Human Immunodeficiency Virus Infected Subjects Research Articles

Evaluation of First-Line Coagulation Tests in Highly Active Antiretroviral Therapy (HAART) Naïve and Treated Group of HIV Infected Subjects

Background: Coagulation disorders are common in patients with Human Immunodeficiency virus (HIV). Coagulation abnormalities occur as a result of HIV-related thrombocytopenia, induced hepatotoxicity due to highly active antiretroviral therapy (HAART) that impairs liver function and diminishes the function and synthesis of coagulation factors. The aim of this study was to evaluate prothrombin time (PT), activated partial thromboplastin time (APTT), platelet count, mean platelet volume, plateletcrit and platelet distribution width in HAART-naïve HIV infected patients, HAART treated and HIV-seronegative controls.
 Place and Duration of Study: Department of Haematology and antiretroviraltherapies (ART) clinic both of Enugu State University of Science and Technology Teaching Hospital, between March and June 2023.
 Methodology: A total of 150 study participants, consisting of 50 HAART-naïve HIV-infected subjects, 50 HIV-infected subjects who were taking HAART, and 50 HIV-seronegative apparently healthy subjects, were included. Coagulation tests such as PT, APTT were determined by manual procedures. Platelet counts (PC), mean platelet volume (MPV), plateletcrit (PCT), platelet distribution width (PDW) were analyzed by Mindray/BC-5150 automated analyzer. The data were analyzed using SPSS version 21. Analysis of variance (ANOVA) and Pearson correlation analysis were used. P-Value < 0.05 was considered as statistically significant.
 Results: Mild thrombocytopenia (100-<150 x 109/L) was found in 48% of HIV-infected subjects who were taking HAART, 76% mild thrombocytopenia and 24% moderate thrombocytopenia (50-<100 x109/L) was found in HAART-naïve HIV-infected subjects, but no thrombocytopenia was found in apparently healthy HIV-seronegative control. Prothrombin time and APTT were significantly higher, whereas PC and PDW was significantly lower in HIV-infected subjects (both who were taking HAART and HAART-naïve) than HIV-seronegative subjects (p<0.05). Prothrombin time and APTT were significantly higher, and PC was significantly lower in HAART-naïve HIV-infected subjects than HIV-infected subjects who were taking HAART. In Pearson correlation analysis, PT and APTT has shown a significant negative correlation with a PC in those taking HAART and HAART-naïve HIV-infected subjects, whereas significant positive correlation was found in HIV-seronegative subjects.
 Conclusion: Prothrombin time and APTT significantly increased, whereas platelet count and PDW significantly decreased in HIV-infected subjects who were taking HAART and HAART-naïve. Basic coagulation parameters need to be monitored regularly in HIV-infected subjects in Enugu.

Evaluation of Thyroid Function of HIV Patients in Umunze, Anambra State, Nigeria

Background: Abnormal thyroid function tests have been detected at various phases in people living with Human immunodeficiency virus (HIV) and the effect of highly active antiretroviral therapy (HAART) not well understood. However, there is insufficient study among Nigerians living with HIV.
 Objective: This study is aimed to determine thyroid hormones in HIV positive individuals compared with HIV negative individuals in Umunze, Anambra State, Nigeria.
 Materials and Methods: This cross-sectional study was carried out over a period of six months among 95 HIV positive and 30 HIV negative individuals attending USAID/FHI clinic of Immaculate Heart Hospital in Umunze, Nigeria. The subjects were divided into three groups on the basis of HAART (those on HAART [48] – GROUP 1, HAART naïve [47] – GROUP 2 and Control [30] – GROUP 3). The subjects were interviewed, examined and blood sample collected for determination of thyroid function parameters which include thyroid stimulating hormone (TSH), free triiodothyronine (fT3), triiodothyronine (T3), free thyroxine (fT4), and thyroxine (T4).
 Results: Among the 125 subjects recruited for the study 67.2% were females and 32.8% males. The mean levels of TSH and fT3 was found to be higher in group 1 subjects than in group 2 and the group 3 subjects. The mean level of T4 was significantly higher in group 2 subjects than group 1 and the group 3 subjects. The level of T3 was significantly lower in control subjects in comparison to both HAART and non-HAART subjects. Primary hypothyroidism is the commonest pattern of thyroid dysfunction among the HIV positive patients followed by isolated low fT4.
 Conclusion: Serum levels of thyroid hormones as shown in this study may be used as baseline periodic markers during antiretroviral therapy while people living with HIV may benefit from supplementation if appropriate. There is also need for a larger study to identify the risk factors for progression to overt thyroid disease in HIV infected subjects with thyroid autoimmunity.

