Highly Active Antiretroviral Therapy Research Articles

The Crosstalk Between HIV-TB Co-Infection and Associated Resistance in the Indian Population

Extensive research on tuberculosis (TB) and HIV co-infection reveals the diverse prevalence and co-epidemic patterns across populations, necessitating tailored public health strategies. Co-infection is bidirectional; individuals with HIV are more susceptible to TB, and vice versa. Antiretroviral therapy (ART) and antituberculosis treatment (ATT) are critical for managing these conditions, but pose risks due to drug–pathogen and drug–drug interactions, potentially leading to immune reconstitution inflammatory syndrome (IRIS) in patients with HIV/AIDS. IRIS, often triggered by highly active antiretroviral therapy (HAART), can exacerbate HIV progression, increase drug resistance, and deteriorate patients’ quality of life. Approximately one-third of the global population with HIV is also infected with TB, with extensive drug-resistant (XDR) and multidrug-resistant (MDR) strains posing significant challenges. Latent TB infection (LTBI) further complicates the scenario, as it can progress to active TB, particularly in individuals with both conditions. The global and Indian mortality rates for TB-HIV co-infection remain high, emphasizing the need for new strategies. Additionally, unreported cases and inadequate post-treatment monitoring contribute to the high mortality rate, particularly among patients with LTBI. The complexity of managing HIV-TB co-infection, especially with LTBI, underscores the urgency of addressing these challenges to improve the outcomes for the affected populations.

Pathophysiology of Adipose Tissue Macrophages indicating a potential reservoir site for HIV infection that might be troublesome to eradicate HIV-1

Human Immunodeficiency Virus Type 1 (HIV-1) is a condition that affects over 60 million people worldwide. Viral infection can be controlled using highly active antiretroviral therapy (HAART) to suppress HIV-1 replication and hinder disease progression, but viremia quickly rebounds following HAART interruption. It is highly likely that the persistence of virus occurs predominantly in latently infected CD4+ T cells, a new strategy to eradicate HIV-1. Previously it has been shown that the viral reservoir is seeded rapidly following the initial infection of rhesus macaques with SIV, even before the establishment of a systemic infection, so destroying this reservoir may be vital to the effective clearance of HIV. We reasoned that long-lived tissue macrophages contribute significantly to the SIV/HIV reservoir, such as those that may be found in adipose tissue. Mediscope 2024;11(2): 68-72

Immuno-hematological parameters among adult HIV patients before and after initiation of Dolutegravir based antiretroviral therapy, Addis Ababa, Ethiopia.

Immuno-hematological abnormalities are common among HIV infected individuals as well as patients with highly active antiretroviral therapy (HAART). However, the immuno-hematological outcome of Dolutegravir based antiretroviral therapy (ART) usage is not well investigated. To assess hematological and immunological parameters among adult HIV patients before and after initiation of Dolutegravir based ART regimen at St. Peter Specialized Hospital, Addis Ababa, Ethiopia. A cross-sectional study was conducted from May to July 2021 at St. Peter Specialized Hospital among adult HIV patients. A total of 422 HIV patients on Dolutegravir based ART (combination of Dolutegravir/lamivudine/tenofovir disoproxil fumarate (DTG/3TC/TDF)) for a minimum of 3 months were selected using convenient sampling methods. Socio-demographic as well as clinical data of the participants was obtained using pre-tested structured questionnaires and a review of medical records. Hematological parameters such as CBC was obtained using Beckman coulter automated hematology analyzer and immunological parameters such as CD4 count were determined using BD FACS presto. Statistical analysis of the data was done using SPSS version 21. Paired t-test was used to compare dependent variables before and after initiation of the new HAART and binary logistic regression was used to determine predictors of immuno-hematological abnormalities. P-value < 0.05 was considered as statistically significant. Of 422 adult HIV patients, about 273(64.7%) were females. The mean age of study participants was 42.2 years (±10.4SD). The mean white blood cell (WBC) count, red blood cell (RBC) count, hemoglobin (Hb), platelet distribution width (PDW), CD4 count, as well as lymphocyte percentage, neutrophil percentage, and platelet counts (PLT) were increased significantly(P<0.05) after 3 months of the Dolutegravir based therapy. While, red cell distribution width (RDW) and mean cell hemoglobin (MCH) were decreased (P<0.05) after the treatment. Other hematological parameters such as mean cell volume (MCV), hematocrit (HCT), mean cell hemoglobin concentration (MCHC), mean platelet volume (MPV) and platelet distribution width (PDW) showed no significant change. On the other hand, the most common hematological abnormalities identified after the new HAART were anemia (12.1%); followed by Leucopenia (11.3%), neutropenia (6%), and thrombocytopenia (4%). Anemia was associated with female sex (AOR = 7.8, 95% CI: 1.9-32.2, P<0.005) and WHO clinical stage III/IV (AOR = 16, 95% CI: 10.63-66.46, P<0.01). There was a significant change in certain immuno-hematological parameters such as WBC count, RBC count, PLT count, Hb, PDW, CD4 count, lymphocyte and neutrophil percentage after initiation of the Dolutegravir based therapy. Anemia was the most common hematological abnormality. Further studies are required to fully comprehend the outcome of the new treatment regimen on immuno-hematological parameters.

