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Investigation of potential inhibitor properties of violacein against HIV-1 RT and CoV-2 Spike RBD:ACE-2. World J Microbiol Biotechnol 2022; 38:161. [PMID: 35834025 PMCID: PMC9281270 DOI: 10.1007/s11274-022-03350-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 06/28/2022] [Indexed: 11/18/2022]
Abstract
A violacein-producing bacterium was isolated from a mud sample collected near a hot spring on Kümbet Plateau in Giresun Province and named the GK strain. According to the phylogenetic tree constructed using 16S rRNA gene sequence analysis, the GK strain was identified and named Janthinobacterium sp. GK. The crude violacein pigments were separated into three different bands on a TLC sheet. Then violacein and deoxyviolacein were purified by vacuum liquid column chromatography and identified by NMR spectroscopy. According to the inhibition studies, the HIV-1 RT inhibition rate of 1 mM violacein from the GK strain was 94.28% and the CoV-2 spike RBD:ACE2 inhibition rate of 2 mM violacein was 53%. In silico studies were conducted to investigate the possible interactions between violacein and deoxyviolacein and three reference molecules with the target proteins: angiotensin-converting enzyme 2 (ACE2), HIV-1 reverse transcriptase, and SARS-CoV-2 spike receptor binding domain. Ligand violacein binds strongly to the receptor ACE2, HIV-1 reverse transcriptase, and SARS-CoV-2 spike receptor binding domain with a binding energy of −9.94 kcal/mol, −9.32 kcal/mol, and −8.27 kcal/mol, respectively. Deoxyviolacein strongly binds to the ACE2, HIV-1 reverse transcriptase, and SARS-CoV-2 spike receptor binding domain with a binding energy of −10.38 kcal/mol, -9.50 kcal/mol, and −8.06 kcal/mol, respectively. According to these data, violacein and deoxyviolacein bind to all the receptors quite effectively. SARS-CoV-2 spike protein and HIV-1-RT inhibition studies with violacein and deoxyviolacein were performed for the first time in the literature.
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Pre-infection plasma cytokines and chemokines as predictors of HIV disease progression. Sci Rep 2022; 12:2437. [PMID: 35165387 PMCID: PMC8844050 DOI: 10.1038/s41598-022-06532-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 02/02/2022] [Indexed: 01/13/2023] Open
Abstract
Previous studies have highlighted the role of pre-infection systemic inflammation on HIV acquisition risk, but the extent to which it predicts disease progression outcomes is less studied. Here we examined the relationship between pre-infection plasma cytokine expression and the rate of HIV disease progression in South African women who seroconverted during the CAPRISA 004 tenofovir gel trial. Bio-Plex 200 system was used to measure the expression of 47 cytokines/chemokines in 69 seroconvertors from the CAPRISA 004 trial. Cox proportional hazards regression analyses were used to measure associations between cytokine expression and CD4 decline prior to antiretroviral therapy initiation. Linear regression models were used to assess whether pre-infection cytokine expression were predictors of disease progression outcomes including peak and set-point viral load and CD4:CD8 ratio at less and greater than180 days post infection. Several cytokines were associated with increased peak HIV viral load (including IL-16, SCGFβ, MCP-3, IL-12p40, SCF, IFNα2 and IL-2). The strongest association with peak viral load was observed for SCGFβ, which was also inversely associated with lowest CD4:CD8 ratio < 180 days post infection and faster CD4 decline below 500 cells/µl (adjusted HR 4.537, 95% CI 1.475–13.954; p = 0.008) in multivariable analysis adjusting for age, study site, contraception, baseline HSV-2 status and trial arm allocation. Our results show that pre-infection systemic immune responses could play a role in HIV disease progression, especially in the early stages of infection.
