Human Immunodeficiency Virus Positive Individuals Research Articles

Quantifying alcohol use among Ecuadorian human immunodeficiency virus positive individuals and assessing alcohol as an independent risk factor for human immunodeficiency virus: A case control study STROBE.

Alcohol abuse has been identified as a risk factor for contracting human immunodeficiency virus (HIV) and accelerating disease progression. Our study aims to determine alcohol consumption rates among Ecuadorian HIV positive (HIV+) patients prior to diagnosis to evaluate its impact as an independent risk factor for contracting HIV. Additionally, we will examine post-diagnosis consumption rates among the HIV+ population.We provided anonymous questionnaires to 300 HIV+ patients and 600 internal medicine patients at 3 hospitals in Quito, Ecuador. Questionnaires quantified alcohol usage prior to HIV diagnosis, at time of diagnosis, and post-diagnosis while accounting for other potential HIV risk factors. We then determined frequencies of alcohol consumption and confounding variables. Finally, we performed a multivariable logistic regression controlling for confounders to determine the statistical significance of alcohol consumption as an independent risk factor for HIV.Our results showed increased odds for contracting HIV among those who drank daily (OR 5.3, CI 2.0–14.0) and those who consumed 6 or more alcoholic beverages on days they drank (OR 5.0, CI 3.1–8.2). Through multivariable analysis, we found that abstaining from binge drinking was a protective factor with an OR 0.5 (0.3–0.96). The percentage of HIV+ patients abstaining from alcohol increased from 30% twelve months prior to diagnosis to 57% after diagnosis.Our results show that alcohol abuse significantly increases the risk of contracting HIV. We found that prior to diagnosis, HIV patients consistently drank more frequently and a greater amount than the control group. Alcohol use significantly decreased among HIV+ patients after diagnosis.

The Lymphatic Cell Environment Promotes Kaposi Sarcoma Development by Prox1-Enhanced Productive Lytic Replication of Kaposi Sarcoma Herpes Virus.

Kaposi sarcoma is the most common cancer in human immunodeficiency virus-positive individuals and is caused by Kaposi sarcoma-associated herpesvirus (KSHV). It is believed that a small number of latently infected Kaposi sarcoma tumor cells undergo spontaneous lytic reactivation to produce viral progeny for infection of new cells. Here, we use matched donor-derived human dermal blood and lymphatic endothelial cells (BEC and LEC, respectively) to show that KSHV-infected BECs progressively lose viral genome as they proliferate. In sharp contrast, KSHV-infected LECs predominantly entered lytic replication, underwent cell lysis, and released new virus. Continuous lytic cell lysis and de novo infection allowed LEC culture to remain infected for a prolonged time. Because of the strong propensity of LECs toward lytic replication, LECs maintained virus as a population, despite the death of individual host cells from lytic lysis. The master regulator of lymphatic development, Prox1, bound the promoter of the RTA gene to upregulate its expression and physically interacted with RTA protein to coregulate lytic genes. Thus, LECs may serve as a proficient viral reservoir that provides viral progeny for continuous de novo infection of tumor origin cells, and potentially BECs and mesenchymal stem cells, which give rise to Kaposi sarcoma tumors. Our study reveals drastically different host cell behaviors between BEC and LEC and defines the underlying mechanisms of the lymphatic cell environment supporting persistent infection in Kaposi sarcoma tumors. SIGNIFICANCE: This study defines the mechanism by which Kaposi's sarcoma could be maintained by virus constantly produced by lymphatic cells in HIV-positive individuals.

