Infection In HIV-positive Individuals Research Articles

Helicobacter pylori infection and associated risk factors among HIV-positive and HIV-negative individuals in Northern Ethiopia

BackgroundH. pylori infection is a common bacterial infection worldwide, but its prevalence varies widely between different regions and populations. The objective of this study was to determine the prevalence of H. pylori infection and associated risk factors among HIV-positive and HIV-negative individuals in northern Ethiopia. MethodsA cross-sectional study was conducted from June to September 2020 in four randomly selected health facilities located in the Tigray region of Ethiopia. A total of 463 study participants were enrolled, of whom 288 were HIV-positive and 175 were HIV-negative individuals. H. pylori stool antigen tests were performed to detect H. pylori infection. Additionally, CD4+ T cell counts were measured from only a certain number of participants. ResultsThe overall prevalence of H. pylori infection among enrolled study participants was 39.7 %. Notably, the H. pylori infection rate was significantly higher in HIV-positive patients (43.4 %) compared to HIV-negative individuals (33.7 %); χ2 = 4.27, p = 0.039. Higher H. pylori prevalence was observed in participants with higher CD4+ T cell counts in both HIV-positive and HIV-negative individuals. Khat chewing habit, education, and monthly income levels were significantly associated with H. pylori infection in HIV-negative individuals, while the association between Body mass index (BMI) and H. pylori infection was observed in HIV-positive patients, but not HIV-negative individuals. ConclusionThis study demonstrates a higher prevalence of H. pylori infection in HIV-positive patients compared to HIV-negative individuals, emphasizing the importance of comprehensive diagnostics, patient care, and management of H. pylori infection in HIV-positive individuals.

Assessing COVID-19 Vulnerability Among HIV-positive Men Who Have Sex With Men in Korea: The Role of Vaccination and Sexual Behaviors.

Comorbidities increase susceptibility to severe coronavirus disease 2019 (COVID-19) infections, but limited information has been published regarding human immunodeficiency virus (HIV) and COVID-19 co-infections. This study explored the relationships among socioeconomic characteristics, sexual behaviors, and COVID-19 infection rates among Korean men who have sex with men (MSM) who are also living with HIV. Data were collected through a web survey aimed at members of the largest gay portal site in Korea, supported by the National Research Foundation of Korea (n=1005). The primary independent variables included COVID-19-related vaccinations and sexual behaviors. The dependent variable was the incidence of COVID-19 infection among respondents during the pandemic. For statistical analysis, hierarchical multiple logistic regression was performed, controlling for potential confounding variables. Model I indicated that older MSM were less likely to contract COVID-19 (adjusted odds ratio [aOR], 0.98; 95% confidence interval [CI], 0.96 to 0.99). Model II demonstrated that HIV-positive MSM were nearly twice as likely to be infected with COVID-19 compared to their HIV-negative counterparts (aOR, 1.97; 95% CI, 1.14 to 3.41). Furthermore, even after accounting for COVID-19 vaccination status in model III, HIV-positive MSM continued to show a higher risk of infection (aOR, 1.93; 95% CI, 1.12 to 3.35). The findings of this study indicate that HIV-positive MSM are at an increased risk of contracting COVID-19, even when their vaccination status is considered. Therefore, it is essential to prioritize the prevention of COVID-19 infections in HIV-positive individuals by administering appropriate antiretroviral therapy and ensuring adherence to public health guidelines.

Gastrointestinal Bleeding as a Clinical Manifestation of Strongyloides stercoralis Hyperinfection in a Patient with HIV: A Case Report

AbstractStrongyloidiasis, caused by the nematode Strongyloides stercoralis, is an often neglected parasitic disease, with deeper prevalence in tropical and subtropical regions. This parasitic infection can range from asymptomatic to symptomatic, with nonspecific manifestations, including gastrointestinal symptoms. Herein, we reported the case of an human immunodeficiency virus (HIV)-positive patient, under effective antiretroviral treatment with a normal CD4 count, who was hospitalized due to gastrointestinal bleeding. The diagnosis of strongyloidiasis hyperinfection was confirmed following endoscopic biopsies of both the gastric and duodenal mucosa. Subsequently, a treatment regimen of ivermectin at a dosage of 200 mcg/kg/day for a duration of 14 days was initiated, leading to notable amelioration in the patient's clinical presentation. In considering the differential diagnosis of gastrointestinal bleeding, it is crucial to explore various possibilities, including peptic ulcers, portal hypertension, and cancer. Among immunocompromised individuals like those with HIV, chronic infection can compromise the Th2 immune response, which is pivotal in combating helminthic infections. This underscores the importance of remembering intestinal parasitosis, particularly strongyloidiasis, in such cases. Even in patients with preserved CD4 counts, careful evaluation for opportunistic infections in HIV-positive individuals is paramount. Early initiation of treatment is essential to mitigate the risk of serious complications.