Evaluation of Right Ventricular Diastolic Function among HIV-1-Infected Patients on Highly Active Antiretroviral Therapy and its Relationship with CD4 Cell Count and Viral Load

Abstract Context: With the introduction of highly active antiretroviral therapy, human immunodeficiency virus (HIV) patients live longer and therefore develop complications such as cardiovascular diseases. The prevalence of left ventricular diastolic dysfunction among HIV-infected patients ranges from 2.7% to 64%. Data on right ventricular diastolic function among HIV-infected patients in our region of northeastern Nigeria are lacking. Aims: We therefore assessed right ventricular diastolic function among HIV-infected patients on highly active antiretroviral therapy (HAART). Materials and Methods: This cross-sectional study was conducted among HIV-infected patients receiving HAART at the Federal Medical Centre Nguru, Yobe State, Northeastern Nigeria. Tricuspid flow E/A ratio, right ventricular deceleration time, and tissue Doppler E/e’ waves were used to assess the right ventricular diastolic function. Results: One hundred and seven subjects were recruited into the study comprising 70 (65.4%) females and 37 (34.6%) males. The prevalence of right ventricular diastolic dysfunction is 12.15%. CD4 cell count correlated positively with right ventricular deceleration time and negatively with tricuspid E/A ratio. Viral load correlated positively with the tricuspid E/A ratio and negatively with the tricuspid E/e ratio and right ventricular deceleration time. Conclusion: Right ventricular diastolic dysfunction is not uncommon among HIV-infected patients in northeastern Nigeria; its prevalence was found to be 12.15%, and there was a significant positive correlation between right ventricular deceleration time and CD4 cell count and a significant negative correlation between right ventricular deceleration time and viral load, suggesting that lower CD4 cell count and higher viral load are associated with worsening right ventricular diastolic function.

Current Nanotechnological Strategies for Delivery of Anti-Retroviral Drugs: Overview and Future Prospects

Abstract: Globally, over forty million people are living with Human Immunodeficiency Viral (HIV) infections. Highly Active Antiretroviral Therapy (HAART) consists of two or three Antiretroviral (ARV) drugs and has been used for more than a decade to prolong the life of AIDS-diagnosed patients. The persistent use of HAART is essential for effectively suppressing HIV replication. Frequent use of multiple medications at relatively high dosages is a major reason for patient noncompliance and an obstacle to achieving efficient pharmacological treatment. Despite strict compliance with the HAART regimen, the eradication of HIV from the host remains unattainable. Anatomical and Intracellular viral reservoirs are responsible for persistent infection. Elimination of the virus from these reservoirs is critical for successful long-term therapy. Therefore, innovative approaches are required to design safe and effective therapies. Nanotechnology has revolutionized HIV drug delivery by addressing key challenges, including improving drug solubility, targeting specific cells, extending drug release, protecting drugs from degradation, overcoming biological barriers, enabling combination therapy, and enhancing vaccine delivery. Several nanocarrier systems, such as dendrimers, nanoemulsions, liposomes, solid nanoparticles (SLNs), and nanostructured lipid carriers, have been proposed to treat HIV infection. Additionally, nanosuspensions of antiretroviral drugs offer promising strategies for improving treatment outcomes. While these advancements have significantly improved HIV management strategies, challenges remain, including unexpected toxicity, avoiding harmful biological interactions, and costs associated with the large-scale production of nanopharmaceuticals.