HIV and metabolic syndrome in an Ethiopian population

Background The global prevalence of metabolic syndrome (MS) is increasing due to lifestyle changes. Studies have found that MS is associated with human immunodeficiency virus (HIV) and antiretroviral treatment (ART), but controversies still exist on associations between HIV and MS. Aims To assess associations between HIV and MS among ART-naïve HIV positive individuals compared to HIV negative individuals. Subjects and methods A cross-sectional study among ART-naïve HIV positive and HIV negative individuals recruited from HIV treatment and testing facilities in Ethiopia. Information was collected on components of MS: waist circumference, triglycerides, high-density lipoprotein cholesterol (HDL-C), blood pressure and fasting plasma glucose (FPG). Data were analysed using logistic and linear regression stratified by sex and adjusted for age, wealth and education. Results Data from 329 HIV positive and 100 HIV negative individuals were included. HIV positive status was associated with higher odds of MS in women (OR: 3.56, 95%CI: 1.25; 10.15) (n = 292), but not in men (OR: 0.98, 95%CI: 0.22; 4.30) (n = 137), interaction: p= .11. Associations between HIV and components of MS were strongest for HDL-C among women and for FPG among men. The most prevalent components of MS in HIV positive individuals were elevated triglycerides, reduced HDL-C and elevated FPG. Conclusions HIV was associated with MS among ART-naïve women, suggesting that MS should be evaluated before initiating ART and monitored during treatment to identify those at risk of developing diabetes and cardiovascular disease (CVD).

Bacterial associated urinary tract infection, risk factors, and drug susceptibility profile among adult people living with HIV at Haswassa University Comprehensive Specialized Hospital, Hawassa, Southern Esthiopia

People living with human immunodeficiency virus (HIV) are more likely to develop urinary tract infections (UTI) due to the suppression of their immunity. The aim of this study was to determine the prevalence, risk factors of UTI, and drug susceptibility pattern of bacteria isolated among peoples infected with HIV. A hospital-based cross-sectional study was conducted among 224 HIV positive individuals attending Hawassa University Comprehensive Specialized Hospital (HUCSH) from September 17 to November 16, 2018. Midstream urine was collected from all study participants and inoculated on to Blood and MacConkey agar. Bacterial isolates were characterized by Gram stain and standard biochemical tests. Kirby-Bauer method was used for antimicrobial susceptibility testing. Sociodemographic and clinical data were collected by a semi-structured questionnaire. Data were analyzed using SPSS version 20. A bivariate and a multivariable regression model were employed to determine the association between dependent and independent variables. From the total 224 study participants, 23 (10.3%) (95% CI 6.7–14.7) had culture-confirmed UTIs. The distributions of the bacteria were as follows: Escherichia coli 16 (69.6%), Staphylococcus aureus 2 (8.7%), Klebsiella pneumoniae 2 (8.7%), Enterobacter aerogenes 2 (8.7%) and Pseudomonas species 1 (4.3%). UTI prevalence was also high among study participants with a previous history of UTI and CD4+ count < 200/mm3. Female study participants were about five times more likely to have UTI (AOR 5.3, 95% CI 1.5–19.2). Ninety-three percent of bacteria isolated were susceptible to nitrofurantoin, ceftriaxone, and gentamycin; 87.5% were susceptible to meropenem and norfloxacin; whereas 93.8%, 68.8%, and 62.5% of isolates were resistant to ampicillin, tetracycline, and cotrimoxazole respectively. Multidrug resistance (MDR) was seen in 18 (78.3%) of bacterial isolates.

History of Alcohol Consumption and HIV Status Related to Functional Connectivity Differences in the Brain During Working Memory Performance.

Poorer working memory function has previously been associated with alcohol misuse, Human Immunodeficiency Virus (HIV) positive status, and risky behavior. Poorer working memory performance relates to alterations in specific brain networks. The current study examined if there was a relationship between brain networks involved in working memory and reported level of alcohol consumption during an individual's period of heaviest use. Furthermore, we examined whether HIV status and the interaction between HIV and alcohol consumption was associated with differences in these brain networks. Fifty adults, 26 of whom were HIV positive, engaged in an n-back working memory task (0-back and 2-back trials) administered in a magnetic resonance imaging (MRI) scanner. The Kreek- McHugh-Schluger-Kellogg (KMSK) scale of alcohol consumption was used to characterize an individual's period of heaviest use and correlates well with their risk for alcohol dependence. Connectivity analyses were conducted using data collected during n-back task. Functional connectivity differences associated with greater alcohol consumption included negative connectivity, primarily from parietal attention networks to frontal networks. Greater alcohol consumption was also associated with positive connectivity from working memory nodes to the precuneus and paracingulate. HIV positive status was associated with more nodes of negative functional connectivity relative to alcohol consumption history alone, particularly in the frontoparietal networks. The HIV positive individuals with heavier drinking history related to negative fronto-parietal connectivity, along with positive connectivity from working memory nodes to mesolimbic regions. Findings allow for a better understanding of brain networks affected by HIV and alcohol and may provide avenues for interventions.