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Belay YB, Ali EE, Chung KY, Gebretekle GB, Sander B. Cost-Utility Analysis of Dolutegravir- Versus Efavirenz-Based Regimens as a First-Line Treatment in Adult HIV/AIDS Patients in Ethiopia. PHARMACOECONOMICS - OPEN 2021; 5:655-664. [PMID: 34133017 PMCID: PMC8611130 DOI: 10.1007/s41669-021-00275-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/27/2021] [Indexed: 06/02/2023]
Abstract
BACKGROUND In several countries, the dolutegravir (DTG)-based regimen is generally preferred as first-line antiretroviral therapy (ART) over the efavirenz (EFV)-based regimen, but the evidence in low-income countries is limited. OBJECTIVE Our study aimed to evaluate the cost effectiveness of DTG- versus EFV-based first-line human immunodeficiency virus (HIV) treatment in Ethiopia. METHODS We developed a microsimulation model for the progression of HIV/acquired immune deficiency syndrome (AIDS) to examine the cost effectiveness of DTG-based first-line ART compared with an EFV-based regimen from a healthcare payer perspective. We used a lifetime horizon with a 1-month cycle length and a 3% annual discount rate. The primary outcomes were a lifetime cost in US dollars ($), quality-adjusted life-months (QALMs) that converted to QALYs using the formula QALY = QALM/12, and incremental cost-effectiveness ratio (ICER). Deterministic sensitivity analysis was conducted to account for parameter uncertainty. RESULTS Compared with the EFV-based regimen, the DTG-based regimen was associated with an expected lifetime cost of $12,709 (vs. $12,701) and expected QALYs of 15.3 (vs. 14.7 QALYs) per patient, resulting in an ICER value of $13.33 per QALY. From an alternative analysis with a 5-year time horizon, DTG-based ART was found to be dominant, with expected gains of 0.17 QALYs at a lower cost of $1 per patient. The deterministic sensitivity analysis depicted that the maximum increase in ICER value was $72 per QALY, and all ICER values were below the estimated threshold value. CONCLUSIONS The DTG-based first-line regimen appears to be cost effective compared with the EFV-based regimen for the treatment of HIV/AIDS patients in an Ethiopian setting.
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Affiliation(s)
- Yared Belete Belay
- School of Pharmacy, College of Health Sciences, Mekelle University, PO Box 1871, Mekelle, Ethiopia.
| | - Eskinder Eshetu Ali
- Department of Pharmaceutics and Social Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Karen Y Chung
- Division of Plastic Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Toronto Health Economics and Technology Assessment (THETA) Collaborative, University Health Network, Torono, ON, Canada
| | - Gebremedhin Beedemariam Gebretekle
- Department of Pharmaceutics and Social Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Toronto Health Economics and Technology Assessment (THETA) Collaborative, University Health Network, Torono, ON, Canada
| | - Beate Sander
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Toronto Health Economics and Technology Assessment (THETA) Collaborative, University Health Network, Torono, ON, Canada
- Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
- Public Health Ontario, Toronto, ON, Canada
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Cervino L, Raybould J, Fulco P. Resolution of possible acquired protein S deficiency after viral suppression in HIV infection. BMJ Case Rep 2021; 14:e244983. [PMID: 34794977 PMCID: PMC8603259 DOI: 10.1136/bcr-2021-244983] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/28/2021] [Indexed: 12/17/2022] Open
Abstract
Current literature suggests an increased risk of venous thromboembolism (VTE) in people living with HIV (PLWH) with poorly controlled viraemia and immunodeficiency. VTE treatment guidelines do not specifically address anticoagulation management in PLWH. We report a case of a 33-year-old woman diagnosed with an unprovoked pulmonary embolism (PE) and deemed protein S deficient. Three years later, she was diagnosed with AIDS. Antiretroviral therapy (ART) was promptly initiated with viral suppression and immune reconstitution within 12 months. Eight years after her initial PE, the patient self-discontinued warfarin. Multiple repeat protein S values were normal. ART without anticoagulation has continued for 3 years with no thrombotic events. This case describes a patient with VTE presumably secondary to undiagnosed HIV with possible consequent acquired protein S deficiency. Additional research is needed to understand the characteristics of PLWH with VTE who may warrant long-term anticoagulation as opposed to shorter courses.