Immunological Characterization of HIV and SARS-CoV-2 Coinfected Young Individuals.

While the risk of SARS-CoV-2 infection and/or COVID-19 disease progression in the general population has been largely assessed, its impact on HIV-positive individuals remains unclear. We present clinical and immunological data collected in a cohort of HIV-infected young individuals during the first wave of COVID-19 pandemic. SARS-CoV-2 RNA, virus-specific antibodies, as well as the expression of factors involved in the anti-viral immune response were analyzed. Moreover, we set up an in vitro coinfection assay to study the mechanisms correlated to the coinfection process. Our results did not show any increased risk of severe COVID-19 in HIV-positive young individuals. In those subjects who contracted SARS-CoV-2 infection, an increase in IL-10 expression and production was observed. Furthermore, in the in vitro coinfection assay, we revealed a reduction in SARS-CoV-2 replication associated to an upregulation of IL-10. We speculate that IL-10 could play a crucial role in the course of SARS-CoV-2 infection in HIV-positive individuals. These results might help defining clinical management of HIV/SARS-CoV-2 co-infected young individuals, or putative indications for vaccination schedules in this population.

A Literature Review of Neospora caninum Infection in Humans

Background: Neosporosis is a parasitic disease caused by Neospora caninum. This parasite is an obligate intracellular coccidia similar to Toxoplasma gondii with a global distribution. With regard to the experimental studies, vertical transmission of the parasite in the monkey (non-human primates) has increased the concern about the zoonotic potential of this disease. The principal aim of the current research was to perform a mini-review on investigations regarding the Neospora infection in humans on a global scale for the first time. Methods: All peer-reviewed articles (published until April 2021) on the Neospora infection in humans were searched in English databases such as Google Scholar, ScienceDirect, Scopus, PubMed, and ProQuest. Results: Based on data in the available articles, the presence of antibodies against the Neospora infection was between 0 and 37.7% in people from different countries. The seroprevalence rate of this infection in HIV-positive individuals was higher (26.6% and 37.7%) compared to other cases. Finally, the genomic DNA of Neospora was detected up to 1% using molecular biology techniques. Conclusions: Overall, the detection of anti-Neospora antibodies in humans indicated that people have been exposed to the parasite. Comprehensive research studies are essential for clarifying the risk factors associated with the Neospora infection in humans. This report provides the baseline information for future researchers. Molecular investigations and genotypic works on N. caninum isolates are highly recommended as well.

Automated production of CCR5-negative CD4+-T cells in a GMP-compatible, clinical scale for treatment of HIV-positive patients

Ex-vivo gene editing in T lymphocytes paves the way for novel concepts of immunotherapy. One of those strategies is directed at the protection of CD4+-T helper cells from HIV infection in HIV-positive individuals. To this end, we have developed and optimised a CCR5-targeting TALE nuclease, CCR5-Uco-hetTALEN, mediating high-efficiency knockout of C-C motif chemokine receptor 5 (CCR5), the HIV co-receptor essential during initial infection. Clinical translation of the knockout approach requires up-scaling of the manufacturing process to clinically relevant cell numbers in accordance with good manufacturing practice (GMP). Here we present a GMP-compatible mRNA electroporation protocol for the automated production of CCR5-edited CD4+-T cells in the closed CliniMACS Prodigy system. The automated process reliably produced high amounts of CCR5-edited CD4+-T cells (>1.5 × 109 cells with >60% CCR5 editing) within 12 days. Of note, about 40% of total large-scale produced cells showed a biallelic CCR5 editing, and between 25 and 42% of produced cells had a central memory T-cell phenotype. In conclusion, transfection of primary T cells with CCR5-Uco-hetTALEN mRNA is readily scalable for GMP-compatible production and hence suitable for application in HIV gene therapy.

