Human Immunodeficiency Virus/acquired Immunodeficiency Syndrome Research Articles

Human monkeypox coinfection with syphilis in an immunocompromised patient.

Monkeypox is a viral zoonosis from the Poxviridae family that spreads at an unprecedented rate. It is transmitted through contact with skin lesions, respiratory droplets, body fluids, and sexual contact. The diverse presentation of the disease leads to misdiagnosis. Thus, clinicians should have a high index of suspicion, mainly with diseases with skin lesions. The most vulnerable group to developing this disease are individuals with risky sexual relationships, sexually transmitted infections, or human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS). To date, only one case of coinfection with the monkeypox virus, syphilis, and HIV has been reported; however, no cases have been revealed in the Mexican territory. Herein we describe an unusual case of syphilis-monkeypox coinfection in an immunocompromised patient; despite his coinfection, he had a favorable prognosis. Furthermore, we attach allusive pictures of the natural evolution of dermatological lesions.

Human leukocyte antigens class I and class II alleles associated with vertical human immunodeficiency virus transmission - an exploratory study from Mumbai, India.

Background Human leukocyte antigens (HLA) an important host genetic factor is responsible for influencing human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) transmission and disease progression. Contributions of HLA I and II alleles have not been reported in the Indian population with respect to vertical HIV transmission. Aim In the current study we determined the frequencies of HLA class I and class II alleles in a cohort of children exposed to HIV through their mothers. Method In this exploratory study children perinatally exposed to HIV-1 who fit the study criteria and had completed 18 month follow-up were typed for HLA class I and class II alleles using polymerase chain reaction combined with sequence-specific oligonucleotides probes (PCR-SSOP) and sequence-specific primer (SSP) method. HLA typing was done in 30 positive and 60 HIV negative children along with confounding factors such as treatment regimens, viral load and CD4 count of the mother, feeding option, etc. SPSS software was used for statistical analysis and online docking tools for in-silico analysis. Results HLA-B*40 (p = 0.018) was significantly higher in negative children and was associated with protection, whereas HLA-A*01 (p = 0.05), HLA-B*37 (p = 0.032) and HLA-DRB1*09 (p = 0.017) were associated with transmission. Known protective allele HLA-B*27 was only present in negative children. Many specific haplotypes were exclusively present in the negative children or the positive ones. In-silico analysis was performed to predict the ability of HLA-B*40 to bind to antigenic peptides obtained from HIV-1 sequences in our study group. Limitations Small sample size is a concerning limitation of the study. Nonetheless this is a comprehensive study on HLA alleles in HIV exposed Indian children Conclusion Our study highlights the contribution of HLA class I and II alleles in the Indian children and further adds to understanding the immunogenetic mechanisms. These can be developed as markers for prediction of infection transmission. The observations also contribute to the database of genetic makeup of our population and can help in designing vaccine strategies.

