Human Immune Deficiency Virus Research Articles

Pharmacogenetics of tenofovir drug transporters in the context of HBV: Is there an impact?

BackgroundCurrent treatments for chronic hepatitis B management include orally administered nucleos(t)ide analogues, such as tenofovir (TDF), which is an acyclic adenine nucleotide analogue used both in HBV and human immune deficiency virus (HIV). The course of HBV infection is mainly dependent on viral factors, such as HBV genotypes, immunological features and host genetic variables, but a few data are available in the context of HBV, in particular for polymorphisms of genes encoding proteins involved in drug metabolism and elimination.Consequently, the aim of this study was to evaluate the potential impact of genetic variants on TDF plasma and urine concentrations in patients with HBV, considering the role of HBV genotypes. MethodsA retrospective cohort study at the Infectious Disease Unit of Amedeo di Savoia Hospital, Torino, Italy, was performed. Pharmacokinetic analyses were performed through liquidi chromatography, whereas pharmacogenetic analyses through real-time PCR. FindingsSixty - eight patients were analyzed: ABCC4 4976 C>T genetic variant showed an impact on urine TDF drug concentrations (p = 0.014). In addition, SLC22A6 453 AA was retained in the final regression multivariate model considering factors predicting plasma concentrations, while ABCC4 4976 TC/CC was the only predictor of urine concentrations in the univariate model. InterpretationIn conclusion, this is the first study showing a potential impact of genetic variants on TDF plasma and urine concentrations in the HBV context, but further studies in different and larger cohorts of patients are required.

ИССЛЕДОВАНИЕ СЕКРЕЦИИ ЭРИТРОПОЭТИНА У БОЛЬНЫХ ВИЧ-ИНФЕКЦИЕЙ С АНЕМИЕЙ ХРОНИЧЕСКИХ ЗАБОЛЕВАНИЙ, ЖЕЛЕЗОДЕФИЦИТНОЙ АНЕМИЙ И СОЧЕТАНИЕМ ДВУХ ТИПОВ АНЕМИЙ

Aim. To compare the secretion of erythropoietin in patients with infection caused by human immune deficiency virus (HIV infection) with anemia of chronic diseases (ACD), iron deficiency anemia (IDA), and their combination. Material and methods. 125 patients with HIV infection were examined: 101 with anemia (55 males, 46 women, 39.4±9.6 years), 24 - a control group of patients with HIV infection without anemia (13 males, 11 women, average age 37.6± 7.37 years). In all patients, the number of red blood cells, the concentration of hemoglobin, ferritin, C-reactive protein (CRP), transferrin saturation index (TSI) and erythropoietin were examined. All patients with anemia after determining TSI, CRP, ferritin based on Van Santen and Worwood criteria were divided into three groups depending on the type of anemia: group 1 - 36 patients with ACD (19 males, 17 women, average age 41.7 ± 11, 8 years, TSI 16.9[IQR, 10.2-23.1]%, ferritin 638.7[IQR, 326-861] μg/l, CRP 54.5 [IQR, 4.8-103.3] mg/l), group 2 – 30 patients with a combination of ACD/IDA (18 males, 12 women, average age 41.2±10 years, TSI 13.2[IQR, 9.8-14]%, ferritin 156.2 [IQR, 123-235] mcg/l, CRP 5.9 [IQR, 0.5-8.2] mg/l), group 3 – 35 patients with IDA (18 males, 17 women, average age 35.4 ±7.1 years, TSI 11.1[IQR, 4.7-13.7]%, ferritin 29[IQR, 4.2-38.9] µg/l, CRP 2.9[IQR, 0.4 -1.6] mg/l). For quantitative indicators, the median (Me), standard error of the mean (m), and interquartile range (IQR) were calculated. The significance of differences between several unrelated groups was determined using the Kruskal-Wallis test. Results. In the ACD group, a lower number of red blood cells was detected (3.3(2.7-3.8)×1012/l), compared to the group of patients with IDA (3.8(3.7-4.1)×1012/l ). Also, in the group of patients with ACD, the maximum concentration of erythropoietin was detected (28.5[11.2-28.5], U/ml), significantly higher than the concentration of this indicator in the ACD/IDA groups (14[8.1-16.3], U/ml), IDA (15.8[6.2-27.4], U/ml) and patients in the control group (6.3[4.9-7.8], U/ml). Conclusions. In the present study, ACD in isolated form or in combination with IDA was diagnosed in 65.3% of patients with HIV infection and anemic syndrome. In patients with ACD, an increased concentration of erythropoietin is combined with the lowest number of red blood cells in comparison with other groups of patients with anemia (p<0.05). The results obtained indicate a compensatory increase in erythropoietin secretion in response to suppressed erythropoiesis, or to reduced sensitivity of erythropoietin receptors. Further study of the importance of erythropoietin in the pathogenesis of chronic disease in patients with HIV infection is necessary, including to improve its treatment.

