Human Immunodeficiency Virus Seronegative Individuals Research Articles

Use of ATP, GTP, ADP and AMP as an Index of Energy Utilization and Storage in HIV Infected Individuals at NAUTH, Nigeria: A Longitudinal, Prospective, Case-Controlled Study

Human immunodeficiency virus (HIV) is associated with altered metabolism and increased energy expenditure, this energy requirement increases significantly as the HIV disease progresses. This study aimed on the use of Adenosine triphosphate (ATP), Guanosine triphosphate (GTP), Adenosine diphosphate (ADP) and Adenosine monophosphate (AMP) as an index of energy utilization, storage and energy balance in HIV infected individuals. This is a longitudinal, prospective, case-controlled study involving seventy seven (77) HIV Sero-positive individuals newly diagnosed attending retroviral disease treatment centre of Nnamdi Azikiwe University University Teaching Hospital (NAUTH) aged 18-60 years both male and female not on highly active antiretroviral therapy (HAART), were enrolled in the study as test subjects and thirty six (36) apparently healthy HIV Sero-negative individuals both male and female as control subjects. ATP, GTP, ADP and AMP were estimated by enzyme linked immunosorbent assay (ELISA), while, total Energy Balance was determined by calculation. The data obtained were subjected to statistical analysis using SPSS software application (version 21.0) and the results expressed as mean ± standard deviation. The plasma ATP and GTP were significantly lower (P<0.05) in both HIV pre-treatment and post-treatment group compared with control group. Meanwhile, the plasma level of ADP and AMP were significantly lower (P<0.05) in HIV post-treatment group compared with HIV pre-treatment and control group. There was also a significant difference (P<0.05) in ATP, ADP, AMP and GTP level between HIV pre-treatment and post-treatment group. Meanwhile, the energy balance was lower (P<0.05) in HIV groups compared with control group. However, the energy balance in HIV post-treatment group was significantly lower (P<0.05) compared to HIV pre- treatment group. In conclusion, the significant changes in the biochemical parameters measured suggest altered metabolism, increased energy expenditure and energy deficit/negative energy balance in HIV subjects resulting from increased energy expenditure. Hence, High energy molecules such ATP, ADP, GTP and AMP can be used to predict early energy deficit and manage energy imbalance in HIV infected individuals.

Helicobacter pylori infection and hypochlorhydria in Zambian adults and children: A secondary data analysis.

BackgroundHypochlorhydria (gastric pH >4) increases susceptibility to diarrhoea, iron deficiency, and gastric cancer. We sought to clarify the prevalence of this condition and its predisposing factors in Zambia by pooling data from previous studies conducted in hospital and community settings.MethodsGastric pH was measured in participants from five separate studies by collecting gastric aspirate from fasted adults and children under 3 years of age undergoing gastroscopy. Gastric pH was correlated with serological testing for Human Immunodeficiency Virus (HIV) and Helicobacter pylori (H. pylori) infections.ResultsWe studied 597 individuals (487 adults and 110 children). Hypochlorhydria was present in 53% of adults and 31% of children. HIV infection was detected in 41% of adults and 11% of children. H. pylori serology was available for 366 individuals: 93% of adults and 6% of children were seropositive. In univariate analysis, hypochlorhydria was significantly associated with HIV seropositivity (OR 1.7; 95% CI 1.2–2.4; p = 0.004) and H. pylori antibody seropositivity (OR 4.9; 95% CI 2.8–8.6; p<0.0001), and with advancing age in HIV negative individuals (p = 0.0001). In multivariable analysis, only H. pylori was associated with hypochlorhydria (OR 4.0; 95% CI 2.2–7.2; p<0.0001) while excluding possible exposure to proton pump inhibitors.ConclusionsHypochlorhydria is common in our population, with H. pylori being the dominant factor. Only young HIV seronegative individuals had a low prevalence of hypochlorhydria. This may have implications for the risk of other health conditions including gastric cancer.