S3242 A Case of Isolated Hepatic Tuberculosis in an Immunocompromised Patient

Introduction: Primary hepatic tuberculosis is a rare clinical entity with non-specific clinical and imaging features that can mimic other liver diseases, presenting a diagnostic challenge. We present a case of a patient with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) who developed fevers of unknown origin and elevated liver enzymes. Liver biopsy was key to diagnosis as it revealed necrotizing granulomas consistent with tuberculous hepatitis. Case Description/Methods: The patient is a 54-year-old female with uncontrolled HIV/AIDS (CD4 6/1%) who presented with fever, encephalopathy, and abdominal pain. She was febrile to 38, tachycardic to 103, blood pressure 144/115, 96% on room air. She was ill-appearing, altered, nonverbal, with epigastric and lower abdominal tenderness on exam. Complete metabolic panel, complete blood count, lipase, and lactic acid were all within normal limits on presentation. CT of the abdomen and pelvis was unrevealing. On admission, she was found to have community acquired pneumonia, a urinary tract infection, a pulmonary embolism, and HIV-associated neurocognitive disorder. She was started on antiretrovirals and improved until she developed fevers of unknown origin and newly elevated liver enzymes (aspartate transaminase 400s, alanine aminotransferase 300s, alkaline phosphatase 1200s, total bilirubin 12.4, direct bilirubin 7.1) over the course of her prolonged hospitalization. A hepatic workup was largely unrevealing for etiology. Hepatitis panel, drug panel, cytomegalovirus, and Epstein-Barr virus were all negative. Autoimmune workup was weakly positive for anti-nuclear and anti-smooth muscle antibodies, but these were felt to be clinically insignificant due to low titers. The patient was also trialed on intravenous steroids with little improvement, further arguing against the diagnosis of autoimmune hepatitis. Liver biopsy revealed lobular necrotizing granulomas with scattered histiocytes and lymphocytes, consistent with tuberculous granulomatous hepatitis. She started tuberculosis therapy and tolerated it well. Discussion: Primary hepatic tuberculosis with no clinical extrahepatic manifestations is a rare presentation and sporadically reported in the literature. This clinical case highlights the diagnostic difficulty of hepatic tuberculosis, which should be considered in immunocompromised patients with elevated liver enzymes and unrevealing initial workup. Liver biopsy is essential for diagnosis.Figure 1.: a) Lobular necrotizing granuloma; b) Center of necrotizing granuloma with histiocytes (black arrow) and lymphocytes (blue arrow).

Immunotoxicity and proliferation of human peripheral blood mononuclear cells of HIV-positive patient after treatment with aqueous extract of polyherbal formulation

Medicinal plants have been widely used for medicinal purposes in the treatment of various ailments including human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS). This study evaluated the effect of aqueous extracts of polyherbal formulation (PHF) on peripheral blood mononuclear cells (PBMCs) of an HIV+ patient. In this study, 4 ml of blood was collected from HIV+ patient who has not commenced antiretroviral treatment. PBMCs were isolated using the Ficoll-Paque method and counted using the trypan blue assay. The isolated PBMCs were treated with different concentrations of the PHF (25 50, 100, and 200 μg/ml). Cytotoxicity and proliferation were determined using the WST-8 assay. The percentage viability in this study was 96.74%, whereas the non-viable cell percentage was 3.26%. The lowest percentage of cytotoxicity for the PHF was 0.05% at 25 µg/ml of the extract, while the highest was 5.35% at 200 µg/ml. The mean absorbance scores of the formulation's various concentrations and the control group did not significantly differ from one another (F=0.622, df = 5, p=0.69). There was significant difference (t= -4.887, df =6, 95% CI= -0.1566 to -0.0521, p = 0.003) in mean absorbance scores between control and treatment. The polyherbal formulation exerts the lowest cytotoxicity of 0.05% and significant proliferation on the PBMCs at 25 µg/ml. The PHF has potential immunoproliferative activity with a good safety margin. An in-depth study of the bioactivity of the PHF on individual immune cells is recommended.

Appraisal of antiretroviral herbal medicines with proven efficacy: modulation of drug-metabolizing enzymes and permeability glycoprotein activities

Human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) constitutes a source of great concern to health authorities worldwide. Herbal medicinal products are used as a significant treatment option for highly active antiretroviral therapies, the efficacies of which are negatively impacted by the emergence of multidrug-resistant strains to the recommended treatment guidelines. This review provides an updated synopsis of available documents on herbal medicinal products with anti-HIV activities. Concurrent consumption of herbal products with conventional drugs, which is often necessitated by co-morbidity of HIV with other diseases, can potentially alter the pharmacokinetics of the co-administered orthodox drugs. Phytochemical constituents of the herbal medicinal products with antiretroviral activities were identified, and their potential to mediate pharmacokinetic changes through modulation of drug-metabolizing enzymes and P-glycoprotein was reported. Herb-drug interactions (HDIs) that can result in significant adverse effects were also discussed with documenting the information for the therapeutic utility of these clinically effective antiretroviral herbal medicinal products with potential for development into newer anti-HIV drugs.

