Human Acquired Immune Deficiency Syndrome Research Articles

Women and HIV/AIDS in Low to Middle-income Countries

The preliminary confusion that acquired immune deficiency syndrome (AIDS) was a sickness of men, which can be recognized, possibly to historical misfortune [1]. The AIDS disease first categorized in the United States of America (USA), nevertheless, this deadly disease mainly contracted men [1]. However, from the beginning of the worldwide pandemic, it was visible that women were also susceptible to human immunodeficiency virus (HIV) and AIDS, and, within in a year, there were statistics to recommend that women were no less than as likely to become infected as men [2].

HIV-associated thrombocytopenia: Profiling hematological changes in the HIV infected and AIDS patients

Background and Aim: The first Acquired Immune Deficiency Syndrome (AIDS) case in India was detected in the year 1986. Seldom studies have been conducted correlating Cluster of Differentiation-4 cell counts (CD4 cell counts) and complete blood picture including platelet counts in the Human Immunodeficiency Virus (HIV) infected and AIDS patients in the Indian population. The present study was carried-out with the same intent to evaluate the CD4 cell counts and complete blood picture including platelet counts in the HIV infected and AIDS patients and correlate them with the sero-negative controls. Materials and Methods: The present study was a cross-sectional, hospital-based study on the HIV infected and AIDS patients. Evaluation of complete blood picture including platelet counts was done using Sysmex XP 100- (Sysmex Corp., Hyogo, Japan), a fully automated analyzer while CD4 cell counts were evaluated using Partec Cyflow Counter- (Partec GmbH, Munster, Germany). Statistical Analysis Used: The data was analyzed using SPSS version 15.0 (SPSS Inc., Chicago, IL, USA). Comparison of the said parameters was done using Analysis of Variance (ANOVA) and post-hoc Games-Howell test. p-value of <0.05 was considered statistically significant. Results: The levels of hemoglobin (Hb), white cell counts (WBCs) and platelet counts showed statistically significant results (p <0.001) with the levels of Hb and platelet counts significantly decreased and levels of WBCs significantly increased in the HIV infected and AIDS groups as against the sero-negative controls. Conclusion: Hb, WBCs and platelet counts were significantly altered in the HIV infected and AIDS groups when compared with the sero-negative controls.

Frequency of HIV in Patients with Central Nervous System Tuberculosis

Background: Tuberculosis (TB) is the most widely recognized reason for death in patients of acquired immune deficiency syndrome (AIDS). Human Immunodeficiency virus (HIV) and AIDS continue to be on an increase in Pakistan. This study aimed to assess the magnitude of HIV among patients with Central nervous system (CNS) tuberculosis as its progression to AIDS significantly influences mortality in these patients. The main objective of the study was to determine the frequency of HIV among patients with CNS tuberculosis. Methods: This Cross-Sectional study was conducted at Medicine Wards of Civil Hospital, Karachi from 7th October 2016 to 7th April 2017. A total of 140 newly diagnosed Central Nervous System tuberculosis patients were included. Blood sample collected for HIV test (ELISA) was interpreted as either: Reactive for HIV or Non-reactive for HIV. HIV infection was considered as HIV positive by using 3 Rapid Diagnostic testing kits according to guidelines of World Health Organization (WHO). All the patient data were collected through a pre-designed proforma. Data were analyzed using SPSS v.23.0. Chi-square test was applied post stratification with p- value≤0.05 taken as statistically significant. Results: Sixteen patients (11.43%) of CNS tuberculosis were found to have HIV positive results. Out of total 140 patients, 50(35.71%) were female and 90(64.29%) were male. The average age of the patients was 39.37±12.8 years. Conclusion: CNS tuberculosis can be the primary clinical manifestation of HIV positive patients. Early recognizable proof of HIV in patients with CNS tuberculosis may warrant early inception of anti-HIV treatment.