Epidemiology of Infections Caused by Seasonal Human Coronavirus in Hospitalized Adults with HIV Over a 5-year Period in Mexico City

Although the incidence of HIV-associated lung infections has changed due to the use of antiretrovirals, and the knowledge of the contributions of respiratory viruses, including subtypes of seasonal human coronavirus (HCoV) has increased, studies to analyze and compare prognosis and risk factors between HIV-positive and negative individuals with HCoV respiratory infections are scarce. Patients with HIV are at a higher risk of getting infected with various pathogens, including viruses, therefore, it is important to comprehend the epidemiology of these infections. This study aimed to expose the epidemiological aspects of HCoV infections, comparing HIV-positive and negative patients. This study used a retrospective design and the data analyzed were collected from November 2013 to March 2018, a comparison of characteristics between patients with HIV and without HIV infected with HVoC using χ2, Student's T or Mann-Whitney U tests was performed. The detection of coronavirus species by the Luminex system in patients with HIV showed that HCoV-NL63 was the most frequent, with a prevalence of 45.5%, followed by HCoV-OC43 and HCoV- 22E9, with 36% and 18.2%, respectively. Overall, the HCoV-OC43 species was detected more frequently and winter was the season when more cases occurred. Pneumonia was the most frequent clinical manifestation and the main coinfection was due to Pneumocystis jirovecii. Seasonal human coronaviruses are an important cause of infection in HIV-infected patients, resulting in several clinical repercussions. Further studies are necessary to determine the implications of HCoV in these patients, as well as the epidemiological significance of HCoV infections in HIV-positive individuals in Mexico and throughout the globe.

Serological evidence of HIV, Hepatitis B, C, and E viruses among liver disease patients attending tertiary hospitals in Osun State, Nigeria

ABSTRACT Hepatitis infection in HIV positive individuals with liver diseases causes high mortality worldwide. HIV worsens the pathological effect of hepatitis viruses and potentiates reactivation of latent hepatitis infections due to reduced immunity. This research therefore aimed to study the occurrence of HIV and hepatitis viruses among liver diseases patients (LVDP) attending tertiary hospitals in Osun State, southwestern Nigeria. A total of 121 LVDP blood samples collected were tested for HIV and Hepatitis B, C, and E using and enzyme linked Immunossorbent assay (ELISA). Data were analyzed using packages within SPSS and P ≤ 0.05 was considered significant. Prevalence of 32.2%, 0.8%, 10.7%, and 18.2% for HBsAg, Anti-HCV, HEV-IgM, and HIV were found respectively. Marital status showed a significant association with HEV-IgM infection (χ2 = 9.869, P = .020). The prevalence of HBsAg, HEV, and HIV among LVDP in Osun State is alarming and health education among the patients and general populace is hereby advocated. High HEV-IgM seroprevalence implies that HEV routine screening should be incorporated into blood screening. Since HEV is associated with unhygienic practice, people should be enlightened on how to improve their living conditions.

A study of seroprevalence of herpes simplex virus infection in STI clinic attendees

