Acquired Immunodeficiency Syndrome Research Research Articles

Measures to improve participation of registered nurses in HIV and AIDS research.

Registered nurses are crucial in lowering the complications of human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) in Nigeria. Human immunodeficiency virus infects individuals and impairs the immune system, impairing the body's capacity to fight bacteria, viruses, and other pathogens. Therefore, registered nurse-led initiatives are beneficial in promoting HIV and AIDS research development. However, these evidence-based treatments and professional expectations for registered nurse research creation do not represent contemporary research development on HIV and AIDS by registered nurses. This study aimed to explore measures to improve the participation of registered nurses in HIV and AIDS research in Nigeria. The study was conducted at a general hospital in Ijebu Ode, Ogun State, Nigeria. A qualitative approach design was employed. Participants of the study comprised 31 registered nurses in three focus groups. This study demonstrated the importance of research in effectively reducing HIV and AIDS transmission and maintaining good practices in a hospital setting in Nigeria. However, this understanding did not translate into knowledge creation through autonomous research productivity in this context. The study discovered that registered nurses were primarily involved in data collection and validation, which did not result in publications. The study found that registered nurses in Nigeria are typically worried about ways to promote nurses' engagement in research in Nigeria. These results might be utilised to improve the supply of research services and act as a baseline for future research linked to HIV and AIDS transmission prevention in Nigeria.

Nurses' awareness of the availability of HIV and AIDS research.

Hardship of human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) transmission in Nigeria needs research-based strategies that scientifically inform research findings for relevant research advocacy. This study aimed to enhance nurses' awareness of the availability of HIV and AIDS research in Nigeria. The research was carried out in a general hospital, a tertiary hospital in Ijebu Ode, Ogun State, Nigeria. A qualitative technique was used, as well as an exploratory-descriptive design was employed. Semi-structured interviews were carried out. Three focus group interviews with seven participants in each group were used to gather data. This study showed the value of nurses' awareness of the availability of HIV and AIDS research in overcoming obstacles to successfully controlling HIV and AIDS transmission in a hospital context in Nigeria. The study results demonstrated the nurses' understanding of local and global research. The result of the study also demonstrated the essential role of collaboration with partners in enhancing nurses' awareness of the availability of HIV and AIDS research in Nigeria. The study found that nurses in Nigeria were usually unaware of their role in healthcare research development in the context of HIV and AIDS. They preferred to go with the flow of events. This study affirms the importance of nurses' awareness of the availability of HIV and AIDS research in overcoming obstacles to successfully controlling HIV and AIDS transmission in a hospital context in Nigeria.

The Role of Innate Immunity in Natural Elite Controllers of HIV-1 Infection.

The natural process of human immunodeficiency virus type 1(HIV-1) infection is characterized by high viral load, immune cell exhaustion, and immunodeficiency, which eventually leads to the stage of acquired immunodeficiency syndrome (AIDS) and opportunistic infections. Rapidly progressing HIV-1 individuals often die of AIDS several years after infection without treatment. The promotion of ART greatly prolongs the survival time of HIV-infected persons. However, some patients have incomplete immune function reconstruction after ART due to latent storage of HIV-infected cells. Therefore, how to achieve a functional cure has always been the focus and hot spot of global AIDS research. Fortunately, the emergence of ECs/LTNPs who can control virus replication naturally has ignited new hope for realizing a functional cure for AIDS. Recently, a special category of infected individuals has attracted attention that can delay the progression of the disease more rigorously than the natural progression of HIV-1 infection described above. These patients are characterized by years of HIV-1 infection, long-term asymptomatic status, and normal CD4+T cell count without ART, classified as HIV-infected long-term nonprogressors (LTNPs) and elite controllers (ECs). Numerous studies have shown that the host and virus jointly determine the progression of HIV-1 infection, in which the level of innate immunity activation plays an important role. As the first line of defense against pathogen invasion, innate immunity is also a bridge to induce adaptive immunity. Compared with natural progressors, innate immunity plays an antiviral role in HIV-1 infection by inducing or activating many innate immune-related factors in the natural ECs. Learning the regulation of ECs immunity, especially the innate immunity in different characteristics, and thus studying the mechanism of the control of disease progression naturally, will contribute to the realization of the functional cure of AIDS. Therefore, this review will explore the relationship between innate immunity and disease progression in ECs of HIV-1 infection from the aspects of innate immune cells, signaling pathways, cytokines, which is helpful to provide new targets and theoretical references for the functional cure, prevention and control of AIDS, and development of a vaccine.

