Staphylococcus aureus is an important pathogen exhibiting antibiotic resistance and multiple virulence factors. This study analyses the antimicrobial resistance and virulence genes of Staphylococcus aureus isolates from HIV patients and non-HIV patients from southern India. S. aureus strains from HIV (n=125) and non-HIV (n=100) patients were isolated using conventional bacterial culture techniques. Antimicrobial resistance and virulence genes were analysed using polymerase chain reaction (PCR). Methicillin resistance was detected in 88.8% and 34% of the S. aureus isolates from HIV and non-HIV patients, respectively, and all tested positive for the mecA gene. SCCmec type V (42.3%) was the most frequently detected SCCmec cassette in MRSA from HIV patients, and SCCmec type II (44.1%) was the most frequently detected SCCmec cassette in MRSA from non-HIV patients. MRSA isolates from HIV patients were 98.2% positive for the penicillin resistance gene blaZ, followed by the aminoglycoside resistance genes aacA-aphD (82%), aac(6')/aph(2") (75.7%) and aph(3")-IIIa (51.4%), the tetracycline resistance genes tet(K) (42.3%) and tet(M) (13.5%) and the erythromycin resistance genes erm(C) (55%). Among the non-HIV-infected MRSA strains, 73.5% were positive for blaZ, followed by aac(6')/aph(2") (50%), aacA-aphD (47.1%), aph(3")-IIIa (23.5%), and erm(C) (29.4%). The seb (7.2%), sea (5.4%), seb and sed (2.7%), exfoliative toxin gene eta (3.6%) and toxic shock syndrome toxin gene tst (8.1%) were detected among MRSA from HIV patients, and the sea (5.9%), sec (5.9%), eta (5.9%) and tst (8.8%) were found among MRSA from non-HIV patients. HIV patients are at a relatively greater risk of acquiring virulent and multidrug-resistant methicillin-resistant S. aureus infections than non-HIV patients.

Introduction Virological failure remains a major challenge in treating HIV. Lopinavir/ritonavir, a protease inhibitor, is a recommended second-line option in Malaysia for patients failing first-line regimens. This study investigated the use of Lopinavir/ritonavir in terms of its efficacy in viral suppression, CD4 response, metabolic side effects, and tolerability following first-line treatment failure. Methods A retrospective review was conducted on adult HIV patients treated with Lopinavir/ritonavir for at least 6 months after confirmed virological failure (HIV viral load > 1000 copies/mL) on first-line therapy. Data were collected from 265 patients at Hospital Sultanah Aminah between January 2015 and December 2020, and 79 eligible patients were identified from the electronic database. Metabolic data, including lipid profile, were collected from case notes. Results Among 79 patients who fulfilled the criteria, most were male (n=52, 65.8%) with a mean age of 41, and the majority were of Malay ethnicity (n=51, 64.5%). Unprotected sexual intercourse was the most common transmission mode (44.3%). After one year, 96% achieved viral suppression (VL <400 copies/mL). Non-suppression was linked to non-adherence due to pill burden. Metabolic complications were common: 77% developed hypertriglyceridemia (mean triglycerides: 3.6 mmol/L), 94% had elevated LDL (mean: 3.1 mmol/L), with smaller numbers developing transaminitis (7.6%), impaired glycaemia (10.1%), hypertension (6.3%), and lipodystrophy (1.3%). Discussion Our study demonstrates that lopinavir/ritonavir (LPV/r) remains clinically effective at achieving viral suppression among HIV patients who have failed first-line therapy, with 76 subjects (96%) achieving viral suppression after 1 treatment. LPV/r continues to play a role in specific clinical contexts, particularly where newer antiretrovirals are not available or are contraindicated. However, LPV/r is associated with notable adverse events including GI intolerance, metabolic complications (most notably dyslipidemia), and high pill burden, all of which can negatively impact adherence and long-term treatment success. Conclusion LPV/r remains effective in achieving viral suppression but is associated with significant metabolic side effects. It should be reserved for individuals with limited treatment alternatives, and regimen selection should be guided by individual metabolic risk assessments. Regular metabolic monitoring and adherence support are essential, and multidisciplinary management together with further comparative studies are warranted to optimise treatment strategies that balance virological efficacy with long term metabolic safety.