Topics on HIV/AIDS for Inclusion Into a Physical Therapy Curriculum: Consensus Through a Modified Delphi Technique

Introduction. An understanding of Human Immunodeficiency Virus and Acquired Immune Deficiency Syndrome (HIV/AIDS) has become increasingly important for physical therapists due to the changing nature of the morbidity and mortality patterns of the syndrome. The involvement of physical therapists in management, treatment, and care for people with HIV/AIDS is growing, and with this involvement the need to educate both pre- and post-graduate physical therapists also is growing. Subjects/Methods. This study determined the level of consensus among academic staff at 8 South African universities with regard to the curriculum topics related to HIV/AIDS. The list of themes and topics considered core to understanding HIV in physical therapy and deemed necessary for inclusion in a mainstreamed curriculum was developed from the results of 3 preceding studies and incorporated into a questionnaire. Sixty-eight faculty members from physical therapy schools in South Africa were invited to participate in a modified Delphi process using e-mail as the method of contact. Consensus was set at 80%. Results. The final sample used in the study was 58, 10 being excluded from the sample due to unavailability. Forty-seven faculty members responded to the first round of the Delphi study, giving a response rate of 81%. A response rate of 91% was attained in the second round with 43 of the 47 respondents from the first round answering. Consensus was obtained in the first round for all topics except hematology and anemia, lipodystrophy (abnormal distribution of the body's adipose tissue), and the relation of anemia and lipodystrophy to physical therapy. These 3 topics obtained consensus in the second round. Discussion and Conclusion. The level of consensus was considered to be high, as the majority of topics attained at least 90% consensus after 2 rounds. The comprehensive list of topics that had consensus and emerged out of this study represents a solid starting point for the inclusion of HIV into physical therapy curricula in a mainstreamed manner. Key Words: HIV/AIDS, Physical therapy, Education, Delphi study. INTRODUCTION Over 20 years after the first case of Acquired Immune Deficiency Syndrome (AIDS) was described, 33.4 million people are reported to be living with Human Immunodeficiency Virus (HIV) or AIDS in Sub-Saharan Africa.1 Developments in the pharmacological management of HIV /AIDS have resulted in longer life expectancies. Longer life expectancy and the chronic nature of HIV lead to the need for rehabilitation intervention among people with HIV/AIDS.2 Studies have shown that problems from contracting HIV manifest across the entire spectrum of disability. These manifestations include impairments, activity limitations, and participation restrictions.3 Specific problems at the impairment level include pain, proximal muscle weakness, breathlessness, and poor energy and drive. Activities such as mobility, self-care, and domestic life tasks (eg, lifting and carrying) can become difficult. Participation in social and civic life and interpersonal relationships are negatively affected for reasons ranging from immobility to fear of stigma and lack of availability of public toilets (especially for those suffering from conditions such as diarrhea).3'4 The association between the problems experienced at impairment, activity, and participation levels is evident; for example, people who experience pain also experience mobility problems that may in turn affect their community, social, and civic-related activities.3 These problems experienced by people with HIV/ AIDS can be minimized or counteracted by physical therapy and rehabilitation interventions.5 Many physical therapists already work with people with HIV/AIDS, and with the exception of a few, most feel ill-equipped to do so.3'6 It is therefore important for physical therapist education to be re-evaluated to meet health and community needs for this population. …

AIDS-related vasculopathy: evidence for oxidative and inflammatory pathways in murine and human AIDS

