Human Immunodeficiency Virus Seropositive Subjects Research Articles

Assessment of Antinuclear Antibodies, Anti-Beta 2-Glycoprotein-1, and Thyroid Peroxidase Autoantibody Levels in Human Immunodeficiency Virus Sero-positive Pregnant Women at Nnamdi Azikiwe University Teaching Hospital, Nnewi Nigeria

Abstract Background: Pregnancy is associated with biochemical alterations and may be compounded by human immunodeficiency virus (HIV) infection potentially affecting pregnancy outcome. Aims: This study evaluated some biochemical parameters that could possibly affect pregnancy outcomes in HIV-infected women. Patients, Materials and Methods: The study involved 136 HIV sero-positive on highly active antiretroviral therapy (HAART) and 137 HIV sero-negative pregnant women, recruited from the Antenatal Clinic of Nnamdi Azikiwe University Teaching Hospital, Nnewi. Antinuclear antibodies (ANAs), anti-beta 2-glycoprotein-1 (βGP1), and thyroid peroxidase autoantibody (TPOab) were analysed using the enzyme-linked immunosorbent assay methods. Results: TPOab in HIV sero-positive subjects (104.9 ± 51.06 IU/mL) was significantly higher (P > 0.05) compared with controls (89.5 ± 33.5 IU/mL). ANA and βGP1 in test group (0.89 ± 0.31; 12.94 ± 8.9, respectively) did not change significantly (P > 0.05) compared with the controls (0.84 ± 0.27; 10.37 ± 9.6, respectively). There were no significant changes in measured biochemical parameters between trimesters (P > 0.05). Furthermore, there were no significant differences in measured biochemical parameters between subjects with different APGAR scores in all subject groups. Conclusion: HIV infection affected TPOab level but had no impact on ANA, bGP1, and APGAR score in HIV pregnancy under HAART.

Association of CD4 cell count and antiretroviral therapy antibody production in Human Immunodeficiency virus seropositive subjects on antiretroviral drugs in Benin City, Nigeria.

Antiretroviral therapy (ART) is widely used and subjects on ART were reported to develop antibodies against these drugs when used as monotherapy. The aim of this study was to determine the proportion of HIV-sero positive subjects on antiretroviral therapy who developed antibodies to the drugs used as combination therapy and to associate the presence of antibodies to CD4 cell count which is a marker of disease progression. A total of 300 subjects were randomly selected for the study, consisting of 100 HIV-sero positive subjects already on ART, 100 newly diagnosed HIV-sero positive ART- naive subjects and 100 HIV-sero negative individuals who were monitored as controls. CD4 cell count and complete blood count were assayed using BD FASCOUNT CD3/CD4 and Sysmex KX-21N autoanalyzer respectively. Antigen-Antibody agglutination technique was used to detect antibodies produced against antiretroviral drugs in HIV -sero positive subjects on ART. The results showed that antibodies to antiretroviral drugs (tenofovir disoproxil fumarate/lamivudine Efavirenz + lamivudine/ nevirapine/zidovudine combination) were detected in 33(33%) out of the 100 HIV-sero positive subjects on ART studied. Significantly higher CD4 cell count (p<0.001), PCV (p<0.001) and white blood cell count (p<0.001) were recorded among control group than HIV positive subjects whether they in 33(33%) out of the 100 HIV- sero positive subjects on ART combination studied. The use of combination therapy has led to a smaller number of subjects on ART who developed antibody as against a higher percentage on monotherapy that was previously reported. Significantly lower level of platelet was observed among HIV-sero positive subjects who developed ART antibodies.

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.

Determination of Serum IL-8, CD4+ and CD8+ in Patients with Human Immunodeficiency Virus