Functional outcome of stroke inpatients according to human immunodeficiency virus status: A feasibility study.

BackgroundStroke in human immunodeficiency virus positive (HIV+) individuals is becoming an increasing concern. Being significantly younger than typical stroke patients, the impact of functional challenges on quality of life and burden on society becomes more eminent.ObjectivesThis feasibility study aims to determine the requirements for a large descriptive cohort, to adequately describe the functional outcome of stroke patients with varying HIV status.Method All stroke patients meeting the inclusion criteria were recruited over a 6-month period at a South African inpatient rehabilitation centre. Data were collected on admission and discharge using outcome measures including the Barthel Index (BI), Berg Balance Scale (BBS) and the use of assistive devices used to describe independence with activities of daily living (ADL), mobility and safety post-stroke. Statistical analysis was performed using Stata version 14.2.ResultsThe feasibility study identified appropriate procedures and barriers to a successful study in addition to describing preliminary data on participant demographics, relevant medical history and functional outcomes post-stroke. Limitations that affected feasibility included minimal recruitment sites, length of data collection period, timely communication of participant discharge plans and dates, and confirmation of participant HIV status. An appropriate comparison between sub-groups could not be made because of disproportionate group sizes, median age differences and no assessor blinding.ConclusionTo increase generalisability and the understanding of the unique HIV+ stroke profile, multiple recruitment sites, longer data collection periods, assessor blinding and age-matched groups with HIV status confirmation are recommended.

Factors Associated With Cryptosporidium Infection Among Adult HIV Positive Population in Contact With Livestock in Namwala District, Zambia.

Cryptosporidium spp. is one of the leading causes of diarrhoeal disease globally. In Zambia, the burden of Cryptosporidium infection in the general human population is unknown and factors associated with it are unclear. A study was conducted to determine the prevalence of Cryptosporidium spp. and identify factors associated with its infection among Human Immunodeficiency Virus (HIV) positive individuals in contact with livestock in Namwala district of Zambia. Three hundred and twenty six stool samples were collected from HIV infected individuals presenting at local health centers in Namwala district of Zambia between August 2015 and June 2016. The Meriflour Cryptosporidium/Giardia test kit was used to test for presence of oocysts. Demographic information such as age and sex and information on hypothesized risk factors was collected using a structured questionnaire. Overall prevalence of Cryptosporidium infection was 9.5% (95% CI = 6.7–13.2%); 13.3% and 7.1% among male and female participants, respectively. Males were 2.5 times more likely to be infected than females whereas the divorced had higher odds of being infected (OR = 14.8). Participants who kept animals had a higher prevalence (11.4%) than those that did not (7.0%). Those that shared water with neighbors were 5.7 times more likely to be infected than those who did not. We conclude that Cryptosporidium infection is prevalent among HIV positive adults in Namwala district and infection is associated with sex, marital status and sharing water sources among neighbors. Community sensitization is required to create awareness and reduce human exposure to Cryptosporidium infection.

A meta-analysis of the efficacy of HAART on HIV transmission and its impact on sexual risk behaviours among men who have sex with men

