Journal of AIDS & Clinical Research

Background: Globally HIV/AIDS is a disease of great public health importance, Nigeria has the second largest burden of the disease in the world and currently about 3.4% of the general population are HIV positive. Purpose of the study: The study aims to understand the causes of stigma and discrimination against people living with HIV/AIDS (PLWHA) and the effects of stigma and discrimination on the lives of PLWHA Methods: The study conducted using focused group discussions among people living with HIV/AIDS, who regularly attends ARV clinic, participants were selected based on the number of years of commencement of ARVs and those that have experienced one form of discrimination or the other. The interviews were transcribed verbatim and both manifest and latent content analysis was applied to analyze the texts. Findings: Following the analysis, two major themes emerged from the study: (1) Broken relationship and nondisclosure are consequences of stigma and discrimination, (2) Poor information strongly contributes to stigma and discrimination. These two themes were able to bring out the cause and effect of stigma and discrimination on the lives of PLWHA. Conclusion: Stigma and discrimination has contributed to broken relationship and promotes non-disclosure of HIV status to sexual partners, dissolution of families in Nigeria. Lack of proper information on the disease and poor education and information among the general public and especially health care workers (HCW) worsens stigma and discrimination.

Numerous human immunodeficiency virus-1 (HIV-1) broadly neutralizing antibodies (bNAbs) have been produced and details of their generation, evolution and structure provide a blueprint for effective vaccination. Recent advances in next generation sequencing (NGS) technologies have allowed high-resolution characterization of the antibody repertoire, and have enabled thorough characterization of many HIV-1 bNAbs. These bNAbs identified conserved epitopes that may be used to design new vaccines and provided new tools for prophylaxis and therapy for HIV- 1 disease. In this review, we summarize the advance in HIV-1 bNAbs discovery, maturation and further describe emerging applications in vaccine design.

Introduction: Human immunodeficiency virus infection is a serious health issue. In 2014, around 36.9 million people were living with the human immunodeficiency virus worldwide. Saudis perceive AIDS as a moral disease. The gap between the proper attitude and knowledge of physicians and dentists about AIDS has adversely influenced the quality of HIV-related health care. Our target for this study is to evaluate the knowledge and attitude of physicians and dentists toward the human immunodeficiency virus infection in our society. Method: A cross-sectional study was designed to collect data using a self-administered, structured questionnaire from physicians and dentists. It was distributed among them on specific days and times in a tertiary care center located in Riyadh, Saudi Arabia. Results: The study included a total number of 201 physicians and dentists, of which 189 were physicians and 19 were dentists. Most of them (69%) are Saudis. Around 99% of the participants know that AIDS is viral in etiology. Around 127 (63%) of them know the estimated chance of transmitting HIV from a needle stick injury correctly. Also, all physicians and dentists believe that confidentiality is important for patients with AIDS. Approximately 36 (18%) think that AIDS is a curable disease. Conclusion: There is an acceptable level of information and knowledge about HIV infection among our physicians and dentists. However, regular educational assistance by specialists would be beneficial to improve the current perception. This result can give us some knowledge for further studies in order to advance HIV-related awareness among healthcare workers and the community.

HIV counseling and testing remains a fundamental entry point of care in limiting transmission of HIV/AIDS. Community outreaches serves the dual function of improving access to service and outcome of care through early linkages and subsequent initiation of Anti-Retroviral Therapy (ART). Gender and socio-cultural factors affects uptake of screening services and ultimately early treatment. This study therefore assessed gender-related HIV counseling and testing uptake and linkage to care among those who were tested. A review of data from 423 community outreaches conducted between August 2012 to July 2015 by AHF Nigeria in which information on socio-demographic characteristics, HIV counseling and testing and time to accessing care was obtained. Means and proportions were used to document the results. With a monthly Mean of 2650 [male 68.8% female 38%] clients counselled, tested and received results, 2.6% (SD 0.7) were positive; male 33.5% (SD 10) female 60.8% (SD 9). An average of 64% of positive clients were linked to care; male 40% (SD 10) female 60% (SD 10). Male predominance in testing uptake with more female positive results and early linkage to care forms a persisting trend. HIV testing activities aimed at increasing female participation by addressing social and cultural barriers limiting their participation through advocacy and community dialogue approaches would increase case detection and early linkages to care and help reduce gaps in prevention and treatment in HIV.

