Human Immunodeficiency Virus Subjects Research Articles

HIV status and lay bystander cardiopulmonary resuscitation initiation for witnessed cardiac arrest

IntroductionEarly initiation of cardiopulmonary resuscitation (CPR) by bystanders of out-of-hospital cardiac arrest (OHCA) significantly improves survival and neurological outcomes. However, misconceptions about human immunodeficiency virus (HIV) transmission risk during CPR can deter lay bystanders from performing resuscitation. The aim of this study was to compare the rate of CPR initiation by lay bystanders who witnessed OHCA in subjects with and without HIV infection. MethodsWe analysed data from the two French cardiac arrest registries (SDEC and RéAC) from 2012 to 2020. We identified HIV-positive individuals from the French National Health Insurance database for the SDEC registry, and directly from the RéAC registry data. We used logistic regression models to assess the association between CPR initiation by lay bystanders and the victim’s HIV status. ResultsOf 58,177 witnessed OHCA cases, 192 (0.3%) occurred in HIV-positive subjects. These individuals were younger, more often male, and presented more shockable initial rhythms compared with subjects without HIV. Overall, there was no difference in the CPR initiation rate according to the HIV status (57.3% vs 47.6%, adjusted odds ratio 1.11, 95% confidence interval 0.83–1.48). The CPR initiation rate also did not differ by location between victims with or without HIV (home: 57.7% vs 45.4%; public places: 56.0% vs 53.6%; p for interaction = 0.46). Survival and neurological outcomes at hospital discharge did not differ based on the HIV status. ConclusionsThis study revealed that the rate of CPR initiation by lay bystanders did not differ between HIV and non-HIV subjects during OHCA.

Brain white matter and resting state eeg markers are abnormal in HIV subjects with relatively good cognitive status

AbstractBackgroundThis retrospective and exploratory study tested the concept that at the group level, human immunodeficiency virus (HIV) can significantly affect brain structure and function before the manifestation of significant cognitive deficits.MethodFrom a multicenter database, we selected structural 3T magnetic resonance imaging (MRI) and resting state eyes‐closed electroencephalographic (rsEEG) datasets in 30 HIV‐positive (HIV) subjects with relatively good cognitive status and serological markers (i.e., HIV‐RNA copies and CD4 count). Control datasets of matched non‐infected subjects included rsEEG (N = 50) and MRI (N = 30) recordings. MRI markers of interest in HIV were derived from gray matter (GM) volume decrements and white matter (WM) lesion load, while rsEEG markers were cortical source current density estimated by LORETA freeware at relevant delta (< 4 Hz) and alpha (6‐12 Hz) individual frequency bands.ResultIn the HIV group, the subjects exhibited no abnormal score in neuropsychological tests. However, those subjects showed brain GM volume and WM abnormalities correlated with serum CD4 count (Figure 1). They also showed diffuse abnormalities in rsEEG alpha source activities.ConclusionAt the group level, HIV subjects with relatively good cognitive status can show abnormalities in both structural MRI and rsEEG markers. If cross‐validated in longitudinal studies, combined MRI and rsEEG markers may be a useful surrogate endpoint to test antiretroviral therapies with putative neuroprotective function.

Gender-Based Comparison of Anthropometric and Hematological Parameters in Asymptomatic HIV Subjects at Nnamdi Azikiwe Teaching Hospital (NAUTH), Nnewi, Anambra State, Nigeria

Human Immunodeficiency Virus (HIV) has posed a severe global issue with over thirty years of its epidemic. Nigeria is one of the African countries with higher number of HIV cases with over 1,700,000 cases in 2022. 43 adult female and 57 adult male asymptomatic HIV subjects, aged 18-65 years were randomly recruited at the voluntary counselling and Testing (VCT) Centre Nnamdi Azikiwe University Teaching Hospital (NAUTH) Nnewi. The anthropometric parameters such as Body Mass Index (BMI), Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP), and the hematological parameters such as CD4+ cell count, Packed Cell Volume (PCV), Erythrocyte Sedimentation Rate (ESR), Hemoglobin (Hb), and Absolute Neutrophil (Ab.neu) were analyzed using routine laboratory analyses. The data were analyzed using Statistical Product and Service Solution (SPSS) version 21, independent Students’-test and one way analysis of variance (ANOVA) were used to compare means. The SBP and DBP were significantly elevated in the female asymptomatic HIV subjects than in the male asymptomatic HIV subjects with p<0.05. There was no significant difference in the values of BMI, CD4+, WBC, ESR, Hb, and Ab.neu among the female and male asymptomatic HIV subjects with p>0.05. In conclusion, there are no difference in the hematological parameters.

