Diagnosis Of Human Immunodeficiency Virus Infection Research Articles

Implementation of digital HIV services in Guangzhou's primary health-care system, China.

To describe changes in access to voluntary human immunodeficiency virus (HIV) counselling and testing services following the implementation of a mini-application (app) at primary health-care facilities across Guangzhou, China. In 2018, the Guangzhou Center for Disease Control and Prevention and the Lingnan Community Support Center co-developed WellTest, a mini-app within the WeChat environment, to address voluntary counselling and testing service needs. The mini-app provides on-demand information for clients, links them to health services, and allows users to provide feedback on health-care quality and share test results with partners. We retrieved data from the National HIV/AIDS Prevention and Control Information System and the app backend to assess adoption and service use after implementation of WellTest in primary health-care facilities in December 2018. Between 2018 and 2023, WellTest adoption at primary health-care facilities increased from 1.5% (2/134) to 90.1% (172/191). The annual number of visits for voluntary HIV counselling and testing services at these facilities rose from 7376 to 20 002, representing 83.6% of all 23 930 voluntary HIV counselling and testing visits in 2023, compared with 36.6% (7376/20 129) in 2018. The proportion of newly diagnosed HIV infections at primary health-care facilities increased from 21.7% (187/862) to 50.4% (239/474). The increased access to HIV services in Guangzhou's primary health-care facilities highlights the value of digital health interventions in addressing service delivery gaps and meeting the needs of providers and clients. Expanding such interventions has the potential to strengthen decentralized health care and disease screening in low-resource settings.

Human Immunodeficiency Virus

ABSTRACT Often overlooked or misdiagnosed, cutaneous symptoms are common in chronic human immunodeficiency virus (HIV) disease and can serve as early signs of the disease. These cutaneous signs prompted to test for HIV on the three patients, which all were found to be positive. In this article, we are attempting to highlight the importance of recognizing cutaneous manifestations of HIV for early diagnosis and timely initiation of antiretroviral therapy. Three cases of cutaneous symptoms are presented: (a) generalized hyperpigmentation; (b) generalized hyperpigmentation with oral hairy leukoplakia; and (c) seborrheic dermatitis, xerosis, oral hairy leukoplakia, multiple foci of furuncles, and linear gingival erythema. Studies have shown that various cutaneous symptoms are common in chronic HIV disease. The most common are seborrheic dermatitis, xerosis, oral candidiasis, and folliculitis. Recognition of these skin findings is crucial, as it can lead to early diagnosis and treatment of HIV infection, thereby reducing morbidity and mortality associated with HIV infection and improving quality of life for patients.

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

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

Guidance for the occupational medicine service regarding the prevention of hepatitis C and HIV infection in Poland

The set up of new healthcare models by taking into account diagnosis and health education of the viral infection, aims to achieve the goals of the World Health Organization Global Health Sector Strategy on viral diseases for 2022-2030. In comparison to Europe, Poland is ranked among countries with an moderate prevalence of hepatitis B and C virus (HBV and HCV), also human immunodeficiency virus (HIV). An additional challenge is the changing epidemiological situation due to the impact of immigrants, resulting mainly from the war in Ukraine. The article presents current guidance for HCV and HIV diagnosis and presents the role of occupational health service (OHS) for primary and secondary prevention of the infectious diseases. It was considered to expand the scope of periodic examinations to include diagnosis of HBV, HCV and HIV infections among health care workers, who have not had it performed so far. In the case of abnormal level of alanine aminotransferase (ALT), aspartate aminotransferase (AST) or γ-glutamyl transpeptidase (GGT) found during routine pre-employment or periodic examinations for specific occupational exposures and it is considered crucial to implement further measures to exclude or confirm HBV or HCV infection, with indications for further management in primary care, and followed by subsequent periodic examinations. The need to pay attention to any symptoms that may indicate HBV, HCV and/or HIV infection, to perform additional diagnostic tests (e.g., point of care), and to determine the next steps in case of positive result was indicated. It emphasized the need to tailor the delivery of information to the patient, including taking care to ensure that immigrants' workers understand the next steps. It was recommended that the OHS conduct educational activities to raise health awareness of HIV, HCV, HBV infections, both through health policy programs as well as through broader activities in cooperation with the employer. Med Pr Work Health Saf. 2024;75(5):485-494.

