonne; Fisher, Martin

    2007-03-01

    Over the past 6 to 7 years an increasing incidence of acute hepatitis C virus (AHCV) has been fuelled by two different changing epidemics: (1) a new resurgence of AHCV amongst intravenous drug users (IVDU); and (2) presumed sexually transmitted AHCV amongst predominantly HIV-positive men who have sex with men (MSM). Increasing incidence amongst IVDUs is likely to be a consequence of changing injecting behaviour, possibly related to changes in perception of HIV as well as HCV risk and consequences. Increasing incidence amongst MSM is likely to be a consequence of changing sexual practices, for example number of sexual partners and type of sexual behaviour, as well as increasing availability of recreational drugs associated with sexual risk-taking, and wider availability of casual sexual partners via the internet or sex-on-premises venues. It remains unclear whether the current outbreaks in MSM, predominantly seen in HIV-positive individuals, reflect a predisposition to AHCV secondary to HIV status per se, or whether this reflects differences in behaviour amongst HIV-positive versus HIV-negative MSM, or potentially increased screening (either routine or secondary to abnormal liver function tests) in HIV-positive MSM. The majority of individuals with AHCV are asymptomatic and therefore routine screening of individuals in at-risk groups with abnormal liver function tests should be considered. Previous historical studies suggest that individuals with concomitant HIV infection are far less likely than those without to spontaneously clear HCV. It is currently recommended that such individuals acutely infected with HCV should undergo monitoring of HCV viral load levels to determine whether spontaneous clearance is likely or whether the opportunity for early treatment should be considered.

  9. Viral suppression and adherence among HIV-infected children and adolescents on antiretroviral therapy: results of a multicenter study

    Directory of Open Access Journals (Sweden)

    Maria L.S. Cruz

    2014-12-01

    Full Text Available OBJECTIVE: To evaluate treatment adherence among perinatally-infected pediatric human immunodeficiency virus (HIV patients followed in pediatric centers in Brazil. METHODS: This was a cross-sectional multicenter study. Medical records were reviewed and adherence scale, assessment of caregivers' quality of life (WHOQOL-BREF, anxiety, depression, and alcohol/substances use/abuse were assessed. Outcomes included self-reported 100% adherence in the last three days and HIV viral load (VL < 50 copies/mL. Statistical analyses included contingency tables and respective statistics, and multivariable logistic regression. RESULTS: 260 subjects were enrolled: 78% children and 22% adolescents; 93% of caregivers for the children and 77% of adolescents reported 100% adherence; 57% of children and 49% of adolescents had VL < 50 copies/mL. In the univariate analyses, HIV diagnosis for screening due to maternal infection, lower caregiver scores for anxiety, and higher scores in physical and psychological domains of WHOQOL-BREF were associated with 100% adherence. Shorter intervals between pharmacy visits were associated with VL < 50 copies/mL (p ≤ 0.01. Multivariable regression demonstrated that caregivers who did not abuse alcohol/other drugs (OR = 0.49; 95% CI: 0.27-0.89 and median interval between pharmacy visits < 33 days (OR = 0.97; 95% CI: 0.95-0.98 were independently associated with VL < 50 copies/mL; whereas lower caregiver scores for anxiety (OR = 2.57; 95% CI: 1.27-5.19 and children's HIV diagnosis for screening due to maternal infection (OR = 2.25; 95% CI: 1.12-4.50 were found to be independently associated with 100% adherence. CONCLUSIONS: Pediatric HIV programs should perform routine assessment of caregivers' quality of life, and anxiety and depression symptoms. In this setting, pharmacy records are essential to help identify less-than-optimal adherence.

  10. Copenhagen comorbidity in HIV infection (COCOMO) study

    DEFF Research Database (Denmark)

    Ronit, Andreas; Haissman, Judith M; Kirkegaard-Klitbo, Ditte Marie

    2016-01-01

    elastography of the liver, computed tomography (CT) angiography of the heart, unenhanced CT of the chest and upper abdomen, and a number of routine biochemical analysis are uniformly collected in participants from the COCOMO study and the CGPS. Plasma, serum, buffy coat, peripheral blood mononuclear cells...... (PBMC), urine, and stool samples are collected in a biobank for future studies. Data will be updated through periodical linking to national databases. DISCUSSION: As life expectancy for PLWHIV improves, it is essential to study long-term impact of HIV and cART. We anticipate that findings from...... to a more personalized HIV care. TRIAL REGISTRATION: ClinicalTrials.gov: NCT02382822 ....

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

    DEFF Research Database (Denmark)

    Katzenstein, Terese L; Oliveri, Roberto S; Benfield, Thomas

    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...

  12. HIV-1 infection of in vitro cultured human monocytes: early events and influence of anti HIV-1 antibodies

    DEFF Research Database (Denmark)

    Arendrup, M; Olofsson, S; Nielsen, Jens Ole;

    1994-01-01

    To characterize the role of the humoral immune response on HIV-1 infection of monocytes and macrophages (M phi s) we examined the susceptibility of in vitro cultured monocyte/M phi s to various HIV-1 isolates and the influence of heterologous and particularly autologous anti HIV-1 sera on this in...

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

    Energy Technology Data Exchange (ETDEWEB)

    Monteiro, P. [Serviço de Doenças Infecciosas, Faculdade de Medicina, Universidade de Pernambuco, Recife, PE (Brazil); Miranda-Filho, D.B. [Departamento de Medicina Clínica, Faculdade de Medicina, Universidade de Pernambuco, Recife, PE (Brazil); Bandeira, F. [Serviço de Endocrinologia, Faculdade de Medicina, Universidade de Pernambuco, Recife, PE (Brazil); Lacerda, H.R. [Departamento de Medicina Clínica, Faculdade de Medicina, Universidade de Pernambuco, Recife, PE (Brazil); Departamento de Medicina Tropical, Faculdade de Medicina, Universidade Federal de Pernambuco, Recife, PE (Brazil); Chaves, H. [Departamento de Cardiologia, Faculdade de Medicina, Universidade Federal de Pernambuco, Recife, PE (Brazil); Albuquerque, M.F.P.M. [Centro de Pesquisa Aggeu Magalhães,FIOCRUZ, Recife, PE (Brazil); Montarroyos, U.R. [Departamento de Medicina Tropical, Faculdade de Medicina, Universidade Federal de Pernambuco, Recife, PE (Brazil); Ximenes, R.A.A. [Departamento de Medicina Clínica, Faculdade de Medicina, Universidade de Pernambuco, Recife, PE (Brazil); Departamento de Medicina Tropical, Faculdade de Medicina, Universidade Federal de Pernambuco, Recife, PE (Brazil)

    2012-07-13

    We investigated the association between pulse wave velocity (PWV) and HIV infection, antiretroviral treatment-related characteristics, viral load, immune status, and metabolic changes in a cross-sectional study nested in a cohort of HIV/AIDS patients who have been followed for metabolic and cardiovascular changes since 2007. The study included patients recruited from the cohort (N = 261) and a comparison group (N = 82) of uninfected individuals, all enrolled from April to November 2009. Aortic stiffness was estimated using the carotid-femoral PWV (Complior-Artech, Paris, France). The groups were similar with respect to age, metabolic syndrome, diabetes mellitus, Framingham score, and use of antihypertensive and hypolipidemic medications. Hypertension was more frequent among the controls. Individuals with HIV had higher triglyceride, glucose and HDL cholesterol levels. Among individuals with HIV/AIDS, those with a nadir CD4{sup +} T-cell count <200 cells/mm{sup 3} had a higher PWV (P = 0.01). There was no statistically significant difference when subjects were stratified by gender. Heart rate, age, male gender, and blood pressure were independently correlated with PWV. Nadir CD4{sup +} T-cell count did not remain in the final model. There was no significance difference in PWV between HIV-infected individuals and uninfected controls. PWV was correlated with age, gender, and blood pressure across the entire population and among those infected with HIV. We recommend cohort studies to further explore the association between inflammation related to HIV infection and/or immune reconstitution and antiretroviral use and PWV.

  14. Hyperproinsulinaemia in normoglycaemic lipodystrophic HIV-infected patients

    DEFF Research Database (Denmark)

    Haugaard, Steen B; Andersen, Ove; Hales, CN;

    2006-01-01

    BACKGROUND: We aimed to investigate whether the insulin precursors, intact (IP) and 32-33 split proinsulin (SP), which are elevated in states of insulin resistance and predict type 2 diabetes, would be elevated in human immunodeficiency virus (HIV)-infected patients with lipodystrophy (LIPO......). MATERIALS AND METHODS: Forty-three normoglycaemic HIV-infected patients [18 LIPO and 18 without lipodystrophy (NONLIPO) receiving antiretroviral drugs, and seven patients naïve to antiretroviral drugs (NAIVE)] were examined. Insulin precursors were measured during fasting, during an intravenous glucose.......01), but did not differ between study groups. CONCLUSIONS: Proinsulin appeared to be increased in HIV-lipodystrophy, but no more than caused by the increased ISR. Nevertheless, the inverse correlations between SP/insulin ratio versus Si(RD) and incremental total proinsulin/insulin ratio versus DI may argue...

  15. Hepatitis C seroconversions in HIV infection across Europe

    DEFF Research Database (Denmark)

    Boesecke, Christoph; Grint, Daniel; Soriano, Vincent

    2015-01-01

    BACKGROUND & AIMS: In the last decade, several outbreaks of sexually acquired acute hepatitis C (HCV) infection have been described in HIV-positive men who have sex with men (MSM). The aims of this study were to determine whether there has been an increase in the number of acute HCV infections....... Similar patterns were observed across all European regions (P = 0.69, test for interaction) and HIV transmission risks groups (P = 0.69, test for interaction). In multivariate analysis, North, South and East Europe had higher odds of HCV seroconversion compared with Western Europe [OR 1.90 (1.28-2.81), 1...... prevention efforts among HIV-positive persons in Europe....