Background: Human Immunodeficiency Virus (HIV) is associated with a decline of immunity and progression to Acquired Immunodeficiency Syndrome (AIDS). This current study was aimed at evaluating the serum level of Interleukin-8 (IL-8), CD4+ and CD8+ T-cells counts among newly diagnosed Human Immunodeficiency Virus (HIV)-positive adults in Sokoto-Nigeria. Materials and methods: A total of 60 adults were enrolled into the study, comprising of 30 newly diagnosed HIV seropositive subjects and 30 age-and sex-matched apparently healthy controls. CD4+ and CD8+ T-cells were enumerated using flow cytometry. Serum IL-8 was analyzed using ELISA kit. Data were analyzed using SPSS 20.0 statistical package. A p-value ≤ 0.05 was considered significant in all statistical comparisons. Results: The mean of CD4+ (632.63 ± 34.83 cells/μl), CD8+ (579.98 ± 30.74 cells/μl) and CD4+/CD8+ ratio (1.10 ± 0.03 cells/μl) were significantly higher (p &lt; 0.05) in controls compared to newly diagnosed HIV patients (160.60 ± 29.47 cells/μl, 521.10 ± 46.34cells/μl and 0.32 ± 0.52 respectively. The mean of IL-8 (6.56 ± 0.09 pg/ml) was significantly (p &lt; 0.05) lower in controls compared to newly diagnosed patient IL-8 (6.60 ± 0.07 pg/ml). There were insignificant negative correlation between IL-8 and CD4+ (r = -0.064, p &gt; 0.05) as well as CD8+ (r = -0.074, p &gt; 0.05) in controls. And conversely, an insignificant positive correlation occurred between IL-8 and CD4+ (r = 0.025, p &gt; 0.05) as well as CD8+ (r = 0.016, p &gt; 0.05) in newly diagnosed HIV patients. Moreover, it has also shown a statistically insignificant positive correlation between IL-8 and CD4+/CD8+ ratio (r = 0.039, p &gt; 0.05) in controls compared to newly diagnosed HIV patients where it shows a statistically insignificant negative correlation between the IL-8 and CD4+/CD8+ ratio (r = -0.076, p &gt; 0.05). Conclusion: It could be concluded that, both CD4+, CD4+/ CD8+ ratio in newly diagnosed HIV patients are significantly decrease compared to controls (p &lt; 0.05), while serum IL-8 was significantly increased, the serum levels of IL-8 did not correlate with CD4+ T-cells and CD8+ T-cells population, as well as CD4+/CD8+ ratio.

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

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

English

Patients with human immunodeficiency virus (HIV) infection exhibit a generalized, non-HIV-specific polyclonal B-cell activation resulting in hypergammaglobulinemia of all immunoglobulin isotypes as well as increased production of HIV-specific IgG and IgM. These immunoglobulins have the potential to be used as markers for monitoring the progression of HIV infection. With the inherent challenges of cost and convenience in the use of the conventional markers for HIV monitoring, that is, viral load and CD4+ count, there is the need to investigate the possible prognostic role of the above mentioned immunoglobulins in the management of HIV patients in Nigeria. The IgG, IgA and IgM profile as well as the CD4+ T cell count of forty HIV seropositive subjects was assayed before and after 3 months follow-up in a case series descriptive study. The Igs were measured using enzyme linked immunosorbent assay (ELISA), while CD4 count was done using flow cytometry. In the determination of concentration/value changes of parameters at baseline and follow up in HIV progression, only IgM, waist and hip circumference showed significant differences (p &lt; 0.05) within the period under study. While in the determination of the effect of therapy on the subjects, significant differences (p &lt; 0.05) were observed only in the values of CD4 count and BMI. While statistically significantly inverse relationship was observed between the CD4 counts and IgM concentrations, the values of IgG and IgA were inverse but not significant in relation to CD4 count. This study concluded that immunoglobulins (G, A and M) are not reliable in monitoring short term response to therapy unlike CD4 count although IgM has good diagnostic value like CD4 at baseline. Key words: HIV/AIDS, CD4+ count, viral load, antiretroviral, immunoglobulins.

The Levels of Serum C - reactive protein and Creatine Kinase-MM in Human Immunodeficiency Virus Seropositive Subjects Co-infected with &amp;lt;i&amp;gt;Plasmodium falciparum&amp;lt;/i&amp;gt;

The present study was designed to determine the levels of C-reactive protein and creatine kinase-MM in Nigerian naïve (stage 2) HIV seropositive subjects co-infected with <i>Plasmodium falciparum</i>. A total of 204 subjects (aged between 18 and 45 years) were randomly studied. Among these were 74 naïve (stage 2) HIV seropositive subjects (confirmed by Western blot method), 70 naïve (stage 2) HIV seropositive subjects co-infected with <i>P. falciparum</i> (confirmed by Western blot and microscopic methods respectively) and 60 apparently healthy individuals (confirmed to be negative for Human immunodeficiency virus and <i>P. falciparum</i> by Western blot and microscopic methods respectively). Absolute lymphocyte counts was estimated using Sysmex® Automated Hematology Analyzer, whereas CD4⁺ cell count was estimated using Partec® Cyflow Counter. C-reactive protein and creatine kinase was estimated using enzyme-linked immunosorbent assay methods. The creatine kinase-MM and C-reactive protein concentrations were significantly higher in HIV seropositive subjects co-infected with malaria when compared with the controls subjects (P = 0.000) respectively. Whereas the absolute lymphocyte counts and CD4⁺ T cell counts were significantly lower in HIV seropositive subjects co-infected with malaria when compared with the controls subjects (P = 0.000). The increased expression of C- reactive protein and creatine kinase-MM coupled with the decrease in absolute lymphocyte and CD4⁺ cell counts significantly contributes to the pathogenesis of HIV and <i>P. falciparum</i> infections.

