HIV Group Research Articles

HIV and stigma in the healthcare setting.

People living with HIV (PLHIV) continue to endure stigma and discrimination in the context of health care despite global improvements in health outcomes. HIV stigma persists within healthcare settings, including dental settings, manifesting itself in myriad, intersecting ways, and has been shown to be damaging in the healthcare setting. Stigmatising practices may include excessive personal protective equipment, delaying the provision of care or unnecessary referral of PLHIV to specialist services in order to access care. The workshop entitled "HIV and Stigma in the Healthcare Setting" provided an overview of the concept and manifestation of HIV stigma and explored the disproportionate burden it places on groups that face additional disadvantages in accessing care. The final part of the workshop concluded with a review of institutional and community-based interventions that worked to reduce HIV stigma and group discussion of the ways in which these strategies might be adapted to the dental workforce.

Near normalization of peripheral blood markers in HIV-infected patients on long-term suppressive antiretroviral therapy: a case-control study.

To explore the differences in peripheral blood markers between HIV well controlled patients on long-term suppressive antiretroviral therapy (HIV-group) and age-matched healthy controls, to evaluate the benefits of virological suppression in those patients. We performed a case-control study in 22 individuals in the HIV-group and 14 in the healthy control-group. RNA-seq analysis was performed from peripheral blood mononuclear cells. Peripheral blood T-cell subsets were evaluated by flow cytometry and plasma biomarkers by immunoassays. All P values were corrected by the false discovery rate (q values). Only the serine/arginine repetitive matrix 4 gene, which is involved in alternative RNA splicing events, was differentially expressed between HIV and healthy control groups (q value ≤0.05 and fold-change ≥2). However, 147 differentially expressed genes were found with a more relaxed threshold (P value ≤0.05 and fold-change ≥1.5), of which 67 genes with values of variable importance in projection at least one were selected for pathway analysis. We found that six ribosomal genes represented significant ribosome-related pathways, all of them downregulated in the HIV-group, which may be a strategy to facilitate viral production. T cells subset and plasma biomarkers did not show significant differences after false discovery rate correction (q value >0.05), but a noncorrected analysis showed higher values of regulatory CD4 T cells (CD4CD25CD127), MCP-1, and sVEGF-R1 in the HIV-group (P value ≤0.05). T-cell subsets, plasma biomarkers, and gene expression were close to normalization in HIV-infected patients on long-term suppressive combination antiretroviral therapy compared with healthy controls. However, residual alterations remain, mainly at the gene expression, which still reveals the impact of HIV infection in these patients.

Mitochondrial and Oxidative Impacts of Short and Long-term Administration of HAART on HIV Patients.

BackgroundThere may be a possible link between the use of HAART and oxidative stress-related mitochondrial dysfunction in HIV patients. We evaluated the mitochondrial and oxidative impacts of short and long-term administration of HAART on HIV patients attending the Enugu State University Teaching (ESUT) Hospital, Enugu, Nigeria following short and long-term therapy.Methods96 patients categorized into four groups of 24 individuals were recruited for the study. Group 1 comprised of age-matched, apparently healthy, sero-negative individuals (the No HIV group); group 2 consisted of HIV sero-positive individuals who had not started any form of treatment (the Treatment naïve group). Individuals in group 3 were known HIV patients on HAART for less than one year (Short-term treatment group), while group 4 comprised of HIV patients on HAART for more than one year (Long-term treatment group). All patients were aged between 18 to 60 years and attended the HIV clinic at the time of the study. Determination of total antioxidant status (TAS in nmol/l), malondialdehyde (MDA in mmol/l), CD4+ count in cells/μl, and genomic studies were all done using standard operative procedures.ResultsWe found that the long-term treatment group had significantly raised the levels of MDA, as well as significantly diminished TAS compared to the Short-term treatment and No HIV groups (P<0.05). In addition, there was significantly elevated variation in the copy number of mitochondrial genes (mtDNA: D-loop, ATPase 8, TRNALEUuur) in the long-term treatment group.ConclusionLong-term treatment with HAART increases oxidative stress and causes mitochondrial alterations in HIV patients.