The common cause of death in HIV and AIDS patients are opportunistic infections such as diarrhoea, acute respiratory infections, and skin conditions. Many of these infections are spread through contaminated hands. Therefore, this study aimed at exploring hand hygiene practices among HIV positive children and adolescents in Mzuzu City, Malawi. A cross-sectional study was used to collect data from children and adolescents living with HIV (aged between 9 and 18years) WHO were attending teen clubs in Mzuzu City. Data were analysed using Stata 17. Chi-Square and logistic regression analysis were used to examine the association among multiple independent variables on hand hygiene practices. The level of significance for fisher exact and Chi-square tests was set at P ≤ 0.05. The study found that each additional year of age slightly increases the likelihood of practicing hand hygiene by about 3%. However, individuals with very high emotional levels are approximately 17% less likely to practice hand hygiene compared to those with average emotional levels. Additionally, those without handwashing facilities at home are about 28% less likely to engage in hand hygiene practices compared to those with such facilities. The study revealed several significant insights into the factors influencing hand hygiene practices among children and adolescents living with HIV. The findings emphasize the importance of tailored interventions addressing developmental, emotional, familial, religious, and social factors to promote sustained hygienic behaviors among children and adolescents.

Introduction: Coccidioidomycosis, commonly known as Valley fever, is an infectious disease caused by two highly virulent fungi, Coccidioides immitis and C. posadasii. Around 60% of the infections are asymptomatic, however one-third of the cases develop pulmonary infection. About 0.5–2% of the cases disseminate to extrapulmonary locations which can be skin, bones/joints, and central nervous system, frequently seen in immunocompromised individuals (e.g., transplant recipients, HIV patients, pregnancy, diabetics, and patients on steroids). Case Report: We report a case of coccidioidomycosis in a 33-year-old diabetic male who presented with extrapulmonary manifestations involving thigh and facial skin followed by right chest wall complex collection which disseminated further to rib bone. The patient was found to be non-compliant on his antifungal drug regime which ultimately led to dissemination of the infection in the setting of preexisting diabetes. Following a surgical debridement procedure of the chest wall lesion and rib excision in addition with compliant antifungal regime led to eradication of the infection. Conclusion: The diagnosis of coccidioidomycosis relies upon clinical suspicion, laboratory findings (serology, cultures, and histopathology) coupled with imaging findings. The key to eradicating infection is ultimately based on an appropriate course of antifungal antibiotics and patient compliance following an accurate and timely recognition of the infection.