  16. Altered sialylation of alveolar macrophages in HIV-1-infected individuals.

    Science.gov (United States)

    Perrin, C; Giordanengo, V; Bannwarth, S; Blaive, B; Lefebvre, J C

    1997-10-01

    In previous studies, we have demonstrated that O-glycans at the surface of HIV-1-infected cell lines were hyposialylated. Moreover, we and others have shown that HIV+ individuals produced autoantibodies that react with hyposialylated CD43, on T cell lines. Since the autoantigen responsible for this abnormal immune response was not easily found in the peripheral blood cells of corresponding patients, we searched for its possible presence in other sites. Using fluorescence staining of alveolar macrophages with various lectins, we show that the binding of the PNA lectin specific for asialo O-glycans is much more efficient on cells from HIV-1-infected individuals. Moreover, the degree of reactivity of PNA is correlated with the clinical stage of the illness.

  17. 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.

  18. Thiolated pyrimidine nucleotides may interfere thiol groups concentrated at lipid rafts of HIV-1 infected cells.

    Science.gov (United States)

    Kanizsai, Szilvia; Ongrádi, Joseph; Aradi, János; Nagy, Károly

    2014-12-01

    Upon HIV infection, cells become activated and cell surface thiols are present in increased number. Earlier we demonstrated in vitro anti-HIV effect of thiolated pyrimidine nucleotide UD29, which interferes thiol function. To further analyse the redox processes required for HIV-1 entry and infection, toxicity assays were performed using HIV-1 infected monolayer HeLaCD4-LTR/ β-gal cells and suspension H9 T cells treated with several thiolated nucleotide derivatives of UD29. Selective cytotoxicity of thiolated pyrimidines on HIV-1 infected cells were observed. Results indicate that thiolated pyrimidine derivates may interfere with -SH (thiol) groups concentrated in lipid rafts of cell membrane and interacts HIV-1 infected (activated) cells resulting in a selective cytotoxicity of HIV-1 infected cells, and reducing HIV-1 entry.

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

    DEFF Research Database (Denmark)

    Knudsen, Andreas; Benfield, Thomas; Kofoed, Kristian

    2009-01-01

    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 ... 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....

  20. Traditional medicines, HIV, and related infections: workshop 2C.

    Science.gov (United States)

    Patel, M; Bessong, P; Liu, H

    2011-04-01

    Traditional medicines are an integral part of health care worldwide, even though their efficacy has not been scientifically proven. HIV-infected individuals may use them singularly or in combination with conventional medicines. Many in vitro studies have proven the anti-HIV, anti-Candida, and anti-herpes simplex virus potential of traditional plants and identified some of the mechanisms of action. Very few in vivo studies are available that involve a small number of participants and show controversial results. In addition, knowledge is limited of the role of traditional medicines in the enhancement of the immune system. The use of traditional medicines with antiretroviral drugs (ARVs) has created a problem because drug interactions compromise the efficacy of ARVs. Several currently popular plants have been studied in the laboratory for their interaction with ARVs, with disadvantageous results. Unfortunately, no clinical trials are available. The science of traditional medicines is relatively new and is at present being modernized worldwide. However, there are still ethical issues regarding traditional medicines that need to be addressed-for example, regulations regarding quality control and standardization of medicines, regulation and education of healers who deliver these medicines, and unregulated clinical trials. The workshop addressed the following questions about traditional medicine and their use in HIV infection: What are the mechanisms of action of anti-HIV traditional medicines? Should traditional medicines be used in conjunction with ARV? Do traditional medicines enhance the immune system? Should medicinal plants be used for the control of oral infections associated with HIV? What are the ethical issues surrounding the use of traditional medicines for the treatment of HIV and associated infections?

  1. Combination of anti-retroviral drugs and radioimmunotherapy specifically kills infected cells from HIV infected individuals

    Directory of Open Access Journals (Sweden)

    Dina Tsukrov

    2016-09-01

    Full Text Available Eliminating virally infected cells is an essential component of any HIV eradication strategy. Radioimmunotherapy (RIT, a clinically established method for killing cells using radiolabeled antibodies, was recently applied to target HIV-1 gp41 antigen expressed on the surface of infect-ed cells. Since gp41 expression by infected cells is likely down-regulated in patients on an-tiretroviral therapy (ART, we evaluated the ability of RIT to kill ART-treated infected cells us-ing both in vitro models and lymphocytes isolated from HIV-infected subjects. Human peripheral blood mononuclear cells (PBMCs were infected with HIV and cultured in the presence of two clinically relevant ART combinations. Scatchard analysis of the 2556 human monoclonal anti-body to HIV gp41 binding to the infected and ART-treated cells demonstrated sufficient residual expression of gp41 on the cell surface to warrant subsequent RIT. This is the first time the quantification of gp41 post-ART is being reported. Cells were then treated with Bismuth-213-labeled 2556 antibody. conjugated to the human monoclonal antibody 2556, which binds to HIV gp41. Cell survival was quantified by Trypan blue and residual viremia by p24 ELISA. Cell surface gp41 expression was assessed by Scatchard analysis. The experiments were repeated using PBMCs isolated from blood specimens obtained from 15 HIV-infected individuals: ten on ART and five ART-naive. We found that 213Bi-2556 killed ART-treated infected PBMCs and reduced viral production to undetectable levels. ART and RIT co-treatment was more effective at reducing viral load in vitro than either therapy alone, indicating that gp41 expression under ART was sufficient to allow 213Bi-2556 to deliver cytocidal doses of radiation to infected cells. This study provides proof of concept that 213Bi-2556 may represent an innovative and effective targeting method for killing HIV-infected cells treated with ART, and supports continued development of 213Bi

  2. Microbial translocation and cardiometabolic risk factors in HIV infection

    DEFF Research Database (Denmark)

    Trøseid, Marius; Manner, Ingjerd W; Pedersen, Karin K;

    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 i...

  3. Arterial hypertension and cardiovascular risk in HIV-infected patients.

    Science.gov (United States)

    Calò, Lorenzo A; Caielli, Paola; Maiolino, Giuseppe; Rossi, Gianpaolo

    2013-08-01

    The dramatic change of the natural history of HIV-infected patients by highly active antiretroviral therapy (HAART) has exposed these patients to cardiovascular risk, including cardiovascular disease and hypertension. In HIV-infected patients, the development of arterial hypertension, at least in the medium-long term is an established feature, although recognized predictors of its development have not been clearly identified. In addition, conflicting data regarding the influence of antiretroviral therapy (ART) are reported. The presence of a proinflammatory state and oxidative stress-mediated endothelial dysfunction seem, however, to play a pathophysiologic role. In this review, we examine and provide a comprehensive, literature based, consideration of the pathophysiologic aspects of hypertension in these patients. HIV-infected patients, independently of the presence of hypertension, remain at very high cardiovascular risk due to the presence of the same cardiovascular risk factors recognized for the general population with, in addition, the indirect influence of the ART, essentially via its effect on lipid metabolism. This review based on the evidence from the literature, concludes that the management of HIV-infected patients in terms of cardiovascular prevention emerges as a priority. The consideration of cardiovascular risk in these patients should receive the same emphasis given for the general population at high cardiovascular risk, including adequate blood pressure control according to international guidelines.

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

    Directory of Open Access Journals (Sweden)

    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.

  5. Coccidioides thyroiditis in an HIV-infected patient.

    Science.gov (United States)

    Jinno, Sadao; Chang, Shelley; Jacobs, Michael R

    2012-07-01

    We report a case of Coccidioides thyroiditis in an HIV-infected patient with a history of recent Coccidioides pneumonia but with negative Coccidioides serology determined by enzyme immunoassay at presentation. Diagnosis of Coccidioides thyroiditis was made based on histopathologic examination and culture of thyroid abscess material obtained by fine-needle aspiration biopsy.

  6. Optimizing Antiretroviral Therapy in Children and Adolescents with HIV Infection

    NARCIS (Netherlands)

    N.Y. Rakhmanina (Natella)

    2010-01-01

    textabstractHIV infection became a newly recognized disease in the mid 1980s. High morbidity and mortality associated with it prompted the urgent development of new therapeutic agents and combination therapies. Throughout the next 20 years the hopes for cure have risen and fallen, and the vaccine re

  7. HIV and parasitic co-infections in tuberculosis patients

    DEFF Research Database (Denmark)

    Range, N.; Magnussen, Pascal; Mugomela, A.

    2007-01-01

    A cross-sectional study was conducted in Mwanza, Tanzania, to determine the burden of HIV and parasitic co-infections among patients who were confirmed or suspected cases of pulmonary tuberculosis (PTB). Of the 655 patients investigated, 532 (81.2%) had been confirmed as PTB cases, by microscopy...

  8. HLA-DP antigens in HIV-infected individuals

    DEFF Research Database (Denmark)

    Ødum, Niels; Georgsen, J; Fugger, L;

    1991-01-01

    We studied the distribution of HLA-DP antigens in 74 HIV-infected Danish homosexual men and 188 ethnically matched healthy individuals, using the primed lymphocyte typing (PLT) technique. Forty of the patients developed AIDS within 3 years after diagnosis, whereas the remaining 34 were healthy...

  9. Molar incisor hypomineralization in HIV-infected children and adolescents.

    Science.gov (United States)

    Andrade, Natália Silva; Pontes, Alessandra Silva; de Sousa Paz, Hélvis Enri; de Moura, Marcoeli Silva; Moura, Lúcia de Fátima Almeida de Deus; Lima, Marina de Deus Mourade

    2017-01-01

    The objective was to determine the prevalence of molar incisor hypomineralization (MIH) among individuals between 7 and 15 years old infected or noninfected with human immunodeficiency virus (HIV). The study was conducted with 33 HIV-infected individuals (study group; SG) and 66 non-HIV-infected schoolchildren (control group; CG), paired by gender and age. Data collection was based on medical records (SG), a questionnaire for caregivers and oral examination for diagnosis of MIH (European Academy of Pediatric Dentistry criteria) and caries (DMFT index and ICDAS). Data were analyzed with Mann-Whitney, chi-square, and Fisher's exact tests and logistic regression. In SG, MIH (45.5%) and caries (87.9%) had higher prevalence. MIH was associated with use of protease inhibitors in SG (OR: 2.14; 95% CI: 1.21 to 3.77) and incubator need in CG (OR: 2.80; 95% CI: 1.71 to 9.10). HIV-infected patients had a higher prevalence of MIH and dental caries in the permanent dentition.