Background: Herpes simplex virus infections are prevalent worldwide. They are caused by Herpes simplex virus Type-1 (HSV-1) and type-2 (HSV-2). HSV-1 causes orolabial disease. Genital herpes may be caused by either HSV-2 or HSV-1, large majority of cases being caused by HSV-2. HSV-1 is acquired during early childhood by most of the individuals. The acquisition of HSV-2 starts around puberty or thereafter. The ability of the virus to successfully avoid clearance by the immune system by entering a non-replicating state known as latency leads to life long persistence of infection with unpredictable reactivation and transmission. Detecting antibodies plays an important role in identifying those infected. Type specific tests have been developed that are based on the protein Glycoprotein G from HSV-2 (gG2) or Glycoprotein G from HSV-1 (gG1). As very limited sequence homology exists between gG1 and gG2, assays based on detecting these type specific epitopes using ELISA can reliably differentiate between antibodies to HSV-1 and HSV-2. Objectives 1. To study the Seroprevalence of Herpes simplex virus infection in patients attending the STI clinic.2. To study the risk factors and other socioepidemiological factors associated with HSV-2 seropositivity.3. To study the seroprevalence of HSV infection in HIV positive individuals.4. To study the proportion of subclinical seropositives for HSV infection. Material and methods: The study was carried out from July 2017 to June 2019. All patients reporting to DVL OPD at GITAM institute of Medical sciences & Research, Visakhapatnam, Andhra Pradesh were examined and evaluated. 82 consecutive patients of both sexes with STI complaints, in the age group of 15-70 years were studied. Patients with genital herpes as well as patients with other STI complaints including both HIV positive and HIV negative patients were included in the study.With prior permission from ethical committee and consent from patients, blood samples were collected and tested for HSV-1 IgG and IgM antibodies and HSV-2 IgG and IgM antibodies.Results: Out of 82 patients 42 (51%) were females and 40 (49%) were males; 41 (50%) were HIV positive and the other 41(50%) were HIV negative.Out of 82 patients, 39(47.6%) had genital herpes and 43 (52.5%) had other STDs which include genital candidiasis (18.3%), non specific urethritis (13.4%), Condyloma acuminate (14.6%) and genital molluscum contagiosum (6.1%).Out of 82 patients, 2(2.4%) were seropositive for HSV-1 IgM and 68 (82.9%) were seropositive for HSV-1 IgG.Out of 82 patients, 4(5%) were seropositive for HSV-2 IgM and 40(48.8%) are seropositive for HSV-2 IgG.Out of 39 patients with genital herpes 21(53.8%) were seropositive for HSV-2 and out of 43 patients with other STDs without genital herpes 19 (44.2%) were seropositive for HSV-2, indicating that the proportion of subclinical seropositivity was 44.2% in our studyConclusion: From our study we conclude that Herpes simplex virus infection is common in STI clinic attendees in our hospital. Prevalence of HSV-1 and HSV-2 serum antibodies provide an epidemiological measure of population burden of these infections. The high seroprevalence of HSV-2 in HIV patients potentiates the need for regular HSV-2 screening in HIV positive individuals and proper counselling and treatment of HSV-2 seropositives during outbreaks will efficiently lower the frequency of recurrences and decrease the transmission of both HSV and HIV infections.

Epidemiological studies of malaria parasite on HIV patients attending General Hospital Awo-Omamma, Oru East, Imo State,Nigeria

HIV and malaria are the two most prevalent and deadly diseases in the world. Malaria and HIV accounted for about 255 million cases in 2017, with malaria having 86% of this distribution and HIV having 14% of the distribution. Given the overlap of their geographic distribution and resultant rates of coinfection, interactions between the two diseases pose major public health problems. This study was aimed at investigating the epidemiology of malaria –HIV co-infection in respect to sex, age and its association with CD4+ count and viral load. 230 HIV sero-positive participants and 100 HIV sero-negative participants(control) were employed for this study. 52 (22.6%) of the HIV infected participants tested positive for malaria while only 9(9.0%) of the non-HIV participants tested positive to malaria. The prevalence of malarial infection in HIV positive individuals was higher in females (23.9%) than in males (18.5%). While in age group of 30-39 showed the highest prevalence (35.3%) of co-infection. A high prevalence of 47.7% was recorded with CD4+ below 200 cells/μl than 7.6% in participants with CD4+ greater than 200 cells/μl. A highprevalence (49.2%) was also detected in patients with viral load of above 10,000 copies/μl compared to that of those with viral load less than 10,000 copies/μl(12.6%). This study showed a high prevalence of malaria in HIV patients in Awo-Omamma,Oru East, Imo state. This should be considered a great concern to public health. Thus, more effort should be put in research to curb this health issue.

Epidemiological Features and Risk Factors for Acquiring Hepatitis B, Hepatitis C, and Syphilis in HIV-Infected Patients in Shaanxi Province, Northwest China.