Clinical features and prognostic factors of cryptococcal infections in HIV-infected patients: a 10-year study from an infectious disease specialist hospital.

Cryptococcosis is an invasive infection that commonly affects immunosuppressed individuals, especially patients with HIV infection. Cryptococcal infection in HIV-infected patients should be considered a major health concern because it is associated with high morbidity and mortality rates. In this study, we aimed to evaluate the clinical characteristics and prognostic factors of cryptococcal infections in human immunodeficiency virus (HIV)-infected patients to facilitate effective clinical management and improve patient outcomes. We reviewed and analyzed the clinical data and relevant laboratory test results of HIV-infected patients with positive cryptococcal cultures and reserved strains between 2013 and 2023 from Beijing Youan Hospital affiliated to Capital Medical University. The clinical characteristics and laboratory test results of the patients were compared, and the correlation between parameters and the prognoses of the patients at different observation timepoints (3, 6, 9, and 12 months) was analyzed. A total of 76 patients (70 males and six females; median age, 37 years) were included in this study. The results indicated that the later the initiation of antiretroviral therapy (ART) after the diagnosis of HIV infection (> 6 months), the higher the probability of death. Analysis of the correlation between the time of ART initiation and the timing of treatment for cryptococcal infections showed that the time of ART initiation was strongly related to survival at different timepoints. Initiation of ART time within 0-4 weeks, 4-6 weeks and more than 6weeks of starting treatment for Cryptococcus infection was associated with a lower mortality rate at 12-month, the 3-month, 6- and 9-month follow-up timepoint separately. Although cryptococcal infection in HIV-infected patients continues to be a challenging and intricate issue, ART is a key factor that affects its prognosis. The later ART is started, the worse the prognosis of the infection. The time of ART initiation and the timing of treatment for cryptococcal infections should be further refined and balanced based on different clinical courses. Thus, clinicians should pay closer attention to cryptococcal infections in patients with HIV infection and initiate ART based on the patient's clinical condition.

Changes in the epidemiology and clinical manifestations of human immunodeficiency virus-associated tuberculosis in Hong Kong.

Human immunodeficiency virus (HIV)-associated tuberculosis (TB) remains an important health challenge worldwide. Although TB prevalence has decreased in the general population, there is limited information regarding temporal trends in the incidence of HIV-associated TB in Hong Kong. There are also insufficient data regarding changes in clinical manifestation patterns among HIV-associated TB patients over time. This study aimed to describe temporal trends in the epidemiology and clinical manifestations of HIV-associated TB in Hong Kong. We retrospectively reviewed data regarding HIV-associated TB patients that were reported to the TB-HIV Registry of the Department of Health during the period 2007 to 2020. Trends of TB as a primary acquired immunodeficiency syndrome (AIDS)-defining illness, as well as changes in demographic features and clinical manifestations of HIV-associated TB during this period were examined using Cochran-Armitage trend test. A decreasing trend was observed in the proportion of all reported cases of AIDS in which TB was a primary AIDS-defining illness during the study period. The proportions of female patients and patients with extrapulmonary involvement significantly increased, whereas the proportions of ever-smokers and patients with sputum smear positivity significantly decreased during the same period. A decreasing trend was observed in the proportion of patients with pulmonary TB in which the lower zone was the predominant site of lung parenchymal lesions. Among patients with a diagnosis of HIV infection before TB, an increasing trend was observed in the proportion of patients receiving antiretroviral therapy. Important temporal changes were observed in the epidemiology and clinical manifestations of HIV-associated TB. These results highlight the need for continued surveillance regarding the patterns of demographic features and clinical manifestations to inform policymakers when planning control strategies for HIV-associated TB.

HIV infection among children in Malanje province, Angola: a twelve-year follow-up study.