A young male patient with cardiomyopathy associated with human immunodeficiency virus infection in the era of highly active antiretroviral therapy

Background: Cardiomyopathy in young people, especially those associated with HIV infection, has been reduced since the era of Highly Active Antiretroviral Therapy (HAART). In the era of post-HAART, manifestations of human immunodeficiency virus (HIV)-associated cardiomyopathy with impaired left ventricular (LV) systolic function are approximately about 1-3% of HIV-infected people. In this case, we presented how to diagnose and appropriately manage such a patient. Case Illustration: A 27-year-old male patient who works as a health worker came to the emergency room with complaints of shortness of breath; it worsened in the last 2 weeks. He got vital signs: blood pressure 97/60 mmHg, heart rate 118 bpm, respiratory rate 23 tpm, and oxygen saturation 99 % with oxygen supplementation of 8 lpm. Risk factors in patients such as smoking, family history, hypertension, diabetes mellitus, and dyslipidemia were denied. He was diagnosed with HIV on (antiretroviral therapy) ART 3 years ago with risk factors for free sex without protection. The last CD4 value was 796 cells/ul (normal value 637 – 1485). The echocardiography showed all chamber dilatation, global hypokinetic, and a significant decrease in LV systolic function (LVEF 16%). Laboratory examination showed an increase of N-terminal prohormone of brain natriuretic peptide (NT-proBNP) into 6824 pg/mL (normal value &lt;85.8). It was then treated by optimizing HF therapy continue HIV therapy. Conclusion: In HIV patients who have fallen into heart failure, a proper diagnosis using relevant tools could be a reference for clinicians to make the right decision. Prompt treatment combination of optimal HF therapy and HIV therapy are becoming the keys to the treatment. Keyword: antiretroviral, cardiomyopathy, heart failure, human immunodeficiency virus

Thrombus aspiration in people living with HIV- a night mare for interventionist

Abstract Background Cardiovascular disease, particularly atherosclerosis, and its complications are a growing cause of morbidity and mortality among individuals living with human immunodeficiency virus (HIV) in the post-antiretroviral therapy era. The role of thrombus aspiration combined with primary percutaneous coronary intervention (PCI) in ST-segment elevation myocardial infarction (STEMI) within this population remains contentious. While PCI is the preferred strategy for immediate revascularization in acute STEMI, challenges persist, with about 30% of patients experiencing persistent chest pain and ST-segment elevation despite achieving TIMI III flow in the culprit vessel. Methods We conducted a prospective observational study spanning from January 2015 to September 2023, involving ten consecutive HIV-infected patients presenting with STEMI to our acute coronary care unit. The study encompassed an analysis of baseline clinical characteristics, response to fibrinolytic therapy, angiographic findings, thrombus aspiration using the Export Aspiration Catheter, and the outcomes of percutaneous coronary intervention (PCI). Patients were closely monitored for in-hospital outcomes and followed up for five years, during which they received adjuvant highly active antiretroviral therapy (HAART). Results The mean age of the patients was 46 years, lower than their uninfected counterparts. Most patients presented with a lower Killip class, indicating favorable outcomes. CD4 count distribution showed variability, with ten patients undergoing rescue angioplasty with thrombus aspiration using the Export Catheter. The cohort was followed for five years, receiving consistent HAART therapy. Conclusion HIV-associated atherosclerosis presents a considerable health burden, characterized by distinctive non-calcified and inflammatory plaques vulnerable to rupture. Thrombus aspiration during PCI emerged as a valuable strategy, reducing thrombotic burden and contributing to improved clinical outcomes in people living with HIV.

