Human Immunodeficiency Virus/acquired Immunodeficiency Syndrome Research Articles

Spatio-temporal analysis of pulmonary tuberculosis in Astambul District, South Kalimantan, Indonesia 2020-2021

Respiratory tuberculosis (TB) remains a significant global health concern and ranks among the top 10 leading causes of death worldwide, following human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS). Globally, it is estimated that 1.2 billion people are at risk of being infected with tuberculosis, and Indonesia is the country that contributes the third-highest number of TB cases worldwide, behind China and India. Tuberculosis is still a significant issue in South Kalimantan, notably in Banjar Regency. This study is a descriptive study that intends to identify respiratory TB clusters spatially and temporally in Astambul District during 2020–2021 with the SatScan application, which is visualized as a map of respiratory TB clusters using the Quantum GIS 3.28 application. Data on respiratory TB cases collected from the Banjar District Health Office were examined using retrospective space-time scan statistics, employing a Poisson probability model for analysis. This study found 4 respiratory TB clusters, and 2 of them had significant results, namely in 2020 (RR=6.90, p-value=0.000030) and 2021 (RR=5.27, p-value=0.00003). Factors that affect these clusters are population density, the physical condition of houses, humidity levels, and the availability of health facilities.

Factors influencing adherence to antiretroviral treatment among people living with HIV aged 15 – 60 years at Cité des Palmiers District Hospital, Cameroon

Antiretroviral therapy (ART), essential for halting the progression of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) infection and restoring immunity, should be taken regularly to be effective. This study aimed to assess the factors that may affect adherence to ART among people living with HIV (PLHIV) aged between 15 and 60 years at the Cité des Palmiers District Hospital. Thus, we conducted a descriptive and analytical cross-sectional study using a non-probabilistic, convenience survey. Data were collected using a questionnaire administered to PLHIV aged between 15 and 65 years (n = 309). These factors affecting adherence were established by determining relative and absolute frequencies, and associations were estimated by calculating the odds ratios, confidence intervals, and P-values. Subsequently, 48.5% of participants were found to comply with ART and 51.5% were not. The independent predictors of poor adherence to ART were missed appointments at the HIV unit, occasional use of excitants/cigarettes, fear of disclosing HIV status, perceived limited opening hours of HIV-related services, discomfort with medication, recent initiation of treatment, and use of therapy reminders. Our study results are essential to orient public health policies and measures toward PLHIV non-adherents to ART treatment and mitigate the social, economic, and health impact of HIV threats on developing countries by focusing on good adherence.

Toward a cure - Advancing HIV/AIDs treatment modalities beyond antiretroviral therapy: A Review.

Antiretroviral therapy, also known as antiretroviral therapy (ART), has been at the forefront of the ongoing battle against human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDs). ART is effective, but it has drawbacks such as side effects, medication resistance, and difficulty getting access to treatment, which highlights the urgent need for novel treatment approaches. This review explores the complex field of HIV/AIDS treatment, covering both established alternative treatment modalities and orthodox antiretroviral therapy. Numerous reliable databases were reviewed, including PubMed, Web of Science, Scopus, and Google Scholar. The results of a thorough literature search revealed numerous therapeutic options, including stem cell transplantation, immunotherapy, gene therapy, latency reversal agents, and pharmaceutical vaccinations. While gene therapy has promise for altering cellular resistance to infection and targeting HIV-positive cells, immunotherapy treatments seek to strengthen the immune system's ability to combat HIV. Latency reversal agents offer a promising method of breaking the viral latency and making infected cells vulnerable to immune system destruction or antiretroviral drugs. Furthermore, there is potential for improving immune responses against HIV using medical vaccinations. This review stresses the vital significance of ongoing research and innovation in the hunt for a successful HIV/AIDS treatment through a thorough examination of recent developments and lingering challenges. The assessment notes that even though there has been tremendous progress in treating the illness, there is still more work to be done in addressing current barriers and investigating various treatment options in order to achieve the ultimate objective of putting an end to the HIV/AIDS pandemic.