Increasing HIV/AIDS knowledge among urban ethnic minority youth: Findings from a community-based prevention intervention program

HIV (Human Immunodeficiency Virus)/AIDs (Acquired immunodeficiency syndrome) prevention and research are imperative. Prevention-intervention programming is minimal in low-income communities of color. Additional research is needed that uncovers points of support and prevention to increase HIV knowledge and awareness and limit new HIV infections among adolescents of color. This study presents preliminary findings from a community-based HIV/AIDS, substance abuse, and viral hepatitis (VH) prevention education intervention for ethnic minority youth in a northeastern urban community. We evaluated HIV/AIDS knowledge and factors associated with knowledge. Participants (N = 599) completed a baseline survey followed by an exit survey measuring HIV/AIDS knowledge. Exit survey findings indicated that there was an increase in HIV/AIDs knowledge. Multivariate regression analyses showed that change scores in VH knowledge accuracy, sexual negotiation skills, risk perception, and ethnic identity were positively associated with change in HIV/AIDs knowledge score. The development and implementation of HIV/AIDS knowledge interventions can be crucial in alleviating new infections in the U.S.

Advances in Studies on Prevalence and Interaction Mechanism of Acquired Immunodeficiency Syndrome and Tuberculosis Coinfection

AbstractHuman immunodeficiency virus (HIV) and tuberculosis (TB) coinfection is a serious public health problem. HIV and TB promote each other, accelerating development of HIV to acquired immunodeficiency syndrome (AIDS) and heightening TB mortality. Determining interaction mechanism between HIV andMycobacterium tuberculosiscan lead to development of effective treatments. This study summarizes prevalence status of AIDS and TB coinfection and research advances concerning their interaction mechanism.

Immunity in natural SIV infections

In stark contrast to human immunodeficiency virus (HIV)-infected individuals who, if left untreated, almost invariably progress to acquired immunodeficiency syndrome (AIDS), natural hosts for the simian immunodeficiency viruses (SIV) remain asymptomatic throughout the course of infection. This observation represents one of the main unresolved puzzles of AIDS research, particularly if one considers that natural SIV infections are characterized by chronically high levels of viraemia as well as intrinsic virus cytopathicity comparable with that of HIV. In this review, I discuss the basic immunological features of natural, nonpathogenic SIV infections, the evidence suggesting that attenuated, rather than extraordinarily strong, immune responses to the virus may favour their benign course, and the implications of these findings in terms of HIV therapy and vaccines.

The Impact of Medical Nutrition Therapy in Ryan White Care Centers

In 1990, the US Congress passed the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act in honor of Ryan White, a teenager from Indiana who contracted the human immunodeficiency virus (HIV) from contaminated blood during a hemophilia treatment in 1984. Ryan was expelled from school for having the disease and soon became well known in the media as one of the first known people to have contracted the disease from a blood transfusion. For the next 5 years, Ryan became an advocate for AIDS (acquired immunodeficiency syndrome) education, research, and awareness. Ryan White died in 1990 at the age of 18 ( 1 Ryan White. http://en.wikipedia.org/wiki/Ryan_White Google Scholar ).