Human immunodeficiency virus (HIV)-infected patients are at a higher risk for co-infection with Hepatitis B virus (HBV), Hepatitis C virus (HCV), and Treponema pallidum (TP; the agent causing syphilis) than the general population. The prevalence of HBV, HCV, and syphilis has geographic differences and varies from region to region among HIV-positive individuals. A retrospective study was carried out on HIV-positive individuals between June 2011 and June 2016 in Shaanxi Province. Univariate and multivariate logistic regression analyses using stepwise regression analysis regarding risk factors for HIV–HBV, HIV–HCV, and HIV–syphilis co-infection. HBV–HCV, HCV–syphilis, HBV–syphilis, and HBV–HCV–syphilis co-infection rates were 1.7%, 2.2%, 2.6%, and 0.1%, respectively. The rate of ineffective hepatitis B vaccine immunization was as high as 30.2% among HIV-positive individuals. Ethnicity (OR = 31.030, 95% CI: 11.643–82.694) and HIV transmission routes (OR = 134.024, 95% CI: 14.328–1253.653) were the risk factors for HCV infection in HIV-positive individuals. Among the HIV-positive individuals with the antibodies of TP, the rate of homosexual transmission was also higher, but heterosexual transmission was lower (OR = 0.549 95% CI: 0.382–0.789) The HIV-infected patients in Shaanxi Province had the characteristics of low active detection rate and late diagnosis. The high rate of ineffective vaccination against HBV suggests a need for improved vaccination services.

Patterns of Fungi Isolates from Sputum Samples of HIV Subjects Co-Infected with Pulmonary Tuberculosis in Eastern Nigeria

Opportunistic infection in HIV positive individuals has a high risk of morbidity and mortality as it could be a pointer to systemic infection. Aim: This study was designed to determine the patterns of some pathogenic fungal infections isolated from HIV positive individuals from ART clinics in south eastern Nigeria. Materials and methods: A total of 132 patients (62 males and 70 females) were recruited for this study. Their sputum samples were screened for Tuberculosis (TB) using Ziehl Nelsen staining technique and were also cultured on Sabouaurd dextrose agar with and without chloramphenicol incubated at 25℃ with examination of growth every 3 days for two weeks. Identification of isolates was done using Gram staining methods, chromogenic media and slide culture. Results: 46(34.8%) of the test subjects (132) were co-infected with TB while 94(71.2%) tested positive for fungi infection; 36(60.0%) for HIV-sero positive subjects on ART and 58(80.6%) for those not on ART (P<0.05). The prevalence of fungi isolates from test subjects shows that Candida albicans has the highest frequency of 25(26.6%), followed by Penicillum marneiffei with 18(21.6%), with the least prevalent being Aspergillus flavus and Phialemonium curvatum at 2(2.1%) respectively. In HIV-sero negative indivuals, Candida albicans was of the highest prevalence with 7(53.9%), followed by Candida tropicalis with 3(23.1%) and Aspergillus fumigatus and A. flavus with the least prevalence of 1(7.7%) respectively. Furthermore, there was a positive significant correlation between TB and fungi infection in HIV-sero positive subjects (P<0.05). Conclusion: The high prevalence of fungi infection amongst TB co-infected HIV-sero positive individuals suggests a high degree of drug resistance in said patients thus, could be the mitigating factor behind the increasing morbidity and mortality among TB co-infected HIV positive subjects.

Prevalence and molecular-genetic characteristics of hepatitis B virus in HIV-positive individuals at the Far Eastern Federal District