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Affiliation(s)
- Leigh Cervino
- Pharmacy, Johns Hopkins Hospital, Baltimore, MD, USA
| | - Jillian Raybould
- Department of Internal Medicine/Division of Infectious Diseases, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Patricia Fulco
- Department of Pharmacy, Virginia Commonwealth University Health System, Richmond, Virginia, USA
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Factors Affecting Changes of Cluster of Differentiation 4 Cell Counts Among Human Immunodeficiency Virus-positive People Who Inject Heroin and Receive Methadone Maintenance Treatment. J Addict Med 2021; 14:e310-e315. [PMID: 32433362 DOI: 10.1097/adm.0000000000000658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIMS Opioids have been hypothesized to suppress the immune function and worsen outcomes among people living with human immunodeficiency virus (HIV). The study aimed to identify key factors associated with the increased cluster of differentiation 4 (CD4) cell counts among HIV-positive people who inject heroin and receive methadone maintenance treatment (MMT). METHODS This longitudinal study was conducted at a psychiatric hospital in Northern Taiwan. Participants were recruited from 2006 through 2011, and received CD4 cell counts and HIV viral load monitoring once every 4 to 6 months. Trend in CD4 cell counts, defined as change in CD4 cell count over time, was used as the outcome measure. Independent variables included MMT-related factors and baseline characteristics. Baseline characteristics included age, gender, CD4 cell count, HIV viral load, tests for other infections, liver function tests, and urine drug screens. RESULTS Three hundred and fifty one participants were recruited during the study period. The multivariate linear mixed model analysis revealed a higher MMT attendance rate, a higher baseline CD4 cell count, and a shorter duration of MMT were associated with an increase in CD4 cell count over time. CONCLUSIONS The study showed better adherence to MMT was associated with better preserved immune functions. The negative impact of duration of MMT on CD4 cell counts may be ameliorated by improving the attendance rate, initiation of MMT earlier when the baseline CD4 cell count is still relatively high and by the other beneficial effects of MMT, such as healthier lifestyles with reduced use of short-acting opioids.
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Katusiime MG, Van Zyl GU, Cotton MF, Kearney MF. HIV-1 Persistence in Children during Suppressive ART. Viruses 2021; 13:v13061134. [PMID: 34204740 PMCID: PMC8231535 DOI: 10.3390/v13061134] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 06/06/2021] [Accepted: 06/08/2021] [Indexed: 12/16/2022] Open
Abstract
There is a growing number of perinatally HIV-1-infected children worldwide who must maintain life-long ART. In early life, HIV-1 infection is established in an immunologically inexperienced environment in which maternal ART and immune dynamics during pregnancy play a role in reservoir establishment. Children that initiated early antiretroviral therapy (ART) and maintained long-term suppression of viremia have smaller and less diverse HIV reservoirs than adults, although their proviral landscape during ART is reported to be similar to that of adults. The ability of these early infected cells to persist long-term through clonal expansion poses a major barrier to finding a cure. Furthermore, the effects of life-long HIV persistence and ART are yet to be understood, but growing evidence suggests that these individuals are at an increased risk for developing non-AIDS-related comorbidities, which underscores the need for an HIV cure.
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Affiliation(s)
- Mary Grace Katusiime
- HIV Dynamics and Replication Program, CCR, National Cancer Institute, Frederick, MD 21702, USA;
- Correspondence:
| | - Gert U. Van Zyl
- Division of Medical Virology, Stellenbosch University and National Health Laboratory Service Tygerberg, Cape Town 8000, South Africa;
| | - Mark F. Cotton
- Department of Pediatrics and Child Health, Tygerberg Children’s Hospital and Family Center for Research with Ubuntu, Stellenbosch University, Cape Town 7505, South Africa;
| | - Mary F. Kearney
- HIV Dynamics and Replication Program, CCR, National Cancer Institute, Frederick, MD 21702, USA;
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Jones AD, Khakhina S, Jaison T, Santos E, Smith S, Klase ZA. CD8 + T-Cell Mediated Control of HIV-1 in a Unique Cohort With Low Viral Loads. Front Microbiol 2021; 12:670016. [PMID: 34122382 PMCID: PMC8192701 DOI: 10.3389/fmicb.2021.670016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 04/27/2021] [Indexed: 12/30/2022] Open
Abstract
A unique population of HIV-1 infected individuals can control infection without antiretroviral therapy. These individuals fall into a myriad of categories based on the degree of control (low or undetectable viral load), the durability of control over time and the underlying mechanism (i.e., possession of protective HLA alleles or the absence of critical cell surface receptors). In this study, we examine a cohort of HIV-1 infected individuals with a documented history of sustained low viral loads in the absence of therapy. Through in vitro analyses of cells from these individuals, we have determined that infected individuals with naturally low viral loads are capable of controlling spreading infection in vitro in a CD8+ T-cell dependent manner. This control is lost when viral load is suppressed by antiretroviral therapy and correlates with a clinical CD4:CD8 ratio of <1. Our results support the conclusion that HIV-1 controllers with low, but detectable viral loads may be controlling the virus due to an effective CD8+ T-cell response. Understanding the mechanisms of control in these subjects may provide valuable understanding that could be applied to induce a functional cure in standard progressors.
