Journal of AIDS & Clinical Research

Study background: DEFB4/103A encoding β-defensin 2 and 3, respectively, inhibit CXCR4-tropic (X4) viruses in vitro. We determined whether DEFB4/103A Copy Number Variation (CNV) influences time-to-X4 and time-to-AIDS outcomes. Methods: We utilized samples from a previously published Multicenter AIDS Cohort Study (MACS), which provides longitudinal account of viral tropism in relation to the full spectrum of rates of disease progression. Using traditional models for time-to-event analysis, we investigated association between DEFB4/103A CNV and the two outcomes, and interaction between DEFB4/103A CNV and disease progression groups, Fast and Slow. Results: Time-to-X4 and time-to-AIDS were weakly correlated. There was a stronger relationship between these two outcomes for the fast progressors. DEFB4/103A CNV was associated with time-to-AIDS, but not time-to-X4. The association between higher DEFB4/103A CNV and time-to-AIDS was more pronounced for the slow progressors. Conclusion: DEFB4/103A CNV was associated with time-to-AIDS in a disease progression group-specific manner in the MACS cohort. Our findings may contribute to enhancing current understanding of how genetic predisposition influences AIDS progression.

In HIV-infected persons, low serum concentrations of trace elements have been associated with an increased risk of HIV disease progression and mortality. Few data are available to determine whether HAART ameliorates micronutrient deficiencies in HIV-positive persons. In the current study, we investigated the effects of HAART on selected trace elements such as selenium, zinc and copper and on CD4+T-cell count in HIV-positive persons. Fifty HIV-positive individuals with 25 on HAART and 25 who were not on HAART were recruited for the study. Twenty five apparently health persons who were HIV-negative serve as a control group. Serum concentrations of selenium, zinc and copper were estimated by atomic absorption spectrophometric method while CD4+T-cell count was determined by flow cytometric method. Persons on HAART showed significantly (P<0.05) high Zn and CD4+Tcell count compared to PRE-HAART. There was no significant difference in the serum selenium and copper levels between HAART and PRE-HAART persons. In conclusion, HAART significantly improved the immunological status as evidenced by increased CD4+T-cell count and also significantly increased the zinc level in the same group. A large randomized placebo-controlled trial is recommended for future study.

Objectives: To estimate the incidences of first-line HAART discontinuation (for intolerance, treatment failure or treatment simplification) and their risk factors by standard survival (1-KM, Cox model) or competing risk approach (CIF, Fine-Gray model) in HIV infected patients. Methods: We studied 1136 patients receiving first-line Highly Active Antiretroviral Therapies (HAART), aged over 18 years, from the Dat’AIDS cohort, Toulouse, France, between January 2000 and June 2008. Cumulative incidence was estimated with 1-KM and CIF estimators and risk factors with Cox and Fine-Gray models. Results: There were 265 discontinuations for intolerance, 136 simplifications, 101 treatment failure and 274 other reasons. One year incidences were 19.0% versus 16.8%, 8.0% versus 6.0%, 6.3% versus 4.8% and 20.0% versus 17.3%, with the estimators 1-KM and CIF, respectively. For intolerance, both models identified similar risk factors. For risk factors of simplification or treatment failure, results differed by the model. Conclusions: As expected, the 1-KM overestimates the incidence of treatment discontinuation. For early and frequent events such as intolerance, the Cox and the Fine-Gray models appear to give similar results. For late and rare events, potentially exposed to competing risk, results differed. The common or specific nature of a factor may also play a role.

Objectives: The aim of this study was to determine and compare the radiological appearance of pulmonary tuberculosis (PTB) in groups of patients with and without human immunodeficiency virus (HIV) infection in a main referral center for Infectious disease in Iran. Materials and Methods: One hundred and nineteen six patients with and without HIV infection was referred to infectious disease department of Imam Khomeini hospital. The diagnosis of PTB was made on the basis of clinical history, physical examination, Ziehl-Neelsen microscopy on three sputum samples and chest radiography. The following issues were recorded for each radiograph: the number of zones involved with consolidation, cavitation, pleural effusion, bronchopulmonary pattern of spread; milliary disease; hilar and mediastinal lymphadenopathy. Results: Out of all participant 65% were male. The diffuse pulmonary involvement was more common in PTB / HIV confection group than PTB without HIV infection (27.7% vs 12%) Milliary pattern on chest X- ray in PTB / HIV group was more common too (17% vs 4.7%). However, HIV positive patients less commonly had cavitary lesion (4.3% vs 20.1%). The presence of pleural effusion was less common in PTB/ HIV group (13% vs 23.5%) and hilar lymphadenopathy was more common (10.6 vs 7.4%) in this group. Conclusion: This study suggests that the rate of atypical patterns of CXR in PTB patients are growing because of increased frequency of HIV infection as well as IDUs, the main reason for the altered radiographic appearance of PTB may be due to way of selecting patients from a referral centre of infectious disease in country.