Acquired Immunodeficiency Syndrome Cases Research Articles

The Global Impact of HIV: A Comprehensive Review

The Human Immunodeficiency Virus (HIV) has been a significant global health challenge since its discovery in the 1980s, leading to the devastating Acquired Immunodeficiency Syndrome (AIDS). Despite advancements in medical research and antiretroviral therapies, HIV/AIDS remains a pressing public health concern, particularly in resource-limited regions. This comprehensive review provides updated data and scientific insights on the global impact of HIV, shedding light on the current state of the epidemic and the challenges faced in combating it. The review highlights the resurgence of HIV cases in Eastern European countries, such as Ukraine, Estonia, and Latvia, with surprising increases in AIDS cases observed in East Asian countries. However, it is in sub-Saharan Africa that the burden of HIV remains most acute, with high prevalence rates and a significant number of affected individuals. The region requires continued attention and resources to address the complex challenges associated with HIV prevention, treatment, and care. The article delves into the classification and structure of HIV, emphasizing its belonging to the Lentivirinae subfamily, specifically HIV-1 and HIV-2. HIV-1, the predominant viral species globally, exhibits a distinct clinical latency phase, contributing to its persistence and infectivity. The high replication rate and genetic variability of HIV, driven by the error-prone reverse transcriptase enzyme, result in the emergence of diverse subtypes and strains across different regions. Furthermore, the article explores the structural components of HIV-1, including the envelope glycoproteins (gp120 and gp41), matrix protein, and various enzymes critical to the viral life cycle. Despite progress in medical research and access to antiretroviral therapies, HIV/AIDS continues to present challenges such as limited resources, drug resistance, and regional disparities.

The use of condoms to customers

Data from the Health Department of Riau until early 2014 quarter there were 132 new cases of Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS). Pekanbaru tops the number of people with HIV and AIDS. The details of HIV cases and 76 56 AIDS cases cumulatively from 1997 until 2014 there were 2,388 cases of HIV and AIDS. The purpose of this research is to analyze the use of condoms to customers in the Jondul city of Pekanbaru by 2014. This research was qualitative research with the narrative approach gleaned from the results of the in-depth interviews on the main informant 4 persons ie customers and additional informants that "Mami" and sex workers. Data analysis was carried out with thematic analytical transcription, verification and the making of the matrix. The research showed that customers do not want the use of a condom during sexual intercourse to sex workers. Although sex workers have been trying to do deals to use condoms to customers but still no luck. The use of condoms to customers affected by perception, hassle and comfort in using those condoms. The City Health Office expects Soweto to conduct counseling regarding condom use, and required cooperation with local health professionals and NGOs in conducting coaching and training fitting condoms is good, correct and fast by sex workers to its customers.

PREVALENCE OF DEATHS IN ELDERLY PEOPLE WITH ACQUIRED HUMAN IMMUNODEFICIENCY SYNDROME IN THE NORTHEAST REGION

Acquired Immunodeficiency Syndrome (AIDS) is a disease of the immune system caused by the retrovirus HIV ― from English, Human Immunodeficiency Virus and the present study aims to analyze the prevalence and cases of AIDS deaths in the elderly population in the Northeastern state, from 2015 to 2019. This is a descriptive study obtained from the Health Information System provided by TABNET, referring to elderly people with HIV/AIDS, who were notified in the northeast region in the period from 2015 to 2017. Thus, in the years 2015 and 2017, there were 76 deaths from the Human Immunodeficiency Virus (HIV) reported in the Northeast region of Brazil. Of these, 22 cases of deaths were related to the elderly population of Bahia, and the State of Alagoas had the lowest number, just 2 deaths. Regarding AIDS cases identified in the Northeast state, from 2015 to 2019, 1,204 cases of AIDS were reported. Absolutely, the states that reported the most were Bahia (233 cases), Pernambuco (224 cases), Maranhão (190 cases) and Ceará (185 cases). Based on above considerations, prevention campaigns aimed only at the elderly population, health professionals and caregivers unprepared are necessary to provide information regarding sexuality and sexual practices for elderly people in the Federative Units and regions.