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

    DEFF Research Database (Denmark)

    Nielsen, S D; Nielsen, Jens Ole; Hansen, J E

    1997-01-01

    In order to offer a gene therapy-based treatment against AIDS, it is likely to be necessary to harvest and culture CD4 cells from HIV-positive patients without activating the HIV infection. We have used a magnetic cell sorting (MACS) system to enrich CD4 cells. Using positive selection, CD4 cells...... from a total of 14 patients were enriched from a mean percentage of CD4 cells in PBMC of 18% to 91% CD4 cells in the enriched cell fraction. Furthermore, we found that this separation did not lead to an increase in viral load. The MACS performed equally well on cells from HIV-positive patients and HIV......-negative donors. CD4 cells from HIV-positive patients were readily expanded with PHA; 19-fold by day 10, 50-fold by day 20, and 156-fold by day 25. However, CD4 cells from HIV-positive patients grew at a slower rate than CD4 cells from HIV-negative donors. The expanded CD4 cells showed a high degree of CD4...

  11. HIV-infection and periodontal diseases: an overview of the post-HAART era

    OpenAIRE

    Mataftsi, Maria; Skoura, Lemonia; Sakellari, Dimitra

    2010-01-01

    Abstract HIV infection remains a global health problem of unprecedented dimensions, although the development of highly active antiretroviral therapy (HAART) has significantly modified the course of HIV disease into a manageable chronic disease with longer survival and improved quality of life in HIV-infected subjects. Among the HIV-associated infections, oral lesions have been recognized as prominent features since the beginning of the epidemic and continue to be important. Periodo...

  12. Thalamic volume deficit contributes to procedural and explicit memory impairment in HIV infection with primary alcoholism comorbidity.

    Science.gov (United States)

    Fama, Rosemary; Rosenbloom, Margaret J; Sassoon, Stephanie A; Rohlfing, Torsten; Pfefferbaum, Adolf; Sullivan, Edith V

    2014-12-01

    Component cognitive and motor processes contributing to diminished visuomotor procedural learning in HIV infection with comorbid chronic alcoholism (HIV+ALC) include problems with attention and explicit memory processes. The neural correlates associated with this constellation of cognitive and motor processes in HIV infection and alcoholism have yet to be delineated. Frontostriatal regions are affected in HIV infection, frontothalamocerebellar regions are affected in chronic alcoholism, and frontolimbic regions are likely affected in both; all three of these systems have the potential of contributing to both visuomotor procedural learning and explicit memory processes. Here, we examined the neural correlates of implicit memory, explicit memory, attention, and motor tests in 26 HIV+ALC (5 with comorbidity for nonalcohol drug abuse/dependence) and 19 age-range matched healthy control men. Parcellated brain volumes, including cortical, subcortical, and allocortical regions, as well as cortical sulci and ventricles, were derived using the SRI24 brain atlas. Results indicated that smaller thalamic volumes were associated with poorer performance on tests of explicit (immediate and delayed) and implicit (visuomotor procedural) memory in HIV+ALC. By contrast, smaller hippocampal volumes were associated with lower scores on explicit, but not implicit memory. Multiple regression analyses revealed that volumes of both the thalamus and the hippocampus were each unique independent predictors of explicit memory scores. This study provides evidence of a dissociation between implicit and explicit memory tasks in HIV+ALC, with selective relationships observed between hippocampal volume and explicit but not implicit memory, and highlights the relevance of the thalamus to mnemonic processes.

  13. Sometimes you just have to have a lot of bitter to make it sweet: Substance abuse and partner abuse in the lives of HIV+ men who have sex with men.

    Science.gov (United States)

    Andrasik, Michele P; Valentine, Sarah E; Pantalone, David W

    2013-07-01

    Although links between partner abuse (PA) and substance abuse (SA) are well-documented in the literature, we know less about these relations among HIV-positive men who have sex with men (MSM). We conducted a qualitative study with this group (N = 28). Participants reported (1) social modeling of SA in childhood and in adult social networks, (2) initial use of substance to cope with child abuse and neglect, and (3) the reinforcement of problematic SA by experiences of PA, whereby SA led to PA, resulting in increased SA. Recommendations for clinicians working with HIV+ MSM are discussed.

  14. Adapting an evidence-based HIV prevention intervention for pregnant African-American women in substance abuse treatment

    Directory of Open Access Journals (Sweden)

    Winona Poulton

    2011-02-01

    Full Text Available Wendee M Wechsberg1, Felicia A Browne1, Winona Poulton1, Rachel Middlesteadt Ellerson1, Ashley Simons-Rudolph1, Deborah Haller2,  1RTI International,* Research Triangle Park, NC, USA; 2Columbia University College of Physicians and Surgeons, New York, NY, USA,  *RTI International is a trade name of Research Triangle InstituteAbstract: An adaptation of an evidence-based, woman-focused intervention designed to reduce HIV risk behaviors was conducted for pregnant, African-American women in substance abuse treatment in North Carolina. The intervention adaptation process included focus groups, expert panels, and the filming of women who spoke about their experiences with pregnancy, drug use, sex risk behaviors, HIV testing and treatment, need for substance abuse treatment, violence, and victimization. The assessment instrument was adapted for pregnant women and the intervention was organized into a 4-session PowerPoint presentation, with an additional session if a woman tested positive for HIV. All sessions and assessment instrument were installed on laptop computers for portability in treatment programs. We pilot tested our adaptation with 59 pregnant African-American women who had used an illicit drug within the past year and were enrolled in substance abuse treatment. At baseline, 41% were currently homeless, 76% were unemployed, 90% had not planned their current pregnancy, and approximately 70% reported drug use since finding out about the pregnancy. This sample of participants rated the intervention sessions and were highly satisfied with their experience, resulting in a mean satisfaction score of 6.5 out of 7. Pregnant African-American women who use drugs need substance abuse treatment that they do not currently access. Woman-focused HIV interventions help to address intersecting risk behaviors and need for treatment prevalent among this vulnerable group.Keywords: African-American woman, HIV prevention pregnancy, drug use, violence, sexual

  15. Prevalence of HIV Infection Among Tuberculosis Patients in Bali, Indonesia

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    Partha Muliawan

    2016-01-01

    Full Text Available Background: During 1998-2007, TB and HIV cases in Bali had shown a significant increase respectively. In general, both of these diseases are chronic diseases that need long term treatment, and together they could worsen the patients’ condition. To prevent the double burden of those patients, we need to know HIV infection prevalence among TB cases in Bali. Method: One thousands of TB cases diagnosed at TB health services unit (UPK at primary health centers (puskesmas and public hospitals in Bali, in September-November 2008, were given information and their blood samples were taken for HIV tests. Samples were chosen proportionally according to the number of TB cases registered in each UPK. Five milliliters of blood sample were taken from each eligible patient by laboratory staff or nurse at the UPK for HIV tests which were conducted at Bali Health Laboratory. HIV test used in this study were the two types of rapid test in accordance with WHO standard. Discussion: Thirty-nine out of 1,000 blood samples were found HIV positive. The highest HIV prevalence among TB cases was in the Buleleng District (11.5% and followed by Denpasar City (5.1%. This prevalence showed a different figure from the HIV/AIDS cases in VCT clinics registered at Bali Provincial Health Agency, where the highest prevalence found in Denpasar, followed by Buleleng and Badung. If we compare, the difference in figure between Badung and Buleleng, might be due to the difference in routes of HIV transmission. In Buleleng, most of the cases (90% were sexually transmitted, while in Badung 48% transmission were through injecting drug users. The IDUs seek health services at private health centers and rarely utilize public/government services such as puskesmas and hospitals. Conclusion: The HIV prevalence among TB patients in Bali was 3.9%. The characteristics of the patients showed that they are mostly male, aged between 31-40 years old, have junior high school-university education

  16. Primary HIV infection presenting as non-traumatic rhabdomyolysis with acute renal failure.

    Science.gov (United States)

    Prabahar, Murugesan Ram; Jain, Manish; Chandrasekaran, Venkatraman; Indhumathi, Elayaperumal; Soundararajan, Periasamy

    2008-07-01

    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 infection is usually symptomatic, and infected patients can present with a variety of symptoms. 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.

  17. Barriers Preventing Liver Transplantation in Canadians with HIV Infection – Perceptions of HIV Specialists

    Directory of Open Access Journals (Sweden)

    Curtis L Cooper

    2007-01-01

    Full Text Available Liver transplantation is a life-saving procedure with demonstrated utility. There are accumulating data indicating that this procedure is helpful in HIV-infected patients as well. Liver transplantation is currently largely unavailable to those living with HIV in Canada. Understanding the obstacles to this procedure is the first step to increasing access. Between August 2005 and November 2005, HIV physicians, one from each Canadian HIV Trials Network site, were asked to complete a quantitative questionnaire on adult liver transplant access and need. Forty-six per cent (16 of 35 of sites responded. A median 20% of the nearly 12,700 HIV patients followed at these sites had concurrent liver disease (20% caused by hepatitis C virus, 5% caused by hepatitis B virus and 5% were alcohol-related. On average, two patients per site were thought to be appropriate candidates for liver transplant evaluation. Eighty per cent of respondents anticipated increased need for liver transplantation over the next five years. Organ supply was universally identified as the chief obstacle to transplantation in patients with HIV. Other key issues included risk of hepatitis C virus reinfection and transplant surgical team willingness. Based on these data, it is believed that these issues should be the focus of efforts designed to increase access to transplantation in Canadians with end-stage liver disease and concurrent HIV.

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

    Directory of Open Access Journals (Sweden)

    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.

  19. HIV-associated dementia in the Dominican Republic: a consequence of stigma, domestic abuse and limited health literacy.

    Science.gov (United States)

    Santoso, Laura Frances; Erkkinen, Emily E; Deb, Anindita; Adon, Carlos

    2016-04-20

    A 38-year-old Dominican woman presented at an infectious disease clinic in Santo Domingo, with subacute dementia and psychomotor slowing. Based on physical findings and laboratory results, she was diagnosed with AIDS and HIV-associated dementia (HAD). She subsequently began combined antiretroviral therapy (cART). Psychiatric complications later emerged: the patient developed suicidal ideation and her partner expressed homicidal thoughts. After extensive interviewing, it was revealed that the patient had known her HIV-positive serostatus for years. However, several factors, including HIV stigma, mental illness stigma, domestic abuse and limited health literacy, had prevented her from seeking treatment and from disclosing her status to her partner. This patient's HIV was unmanaged as a consequence of social and educational circumstance, which resulted in severe sequelae, namely HAD. Compounded barriers to care can lead to the presentation of disease complications that are rarely seen today in countries with widespread access to antiretroviral therapy.