HIV-1 immunopathogenesis: How good interferon turns bad

The hallmark of acquired immunodeficiency syndrome (AIDS) is the progressive loss of CD4 + T cells that results from infection with human immunodeficiency virus type-1 (HIV-1). Despite 25 years of AIDS research, questions remain concerning the mechanisms responsible for HIV-induced CD4 + T cell depletion. Here we briefly review the in vitro and in vivo literature concerning the protective role of interferon-alpha (IFN-α) in HIV/AIDS. We then develop a laboratory- and clinically supported model of CD4 + T cell apoptosis in which either infectious or noninfectious HIV-1 induces the production of type I interferon by plasmacytoid dendritic cells (pDC). The interferon produced binds to its receptor on primary CD4 + T cells resulting in membrane expression of the TNF-related apoptosis-inducing ligand (TRAIL) death molecule. The binding of infectious or noninfectious HIV-1 to CD4 on these T cells results in expression of the TRAIL death receptor 5 (DR5), leading to the selective death of HIV-exposed CD4 + T cells.

Twenty-Five Years of HIV/AIDS

![Figure][1] CREDIT: NIH On 5 June 1981, a report in the Morbidity and Mortality Weekly Report ( MMWR ) described five young and previously healthy gay men with Pneumocystis carinii pneumonia (PCP) in Los Angeles. One month later, a second report in MMWR described 26 men in New York and California with Kaposi's sarcoma and 10 more PCP cases in California. No one who read those reports, certainly not this author, could have imagined that this was the first glimpse of a historic era in the annals of global health. Twenty-five years later, the human immunodeficiency virus (HIV), the cause of acquired immunodeficiency syndrome (AIDS), has reached virtually every corner of the globe, infecting more than 65 million people. Of these, 25 million have died. The resources devoted to AIDS research over the past quarter-century have been unprecedented; $30 billion has been spent by the U.S. National Institutes of Health (NIH) alone. Investigators throughout the world rapidly discovered the etiologic agent and established the direct relationship between HIV and AIDS, developed a blood test, and delineated important aspects of HIV pathogenesis, natural history, and epidemiology. Treatment was initially confined to palliative care and management of opportunistic infections, but soon grew to include an arsenal of antiretroviral drugs (ARVs). These drugs have dramatically reduced HIV-related morbidity and mortality wherever they have been deployed. The risk factors associated with HIV transmission have been well defined. Even without a vaccine, HIV remains an entirely preventable disease in adults; and behavior modification, condom use, and other approaches have slowed HIV incidence in many rich countries and a growing number of poor ones. With most pathogens, this narrative would sound like an unqualified success story. Yet it is very clear that scientific advances, although necessary for the ultimate control of HIV/AIDS, are not sufficient. Many important challenges remain, and in several of these the global effort is failing. New infections in 2005 still outstripped deaths by 4.1 to 2.8 million: The pandemic continues to expand. Despite substantial progress, only 20% of individuals in low- and middle-income countries who need ARVs are receiving them. Worldwide, fewer than one in five people who are at risk of becoming infected with HIV has access to basic prevention services, which even when available are confounded by complex societal and cultural issues. Stigma and discrimination associated with HIV/AIDS, and sometimes community or even governmental denial of the disease, too often dissuade individuals from getting tested or receiving medical care. Women's rights remain elusive at best in many cultures. Worldwide, thousands of women and girls are infected with HIV daily in settings where saying no to sex or insisting on condom use is not an option because of cultural factors, lack of financial independence, and even the threat of violence. ![Figure][1] CREDIT: MALCOLM LINTON In the laboratory and the clinic, HIV continues to resist our efforts to find a cure (eradication of the virus from an infected individual) or a vaccine. In 25 years, there has not been a single well-documented report of a person whose immune system has completely cleared the virus, with or without the help of ARVs. This is a formidable obstacle to the development of an effective vaccine, for we will need to do better than nature rather than merely mimic natural infection, an approach that has worked well with many other microbes. The development of next-generation therapies and prevention tools, including topical microbicides that can empower women to directly protect themselves, will require a robust and sustained commitment to funding the best science. Meanwhile, as we enter the second quarter-century of AIDS, we know that existing HIV treatments and prevention modalities, when appropriately applied, can be enormously effective. Programs such as President Bush's Emergency Plan for AIDS Relief; the Global Fund to Fight AIDS, Tuberculosis, and Malaria; and the efforts of philanthropies and nongovernmental organizations have clearly shown that HIV services can indeed be delivered in the poorest of settings, despite prior skepticism. We cannot lose sight of the fact that these programs must be sustained. As we commemorate the first 25 years of HIV/AIDS and celebrate our many successes, we are sobered by the enormous challenges that remain. Let us not forget that history will judge us as a global society by how well we address the next 25 years of HIV/AIDS as much as by what we have done in the first 25 years. [1]: pending:yes