Human immunodeficiency virus (HIV) / acquired immunodeficiency syndrome (AIDS) infection has been a serious health problem in pediatric age groups globally, and especially in African countries such as Angola. Our aim was to determine the prevalence rate, accumulate incidence rate, and mortality rate of HIV/AIDS infection in children under 14 years of age residing in four municipalities of Malanje (Malanje, Cacuso, Calandula, and Caculama), from 2010 to 2021. This was a documentary research study, with data from 2010 to 2021, developed from a sample size of 10,984 children. The prevalence rate data showed a certain level of dispersion, and no relationship was identified in its behavior over the years (R2 = 0.0036). On the other hand, the accumulate incidence rate presented a tendency to decrease, indicating a moderate level of correlation in its behavior over the years (R2 = 0.4278). Finally, the mortality rate has been decreasing and presented a high correlation in its association with the years under analysis (R2 = 0.8142). Primary schooling and low purchasing power were frequent (60% and 82%, respectively) among the families of HIV-infected children under study. Despite the temporal variation of HIV in children under 14 years of age living in the different municipalities, there was a tendency of its diminishing in the later part of the period, from 2010 to 2021. Nevertheless, the key players should focus on strengthening community strategies for prevention, investigation, and diagnosis of HIV infections in this population.

2024 The Guidelines from the Polish Society forLaboratory Diagnostics on the diagnostic of the HumanImmunodeficiency Virus infection

These recommendations of the Polish Society for Laboratory Diagnostics concern thediagnostic strategy for detecting infection with the Human Immunodeficiency Virus (HIV),implemented with the participation of medical laboratories in Poland. A medical diagnosticlaboratory should ensure that the diagnostic process is performed completely, includingconfirmatory test if needed. The use of 4th generation immunoassay tests is recommendedfor screening testing. For confirmatory diagnostics, it is recommended to apply nucleicacid amplification tests, using specific molecular probes with real-time detection of theluminescent signal. Particular attention should be paid to obtaining the appropriate amountand type of biological material used in the entire diagnostic process. The document considersthe different profiles of medical facilities doing tests, the diverse needs of clients and theanalytical differences of diagnostic tests available on the market. Considering currentknowledge in prevention, diagnosis, and treatment of HIV infection, it constitutes guidelinesfor unifying the diagnostic process in the country.

Diagnostic and prognostic significance of mast cell markers in HIV/AIDS: Current insights and future directions.

Human immunodeficiency virus (HIV) infection continues to pose significant global health challenges, necessitating advancements in diagnostic and prognostic approaches to optimize disease management. While primarily recognized for their roles in allergic responses, mast cells have emerged as potential markers with diagnostic and prognostic significance in the context of HIV/AIDS. This paper aims to synthesize current insights and delineate future directions regarding the utility of mast cell markers in diagnosing HIV infection, predicting disease progression, and guiding therapeutic strategies. Mast cells, equipped with distinct markers such as tryptase, chymase, carboxypeptidase A3, and c-kit/CD117 receptors, exhibit tissue-specific expression patterns that offer potential as diagnostic indicators for HIV infection. Understanding the dynamics of these markers in different tissues and body fluids holds promise for accurate HIV diagnosis, disease staging, and monitoring treatment responses. Moreover, the prognostic significance of mast cell markers in HIV/AIDS lies in their potential to predict disease progression, immune dysregulation, and clinical outcomes. The integration of mast cell markers into clinical applications offers promising avenues for refining diagnostic assays, patient monitoring protocols, and therapeutic strategies in HIV/AIDS. Future research directions involve the development of novel diagnostic tools and targeted therapies based on mast cell-specific markers, potentially revolutionizing clinical practice and enhancing patient care in the management of HIV/AIDS. Continued investigations into mast cell markers' diagnostic and prognostic implications hold immense potential to advance our understanding and improve outcomes in HIV/AIDS management.

The Role of MicroRNAs in HIV Infection.