Prevalence of intestinal parasitic infections in HIV-infected individuals and their relationship with immune status

Background and Objectives: Intestinal parasitic infection is a common entity in patients infected with human immunodeficiency virus (HIV). These infections may lead to fatal complications in the immuno suppressed individuals. The aim of the present study was to determine the prevalence of intestinal parasitic infections in HIV sero-positive patients and their relationship with the immune status of individuals. Materials and Methods: Fecal samples from 100 HIV sero-positive and an equal number of HIV sero-negative individuals were collected and examined for enteric parasites by direct microscopy. CD4 counts were carried out in only HIV sero-positive patients. Prevalence of intestinal parasites in patients with CD4 count <200 cells/μl, 200-499 cells/μl, and ≥500 cells/μl in HIV-infected patients were compared. Results: Enteric parasites were detected in 59.3% HIV-infected patients with CD4 count <200 cells/μl as compared with 23.5% in patients with CD4 count>200 cells/μl (P < 0.01). Prevalence of coccidian parasites was significantly (P < 0.01) higher (14%) in HIV sero-positive subjects compared with HIV sero-negative subjects (2%). Isospora belli (25%) was the most common parasite with CD4 count <200 cells/μl, followed by Cryptosporidium parvum (12.5%). Prevalence of intestinal parasitic infections was significantly higher in patients with diarrhea, 73.6% than without diarrhea, 25.9%, (P < 0.05). The mean CD4 count of HIV sero-positive patients presenting with diarrhea was significantly (P < 0.01) lower (181.26 ± 135.14) than without diarrhea (352.02 ± 204.03). Conclusion: This study emphasizes the need for routine screening of parasites especially in patients with lower CD4 count so as to decrease the morbidity by ensuring the early treatment of the cases.

Genetic Polymorphisms in the Open Reading Frame of the CCR5 gene From HIV-1 Seronegative and Seropositive Individuals From National Capital Regions of India

C-C chemokine receptor type 5 (CCR5) serves as a co-receptor for Human immunodeficiency virus (HIV), enabling the virus to enter human CD4 T cells and macrophages. In the absence of CCR5, HIV strains that require CCR5 (R5 or M-tropic HIV) fail to successfully initiate infection. Various natural mutations of the CCR5 gene have been reported to interfere with the HIV-CCR5 interaction, which influences the rate of AIDS progression. Genetic characterization of the CCR5 gene in individuals from the National Capital Regions (NCRs) of India revealed several natural point mutations in HIV seropositive/negative individuals. Furthermore, we identified novel frame-shifts mutations in the CCR5 gene in HIV seronegative individuals, as well as the well reported CCR5Δ32 mutation. Additionally, we observed a number of mutations present only in HIV seropositive individuals. This is the first report to describe the genetic variations of CCR5 in individuals from the NCRs of India and demonstrates the utility of investigating understudied populations to identify novel CCR5 polymorphisms.

Homozygous deletion of both GSTM1 and GSTT1 genes is associated with higher CD4+ T cell counts in Ghanaian HIV patients.

