Acquired Immunodeficiency Syndrome Research Articles

Identifying 10-year cumulative incidence and risk of revision following total hip arthroplasty in patients with and without a diagnosis of human immunodeficiency virus.

Prior studies have shown human immunodeficiency virus (HIV) may be a risk factor for early revision following THA, but little data exists looking at long-term implant survivorship. Therefore, the purpose of this study was to compare the 10-year cumulative incidence rate for revision following THA in patients with and without HIV. A retrospective cohort analysis of patients with HIV undergoing elective THA was conducted using a national database. Patients were stratified into asymptomatic HIV (AHIV) and acquired immune deficiency syndrome (AIDS) cohorts. These patients were propensity-score matched to a group of elective THA patients without HIV based on age, gender, and Charlson Comorbidity Index (CCI) at a 1:2 ratio. Kaplan-Meier and Cox Proportional Hazards Regression Analyses were used to assess cumulative incidence and risk of revisions within 10-years of the index procedure. In total, 678 patients were at-risk at the 10-year mark. There were no differences in 10-year risk of revision THA, amongst patients with HIV when compared to matched and unmatched controls (p > 0.05 for all). Patients with HIV did have an increased risk of periprosthetic joint infection (PJI) following THA when compared to the unmatched control (p = 0.001). Surgeons and patients can be reassured of comparable 10-year revision rates in patients with and without HIV. However, as these patients are at increased risk for PJI and PPF, especially those with AIDS, when compared to the general population, surgeons should consider PJI prophylactic modalities in this patient population.

Structural aspects of HIV-1 integrase inhibitors: SAR studies and synthetic strategies.

Acquired immunodeficiency syndrome (AIDS) poses a significant threat to life. Antiretroviral therapy is employed to diminish the replication of the human immunodeficiency virus (HIV), extending life expectancy and improving the quality of patients' lives. These HIV-1 integrase inhibitors form robust covalent interactions with Mg2+ ions, contributing to their tight binding, thereby inhibiting the integration of viral DNA into the CD4 cell DNA. The second-generation INSTIs, the most recently approved, exhibit a higher genetic barrier compared to first-generation drugs. Hence, there is a need to develop novel and safe compounds as inhibitors of HIV-1 integrase. This article presents an overview of the current landscape of anti-HIV-1 integrase inhibitors, emphasizing the structure-activity relationship (SAR) of small molecules. The molecules discussed include monocyclic rings consisting of triazoles moiety, and pyrimidine analog along with bicyclic rings with nitrogen-containing moieties. Researchers are exploring anti-HIV-1 integrase inhibitors from natural sources like marine environments, plant extracts, and microbial products, emphasizing the importance of diverse bioactive compounds in combating the virus, which have also been included in the manuscript. The current manuscript will be helpful to the scientific community engaged in the manipulation of small molecules as anti-HIV integrase inhibitors for designing newer leads.

Combination Therapy for Cryptosporidiosis in Immunocompromised Patients: A Systematic Review

Cryptosporidium sp. is a pathogen that causes gastroenteritis and may increase mortality and morbidity in immunocompromised patients. Cryptosporidium became widely recognized as a human pathogen. Diarrhea is a common problem in AIDS patients and about 30%–60% of patients in developed countries and 90% in developing countries experience diarrhea. This study was conducted using a systematic review design. Two articles with cohort design and two with case report design were selected based on the eligibility criteria. Three of these studies used a combination of nitazoxanide with azithromycin as an intervention, one in cohort design and two in case report design. One cohort study used a nitazoxanide and fluoroquinolone combination as an intervention. 54 samples participated in this study were post kidney transplantation patients and one sample was with acute lymphoblastic leukemia (ALL). Nitazoxanide and fluoroquinolone combination is a better therapy for cryptosporidiosis in immunocompromised patients compared to nitazoxanide and azithromycin combination. The(OR) for stool clearance was significantly lower with nitazoxanide alone compared to that of nitazoxanide and fluoroquinolone (OR: 0.65, 95% CI: 0.34, 0.92, P= 0.01), and the OR for diarrhea stopped was significantly lower with nitazoxanide alone compared to that of nitazoxanide and fluoroquinolone (OR: 0.45, 95% CI: 0.21, 0.81, P= 0.004). The OR for stool clearance was lower with nitazoxanide and azithromycin than monotherapy (OR 0.27, 95% CI: 0.01, 5.77), but P=0.24, which means not statistically significant.