HIV incidence before and during the COVID-19 pandemic in Japan

<abstract> <p>At the end of 2022, a total of 20,003 diagnoses of human immunodeficiency virus (HIV) infection and 8,983 cases of acquired immunodeficiency syndrome (AIDS) among Japanese nationals, and 3,860 HIV diagnoses and 1,575 AIDS cases among foreign residents, had been notified to the government in Japan. This study updates the estimate of HIV incidence, including during the COVID-19 pandemic. It aimed to reconstruct the incidence of HIV and understand how the disruption caused by COVID-19 affected the epidemiology of HIV. Using a median incubation period of 10.0 years, the number of undiagnosed HIV infections was estimated to be 3,209 (95% confidence interval (CI): 2,642, 3,710) at the end of 2022. This figure has declined steadily over the past 10 years. Assuming that the median incubation period was 10.0 years, the proportion of diagnosed HIV infections, including surviving AIDS cases, was 89.3% (95% CI: 87.8%, 91.0%). When AIDS cases were excluded, the proportion was 86.2% (95% CI: 84.3%, 88.3%). During the COVID-19 pandemic, the estimated annual diagnosis rate was slightly lower than during earlier time intervals, at around 16.5% (95% CI: 14.9%, 18.1%). Japan may already have achieved diagnostic coverage of 90%, given its 9% increment in the diagnosed proportion during the past 5 years. The incidence of HIV infection continued to decrease even during the COVID-19 pandemic from 2020 to 2022, and the annual rate of diagnosis decreased slightly to 16.5%. Monitoring the recovery of diagnosis along with the effective reproduction number is vital in the future.</p> </abstract>

Disseminated Kaposi’s sarcoma as the sole clinical manifestation in an intravenous drug abuse patient with acquired immunodeficiency syndrome

A 31-year-old married acquired immunodeficiency syndrome (AIDS) male patient with clonal differentiation 4 count of 162 cells/mm3 and history of intravenous drug abuse presented with multiple discrete hyperpigmented and violaceus papules and plaques distributed on the trunk, upper and lower extremeties, medial canthi of the right eye, and the glans penis. He had also generalized lymphadenopathy. Biopsy of the papules and lymph node showed features of Kaposi’s sarcoma (KS). There were no other systemic or cutaneous manifestations. We are reporting an interesting case of AIDS acquired through I/V drug abuse and presenting only with dessiminated KS and no other features.

Role of social organization engagement in high-risk groups intervention against HIV/AIDS: a case study from 176 cities of China

BackgroundA high-risk prevention strategy is an effective way to fight against human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS). The China AIDS Fund for Non-Governmental Organizations (CAFNGO) was established in 2015 to help social organizations intervene to protect high-risk populations in 176 cities. This study aimed to evaluate the role of social organizations in high-risk population interventions against HIV/AIDS.MethodsThis study was based on the CAFNGO program from 2016 to 2020. The collected data included the number and types of social organizations participating in high-risk group interventions and the amount of funds obtained by these organizations each year. We explored the factors influencing the number of newly diagnosed AIDS cases using a spatial econometric model. Furthermore, we evaluated the effectiveness of intervention activities by comparing the percentages of the individuals who initially tested positive, and the individuals who took the confirmatory test, as well as those who retested positive and underwent the treatment.ResultsOverall, from 2016 to 2020, the number of social organizations involved in interventions to protect HIV/AIDS high-risk populations increased from 441 to 532, and the invested fund increased from $3.98 to $10.58 million. The number of newly diagnosed cases decreased from 9128 to 8546 during the same period. Although the number of cities with overall spatial correlations decreased, the spatial agglomeration effect persisted in the large cities. City-wise, the number of social organizations (direct effect 19.13), the permanent resident population (direct effect 0.12), GDP per capita (direct effect 17.58; indirect effect − 15.38), and passenger turnover volume (direct effect 5.50; indirect effect − 8.64) were the major factors influencing new positive cases confirmed through the testing interventions performed by the social organizations. The initial positive test rates among high-risk populations were below 5.5%, the retesting rates among those who initially tested positive were above 60%, and the treatment rates among diagnosed cases were above 70%.ConclusionsThe spatial effect of social organizations participating in interventions targeting high-risk populations funded by CAFNGO is statistically significant. Nevertheless, despite the achievements of these social organizations in tracking new cases and encouraging treatment, a series of measures should be taken to further optimize the use of CAFNGO. Working data should be updated from social organizations to CAFNGO more frequently by establishing a data monitoring system to help better track newly diagnosed AIDS cases. Multichannel financing should be expanded as well.