The Impact of Antiretroviral Therapy on Birth Outcomes: A Retrospective Cohort Study

Objective: This study aimed to evaluate the impact of highly active antiretroviral therapy (HAART) on pregnancy outcomes at a major tertiary hospital in Abuja, Nigeria. Design: A cohort study was conducted. Methods: HIV-infected pregnant women who initiated HAART during pregnancy for the prevention of mother-to-child transmission (pMTCT) were recruited, alongside a randomly selected group of HIV-uninfected pregnant women. Results: A total of 489 pregnant women participated, including 237 HIV-infected and 252 HIV-uninfected women. HAART initiation during pregnancy was significantly associated with higher mean birth weights (p = 0.0007). While there were 30 cases of low birth weight in the HIV-infected group compared to 21 in the HIV-uninfected group, HAART was not significantly associated with low birth weight (OR 1.59, p = 0.1182). There were 6 stillbirths in the HIV-infected group and 5 in the uninfected group, with no significant association between HIV status and stillbirth (OR 1.28, p = 0.6836). However, 29 preterm deliveries occurred in the HIV-infected group compared to 8 in the uninfected group, showing a strong association between HIV infection and preterm deliveries despite HAART initiation (OR 4.25, p = 0.0002). Conclusion: HIV-infected women receiving HAART during pregnancy have a significantly reduced risk of low birth weight but face an increased risk of preterm delivery.

In silico drug repurposing approach to predict most effective HAART for HIV drug resistance variants prevalent in the Indian HIV-positive population.

HIV epidemics still exist as a major global public health burden, especially in middle- and low-income countries. Given the lack of approved vaccines, antiretroviral therapy (ART) remains the primary approach to reduce the mortality and morbidity linked to this disease. Effective treatment for HIV-1 requires the simultaneous administration of multiple drugs. However, the virus can show resistance to antiretroviral drugs, resulting in treatment failure. Therefore, this study focused on assessing the prevalence of mutations within the Indian HIV-positive population. After assessing the data, we intended to identify the most effective highly active ART (HAART) regimens for individuals with drug-resistant variants. Furthermore, our analysis revealed a spectrum of HIV mutations, with varying effects on protein stability. The significance of this analysis lies in its potential to optimize HAART selection for HIV-positive individuals by accounting for both prevalence and stability-altering mutations. By considering mutation effects on protein stability, we can modify treatment regimens, increasing the likelihood of therapy success and diminishing the risk of resistance. Moreover, this study contributes to the broader field of drug repurposing, offering insights into the rational design of antiretroviral therapies.

Complete renal response of IgA vasculitis with steroid and mycophenolate mofetil in an adult HIV patient.

IgA vasculitis in adult HIV patients is rare and not well understood. Data on treatment of IgA vasculitis associated with HIV is sparse and limited to case reports. Highly active antiretroviral therapy (HAART) is the mainstay therapy for inducing remission. We report a case of a 41-year old HIV patient who presented with palpable purpura, melaena and oedema and was diagnosed with IgA vasculitis with severe renal (crescentic glomerulonephritis), gastrointestinal and skin involvement. He was treated with immunosuppressive drugs and HAART which led to remission of disease. This case is unusual due to the presence of crescentic glomerulopathy and the requirement of immunosuppression for remission induction.

Analysis of ICAM-1 rs3093030, VCAM-1 rs3783605, and E-Selectin rs1805193 Polymorphisms in African Women Living with HIV and Preeclampsia.