  20. Recent Infection, Sexually Transmitted Infections and Transmission Clusters Frequently Observed Among Persons Newly-Diagnosed with HIV in San Francisco

    Science.gov (United States)

    Truong, Hong-Ha M.; Pipkin, Sharon; O’Keefe, Kara J.; Louie, Brian; Liegler, Teri; McFarland, Willi; Grant, Robert M.; Bernstein, Kyle; Scheer, Susan

    2015-01-01

    There were 1,311 newly-diagnosed HIV cases in San Francisco between 2005 and 2011 that were linked to care at publicly-funded facilities and had viral sequences available for analysis. Of the 214 cases characterized as recently-infected with HIV at time of diagnosis, 25% had a recent sexually transmitted infection (STI) diagnosis (vs. 10% among longer-standing HIV infections, p<0.001) and 57% were part of a phylogenetic transmission cluster (vs. 42% among longer-standing HIV infection, p<0.001). The association observed between recent HIV infection and having a STI diagnosis during the interval overlapping likely HIV acquisition points to potential opportunities to interrupt HIV transmission. PMID:25967271

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

    Directory of Open Access Journals (Sweden)

    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

  2. Mechanism(s) involved in opioid drug abuse modulation of HAND.

    Science.gov (United States)

    Dutta, Raini; Roy, Sabita

    2012-07-01

    Drug abuse and HIV infection are interlinked. From the onset of the HIV/AIDS epidemic, the impact of illicit drug use on HIV disease progression has been a focus of many investigations. Both laboratory-based and epidemiological studies strongly indicate that drug abuse may exacerbate HIV disease progression and increase mortality and morbidity in these patients. Increase susceptibility to opportunistic infection has been implicated as one of the major causes for this detriment. Furthermore, opioids are known to elicit prevalence of neurodegenerative disorders in HIV-infected patients. Numerous authors have delineated various molecular as well as cellular mechanisms associated with neurological complications in these patients. This review gives an overview of these findings. Understanding the mechanisms will allow for the development of targeted therapies aimed at reducing the progression of neurocognitive decline in the drug abusing HIV infected individuals.

  3. Xerostomia related to HIV infection /AIDS: a critical review

    Directory of Open Access Journals (Sweden)

    Adriana Maria Fuzer Grael TINÓS

    Full Text Available Introduction: The presence of oral manifestations in HIV positive individuals is quite common. Xerostomia appears as one of the most frequent problems and may lead to a reduction in the quality of life of this population. Objective: This study was a critical review of the relationship between xerostomia and HIV infection, to attract the attention of dentists on the importance of dental care to these patients. Material and method: We included articles published between 2000 and 2009, indexed in PUBMED database. The descriptors used were "HIV" and "xerostomia", the exclusion criteria adopted were: the absence of these descriptors associated, non-location of the full-text, articles based on case studies or case series and the absence of the abstract in the database. Result: Based on studies in the review, it can be said that the xerostomia is a common manifestation of HIV infection, predisposing the patient to several other oral problems. Among the risk factors for its occurrence it was reported: low counts of CD4+ T cells, high plasma viral load, the use of some medications and antiretroviral therapy. Conclusion: The HIV/AIDS can change the salivary glands, and were considered important risk factors for the occurrence of xerostomia the presence of didanosine and the drug class which corresponds to protease inhibitors in antiretroviral therapy.

  4. Prevalence of and risk factors for pulmonary tuberculosis among newly diagnosed HIV-1 infected Nigerian children

    Science.gov (United States)

    Ebonyi, Augustine O.; Oguche, Stephen; Ejeliogu, Emeka U.; Agbaji, Oche O.; Shehu, Nathan Y.; Abah, Isaac O.; Sagay, Atiene S.; Ugoagwu, Placid O.; Okonkwo, Prosper I.; Idoko, John A.; Kanki, Phyllis J.

    2016-01-01

    Introduction Studies on the prevalence of and risk factors for tuberculosis (TB) among newly diagnosed human immunodeficiency virus (HIV)-infected children in sub-Saharan Africa are scarce and in Nigeria there is paucity of reported data. We determined the prevalence of and risk factors for pulmonary TB (PTB) in newly diagnosed (treatment-naïve) HIV-1 infected children at the pediatric HIV clinic of the Jos University Teaching Hospital (JUTH) in Nigeria. Methods We performed a retrospective analysis of 876 children, aged 2 months – 13 years, diagnosed with HIV-1 infection between July 2005 and December 2012, of which 286 were diagnosed with PTB at presentation after TB screening. The study site was the AIDS Prevention Initiative in Nigeria (APIN)-supported Pediatric HIV clinic at JUTH, Jos. A multivariate forward logistic regression modelling was used to identify risk factors for PTB-HIV co-infection. Results The prevalence of PTB-HIV co-infection was 32% (286/876). Severe immunosuppression (SI) and World Health Organization (WHO) HIV clinical stage 3/4 were identified as independent risk factors for PTB-HIV co-infection in HIV infected children. The odds of PTB-HIV co-infection was increased two-fold in HIV-infected children with WHO clinical stage 3/4 compared to those with stage 1/2 (adjusted odds ratio (AOR) 1.76 [1.31-2.37], p<0.001) and 1.5-fold in children with SI compared to those without SI (AOR 1.52 [1.12-2.06], p=0.007). Conclusion In our setting, the burden of PTB was high among newly diagnosed HIV-infected children, and late WHO HIV clinical stage and severe immunosuppression were associated with PTB-HIV co-infection. Therefore there is a clear need to improve strategies for early diagnosis of both HIV and PTB to optimize clinical outcomes. PMID:27019829

  5. 阿片类毒品对HIV-1感染者PBMCs中TLR9基因表达的影响%Influence of Opiate Abuse on Expression of Toll-like Receptor 9 in Peripheral Blood Mononuclear Cells of HIV-1-Infected Individuals

    Institute of Scientific and Technical Information of China (English)

    潘沛江; 韦富梅; 蒋俊俊; 梁冰玉; 黄颉刚; 廖艳研; 苏锦明; 李彧; 杨小艺

    2015-01-01

    探讨滥用阿片类毒品(Opiates)对Ⅰ型艾滋病病毒(Human immunodeficiency virus,HIV-1)感染者外周血单个核细胞(PBMCs)中TLR9基因表达水平的影响,为阐明阿片类毒品促进HIV-1复制的作用机制奠定基础.首先在南宁、柳州、钦州市地区的美沙酮、艾滋病自愿咨询检测门诊招募对象,经研究对象知情同意,分为4组,即阿片类毒品滥用的HIV-1感染组(Opiates HIV(+)组)、阿片类毒品滥用非HIV-1感染组(Opiates HIV(-)组)、非阿片类毒品滥用的HIV感染组(Non-opiates HIV(+)组)和健康对照组(Control组),每组随机招募50人.其次,以问卷形式调查对象的人口学特征,并采集其外周静脉血,分离出PBMCs后提取RNA.最后采用qPCR、蛋白质印迹法(Western blot,WB)法检测4组人群PBMCs中TLR9的mRNA、蛋白表达水平.经调查发现4组人群在年龄、性别、民族、户籍所在地、婚姻状况、文化程度和吸毒年限等人口学特征方面差异均无统计学意义(P>0.05).Opiates HIV(+)与Non Opiates HIV(+)组病毒载量中位数分别为4.450×103和3.977×103 cp/mL,差异有统计学意义(P<0.05).TLR9 mRNA相对表达量在Opiates HIV(+)、Non-Opiates HIV(+)、Opiates HIV(-)和Control组中分别为(2.13±1.59)×10-3、(3.66±2.22)×10-3、(1.96±1.42)× 10-3和(7.66±4.87)×10-3.阿片类毒品滥用和HIV感染对TLR9的表达存在交互作用(F=25.91,P=0.000).经单独效应分析,HIV阳性与阴性人群中,阿片类毒品滥用者TLR9相对表达量均明显低于非毒品滥用者(P<0.05);在吸毒人群中,HIV阳性者与HIV阴性者两组间差异没有统计学意义(P>0.05);在不吸毒人群中,HIV阳性者低于正常组,两组间差异有统计学意义(P<0.05).WB的结果显示,Opiates HIV(+)、Non-Opiates HIV(+)、Opiates HIV(-)三组TLR9蛋白的表达量均低于Control组.上述结果表明阿片类毒品能够下调HIV-1感染者PBMCs中TLR9的表达水平,提示阿片类毒品可能通过影响TLR9

  6. Late Presentation of HIV Infection: Prevalence, Trends, and the Role of HIV Testing Strategies in Guangzhou, China, 2008–2013

    Directory of Open Access Journals (Sweden)

    Weibin Cheng

    2016-01-01

    Full Text Available Background. The prevalence, trends, and the role of different HIV testing strategies in late presentation of HIV infection in China were unknown. Methods. Data of newly reported HIV cases in Guangzhou between 2008 and 2013 was analyzed to examine the prevalence, trends, and characteristics of late presentation of HIV infection by three types of HIV testing strategies. Results. Overall, 53.2% (1412/2653 and 27.3% (724/2653 met the criteria of late presentation and presentation with advanced HIV disease. The overall trend of late presentation of HIV infection within the study period was declining. Late presentation was 62.9% in 2008 and dropped to 43.3% in 2013 (P<0.001; presentation with advanced HIV disease was 40.3% in 2008 and dropped to 15.2% in 2013 (P<0.001. Of the three testing strategies, PITC presented higher odds of both late presentation [AOR (95% CI: PITC versus VCT: 1.37 (1.09, 1.73; PITC versus MHT: 3.09 (2.16, 4.42] and presentation with advanced HIV disease [AOR (95% CI: PITC versus VCT: 1.65 (1.29, 2.11; PITC versus MHT: 13.14 (8.47, 20.39]. Conclusions. Although the late presentation of HIV infection was declining, it was still high in Guangzhou. The worse situation among PITC cases urges the policy adjustment in medical settings to increase early HIV diagnosis.

  7. Understanding HIV infection for the design of a therapeutic vaccine. Part I: Epidemiology and pathogenesis of HIV infection

    NARCIS (Netherlands)

    Goede, A.L. de; Vulto, A.G.; Osterhaus, A.D.; Gruters, R.A.