Gene dysregulation in acute HIV-1 infection - early transcriptomic analysis reveals the crucial biological functions affected.

Transcriptomic analyses from early human immunodeficiency virus (HIV) infection have the potential to reveal how HIV causes widespread and lasting damage to biological functions, especially in the immune system. Previous studies have been limited by difficulties in obtaining early specimens. A hospital symptom-based screening approach was applied in a rural Mozambican setting to enrol patients with suspected acute HIV infection (Fiebig stage I-IV). Blood samples were collected from all those recruited, so that acute cases and contemporaneously recruited, uninfected controls were included. PBMC were isolated and sequenced using RNA-seq. Sample cellular composition was estimated from gene expression data. Differential gene expression analysis was completed, and correlations were determined between viral load and differential gene expression. Biological implications were examined using Cytoscape, gene set enrichment analysis, and enrichment mapping. Twenty-nine HIV infected subjects one month from presentation and 46 uninfected controls were included in this study. Subjects with acute HIV infection demonstrated profound gene dysregulation, with 6131 (almost 13% of the genome mapped in this study) significantly differentially expressed. Viral load was correlated with 1.6% of dysregulated genes, in particular, highly upregulated genes involved in key cell cycle functions, were correlated with viremia. The most profoundly upregulated biological functions related to cell cycle regulation, in particular, CDCA7 may drive aberrant cell division, promoted by overexpressed E2F family proteins. Also upregulated were DNA repair and replication, microtubule and spindle organization, and immune activation and response. The interferome of acute HIV was characterized by broad activation of interferon-stimulated genes with antiviral functions, most notably IFI27 and OTOF. BCL2 downregulation alongside upregulation of several apoptotic trigger genes and downstream effectors may contribute to cycle arrest and apoptosis. Transmembrane protein 155 (TMEM155) was consistently highly overexpressed during acute infection, with roles hitherto unknown. Our study contributes to a better understanding of the mechanisms of early HIV-induced immune damage. These findings have the potential to lead to new earlier interventions that improve outcomes.

Evaluation of Serum Cytokines Biomakers in HIV-Infected Subjects Before and After Commencement of Haart in Federal Teaching Hospital Gombe

The Human Immunodeficiency Virus (HIV) infection causes the acquired immunodeficiency syndrome (AIDS), which is a systemic disorder characterized by severe impairment and progressive damage of both cellular and humoral immune responses. The aim of this study is to evaluate the effect of long administration of HAART on haematological indices, immunological biomarkers, Biochemical and some cytokines in HIV infected subjects   at federal teaching hospital Gombe.  This is a cross sectional study carried out from May to December 2021 on 132 HIV infected adults. The design entails collecting pre and post blood sample after treatment with highly anti-retroviral treatment (HAART) for more than six months. Out of the 132 subjects studied, 66 were HIV sero-positive and these were the test group, while the remaining 66 were HIV Sero-negative drawn from client visiting blood bank of FTH Gombe to make voluntary donation and HIV Testing Unit (HTS) for Marital and Medical Certificate of Fitness Screening and served as control group. All the subjects were between the ages of 15 - 65 years and are aged matched with the control group. Demographic data was collected using structured questionnaire.  The protocol entails collecting 9mls of venous blood from those who were seropositive for HIV 1 &2 before commencement of HAART. This sample is designed pre- treatment sample and these individuals were followed up for 6 months and a second sample collection was done some were lost to follow up and so the attrition was compensated by also collecting blood samples from other HIV individual who had been on HAART for several years. 4ml was dispensed into EDTA bottle for Full blood count using ELIZA analyzer. P<0.05 was considered as significant.The result of the analysis indicated that the mean±se of Interleukines-2 (IL-2) (pg/ml) and Interleukines -6 (IL-6) (pg/ml) parameters for the control group are 65.43 ± 3.37and 34.74 ± 1.20 respectively. The mean±se of the treatment naïve for IL-2 and IL-6 are 101.61 ± 16.47 and 14.63 ± 1.65 respectively. Also, the mean±se of the treatment/HAART for Interleukines-2 (IL-2) (pg/ml) and Interleukines -6 (IL-6) (pg/ml) are 67.43 ± 1.40 and 10.80 ± 0.45 respectively. The IL-2 significantly higher among treatment Naïve HIV infected participants when compared with treatment and control group with (p-value < 0.05). The result is also shown in table 2.0 Above.From this work it is clear that all the cases in this regard, confirm the fact that Long-term HAART remarkably drops the viral load and inflammation in HIV positive  subjects and shows  that  a  low-level  inflammation  continues  which probably leads to  chronic inflammatory  state, morbidity  and mortality in this group of subjects among HIV positive patients in this part of Northern Nigeria despite the reported side effects