Serum Cardiac Troponin I As a Diagnostic Marker of Myocardial Injury Among Human Immunodeficiency Virus Infected Children in Ilorin Kwara State Nigeria

Background: Cardiac Troponin I (cTnI) is a unique marker of myocardial injury. It is the most sensitive and specific of the cardiac markers. Studies have shown its elevation among Human Immunodeficiency Virus (HIV) infected subjects. Most of these were in adults hence we determined the use of cTnI as a marker of myocardial injury among HIV subjects. Methods: The study was a comparative cross-sectional study among 100 HIV - infected children aged 2 – 14 years and equal age-matched HIV-uninfected controls. Recruitment was through the Paediatric HIV and outpatient clinics of the hospital respectively. Both groups had serum cTnI assay (normal is <0.1μ/L) over four months period. Data analysis was done using the SPSS® v 20. Normally distributed data had mean standard deviation while not normally distributed data had a median with an interquartile range determined. The diagnostic performance of cTnI was determined using the Receiver Operating Characteristics curve. Significant p is < 0.05. Results: A total of 200 (subjects and controls) were studied. The mean age of participants was 9.42 years. There was a significant difference in the median (IQR) cTnI of HIV-infected subjects [73.8 (51.8 – 149.1)] compared with HIV uninfected controls [25.0 (13.3 – 51.4)] p < 0.001. The prevalence of myocardial injury among subjects was 48% compared with 8% among controls, also statistically significant (p < 0.001). Serum cTnI has 91.3% and 88.9% sensitivity and specificity respectively. Conclusions: The prevalence of myocardial injury was high in HIV - infected children. Serum cTnI is a reliable predictive marker of myocardial injury.

SEROPREVALENCE OF HEPATITIS A VIRUS INFECTION AMONG ANTIRETROVIRAL TREATMENT–NAIVE HIV PATIENTS IN BENIN CITY, NIGERIA.

Human immunodeficiency virus (HIV)-infected persons are at increase risk ofHepatitis A virus (HAV) infection. Against the background of no data on theprevalence of HAV infection among HIV patients in our environment this study wasconducted. A total of 400 subjects consisting of 200 antiretroviral naive HIV patientsand 200 non–HIV subjects were recruited for this study. Detection of HAV 1gMantibodies was performed for all subjects while CD4 count was performed for HIVpatients only using standard technique. A structured questionnaire was used tocollect data on demography and risk factors. There was no significant difference inthe prevalence of HAV among HIV patients and their non–HIV counterpart (P =0.7030). CD4 count < 200 cells/ul was not significantly associated with HAV infectionamong the HIV patients (OR = 0.195 95% CI = 0.010, 3.678; P = 0.3315). Level ofeducation was the only demography that significantly affected the prevalence of HAVinfection (P < 0.0001) with patients with no formal education having the highestprevalence (40.00%). HIV patients who travelled to HAV endemic countries aresignificantly more likely to be seropositive for HAV infection (OR = 38.200 95% CI= 4.440, 328.68; P = 0.0002) while other risk factors did not significantly affect theseroprevalence of HAV infection among HIV patients (P > 0.05). An overallseroprevalence of 2.00% of acute HAV infection was observed among HIV patientsin this study. Measures to reduce or eliminate HAV infection among HIV patients areadvocated.