Introduction CD4 cell counts provide insight into the health of a person’s immune system, as well as information about how their disease is progressing. Boosting the immune level of individuals living with HIV through antiretroviral medication is the most effective way to prevent complications and illnesses caused by Opportunistic Infections (OIs). Methods In this study, we conducted a longitudinal cohort analysis of CD4 count in people living with HIV using additive negative binomial mixed-effects models. A flexible Generalized Additive Mixed-effects Model (GAMM) framework was employed to capture complex nonlinear patterns in repeated CD4 measurements. The analysis was based on longitudinal data from the CAPRISA 002 Acute Infection (AI) study at the Centre for the AIDS Programme of Research in South Africa. Key variables, such as age, baseline BMI, and follow-up duration (time), were analyzed nonparametrically, along with other relevant factors analyzed parametrically. Results The study results revealed significant effects of baseline viral load and HAART initiation on CD4 count progression. Patients initiating HAART showed a 1.233-fold increase in expected CD4 count compared to pre-treatment levels. Baseline viral load negatively impacted CD4 count, even with small unit changes (γ =-1.581e-07, p -value=0.00079). Smooth terms of age ( edf = 14.24, p -value < 2e-16), time (edf = 10.343, p -value < 2e-16), and baseline BMI ( edf = 3.044, p -value = 2.21e-06) exhibited significant non-linear relationships with CD4 count. Spline plots indicated gradual CD4 improvement over time, suggesting long-term benefits of HAART, especially in older and higher-BMI patients. Discussion The findings of our analysis offer a deeper understanding of the functional relationship between the outcome variable and key predictors over time. The research found that initiating antiretroviral therapy improves trajectories of CD4 counts, whereas higher baseline viral load significantly impairs immune recovery over time. The modeling further revealed that age, time, and baseline BMI have a significant nonlinear impact on CD4 count dynamics over time. Conclusion The study establishes that BMI has an impact on the progression and immune responses of Highly Active Antiretroviral Therapy (HAART). The significant nonlinear effect of time suggests that the progress of patients’ CD4 count is slow, and higher CD4 count levels are observed after several treatment visits based on the studied data set. HIV patients who do not maintain immunological stability by consistently receiving antiretroviral medication face an increased risk of illness if they contract OIs due to weakened immune response.

Pulmonary diseases caused by Mycobacterium avium complex (MAC) show species-specific epidemiology: M. avium predominates in HIV-positive patients, while M. intracellulare mainly affects immunocompetent hosts. This study aimed to elucidate the bacterial and host mechanisms underlying these differences. We integrated clinical metagenomic next-generation sequencing (mNGS), k-mer-based bacterial genome-wide association study (GWAS) of clinical isolates, peripheral blood immunophenotyping of 175 patients, and mouse infection models with or without CD4 depletion. K-mer GWAS identified lipid metabolism and transport genes (notably mce) enriched in isolates from hosts with different HIV statuses. Immunophenotyping showed that in HIV-negative patients, M. intracellulare infection elicited higher NKT cell frequencies than M. avium, a difference absent in HIV-positive hosts. In mice, anti-CD4-/M. intracellulare infection showed steadily increasing bacterial burden with time (ρ = 0.824), whereas M. avium exhibited no such trend. Early after infection (weeks 1-2), anti-CD4-/M. avium group had higher bacterial burden and NKT levels than anti-CD4-/M. intracellulare, but by week 4 the pattern reversed (all p < 0.05). CD4 depletion eliminated species-specific differences in NKT activation, and at both weeks 2 (p < 0.05) and 4 post-infection (p > 0.05), the anti-CD4+/M. avium groups carried a higher bacterial burden than the anti-CD4+/M. intracellulare groups. MAC species exhibit fundamentally divergent infection dynamics driven by differential NKT cell activation, likely shaped by species-specific lipid antigens. This lipid-NKT axis explains contrasting clinical patterns of M. avium and M. intracellulare and highlights a potential target for host-directed interventions.

Pre-treatment drug resistance surveillance among ART- Naive HIV-1 patients in Tunisia

Advances in Treatment of Psychiatric Disorders in Patients with HIV.

People living with HIV navigate complex medical and social challenges that impact engagement in care, including stigma, poverty and systemic inequities. Patient navigation has emerged as a promising approach to improve linkage, retention and adherence across the HIV care continuum. While evidence suggests that navigation enhances care engagement and health outcomes, little is known about how these programs are implemented in real-world settings, particularly with respect to equity. This scoping review mapped the literature on the implementation of HIV patient navigation programs, with attention to program components, barriers, facilitators and equity considerations. Following the Joanna Briggs Institute framework and PRISMA-ScR guidelines, we searched six databases (MEDLINE, Embase, PsycINFO, JBI, Scopus, Web of Science) and identified 31 eligible studies (2000-2025). Data extraction and synthesis were guided by the Consolidated Framework for Implementation Research (CFIR) and PROGRESS-Plus. Most programs were based in the United States, with others in Africa and Latin America. Navigation was delivered by professionals (35%), peers (35%), or both, with interventions spanning 6-12 months and often including psychosocial support, care coordination and linkage to social services. Facilitators included navigator accessibility, cultural responsiveness and organizational support, while barriers involved system fragmentation, limited funding and structural inequities. Few studies explicitly operationalized equity within implementation strategies. Navigation programs were associated with improvements in ART adherence, care engagement and psychosocial well-being. Findings underscore the importance of embedding equity frameworks into navigation design to ensure sustainable, person-centered models of HIV care that address the needs of marginalized populations.

