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Zhang Y, Yang X, Chai X, Han S, Zhang L, Shao Y, Ma J, Li K, Wang Z. Psychometric properties of stigma and discrimination measurement tools for persons living with HIV: a systematic review using the COSMIN methodology. Syst Rev 2024; 13:115. [PMID: 38678285 PMCID: PMC11055308 DOI: 10.1186/s13643-024-02535-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 04/17/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND The development of antiretroviral therapy broadly extends the life expectancy of persons living with HIV (PLHIV). However, stigma and discrimination are still great threat to these individuals and the world's public health care system. Accurate and reproducible measures are prerequisites for robust results. Therefore, it is essential to choose an acceptable measure with satisfactory psychometric properties to assess stigma and discrimination. There has been no systematic review of different stigma and discrimination tools in the field of HIV care. Researchers and clinical practitioners do not have a solid reference for selecting stigma and discrimination measurement tools. METHODS We systematically searched English and Chinese databases, including PubMed, EMBASE, CINAHL, Web of Science, PsycINFO, ProQuest Dissertations and Theses, The Cochrane Library, CNKI,, and Wanfang, to obtain literature about stigma and discrimination measurement tools that have been developed and applied in the field of HIV. The search period was from 1st January, 1996 to 22nd November 2021. The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guideline (2018 version) was applied to assess the risk of bias for each involved study and summarize the psychometric properties of each tool. The modified version of the Grading of Recommendations Assessment, Development, and, Evaluation (GRADE) method was used to grade the evidence and develop recommendations. RESULTS We included 45 studies and 19 PROMs for HIV/AIDS-related stigma and discrimination among PLHIV. All studies had sufficient methodological quality in content validity, structural validity, internal consistency, and the hypothesis testing of structural validity. Limited evidence was found for cross-cultural validity, stability, and criterion validity. No relevant evidence was found concerning measurement error and responsiveness. The Internalized AIDS-related Stigma Scale (IARSS), Internalized HIV Stigma Scale (IHSS), and Wright's HIV stigma scale (WHSS) are recommended for use. CONCLUSIONS This study recommends three PROMs for different stigma and discrimination scenarios, including IARSS for its good quality and convenience, IHSS for its broader range of items, higher sensitivity, and greater precision, and WHSS for its comprehensive and quick screening. Researchers should also consider the relevance and feasibility of the measurements before putting them into practice. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42022308579.
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Affiliation(s)
- Yizhu Zhang
- School of Nursing, Peking University, Beijing, 100191, China
| | - Xianxia Yang
- School of Public Health, Wuhan University, Wuhan, China
| | - Xinru Chai
- School of Nursing, Peking University, Beijing, 100191, China
| | - Shuyu Han
- School of Nursing, Peking University, Beijing, 100191, China.
| | - Lili Zhang
- Department of Nursing, Beijing Youan Hospital Affiliated with Capital Medical University, Beijing, 100069, China
| | - Ying Shao
- Department of Infection, Beijing Youan Hospital Affiliated with Capital Medical University, Beijing, 100069, China
| | - Jianhong Ma
- Department of Infection, Beijing Youan Hospital Affiliated with Capital Medical University, Beijing, 100069, China
| | - Ke Li
- Department of Emergency, Peking University First Hospital, Beijing, 100034, China
| | - Zhiwen Wang
- School of Nursing, Peking University, Beijing, 100191, China
- Peking University Health Science Centre for Evidence-Based Nursing: A Joanna Briggs Institute Affiliated Group, Beijing, 100191, China
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Dimapasoc M, Moran JA, Cole SW, Ranjan A, Hourani R, Kim JT, Wender PA, Marsden MD, Zack JA. Defining the Effects of PKC Modulator HIV Latency-Reversing Agents on Natural Killer Cells. Pathog Immun 2024; 9:108-137. [PMID: 38765786 PMCID: PMC11101012 DOI: 10.20411/pai.v9i1.673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 04/05/2024] [Indexed: 05/22/2024] Open
Abstract
Background Latency reversing agents (LRAs) such as protein kinase C (PKC) modulators can reduce rebound-competent HIV reservoirs in small animal models. Furthermore, administration of natural killer (NK) cells following LRA treatment improves this reservoir reduction. It is currently unknown why the combination of a PKC modulator and NK cells is so potent and whether exposure to PKC modulators may augment NK cell function in some way. Methods Primary human NK cells were treated with PKC modulators (bryostatin-1, prostratin, or the designed, synthetic bryostatin-1 analog SUW133), and evaluated by examining expression of activation markers by flow cytometry, analyzing transcriptomic profiles by RNA sequencing, measuring cytotoxicity by co-culturing with K562 cells, assessing cytokine production by Luminex assay, and examining the ability of cytokines and secreted factors to independently reverse HIV latency by co-culturing with Jurkat-Latency (J-Lat) cells. Results PKC modulators increased expression of proteins involved in NK cell activation. Transcriptomic profiles from PKC-treated NK cells displayed signatures of cellular activation and enrichment of genes associated with the NFκB pathway. NK cell cytotoxicity was unaffected by prostratin but significantly decreased by bryostatin-1 and SUW133. Cytokines from PKC-stimulated NK cells did not induce latency reversal in J-Lat cell lines. Conclusions Although PKC modulators have some significant effects on NK cells, their contribution in "kick and kill" strategies is likely due to upregulating HIV expression in CD4+ T cells, not directly enhancing the effector functions of NK cells. This suggests that PKC modulators are primarily augmenting the "kick" rather than the "kill" arm of this HIV cure approach.
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Affiliation(s)
- Melanie Dimapasoc
- Molecular Biology Institute, University of California Los Angeles, Los Angeles, California
- Department of Microbiology, Immunology, and Molecular Genetics, University of California Los Angeles, Los Angeles, California
| | - Jose A. Moran
- Department of Microbiology and Molecular Genetics, School of Medicine, University of California Irvine, California
| | - Steve W. Cole
- UCLA Department of Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Alok Ranjan
- Department of Chemistry, Stanford University, Stanford, California
| | - Rami Hourani
- Department of Chemistry, Stanford University, Stanford, California
| | - Jocelyn T. Kim
- Department of Medicine, Division of Infectious Diseases, University of California Los Angeles, Los Angeles, California
| | - Paul A. Wender
- Department of Chemistry, Stanford University, Stanford, California
- Department of Chemical and Systems Biology, Stanford University, Stanford, California
| | - Matthew D. Marsden
- Department of Microbiology and Molecular Genetics, School of Medicine, University of California Irvine, California
- Department of Medicine, Division of Infectious Diseases, School of Medicine, University of California, Irvine, Irvine, California
| | - Jerome A. Zack
- Department of Microbiology, Immunology, and Molecular Genetics, University of California Los Angeles, Los Angeles, California
- Department of Medicine, Division of Hematology and Oncology, University of California Los Angeles, Los Angeles, California
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Díaz-Basilio F, Vergara-Mendoza M, Romero-Rodríguez J, Hernández-Rizo S, Escobedo-Calvario A, Fuentes-Romero LL, Pérez-Patrigeon S, Murakami-Ogasawara A, Gomez-Palacio M, Reyes-Terán G, Jiang W, Vázquez-Pérez JA, Marín-Hernández Á, Romero-Rodríguez DP, Gutiérrez-Ruiz MC, Viveros-Rogel M, Espinosa E. The ecto-enzyme CD38 modulates CD4 T cell immunometabolic responses and participates in HIV pathogenesis. J Leukoc Biol 2024:qiae060. [PMID: 38466822 DOI: 10.1093/jleuko/qiae060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 01/31/2024] [Accepted: 02/23/2024] [Indexed: 03/13/2024] Open
Abstract
Despite abundant evidence correlating T cell CD38 expression and HIV infection pathogenesis, its role as a CD4 T cell immunometabolic regulator remains unclear. We find that CD38's extracellular glycohydrolase activity restricts metabolic reprogramming after TCR-engaging stimulation in Jurkat T CD4 cells, together with functional responses, while reducing intracellular NAD and NMN concentrations. Selective elimination of CD38's ectoenzyme function licenses them to decrease the OCR/ECAR ratio upon TCR signaling and to increase cycling, proliferation, survival, and CD40L induction. Pharmacological inhibition of ectoCD38 catalytic activity in memory CD4 T cells from chronic HIV-infected patients rescued TCR-triggered responses, including differentiation and effector functions, while reverting abnormally increased basal glycolysis, cycling, and spontaneous pro-inflammatory cytokine production. Additionally, ecto-CD38 blockage normalized basal and TCR-induced mitochondrial morpho-functionality, while increasing respiratory capacity in cells from HIV+ patients and healthy individuals. Ectoenzyme CD38's immunometabolic restriction of TCR-involving stimulation is relevant to CD4 T cell biology and to the deleterious effects of CD38 overexpression in HIV disease.
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Affiliation(s)
- Fernando Díaz-Basilio
- Laboratory of Integrative Immunology, National Institute of Respiratory Diseases "Ismael Cosío Villegas", Mexico City, Mexico
- PECEM Graduate Program, Faculty of Medicine, National Autonomous University of Mexico (UNAM), Mexico City, Mexico
| | - Moisés Vergara-Mendoza
- Department of Infectious Diseases, National Institute of Medical Sciences and Nutrition "Salvador Zubirán", Mexico City, Mexico
| | - Jessica Romero-Rodríguez
- Flow Cytometry Core Facility, National Institute of Respiratory Diseases "Ismael Cosío Villegas", Mexico City, Mexico
| | - Sharik Hernández-Rizo
- Laboratory for Cellular Physiology and Translational Medicine, Department of Health Sciences, Autonomous Metropolitan University - Iztapalapa, Mexico City, México
| | - Alejandro Escobedo-Calvario
- Laboratory for Cellular Physiology and Translational Medicine, Department of Health Sciences, Autonomous Metropolitan University - Iztapalapa, Mexico City, México
| | - Luis-León Fuentes-Romero
- Department of Infectious Diseases, National Institute of Medical Sciences and Nutrition "Salvador Zubirán", Mexico City, Mexico
| | - Santiago Pérez-Patrigeon
- Department of Infectious Diseases, National Institute of Medical Sciences and Nutrition "Salvador Zubirán", Mexico City, Mexico
| | - Akio Murakami-Ogasawara
- Center for Research in Infectious Diseases (CIENI), National Institute of Respiratory Diseases "Ismael Cosío Villegas", Mexico City, Mexico
| | - María Gomez-Palacio
- Center for Research in Infectious Diseases (CIENI), National Institute of Respiratory Diseases "Ismael Cosío Villegas", Mexico City, Mexico
| | - Gustavo Reyes-Terán
- Center for Research in Infectious Diseases (CIENI), National Institute of Respiratory Diseases "Ismael Cosío Villegas", Mexico City, Mexico
| | - Wei Jiang
- Department of Microbiology and Immunology, Medical University of South Carolina, Charleston, SC, USA
| | - Joel-Armando Vázquez-Pérez
- Laboratory for Emergent Diseases and COPD, National Institute of Respiratory Diseases "Ismael Cosío Villegas", Mexico City, Mexico
| | - Álvaro Marín-Hernández
- Department of Biochemistry, National Institute of Cardiology "Ignacio Chávez", Mexico City, Mexico
| | | | - María-Concepción Gutiérrez-Ruiz
- Laboratory for Cellular Physiology and Translational Medicine, Department of Health Sciences, Autonomous Metropolitan University - Iztapalapa, Mexico City, México
| | - Mónica Viveros-Rogel
- Department of Infectious Diseases, National Institute of Medical Sciences and Nutrition "Salvador Zubirán", Mexico City, Mexico
| | - Enrique Espinosa
- Laboratory of Integrative Immunology, National Institute of Respiratory Diseases "Ismael Cosío Villegas", Mexico City, Mexico
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Sukeri S, Sulaiman Z, Hamid NA, Ibrahim SA. Decision-Making on Contraceptive Use among Women Living with Human Immunodeficiency Virus in Malaysia: A Qualitative Inquiry. Korean J Fam Med 2024; 45:27-36. [PMID: 37848368 PMCID: PMC10822730 DOI: 10.4082/kjfm.23.0088] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 07/21/2023] [Accepted: 07/31/2023] [Indexed: 10/19/2023] Open
Abstract
BACKGROUND Malaysia is the first country in the Western Pacific Region to receive the validation certificate for the elimination of mother-to-child transmission of human immunodeficiency virus (HIV). The validation report recommends making sexual and reproductive health and rights of women living with HIV a priority. This article explores and assesses the sexual and reproductive health, rights, and access to healthcare services of Malaysia's women living with HIV (WLHIV). METHODS A qualitative secondary analysis conducted on 73 WLHIV from all over Malaysia comprised 11 in-depth interviews and 16 focus group discussions. Data were extracted from the original interview transcripts that emerged from the following questions: (1) "What are your experiences as a woman living with HIV in relation to your sexual and reproductive health and rights?" (2) "What are your experiences in accessing contraception?" (3) "What are your day-to-day experiences as a woman living with HIV?" Data were analyzed using thematic analysis. RESULTS Four themes emerged from the study findings: "lack of negotiation," "idealism in pregnancy," "coping with restrictions," and "past and future fears." The four themes are grounded in religion, a patriarchal culture, meaning and expectations of motherhood, taking risks and going against medical advice to pursue fertility desires, fear of HIV transmission, and the side effects of contraceptive use. CONCLUSION The complexities involved in decision-making regarding contraceptive use revealed how WLHIV may have unresolved reproductive health needs inconsistent with healthcare providers' focus on HIV management and prevention. Suggestions are made for improving the sexual and reproductive health and rights of WLHIV in Malaysia, which include establishing a reproductive health counseling program.