PNPLA3 as a driver of steatotic liver disease: navigating from pathobiology to the clinics via epidemiology

Steatotic liver disease (SLD), particularly metabolic dysfunction-associated SLD, represents a significant public health concern worldwide. Among the various factors implicated in the development and progression of this condition, the patatin-like phospholipase domain-containing protein 3 (PNPLA3 ) gene has emerged as a critical player. Variants of PNPLA3 are associated with altered lipid metabolism, leading to increased hepatic fat accumulation and subsequent inflammation and fibrosis. Understanding the role of PNPLA3 not only enhances our comprehension of the pathomechanisms driving SLD but also informs potential therapeutic strategies. The molecular mechanisms through which PNPLA3 variants contribute to lipid dysregulation and hepatocyte injury in SLD are critically discussed in the present review article. We extensively analyze clinical cohorts and population-based studies underpinning the association between PNPLA3 polymorphisms and the risk of developing SLD, and its liver-related and protean extrahepatic outcomes, in concert with other risk modifiers, notably including age, sex, and ethnicity in adults and children. We also discuss the increasingly recognized role played by the PNPLA3 gene in liver transplantation, autoimmune hepatitis, and acquired immunodeficiency syndrome. Finally, we examine the clinical implications of PNPLA3 diagnostics regarding risk stratification and targeted therapies for patients affected by SLD in the context of precision medicine approaches.

Health Promoting Properties of Vitamins C and D Against HIV Disease Progression, a Narrative Review

Human immunodeficiency virus (HIV) has troubled humankind for many years. The rate of new HIV cases is decreasing steadily, mostly because of safer sexual practices and scientific advances in medicine. However, the number of HIV-related trials has significantly increased, as the search for a definite cure for HIV is still fruitless. Our current treatment options involve antiretroviral therapy (ART) with various drug combinations that lower the patients’ viral load in order for the immune system to reconstitute itself. This way, adherent patients achieve a life expectancy similar to the general population. Besides the established treatment protocols, the focus has currently shifted towards secondary pharmaceutical regimen programs that enhance a patient’s immune system and response to opportunistic infections. Vitamins C and D are easily obtainable even in the developing world and are known to improve an individual’s daily life, with vitamin D enhancing the human immune response and vitamin C having an assisting role in both the immune response and as an important antioxidant. Recently, many studies assessing the effect of these vitamins on the progression of HIV have been performed. We aimed to collect and review these studies in order to determine the necessity of the supplementation of these vitamins in HIV-infected patients, which might complement the existing ART. To this day, the scientific community is conflicted, and more studies must be conducted before a definite conclusion about these vitamins’ effects on HIV patients can be reached.

Care-educational game for men who have sex with men and live with HIV and Aids

Objective: To describe the construction of a board game-type care-educational technology for the health education of men who have sex with men and live with the Human Immunodeficiency Virus and Acquired Immunodeficiency Syndrome, within the scope of Primary Health Care. Methods: Methodological study, developed from a participatory perspective in four stages: development of a scoping review; theorization and construction of the technology; appraisal; and final design. Results: The game “HIVIVENDO E APRENDENDO” was constructed considering the integrative perspective of care for the target population, addressing in its content aspects about the infection and the disease, welcoming, treatment adherence, related stigmas and prejudices, citizenship, and quality of life. Conclusion: With the developed care-educational technology, it is intended that, after the validation phase, it can become a facilitating tool for promoting health education for both professionals and users in Primary Health Care.