Increased life expectancy of human immunodeficiency virus (HIV)-positive patients has led to evidence of complications apparently not directly related to immunodeficiency or opportunistic infection, including increased cardiovascular risk. We tested the hypothesis that vascular dysfunction occurs in the murine acquired immune deficiency syndrome (AIDS) model and evaluated potential mechanisms in murine AIDS tissues and relevant human HIV/AIDS vascular tissues. We also investigated endothelial activation and/or endothelial protein nitration and their association with time-dependent vascular dysfunction. At 1 and 5 wk of murine AIDS, statistically significant decreases in KCl contractility and time-dependent contractile deficits in response to phenylephrine were observed. The maximal response (E(max)) was reduced by approximately 40% at 10 wk, and EC(50) values were significantly changed: 102 +/- 7.3 ng for control vs. 190 +/- 37 and 130 +/- 22 ng at 5 and 10 wk, respectively (P < 0.05). Endothelium-dependent relaxation to ACh was decreased (EC(50) = 120 +/- 27 and 343 +/- 94 nM for control and at 10 wk, respectively), whereas the response to an exogenous nitric oxide donor, sodium nitroprusside, remained unchanged, suggesting a specific endothelial dysfunction. Histochemical investigations of the same vascular tissues as well as corresponding coronary endothelium showed an increase in protein 3-nitrotyrosine, intercellular adhesion molecule, and nitric oxide synthase isoforms 2 and 3. These findings were corroborated in concurrent experiments in a cohort of well-cataloged human cardiac microvascular tissues. We have demonstrated, for the first time, a specific functional vasculopathy with endothelial involvement in a murine model of AIDS that was also associated with and correlated to increased oxidative stress and specific endothelial activation. This finding was echoed in a relevant population of human HIV/AIDS patients. Research into sources and intracellular targets of oxidants in this disease could provide important mechanistic insights and may reveal new therapeutic opportunities for this increasingly important cardiovascular disease state.

Side-stream cigarette smoke accentuates immunomodulation during murine AIDS

Side-stream cigarette smoke has become a hotly debated social, political, and scientific health and safety issue for nonsmokers. The harmful influences of side-stream cigarette smoke on human health are its adverse effects on the immune system, especially when already compromised by other agents. Acquired immune deficiency syndrome (AIDS) is a clinical disorder caused by human immunodeficiency virus (HIV). To facilitate studies, murine AIDS was induced in C57BL/6 mice by LP-BM5 murine leukemia virus infection, which mimics human AIDS. After 2 weeks of retroviral infection, the mice were exposed to side-stream cigarette smoke for 30 min, 5 days/week for 12 weeks using a side-stream cigarette smoke exposure system. Murine retrovirus infection reduced the in vitro proliferation of T lymphocytes stimulated by concanavalin A, increased the release of pro-inflammatory cytokine interleukin-6 (IL-6) tumor necrosis factor-alpha (TNF-α), increased the hepatic lipid peroxidation and decreased the α-tocopherol levels in liver, lung and heart. Concomitant side-stream cigarette smoke exposure for 12 weeks further inhibited the proliferation of T cells, increased the release of TNF-α, IL-6 cytokines and enhanced the hepatic lipid peroxidation from retrovirus infected mice. The loss of α-tocopherol was also further enhanced by side-stream cigarette smoke exposure during retrovirus infection. Our conclusions are that side-stream cigarette smoke induced increasing oxidative stress, reducing nutrient concentrations and suppressing immune function could make mice with murine AIDS more susceptible to opportunistic infections, potentially accelerating murine AIDS progression. Thus, the reduction of side-stream cigarette smoke exposure is an important health issue in AIDS patients to improve the quality and quantity of their lives.

Acute renal failure with interstitial nephritis in a patient with AIDS

There is a broad differential diagnosis of acute renal failure (ARF) in patients with acquired immune deficiency syndrome (AIDS). Indeed, the spectrum of renal disease with human immunodeficiency virus (HIV) and AIDS has evolved since the advent of protease inhibitor therapy, along with the use of highly active anti-retroviral therapy (HAART). Herein we present a case of ARF with low-grade proteinuria in a patient with AIDS.

Vitamins and immunomodulation in AIDS

Acquired immune deficiency syndrome (AIDS) is a clinical disorder caused by a retrovirus infection and represents the end point in a progressive sequence of immunosuppressive changes. Vitamins can enhance disease resistance in animals and humans. As such they are important co-factors in optimal functioning of the immune systems. In this article, the immunological and nutritional modifications caused by AIDS are summarized. The effects of murine and human retrovirus infection on vitamin status are analyzed as co-factors in the development of severe immune dysfunction, AIDS. The properties of immunoenhancing antioxidative vitamins, vitamin A, B 6, B 12, C, E, and β-carotene, which are frequently low in AIDS patients, are evaluated relative to the development of immunodeficiency during retrovirus infection. Vitamin A, E, and B 12 deficiency accelerated the development of AIDS with low T cells, whereas their normalization retarded the development of immune dysfunction. The interactions between these vitamins and the immune system in human AIDS patients and animal models of AIDS are reviewed. Our purpose is to provide data on how retrovirus infection can cause nutritional deficiencies that accentuate immune damage and to evaluate the potential therapeutic role of vitamins in the treatment of immune dysfunctions in AIDS patients.