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Affiliation(s)
- Amber D. Jones
- Department of Biological Sciences, University of the Sciences, Philadelphia, PA, United States
| | - Svetlana Khakhina
- Department of Biological Sciences, University of the Sciences, Philadelphia, PA, United States
| | - Tara Jaison
- Department of Biological Sciences, University of the Sciences, Philadelphia, PA, United States
| | - Erin Santos
- The Smith Center for Infectious Diseases and Urban Health, West Orange, NJ, United States
| | - Stephen Smith
- The Smith Center for Infectious Diseases and Urban Health, West Orange, NJ, United States
| | - Zachary A. Klase
- Department of Pharmacology and Physiology, Drexel University College of Medicine, Philadelphia, PA, United States,Center for Neuroimmunology and CNS Therapeutics, Institute of Molecular Medicine and Infectious Diseases, Drexel University College of Medicine, Philadelphia, PA, United States,*Correspondence: Zachary A. Klase,
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Patel K, Zhang A, Zhang MH, Bunachita S, Baccouche BM, Hundal H, Lavado LK, Agarwal A, Malik P, Patel UK. Forty Years Since the Epidemic: Modern Paradigms in HIV Diagnosis and Treatment. Cureus 2021; 13:e14805. [PMID: 34094761 PMCID: PMC8172004 DOI: 10.7759/cureus.14805] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 05/02/2021] [Indexed: 12/29/2022] Open
Abstract
Human immunodeficiency virus (HIV) is a viral infection that, when transmitted through the exchange of certain bodily fluids, destroys various immune cells and contributes to an overall weakened immune system. If left untreated, HIV progresses to acquired immunodeficiency syndrome (AIDS) - a chronic, life-threatening condition that puts patients at risk for opportunistic infections. Since the emergence of HIV nearly a century ago, the world has seen tremendous advances in elucidating its pathology and progression. These advances have been accompanied by an increased understanding of how subsequent effects and symptoms manifest in afflicted individuals. These discoveries, coupled with the ever-improving technologies and methodologies used for detection and treatment, provide the scientific and medical community with a solid grasp of HIV. Despite this significant headway, there is still much progress to be made; medical advances have allowed people with HIV to manage their disease and live a longer, healthier life, but a definite cure is yet to be found. Thus, the following literature review serves as both an extensive compendium of our current understanding of HIV - its pathology, testing/detection, repercussions, and treatment - and an acknowledgement of the areas that still require further research.
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Affiliation(s)
- Karan Patel
- Medicine, Cooper Medical School of Rowan University, Camden, USA
| | - Alex Zhang
- Medicine, Cooper Medical School of Rowan University, Camden, USA
| | - Michelle H Zhang
- Psychological & Brain Sciences and Biology, Johns Hopkins University, Baltimore, USA
| | - Sean Bunachita
- Molecular and Cellular Biology, Johns Hopkins University, Baltimore, USA
| | | | - Henna Hundal
- Max Bell School of Public Policy, McGill University, Montreal, CAN
| | | | | | - Preeti Malik
- Public Health, Icahn School of Medicine at Mount Sinai, New York, USA
- Neurology, Massachusetts General Hospital, Boston, USA
| | - Urvish K Patel
- Public Health and Neurology, Icahn School of Medicine at Mount Sinai, New York, USA
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Cumulative viral load as a predictor of CD4+ T-cell response to antiretroviral therapy using Bayesian statistical models. PLoS One 2019; 14:e0224723. [PMID: 31721805 PMCID: PMC6853324 DOI: 10.1371/journal.pone.0224723] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 10/21/2019] [Indexed: 01/10/2023] Open
Abstract
INTRODUCTION There are Challenges in statistically modelling immune responses to longitudinal HIV viral load exposure as a function of covariates. We define Bayesian Markov Chain Monte Carlo mixed effects models to incorporate priors and examine the effect of different distributional assumptions. We prospectively fit these models to an as-yet-unpublished data from the Tshwane District Hospital HIV treatment clinic in South Africa, to determine if cumulative log viral load, an indicator of long-term viral exposure, is a valid predictor of immune response. METHODS Models are defined, to express 'slope', i.e. mean annual increase in CD4 counts, and 'asymptote', i.e. the odds of having a CD4 count ≥500 cells/μL during antiretroviral treatment, as a function of covariates and random-effects. We compare the effect of using informative versus non-informative prior distributions on model parameters. Models with cubic splines or Skew-normal distributions are also compared using the conditional Deviance Information Criterion. RESULTS The data of 750 patients are analyzed. Overall, models adjusting for cumulative log viral load provide a significantly better fit than those that do not. An increase in cumulative log viral load is associated with a decrease in CD4 count slope (19.6 cells/μL (95% credible interval: 28.26, 10.93)) and a reduction in the odds of achieving a CD4 counts ≥500 cells/μL (0.42 (95% CI: 0.236, 0.730)) during 5 years of therapy. Using informative priors improves the cumulative log viral load estimate, and a skew-normal distribution for the random-intercept and measurement error results is a better fit compared to using classical Gaussian distributions. DISCUSSION We demonstrate in an unpublished South African cohort that cumulative log viral load is a strong and significant predictor of both CD4 count slope and asymptote. We argue that Bayesian methods should be used more frequently for such data, given their flexibility to incorporate prior information and non-Gaussian distributions.