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Affiliation(s)
- Surianti Sukeri
- School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Malaysia
| | - Zaharah Sulaiman
- School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Malaysia
| | - Noor Aman Hamid
- School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Malaysia
| | - Siti Aishah Ibrahim
- School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Malaysia
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Parra-Lara LG, Arango-Ibañez JP, Martínez-Arboleda JJ, Bravo JC, Zambrano ÁR, Collazos P, Andino F, Badillo A, Estrada S, Rosso F. Survival of patients living with HIV and cancer in Cali, Colombia. Colomb Med (Cali) 2023; 54:e2015558. [PMID: 38098512 PMCID: PMC10719985 DOI: 10.25100/cm.v54i3.5588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 08/22/2023] [Accepted: 09/21/2023] [Indexed: 12/17/2023] Open
Abstract
Background People living with HIV have an increased risk of cancer compared to the general population. However, with the increase in life expectancy and advances in antiretroviral therapy, the survival of patients with cancer and HIV has changed. Objective To determine the survival of patients living with HIV and cancer in Cali, Colombia. Methods A retrospective cohort study was conducted at the Fundación Valle del Lili, Cali, Colombia. Data from the HIV database was crossed with data from the hospital and population-based cancer registries between 2011-2019. Patients <18 years, limited available clinical information on the diagnosis and treatment of HIV and cancer, and non-oncological tumor diagnosis were excluded. Results A total of 173 patients were included. The frequencies of AIDS-defining neoplasms were: Non-Hodgkin lymphoma (42.8%), Kaposi sarcoma (27.8%), and cervical cancer (4.6%). Overall survival was 76.4% (95% CI 68.9-82.3) at five years. Poorer survival was found in patients with AIDS-defining infections (56.9% vs. 77.8%, p=0.027) and non-AIDS-defining infections (57.8% vs. 84.2%, p=0.013), while there was better survival in patients who received antiretroviral therapy (65.9% vs. 17.9%, p=0.021) and oncological treatment (66.7% vs. 35.4%, p<0.001). The presence of non-AIDS-defining infections increases the risk of dying (HR = 2.39, 95% CI 1.05-5.46, p=0.038), while oncological treatment decreases it (HR = 0.33, 95% CI 0.14-0.80, p=0.014). Conclusions In people living with HIV, Non-Hodgkin lymphoma and Kaposi sarcoma are the most common neoplasms. Factors such as AIDS-associated and non-AIDS-associated infections have been identified as determinants of survival. Cancer treatment seems to improve survival.
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Affiliation(s)
- Luis Gabriel Parra-Lara
- Universidad Icesi, Facultad de Ciencias de la Salud, Cali, Colombia
- Fundación Valle del Lili, Centro de Investigaciones Clínicas (CIC), Cali, Colombia
| | | | | | - Juan C. Bravo
- Fundación Valle del Lili, Departamento de Patología y Laboratorio Clínico, Cali, Colombia
| | - Ángela R. Zambrano
- Fundación Valle del Lili, Departamento de Medicina Interna, Servicio de Hematología & Oncología Clínica, Cali, Colombia
| | - Paola Collazos
- Universidad del Valle, Facultad de Salud, Registro Poblacional de Cáncer de Cali (RPCC), Cali, Colombia
| | - Francisco Andino
- Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador
| | - Angélica Badillo
- Fundación Valle del Lili, Centro de Investigaciones Clínicas (CIC), Cali, Colombia
| | - Sebastián Estrada
- Fundación Valle del Lili, Centro de Investigaciones Clínicas (CIC), Cali, Colombia
| | - Fernando Rosso
- Universidad Icesi, Facultad de Ciencias de la Salud, Cali, Colombia
- Fundación Valle del Lili, Centro de Investigaciones Clínicas (CIC), Cali, Colombia
- Fundación Valle del Lili, Departamento de Medicina Interna, Servicio de Infectología, Cali, Colombia
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Valenzuela-Rodríguez G. [Cardiovascular compromise in the infection by the human immunodeficiency virus]. Arch Peru Cardiol Cir Cardiovasc 2023; 4:21-29. [PMID: 37408781 PMCID: PMC10318990 DOI: 10.47487/apcyccv.v4i1.269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 03/15/2023] [Indexed: 07/07/2023]
Abstract
Human immunodeficiency virus (HIV) infection was associated with increased morbidity and mortality, predominantly for opportunistic infections, before using antiretroviral therapy. With this, patients have experienced increased survival and cardiovascular compromise too. The etiology of these clinical conditions could be related to the infection itself, adverse events associated with antiretroviral therapy, or adverse events produced by the combination with other drugs. Some of these conditions have an acute onset, and their rapid recognition is vital for a better prognosis.
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Affiliation(s)
- Germán Valenzuela-Rodríguez
- Clínica Delgado-AUNA, Lima, Perú.Clínica Delgado-AUNALimaPerú
- Unidad de Revisiones Sistemáticas y Metaanálisis (URSIGET), Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Perú.Universidad San Ignacio de Loyolanidad de Revisiones Sistemáticas y Metaanálisis (URSIGET)Vicerrectorado de InvestigaciónUniversidad San Ignacio de LoyolaLimaPeru
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Okoroiwu HU, Umoh EA, Asanga EE, Edet UO, Atim-Ebim MR, Tangban EA, Mbim EN, Odoemena CA, Uno VK, Asuquo JO, Effiom-Ekaha OO, Dozie-Nwakile OC, Uchendu IK, Echieh CP, Emmanuel KJ, Ejemot-Nwadiaro RI, Nja GME, Oreh A, Uchenwa MO, Ufornwa EC, Nwaiwu NP, Ogar Ogar C, Nkang A, Kabiri OJ, Povedano-Montero FJ. Thirty-five years (1986-2021) of HIV/AIDS in Nigeria: bibliometric and scoping analysis. AIDS Res Ther 2022; 19:64. [PMID: 36539804 PMCID: PMC9768871 DOI: 10.1186/s12981-022-00489-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 12/08/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Acquired immunodeficiency syndrome (AIDS) is an acquired defect of the cellular immunity associated with the infection by the human immunodeficiency virus (HIV). The disease has reached pandemic proportion and has been considered a public health concern. This study is aimed at analyzing the trend of HIV/AIDS research in Nigeria. METHOD We used the PUBMED database to a conduct bibliometric analysis of HIV/AIDS-related research in Nigeria from 1986 to 2021 employing "HIV", "AIDS", "acquired immunodeficiency syndrome", "Human immunodeficiency virus", and "Nigeria" as search description. The most common bibliometric indicators were applied for the selected publications. RESULT The number of scientific research articles retrieved for HIV/AIDS-related research in Nigeria was 2796. Original research was the predominant article type. Articles authored by 4 authors consisted majority of the papers. The University of Ibadan was found to be the most productive institution. Institutions in the United States dominated external production with the University of Maryland at the top. The most utilized journal was PLoS ONE. While Iliyasu Z. was the most productive principal author, Crowel TA. was the overall most productive author with the highest collaborative strength. The keyword analysis using overlay visualization showed a gradual shift from disease characteristics to diagnosis, treatment and prevention. Trend in HIV/AIDS research in Nigeria is increasing yet evolving. Four articles were retracted while two had an expression of concern. CONCLUSION The growth of scientific literature in HIV/AIDS-related research in Nigeria was found to be high and increasing. However, the hotspot analysis still shows more unexplored grey areas in future.
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Affiliation(s)
| | | | | | - Uwem Okon Edet
- Department of Biological Sciences, Arthur Jarvis University, Akpabuyo, Nigeria
| | | | - Edum Abang Tangban
- Department of Nursing Science, Arthur Jarvis University, Akpabuyo, Nigeria
| | - Elizabeth Nkagafel Mbim
- Department of Public Health, Arthur Jarvis University, Akpabuyo, Nigeria ,grid.413097.80000 0001 0291 6387Microbiology Department, University of Calabar, Calabar, Nigeria
| | | | - Victor Kanu Uno
- Department of Human Anatomy, Arthur Jarvis University, Akpabuyo, Nigeria
| | - Joseph Okon Asuquo
- Department of Human Physiology, Arthur Jarvis University, Akpabuyo, Nigeria
| | | | - Ogechukwu C. Dozie-Nwakile
- grid.10757.340000 0001 2108 8257Department of Medical Laboratory Sciences, University of Nigeria, Enugu Campus, Enugu State, Nigeria
| | - Ikenna K. Uchendu
- grid.10757.340000 0001 2108 8257Department of Medical Laboratory Sciences, University of Nigeria, Enugu Campus, Enugu State, Nigeria
| | - Chidiebere Peter Echieh
- grid.413097.80000 0001 0291 6387Division of Cardiothoracic Surgery, University of Calabar Teaching Hospital, Calabar, Nigeria
| | | | - Regina Idu Ejemot-Nwadiaro
- grid.413097.80000 0001 0291 6387Department of Public Health, Faculty of Allied Medical Sciences, University of Calabar, Calabar, Nigeria
| | - Glory Mbe Egom Nja
- grid.413097.80000 0001 0291 6387Department of Public Health, Faculty of Allied Medical Sciences, University of Calabar, Calabar, Nigeria
| | - Adaeze Oreh
- Department of Planning, Research and Statistics, National Blood Service Commission, Abuja, Nigeria
| | - Mercy Ogechi Uchenwa
- grid.413097.80000 0001 0291 6387Microbiology Department, University of Calabar, Calabar, Nigeria
| | - Emmanuel Chukwuma Ufornwa
- grid.414823.80000 0004 1764 1103Medical Research Department, Federal Medical Centre, Owerri, Imo State Nigeria
| | - Ndidi Patience Nwaiwu
- grid.411539.b0000 0001 0360 4422Medical Laboratory Science Department, Imo State University, Owerri, Nigeria
| | - Christopher Ogar Ogar
- grid.413097.80000 0001 0291 6387Medical Laboratory Science, University of Calabar, Calabar, Nigeria
| | - Ani Nkang
- Department of Biological Sciences, Arthur Jarvis University, Akpabuyo, Nigeria
| | - Obinna Justice Kabiri
- grid.411539.b0000 0001 0360 4422Department of Medical Laboratory Science, Imo State University, Owerri, Imo State Nigeria
| | - F. Javier Povedano-Montero
- grid.119375.80000000121738416School of Biomedical and Health Sciences, Universidad Europea de Madrid, Madrid, Spain ,grid.4795.f0000 0001 2157 7667Department of Optics V (Optometry and Vision, Faculty of Optics and Optometry, Complutense University of Madrid, Madrid, Spain ,grid.144756.50000 0001 1945 5329Neurology Unit, Hospital 12 de Octubre Research Institute (I+12), Madrid, Spain
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Cari CQ, Yuko M, Sheila SV, Roland KB, Taylor RD, Zhang J. Reducing Homelessness among Persons with HIV: An Ecological Case Study in Delaware. J HIV AIDS Soc Serv 2022; 21:1-15. [PMID: 35937313 PMCID: PMC9348807 DOI: 10.1080/15381501.2021.2015502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 12/01/2021] [Accepted: 12/02/2021] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Among persons with HIV (PWH), homelessness is associated with poorer health. From 2009-2014, national HIV prevention goals included a reduction in homelessness among PWH. We sought to examine social ecological factors associated with homelessness among PWH at a sub-national level during that period. METHODS National data were used to identify Delaware as the only jurisdiction where homelessness among PWH declined from 2009-2014. We analyzed population-level indicators and conducted telephone interviews with 6 key stakeholders to further examine this trend. RESULTS Overall homelessness, household poverty, and median housing price were associated with homelessness among PWH in Delaware. Key stakeholders indicated that centralized intake processes improved screening, referral, and linkages of clients to housing units. DISCUSSION In addition to social and economic factors, collaborative program strategies may improve housing outcomes for PWH. Monitoring trends at sub-national levels can help identify successful approaches as well as needed services or policy change.