Current study was aimed at investigating prevalence of overt and occult hepatitis B infection in HIV-positive individuals as well as molecular-epidemiological characteristics of the circulating hepatitis B virus (HBV) strains in the Far Eastern Federal District (FEFD). A total number of 297 blood serum/plasma samples obtained from HIV-positive patients residing in the FEFD were enrolled in the study. The first control group included 351 blood serum/plasma samples of general population without indication on HIV and HBV-infection that underwent laboratory check up at the Centers for AIDS Prevention and Control. After evaluating the group of HIV-positive patients 20 HIV-HBV positive samples were selected for further detailed analysis. The second control group included 43 patients with chronic hepatitis B. All groups were age and gender-matched. The research included serological and molecular-genetic (real-time PCR, positive for HBV DNA samples underwent clonal sequencing of PCR-amplified HBV P/S gene) assessment of the biological material followed by a phylogenetic analysis of the HBV sequences. Our research revealed that HIV-positive patients are exposed to a higher risk of HBV infection compared to general population enrolled in the study, which is evident from the prevalence of anti-HBcAg antibodies in the groups examined. HIV-positive vs. first control group was positive for anti-HBcAg antibodies at higher rate (35.02%, CI 95: 29.5940.45% versus 22.22%, CI 95: 17.8726.57%, p = 0.0003). Abundance of ongoing HBV-infection markers was also higher in HIV-positive individuals compared to general population (6.73%, CI 95: 3.889.58% versus 0.85%, CI 95: 01.81%, p = 0.0001, respectively). Should be noted, that HBsAg-negative HBV infection in HIV-positive patient cohort comprised 1.01% (CI 95: 02.15%) whereas in general population this index was as low as 0.28% (CI 95: 00.84%). Virus hepatitis С and D were revealed at higher rate in HIV-positive individuals compared to patients with HIV-negative chronic HBV infection (p = 5.84 107 and p = 0.000001 respectively). HCV and HDV prevalence rates comprised 50.0% (CI 95: 27.4677.46%) and 40.0% (CI 95: 17.9762.03%) in HIV-positive patients. Similar indices in control group were 4.65% (CI 95: 010.94%) and 4.65% (CI 95: 010.94%), respectively. The phylogenetic analysis of the six isolated HBV sequences showed that the five samples belonged to genotype D, with dominant subtype D2 (verified in 4 cases). Further, HBV genotype С was detected only in one case. The obtained data indicate a necessity for further in-depth diagnostic examination of viral hepatitis in HIV-positive patients to lower a risk of developing life-threatening complications as well as preventing hepatitis spread in human population.

High Incidence of Infections in HIV-positive Patients Treated for Lymphoproliferative Disorders.

Lymphoproliferative disorders are frequently diagnosed in HIV-positive patients and severe infections may occur during antineoplastic treatments: the incidence and impact of such events are not well-characterized. To describe the occurrence and mortality of incident infections in HIV-positive individuals treated for lymphoproliferative disorders. A retrospective study in HIV-positive adults with lymphoproliferative disorders (2000- 2012) who were hospitalised to receive antineoplastic chemotherapy; antimicrobial prophylaxis with alternate day co-trimoxazole (800/160 mg) was administered to all individuals. 103 patients were included: mostly males (81, 78.6%), Caucasians (101, 98.1%), with a median age of 43 years (39-51). Fifty-eight (56.3%) patients had non-Hodgkin's lymphoma (NHL), thirty-two (29.1%) had Hodgkin's lymphoma (HL) and ten patients (9.7%) had Burkitt's lymphoma (BL). Five year survival was 63.1%: the best survival rates were reported in HL (78.1%), followed by NHL (58.6%) and BL (50%). Forty-four patients (42.7%) developed 82 infections during follow up: identified causative agents were bacteria (35, 42.7%), viruses (28, 34.1%), mycobacteria (7, 8.5%), protozoa (7, 8.5%) and fungi (5, 6.1%). Cytomegalovirus infections (n=17, including 5 endorgan diseases) emerged 53 days after the diagnosis: multivariate analysis showed CD4+ cell count <100/uL as the only independently associated factor (p<0.001, aOR=23.5). Two factors were associated with mortality risk: an IPI/IPS-score of >2 (p=0.004, aOR=6.55) and the presence of CMV disease (p=0.032, aOR=2.73). HIV positive patients receiving treatment for lymphoproliferative disorders suffer from a high incidence of infections and associated mortality risk. Tailored prophylactic strategies need to be considered in this setting.

Response to Pneumococcal Polysaccharide Vaccination in HIV-Positive Individuals on Long Term Highly Active Antiretroviral Therapy