The influence of low-level viremia on CD4+ cell count in human immunodeficiency virus–infected patients

Following initiation of combined antiretroviral therapy, the majority of human immunodeficiency virus-infected patients experience immune reconstitution indicated by virologic suppression and an increase in peripheral CD4+ T-cell counts. Some patients may suffer from low-level viremia, which was reported to be significantly associated with acquired immunodeficiency syndrome cases, virologic failure, and death. We aimed to further investigate the influence of low-level viremia on CD4+ T-cell count. In our study, we included human immunodeficiency virus-seropositive patients on combined antiretroviral therapy, for at least 6 months, who received at least one assessment of human immunodeficiency virus plasma viral load and CD4+ cell count every 6 months, from January 2009 to January 2019. The copy-year viremia was determined by calculating the area under the curve of the plasma human immunodeficiency virus viral load. When comparing patients with a mean CD4+ cell count <200 cells/μL, there was no significant difference between patients with a mean viral load <1000 copies/mL and patients with a mean viral load ≥1000 copies/mL (p = 0.219). Among those with a mean viral load <1000 copies/mL, a higher proportion of patients had a mean CD4+ cell count ≥500 cells/µL (p < 0.001). The mean CD4+ cell count of patients with copy-years viremia (log10) <4 (577.7, interquartile range 429.2-736.7) was significantly higher than that of patients with copy-years viremia (log10) ≥4 (443.3, interquartile range 319.0-558.4) (p < 0.001). In multivariate logistic regression analysis, we observed that malignancy without history, lower copy-years viremia, and high nadir CD4+ cell count were independent predictors of mean CD4+ cell count ≥500 cells/µL. Human immunodeficiency virus-infected patients with a history of malignancy, high copy-year viremia, and lower nadir CD4+ cell counts should be monitored carefully in clinical settings.

Mathematical Model of HIV/AIDS Considering Sexual Preferences Under Antiretroviral Therapy, a Case Study in San Juan de Pasto, Colombia.

While several studies on human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) in the homosexual and heterosexual population have demonstrated substantial advantages in controlling HIV transmission in these groups, the overall 2benefits of the models with a bisexual population and initiation of antiretroviral therapy have not had enough attention in dynamic modeling. Thus, we used a mathematical model based on studying the impacts of bisexual behavior in a global community developed in the PhD thesis work of Espitia (2021). The model is governed by a nonlinear ordinary differential equation system, the parameters of which are calibrated with data from the cumulative cases of HIV infection and AIDS reported in San Juan de Pasto in 2019. Our model estimations show which parameters are the most influential and how to modulate them to decrease the HIV infection.

HIV epidemic in a province of the Brazilian Amazon region: Temporal trend analysis.

BackgroundAlthough considerable progress has been made over the last decades, human immunodeficiency virus (HIV) incidence and acquired immunodeficiency syndrome (AIDS) mortality rates have remarkably increased in the Brazilian Amazon region. Here, we employed temporal analysis to determine the impact of public policies on the HIV epidemic in the state of Pará, Brazil, which has the second highest HIV incidence rate in the Amazon region.Design and methodsThis is an ecological study conducted in the state of Pará, employing secondary data of HIV/AIDS cases notified to the Information System for Notifiable Diseases, 2007– 2018. The following epidemiological variables were collected: year of notification, municipality of residence, age, sex, education, exposure category, and HIV/AIDS diagnostic criteria. The study population was composed of 21,504 HIV/AIDS cases. The HIV/AIDS incidence rates were analyzed employing the temporal trend analysis (TTA) followed by the chi-square test and residue analysis to determine the association between the epidemiological variables and time series periods.ResultsA total of 50% of the notifications were composed of AIDS cases. TTA identified two periods in HIV/AIDS incidence, with stabilization of cases in the first period (G1, 2007–2012) and an upward trend in the second period (G2, 2012–2018). The most prevalent epidemiological characteristics in G2 (versus G1) were as follows: young people, brown skin color, higher schooling, and homosexuals.ConclusionsPublic policy to control HIV infection in the Brazilian Amazon region has been partially effective. HIV screening tests and treatment should be made widely available to eradicate HIV infection in the Amazon region by 2030.

