Evolution Of HIV Infection Research Articles

Manifestaciones reumatológicas en pacientes infectados con virus de la inmunodeficiencia humana

La infección por virus de la inmunodeficiencia humana adquirida se ha convertido en una pandemia mundial, en Colombia la prevalencia en 2008 fue de 0.6% a 0.8%.
 Los últimos 21 años desde que conocemos la infección se han visto inicialmente las manifestaciones reumatológicas de la inmunodeficiencia, y con los avances en materia de terapia antirretroviral en la actualidad dichas manifestaciones están más en relación con el tratamiento.
 Se realizó búsqueda de literatura empleando términos MesH en Pubmed encontrando 131 artículos de los cuales se incluyeron 26 que cumplían con los objetivos del tema.
 La infección VIH y el SIDA presentan una gran variedad de manifestaciones reumatológicas, que incluso pueden ser el debut de la infección.
 Las espondiloartropatías son la expresión reumatológica más frecuente.
 El inicio de la terapia antirretroviral de alta eficiencia en 1996, partió en dos la evolución de la infección por virus de la inmunodeficiencia humana, y las manifestaciones reumatológicas asociadas a ésta

Study of the association of haplotypes HLA-B 57.01 and HLA-B35 in the evolution of HIV infection

Study of the association of haplotypes HLA-B 57.01 and HLA-B35 in the evolution of HIV infection

Joint Modeling of Longitudinal CD4 Count and Time-to-Death of HIV/TB Co-infected Patients: A Case of Jimma University Specialized Hospital

Tuberculosis (TB) and HIV have been closely linked since the emergence of AIDS; TB enhances HIV replication by accelerating the natural evolution of HIV infection which is the leading cause of sickness and death of peoples living with HIV/AIDS. To improve their life the co-infected patients are started to take antiretroviral treatment as patient started to take ART it is common to measure CD4 and other clinical outcomes which is correlated with survival time. However, the separate analysis of such data does not handle the association between the longitudinal measured out come and time-to-event where the joint modeling does to obtain valid and efficient survival time. Joint modeling of longitudinally measured CD4 and time-to death to understand their association. Furthermore, the study identifies factors affecting the mean change in square root CD4 measurement over time and risk factors for the survival time of HIV/TB co-infected patients. The study consists of 254 HIV/TB co-infected patients who were 18 years old or older and who were on antiretroviral treatment follow up from first February 2009 to fist July 2014 in Jimma University Specialized Hospital, West Ethiopia. First, data were analyzed using linear mixed model and survival models separately. After having appropriate separate models using Akaki information criteria, different joint models employed with different random effects longitudinal model and different shared parameters association structure of survival model and compared with deviance information criteria score. The linear mixed model showed functional status, weight, linear time and quadratic time effects have significant effect on the mean change of CD4 measurement over time. The Cox and Weibull survival model showed base line weight, baseline smoking, separated marital status group and base line functional status have significant effect on hazard function of the survival time whereas the joint model showed subject specific base line value; subject specific linear and quadratic slopes of CD4 measurement of were significantly associated with the survival time of co-infected patient at 5% significance levels. The longitudinally measured CD4 count measurement marker process is significantly associated with time to death and subject specific quadratic slope growth of CD4 measurement, base line clinical stage IV and smoking is the high risk factors that lower the survival time of HIV/TB co-infected patients. Since the longitudinally measured CD4 measurement is correlated with survival time joint modeling are used to handle the associations between these two processes to obtain valid and efficient survival time.

