Journal of AIDS & Clinical Research

Mother-to-child transmission is considered to be the main cause of HIV infection in children below 10 years of age. Several opportunist pathogens take the advantage of this compromised immune condition and manifest their deadly effects. Cytomegalovirus (HCMV) is one of the most dreaded opportunist pathogen associated with HIV infection and perhaps the leading cause of congenital infection in the world. In this study we report a very interesting case where a HIV seropositive woman delivers a HIV seronegative child who suffered from pulmonary hypertension and pulmonary interstitial emphysema from the time of birth due to congenital cytomegaloviral infection. This case report suggests that suitable prophylactic measures should be taken by pregnant women especially when they are in an immunocompromised condition to evade being targeted by HCMV and prevent its vertical transmission. Early diagnosis, intravenous gancyclovir administration along with ionotropic support, mechanical ventilation and other respiratory supports is irreplaceable for treating this condition.

Objectives: To evaluate the Chinese version of the 35-item Medical Outcomes Study HIV Health Survey (MOSHIV) in people living with HIV/AIDS (PLWHA) in mainland China and to study its relationship with socio-demographic characteristics and disease-related factors.

Methods: 222 PLWHA recruited from outpatient clinics in Hunan province completed measures of quality of life and related factors.

Results: Internal consistency of the overall score on the Chinese version of the MOS-HIV was high (α=0.95); internal consistency of the eight subscales was also high (α=0.79-0.91). Factor analysis of the MOS-HIV revealed a one-factor solution, accounting for 54.97% of the total variance. At linear regression analysis, all domains of quality of life (QOL) and Total Health Summary Score (THS) were correlated with KPS scores (r2 range 0.06-0.32), but only physical function and social function scores showed a significant correlation with CD4 cell count; the MOS-HIV however, did not distinguish between HIV disease stage. Using logistic regression analysis, KPS scores, as well as the variables of marriage, employment status, occupation before diagnosis, somebody to talk to, transmission modality of injection drug use and sex partner HIV positive showed statistically associated with a lower quality of life.

Conclusions: This study presents the first evidence for the reliability and validity of the Chinese version of MOSHIV among PLWHA in mainland China. Lower scores of the MOS-HIV indicate that the QOL of the PLWHA in our study sample have been poor. This was irrespective of the stage of their disease and CD4 cell counts. This questionnaire has the potential to inform interventions aimed at enhancing and maintaining QOL of PLWHA.

Background: Infection by Human immunodeficiency virus (VIH) constitutes a world health problem. The antiretroviral therapy accordingly recent WHO recommendation is proposed for all HIV seropositive individuals. Treatment optimization is encouraged due to certain risk of toxic adverse effects and resistance. The use of antioxidants has been indicated as a plausible option in these patients indeed pre or post exposition to antiretroviral treatment.

Methods: In an open randomized control trial, 170 aids delayed diagnosis patients whose received prescription of High active antiretroviral therapy (HAART) will selected to be covered under Hospital-IPK monitoring consults (Cuban Referral HIV/aids Research Centre). Patients will be randomised to receive 10 mL of Vimang® aqueous extract twice a day or Spirel® tablets (400 mg) three times a day or only HAART, but all groups will consume HAART during 12 months. The baseline assessment of the patients who meet the inclusion criteria includes doing some lab tests to determine the absolute count of CD4+ T lymphocyte, viral load, chemical, haematological and seven plasma redox indexes. Both, opportunistic infection and adverse reaction occurrence will be reported during the monthly visits in the first six months of the follow-up and at the end of the 12th month. For evaluating the effect of both products concomitant to antiretroviral all variables will be measured in the final follow-up session and compared with the baseline value. Also quality of life interview, physical activity and dietary questionnaires will be assessed at pre and post study period in the three groups.

Background: Chronic co-infection with hepatitis C (HCV) and HIV leads to progressive liver fibrosis and increases the risk for hepatocellular carcinoma (HCC), creating the need for cancer surveillance. However, screening methods for HCC are controversial. We evaluated Fibrosis-4 (FIB-4); an index calculated from platelet count, alanine aminotransferase, aspartate aminotransferase and age; as a screening tool for HCC in patients with HIV-HCV coinfection.