HIV serostatus, inflammatory biomarkers and the frailty phenotype among older people in rural KwaZulu-Natal, South Africa

Objective: We compared the prevalence of frailty by HIV serostatus and related biomarkers to the modified frailty phenotype among older individuals in a rural population in South Africa. Methods: Questionnaire data were from a cohort of people living with HIV (PWH) on antiretroviral therapy (ART) and HIV-uninfected people aged 50 years and older sampled from the Africa Health Research Institute Demographic Health and Surveillance area in northern KwaZulu-Natal. The prevalence of frailty was compared using five categories: (1) physical activity; (2) mobility; (3) fatigue; (4) gait speed; and (5) grip strength, and assessed for demographic, clinical, and inflammatory correlates of frailty. Results: Among 614 individuals in the study, 384 (62.5%) were women. The median age at study enrolment was 64 years [Interquartile range (IQR) (58.6–72.0)]. 292 (47.6%) were PWH. 499 (81%) were classified as either pre-frail or frail. 43 (7%) were frail and HIV positive, 185 (30%) were pre-frail and HIV positive, 57 were frail and HIV negative and 214 (35%) were pre-frail and HIV negative. Frailty was similar for HIV negative and PWH (17.7% vs 14.7%, p = 0.72). Women were more likely to be frail (18.3% vs 13.04%, p = 0.16). The prevalence of frailty increased with age for both HIV groups. In the multivariable analysis, the odds of being frail were higher in those aged 70 years and above than those aged between 50 and 59 years (p < 0.001). Females were less likely to be pre-frail than males (p < 0.001). There was no association between any of the inflammatory biomarkers and frailty and pre-frailty. Conclusion: In this population, the prevalence of frailty is similar for PWH and people without HIV, but higher for women than men. These data suggest that the odds of developing frailty is similar for PWH over the age of 50 years, who survive into older age, as for people without HIV.

The Role of Forsis LSM (Fort De Kock Society in Social) for Reach The Risk Groups of HIV / AIDS (Case Study: LGBT And Penasun Group�s in The City of Padang)

One of the existing NGOs is FORSIS which is engaged in the grouping of HIV / AIDS risk groups to cope with the spread of HIV / AIDS in the city of Padang. The purpose of this study is to describe how the role of FORSIS in outreach groups at risk of HIV / AIDS in the city of Padang. The approach used in this research is a qualitative descriptive researcher, a technique used for data collection in interviews, observations, and document studies. In addition to the selection of informants is purposive sampling, which consists of informants who are considered to know about the role of FORSIS in outreach groups at risk of HIV / AIDS. The subjects in this research are Padang city community that is the board of FORSIS, LGBT group, caretaker of soul conscience, and LGBT with HIV. The results of this study are to describe the role of FORSIS in outreach groups at risk of HIV / AIDS. Prior to outreach there was a process planned for outreach. This NGO plays a role in improving community knowledge through socialization, then invites VCT to know the status of self so that can cope with the spread of viruses and NGOs also do cooperation with NGOs taratak soul heart to accompany PLWHA. It can be concluded that this FORSIS NGO plays an important role in providing counselling, inviting VCT and working with specific NGOs to assist in the prevention and transmission of HIV / AIDS.

Sustaining tuberculosis preventive therapy scale-up through direct supportive supervision.

Tuberculosis preventive therapy (TPT) is recommended for tuberculosis (TB) prevention among people living with HIV (PLHIV) and other high-risk groups. The Nigerian Military HIV Program embarked on TPT-specific 'direct supportive supervision' (DSS) in May 2018 to increase TPT initiation and completion rates. Interventional approaches included site visits to conduct root cause analysis, didactic teaching approach on the concepts of quality improvement and mentorship to address barriers. The DSS introduced TPT monitoring tools, sticker reminders on clients' folders, and bi-weekly data collection and review for decision making. TPT initiation increased from a monthly pre-intervention median of 323 clients to monthly medians of 2611 during the 'surge' and 1212 clients during the 'sustained' phases. Due to an isoniazid stock-out, a 'dip phase', with a median of 559 clients was recorded. Overall, 10 463 clients were started on TPT in fiscal year (FY) 2018 and 12 596 in FY2019, with an overall initiation rate of 79%. Completion rates were respectively 73% and 70% for FY2018 and FY2019. With the implementation of a tailored DSS, programmatic barriers to TPT were easily identified and quickly addressed to increase initiation and completion rates.

Liver Stiffness Hinders Normalization of Systemic Inflammation and Endothelial Activation after Hepatitis C Virus (HCV) Eradication in HIV/HCV Coinfected Patients.