The Relationship between Medication Adherence to the Incidence of Failure of First-Line Antiretroviral Therapy (ARV) in HIV/AIDS Patients in Haji Adam Malik Hospital

Introduction: Acquired Immunodeficiency Syndrome (AIDS) is a compilation of symptoms or diseases caused by decreased immunity due to infection with Human Immunodeficiency Virus (HIV). The number of HIV and AIDS cases continued to increase until 2019, United Nations Program on HIV and AIDS (UNAIDS) reported that HIV and AIDS cases worldwide had reached around 37.8 million with the highest number of cases found in Africa. Based on the latest report of the Directorate General of P2P (HIV/AIDS and STI Information System (SIHA) in 2019, for the last eleven years, HIV cases in Indonesia reached a peak in 2019, which was 50,282 cases. ARV is the most successful HIV treatment that consists of a combination of several types of drugs that must be taken for life, therefore high compliance is required (&gt;95%) and each patient must take medication according to the prescribed dose and time. Methods: This study was a cross-sectional study, the population has taken in the VCT Unit/center of Haji Adam Malik Hospital, the patients who experienced failure of first-line therapy from February to June 2021. With a total sample of 96 people. Data collection techniques were carried out using a questionnaire sheet. Results: There was a significant relationship between PLWHA who failed first-line therapy on drug side effects (p-value = 0.05) and there was no significant relationship found between knowledge level and adherence to ARV medication (p-value = 0.182). Conclusion: Factors that influence adherence to taking PLWHA medication at Haji Adam Malik Hospital Medan, such as level of knowledge and drug regimen, motivation, family support, support from health workers, side effects of drugs. Keywords: HIV/AIDS; ARV; First Line; PLWHA.