Profile of HIV/AIDS Patients with Neurological Manifestations in The Tertiary Referral Hospital in Bali

Background: Neurological manifestations in approximately half of Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) patients are related to high morbidity and mortality worldwide. Therefore, there is a need for epidemiological data on HIV/AIDS patients with neurological manifestations in Bali, as an international tourism destination. Objective: This study aimed to describe the clinical profile of neurological manifestations among patients with HIV/AIDS in the tertiary referral hospital for Bali and Nusa Tenggara region. Methods: A descriptive-retrospective study was conducted on HIV/AIDS patients presenting with neurological manifestations hospitalized in the Neurology Department of Prof. Dr. I.G.N.G Ngoerah Hospital Denpasar from January 2018 to December 2021. Results: Among the 227 subjects included in this study, the majority were male (69.9%) and HIV positive newly diagnosed (69.2%). Furthermore, out of 126 subjects who had CD4 data, the majority were with CD4 <200 cells/mm3 (85.7%) and 53.1% were <50 cells/mm3, with ages ranging from 18 to 67 years old, at a median of 36 years old. The most common neurological signs and symptoms found were paresis/paralysis (61.7%), headache (54.6%), decreased consciousness (52.9%), and cranial nerve palsy (52%). Cerebral toxoplasmosis (67.4%) and tuberculous meningoencephalitis (20.3%) were the prevalent opportunistic infections, while the mortality rate was 39.6% with sepsis as the major cause. Conclusions: Neurological manifestations are common initial symptoms in diagnosing HIV infection. Therefore, better awareness and earlier detection are required among people with risk factors of HIV transmission, particularly in groups of young and productive age with signs of immunocompromised condition as well as neurological manifestations.

Improvement and exacerbation of multiple disparities in sexually transmitted infections among children and adolescents aged 6-22 years: An analysis of national surveillance data from 2013 to 2021.

To investigate the progress of disparities in human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), gonorrhea, and syphilis among children and adolescents aged 6-22 years in China during 2013-2021. A total of 614 325 cases data were extracted from the Chinese Information System for Infectious Diseases Control and Prevention during 2013-2021. Puberty health education data were drew from the Student Health Surveillance in 2021. Disparity patterns and average annual percentage changes (AAPCs) in sexually transmitted infections (STIs) incidence or new cases in China were examined using descriptive statistics and joinpoint regression. The incidence across 345 cities was stratified by gross domestic product (GDP). Between 2013 and 2021, there were 614 325 reported cases of HIV/AIDS, gonorrhea, and syphilis among children and adolescents aged 6-22, with an annual average incidence of 24.0967 per 100 000. The expansion of HIV/AIDS has halted, yet the surge in gonorrhea and syphilis remains notably pronounced. The ratio of male to female AIDS incidence increased from 2.75 (2.60, 2.90) to 7.13 (6.68, 7.62), but that of syphilis changed from 0.33 (0.32, 0.34) to 0.56 (0.55, 0.57). Students and out-of-school individuals aged 13-15 experienced a notably high increase in STI cases, surpassing other age groups, with an average annual percentage increase of 29.2% and 26.3%, respectively. Nonstudents consistently had a higher incidence rate than students, with an IRR reaching 31.80 (31.24, 32.37) in 2021. A noticeable clustering pattern of new cases emerged in the southeastern region of the Heihe-Tengchong line, extending inland from the coastal areas. Districts and counties with lower rates of puberty sexual health education tended to have higher average STI incidence rates. At the prefecture and city levels, there was a noticeable upward trend on average STI incidence rates in cities with per capita GDPs. Strategies to address those disparities include promoting equitable health education, and widespread sexual health education, particularly in areas with limited access to education and experiencing rapid economic development. The effectiveness of sexual health education intervention needs to be further evaluated in well-designed studies.

Is the Risk of Alzheimer's Disease and Related Dementias Among U.S. Veterans Influenced by the Intersectionality of Housing Status, HIV/AIDS, Hepatitis C, and Psychiatric Disorders?