Aids-Related Knowledge and Attitudes of Social Workers in South Carolina

This study examines the association between knowledge of acquired immune deficiency syndrome (AIDS) and skill among social workers in South Carolina and attitudes toward people with human immunodeficiency virus (HIV) and AIDS. A stratified random sampling method was used to obtain a representative sample of social workers in South Carolina. Findings show that AIDS-related knowledge and skill were significantly associated with improving the general attitudes of social workers toward HIV/AIDS clients. In addition to knowledge and skill-related measures, other significant covariates of attitudes include levels of contact with HIV/AIDS clients and sensitivity to minorities. As with previous studies, demographic variables such as age and gender were not found to be significantly related to variations in attitudes toward HIV/AIDS clients. Furthermore, locality of practice and supervisory position did not significantly correlate with attitudes. The implications of these findings for social services agencies are discussed.

Developing, Testing, and Marketing an AIDS Vaccine: Legal Concerns for Manufacturers

t A.B. 1982, Brown University; M.A. 1988, Wesleyan University; J.D. Candidate 1991, University of Pennsylvania. This Comment is dedicated to my family, in appreciation for their support and encouragement, and to my former colleagues in the pharmaceutical industry who remain undaunted by the obstacles. I am grateful to Scott Burris for his comments on earlier drafts of this manuscript. Acquired Immune Deficiency Syndrome (AIDS) is a communicable and sexually transmitted disease caused by the human immuno-deficiency virus (HIV). It is the final phase in a continuum characterized by four distinct disease stages: first, an initial infection which often mimics mononucleosis; second, a period of latent, asymptomatic infection; third, persistent, regionalized lymph node enlargement sometimes called AIDS-related Complex (ARC); and finally, the multiple opportunistic infections, neurological impairments, and other clinical presentations that constitute AIDS. See Centers for Disease Control, U.S. Dep't of Health & Human Servs., Classification System for Human T-Lymphotrophic Virus Type III/LymphadenopathyAssociated Virus Infection, 105 ANNALS INTERNAL MED. 234, 234-35 (1986). The HIV virus is a retrovirus; it uses an enzyme called reverse transcriptase to introduce its genetic material (ribonucleic acid, or RNA) into the genetic material (deoxyribonucleic acid, or DNA) of a host cell. Initially, the virus is virtually undetectable. Seropositivity (the appearance of viral antibody in the serum) occurs when the altered host cell is properly stimulated by antigens. At that point, the infected host cell's replicatory machinery sees both the foreign viral material, as well as its own cellular DNA, and thus produces infected cells. Viral proteins are then synthesized and are subsequently packaged together witlh viral genome and released, going on to attack additional cells. HIV has a predilection for particular host cell types, namely, T-helper lymphocytes (also called T-4 cells), macrophages, and monocytes. Since the T-helper lymphocytes are responsible for cell-mediated immunity, their destruction by the virus is a critical cellular event in the development of the disease, causing the immunodeficiency which gives AIDS its name. See Fauci, Temin & Martin, The Scientific Agenda for AIDS, ISSUES SCI. & TECH., Winter 1988, at 33, 33-35; Mayer, The Clinical Challenges of AIDS and HIV Infection, 14 LAW, MED. & HEALTH CARE 281 (1986); Schild & Minor, Human Immunodeficieney Virus and AIDS: Challenges and Progress, 335 LANCET 1081, 1081-82 (1990). 2 For example, Larry Kramner is the founder of the AIDS Coalition to Unleash

Comparative Pathogenesis of Animal and Human Retrovirus Infections

ABSTRACT The human immunodeficiency virus (HIV) shares some structural and biological features with other lentiviruses such as maedi, visna, and equine infectious anemia viruses. Both the budding p...