HIV-TB Coinfection: A Systemic Review and Meta-analysis Insights

HIV and Tuberculosis (TB) are the leading global causes of death among patients with infectious diseases. They contribute significantly to morbidity around the world because of their impact on shared immune defense mechanisms. Tuberculosis is an infection that exploits the vulnerability of compromised immune systems. Opportunistic infections are illnesses that are more frequent or severe in individuals with compromised immune systems. HIV weakens the immune system, making people more susceptible to tuberculosis. When someone is infected with both HIV and tuberculosis, this is known as HIV/TB coinfection. HIV and tuberculosis represent the primary infectious disease challenges in countries with limited resources. In affected individuals, the interaction between Mycobacterium tuberculosis and HIV exacerbates the effects of each other, hastening the decline of immune function and leading to premature mortality if left untreated. Individuals with HIV are more likely than those without HIV to develop active tuberculosis as a result of untreated latent tuberculosis. Antiretroviral therapy (ART) is the use of HIV medications to protect the immune system and prevent the progression of HIV to acquired immunodeficiency syndrome (AIDS). In people with HIV and latent tuberculosis, combined treatment with HIV and TB medications reduces the likelihood of latent tuberculosis progressing to active tuberculosis. The purpose of this research is to understand better the pathogenesis and pathways of HIV/TB co-infection, as well as to investigate drug-drug interactions in multi-drug therapies.

Ocular manifestations and treatment course of monkeypox virus in two males with acquired immunodeficiency syndrome

Introduction: Mpox (formerly monkeypox) is a previously endemic virus that has become a global concern. Case Report: In this case series, we present two cases of ocular mpox in men with acquired immunodeficiency syndrome (AIDS), highlighting their clinical presentation, diagnosis, and management. Treatment involved the use of antiviral medications, tecovirimat and ganciclovir, based on limited existing data and recommendations from the Center for Disease Control (CDC). Conclusion: These cases highlight the variability in presentation among AIDS patients with extensive corneal and conjunctival involvement and the potential for immune reconstitution inflammatory syndrome upon re-initiation of anti-retroviral therapy during active mpox infection. These cases emphasize the importance of early recognition, involvement of ophthalmology, and a multidisciplinary approach to prevent vision-threatening complications.

A systematic review of multi-level intervention to enhance the quality of life patient with human immunodeficiency virus

Human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) are still challenges worldwide. Improvement in quality of life (QoL) is crucial for HIV-infected people. The QoL of HIV-infected patients has been improved by the use of multilevel interventions in various circumstances. This study evaluates the evidence for interventions that target the quality of life of persons with HIV. A systematic review was performed according to the PRISMA guidelines. Science Direct, the Cochrane Library database, and Pubmed were also searched. Three independent reviewers extracted the data. Searches were conducted for articles published from 2013 to 2023. Searching procedures and data abstraction techniques were standardized. The 27 research examined the effects of interventions on HIVinfected people's quality of life. China is the most frequently mentioned country in the 27 studies, appearing as the setting in 8 (29.6%). Following South Africa (14.8%), New York (11.11%) and Kenya (7.4%) were the next most often mentioned countries. For analysis purposes, the interventions used in the 27 reviewed studies were classified into three main categories: individual intervention, family-community intervention, and health service intervention. Significant intervention innovations in quality-of-life research combining several interventions, including individual, family, community, and health system intervention, show the most promising results

The elderly population’s social networks and HIV perceptions: Evidence from China

ABSTRACT Background: Previous studies have found that people with low participation in social activities and living alone were prone to have risky sexual behaviors, while people with high participation in social activities were less prone to have risky sexual behaviors. Based on the above assumptions, we conducted an analysis on elderly population’s social networks and human immunodeficiency virus (HIV) risky behaviors in China. In the survey study, considering the sensitivity of sexual behavior, HIV risk behavior of the elderly population is more difficult to measure, so the intermediate variable of HIV perceptions was used instead of the sexual behavioral variable. Methods: A cross-sectional study was conducted in July to September 2023 among the elderly aged ≥ 50 years in China to measure the social networks with the Social Support Rate Scale (SSRS) and to measure the HIV perceptions of the elderly with the degree of knowledge of acquired immunodeficiency syndrome (AIDS) prevention and treatment and the degree of discrimination of HIV/AIDS patients, and the data were statistically analyzed with SPSS 27.0 software. Statistical analysis methods included descriptive analyses such as frequency, percentage, mean ± standard deviation, and median, two independent samples t-test analysis, and multivariate logistic regression model analysis. Results: Among the 1022 elderly people surveyed, the proportion of those with weak and strong levels of social support was 46.9% and 53.1%, respectively; the proportion of those with low, medium, and high levels of HIV knowledge perceptions was 4.8%, 5.9%, and 89.3%, respectively; and the proportion of those with low, medium, and high levels of attitudinal perceptions was 24.7%, 35.0%, and 40.3%, respectively. Based on the Goodman–Kruskal Gamma test, it was found that there was a positive correlation between social support and HIV knowledge perceptions in the elderly population, and there was a negative correlation between social support and HIV attitudinal perceptions in the elderly population. Ethnicity, current occupation or pre-retirement occupation, personal average after-tax monthly income, attitudinal perceptions, and social support were the influencing factors for the knowledge perceptions in the elderly population (P < 0.05); literacy, number of children, mode of residence, personal average monthly income after tax, knowledge perceptions, and social support were the influencing factors of attitudinal perceptions in the elderly population (P < 0.05). Conclusions: There is a correlation between social networks and HIV perceptions in China’s elderly population, which is positively correlated with HIV knowledge perceptions and negatively correlated with HIV attitudinal perceptions, and it is important to improve the HIV prevention and knowledge of the elderly population and reduce their HIV-related discrimination.