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Affiliation(s)
- Courtenay-Quirk Cari
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta GA
| | - Mizuno Yuko
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta GA
| | | | - Katherine B Roland
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta GA
| | - Raekiela D Taylor
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta GA
| | - Jun Zhang
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta GA
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Guiraud V, Verney C, Tetelboum N, Argy N, Debus J, Herbel S, Thy M, Ricard JD, Roux D, Zucman N. Life-threatening hemophagocytic syndrome triggered by disseminated toxoplasmosis in a young patient with previously unknown AIDS. Rev Med Interne 2022; 43:622-625. [PMID: 36089427 DOI: 10.1016/j.revmed.2022.07.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 07/19/2022] [Accepted: 07/27/2022] [Indexed: 10/14/2022]
Abstract
Hemophagocytic syndrome is a rare life-threatening disorder that can be triggered by various conditions such as HIV infection and opportunistic agents. We report a case of disseminated toxoplasmosis complicated with severe hemophagocytic syndrome and revealing an unknown acquired immunodeficiency syndrome. The patient presented with multiple organ failure in intensive care unit. Once diagnosed, he benefitted from etoposide infusion, administration of specific anti-toxoplasmosis treatments and secondary antiretroviral therapy. He was alive at intensive care unit discharge and returned home with little sequalae. This case illustrates both the importance of rapid investigations of hemophagocytic syndrome etiologies in HIV positive patients and the necessity to prompt etoposide and specific treatments in order to improve potentially dramatic outcomes.
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Affiliation(s)
- V Guiraud
- Université de Paris, AP-HP, hôpital Louis Mourier, DMU ESPRIT, médecine intensive réanimation, 92700 Colombes, France
| | - C Verney
- Université de Paris, AP-HP, hôpital Louis Mourier, DMU ESPRIT, médecine intensive réanimation, 92700 Colombes, France
| | - N Tetelboum
- Université de Paris, AP-HP, hôpital Louis Mourier, DMU DREAM, department of radiology, 92700 Colombes, France
| | - N Argy
- Université de Paris, AP-HP, Hôpital Bichat-Claude Bernard, DMU BIOGEM, Laboratoire de Parasitologie-Mycologie, 75018 Paris, France; Université de Paris, UMR 261 MERIT, IRD, faculté de pharmacie, 75006 Paris, France
| | - J Debus
- Université de Paris, AP-HP, hôpital Louis Mourier, DMU BIOGEM, hématologie biologique et transfusion, 92700 Colombes, France
| | - S Herbel
- Université de Paris, AP-HP, hôpital Bichat-Claude Bernard, DMU INVICTUS, service de maladies infectieuses et tropicales, 75018 Paris, France
| | - M Thy
- Université de Paris, AP-HP, hôpital Bichat-Claude Bernard, DMU INVICTUS, service de maladies infectieuses et tropicales, 75018 Paris, France
| | - J D Ricard
- Université de Paris, AP-HP, hôpital Louis Mourier, DMU ESPRIT, médecine intensive réanimation, 92700 Colombes, France; Université de Paris, UMR 1137 IAME, Inserm, 75018 Paris, France
| | - D Roux
- Université de Paris, AP-HP, hôpital Louis Mourier, DMU ESPRIT, médecine intensive réanimation, 92700 Colombes, France; Université de Paris, institut Necker-Enfants Malades, Inserm U1151, CNRS UMR 8253, 75015 Paris, France
| | - N Zucman
- Université de Paris, AP-HP, hôpital Louis Mourier, DMU ESPRIT, médecine intensive réanimation, 92700 Colombes, France.
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Metekiya WM, Gebreselassie AT, Amare TA, Wondafrash DZ. Prevalence and Determinants of Suicidal Ideation and Suicide Attempt in People With Human Immunodeficiency Virus in Africa: a Systematic Review. East Asian Arch Psychiatry 2022; 32:39-42. [PMID: 35732479 DOI: 10.12809/eaap20104] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND People with human immunodeficiency virus (HIV) are at higher risk of suicidal ideation and suicide attempts. We reviewed the literature for the prevalence and determinants of suicidal ideation and suicide attempt in people with HIV in Africa. METHODS The PubMed, Scopus, and Google scholar were searched for original studies published in peer-reviewed journals in English language between January 2015 to July 2020, using the key words: 'suicidal behavior', 'suicidal attempt', 'suicidal ideation', 'HIV/AIDS', and/or 'Africa'. The quality of included studies was assessed using the Newcastle-Ottawa scale. RESULTS 12 cross-sectional studies published in the past 5 years in African countries were included. The quality of studies was high, with score ranging from 6 to 9. The prevalence of suicidal ideation ranged from 8.8% to 39%. The prevalence of suicide attempt ranged from 2.8% to 20.1%. The most common risk factors for suicidal behaviour were mental health-related problems. Other factors included high clinical stage of HIV, being unmarried, poor medication adherence, poorer quality of life, not taking highly active antiretroviral therapy, female sex, no education, substance use, low CD4 level, and opportunistic infection. CONCLUSION Patients with HIV/AIDS have an increased risk of suicidal ideation and suicide attempts. Early screening, treatment, and referral of suicidal patients are necessary for HIV clinics.
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Affiliation(s)
- W M Metekiya
- Department of Psychiatry, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - A T Gebreselassie
- Department of Psychiatry, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - T A Amare
- Department of Psychiatry, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - D Z Wondafrash
- Department of Pharmacology, Saint Pauls Hospital Millennium Medical College, Addis Ababa, Ethiopia
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11
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Kibuuka H, Musingye E, Mwesigwa B, Semwogerere M, Iroezindu M, Bahemana E, Maswai J, Owuoth J, Esber A, Dear N, Crowell TA, Polyak CS, Ake JA. Predictors of All-Cause Mortality among People with HIV in a Prospective Cohort Study in East Africa and Nigeria. Clin Infect Dis 2021; 75:657-664. [PMID: 34864933 PMCID: PMC9464064 DOI: 10.1093/cid/ciab995] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Indexed: 11/21/2022] Open
Abstract
Background Introduction of antiretroviral therapy (ART) has been associated with a decline in human immunodeficiency virus (HIV)-related mortality, although HIV remains a leading cause of death in sub-Saharan Africa. We describe all-cause mortality and its predictors in people living with HIV (PLWH) in the African Cohort Study (AFRICOS). Methods AFRICOS enrolls participants with or without HIV at 12 sites in Kenya, Uganda, Tanzania, and Nigeria. Evaluations every 6 months include sociobehavioral questionnaires, medical history, physical examination, and laboratory tests. Mortality data are collected from medical records and survivor interviews. Multivariable Cox proportional hazards models were used to calculate adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for factors associated with mortality. Results From 2013 through 2020, 2724 PLWH completed at least 1 follow-up visit or experienced death. Of these 58.4% were females, 25.8% were aged ≥ 50 years, and 98.3% were ART-experienced. We observed 11.42 deaths per 1000 person-years (95% CI: 9.53–13.68) with causes ascertained in 54% of participants. Deaths were caused by malignancy (28.1%), infections (29.7%), and other non-HIV related conditions. Predictors of mortality included CD4 ≤ 350 cells/µL (aHR 2.01 [95% CI: 1.31–3.08]), a log10copies/mL increase of viral load (aHR 1.36 [95% CI: 1.22–1.51]), recent fever (aHR 1.85[95% CI: 1.22–2.81]), body mass index < 18.5 kg/m2 (aHR 2.20 [95% CI: 1.44–3.38]), clinical depression (aHR 2.42 [95% CI: 1.40–4.18]), World Health Organization (WHO) stage III (aHR 2.18 [95% CI: 1.31–3.61]), a g/dL increase in hemoglobin (aHR 0.79 [95% CI: .72–.85]), and every year on ART (aHR 0.67 [95% CI: .56–.81]). Conclusions The mortality rate was low in this cohort of mostly virally suppressed PLWH. Patterns of deaths and identified predictors suggest multiple targets for interventions to reduce mortality.
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Affiliation(s)
- Hannah Kibuuka
- Makerere University Walter Reed Project, Kampala, Uganda
| | - Ezra Musingye
- Makerere University Walter Reed Project, Kampala, Uganda
| | - Betty Mwesigwa
- Makerere University Walter Reed Project, Kampala, Uganda
| | | | - Michael Iroezindu
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA.,HJF Medical Research International, Abuja, Nigeria
| | - Emmanuel Bahemana
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA.,HJF Medical Research International, Mbeya, Tanzania
| | - Jonah Maswai
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA.,HJF Medical Research International, Kericho, Kenya
| | - John Owuoth
- U.S. Army Medical Research Directorate - Africa, Kisumu, Kenya.,HJF Medical Research International, Kisumu, Kenya
| | - Allahna Esber
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | - Nicole Dear
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | - Trevor A Crowell
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | - Christina S Polyak
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | - Julie A Ake
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA
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12
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Rua T, Brandão D, Nicolau V, Escoval A. The Utilisation of Payment Models Across the HIV Continuum of Care: Systematic Review of Evidence. AIDS Behav 2021; 25:4193-4208. [PMID: 34184134 PMCID: PMC8602234 DOI: 10.1007/s10461-021-03329-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2021] [Indexed: 10/31/2022]
Abstract
The increasing chronicity and multimorbidities associated with people living with HIV have posed important challenges to health systems across the world. In this context, payment models hold the potential to improve care across a spectrum of clinical conditions. This study aims to systematically review the evidence of HIV performance-based payments models. Literature searches were conducted in March 2020 using multiple databases and manual searches of relevant papers. Papers were limited to any study design that considers the real-world utilisation of performance-based payment models applied to the HIV domain. A total of 23 full-text papers were included. Due to the heterogeneity of study designs, the multiple types of interventions and its implementation across distinct areas of HIV care, direct comparisons between studies were deemed unsuitable. Most evidence focused on healthcare users (83%), seeking to directly affect patients' behaviour based on principles of behavioural economics. Despite the variability between interventions, the implementation of performance-based payment models led to either a neutral or positive impact throughout the HIV care continuum. Moreover, this improvement was likely to be cost-effective or, at least, did not compromise the healthcare system's financial sustainability. However, more research is needed to assess the durability of incentives and its appropriate relative magnitude.
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13
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Viard JP. [Long-term follow-up of persons living with HIV]. Rev Prat 2021; 71:965-971. [PMID: 35147310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Long-term Follow-up of persons Living with hiv Life expectancy of persons living with Hiv is reaching that of the general population. In consequence they are exposed To age-related comorbidities and Complications, with both classical and Hiv- or treatment-related risk factors. Patients with long treatment histories Should therefore be screened for cardiovascular Disease, hyperglycemia and Dyslipidemia, osteoporosis and certain Malignancies. Preventive actions should Be implemented. Although current antiretroviral Drugs are considerably less Toxic than first generation medications, Patient cohorts will inexorably become Older and accumulate comorbidities and Comedications. This evolution warrants a Global and mutidisciplinary approach to Medical care.