Hubungan Dukungan Sosial Terhadap Quality of Life Pada ODHA (Orang dengan HIV/AIDS)

Background: HIV or Human Immunedeficiency Virus is a disease that attacks the human immune system so that this disease causes a weakening of the immune system to fight a disease. While AIDS or Acquired Immunne Deficiency Syndrome is a collection of diseases caused by a decrease in the human immune system caused by HIV infection. A person infected with HIV / AIDS will feel depressed, unable to accept the situation, feel helpless and experience fear for the future. This is because in Asia the negative stigma of HIV/AIDS is still very high. Thus, it is very necessary to know the relationship of social support to the quaity of life for PLHIV at Bangli General Hospital. Purpose: The purpose of this study was to determine the relationship of social support to the quaity of life in PLHIV. Methods: The research method used quantitative analytics with a cross sectional approach using primary data with data collection instruments in the form of questionnaires distributed to 60 respondents where the sampling technique used was the Non Probability Sampling technique with a saturated sampling method carried out in November-January 2024 at Bangli General Hospital. Data were analyzed univariately and bivariately chi square. Results: The results showed that there was a significant relationship between social support for quality of life in PLHIV with a p value of < 0.05 which means ha was accepted and h0 was rejected. Conclusion: Social support is very influential on the quality of life in PLHIV. The better the support provided, the higher the quality of life that will be owned by PLHIV.

Utilization of Female Condoms among Women Living with Human Immunodeficiency Virus (HIV) in Murang’a County, Kenya

Background: To prevent the risk of transmission of the Human Immune Deficiency Virus (HIV) and other sexually transmitted infections (STIs), as well as achieve family planning targets, the use of Female Condom, a women-initiated method, has been prioritized across the globe. Nevertheless, knowledge regarding the utilization of Female Condoms among HIV-positive women remains inconclusive. The main objective of this study was to determine the utilization of Female Condoms (FC) among HIV-positive women in Murang’a County, Kenya. Method: This study adopted a cross-sectional analytical survey design. A total of 204 women living with HIV (WLHIV) were recruited in the study. Multi-stage sampling was conducted to get three participating sub-counties and three clinics. Systematic sampling and purposive sampling techniques were used to select WLHIV. Structured questionnaires, interview schedules and focus group discussions were used to collect data. Descriptive and inferential statistics were generated using Statistical Package for Social Sciences (SPSS) version 25.0. The statistical significance of the association between categorical variables was determined using Pearson’s Chi-square test. The level of significance was fixed at a P-value of 0.05 level of significance (p ≤ 0.05). Results: 38.8% of the respondents were aged 31–40 years (Mean = 3.11; SD = 1.004). 42.2% of study participants had attained secondary education (mean = 2.05; SD = 0.899). FC use was low at 17.6% among the women living with HIV. There was a statistically significant association between the age of the respondents and the view that FC has the potential to prevent unwanted pregnancy (p = 0.002; χ2 = 17.246; df = 4). The relationship between marital status and “ever heard about FC” (p = 0.042; χ2 = 32.529; df = 5), “ever seen an FC” (p = 0.048; χ2 = 34.982; df = 5), “FC has a potential to prevent unwanted pregnancy” (p = 0.006; χ2 = 23.079; df = 5) was significant. Married women who were revealed to have seen FC were significantly associated with the current use of the FC (p = 0.001; χ2 = 12.852; df = 1). 26.5% of the participants put on FC as a measure to prevent HIV during sexual activities. Most married women did not know whether their sexual partner does not like them to use FC when having sex compared to separated, cohabiting, divorced or single WLHIV (p=0.034; χ2=7.949; df = 10). Conclusion: The relatively high knowledge among WLHIV does not translate to the use of FC for appropriate and consistent utilization of the device.