    2015-01-01

    HIV infection leads to a gradual loss CD4+ T lymphocytes comprising immune competence and progression to AIDS. Effective treatment with combined antiretroviral drugs (cART) decreases viral load below detectable levels but is not able to eliminate the virus from the body. The success of cART is frust

  8. Transcriptomic assay of CD8+ T cells in treatment-naive HIV, HCV-mono-infected and HIV/HCV-co-infected Chinese.

    Directory of Open Access Journals (Sweden)

    Jin Zhao

    Full Text Available BACKGROUND: Co-infection with HIV and HCV is very common. It is estimated that over 5 million people are co-infected with HIV and HCV worldwide. Accumulated evidence shows that each virus alters the course of infection of the other one. CD8+ T cells play a crucial role in the eradication of viruses and infected target cells. To the best of our knowledge, no one has investigated the gene expression profiles in HIV/HCV-co-infected individuals. METHODOLOGY: Genome-wide transcriptomes of CD8+ T cells from HIV/HCV-co-infected or mono-infected treatment-naïve individuals were analyzed by microarray assays. Pairwise comparisons were performed and differentially expressed genes were identified followed by quantitative real-time PCR (qRT-PCR validation. Directed Acyclic Graphs (DAG from Web-based Gene SeT AnaLysis Toolkit (WebGestalt and DAVID bioinformatics resources 6.7 (the Database for Annotation, Visualization, and Integrated Discovery were used to discover the Gene Ontology (GO categories with significantly enriched gene numbers. The enriched Kyoto Encyclopedia of Genes and Genomes (KEGG pathways were also obtained by using WebGestalt software. RESULTS AND CONCLUSIONS: A total of 110, 24 and 72 transcript IDs were shown to be differentially expressed (> 2-fold and p<0.05 in comparisons between HCV- and HIV-mono-infected groups, HIV/HCV-co-infected and HIV-mono-infected groups, and HIV/HCV-co-infected and HCV-mono-infected groups, respectively. In qRT-PCR assay, most of the genes showed similar expressing profiles with the observation in microarray assays. Further analysis revealed that genes involved in cell proliferation, differentiation, transcriptional regulation and cytokine responses were significantly altered. These data offer new insights into HIV/HCV co-infections, and may help to identify new markers for the management and treatment of HIV/HCV co-infections.

  9. Impact of selenium status on the pathogenesis of mycobacterial disease in HIV-1-infected drug users during the era of highly active antiretroviral therapy.

    Science.gov (United States)

    Shor-Posner, Gail; Miguez, Maria-Jose; Pineda, Luisa Maria; Rodriguez, Allan; Ruiz, Philip; Castillo, Gloria; Burbano, Ximena; Lecusay, Robert; Baum, Marianna

    2002-02-01

    The risk of mycobacterial disease is significantly increased in drug abusers as well as in immunocompromised HIV-1-infected individuals. The essential trace element selenium has an important function in maintaining immune processes and may, thus, have a critical role in clearance of mycobacteria. The impact of selenium status on the development of mycobacterial diseases in HIV-1-seropositive drug users was investigated over a 2-year period (1999-2001). Twelve cases of mycobacterial disease (tuberculosis, 9; infection due to atypical Mycobacterium species, 3) occurred; these 12 cases were compared with 32 controls with no history of respiratory infections who were matched on age, sex, and HIV status. Significant risk for development of mycobacterial disease was associated with a CD4 cell count of impact on the pathogenesis of mycobacterial disease.

  10. Enhancing HIV Treatment Access and Outcomes Amongst HIV Infected Children and Adolescents in Resource Limited Settings.

    Science.gov (United States)

    Goga, Ameena Ebrahim; Singh, Yagespari; Singh, Michelle; Noveve, Nobuntu; Magasana, Vuyolwethu; Ramraj, Trisha; Abdullah, Fareed; Coovadia, Ashraf H; Bhardwaj, Sanjana; Sherman, Gayle G

    2017-01-01

    Introduction Increasing access to HIV-related care and treatment for children aged 0-18 years in resource-limited settings is an urgent global priority. In 2011-2012 the percentage increase in children accessing antiretroviral therapy was approximately half that of adults (11 vs. 21 %). We propose a model for increasing access to, and retention in, paediatric HIV care and treatment in resource-limited settings. Methods Following a rapid appraisal of recent literature seven main challenges in paediatric HIV-related care and treatment were identified: (1) lack of regular, integrated, ongoing HIV-related diagnosis; (2) weak facility-based systems for tracking and retention in care; (3) interrupted availability of dried blood spot cards (expiration/stock outs); (4) poor quality control of rapid HIV testing; (5) supply-related gaps at health facility-laboratory interface; (6) poor uptake of HIV testing, possibly relating to a fatalistic belief about HIV infection; (7) community-associated reasons e.g. non-disclosure and weak systems for social support, resulting in poor retention in care. Results To increase sustained access to paediatric HIV-related care and treatment, regular updating of Policies, review of inter-sectoral Plans (at facility and community levels) and evaluation of Programme implementation and impact (at national, subnational, facility and community levels) are non-negotiable critical elements. Additionally we recommend the intensified implementation of seven main interventions: (1) update or refresher messaging for health care staff and simple messaging for key staff at early childhood development centres and schools; (2) contact tracing, disclosure and retention monitoring; (3) paying particular attention to infant dried blood spot (DBS) stock control; (4) regular quality assurance of rapid HIV testing procedures; (5) workshops/meetings/dialogues between health facilities and laboratories to resolve transport-related gaps and to facilitate return of

  11. Dietary intakes of HIV-infected adults in urban UK.

    Science.gov (United States)

    Klassen, K; Goff, L M

    2013-08-01

    Maintaining a good nutritional status is important for immune health and for managing metabolic comorbidities in adults with HIV infection. Little is known about the dietary habits of adults living with HIV infection in the United Kingdom. The aims of this study were to characterise their dietary intakes, and to identify subgroups of patients who may require nutritional counselling and/or food support services. An observational study of adults attending a London HIV out-patient clinic who completed a demographics questionnaire and a structured 24 h diet recall interview was conducted. In all, 196 (162 men, 34 women) adults participated. Forty-three percent (n=66) of men and thirty-six percent (n=11) of women did not consume enough energy to meet their basal metabolic requirements and activity factor. The majority of both men (64%) and women (56%) consumed more than the recommended amount of saturated fat. Self-report of lipodystrophy (B coefficient -2.27 (95% CI -3.92 to -0.61), P=0.008) was associated with lower dietary fibre intake/1000 kcal per day, and a more recent diagnosis of HIV (B coefficient -0.11 (95% CI -0.20 to -0.02), P=0.013) was associated with a higher dietary fibre/1000 kcal intake per day. Recreational drug use was associated with a higher overall calorie (P=0.003) and protein (P=0.001) intake than non-usage after adjusting for basal metabolic requirements and weight, respectively. Our data describe the dietary intakes of a diverse group of adults with HIV infection in the United Kingdom. These dietary habits may have an impact on their overall health and development of other metabolic comorbidities common in people with HIV.

  12. 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...

  13. Anxiety symptoms in HIV-infected individuals.

    Science.gov (United States)

    Kemppainen, Jeanne K; MacKain, Sally; Reyes, Darcel

    2013-01-01

    Anxiety is one of the most frequent symptoms recognized by providers who care for persons living with HIV disease (PLWH). This evidence-based review of anxiety and HIV disease includes an overview of anxiety symptoms, their prevalence in PLWH, and co-existing mood and behavioral disorders. Harmful physiologic effects are also highlighted. Valid and reliable clinical measurement tools used for assessing anxiety include the Clinical Diagnostic Questionnaire, the Hamilton Anxiety Scale, the State-Trait Anxiety Scale, the Profile of Mood States, and the Hospital Anxiety and Depression Scale. Evidence supports the use of cognitive behavioral therapy as a recommended intervention for the treatment of anxiety symptoms and/or anxiety disorders in PLWH. Medications for use with more severe and disabling anxiety are discussed, as well as evidence based on expert opinion for anxiety self-management.

  14. Novel treatment options for pediatric HIV infection.

    Science.gov (United States)

    Day, Eleanor; Buckberry, Karen; Sharland, Michael R; Chakraborty, Rana

    2008-02-01

    The development of effective antiretroviral therapy for HIV has led to significant virological suppression and immune reconstitution, and resulted in dramatic reductions in HIV-related morbidity and mortality. However, in children initial regimens were unpalatable and inconvenient due to a high pill burden. Management was further compromised by a paucity of pharmacokinetic data and the late development of associated toxicities. These factors have resulted in the emergence of drug-resistant virus in many treated children and adolescents. In this review, therapeutic options that may be available for treatment-experienced pediatric individuals are summarized on the basis of data from adult clinical trials evaluating protease, non-nucleoside reverse transcriptase, fusion, integrase and CCR5 inhibitors.

  15. Discrimination against HIV-infected people and the spread of HIV: some evidence from France.

    Directory of Open Access Journals (Sweden)

    Patrick Peretti-Watel

    Full Text Available BACKGROUND: Many people living with HIV/AIDS (PLWHA suffer from stigma and discrimination. There is an ongoing debate, however, about whether stigma, fear and discrimination actually fuel the persisting spread of HIV, or slow it down by reducing contacts between the whole population and high-risk minorities. To contribute to this debate, we analysed the relationship between perceived discrimination and unsafe sex in a large sample of French PLWHAs. METHODOLOGY/PRINCIPAL FINDINGS: In 2003, we conducted a national cross-sectional survey among a random sample of HIV-infected patients. The analysis was restricted to sexually active respondents (N = 2,136. Unsafe sex was defined as sexual intercourse without a condom with a seronegative/unknown serostatus partner during the prior 12 months. Separate analyses were performed for each transmission group (injecting drug use (IDU, homosexual contact, heterosexual contact. Overall, 24% of respondents reported experiences of discrimination in their close social environment (relatives, friends and colleagues and 18% reported unsafe sex during the previous 12 months. Both prevalences were higher in the IDU group (32% for perceived discrimination, 23% for unsafe sex. In multivariate analyses, experience of discrimination in the close social environment was associated with an increase in unsafe sex for both PLWHAs infected through IDU and heterosexual contact (OR = 1.65 and 1.80 respectively. CONCLUSIONS: Our study clearly confirms a relationship between discrimination and unsafe sex among PLWHAs infected through either IDU or heterosexual contact. This relationship was especially strong in the heterosexual group that has become the main vector of HIV transmission in France, and who is the more likely of sexual mixing with the general population. These results seriously question the hypothesis that HIV-stigma has no effect or could even reduce the infection spread of HIV.