Solid Dispersion of Dolutegravir: Formulation Development, Characterization, and Pharmacokinetic Assessment

A recently authorized antiviral drug called dolutegravir has solubility problems and could be a Biopharmaceutical Classification System (BCS) class II candidate. The current study aimed to improve dolutegravir’s solubility and efficiency by employing the solid dispersion method. Different ratios of hydrophilic polymeric carriers, including polyethylene glycol (PEG) 6000, polyvinyl pyrrolidone (PVP) (30K), and hydroxypropyl methylcellulose (HPMC), were used. Dolutegravir (DTG) and soluplus were produced as a solid dispersion at 1:5 ratio using the solvent evaporation method. A variety of techniques were utilized to describe the solid state, including powder X-ray diffraction (XRD), differential scanning calorimetry (DSC), and fourier transform infrared spectroscopy (FTIR). Produced solid dispersion did not reveal any physicochemical interactions between the DTG and soluplus, but the X-ray diffractogram clearly showed that the drug’s crystalline state had transformed to an amorphous state. DTG was released quickly from solid dispersion (92%) compared to pure drug (10.12%), physical mixture (22.06%), and commercially available DTG (62.90%). The formed solid dispersion’s drug release kinetics was in line with the Higuchi Model. Finally, the rapid drug release from the solid dispersion formulation showed higher Cmax (15.25 ± 0.40 μg/mL) compared to the physical mixture (5.11 ± 0.20 μg/mL) and pure drug (4.91 ± 0.73 μg/mL). DTG’s enhanced bioavailability in experimental wistar rats (AUC: 147.99 ± 23.86 μg/h/mL) further supported this when compared to the AUC of animals administered with physical mixture (52.35 ± 4.32 μg/h/mL) and pure drug (43.32 ± 3.13 μg/h/mL). Thus, it could be inferred that by employing the solid dispersion delivery system and the hydrophilic carrier, soluplus, the bioavailability and dissolution profile of DTG could both be improved, which could be expected to improve the drug’s effectiveness in treating Human immunodeficiency virus/Acquired immunodeficiency syndrome (HIV/AIDS).

Challenges faced by people living with HIV/AIDS during COVID-19 pandemic in India

HIV/AIDS is considered as one of the most demanding public health problems faced by the country. It is a public threat and needs collective efforts in addressing the issue. In this line, a study was conducted among 30 people living with Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) in Chennai, Tamilnadu, India to study the challenges faced by women living with HIV/AIDS during the lockdown COVID 19 Pandemic in India. The data was collected with the support of the International Alliance for the Prevention of AIDS (IAPA) India, Chennai. In this study, descriptive research design and Simple random (lottery method) sampling technique was adopted. The researcher designed a questionnaire comprising both structured and semi structured questions along with “Depression Anxiety Stress Scale (DASS) – 21 item” standardized scale to obtain the data. The study shows that 76.7 percent of the respondents felt depressed because they do not have income to support their family needs and 53.3% shared that they are living in fear of HIV/AIDS and now during lockdown fear of survival is another painful one. Social work revolves around service, but is inherently interdisciplinary in nature. In this study Seven-Stage Crisis Intervention Model by Albert R. Roberts and Allen J. Ottens, was used for intervention. It was found after intervention that the p value of Depression, Anxiety and Stress is 0.00, which is less than the significance level of 0.05, hence the null hypothesis is rejected. Thus the results after the intervention showed that there was a visible decrease in their depression, stress and anxiety level.
 
 Keywords: HIV/AIDS, COVID 19 Pandemic, Depression, Social Work Interventions

Impact of Human Immunodeficiency Virus on Postoperative Outcomes following Osteonecrosis-Indicated Total Hip Arthroplasty