Systemic inflammation, endothelial dysfunction and coagulopathy are of high clinical relevance in the management of people living with HIV (PLWH), and even more in patients coinfected with hepatitis C virus (HCV). It has been suggested a significant impact of HCV coinfection on these conditions. However, HCV can be eradicated in most patients with the new direct-acting antivirals (DAAs) therapy. We have analyzed the effect of HCV on systemic inflammation, endothelial activation and coagulopathy in PLWH and its evolution after HCV eradication with DAAs. Twenty-five HIV/HCV coinfected (HIV/HCV group), 25 HIV monoinfected (HIV group) and 20 healthy controls (HC) were included in the study. All patients were on ART and HIV suppressed. Levels of fourteen markers of systemic inflammation, endothelial activation and coagulopathy (IL-1ß, IL-6, IL-12p70, IL-8, TNFα, D-dimer, Eotaxin, IL-18, IP-10, monocyte chemotactic protein-1 (MCP-1), plasminogen activator inhibitor-1 (PAI-1), TNFα receptor 1 (TNFR1), vascular cell adhesion molecule 1 (VCAM-1) and intercellular adhesion molecule 1 (ICAM-1)) were measured on plasma at baseline and after DAAs-mediated HCV eradication. Non-parametric tests were used to establish inter/intra-group differences. At baseline, the HIV/HCV group showed increased levels of IL-18 (p = 0.028), IP-10 (p < 0.0001), VCAM-1 (p < 0.0001) and ICAM-1 (p = 0.045), compared to the HC and HIV groups, with the highest levels for IL18 and IP10 observed in HIV/HCV patients with increased liver stiffness (≥7.1 KPa). Eradication of HCV with DAAs-based therapy restored some but not all the evaluated parameters. VCAM-1 remained significantly increased compared to HC (p = 0.001), regardless of the level of basal liver stiffness in the HIV/HCV group, and IP-10 remained significantly increased only in the HIV/HCV group, with increased level of basal liver stiffness compared to the HC and to the HIV groups (p = 0.006 and p = 0.049, respectively). These data indicate that DAAs therapy in HIV/HCV co-infected patients and HCV eradication does not always lead to the normalization of systemic inflammation and endothelial dysfunction conditions, especially in cases with increased liver stiffness.

Increased risk of cervical dysplasia in females with autoimmune conditions-Results from an Australia database linkage study.

BackgroundAutoimmune conditions (AICs) and/or their treatment may alter risk of human papilloma virus (HPV) infection and females with AICs are therefore at an increased risk of cervical dysplasia. However, inclusion of these at-risk populations in cervical cancer screening and HPV-vaccination guidelines, are mostly lacking. This study aimed to determine the prevalence of cervical dysplasia in a wide range of AICs and compare that to HIV and immunocompetent controls to support the optimisation of cervical cancer preventive health measures.MethodsData linkage was used to match cervical screening episodes to emergency department records of females with AICs or HIV to immunocompetent controls over a 14-year period. The primary outcome was histologically confirmed high-grade cervical disease. Results, measured as rates by cytology and histology classification per 1,000 females screened, were analysed per disease group, and intergroup comparisons were performed.ResultsFemales with inflammatory bowel disease (2,683), psoriatic and enteropathic arthropathies (1,848), multiple sclerosis (MS) (1,426), rheumatoid arthritis (1,246), systemic lupus erythematosus and/or mixed connective tissue disease (SLE/MCTD) (702), HIV (44), and 985,383 immunocompetent controls were included. SLE/MCTD and HIV groups had greater rates of high-grade histological and cytological abnormalities compared to controls. Increased rates of low-grade cytological abnormalities were detected in all females with AICs, with the exception of the MS group.ConclusionsFemales with SLE/MCTD or HIV have increased rates of high-grade cervical abnormalities. The increased low-grade dysplasia rate seen in most females with AICs is consistent with increased HPV infection. These findings support expansion of cervical cancer preventative programs to include these at-risk females.