HYPERCALCEMIA UNMASKING UNDERLYING MYCOBACTERIUM AVIUM-INTRACELLULARE INFECTION

TOPIC: Chest Infections TYPE: Medical Student/Resident Case Reports INTRODUCTION: Common causes of hypercalcemia include malignancy and granulomatous disease; however nontuberculous mycobacteria (NTM) infections are also rarely associated with hypercalcemia. We present a case of hypercalcemia secondary to underlying Mycobacterium avium-intracellulare (MAI) infection in a patient with acquired immunodeficiency syndrome (AIDS). CASE PRESENTATION: A 36-year-old male with recently diagnosed AIDS (CD4 count 17 cell/uL, viral load 52,400 copies/mL at diagnosis) on anti-retroviral therapy (ART) presented with three days of generalized weakness, nausea, vomiting, and poor appetite associated with night sweats, 20-pound weight loss, dyspnea, and non-productive cough. Vital signs were unremarkable, physical exam revealed moderate lower abdominal tenderness with hepatosplenomegaly, and bloodwork was notable for a corrected calcium of 13.1 mg/dL, undetectable parathyroid hormone (PTH) of <1 pg/mL, elevated 1,25-dihydroxyvitamin D to 112 pg/mL, and decreased PTH-related protein of 7 pg/mL. Hypercalcemia was treated with intravenous fluid hydration and pamidronate. Computed Tomography of Chest/Abdomen/Pelvis revealed bulky retroperitoneal and mesenteric adenopathy and splenomegaly, concerning for lymphoma versus paradoxical worsening of existing opportunistic infection secondary to immune reconstitution with the initiation of ART (CD4 70 cell/uL, viral load 42 copies/mL). He underwent diagnostic laparoscopy with mesenteric lymph node biopsy for definitive diagnosis, with both biopsy and acid-fast bacillus (AFB) culture positive for MAI, clinical picture consistent with disseminated infection. He was started on Ethambutol and Azithromycin and discharged with close infectious disease follow-up. DISCUSSION: Many etiologies exist for hypercalcemia, the most notable being malignancy and granulomatous diseases. In patients with AIDS, NTM infection should also be considered in the differential. To date, there have only been eight reported cases of MAI-associated hypercalcemia, making this the ninth case, and the fourth one with hypercalcemia as the presenting symptom [1]. Though the mechanism is not well understood, one theory postulates the involvement of immune reconstitution inflammatory syndrome (IRIS). In newly diagnosed AIDS patients, the restoration of the immune system due to ART to fight off latent infection causes rebound production of interferon-gamma, which enhances granuloma formation to facilitate the eradication of infection. In turn, granulomas produce 1-alpha hydroxylase, leading to increased 1,25-vitamin D and calcium production [2]. CONCLUSIONS: Non-PTH-mediated hypercalcemia is often attributed to malignancy. However further investigation is warranted to rule out opportunistic infections, especially in newly diagnosed cases of AIDS. REFERENCE #1: Ayoubieh H, Alkhalili E. Mycobacterium avium-intracellulare and the unpredictable course of hypercalcemia in an AIDS patient. Braz J Infect Dis. 2017;21(1):116-118. doi:10.1016/j.bjid.2016.08.002 REFERENCE #2: Tsao YT, Wu CC, Chu P. Immune reconstitution syndrome-induced hypercalcemic crisis. Am J Emerg Med. 2011;29(2):244.e3-244.e244006. doi:10.1016/j.ajem.2010.03.013 DISCLOSURES: No relevant relationships by Sudheer Konduru, source=Web Response No relevant relationships by SANA MULLA, source=Web Response No relevant relationships by Mrunal Sharma, source=Web Response No relevant relationships by Vihitha Thota, source=Web Response No relevant relationships by Manaswitha Thota, source=Web Response

TINGKAT KEPATUHAN ODHA MINUM OBAT ARV DI POLI VCT MUTU MANIKAM RSUD DR H MOCH ANSARI SALEH BANJARMASIN

Acquired Immunodeficiency Syndrome (AIDS ) is a collection of symptoms of a disease caused by the Human Immunodeficiency Virus (HIV) which damages the body's immunity. People With HIV AIDS (PLWHA) should undergo therapy Antiretroviral (ARV) drugs for life. Provionce was ranked 23 out of 34 provinsi in Indonesia with HIV / AIDS cases are as much as 2,274 cases. This study aims to determine the level of adherence of PLWHA taking ARV drugs in Mutu Manikam VCT Ward Dr. H. Moch Ansari Saleh Banjarmasin as well the relationship of the level of vulnerability with the characteristics of respondents. This study uses a cross-sectional design that is prospective with consecutive sampling techniques . Samples that met the inclusion and exclusion criteria were 109 PLWHA. Data is collected with the distribution of MARS questionnaires. Statistical analysis used was cross tabulation analysis with Pearson Chi Square correlation test. The results of the study showed that the level of adherence of PLWHA taking ARV drugs with a high level of adherence was 75 PLWHA (69%), the level of adherence was 34 PLWHA (31%). There was no significant correlation between adherence to taking ARV drugs with the demographic characteristics of respondents with p &gt; 0.05 . Based on this study it was concluded that PLWHA in Mutu Manikam VCT Ward Dr. H. Moch Ansari Saleh Hospital Banjarmasin has a high level of adherence taking ARV drugs. The relationship between the level of adherence with characteristics of respondents (gender, age, education, occupation, length of treatment and comorbidities) in this study was not statistically significant.