AbstractOsteonecrosis (ON) of the femoral head in human immunodeficiency virus (HIV)-positive patients is often treated with total hip arthroplasty (THA). The purpose of this study was to determine the effect that HIV positive status and acquired immunodeficiency syndrome (AIDS) have on postoperative complication rates and outcomes in patients with ON treated with THA. Patients who underwent primary ON-indicated THA with a minimum of 2-year follow-up were identified in a national database (PearlDiver Technologies) using Current Procedural Terminology and International Classification of Diseases codes. These patients were stratified into two cohorts: those who were HIV-positive and those who were HIV-negative (control). The HIV-positive cohort was further stratified into those with AIDS and those with asymptomatic HIV at the time of THA. Univariate and multivariate analyses were conducted to determine associations between the three cohorts and their 90-day, and 2-year outcomes were each compared with HIV-negative patients. In this study, 1,163 patients were in the HIV-positive cohort and 34,288 were in the HIV-negative cohort. In the HIV-positive cohort, there were significantly higher 90-day rates of renal failure (odds ratio [OR] = 1.874; p < 0.001), pneumonia (OR = 1.682; p = 0.002), and sepsis (OR = 1.975; p < 0.001). The asymptomatic HIV cohort and AIDS cohort followed similar associations as the HIV cohort; however, the AIDS cohort also had significantly higher rate of blood transfusion (OR = 1.692; p = 0.012) and deep vein thrombosis (OR = 1.765; p = 0.036). HIV infection, whether symptomatic or not, and AIDS are associated with a higher risk of short-term complications after THA. Physicians must consider this risk and discuss with their patients to reduce future complications.

Predictors of Dietary Diversity among HIV Clients in a Low-resource Tertiary Health Facility in Southeast Nigeria

Background: In a resource-limited setting where nutrient availability is a challenge, it may be necessary to determine factors that affect dietary diversity in people living with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) as addressing them could lead to better access to diversified diets in this group. Objective: The objective of this study was to determine the factors that influence dietary diversity among HIV clients attending the HIV clinic in a low-resource tertiary health facility. Materials and Methods: An institutional-based cross-sectional study was conducted among HIV clients receiving anti-retroviral therapy in Enugu state, Nigeria. A systematic random sampling technique was employed in selecting the study participants. Bivariate analysis was done using the chi-square test which was further subjected to multivariate logistic regression analyses to determine predictors of dietary diversity. Results: In this study, respondents who earned a family monthly income of 72.5 US dollars and below were 2.6 times less likely to have high dietary diversity (AOR = 0.378, CI = 0.180–0.792) compared to those who earned above 145 dollars. Also, HIV clients on cotrimoxazole prophylaxis were 2.3 times more likely to have high dietary diversity (AOR = 2.304, CI = 1.155–4.598) compared to those who were not on the prophylaxis. Conclusions: High family monthly income and being on cotrimoxazole prophylaxis were predictors of high dietary diversity in People living with HIV/AIDS. Therefore, there is a need to improve the income of PLWHA as well as ensure the ready availability of cotrimoxazole to reduce the rate of opportunistic infections thus leading to better consumption of diversified diets.

Knowledge, Attitude, and Behavior of Clinical Dental Students in the Oral Care of HIV/AIDS Patients

Abstract Introduction In the future, clinical dental students, as health service providers, will play a key role in the oral care of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) patients. Clinical dental students need to increase their knowledge of HIV because it is vital for the diagnosis and management of HIV/AIDS patients that they have a positive attitude regarding oral care behavior toward HIV/AIDS patients. This study aims to explain the relationship between the knowledge, attitudes, and behavior of clinical dental students in the oral care of HIV/AIDS patients at Airlangga University Dental Hospital. Materials and Methods This study used a cross-sectional approach with a sample of 132 respondents. The sample was taken by purposive sampling technique. The independent variable in this study was the attitudes and behavior of clinical dental students toward the care of HIV/AIDS patients. The dependent variable in this study was the knowledge and attitudes of clinical dental students toward the oral care of HIV/AIDS patients. The research data obtained were analyzed using Spearman's rho at ≤0.05. Result There was significant correlation between knowledge and attitudes (p = 0.001, r = 0.596); knowledge and behavior (p = 0.001, r = 0.637); attitudes and behavior (p = 0.001, r = 0.699) of dentistry students in the care of HIV/AIDS patients oral cavity. Conclusion Clinical dental students' knowledge of HIV/AIDS will influence their attitudes toward HIV/AIDS patients and their behavior in the oral care of HIV/AIDS. It is hoped that future research can be conducted by adding other independent variables to determine a wider range of factors that affect oral care in HIV/AIDS patients.