The relationship between infectious agents and juvenile dermatomyositis: a narrative update from the pediatric perspective.

Juvenile dermatomyositis (JDM) is the most common inflammatory myopathy affecting children, being marked by chronic inflammation which mostly impacts on both skin and skeletal muscles; diagnostic criteria of JDM include an unforeseeable mixture of clinical features, while treatment modalities commonly require corticosteroids or immunosuppressant agents. Although the pathogenesis of JDM is not completely understood, several infectious triggers have been linked to its priming via anecdotal reports related to children. Pediatric cases of recent-onset JDM have been temporally associated to an infectious disease by the power of increased titers of circulating antibodies to a putative infectious agent, including parasites, and/or detectable viral RNA or bacterial DNA. With this narrative review we offer an update about JDM association with a host of infections, namely parvovirus B19, Epstein-Barr virus, Coxsackie virus, human immune deficiency virus, severe acute respiratory syndrome coronavirus 2, Mycoplasma pneumoniae and Toxoplasma gondii, as resulting from the medical literature. Few are the evidence-proved results addressing JDM as an unambiguous post-infectious disorder and available data specifically related to children are poor, highlighting the need of further research into the exploration between environmental cut-out factors and JDM.

Community Engagement in Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome Analysis at the Grassroots in Rural Tanzania: A Case of Visual Problem Appraisal for AIDS and Rural Development

Missed grounded analysis of Human Immune Deficiency Virus/ Acquired Immune Deficiency Syndrome Analysis (HIV/AIDS) at the grassroots level has led to the persistence of the pandemic in rural areas. This pseudo-experimental study aimed to explore the potentiality of Visual Problem Appraisal of AIDS and Rural Development (VPA A & RD) in supporting grassroots capacity to make informed choices through grounded analysis of the HIV/AIDS problem. Primary data were collected through VPA A & RD workshops, Focus Group Discussions (FGDs), key informant interviews, physical visits and observations. The secretariat of Matombo Division Farmers Groups’ Local Network (MVIWATAMA) was involved directly in a strategic selection of 20 (14 males and six females) workshop participants from Kifindike, Tawa, Uponda, Kiswira and Konde villages. The collected data, narratives and observations were verified and compared with relevant literature for interpretation and interrelations. The tool was found to be useful in engaging, empowering and supporting small-scale farmers’ informed choices. In addition, findings indicate that the persistence of HIV/AIDS in rural areas is due to improper analysis of the problem and review of HIV/AIDS policy. The study, among other things, recommends the establishment of an HIV/AIDS policy working paper and the incorporation of VPA potential in Tanzania universities’ curricula to enhance critical thinking among graduates.

Incidence and predictors of attrition among human immunodeficiency virus infected children on antiretroviral therapy in Amhara comprehensive specialized hospitals, Northwest Ethiopia, 2022: a retrospective cohort study