MicroRNAs (miRNAs), a class of small, non-coding RNAs, play a pivotal role in regulating gene expression at the post-transcriptional level. These regulatory molecules are integral to many biological processes and have been implicated in the pathogenesis of various diseases, including Human Immunodeficiency Virus (HIV) infection. This review aims to cover the current understanding of the multifaceted roles miRNAs assume in the context of HIV infection and pathogenesis. The discourse is structured around three primary focal points: (i) elucidation of the mechanisms through which miRNAs regulate HIV replication, encompassing both direct targeting of viral transcripts and indirect modulation of host factors critical for viral replication; (ii) examination of the modulation of miRNA expression by HIV, mediated through either viral proteins or the activation of cellular pathways consequent to viral infection; and (iii) assessment of the impact of miRNAs on the immune response and the progression of disease in HIV-infected individuals. Further, this review delves into the potential utility of miRNAs as biomarkers and therapeutic agents in HIV infection, underscoring the challenges and prospects inherent to this line of inquiry. The synthesis of current evidence positions miRNAs as significant modulators of the host-virus interplay, offering promising avenues for enhancing the diagnosis, treatment, and prevention of HIV infection.

Prevalence of cardiac complications in perinatally acquired human immunodeficiency virus infection in children in Southern India: an observational study

Background: Human immunodeficiency virus (HIV) infection is a multisystemic illness that impacts most organ system, to investigate prevalence of cardiovascular abnormalities in children with perinatally acquired HIV infection. Methods: This observational study was conducted in a tertiary care centre in Southern India. HIV-positive children between the ages of 18 months and 15 years were included. Cardiac abnormalities were defined as abnormalities identified on 2D echocardiography and/or electrocardiogram. Results: The 73 children with HIV infection had their cardiac manifestations assessed. Median age of children was 8 years with 52% of female participants, 22 (30.13%) children had cardiac abnormalities, of which 5 (27.27%) were symptomatic. Overall, 21/22 (95.45%) children had abnormalities on their ECG, 16 (72.72%) had abnormalities on 2D echocardiography. Of these, we found that children with delayed diagnosis of HIV infection and with more advanced clinical and immunological staging in HIV are more prone to develop cardiac complications irrespective of antiretroviral therapy (ART). Conclusions: HIV-related heart involvement is not uncommon, rather occur subclinical. A decreasing CD4 count and worsening clinical status are associated with increased risk. Hence its crucial to screen the children, diagnose at the earliest and timely manage the complications appropriately for prevention of early mortality.

Self-Perception of Risk for HIV Acquisition and Calculated Risk for HIV Acquisition Among Active Duty Air Force Members With Newly Diagnosed HIV Infection.

There have been nearly 1,600 new diagnoses of Human Immunodeficiency Virus (HIV) across the US Armed Forces between 2017 and 2022. While treatment has improved overall survival, self-perception of acquiring HIV may not align with actual risk of acquiring HIV, thus slowing diagnosis and treatment. We aim to evaluate self-perceived risk (SPR) versus calculated risk (CR) of HIV infection in US Air Force (USAF) members with incident HIV diagnosis. All USAF members with new HIV diagnosis evaluated at a specialty care military medical center between January 2015 and March 2020 with case report forms were included (n = 142). SPR was compared to CR using the Denver HIV Risk Score (DHRS). The study was approved by the Army Public Health Center's Public Health Review Board (#14-311) and the Walter Reed Army Institute of Research Human Subjects Protection Branch (#1861E). Patients were predominantly male (98%), with a median age of 26 (IQR 22-30) years, and the majority (85%) reported same-sex partners. Most patients reported a low SPR (n = 78; 55%). A higher proportion of low SPR patients were married or partnered than high SPR patients (29% versus 14%; P = 0.04). Both groups had median DHRS scores in the highest risk category with similar results by reason for HIV screening. The majority of USAF members with incident HIV infection reported a low SPR despite risk factors and CRs identical to high SPR patients. In order to inform HIV prevention strategies in the military, further efforts are needed to educate the military population and providers about HIV risk perception.