Methods: This was a retrospective chart review of adult outpatients followed at our HIV clinic for the period 2008- 2014, including 11 patients with HIV-HCV co-infection and HCC. Age- and sex-matched control groups were selected, including patients with co-infection without cirrhosis or HCC, HIV mono-infection; and patients with co-infection and cirrhosis without HCC. Mean FIB-4 indices were calculated for each group for comparison.

Results: The mean patient age was 55 years. Median CD4+ counts for the groups ranged from 413 to 552 /μL (p>0.05). The mean FIB-4 was not significantly different between patients with HIV (1.66 ± 0.93), compared to patients with HIV-HCV (2.11 ± 0.82). Mean FIB-4 score was significantly higher in patients with co-infection and cirrhosis (6.5 ± 5.1) compared to patients with co-infection without cirrhosis (2.11 ± 0.82; p=0.011). The mean FIB-4 score was higher for patients with co-infection and HCC, compared to patients with co-infection (p=0.009), or HIV only (p=0.004) without cancer. Mean FIB-4 score was not significantly different between patients with co-infection and cancer, and patients with co-infection and cirrhosis without cancer (5.87 ± 4.22 and 6.5 ± 5.1 respectively).

Conclusion: FIB-4 appears to be a marker of cirrhosis but not specifically HCC in chronic HIV-HCV co-infection. FIB-4 can be a cost-effective strategy to identify patients with HIV and HCV who have advanced cirrhosis, and thereby are at increased risk for development of HCC.

Objective: Various HIV diagnostic systems are available however; the p24 antigen detection assay is preferred due to its ability to decrease the window period for HIV detection. The p24 antigen assay has been associated with low sensitivity. Antimicrobial Peptides (AMPs) display huge potential in development of more effective diagnostics tools. The aim of this study was to design derivative AMPs from AMPs identified previously, using an in silico approach, as templates, with higher predicted binding affinity for the p24 protein and implement the best suited AMPs in a Point-Of- Care (POC) device for detection of HIV-1 and HIV-2.

Method: This study firstly used an in silico approach to identify derivative AMPs which bind the N-terminal domain of the p24 antigen with increased predicted binding affinity. The in silico approach used the parental AMPs as templates for generation of the derivative AMPs through site-directed mutagenesis, 3-D structure prediction and docking studies. Secondly, the binding between the synthetically synthesized AMPs and the HIV antigen p24 was validated by an in house Lateral Flow Device (LFD) “on/off” binding experiment. The most promising AMPs were conjugated to gold nanoparticles (AuNPs) and implemented in a LFD to detect HIV-1 and HIV-2 using patient sera as well as a panel of international HIV standards (panel C10).

Result: With conjugation of AMPs to gold nanoparticles, parent AMP 1 and derivative AMP 1.1 used in combination most sensitively detected the recombinant protein p24 and was therefore selected for development of a LFD prototype for HIV diagnostics. Global HIV-1 (C10) and HIV-2 (C10) standards were successfully detected by the LFD prototype as well as HIV infected serum samples.

Conclusion: A sensitive HIV-1 and HIV-2 LFD prototype was developed which would within 15 minutes provide patients with accurate and sensitive diagnosis of HIV.

Objective: The southeastern United States has the fastest-growing Hispanic/Latino population in the country and carries a disproportionate HIV burden. Among Hispanics/Latinos, men, and men who have sex with men (MSM) in particular, are at elevated risk of HIV infection; however, very few efficacious behavioral HIV prevention interventions are available for use with this vulnerable population. To address this shortage of prevention resources, our communitybased participatory research (CBPR) partnership developed and is currently evaluating the efficacy of the HOLA en Grupos intervention to increase condom use and HIV testing among Hispanic/Latino MSM.