Background and objectivesStreptococcus pneumoniae continues to cause serious infections in HIV-positive individuals in the era of highly active anti-retroviral therapy. This led to the recommendation to revaccinate HIV-positive individuals with PPV23 five years after primary vaccination. The benefits of revaccination and the impact of long term highly active anti-retroviral therapy (HAART) on antigen-specific B cell reconstitution have remained unclear thus far and were investigated.Design and methodsWe assessed antibody levels, opsonophagocytic activity and phenotype of pneumococcal polysaccharide (PPS) specific-B cells post-revaccination in long term HAART cohorts stratified according to CD4 count as group A (CD4>200) and group B (CD4<200). Anti-PPS IgG, IgM and functional antibody response against vaccine serotypes 14 and 23F were measured by ELISA and opsonophagocytic assay followed by phenotypic analysis of PPS14 and 23F-specific B cells using fluorescently labeled PPS.ResultsSignificant increases in total and functional antibody titers were noted in groups A and B post-vaccination concomitant with significant rise in PPS-specific IgM memory B cells, a critical B cell subset required for protection against PPS although the overall response remained significantly diminished compared to HIV-negative volunteers.ConclusionComparable increases in opsonophagocytic titers between study groups A and B concomitant with a comparable rise in PPS-specific IgM memory B cells indicate revaccination to be beneficial regardless of the degree of CD4 T cell reconstitution. These findings emphasize the importance of defining effective vaccination practices amongst high-risk individuals.

Optimal Management of HIV-HCV Coinfection

Around 25 % of HIV-positive individuals are HCV coinfected. HIV infection clearly worsened the natural history of chronic HCV infection, and despite the improved cares of comorbidities (chronic alcohol intake, metabolic syndrome, poor immune status by an earlier and better immune restoration with antiretrovirals (ARV), and finally by a decreasing hepatotoxicity of ARV), liver-related mortality remains one of the main causes of mortality in HIV/HCV-coinfected patients as compared to HIV monoinfected patients. Treatment options in HIV-HCV-coinfected patients have been greatly improved in the last few years. The treatment of acute HCV infection in HIV-positive individuals using the association of pegylated interferon/ribavirin (PEG-IFN/RBV) (with a first-generation protease inhibitor in genotype 1-infected patient) will allow a HCV virologic cure in around 80 %. In chronically infected patients, the PEG-IFN/RBV association has demonstrated an efficacy of 20–40 % in genotype 1 and higher in other genotypes, and increasing with optimization of dosing and duration, stopping rules and ART adjustment; the adjunction of telaprevir or boceprevir for genotype 1 increased the chance of HCV cure to around drug-70 % with drug interaction concerns. Physicians are today, in 2014, in a period of transition between the standard treatment combining PEG-IFN and RBV with or without first-generation HCV protease inhibitors according to HCV genotype and oral combinations of different classes of direct-acting antivirals (DAAs) with a pan-genotypic antiviral potency and a fair safety which will clearly change the prognosis of HIV/HCV-infected patients. The DAA combination removes HIV-infected patients (like cirrhotics or liver transplant recipients) as difficult-to-treat patients.

The Seroprevalence of Hepatitis B Viral Infection in HIV Tested Positive Individuals in Owerri, Imo State, Nigeria

Background: The contribution of hepatitis B viral infection in HIV positive individuals is becoming increasingly recognized especially with the advent of Highly Active Antiretroviral drugs (HAART) which tend to prolong the life expectancy of HIV patients, thus increasing the tendency for chronic sequalae of hepatitis B in HIV/HBV co infection. Method: A total of 300 HIV positive adults who were >18years and residing in Owerri were enrolled in this study. Participants were drawn from twenty (20) private laboratory services between January, 2013 and August, 2013. Result: Out of the three hundred (300) individuals who tested positive for HIV, thirty two (32) persons (10.6%) showed positive serology test for Hepatitis B in our series. Out of these persons, twenty one (21) (65.6%) were females while eleven (11) (34.4%) were males. Among the study population, persons aged 25-34.9 years had the highest prevalence of co infection (56.25%), while patients aged 55-64.9 years had the least prevalence. Males aged 35-44.9 years had the highest prevalence. Majority of the females were secondary school holders (46.9%) who were selfemployed and having multiple unprotected heterosexual lifestyles. Conclusions: HIV and Hepatitis B viral infections share common route of transmission and they synergistically accelerate each progression. Greater public health enlightenment in areas of health seeking behavior, safer sex practice, and overall health promotion must be intensified if reduction of this hepatitis B viral burden is to be achieved.