Synthetic peptides for AIDS research.

In spite of the relevance of the results obtained through the clinical application of chemotherapeutic agents (reverse transcriptase and proteinase inhibitors) that are able to prolong the life span of affected people, acquired immunodeficiency syndrome (AIDS) remains a serious and lethal disease. AIDS is caused by a type 1 human immunodeficiency virus (HIV-1) and formation of a complex among the gp120, CD4 and CCR5/CXCR4 surface proteins represents a key-step in the infection. The use of synthetic peptides reproducing reduced sequences of these proteins has contributed to increase the knowledge of the mechanism that determines the penetration of the HIV viruses into the target-cells. In addition, short peptides with minimum structural requirements for anti-HIV activity hold greater potential as lead compounds for rational drug design than macromolecular proteins. In this context, our studies concern: the role of gp120 V3 loop in CD4 binding, the importance of the N-terminal sequence of HIV CCR5 coreceptor, the potential inhibitory properties of sequences patterned on CXCR4 natural ligand (SDF-1) and the role of secondary structure in determining gp160 enzymatic processing into gp120.

From the cell to the community: AIDS research in California

Between 1981 and 1999, more than 110,00 cases of the acquired immunodeficiency syndrome (AIDS) have been reported in California, of whom nearly 70,000 patients have died. Since 1983, the University of California has funded basic, clinical, social, and behavioral research on the human immunodeficiency virus (HIV)/AIDS through the University wide AIDS ResearchProgram (UARP). Major accomplishments of UARP-supported research include the isolation and characterization of HIV, the detection and elimination of HIV in blood clotting factor VIII, and in early studies, the demonstration of the rapid production and turnover of HIV in the blood of infected persons. Together with its advisory group, the University wide Task Force on AIDS, UARP convenes an annual meeting that provides an opportunity for the exchange of new information on HIV/AIDS in California. Participants include bench scientists, clinicians, policymakers, outreach workers, community-based organizations, and members of affected communities. Most of the studies presented at the UARP conference are in their early stages and modestly funded. While some go on to receive larger federal grants, others are quickly integrated into new interventions or investigations. In this issue of wjm, we share highlights of the 3rd AnnualConference on AIDS Research inCalifornia.† The plenarytheme for the year 2000 was “Early Events and Intervention in HIVInfection.” Although the recent and ongoing advances in highly active antiretroviral therapy are well known, the meeting provided a fertile venue for presenting other innovative areas for treatment and prevention.

Acquired Immunodeficiency Syndrome-Related Cancers: the Community Perspective

Acquired Immunodeficiency Syndrome-Related Cancers: the Community Perspective

Diseases Chasing Money and Power: Breast Cancer and Aids Activism Challenging Authority

Through the 1980s and early 1990s, the course of American health research was increasingly shaped by politically-aggressive activism for two particular diseases, breast cancer and AIDS (Acquired Immunodeficiency Syndrome). Even as national stakes rose, both in dollars spent and growing demands on the medical system, breast cancer and AIDS advocates made government policy-making for research ever more public and controversial. Through skillful cultivation of political strength, interest groups transformed individual health problems into collective demands, winning notable policy influence in federal agencies such as the National Institutes of Health (NIH) and Food and Drug Administration (FDA). Activists directly challenged fundamental principles of both government and medical systems, fighting to affect distribution of research funds and questioning well-established scientific methods and professional values. In the contest for decision-making power, those players achieved remarkable success in influencing and infiltrating (some critics said, undermining) both the politics and science of medical research. Between 1990 and 1995, federal appropriations for breast cancer study rose from $90 million to $465 million, while in that same period, NIH AIDS research rose from $743.53 million to $1,338 billion.