Predictors of Sleep Disorders among HIV Out-Patients in a Tertiary Hospital

Human immunodeficiency virus (HIV)-infected individuals have been shown to have a high prevalence of sleep disturbances. Both the effects of the virus and the antiretroviral drugs may cause sleep disturbances. We sought to determine the prevalence and predictors of sleep disorders among HIV seropositive adult subjects presenting at an outpatient hospital setting. One hundred and fifty six subjects were recruited for the study by using a sleep disorder screening questionnaire. The mean ages of the participants were 38.7 ± 9.23 and 39.5 ± 9.23 for those with and those without sleep disorder, respectively. The prevalence rate of sleep disorders was 46.2%. Elevated systolic blood pressure, lower CD4 count levels, and being on the highly active antiretroviral therapy combination TDF/3TC/ATZ/lpvr were associated with sleep disorders. The high prevalence rate observed necessitates routine screening for sleep disorders among HIV/AIDs patients.

Candida Species Prevalence Profile in HIV Seropositive Patients from a Major Tertiary Care Hospital in New Delhi, India.

Candida is a common opportunistic pathogen during the course of human immunodeficiency virus (HIV) disease progression. Changes in the clinical severity of candidiasis and the Candida species prevalence profile may be a reflection of immunological changes in HIV positive patients. The aim of this study was to document the changing pattern of Candida species prevalence profile in HIV seropositive patients from a tertiary care hospital in North India. One hundred and twenty HIV seropositive subjects were recruited for Candida microbial screening. Clinical specimens including blood, oral swabs, expectorated or induced sputum/bronchoalveolar lavage specimens, and urine were collected depending on the patient's symptoms. A total of 128 Candida isolates were obtained from 88 cases and 7 different Candida species were identified. C. albicans (50%) was the most common species isolated followed by C. glabrata (17%) and C. dubliniensis (12.5%). Other species isolated were C. parapsilosis (7.8%), C. krusei, C. tropicalis (4.6% each), and C. kefyr (3%). Strong clinical suspicion along with optimal sampling of an accurate diagnosis of Candida species involved would go a long way in decreasing the morbidity associated with non-albicans Candida species.

English

Diabetes mellitus (DM), mycobacterium tuberculosis (TB) and human immunodeficiency virus (HIV) are important health issues. A bi-directional association between them has been demonstrated by many researchers. The link of DM and TB/HIV is more prominent in developing countries where TB and HIV are endemic and the burden of diabetes mellitus is increasing. A total of 845 subjects were recruited for this study. Fasting blood sugar was determined by the glucose oxidase method while HIV serology was performed using the National Algorithm. The method adopted for mycobacterium tuberculosis identification was the geneXpart as described by Tenover. The prevalence of DM in HIV seropositive subject co-infected with mycobacterium tuberculosis was 107 (12.6%). Out of the 350 patient that tested positive for HIV, 38 (4.5%) had DM, 11 (1.3%) were of Type-1 origin while 27 (3.2%) were of Type-2 origin. On the other hand, 450 patients were TB positive, 45 (5.3%) had DM, 9 (1.0%) were of Type-1 origin while 36 (4.3%) were of Type-2 origin while that of HIV seropositive subjects co-infected with TB: 24 (2.8%) had DM, 5 (0.5%) were Type-1 origin while 19 (2.2%) were of Type-2 origin. There are highly more female 57 (6.7%) with DM than male 50 (5.9%). Our finding has shown no significant increase in the mean blood glucose concentration of HIV seropositive subjects compared with individuals infected with TB (P 0.05). The same pattern was observed in HIV seropositive subjects co-infected with TB compared with individual infected with HIV (P > 0.05). It is recommended that all patients with HIV and mycobacterium tuberculosis infections should be screened for diabetes mellitus as this would help in effective management of the disease conditions. Keywords: Diabetics mellitus, TB, HIV, mycobacterium tuberculosis, seropositive.

