Human Immunodeficiency Virus Seronegative Subjects Research Articles

Estimation of Serum Levels of AST, LDH, CKMB AND TCK Among HIV Patients on HAART, HAART Naïve and Controls

Human Immunodeficiency virus (HIV) infection is associated with increased of developing heart disease. Information on the cardiac status of HIV-infected Nigerians is lacking. HIV/AIDS infection is a global pandemic and poses a serious health challenge in sub-Saharan Africa, Nigeria inclusive. The cardiac disease may occur at any stage of HIV infection, but important manifestations are more frequent with advanced immunodeficiency. Moreover, it has been reported that complications from HIV infection include arrhythmias, heart failure myocardial infarction and coronary heart disease. This study aimed to estimate serum levels of AST, LDH, CKMB and TCK among HIV patients on HAART, HAART naïve and controls subjects attending Bauchi State Tertiary hospital, Nigeria. The results showed that the mean serum total Creatine kinase, CK-MB, LDH and AST were significantly higher in HIV participants not on HAART compared with HIV participants on HAART at P<0.05 respectively. Similarly, the mean serum total Creatine kinase, CK-MB, LDH and AST were significantly higher in symptomatic HIV participants not on HAART compared with HIV seronegative control subjects at P<0.05 in each case. Once again, the mean serum total Creatine kinase, CK-MB, LDH and AST were significantly higher in asymptomatic HIV participants compared with HIV seronegative control subjects at P<0.05 respectively. Increased levels of some cardiac markers were seen in HIV-infected participants. The study reveals that there is a need to monitor these parameters to prevent sudden cardiovascular complications in HIV seropositive patients. Hence, it is recommended that more investigations need to be carried out to further evaluate the levels of CK-MB (cardiac-specific) isoenzyme of CK and other cardiac biomarkers such as troponins I and T, and myoglobin, among others.

COMPARITIVE STUDY ON THE BACTERIAL QUALITIES IN TEARS BETWEEN HIV SEROPOSITIVE AND HIV SERONEGATIVE PERSONS IN BENIN CITY

HIV(Human immunodeficiency virus) is the etiological agent that produces the immunosuppression resulting in AIDS. The bacterial microbes from tears of HIV seropositive individuals were isolated and compared with those of HIV seropositive individuals. Tear samples were collected from 50 newly diagnosed subjects and from another 50 who were screened to be seronegative, all within the age range of 16-55 years (mean age 29 ± 0.78). Bacteriological analysis included isolation, characterization and enumeration of bacterial isolates found in tears. Microbial count was determined using the Miles and Misra serial dilution technique. Results were presented in tables and graphs and revealed the presence of Staphylococcus aureus and Pseudomonas auruginosa in all age groups irrespective of HIV status. Statistical analysis using the unpaired t-test revealed a statistical difference between the bacterial count in HIV seropositive and HIV seronegative subjects. P < 0.05.

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.

Both HCV Infection and Elevated Liver Stiffness Significantly Impacts on Several Parameters of T-Cells Homeostasis in HIV-Infected Patients.

(1) Background: The role of hepatitis C virus (HCV) co-infection on the T-cell homeostasis disturbances in human immunodeficiency virus (HIV)-infected patients as well as its reversion after HCV eradication with direct acting antivirals (DAAs) therapy has not been yet clarified. We extensively analyzed the effect of HCV co-infection on immune parameters of HIV pathogenesis and its evolution after HCV eradication with DAAs. (2) Methods: Seventy individuals were included in the study—25 HIV-monoinfected patients, 25 HIV/HCV-coinfected patients and 20 HIV and HCV seronegative subjects. All patients were on antiretroviral therapy and undetectable HIV-viremia. Immune parameters, such as maturation, activation, apoptosis, senescence and exhaustion of T-cells were assessed by flow cytometry. Cross-sectional and longitudinal (comparing pre- and post-DAAs data in HIV/HCV coinfected patients) analyses were performed. Univariate and multivariate (general linear model and canonical discriminant analysis -CDA-) analyses were used to assess differences between groups. (3) Results—The CDA was able to clearly separate HIV/HCV coinfected from HIV-monoinfected patients, showing a more disturbed T-cells homeostasis in HIV/HCV patients, especially activation and exhaustion of T-cells. Interestingly, those perturbations were more marked in HIV/HCV patients with increased liver stiffness. Eradication of HCV with DAAs restored some but not all the T-cells homeostasis disturbances, with activation and exhaustion of effector CD8 T-cells remaining significantly increased three months after HCV eradication. (4) Conclusions—HCV co-infection significantly impacts on several immune markers of HIV pathogenesis, especially in patients with increased liver stiffness. Eradication of HCV with DAAs ameliorates but does not completely normalize these alterations. It is of utmost relevance to explore other mechanisms underlying the immune damage observed in HIV/HCV coinfected patients with control of both HIV and HCV replication.