Epstein-Barr virus (EBV)-associated smooth muscle tumor (EBV-SMT) is a rare spindle cell tumor found in immunocompromised patients with HIV. This case report presents a patient with HIV-positive Epstein-Barr virus (EBV)-associated smooth muscle tumor (EBV-SMT) involving the brain and spine-a 39-year-old Hispanic female with HIV presented with severe headache, neck pain, and seizure-like activity. Magnetic resonance imaging (MRI) revealed multiple brain masses, prompting a diagnostic cerebral angiogram and subsequent surgery to remove them. Despite initial improvement, the patient later succumbed to aspiration pneumonia and cardiac arrest. Epstein-Barr virus (EBV)-associated smooth muscle rare tumors (EBV-SMTs) in HIV patients with low CD4 counts require clinical suspicion and Epstein-Barr virus (EBV) involvement in brain tumor diagnosis. Early HIV detection, CD4 monitoring, and antiretroviral therapy (ART) management can decrease the risk of these malignancies.

ABSTRACT Purpose This study aims to determine the proportion of bone marrow dysplasia in advance of HIV infection. Patients and methods A cross-sectional study was conducted on advanced HIV patients, stage III and IV, with cytopenia at Hasan Sadikin General Hospital, Bandung, from January 2021 to November 2023. Patient characteristics and laboratory data were obtained from patients diagnosed with HIV stages III and IV who presented with cytopenia and underwent bone marrow examinations, as documented in the medical records. The differences between the two groups were analyzed using the Mann–Whitney U test or the Independent T-test for numerical data and Chi-square or Fisher’s exact for categorical data. Results A total of 42 subjects were enrolled, consisting of 8 (19%) HIV stage III and 34 (81%) stage IV patients. Patients with HIV stage IV exhibited a higher incidence of pancytopenia, with 15 cases (44.1%). The bone marrow cellularity in HIV stage IV was predominantly hypocellular, accounting for 22 cases (64.7%). Dyserythropoiesis was the most common type of bone marrow dysplasia observed in HIV stage IV, present in 19 cases (55.9%). The prevalence of Bone Marrow Dysplasia in HIV stage IV was higher than in HIV stage III, with 23 (64.7%) and 2 (37.5%), respectively (p = 0.2348) Conclusion Cytopenias related to HIV are common and tend to worsen as the disease advances. This emphasizes the importance of investigating the potential for bone marrow dysplasia and conducting cytogenetic diagnostic testing for myelodysplastic syndromes (MDS), as a significant non-AIDS-defining hematological malignancy in individuals with advanced HIV.

Enhanced immune recovery with B/F/TAF compared with DTG/3TC in HIV patients: A prospective observational study.