Evidence showed preventive impacts of the highly active antiretroviral therapy (HAART) on the Human Immunodeficiency Virus (HIV) transmission amomg heterosexual population, however, that is of deficit among men who have sex with men (MSM). The aim was to systematically examine the efficacy of HAART on HIV transmission and the association between the HAART initiation and unprotected anal intercourse (UAI) in MSM population. Three electronic databases were fully searched for articles published in peer-reviewed journals between 1996 and 2017. Of 1616 identified articles, fifteen articles were eligible for meta-analyses. The summary incidence rate (IR) of HIV was 6.63/100 person-year (95%CI 2.06–11.20/100 person-year)(p = 0.004). The pooled per-contact rate (PCR) of HIV was 0.42% (95% CI 0.21–0.63%)(p < 0.05). The HAART initiation (vs non-HAART) was not associated with engaging in UAI, with odds ratio (OR) 1.09 (95% CI 0.90–1.34)(p > 0.05). In the stratified analysis, participants with no less than 6 months recall period was slightly more likely to engage in UAI (OR 1.32; 95% CI 1.01–1.74)(p < 0.05). It indicated that HAART has potential efficacy on reducing infectivity of HIV positive individuals in anal intercourses. The relationship between the HAART initiation and UAI was not significant and may be influenced by some social-demographic factors. Consistent condom use and education on safe sex among MSM are crucial.

Effect of lifestyle education based on Pender model on health-promoting behaviors in HIV positive individuals: A randomized clinical trial study

Background &amp; Aim: Human Immunodeficiency Virus (HIV) prevalence is increasing, and this disease has become a crisis for the modern world. Today, the survival of patients has been increased, such that HIV is considered a chronic disease. So, Paying attention to health-promoting intervention is necessary. Thus, the current study aims to determine the effect of educating lifestyle based on the Pender model on health-promoting behaviors in HIV patients. Methods &amp; Materials: In this randomized clinical trial study, 70 HIV patients who had inclusion criteria were selected and then divided into intervention and control groups randomly. The intervention group received 6 one-hour education sessions weekly based on Pender lifestyle (nutrition, physical activity, stress management, spiritual growth, interpersonal relationships, and health responsibility). A demographic questionnaire and HPLP2 were used, which were completed by both groups before the intervention and 8 weeks after the intervention. Chi-Square, Fisher, Independent t, and ANCOVA statistical tests and SPSS 16 software were used to analyze data. Results: results showed that there was no significant difference in various dimensions of health-promoting lifestyle between two groups before intervention. However, intervention group scores for nutrition (28.08±6.23 vs. 23.58±6.04), physical activity (22.26±6.46 vs. 16.39±6.09), stress management (25.03±5.14 vs. 19.96±6.41), spiritual growth (29.49±6.11 vs. 25.45±8.54), interpersonal relationships (29.17±6.14 vs. 23.11±7.45) and health responsibility (28.36±6.06 vs. 23.89±5.74) were significantly higher than control group 8 weeks after intervention. Moreover, the total score of health-promoting behaviors had a significant difference in the intervention group compared to the control group (166.7±28.43 vs. 134.5±35.68, p&lt;0.001). Conclusion: Based on the findings, it can be said that educating lifestyle based on the Pender model causes HIV patients to use health-promoting behaviors, which are recommended as a useful theory-based program for managers and providers of health services.

Oxidative Stress as a Risk Factor for Hearing Changes in HIV-positive Normal Listeners

OBJECTIVES:Human immunodeficiency virus-positive (HIV+) individuals can experience a decrease in antioxidants. Such deficiency can make inner ear cells and synapses more vulnerable to oxidative stress, resulting in auditory alterations, even in the presence of normal thresholds. This study aims to compare the audiological findings of HIV+ patients (with and without exposure to anti-retroviral treatment) to those of healthy individuals.METHODS:This was a cross-sectional observational study, comprising 42 normal-hearing adults divided into the Control Group (CG), without HIV; Group I (GI), HIV+, without exposure to the highly active anti-retroviral therapy (HAART); Group II (GII), HIV+, with exposure to HAART. All participants underwent conventional audiometry (0.25-8 kHz), high-frequency audiometry (9-20 kHz), transient evoked otoacoustic emissions (TEOAEs), efferent auditory pathway’s inhibitory effect assessment, brainstem auditory evoked potentials (BAEPs), and cognitive potential (P300).RESULTS:In the comparison of the hearing thresholds between the groups, there was a statistically significant difference for most of the frequencies assessed (GII presented hearing thresholds significantly poor when compared with other groups). The presence of TEOAE and the inhibitory effect was also verified in a significantly higher number of individuals in the CG than in the other groups. As for the BAEP, there was a statistically significant difference for the interpeak intervals I-V (GII showed higher values when compared with CG). For P300, there were no statistically significant differences.CONCLUSION:Normal-hearing HIV+ individuals (with and without exposure to HAART) presented with poor performance in the audiological procedures, suggesting the presence of auditory alterations even in the presence of normal-hearing thresholds.