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Affiliation(s)
- Jean-Paul Viard
- Unité d'immunoinfectiologie, centre de diagnostic et de thérapeutique, Hôtel-Dieu, Paris, France
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14
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Sibiude J. [Mother-to-child transmission of HIV : a success of prevention]. Rev Prat 2021; 71:960-962. [PMID: 35147308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- Jeanne Sibiude
- Service de gynécologieobstétrique, hôpital Louis-Mourier, Colombes, France
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Abstract
INTRODUCTION Adrenal insufficiency (AI) is one of the most common potentially life-threatening endocrine complications in people living with human immunodeficiency virus (PLHIV) infection and acquired immunodeficiency syndrome (AIDS). AREAS COVERED In this review, the authors explore the definitions of relative AI, primary AI, secondary AI and peripheral glucocorticoid resistance in PLHIV. It also focuses on the pathophysiology, etiology, diagnosis and management of this endocrinopathy in PLHIV. A literature review was conducted through Medline and Google Scholar search on the subject. EXPERT OPINION Physicians need to be aware of the endocrinological implications of HIV infection and its treatment, especially CYP3A4 enzyme inhibitors. A high index of clinical suspicion is needed in the detection of AI, especially in PLHIV, as it may present insidiously with nonspecific signs and symptoms and may be potentially life threatening if left untreated. Patients with overt primary and secondary AI require glucocorticoid replacement therapy. Overt primary AI also necessitates mineralocorticoid replacement. On the other hand, the management of relative AI remains controversial. In order to reduce the risk of adrenal crisis during periods of stress, the short-term use of glucocorticoids may be necessary in relative AI.
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Affiliation(s)
- Simon Mifsud
- Department of Diabetes, Endocrinology and General Medicine, Mater Dei Hospital, Msida, Malta
| | - Zachary Gauci
- Department of Diabetes, Endocrinology and General Medicine, Mater Dei Hospital, Msida, Malta
| | - Mark Gruppetta
- Department of Diabetes, Endocrinology and General Medicine, Mater Dei Hospital, Msida, Malta
| | | | - Stephen Fava
- Department of Diabetes, Endocrinology and General Medicine, Mater Dei Hospital, Msida, Malta
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16
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Palich R. [Current treatment of HIV infection]. Rev Prat 2021; 71:976-982. [PMID: 35147313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Current treatment. Of hiv infection Thirty-five years have passed since the first cases of human immunodeficiency Virus (hiv)/acquired immunodeficiency syndrome (aids). The hiv infection has become a chronic viral infection, With the sustained control of the viral replication under antiretroviral Therapy. The major individual benefit of antiretrovirals is to Stop the progression of the disease, reducing the morbi-mortality, And the major collective benefit is to stop the transmission of the Virus from one individual to another. Despite their effectiveness on Viral replication, antiretrovirals fail to eradicate the virus due to its Integration into cellular reservoirs, reason why the antiretroviral Treatment must be continued for life: it requires rigorous and Prolonged compliance. Many therapeutic possibilities are now Available, based on simple and well-tolerated drugs. The aging of The population of patients living with hiv and the long-term exposure To antiretrovirals are new challenges for clinicians: the management Of drug-drug interactions and the prescription of Drug-reduced regimens, including dual therapies and intermittent Treatments. In the near future, new long-acting drugs, with various Modes of administration, are expected to further revolutionize the Management of hiv infection.
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Affiliation(s)
- Romain Palich
- Service des maladies infectieuses et tropicales, hôpital de la Pitié-Salpêtrière, AP-HP, Paris, France
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17
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Viard JP. [The future of persons born with HIV]. Rev Prat 2021; 71:974-975. [PMID: 35147312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- Jean-Paul Viard
- Unité d'immunoinfectiologie, centre de diagnostic et de thérapeutique, Hôtel-Dieu, Paris, France
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18
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Viard JP. [Excessive weight gain in persons treated for HIV : an adverse effet of integrase inhibitors and « TAF » ?]. Rev Prat 2021; 71:972-973. [PMID: 35147311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- Jean-Paul Viard
- Unité d'immunoinfectiologie, centre de diagnostic et de thérapeutique, Hôtel-Dieu, Paris, France
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Viard JP. [HIV infection : 10 key messages]. Rev Prat 2021; 71:986. [PMID: 35147315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- Jean-Paul Viard
- Unité d'immunoinfectiologie, centre de diagnostic et de thérapeutique, Hôtel-Dieu, Paris, France
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20
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Slama L. [PrEP for HIV prevention, major tool of the global diversified prevention strategy]. Rev Prat 2021; 71:957-959. [PMID: 35147307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- Laurence Slama
- Service d'immunoinfectiologie, Hôtel-Dieu, Paris, France
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21
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Linard F. [Fragility and precariousness of people living with HIV]. Rev Prat 2021; 71:941-946. [PMID: 35147305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Fragility and Precariousness of People living with hiv Living with hiv in 2021 means having a Chronic disease that is still not "like the Others". Stigma and discrimination persist. And the prognosis remains uncertain in the Countries of the south where access to care Can be problematic and the emergence of Resistance is a concern. Being treated during the covid-19 pandemic Represented a public health challenge, but Persons living with hiv (plwhiv), who were More precarious and psychologically fragile Than the general population, were more Affected by the difficulties in accessing Care. The population of plwhiv includes two main Groups in particular migrants and msm (men who have sex with men) as indicated By the figures for new infections in 2020. The migrant population affected is heterogeneous, With people who have been living in France for decades but also newcomers Whose migration path is often marked by Traumatic events. In addition to the weight Of the hiv infection itself, frequent aggressions And concerns for loved ones back Home, as well as the weight of exile, result In a high prevalence of psychological disorders. Even today, being homosexual is not always Self-evident, whether the stigma comes from Others or is integrated by the person himself (internalized stigma). Aging is globally depreciated In our society but particularly in The gay community. This community is also Affected by the practice of chemsex and Slam, use of psychoactive substances. All of these elements lead to a high prevalence Of psychological disorders and possible Social insecurity. The care of plwhiv Must be global, it requires taking into account All these aspects, medical, psychological And social, and associating the patients To the care.
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Affiliation(s)
- Françoise Linard
- Psychiatre, psychanalyste, service des maladies infectieuses et tropicales, Sorbonne université et AP-HP. Centre-Université de Paris (SMIT Tenon et Hôtel-Dieu), Paris, France
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22
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Slama L. [Impact of prevention and treatment strategies on the epidemiology of HIV infection in France and around the world]. Rev Prat 2021; 71:950-956. [PMID: 35147306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Impact of prevention and treatment for hiv infection in france and around the world. The unaids goals will not be achieved in 2030 without a global effort specifically focused on hiv prevention. Many tools are available, named as diversified prevention, adapted To each individual, each sexuality, each need and expectation. From simplified access to hiv testing to universal hiv treatment, antiretroviral therapies as a tool to prevent hiv Transmission no longer needs to be proven. On the other hand, with more than 1.5 million new diagnoses per year, prevention, including prep, remains insufficient and highlights Social and economic inequalities. Promoting hiv prevention is a major public health issue in the global hiv/aids control system.
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Affiliation(s)
- Laurence Slama
- Service d'immunoinfectiologie, Hôtel-Dieu, Paris, France
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23
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Deleuze J. [Forty years of AIDS]. Rev Prat 2021; 71:931. [PMID: 35147303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
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24
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Palich R. [Primary HIV infection: a therapeutic emergency]. Rev Prat 2021; 71:983-985. [PMID: 35147314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- Romain Palich
- Service des maladies infectieuses et tropicales, hôpital Pitié-Salpêtrière, AP-HP, Paris, France
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25
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Slama L. [Let's talk about sexuality with our patients]. Rev Prat 2021; 71:963-964. [PMID: 35147309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- Laurence Slama
- Service d'immunoinfectiologie, Hôtel-Dieu, Paris, France
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Lourenção Tauyr TF, Garcia Lourenção L, Zanon Ponce MA, Guimarães Ximenes Neto FR, Sperli Geraldes Santos MDL, Sperli Geraldes Marin Dos Santos Sasaki N, Figueiredo Vendramini SH. Vulnerability of the Brazilian LGBT population in HIV treatment. J Infect Dev Ctries 2021; 15:1481-1488. [PMID: 34780371 DOI: 10.3855/jidc.13707] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 01/10/2021] [Indexed: 10/31/2022] Open
Abstract
INTRODUCTION Human immunodeficiency virus (HIV) infection affects the lesbian, gay, bisexual, transvestite, and transsexual (LGBT) population. We aimed to identify the indidual vulnerability profile of the LGBT population ling with H/acquired immunodeficiency syndrome (AIDS) and correlate it with the treatment situation. METHODOLOGY This cross-sectional study included 510 LGBT people living with HIV (PLHIV)/AIDS who attended the Complex of Chronic Communicable Diseases of the municipality of São José do Rio Preto, São Paulo, Brazil, between 2008 and 2015. RESULTS There was a predominance of indiduals who were white (70.2%), male (98.4%), single (87.1%), aged 25-44 years (70.0%), educated up to high school (47.7%), economically acte (91.2%), under treatment (80.8%), having CD4 > 350 cells/mm3 (77.1%), and having undetectable viral load (53.3%). HIV transmission was mainly sexual (97.0%) and most people used drugs (76.5%). There was a weak correlation between the variables 'in treatment' and acte occupation (r = 0.148, p = 0.001), single marital status (r = 0.128, p = 0.004), white race/colour (r = 0.117, p = 0.008), high school education (r = 0.111, p = 0.012), sexual transmission (r = 0.222, p = 0.000), drug use (r = 0.087, p = 0.049), and CD4 > 350 cells/mm3 (r = 0.118, p = 0.008); and strong correlation between the variables 'in treatment' and undetectable viral load (r = -0.937, p = 0.113). CONCLUSIONS The characteristics of the indidual vulnerability of LGBT people involve, among other aspects, issues of gender and social exclusion, a situation that is part of the daily life of PLHIV/AIDS in many scenarios and territories. This can be alleviated with a network of social and health support and effecte and efficient, protecte, attitudinal, and behavioural public policies.
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Ferguson J, Mathur S, Armstrong A. Assessing the Vulnerability and Risks of Adolescent Girls and Young Women in East and Southern Africa: A Preliminary Review of the Tools in Use. Trop Med Infect Dis 2021; 6:tropicalmed6030133. [PMID: 34287365 PMCID: PMC8293427 DOI: 10.3390/tropicalmed6030133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 07/08/2021] [Accepted: 07/11/2021] [Indexed: 12/01/2022] Open
Abstract
The sexual and reproductive health (SRH) needs of adolescent girls and young women (AGYW) aged 10–24 years remain a cause for concern in the countries of East and Southern Africa (ESA). High rates of adolescent pregnancy and HIV prevalence prevail, and prevention programmes are challenged to identify those at greatest risk. This review aimed to identify tools being used in ESA countries that support the recording of factors that make AGYW vulnerable to SRH risks and document their use. A mixed-methods approach was used to find available English language tools that had been designed to assess the vulnerability of AGYW SRH risks including literature reviews and key informant interviews with thirty-five stakeholders. Twenty-two tools were identified, and experiences of their use obtained through the interviews. All but one tool focused on HIV prevention, and most aimed at establishing eligibility for programmes, though not aligned with programme type. Analyses of the content of seventeen tools showed information collection related to behavioral, biological, and structural risk factors of HIV and other aspects of AGYWs’ lives. There was considerable diversity in the ways in which these questions were framed. Aspects of the processes involved in undertaking the risk and vulnerability assessments are presented.