Knowledge, Attitudes, and Practices of Urban Workers toward Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome: Results from a Cross-sectional Study in Lubumbashi, Democratic Republic of the Congo

Objective: This study aims to describe knowledge, attitudes, and practices about human immunodeficiency virus/ acquired immunodeficiency syndrome (HIV/AIDS) among a sample of 563 urban workers in Lubumbashi, in the Democratic Republic of the Congo. Material and Methods: This was a cross-sectional study where workers’ knowledge of HIV/AIDS was measured through a French adaptation of the Brief HIV Knowledge Questionnaire. Results: Overall, the level of knowledge of participating workers was poor (81.9%). Working in a private company (adjusted odds ratio [aOR] = 2.0 [1.2–3.3]) and having previously tested for HIV/AIDS (aOR = 2.5 [1.5–4.3]) were associated with good knowledge level about HIV/AIDS. Conclusion: Our results highlight the importance of implementing different awareness and education strategies for workers.

Could a Dolutegravir-Based Antiretroviral Therapy Lead to Clinical Obesity? A Retrospective Cohort Study Conducted at Hawassa University Comprehensive Specialized Hospital in Hawassa, Sidama, Ethiopia.

Background As of April 2019, the dolutegravir (DTG)-based regimen is replacing the efavirenz-based regimen in Ethiopia, mainly due to its superiority in viral load suppression. However, there is a growing concern about this medication-based regimen, the most serious of which is excessive weight gain. In this study, we looked at weight gain disparities among human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) patients on antiretroviral therapy (ART) who have been shifted to tenofovir/lamivudine/dolutegravir (TLD) from a tenofovir/lamivudine/efavirenz (TLE)-based regimen versus those who are maintained on a tenofovir/lamivudine/efavirenz-based regimen. Methods A facility-based retrospective observational cohort study was conducted in pursuit of weight change disparities between tenofovir/lamivudine/dolutegravir and tenofovir/lamivudine/efavirenz-based regimens among patients who have attained optimal viral suppression at Hawassa University Comprehensive Specialized Hospital antiretroviral clinic. Chi-square and logistic regression were used as appropriate using an SPSS version 21 program to test the association of specific variables to outcome variables, and a P value <0.05 was considered statistically significant. Results This study included 422 patients, 211 of whom were switched from tenofovir/lamivudine/efavirenz to tenofovir/lamivudine/dolutegravir and the remaining were who kept on a tenofovir/lamivudine/efavirenz-based regimen. Patients on a tenofovir/lamivudine/dolutegravir-based regimen had a mean weight gain of 3.88 ± 2.021 kg in one year compared to those on TLE (2.26 ± 2.39). In a bivariate analysis, being male was found to protect against unwanted weight gain at COR 0.531 (0.345, 0.816). A current CD4 count of more than 500 has been found to be strongly correlated with weight gain in multivariate analysis at an AOR of 0.315 (0.188, 0.527) at a P value ≤0.001. Conclusion According to this study, tenofovir/lamivudine/dolutegravir (TLD)-based antiretroviral medication (ART) users are more likely to gain weight, and clinicians should advise them of the risks of weight gain as well as cost-effective ways to prevent weight gain linked to poor health outcomes in these patients. Future investigations should confirm the findings of this study, and more research into the effects of weight gain in these people is required.

Chest radiograph patterns and their correlation with CD4 count in adults with Human Immunodeficiency Virus (HIV) in Lagos University Teaching Hospital, Nigeria