Prevalence of Human Immunodeficiency Virus and Malaria Co-Infection in Nigeria: A Review of Published Literature

Background: Human immunodeficiency virus and malaria are significant global health challenges. Both diseases contribute to the global burden of disease and poverty notable amongst low-income countries, including sub-Sahara Africa and Nigeria. There are little or no available review articles on the prevailing epidemiological data on human immunodeficiency virus and malaria interaction in Nigeria. &#x0D; &#x0D; Aim: This literature review aims to update knowledge on human immunodeficiency virus and malaria co-infection and determine the prevalence of human immunodeficiency virus and malaria from published literature.&#x0D; &#x0D; Method: This work reviewed published articles on human immunodeficiency virus/malaria co-infection published in English in PubMed, Google Scholar, and ScienceDirect. An internet search on Google Scholar was also conducted for studies that were conducted between 2007 and 2017 in Nigeria. &#x0D; &#x0D; Result: The literature review indicated that the highest prevalence of human immunodeficiency virus and malaria co-infection in Nigeria is 86.2%. The mean &amp;plusmn; SD among the HIV-malaria co-infected group and the negative malaria group in all of Nigeria&amp;rsquo;s geo-political zones are 36.6 &amp;plusmn; 25.5 and 19.5 &amp;plusmn; 15.3, respectively. The highest mean prevalence of 64.5% was reported in human immunodeficiency virus patients co-infected with malaria in the northwest zone. The use of highly active antiretroviral therapy is also associated with a reduced mean positive prevalence of 31.26%. &#x0D; &#x0D; Conclusion: Human immunodeficiency virus-positive individuals across all the geopolitical zones in Nigeria are at high risk of malaria. Findings from this review of literature will provide additional information on HIV-malaria co-infection prevalence and guide public health prevention, control and management practice.

Hepatitis E Virus Infections Among Human Immunodeficiency Virus-Positive Individuals During an Outbreak of Acute Hepatitis A in Taiwan.

Hepatitis A virus (HAV) and hepatitis E virus (HEV) share the similar fecal-oral transmission route. During an outbreak of sexually transmitted acute hepatitis A among men who have sex with men (MSM) worldwide between 2015 and 2017, we investigated the possibility of sexual transmission and related morbidity of HEV infection among human immunodeficiency virus (HIV)-positive patients. From March 1, 2015 to August 31, 2017, anti-HEV immunoglobulin G was retrospectively determined among 3,293 HIV-positive patients, who were mainly MSM (87.6%) with a median CD4 count of 575 cells/μL. Prevalence and incidence of HEV infection were 3.7% (123 of 3,293) and 4.35 per 1,000 person-years of follow-up (PYFU), respectively, which were significantly lower compared with those of HAV infection (31.1% [996 of 3,204] and 12.61 per 1,000 PYFU, respectively). The number of patients with HEV infection did not increase with the hepatitis A epidemic. The factor associated with prevalent HEV infection was older age (per 1-year increase, adjusted odds ratio, 1.07; 95% confidence interval, 1.05-1.09), but neither sexual orientation nor acquisition of sexually transmitted infections was related to prevalent or incident HEV infection. Among 23 patients with incident HEV infection, 22 patients had viremia caused by HEV genotype 4. No patients had prolonged HEV viremia or clinical symptoms, and only a mild elevation of serum aminotransferase, ranging from 34 to 77 IU/L, was noted. Although 4 patients had hepatitis for a prolonged duration of between 8 and 17 months, no abdominal imaging revealed liver fibrosis or cirrhosis. Conclusion: HEV endemicity remained low among HIV-positive patients in Taiwan during the outbreak of acute hepatitis A. Our data suggest that sexual transmission of HEV with significant morbidity of HEV infection, if any, is rare in this population.

