Human Immunodeficiency Virus Infected Patients Research Articles

Cardiovascular Diseases Associated Inflammatory Biomarker Levels in a Small Cohort of HIV-1 Infected Patients Deintensificated from Abacavir/Lamivudine/ Dolutegravir to Lamivudine Plus Dolutegravir Running Head: Risk of Cardiovascular Diseases and Abacavir Use

Following the successful introduction of combined Antiretroviral Therapy (cART), a dramatic decrease in viral burden and opportunistic infections along with a consistent increase in life expectancy has been observed in Human Immunodeficiency Virus (HIV) infected patients [1]. This deep change in the HIV disease evolution has determined that HIV positive subjects were effectively monitored for several alterations of many tissue and organs due to HIV chronic disease and antiretroviral treatment for example, cardiovascular system, bone, adipose tissues, kidney and central nervous system represent the major target of these structural and functional damages during HIV infection. In particular, Cardiovascular Diseases (CVD) were considered important clinical complications in the HIV patient and represent a leading cause of death among HIV-positive patients, accounting for approximately 11% of the total deaths in this population [2]; the risk of CVD is higher in HIV positive individuals compared with HIV negative people, and particularly the reported Myocardial Infarction (MI) incidence in cohort study ranges from 3 to 11 cases per 1000 patients a year in HIV- positive individuals against 2 to 7 cases per 1000 patients-years in HIV-negative population [3,4]. Although initial studies indicated a higher prevalence of traditional CVD risk factors in HIV infected population [5,6] as a possible cause, the molecular mechanisms of increased CVD risk in HIV still remain incompletely defined and should be probably attributable to a combination of multiple factors, including both direct and indirect effects of HIV infection on metabolism. Evidence from experimental and observational studies [7,8] in recent years suggested a more important role of HIV itself in contributing to CVD. Endothelial dysfunction due to gp120, Tat and Nef proteins have been identified as a critical link between infection, inflammation, immune activation, atherosclerosis and cardiovascular system. Moreover, ART may play a role in the exacerbation of risk factors for CVD [9]; since the presentation of findings from the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) study in 2008 demonstrating a 90% increased risk of MI in HIV- positive individuals receiving ART regimens including Abacavir (ABC), subsequent studies, conducted by FDA [10], GlaxoSmithKline [11] and independent researchers [12], to investigate this risk have yielded conflicting results. Although more recent studies have shown an effective increased risk of CVD associated with use of ABC, many results did not reach statistical significance [13-17]. The absence of a demonstrated underlying biological mechanism for such a risk added interest and confusion about the question, as well as the higher prevalence of risk factors for CVD, such as renal impairment and substance abuse among abacavir recipients; in addition, a recent meta analysis suggests that Relative Risk (RR) for MI is increased within a 6 months exposure to ABC (RR=1.61; 95% confidence interval: 1.48–1.75) and in cART-naive population [18]. While the published evidence remains conflicting and a plausible biological mechanism for this potential association has not yet been identified, in the following study we have tried to verify whether, after introduction of ABC and its discontinuation in the contest of HAART deintensification, common metabolic markers CVD related such as glucose, LDL, HDL, total cholesterol and triglycerides and inflammatory biomarkers such as IL-6 and D-dimer could change in a small cohort of HIV-1 infected patients.

Unilateral frosted branch angiitis in an human immunodeficiency virus-infected patient with concurrent COVID-19 infection: a case report

BackgroundFrosted branch angiitis (FBA) is an uncommon ocular sign with multiple causes. With the recent outbreak of coronavirus disease 2019 (COVID-19), many cases of ocular manifestation in association with this disease have been reported. However, as yet we have no complete understanding of this condition. We report here the first case of FBA in a human immunodeficiency virus-infected patient with coexisting cytomegalovirus (CMV) and COVID-19 infection.Case presentationA 33-year-old Malay man with underlying acquired immunodeficiency syndrome receiving highly active antiretroviral therapy was referred to the Opthalmology Department with complaints of blurry vision for the past 2 months. He had tested positive for and been diagnosed with COVID-19 1 month previously. Clinical examination of the fundus revealed extensive perivascular sheathing of both the artery and vein suggestive of FBA in the right eye. Laboratory testing of nasal swabs for COVID-19 polymerase chain reaction (PCR) and serum CMV antibody were positive. The patient was then admitted to the COVID-19 ward and treated with intravenous ganciclovir.ConclusionClinicians should be aware of and take the necessary standard precautions for possible coexistence of COVID-19 in an immunocompromised patient presenting with blurred vision, eye redness, dry eye and foreign body sensation despite the absence of clinical features suggestive of COVID-19. Whether FBA is one of the ocular signs of co-infection of COVID-19 and CMV remains unknown. Further studies are needed to provide more information on ocular signs presented in patients with concurrent COVID-19 and CMV infections.