Methods: We recruited 304 Hispanic/Latino MSM who were randomized to receive the small group HOLA en Grupos intervention that was implemented during four 4-hour long sessions over four consecutive Sundays, or a 4-session small group general health education comparison intervention. At the end of the fourth session of the HOLA en Grupos intervention, the intervention facilitators asked participants to write down the sexual health-related behaviors they intended to change as a result of their participation.

Results: Qualitative analysis of the participants’ responses identified six types of intended behavior changes: increasing and maintaining condom use; identifying strategies to support correct and consistent condom use; increasing communication and negotiation with sexual partners about condom use; getting tested for HIV and other sexually transmitted infections; applying other sexual health promotion strategies; and sharing newly learned sexual health information with their peers.

Conclusion: Most risk-reduction intentions aligned with the intervention’s key messages of using condoms consistently and getting tested for HIV. However, participants’ stated intentions may have also depended on which behavior changes they perceived as most salient after participating in the intervention. Participants’ intentions to share information with their peers may result in elements of the intervention content reaching others within their social networks, and potentially contributing to a broader community-level impact.

India is a developing country where resources are limited. HIV/ AIDS is an ominous public health problem faced by our population and the affordability of patients for 3-6 monthly monitoring of CD4 counts becomes difficult for most patients. The intent of the study was to identify parameters on complete blood counts that can predict a CD4 count of <200/μL. We found that an absolute lymphocyte count obtained by a 5-part cell counter >1250/μL is predictive of a CD4 count <200/μL with a sensitivity and specificity of 87.3% and 70.0% respectively. In addition, a haemoglobin value <11.15g/dL is also a good predictor of the CD4 count <200/μL. The combination of both Hb <11.15g/dl and ALC counter <1250/μL was like a confirmatory test with a specificity of 92.2% and a NPV of 79.5%. Hemoglobin and absolute lymphocyte counts obtained on automated cell counter are robust, cost-effective and easily available methods to follow up PLHA patients and patients on ART. These can effectively predict the CD4 count <200/μL and are especially useful in a developing country where the cost of these tests is one-fifth of flow cytometry.

Objective: Acquired Immune Deficiency Syndrome (AIDS) was identified in 1981, among homosexuals in the United State of America, since that time more than 60 million individuals were living with this disorder. Human immunodeficiency virus (HIV) is the causative agent of AIDS that has no cure at present. The level of knowledge about HIV/AIDS and the attitudes toward patients are crucial factors in eradicating the disease.

Methods: A cross-sectional study has been conducted for a period of two months and 155 undergraduate male students in the College of Applied Medical Sciences at Taif University participated in the study. The study aimed to assess their scientific knowledge, awareness and attitude.

Results: the survey results showed that more than half of the participants did not know the relation between AIDS and HIV and low awareness level toward the modes of HIV transmission was observed. For example 54% of students were not aware that coughing and spitting could not transmit the infection. However, many students were aware of the link between toilet seat used by a person with AIDS and HIV infection and between sharing cloths with AIDS patients and HIV with 81% and 83% respectively. Negative attitude towards HIV/AIDS persons was seen in the majority of participants.

Conclusion: This study is the first of its kind to be conducted among undergraduate male students at Taif University, and brought into limelight some important issues in relation to AIDS. This study concluded that, these students need to be more aware about HIV transmission modes and protection methods, which can be achieved by enhancing their knowledge about HIV.

The coexistence of inflammatory bowel disease and human immunodeficiency virus infection is rare but does occur. Since immune mechanisms have an important role in the pathophysiology of both diseases, we might expect HIV infection to significantly alter the course of IBD. The pathophysiologic relationship between HIV and IBD is complex and controversial. Although many studies suggest spontaneous improvement in IBD symptoms and stable remissions after HIV infection, there are reports of relapse and new onset IBD with the decline in CD4 counts. Many of the opportunistic infections in HIV can mimic IBD and can lead to misdiagnosis and treatment as IBD. The treatment of IBD in HIV is associated with an increased risk of infections and lymphoma, and careful follow-up is essential.