The Role of Forsis LSM (Fort De Kock Society in Social) for Reach The Risk Groups of HIV / AIDS (Case Study: LGBT And Penasun Group’s in The City of Padang)

The Role of Forsis LSM (Fort De Kock Society in Social) for Reach The Risk Groups of HIV / AIDS (Case Study: LGBT And Penasun Group’s in The City of Padang)

The long-term effect of human immunodeficiency virus infection on retinal microvasculature and the ganglion cell–inner plexiform layer: an OCT angiography study

To investigate the long-term effect of HIV infection on the ganglion cell-inner plexiform layer and retinal capillary network. This prospective, cross-sectional case-control study included 45 HIV-infected patients and 45 healthy individuals. Optical coherence tomography angiography (OCTA) was used for the assessment of macular, peripapillary retinal nerve fiber layer (RNFL) thicknesses, ganglion cell-inner plexiform layer, vessel density, perfusion density, and foveal avascular zone. The mean disease duration was 7.3 ± 1.9 years (range, 5-12 years) in the HIV group. The mean CD4 count (nadir) for all the patients was 147.09 ± 122 cells/mm3 and the mean RNA was 173.6 ± 913.8 copies/ml. No statistically significant difference was determined between the groups in respect of the average and foveal MT (p = 0.05). A significant difference was found between the two groups in respect of the mean VD and PD parameters (p < 0.05). Peripapillary PD was significantly decreased in the HIV group. There was a significant difference between the average and superior and inferior half-region of GC-IPL values. Using Pearson's correlation analysis, no significant correlation was determined between the duration of HIV infection and mean GC-IPL, MT and VD, and PD values (r - 0.223, p 0.141; r - 0.223, p 0.141; r - 0.169, p 0.268; r - 0.105, p 0.491; r - 0.095, p 0.535 respectively). The results of this study provide evidence of microvascular and neuroretinal loss in individuals with well-suppressed HIV infection, compared with healthy control subjects. OCTA is an important test for the screening of retinal microvascular changes over time in HIV-infected cases.

Comparative Diagnosis of Latent Tuberculosis Infection amongst HIV and Diabetic Patients Attending Tertiary Hospitals in Anambra State

Aims: The aim of this research work was to survey the epidemiology and diagnosis of Latent Tuberculosis Infection (LTBI) amongst HIV and Diabetic patients in Anambra state of Nigeria using Tuberculin Skin Test (TST) and Interferon Gamma Release Assay (IGRA).&#x0D; Study Design: This was a multicenter study covering three tertiary hospitals in Anambra State involving 480 adult HIV positive and Diabetic patients with 240 normal participants as control.&#x0D; Place and Duration of Study: This study conducted from February 2016 to April 2018 involved the general hospitals chosen from the three senatorial zones in the state. &#x0D; Methodology: IGRA using T spot TB as well as TST were done for all the participants. HIV screening, CD4 count and Fasting Blood Sugar were also done accordingly.&#x0D; Results: Overall prevalence of Latent Tuberculosis Infection (LTBI) was 24.4% and 22.5% for IGRA and TST respectively, of the two health groups, HIV group had 35% and 20% for IGRA and TST respectively in their overall prevalence, this was significant (P&lt;.05) compared with the controls which had 2.5% and 4% respectively to IGRA and TST. The diabetics group on the other hand had 13.8% and 25% for IGRA and TST respectively, this also was significant (P&lt;.05) in comparison to its control group with 1.6% each for both IGRA and TST. Out of the 480 patients, 74(15.4%) of them had concordant result, this was 63.2% of the total positive value in the two groups worked on while 43(8.95%) and 34(7%) patients constituted the discordant figures for IGRA and TST respectively.CD4 count was inversely proportional to the presence of LTBI amongst HIV patients using the TST method. Age and duration of illness were significantly associated with LTBI in diabetics (P&lt;.05). Participation rates were higher among males, though females recorded a non significant higher prevalence on the two test methods.&#x0D; Conclusion: There was a high prevalence of latent tuberculosis infection amongst HIV and Diabetic patients in Anambra State. IGRA and TST diagnostic results were not concordant with each other but IGRA appeared to be more specific than TST in diagnosing LTBI.