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Affiliation(s)
- Jane Ferguson
- Independent Consultant, 1295 Tannay, Switzerland
- Correspondence:
| | - Sanyukta Mathur
- HIV and AIDS Program, Population Council, Washington, DC 20008, USA;
| | - Alice Armstrong
- Adolescent and HIV/AIDS Specialist, UNICEF Eastern and Southern Africa Regional Office, Nairobi 00100, Kenya;
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28
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Coldiron ME, Gutierrez Zamudio AG, Manuel R, Ciglenecki I, Trellu LT, Molfino L. Authors' response to "Evaluation of Treatments for HIV-Associated Kaposi Sarcoma in Africa". Infect Agent Cancer 2021; 16:27. [PMID: 33952333 PMCID: PMC8097918 DOI: 10.1186/s13027-021-00372-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 04/29/2021] [Indexed: 12/03/2022] Open
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29
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Truzzi GDM, Teixeira IDL, do Prado LBF, do Prado GF, Tufik S, Coelho FM. Sleep state misperception: is there a CNS structural source? Sleep Sci 2021; 14:94-96. [PMID: 34917280 PMCID: PMC8663728 DOI: 10.5935/1984-0063.20200039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Accepted: 11/17/2018] [Indexed: 11/25/2022] Open
Abstract
Introduction We describe a case of sleep state misperception in a patient with a neurotoxoplasmosis lesion in the left nucleocapsular region. Case report A 40-year-old female patient presented relating sleeplessness over the past 2 years, concurrent with progressive headaches, dizziness and motor and sensory deficits in the right upper and lower limbs. She had a history of AIDS, on irregular antiretroviral therapy and neurotoxoplasmosis. A polysomnography confirmed the hypothesis of sleep state misperception, and magnetic resonance imaging revealed a residual lesion in the left nucleocapsular region. Conclusion Different models consider that the sleep state misperception could be correlated to structural abnormalities of the central nervous system. A recent study showed that the medial prefrontal cortex had a lower activation in patients with unrefreshing sleep due to chronic fatigue syndrome. This case report highlights the possibility of sleep state misperception having - at least partially - an anatomical substrate in the left nucleocapsular region.
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Affiliation(s)
| | - Igor de Lima Teixeira
- Universidade Federal de São Paulo, Departamento de Neurologia e Neurocirurgia - São Paulo - Brazil
| | | | | | - Sergio Tufik
- Universidade Federal de São Paulo, Departamento de Psicobiologia - São Paulo - Brazil
| | - Fernando Morgadinho Coelho
- Universidade Federal de São Paulo, Departamento de Psicobiologia - São Paulo - Brazil.,Universidade Federal de São Paulo, Departamento de Neurologia e Neurocirurgia - São Paulo - Brazil
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Peluso MJ, Colby DJ, Pinyakorn S, Ubolyam S, Intasan J, Trichavaroj R, Chomchey N, Prueksakaew P, Slike BM, Krebs SJ, Jian N, Robb ML, Phanuphak P, Phanuphak N, Spudich S, Ananworanich J, Kroon E. Liver function test abnormalities in a longitudinal cohort of Thai individuals treated since acute HIV infection. J Int AIDS Soc 2020; 23:e25444. [PMID: 31953919 PMCID: PMC6968973 DOI: 10.1002/jia2.25444] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 12/04/2019] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Liver disease is a common cause of non-AIDS morbidity and mortality in people living with HIV (PLHIV), but the prevalence and significance of liver function test (LFT) abnormalities in early HIV infection is unknown. This study aimed to characterize LFTs in a large cohort of participants with acute HIV infection initiating immediate antiretroviral therapy (ART) and examine the association between LFTs and biomarkers of HIV infection and inflammation. METHODS We measured LFTs at the time of HIV diagnosis and at 4, 12, 24 and 48 weeks after ART initiation in 426 Thai individuals with acute HIV infection from 2009 to 2018. A subset of individuals had data available at 96 and 144 weeks. We excluded individuals with concomitant viral hepatitis. Alanine aminotransferase (ALT) was the primary outcome of interest; values greater than 1.25 times the upper limit of normal were considered elevated. Analyses utilized descriptive statistics, non-parametric tests and multivariate logistic regression. RESULTS Sixty-six of the 426 individuals (15.5%) had abnormal baseline ALT levels; the majority (43/66, 65.5%) had Grade 1 elevations. Elevated baseline ALT correlated with Fiebig stages III to V (p = 0.001) and baseline HIV RNA >6 log10 copies/mL (p = 0.012). Baseline elevations resolved by 48 weeks on ART in 59 of the 66 individuals (89%). ALT elevations at 24 and 48 weeks correlated with Fiebig stages I to II at diagnosis (p < 0.001), baseline plasma HIV RNA levels <6 log10 copies/mL (p < 0.001), abnormal baseline ALT (p < 0.001), baseline CD4 >350 cells/μL (p = 0.03) and older age (p = 0.03). Individuals initiating efavirenz-based regimens were more likely to have elevated ALT levels at 48 weeks compared with those on non-efavirenz-based regimens (p = 0.003). CONCLUSIONS One in six people with acute HIV infection have elevated LFTs. Clinical outcomes with ART started in acute HIV are generally good, with resolution of ALT elevations within 48 weeks on ART in most cases. These results suggest a multifactorial model for hepatic injury involving a combination of HIV-associated and ART-associated processes, which may change over time.
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Affiliation(s)
- Michael J Peluso
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, CA, USA
| | - Donn J Colby
- SEARCH, Thai Red Cross AIDS Research Centre, Bangkok, Thailand.,U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | - Suteeraporn Pinyakorn
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | | | - Jintana Intasan
- SEARCH, Thai Red Cross AIDS Research Centre, Bangkok, Thailand
| | - Rapee Trichavaroj
- Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Nitiya Chomchey
- SEARCH, Thai Red Cross AIDS Research Centre, Bangkok, Thailand
| | | | - Bonnie M Slike
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | - Shelly J Krebs
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | - Ningbo Jian
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | - Merlin L Robb
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | | | | | | | - Jintanat Ananworanich
- SEARCH, Thai Red Cross AIDS Research Centre, Bangkok, Thailand.,U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA.,The University of Amsterdam, Amsterdam, The Netherlands
| | - Eugène Kroon
- SEARCH, Thai Red Cross AIDS Research Centre, Bangkok, Thailand
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Abstract
Before a vaccine against SARS-CoV-2 became available, several measures to control COVID-19 pandemic are necessary. Analogously, in the absence of an available vaccine, Combination HIV Prevention Programmes have consolidated a large experience of biomedical, behavioral and structural interventions suitable for several epidemiological settings. Adaptation of such experiences can organize mid-term and long-term responses to face COVID-19.
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Affiliation(s)
- Ricardo Palacios
- Instituto Butantan, Clinical Trials and Pharmacovigilance Center, São Paulo, Brazil
| | - Augusto Mathias
- Universidade de São Paulo, School of Medicine, Department of Preventive Medicine, São Paulo, Brazil
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Millar A, Joubert K, Naude A. Prevalence of hearing loss and tinnitus in a group of adults with Human Immunodeficiency Virus. S Afr J Commun Disord 2020; 67:e1-e7. [PMID: 32129664 PMCID: PMC7059238 DOI: 10.4102/sajcd.v67i1.631] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 07/25/2019] [Accepted: 08/06/2019] [Indexed: 11/16/2022] Open
Abstract
Background The Human Immunodeficiency Virus (HIV) has become a global pandemic. With the improvement of antiretroviral (ARV) treatment regimens, life-expectancy of HIV-positive individuals has increased. HIV literature suggests that head and neck manifestations may be the first indication of supressed immunity. Therefore, research regarding the effects of HIV and new treatment regimens on auditory function remains a priority. Objectives To describe the audiological characteristics and determine the prevalence of hearing loss and tinnitus in a group of HIV-positive individuals on ARV treatment residing in a rural province. Methods The study employed a cross-sectional descriptive research design. Participants were recruited from the clinic and pharmacy waiting areas of a medical centre in a rural area of Limpopo province, South Africa. Two participant groups, an HIV-positive group (N1 = 60) and an HIV-negative group (N2 = 32) were included in the study. The test battery comprised a comprehensive case history and a routine audiological test battery, which included otoscopy, tympanometry and pure tone audiometry (250 Hz to 8000 Hz). Results No statistically significant difference was found regarding the prevalence of hearing loss in the two participant groups (p = 0.709). However, the prevalence of tinnitus was significantly higher in the HIV-positive group (p = 0.05). Conclusion The insignificant difference in the audiological test battery results found between the two participant groups may be due to improved ARV treatment regimens and management strategies employed at the medical centre. However, the increased prevalence of tinnitus in the HIV-positive group may also be attributed to the ARV regimen and/or the result of subtle damage to the auditory system, which was not identified by the current audiological test battery. More insight may be obtained about the effects of HIV on hearing by employing a longitudinal research design and inclusion of a more ototoxicity sensitive test battery.
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Affiliation(s)
- Alison Millar
- Department of Speech Pathology and Audiology, University of the Witwatersrand, Johannesburg.
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Sridevi K, Malathi S, Kv C, G CN, Gayathri M, Chand GE, Nayyar AS. CD4 Cell Counts, Lipid Profile, and Oral Manifestations in HIV-Infected and AIDS Patients. Front Dent 2019; 16:436-449. [PMID: 33089245 PMCID: PMC7569270 DOI: 10.18502/fid.v16i6.3443] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 10/01/2019] [Indexed: 11/24/2022] Open
Abstract
Objectives The present study aimed to evaluate CD4 cell counts, lipid profile, and oral manifestations in human immunodeficiency virus (HIV)-infected and acquired immune deficiency syndrome (AIDS) patients and their correlation with seronegative controls. Materials and Methods In this cross-sectional, hospital-based study, there were three groups of subjects: group A consisting of 500 healthy patients (controls), group B composed of 500 HIV-infected patients, and group C comprised of 500 AIDS patients based on their CD4 cell counts. CD4 cell counts were assessed using the CyFlow counter. Lipid profile was evaluated with the Erba EM 360 analyzer. Results The results were statistically significant for CD4 cell counts (P<0.001). The levels of total cholesterol (TC) and low-density lipoproteins (LDLs) were significantly decreased while triglycerides (TGs) and very-low-density lipoproteins (VLDLs) were significantly increased in AIDS patients compared to the controls and HIV-infected patients. Various results were obtained regarding oral manifestations with different levels of significance. Conclusion CD4 cell counts, TC, LDLs, TGs, and VLDLs were significantly changed in HIV-infected and AIDS patients compared to the controls.
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Affiliation(s)
- Koduri Sridevi
- Department of Oral Medicine and Radiology, Lenora Institute of Dental Sciences, Rajahmundry, Andhra Pradesh, India
| | - Saka Malathi
- Department of Oral Medicine and Radiology, Army College of Dental Sciences, Secunderabad, Telangana, India
| | - Chalapathi Kv
- Department of Oral Pathology and Microbiology, Care Dental College and Hospital, Guntur, Andhra Pradesh, India
| | - Chowdary Nagarjuna G
- Department of Pedodontics and Preventive Dentistry, MNR Dental College and Hospital, Sangareddy, Telangana, India
| | - M Gayathri
- Department of Oral Medicine and Radiology, Adhiparasakthi Dental College and Hospital, Melmaruvathur, Tamilnadu, India
| | - G Eswar Chand
- Medical Graduate, Mamata Medical College, Khammam, Telangana, India
| | - Abhishek Singh Nayyar
- Department of Oral Medicine and Radiology, Saraswati Dhanwantari Dental College and Hospital and Post-graduate Research Institute, Parbhani, Maharashtra, India
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Chiampas TD, Biagi MJ, Badowski ME. Impact of an HIV-trained clinical pharmacist intervention on error rates of antiretroviral and opportunistic infection medications in the inpatient setting. Pharm Pract (Granada) 2019; 17:1543. [PMID: 31592015 PMCID: PMC6763295 DOI: 10.18549/pharmpract.2019.3.1543] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 08/11/2019] [Indexed: 11/14/2022] Open
Abstract
Background: Based on a retrospective study performed at our institution, 38% of inpatients living with human immunodeficiency virus (HIV) were found to have a medication error involving their anti-retroviral (ARV) and/or opportunistic infection (OI) prophylaxis medications. Objective: To determine the impact of a dedicated HIV-trained clinical pharmacist on the ARV and OI prophylaxis medication error rates at our institution. Methods: A prospective quality improvement project was conducted over a six month period to assess the impact of a dedicated HIV-trained clinical pharmacist on the ARV and OI prophylaxis medication error rates. IRB approval received. Results: There were 144 patients included in this analysis, who experienced a combined 76 medication errors. Compared to historical control study conducted at our institution, the percent of patients who experienced a medication error remained stable (38% vs. 39%, respectively) and the error rate per patient was similar (1.44 vs. 1.36, p=NS). The percent of medication errors that were corrected prior to discharge increased from 24% to 70% and the median time to error correction decreased from 42 hours to 11.5 hours (p<0.0001). Conclusions: Errors relating to ARV or OI prophylaxis medications remain frequent in inpatient people living with HIV/AIDS. After multiple interventions were implemented, ARV and OI prophylaxis medication errors were corrected faster and with greater frequency prior to discharge, however, similar rates of errors for patients existed. Dedicated HIV clinicians with adequate training and credentialing are necessary to manage this specialized disease state and to reduce the overall number of medication errors associated with HIV/AIDS.