Relationship between Clusters of Differentiation 4 Count and Type of Human Papilloma Virus with Giant Condyloma Acuminata

BACKGROUND: Condyloma acuminata (CA) is a sexually transmitted infection caused by the human papilloma virus (HPV). HPV infection is increasing in immunosuppressed patients which causes the development of CA lesions to be longer, recurrent, and larger. Clusters of differentiation 4 (CD4) count showed an association with the occurrence of giant condyloma acuminata (GCA). AIM: The aim of the study was to determine the relationship between CD4 count and type of HPV with GCA. SUBJECTS AND METHODS: This study was an analytic and observational study with a cross-sectional design with 20 human immunodeficiency virus-infected subjects (10 GCA and 10 non-GCA) selected using the consecutive sampling technique. CD4 examination using blood samples which were analyzed using fluorescence-activated cell sorting. CA lesions were taken using a shave biopsy technique and then the HPV type was examined using the polymerase chain reaction method. RESULTS: The majority of the study subjects were male with GCA 7 people (41.2%). The most age group was 26–35 years old with GCA 6 people (66.7%). The education of the subjects was mostly senior high school with GCA 9 people (56.2%). The employment of the subjects was mostly service and sales personnel with GCA 4 people (57.1%). Based on the location of the GCA lesions, there were 4 people (57.1%) in the genital area and 6 people (46.2%) in the anal area. A total of 9 people (90%) with GCA had severe immunosuppression. The results of the analysis showed that there was a significant relationship between CD4 count and GCA (p < 0.001). The most common HPV type in GCA was HPV-11, amounting to 6 people (46.2%). The results of the analysis showed that there was no significant relationship between the type of HPV and GCA (p = 0.275). CONCLUSION: There is a significant relationship between CD4 count with GCA and there is no relationship between type of HPV with GCA.

Serum Cardiac Troponin I As a Diagnostic Marker of Myocardial Injury Among Human Immunodeficiency Virus Infected Children in Ilorin Kwara State Nigeria

Background: Cardiac Troponin I (cTnI) is a unique marker of myocardial injury. It is the most sensitive and specific of the cardiac markers. Studies have shown its elevation among Human Immunodeficiency Virus (HIV) infected subjects. Most of these were in adults hence we determined the use of cTnI as a marker of myocardial injury among HIV subjects. Methods: The study was a comparative cross-sectional study among 100 HIV - infected children aged 2 – 14 years and equal age-matched HIV-uninfected controls. Recruitment was through the Paediatric HIV and outpatient clinics of the hospital respectively. Both groups had serum cTnI assay (normal is <0.1μ/L) over four months period. Data analysis was done using the SPSS® v 20. Normally distributed data had mean standard deviation while not normally distributed data had a median with an interquartile range determined. The diagnostic performance of cTnI was determined using the Receiver Operating Characteristics curve. Significant p is < 0.05. Results: A total of 200 (subjects and controls) were studied. The mean age of participants was 9.42 years. There was a significant difference in the median (IQR) cTnI of HIV-infected subjects [73.8 (51.8 – 149.1)] compared with HIV uninfected controls [25.0 (13.3 – 51.4)] p < 0.001. The prevalence of myocardial injury among subjects was 48% compared with 8% among controls, also statistically significant (p < 0.001). Serum cTnI has 91.3% and 88.9% sensitivity and specificity respectively. Conclusions: The prevalence of myocardial injury was high in HIV - infected children. Serum cTnI is a reliable predictive marker of myocardial injury.

The Aural Defilement-Otitis Media

Otitis media is an infectious disease arising within the middle ear. Otitis media emerges as an acute or chronic inflammation or infection of middle ear cavity or middle ear space. The condition is preponderantly constituted of acute otitis media, chronic suppurative otitis media and otitis media with effusion. A globally discerned infection, otitis media appears due to diverse bacterial or viral agents although fungal or pneumocystis infection can exceptionally appear in immunocompromised or human immunodeficiency virus (HIV) infected subjects.