Comparison of IL-6, IL-10, and TNFα levels between PLWHIV with and without Kaposi Sarcoma and healthy controls.

Kaposi sarcoma (KS) is an angioproliferative disease caused by human herpesvirus 8 (HHV-8) and is mediated by cytokines in an immunodeficient environment. This study aimed to compare IL-6, IL-10, and TNFα levels among AIDS patients with disseminated KS (DKS), treatment naïve patients living with HIV (PLWHIV) without DKS, and healthy controls. Secondary outcomes were to compare cytokines levels in patients with DKS and unfavorable outcomes, as well as an analysis of the behavior of cytokines over time. This cohort study was performed at two centers in Mexico City. Three groups were included. Group 1: HIV+ treatment naïve with DKS, Group 2: HIV+ treatment naïve without KS, and Group 3: HIV negative, healthy controls. Plasmatic IL-6, IL-10, and TNFα levels were measured at baseline and over time in Groups 1 and 2. Seventy-six patients were included: 39 (52%) in Group 1, 17 (22%) in Group 2, and 20 (26%) in Group 3. The median baseline IL-6, IL-10, and TNFα levels were significantly higher in group 1. In group 1, baseline IL-6 was higher in patients who died than in survivors (14.4 vs 5.8 pg/mL p=0.048). Patients with severe immune reconstitution inflammatory syndrome due to KS (S-IRIS-KS) had higher IL-6 values than those without it (14.4 vs 5.8 pg/mL p=0.004). In the repeated-measures model in group 1, IL-10 levels were higher in patients who died (p<0.001) and developed IRIS-KS (p=0.01). IL-6, IL-10, and TNF α levels were markedly higher in patients with DKS. IL-6 and IL-10 levels were higher in patients with unfavorable outcomes.

Evaluating compliance with quality indicators of HIV and AIDS clinical care and analyzing those associated with mortality in the Democratic Republic of Congo

BackgroundSince human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) infection have been identified, significant improvements have been made concerning its diagnosis and treatment. Few contributions have been made in the area of quality indicators in the Democratic Republic of Congo (DRC). To address this gap, a recent study conducted in the said area in 2023 resulted in the development of a comprehensive list of 88 indicators for assessing the quality of clinical care for HIV and AIDS. Out of these, 66 were identified as a core set of quality indicators for the assessment of HIV and AIDS clinical care. The aim of this study was to evaluate compliance with these quality indicators and determine those that are associated with mortality among people living with HIV and AIDS (PLWHA) in the DRC.MethodsA retrospective cohort study was conducted at Panzi Hospital in Bukavu, South Kivu province of the DRC. The study population included PLWHA adult patients who were followed for a period of five years at the antiretroviral (ARV) clinic from January 2017 to December 2021. Descriptive analysis was performed to evaluate essential characteristics, and inferential statistics were performed including a multivariable logistic regression analysis performed to assess the association between selected clinical care indicators and PLWHA mortality, to estimate the odds ratios of mortality based on various factors, and to control for confounding variables.ResultsA total of 884 PLWHA were included. The level of compliance with the quality indicators was 78.79%. In the multivariate analysis, the quality-of-care indicators associated with mortality in the follow-up PLWHA on treatment were items 12 (Late diagnosis of HIV infection in specialized care), 24 (Assessment of resistance in cases of virologic failure), and 38 (Evaluation of Cardiac risk). Other factors associated with mortality were male sex, lower CD4 (< 500mm3) and high viral load (> 50 copies/ml).ConclusionThe level of compliance with the indicators was moderate. Some quality indicators were associated with mortality. These indicators are associated with delayed diagnosis of HIV infection, assessment of resistances in case of virologic failure, and evaluation of cardiac risk. Addressing gaps in adherence to these quality of care indicators (clinical care standards) could potentially reduce mortality rates and enhance the overall management of HIV and AIDS, particularly at Panzi Hospital in Bukavu, South Kivu Province, and in general in the DRC.