Timing of antiretroviral therapy for HIV-infected patients with cytomegalovirus retinitis: study protocol of a multi-center prospective randomized controlled trial

BackgroundCytomegalovirus retinitis (CMVR) is an important opportunistic infection (OI) occurring mainly in patients with acquired immunodeficiency syndrome (AIDS) and has the potential to cause severe visual impairment and blindness among AIDS patients. Subsequent to the adoption and implementation of widespread antiretroviral therapy (ART), the prognosis of AIDS-associated CMVR has been substantially improved. Nevertheless, the equivocal clinical evidence as regards the optimal timing for ART initiation in patients with an established CMVR diagnosis is required. We therefore designed the present study in order to investigate the optimal timing for ART initiation in AIDS/CMVR patients.MethodsThis will be a prospective, randomized controlled trial to be performed at 17 hospitals in mainland China. A total of 300 participants with CMVR will be randomly assigned to an early ART initiation group (ART initiation within 2 weeks after anti-CMV therapy), or a deferred ART initiation group (initiation of ART more than 2 weeks after anti-CMV therapy) at a 1:1 ratio. All participants will receive 48 weeks of follow-up after anti-CMV therapy initiation. Our primary outcome will be the incidence of visual loss (to a visual acuity worse than 20/40 or 20/200) in the two groups during the 48-week follow-up period. Secondary outcomes will include changes in HIV virological suppression and serum CD4+ T-cell counts, the incidence of mortality, retinitis progression (movement of the peripheral border of a CMV lesion ≥ ½ disc diameter, or occurrence of a new CMV lesion), retinal detachment, immune recovery uveitis (IRU), and other OIs and adverse events between the two study groups during the 48 weeks of follow-up.DiscussionThe study aims to investigate the optimal timing for ART initiation in AIDS/CMVR patients. We hope to be able to extract robust clinical evidence for use in optimal AIDS/CMVR management should our trial be successful.Trial registrationThis research was registered as one of the twelve clinical trials under the name of a general project “A study for precision diagnosing and treatment strategies in difficult-to-treat AIDS cases and HIV-infected patients with highly fatal or highly disabling opportunistic infections”, ChiCTR1900021195. Registered on 1 February 2019, http://www.chictr.org.cn/showproj.aspx?proj=35362.

Prevalence and risk factors for hepatitis c virus co-infection among human immunodeficiency virus-infected patients and effect of hepatitis c virus infection on acquired immunodeficiency syndrome cases at baseline.

Background:Hepatitis C virus (HCV) co-infection with human immunodeficiency virus (HIV) exists as both viruses have the common routes of transmission. HIV infection has adverse effect on the natural history of HCV infection; however, the effect of HCV infection on the natural history of HIV infection is unclear.Materials and Methods:This study was cross-sectional comprising of treatment-naïve adult HIV-infected patients attending clinics at Usmanu Danfodiyo University Teaching Hospital, Sokoto and Specialist Hospital Sokoto. The study participants were screened for HCV anti]body and assayed for transaminases and CD4+ T-lymphocytes count levels. The symptoms of acquired immunodeficiency syndrome (AIDS)-defining illnesses were asked among the study participants. The questionnaire was used for the collection of data, and SPSS software version 20 was used for the analysis of data. Student's t-tests, Pearson’s, Chi-square, and Fisher's exact tests were used for the statistical analysis, and P < 0.05 was considered statistically significant.Results:The prevalence of HIV/HCV co-infection was 20.6%. Self-intravenous drugs usage was not statistically significant (P = 0.210). HIV mono-infected patients had significantly lower alanine aminotransferase levels compared to HIV/HCV co-infected study participants (P = 0.048). AIDS status at the baseline was comparable between HIV mono-infected and HIV/HCV co-infected study participants. (P = 0.227; 0.200; 0.130).Conclusion:Moderately high prevalence of HIV/HCV co-infection was observed in the current study. HCV co-infection had no effect on AIDS status at baseline. There is a need for routine screening of HCV infection in HIV-infected individuals.