Cryptococcus neoformans seropositivity and some haematological parameters in HIV seropositive subjects

BackgroundCryptococcus neoformans is an opportunistic fungal pathogen that causes meningitis worldwide and may be fatal in immunocompromised subjects. In Nigeria, cases have been reported with prevalence between 4 and 13.1% in Human Immunodeficiency virus (HIV) patients depending on the study subjects. This study was designed to assess the prevalence of cryptococcosis, CD4+T cell counts and possible effect on haematological parameters in HIV seropositive subject in Nnewi, South-Eastern Nigeria. MethodA total of four hundred and twenty-nine (429) subjects were recruited for the study. Of these, two hundred and ninety (290) were HIV positive and one hundred and thirty-nine (139) were HIV seronegative subjects recruited from the voluntary counseling and testing (VCT) unit and HIV care clinic at Nnamdi Azikiwe University Teaching Hospital Nnewi, Anambra State, Nigeria. Their ages were between 18–80 years. One hundred and thirty nine (139) apparently healthy HIV seronegative subjects were recruited as controls. Blood samples were taken for C. neoformans by Antigen lateral flow assay (CrAgLFA), HIV testing, CD4+T cell, platelet and Full blood count (FBC). ResultsOur results show that of the two hundred and ninety (290) who were HIV positive subjects investigated for cryptococcosis, 4 (1.4%) tested positive for CrAg of whom 1(25%) were male and 3(75%) were female. All those with cryptococcosis had their CD4 count below 200 cells/μL, three of them were on ART and one was not. There were significant differences in the CD4 counts (P<0.05) between those infected and not infected with C. neoformans. None of the control group tested positive to cryptococcosis. ConclusionWidespread use of anti-retroviral therapy may have reduced C. neoformans infection. However, the threat remains and there may be a possibility that women may be a more vulnerable population.

Insights Into Circulating Cytokine Dynamics During Pregnancy in HIV-Infected Beninese Exposed to Plasmodium falciparum Malaria.

We investigated the circulating plasma levels of Th1- (Interleukin-2 [IL-2], tumor necrosis factor-α [TNF-α], interferon-gamma [IFN-γ]) and Th2-type (IL-4, IL-5, IL-10) cytokines in human immunodeficiency virus (HIV)-infected pregnant women living in a malaria-endemic area. We analyzed samples from 200 pregnant women included in the prevention of pregnancy-associated malaria in HIV-infected women: cotrimoxazole prophylaxis versus mefloquine (PACOME) clinical trial who were followed until delivery. Cytokine concentrations were measured by flow cytometry-based multiplex bead array. Significantly elevated levels of IL-10 and lower levels of TNF-α were observed at delivery compared with inclusion (P = 0.005). At inclusion, the presence of circulating IFN-γ, a higher CD4(+) T cell count and having initiated intermittent preventive treatment of malaria with sulfadoxine pyrimethamine (SP-IPTp) were all associated with a lower likelihood of Plasmodium falciparum infection. At delivery, the inverse relationship between the presence of infection and circulating IFN-γ persisted, although there was a positive association between the likelihood of infection and the presence of circulating TNF-α. Initiation of antiretroviral therapy was associated with elevated IL-5 production. Consistent with our own and others' observations in HIV seronegative subjects, this study shows circulating IL-10 to be a marker of infection with P. falciparum during pregnancy even in HIV-infected women, although plasma IFN-γ may be a marker of anti-malarial protection in such women.

English

This study investigated the prevalence and associated factors of proteinuria in treatment naive human immunodeficiency virus (HIV) infected individuals. It also evaluated utility of dipstick urinalysis for the detection of impaired renal function. Two hundred (200) HIV seropositive patients and 72 HIV seronegative subjects were evaluated and tested for proteinuria using dipstick reagent strips. Serum urea and creatinine, haemoglobin, CD4+ T-lymphocyte (CD4+ cell) count and HIV RNA viral load were performed. Cockroft-Gault (CG) equation was used to estimate glomerular filtration rate (eGFR). Dipstick proteinuria was detected in 85 (43%) of the seropositive population compared to 6 (8.3%) in HIV seronegative subjects (odds ratio (OR) 8.3, p < 0.001). One hundred (50%) HIV positive subjects had CD4+ cell < 200 cells at baseline and 63 (31%) had impaired renal function. Although dipstick proteinuria was associated with male gender, severe anaemia, elevated serum urea and creatinine, significantly lower CD4+ cell count and impaired renal function, only the inverse association of dipstick proteinuria and CD4+ cell count remained on logistic regression (OR 0.4, 95% CI: 1.6 to 5.2). We have documented the high prevalence of proteinuria in HIV subjects prior to anti retroviral therapy (ART), and the important role of proteinuria as a significant risk factor for severe immunosuppression. We also show that dipstick proteinuria is not sensitive for the identification of impaired renal function, but has moderate utility in excluding renal insufficiency in subjects negative for proteinuria on dipstick testing. Key words: Proteinuria, estimated glomerular filtration rate, immunosuppression.