Diagnostic tests of HIV infection and AIDS

Background: Human immunodeficiency virus (HIV) infection presents a major global health challenge. According to the World Health Organization, approximately 39.0 million people have HIV, as of 2022, with 1.3 million new infections annually. In Korea, the first HIV cases were reported in 1985, and the number of cases has increased continuously since 1988. In 2022, 1,066 cases were newly diagnosed, increasing the total number of cases to approximately 15,880.Current Concepts: Diagnostics play a crucial role in the management of HIV, for early diagnosis and initiation of antiretroviral therapy. Approval of the first HIV antibody test in 1985 by the US Food and Drug Administration marked a notable advance in the ability to diagnose HIV infection. The screening test for HIV infection typically consists of a two-step approach, in which a fourth-generation combination HIV-1/2 immunoassay is followed by a confirmatory Western blot. Despite its high accuracy for chronic infections, the window period and the early-stage of HIV infections are problematic, and populations with low HIV prevalence show a low positive predictive value. A false positive result can occur from blood transfusions, vaccinations, and autoantibodies. Novel diagnostic tools, such as nucleic acid testing for viral RNA/DNA and antigen testing for p24 antigen have reduced the window period, allowing for earlier detection and differentiation between HIV-1 and HIV-2. Pointof-care tests are beneficial in resource-limited settings although their lower sensitivity and specificity require additional confirmatory follow-up testing.Discussion and Conclusion: In this review, we provide a historical perspective on the evolution of HIV diagnostics (serological and molecular) and describe the roles of conventional and point-of-care testing within the laboratory diagnostic network.

The current state and outlook of HIV infection and AIDS in South Korea

Background: Over the past decade, approximately 1,100 newly diagnosed cases of human immunodeficiency virus (HIV) infection have been reported annually in South Korea, with 1,066 newly diagnosed cases reported in 2022. A decrease in HIV infection rate can be achieved only through coordinated prevention, diagnosis, and treatment. South Korea is lagging in the worldwide decreasing trend of HIV infection, and a brief review of this situation may suggest improvements necessary for progress.Current Concepts: In South Korea, the proportion of patients with CD4 cell count below 200 cells/mm&lt;sup&gt;3&lt;/sup&gt; at initial diagnosis of HIV infection remains high, suggesting that a significant population is diagnosed at the late stage of the disease. Since 2019, the Korean National Health Insurance Service began to cover the cost of preexposure prophylaxis for sexual partners of patients living with HIV, but few have started the regimen due to several barriers. Insurance criteria for a prophylaxis regimen should be modified, and accessibility to the regimen should be made available through multiple pathways. Proactive use of rapid HIV testing kits in community health centers and clinics should be expanded. Legal and administrative environments encouraging voluntary testing, early diagnosis, and treatment should be fostered. Medical personnel must be able to offer medical care without discrimination regardless of HIV infection status.Discussion and Conclusion: The HIV epidemic in South Korea has not yet decreased. To end it, efforts should be required across broad areas, including voluntary HIV testing, early diagnosis, active pre-exposure prophylaxis, a stigma- and discrimination-free social environment, and changes in legal and medical environments.

Using adult care visits to diagnose HIV infection in children, Burkina Faso.

To estimate the feasibility, positivity rate and cost of offering child testing for human immunodeficiency virus (HIV) to mothers living with HIV attending outpatient clinics in Burkina Faso. We conducted this implementation study in nine outpatient clinics between October 2021 and June 2022. We identified all women ≤ 45 years who were attending these clinics for their routine HIV care and who had at least one living child aged between 18months and 5years whose HIV status was not known. We offered these mothers an HIV test for their child at their next outpatient visit. We calculated intervention uptake, HIV positivity rate and costs. Of 799 eligible children, we tested 663 (83.0%) and identified 16 new HIV infections: 2.5% (95% confidence interval, CI: 1.5-4.1). Compared with HIV-negative children, significantly more HIV-infected children were breastfed beyond 12 months (P-value: 0.003) and they had not been tested before (P-value: 0.003). A significantly greater proportion of mothers of HIV-infected children were unaware of the availability of child testing at 18 months (P-value: < 0.001) and had more recently learnt their HIV status (P-value: 0.01) than mothers of HIV-negative children. The intervention cost 98.1 United States dollars for one child testing HIV-positive. Barriers to implementing this strategy included shortages of HIV tests, increased workload for health-care workers and difficulty accessing children not living with their mothers. Testing HIV-exposed children through their mothers in outpatient clinics is feasible and effective in a low HIV-prevalence setting such as Burkina Faso. Implementation of this strategy to detect undiagnosed HIV-infected children is recommended.