Objective: HIV and AIDS have adverse effects on the livelihood of adolescents especially when parents die or are poor due to ill health. Mildmay Uganda has an apprenticeship programme that helps such adolescents acquire skills in order to improve their quality of life. The aim of this study was to examine the role of apprenticeship in improving the livelihood of HIV-positive adolescents who prematurely dropped out of school. Methods: A retrospective review of data of all adolescents who had been enrolled on the apprenticeship programme from January 2012 to January 2014 was done to document their progress and any lessons learnt. A vulnerability index tool was used to assess vulnerability levels and at same time to measure the progress and improvement of livelihood. Results: A total of twenty (20) adolescents were enrolled on the apprenticeship programme during the stated period. Sixty percent were male and were in the age range of 17-24 years. Sixteen out of the 20 (80%) were able to use the acquired skills through apprenticeship to improve their livelihood. The other four adolescents completed apprenticeship, but did not practice their acquired skills. One male opted to venture into another business and three females abandoned their vocations when they got married. The vulnerability level assessment outcome showed a graduation from extremely poor to poor. Adolescents were able to meet their basic needs, keep clinic appointments and were emotionally stable by end of period of review. Conclusion: Apprenticeship is one way that can be used successfully to improve the livelihood of adolescents who prematurely drop out of school.

HIV pathogenesis is known to cause a progressive depilation of CD4+ T-cell cell population in close association with progressive impairment of cellular immunity and increase the susceptibility to infection. This new study is giving a new explanation about the mode of action of this virus. We assume that there is an alteration in the physiological behavior of CD4+ T-cells causing it to mutate to CD8+ T-cells and that CD4+ T-cell are neither destroyed nor lost during the infection. Twelve consenting adults took part in a randomized control trail, six were tested positive for HIV and had never received any antiretroviral therapy while the other six were tested negative. Blood samples withdrawn from participants were tested for total CD4+ T-cells and CD8+ T-cells .Infected cells from HIV positive patients were stimulated with a purified recombinant HIV-1 p17 matrix as a viral protein along with other immunological assays. The collected data showed that the sum of both CD4+ T-cells and CD8+ T-cells did not change in HIV positive patients, although there were a decrease in CD4+ T-cells and an increase in CD8+ T-cell count. Our study confirms that CD8+ T-cells is responsible for the increase in scope of HIV and the susceptibility to (OI), we assumed that this resulted from the duplication in cell signals of both newly formed (mutant) and originally found CD8+ T-cells causing a complete cellular discrepancy. According to our findings a new area of medications could arise to be a promising therapeutical modality for treating HIV-1 infection.

Objective: The spectrum of neuropsychiatric illness (NI) associated with the Human Immunodeficiency Virus (HIV) and/or the Hepatitis C Virus (HCV) is far reaching and significantly impacts the clinical presentation and outcome of infected persons; however, the etiological and pathophysiological background remains partially understood. The present work was aimed to investigate the potential significance of formin binding protein 1 (FNBP-1)-dependent pathways in NI-pathogenesis by elaborating on previous microarray-based research in HIV and/or HCV-infected patients receiving interferon-? (IFN-?) immunotherapy via a rigorous data mining procedure. Methods: Using microarray data of peripheral whole blood (PB) samples obtained from HCV mono-infected persons (n=25, Affymetrix? HG-U133A_2) 12 h before and after the 1st dose of pegylated IFN-? (PegIFN-?), we reapplied the same analytical algorithm that we had developed and published in an earlier study with HIV/HCV coinfected subjects (N=28, Affymetrix? HG-U133A), in order to evaluate reproducibility of potential NI-related molecular findings in an independent cohort. Results: Among 28 gene expression profiles (HIV/HCV: N=9 vs. HCV: N=19) selected by applying different thresholds (a Mean Fold Difference value (MFD) in gene expression of ? 0.38 (log2) and/or P value from <0.05 to ? 0.1) FNBP-1 was identified as the only overlapping marker, which also exhibited a consistent upregulation in association with the development of NI in both cohorts. Previous functional annotation analysis had classified FNBP-1 as molecule with significant enrichment in various brain tissues (P<0.01). Conclusion: Our current findings are strongly arguing for intensifying research into the FNBP-1-related mechanisms that may be conferring risk for or resistance to HIV- and/or HCV-related NI.