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Affiliation(s)
- Thomas D Chiampas
- Clinical Assistant Professor. College of Pharmacy, University of Illinois. Chicago (United States).
| | - Mark J Biagi
- Infectious Diseases Pharmacy Fellow. College of Pharmacy, University of Illinois. Chicago (United States).
| | - Melissa E Badowski
- Clinical Associate Professor. College of Pharmacy, University of Illinois. Chicago (United States).
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Saloner R, Campbell LM, Serrano V, Montoya JL, Pasipanodya E, Paolillo EW, Franklin D, Ellis RJ, Letendre SL, Collier AC, Clifford DB, Gelman BB, Marra CM, McCutchan JA, Morgello S, Sacktor N, Jeste DV, Grant I, Heaton RK, Moore DJ; CHARTER and HNRP Groups. Neurocognitive SuperAging in Older Adults Living With HIV: Demographic, Neuromedical and Everyday Functioning Correlates. J Int Neuropsychol Soc 2019; 25:507-19. [PMID: 30890191 DOI: 10.1017/S1355617719000018] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES Studies of neurocognitively elite older adults, termed SuperAgers, have identified clinical predictors and neurobiological indicators of resilience against age-related neurocognitive decline. Despite rising rates of older persons living with HIV (PLWH), SuperAging (SA) in PLWH remains undefined. We aimed to establish neuropsychological criteria for SA in PLWH and examined clinically relevant correlates of SA. METHODS 734 PLWH and 123 HIV-uninfected participants between 50 and 64 years of age underwent neuropsychological and neuromedical evaluations. SA was defined as demographically corrected (i.e., sex, race/ethnicity, education) global neurocognitive performance within normal range for 25-year-olds. Remaining participants were labeled cognitively normal (CN) or impaired (CI) based on actual age. Chi-square and analysis of variance tests examined HIV group differences on neurocognitive status and demographics. Within PLWH, neurocognitive status differences were tested on HIV disease characteristics, medical comorbidities, and everyday functioning. Multinomial logistic regression explored independent predictors of neurocognitive status. RESULTS Neurocognitive status rates and demographic characteristics differed between PLWH (SA=17%; CN=38%; CI=45%) and HIV-uninfected participants (SA=35%; CN=55%; CI=11%). In PLWH, neurocognitive groups were comparable on demographic and HIV disease characteristics. Younger age, higher verbal IQ, absence of diabetes, fewer depressive symptoms, and lifetime cannabis use disorder increased likelihood of SA. SA reported increased independence in everyday functioning, employment, and health-related quality of life than non-SA. CONCLUSIONS Despite combined neurological risk of aging and HIV, youthful neurocognitive performance is possible for older PLWH. SA relates to improved real-world functioning and may be better explained by cognitive reserve and maintenance of cardiometabolic and mental health than HIV disease severity. Future research investigating biomarker and lifestyle (e.g., physical activity) correlates of SA may help identify modifiable neuroprotective factors against HIV-related neurobiological aging. (JINS, 2019, 25, 507-519).
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Kirkner RM. In Trump, HIV/AIDS Groups Find an Ally Who's Tough To Love. Manag Care 2019; 28:30-32. [PMID: 31188121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Adjusting their vision so it looks past the messenger and focuses on President Trump's stated goal to end AIDS by 2030 isn't easy for HIV/AIDS advocates. But they aren't being entirely dismissive, either. They have some faith in, and working relationships with, federal government health officials who will oversee implementation of the plan.
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Reinke T. To Be Continued:The Search for a Cure for HIV. Manag Care 2019; 28:35-36. [PMID: 31188123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Effective treatment has helped curb the epidemic, but practical cures have been elusive. Now being tested: a "sterilizing cure" that eradicates HIV from the body, and a "functional cure" that effectively reduces the viral load so it cannot be transmitted or progress to AIDS.
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Lopes CCB, Crivillari M, Prado JCM, Ferreira CR, Dos Santos PJ, Takayasu V, Laborda LS. Progressive multifocal leukoencephalopathy: a challenging diagnosis established at autopsy. Autops Case Rep 2019; 9:e2018063. [PMID: 30863734 PMCID: PMC6394363 DOI: 10.4322/acr.2018.063] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2018] [Accepted: 11/13/2018] [Indexed: 01/19/2023] Open
Abstract
Progressive multifocal leukoencephalopathy (PML) is a feared entity that occurs most frequently in conditions of extreme immunodeficiency. The diagnosis is often made long after the onset of symptoms due to the physicians’ unfamiliarity, and the unavailability of diagnostic tests in some medical centers. Although the incidence of PML is decreasing among HIV patients with the advent of highly active antiretroviral therapy (HAART), in Brazil this entity is the fourth highest neurological complication among these patients. The authors present the case of a middle-aged man who tested positive for HIV concomitantly with the presentation of hyposensitivity in the face and the right side of the body, accompanied by mild weakness in the left upper limb. The clinical features worsened rapidly within a couple of weeks. The diagnostic work-up pointed to the working diagnosis of PML after brain magnetic resonance imaging; however, the detection of the John Cunningham virus (JCV) in the cerebral spinal fluid was negative. HAART was started but the patient died after 7 weeks of hospitalization. The autopsy revealed extensive multifocal patchy areas of demyelination in the white matter where the microscopy depicted demyelination, oligodendrocytes alterations, bizarre atypical astrocytes, and perivascular lymphocytic infiltration. The immunohistochemistry was positive for anti-SV40, and the polymerase chain reaction of the brain paraffin-embedded tissue was positive for JCV. The authors highlight the challenges for diagnosing PML, as well as the devastating outcome of PML among HIV patients.
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Affiliation(s)
| | | | - José Carlos Mann Prado
- Universidade de São Paulo (USP), Biomedical Sciences Institute, Department of Microbiology, Laboratory of Oncovirology. São Paulo, SP, Brazil
| | - Cristiane Rubia Ferreira
- Universidade de São Paulo (USP), Hospital Universitário, Anatomic Pathology Service. São Paulo, SP, Brazil
| | - Pedro José Dos Santos
- Universidade de São Paulo (USP), Hospital Universitário, Department of Radiology. São Paulo, SP, Brazil
| | - Vilma Takayasu
- Universidade de São Paulo (USP), Hospital Universitário, Internal Medicine Division. São Paulo, SP, Brazil
| | - Lorena Silva Laborda
- Universidade de São Paulo (USP), Hospital Universitário, Internal Medicine Division. São Paulo, SP, Brazil
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Jin Y, Meng X, Liu S, Yuan J, Guo H, Xu L, Xu Q. Prevalence trend and risk factors for anemia among patients with human immunodeficiency virus infection receiving antiretroviral therapy in rural China. J TRADIT CHIN MED 2019; 39:111-117. [PMID: 32186031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To estimate the prevalence trend and risk factors for anemia in patients with human immunodeficiency virus (HIV) infection receiving antiretroviral therapy (ART) in rural China. METHODS We conducted cross-sectional studies among the same population in 2010, 2012, and 2014, based on data from standard medical record registers. Factors associated with anemia were evaluated using a logistic regression model. RESULTS The number of patients with HIV infection included in each cross-sectional study was 1456 in 2010, 1531 in 2012, and 1567 in 2014, and the prevalence of anemia was 44.3%, 34.7%, and 27.6%, respectively. The prevalence of anemia was lower in female patients in 2010 [odds ratio (OR) 0.68; 95% confidence interval (CI) 0.55-0.85]; however, there was no difference by sex in 2012 (OR 0.90; 95% CI 0.72-1.11) and 2014 (OR 1.05; 95% CI 0.84-1.32). Patients with a higher level of education had a lower risk of anemia in 2014 (OR 0.72; 95% CI 0.56-0.92), but there was no difference in 2010 (OR 1.00; 95% CI 0.79-1.25) and 2012 (OR 0.99; 95% CI 0.79-1.24). Patients who had received a longer duration of ART had a higher risk of anemia in 2014 (OR 1.74; 95% CI 1.15-2.64), but there was no difference in 2010 and 2012 (P > 0.05). Patients receiving Traditional Chinese Medicine (TCM) therapy had a lower risk of anemia. CONCLUSION The prevalence of anemia among patients with HIV infection receiving ART decreased between 2010 and 2014 in Henan Province but was still higher than the prevalence in the general population of China. TCM therapy can potentially decrease the risk of anemia among patients with HIV infection.
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Affiliation(s)
- Yantao Jin
- Department of Acquired Immune Deficiency Syndrome Treatment and Research Center, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou 45000, China
- Institute of Clinical Pharmacology, Guangzhou University of Chinese Medicine, Guangzhou 510006, China
| | - Xiangle Meng
- Department of Acquired Immune Deficiency Syndrome Treatment and Research Center, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou 45000, China
- Institute of Clinical Pharmacology, Guangzhou University of Chinese Medicine, Guangzhou 510006, China
| | - Sa Liu
- Department of Acquired Immune Deficiency Syndrome Treatment and Research Center, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou 45000, China
| | - Jun Yuan
- Department of Acquired Immune Deficiency Syndrome Treatment and Research Center, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou 45000, China
| | - Huijun Guo
- Department of Acquired Immune Deficiency Syndrome Treatment and Research Center, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou 45000, China
| | - Liran Xu
- Department of Acquired Immune Deficiency Syndrome Treatment and Research Center, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou 45000, China
| | - Qianlei Xu
- Department of Acquired Immune Deficiency Syndrome Treatment and Research Center, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou 45000, China
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Gómez-Ricárdez LA, Gómez-Dantes H, Krug-Llamas E, Mohela-Gómez A. [Evaluation of Chiapas’ HIV/AIDS information system of epidemiological surveillance]. Rev Med Inst Mex Seguro Soc 2019; 56:468-477. [PMID: 30777415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
BACKGROUND The functionality and performance of a health information system should be evaluated from the perspective of those who develop its processes. Considering the above, this study evaluated the performance of the HIV/AIDS Epidemiological Surveillance System (SIVE VIH/SIDA, according to its initials in Spanish) in Chiapas, Mexico. METHODS Qualitative study on the performance, structure and dynamics of SIVE VIH/SIDA, based on interviews with the personnel participating in this surveillance system, using the Updated Guidelines for the Evaluation of Public Health Surveillance Systems. The analysis was performed through the cyclic interactive method of content analysis, from which the evaluation indices were constructed. RESULTS A total of 32 interviews were conducted. The structure was described as well defined, at the expense of organizational dimensions, procedures and material resources. The dynamics of information, from the perspective of the collection, processing and use of information, was rated as regular. The performance of the SIVE HIV/AIDS in Chiapas was regular at the expense of these attributes of the information system: simplicity, flexibility, quality of data, acceptability, sensitivity, representativeness, timeliness and stability. CONCLUSIONS In order to improve the performance of SIVE VIH/SIDA, it is necessary to strengthen the human resources and use of information dimensions, so that it can be an instrument for action.