Recent cocaine use and memory impairment in HIV

Both Human Immunodeficiency Virus (HIV) and cocaine use have been associated with impairment in neuropsychological functioning. The high comorbidity between HIV and cocaine use highlights the importance of ascertaining whether there is a compounding effect of cocaine use in individuals with HIV. Among neuropsychological domains impacted by HIV, verbal memory deficits have received substantial attention partly because they have been associated with declines in functional status in HIV positive individuals. We collected California Verbal Learning Test-II data from HIV participants who met lifetime diagnostic criteria of cocaine abuse and/or dependence (HIV/CocDx+, N = 80 & HIV/CocDx−, N = 30, respectively) and those with and without recent cocaine use, which was confirmed by toxicology analysis (HIV/Coc+, N = 56 & HIV/Coc−, N = 57, respectively). The Item Specific Deficit Approach (ISDA) was employed to determine any additional cocaine-associated deficits in encoding, consolidation, and retrieval, which attempts to control for potential confounding factors of memory such as attention. Using conventional methods of evaluating memory profiles, we found that the HIV/Coc + group demonstrated worse learning, immediate and delayed free recall, and recognition in contrast to the HIV/Coc − group; although using the ISDA, we found that encoding was the only significant difference between HIV/Coc + and HIV/Coc-participant, with HIV/Coc − performing better. Our data suggest that for individuals with HIV, cocaine use is associated with a temporary decline in verbal memory, is characterized by greater encoding deficits, and these effects may reduce with abstinence. Clinically, our findings suggest that reduced encoding is the likely contributor to verbal memory decline in HIV/Coc + and these effects are partially reversible—at least to the level of their HIV/Coc − counterparts.

Primary effusion lymphoma in a human immunodeficiency virus-negative patient with unexpected unusual complications: a case report

BackgroundPrimary effusion lymphoma is a rare, high-grade non-Hodgkin’s lymphoma that usually occurs in immunosuppressed or human immunodeficiency virus-positive individuals in advanced stages of the disease. However, primary effusion lymphoma occasionally affects immunocompetent patients who are infected with human herpes virus type 8 or Epstein-Barr virus. This disease manifests with liquid collections in cavities, producing constitutional symptoms; fever; weight loss; and symptoms related to extrinsic compression, such as dyspnea or abdominal discomfort. Diagnosis is confirmed with cytological or tissue evaluation showing large, multinucleated lymphoid cells with positive specific markers for the disease, such as CD45 and markers related to viral infections, when present. There is no standard treatment for primary effusion lymphoma, but several chemotherapy protocols are recommended, usually with poor results.Case presentationWe present a case of an adult human immunodeficiency virus-negative Hispanic origin woman with primary effusion lymphoma with pleuritic, pericardial, and peritoneal compromise who also had unusual complications during a diagnostic procedure: the accidental rupture of the left ventricle and the development of a secondary left ventricular pseudoaneurysm. We describe the clinical, radiological, and laboratory characteristics as well as the outcome of this case.ConclusionsPrimary effusion lymphoma is a very rare entity that represents 4% of non-Hodgkin’s lymphoma cases associated with human immunodeficiency virus and 0.1% to 1% of all lymphomas in patients with another type of immunodeficiency in regions where human herpes virus type 8 is not endemic. This reported case is an unusual presentation of primary effusion lymphoma because it occurred in an immunocompetent human immunodeficiency virus-negative adult woman without the presence of Kaposi’s sarcoma or Castleman’s disease and for whom the clinical course after chemotherapy was successful. However, the rupture of the free wall of the left ventricle is a very rare catastrophic event that usually occurs after myocardial infarction. Left ventricle free wall rupture rarely goes unnoticed, but when it occurs, it leads to the development of a ventricular pseudoaneurysm in which the rupture is contained by the pericardium with an organized thrombus and an adjacent hematoma.

Evaluation of IL-2, IL-10, IL-4 and ɤ-interferon levels in the oral fluids of patients with hepatitis C, B and HIV.