Body weight changes in treated hepatitis B patients switching to tenofovir alafenamide☆

Switching to a tenofovir alafenamide (TAF)-containing regimen has been reported to be associated with body weight gain in human immunodeficiency virus-infected subjects. We aimed to investigate the body weight change and virological, hepatic, and renal outcomes of TAF switching among chronic hepatitis B (CHB) patients. This retrospective study included 121 CHB patients who were switched to TAF after >12 months of treatment with another nucleot(s)ide analog (NUC). All patients were monitored for 12 months. The cohort was mostly Asian (96.7%) with a mean age of 55 years, 72% male, 14% cirrhosis, 21% HBeAg positive, and 75% with prior use of tenofovir disoproxil fumarate. At 12 months after TAF switching, their body weight significantly increased from 66.4±11.8 to 67.8±12.3kg (p<0.001), and 21.1% of the subjects had a ≥5% weight gain. Patients without diabetes or hypertension were more likely to have a body weight gain. Meanwhile, the complete viral suppression rate increased significantly from 89.3% to 96.2% (p=0.016). The rate of alanine aminotransferase normalization also increased significantly from 71.1% to 87.6% (p<0.001) by local criteria and from 58.7% to 70.2% (p=0.029) by AASLD criteria. The mean eGFR (mL/min/1.73m2) did not change (88.2±18.8 vs. 87.2±17.5, p=0.28). However, for the subgroup with GFR <90at TAF switching, there was a significant improvement in eGFR (72.9±12.0 vs. 75.7±14.2, p=0.027). In real-world NUC-experienced CHB patients, unexpected body weight gain was observed after TAF switching. The mechanism needs to be investigated in the future.

Assessment of Oral Health and Prevalence of oral Conditions in Human Immunodeficiency Virus-infected Subjects Visiting Antiretroviral Therapy Centers.

Background:Weakened immune system from acquired immunodeficiency syndrome (AIDS) makes the individual prone to various opportunistic infections which are life-threatening including various carcinomas and disorders affecting the neurological system.Aims:The present trial was done to assess the prevalence of oral presentations and treatment needs in AIDS/human immunodeficiency virus (HIV)-infected subjects visiting antiretroviral therapy centers.Materials and Methods:The study included 126 subjects. Oral cavity was assessed and dentition, periodontal condition, and lesions and conditions affecting the oral mucosa were identified along with their treatment needs. The collected data were subjected to statistical evaluation and the results were formulated.Results:Candidiasis was seen in 25.39% (n = 32) of total subjects. Concerning the periodontal status of HIV-infected study population, it was seen that maximum attachment loss both in males and females was within the range of 0–3 mm. Regarding decayed, missing, and filled teeth scores, these were statistically significantly higher in males (P = 0.001).Conclusion:The present study concluded that the majority of subjects infected with HIV present one or more oral presentation and lesion, with candidiasis being the most common condition.

Prevalence and Predictors of Malaria Among HIV Infected Subjects Attending an Antiretroviral Therapy (ART) Clinic in a Tertiary Healthcare Facility in Central Nigeria

Malaria is still considered globally as a leading cause of morbidity with Nigeria carrying the highest burden of 19%. Coinfection of malaria and Human Immunodeficiency Virus (HIV) accelerate disease progression of HIV/AIDS subjects. This study investigated the prevalence and predictors of malaria among HIV infected subjects attending the antiretroviral therapy Clinic at Federal the Medical Centre, Keffi, Nigeria. After ethical clearance, 200 whole blood specimens were collected from patients who gave informed consent and completed a self-structured questionnaire. The specimens were examined for malarial parasite using rapid kits and microscopy. The overall prevalence of the infection was 78/200 (39.0%). The prevalence was higher in male (44.7%) than female (34.0%) subjects. Those subjects aged &lt; 20 years (54.5), male gender (44.7%), non-formal education holders (61.5%), farmers (62.5%), stream water users (48.1%), those that lives in rural setting (43.6%), those that do not use Insecticides Treated Nets (ITNs) (39.4%) and swampy environment dwellers (41.7%) were identified predictors for malaria infection in the area. All the predictors studied did not show any statistically significant difference with the infection but some arithmetic difference exists (P &gt; 0.05). The 39.0% prevalence of malaria in HIV infected subjects is a public health concern. Therefore, Public health surveillance and health education among HIV population should be advocated to help eradicate malaria comes 2030. Further study that will characterize the genes of the parasite should be carried out.