Profile of Acquired Immunodeficiency Syndrome (AIDS): an Epidemiological Study

Objective: To describe the profile of the population with Acquired Immunodeficiency Syndrome (AIDS) in Brazil from 2009 to 2019. Methods: This is a descriptive, quantitative study, performed with secondary data from the Sistema de Informação Hospitalar do Sistema Único de Saúde (SIH/SUS). The analyzed data referred to cases diagnosed with Acquired Immunodeficiency Syndrome between 2009 and 2019. The variables evaluated were selected from categories, “year of diagnosis”, “sex”, “age range”, “race/skin color” and “exposure category”. Data were made available in absolute frequency, and relative frequencies were calculated in Microsoft Excel ® 2016 software. Results: It is observed that 91.14% (n=383,531) of Acquired Immunodeficiency Syndrome cases in Brazil occur in the population from 20 to 59 years. Among these, 66.44% (n= 254,840) were male and 33.55% (n=128,691) female. Since 44.97% (n=108,327) were white people; 10.93% (n=26,337) black; 0.48% (n=1.168) yellow; 43.30% (n=104.306) brown; 0.32% (n=772) indigenous. And, 24.03% (n=49,596) from homosexual exposure category; 6.40% (n=13,216) bisexual; 65.27% (n=134,703) heterosexual; 3.70% (n=7,623) UDI; 0.02% (n=48) transfusion; 0.01% (n=14) Biological material accident; 0.54 (n=1,126) vertical transmission; 0.03 (n=53) hemophiliac. Conclusion: Epidemiological profile of Acquired Immunodeficiency Syndrome in Brazil, presents a greater prevalence in male, aged from 20 to 59 years, white, posteriorly the brown race, being of heterosexual exposure category. This knowledge enables contributions to the scientific field and planning of possible public policies for the prevention and treatment of Acquired Immunodeficiency Syndrome.

A study for precision diagnosing and treatment strategies in difficult-to-treat AIDS cases and HIV-infected patients with highly fatal or highly disabling opportunistic infections: Study protocol for antiretroviral therapy timing in AIDS patients with toxoplasma encephalitis.

Background:Toxoplasma encephalitis (TE) is one of the main opportunistic infections in acquired immunodeficiency syndrome (AIDS) patients, and represents a social burden due to its high prevalence and morbidity. Concomitant antiretroviral therapy (ART), together with effective anti- toxoplasma combination therapy, is an effective strategy to treat AIDS-associated TE (AIDS/TE) patients. However, the timing for the initiation of ART after diagnosis of TE remains controversial. We therefore designed the present study to determine the optimal timing for ART initiation in AIDS/TE patients.Methods/Design:This trial is a 17-center, randomized, prospective clinical study with 2 parallel arms. A total of 200 participants will be randomized at a 1:1 ratio into the 2 arms: the early ART initiation (≤14 days after TE diagnosis) arm and the deferred ART (>14 days after TE diagnosis) arm. The primary outcome will be the difference of mortality between the 2 arms at 48 weeks. The secondary outcomes will be the differences between the 2 arms in the changes of CD4+ counts from baseline to week 48, the rate of virologic suppression (HIV ribonucleic acid <50 copies/mL) from baseline to week 48, the incidence of TE-associated immune reconstitution inflammatory syndrome during the study period, and the incidence of adverse effects during the study period.Discussion:This present trial aims to evaluate the optimal timing for ART initiation in AIDS/TE patients, and will provide strong evidence for AIDS/TE treatment should it be successful.Trial registration:This trial was registered as one of the 12 trials under the name of a general project at the chictr.gov (http://www.chictr.org.cn/showproj.aspx?proj=35362) on February 1, 2019, and the registration number of the general project is ChiCTR1900021195.

Escalating and sustained immunovirological dissociation among antiretroviral drug-experienced perinatally human immunodeficiency virus-1-infected children and adolescents living in the Central African Republic: A STROBE-compliant study.