Intercellular adhesion molecule-1 (ICAM-1), vascular adhesion molecule-1 (VCAM-1), and E-selectin are cell adhesion molecules that play a significant role in inflammation and are implicated in the pathophysiology of preeclampsia development and HIV infection. More specifically, the immune expression of ICAM-1, VCAM-1, and E-selectin within cyto- and syncytiotrophoblast cells are dysregulated in preeclampsia, indicating their role in defective placentation. This study investigates the associations of ICAM-1, VCAM-1, and E-selectin gene variants (rs3093030, rs3783605, and rs1805193, respectively) with preeclampsia comorbid with HIV infection in women of African ancestry. It also examines the susceptibility to preeclampsia development and the effect of highly active antiretroviral therapy (HAART). A total of 405 women were enrolled in this study. Out of these women, 204 were preeclamptic and 201 were normotensive. Clinical characteristics were maternal age, weight, blood pressure (systolic and diastolic), and gestational age. Whole blood was collected, DNA was extracted, and genotyping of the ICAM-1 (rs3093030 C>T), VCAM-1(rs3783605 A>G), and E-selectin (rs1805193 A>C) gene polymorphisms was performed. Comparisons were made using the Chi-squared test. Our results demonstrated that preeclamptic women exhibited a higher frequency of analyzed variants, in contrast to those with the duality of preeclampsia and HIV infection. Additionally, the C allele of the ICAM-1 (rs3093030 C>T) and G allele of the VCAM-1 (rs3783605 A>G) genes were found to have a greater role in the co-morbidity and may be considered as a risk factor for preeclampsia development in women of African ancestry. In contrast, the SNP of rs1805193 of the E-selectin gene indicated that A>C was only significantly associated with HIV infection and not with preeclampsia. These findings highlight a strong association of the rs3093030 SNP of the ICAM-1 gene and of the VCAM-1 rs3783605 gene with the development of preeclampsia, indicating their role in the defective trophoblast invasion of preeclampsia. Sub-group analysis further reveals an association of the AA genotype with late-onset preeclampsia, a less severe form of disease indicating differing genetic predispositions between early and late-onset forms.

Long-Term Resolution of HIV-Associated Nephropathy (HIVAN) after Treatment with Highly Active Antiretroviral Therapy (HAART)

Long-Term Resolution of HIV-Associated Nephropathy (HIVAN) after Treatment with Highly Active Antiretroviral Therapy (HAART)

Clinical efficacy and safety of new compound single tablet antiviral drugs in the treatment of HIV/AIDS

AimsGenvoya, Biktarvy and Dovato are novel single-tablet antiretroviral therapy(ART). The aim of this study is to explore the therapeutic effects of these novel drugs on HIV/AIDS. Main methodsThis retrospective cohort study, conducted at a single center, included a total of 200 HIV-treated patients who transitioned to these new antiretroviral drugs from July 2021 to August 2023. Data were extracted from electronic medical records at Ditan Hospital. The Genvoya group comprised 22 patients, and all subsequent switches in this group were to Biktarvy. The primary HAART group consisted of 178 patients initially treated with a first-line triple Highly Active Antiretroviral Therapy (HAART) regimen during the same period. This group was further subdivided into HAART+Dovato, HAART+Biktarvy, and HAART+Genvoya groups based on the switching regimen. The primary outcomes focused on changes in viral load and immune efficacy, while secondary safety indicators included blood/liver function, lipid parameters, renal function, blood glucose, blood uric acid, etc. Key findingsThe viral suppression rate was 100 % after the drug change treatment, and CD4+ T cell counts increased significantly across all four groups. Over the 6-month treatment period, there were increases in creatinine (Cr), low-density lipoprotein (LDL), high-density lipoprotein (HDL), erythrocyte count, and glomerular filtration rate (eGFR). Conversely, Alanine transaminase (ALT), Aspartate aminotransferase (AST), C-reactive protein (CRP), albumin (ALB), and blood glucose (Glu) levels decreased. SignificanceGenvoya, Biktarvy and Dovato are recommended for the treatment of HIV/AIDS and have a good safety profile.