Glutathione S-transferase (GST) family of enzymes are involved in a two-stage detoxification process of a wide range of environmental toxins, carcinogens and xenobiotics. The GST enzymes play important roles in oxidative stress pathways, and polymorphisms in the GSTM1 and GSTT1 genes mediate susceptibility and outcome in different diseases. Human immunodeficiency virus (HIV) infection is associated with oxidative stress, but there is limited data on the frequency of deleted GSTM1 and GSTT1 genes in HIV/AIDS patients and their effect on progression among Ghanaians. This study sought to investigate the association between homozygous deletion of GSTM1 and GSTT1 genes (both null deletion) with HIV/AIDS disease progression in Ghanaian patients. HIV-infected individuals on antiretroviral therapy (ART), ART-naïve HIV patients, and HIV seronegative individuals were recruited for the study. HIV/AIDS disease progression was assessed by measuring CD4+ cell count and viral load of the patients, and GST polymorphism was determined by amplifying the GSTT1 and GSTM1 genes using multiplex PCR, with CYP1A1 gene as an internal control. The mean CD4+ count of patients that were naïve to ART (298 ± 243 cells/mm3) was significantly lower than that of patients on ART (604 ± 294 cells/mm3), and viral load was significantly lower in the ART-experienced group (30379 ± 15073 copies/mm3) compared to the ART-naïve group (209882 ± 75045 copies/mm3). Frequencies of GSTM1 and GSTT1 deletions were shown to be 21.9% and 19.8%, respectively, in the HIV patients, and patients with homozygous deletion of both GSTM1 and GSTT1 were more likely to have their CD4+ count rising above 350 cells/mm3 (OR = 6.44, 95% CI = 0.81–51.49, p = 0.039) suggesting that patients with homozygous deletion of GSTM1 and GSTT1 genes have slower disease progression. The findings of this study show that double deletion of glutathione S-transferases M1 and T1 is statistically associated with normal CD4+ count in patients diagnosed with HIV/AIDS. Further study is required to investigate the clinical importance of the both null deletion in HIV patients.

Enumeration of CD4 + T lymphocytes Count among Healthy HIV Seronegative Individuals & People Living with HIV in Manipur

Introduction: The CD4+ T lymphocytes are the primary target cells for Human Immunodeficiency Virus (HIV). The enumeration of CD4+ T cells is the most important marker for HIV disease progression. The estimation of CD4+ T cell counts is used to decide the initiation of anti retroviral therapy (ART), to monitor the efficacy and to start treatment for opportunistic infections (OIs). Hence it is important to establish the reference ranges for the CD4+ T cell counts in the target population to understand the immune dysfunction.Objectives: To determine the reference range of CD4 + T cell counts in healthy HIV seronegative individuals and its comparison with those people living with HIV in Manipur.Materials and Methods: The study was carried out between August 2013 to June 2015 in the Dept. Of Microbiology, RIMS, Imphal, Manipur. Blood samples from 334 HIV seronegative volunteers comprising group I (188 males and 146 females) and 1058 HIV-positive patients comprising group II (525 males and 533 females) in the age group of 17-60 years, were analyzed for enumeration of CD4+ T cell counts by fluorescent activated cell sorter (FACS) counter (Becton Dickinson).Results: In group I mean CD4 levels were 741 180.349 cells/l. In normal healthy males CD4 levels were 656.99 122.73 cells/l and 849.36 185.190 cells/l among healthy females. In group II mean CD4 levels were 341.43 301.885 cells/l. Among the HIV positive males CD4 levels were 300.35 200.634 cells/l while among the females CD4 levels were 381.89 371.638 cells/l.Conclusion: As there is heterogeneity in baseline CD4 + T cell counts, our findings on T-cell subset reference ranges of normal healthy seronegative people in Manipur validate the utility of determination of CD4 cell count.

The human immunodeficiency virus infection is associated with positive iron balance among subjects in Nnewi, South East Nigeria

BACKGROUND: The human immunodeficiency virus (HIV) infection is associated with a number of metabolic derangements which have a remarkable impact on disease mortality and morbidity. OBJECTIVE: To evaluate the effect of HIV infection on iron status in apparently healthy seropositive adult subjects seen at a tertiary hospital in South East Nigeria. SUBJECTS AND METHODS: A total of eighty subjects were recruited for the study which comprised of randomly selected forty HIV seropositive and seronegative individuals, respectively. Each participant had 5 ml of blood collected for serum ferritin, iron, total binding capacity (TIBC), and percentage saturation of transferrin estimation. Ferritin was determined using the enzyme-linked immunosorbent assay technique while iron and TIBC were measured by spectrophotometry; percentage transferrin saturation was calculated using the standard formula. Statistical analysis was performed using SPSS (version 20), the Student's t -test was used for the comparison of means while the level of statistical significance was set at P RESULTS: The means of serum ferritin and transferrin saturation were significantly higher (164.30 ± 138.52 ng/ml vs. 88.10 ± 57.75 ng/ml; P = 0.002 and 44.67 ± 12.95% vs. 32.42 ± 4.67%; P P = 0.004, respectively) in test subjects compared with controls. Serum iron was not significantly different in the two populations of study subjects ( P = 0.30). CONCLUSION: Infection with the HIV is associated with significant tissue iron loading; this could have important implications on disease course and morbidity.