Abstract TP479: Early Effect of Human Immunodeficiency Virus on Cerebral Blood Flow and Autoregulation

Introduction: Human immunodeficiency virus (HIV)-infected individuals are at high risk for ischemic stroke. We measured cerebral blood flow (CBF), oxygen extraction fraction (OEF), and autoregulation in HIV infected subjects and controls. Methods: In treatment-naive HIV infected subjects and age-, gender-, and race-matched controls, OEF was measured by using MRI T2*-weighted echo-planar imaging sequences and CBF was measured by MRI pulsed arterial spin labeling (PASL) approach. Static cerebral autoregulation was determined by measuring changes in CBF and OEF, in response to ≈10% reductions in MAP induced by using IV Nicardipine infusion. All images were acquired using a Siemens 3T MR scanner (Treo, Siemens Medical Systems Inc). Cerebral autoregulation was measured globally and regionally in gray matter (GM), white matter (WM) and subcortical GM. Autoregulatory Index (AI) was computed using the equation AI = %CBF change/% MAP change supplemented by CBF associated OEF changes. Nominal p-values are uncorrected for multiple comparisons. Results: Forty-one treatment naive HIV-infected subjects and 47 age-, gender-, race-matched controls participated. HIV-infected subjects had higher CBF in cortical GM compared to the controls (76.8± 12 mL/100 g/min versus 71.6 ± 11 mL/100 g/min; p= 0.04), but not in white matter (30.9± 8 mL/100 g/min versus 30.0 ± 8 mL/100 g/min; p = 0.60) or subcortical GM (62.8± 13 mL/100 g/min versus 61.3 ± 13 mL/100 g/min; p = 0.57). Whole brain (WB), GM, WM, and subcortical GM, OEF were similar between the groups (p &gt; .05). The median AI were similar between cases and controls in WB (0.40 vs 0.18, p=0.86), GM (0.10 vs. 0.16, p=0.87), WM (0.80 vs. 0.87, p=0.31), and subcortical GM (1.65 vs. 1.77, p=0.26). A 12-month follow-up (N=30) in HIV-subjects on antiretroviral therapy did not produce a significant change in CBF or OEF in the WB, GM, WM, or subcortical GM (Paired sample t test p&gt;0.05). Similarly, no changes were noted on the AI (Wilcoxon Match Rank test p&gt;0.05). Conclusions: AI was similar between HIV cases and control and remained so after 12-months of antiretroviral therapy. We found no evidence of a defect in autoregulation to explain the high-risk of ischemic stroke documented in other studies.

Visual Status of HIV and Non-HIV Infected Children in Relation to Anti-retroviral Drug Use and CD4+ Count in Jos, Plateau State Nigeria

In immunodeficiency diseases such as Human Immunodeficiency Virus (HIV) infection, various body functions may be affected; visual function could be one of them. In a child, there are predictable adverse outcomes of the disease that bother physical and mental development. This study sought to investigate any potential compromise of visual function amongst HIV-infected children on anti-retroviral drugs known as Highly Active Antiretroviral Therapy (HAART) use by comparing the visual acuity, colour sense and field of vision in infected and non-infected children. One hundred (100) children aged between 5 to 15 years consisting of fifty (50) HIV infected and fifty (50) non-HIV infected were selected through random sampling. Visual acuity test (Snellen’s method), colour sense test (Ishihara chart method) and field of vision test (confrontational method) were carried out. Latest Cluster of Differentiation 4 (CD4+) count of the HIV infected subjects also was collected. Statistical analysis was carried out using the Student T Test and ANOVA. The mean visual acuity of Human Immunodeficiency Virus (HIV) infected children was slightly low compared to the negative group (94.2±4.61and 96.4±12.58 respectively) but was not statistically significant (p>0.05). The mean of Ishihara colour sense test and that of the field of vision test also showed no statistically significant change between infected and non-infected children. Mean CD4+ count of the HIV infected children increased with age and use of anti-retroviral drugs. From 11 to 15 years, percentage defect in visual acuity increased amongst the HIV infected children, compared to the other ages but not statistically significant (p>0.05). It was concluded that visual acuity decreases slightly with improving CD4+ count and increasing age, for HIV positive children on anti-retroviral drugs. These parameters could be observed in subsequent years and subjects monitored for further investigation.