  16. Understanding HIV infection for the design of a therapeutic vaccine. Part II: Vaccination strategies for HIV

    NARCIS (Netherlands)

    Goede, A.L. de; Vulto, A.G.; Osterhaus, A.D.; Gruters, R.A.

    2015-01-01

    HIV infection leads to a gradual loss CD4+ T lymphocytes comprising immune competence and progression to AIDS. Effective treatment with combined antiretroviral drugs (cART) decreases viral load below detectable levels but is not able to eliminate the virus from the body. The success of cART is frust

  17. 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

  18. [Improvement of parodontitis therapy of patients with HIV-infection].

    Science.gov (United States)

    Soboleva, L A; Oseeva, A O; Shul'diakov, A A; Bulkina, N V

    2010-01-01

    For the purpose to determine the clinic-pathogenetic efficacy of cycloferon liniment in the combined therapy of periodontitis of patients with subclinical stage of HIV-infection medical examination and treatment of 40 patients was carried out. It was established that use of liniment cycloferon in the combined treatment of patients with subclinical stage of HIV-infection allowed to accelerate process of normalization of lipid peroxidation parameters and antioxidant potential of blood, to decrease infection load (herpes symplex virus I, Candida albicans, Staphylococcus aureus) in parodontal recess and evidence of local inflammation with reduction of activity of the tumours necrosis factor and interleukin 1beta, what provided acceleration of recuperation processes, lowering the frequency of parodontitis relapses.

  19. HIV-1 clade B pol evolution following primary infection.

    Directory of Open Access Journals (Sweden)

    George K Hightower

    Full Text Available OBJECTIVE: Characterize intra-individual HIV-1 subtype B pol evolution in antiretroviral naive individuals. DESIGN: Longitudinal cohort study of individuals enrolled during primary infection. METHODS: Eligible individuals were antiretroviral naïve participants enrolled in the cohort from December 1997-December 2005 and having at least two blood samples available with the first one collected within a year of their estimated date of infection. Population-based pol sequences were generated from collected blood samples and analyzed for genetic divergence over time in respect to dual infection status, HLA, CD4 count and viral load. RESULTS: 93 participants were observed for a median of 1.8 years (Mean = 2.2 years, SD =1.9 years. All participants classified as mono-infected had less than 0.7% divergence between any two of their pol sequences using the Tamura-Nei model (TN93, while individuals with dual infection had up to 7.0% divergence. The global substitution rates (substitutions/nucleotide/year for mono and dually infected individuals were significantly different (p<0.001; however, substitution rates were not associated with HLA haplotype, CD4 or viral load. CONCLUSIONS: Even after a maximum of almost 9 years of follow-up, all mono-infected participants had less than 1% divergence between baseline and longitudinal sequences, while participants with dual infection had 10 times greater divergence. These data support the use of HIV-1 pol sequence data to evaluate transmission events, networks and HIV-1 dual infection.

  20. Epidemiology of tuberculosis in HIV-infected patients in Denmark

    DEFF Research Database (Denmark)

    Dragsted, Ulrik Bak; Bauer, J; Poulsen, S;

    1999-01-01

    increased in the younger age groups, indicating more newly infected persons. This study was performed in order to assess the impact of the HIV epidemic and immigration on TB incidence among native Danes. The study was also designed to reveal transmission patterns of TB among HIV-positive patients. Data from......Denmark is an area of low incidence of HIV and tuberculosis (TB). The number of newly reported cases of HIV has been stable during the 1990s, whereas the number of TB cases has doubled in Denmark in the past decade, mainly due to immigration. However, among native Danes the incidence of TB has...... in the nationwide Danish RFLP database (approximately 1,700 patients). Sixty-seven co-infected patients were identified, 26 Danes and 41 immigrants, representing only 4% of all TB cases during the study period. Danish co-infected patients were part of a cluster, i.e. they had a RFLP-pattern identical to a pattern...

  1. 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.)

  2. The Prevalence and Risk Factors of Hepatitis Delta Virus in HIV/HBV Co-Infected Patients in Shiraz, Iran, 2012

    Directory of Open Access Journals (Sweden)

    Mohammad Motamedifar

    2015-09-01

    Full Text Available Evidence has shown that liver disease caused by hepatitis viruses can be more aggressive and severe in HIV infected subjects. Therefore, the present cross-sectional study aimed to evaluate the seroprevalence of HDV infection among HIV/HBV co-infected clients in Shiraz, southwest Iran. In this study, 178 patients co-infected with HBV and HIV individuals were enrolled. The diagnosis of HIV infection was documented based on serological assays. The demographic and complementary data were collected by a questionnaire. HBsAg and HDV Ab were detected by commercial quantitative enzyme linked immunosorbent assay kits according to the manufacturer’s instructions. Alanine aminotransferase (ALT and aspartate aminotransferase (AST were also measured. The mean age of the participants was 37.4±7.4 years (range 22-63. 175 (98.4 % patients were male and 3 (1.6 % were female. Among 178 patients co-infected with HIV/HBV, 35 cases (19.7%, 95% CI: 14%-25% were anti-HDV‏ positive and 143 (80.3% were negative for anti-HDV. HDV exposure in HIV/HBV co-infected patients was associated with blood transfusion (P=0.002, OR: 14.3 and prison history (P=0.01, OR: 2.31 but not with age, marital status, unsafe sex contact, and injection drug abuse. Our data showed a relatively high prevalence of HDV infection in HIV infected population in Shiraz, Iran. The high frequency of HDV Ab in patients with blood transfusion and prison history reveals that HDV transmission occurs more frequently in the parental route than sexual contacts; therefore, blood screening for HDV diagnosis in the high-risk group is recommended.

  3. Occurrence of occult HCV infection among Hiv infected patients in Georgia.

    Science.gov (United States)

    Gatserelia, L; Sharvadze, L; Karchava, M; Dolmazashvili, E; Tsertsvadze, T

    2014-01-01

    Occult hepatitis C (OCI) infection has been known as detectable HCV-RNA in the liver or peripheral blood mononuclear cells (PBMCs) in the absence of detectable serum or plasma HCV-RNA. OCI has been detected among different patients groups worldwide, it has been found not only in chronic hepatitis patients of unknown origin, but also among several groups at risk for HCV infection (hemodialysis patients or family members of patients with occult HCV). This occult infection has been reported also in healthy populations without evidence of liver disease. Prevalence of occult Hepatitis C virus has not been investigated in Georgian population, where a rate of HCV infection is highest (6.7%) among Eastern European Countries. The aim of this study was to investigate the occurrence of occult HCV infection among HIV infected individuals in Georgia. As a pilot study, we have selected three groups of HIV infected patients for analyses: Group 1- HIV infected patients without evidence of liver disease (n=98), group 2- HIV infected patients with cryptogenic liver disease (n=34) and group 3- HIV/HBV co infected patients (n=29). HCV RNA was tested in PBMCs samples by real-time polymerase chain reaction. HCV genotyping was performed by Line-probe assay based on reverse-hybridization technology. Liver fibrosis was evaluated by transient elastography (FibroScan®). HCV-RNA was detected in PBMCs specimens among 2 (2%) subjects from group 1, 4 (12%) subjects from group 2, and 9 (31%) subjects from group 3. HCV genotypes were determined for 14 of 15 OCI subjects resulting following genotype distribution: 6 (46%) - 1b, 3 (23%) - 2a/2c and 5 (38%) - 3a. One samples failed to be genotyped due to extremely low HCV viral load. Our data revealed the occurrence of occult HCV infection in HIV infected patients. No single HCV genotype was predominant in the present study. Liver fibrosis was found more frequently and the fibrosis score was significantly higher in OCI patients versus negative ones

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

    DEFF Research Database (Denmark)

    Lohse, Nicolai; Hansen, Ann-Brit Eg; Gerstoft, Jan

    2007-01-01

    . 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......, 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...

  5. Dynamics of a stochastic HIV-1 infection model with logistic growth

    Science.gov (United States)

    Jiang, Daqing; Liu, Qun; Shi, Ningzhong; Hayat, Tasawar; Alsaedi, Ahmed; Xia, Peiyan

    2017-03-01

    This paper is concerned with a stochastic HIV-1 infection model with logistic growth. Firstly, by constructing suitable stochastic Lyapunov functions, we establish sufficient conditions for the existence of ergodic stationary distribution of the solution to the HIV-1 infection model. Then we obtain sufficient conditions for extinction of the infection. The stationary distribution shows that the infection can become persistent in vivo.

  6. Overt and occult hepatitis B virus infection in adult Sudanese HIV patients

    Directory of Open Access Journals (Sweden)

    Hatim Mudawi

    2014-12-01

    Conclusions: Evidence of HBV infection was detected in 26.8% of HIV patients with HBsAg-negative infection, with viraemia detected in 15.1% of the patients. All HIV-infected patients should be screened carefully for HBV infection with HBsAg and anti-HBc IgG antibodies prior to starting antiretroviral therapy.

  7. Depression and Posttraumatic Stress Disorder Among HIV-Infected Gambians on Antiretroviral Therapy

    NARCIS (Netherlands)

    Peterson, Kevin; Togun, Toyin; Klis, Sandor; Menten, Joris; Colebunders, Robert

    2012-01-01

    Mood disorders are more frequent among people with HIV infection than among non-HIV-infected individuals of the same age, socioeconomic status, and HIV risks. They have been associated with worse adherence and clinical outcomes, yet remain underdiagnosed and undertreated in sub-Saharan Africa. We ex

  8. HIV and tuberculosis co-infection in Uganda: clinical management, immune reconstitution and health service delivery

    NARCIS (Netherlands)

    Hermans, S.M.

    2012-01-01

    Background In HIV-infected patients, tuberculosis (TB) occurs 20 to 30 times more often and is a leading cause of death. Triple combination antiretroviral therapy (cART) reduces mortality and risk of TB in HIV-infected patients. Uganda is a high-burden country of both HIV and TB; more than half of T

  9. Trajectories of childbearing among HIV infected Indian women: A sequence analysis approach

    NARCIS (Netherlands)

    Darak, S.; Mills, M.; Kulkarni, V.; Kulkarni, S.; Hutter, I.; Janssen, F.