CD4+ CD38+ HLA-DR+ level as biomarker for evolution of HIV infection regardless of antiretroviral therapy

Introduction. HIV infection is characterized by an enhanced synthesis of cytokines and chemokines, a quantitative T cells disequilibrium and increased Turn over that signs a chronic activation of the immune system. Phenotype change in CD4+ T cells by over-expression of activation antigens CD38 and HLA-DR are suggested as markers of this process. Materials and methods. We investigated by four-color flow cytometry the expression of both activation markers on peripheral CD4+ T cells in 106 HIV-1 Algerian infected patients and 34 uninfected controls. Percentage’s expression of CD4+CD38+HLA-DR+ cells was compared with clinical stages, viral load and anti-retroviral treatment (ARV). Results. The proportion of CD4+ T cells coexpressing HLA-DR and CD38 was higher in infected patients than in controls (respectively, 14.2 % ± 3.6 vs. 5.8 % ± 4.1, P=0.01), in symptomatic HIV patients than asymptomatic (13 % ± 3 vs. 15.9 % ± 4.6, P=0.01) and followed viral load kinetics. In matched treated and untreated patients, activated CD4+T proportion does not show any statical difference (respectively, 13 % and 14 %, p=0.09). Conclusion. In our cohort, CD4+ T cells expressing CD38 and HLA-DR were associated with HIV infection and correlated with disease progression, regardless of ARV treatment. As CD4+ count and viral load, this lymphocyte subset may be an interesting disease evolution marker; its value remains to be determined in prognostic or as therapy response indicator.

Genetically Intact but Functionally Impaired HIV-1 Env Glycoproteins in the T-Cell Reservoir.

HIV-infected subjects under antiretroviral treatment (ART) harbor a persistent viral reservoir in resting CD4+ T cells, which accounts for the resurgence of HIV replication after ART interruption. A large majority of HIV reservoir genomes are genetically defective, but even among intact proviruses few seem able to generate infectious virus. To understand this phenomenon, we examined the function and expression of HIV envelope glycoproteins reactivated from the reservoir of four HIV-infected subjects under suppressive ART. We studied full-length genetically intact env sequences from both replicative viruses and cell-associated mRNAs. We found that these Env proteins varied extensively in fusogenicity and infectivity, with strongest functional defects found in Envs from cell-associated mRNAs. Env functional impairments were essentially explained by defects in Env protein expression. Our results support the idea that defects in HIV Env expression, preventing cytopathic or immune HIV clearance, contribute to the persistence of the HIV T-cell reservoir in vivoIMPORTANCE In most individuals, evolution of HIV infection is efficiently controlled on the long-term by combination antiviral therapies. These treatments, however, fail to eradicate HIV from the infected subjects, a failure that results both in resurgence of virus replication and in resumption of HIV pathogenicity when the treatment is stopped. HIV resurgence, in these instances, is widely assumed to emerge from a reservoir of silent virus integrated in the genomes of a small number of T lymphocytes. The silent HIV reservoir is mostly composed of heavily deleted or mutated HIV DNA. Moreover, among the seemingly intact remaining HIV, only very few are actually able to efficiently propagate in tissue culture. In this study, we find that intact HIV in the reservoir often carry strong defects in their capacity to promote fusion to neighboring cells and infection of target cells, a defect related to the function and expression of the HIV envelope glycoprotein. Impaired envelope glycoprotein expression and function could explain why cells harboring these viruses tend to remain undetected and unharmed in the reservoir.

Predictors of Delayed Diagnosis and Evolution in Sub-Saharan Immigrants with HIV Infection in a Hospital in Madrid (2004–2013)

The aim of this study was to analyze the delayed diagnosis and evolution of HIV infection in predominantly sub-Saharan immigrants compared to other patients in a hospital in Madrid between 2004 and 2013.

CYTOLOGICAL PROFILE OF RED BLOOD CELLS IN HIV-INFECTED PATIENTS: CASE OF THE DOUALA GENERAL HOSPITAL (CAMEROON)

BackgroundHaematological abnormalities have been documented as strong independent predictors of morbidity and mortality in HIV-infected individuals. Those infected with HIV without antiretroviral treatment (ART) have a high prevalence of abnormal...