Combined HIV Prevention, the New York City Condom Distribution Program, and the Evolution of Safer Sex Behavior Among Persons Who Inject Drugs in New York City

Examine long term sexual risk behaviors among persons who inject drugs (PWID) in New York City following implementation of "combined" prevention programming, including condom social marketing. Quantitative interviews and human immunodeficiency virus (HIV) testing were conducted among PWID entering Beth Israel Medical Center drug treatment programs 1990-2012. Data were analyzed by four time periods corresponding to the cumulative implementation of HIV prevention interventions. 7,132 subjects were recruited from 1990 to 2012; little change in sexual behavior occurred among HIV seronegative subjects, while HIV seropositive subjects reported significant decreases in being sexually active and significant increases in consistent condom use. HIV transmission risk (being HIV positive and engaging in unprotected sex) declined from 14 % in 1990-1995 to 2 % in 2007-2012 for primary sexual partners and from 6 to 1 % for casual partners. Cumulative implementation of combined prevention programming for PWID was associated with substantial decreases in sexual risk behavior among HIV seropositives.

Decreased memory T-cell response and function in human immunodeficiency virus-infected patients with tegumentary leishmaniasis

The effects of human immunodeficiency virus (HIV) on the immune response in patients with cutaneous leishmaniasis have not yet been fully delineated. This study quantified and evaluated the function of memory T-cell subsets in response to soluble Leishmania antigens (SLA) from patients coinfected with HIV and Leishmania with tegumentary leishmaniasis (TL). Eight TL/HIV coinfected subjects and 10 HIV seronegative subjects with TL were evaluated. The proliferative response of CD4+and CD8+T-cells and naïve, central memory (CM) and effector memory (EM) CD4+T-cells in response to SLA were quantified using flow cytometry. The median cell division indices for CD4+and CD8+T-cells of coinfected patients in response to SLA were significantly lower than those in patients with Leishmania monoinfection (p < 0.05). The proportions of CM and EM CD4+T-cells in response to SLA were similar between the coinfected patients and patients with Leishmania monoinfection. However, the median CM and EM CD4+T-cell counts from coinfected patients were significantly lower (p < 0.05). The reduction in the lymphoproliferative response to Leishmania antigens coincides with the decrease in the absolute numbers of both EM and CM CD4+T-cells in response to Leishmania antigens in patients coinfected with HIV/Leishmania.

KSHV/HHV-8 associated lymph node based lymphomas in HIV seronegative subjects. Report of two cases with anaplastic large cell morphology and plasmablastic immunophenotype

Background: Kaposi sarcoma associated herpesvirus (KSHV)/human herpesvirus 8 (HHV-8) associated lymphomas, which often develop in human immunodeficiency virus (HIV) infected patients with advanced AIDS, present predominantly as primary effusion lymphoma...

Clinical progression of HIV infection: role of NK cells.

The purpose of the study was to examine how immune parameters related to non-major histocompatibility complex (MHC) restricted cytotoxicity changed with respect to progression and duration of human immunodeficiency virus (HIV) infection. Forty-one HIV seropositive subjects with a known time for seroconversion were included. The major finding was that a low percentage and number of natural killer (NK) cells were found in the group who had a rapid progression to acquired immune deficiency syndrome (AIDS) (less than 70 months following seroconversion) compared with those progressing more slowly to AIDS (more than 70 months following seroconversion). Furthermore, a significant correlation was found between the number of months from seroconversion to the diagnosis of AIDS and percentages of CD16+ cells (rs = 0.811, P < 0.01), CD56+ cells (rs = 0.647, P < 0.05), and CD16+CD56+ cells (rs = 0.839, P < 0.01) as well as the concentration of CD16+CD56+ cells in the blood (rs = 0.699, P < 0.05) No differences were found in percentages and concentrations of NK cell subsets between subjects with a long history (more than 6 years) versus a short history (less than 6 years) of HIV infection without AIDS. Furthermore, no negative correlations were found between the concentration of any NK subsets and the number of months since seroconversion in HIV seropositive individuals without AIDS. The total concentration of CD16+, CD56+, and CD16+CD56+ cells was lower in the group of HIV seropositive subjects compared with HIV seronegative subjects (age and sex matched), and the concentration of CD16+ cells was lower in those with AIDS than in those without AIDS. In conclusion, low concentration of NK cells in the blood was associated with a more rapid disease progression, indicating that defective non-MHC restricted cytotoxicity may be associated with HIV disease progression.