Peer education for HIV prevention among high-risk groups: a systematic review and meta-analysis

BackgroundPeer education has become a strategy for health promotion among high-risk groups for HIV infection worldwide. However, the extent to which peer education could have an impact on HIV prevention or the long-term effect of this impact is still unknown. This study thus quantifies the impact of peer education over time among high-risk HIV groups globally.MethodFollowing the PRISMA guidelines, a systematic review and meta-analysis was used to assess the effects and duration of peer education. A thorough literature search of PubMed, Web of Science, Embase and Cochrane Library was performed, and studies about peer education on high-risk HIV groups were reviewed. Pooled effects were calculated and the sources of heterogeneity were explored using meta-regression and subgroup analysis.ResultsA total of 60 articles with 96,484 subjects were identified, and peer education was associated with 36% decreased rates of HIV infection among overall high risk groups (OR: 0.64; 95%CI: 0.47–0.87). Peer education can promote HIV testing (OR = 3.19; 95%CI:2.13,4.79) and condom use (OR = 2.66, 95% CI: 2.11–3.36) while reduce equipment sharing (OR = 0.50; 95%CI:0.33,0.75) and unprotected sex (OR = 0.82; 95%CI: 0.72–0.94). Time trend analysis revealed that peer education had a consistent effect on behavior change for over 24 months and the different follow-up times were a source of heterogeneity.ConclusionOur study shows that peer education is an effective tool with long-term impact for behavior change among high-risk HIV groups worldwide. Low and middle-income countries are encouraged to conduct large-scale peer education.

Micronutrients, Metabolic Complications, and Inflammation in Ugandan Children With HIV.

Selenium, zinc, and chromium are essential micronutrients. Their alterations have been associated with HIV disease progression, metabolic complications, and mortality. This is a cross-sectional study in children with perinatally acquired HIV (PHIV, n = 57), HIV-exposed uninfected (HEU, n = 59), and HIV-unexposed uninfected (HIV-, n = 56) children aged 2 to 10 years old, age- and sex-matched, enrolled in Uganda. PHIV were on stable antiretroviral therapy (ART) with undetectable viral load. We measured plasma concentrations of selenium, zinc, and chromium as well as markers of systemic inflammation, monocyte activation, and gut integrity. Among PHIV children, 93% had viral load ≤20 copies/mL, median CD4 was 37%, and 77% were receiving a nonnucleotide reserve transcriptase regimen. Median age of all participants was 8 years and 55% were girls. Median selenium concentrations were higher in PHIV compared with the HEU and HIV groups (P < 0.001), 46% of children overall had low zinc status (P = 0.18 between groups). Higher selenium, but not chromium or zinc, was associated with lower IL6, sTNFRI and II, and higher beta d glucan, a marker of fungal translocation, zonulin, a marker of gut permeability, oxidized LDL and insulin resistance (P ≤ 0.01). In this cohort of PHIV on ART in Uganda, there is a high prevalence of low zinc status overall. Higher plasma selenium concentrations were associated with lower systemic inflammation and higher gut integrity markers. Although our findings do not support the use of micronutrient supplementation broadly for PHIV in Uganda, further studies are warranted to assess the role of selenium supplements in attenuating heightened inflammation.

Beyond Their HIV Status: the Occurrence of Multiple Health Risk Behavior Among Adolescents from a Rural Setting of Sub-Saharan Africa

BackgroundHealth risk behaviors during adolescence may cluster into patterns that might be predicted by specific factors, among which HIV may have an important role.MethodIn a cross-sectional study conducted between 2017 and 2018, clustering of HRB and its associated factors was investigated in rural Kenya among 588 adolescents (36% perinatally HIV infected; 28% perinatally HIV exposed but uninfected; and 36% HIV unexposed/uninfected). Latent class analysis of 22 behaviors followed by multinomial logistic regression were conducted. Four risk behavior classes were identified.ResultsNo significant differences were found in behavioral class membership across the three HIV groups (p = 0.366). The risk of membership to the higher risk behavioral classes relative to class 1 (the substance and drug abstinent low risk takers) increased with older adolescent age (p = 0.047), increased among adolescent who experienced mental distress (p < 0.001), and those who felt unsafe in their neighborhood (p < 0.002). Better working memory (p = 0.0037) was found to be protective.ConclusionThe results highlight a need to include screening and interventions for internalizing mental health problems and deficits in executive functioning, as well as steps to involve family members and communities to address psychosocial risk factors in adolescents in Kenya.