Homelessness and housing instability disproportionately affect U.S. veterans with psychiatric disorders, human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), hepatitis C, and Alzheimer's disease and related disorders (ADRD). We examined housing status and/or HIV/AIDS in relation to ADRD risk and evaluated hepatitis C, substance use, and mental health disorders as mediators and/or moderators of hypothesized relationships, among U.S. veterans ≥50 years of age seeking Department of Veterans Affairs (VA) healthcare services. A retrospective cohort study was conducted using linked VA Homeless Operations Management and Evaluation System and Corporate Data Warehouse databases (2017-2023) on 3 275 098 eligible veterans yielding 133 388 ADRD cases over 5 years of follow-up. Multivariable regression and causal mediation analyses were performed, controlling for demographic and clinical characteristics. Taking stably housed veterans without HIV/AIDS as referent, ADRD risk was higher among veterans with homelessness/housing instability alone (adjusted hazard ratio [aHR] = 1.67, 95% confidence interval [CI]: 1.63,1.72), lower among veterans with HIV/AIDS alone (aHR = 0.65, 95% CI: 0.58,0.73), but similar to veterans with homelessness/housing instability and HIV/AIDS (aHR = 1.01, 95% CI: 0.79,1.29). In adjusted models, hepatitis C and psychiatric disorders were positively related to homelessness/housing instability and ADRD risk, but negatively related to HIV/AIDS. Statistically significant mediation and/or moderation of hepatitis C and psychiatric disorders were observed, although <10% of total effects were explained by these characteristics, controlling for confounders. Among older veterans, ADRD diagnoses over 5 years were less among those with HIV/AIDS, but more among those with homelessness/housing instability, and these relationships were partly explained by hepatitis C and psychiatric disorders.

Prevalence of and factors associated with chronic kidney disease among patients infected with human immunodeficiency virus attending care and treatment centers at tertiary hospitals in dodoma, Tanzania

BackgroundThe burden and risk of developing chronic kidney disease (CKD) among patients with Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) is higher than in the general population. This study aimed to determine prevalence of and associated factors with CKD among adults infected with human immunodeficiency virus at tertiary hospitals in Dodoma, Tanzania. Methodology: A cross-sectional study was carried out between November 2022 to April 2023. Patients’ demographic data, and clinical measurements were obtained on the day of the visit. Laboratory investigations were performed as standard of care. Descriptive and inferential analyses were performed, and variables associated with CKD were identified by multivariable logistic regression. ResultsA total of 223 patients were enrolled, with a median age of 47 (IQR 38–56) years, and 72.2 % were female. The CKD prevalence was 23.3 % whereby 18.4 % had CKD stage 3a, 4.5 % had CKD stage 3 b, and 0.4 % had CKD stage 4. CKD was observed largely among patients with obesity (34.15 %), anemia (29.41 %), hypertension (45.00 %), and diabetes mellitus (50.00 %). Variables with higher odds for CKD after adjusted analysis were hypertension (OR 3.03, 95 %% CI 1.29–7.11, P = 0.0109), diabetes mellitus (OR 4.50, 95 % CI 1.35–15.03, P = 0.0144), obesity (OR 3.07, 95 % CI 1.11–8.47, P = 0.0301), anaemia (OR 2.42, 95 % CI 1.12–5.26, P = 0.0252) and for each one-unit increase in age (years), there was statistically significant increase in the odds of having CKD by 1.084 folds (OR = 1.084, 95 % CI 1.039–1.131, p = 0.0002). ConclusionThe prevalence of CKD among patients with HIV/AIDS is high. Age, obesity, anaemia, hypertension, and diabetes mellitus were strongly associated with CKD suggesting a need for integrating initiatives for non-communicable disease control in this population.

Identification of a Diagnostic Multiomics-Based Biomarker Cluster in a Mouse Model of Pulmonary Tuberculosis.