Attrition rate is higher in developing nations and it leftovers a major obstacle to enhance the benefits of therapy and achieve the 90–90–90 plan targets. Despite this fact, data on the incidence and its predictors of attrition among human immune deficiency virus infected children on antiretroviral therapy are limited in developing countries including Ethiopia especially after the test and treat strategy implemented. This study aimed to assess the incidence and predictors of attrition among human immune deficiency virus infected children on antiretroviral therapy in Amhara Comprehensive Specialized Hospitals, Northwest Ethiopia. A retrospective follow-up study was conducted among 359 children on ART from June 14, 2014, to June 14, 2022. Study participants were selected using simple random sampling method and the data were collected using Kobo Toolbox software and analysis was done by STATA version 14. Both bi-variable and multivariable Cox regression models were fitted to ascertain predictors. Lastly, an AHR with a 95% CI was computed and variables with a p-value of < 0.05 were took an account statistically key predictors of attrition. The overall incidence of attrition rate was 9.8 (95% CI 7.9, 11.9) per 100 PYO. Children having baseline hemoglobin < 10 mg/dl (AHR 3.94; 95% CI 2.32, 6.7), suboptimal adherence (AHR 1.96; 95% CI 1.23, 3.13), baseline opportunistic infection (AHR 1.8; 95% CI 1.17, 2.96), and children who had experienced drug side effects (AHR 8.3; 95% CI 4.93, 13.84) were established to be a significant predictors of attrition. The attrition rate was relatively high. Decreased hemoglobin, suboptimal adherence, presence of drug side effects and baseline opportunistic infection were predictors of attrition. Therefore, it is crucial to detect and give special emphasis to those identified predictors promptly.

Factors influencing self-efficacy for self-management among adult people with human immune deficiency virus on antiretroviral therapy in public hospitals of south-west Ethiopia.

Self-management is crucial for effective HIV management, and self-efficacy is a mechanism for achieving it, but there is limited evidence on variables that affect self-efficacy. This study aimed to identify factors influencing self-efficacy for self-management among adults on antiretroviral therapy in resource constraint settings. A cross-sectional study was conducted among 422 adult people on antiretroviral therapy in southwest Ethiopia from March to April 2022. Face-to-face interviews were used to gather data using a structured questionnaire on the self-efficacy measure. The data were then imported into Epi Data version 4.2 and exported to SPSS version 26. Descriptive statistics, independent tests, one-way analysis of variance, Pearson correlation, and multivariate linear regression were used to analyze the data. The predictors with p-value of less than 0.05 were declared statistically significant. A total of 413 adults on antiretroviral therapy were interviewed with response rate of 97.9%. The total mean score of self-efficacy for self-management was 15.12 (±2.22) out of 24. Higher age, gender of the female, divorced, duration of diagnosis, and drug side effects were negatively predictors of low self-efficacy. Higher schooling, urban residence, better income, and the use of reminders positively influenced self-efficacy for self-management. The study found low self-efficacy among adults on antiretroviral therapy and higher age, female gender, HIV duration, and presence of drug side effects were associated with lower self-efficacy, while higher schooling, better income, and use of reminder use were associated with higher self-efficacy for self-management. Further research is needed to determine the causal relationship between these variables and self-efficacy.

Polymer Delivery Systems for Long-Acting Antiretroviral Drugs.

The success of long-acting (LA) drug delivery systems (DDSs) is linked to their biocompatible polymers. These are used for extended therapeutic release. For treatment or prevention of human immune deficiency virus type one (HIV-1) infection, LA DDSs hold promise for improved regimen adherence and reduced toxicities. Current examples include Cabenuva, Apretude, and Sunlenca. Each is safe and effective. Alternative promising DDSs include implants, prodrugs, vaginal rings, and microarray patches. Each can further meet patients' needs. We posit that the physicochemical properties of the formulation chemical design can optimize drug release profiles. We posit that the strategic design of LA DDS polymers will further improve controlled drug release to simplify dosing schedules and improve regimen adherence.

The Moderating Role of HIV Stigma on the Relationship between Perceived Social Support and Antiretroviral Therapy Adherence Self-Efficacy among Adult PLHIV in South Africa.

People living with human immune deficiency virus (PLHIV) grapple with distinct challenges, including HIV stigma which affects their antiretroviral therapy (ART) adherence self-efficacy. This study investigates the interaction of HIV stigma and perceived social support on ART adherence self-efficacy among adult PLHIV in South Africa. This study utilized a cross-sectional design that involved 201 participants selected using time location sampling at a tertiary health facility in Durban. HIV stigma was significantly and negatively associated with self-efficacy (β = -7.860, t = -4.654, p = .001), with variations across different stigma levels (β = -5.844, t = -4.003, p = .001). Social support was significantly and positively associated with self-efficacy at lower HIV stigma levels (β = 7.440, t = 3.887, p = .001), in contrast to higher levels (β = -2.825, t = 1.400, p = .163). Social support significantly influences ART adherence self-efficacy, particularly at lower levels of HIV stigma, but the effect of support weakens as stigma intensifies.