IntroductionVirological failure is defined as a plasma viral load >1000 copies/mL on 2 consecutive tests after 3 months of adherence support and 6 months of ART. In Ethiopia, limited studies have developed risk prediction models, though such models are vital for guiding patient-specific interventions and improving HIV treatment outcomes.ObjectiveThis study aims to determine the incidence and prognostic factors of virologic failure among HIV patients on first-line HAART following the one-J program at Felege Hiwot Hospital, Northwest Ethiopia, in 2025.MethodsA retrospective cohort study was conducted using patient records from Felegehiwot Comprehensive Specialized Hospital. Data were analyzed with STATA 17 and R 4.5.0. Descriptive statistics and multivariable logistic regression (via LASSO-selected predictors) were applied to develop a simplified nomogram. Model performance was evaluated using discrimination, calibration, and decision curve analysis to assess clinical utility.ResultThe incidence of virologic failure was 20.2% (95% CI: 17.9-22.6). Key predictors included TB-HIV co-infection, INH prophylaxis, CPT, adverse drug reactions, disclosure, alcohol use, smoking, and CD4 level. The model showed good performance (AUC = 0.817; reduced AUC = 0.810), strong calibration (Brier = 0.117), and superior clinical benefit in decision curve analysis.ConclusionA nomogram integrating 8 predictors TB-HIV co-infection, INH prophylaxis, CPT, adverse drug reaction history, disclosure status, alcohol use, smoking status, and CD4 count showed excellent discrimination (AUC = 0.817) and good calibration, indicating strong potential for individualized risk prediction in HIV patient management.

Monocyte Distribution Width (MDW) is the standard deviation of the mean volume of monocytes and may indicate innate immune activation. We investigated the possible association between MDW values and late HIV diagnosis in consecutive patients. We retrospectively enrolled newly diagnosed HIV patients admitted to our clinical center. Demographic and clinical characteristics were analyzed. A total of 97 patients were enrolled. Of these, 63% were late presenters and 43% fulfilled the criteria for advanced HIV disease. Continuous measures showed a significant inverse correlation between CD4 T-cell count and MDW. Multivariate analysis showed that MDW≥21.1 (OR:7.45, 2.13-30.54), HIV viral load >5 log (10) c/mL (OR:3.62, 1.04-13.30), blood lymphocytes<2 x103/μL (OR:14.82, 3.19-111.8) and HIV testing without symptoms (OR:0.21, 0.05-0.82) were independently associated with late presentation. Similarly, adjusted ORs for MDW≥22.5 (OR:4.03, 1.28-13.17), blood lymphocytes<1 x103/μL (OR:9.67, 2.19-57.57), age (OR:1.05, 1.00-1.10) and HIV testing without symptoms (OR:0.16, 0.04-0.52) were significantly associated with advanced HIV disease. Our results suggest that MDW may be a potential flagging parameter of innate immune activation in HIV infection. Continuous measurements of MDW showed a significant inverse correlation with CD4 T-cell count.Patients with increased MDW values were more likely to be diagnosed late.

The need to compare the effectiveness and adverse effects of Dolutegravir-based regimens versus older TLE regimens in HIV treatment is relevant. Therefore, it is of interest to evaluate their comparative outcomes in a clinical setting including 180 adults with HIV. Results showed comparable efficacy in CD4 counts and viral load between the two groups, although Dolutegravir seemed to cause a quicker increase in CD4 counts. This study contributes to the existing body of knowledge by providing direct comparisons of Dolutegravir-based and older TLE regimens in HIV treatment, highlighting both efficacy and safety outcomes, with a specific focus on CD4 count progression and adverse effects.

Background: HIV/AIDS is an immunosuppressive condition often accompanied by other health problems, including fungal infections such as oral candidiasis. This infection is caused by Candida albicans, an opportunistic pathogen that commonly affects immunocompromised patients. Vitamin D is a vitamin which plays a key role in immune regulation and mucosal defenses, and deficiency has been linked to increase in opportunistic infection. Objective: This study aims to review relevant literature to determine the relationship and effect of vitamin D deficiency in HIV/AIDS patients with oral candidiasis. Methods: Research was conducted on PubMed, ScienceDirect, and Google Scholar using predetermined keywords and the results were limited to articles published in 2015-2025. Discussion: Vitamin D is an important immunomodulator that regulates innate and adaptive immune responses through vitamin D receptor (VDR) signaling in immune cells. Vitamin D deficiency is common in people living with HIV and is associated with increased immune activation, disease progression, and susceptibility to opportunistic infections. Through reviewing relevant literature, findings suggest that adequate vitamin D status may play a protective role against oral candidiasis and other opportunistic infections in HIV. Conclusion: Existing studies suggest that vitamin D deficiency may be an important factor in the occurrence of oral candidiasis in HIV patients. However, more research is needed to sufficiently establish a significant correlation between the two conditions.