Level of Cardiovascular Disease Risk and Associated Factors among Clients on Highly Active Antiretroviral Therapy in Vihiga County, Kenya

Context: HIV/AIDS is still a public health concern globally, especially in sub-Saharan Africa and Kenya. HIV-positive clients are initiated on highly active antiretroviral therapy (HAART) to reduce the multiplication of HIV and improve their immunity. These clients are at an increased cardiovascular disease risk due to a complex interplay of factors, including traditional cardiovascular risk factors such as smoking cigarettes, obesity due to inactivity, and diabetes. Aim: This study sought to determine the level of cardiovascular disease (CVD) risk factors among people living with HIV (PLHIV) on highly active antiretroviral therapy (HAART) in Vihiga County, Kenya. Methods: The study employed a cross-sectional survey design to report baseline survey data for an interventional study on the level of CVD risk factors. The study involved a systematic sample of 211 patients on HAART in six health facilities purposively selected from Vihiga County. Data was collected using the WHO STEPWISE questionnaire from six comprehensive care clinics in Vihiga County from March to July 2022. The World Health Organization-International Society of Hypertension (WHO-ISH) tool AFRI E CHART was used to estimate the cardiovascular risk. Results: The majority (96.68%) of PLWHIV on HAART in Vihiga county had low overall cardiovascular risk as predicted WHO/ISH score. Age (OR = 1.199, 95% CI [1.031, 1.394], p = 0.018) and smoking status (OR = 0.115, 95% CI [0.024, 0.558], p = 0.007) exhibited a significant association with the level of cardiovascular risk. Conclusion: The majority of PLHIV have a low estimated CVD risk. There is a need to prioritize weight management in HIV care, integrating healthy lifestyle behaviors and nutritional support while conducting regular cardiovascular risk assessments, focusing on modifiable factors like smoking. Age-specific interventions can also help mitigate the risk across the different age groups.

Effect of highly-active antiretroviral therapy on neuroendocrine regulation of immunogenesis in HIV-infected children

Comparative assay has been made against the parameters of the immune and endocrine systems in 84 HIV-infected children born from HIV-infected mothers. One group of analyzed children (36 patients) did not receive highly-active antiretroviral therapy. Another group (48 patients) received different variants of highly-active antiretroviral therapy. Children aged from 1 to 182 months were examined. Venous blood samples taken from young patients were used to determine leukocyte blood composition considering the relative (%) and absolute number of blood cell counts. Hormone concentration was determined concurrently. CD-molecule expression by mononuclear cells was registered using flow cytofluorimeter. Plasma viral load in HIV-infected children was quantitatively detected with RT-PCR. Statistically significant lowering in the levels of free thyroxin, cortisol and progesterone was observed in children against a background of highly-active antiretroviral therapy as compared to those without HAART use. Correlation assay between the hormone level and the immunological parameters in children not receiving the antiretroviral preparations revealed marked positive correlations among the somatotropic hormone level and CD3+, CD4+ and CD8+ absolute numbers. Similar positive correlation with absolute T-subset number was found against free T4. The progesterone level also positively correlated with relative CD3+ and CD8+ numbers and showed negative correlation with absolute CD4+ amount. There is another positive correlation with relative T-subset number against the dehydroepiandrosterone level in the group of children without antiretroviral preparation therapy. As for HIV-infected group of children, against a background of highly-active antiretroviral therapy, the results of correlation assay between the hormone concentrations and cell parameters were found to significantly vary. There were observed positive correlations between the levels of cortisol and CD3+ (%), cortisol and CD8+ (%), estradiol and CD4/CD8, progesterone and absolute CD8+ number. As with children not receiving the antiretroviral preparations marked positive relation was revealed between the concentration of free thyroxin and absolute values of CD4+. Negative correlations were recorded between the estradiol level and the relative CD3+ numbers. Against a background of applying the antiretroviral preparations the correlation assay conducted between the viral RNA concentration (lg of copy number of mRNA/ml) and analyzed endocrinological parameters was found to have marked positive correlation with HIV concentration demonstrated by estradiol and testosterone. During the antiretroviral therapy, however, the negative correlation between the thyrotropin level and lg concentration of viral RNA was observed. Analytical results of correlation among the viral RNA concentration (lg copy number of mRNA/ml) and analyzed immunological parameters in this group of children evidence for specific ‘normalization’ due to highly-active antiretroviral therapy as the only positive correlation with virus concentration was detected for CD4+T subsets. Therefore, the alteration in endocrine system state in children born from HIV-infected mothers could be of great significance while monitoring the systemic regulation of the immunogenesis.