Modeling Health Systems and Male-Partner Involvement Determinants of Prevention of Mother to Child Transmission of Human Immune-deficiency Virus among Women in Homa Bay County Referral Hospital, Kenya

In 2017, Homa Bay County accounted for 10% of HIV cases among children aged 0-14 years in Kenya. Additionally, it reported 8.8% of new HIV infections among children of the same age group and 9.7% of annual AIDS-related mortalities. In 2018, the County reported a mother-to-child transmission (MTCT) rate of 8.1%, higher than the 5% target set by WHO. Limited studies in Kenya have documented health systems and male-partner involvement determinants of prevention of MTCT (PMTCT) of HIV, which vary by context. Thus, this paper documents health systems and male-partner involvement determinants of PMTCT outcomes among women attending Homa Bay County Referral Hospital. We used an analytical cross-sectional study design that had a sample of 274 (Fishers et al. 1998) randomly selected from 4129 women of reproductive age ever on PMTCT follow-up. Questionnaires were used to collect data from the women on child HIV status, health systems factors, and male partner-involvement factors. The mean age of the women was 32.16 years. Results show that provision and discussion of infant diagnosis results by health care providers increased the chances of occurrence of HIV seronegative PMTCT outcome by 1.5 times (OR=1.530, 95% CI: 0.361-6.486; p&lt;0.0001). Provision of routine pre-conception counselling decreased the odds of determining PMTCT outcome by 60% (OR=0.404, 95% CI: 0.046-3.521; p=0.018). Males knowing the HIV status of their partner had higher odds of determining the occurrence of HIV seronegative PMTCT outcome (OR=6.0, 95% CI: 0.655-54.997; p&lt;0.0001). Health systems factors aligned with the provision and discussion of infant diagnosis results by healthcare provider and male-partner involvement factor related to the male partner knowing the HIV status of participant(s) demonstrated higher chances of predicting the occurrence of HIV seronegative for the child. These findings will inform the formulation of interventions geared towards reducing the high MTCT rates in Homa Bay County

Health literacy and adherence to care by people living with Human Immune Deficiency Virus (PLWHIV) in Nasarawa State

Background: Adherence to care among people living with the Human Immunodeficiency Virus (PLWHIV) has become a serious concern for healthcare practitioners. This study aimed to determine the health literacy (HL) and level of adherence to care among PLWHIV in Nasarawa State.Methodology: This was a cross-sectional study conducted on 396 HIV patients accessing antiretroviral therapy in Nasarawa State from June to July 2023. Two pretested interview-administered questionnaires were used to collect data on HL and adherence to care. Data entry and analysis were done using IBM Statistical Package for Social Science (SPSS) version 25.0. Descriptive statistics were used to describe respondent’s characteristics. Categorical variables were reported as frequencies and percentages. The association of HL domains with the level of adherence to care was determined using F-stat.Results: The dimensions of health literacy, including feeling understood and supported by healthcare providers, the ability to actively engage with healthcare providers, and navigating the healthcare system, were found to be significantly associated with the age of the respondents (p&lt; 0.05). High health literacy and a good level of adherence to care were found in 65.7% of the population. Adherence to care was significantly associated with HL, age, level of education, and marital status (p&lt; 0.05).Conclusion: The level of adherence to care by PLWHIV in Nasarawa State is significantly associated with HL. To enhance treatment adherence, healthcare professionals should boost the HL of PLWHIV in Nasarawa State by providing clearer and more accessible health information to patients during clinic visits.

Varicella-associated disseminated intravascular coagulation secondary to Henoch-Schönlein purpura with renal and gastrointestinal system involvement in a child: A case report.