Cytomegalovirus Identification and Quantification from the Saliva of Human Immunodeficiency Virus Seropositive and Seronegative Patients Using Real Time Polymerase Chain Reaction

Cytomegalovirus Identification and Quantification from the Saliva of Human Immunodeficiency Virus Seropositive and Seronegative Patients Using Real Time Polymerase Chain Reaction

An in vitro study of antifungal drug susceptibility of Candida species isolated from human immunodeficiency virus seropositive and human immunodeficiency virus seronegative individuals in Lucknow population Uttar Pradesh.

Background:Candidiasis is the most common opportunistic infection in human immunodeficiency virus (HIV) seropositive patients, starting from asymptomatic colonization to pathogenic forms and gradual colonization of non-albicans in patients with advanced immunosuppression leads to resistance for azole group of antifungal drugs with high rate of morbidity and mortality.Objectives:To isolate the Candida species and determine of antifungal drug susceptibility against fluconazole, itraconazole, nystatin, amphotericin B, and clotrimazolein HIV seropositive and control individuals, with or without clinical oropharyngeal candidiasis (OPC).Materials and Methods:Includes samples from faucial region of 70 subjects with and without clinical candidiasis in HIV seropositive and controls were aseptically inoculated onto Sabaraud's Dextrose Agar media and yeasts were identified for the specific species by Corn Meal Agar, sugar fermentation and heat tolerance tests. Antifungal drug susceptibility of the isolated species was done against above-mentioned drugs by E-test and disc diffusion method.Results:The commonly isolated species in HIV seropositive and controls were Candida albicans, Candida glabrata and Candida tropicalis Candida guilliermondii and Candida dubliniensis isolated only in HIV seropositive patients. Susceptibility against selected antifungal drugs was observed more in HIV-negative individuals whereas susceptible dose-dependent and resistance were predominant in HIV-positive patients.Conclusion:Resistance is the major problem in the therapy of OPC, especially in HIV seropositive patients due to aggressive and prolonged use of antifungal agents, therefore, our study emphasizes the need for antifungal drug susceptibility testing whenever antifungal treatment is desired, especially in HIV-infected subjects.

Neurocognitive impairment associated with predominantly early stage HIV infection in Abuja, Nigeria.

Detailed neuropsychological testing was performed on 133 human immunodeficiency virus (HIV) seropositive (SP) and 77 HIV seronegative (SN) individuals, 86 % with early stage HIV infection in Nigeria, to determine the frequency of HIV-related neurocognitive impairment among the HIV-infected group. The tests were administered to assess the following seven ability domains: speed of information processing, attention/working memory, executive functioning, learning, memory, verbal fluency, and motor function motor. Demographically corrected individual test scores and scores for each domain or reflecting a global deficit (a global deficit score, or GDS) were compared for the SP and SN groups. SP participants were older, had fewer years of education, were more likely to be married, differed in ethnicity, and had higher depression scores than SN individuals. Within the seven ability domains, SP performed worse than SN with respect to speed of information processing, executive function, learning, memory, and verbal fluency and also on the global measure. SP were also more frequently impaired on tests of SIP, and there was a borderline increase in the frequency of global impairment. On the individual tests, SP performed worse than SN on four tests that assessed learning, verbal fluency, memory, and motor function (the Timed Gait). SP subjects, however, performed better than SN on the Finger-tapping test, also a motor task. Performance by SP subjects was not associated on the timed gait which showed a borderline statistically significant correlation with CD4 counts. However, there were significant correlations between viral load measurements and individual tests of speed of information processing, executive function, learning, and verbal fluency and with overall executive function and a borderline correlation with the GDS. Depression scores for SP were associated with impairment on only a single test of executive function. These results demonstrate the ability of these assessments to identify areas of impairment that may be specifically linked to a history of HIV infection among individuals in Nigeria. Confirmation of these findings awaits analyses using data from a larger number of control subjects.