Tuberculosis (TB) stands as the second most prevalent infectious agent-related cause of death worldwide in 2022, trailing only COVID-19. With 1.13 million reported deaths, this figure is more than half of the mortality associated with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), which accounted for 0.63 million deaths. Diagnosing Mycobacterium tuberculosis (MTB) infection remains a formidable challenge due to the inability to isolate and detect MTB in sputum and within the human body. The absence of universally reliable diagnostic criteria for MTB infection globally poses a significant obstacle to preventing the progression of tuberculosis from the MTB infection stage. In this study, our objective was to formulate a diagnostic biomarker cluster capable of discerning the progression of MTB infection and disease. This was achieved through a comprehensive joint multiomics analysis, encompassing transcriptome, proteome, and metabolome, conducted on lung tissue samples obtained from both normal control mice and those infected with MTB. A total of 1690 differentially expressed genes and 94 differentially expressed proteins were systematically screened. From this pool, 10 core genes were singled out. Additionally, eight long non-coding ribonucleic acids and eight metabolites linked to these core genes were identified to establish a cohesive cluster of biomarkers. This multiomics-based biomarker cluster demonstrated its capability to differentiate uninfected samples from MTB-infected samples effectively in both principle component analysis and the construction of a random forest model. The outcomes of our study strongly suggest that the multiomics-based biomarker cluster holds significant potential for enhancing the diagnosis of MTB infection.

Triple Burden: The Incorrigible Threat of Tuberculosis, HIV, and COVID-19.

<p>The Coronavirus-19 (COVID-19) hasn't seen the dawn since its emergence, however waxing and waning has resulted in the emergence of deadly variants. The effects of pandemic have not been limited to its virulence, but have rather conferred multiple collateral effects, especially in developing countries; thereby, designating it as a SYNDEMIC. The same culminated in neglect of non-COVID-19 conditions like tuberculosis (TB) and human immunodeficiency virus-acquired immunodeficiency syndrome (HIV/AIDS). Besides being the prognostic factor for severe COVID-19, these infections in hidden pockets served as reservoir for emergence of the deadly Omicron. Another significant impact of this juxtaposition was on the delivery of healthcare services for TB and HIV. <p> The unanticipated COVID-19 pandemic turned the path of ongoing progress of elimination programs. Direct consequences of the COVID-19 pandemic were pronounced on diagnosis, treatment, and services for patients with TB and HIV. Essential TB services were reallocated to the COVID-19 rapid response task force. However, despite escalating the tribulations, this triple burden has simultaneously taught lessons to escalate the progress of halted programs. The pandemic has catalyzed an unusual level of collaboration among scientists, which can be exploited for TB and HIV. Fast-track diagnostics, digitalization, contact tracing, and vaccine development have enabled world to envision the same for TB/HIV.</p>.

Nutrition Requirements and Nutrition Intervention for People Living with HIV/AIDS (Adults)

AbstractNutrition plays a crucial role in the overall health and well-being of people living with human immunodeficiency virus (HIV). This review aims to provide a current summary of the macronutrient and micronutrient requirements for HIV-positive individuals. The author emphasizes the fundamentals of nutrition treatment as a guide for medical professionals to adopt the right strategy based on risk-adapted nutrition therapy. The majority of nutrition guidelines were published over 10 years ago and have failed to address the protein requirements for people with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS). Proper nutrition can reduce the risk of malnutrition, infections, and other complications, while also assisting with symptom management, maintaining a healthy weight, and improving immune function. In this review, the author has identified the latest reliable and validated nutrition screening tool specifically designed for people with HIV/AIDS, along with a risk-stratified nutrition therapy based on the screening tool to facilitate the nutrition care process. People living with HIV/AIDS have unique nutritional needs due to the virus's impact on the body's immune system, metabolism, and nutrient absorption. It is important for them to work with a healthcare professional, namely a dietitian, to assess nutrition risk and develop an individualized dietary intervention for a healthy lifestyle.

Factors Associated With Extrapulmonary Tuberculosis in Southeastern Mexico: A Case-Control Study.