Immunocompromised patients who developed varicella-zoster virus (VZV)-associated disseminated intravascular coagulation (DIC) previously included recipients of bone marrow, hematopoietic stem cell, or organ transplantations, patients with primary nephropathy receiving corticosteroid therapy, cancer patients receiving chemotherapy, and patients with human immune deficiency virus infection. The case reported here is novel because, to our knowledge, there has been no report of VZV-associated DIC after the onset of Henoch-Schönlein purpura (HSP). To report the successful treatment of a novel pediatric case with VZV-associated DIC secondary to HSP. An 8-year-old girl developed VZV-associated DIC 24 days after diagnosis of HSP with renal and gastrointestinal involvement. She was treated with methylprednisolone at a local hospital for 19 days, and suddenly developed fever starting from day 4 in our hospital. Her fever persisted with vesicular skin rashes on her back, strong abdominal and lower back pain, epistaxis, hematochezia, erosion and bleeding on her lips, in her mouth and at puncture sites on day 5. She was diagnosed with DIC with the laboratory evidence of dramatically decreased platelet count and fibrinogen, prolonged activated partial thromboplastin time and prothrombin time, and increased fibrin degradation products including d-dimers. She also developed multiple organ dysfunction syndrome. On day 7, the patient VZV nucleic acid result turned out to be positive. Methylprednisolone treatment was discontinued, and she was given a multi-modality therapy including medications of acyclovir and antibiotics, intravenous gamma-immunoglobulin, various blood product transfusions, continuous renal replacement therapy, plasma exchange, and administration of liver and gastrointestinal system protection drugs. The patient multi-organ function damage gradually recovered. After VZV control, the patient was treated with oral methylprednisolone again for HSP with nephritis. Urine analysis was normal 1 year later, and oral hormone was discontinued. No complication or relapse occurred during 2 years of follow-up. This case report, for the first time, adds HSP treated with corticosteroids to the spectrum of clinical conditions that progressed to life-threatening secondary varicella-associated DIC. Early identification of varicella infection and DIC, combined with timely antiviral, immunoglobulin transfusion, plasma exchange, and other combined therapies are essential for saving patients' lives.

The association between depression and efavirenz-based antiretroviral treatment in people living with human immune-deficiency virus: a systematic review

The neuropsychiatric disturbance such as depression in people living with (PLHIV) requires serious attention as this affects their health outcome. Efavirenz (EFV)-based treatment has been associated with neuropsychiatric adverse events, but its mechanism still unknown. The purpose of this systematic review is to dissect recent studies regarding EFV and depression, in the hope to discover reasonings behind this association. PRISMA flow chart was used to search for the related literatures in the last five years (2018-2023). Targeted population was PLHIV on EFV-based ART only and/or compared with non-EFV-based ART. Relevant keywords used to search were HIV, efavirenz and depression. Five eligible articles were selected which included a total of 3272 PLHIV. Overall, three studies agreed that EFV-based ART was related to depression, while the other two studies did not. It was shown that EFV-based ART did cause neuropsychiatric adverse effects in the first few weeks of treatment, but subsided after several months. However, longer-term research is needed to determine its long-term effects. Variation of results in different studies must be influenced by the possible genetic factors, baseline depression, different social and psychological circumstances throughout the treatment and different assessment tools for depression. Depression on EFV-based treatment in PLHIV may manifest in the initial few weeks of treatment, and additional research is still needed to determine its effects throughout longer treatment durations. Early diagnosis of depression in PLHIV is essential to decide the best choice of ARV for better outcome.