Oral fluid cytokine levels can vary considerably during the onset of Inflammatory Periodontitis (IP) especially in people with hepatitis C virus (HCV), hepatitis B virus (HBV) and human immunodeficiency virus (HIV). Aim of our study was to evaluate levels of oral cytokines during the onset of IP among HCV, HBV and HIV negative and positive individuals in order to evaluate local immunity state during these infections. This was a case control study with 3 groups of virally infected individuals and control group. All had IP including control group. 45 patients (51.7%) had HCV, 18 (20.7%) HBV and 24 (27.6%) HIV. For IL-2 we received significant difference for all groups compared with control -2.83; HBV-31.1 (p < 0.001), HCV-25.99 (p < 0.001) and HIV-24.57 (p < 0.001). For IL-10 significant difference was observed between control -0.94 and HCV-3.63 (p = 0.027), HBV-8.38 (15.51) groups (p < 0.001). IL-4 was significantly higher in control group 14.29 compared to HCV 0.2 (p < 0.001) and HIV 0.21 (p = 0.037) group. The adjusted analysis where we consider age as possible confounder revealed that only IL-2 significantly differs for all groups compared with control group: control vs HCV (p = 0.001); control vs HBV (p = 0.024); control vs HIV (p = 0.004). Evidence for significant differences when comparing oral fluid cytokines of individuals with HCV, HBV and HIV with non-viral individuals was more obvious for IL-2. IL-2 levels were significantly higher in all 3 groups vs non-viral group even when age is confounder.

Seroprevalence of IgM and IgG antibodies to toxoplasma infection in human immunodeficiency virus-positive antiretroviral therapy-naive individuals

Introduction: Toxoplasmosis, a zoonotic disease infecting about one-third of the world's population, is caused by intracellular parasite Toxoplasma gondii. It is a major health concern in immunocompromised individuals as in human immunodeficiency virus (HIV)-positive patients. The aim of the study was to determine the seroprevalence of T. gondii infection among HIV-infected antiretroviral therapy-naive individuals attending Integrated Counseling and Testing Center. Materials and Methods: It was a cross-sectional observational study conducted at a tertiary care hospital between April 2015 and March 2016 on 400 HIV-positive patients and 100 HIV-negative healthy adults. Anti-toxoplasma IgM and IgG antibodies were detected using a commercially available enzyme-linked immunosorbent assay kit. Sociodemographic and associated risk factors for T. gondii infection were obtained and the data were analyzed using SPSS version 17.0. Results: Seroprevalence of anti-toxoplasma antibodies among 400 HIV-positive patients and 100 HIV-negative healthy adults was 19.75% and 11%, respectively. Majority of seropositive individuals were in the childbearing age groups. Out of 79 toxoplasma-seropositive cases, 10 were clinically confirmed cases of toxoplasma encephalitis (TE). The mean CD4+ T-lymphocyte count of HIV-positive patients was 255.32 ± 221.19 cells/cmm. Conclusion: The seroprevalence of toxoplasma infection is significantly higher in HIV-positive patients than in HIV-negative healthy individuals. It is important to test all HIV-positive patients for toxoplasma antibodies to prevent life-threatening complication and TE in these patients.

HIV Epidemiology in Uganda: survey based on age, gender, number of sexual partners and frequency of testing.

Human Immunodeficiency Virus (HIV) is a major cause of morbidity and mortality in the world. When compared to the developed countries where HIV prevalence is on the decline, sub-Saharan Africa has experienced either a rise or stagnation in rates. The aim of this study was to test and educate the community in the villages of Masajja and Kibiri of Wakiso district in Uganda for HIV and safe sex practices. A sociodemographic survey was also performed to obtain data for gender, age, number of sexual partners during the previous year, frequency of testing and if ever tested positive for other sexually transmitted diseases (STDs). While 7 of the tested individuals were positive for HIV, 77 reported that they had once tested positive for other STDs. Of the 7 HIV positive individuals, 4 were females and 3 males. Over half of the tested individuals reported only one sexual partner in past 12 months and more than a quarter were sexually active with more than one partner. Majority of our population also reported getting HIV tested every 6 months or less. Robust implementation of methods such as education and frequent testing can lower Uganda's prevalence of HIV even further.

Relationship Between Brain Arterial Pathology and Neurocognitive Performance Among Individuals With Human Immunodeficiency Virus.