Extrapulmonary tuberculosis (EPTB) is a disease that can affect any organ or tissue. Due to its potential to cause more dangerous sequelae and the barriers to its timely diagnosis, greater clinical awareness of this disease is crucial.This study aimedto identify the factors associated with EPTB in the population of Oaxaca, Mexico. This is an unpaired case-control study. The cases were patients with EPTB+ while the controls were patients with pulmonary tuberculosis (PTB+) registered in the Tuberculosis Epidemiological Surveillance System. Sociodemographic, clinical, and microbiological variables were recovered. Bivariate analyses were performed and logistic regression analyses were performed to calculate the odds ratio (OR). A total of 75 EPTB+ cases and 300 PTB+ controls were included. Of the total sample, 57.1% were men and 60.3% indigenous. The most frequent clinical presentations of EPTB+ were nodal (21.3%), miliary (21.3%), and breast (20.0%). According to logistic regression analysis, age <40 years (OR: 2.25(95% CI: 1.13-4.49), female sex (OR: 1.92(95% CI: 1.03-3.56)], urban residence (OR: 2.25 (95% CI: 1.11-4.55)), comorbidity with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) (OR: 3.46 (95% CI: 1.31-9.10)), dyspnea (OR: 2.67 (1.22-5.82)), and adenopathy (OR: 3.38 (95% CI: 1.42-8.06)) were positively associated with EPTB+. These results can serve as a basis for screening EPTB+, thus improving the preventive and diagnostic capacity of local health services, taking as a starting point women under 40 years of age and patients with HIV/AIDS in urban areas, as well as the presence of adenopathy and dyspnea as clinical characteristics of the disease.

Maternal Complications during Pregnancy and Risk Factors for Stunting.

Stunting can be prevented by early detection when the mother is pregnant. Early detection can be carried out by looking for risk factors of stunting during pregnancy so that interventions can be early detected. This study aims to assess complications during pregnancy (disease and infection) and risk factors associated with stunting. The type of research was observational analytic with a case-control design on 450 mothers who were selected with simple random sampling (150 mothers who have stunting babies aged 0-2 months and 300 mothers who have not stunting babies aged 0-2 months in Malang Regency, Indonesia. This study used secondary data by looking at medical records, namely, laboratory examinations in the mother's book and cohort records at the public health center. This study was conducted from December 2021 to August 2022. Bivariate analysis with Chi-square and multivariate logistic regression was carried out to determine the variables that most influenced the incidence of stunting. The results of multivariate analysis with logistic regression of maternal complications during pregnancy, which are a risk as a factor causing stunting, are Sexually Transmitted Infections (STIs) (Odds Ratio [OR]: 6.36; 95% Confidence Interval [CI]: 2.97-13.62), coronavirus disease 2019 (COVID-19) accompanied by pneumonia (OR: 5.12; 95% CI: 1.87-14.052), human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) (OR: 4.63; 95% CI: 1.10-19.59), hepatitis B (OR: 3.97; 95% CI: 1.253-12.565), pre-eclampsia (OR: 3.88; 95% CI: 1.81-8.30), and heart disease (OR: 3.373; 95% CI: 0.99-11.40). After recognizing the maternal factors that cause stunting, intervention should immediately be carried out on pregnant women with diseases (pre-eclampsia and heart disease) and infections (STI, COVID-19 + pneumonia, HIV/AIDS, and hepatitis B) to prevent stunting early.