Prevalence of tuberculosis among HIV positive patients on anti-retroviral therapy with special emphasis on pattern of adverse events of first-line anti-tubercular drug

Background: Survival rates have been improved with concomitant use of anti-tubercular drugs in HIV subjects with tuberculosis. The use of anti-tubercular drugs combined with ART can lead to more drug interactions, non-compliance, toxicity, and adverse effects. Aim: To assess the pattern, severity, and prevalence of adverse drug reactions of first-line anti-tubercular drugs in HIV (Human Immunodeficiency Virus) positive subjects with tuberculosis. Methods: The present prospective, observational study included 391 subjects out of 19522 subjects who were diagnosed HIV Positive and scheduled for Anti-Retroviral therapy at the ART Centre. 102 subjects were enrolled as tuberculosis confirmation of HIV-TB Co-Infection disease during the study period. All the subjects were evaluated for adverse drug events including blurred vision, jaundice, neuropathy, skin infection, itching, blood urea, hepatotoxicity, tingling, numbness, pain, pancreatitis, diarrhea, skin rashes, and anemia. Results: The most prevalent side-effect noted was neuropathy reported in 26.13% (n=10) study participants followed by skin rashes reported in 21.05% (n=8) study subjects. Jaundice, vomiting, and body weakness were all reported in 15.78% (n=6) of study subjects each. Diarrhea, headache, hepatotoxicity, insomnia, mental confusion, and anorexia were all reported in 10.52% (n=4) of study participants each.

Thyroid Hormones and Red Cell Indices of HIV Subjects at Enugu

Background: Thyroid hormones act on nearly every cell in the body including red blood cells. Thyroid hormones are also important to proper development and differentiation of all cells of the human body. Human Immunodeficiency Virus (HIV) is a virus that destroys certain cells in the immune system. The aim of this study was to determine free triiodothyronine (FT3), free thyroxine (T4) and red cell indices level of HIV subjects attending clinic at Enugu State University of Science and Technology Teaching Hospital.
 Study Design: Case control study.
 Place and Duration of Study: Human Immunodeficiency Virus (HIV) clinic and Haematology Laboratory both of Enugu State University of Science and Technology Teaching Hospital, between August and October 2021.
 Methodology: Sixty HIV subjects and thirty apparently healthy individuals within the age range of 30 - 60 years were recruited for this study. Free triiodothyronine (FT3), free thyroxine (FT4), hemoglobin (HGB), packed cell volume (PCV), red blood cell count (RBC), mean cell volume (MCV), mean cell hemoglobin (MCH), mean cell hemoglobin concentration (MCHC), red cell distribution width standard deviation (RDW-SD), red cell distribution width coefficient of variation (RDW-CV) were determined in HIV subjects and apparently healthy individuals. 
 Results: There was significant difference in MCV (125.79+/- 7.57 vs 78.89+/- 5.71 fl), MCH (23.17+/- 2.10 vs27.21+/- 3.68 pg), MCHC (25.08+/- 2.74 vs30.09+/- 3.27 g/dl), RDW-SD (61.52+/- 7.55 vs46.23+/- 5.87 fl), RDW-CV (23.06+/- 5.78 vs43.87+/- 1.28 fl) and PCV (39.38+/- 3.06 vs31.75+/- 2.44 %) between patients on antiretroviral therapy (ART) and ART-naïve patients respectively. There was significant difference in T4 (8.29+/- 1.29 vs 6.12 µg/dl), MCV (78.89+/- 5.71 vs 84.47 +/- 3.79 fl), MCH (27.21+/- 3.68 vs 29.20 +/- 2.27 pg), RDW-CV (43.87+/- 1.28 vs 12.51 +/- 1.08 fl) and PCV (31.75+/-2.44vs 37.63+/-2.95 %) on ART-naïve patients and apparently healthy subjects respectively. There was a positive correlation between FT3 and MCH in HIV patients on antiretroviral therapy (ART) (p= 0.016).
 Conclusion: In people taking antiretroviral therapy, mean cell haemoglobin, mean cell hemoglobin concentration and red cell distribution width coefficient of variation significantly reduced, as well as raised mean cell volume and red cell distribution width standard deviation. This study also observed reduced mean cell haemoglobin, mean cell haemoglobin concentration and mean cell volume in ART- naïve subjects.