Human immunodeficiency virus-positive (HIV+) individuals have higher rates of cognitive impairment and cerebrovascular disease compared with uninfected populations. We hypothesize that cerebrovascular disease, specifically brain large artery disease, may play a role in HIV-associated neurocognitive disorders (HAND). Participants (N = 94) in the Manhattan HIV Brain Bank study were followed on average 32 ± 33 months with repeated neuropsychological examinations until death. We used five cognitive domains (motor, processing speed, working memory, verbal fluency, and executive functioning) to assess ante mortem performance. We quantified the diameter of the lumen and arterial wall thickness obtained during autopsy. The diagnoses of HAND were attributed using the American Academy of Neurology nosology. We used generalized linear mixed model to account for repeated measures, follow-up time, and codependence between arteries. Models were adjusted for demographics, viral loads, CD4 counts, history of opportunistic infections, and vascular risks. We included 94 HIV+ individuals (mean age 56 ± 8.3, 68% men, 54% African American). In adjusted models, there was an association between arterial wall thickness and global cognitive score (B = -0.176, P value = .03), processing speed (B = -0.175, P = .05), and verbal fluency (B = -0.253, P = .02). Participants with incident or worsening HAND had thicker brain arterial walls (B = 0.523 ± 0.234, P = .03) and smaller arterial lumen (B = -0.633 ± 0.252, P = .01). We report here a novel association between brain arterial wall thickening and poorer ante mortem cognitive performance and diagnosis of incident or worsening HAND at death. Strategies to preserve the arterial lumen or to prevent wall thickening may impact HAND.

Serologic responses and effectiveness of hepatitis A vaccination among human immunodeficiency virus-positive individuals during the outbreak of acute hepatitis A.

During the outbreak of acute hepatitis A, two-dose HAV vaccination is effective at preventing HAV infection among HIV-positive individuals receiving combination antiretroviral therapy; our data highlight the importance of HAV serologic screening and vaccination to prevent outbreaks of acute hepatitis A in at-risk populations. (Hepatology 2018;68:22-31).

Analysis of risk factors associated with hepatocellular carcinoma in black South Africans: 2000-2012.

ObjectiveThe aims of this study were to determine the prevalence of risk factors associated with hepatocellular carcinoma (HCC) in black adult South Africans and to estimate the size of the associated risks.MethodsA case-control analysis of 150 black South African patients (aged 18–75 years) with HCC—who were a subset of patients recruited for the Johannesburg Cancer Case Control Study 2000 to 2012—was undertaken. The association between this tumour and hepatitis B/C virus infections, and human immunodeficiency virus (HIV) mono- and co-infections was investigated. Odds ratios (ORs) and 95% confidence intervals (CI) adjusted for age, year of diagnosis, marital status, place of birth and selected modifiable risk factors were calculated.ResultsHCC was significantly associated with a rural birthplace (p<0.05), being male and living in an urban area for 14 years or less. The Odds Ratio (OR) for HCC increased significantly with HBV DNA+/HBsAg+ (OR 34.5; CI:16.26–73.13), HBV DNA+/HBsAg- (OR 3.76; CI:1.79–7.92), HBV DNA level >2000 IU/ml (OR 8.55; CI:3.00–24.54) to ≥200,000 (OR 16.93; CI:8.65–33.13), anti-HCV (OR 8.98; CI:3.59–22.46), HBV DNA+/HIV+ co-infection (OR 5.36; CI:2.59–11.11), but not with HBV DNA-/HIV+ (OR 0.34; CI:0.14–0.85). We did not find a synergistic interaction between HBV and HIV. Modifiable risk factors (alcohol consumption, tobacco smoking, number of sexual partners, diabetes and hormonal contraceptive use) were nonsignificant.DiscussionA considerable portion of the HCC burden in Johannesburg and surrounding provinces falls on rural migrants to urban areas, most of whom are men. The HBV will continue to contribute to HCC incidence in older age-groups and in others who missed vaccination. Although we did not find an increased risk for HCC in HIV positive individuals this may change as life expectancy increases due to greater access to antiretroviral therapies, necessitating the addition of hepatitis virus screening to preventive medical care.