Geographical Patterns of AIDS in the United States

Geographical Patterns of AIDS in the United States

Disease-specific and tissue-specific production of unintegrated feline leukaemia virus variant DNA in feline AIDS

Feline leukaemia viruses (FeLVs) have long been known to be associated with induction of proliferative and anti-proliferative diseases of domestic cats. Strains of FeLV have been recognized which specifically induce lymphosarcoma, aplastic anaemia, myelodysplastic anaemia, and, recently, feline AIDS (acquired immune deficiency syndrome), a naturally occurring immunosuppressive syndrome strikingly similar to human AIDS which is lethal in 100% of inoculated and viraemic specific-pathogen-free (SPF) cats. Here, we have analysed FeLV DNA in tissues of 22 SPF cats that had been inoculated with the feline AIDS strain (FeLV-FAIDS) and we find two classes of viral DNA--a monotypic common form which is detectable in bone marrow regardless of disease state, and variant forms, recognizable by restriction site differences, whose appearance correlates with onset of disease symptoms and persists throughout the course of the disease. FeLV-FAIDS variant DNA is detected at high concentration (10-50 copies per cell) and principally as unintegrated viral DNA (UVD) in bone marrow of cats with feline AIDS. In marked contrast high levels of UVD were not present in cats in the terminal-stages of T-cell lymphosarcoma, aplastic anaemia, or myelodysplastic anaemia induced by other FeLV strains. These results parallel recent observations in humans, where high levels of UVD were sometimes found in cells derived from AIDS patients infected with human T-lymphotropic virus type III (HTLV-III)/lymph-adenopathy-associated virus (LAV), and suggest that persistence of unintegrated variant viral DNA is a crucial indicator of retrovirus-induced cytopathic disease syndromes such as AIDS.

Isolation of T-lymphotropic retrovirus related to HTLV-III/LAV from wild-caught African green monkeys.

Present evidence suggests that the acquired immune deficiency syndrome (AIDS) emerged in Central Africa as a new disease in recent decades. This disease has recently approached epidemic proportions in many parts of the world. The etiologic agent of AIDS is believed to be the virus HTLV-III/LAV, which has been proposed as having originated from a recent simian-human transmission in Africa. This report describes the isolation of a designated STLV-IIIAGM retrovirus closely related to HTLV-III/LAV from seven healthy wild-caught African Green monkeys (Cercopithecus aethiops) that showed the presence of antibodies designated STLV-IIIAGM. In vitro growth characteristics, ultrastructural morphology, and major proteins of 160,000 kilodaltons (kD), 120 kD, 55 kD, and 24 kD are similar to and cross-reactive with the analogous antigens of HTLV-III/LAV. The use of these serologic markers in the detection of STLV-IIIAGM-infected monkeys may be important in assuring the continued safety of a variety of biologic reagents that are derived from these primate species. The existence of a retrovirus closely related to HTLV-III/LAV that naturally infects an African nonhuman primate in the apparent absence of disease may provide a unique model for the study of human AIDS and the development of an effective vaccine.

Induction of AIDS-Like Disease in Macaque Monkeys with T-Cell Tropic Retrovirus STLV-III

The T-cell tropic retrovirus of macaque monkeys STLV-III has morphologic, growth, and antigenic properties indicating that it is related to HTLV-III/LAV, the etiologic agent of the acquired immune deficiency syndrome (AIDS) in humans. Four of six rhesus monkeys died within 160 days of STLV-III inoculation with a wasting syndrome, opportunistic infections, a primary retroviral encephalitis, and immunologic abnormalities including a decrease in T4+ peripheral blood lymphocytes. These data show that an immunodeficiency syndrome can be produced experimentally in a nonhuman primate by an agent from the HTLV-III/LAV group of retroviruses. The STLV-III-macaque system will thus provide a useful model for the study of antiviral agents and vaccine development for human AIDS.