Evaluation of the probability of using total lymphocyte count as an alternative to CD4 count in initiation of art

Measurement of CD4+ T cell count in the diagnosis of HIV in a resource-constrain settings is often difficult due to high cost of equipments, reagents, and demand for trained personnel. There is need for relatively cost effective technique with good Prognosis for Human Immunodeficiency Virus (HIV) infection. Two hundred and fourty four (244) HIV seropositive (tests) and fifty (50) HIV seronegative individuals (controls) were analyzed for CD4 count and TLC. The result of the study was analyzed using SPSS 14, the mean + SEM 930 + 43 cells/ìl (CD4 count) and 2026 + 75 cells/mm3 Total Lymphocyte Count (TLC) in control and 196 + 8.0 cells/ìl (CD4 count) and 1969 + 66 cells/mm3 (TLC) in Test group were obtained. There was significant difference between the values of CD4 count recorded in Test (196 + 8.0 cells/ì) when compared with the value recorded in Control (930 + 43 cells/ìl) (p&lt;0.01), but there was no significant difference in the values of TLC recorded in Test (1969 + 66 cells/mm3) when compared with the values recorded in the control (2026 + 75 cells/mm3) (p&lt;0.01). This is due to the fact that CD4+T lymphocyte are specificallytargeted by HIV which results in linear reduction in CD4 count not the whole population of Tlymphocytes and B-lymphocytes. A spearman’s correlation study was done between the CD4 counts and TLC, indicated a slightly positive correlation (r= 0.586) among the test individuals and strongpositive correlation in the control (r = 0.739). It could be concluded that total lymphocyte count can not be used alone as an alternative to CD4 count in initiating ART, but in conjunction with clinical sign and symptoms.Keywords: Human immunodeficiency virus, CD4 count, Total lymphocyte count, and Antiretroviral therapy.

Recurrent Isosporiasis in a Patient With Human T-cell Lymphotropic Virus 1 Infection

Infection with Isospora belli is a well-known cause of chronic diarrhea in patients with human immunodeficiency virus/acquired immunodeficiency syndrome. Recurrent isosporiasis, causing chronic diarrhea in human immunodeficiency virus–seronegative individuals, should lead to a search for other causes of immunosuppression, including human T-cell lymphotropic virus 1 infection.

Comparative study on the microbiological features of angular cheilitis in HIV seropositive and HIV seronegative patients from South India

Objective:This study was designed to compare the microbiological features of angular cheilitis (AC) in human immunodeficiency virus (HIV) seropositive and HIV seronegative individuals, in a group of south Indians.Materials and Methods:Swabs from oral commissures of 46 patients were obtained and inoculated on to Sabouraud's dextrose agar (SDA) supplemented with chloramphenicol, blood agar (BA) and MacConkey's agar (MCA) plates and cultured. α-hemolytic Streptococci, Staphylococcus albus, Staphylococcus aureus, Candida species, Klebsiella species and Pseudomonas species were cultured. Candidal colonies were further speciated by the conventional biotyping technique.Results:In AC of HIV seropositive patients Candida albicans and Staphylococcus aureus were more prevalent than that in HIV seronegative patients. Incidentally in patients with CD4 cell count less than 200 there was an increase in the incidence of Candidal and Staphylococcus aureus colonization when compared to patients with CD4 cell count higher than 200.Conclusion:The present study suggests a definite difference in the microbial flora of AC in HIV seropositive patients than that of HIV seronegative population.