Surrogate Markers in AIDS Research

MATHEMATICAL models and statistical evaluations are often used to explain biologic phenomena. The acquired immunodeficiency syndrome (AIDS) is no exception. Through the years of studying the human immunodeficiency virus (HIV) and its effect on the immune system, investigators have emphasized counting CD4 + cells and CD8 + cells and/or measuring p24 antigen levels or, more recently, the viral RNA content of the plasma. What is known, but not always appreciated, is the limited information that may be reflected by these parameters when measured in the blood. Peripheral blood lymphocyte numbers represent only a small percentage (3%) of the total white blood cells in the body, 1 and plasma virion content is just a portion of the total HIV virions, which are concentrated primarily in lymphoid organs. 2 Thus, in several experimental systems, plasma viral RNA may not reflect the actual viral load. Moreover, although CD4 + cell numbers may be helpful in predicting

AIDS: A Global Response

The author is executive director of UNAIDS in Geneva, Switzerland. The U.S. Centers for Disease Control and Prevention estimate that 40,000 U.S. citizens became infected last year with the human immunodeficiency virus (HIV), which causes acquired immunodeficiency syndrome (AIDS). Globally, over 8500 newly infected people daily join the ranks of the 21 million already living with one of the 10 known subtypes of the virus. In heavily affected countries in Africa and Asia, where one out of three urban adults may be infected, AIDS deaths among young and middle-aged adults—workers, managers, political leaders, and military personnel—are threatening health systems, economies, and national stability. With the current scale of global travel, the largely invisible, shifting, and expanding global epidemic of HIV makes the planet a more dangerous place for all. This is not to say that there is no hope. For the first time, a number of developing countries are registering a genuine drop in new HIV infections, which shows that prevention efforts focused on safer sexual and drug-related behavior are beginning to pay off. The clearest indications come from Thailand, where the reductions in incidence and prevalence are most dramatic among young men. In cities in Uganda, one of the hardest-hit countries in the world, the number of HIV-infected pregnant women is lower now than 5 years ago. Existing prevention approaches, though imperfect, demonstrably work. But maximizing protection from HIV over future decades of foreseeable transmission calls for improved approaches and technologies. Research is key to making a serious dent in the unstable global HIV situation and bringing the numbers down to stable and safer levels. Recent scientific breakthroughs are encouraging. For example, combination therapy with antiretroviral drugs now promises not only to defer disease progression and improve quality of life but perhaps even to turn HIV infection into a chronic nonprogressive condition. Progress in the development of HIV prevention technologies has been slower than was once hoped, but again there are encouraging advances, particularly the discovery that zidovudine can interrupt mother-to-child transmission. If these and other potential breakthroughs are to result in a safer world, the global research agenda needs to be turned on its head. Immediately. Fact 1: The AIDS problem is overwhelmingly concentrated in the developing world, where more than 90% of all HIV-infected people now live. Fact 2: AIDS intelligence and RD anything else offers false security for all. A rationally prioritized AIDS research agenda would offer hope to the whole planet. It would indeed be “One world, one hope”: the theme of this year9s International Conference on AIDS, now about to begin in Vancouver, and of World AIDS Day 1996.