Perceptions of HIV Positive Mothers on Feeding Options for their Potentially HIV Infection-Exposed Infants at Beitbridge Hospital, Zimbabwe

Infant feeding directly affects the nutritional status of children under 2-years of age and, ultimately, impact child survival. Human Immune Deficiency Virus (HIV) infection brings even more challenges to the feeding practices of HIV positive mothers due to adjustments with the aim of preventing mother-to-child HIV transmission. The perceptions of HIV positive mothers on the feeding options adopted for their exposed infants at Beitbridge District Hospital, Zimbabwe, was explored. A qualitative approach was utilized for the study using purposive sampling to select a sample of 11 mothers on whom in-depth structured interviews were conducted. Knowledge gaps pertaining to the recommended feeding options with most of them not adhering to the ideal feeding options existed amongst HIV naïve mother. Some practiced exclusive breastfeeding, others used mixed feeding. Constraints included culture which has a strong impact on feeding options and lack of partner and family support, coupled with low HIV status disclosure levels. Ways of improving adherence to ideal feeding options were suggested as educating and counselling HIV positive mothers on feeding options and follow-ups to enhance ideal feeding practices. Recommendations were to capacitate the midwives with the requisite information to facilitate education and empowerment of the mothers for informed infant feeding choices through review of curriculum. Review of strategies for enforcing a breastfeeding environment was also recommended. There is also need to address cultural, autonomy and stigma challenges through scaling up psycho-social and gender empowerment strategies for women. Promotion of the integration of HIV infant feeding strategies into other child health services is essential.

Assessments of viral load and haematological parameters in HIV patients on HAART in Ilorin, Kwara state

Human immune deficiency virus (HIV) infection represents the most common cause of acquired immune deficiency and leads to clinical disease referred to as Acquired Immune Deficiency Syndrome (AIDS). Highly active antiretroviral therapies (HAART) are the gold standard for the management of HIV disease. Viral load indicates that treatment is effective. A high viral load in a person on treatment indicates either that the medication is not being taken properly or that the virus is becoming resistant to the medication. This is a comparative study aimed at assessing the Viral load count and haematological parameters. 120 HIV positive individual and 40 HIV negative subjects were recruited for this study,while haematological parameters were carried out using Sysmex KX-21 analyser. Results was analyzed using SPSS version 20. .Our result shows the following mean absolute counts of haematological parameters; lymphocyte count of HIV positive persons to be 1.42±1.82, Neutrophil 1.64±2.80, Monocyte 0.07±0.08, Basophil 0.05±0.06 Eosinophil 1.71±3.42 while the mean value of TWBC 5.130±1.43, RBC 3.97±0.48, HB 11.41±1.65, MCV 87.054±15.59 and MCHC MCHCf/l, compared to 0.78±0.08, 1.10±0.32, 0.06±0.02, 0.01±0.01 and 1.14±3.42 respectively among the HIV negative individual. In conclusion, we found that the use of antiretroviral drugs could positively or negatively affect haematological parameters, depending on the choice of combination used.

Detection of KatG Mutation in MDR Mycobacterium Tuberculosis Isolates by PCR-RFLP and DNA Sequencing

Objective: Tuberculosis (TB) is among the widespread and rapidly growing infections in the world. Furthermore, TB is one of the major public health problems in Pakistan as every year 48,000 Pakistani dies due to this infection. Pakistan ranks fifth among high burden countries worldwide. As the TB has become most threatening because of the epidemics of human immune deficiency virus (HIV), Covid-19 and the emergence of multi-drug resistance (MDR) strains of Mycobacterium tuberculosis (M. tb). This study was aimed to understand the genetic mechanism of drug resistance in local TB isolates. Methodology: For the genetic studies of INH resistance, KatG (encoding catalase peroxidase) hotspot region was amplified through PCR followed by RFLP and sequencing. Results: The study of PCR-RFLP showed that forty-five out eighty INH resistant M. tb strains had mutations in KatG (codon 315) which is 56.2% of all cases. Sequencing results revealed that this is substitution mutation; AGC to ACC (Ser315Thr). Conclusion: It may be concluded that majority of INH resistance is due to the mutation in the codon 315 of KatG in local isolates. Furthermore, PCR-RFLP technique could be considered as a reliable method for the early detection of KatG mutations in MDR-TB. Bangladesh Journal of Medical Science Vol. 22 No. 04 October’23 Page : 804-808

Prevalence of Trichomonas vaginalis infections amongst female students’ of tertiary institutions in Ogun State, Nigeria