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Rodriguez J, Prieto S, Correa C, Melo M, Dominguez D, Olarte N, Suárez D, Aragón L, Torres F, Santacruz F. Prediction of CD4+ Cells Counts in HIV/AIDS Patients based on Sets and Probability Theories. Curr HIV Res 2019; 16:416-424. [PMID: 30843490 DOI: 10.2174/1570162x17666190306125819] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 02/26/2019] [Accepted: 03/05/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND Previous studies have developed methodologies for predicting the number of CD4+ cells from the total leukocyte and lymphocytes count based on mathematical methodologies, obtaining percentages of effectiveness prediction higher than 90% with a value of less than 5000 leukocytes. OBJECTIVE To improve the methodology probabilities prediction in 5000-9000 leukocytes ranges. METHOD from sets A, B, C and D defined in a previous study, and based on CD4+ prediction established on the total number of leukocytes and lymphocytes, induction was performed using data from 10 patients with HIV, redefining the sets A and C that describe the lymphocytes behavior relative to leukocytes. Subsequently, we evaluated with previous research prediction probabilities parameters from a sample of 100 patients, calculating the belonging probability to each sample and organized in predetermined ranges leukocytes, of each of the sets defined, their unions and intersections. Then the same procedure was performed with the new sets and the probability values obtained with the refined method were compared with respect to previously defined, by measures of sensitivity (SENS) and Negative Predictive Value (NPV) for each range. RESULTS probabilities with values greater than 0.83 were found in five of the nine ranges inside the new sets. The probability for the set A∪C increased from 0.06 to 0.18 which means increases between 0.06 and 0.09 for the intersection (A∪C) ∩ (B∪D), making evident the prediction improvement with new sets defined. CONCLUSION The results show that the new defined sets achieved a higher percentage of effectiveness to predict the CD4+ value cells, which represents a useful tool that can be proposed as a substitute for clinical values obtained by the flow cytometry.
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Affiliation(s)
- Javier Rodriguez
- Insight Group Director, Focusing Area and Special Internship "Physical and Mathematical Theories Applied to Medicine", Nueva Granada Military University - Clinica del Country Research Center, Bogota, Colombia
| | - Signed Prieto
- Insight Group Researcher, Nueva Granada Military University, Clinica del Country Research Center, Bogota, Colombia
| | - Catalina Correa
- Insight Group Researcher, Teacher of Major and Special "Physical and Mathematical Theories Applied to Medicine", Medicine Faculty, Nueva Granada Military University, Clinica del Country Research Center, Bogota, Colombia
| | - Martha Melo
- Magister in Educational Institutions Management, FRACUMNG Group Researcher, Basic and Applied Sciences Faculty, Nueva Granada Military University, Bogota, Colombia
| | - Dario Dominguez
- Magister in Economics, FRACUMNG Research Group Director, Basic and Applied Sciences Faculty, Nueva Granada Military University, Bogota, Colombia
| | - Nancy Olarte
- Esp in Information Technologies Applied to Education, GI-iTEC Group Researcher, Engineering Faculty, Nueva Granada Military University, Bogota, Colombia
| | - Daniela Suárez
- Special Internship and Focusing Area "Physical and Mathematical Theories Applied to Medicine", Medicine Faculty, Nueva Granada Military University, Bogota, Colombia
| | - Laura Aragón
- Special Internship and Focusing Area "Physical and Mathematical Theories Applied to Medicine", Medicine Faculty, Nueva Granada Military University, Bogota, Colombia
| | - Fernando Torres
- Special Internship and Focusing Area "Physical and Mathematical Theories Applied to Medicine", Medicine Faculty, Nueva Granada Military University, Bogota, Colombia
| | - Fernando Santacruz
- Special Internship and Focusing Area "Physical and Mathematical Theories Applied to Medicine", Medicine Faculty, Nueva Granada Military University, Bogota, Colombia
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Solomon DA. HIV Initial Assessment and Routine Follow-up: What Tests to Order and Why. Infect Dis Clin North Am 2019; 33:647-662. [PMID: 31239091 DOI: 10.1016/j.idc.2019.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Laboratory tests are an important tool in the care of patients with human immunodeficiency virus. An organized approach to laboratory ordering helps clinicians to understand the utility of each test, ensure a comprehensive evaluation, and decrease use of unnecessary tests. Tests are organized around the following goals of care: confirm the diagnosis, assess for immune suppression, guide antiretroviral therapy, screen for coinfections and latent infections, monitor response to therapy, and provide preventative care. This article reviews appropriate testing for patients with human immunodeficiency virus to accomplish these goals with a focus on how each test is useful in clinical practice.