Diversity and antifungal resistance patterns of prevalent opportunistic pathogenic yeasts colonizing the oral cavities of asymptomatic human immunodeficiency virus-infected individuals, and their relation to CD4(+) counts.

Yeasts are important opportunistic pathogens, in individuals infected with human immunodeficiency virus (HIV). Yeast species inhabiting the oral mucosa of HIV-infected persons can act as source of oral lesions, especially as the individual progresses towards immunocompromised state. Present study was conducted to evaluate the diversity of yeasts in oral cavities of asymptomatic HIV-infected persons and their association with CD4(+) cell counts. 100 HIV seropositive subjects and 100 healthy controls were screened for oral yeast carriage using standard procedures. Of the 100 HIV-seropositive persons screened, 48 were colonized by different yeasts, either alone or in association with another species. Candida albicans was the most common species (56.90%) while non C. albicans Candida (NCAC) accounted for 39.65%. Among NCAC, Candida tropicalis and Candida krusei were most common. One isolate each of rare opportunistic pathogenic yeasts, Geotrichum candidum and Saccharomyces cereviseae, was recovered. The control group had an oral candidal carriage rate of 23%; C. albicans was the predominant species, followed by Candida glabrata, C. tropicalis and Candida parapsilosis. Antifungal susceptibility testing revealed no resistance in C. albicans, to the commonly used antifungal agents, whereas resistance or dose dependent susceptibility to fluconazole was observed in some of the NCAC species. Oral carriage of opportunistic pathogenic yeasts was greater in HIV-seropositive persons heading towards immunocompromised state, as evidenced by their CD4(+) cell count. The predominant yeast isolated in this study (C. albicans), was found to be susceptible to commonly used antifungals.

Diversity and antifungal resistance patterns of prevalent opportunistic pathogenic yeasts colonizing the oral cavities of asymptomatic human immunodeficiency virus-infected individuals, and their relation to CD4+ counts

Background:Yeasts are important opportunistic pathogens, in individuals infected with human immunodeficiency virus (HIV). Yeast species inhabiting the oral mucosa of HIV-infected persons can act as source of oral lesions, especially as the individual progresses towards immunocompromised state. Present study was conducted to evaluate the diversity of yeasts in oral cavities of asymptomatic HIV-infected persons and their association with CD4+ cell counts.Materials and Methods:100 HIV seropositive subjects and 100 healthy controls were screened for oral yeast carriage using standard procedures.Results:Of the 100 HIV-seropositive persons screened, 48 were colonized by different yeasts, either alone or in association with another species. Candida albicans was the most common species (56.90%) while non C. albicans Candida (NCAC) accounted for 39.65%. Among NCAC, Candida tropicalis and Candida krusei were most common. One isolate each of rare opportunistic pathogenic yeasts, Geotrichum candidum and Saccharomyces cereviseae, was recovered. The control group had an oral candidal carriage rate of 23%; C. albicans was the predominant species, followed by Candida glabrata, C. tropicalis and Candida parapsilosis. Antifungal susceptibility testing revealed no resistance in C. albicans, to the commonly used antifungal agents, whereas resistance or dose dependent susceptibility to fluconazole was observed in some of the NCAC species.Conclusion:Oral carriage of opportunistic pathogenic yeasts was greater in HIV-seropositive persons heading towards immunocompromised state, as evidenced by their CD4+ cell count. The predominant yeast isolated in this study (C. albicans), was found to be susceptible to commonly used antifungals.

Semen lactoferrin promotes CCL20 production by epithelial cells: Involvement in HIV transmission.