Trichomonas vaginalis is a parasitic protozoan and the causative agent responsible for vaginal trichomoniasis in women. Trichomoniasis is a sexually transmitted disease with significant public health impacts with vaginitis, cervicitis, urethritis, and pelvic inflammatory disease. TV also affects birth outcomes and is known to be associated with human immune deficiency virus transmission and its acquisition. A cross-sectional study was undertaken; it involves 250 female undergraduate students assessed for Trichomonas vaginalis infection. Fifteen milliliters of early morning urine samples were collected with a sterile disposable universal bottle, the trophozoites presence observed within 10 min of samples collection. The urine samples were centrifuged at 25 ℃ for 13 min at 1,500 rpm. Wet-mount microscopy examination performed using a drop of vortex sediments from the urine samples for their appearances, if bloody or cloudy and also screened for the presence of trophozoites of Trichomonas vaginalis. 56 (22.4%) were within the age bracket of 17 – 21 years, 124 (49.9%) were of the age range of 22 – 26 years, 42 (16.8%) were in the age group of 27 – 31 years, and 28 (11.2%) were 31 years and above. The rate of infections was significantly varied by age group, with the highest being in sexually active young women aged between 22–26 years 10 (80.7%) and the lowest in the age group 31 years (7.1%). It concluded that Trichomonas vaginalis control should be a public health authorities concern that can manage multiple health inequalities noted in some less privileged towns and villages in Nigeria.

A review of the role of liver resection in the treatment of human immuno-deficiency virus-positive patients with hepatocellular carcinoma

Patients with human immune-deficiency virus (HIV) have increased risk of developing hepatocellular carcinoma (HCC); this neoplasm apparently behaves more aggressively in this population, leading to worse outcomes. Questions remain regarding the best treatment of HCC in these patients, mainly related to the role of surgical resection. Some studies show that, after transplantation, this group of patients has an overall survival rate comparable to that of uninfected patients. This integrative review assesses and summarize the survival outcome of resection in the treatment of HIV-positive patients with HCC. Integrative review of articles published in English, in PubMed and Scielo databases until October 2021, using the terms: HIV, HCC, and resection. Four publications were analyzed in relation to their content and relevance to the research question. We identified 54 patients who underwent surgical resection, with great variability in overall survival between studies (median between 18 and 72 months); only one study demonstrated disease-free survival. There was also great variability in morbidity and mortality rates after the procedure. All studies were non-comparable. Data regarding the impact of surgical resection on survival in HIV-positive patients with HCC are scarce, and questions remain about the best treatment options with curative intent. Further studies on the topic are needed, given the practical implications for decision-making. Therefore, we suggest that the treatment of these patients should still be conducted similarly to that indicated by the main guidelines on the treatment of patients with HCC, without distinction to HIV serology.  

A microfluidics chemiluminescence immunosensor based on orientation of antibody for HIV-1 p24 antigen detection

The HIV-1 capsid protein, p24 antigen, is a recognizable early diagnostic biomarker for human immune deficiency virus (HIV) infection. However, the existing methods address the limitations of high cost, cumbersome operations, long analysis time, and insufficient sensitivity and selectivity. Herein, an antibody oriented microfluidic chemiluminescence biosensor based on multiple signal amplification strategy was developed for rapid and ultrasensitive detection of HIV-1 p24 antigen. The microfluidic device contained an upstream snake-shape mixing channel and a downstream ship-shape microcavity with micropillar arrays for sufficient mixing of CL reagents, efficient capture of p24 antigen, double antibody sandwich reaction, hybridization chain reaction (HCR) amplification and CL detection. The multiple signal amplification was realized by antibody orientation, multiple HCRs on antibody and initiator chain modified gold nanoparticles (Ab2-AuNPs-I), and HRP and AuNPs synergistic catalyzed CL reaction. Using the platform, the detection of target p24 is converted to the detection of nucleic acid with a limit detection of 0.212 pg mL−1 and excellent specificity within 2 h of total analysis time, which is better or comparable to previously reported biosensors. Moreover, the biosensor exhibited an excellent recovery rate ranging from 92.7% to 102.3%. Therefore, the proposed method holds great potential in clinical diagnosis.