Evaluation of Activated Partial Thromboplastin Time and Prothrombin Time in HIV and TB Patients in Owerri Metropolis

Background: Human immunodeficiency Virus (HIV) and Tuberculosis (TB) are the leading infectious diseases with high morbidity and mortality in the developing countries; it has been known to be associated with some coagulation abnormalities especially as the disease progresses.
 Aim: The study aimed at evaluating the effect of HIV- Tuberculosis co- infection on some haemostatic parameters (APTT & PT). It was carried out at Federal Medical Centre Owerri, Imo state.
 Materials and Methods: Sixty (60) subjects were sampled comprising fifteen (15) HIV positive subjects, fifteen (15) TB positive subjects, fifteen (15) HIV-TB co-infected subjects and fifteen (15) HIV and TB negative subjects (Control). Activated Partial Thromboplastin Time (APTT) and Prothrombin Time (PT) were analyzed using standard techniques.
 Results: The results showed that HIV positive subjects showed a significant values of PT (15.45±1.44sec, P < 0.05) when compared with control subjects (12.45 + 1.23) and a non-statistically significant values of Activated Partial Thromboplastin Time (APTT) (33.33± 6.27sec, P > 0.05) when compared with the control subjects (29.05+2.19). TB subjects showed statistical significant values of PT (15.84±0.98scc, P < 0.05) when compared with control subjects (12.45 + 1.23) and non- statistical significant values of APTT (33.55+5.26 sec P > 0.05) when compared with the control subjects (29.05+2.19 sec). Both the PT and APTT of HIV- tuberculosis Co-infected subjects showed significant values (17.03±1.46sec; 37.59±4.69sec, P < 0.05) compared with the control subjects (12.45+ 1.23sec; 29.05+2.19). One way analysis of variance showed no significant difference of a PT of TB patient (15.84+0.98) compared to PT of HIV patients (15.45+1.44 sec). PT of HIV- TB co-infected subjects higher values (P< 0.05) when compared with HIV patients but not significantly (P> 0.05) higher than compared with TB patients. Also there is a significant increase in APTT of TB patients (P<0.05) when compared with HIV patients. APTT of HIV-TB Co-¬infected subjects were not significantly elevated when compared with HIV and TB patients (P> 0.05).
 Conclusion: HIV infections have been shown to affect both the Activated partial thromboplastin time and prothrombin time. There is significant alteration in coagulation parameters (particularly PT and APTT) on tuberculosis, lesions as a result of the mycobacterial infection can induce pro- coagulant tissue factor expression which can lead to coagulation defects.

Trace elements and antioxidant status in human immunodeficiency virus positive patients

Objectives: This study was conducted to determine the plasma levels of the antioxidants and mineral trace elements in three severity groups of human immunodeficiency virus (HIV) patients compared with non-HIV-infected controls. Methods: The plasma levels of antioxidants (Total antioxidant, albumin, bilirubin, uric acid) and trace elements (Mg, Fe, Zn, Mn, Cu, Cr, Cd and Se) were estimated in spectrophotometrically in controls and patients with CD4 counts <200; 200–499 and ≥500 cells/µL. Results: Plasma uric acid and plasma zinc (Zn) were significantly high, while vitamin E and all the micro trace elements (except Zn) were significantly lower in HIV-infected patients compared to healthy controls human beings. The higher level of plasma uric acid was observed in those with CD4 counts <200 cells/µL. All the trace elements (except Zn) were high levels in HIV subjects with a CD4 count of 200–499 cells/µL compared to >500 cells/µL. Only plasma uric acid and zinc showed significant correlation with CD4 cell count. Conclusion: Routine assessment of antioxidant/ trace element levels in HIV subjects is recommended. This supplementation is given to strengthen the immune system and reduce the adverse consequences of HIV related oxidative stress and sometimes suggests that assessing antioxidant levels or enzymes activities of patients infected with HIV should be considered during therapy. Keywords: trace elements; human immunodeficiency virus; antioxidants; CD4 cell; AIDS; oxidative stress

Clinical and echocardiographic findings in a cross-sectional study of HIV-infected adults in Enugu, Nigeria.