Beneficial Efficacy of Histone Deacetylase Inhibitor Butyrate and Histone Crotonylation to Human Immunodeficiency Virus-Infected Subjects

The mechanism of how gut microbiota is involved in the host inflammatory processes that influence human immunodeficiency virus (HIV) replication and disease progression in HIV is elucidated in present review.

The effects of highly active antiretroviral therapy on the serum levels of pro-inflammatory and anti-inflammatory cytokines in HIV infected subjects

BackgroundCytokines play an important role in controlling the homeostasis of the immune system and infection with Human Immunodeficiency virus (HIV) leads to deregulated production of both pro- and anti-inflammatory cytokines. This study was designed to determine the effects of HIV and Highly Active Antiretroviral Therapy (HAART) on the levels of pro-and anti-inflammatory cytokines in HIV infected subjects.MethodA total of 50 HIV infected and 50 HIV seronegative control participants were recruited for the study. The HIV infected subjects were recruited before commencement of antiretroviral therapy and were followed up for 12 months. Blood samples were collected at 3 different points: before initiation of therapy, 6 months into therapy and 12 months into therapy. Serum cytokines were analyzed using ELISA method while CD4+ T cells and viral load counts were measured using standard laboratory methods.ResultThe results showed that pro-inflammatory cytokines: Tumour necrosis factor-alpha (TNF-α), Interleukin-6 (IL-6) and anti-inflammatory cytokines Interleukin-4 (IL-4), Interleukin-10 (IL-10) and Transforming growth factor-beta (TGF-β) were significantly elevated in HIV infected subjects before commencement of therapy compared to 6 months and 12 months into therapy (P < 0.01) and compared to control participants (P < 0.01). TNF-α, TGF-beta remained significantly elevated even after 12 months of therapy compared to control participants (P < 0.01), while IL-4, IL-6, and IL-10 showed no significant difference compared to control participants after 12 months of therapy (P > 0.05). INF-γ was significantly reduced before commencement of therapy and after 12 months of therapy compared to control participants (P < 0.05) respectively.ConclusionTNF-α and TGF-β remained significantly elevated even after 12 months of therapy, while IFN-γ remained significantly reduced after 12 months of therapy. Regulating these cytokines which were unresponsive to therapy could serve as a potential measure of therapy for HIV infected subjects. The positive effect of 12 months therapy on IL-4, IL-6 and IL-10 levels can be used to monitor disease prognosis during therapy especially in resource poor setting where regular viral load monitoring is unavailable.

Risk factors for liver Cancer in HIV endemic areas of Western Kenya

BackgroundHepatocellular carcinoma (HCC) is a malignant cancer of the liver and a leading cause of cancer-related mortality worldwide. Human immunodeficiency virus (HIV) has not been known to have a direct causal relationship with HCC despite independently causing inflammation of the liver. However, little is known on risk factors for HCC patients in an HIV endemic area. The objective of this study was to ascertain the risk factors of HCC and its association with HIV infection.MethodsThis was an un-matched case-control study conducted between June 2015 and June 2016 in Kisumu County Referral Hospital, Kenya. The study enrolled 257 patients with HCC cases and 257 controls. A multivariable logistic regression analysis was used to assess the risk factors for HIV and controlling for exploratory variables. Independent t-test was used to compare means. Exposure variable with values < 0.05 were considered to be statistically significant.ResultsHCC cases were more likely to be above 35 years old compared to controls (88.3% vs 23.0%), [aOR =51.6, 95% CI (27.8–95.6), P < 0.001)]. HBV infected patients have higher risk of HCC (47.1% vs 30.4%), [aOR = 3.3; 95% CI (1.7–5.0), P < 0.0001)]. HIV positive patients were more likely to have HCC than HIV negative patients (33.5% vs 10.9%), [aOR =4.3, 95% CI (2.2–8.4)), P < 0.001]. Females have lower risk of HCC than males (32.7 vs 23.7) [aOR = 0.2, 95% CI (0.1–0.4), P < 0.001]. The majority of HCC patients were at the time of diagnosis at stages C (35.1%) and D (48.6%) according to the Barcelona Clinic Liver Clinic (BCLC) criteria.ConclusionLiver cancer was more frequent among adults and subjects co-infected with HBV and HIV. Thus, HIV represents an additional risk factor for liver cancer in this Kenyan population. Regular health screening of HIV and HBV infected subjects may significantly improve the early diagnosis and effective therapy of liver cancer.