Predictors of quality of life of TB/HIV co-infected patients in the Northern region of Ghana

BackgroundTuberculosis (TB) and human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) co-morbidity continues to be a serious worldwide health issue, particularly in Sub-Saharan Africa. Studies on the quality of life (QOL) of TB/HIV co-infected patients guide stakeholders on the delivery of patient-centred healthcare. This study evaluated QOL of TB/HIV co-infected individuals and its contributing factors.MethodsWe conducted a cross-sectional study among TB/HIV co-infected patients, receiving treatment at clinics in the Northern Region of Ghana. Simple random sampling technique was used to select 213 patients from 32 clinics. We gathered information on patients’ QOL using the World Health Organization QOL-HIV BREF assessment tool. At a 5% level of significance, multiple logistic regression analyses were carried out to find correlates of QOL among the patients.ResultsThe mean age of the patients was (38.99 ± 14.00) years with most, 33.3% (71/213) aged 30–39 years. Males constituted 54.9% (117/213). About 30.0% (64/213) of the patients reported a good QOL. Being employed (aOR = 5.23, 95% CI: 1.87 – 14.60), and adhering to treatment (aOR = 6.36, 95% CI: 1.51 – 26.65) were significantly associated with a good QOL. Being depressed (aOR = 0.02, 95% CI: 0.03 – 0.29), stigmatized (aOR = 0.31, 95% CI : 0.11 – 0.84), and not exercising (aOR = 0.28, 95% CI: 0.12 – 0.67) were negatively associated with a good QOL.ConclusionLess than one-third of TB/HIV co-infected patients in the region have good QOL. To guarantee good QOL, modifiable predictors such as patients’ physical activity and medication adherence should be targeted by the National AIDS and TB Control Programs.

Exploring factors influencing the perspective regarding HIV transmission and prevention among college students in India.

Although many studies have been conducted to assess the knowledge and practices among healthcare workers, high-risk groups or medical students, very few studies have been conducted among college students from non-medical backgrounds. Our study aimed to assess the knowledge, attitudes and perception about human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) among the college students of the Mumbai region and to determine their association with the socio-demographic variables. A cross-sectional online and offline questionnaire survey was conducted among 401 college students from the month of August 2022 to October 2022. Mean score and percentage were used to analyse the data. About 82.04% of participants exhibited good knowledge about HIV transmission and prevention, while 46.38% had a positive attitude towards HIV. Age, gender, religion and education had not influenced either knowledge or attitude significantly. Overall, knowledge score had a weak positive correlation with attitude of the participants. Our study findings indicate that a holistic approach covering knowledge, psychological and societal health aspects is necessary among youth in India for positive changes in people's behaviour and achieving HIV prevention and management goals which will benefit public health at large.

CD4 Count and Central Nervous System Infection among HIV/AIDS Patients in an Indonesian Presidential Hospital from 2020 to 2022

Highlights:1. There were insufficient data on the correlation between CD4 count and central nervous system infection as well as the risk magnitude of the infection for HIV/AIDS patients in Indonesia.2. This study revealed a significant correlation between CD4 count and the incidence of central nervous system infection in HIV/AIDS patients, showing an increased risk with a low CD4 count.3. The findings suggest that CD4 count is a vital parameter in determining therapy and evaluating the presence of opportunistic infections in HIV/AIDS patients. Abstract People living with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), referred to as PLWHA, have a high rate of mortality and morbidity due to opportunistic central nervous system infections. The infections are attributed to the immune deficiency caused by HIV exposure to the immune system's cluster of differentiation 4 (CD4) cells. This allows the central nervous system, the most vital body system, to acquire an opportunistic infection. The purpose of this study was to determine the existence and magnitude of a risk by examining the correlation between CD4 count and the incidence of central nervous system infection among HIV/AIDS patients. This analytical cross-sectional study utilized a simple random sampling technique on the population of HIV/AIDS patients, which consisted of 80 medical records from January 2020 to December 2022. This study was conducted at Gatot Soebroto Presidential Hospital, also known as Gatot Soebroto Central Army Hospital, in Jakarta, Indonesia. The data analysis was performed using Fisher's exact test (p&lt;0.05) and the prevalence odds ratio (POR). The results showed that 16.3% of the patients suffered a central nervous system infection, which consisted of cerebral toxoplasmosis (76.9%) and brain abscess (23.1%). The bivariate analysis suggested a significant correlation between CD4 count and the incidence of central nervous system infection, with an 11.5-fold increased risk for HIV/AIDS patients who had a CD4 count of &lt;200 cells/mm3 (p=0.000; OR=11.5; 95% CI=2.9–43.8). This study concludes that CD4 count is correlated with the incidence of central nervous system infection, indicating a higher risk for HIV/AIDS patients with a low CD4 count.