Clinical and Laboratory Characteristics of Herpes Zoster in Patients With HIV/AIDS and Those With Juvenile Systemic Lupus Erythematosus

HIV infection and juvenile systemic lupus erythematosus (jSLE) are risk factors for the development of herpes zoster (HZ) and its complications. Both diseases share similar immunologic aspects, such as immunodeficiency and immune activation. Therefore, our objective was to evaluate and compare the frequency and characteristics of HZ episodes in pediatric patients with HIV infection and jSLE. A retrospective cohort study was carried out with the evaluation of 2 pediatric cohorts: HIV patients who were followed from January 1987 to December 2014 and patients with jSLE followed up from January 1990 to December 2014 in outpatient clinics. Of the 190 HIV patients, 48 had HZ (25.3%), with 67 episodes; of the 92 patients with jSLE, 27 had HZ (29.3%), totaling 28 episodes. The median age at the first episode of HZ was higher in the jSLE than in the HIV group (8.9 vs. 12.5 years, respectively) (P = 0.020). HIV patients were more likely to have recurrent HZ (P = 0.025). In addition, there was a tendency for HIV patients to present with disseminated HZ more frequently (P = 0.060). Although the hospitalization rate was similar between groups, patients with jSLE received intravenous acyclovir more frequently (P = 0.014). When HIV non-immune reconstitution syndrome patients were compared with jSLE group, recurrence of HZ in HIV was the only significant difference between groups (P = 0.017). Patients with HIV had more recurrent HZ than patients with jSLE.

Nurses Role in Prevention of HIV/AIDS

Acquired immunodeficiency syndrome (AIDS) is a chronic, potentially life-threatening condition as per World Health Organization there are about 37.9 Million peoples living with AIDS/HIV in the world and out of which only 23.3 Million peoples accessing antiretroviral therapy but remaining are still not under treatment and such peoples may spread/transmit HIV more and rapid. Awareness is required among peoples living with HIV and high risk groups should consider on high priority. Nurses play key role in prevention of HIV/AIDS by significant functions such as health education to youths, high risk groups and eligible couples and prophylaxis. There is no treatment or vaccine not available to cure this syndrome, so for this deadly syndrome prevention is much better than cure is possible.

Clinical Assessment of Nutritional and Metabolic Status in HIV Outpatients

Background: After the World Health Organization’s first technical consultation on Nutrient Requirements for People Living with HIV/AIDS in Geneva, 2003, a lot of research questions that are considered crucial for enhancing our understanding of the interaction of nutrition and HIV infection were raised and until this moment, left unanswered. To gain a better understanding of HIV and nutrition, we implemented a comprehensive approach. The aim of our study was to assess the nutritional and metabolic status in order to enhance the provision of medical care to people living with HIV. Methods: 45 HIV patients and 32 healthy volunteers were enrolled in the study. Within the HIV group, 32 (71%) were male and 13 (29%) female. Only 7 (15%) were ART naïve. Overall their median age, CD4 count and viral load were 30 years (IQR: 28-40), 407 (IQR: 357-490) cells/mm3 and 500 (IQR: 0-1000) copies/ml, respectively. None of the participants in the HIV group had any active infection. Food intake by monthly dietary recall was determined. Body composition was measured using bioelectrical impedance analysis. The selected biochemical parameters were evaluated and the resting metabolic rates were calculated using indirect calorimetry to accurately understand the metabolism of participants. Results: Participants in the HIV group did not meet the recommended daily allowance level (RDA) of carbohydrate requirements. The fat-free mass significantly decreased in the HIV group (P &lt; 0.05). Resting energy expenditure was excessive in the HIV group compared to the control group (P &lt; 0.05). Values of urea nitrogen concentration, fat and protein oxidation rates in the HIV group significantly increased (P &lt; 0.01). The carbohydrate oxidation in the HIV group significantly decreased (P &lt; 0.01) Conclusions: The study reveals a catabolic status in the HIV group and suggests an adjustment in the nutrient RDA to compensate such status. Further investigation should be extended to vulnerable population group particularly children.

Higher levels of TNF and IL-4 cytokines and low miR-182 expression in visceral leishmaniasis-HIV co-infected patients.

The aim of the present study was to assess serum cytokine and miRNA expression in visceral leishmaniasis-HIV (VL-HIV) co-infection and HIV mono-infection. We analysed 113 serum samples from HIV patients in areas endemic for leishmaniasis. The diagnosis of VL was confirmed in 65 of these 113 samples. The VL-HIV and HIV groups presented significant differences regarding haemoglobin level (P<.0001), lymphocyte count (P=.0444), white blood cell count (P=.0108), weight loss (P=.0310), HIV load (P<.0001) and CD4+ T-lymphocytes count (P=.0003). Levels of IL-6 and IL-10, IFN-γ and IL-6, IFN-γ and IL-10, TNF and IL-2 were positively correlated in VL-HIV co-infection, indicating higher serum levels of TNF and IL-4 (P<.0001). In addition, miR-182 expression was found to be significantly higher in HIV (P=.009), miR-210 exhibited no statistically significant difference between groups, and nonexpression of miR-122 was found in both groups. Together, TNF, IL-4 and miR-182 may represent circulatory biomarkers of VL-HIV co-infection.