Toxoplasma gondii: The Prevalence and Risk Factors in HIV-Infected Patients in Fars Province, Southern Iran

Background: Toxoplasma gondii is a zoonotic protozoan that threatens the health of the people infected with human immunodeficiency virus (HIV). HIV-positive subjects are at risk of cerebral toxoplasmosis. Objectives: The current study was designed to find out the seroprevalence of toxoplasmosis in HIV-infected individuals in Fars province, in the South of Iran. Methods: This cross-sectional study was performed on 251 HIV-infected individuals referred to Shiraz HIV/AIDS Research Center in Fars province, Southern Iran, in 2016. Blood samples (5 mL) were collected from each individual and sera as well as buffy coat were isolated from each sample. Demographic and HIV-associated data were obtained from the patients’ medical records. Anti-Toxoplasma antibodies (both IgG and IgM) were determined by ELISA, using a commercial kit. In addition, PCR, targeting a 529 bp gene of T. gondii was performed on the patients’ buffy coats for detection of Toxoplasma DNA. Results: Anti-Toxoplasma antibodies were detected in the sera of 42 out of 251 (16.7%) HIV infected patients. Of these, 39 cases (15.5%) were seropositive only for IgG and 3 (1.2%) were positive only for IgM. Seropositive subjects mainly belonged to 40 - 49 year age group. None of the subjects were positive for Toxoplasma DNA when evaluated by the PCR. No significant associations were found between Toxoplasma seropositivity and gender, age, and CD4+ cell level (P > 0.05). Conclusions: Findings of this study demonstrated a significant rate of seroprevalence of Toxoplasma in HIV infected subjects in Fars province, Southern Iran. The seropositive cases are at risk of Toxoplasma reactivation and subsequent cerebral encephalitis. Treatment and also prevention of toxoplasmosis in HIV positive people should be considered.

Chained regularization for identifying brain patterns specific to HIV infection

Human Immunodeficiency Virus (HIV) infection continues to have major adverse public health and clinical consequences despite the effectiveness of combination Antiretroviral Therapy (cART) in reducing HIV viral load and improving immune function. As successfully treated individuals with HIV infection age, their cognition declines faster than reported for normal aging. This phenomenon underlines the importance of improving long-term care, which requires a better understanding of the impact of HIV on the brain. In this paper, automated identification of patients and brain regions affected by HIV infection are modeled as a classification problem, whose solution is determined in two steps within our proposed Chained-Regularization framework. The first step focuses on selecting the HIV pattern (i.e., the most informative constellation of brain region measurements for distinguishing HIV infected subjects from healthy controls) by constraining the search for the optimal parameter setting of the classifier via group sparsity (ℓ2,1-norm). The second step improves classification accuracy by constraining the parameterization with respect to the selected measurements and the Euclidean regularization (ℓ2-norm). When applied to the cortical and subcortical structural Magnetic Resonance Images (MRI) measurements of 65 controls and 65 HIV infected individuals, this approach is more accurate in distinguishing the two cohorts than more common models. Finally, the brain regions of the identified HIV pattern concur with the HIV literature that uses traditional group analysis models.

ASSESSMENT OF KIDNEY FUNCTION, ESTIMATED GLOMERULAR FILTRATION RATE AND BODY MASS INDEX IN HIV SEROPOSITIVE SUBJECTS ON ANTIRETROVIRAL THERAPY IN NNEWI