Effects of Socio-Economic and Health Variables on Survival Time of HIV/AIDS Patients in Manipuir

Background: The survival time of patients with human immunodeficiency virus (HIV)/ acquired immune deficiency syndrome (AIDS) is associated with many socio-economic, education, employment and socio-cultural factors. High prevalence rates of HIV/AIDS are observed in some Indian States including Manipur. Objectives: It is to examine the effects of socio-economic and health related variables on the survival time of HIV and Hepatitis-C virus (HCV) patients. Materials and Methods: Under simple random sampling without replacement (SRSWOR), it analysed a sample of 200 HIV+ patients attending the ART Centre of Jawaharlal Institute of Medical Science (JNIMS), Imphal during March – July 2016. Using multiple regression models, the significant covariates of the survival time of patients are explored. Findings: The five factors – sex of patient (P&lt;0.05), marital status (P&lt;0.05), family income (P&lt;0.05), patient type (P&lt;0.01) and CD4 count (P&lt;0.05) are found to be significantly influencing the dynamics of survival duration of the patients. Conclusion: In Manipur, the average survival time of the HIV/ AIDS patients is observed to be about six years varying with their sex, marital status, size of family, employment and CD4 count. Keywords: Manipur, regression model, sex, marital status, CD4

Survival and predictors of mortality among HIV-infected adults after initiation of antiretroviral therapy in Eastern Ethiopia Governmental hospitals, from January 2015 to December 2021 (multi-center retrospective follow-up study)

BackgroundHuman Immune Deficiency Virus (HIV) remains the leading cause of morbidity and mortality globally. It can lead to Acquired Immunodeficiency Syndrome (AIDS), which results in gradual deterioration and failure of the immune system. As the immune system becomes compromised, the patient becomes highly susceptible to life-threatening infection which ends with early death. Even though Antiretroviral Therapy (ART) significantly decreases mortality as a whole, the rate of death is still the highest, especially in the first and second years of ART initiation. The study aims to assess the survival and predictors of mortality among HIV-infected adults after initiation of antiretroviral therapy in Jigjiga City Governmental Hospitals, Eastern Ethiopia.MethodInstitution-based Retrospective follow-up study was employed among ART patients from January 1, 2015, to December 31, 2021. Data were cleaned and entered in Epi-data version 3.1 and exported to STATA 14 for further analysis. Kaplan–Meier and Log-Rank tests were applied to compare survival differences among categories of different variables. In bi-variable analysis, P-values < 0.20 were included in a multivariable analysis. A multivariable Cox regression model was used to measure the risk of death identify the and significant predictors of death. Variables that a P-value < 0.05 were considered statistically significant predictors of mortality.ResultIn this study 466(53.34%) participants were male and 552(65.56%) were urban residents about 91(10.81%) have died with an overall incidence rate of 3.92 (95% CI (2.43–5.41)) per 100-person year of observation. The overall survival probability of the study group was 83.97%. In the multivariable Cox regression analysis, baseline World Health Organization (WHO) stage III/IV (AHR = 2.42(1.43–4.09)) have no caregiver (AHR = 2.23; 95% CI (1.16–4.29)), being bedridden functional status (AHR = 2.18; 95% CI (1.01–4.72)), and poor last known adherence level (AHR = 4.23; 95%CI (2.39–7.47)) were found to be significant predictors of mortality.ConclusionThe incidence of death was relatively high, especially in the second year of ART. Baseline clinical WHO stage III/IV, bedridden functional status at enrolment, and absence of caregiver, poor level of recent adherence were found to be independent predictors of mortality. Patients with these risk factors need special attention and are crucial to reducing the rate of mortality.