The use of statistical phylogenetics in virology

Molecular phylogenetics, particularly statistical phylogenetics, is widely used to solve the fundamental and applied problems in virology. Bayesian, or statistical, phylogenetic methods, which came into practice 10—15 years ago, markedly expanded the range of questions that can be answered based on analyzing nucleotide and amino acid sequences. An opportunity of using various evolution models allows inferring the chronology, geography and dynamics of the infection spreading. For example, analysis of globally distributed HIV group M by Bayesian methods demonstrated with a probability of 99% that the most recent common ancestor of these viruses existed in the surroundings of the city of Kinshasa (Democratic Republic of the Congo) in the early 1920s. Another study showed that H9N2 influenza virus most likely passed on to humans from wild ducks in Hong Kong in the late 1960s. In addition, using of the Bayesian analysis allows to evaluating the effect of measures taken on the development of the epidemic process. For example, it was shown retrospectively that the rate of hepatitis C virus infection cases in Egypt increased by several orders of magnitude in the mid-20th century. A sharp rise in new case rate is associated with the treatment for schistosomiasis by using non-sterile repeatedly used syringes. A set of Bayesian analysis methods has been applied in tens of thousands of researches describing various aspects of the occurrence and spread of infectious diseases in humans and animals. This was facilitated by the development and accessibility of software that implements these methods. The complexity of Bayesian phylogenetic methods imposes strict requirements on the data being analyzed. The correctness of the phylogenetic analysis data depends on various factors. For example, it is necessary to choose an evolutionary model that most adequately describes the studied objects. A mandatory step in formulating the results is the justification of the selected model. For viruses, the acquisition of genetic elements from other organisms is typical, therefore, the genomes even from closely related viruses may have non-homologous regions unsuitable for phylogenetic analysis. Another aspect is the creation of a representative dataset. Sometimes, all stages of the analysis are not indicated in publications, so that the data obtained can be interpreted ambiguously. The correct use of statistical phylogenetics methods in virology is possible only upon understanding their principles, proper methods of data preparation and evolutionary model selection criteria.

Neurocognitive and quality of life study in perinatally HIV-infected young people and their peers. NeuroCoRISpeS study

BackgroundAssessing the role of HIV and non-HIV related factors is essential for a better understanding of the neurocognitive outcomes in perinatally HIV-infected (PHIV+) young people. The aim of our study was to assess cognition and quality of life (QoL) of a PHIV+ cohort of young people and to compare it with a control group. MethodsThirty PHIV+ and 30 HIV(−) healthy young adults matched by age, sex and socioeconomic status completed a protocol that included neurocognitive tests, a psychosocial semi-structured interview and a QoL questionnaire (PedsQL). Neurocognitive domain-specific and domain-general (NPZ-5) Z-scores were calculated. CDC AIDS-defining category C or not C (PHIV+/C, PHIV+/noC) was considered to evaluate differences within the PHIV+ group. Univariate and multivariate analysis were performed. ResultsSixty patients were included; 67% were female; median age (IQR) 19 years (18–21). Regarding PHIV+ young people, 27% showed CDC C category (none encephalopathy), 93% were on ART and 77% had undetectable viral load. No differences regarding occupation were found, although the HIV(−) group repeated less grades (p=0.028) and had a higher education level (p=0.021).No differences were found between PHIV+/noC and HIV(−) participants. However, the PHIV+/C group showed poorer performance than PHIV+/noC (NPZ-5, p=0.037) and HIV(−) subjects (crystallised intelligence, p=0.025; intelligence quotient, p=0.016). Higher nadir CD4+ T-cell count was related to better Z-score in memory (p=0.007) and NPZ-5 (p=0.025). Earlier and longer exposure to ART resulted in better performance in memory (p=0.004) and executive functions (p=0.015), respectively. ConclusionsNo significant differences were found in the neurocognitive profile nor QoL between PHIV+/noC and HIV(−) adolescents; however, PHIV+/C participants obtained lower scores. The use of longer and earlier ART seems to have a beneficial effect.