    2015-01-01

    Background HIV infection closely relates to and deeply affects the reproductive career of those infected. However, little is known about the reproductive career trajectories, specifically the interaction of the timing of HIV diagnosis with the timing and sequencing of reproductive events among HIV i

  10. Duration of hospitalization and appetite of HIV-infected South-African children

    NARCIS (Netherlands)

    Mda, S.; Raaij, van J.M.A.; MacIntyre, U.E.; Villiers, de F.R.M.; Kok, F.J.

    2011-01-01

    Human immunodeficiency virus (HIV)-infected children generally show poor growth. Episodes of diarrhoea and pneumonia in HIV-infected children are thought to be more severe than in HIV-uninfected children. The objective of this study was to compare duration of hospitalization, appetite and nutritiona

  11. Trajectories of Childbearing among HIV Infected Indian Women : A Sequence Analysis Approach

    NARCIS (Netherlands)

    Darak, Shrinivas; Mills, Melinda; Kulkarni, Vinay; Kulkarni, Sanjeevani; Hutter, Inge; Janssen, Fanny

    2015-01-01

    Background HIV infection closely relates to and deeply affects the reproductive career of those infected. However, little is known about the reproductive career trajectories, specifically the interaction of the timing of HIV diagnosis with the timing and sequencing of reproductive events among HIV i

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

    Directory of Open Access Journals (Sweden)

    Silvana Pasetto

    Full Text Available 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.

  13. Methamphetamine abuse affects gene expression in brain-derived microglia of SIV-infected macaques to enhance inflammation and promote virus targets

    KAUST Repository

    Najera, Julia A.

    2016-04-23

    Background Methamphetamine (Meth) abuse is a major health problem linked to the aggravation of HIV- associated complications, especially within the Central Nervous System (CNS). Within the CNS, Meth has the ability to modify the activity/function of innate immune cells and increase brain viral loads. Here, we examined changes in the gene expression profile of neuron-free microglial cell preparations isolated from the brain of macaques infected with the Simian Immunodeficiency Virus (SIV), a model of neuroAIDS, and exposed to Meth. We aimed to identify molecular patterns triggered by Meth that could explain the detection of higher brain viral loads and the development of a pro-inflammatory CNS environment in the brain of infected drug abusers. Results We found that Meth alone has a strong effect on the transcription of genes associated with immune pathways, particularly inflammation and chemotaxis. Systems analysis led to a strong correlation between Meth exposure and enhancement of molecules associated with chemokines and chemokine receptors, especially CXCR4 and CCR5, which function as co-receptors for viral entry. The increase in CCR5 expression was confirmed in the brain in correlation with increased brain viral load. Conclusions Meth enhances the availability of CCR5-expressing cells for SIV in the brain, in correlation with increased viral load. This suggests that Meth is an important factor in the susceptibility to the infection and to the aggravated CNS inflammatory pathology associated with SIV in macaques and HIV in humans.

  14. Multi-micronutrient supplementation in HIV-infected South African children : effect on nutritional s tatus, diarrhoea and respiratory infections

    NARCIS (Netherlands)

    Mda, S.

    2011-01-01

      Background: The nutritional status of HIV-infected children is reported to be poor. Diarrhoea and acute respiratory infections tend to be more common and severe in HIV-infected children than in uninfected ones. Deficiencies of micronutrients may result in poor growth and inc

  15. Addressing intravaginal practices in women with HIV and at-risk for HIV infection, a mixed methods pilot study

    Science.gov (United States)

    Alcaide, Maria L; Rodriguez, Violeta J; Fischl, Margaret A; Jones, Deborah L; Weiss, Stephen M

    2017-01-01

    Intravaginal practices (IVPs), include intravaginal cleansing (cleansing the inside of the vagina) or intravaginal insertion of products for hygiene, health or sexuality reasons. IVPs are associated with adverse female health outcomes, development of bacterial vaginosis, HIV acquisition and transmission. A mixed methods approach was used in this study to examine the prevalence of IVP, assess reasons for engagement, and perceptions of IVP among a sample of minority (African-American and Hispanic) women infected, or at-risk, for HIV in Miami, USA, a city with increasing numbers of sexually transmitted infections (STIs) and HIV. Three focus groups (total n=20) and quantitative assessments (n=72) were conducted with women infected or uninfected with HIV. In the qualitative assessments, most women reported engaging in both intravaginal cleansing and intravaginal insertion, and stated the main motivation for IVP was hygiene. The quantitative assessments confirmed that cleansing with water alone, soap with water or using commercial douches was common, as well as intravaginal insertion using a cloth or a rag in both HIV-infected and uninfected women. Women with HIV infection reported less use of water and water and soap for IVPs, and reported learning about the potential harm of IVP from their HIV health care providers. Despite their health risks, IVP appeared common in both HIV-infected and at-risk minority women, and interventions to decrease IVP could have important health implications among populations with high rates of IVP, STIs and HIV. PMID:28280394

  16. Prognostic value of a CCR5 defective allele in pediatric HIV-1 infection.

    OpenAIRE

    2000-01-01

    BACKGROUND: A deletion of 32 base pairs in the CCR5 gene (delta32 CCR5) has been linked to resistance to HIV-1 infection in exposed adults and to the delay of disease progression in infected adults. MATERIALS AND METHODS: To determine the role of delta32 CCR5 in disease progression of HIV-1 infected children born to seropositive mothers, we studied a polymerase chain reaction in 301 HIV-1 infected, 262 HIV-1 exposed-uninfected and 47 HIV-1 unexposed-uninfected children of Spanish and Italian ...

  17. [Coping and perception of women with HIV infection].

    Science.gov (United States)

    Renesto, Helana Maria Ferreira; Falbo, Ana Rodrigues; Souza, Edvaldo; Vasconcelos, Maria Gorete

    2014-02-01

    OBJECTIVE To analyze women's perceptions and coping regarding the discovery of an HIV infection. METHODS A qualitative study in an HIV/AIDS Specialist Helpdesk in Recife, PE, Northeastern Brazil, from January to September 2010, involving eight women living with asymptomatic HIV aged between 27 and 37 years, without criteria for diagnosis of AIDS infected through intercourse and monitored by the service for at least one year. Forms were used to characterize the clinical situation and semi-structured interviews to understand perceptions and feelings related to personal trajectory after diagnosis and different ways of facing the diagnosis in family and social life. Content analysis was performed as suggested by Bardin. RESULTS The thematic category that emerged was stigma and discrimination. The women had life trajectories marked by stigma, which was perceived as discrimination after the diagnosis and in the experiences of everyday life. The revelation of the infection was perceived as limiting to a normal life, leading to the need to conceal the diagnosis. The discriminatory attitudes of some health care professionals, non-specialist in HIV/AIDS, had a negative impact on future experiences in other health services. Besides the effects of institutional stigma, the perception of women was that the service did not include dedicated space for the expression of other needs beyond the disease, which could help in fighting the infection. CONCLUSIONS Living with HIV was strongly linked to stigma. The results show the importance of strengthening educational approaches and emotional support at the time of diagnosis in order to facilitate coping with the condition of seropositivity.

  18. Coping and perception of women with HIV infection

    Science.gov (United States)

    Renesto, Helana Maria Ferreira; Falbo, Ana Rodrigues; Souza, Edvaldo; Vasconcelos, Maria Gorete

    2014-01-01

    OBJECTIVE To analyze women’s perceptions and coping regarding the discovery of an HIV infection. METHODS A qualitative study in an HIV/AIDS Specialist Helpdesk in Recife, PE, Northeastern Brazil, from January to September 2010, involving eight women living with asymptomatic HIV aged between 27 and 37 years, without criteria for diagnosis of AIDS infected through intercourse and monitored by the service for at least one year. Forms were used to characterize the clinical situation and semi-structured interviews to understand perceptions and feelings related to personal trajectory after diagnosis and different ways of facing the diagnosis in family and social life. Content analysis was performed as suggested by Bardin. RESULTS The thematic category that emerged was stigma and discrimination. The women had life trajectories marked by stigma, which was perceived as discrimination after the diagnosis and in the experiences of everyday life. The revelation of the infection was perceived as limiting to a normal life, leading to the need to conceal the diagnosis. The discriminatory attitudes of some health care professionals, non-specialist in HIV/AIDS, had a negative impact on future experiences in other health services. Besides the effects of institutional stigma, the perception of women was that the service did not include dedicated space for the expression of other needs beyond the disease, which could help in fighting the infection. CONCLUSIONS Living with HIV was strongly linked to stigma. The results show the importance of strengthening educational approaches and emotional support at the time of diagnosis in order to facilitate coping with the condition of seropositivity. PMID:24789635

  19. Identification of Host Micro RNAs That Differentiate HIV-1 and HIV-2 Infection Using Genome Expression Profiling Techniques

    Directory of Open Access Journals (Sweden)

    Krishnakumar Devadas

    2016-05-01

    Full Text Available While human immunodeficiency virus type 1 and 2 (HIV-1 and HIV-2 share many similar traits, major differences in pathogenesis and clinical outcomes exist between the two viruses. The differential expression of host factors like microRNAs (miRNAs in response to HIV-1 and HIV-2 infections are thought to influence the clinical outcomes presented by the two viruses. MicroRNAs are small non-coding RNA molecules which function in transcriptional and post-transcriptional regulation of gene expression. MiRNAs play a critical role in many key biological processes and could serve as putative biomarker(s for infection. Identification of miRNAs that modulate viral life cycle, disease progression, and cellular responses to infection with HIV-1 and HIV-2 could reveal important insights into viral pathogenesis and provide new tools that could serve as prognostic markers and targets for therapeutic intervention. The aim of this study was to elucidate the differential expression profiles of host miRNAs in cells infected with HIV-1 and HIV-2 in order to identify potential differences in virus-host interactions between HIV-1 and HIV-2. Differential expression of host miRNA expression profiles was analyzed using the miRNA profiling polymerase chain reaction (PCR arrays. Differentially expressed miRNAs were identified and their putative functional targets identified. The results indicate that hsa-miR 541-3p, hsa-miR 518f-3p, and hsa-miR 195-3p were consistently up-regulated only in HIV-1 infected cells. The expression of hsa-miR 1225-5p, hsa-miR 18a* and hsa-miR 335 were down modulated in HIV-1 and HIV-2 infected cells. Putative functional targets of these miRNAs include genes involved in signal transduction, metabolism, development and cell death.