PERFIL CLÍNICO E EPIDEMIOLÓGICO DE CRIANÇAS E ADOLESCENTES PORTADORES DE HIV/AIDS NO BRASIL

The immunodeficiency virus (HIV) is the etiological agent that causes acquired immunodeficiency syndrome (AIDS). Since the appearance of the first cases, HIV/AIDS has been considered an emerging disease and is characterized as a public health problem due to its high transmission and clinical character. This is a literature review study, with a descriptive qualitative approach, in which articles from 2010 to 2024 were analyzed, with an emphasis on the clinical and epidemiological profile of children and adolescents with HIV/AIDS in Brazil. The results indicate that the majority of children and adolescents with HIV/AIDS are males in the age group of 15 to 19 years and although the incidence rates have remained stable over the years, attention is needed to the distribution of cases, due to the affected population.

Sustained immune activation and impaired epithelial barrier integrity in the ectocervix of women with chronic HIV infection.

Chronic systemic immune activation significantly influences human immunodeficiency virus (HIV) disease progression. Despite evidence of a pro-inflammatory environment in the genital tract of HIV-infected women, comprehensive investigations into cervical tissue from this region remain limited. Similarly, the consequences of chronic HIV infection on the integrity of the female genital epithelium are poorly understood, despite its importance in HIV transmission and replication. Ectocervical biopsies were obtained from HIV-seropositive (n = 14) and HIV-seronegative (n = 47) female Kenyan sex workers. RNA sequencing and bioimage analysis of epithelial junction proteins (E-cadherin, desmoglein-1, claudin-1, and zonula occludens-1) were conducted, along with CD4 staining. RNA sequencing revealed upregulation of immunoregulatory genes in HIV-seropositive women, primarily associated with heightened T cell activity and interferon signaling, which further correlated with plasma viral load. Transcription factor analysis confirmed the upregulation of pro-inflammatory transcription factors, such as RELA, NFKB1, and IKZF3, which facilitates HIV persistence in T cells. Conversely, genes and pathways associated with epithelial barrier function and structure were downregulated in the context of HIV. Digital bioimage analysis corroborated these findings, revealing significant disruption of various epithelial junction proteins in ectocervical tissues of the HIV-seropositive women. Thus, chronic HIV infection associated with ectocervical inflammation, characterized by induced T cell responses and interferon signaling, coupled with epithelial disruption. These alterations may influence HIV transmission and heighten susceptibility to other sexually transmitted infections. These findings prompt exploration of therapeutic interventions to address HIV-related complications and mitigate the risk of sexually transmitted infection transmission.

Chinese guidelines for the diagnosis and treatment of human immunodeficiency virus infection/acquired immunodeficiency syndrome (2024 edition).

The Acquired Immunodeficiency Syndrome Professional Group of the Society of Infectious Diseases of the Chinese Medical Association formulated the first edition of the Chinese Guidelines for the Diagnosis and Treatment of human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) (referred to as the Guidelines) in 2005. The 2024 edition of the Guidelines has been compiled by updating the 2021 fifth edition, incorporating the latest research advancements in antiviral therapy, comprehensive management, opportunistic infections, concurrent tumors, and the prevention and intervention of HIV infection. The new edition also introduces a new section on "Incomplete immune reconstitution", proposes the concept of "HIV vulnerable populations" for the first time with recommendations for their diagnosis and treatment. This edition of the Guidelines covers 14sections: epidemiology, pathogenic characteristics, laboratory tests, pathogenesis, clinical presentation and staging, diagnostic criteria, common opportunistic infections, antiretroviral therapy, immune reconstitution inflammatory syndrome, incomplete immune reconstitution, AIDS-related neoplasms, prevention of mother-to-child transmission and conception in serodiscordant couples, pre- and post-exposure prophylaxis, and whole-course management of HIV infection. This edition of the Guidelines aims to assist clinical physicians in making informed decisions in the diagnosis, treatment, and management of HIV/AIDS and will be periodically revised and updated based on domestic and international research progress.