Human immunodeficiency virus (HIV) infection and highly active antiretroviral therapy (HAART) are implicated in cardiovascular diseases. The objective of this study was to evaluate the clinical and echocardiographic findings in HIV-infected adults. One hundred HIV subjects on HAART, 100 HAART-naïve patients and 100 controls were recruited in this cross-sectional study. Mean CD4 cell count was significantly higher in the HAART-exposed (408.43 ± 221.62) than the HAART-naïve groups (250.06 ± 154.26) (p < 0.001). Weight loss (49%), skin lesions (14%), body weakness (24%), oral thrush (10%) and lymphadenopathy (10%) were more prevalent in HAART-naïve patients (p < 0.05). Dimensions of aortic root (2.71 cm), left atrium (3.27 cm) and left ventricular mass index (79.95) were significantly higher in HIV-positive subjects on HAART (p < 0.05). Clinical features of HIV and the CD4 nadir were more prevalent in the HIV-positive, HAART-naïve subjects. Dimensions of the aortic root, left atrium and left ventricle were relatively larger in the HAART-exposed patients while wall thickness and ejection fraction were higher in the HAART-naïve subjects.

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&lt;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&lt;0.05) in HIV post-treatment group compared with HIV pre-treatment and control group. There was also a significant difference (P&lt;0.05) in ATP, ADP, AMP and GTP level between HIV pre-treatment and post-treatment group. Meanwhile, the energy balance was lower (P&lt;0.05) in HIV groups compared with control group. However, the energy balance in HIV post-treatment group was significantly lower (P&lt;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.

Immunovirological Assessment of HIV-Infected Patients and Phylogenetic Analysis of the Virus in Northeast of Iran

Background: The reliable laboratory tests, co-infection with other tumor viruses, and determining the genetic types are very important for therapy and monitoring of the clinical status of human immunodeficiency virus (HIV)-infected subjects. Objectives: This study evaluated the co-infection of HIV with hepatitis B virus (HBV), hepatitis C virus (HCV), and human T-cell leukemia virus type 1 (HTLV-1), the viral load, the progression of infection, and its correlation with the clinical status. Methods: Twenty HIV-infected cases were assessed for T cell subpopulations, HBV, HCV, and HTLV-1 co-infection, as well as the viral load. For phylogenetic relationships analysis, the HIV-c2-v5 fragment and p17 of gag were amplified, sequenced, and then clustered using phylogenetic analysis by MEGA software with maximum-likelihood. Results: The quantity of HIV viral load by qRT-PCR (TaqMan) and Cobas-Amplicor monitor test had a very strong correlation (R = 0.881, P &lt; 0.0001). A significant negative correlation was also found between CD4+ cell count and Cobas-Amplicor (R = -0.41, P = 0.06). A significant negative correlation was also found between CD4+ cell count and Cobas-Amplicor (R = -0.41, P = 0.06) with HIV monitor test results (R = -0.41, P = 0.06). The phylogenetic analysis for p17 regions in gag and c2-v5 in env genes showed that all subjects had AD genotype. The co-infection of the HIV subjects with HBV, HCV, and HTLV-1 was 75%, 75%, and 15%, respectively. A direct correlation was observed between CD8+ and HIV-HTLV-1 co-infection. Conclusions: The results showed that HIV CRF35-AD, (M group) is more frequent in the northeast of Iran, and both real-time quantification methods were reliable for monitoring the HIV-1 viral load. In addition, the transmission rate of HTLV-1 is lower than HBV and HCV among drug abusers.

HIV-1 Latency and Viral Reservoirs: Existing Reversal Approaches and Potential Technologies, Targets, and Pathways Involved in HIV Latency Studies.

Eradication of latent human immunodeficiency virus (HIV) infection is a global health challenge. Reactivation of HIV latency and killing of virus-infected cells, the so-called “kick and kill” or “shock and kill” approaches, are a popular strategy for HIV cure. While antiretroviral therapy (ART) halts HIV replication by targeting multiple steps in the HIV life cycle, including viral entry, integration, replication, and production, it cannot get rid of the occult provirus incorporated into the host-cell genome. These latent proviruses are replication-competent and can rebound in cases of ART interruption or cessation. In general, a very small population of cells harbor provirus, serve as reservoirs in ART-controlled HIV subjects, and are capable of expressing little to no HIV RNA or proteins. Beyond the canonical resting memory CD4+ T cells, HIV reservoirs also exist within tissue macrophages, myeloid cells, brain microglial cells, gut epithelial cells, and hematopoietic stem cells (HSCs). Despite a lack of active viral production, latently HIV-infected subjects continue to exhibit aberrant cellular signaling and metabolic dysfunction, leading to minor to major cellular and systemic complications or comorbidities. These include genomic DNA damage; telomere attrition; mitochondrial dysfunction; premature aging; and lymphocytic, cardiac, renal, hepatic, or pulmonary dysfunctions. Therefore, the arcane machineries involved in HIV latency and its reversal warrant further studies to identify the cryptic mechanisms of HIV reservoir formation and clearance. In this review, we discuss several molecules and signaling pathways, some of which have dual roles in maintaining or reversing HIV latency and reservoirs, and describe some evolving strategies and possible approaches to eliminate viral reservoirs and, ultimately, cure/eradicate HIV infection.