HIV viral load assessment in multiple sanctuaries – case presentation

Case report We present the case of a 57 year-old male patient, diagnosed with HIV infection for 14 years, and polyexperienced to antiretroviral (ARV) therapy (history of over 15 past ARV regimens). Early on in the evolution of HIV infection, the patient developed arterial hypertension, cardiomyopathy, 80% bi-carotid atheromatosis, and neurocognitive impairment. The patient also developed dyslipidemia and significant lipodystrophy correlated with the use of first generation protease inhibitors. The impressive size of the buffalo hump led to impaired respiratory movements and trachea compression (identified through bronchoscopy, which had been indicated for the differential diagnosis of lung cavities; unfortunately because of the tracheal compression, bronchoscopy could not be performed). A surgical intervention for lipodystrophy had to be deferred because of the inability to maintain a stable ARV regimen, with undetectable viral loads. In Sep 2010 we managed to establish a stable ARV regimen, with boosted darunavir plus etravirine plus raltegravir. Plasma viral load decreased slowly, but it fluctuated, and it was only in Jan 2013 that the patient reached stable undetectable levels, and at this point, his CD4 cell count had increased to 321 cells/cmm. In early 2014, after the patient had been virally suppressed for approximately one year, he was referred to a plastic surgery clinic, where he underwent successful lipoaspiration of 12 kg of adipose tissue from the buffalo hump, along with reconstruction of adipose facial features. Thus, the surgical procedure had a double role, both esthetic and functional, leading to improved pulmonary ventilation and a better tolerability to performing daily activities. Given the history of difficulty maintaining a suppressed viral load in his patient, we assessed the potential HIV compartmentalization: after 6 months of consistently undetectable viremia, we performed sperm viral load (undetectable) and CSF viral load (undetectable), and after one year of viral suppression, we performed a viral load from the adipose tissue (results still in process).

Epidemiological considerations on HIV infection in Constanța region

Background Lack of available epidemiological studies and circulation of unverified and unsubstantiated scientific information contributed to the uncertainty regarding the onset, causes and epidemiological developments in Romania. This paper aims to formulate epidemiological considerations on evolution of HIV infection based on a retrospective and prospective epidemiological analysis of 2 groups (A and B) of patients from Constanța, period 1987-2013.

Presence of p24-Antigen Associated to Erythrocyte in HIV-Positive Individuals Even in Patients with Undetectable Plasma Viral Load

BackgroundHIV adherence to erythrocytes has been demonstrated in vitro, and it has been suggested that erythrocytes may be carriers of the virus. However, the association between HIV particles or viral proteins and erythrocytes in HIV-infected individuals is still to be elucidated.Methodology/Principal FindingsHIV-positive participants (n = 112) were classified into two groups according to values of three plasma viral loads (pVL) determined during the 12-month period prior to the study. The first group included 71 individuals with detectable pVL, whereas the second group included 41 individuals with undetectable pVL. Plasma viral load, erythrocyte-associated p24-antigen and p24-antigen in plasma were determined at the moment of the study. A total of 51 out of the 71 patients with detectable pVL showed erythrocyte-associated p24-antigen whereas 13 showed p24-antigen in plasma. Twenty-two out of the 51 patients with erythrocyte-associated p24-antigen showed pVL<10,000 copies/ml and undetectable p24-antigen in plasma. The data indicates that the amount of erythrocyte-associated p24-antigen was not related to p24-antigen in plasma or pVL levels in this group. Among the 41 patients with prior undetectable pVL, eight presented detectable pVL and erythrocyte-associated p24-antigen at the moment of the study. The other 33 showed undetectable pVL and five of these presented erythrocyte-associated p24-antigen. A positive relationship was found between the presence of erythrocyte-associated p24-antigen and the detectable pVL at the moment of the study (p<0.00001). Even more, in another series of assays, a detectable viral load associated to erythrocytes was determined and it was always accompanied by erythrocyte-associated p24-antigen detection.Conclusions/SignificanceThis study demonstrates the presence of erythrocyte-associated p24-antigen in HIV-infected individuals. Since erythrocyte-associated p24-antigen is not always related to pVL or p24-antigen in plasma, erythrocyte-associated p24-antigen showed viral expression not represented in plasma. Therefore, the determination of erythrocyte-associated p24-antigen may contribute to better understand the kinetics and/or evolution of HIV infection.