Objective: This secondary data analysis determined how far the eight South African metropolitan municipalities have progressed in the expansion of HIV treatment. The framework of HIV care cascades (HCC) was used. Methods: We collated data sources to understand the HCC in metro and non-metro populations including demographic, HIV prevalence and laboratory data (2014-2015) that we linked to unique individuals using a probabilistic matching algorithm. We defined the HCC using: number of persons living with HIV (PLHIV); total remaining on ART; numbers with a CD4 count and viral load (VL) test results in the past year and the number of suppressed VL tests. Results: 37% of South Africa’s PLHIV live in metros. Progress along the HCC for metro and non-metro populations was 53% of PLHIV in care and 45% on ART for both populations and 27% of metro/26% of non-metro populations virally suppressed. Achievement varied widely by metro, 35%-63% of PLHIV were on ART, 21%-48% of ART clients were virally suppressed. The largest treatment gap was in Ekurhuleni metro. The metros spend approximately US$383 million per year on ART. Annual VL testing of all ART clients in the eight metros would amount to approximately US$ 42 million or 11% of ART programme cost. Conclusion: South Africa sees rapid growth of its urban centres which are chiefly affected by HIV. There are currently large gaps in the metro’s 90-90-90 level of achievements. The District Implementation Plans offer a mechanism to focus investment on ART scale-up. Supporting factors are the existing expertise, service integration and infrastructure for largescale ART, the close network of service delivery sites and service delivery solutions. Ensuring scale and quality of the HIV treatment programmes is vital for the metros’ economic prosperity - and for South Africa as a whole.

People with disability are at significant risk of becoming Human Immunodeficiency Virus (HIV) infected due to various factors including lack of education and resources to ensure safe sex, risk of violence and rape, stigma and lack of legal protection amongst others. Situation analysis of HIV prevention intervention amongst in-school PWD in the three specials schools in the state show that 48% of the total populations in these schools are hearing impaired, 16% visually impaired and 6% intellectually impaired. To this end, Ekiti State AIDS Control Agency with the funding of the World Bank and in collaboration with a Community Based Organizations (Eyelosun) carried out a two year intervention programme targeted at reaching the PWD population with HIV prevention services. The project community Entry phase activities included Issue Based Advocacy, Selection and Training of PWDs as peer educators, Community dialogue, Interpersonal Communication and Focused Group Discussions. Age peers’ education approach was used to build the capacity of PWDs on HIV prevention. Peer Education manual and IEC materials were produced in Braille and sign language (target group specific communication materials) to ease communication barriers. Thirty five able teachers with specialization in Braille and sign languages were selected and trained as Peer Educator Trainers (Training of Trainers TOT) and 25 PWDs (hearing and visually impaired) were selected and trained by the trained teachers to carry out peer education using the Braille and sign language manuals. The use of Braille and Sign language HIV prevention specific materials to communicate with PWD improved their understanding and knowledge of HIV/AIDS with 80% increase in HIV Counseling and Testing (HCT) uptake and other HIV services. There was active participation of PWD in all the structural interventions including Community dialogues and Anti-AIDS club. However, the intellectually impaired, who are highly sexually active and at risk of HIV remain a neglected population due to communication challenge.

Parasitic infections are common cause of diarrhea in patients with HIV combined with symptoms such as fatigue, nausea, intestinal cramps and flatulence. In HIV seropositive patients, the disease is often prolonged and severe. Parasites most frequently found in biological samples of HIV infected people are Cryptosporidium spp., Microsporidium and Giardia, Isospora and Cyclospora. The purpose of this study was to know the prevalence of parasitic infections in HIV infected patients and to establish the relationship with CD4 counts and viral load. 109 stool three serial samples from HIV seropositive patients were collected and analyzed by Zinc sulphate centrifugal floatation method and then stained with Ziehl-Neelsen Staining procedure. A “t” distribution analyses was made. A low viral load, CD4 count greater than 500, the absence of diarrhea and the ART treatment are not indicative in all cases of free parasitic infection.

Objective: Research has established that human immunodeficiency virus (HIV) causes hearing loss. Studies have yet to evaluate the impact on quality of life (QOL). This project evaluates the effect of hearing loss on QOL by HIV status. Methods: The study participants were from the Multicenter AIDS Cohort Study (MACS) and the Women’s Interagency HIV study (WIHS). A total of 248 men and 127 women participated. Pure-tone air conduction thresholds were collected for each ear at frequencies from 250 through 8000 Hz. Pure-tone averages (PTAs) for each ear were calculated as the mean of air conduction thresholds in low frequencies (i.e., 250, 500, 1000 and 2000 Hz) and high frequencies (i.e., 3000, 4000, 6000 and 8000 Hz). QOL data were gathered with the Short Form 36 Health Survey and Medical Outcome Study (MOS)-HIV instrument in the MACS and WIHS, respectively. A median regression analysis was performed to test the association of PTAs with QOL by HIV status. Results: There was no significant association between hearing loss and QOL scores at low and high pure tone averages in HIV positive and negative individuals. HIV status, HIV biomarkers and treatment did not change the lack of association of low and high pure tone averages with poorer QOL. Conclusion: Although we did not find a statistically significant association of hearing loss with QOL by HIV status, testing for hearing loss with aging and recommending treatment may offset any presumed later life decline in QOL.