The only available treatment for Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) at the moment is antiretroviral therapy (ART). The chest radiograph patterns in adults with HIV could be used as an alternative or surrogate to CD4 count in monitoring the progress of treatment in resource poor settings where these tests and expertise are not available. This study was aimed at evaluating chest the radiograph patterns in HIV sero-positive adults and correlating with the CD4 cells count. This was a cross-sectional study conducted among patients diagnosed of HIV using the National algorithm at the HIV Clinic of the Lagos University Teaching Hospital. A purposive sampling method was employed and three hundred and twenty (320) HIV sero-positive adult participants were recruited. Postero-anterior chest x-ray projection was performed on all the participants and the radiographs were reported by two consultant Radiologists and the CD4 counts was determined. Pulmonary TB was the most frequent finding (22.1%) while bronchitis was the least frequent finding (0.9%). and normal radiograph (52.6%). The CD4 count was less than, 200 cells/mm3 in 38.3% of the participants. There was a strong correlation between chest radiograph patterns and CD4 cells count (r=-0.53; p=0.001). This study revealed that the most predominant radiographic patterns are Pulmonary Tuberculosis. A strong negative correlation was observed between chest radiograph patterns and CD4 count. The Chest radiograph patterns may be recommended as a measure of immunosuppression in adults with HIV in Nigeria.

CD4 Tcells are rapidly depleted from tuberculosis granulomas following acute SIV co-infection.

HIV/Mycobacterium tuberculosis (Mtb) co-infected individuals have an increased risk of tuberculosis prior to loss of peripheral CD4 Tcells, raising the possibility that HIV co-infection leads to CD4 Tcell depletion in lung tissue before it is evident in blood. Here, we use rhesus macaques to study the early effects of simian immunodeficiency virus (SIV) co-infection on pulmonary granulomas. Two weeks after SIV inoculation of Mtb-infected macaques, Mtb-specific CD4 Tcells are dramatically depleted from granulomas, before CD4 Tcell loss in blood, airways, and lymph nodes, or increases in bacterial loads or radiographic evidence of disease. Spatially, CD4 Tcells are preferentially depleted from the granuloma core and cuff relative to B cell-rich regions. Moreover, live imaging of granuloma explants show that intralesional CD4 Tcell motility is reduced after SIV co-infection. Thus, granuloma CD4 Tcells may be decimated before many co-infected individuals experience the first symptoms of acute HIV infection.

Mathematical Model of HIV/AIDS Considering Sexual Preferences Under Antiretroviral Therapy, a Case Study in San Juan de Pasto, Colombia.

While several studies on human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) in the homosexual and heterosexual population have demonstrated substantial advantages in controlling HIV transmission in these groups, the overall 2benefits of the models with a bisexual population and initiation of antiretroviral therapy have not had enough attention in dynamic modeling. Thus, we used a mathematical model based on studying the impacts of bisexual behavior in a global community developed in the PhD thesis work of Espitia (2021). The model is governed by a nonlinear ordinary differential equation system, the parameters of which are calibrated with data from the cumulative cases of HIV infection and AIDS reported in San Juan de Pasto in 2019. Our model estimations show which parameters are the most influential and how to modulate them to decrease the HIV infection.

Cutaneous Manifestations of HIV/AIDS in the Era of Highly Active Antiretroviral Therapy: Evidence from Bangladesh