Every Nurse Is an HIV Nurse

The evolution of HIV infection into a chronic disease has implications across all clinical care settings. Every nurse should be knowledgeable about the prevention, testing, treatment, and chronicity of the disease in order to provide high-quality care to people with or at risk for HIV. It's important, therefore, to have an understanding of the changing epidemiology of the disease, the most recent testing recommendations, developments in screening technology, the implications of aging with HIV infection, and the nursing implications of the ongoing epidemic.

Variations in Leprosy Manifestations among HIV-Positive Patients, Manaus, Brazil

Variations in Leprosy Manifestations among HIV-Positive Patients, Manaus, Brazil

Influence of social changes on the evolution of HIV infection in Romania

The Romanian HIV epidemic started and evolved as a paediatric one, accounting for more than a quarter of the total European juvenile AIDS cases. In response to this major AIDS outbreak, emphasis was placed on the patient’s treatment, by implementation of a free, universal access program of Highly Active AntiRetroviral Therapy. This approach has been highly successful, and has greatly increased the rate of survival in infected children. Nevertheless, these children are now teenagers or young adults, representing a large cohort of ‘long‐term survivors’ – a unique population that represent a great challenge for the public health system and for their integration in the civil society. As the number of HIV infected adults is increasing, new high‐risk behaviour groups, as well as vulnerable populations (young people, people living in poverty, Rroma community) need to be reached in prevention programs. This article explores the impact of the socio‐economic changes on the evolution of the HIV epidemic in Romania and speculates about the factors that might drive future increases in the incidence of HIV infections.

Prevalencia de hepatitis C en población infectada por el VIH en el Área 2 de Madrid

The evolution of HIV infection, a rapid and fatal illness not long time ago, has become a chronic disease due to the implementation of new antiretroviral treatment. Therefore it is essential to focus on the management of concurrent illnesses such as chronic hepatitis C infection, specially as they share common routes of transmission. A cross sectional survey was done to determine the prevalence of HIV and HCV coinfection, measuring different HIV and HCV variables among 651 HIV infected patients of a health area in Madrid. 500 patients (76.8%) were male and 151 female (23%). HCV serology was performed in all the patients and resulted positive in 45.7% (298) most of them drug users (84.8%). The CD4 cell count was lower in patients HIV-HCV coinfected compared to those HCV negative (p < 0.001). This study shows a high prevalence of HIV-HCV coinfection, mainly due to parenteral transmission. We emphasize the low percentage of coinfected patients treated with interferon and ribavirine which probably will increase in the future.

HIV-1: maternal prognosis.

Profound modifications in the profile of patients are currently being observed within the epidemic context of AIDS, especially with respect to pauperization and feminization of the disease. The population most frequently affected is in the reproductive age, and among adults aged 18 to 24 years, the ratio is 1 man to 1 woman, a phenomenon occurring uniformly all over the world. One of the main challenges for HIV-1-infected pregnant women and their doctors is the effect of the interaction between HIV infection and pregnancy. The present article is a review of the literature; and its objective is to assess the influence of HIV-1 infection seen from the maternal perspective, with a discussion of immunologic function, maternal prognosis, and the HIV-abortion interface. At present, we cannot conclude that pregnancy has a short-term effect on the evolution of HIV infection, but the concomitance of HIV and pregnancy may adversely affect the prognosis of gestation, especially in view of its frequent association with increased abortion and puerperal morbidity rates.

Epidemiología de la infección por virus de la inmunodeficiencia humana (VIH) en la provincia de Salamanca (1985-2002)