Expressions of Interleukin-4 and Interleukin-5 in Nodular Prurigo and Pruritic Papular Lesions

Highlights:1. An examination of IL-4 and IL-5 expressions in nodular prurigo and pruritic papular eruption is crucial for enhancing the effectiveness of biological agent therapy, specifically for HIV/AIDS patients.2. The findings offer evidence suggesting the possibility of IL-4 as a treatment target for individuals diagnosed with nodular prurigo, as well as IL-4 and IL-5 for those diagnosed with pruritic papular eruption. AbstractPruritic papular eruption is a dermatosis characterized by pruritic symptoms in patients with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS). Similarly, nodular prurigo is an itchy dermatosis with lesions and histopathological features that resemble those of pruritic papular eruption. Both conditions share a common etiopathogenesis, which involves the cytokines produced by T helper 2 (Th2) cells. Nodular prurigo and pruritic papular eruption are chronic and frequently recalcitrant, thus posing challenges in treatment. The use of biological agents represents a treatment development for chronic and recalcitrant dermatoses. This study aimed to determine the difference in the mean percentage of interleukin-4 (IL-4) and interleukin-5 (IL-5) expressions between nodular prurigo and pruritic papular eruption lesions, which may establish a basis for further biological agent therapy. A cross-sectional study was conducted using paraffin block preparations of the skin lesions of patients diagnosed with nodular prurigo (n=16) and pruritic papular eruption (n=16). Each paraffin block preparation involved immunohistochemical staining using IL-4 and IL-5 monoclonal antibodies. The expressions of IL-4 and IL-5 were assessed through ImageJ for Windows, version 1.53 (National Institutes of Health and the Laboratory for Optical and Computational Instrumentation, University of Wisconsin, USA) by pathologists. The data were analyzed using an unpaired t-test with a significance level of p&lt;0.05. The analytical results indicated that data on the average age of the two groups, disease duration, and storage sample duration followed a normal distribution (p&gt;0.05). The mean percentage of IL-4 expression was significantly different between the nodular prurigo and pruritic papular eruption groups (p=0.000). However, the mean percentage of IL-5 expression was not significantly different between the two groups (p=0.060). In conclusion, the expression of IL-4 was higher in the nodular prurigo group in comparison to the pruritic papular eruption group. Nonetheless, the expression of IL-5 was comparably high in both the nodular prurigo and pruritic papular eruption groups.

Social stigma and discrimination towards people living with HIV infection and AIDS patients

Background: Social stigma and discrimination are major barriers to an effective national response to human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS), and there have been repeated calls to transform the current surveillance-focused policy. Serious instances of discrimination and clinical service failings increase the urgency and importance of addressing issues relevant to AIDS-related stigma. Yet, progress in achieving effective and people-centered responses to AIDS is insufficient.Current Concepts: Based on a comprehensive multi-sectoral review of a wide range of literature, this article examines the key features of AIDS-related stigma in South Korea and evaluates governmental and organizational efforts to redress them. Three major areas, of issues and possibilities for change, are identified: (1) addressing discrimination in health care settings, (2) decriminalization of HIV transmission, according to the Undetectable=Untransmittable (U=U) principle, (3) improving the quality of life and social inclusion of people living with HIV.Discussion and Conclusion: An extensive examination of existing evidence on AIDS-related stigma, guided by the authors’ long-term experience of public participation and civic empowerment, suggests that by placing these three issues at the center of the national response to AIDS, significant improvement in the AIDS care continuum is achievable. People-centered service delivery models that focus on dismantling structural barriers and incorporating leadership from key populations will enable high-impact public health responses to AIDS and HIV infection.