A study of enteric parasitic infections in HIV/AIDS and HIV sero negative individuals in population of Khammam district

The aim of this study was to verify that the occurrence of intestinal parasitic infections in human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) patients in comparison with non-HIV individuals in Mamata General Hospital, Khammam, and Andhra Pradesh.

Treatment of Kaposi's sarcoma--an update.

Kaposi's sarcoma (KS) is an angioproliferative disease of multifactorial origin arising in different clinic-epidemiologic forms, which show the same histopathological features. It generally starts as a hyperplastic reactive-inflammatory and angiogenic process, which may evolve into monomorphic nodules of KS cells that can be clonal (late-stage lesions) and resemble a true sarcoma. Infection with the human herpesvirus 8, cytokine- and angiogenic factor-induced growth together with an immuno-dysregulated state represent fundamental conditions for the development of this tumor. Several local therapies are used to eradicate early and confined skin lesions, whereas widely disseminated, progressive or symptomatic disease requires a more aggressive treatment. Although different chemotherapeutic agents have been used to treat aggressive KS, the growing understanding of the pathogenetic factors participating in KS development has provided a strong rationale for using less- or non-cytotoxic agents that block the mechanisms involved in KS pathogenesis. The angiogenic nature of KS makes it particularly suitable for using therapies based on anti-angiogenic agents. Of note on this goal, recent studies indicate that the highly active anti-retroviral therapy, including at least one human immunodeficiency virus (HIV) protease inhibitor (PI), is associated with a dramatic decrease in the incidence of AIDS-KS and with a regression of KS in treated individuals. Consistent with this, results from preclinical studies indicate that PIs have potent and direct anti-angiogenic and anti-KS activities, suggesting that they should be further investigated, alone or combined with other therapies, as a novel treatment for KS in both HIV seropositive or seronegative individuals.

Is there an interaction between human immunodeficiency virus and Plasmodium falciparum?

There is a potential for interaction between malaria and human immunodeficiency virus (HIV) infection. HIV infection might reduce immunity to malaria resulting in more frequent and severe infections; conversely malaria might enhance the progression of HIV infection to AIDS. In this paper we have reviewed some of the studies that have addressed this topic. Studies identified by a MEDLINE search were systematically reviewed and the measures of association between the two infections were either abstracted or recalculated from the reported data. Inferences drawn from these studies and the biological plausibility of an interaction are discussed. The prevalence ratio (PR) of peripheral parasitaemia among HIV seropositive (HIVSP) individuals compared to HIV seronegative (HIVSN) individuals ranged from 0.72 to 0.94 in children and from 3.3 to 0.69 in adults. However, only one study showed a statistically significant difference between HIVSP and HIVSN groups (PR 3.3, 95% CI: 2.7-4.2). The rate ratio of non-severe malaria among HIVSP children compared to HIVSN children was 1.4 (95% CI: 0.99-2.0). Data from a trial of chemoprophylaxis during pregnancy suggested that placental malaria may predispose to perinatal transmission of HIV. Studies that have investigated the immune response to P. falciparum among HIVSP subjects have given variable results. There is no convincing evidence for an interaction between malaria and HIV with the possible exception of an interaction between placental malaria and HIV infection. Several studies, however, had potentials for bias and/or an inadequate sample size. There is a need for carefully designed studies to resolve whether mortality from severe malaria, in particular cerebral malaria, is increased in HIVSP subjects, whether malaria infection of the placenta increases the risk of vertical transmission of HIV, and whether malaria infection increases the progression of HIV infection to AIDS.

Rapid culture and quantitation of human immunodeficiency virus type 1 from patient cells without the use of mitogen-stimulated donor cells.