Association of hepatitis B and human immunodeficiency virus infections in Tanzanian population groups

A study was performed to determine whether there is a correlation between hepatitis B virus (HBV) and human immunodeficiency virus (HIV) infection in population groups in the Dar es Salaam area in Tanzania where HBV infection is endemic. A panel of 460 sera from army recruits, health personnel and pregnant women was tested. In the whole group seromarkers of HBV infection were found in 61.9% of 134 HIV positive subjects versus 51.5% of 326 seronegative subjects, a difference which was not statistically significant (p > 0.05). In the group of pregnant women, however, 66.7% of 120 HIV positive subjects had markers of HBV infection versus 49.0% of the 157 HIV seronegative subjects (p < 0.01). This shows that a considerable proportion of young females are also exposed to HBV at the time they acquire HIV infection.

Trends in sexual behaviour in a cohort of homosexual men: a 7 year prospective study.

A cohort of homosexual men at risk for human immunodeficiency virus (HIV) infection were studied prospectively over a 7-year period (1982/88) to assess trends in sexual behaviour and amyl nitrite intake. During the period, there were dramatic declines in the proportion of HIV seropositive and seronegative subjects reporting multiple casual partners for anal intercourse, unprotected anal intercourse and recreational use of amyl nitrite. Reported rates of orogenital intercourse remained the same during the period, whilst the total number of seroconversions fell from 17 for the period 1982-84 to 8 for 1985-88. High-risk sexual and related social behaviour among homosexual men, as assessed by patterns of anal intercourse behaviour and nitrite intake, changed over the 7-year period, with the greatest changes apparent before the widespread availability of HIV antibody testing and public education campaigns. This highlights the effectiveness of peer-group and community-based programmes in modifying the sexual behaviour of their members.

Lack of evidence of occult human immunodeficiency virus in seronegative individuals at very high risk of infection

Reports of human immunodeficiency virus (HIV) infection in seronegative individuals prompted the authors to investigate subjects who are at very high risk of acquisition of HIV in San Francisco. Nine HIV seronegative subjects were evaluated extensively, eight of whom were drawn from a well-characterized cohort of seropositive and seronegative homosexual men who have been followed prospectively since 1983-1984. These men have calculated probabilities of infection based on a fitted model of between 0.22 and 0.94. One additional subject is an intravenous drug user who has shared needles with HIV-infected individuals extensively. Peripheral blood lymphocytes and monocytes were separately cultured from each subject and evidence of HIV infection was sought by a reverse transcriptase assay, enzyme immunoassay, and immunocytofluorographic analysis for HIV antigens, in situ hybridization, RNA slot blot analysis, and polymerase chain reaction amplification of HIV cDNA. Uncultured monocytes and lymphocytes from each donor were also examined by these techniques. Evidence of HIV infection was not found in the peripheral blood mononuclear cells of these high risk individuals.

Increased levels of soluble CD8 molecule in the serum of patients with acquired immunodeficiency syndrome (AIDS) and AIDS-related disorders

In this study we investigated the serological levels of the soluble form of the CD8 molecule (s-CD8) in 97 human immunodeficiency virus (HIV) seropositive patients. The control groups included 20 normal heterosexual subjects and 19 healthy seronegative subjects belonging to risk groups for AIDS. Our results show that patients with HIV infection have significantly higher levels of s-CD8 U/ml than the control groups. When the patients were further subdivided according to the Centers for Disease Control (CDC) classification, s-CD8 U/ml values were consistently increased in all HIV patients, irre-spective of the CDC stages. No statistically significant correlation was found between the serological levels of s-CD8/ml and the absolute numbers of CD8 lymphocytes/mm 3, in both HIV seropositive patients and control groups. Since in the more advanced stages of HIV infection (IV-A, IV-C1) the decrease in the absolute number of CD8 + cells was not followed by a decrease in s-CD8 levels, it is conceivable that an increased release and/or shedding of s-CD8 per cell might occur in these patients. In fact, when the results were expressed as s-CD8 units per CD8 positive cell (s-CD8/absolute number of CD8), the levels of s-CD8/cell were higher in patients belonging to the IV-A and IV-C1 CDC groups (1.94 U/cell ± 0.33 and 3.39 U/cell ± 0.5, respectively) compared to normal controls ( P < 0.001), HIV seronegative subjects at risk for AIDS ( P < 0.001), and the other patients' groups (II and III CDC groups, respectively, P < 0.001 and P < 0.001). The evidence herein provided that in patients with HIV infection s-CD8 levels are increased suggests a possible pathogenetic role of the cells involved in the release of this molecule.