Follow-up for 3 years of a pediatric population diagnosed in 2018 with mother-to-child transmission of HIV in 8 Latin American countries in the PLANTAIDS cohort

IntroductionThe frequency of mother-to-child transmission (MTCT) of human immunodeficiency virus (HIV) in Latin America has decreased considerably. However, new infections continue to be recorded, and the pediatric population remains one of the most vulnerable groups in this region. The main objective of the study was to describe the clinical, epidemiological and psychosocial characteristics of new diagnoses of HIV MTCT in 2018 in the PLANTAIDS network (Paediatric Network for Prevention, Early Detection and Treatment of HIV in Children) during the 3 years following diagnosis.MethodologyRetrospective, multicenter, descriptive study based on a 3-year follow-up of patients diagnosed with HIV infection due to MTCT in 2018 in 10 hospitals in 8 Latin American countries (Costa Rica, Ecuador, Mexico, Honduras, El Salvador, Panama, Guatemala and Venezuela). The hospitals belonged to the PLANTAIDS network, which is included in CYTED (Ibero-American Programme of Science and Technology for Development).ResultsThe study population comprised 72 pediatric patients (38.9% male). The median age at diagnosis was 2.4 years (IQR: 0.8–5.4). There were 35 cases of opportunistic infections corresponding to 25 patients (34.7%), with tuberculosis being the most common. Adequate childhood vaccination coverage was achieved in 80.5%. There were 3 cases of acute SARS-CoV-2 infection, and these were asymptomatic or mildly symptomatic. According to the Centers for Disease Control and Prevention (CDC) classification, the most frequent clinical-immunological stage at all check-ups was C1. Three patients died from opportunistic infections and/or advanced HIV infection.ConclusionsIt is important to diagnose HIV infection early in pediatrics, since early initiation of ART is associated with a decrease in mortality. Despite this, HIV infection has a poor prognosis in children, necessitating adequate follow-up to ensure adherence to health care and ART, although it can sometimes prove difficult in children.

HIV incidence before and during the COVID-19 pandemic in Japan.

At the end of 2022, a total of 20,003 diagnoses of human immunodeficiency virus (HIV) infection and 8,983 cases of acquired immunodeficiency syndrome (AIDS) among Japanese nationals, and 3,860 HIV diagnoses and 1,575 AIDS cases among foreign residents, had been notified to the government in Japan. This study updates the estimate of HIV incidence, including during the COVID-19 pandemic. It aimed to reconstruct the incidence of HIV and understand how the disruption caused by COVID-19 affected the epidemiology of HIV. Using a median incubation period of 10.0 years, the number of undiagnosed HIV infections was estimated to be 3,209 (95% confidence interval (CI): 2,642, 3,710) at the end of 2022. This figure has declined steadily over the past 10 years. Assuming that the median incubation period was 10.0 years, the proportion of diagnosed HIV infections, including surviving AIDS cases, was 89.3% (95% CI: 87.8%, 91.0%). When AIDS cases were excluded, the proportion was 86.2% (95% CI: 84.3%, 88.3%). During the COVID-19 pandemic, the estimated annual diagnosis rate was slightly lower than during earlier time intervals, at around 16.5% (95% CI: 14.9%, 18.1%). Japan may already have achieved diagnostic coverage of 90%, given its 9% increment in the diagnosed proportion during the past 5 years. The incidence of HIV infection continued to decrease even during the COVID-19 pandemic from 2020 to 2022, and the annual rate of diagnosis decreased slightly to 16.5%. Monitoring the recovery of diagnosis along with the effective reproduction number is vital in the future.