Incident hepatitis B infection subsequent to the diagnosis of HIV infection in a Melbourne cohort: missed opportunities for prevention

Background The characteristics associated with incident hepatitis B (HBV) infection in HIV-positive individuals are not well described in the Australian setting. The aim of this study is to determine the characteristics of and risk factors for HBV infection within HIV-infected individuals in a Melbourne cohort between 1985 and 2011. Individuals susceptible to HBV at their HIV diagnosis were identified using their HBV serology stored within the Victorian HIV database. Within this group, those who had a subsequent positive test for hepatitis B surface antigen or hepatitis B core antibody were identified as infected with HBV after their HIV diagnosis. Incident cases were matched with controls from the initially susceptible group who did not seroconvert for analysis. An incidence rate was calculated from the number of seroconversions and the cumulative time at risk (in 1000 patient-years of follow-up). Of the 4711 patients with HIV seen more than once, 3223 had HBV testing. Of the 174 with positive HBV test results, 39 individuals met the definition of seroconversion after HIV diagnosis, representing the incident cases. The estimated HBV incidence rate was 1.81 (95% confidence interval: 1.28-2.47) per 1000 patient-years at risk. These individuals form the basis of a detailed case series and case-control study. Data collected include demographic details, immunological and virological characteristics, antiretroviral treatment and vaccination history. HIV-infected individuals should be screened for HBV and monitored for incident infection. Optimal control of HIV and improved vaccination coverage provide the best opportunity for prevention.

Hepatitis E Virus Infection in HIV Positive ART Naive and Experienced Individuals in Nigeria

Background: Studies have shown Hepatitis E Virus to be a causative agent of acute and chronic hepatitis in severely immunocompromised patients such as organ transplant recipients and person with HIV infection. This study was designed to determine the burden of HEV infection among HIV positive individuals in Nigeria and the effect of HIV treatment on the burden of HEV infection among this group of patients. Methods: Aliquot of plasma samples collected for laboratory investigations such as CD4 enumeration, blood chemistry (AST, ALT, Creatine, Urea) were used to determine the presence of HEV IgG and IgM antibodies using commercially available ELISA. Samples analysed in the study were collected from 180 HIV positive individuals (90 ART naive and 90 ART experienced) attending the ART clinic at the University College Hospital, Ibadan, Nigeria. Results: Twenty two of the 180 (12.2%) samples were positive for either HEV IgG (20/180) or IgM (2/180). The rate of HEV IgG was higher among ART naive individuals and the two IgM positive persons were ART naive. There was no significant difference in the mean CD4 count and mean ALT between HEV seronegative and seropositive individuals (P = 0.8 and 0.2 respectively). Conclusions: The results of this study suggest the need to test for HEV infection in HIV positive individuals for the early diagnosis and proper management since HEV is known to be fulminant in the presence of underlying liver disease that is common among HIV infected persons. In addition, the use of ART may reduce the incidence of HEV infection in HIV positive persons.

Short Communication: Evaluation of GB Virus C/Hepatitis G Viral Load Among HIV Type 1-Coinfected Patients in São Paulo, Brazil

Recent studies suggest that GB virus C/hepatitis G virus (GBV-C/HGV) infection in HIV-positive individuals is associated with a slower progression to AIDS, leading to a lower HIV viral load and higher counts of CD4(+) T cells, although many studies have failed to demonstrate these beneficial effects. We developed a Real-Time PCR (TaqMan RT qPCR) to quantify the viral load of GBV-C/HGV in 102 HIV-1-infected patients, who were also evaluated for the presence of anti-E2. The prevalence of GBV-C/HGV infection was 21% among infected patients and the mean plasma viral load was 3.62 ± 0.64 log(10) copies/ml. Despite the high prevalence, there was no statistical difference when we compared the mean viral load (p≤0.46) and the average count of CD4(+) (p≤0.29) and CD8(+) (p≤0.64) among patients infected by GBV-C/HGV and HIV and patients infected only by HIV. This fact can be explained by the number of patients included in the study. Nevertheless, compared to other studies, we observed a discrete number of patients with undetectable HIV load and lower median viral load in the group presenting GBV-C/HGV RNA. Our study suggests that there may be an impact on HIV viral load in GBV-C/HGV-coinfected patients. However, further studies are needed to elucidate the molecular and cellular mechanisms involved in this viral interaction, previously reported in other studies, with the aim of contributing to the development of new targets for drugs against HIV.