Epidemiology of HIV infection and AIDS

Background: The expansion of antiretroviral therapy (ART) has resulted in a reduction in numbers of new human immunodeficiency virus (HIV) infections and acquired immunodeficiency syndrome (AIDS)-related deaths worldwide, except in some regions. As people with HIV live long and healthy lives, their health issues are also changing. In this review, we briefly summarize the global HIV epidemic and examine the changing trends in the epidemiology of HIV in Korea.Current Concepts: Since 2013, more than 1,000 new infections have been reported in Korea every year, and after reaching its peak at 1,223 in 2019, approximately 1,000 were reported each year during the coronavirus disease 2019 pandemic. Most newly infected people were men, and the proportion of young people aged 20 to 40 years, men who have sex with men, and foreigners has been steadily increasing. AIDS was the most common cause of death, and cancer, chronic diseases, and suicide were also important causes of death in Korea.Discussion and Conclusion: Achieving sustained ART and viral suppression is approaching the UNAIDS 95-95-95 targets in Korea, but additional research and efforts are required to reduce late presentation and scale-up of HIV diagnosis. Targeted and coordinated prevention programs to prevent HIV among people from key populations are also needed. Additionally, supportive services for older people with HIV, including cancer screening and chronic disease management, and multifaceted efforts to reduce stigma and discrimination against people with HIV are needed in Korea.

Effects of solution chemistry on dielectric barrier atmospheric non-thermal plasma for operative degradation of antiretroviral drug nevirapine

The global prevalence of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) has been an environmental menace. Tons of drug wastes from antiretroviral therapy are released into the environment annually. We, for the first time, employed the novel dielectric barrier atmospheric non-thermal plasma (DBANP) discharge, to mitigate the inadvertent pollution arising from the antiretroviral therapy. A 40-min treatment of nevirapine achieved >94 % (0.075 min−1) removal efficiency at discharge power of 63.5 W and plasma working gas of atmospheric air. Chemical probes confirmed •OH, ONOO− and eaq− as the dominant reactive species whilst further revealing the reaction acceleration role of NaNO3 and CCl4 which are known reaction terminators. The commonly coexisting inorganic anions potentiated nevirapine removal with over 98 % efficiency, achieving the highest rate constant of 0.148 min−1 in this study. Moreover, the initial solution pH (1.5–11.1) was no limiting factor either. The insensitivity of the DBANP discharge to actual water matrices was an eminent inference of its potential applicability in practical conditions. With reference to data obtained from the liquid chromatography-mass spectrometer analysis, nevirapine degradation pathway was proposed. A nucleophilic attack by ONOO− at the cyclopropyl group and •OH attack at the carbonyl carbon of the amide group, respectively, initiated nevirapine degradation process. It is anticipated that the findings herein, will provide new insights into antiretroviral drug waste management in environmental waters using the innovative and green non-thermal plasma process.

Related factors to HIV/AIDS prevention behavior of adolescents in Jakarta’s high school

Adolescents are developing self-maturity, so they should have the correct views to become a person with a positive self-concept. Therefore, this period requires the role of parents. The parental roles include educating, teaching, disciplining, and protecting children to reach adulthood according to social norms. However, adolescents prefer to spend time with their peers, so peers are dominant in influential and modeling aspects of adolescents' sexual behavior with their partners. One of the behaviors compulsorily concerned is human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) prevention behavior. This study aimed to determine the relationship between characteristics, communication quality, parenting, peer roles, and HIV/AIDS prevention behavior in adolescents at “Y” Senior High School in North Jakarta. This study employed a cross-sectional research design. Samples were taken using the purposive sampling technique, and 208 students were obtained from 432 students. Gender, parental communication quality, and peer roles affected HIV/AIDS prevention behavior. The dominant variable was parental communication quality (OR=0.509). After controlling for gender and peer role characteristics, adolescents with strong parental communication quality were 0.51 times more likely to participate in HIV/AIDS-positive preventive activities than those with poor parental communication quality. Adolescents are expected to communicate with their parents, especially about sexual issues, more openly.