Neurocysticercosis with Classic Ring Enhancing Lesions in a Patient with AIDS: Case Report, Diagnostic Approach and Literature Review

Introduction: Human immunodeficiency virus (HIV) is a neurotrophic, neuroinvasive, and neurovirulent pathogen, which can cause direct infection of the central nervous system (CNS) but also predisposes to a variety of other neuroinfections through impaired T-cell mediated immunity. Among the imaging findings in HIV patient with CNS infection, the presence of ring-enhancing intracranial lesions are considered not rare but quite puzzling diagnostic dilemma. The differential diagnosis for theses lesions commonly includes metastasis, abscess, glioblastoma, infarct, contusion, demyelinating disease, radiation necrosis, resolving hematoma or infections. Many features need to be considered altogether to help narrow the differential. Case description: Male, 32 years old, with history of chronic smoking, pets: one cat dewormed and vaccinated, and positive diagnosis of HIV infection with a CD4 T lymphocyte count of 24 cells/mm3, without antiretroviral treatment. His main symptom was headache, associated with fever, nausea, and vomiting. Therefore, he was hospitalized for his diagnostic approach. Complete laboratory work was done, head CT, lumbar puncture, and MRI, finding rounded intra-axial lesions with well-defined and hyperintense edges in the parietal and occipital region with annular enhancement after the administration of contrast. After symptomatic treatment and anthelmintic therapy, a follow-up imaging study evidenced involution of these lesions. The patient met diagnostic criteria for definitive diagnosis of neurocysticercosis. Conclusion: Even though, Neurocysticercosis is not a rare disease, our group decided to publish this case report because its asocciation with an HIV positive patient, in which has not been yet linked to, in behalf of the lack of evidence and studies, considering the ethical issue of performing rutinary head CT scans in asymptomatic individuals.

In-house ELISA protocols for capsid p24 detection of diverse HIV isolates

BackgroundThe capsid p24 (CA-p24) antigen is a component of the viral capsid of human immunodeficiency virus (HIV) that has been commonly used for clinical diagnosis and monitoring of HIV infections in Enzyme-linked Immunosorbent Assays (ELISAs). Commercial CA-p24 ELISAs are widely used in research settings, but these kits are costly and have limited breadth for detecting diverse HIV isolates.MethodsCommercial CA-p24 antibodies were used as capture and detection antibodies. Specific CA-p24 ELISAs were established with these antibodies and tested for the detection of HIV-1 isolates with the aim of developing in-house protocols to recognize HIV-1 infections in vitro for research purposes.ResultsHere we present four protocols for in-house ELISAs to detect HIV CA-p24 using commercial antibodies. The assays were able to detect the CA-p24 antigen of different HIV-1 isolates tested. Comparison between the protocols showed that these in-house ELISAs exhibit high specificity, sensitivity, and reproducibility for CA-p24 quantitation but their reactivity varied per HIV-1 isolate and subtype.ConclusionsThese optimized ELISA protocols represent valuable tools to investigate HIV-1 infections in research facilities at a lower price than commercial CA-p24 kits.

Correlation Between HIV Rapid Test and HIV Viral Load in HIV Patients at Haji Hospital in Surabaya

HIV (Human Immunodeficiency Virus) is a virus that causes decreased immunity. Examinations that can be done for HIV testing include a rapid HIV test and HIV viral load. The rapid HIV test is a test that is used to find out the antibodies in the sample, while the viral load test is to find out the amount of HIV. The purpose of this study was to compare HIV using a rapid test with HIV viral load in people with HIV. This type of research is observational with a cross-sectional approach. The sample in this study were 30 samples from HIV sufferers who carried out an HIV viral load examination using the Molecular Rapid Test (TCM) method at the RSUD Haji Provinsi Jawa Timur, then a rapid HIV test was carried out using the immunochromatography method. The results of the HIV rapid test and HIV viral load were processed in the form of a bar chart and tested with the McNemar statistical test. The results of the McNemar test can be concluded that there is a significant difference between the results of the HIV viral load examination of HIV viral load by the Molecular Rapid Test (TCM) method is superior to the HIV rapid test. However, rapid tests can be used in diagnosing HIV infection.