Prevalence of psychiatric comorbidities among adult out-patients living with HIV/AIDS in a tertiary care center, North-Central Nigeria: a cross-sectional study

BackgroundPsychiatric disorders had been reported with higher prevalence among people living with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS), [PLWHA] than the general population and its presence could confer poorer prognosis on infected individuals. However, there is limited research on the above subject matter in the North-Central part of Nigeria. Thus, this study aimed to determine the prevalence of common psychiatric disorders (CPD) among adult out-patients PLWHA at the University of Ilorin Teaching Hospital (UITH), Ilorin, North-Central Nigeria.MethodsIt was a hospital-based descriptive cross-sectional study, conducted among 363 respondents attending the UITH Highly Active Antiretroviral Therapy (HAART) clinic between March and May 2019. Interviewer-administered questionnaires were used to collect data. Mini International Neuropsychiatric Interview (MINI) was used to assess the prevalence of CPD among respondents. Data were analysed using the Statistical Package for Social Sciences version 21 and p value of < 0.05 was taken as statistically significant.ResultsThe prevalence of depression was 24.5%, anxiety disorder (AD) was 16.8% and alcohol use disorder (AUD) was 0.6%. Respondents from the extended family type were more depressed 70.4% and about half 43.3% of the nuclear family had AD while a 1.6% prevalence of AUD was found among the nuclear family. The association was statistically significant with a p value of 0.001.ConclusionCPD exist among PLWHA with increasing prevalence therefore screening for these disorders should be encouraged during routine management of PLWHA to improve their psychological well-being.

The risk of dyslipidemia on PLHIV associated with different antiretroviral regimens in Huzhou

Background Dyslipidemia is increasingly common in people living with HIV (PLHIV), thereby increasing the risk of cardiovascular events and diminishing the quality of life for these individuals. The study of blood lipid metabolism of PLHIV has great clinical significance in predicting the risk of cardiovascular disease. Therefore, this study aims to examine the blood lipid metabolism status of HIV-infected patients in Huzhou before and after receiving highly active antiretroviral therapy (HAART) and to explore the impact of different HAART regimens on dyslipidemia. Method PLHIV confirmed in Huzhou from June 2010 to June 2022 was included. The baseline characteristics and clinical data during the follow-up period were collected, including some blood lipid indicators (total cholesterol and triglycerides) and HAART regimens. A multivariate logistic regression model and the generalized estimating equation model were used to analyze the independent effects of treatment regimens on the risk of dyslipidemia. Result The overall prevalence of dyslipidemia among PLHIV after HAART was 70.11%. PLHIV receiving lamivudine (3TC) + efavirenz (EFV) + zidovudine (AZT) had a higher prevalence of dyslipidemia compared to those receiving 3TC+EFV+tenofovir disoproxil fumarate (TDF). In a logistic analysis adjusted for important covariates such as BMI, age, diabetes status, etc., we found that the risks of dyslipidemia were higher with 3TC+EFV+AZT (dyslipidemia: odds ratio [OR] = 2.09, 95% confidence interval [Cl]: 1.28–3.41; TG ≥1.7: OR = 2.40, 95%Cl:1.50–3.84) than with 3TC+EFV+TDF. Furthermore, on PLHIV that was matched 1:1 by the HAART regimens, the results of the generalized estimation equation again showed that 3TC+EFV+AZT (TG ≥1.7: OR = 1.84, 95%Cl: 1.10–3.07) is higher for the risk of marginal elevations of TG than 3TC+EFV+TDF. Conclusion The prevalence of dyslipidemia varies according to different antiretroviral regimens. Using both horizontal and longitudinal data, we have repeatedly demonstrated that AZT has a more adverse effect on blood lipids than TDF from two perspectives. Therefore, we recommend caution in using the 3TC+EFV+AZT regimen for people at clinical risk of co-occurring cardiovascular disease.