Objective: Antiretroviral therapy (ART) is anticipated to result in an increase in long-term survival in human immunodeficiency virus (HIV) infected individuals, but may present with the development of associated complications including kidney damage. The present study aimed at assessing the kidney function estimated glomerular filtration (eGFR) rate and body mass index (BMI) of HIV seropositive subjects with or without HAART at Nnewi, Nigeria.Methods: A total of 90 subjects were recruited comprising of 30 HIV-seropositive on highly antiretroviral therapy (HAART), 30 HIV-seropositive drug naive, and 30 HIV-seronegative (control subjects). Anthropometric parameters of the subjects were assessed using a well-structured questionnaire. Five millilitres of blood sample was collected from the patients and used for the estimation of urea, creatinine, uric acid, serum total protein and cluster of differentiation (CD4) T-cell counts using diacetyl monoxime method, Jaffe-slot method, Caraway phosphotungstic acid method, refractometry and flow cytometric method respectively.Results: The result shows significantly higher mean serum urea, creatinine and uric acid levels in HIV seropositive drug-naive subjects and HIV seropositive subjects on HAART when compared with control (p&lt;0.05). Similar observation were made with same parameters between HIV seropositive drug-naive subjects and HIV subjects on HAART (p&lt;0.05). However, total protein and CD4 T-cells counts were significantly lower in HIV seropositive drug-naive subjects compared with HIV subjects on HAART and controls (p&lt;0.05). Based on the chronic kidney disease epidemiology collaboration (CKD-EPI) equation, 6 (20.0%) of HIV seropositive subjects on antiretroviral therapy had a mild renal impairment, while 2 (6.6%) had a moderate renal impairment. Based on the modification of diet in renal disease (MDRD) equation, 7 (23.3%) of HIV subjects on therapy had mild renal impairment while 2 (6.6%) had a moderate renal impairment. Among the HIV drug naïve subjects, 8(26.7%) had mild renal impairment based on both equations. However, there were no significant differences in BMI and eGFR between HIV seropositive subjects on therapy and HIV seropositive drug-naive subjects.Conclusion: The present study shows evidence of significant alterations in serum urea, creatinine, and uric acid levels with mild and moderate state of renal impairment in HIV infected subjects with or without therapy. The significantly lower CD4 count and serum total protein in HIV naive subjects compared with HIV on HAART and control indicates reduced cellular immunity. Routine kidney function test using longitudinal study and more sensitive predictors for renal damage are recommended to ascertain the clearer picture of renal disease burden among HIV subjects in this environment.

Changes in Biochemical Parameters in Human immunodeficiency virus Infected Patients: A Pre-Treatment Study

In recent times there have been advances in the management of Human Immunodeficiency Virus infection. However, the disease still poses threat to biochemical parameters of the body. This study was carried out to investigate the biochemical parameters in Human Immunodeficiency Virus infected patients who were yet to start anti-Retroviral drugs regimen. This study was carried out for a period of six weeks using structural questionnaires. A total of one hundred participants were used for the study out of which fifty were Human Immunodeficiency Virus infected while the remaining fifty were Human Immunodeficiency Virus negative, who served as control. There were significant differences (p&lt;0.05) in the values of Total Protein, Albumin, Alkaline Phosphatase, Aspartate aminotransferase, Alanine aminotransferase, Total Cholesterol, High Density Lipoprotein Cholesterol, Triacylglycerol, Calcium and Sodium of Human Immunodeficiency Virus positive patients when compared with the control. However, there were no significant differences (p&gt;0.05) between the mean values of the conjugated Bilirubin, Urea, Creatinine, Potassium, Bicarbonate and Chloride of the infected patients when compared with those of the control. The findings in this study showed significant changes in biochemical parameters in Human Immunodeficiency Virus infected subjects.

Comparison of Interferon-γ Release Assays and the Tuberculin Skin Test for Diagnosis of Tuberculosis in Human Immunodeficiency Virus: A Systematic Review.

BackgroundIt remains uncertain if interferon-γ release assays (IGRAs) are superior to the tuberculin skin test (TST) for the diagnosis of active tuberculosis (TB) or latent tuberculosis infection (LTBI) in immunosuppressed populations including people with human immunodeficiency virus (HIV) infection. The purpose of this study was to systematically review the performance of IGRAs and the TST in people with HIV with active TB or LTBI in low and high prevalence TB countries.MethodsWe searched the MEDLINE database from 1966 through to January 2017 for studies that compared results of the TST with either the commercial QuantiFERON-TB Gold in Tube (QFTGT) assay or previous assay versions, the T-SPOT.TB assay or in-house IGRAs. Data were summarized by TB prevalence. Tests for concordance and differences in proportions were undertaken as appropriate. The variation in study methodology was appraised.ResultsThirty-two studies including 4,856 HIV subjects met the search criteria. Fourteen studies compared the tests in subjects with LTBI in low TB prevalence settings. The QFTGT had a similar rate of reactivity to the TST, although the first-generation version of that assay was reactive more commonly. IGRAs were more frequently positive than the TST in HIV infected subjects with active TB. There was considerable study methodology and population heterogeneity, and generally low concordance between tests. Both the TST and IGRAs were affected by CD4 T-cell immunodeficiency.ConclusionOur review of comparative data does not provide robust evidence to support the assertion that the IGRAs are superior to the TST when used in HIV infected subjects to diagnose either active TB or LTBI.