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.

Population-specific profiling of CCL3L1 copy number of the three major ethnic groups in Malaysia and the implication on HIV susceptibility.

CC chemokine ligand 3 like-1 (CCL3L1) encodes for CCL3L1 protein, which is a human immunodeficiency virus (HIV) suppressive chemokine and a potent ligand of HIV CCR5 co-receptor. CCL3L1 exhibits variation in the gene copy number (CN) and could influence HIV susceptibility through gene dosage effect. The study aims to determine the distribution of CCL3L1 CN among HIV subjects of Malay, Chinese, and Indian ethnics in Malaysia and to evaluate the impact of CCL3L1 CN on susceptibility to HIV. This study involved 182 HIV patients who attended outpatient clinics of three hospitals in Malaysia and 150 non-HIV (control) subjects. Typing of CCL3L1 CN was conducted via multiplex paralogue ratio tests (PRTs), followed by validation of the CCL3L1 CN by microsatellite analyses. Both Malay and Indian HIV subjects had the CN mode of two, while the CN mode for the Chinese was four. The CCL3L1 gene CN was found to be strongly associated with ethnicity (p<0.001) with the diverse distribution of CCL3L1 CN between the Malay (range=0-6), Chinese (range=0-9), and Indian (range=1-4) ethnic groups. CCL3L1 CN higher than and equal to the average was associated with reduced HIV susceptibility among the Malays (p<0.05). However, the negative results found for the Indian and Chinese need to be further analysed in a larger sample size.

Immunochemical evidence of Trypanosoma cruzi and Toxoplasma gondii parasitic infections in human immunodeficiency virus/acquired immunodeficiency syndrome subjects in relationship with the CD4+ count

Study Background: Trypanosoma cruzi and Toxoplasma gondii parasitic infections in human immunodeficiency virus (HIV)-positive patients could accelerate the progression of HIV infection, which may result into immunosuppression due to immune responses involving cytokines and CD4 + cells. Aim and Objective: This work was designed to determine the immunochemical evidence of T. cruzi and T. gondii parasitic infections in HIV/acquired immunodeficiency syndrome subjects in relationship with the CD4+ count. Materials and Methods: Fifty HIV-positive subjects (25 females and 25 males) aged 14–57 years were recruited as test subjects while 100 HIV-seronegative age-matched individuals were recruited as control. T. cruzi and T. gondii parasitic infections were determined in the subjects by ELISA, while CD4+ cells enumeration was carried out in the subjects by cyflowmetry, and HIV test was carried out by immunochromatography and western blotting. Results: The results obtained showed a significantly lower CD4+ cells in T. cruzi- and T. gondii-infected HIV-positive patients than the HIV-positive and HIV-negative subjects who were not infected with any of the parasites ( Conclusion: There parasitic infection caused a significant decrease in CD4+ cells in HIV subjects. There was also a gender difference in the parasitic infection of T. cruzi and T. gondii while the frequency of T. cruzi was 18% (9) and T. gondii was 14% (7).

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.

