Epidemiology of HIV/AIDS and Syphilis among High Risk Groups in Pakistan

An ALP enzyme-based electrochemical biosensor coated with signal-amplifying BaTiO3 nanoparticles for the detection of an antiviral drug in human blood serum

Tenofovir (TFV) is an antiviral drug used to treat the co-infections of HIV/HBV viruses. Accurate monitoring of TFV drug levels is essential for evaluating patient adherence, optimizing dosage, and assessing treatment efficacy. Herein, we propose an innovative electrochemical sensing approach by using the alkaline phosphatase (ALP) enzyme with the support of BaTiO3 nanoparticles. An attractive sensitivity and selectivity of the developed sensor towards TFV detection were achieved. First, the nanoparticles were synthesized by following a single-step sol-gel method and characterized through various analytical techniques, including SEM, EDX, FT-IR, BET, zeta potential, XRD, and UV-vis and Raman spectroscopy. The suggested mechanism demonstrated the formation of a strong bond between TFV and the ALP enzyme, primarily through the phosphate group, resulting in enzyme inhibition. Various parameters like nanoparticle amount, electrode modification time with enzyme and BaTiO3 nanoparticles, and drug incubation time were optimized. The biosensor demonstrated an outstanding limit of detection (LOD) of 0.09 nM and recovery percentages of 98.6-106% in human blood serum, indicating adequate repeatability and selectivity. The proposed biosensor can be converted into a portable device for measuring small sample volumes and observing patients for immediate medical care or personalized therapies. It achieved better sensitivity compared to existing methods, making it suitable for precise drug detection in microdoses.

The worldwide burden of HIV in transgender individuals: An updated systematic review and meta-analysis

Introduction

Transgender individuals are at risk for HIV. HIV risks are dynamic and there have been substantial changes in HIV prevention (e.g., pre-exposure prophylaxis [PrEP]). It is thus time to revisit HIV prevalence and burden among transgender individuals. The objective of this systematic review and meta-analysis was thus to examine worldwide prevalence and burden of HIV over the course of the epidemic among trans feminine and trans masculine individuals.

Methods

We conducted an updated systematic review by searching PsycINFO, PubMed, Web of Science, and Google Scholar, for studies of any research design published in in a peer-reviewed journal in any language that reported HIV prevalence among transgender individuals published between January 2000 and January 2019. Two independent reviewers extracted the data and assessed methodological quality. We then conducted a meta-analysis, using random-effects modelling, to ascertain standardized prevalence and the relative burden of HIV carried by transgender individuals by country and year of data collection, and then by geographic region. We additionally explored the impact of sampling methods and pre-exposure prophylaxis (PrEP).

Results

Based on 98 studies, overall standardized HIV prevalence over the course of the epidemic, based on weights from each country by year, was 19.9% (95% CI 14.7% - 25.1%) for trans feminine individuals (n = 48,604) and 2.56% (95% CI 0.0% - 5.9%) for trans masculine individuals (n = 6460). Overall OR for HIV infection, compared with individuals over age 15, was 66.0 (95% CI 51.4–84.8) for trans feminine individuals and 6.8 (95% CI 3.6–13.1) for trans masculine individuals. Prevalence varied by geographic region (13.5% - 29.9%) and sampling method (5.4% - 37.8%). Lastly, PrEP effects on prevalence could not be established.

Conclusion

Trans feminine and trans masculine individuals are disproportionately burdened by HIV. Their unique prevention and care needs should be comprehensively addressed. Future research should further investigate the impact of sampling methods on HIV prevalence, and monitor the potential impact of PrEP.

Prevalence and associated risk factors of HIV in prisons in Balochistan, Pakistan: a cross-sectional study

Background: The prevalence of HIV is 0.1% in Pakistan, with epidemicity in high-risk groups. The infection is on verge of transmission from key populations to the general population through people who inject drugs and sexual transmission. Prisoners are vulnerable to infectious diseases like HIV. This study was conducted in four prisons in Balochistan, Pakistan to determine the prevalence of HIV and associated risk factors.

Methods: This cross sectional study was conducted from March to June 2018, in the prisons of Balochistan. WHO-approved rapid diagnostic kits were used for determining the prevalence of HIV and structured interviews were conducted for the assessment of risk factors.

Results: Out of 2084 screened prisoners, 33 (1.6%) were found to be positive. A subset of 104 interviews was analyzed for risk factors of HIV. Among HIV-infected prisoners 68.8% (OR 4.48; 95% CI 1.41-14.2) had extramarital sex, 43.8% (OR 2.09 95% CI 0.69-6.28) had a homosexual experience, and 50% had a history of needle sharing (OR 43; 95% CI 7.77-237). About 94% (OR 16.42; 95% CI 2.09-129.81) of prisoners had a history of drug addiction of any type while 50% (OR 13; 95% CI 2.82-60.01) of HIV-infected had a history of using injectable drugs. Around 75% of HIV-infected prisoners had spent 1-5 years in prison, and 25% had spent more than 10 years.

Conclusion: The high prevalence of HIV in prisons of Balochistan demands that preventive and treatment strategies should be designed and implemented carefully, allowing early diagnosis and treatment initiation to minimize the spread of infection among the prisons and ultimately their onward transmission into the community.