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Affiliation(s)
- Daniel A Solomon
- Division of Infectious Disease, Brigham and Women's Hospital, 75 Francis Street, PBB 4A, Boston, MA 02115, USA.
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Colombe S, Corstjens PLAM, de Dood CJ, Miyaye D, Magawa RG, Mngara J, Kalluvya SE, van Lieshout L, van Dam GJ, Downs JA. HIV-1 Viral Loads Are Not Elevated in Individuals Co-infected With Schistosoma spp. After Adjustment for Duration of HIV-1 Infection. Front Immunol 2018; 9:2005. [PMID: 30237799 PMCID: PMC6135873 DOI: 10.3389/fimmu.2018.02005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Accepted: 08/14/2018] [Indexed: 01/13/2023] Open
Abstract
Studies of the role of Schistosoma co-infections on plasma HIV-1 RNA (HIV-1 viral load) have yielded incongruent results. The role of duration of HIV-1 infection on the link between Schistosoma and HIV-1 viral load has not been previously investigated. We aimed to assess the impact of HIV-1/Schistosoma co-infections on viral load in Antiretroviral Treatment (ART)-naïve HIV-1 infected people taking into account the duration of HIV-1 infection. We describe 79 HIV-infected outpatients greater than 18 years of age who had never used ART in Mwanza, Tanzania. Schistosomiasis testing was done by urine and stool microscopy and by serum Schistosoma circulating anodic antigen (CAA) testing. Schistosoma positivity was defined as having either test positive. We conducted univariable and multivariable linear regressions to assess the relationship between Schistosoma infection and the log10 of viral load. Duration of HIV infection was calculated using the first measured CD4+ T-cell (CD4) count as a function of normal CD4 count decay per calendar year in drug naïve individuals. An active Schistosoma infection was demonstrated in 46.8% of the patients. The median log10 viral load was 4.5[3.4–4.9] log10 copies/mL in Schistosoma uninfected patients and 4.3[3.7–4.6] log10 copies/mL in Schistosoma infected patients. Schistosoma co-infection was negatively associated with the log10 of viral load after adjustment for Schistosoma intensity as measured by CAA, CD4 counts at time of testing, and duration of HIV-1 infection (β = −0.7[−1.3;−0.1], p = 0.022). Schistosoma co-infection was not associated with viral load in univariable analysis. There was also no interaction between Schistosoma positivity and duration of HIV-1 infection. Our study is the first, to our knowledge, to report adjustment for duration of HIV-1 infection when analyzing the relationship between HIV-1 viral load and Schistosoma spp. We found that time infected with HIV-1 has a major effect on the relationship between HIV-1 viral load and Schistosoma infection and may be a critical explanatory factor in the disparate findings of studies on HIV-1 viral load and schistosomiasis. The log10 viral load difference found indicates that Schistosoma co-infection does not make HIV progression worse, and could possibly lead to slower HIV disease progression.