A Study of Factors Associated with, and Echocardiographic Findings of HIV Related Heart Failure

Background: With increasing incidence of Human Immunodeficiency Virus (HIV) related heart failure, evidence suggests that diastolic rather than systolic dysfunction is predominant. The pathology of pericardium, myocardium or coronary and pulmonary vasculature is related to heart failure in HIV. Echocardiography helps in detecting cardiac dysfunction before overt clinical manifestations develop. Objectives: To assess cardiac structure, function and cardiac abnormalities related to heart failure in HIV-infected subjects attending medicine department of a tertiary care teaching hospital. Methodology: This was a prospective cross-sectional study of 102 HIV-infected patients presenting with cardiac complaints at the medical department of a tertiary care hospital in western Maharashtra from July 2016 to September 2017. Results: A total of 102 HIV infected patients were included with cardiac complaints, 50 (49%) were in heart failure (HF). Commonest causes of HF were left ventricular hypertrophy, pulmonary hypertension, dilated cardiomyopathy and anaemia. Male gender (OR 4.03), low education (OR 4.91), previous history of tuberculosis (OR 3.01), and low haemoglobin (OR 0.83), were independently associated with diagnosis of HF (p&lt;0.05 for all). Conclusion: Left ventricular wall thickness and function should be monitored regularly in HIV subjects. The echocardiography is a useful and relevant tool in management of HIV infected patients especially in the era of ART.

Effect of HIV and Antiretroviral Treatment on Auditory Functions.

Introduction Numerous studies have evaluated auditory functions in human immunodeficiency virus (HIV) patients; however, these studies had a few major limitations in terms of methodology as they used mainly evoked audiometry although this method is expensive, time consuming and not widely available. Therefore, we conducted a study in naïve HIV subjects with routine audiometry. Objective To determine the effect of HIV and of the drugs used to treat it on the auditory functions. Methods A prospective observational study was conducted in a medical college with 25 naive HIV-seropositive patients for over a year. Pure tone audiometry (250–8,000 Hz) and CD4 T-lymphocyte count were performed at the time of enrollment and 6 months after commencement of highly active antiretroviral treatment. Results The subjects had increased hearing thresholds at high frequencies (4 KHz and 8KHz) in both ears at the time of enrollment that persisted at the same level (p > 0.05) on follow-up at 6 months. None of the subjects had any other otological symptom during the 6 months of observation. Seven subjects had sensorineural hearing loss in one or both ears at 0 and 6 months. These observations did not show any significant difference on Wilcoxon-signed-rank test. Spearman correlation did not find a significant correlation (p > 0.05) between CD4 T-lymphocyte counts and pure tone audiometry during the study. Conclusion We found high-frequency hearing loss in all subjects with no relation with highly active antiretroviral therapy (HAART) and severity of the disease. This study advocates hearing assessment with pure tone audiometry in HIV subjects so that intervention can be initiated in a timely manner.

Benzyl-2-Acetamido-2-Deoxy-α-d-Galactopyranoside Increases Human Immunodeficiency Virus Replication and Viral Outgrowth Efficacy In Vitro.

Glycosylation of host and viral proteins is an important posttranslational modification needed to ensure correct function of glycoproteins. For this reason, we asked whether inhibition of O-glycosylation during human immunodeficiency virus (HIV) in vitro replication could affect HIV infectivity and replication rates. We used benzyl-2-acetamido-2-deoxy-α-d-galactopyranoside (BAGN), a compound that has been widely used to inhibit O-glycosylation in several cell lines. Pretreatment and culture of PHA-blast target cells with BAGN increased the percentage of HIV-infected cells (7.6-fold, p = 0.0115), the per-cell amount of HIV p24 protein (1.3-fold, p = 0.2475), and the viral particles in culture supernatants (7.1-fold, p = 0.0029) compared to BAGN-free cultures. Initiating infection with virus previously grown in the presence of BAGN further increased percentage of infected cells (30-fold, p < 0.0001), intracellular p24 (1.5-fold, p = 0.0433), and secreted viral particles (74-fold, p < 0.0001). BAGN-treated target cells showed less CD25 and CCR5 expression, but increased HLA-DR surface expression, which positively correlated with the number of infected cells. Importantly, BAGN improved viral outgrowth kinetics in 66% of the samples tested, including samples from HIV controllers and subjects in whom no virus could be expanded in the absence of BAGN. Sequencing of the isolated virus indicated no skewing of viral quasi-species populations when compared to BAGN-free culture conditions. BAGN also increased virus production in the ACH2 latency model when used together with latency-reversing agents. Taken together, our results identify BAGN treatment as a simple strategy to improve viral outgrowth in vitro and may provide novel insights into host restriction mechanisms and O-glycosylation-related therapeutic targets for HIV control strategies.