IMPLANTES DENTÁRIOS INSTALADOS EM PACIENTES PORTADORES DO VIRUS DA IMUNODEFICIENCIA HUMANA (HIV)

The Human Immunodeficiency Virus (HIV) compromises the immune system and, as it progresses, causes acquired immunodeficiency syndrome (AIDS), characterized by the emergence of opportunistic infections. Transmission occurs mainly through sexual contact or via blood and, in Brazil, between 1980 and 2022, more than 1 million cases of AIDS were recorded. Regarding implantology, patients with HIV face oral complications such as gingivitis and candidiasis, and although the impact of osseointegrated implants in these patients is not yet entirely clear, prior evaluation of bone health and conditions is essential. This research aims to describe the care in the osseointegration process in HIV-positive patients, investigating the possible complications and the importance of biosafety, in addition to highlighting the relevance of treatment to improve the quality of life of these patients. The methodology used was the bibliographic review, using articles published between 2012 and 2022 in Portuguese. Oral rehabilitation with dental implants in HIV-positive patients has gained importance due to the increase in life expectancy provided by antiretroviral therapy. These patients, with an improved quality of life, are looking for viable options to replace missing teeth, with dental implants being an attractive alternative. Although the literature on the topic is limited, the results indicate that the success rates of implants in patients with HIV are similar to those of healthy patients, as long as the treatment considers the immune status. However, specific care is needed, such as monitoring for possible complications resulting from the continuous use of antiretrovirals, which can cause liver and kidney problems. Additionally, strict biosafety protocols are essential to ensure the safety of patients and healthcare providers. Further research is recommended to clarify outstanding issues and improve pre- and postoperative care, providing more predictable outcomes and greater safety in treatment with osseointegrated implants.

High-Intensity Interval Training vs. Medium-Intensity Continuous Training in Cardiac Rehabilitation Programs: A Narrative Review.

Exercise-based cardiac rehabilitation (ExCR) programs are essential for patients diagnosed with cardiac diseases. Studies have shown that they aid in the rehabilitation process and may even facilitate a return to previous cardiorespiratory fitness. Also, patients who enroll and follow such programs have shown a lower rate of complications and mortality in the long run. The results vary depending on the type of program followed and the degree of debilitation the disease has caused. Therefore, in order to obtain optimal results, it is ideal to tailor each ExCR program to the individual profile of each patient. At the moment, the two most studied and employed training types are medium-intensity continuous training (MICT) and high-intensity interval training (HIIT). For most of the time, MICT was the first-choice program for patients with cardiovascular disease. In recent years, however, more and more studies have pointed towards the benefits of HIIT and how it better aids patients in recovering their cardiovascular fitness. Generally, MICT is more suited for patients with a severe degradation in functional capacity and who require a higher degree of safety (e.g., elderly, with a high number of comorbidities). On the other hand, while HIIT is more demanding, it appears to offer better outcomes. Therefore, this review aimed to summarize information from different publications on both types of training regimens in ExCR and assess their utility in current clinical practice.

Lessons Learnt from HIV and Noncommunicable Disease Healthcare Integration in Sub-Saharan Africa.

In sub-Saharan Africa (SSA), a rising burden of noncommunicable diseases (NCDs) coexists with a persistent high burden of human immunodeficiency virus (HIV). Integrating care for chronic conditions is potentially beneficial, but the optimal approach remains unclear. By use of a narrative review of 14 recent case studies from different SSA countries, examples of NCD and HIV healthcare integration were described. Case studies were categorized into three models: integrating NCD care into existing HIV care (n = 8), integrating HIV care into existing NCD care (n = 2), and simultaneous implementation of HIV and NCD services (n = 4). Facilitators include staff and patient education, while barriers encompass the lack of guidelines and inadequate infrastructure. Providers, patients, and policymakers support integrated care but note several challenges. Available health economics data suggest cost-effectiveness in the long run. Concluding, NCD and HIV healthcare integration in SSA was deemed feasible with models of service integration related to the implementation context.