Ethical and Legal Issues in AIDS Research

This book addresses the difficult ethical and legal issues involved in conducting psychosocial research on the acquired immunodeficiency syndrome (AIDS). Because the disease has primarily affected people belonging to groups who have suffered discrimination and stigmatization—such as gay men, the poor, and those who engage in drug use (an illegal activity)—many living with human immunodeficiency virus (HIV) infection or AIDS are reluctant to seek treatment and counseling or to participate in research projects. The authors describe the need to handle the cases and records of research participants with extreme care, and they explore the broader implications of conducting socially sensitive research. They begin with a thorough and well-argued exploration of the risks and benefits of doing research on HIV/AIDS for researchers, the public, and participants. They illustrate a point that is seldom given due emphasis in discussions of research ethics: researchers have substantial conflicts of interest, and the more important

Early evaluation results of a collaborative partnership.

Early evaluation results of a collaborative partnership.

The HIV/AIDS grants economy in New York City, 1983-1992.

The HIV/AIDS grants economy in New York City, 1983-1992.

Viral protein X.

Since the discovery of the human immunodeficiency viruses types 1 (HIV-1) and 2 (HIV-2) as the causative agents of acquired immunodeficiency syndrome (AIDS) (Barre-Sinoussi et al. 1983; Clavel et al. 1987; Papovic et al. 1984) and the isolation of related lentiviruses from several species of Old World monkeys, much has been learned about their biology and evolution. Based on genetic analysis, five distinct phylogenetic lineages of primate lentiviruses have now been identified: HIV-1/simian immunodeficiency virus (SIV)CPZ, HIV-2/SIVSM/SIVMAC, SIVAGM, SIVMND, and SIVSYK (for review see Johnson et al. 1991; Myers et al. 1992; Sharp et al. 1994). Like all retroviruses, primate lentiviruses are similar in structure and genomic organization. They contain gag, pol, and env genes that encode structural proteins essential for virion architecture (Gag), glycoproteins that enable the virus to recognize and infect its target (Env), and enzymatic proteins essential for processes of virus maturation, reverse transcription, and integration (Pol). While the genomic structure of all five lineages is conserved, differences exist in the composition of auxiliary genes: all five groups of viruses contain tat, rev, nef and vif all but SIVAGM contain vpr, only HIV-1/SIVSYK contains vpu, and only HIV-2/SIVSM/SIVMAC and SIVAGM viruses contain vpx (Cullen and Green 1990; Johnson et al. 1991). Primate lentiviruses have complex life cycles regulated by interactions of viral structural and accessory gene products as well as host factors (Cullen 1991). Viral accessory genes modulate replication, host cell tropism, chronic persistence, and pathogenicity. Defining the role of viral accessory genes is critical for understanding the natural history of infection and disease pathogenesis and thus represents a major goal in biomedical AIDS research. Moreover, knowledge of accessory protein function may facilitate the development of therapeutic and vaccine interventions. In this chapter the author reviews the present understanding of the role of Vpx in the HIV-2/SIV life cycle and the structure-function relationships that mediate incorporation of this protein into virions. Based on genetic and phylogenetic evidence indicating that in the HIV-2/ SIVSM/SIVMAC lineage vpxarose from a gene duplication of vpr and on the proposed reclassification of SIVAGM vpx to vpr (Tristem et al. 1990, 1992), for clarity this review will discuss vpx for only the HIV-2/SIVSM/SIVMAC group of viruses.

Sexually transmitted diseases: a neglected public health priority.

Sexually transmitted diseases remain uncontrolled although millions of cases occur annually in the United States. The advent of acquired immunodeficiency syndrome (AIDS), which is also a sexually transmitted disease, has not altered this situation. The major portion of federal funding for sexually transmitted diseases is allocated to a search for an AIDS vaccine or cure. State health department funding for sexually transmitted diseases, although only a small fraction of the $1.3 billion AIDS research budget of the National Institutes of Health, is largely consumed by AIDS. A single adequately funded sexually transmitted disease control program that applies well-established public health principles for the control of communicable diseases would make sense. However, a consensus to develop and support such a program does not exist in the United States.