To study the effect of seminal plasma on Chemokine (C-C motif) ligand 20 (CCL20) production by epithelial cells and its relationship with lactoferrin. HEC-1A cells, a cell line derived from a monostratified endocervical epithelium, were incubated with samples of seminal plasma (diluted 1:10 in culture medium) recovered from human immunodeficiency virus (HIV) seronegative (HIV-) or HIV seropositive (HIV+) subjects. Recombinant human interleukin 1 beta (IL-1β) was used as positive control, and culture medium only as negative control. The measurement of CCL20 production in the supernatants of HEC-1A cells and of lactoferrin in seminal plasma was determined by enzyme-linked immunosorbent assay techniques. A fractionation of seminal plasma proteins was performed by ion exchange chromatography on a pool of seminal plasma specimens from HIV- subjects. Each fraction was tested for its ability to stimulate the production of CCL20 by HEC-1A cells and for its lactoferrin concentration. The HIV viral load in seminal plasma samples from HIV+ patients was measured using the HIV-Monitor kit (Roche Diagnostic Systems, Branchburg, NJ, United States). The positive control IL-1β was responsible for an increase of 11.36 ± 3.36 times in the production of CCL20. Stimulation of HEC-1A cells was performed in 34 seminal plasma samples (22 from HIV+ subjects and 12 from HIV- subjects). The mean production of CCL20 by HEC-1A in presence of seminal plasma from HIV- and HIV+ subjects was respectively 5.38 ± 0.91 and 7.57 ± 3.26 times higher than that obtained with the untreated cells (P < 0.05 between the two groups). Using the same 34 specimens of seminal plasma, no correlation was observed between the concentration of total proteins in seminal plasma and their ability to stimulate the secretion of CCL20 by HEC-1 cells. In contrast, the ability to produce CCL20 by HEC-1A cells correlated to the concentration of lactoferrin in the seminal plasma samples (r coefficient = 0.56; CI: 0.26-0.76; P < 0.001). After fractionation by ion exchange chromatography, the seminal plasma fractions exhibiting the highest concentrations of lactoferrin were responsible for the greatest stimulation of CCL20 production by HEC-1A cells (r coefficient = 0.89; CI: 0.78-0.95; P < 0.0001). Lactoferrin present in seminal plasma correlated with an increased production of CCL20 by HEC-1A cells and therefore could facilitate HIV entry through the genital mucosa.

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.

Detection of human immunodeficiency virus using oral mucosal transudate by rapid test

On the cusp of the fourth decade of the acquired immunodeficiency syndrome epidemic, the world has turned the corner - it has halted and began to reverse the spread of human immunodeficiency virus (HIV). Oral fluid-based Rapid tests have potential advantages over blood-based tests hence the time is ripe for their use to scale up HIV screening and testing programmes. To detect HIV using oral mucosal transudate (OMT) and to assess the sensitivity and specificity of the HIV Rapid test using OMT. OraQuick Rapid HIV-1/2 Diagnostic test was evaluated in sera and oral fluids from 83 subjects. The study group comprised of 50 HIV seropositive subjects and the control group comprised of 33 seronegative subjects. Serum samples were collected using the standard phlebotomy technique and oral samples were collected using OraQuick Rapid HIV 1/2 Antibody test OMT collecting device. The statistical analysis was done using statistical package for social sciences version 16.0, SPSS Inc., 233 South Wacker Drive, 11(th) Floor, Chicago, IL 60606-6412. The Sensitivity, specificity, positive predictive value, negative predictive value were used. All the subjects who tested either positive/reactive or negative/non-reactive with Western blot/enzyme-linked immunosorbent assay (ELISA) produced similar results with Rapid test using OMT in study, our study also revealed that the subjects whether on anti-retroviral therapy or not had 100% sensitivity and specificity with the Rapid test using OMT. The Rapid test using OMT is highly accurate as the diagnostic efficacy in our study was 100% for HIV antibody detection and produced similar results to that of conventional Western blot/ELISA tests.

Detection of human immunodeficiency virus using oral mucosal transudate by rapid test

Context:On the cusp of the fourth decade of the acquired immunodeficiency syndrome epidemic, the world has turned the corner - it has halted and began to reverse the spread of human immunodeficiency virus (HIV). Oral fluid-based Rapid tests have potential advantages over blood-based tests hence the time is ripe for their use to scale up HIV screening and testing programmes.Aims and Objectives:To detect HIV using oral mucosal transudate (OMT) and to assess the sensitivity and specificity of the HIV Rapid test using OMT.Settings and Design:OraQuick Rapid HIV-1/2 Diagnostic test was evaluated in sera and oral fluids from 83 subjects.Materials and Methods:The study group comprised of 50 HIV seropositive subjects and the control group comprised of 33 seronegative subjects. Serum samples were collected using the standard phlebotomy technique and oral samples were collected using OraQuick Rapid HIV 1/2 Antibody test OMT collecting device.Statistical Analysis Used:The statistical analysis was done using statistical package for social sciences version 16.0, SPSS Inc., 233 South Wacker Drive, 11th Floor, Chicago, IL 60606-6412. The Sensitivity, specificity, positive predictive value, negative predictive value were used.Results:All the subjects who tested either positive/reactive or negative/non-reactive with Western blot/enzyme-linked immunosorbent assay (ELISA) produced similar results with Rapid test using OMT in study, our study also revealed that the subjects whether on anti-retroviral therapy or not had 100% sensitivity and specificity with the Rapid test using OMT.Conclusions:The Rapid test using OMT is highly accurate as the diagnostic efficacy in our study was 100% for HIV antibody detection and produced similar results to that of conventional Western blot/ELISA tests.