Since effective treatment against HIV has become available, HIV infection surveillance is focussed not only on AIDS cases, but also on new cases of HIV infection. One of the methods used for this task is compilation of case records. We report the results of 18 years of recording information on new diagnoses of HIV (1985-2002) in the area of Salamanca (Spain). Our report system is based on active monitoring of results from the microbiology laboratory of the Salamanca Health Area. All patients testing positive in HIV analytical studies and who had not been previously diagnosed as HIV-infected are included in the report system. A total of 188 579 analytical results were studied. We found 16,772 (9.23%) HIV-positive results, 1984 of which were new HIV infection diagnoses. The incidence for the entire period was 556 cases/100,000 inhabitants. The highest incidence was found in 1992 (62.2 cases/100,000), with a progressive decrease thereafter to 2002 (5.18/100,000). Among the total, 75.3% of patients were men between 20 and 39 years old and more than half (62.2%) were intravenous drug users. Over the period studied, there has been an increase in the age of patients at the time of diagnosis, a trend to increases in the number of cases acquired through heterosexual transmission and a reduction in the number of drug users. During the study period, 312 AIDS cases were declared. Epidemiological information systems for HIV surveillance are essential to know the features, magnitude and evolution of the epidemic. Creation of a national HIV infection surveillance system to compile the information from smaller regional or local organisms would contribute substantially to our understanding of the epidemiology and evolution of HIV infection.

Economic and socio-behavioural issues related to highly active antiretroviral therapies for HIV infection: the contribution of social science research

This article presents a synthesis of the main topics covered by social science research (SSR) on HIV/AIDS, since the advent of highly active antiretroviral therapies (HAART) in 1996. SSR has shown that non-adherence cannot be reliably <<predicted>> on the sole basis of a few a priori patient characteristics that clinicians could easily identify before initiation of HAART, and that a dynamic approach to adherence, continuously monitoring the impact of patients' subjective experience with HAART is needed. In relationship with the evolution of HIV infection toward a <<chronic disease>>, SSR has dealt with the impact of HAART on all aspects of patients' daily lives (from employment and professional status to sexuality). It has also emphasised the potential contradictions between the hopes generated by these cost-effective therapeutic advances, on the one hand, and the high social vulnerability of a growing proportion of people living with HIV-AIDS, on the other hand. Finally, SSR suggests recommendations for <<normalising>> AIDS public policies without losing the potential for innovations that the fight against this epidemic has introduced in health care and <<Social Security>> systems, as well as physician-patient's relationships.

Using Cellular Automata to Learn About the Immune System

Cellular automata are very simple systems that can exhibit complex dynamics on its time evolution. Over the last decade there have been many applications of cellular automata to modeling of biological systems. Those applications have been stimulated by the study of complex systems which has brought many insights into the cooperative and global behavior of the biological systems. Along with this discussion we present two different applications of deterministic and also of probabilistic cellular automata that are used to model the dynamics involved in cooperative and collective behavior of the immune system. In the first example, we use a deterministic cellular automata to model the time evolution of the immune repertoire, as a network, according to the Jerne's theory. Using this model we could reproduce some recent experimental results about immunization and aging of the immune system. In the second example, we use a probabilistic cellular automata model to study the evolution of HIV infection and the onset of AIDS. The results are in excellent agreement with experimental data obtained from infected patients. Besides the examples above, other interesting applications, such as models for cancer and recurrent epidemics, are being considered in the present framework.

Impact of Replacement Therapy on the Evolution of HIV Infection in Hemophiliacs

Impact of Replacement Therapy on the Evolution of HIV Infection in Hemophiliacs

The natural history of HIV-1 infection

We evaluated and compared four staging classification systems for HIV infection in a population-based cohort: (1) a staging based on prodromal clinical criteria; (2) the Walter Reed Staging Classification (WRSC); (3) the immunologic staging system (ISS), and (4) a simple staging based on oral disease and CD4+ T-cell depletion. The staging systems were applied to 386 HIV-infected men in the San Francisco Men's Health Study cohort who did not have AIDS at the baseline examination. After 48-56 months of follow-up the cumulative incidence of AIDS and the cumulative mortality by stage was determined for each staging. Unlike the other systems, the WRSC could not classify a substantial proportion of HIV-infected men (51.9%). The WRSC and ISS include one or more stages which did not appear to be associated with a prognosis substantially different from that of adjacent stages. The simplified staging system based on CD4+ T-cell depletion and oral disease may be the most effective of the systems studied. A more complete understanding of the pathophysiology during the evolution of HIV infection will be required to define a more detailed staging of this disease.