Abstract Objective: Skin diseases are common and striking features of patients with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) and may vary considerably by ethnic and geographic regions and by the influence of highly active antiretroviral therapy (HAART). However, little information exists regarding the cutaneous manifestations of patients with HIV/AIDS in Bangladesh. This study was performed to elucidate the spectrum of cutaneous disorders in patients with HIV/AIDS in the era of HAART. Materials: This descriptive cross-sectional study was carried out in Chittagong Medical College Hospital, Bangladesh from January 2017 and December 2020. Diagnosed case of HIV/AIDS for HAART therapy and all cases of HIV/AIDS who are already on HAART therapy were included in this study. Descriptive statistical analysis was carried out by using frequencies and percentages. Results: Of 40 patients with HIV/AIDS, 22 (55.0%) were male and 18 (45.0%) were female. The patients ranged in age from 8 to 60years, with a mean age of 38 ± 0.966years. Among all age groups, the highest 19 (47.5%) patients were in the 31- to 40-year age group. Most of the patients were migrant workers [22/40 (55.0%)] with low socioeconomic status [32/40 (80.0%)], and the most common transmission mode was heterosexual activity [36/40 (90.0%)]. Most of the patients [32/40 (80.0%)] had mucocutaneous disorders, 30/40 (75.0%) had infective dermatoses, and 21/40 (52.5%) had non-infective inflammatory dermatoses. Eight of forty (20.0%) patients presented with three or more skin disorders. The most common infective dermatoses were fungal infections [15/40 (37.5%)], followed by viral infections [8/40 (20.0%)], bacterial infections [4/40 (10.0%)], and scabies [3/40 (7.5%)]. The most common noninfective dermatosis was generalized pruritus [6/40 (15.0%)], followed by prurigo simplex [4/40 (10.0%)], psoriasis [4/40 (10.0%)], eczema [3/40 (7.5%)], pruritic papular eruption [1/40 (2.5%)], seborrheic dermatitis [1/40 (2.5%)], urticaria [1/40 (2.5%)], and xerosis [1/40 (2.5%)]. Patients treated with HAART had decreased rates of oral candidiasis and herpes simplex but increased rates of drug reactions [19/40 (47.5%)]. The most common drug eruption following HAART was a morbilliform rash [11/40 (27.5%)], and the most common offending agent was nevirapine. The prevalence of mucocutaneous disorders was higher in patients with a CD4 cell count of &lt;200cells/mm3. Conclusions: A wide range of mucocutaneous disorders is observed in Bangladeshi patients with HIV/AIDS, and HAART has an impact on the spectrum of HIV/AIDS-associated mucocutaneous disorders. Skin and mucocutaneous disorders are seen at every stage of HIV/AIDS and are the initial presentation in most patients in Bangladesh. There is a need for increased attention to the diagnosis and treatment of skin diseases affecting the quality of life of patients with HIV/AIDS.

The Effectiveness of Peer Group Support to Increase Health Related Quality of Life among Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome Patients: A Systematic Review

BACKGROUND: The quality of life (QoL) of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) patients affects the health condition of HIV/AIDS patients and can cause the condition to worsen, the role of peer groups is very important in increasing the morale of the patients. AIM: This review aims to analyze the effectiveness of Peer Group Support to Increase Health Related to QoL among HIV/AIDS patients. METHODS: A systematic review conducted on September–December 2020 using five electronic databases (Scopus, Science Direct, CINAHL, PubMed, and ProQuest). The study mean was quasi-experimental and randomized control and trial design. The Center for Review and Dissemination and the Joanna Briggs Institute Guideline used to assess quality and PRISMA checklist to guide this review. Title, abstract, full-text, and methodology were assessed for the eligibility of the studies, and result synthesis was analyzed using narrative for every themes. RESULTS: Twenty three studies were found and met inclusion criteria in the review after risk of bias had assessed. The entire article discusses the benefits of peer group support in improving the QoL of HIV/AIDS patients, including: (1) Being a storyteller; (2) provide mutual motivation; (3) success story; (4) increase resilience; (5) preventing negative stigma; and (6) improve patient’s feelings so that immunity continues to improve. CONCLUSION: Based on the summary of the study, it shows that peer group support is very useful in improving the QoL of HIV/AIDS patients, because it can monitor each other’s health conditions.

Prevalence and Determinants of Human Papilloma Virus Infection and Cervical Intraepithelial Neoplasia (CIN) among Women Living with HIV/AIDS in Mumbai, India

AbstractHuman immunodeficiency virus (HIV) infection among women predisposes them to human papillomavirus (HPV) infection, the causative agent for cervical cancer. The study retrospectively analyzed the data of 291 women living with HIV AIDS (Acquired immunodeficiency syndrome) to assess the prevalence and determinants of the HPV infection and cervical intraepithelial neoplasia (CIN). The study found a high prevalence of cervical HPV infection (34.4%), CIN I (6.2%), and CIN II+ (8.6%). Participants with HPV DNA positivity are significantly more likely to be aged younger than 35 years (odds ratio [OR] = 1.64, 95% confidence interval [CI] = 1.01–2.69), housewives (OR = 2.29, 95% CI = 1.31–3.99), married at &lt;20 years of age (OR = 2.02, 95% CI = 1.13–3.58), and have been pregnant more than two times (OR = 1.76, 95% CI = 1.08–2.87). Participants with CIN II+ are significantly more likely to be not married (OR = 3.363, 95% CI = 1.302–8.686). Considering the high prevalence of HPV and CIN observed among HIV women, it is worthwhile to integrate cervical cancer awareness programs and screening with routine follow-up of HIV patients at antiretroviral therapy clinic. This susceptible population needs attention to reduce the burden of cervical cancer in the country.