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Affiliation(s)
- Licely Angélica Gómez-Ricárdez
- Instituto Mexicano del Seguro Social, Jefatura de Servicios de Prestaciones Médicas, Delegación Chiapas, Coordinación de Prevención y Atención a la Salud. Tapachula, Chiapas, México
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Lédo AP, Rodriguez-Prieto I, Lins L, Neto MG, Brites C. Association Between Health-Related Quality of Life and Physical Functioning in Antiretroviral-Naive HIV-Infected Patients. Open AIDS J 2018; 12:117-125. [PMID: 30369996 PMCID: PMC6182873 DOI: 10.2174/1874613601812010117] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2018] [Revised: 08/24/2018] [Accepted: 09/06/2018] [Indexed: 12/31/2022] Open
Abstract
Background: Poor functional status can significantly affect Health-Related Quality of Life (HRQoL) of HIV patients. However, there is scarce information on the functional profile of such patients before starting antiretroviral therapy (ART). Objective: To estimate the association between health-related quality of life and physical functioning in Antiretroviral-Naive HIV-infected patients. Methods: We conducted a cross-sectional study with HIV-infected patients older than 18 years, and naïve to antiretroviral therapy. The patients were evaluated for functional profile by pulmonary function (forced vital capacity, forced expiratory volume at one second, and Tiffeneau index), handgrip strength, and six-minute walk test in a cross-sectional study. HRQoL was evaluated by the 36-Item Short-Form Health Survey and its Physical (PCS) and Mental (MCS) Component Summaries. Multiple linear regression analyses were used to evaluate the association of predictor variables with PCS and MCS scores. Results: We found lower HRQoL among females patients, with far below average impairment of mental health component. Both male and female patients presented lower 6MWD function test values. Patients with dynapenia were older than patients without it, presented lower PCS mean score, lower family income, poor 6 MWD function test, lower FVC, and lower FEV1 t. Multivariable logistic regression analyses showed that Grip Strength, age and family income were predictor variables for Physical component of HRQoL. Female gender and smoking habit were predictive for the mental component of HRQoL. Conclusion: HRQoL in HIV, drug-naïve patients is predicted by level of dynapenia, smoking, income and gender. Therefore, lifestyle changes and active exercising can help to improve HRQoL in such patients.
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Affiliation(s)
- Ana Paula Lédo
- School of Medicine, Federal University of Bahia, Salvador, Bahia, Brazil
| | | | - Liliane Lins
- School of Medicine, Federal University of Bahia, Salvador, Bahia, Brazil
| | | | - Carlos Brites
- Research Laboratory of Infectious Diseases, Edgard Santos Federal University Hospital, Salvador, Bahia, Brazil
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Ascher SB, Scherzer R, Estrella MM, Zhang WR, Muiru AN, Jotwani V, Grunfeld C, Parikh CR, Gustafson D, Young M, Sharma A, Cohen MH, Ng DK, Palella FJ, Witt MD, Ho K, Shlipak MG. Association of Urinary Biomarkers of Kidney Injury with Estimated GFR Decline in HIV-Infected Individuals following Tenofovir Disoproxil Fumarate Initiation. Clin J Am Soc Nephrol 2018; 13:1321-1329. [PMID: 30154221 PMCID: PMC6140559 DOI: 10.2215/cjn.01700218] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 06/22/2018] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND OBJECTIVES Tenofovir disoproxil fumarate (tenofovir) is associated with elevated concentrations of biomarkers of kidney damage and dysfunction in individuals with HIV. The relationship of these kidney biomarkers with longitudinal kidney function decline is unknown. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS We evaluated associations of 14 urinary biomarkers of kidney injury with changes in eGFR among 198 men and women with HIV who initiated tenofovir between 2009 and 2015 in the Multicenter AIDS Cohort Study and Women's Interagency HIV Study. Urinary biomarkers included albumin-to-creatinine ratio, α-1-microglobulin, β-2-microglobulin, cystatin C, kidney injury molecule-1 (KIM-1), IL-18, neutrophil gelatinase-associated lipocalin (NGAL), clusterin, osteopontin, uromodulin, monocyte chemoattractant protein-1, EGF, trefoil factor 3, and chitinase 3-like protein 1. We used multivariable linear mixed-effect models controlling for demographics, traditional kidney disease risk factors, and HIV-related risk factors to evaluate associations of baseline biomarkers with first-year changes in eGFR, and associations of year 1 and first-year change in biomarkers with changes in eGFR from year 1 to year 3. We used the least absolute shrinkage and selection operator method to identify a parsimonious set of biomarkers jointly associated with changes in eGFR. RESULTS Median eGFR before tenofovir initiation was 103 (interquartile range, 88-116) ml/min per 1.73 m2. During the first year of tenofovir use, eGFR decreased on average by 9.2 (95% confidence interval, 6.5 to 11.9) ml/min per 1.73 m2 and was stable afterward (decrease of 0.62; 95% confidence interval, -0.85 to 2.1 ml/min per 1.73 m2 per year). After multivariable adjustment, higher baseline β-2-microglobulin, KIM-1, and clusterin were associated with larger first-year eGFR declines, whereas higher baseline uromodulin was associated with a smaller eGFR decline. First-year increase in urinary cystatin C and higher year 1 IL-18 were associated with larger annual eGFR declines from year 1 to year 3. The parsimonious models identified higher pre-tenofovir clusterin and KIM-1, lower pre-tenofovir uromodulin, and higher year 1 IL-18 as jointly associated with larger eGFR declines. CONCLUSIONS Urinary biomarkers of kidney injury measured before and after tenofovir initiation are associated with subsequent changes in eGFR in individuals with HIV. PODCAST This article contains a podcast at https://www.asn-online.org/media/podcast/CJASN/2018_08_28_CJASNPodcast_18_9_S.mp3.
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Affiliation(s)
- Simon B. Ascher
- Department of Medicine, Kidney Health Research Collaborative, San Francisco Veterans Affairs Medical Center, San Francisco, California
- Department of Medicine, University of California, Los Angeles, Los Angeles, California
| | - Rebecca Scherzer
- Department of Medicine, Kidney Health Research Collaborative, San Francisco Veterans Affairs Medical Center, San Francisco, California
| | - Michelle M. Estrella
- Department of Medicine, Kidney Health Research Collaborative, San Francisco Veterans Affairs Medical Center, San Francisco, California
| | - William R. Zhang
- Department of Medicine, Kidney Health Research Collaborative, San Francisco Veterans Affairs Medical Center, San Francisco, California
| | - Anthony N. Muiru
- Department of Medicine, Kidney Health Research Collaborative, San Francisco Veterans Affairs Medical Center, San Francisco, California
| | - Vasantha Jotwani
- Department of Medicine, Kidney Health Research Collaborative, San Francisco Veterans Affairs Medical Center, San Francisco, California
| | - Carl Grunfeld
- Department of Medicine, Kidney Health Research Collaborative, San Francisco Veterans Affairs Medical Center, San Francisco, California
- Department Epidemiology, and Biostatistics, University of California, San Francisco, San Francisco, California
| | - Chirag R. Parikh
- Section of Nephrology, Department of Medicine, Yale University, New Haven, Connecticut
| | - Deborah Gustafson
- Department of Neurology, The State University of New York (SUNY) Downstate Medical Center, Brooklyn, New York
| | - Mary Young
- Division of Infectious Diseases, Department of Medicine, Georgetown University Medical Center, Washington, DC
| | - Anjali Sharma
- Department of Medicine, Albert Einstein College of Medicine, Bronx, New York
| | - Mardge H. Cohen
- Department of Medicine, Stroger Hospital and Rush University, Chicago, Illinois
| | - Derek K. Ng
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Frank J. Palella
- Division of Infectious Diseases, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Mallory D. Witt
- Department of Medicine, Los Angeles Biomedical Research Institute at Harbor–University of California Los Angeles Medical Center, Torrance, California; and
| | - Ken Ho
- Division of Infectious Diseases, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Michael G. Shlipak
- Department of Medicine, Kidney Health Research Collaborative, San Francisco Veterans Affairs Medical Center, San Francisco, California
- Department Epidemiology, and Biostatistics, University of California, San Francisco, San Francisco, California
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Soares LB, Buccheri R, Palhares RB, Duarte-Neto AN. Fatal disseminated cytomegalovirus infection with necrotizing oophoritis in a patient with acquired immunodeficiency syndrome. Autops Case Rep 2018; 8:e2018029. [PMID: 30101134 PMCID: PMC6066265 DOI: 10.4322/acr.2018.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Accepted: 04/17/2018] [Indexed: 11/25/2022] Open
Abstract
Disseminated human cytomegalovirus (CMV) disease occurs mainly as a congenital infection and among immunocompromised hosts. Patients with acquired immunodeficiency syndrome (AIDS) are at increased risk for CMV infection, and the most prevalent clinical manifestation is retinitis, followed by colitis, esophagitis, pneumonitis, and encephalitis. CMV oophoritis is poorly described in the literature with some cases reported in patients with hematological or solid malignancies, bone marrow or solid organ transplantation, immunosuppressive therapy, and advanced AIDS cases. We report the case of a 61-year-old woman with a recent diagnosis of AIDS, which was associated with a wasting syndrome. The patient presented with abdominal pain, headache, cutaneous vesicular lesions on the abdomen, anemia, lymphopenia, and hyponatremia; she died suddenly on the fourth day of hospitalization. The autopsy was performed and demonstrated disseminated CMV infection with hemorrhagic encephalitis as the immediate cause of death. Additionally, pneumonitis, extensive adrenalitis, ulcerated enteritis, focal hepatitis, and necrotizing oophoritis were found.
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Affiliation(s)
- Laís Braga Soares
- Emilio Ribas Institute of Infectious Diseases. São Paulo, SP, Brazil
| | - Renata Buccheri
- Emilio Ribas Institute of Infectious Diseases. São Paulo, SP, Brazil
| | | | - Amaro Nunes Duarte-Neto
- Universidade de São Paulo, Faculty of Medicine, Department of Anatomic Pathology, Emergency Department and LIM06. São Paulo, SP, Brazil
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Seo MH, Jeong SH. [Life Experiences of Uninfected Women Living with HIV-Infected Husbands: A Phenomenological Study]. J Korean Acad Nurs 2018; 47:781-793. [PMID: 29326409 DOI: 10.4040/jkan.2017.47.6.781] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 11/19/2017] [Accepted: 11/19/2017] [Indexed: 11/09/2022]
Abstract
PURPOSE This study aimed to understand the meaning and essence of the life experiences of uninfected women living with HIV-infected husbands. METHODS This qualitative study adopted van Manen's hermeneutic phenomenological method. Study participants were 8 females whose husband had been diagnosed with HIV for longer than 6 months, who had known about their husband's infection for more than 6 months, who were in a legal or common-law marriage and were living with their husbands at the time of interview for this study, and whose HIV antibody test results were negative. Data were collected from in-depth individual interviews with the participants from May to August 2016, and from related idiomatic expressions, literature, artwork, and phenomenological references. RESULTS The following essential themes were identified regarding the life experiences of uninfected women living with HIV-infected husbands: 'experiencing an abrupt change that came out of the blue and caused confusion', 'accepting one's fate and making desperate efforts to maintain one's family', 'dealing with a heavy burden alone', 'experiencing the harsh reality and fearful future', and 'finding consolation in the ordeal'. CONCLUSION This study provided a holistic and in-depth understanding of the meaning and essence of the life experiences of uninfected women living with HIV-infected husbands. Thus, this study recognizes these unnoticed women as new nursing subjects. Further, the present findings can be used as important basic data for the development of nursing interventions and national policy guidelines for uninfected women living with HIV-infected husbands.
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Affiliation(s)
- Myoung Hee Seo
- Department of Nursing, Kunsan College of Nursing, Kunsan, Korea
| | - Seok Hee Jeong
- College of Nursing · Research Institute of Nursing Science, Chonbuk National University, Jeonju, Korea.
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Khamis F, Al Noamani J, Al Naamani H, Al-Zakwani I. Epidemiological and Clinical Characteristics of HIV Infected Patients at a Tertiary Care Hospital in Oman. Oman Med J 2018; 33:291-298. [PMID: 30038728 DOI: 10.5001/omj.2018.55] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Objectives In 2015, the Joint United Nations Program on HIV/AIDS (UNAIDS) set a target that 90% of all people living with HIV will know their HIV status, 90% of those diagnosed will receive antiretroviral therapy, and 90% of those receiving antiretroviral therapy will have viral suppression by 2020. We sought to elucidate the epidemiological and clinical characteristics of HIV infected patients at the Infectious Diseases Clinic at Royal Hospital, Oman, with a focus on the UNAIDS 90-90-90 achieved rates. Methods We conducted a retrospective analysis of the medical records of 326 HIV infected patients from 1989 to 2016. Data collected included demographics, Word Health Organization (WHO) staging, laboratory analyses, and treatment outcomes. Results The overall mean age of the cohort was 36.0±15.0 years, and 60.4% (n = 197) were males. The majority of patients acquired HIV through heterosexual transmission (58.9%; n = 192). At the time of the first clinic visit, 26.1% (n = 85) of patients had WHO stage 4 HIV infection. The rates of HIV/HBV and HIV/HCV coinfections were 2.7% and 5.8%, respectively. The baseline CD4+ cells count was < 200 cells/mm3 in 38.0% (n = 124) of patients, 201-500 cells/mm3 in 30.1% (n = 99) of patients, and > 500 cells/mm3 in 27.0% (n = 88) of patients. The baseline HIV RNA titer was greater than 1000 copies/mL3 in 74.5% (n = 243) of the cohort. A total of 96.3% (n = 314) of patients received antiretroviral therapy, most commonly non-nucleoside reverse transcriptase inhibitor-based regimens. HIV genotype resistance testing was performed in 165 patients (50.6%) either at baseline in treatment naïve patients or following treatment failure. Among the 326 patients included, 22 patients (6.7%) died, and 29 patients (8.9%) were lost to follow-up. Conclusions Regarding the UNAIDs 90-90-90 target, over a quarter of the patients presented late with WHO stage 4 HIV disease, 96.3% of cohort patients received antiretroviral treatment, and 71.5% achieved virological suppression.