Psychiatric morbidity in asymptomatic human immunodeficiency virus patients

Background:Psychiatric morbidity in human immunodeficiency virus (HIV) patients is being studied all over the world. There is paucity of Indian literature particularly in asymptomatic HIV individuals.Aim:The aim of the following study is to establish the prevalence and the determinants of psychiatric morbidity in asymptomatic HIV patients.Materials and Methods:A cross-sectional study was undertaken to assess psychiatric morbidity as per ICD-10 dacryocystorhinostomy criteria in 100 consecutive asymptomatic seropositive HIV patients and an equal number of age, sex, education, economic and marital status matched HIV seronegative control. All subjects were assessed with the general health questionnaire (GHQ), mini mental status examination, hospital anxiety and depression scale (HADS) and sensation seeking scale (SSS) and the scores were analyzed statistically.Results:Asymptomatic HIV positive patients had significantly higher GHQ caseness and depression but not anxiety on HADS as compared to HIV seronegative controls. On SSS asymptomatic HIV seropositive subjects showed significant higher scores in thrill and adventure seeking, experience seeking and boredom susceptibility as compared to controls. HIV seropositive patients had significantly higher incidence of total psychiatric morbidity. Among the individual disorders, alcohol dependence syndrome, sexual dysfunction and adjustment disorder were significantly increased compared with HIV seronegative controls.Conclusion:Psychiatric morbidity is higher in asymptomatic HIV patients when compared to HIV seronegative controls. Among the individual disorders, alcohol dependence syndrome, sexual dysfunction and adjustment disorder were significantly increased compared with HIV seronegative controls. High sensation seeking and substance abuse found in HIV seropositive patients may play a vital role in engaging in high-risk behavior resulting in this dreaded illness.

Male Out-Migration: A Factor for the Spread of HIV Infection among Married Men and Women in Rural India

IntroductionThus far, the reasons for increasing HIV prevalence in northern and eastern Indian states are unknown. We investigated the role of male out-migration in the spread of human immunodeficiency virus (HIV) infection through a case-control study in rural India.MethodsCurrently married men and women were recruited from HIV testing and treatment centers across seven selected districts with high rates of male out-migration in eastern and northern India in 2010 using a case-control study design. Case subjects (men: 595, women: 609) were people who tested HIV seropositive and control subjects (men: 611, women: 600) were those tested HIV seronegative. For each gender, we obtained adjusted odds ratios (AORs) and population attributable risks (PARs) for migration, and behavioral factors.ResultsFor men, the prevalence of HIV was significantly higher among those with a migration history (AOR, 4·4); for women, the prevalence of HIV was higher among those with migrant husbands (AOR, 2·3). For both genders, the returned male migration (men: AOR, 3·7; women: AOR, 2·8) was significantly associated with higher prevalence of HIV infection. The PAR associated with male migration was higher for men (54·5%–68·6%) than for women (32·7%–56·9%) across the study areas.DiscussionMale out-migration is the most important risk factor influencing the spread of HIV infection in rural areas with high out-migration rates, thereby emphasizing the need for interventions, particularly, for returned migrants and spouses of those migrants.

Expression of Epstein‐Barr Virus Latent Genes in Oral Epithelium: Determinants of the Pathogenesis of Oral Hairy Leukoplakia

This retrospective study examined expression of Epstein-Barr virus (EBV) latent genes in oral epithelium from human immunodeficiency virus-seropositive subjects, to identify genes associated with the pathogenesis of oral hairy leukoplakia (HLP). Transcription of EBV latent genes was detected in tissues with productive EBV replication and, also, in normal oral epithelial tissues without EBV replication. Expression of the EBV EBNA-2 open-reading frame in oral epithelium was identified as an important cofactor associated with the pathogenesis of HLP. In vitro experiments suggested that a recombinant variant of the EBNA-2 gene may play a role in the pathogenesis of HLP, through modulation of EBNA-2 protein function.