American Medical Sociology and Health Problems in the Global South

COVID-19 has focused global attention on disease spread across borders. But how has research on infectious and noncommunicable disease figured into the sociological imagination historically, and to what degree has American medical sociology examined health problems beyond U.S. borders? Our 35-year content analysis of 2,588 presentations in the American Sociological Association’s (ASA) Section on Medical Sociology and 922 articles within the section’s official journal finds less than 15 percent of total research examined contexts outside the United States. Research on three infectious diseases in the top eight causes of death in low-income countries (diarrheal disease, malaria, and tuberculosis [TB]) and emerging diseases—Ebola, Middle East Respiratory Syndrome (MERS), and Severe Acute Respiratory Syndrome (SARS)—was nearly absent, as was research on major noncommunicable diseases. Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) received much more focus, although world regions hit hardest received scant attention. Interviews suggest a number of factors shape geographic foci of research, but this epistemic parochialism may ultimately impoverish sociological understanding of illness and disease.

Water, sanitation, and hygiene (WaSH) practices among people living with HIV/AIDS (PLHA) - need to relook, in the era of COVID-19 pandemic.

Water, sanitation, and hygiene (WaSH) practices always have been neglected among HIV/AIDS (Human immunodeficiency virus/ Acquired immunodeficiency syndrome) programs, even when HIV and WaSH services have robust bearing on each other. With COVID-19 pandemic on the go, it is utmost necessary for the people living with HIV/AIDS (PLHA) to ensure adequate WaSH practices. This study was carried out with an objective to assess baseline WaSH practices among PLHA and to find out if any association between nutritional status and WaSH parameters so as to identify the shortcomings and highlight the importance of WaSH practices among PLHAs and give suitable recommendations to program managers. A cross-sectional study was carried out among PLHA registered in ART centres of western Maharashtra. A sample size of 378 consented to be part of the study were included in the study, by means of systematic random sampling. Data were collected by means of pretested questionnaire prepared from guidelines and previous studies. Institutional ethical clearance was obtained and informed consent was taken from study participants before data collection. Strict confidentiality was maintained throughout the study period. When asked about the water processing method, 76% of them told they do not treat/process the water supplied to them. In contrast, only a few PLHA told they would filter (17%), boil (7%), and use aquaguard (1%). The majority (67%) had their latrines, and while 29% of them were using public latrines and its hygienic sanitation was a concern for them and 4% were still practising open-air defecation in rural areas. Almost all study participants were handwashing after toilet use and handwashing before consuming food. The majority (79%) told they used soap and water, while 20% were using only water, soil and water (1%) and ash and water (1%) which was a concern. Of all the households, 87% cooked their food twice and consumed it thrice a day, while 4% prepared thrice. 10% of them cooked only once and consumed thrice a day; 56% practised consumption of leftover food of the previous night which was a concern. A majority (54%) did not consume street food while remaining said that they used to consume street food. But majority (59%) said they did not follow the habit of checking hygiene or sanitation of hotel where they used to consume food while the remaining 41% did not check the hotel before ordering the food; 50% of them bought packaged milk while 40.9% brought from unpasteurized dairy. On analysis, hygiene and sanitation factors had no statistically significant association with the nutritional status of study participants. WaSH factors act synergistically with other factors to affect the holistic health of PLHA. Information, Education and Communication (IEC) activities (continuous and regular), that focus on improving awareness level on WaSH practices, need to be promoted and integrated into HIV program, including providing basic care packages to PLHA like household water treatment products and soap, etc., Such measures will go a long way in maintaining health of PLHA even during ongoing COVID-19 pandemic scenario.