Sub-Saharan Africa has the vast majority (∼90%) of new pediatric acquired immunodeficiency syndrome cases worldwide. Biologically monitoring HIV-infected pediatric populations remains challenging. The differential interest of human immunodeficiency virus (HIV)-1 RNA loads and CD4 T-cell counts is debated for the treatment of pediatric acquired immunodeficiency syndrome patients.Long-term antiretroviral treatment (ART) outcomes regarding immunological and virological surrogate markers were longitudinally evaluated between 2009 and 2014 (over 57 months) in 245 perinatally HIV-1-infected children and adolescents born from HIV-infected mothers, treated at inclusion for at least 6 months by the World Health Organization-recommended ART in Bangui, Central African Republic.Patients were monitored over time biologically for CD4 T-cell counts, HIV-1 RNA loads, and drug resistance mutation genotyping.Children lost to follow-up totaled 6%. Four categories of immunovirological responses to ART were observed. At baseline, therapeutic success with sustained immunological and virological responses was observed in 80 (32.6%) children; immunological and virologic nonresponses occurred in 32 (13.0%) children; finally, the majority (133; 54.2%) of the remaining children showed discordant immunovirological responses. Among them, 33 (13.4%) children showed rapid virological responses to ART with an undetectable viral load, whereas immunological responses remained absent after 6 months of treatment and increased progressively over time in most of the cases, suggesting slow immunorestoration. Notably, nearly half of the children (40.8% at baseline and 48.2% at follow-up) harbored discordant immunovirological responses with a paradoxically high CD4 T-cell count and HIV-1 RNA load, which are always associated with high levels of drug resistance mutations. The latter category showed a significant increase over time, with a growth rate of 1.23% per year of follow-up.Our STROBE-compliant study demonstrates the high heterogeneity of biological responses under ART in children with frequent passage from 1 category to another over time. Close biological evaluation with access to routine plasma HIV-1 RNA load monitoring is crucial for adapting the complex outcomes of ART in HIV-infected children born from infected mothers.

CD4 binding loop responsible for the neutralization of human monoclonal neutralizing antibody Y498

Broad and potent human monoclonal neutralizing antibodies have considerable potential in the prevention and treatment of acquired immunodeficiency syndrome (AIDS). To identify the key amino acid recognition site contacted with neutralizing antibody Y498, peptides were panned from the PhD-12 peptide library and predicted using online software. Then, four key amino acid sites, G367, D368, E370, and V372 located on the CD4 binding loop on gp120 of envelope of human immunodeficiency virus-1 (HIV-1), were found to determine the neutralization of antibody Y498. Residue E370 is in the deep part of the CD4 binding loop, which affects Y498-mediated neutralization. This form of recognition leads to a somewhat limiting neutralization spectrum of neutralizing antibody Y498, although it has some neutralization ability. Further study of the interactions between the neutralizing antibody Y498 and its epitope on the surface of the virus may facilitate vaccine development and so prevent new AIDS cases.

HIV Infection: What Should We Know?

Acquired Immunodeficiency Syndrome (AIDS) was first known in 1981 in homosexual groups who had opportunistic infections and malignancies. In Indonesia the first AIDS case was reported in 1987 to a Dutch citizen living in the province of Bali. Cases of HIV infection in Indonesia are reported to increase every year and most occur at the age of 25-49 years. HIV transmission is not easily transmitted, even when an HIV-infected person takes antiretroviral drugs can reduce the risk of transmission by up to 96%. But one of the biggest challenges in managing HIV infection is facing stigma and discrimination. As many as 1 in 5 people living with HIV are afraid to come to the clinic because they will experience discrimination and stigma from the community if this condition occurs will cause treatment delay until PLWHA (People living with HIV/AIDS) will fall to the AIDS stage and PLWHA will be susceptible to opportunistic infections. A clinic in Namibia, when stigma and discrimination were successfully overcome, there was a 20% reduction in mortality in PLWHA

Spatiotemporal distribution of acquired immunodeficiency syndrome incidence in Brazil between 2012 and 2016.

INTRODUCTION:Acquired immunodeficiency syndrome (AIDS) remains a major public health issue in Brazil. This ecological study aimed to evaluate the spatiotemporal distribution of notified new AIDS cases in Brazil between 2012 and 2016.METHODS:A Bayesian spatiotemporal model based on the Poisson distribution was used to obtain smoothed incidence estimates of AIDS in each of the 133 Brazilian intermediate regions.RESULTS:Spatial distribution of new AIDS cases is highly heterogeneous. Regions with higher gross domestic product per capita tend to have higher incidence rates of AIDS.CONCLUSIONS:Strategies to prevent and control AIDS should consider regional differences.