New Therapies and Strategies to Curb HIV Infections with a Focus on Macrophages and Reservoirs.

More than 80 million people worldwide have been infected with the human immunodeficiency virus (HIV). There are now approximately 39 million individuals living with HIV/acquired immunodeficiency syndrome (AIDS). Although treatments against HIV infection are available, AIDS remains a serious disease. Combination antiretroviral therapy (cART), also known as highly active antiretroviral therapy (HAART), consists of treatment with a combination of several antiretroviral drugs that block multiple stages in the virus replication cycle. However, the increasing usage of cART is inevitably associated with the emergence of HIV drug resistance. In addition, the development of persistent cellular reservoirs of latent HIV is a critical obstacle to viral eradication since viral rebound takes place once anti-retroviral therapy (ART) is interrupted. Thus, several efforts are being applied to new generations of drugs, vaccines and new types of cART. In this review, we summarize the antiviral therapies used for the treatment of HIV/AIDS, both as individual agents and as combination therapies, and highlight the role of both macrophages and HIV cellular reservoirs and the most recent clinical studies related to this disease.

Highly active antiretroviral therapy adherence among HIV-POSITIVE women in Southern Ethiopia.

Adherence to Highly Active Antiretroviral Therapy (HAART) medication is the major predictor of HIV/AIDS treatment success. Poor adherence to HAART creates the risk of transmitting HIV, deteriorating health conditions, treatment failure, increased occurrences of drug-resistant HIV, morbidity and mortality. The objective of the study was to explore and describe factors influencing HAART adherence among HIV-positive women in Southern Ethiopia. A hospital-based descriptive cross-sectional survey was used among 220 randomly selected respondents. Data was collected with a structured interview guide after each respondent had given consent to take part in the study. The collected data was entered into and analyzed by using the Statistical Package for Social Sciences (SPSS) software program version 27. The level of self-reported adherence (measured by dose) to HAART in the past 30days was found to be 82.7%. In multivariate analysis, the divorced/separated HIV-positive women had poor adherence to their HAART medication as compared to those who were married [AOR: 2.94, 95% CI: (1.02-8.44)]. Respondents who used reminders in their medication were 75% less likely to be poorly adherent to their HAART medication than those who did not use reminders [AOR: 0.25, 95% CI: (0.06-0.97)]. Those who self-reported depression, perceived stigma, and low perceived susceptibility had poor adherence to their HAART than those who did not report depression, perceived stigma, and low perceived susceptibility [AOR:2.34, 95% CI: (1.01-5.42)], [AOR:2.37, 95% CI: (1.06-5.34)], and [AOR: 4.1, 95% CI: (1.53-11.1)] respectively. HIV-positive women who self-reported low perceived severity were poorly adherent to HAART than those who self-reported high perceived severity [AOR: 2.92, 95% CI: (1.14-7.47)]. Factors including being divorced/separated, not using reminders, depression, perceived stigma, perceived susceptibility, and perceived severity negatively impact HIV-positive women's adherence to HAART.

A febrile thrombocytopenia is it always dengue

Dengue is tropic infectious disease which concentrated in tropical and subtropical regions. Human immunodeficiency virus (HIV) is an infection that attacks the body’s immune system. A 29-year-old female admitted to hospital with history of febrile thrombocytopenia with HIV infection on highly active anti-retroviral therapy (HAART). First, the patient was assessed with dengue hemorrhagic fever, but anti-dengue immunoglobulin G (IgG) and IgM were negative. Febrile thrombocytopenia occurs not only in dengue, but also in other conditions. Person with HIV experience a wide range of hematological abnormalities, the most prevalent of which are cytopenias, which can be anemia, leukopenia, thrombocytopenia, or a combination of these. Fever and thrombocytopenia are closely related to dengue infection, but this condition can also be caused by various factors.