What are the most important factors for depression among HIV patients?: a study from Bangladesh

Abstract Background Adeno-tonsillar hyperplasia together with otitis media with effusion (OME) in adults should prompt careful evaluation, as it may reflect an underlying malignant or systemic condition, including lymphoma, carcinoma, or HIV infection. Case report Herein, we present a case of a 50-year-old male whose initial presentation of HIV infection was adenotonsillar hypertrophy and otitis media with effusion. The patient exhibited substantial clinical improvement after 6 months of antiretroviral therapy (ART), with a significant reduction in the size of the nasopharyngeal, palatine, and lingual tonsils. Conclusion Adeno-tonsillar hypertrophy could be an initial manifestation of HIV infection, particularly in patients with lower CD4 levels and higher viral loads. Recognition of this association is crucial for timely diagnosis and management. These manifestations can significantly improve with the use of ART. Further studies with a large cohort of patients addressing adenotonsillar hyperplasia in HIV patients are recommended.

Background: Self-efficacy is a determining factor and predictor of successful treatment for HIV patients. Self-efficacy contributes to a person's ability to overcome the challenges they face. Efforts to manage self-efficacy in HIV patients are needed to support treatment success. One approach is to use a combination of Acceptance Commitment Therapy (ACT) and Rational Emotive Behavior Therapy (REBT). Purpose: The aim of this study was to determine the effect of providing combination therapy of ACT and REBT on increasing self-efficacy in HIV patients. Methods: This study used a quantitative, semi-experimental, one-group pre-test and post-test method. The study population consisted of 31 respondents. The sampling method was total sampling. The study was conducted on 31 HIV patients with at least adequate self-efficacy scores. The Wilcoxon test was used for analysis because the data used were ordinal. Results: There was an effect of combined ACT and REBT therapy on improving self-efficacy in HIV patients, as indicated by a significant value of 0.00. Respondents experienced an increase in efficacy values before and after with an average increase of 16 with a sig value of 0.00 where the value is less than 0.05, which means there is a difference in value between the efficacy values before and after. There is an effect of administering ACT and REBT therapy on the efficacy level of HIV patients. Conclusion: ACT and REBT therapy have been shown to improve self-efficacy in HIV patients. Self-efficacy in HIV patients is influenced by several factors, including patient demographics and stigma. The development and implementation of therapy, particularly for vulnerable groups, is needed, taking into account each patient's characteristics.

Introduction. In the modern context, the diagnosis of socially significant bloodborne viral infections (BBVI) requires continuous improvement and adaptation. This is especially relevant in treatment of the military, where high accuracy and speed of laboratory diagnostics is critical. The aim of the study is to explore extra laboratory diagnostic capacities in military medical institutions to expand the indications for combined molecular biological and immunochromatographic express tests in socially significant bloodborne viral infections. Methods. According to the research objective, the study relies on the data obtained from open access publications available in Russian and international databases, a s well as the authors’ own laboratory findings. Results and analysis. The study identifies key prospects for improved laboratory diagnostics of socially significant bloodborne viral infections in military medical institutions. An advanced regulatory framework is required to enhance the examination and registration of HIV patients. Conclusion. Taking into consideration the existing laboratory diagnostic capacities, the study has identified the demand for higher precision and clarity in legal terminology, as well as unbiased statistical management of patient records in order to ensure prompt anti-epidemic measures, prevention, and treatment. In addition, updated training programs are required for medical laboratory professionals with a special focus on diagnostic algorithms and interpretation of results.