Expression of type I interferon-associated genes at antiretroviral therapy interruption predicts HIV virological rebound

Although certain individuals with HIV infection can stop antiretroviral therapy (ART) without viral load rebound, the mechanisms under-pinning 'post-treatment control' remain unclear. Using RNA-Seq we explored CD4 T cell gene expression to identify evidence of a mechanism that might underpin virological rebound and lead to discovery of associated biomarkers. Fourteen female participants who received 12 months of ART starting from primary HIV infection were sampled at the time of stopping therapy. Two analysis methods (Differential Gene Expression with Gene Set Enrichment Analysis, and Weighted Gene Co-expression Network Analysis) were employed to interrogate CD4+ T cell gene expression data and study pathways enriched in post-treatment controllers versus early rebounders. Using independent analysis tools, expression of genes associated with type I interferon responses were associated with a delayed time to viral rebound following treatment interruption (TI). Expression of four genes identified by Cox-Lasso (ISG15, XAF1, TRIM25 and USP18) was converted to a Risk Score, which associated with rebound (p < 0.01). These data link transcriptomic signatures associated with innate immunity with control following stopping ART. The results from this small sample need to be confirmed in larger trials, but could help define strategies for new therapies and identify new biomarkers for remission.

DECLINING PREVALENCE OF HIV AND OTHER SEXUALLY TRANSMITTED INFECTIONS AMONG FEMALE SEX WORKERS IN JOS, NORTH-CENTRAL NIGERIA

BACKGROUND

Female Sex Workers (FSWs) are key reservoirs of human immunodeficiency virus (HIV) and other sexually transmitted infections (STIs) from which transmission to the general population fuels epidemics. STIs amplify HIV infectiousness and susceptibility. We determined the status of HIV and STIs among brothel-based FSWs in Jos as part of an ongoing prevention intervention.

METHOD

Between January and May 2012, consenting consecutive brothel-based FSWs were recruited from previously designated brothels across Jos. HIV counseling and testing as well as screening for gonorrhoea, syphilis, trichomonasis, candidasis and Bacteria vaginosis (BV) were performed. Positive cases were provided free treatment and follow-up at Solat Women Hospital, Jos. Ethical clearance was obtained from Jos University Teaching Hospital (JUTH) ethical committee.

RESULT

Two hundred FSWs aged 27.6 ± 4.6 years (range 15-55 years) were recruited and of these, 47 (23.5%) were HIV Positive, 20 (10.0%) had syphilis, 9 (4.5%) had Neisseria gonorrhea, 3 (1.5%) had Trichomonas vaginalis and 86 (43.0%) had BV. The association between HIV and bacterial vaginosis was statistically significant (OR of 2.2, 95% CI of 1.1-4.2, P-value=0.02). In comparison to similar prevalence in 2006, the current findings represent 51.5% decline in HIV prevalence, 40.8% decline for syphilis and over 83.3% decline in prevalence for Trichomonas vaginalis. There was no significant change in the prevalence of Neisseria gonorrhoea and BV.

CONCLUSION

The prevalence of HIV and STIs among brothel-based FSWs in Jos remain unacceptably high, although, there is a declining trend. A comprehensive HIV prevention program targeting these women is required to block transmission to the general population.

Pattern of contraception among HIV positive women in Jos University Teaching Hospital

BACKGROUND

Prevention of unintended pregnancies among HIV positive women is a key strategy in preventing the spread of the disease. Contraception is crucial to achieving this and consistent use of condom provides the dual advantage of prevention of pregnancy and reinfection with HIV and other sexually transmitted infections. The purpose of the study is to determine the contraceptive awareness among these women, the types of contraception being used as well as the prevalence and compliance with barrier contraception.

METHOD

A cross-sectional survey using an interviewer-administered proforma among HIV positive women within the reproductive age group receiving prevention of mother to child transmission (PMTCT) in Jos University Teaching Hospital.

RESULT

A total of 140 questionnaires were administered and retrieved. One hundred and thirty nine women (99.3%) had contraceptive awareness. Ninety eight of them (70%) were using contraception, among which 95(96.9% of contraceptive use) were using condom. The condom prevalence rate in the whole population was 67.8% The pattern of contraception showed that 46 (46.9%) used condom alone, 49 (50%) used condom with other methods; among which condom and injectables constitutedthe largest group (41 women, 41.8%). Out of those using condom, 43 (43.2%) were using it consistently.

CONCLUSION

The prevalence of contraception, the use of barrier contraceptive and the rate of the combined use of condom with other contraceptive method, underscores the contraceptive awareness of these women as a means of preventing unplanned pregnancies and prevention of re-infection with HIV and other sexually transmitted infections.