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Affiliation(s)
- Soledad Colombe
- Department of Medicine, Center for Global Health, Weill Cornell Medicine, New York, NY, United States
| | - Paul L A M Corstjens
- Department of Cell and Chemical Biology, Leiden University Medical Center, Leiden, Netherlands
| | - Claudia J de Dood
- Department of Cell and Chemical Biology, Leiden University Medical Center, Leiden, Netherlands
| | - Donald Miyaye
- National Institute for Medical Research, Mwanza, Tanzania
| | - Ruth G Magawa
- National Institute for Medical Research, Mwanza, Tanzania
| | - Julius Mngara
- National Institute for Medical Research, Mwanza, Tanzania
| | | | - Lisette van Lieshout
- Department of Parasitology, Leiden University Medical Center, Leiden, Netherlands
| | - Govert J van Dam
- Department of Parasitology, Leiden University Medical Center, Leiden, Netherlands
| | - Jennifer A Downs
- Department of Medicine, Center for Global Health, Weill Cornell Medicine, New York, NY, United States.,Department of Medicine, Bugando Medical Centre, Mwanza, Tanzania
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Horemheb-Rubio G, Ramos-Cervantes P, Arroyo-Figueroa H, Ávila-Ríos S, García-Morales C, Reyes-Terán G, Escobedo G, Estrada G, García-Iglesias T, Muñoz-Saucedo N, Kershenobich D, Ostrosky-Wegman P, Ruiz-Palacios GM. High HPgV replication is associated with improved surrogate markers of HIV progression. PLoS One 2017; 12:e0184494. [PMID: 28910347 PMCID: PMC5598987 DOI: 10.1371/journal.pone.0184494] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 08/24/2017] [Indexed: 02/06/2023] Open
Abstract
Background Human Pegivirus (HPgV) may have a beneficial effect on HIV disease progression in co-infected patients; however, the virologic characteristics of this infection are not well defined. In this study, we determined HPgV viremia prevalence in Mexico and provide new insights to understand HPgV infection and HPgV/HIV co-infection. Methods We analyzed and quantified 7,890 serum samples for HPgV viremia by One-Step RT-Real-Time PCR, 6,484 from healthy blood donors and 1,406 from HIV-infected patients. Data on HIV progression were obtained from patients’ records. HPgV genotyping was performed in 445 samples by nested PCR of the 5’URT region. Finite Mixture Models were used to identify clustering patterns of HPgV viremia in blood donors and co-infected antiretroviral (ART)-naïve patients. Results HPgV was detected in 2.98% of blood donors and 33% of HIV patients, with a wide range of viral loads. The most prevalent genotypes were 3 (58.6%)and 2 (33.7%). HPgV viral loads from healthy blood donors and HPgV/HIV+ ART-naïve co-infected patients were clustered into two component distributions, low and high, with a cut-off point of 5.07log10 and 5.06log10, respectively. High HPgV viremia was associated with improved surrogate markers of HIV infection, independent of the estimated duration of HIV infection or HIV treatment. Conclusions HPgV prevalence in Mexico was similar to that reported for other countries. The prevalent genotypes could be related to Mexico’s geographic location and ethnicity, since genotype 2 is frequent in the United States and Europe and genotype 3 in Asia and Amerindian populations. HPgV viral load demonstrated two patterns of replication, low and high. The more pronounced beneficial response observed in co-infected patients with high HPgV viremia may explain discrepancies found between other studies. Mechanisms explaining high and low HPgV replication should be explored to determine whether the persistently elevated replication depends on host or viral factors.
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Affiliation(s)
- Gibran Horemheb-Rubio
- Department of Infectious Diseases, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Pilar Ramos-Cervantes
- Department of Infectious Diseases, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Hugo Arroyo-Figueroa
- Department of Infectious Diseases, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Santiago Ávila-Ríos
- Infectious Diseases Research Center, Instituto Nacional de Enfermedades Respiratorias, Mexico City, Mexico
| | - Claudia García-Morales
- Infectious Diseases Research Center, Instituto Nacional de Enfermedades Respiratorias, Mexico City, Mexico
| | - Gustavo Reyes-Terán
- Infectious Diseases Research Center, Instituto Nacional de Enfermedades Respiratorias, Mexico City, Mexico
| | - Galileo Escobedo
- Liver Pancreas and Intestinal Motility Laboratory, Hospital General de México, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Gloria Estrada
- Blood Bank, Hospital General de México, Mexico City, Mexico
| | - Trinidad García-Iglesias
- Immnuology Laboratory, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
| | - Nayeli Muñoz-Saucedo
- Immnuology Laboratory, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
| | - David Kershenobich
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | | | - Guillermo M. Ruiz-Palacios
- Department of Infectious Diseases, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
- * E-mail:
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