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

    Institute of Scientific and Technical Information of China (English)

    Ashwani K Singal; Bhupinderjit S Anand

    2009-01-01

    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 monoinfection; 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 coinfected 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.

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

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    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.

  2. Changes in plasma cytokines after treatment of ascaris lumbricoides infection in individuals with HIV-1 infection.

    Science.gov (United States)

    Blish, Catherine A; Sangaré, Laura; Herrin, Bradley R; Richardson, Barbra A; John-Stewart, Grace; Walson, Judd L

    2010-06-15

    Albendazole treatment of individuals with human immunodeficiency virus type 1 (HIV-1) and Ascaris lumbricoides co-infection has led to significantly improved CD4(+) cell counts and a trend for lower plasma HIV-1 RNA levels in a previous randomized placebo-controlled trial. To define mechanisms by which deworming contributed to changes in markers of HIV-1 disease progression, plasma cytokine levels were evaluated. Albendazole treatment, compared with placebo, was associated with significantly decreased plasma interleukin (IL) 10 levels (P = .01)ot associated with significant changes in levels of IL-1beta, IL-2, IL-4, IL-5, IL-6, IL-7, IL-8, IL-12p70, IL-13, interferon gamma, tumor necrosis factor alpha, or thymic stromal lymphopoietin. Treatment of A. lumbricoides co-infection may delay HIV-1 disease progression by reducing helminth-induced, IL-10-mediated immunosuppression.

  3. 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 HIV tr...

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

    Directory of Open Access Journals (Sweden)

    Carina Nilsen Moreno

    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.This review presents current considerations for renal transplantation in HIV patients. In the last decade, with the advent of highly active antiretroviral therapy (HAART, life expectancy of patients infected with human immunodeficiency virus (HIV has significantly improved, showing a marked decrease in the rates of morbidity and mortality in this population. In this setting, the number of

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

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    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.

  6. Factors Influencing the Nutritional Health and Food Choices of African American HIV-Positive Marginally Housed and Homeless Female Substance Abusers

    Science.gov (United States)

    Mahadevan, Meena; Fisher, Celia B.

    2010-01-01

    The toll of HIV/AIDS and drug abuse on economically disadvantaged women of color in the United States is a public health problem of epidemic proportions. Malnutrition, believed to be pervasive in this population, exacerbates the devastating health effects of addiction and HIV. This study documented dietary deficiencies in this population and…

  7. Porphyromonas gingivalis-mediated signaling through TLR4 mediates persistent HIV infection of primary macrophages

    Science.gov (United States)

    Agosto, Luis M.; Hirnet, Juliane B.; Michaels, Daniel H.; Shaik-Dasthagirisaheb, Yazdani B.; Gibson, Frank C.; Viglianti, Gregory; Henderson, Andrew J.

    2016-01-01

    Periodontal infections contribute to HIV-associated co-morbidities in the oral cavity and provide a model to interrogate the dysregulation of macrophage function, inflammatory disease progression, and HIV replication during co-infections. We investigated the effect of Porphyromonas gingivalis on the establishment of HIV infection in monocyte-derived macrophages. HIV replication in macrophages was significantly repressed in the presence of P. gingivalis. This diminished viral replication was due partly to a decrease in the expression of integrated HIV provirus. HIV repression depended upon signaling through TLR4 as knock-down of TLR4 with siRNA rescued HIV expression. Importantly, HIV expression was reactivated upon removal of P. gingivalis. Our observations suggest that exposure of macrophages to Gram-negative bacteria influence the establishment and maintenance of HIV persistence in macrophages through a TLR4-dependent mechanism. PMID:27639573

  8. 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.

  9. Mycobacterium tuberculosis infection in a HIV-positive patient

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    Maria Theresa Montales

    2015-01-01

    Full Text Available Mycobacterium tuberculosis (MTB and human immunodeficiency virus (HIV coinfection remains a global public health challenge. We report a 40 year old African American male who is a known HIV-positive patient, non-compliant with his antiretrovirals and developed pulmonary tuberculosis. His chief complaints were chronic cough, fever, night sweats and undocumented weight loss. He had a prior positive T-SPOT-TB test; however, chest radiograph and sputum smear examination revealed normal results. PCR-based GeneXPERT MTB/RIF assay was ordered and confirmed MTB infection. The sputum cultures grew MTB and sensitivities showed susceptibility to all primary anti-tuberculosis medications. A delay in diagnosis and initiation of MTB therapy, in the setting of HIV or AIDS, may result in rapid disease progression and worse clinical outcome.

  10. [Pathogenesis of lipodystrophy and metabolic syndromes associated with HIV infection].

    Science.gov (United States)

    Muñoz-Sanz, Agustín; Rodríguez-Vidigal, Francisco F; Domingo, Pere

    2006-09-30

    Lipodystrophy, and the metabolic alterations (dislipemia, insulin-resistance) associated with human immunodeficiency virus (HIV) infection, is a multifactorial syndrome due to the interaction of host related factors (cellular immune status, diet, gene mutations), viral factors (cytokine synthesis, polyunsaturated fatty acid or PUFA depletion), and pharmacological effects (mitochondrial DNA-polymerase inhibition, lipolysis inhibition, adiponectin synthesis reduction). HIV probably modifies the adipocyte differentiation and the lipid metabolism. This retroviral effect is mediated by proinflammatory cytokines (tumor necrosis factor) and the participation of other factors (drugs, diet), all in the context of a particular host genetic setting. The adipocyte (and several cellular receptors, fatty acids, membrane proteins, and cytokines) plays a central role in the pathogenesis of HIV-associated lipodystrophy.

  11. Initiation of Antiretroviral Therapy in Early Asymptomatic HIV Infection

    DEFF Research Database (Denmark)

    Lundgren, Jens D; Babiker, Abdel G; Gordin, Fred

    2015-01-01

    BACKGROUND: Data from randomized trials are lacking on the benefits and risks of initiating antiretroviral therapy in patients with asymptomatic human immunodeficiency virus (HIV) infection who have a CD4+ count of more than 350 cells per cubic millimeter. METHODS: We randomly assigned HIV...... entry, the median HIV viral load was 12,759 copies per milliliter, and the median CD4+ count was 651 cells per cubic millimeter. On May 15, 2015, on the basis of an interim analysis, the data and safety monitoring board determined that the study question had been answered and recommended that patients...... per cubic millimeter provided net benefits over starting such therapy in patients after the CD4+ count had declined to 350 cells per cubic millimeter. (Funded by the National Institute of Allergy and Infectious Diseases and others; START ClinicalTrials.gov number, NCT00867048.)....

  12. Effect of mild-to-moderate smoking on viral load, cytokines, oxidative stress, and cytochrome P450 enzymes in HIV-infected individuals.

    Directory of Open Access Journals (Sweden)

    Anusha Ande

    Full Text Available Mild-to-moderate tobacco smoking is highly prevalent in HIV-infected individuals, and is known to exacerbate HIV pathogenesis. The objective of this study was to determine the specific effects of mild-to-moderate smoking on viral load, cytokine production, and oxidative stress and cytochrome P450 (CYP pathways in HIV-infected individuals who have not yet received antiretroviral therapy (ART. Thirty-two human subjects were recruited and assigned to four different cohorts as follows: a HIV negative non-smokers, b HIV positive non-smokers, c HIV negative mild-to-moderate smokers, and d HIV positive mild-to-moderate smokers. Patients were recruited in Cameroon, Africa using strict selection criteria to exclude patients not yet eligible for ART and not receiving conventional or traditional medications. Those with active tuberculosis, hepatitis B or with a history of substance abuse were also excluded. Our results showed an increase in the viral load in the plasma of HIV positive patients who were mild-to-moderate smokers compared to individuals who did not smoke. Furthermore, although we did not observe significant changes in the levels of most pro-inflammatory cytokines, the cytokine IL-8 and MCP-1 showed a significant decrease in the plasma of HIV-infected patients and smokers compared with HIV negative non-smokers. Importantly, HIV-infected individuals and smokers showed a significant increase in oxidative stress compared with HIV negative non-smoker subjects in both plasma and monocytes. To examine the possible pathways involved in increased oxidative stress and viral load, we determined the mRNA levels of several antioxidant and cytochrome P450 enzymes in monocytes. The results showed that the levels of most antioxidants are unaltered, suggesting their inability to counter oxidative stress. While CYP2A6 was induced in smokers, CYP3A4 was induced in HIV and HIV positive smokers compared with HIV negative non-smokers. Overall, the findings suggest

  13. 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.

  14. Prevalence of HIV and Hepatitis B, C, D Infections and Their Associated Risk Factors among Prisoners in Southern Khorasan Province, Iran.

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    Masood Ziaee

    2014-02-01

    Full Text Available Prison inmates are among the high risk population for dangerous infections such HIV, HBV, HCV and other contagious diseases. In spit of many data about the prevalence and risk factors for blood born diseases among prisoners in the world, such data are spares from Iran. The aim of this study was to determine the prevalence and associated risk factors for HIV, HBV, HCV and HDV infections among a large sample of prison inmates in Iran.In a cross-sectional study in 2009-2010, 881 inmates in three prisons of Southern Khorasan Province in Iran were selected based on a systematic, stratified random sampling method. Sera were analyzed for HBV, HDV, HCV and HIV infections by appropriate commercial ELISA kits. An anonymous questionnaire was used to collect the demographic data and information about risk factors.Overall, 881 prisoners (mean age: 34.7±11.4 years, range: 11-84 years, M/F ratio:4.5/1 were participated in this study. The prevalence of HBV and HCV infection was 6.9% and 7.7%, respectively. Among the HBsAg positive subjects, 6.6% (4/61 and 9.8% (6/61 had HDV and HCV super-infection, respectively. Only one case (0.1% had HIV infection that was co-infection with HCV. Drug abuse and history of traditional phlebotomy were associated risk factors for HBV infection (P<0.05 and history of drug injection was associated with HCV infection (P<0.05.This study show fairly higher prevalence of blood borne infections among prisoners and indicate drug