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Affiliation(s)
- Faryal Khamis
- Department of Medicine, Royal Hospital, Muscat, Oman
| | | | | | - Ibrahim Al-Zakwani
- Department of Pharmacology and Clinical Pharmacy, College of Medicine and Health Science, Sultan Qaboos University, Muscat, Oman.,Gulf Health Research, Muscat, Oman
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Pinheiro MVC, Ho YL, Nicodemo AC, Duarte-Neto AN. The diagnosis of multiple opportunistic infections in advanced stage AIDS: when Ockham's Razor doesn't cut it. Autops Case Rep 2018; 8:e2018028. [PMID: 30584503 PMCID: PMC6287276 DOI: 10.4322/acr.2018.028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2017] [Accepted: 05/27/2018] [Indexed: 11/23/2022]
Abstract
In the advanced stage of AIDS, the diagnosis of the opportunistic infections may be challenging due to the high risk of performing invasive diagnostic methods in a patient with a critical clinical condition, as well as the correct interpretation of the results of microbiological exams. One of the challenges for the diagnosis and treatment of the opportunistic infections is that they may occur concomitantly in the same patient and they may mimic each other, leading to a high discrepancy between clinical and autopsy diagnoses. We describe the case of a 52-year-old man who was hospitalized because of weight loss, anemia, cough, and hepatosplenomegaly. During the investigation, the diagnosis of AIDS was made, and the patient developed respiratory failure and died on the fourth day of hospitalization. At autopsy, disseminated non-tuberculosis mycobacteriosis was found, affecting mainly the organs of the reticuloendothelial system. Also, severe and diffuse pneumonia caused by multiple agents (Pneumocystis jirovecii , Histoplasma capsulatum, suppurative bacterial infection, non-tuberculosis mycobacteria, and cytomegalovirus) was seen in a morphological pattern that could be called "collision pneumonia." The lesson from this case, revealed by the autopsy, is that in advanced AIDS, patients often have multiple opportunistic infections, so the principle of Ockham's razor-that a single diagnosis is most likely the best diagnosis-fails in this clinical context.
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Affiliation(s)
| | - Yeh-Li Ho
- Universidade de São Paulo, Faculty of Medicine, Hospital das Clínicas, Infectious and Parasitic Diseases Department . São Paulo, SP , Brazil
| | - Antonio Carlos Nicodemo
- Universidade de São Paulo, Faculty of Medicine, Hospital das Clínicas, Infectious and Parasitic Diseases Department . São Paulo, SP , Brazil
| | - Amaro Nunes Duarte-Neto
- Universidade de São Paulo, Faculty of Medicine, Department of Anatomic Pathology . São Paulo, SP , Brazil .,Universidade de São Paulo, Faculty of Medicine, Hospital das Clínicas, Emergency Department and LIM 06 . São Paulo, SP , Brazil
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Santos KAR, de Melo L, de Oliveira AMM, Limongi JE. Social welfare related to AIDS in Brazil: factors associated with social assistance and social security, 2004 - 2016. Rev Panam Salud Publica 2018; 42:e73. [PMID: 31093101 PMCID: PMC6385799 DOI: 10.26633/rpsp.2018.73] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Accepted: 03/12/2018] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To describe the occurrence of social welfare benefits related to AIDS in Brazil and to compare the characteristics of the beneficiaries of social assistance and social security in 2004 - 2016. METHODS This was an observational, analytical study based on secondary data obtained from the Ministry of Social Security of Brazil. Sociodemographic and epidemiologic characteristics of the beneficiaries of AIDS-related social assistance and social security were analyzed. RESULTS From 2004 - 2016, a total of 99 369 benefits were granted, the majority of which were sick pay (64%), followed by social assistance benefits (26.5%) and disability retirement (8.1%). At the time that benefits were initiated, 51% of the individuals were unemployed. Those living in urban areas, females, the young, the elderly, and residents of the North and Northeast received more social assistance benefits. Duration of social assistance benefits (average 4 589 days) was greater than that of social security benefits (302 days). Survival among women (578 months) was greater than among men (311 months). CONCLUSIONS In Brazil, the profile of social welfare beneficiaries living with AIDS reveals their social vulnerability. Controlling AIDS should be a priority on public agendas, aiming to minimize the disease's social and economic impact, especially on public health, social security, and social assistance.
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Affiliation(s)
| | - Luciomar de Melo
- Instituto Nacional do Seguro Social, Uberlândia, Minas Gerais, Brazil.
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Lohmann S, Lourentzou I, Zhai C, Albarracín D. Who is Saying What on Twitter: An Analysis of Messages with References to HIV and HIV Risk Behavior. Acta Investig Psicol 2018; 8:95-100. [PMID: 31105910 PMCID: PMC6524990 DOI: 10.22201/fpsi.20074719e.2018.1.09] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
This research aimed to determine the nature of social media discussions about HIV. With the goal of conducting a descriptive analysis, we collected almost 1,000 tweets posted February to September 2015. The sample of tweets included keywords related to HIV or behavioral risk factors (e.g., sex, drug use) and was coded for content (e.g., HIV), behavior change strategies, and message source. Seven percent of tweets concerned HIV/AIDS, which were often referred to as jokes or insults. The majority of tweets coded as behavior change attempts involved attitude change strategies. The majority of the tweets (80%) came from private users (vs. organizations). Different types of sources employed different types of behavior change strategies: For instance, private users, compared to experts or organizations, included more strategies to decrease detrimental attitudes (29% versus 6%, p < .001), and also more strategies to counter myths and misinformation (6% versus 1%, p = .008). In summary, tweets related to HIV/AIDS and associated risk factors frequently use the terms in jokes and insults, come largely from private users, and entail attitudinal and informational strategies. Online health campaigns with clear calls to action and corrections of misinformation may make important contributions to social media conversations about HIV/AIDS.
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Affiliation(s)
- Sophie Lohmann
- Department of Psychology, University of Illinois at Urbana-Champaign
| | - Ismini Lourentzou
- Department of Computer Science, University of Illinois at Urbana-Champaign
| | - Chengxiang Zhai
- Department of Computer Science, University of Illinois at Urbana-Champaign
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Malecki M, Saetre B. HIV Universal Vaccine. Mol Cell Ther 2018; 6:5. [PMID: 30815266 PMCID: PMC6388684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Abstract
BACKGROUND For many deadly viruses, there are no preventive and / or therapeutic vaccines approved by health authorities World-wide (e.g., HIV, Ebola, Dengue, and many others). Although, for some viruses, prophylactic vaccines are very effective (e.g., HBV, and many others).In this realm, we design, manufacture, test, and streamline into the clinics novel viral universal vaccines (VUV). VUV have such unique features, that medical vaccination or natural infection induced immunity against some viruses (e.g., HBV) upon the VUV's administration to the infected with other, different viruses patients, is redirected against these other, newly infecting viruses (e.g., HIV). SPECIFIC AIM The specific aim of this work was biomolecular engineering of the HIV universal vaccine comprising the two main functional domains: CD4 or anti-gp120 - as the HIV tagging domain and HBsAg - as the immune response eliciting domain, so that upon its administration the HBV medical immunization or natural infection induced immunity would be redirected, accelerated, and amplified to fight the HIV infection. HEALTHY DONORS AND PATIENTS Per the Institutional Review Board approval and in compliance with the Declaration of Helsinki, all healthy donors and patients were presented with the Patients' Bill of Rights and provided Patient Informed Consent. All the procedures were pursued by the licensed medical doctors. METHODS & RESULTS We have biomolecularly engineered HIV universal vaccine (HIVUV) comprising human CD4 or anti-gp120 and HBsAg of HBV. By immunoblotting and magnetic activated molecular sorting, we have demonstrated high specificity of this vaccine in binding HIV. By flow cytometry and nuclear magnetic resonance, we have demonstrated high efficacy of these vaccines to engage HBV immunized patients' immune system against HIV. Administration of HIVUV to blood or lymph of the HIV+ patients resulted in rapid reduction of the HIV viremia down to undetectable. It also resulted in protection of populations of CD4+ cells against HIV caused decline. CONCLUSIONS We have demonstrated the proof of concept for high efficacy of VUV, specifically HIVUV, in annihilating HIV. Nevertheless, the same compositions, processes, and methods, for persons skilled in biotechnology, pharmacogenomics, and molecular medicine, are adaptable for other deadly viral infections, which we vigorously pursue.
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Affiliation(s)
- Marek Malecki
- Phoenix Biomolecular Engineering Foundation (PBMEF), San Francisco, CA,
USA
| | - Bianka Saetre
- Phoenix Biomolecular Engineering Foundation (PBMEF), San Francisco, CA,
USA
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50
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Malecki M, Saetre B. HIV Universal Vaccine. Mol Cell Ther 2018; 6:5. [PMID: 30815266 PMCID: PMC6388684 DOI: 10.26781/2052-8426-2018-05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND For many deadly viruses, there are no preventive and / or therapeutic vaccines approved by health authorities World-wide (e.g., HIV, Ebola, Dengue, and many others). Although, for some viruses, prophylactic vaccines are very effective (e.g., HBV, and many others).In this realm, we design, manufacture, test, and streamline into the clinics novel viral universal vaccines (VUV). VUV have such unique features, that medical vaccination or natural infection induced immunity against some viruses (e.g., HBV) upon the VUV's administration to the infected with other, different viruses patients, is redirected against these other, newly infecting viruses (e.g., HIV). SPECIFIC AIM The specific aim of this work was biomolecular engineering of the HIV universal vaccine comprising the two main functional domains: CD4 or anti-gp120 - as the HIV tagging domain and HBsAg - as the immune response eliciting domain, so that upon its administration the HBV medical immunization or natural infection induced immunity would be redirected, accelerated, and amplified to fight the HIV infection. HEALTHY DONORS AND PATIENTS Per the Institutional Review Board approval and in compliance with the Declaration of Helsinki, all healthy donors and patients were presented with the Patients' Bill of Rights and provided Patient Informed Consent. All the procedures were pursued by the licensed medical doctors. METHODS & RESULTS We have biomolecularly engineered HIV universal vaccine (HIVUV) comprising human CD4 or anti-gp120 and HBsAg of HBV. By immunoblotting and magnetic activated molecular sorting, we have demonstrated high specificity of this vaccine in binding HIV. By flow cytometry and nuclear magnetic resonance, we have demonstrated high efficacy of these vaccines to engage HBV immunized patients' immune system against HIV. Administration of HIVUV to blood or lymph of the HIV+ patients resulted in rapid reduction of the HIV viremia down to undetectable. It also resulted in protection of populations of CD4+ cells against HIV caused decline. CONCLUSIONS We have demonstrated the proof of concept for high efficacy of VUV, specifically HIVUV, in annihilating HIV. Nevertheless, the same compositions, processes, and methods, for persons skilled in biotechnology, pharmacogenomics, and molecular medicine, are adaptable for other deadly viral infections, which we vigorously pursue.
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Affiliation(s)
- Marek Malecki
- Phoenix Biomolecular Engineering Foundation (PBMEF), San Francisco, CA,
USA
| | - Bianka Saetre
- Phoenix Biomolecular Engineering Foundation (PBMEF), San Francisco, CA,
USA
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