We report the development of a rapid, sensitive virus culture method for direct quantitation of human immunodeficiency virus (HIV) in peripheral blood mononuclear cells (PBMCs). This new method involves culturing 10(7) PBMCs from HIV-seropositive persons in 10 ml of medium containing phorbol 12-myristate 13-acetate and interleukin-2. Both agents stimulate cell activation and hence viral replication. Cell-associated virus and free virus are quantitated by a commercially available HIV p24 antigen capture enzyme immunoassay. Detection of cell-associated p24 antigen by flow cytometry was less sensitive than by the enzyme immunoassay. In this preliminary study, HIV was detected in 20 of 23 HIV-seropositive patients and in none of the 11 HIV seronegative low-risk individuals. One HIV-seronegative person with Guillain-Barré syndrome following high-risk activity was found to be rapid-HIV-culture positive. The overall sensitivity and specificity were 87 and 100%, respectively. By comparing the quantity of virus produced in infected cells with the amount of virus produced in chronically infected U1 monocytes and ACH-2 lymphocytes stimulated with phorbol 12-myristate 13-acetate and interleukin-2, the approximate number of infected cells per sample is calculated. In the same patient specimens, quantitation of the number of HIV infected cells by the HIV rapid-culture method correlated with the results of the 21-day cell dilution coculture assay (correlation coefficient r = 0.5; 95% confidence interval, 0.07 to 0.77). Advantages of the rapid HIV culture include no requirement for donor PBMCs or change of media, shortened culture time, and the ability to detect p24 viral antigen from cell-associated virus for quantitation of viral load.

Heroin addicts infected by HBV and HIV have a low prevalence of HBV DNA in peripheral blood mononuclear cells.

Several reports show that the prevalence of HBV (hepatitis B virus) carriers in HIV (human immunodeficiency virus) infected populations is significantly higher than in HIV seronegative individuals, independent of the risk group for HIV, that is, homosexuals or drug abusers. In this context, evaluation of the simultaneous presence of HBV and HIV in PBMCs (peripheral blood mononuclear cells) is of particular interest for at least 2 reasons: 1) the possible reciprocal influence of the 2 viruses when they infect the same cell; 2) the possibility that HIV-induced hematological disorders could indirectly influence the settling of HBV in blood cell populations. We report data on the frequency of PCR positivity for HBV DNA in PBMCs from 62 HIV infected patients, rigorously selected by risk group, that is, intravenous use of heroin for at least 3 years and syringe promiscuity. Sixty-seven HIV negative individuals who never used any drug formed the control group. The analysis of the cases positive for HBV DNA in PBMCs showed that: 1) the overall prevalence of PCR positivity found in HIV infected patients was significantly lower than that registered in the control group; 2) PCR positivity among the subjects who were HBsAg negative and anti-HBV positive was extremely low in the HIV infected patients (3.7%) but quite frequent in the HIV negative subjects (37.0%). The results support the hypothesis that, unlike the HIV negative individuals, our HIV infected patients exhibited HBV DNA in PBMCS almost exclusively when they presented with active HBV replication.

Beta-2 microglobulin as a marker of HIV disease status in Nairobi, Kenya.

Serum beta-2 microglobulin (beta 2-M) has prognostic value similar to lymphocyte profiles for predicting disease progression in those infected with the human immunodeficiency virus (HIV). However, the relationship between beta 2-M and HIV disease progression among inhabitants of countries with endemic tropical diseases has not been evaluated. To determine the relationship between serum beta 2-M levels and HIV infection and disease status in an African population, serum beta 2-M levels were measured in 369 patients attending a sexually transmitted disease (STD) clinic in Nairobi, Kenya. Mean serum beta 2-M was significantly higher in HIV seropositive than in HIV seronegative individuals. Among HIV infected patients, higher mean beta 2-M levels were observed in those with HIV associated symptoms or laboratory markers of advanced HIV disease. Significant inverse correlations between beta 2-M and the percentage of CD4 lymphocytes or CD4/CD8 ratio were found. These findings suggest that beta 2-M measurements may have prognostic value for HIV infected populations in developing countries.