Genital Herpes in Human Immunodeficiency Virus Infected Patients

Genital herpes is a recurrent, lifelong sexual transmitted infection caused by HSV, especially type 2. Genital herpes is the most common infection in HIV patient. HSV-2 can increase the risk of HIV acquisition 2 to 3 times. Clinical manifestations of genital herpes can be different between HIV- infected and non-HIV patients. HIV-infected patients have a high risk of developing chronic and severe genital ulcers with atypical manifestation, prolonged healing, and resistant to treatment, depends on CD4 count. Genital herpes can be diagnosed based on history, clinical manifestation, laboratory and histopathologic examination. Management of genital herpes includes education and counseling patients and sexual partners, systemic antiviral, and symptomatic treatment.

Genital Herpes in Human Immunodeficiency Virus Infected Patients

Genital herpes is a recurrent, lifelong sexual transmitted infection caused by HSV, especially type 2. Genital herpes is the most common infection in HIV patient. HSV-2 can increase the risk of HIV acquisition 2 to 3 times. Clinical manifestations of genital herpes can be different between HIV- infected and non-HIV patients. HIV-infected patients have a high risk of developing chronic and severe genital ulcers with atypical manifestation, prolonged healing, and resistant to treatment, depends on CD4 count. Genital herpes can be diagnosed based on history, clinical manifestation, laboratory and histopathologic examination. Management of genital herpes includes education and counseling patients and sexual partners, systemic antiviral, and symptomatic treatment.

Antiretroviral Therapy-Related Problems among Human Immunodeficiency Virus-Infected Patients

Background: There are problems associated with antiretroviral therapy despite its achievement. Poor medication adherence and inability to tolerate large pill burden are major problems facing patients with chronic illnesses. These drug therapy problems are under-studied among people living with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) in Nigeria. We evaluated adherence and pill burden among this set of patients in a tertiary hospital in Lagos. Methods: Data for eligible HIV-infected adults were documented from case notes and through interviews using a well-structured questionnaire. Important details extracted were sociodemographics, pills information, and CD4 counts. The main outcome measures were drug adherence, as assessed by the four-item Morisky Medication Adherence Scale and pill burden, as measured by daily pill >5. Results: Of the 296 patients, 219 (74%) were females. Median age (interquartile range) was 40 (35.0–47.7) years. Majority (262; 88.5%) were married, had at least a secondary education (142:48.0%), and CD4 count >500 cells/ml (215; 72.6%). Pill burden >5 pills/day was observed in 12.2% of the patients, while adherence was documented for 83.4% of the patients. Majority (259; 87.5%) were receiving fixed-dose combination of antiretroviral drugs. Forgetfulness (16.5%) and being too busy to take pills (10.5%) were the most common reasons for nonadherence. Pill burden in those who were not receiving fixed-dose combination was significantly associated with medication nonadherence. However, only pill burden was found to be an independent prognosticator of non-adherance. (Odd ratio = 0.67, confidence interval = 0.03–1.66, P < 0.00). Conclusion: Medication nonadherence and pill burden were observed in more than one-tenth of patients. These were the two major antiretroviral therapy-related problems reported in this study.

Prevalence, Pattern and Clinical Variations of Dermatophytosis in Patients with HIV Infection at the University of Port Harcourt Teaching Hospital, Port Harcourt

Background: Immunosuppression due to various etiologies has been associated with the occurrence of dermatophytosis. Several studies in the past have demonstrated that Human Immunodeficiency Virus (HIV) infection is a risk factor for the acquisition and severity of dermatophytosis. This study examined the prevalence and clinical variations of dermatophytosis amongst HIV positive patients seen in Port-Harcourt, Southern Nigeria.
 Methods: Between July 2019 and 2020 173 seropositive cases and 173 seronegative controls were recruited for this study. They were interviewed with a structured questionnaire and thereafter screened for the presence of dermatophytosis and sent for mycology studies.
 Results: There was a higher prevalence of dermatophytosis in the HIV seropositive group when compared to the control group. Most of the lesions seen were not markedly different from that seen in immunocompetent persons. 41.65% of the cases were found among those with CD4 cell counts below 200. Tinea corporis was the commonest lesion seen (50%). Trichophyton species was the commonest dermatophyte isolated, followed by Microsporum spp.
 Conclusion: Prevalence of dermatophytosis is significantly higher in HIV infected patients and commonly occurs in advanced stages of the disease. Tinea corporis is the most common lesion in this group of patients and Trichophyton spp. a common causative agent.

Primary HIV drug resistance among newly HIV type-1 diagnosed patients in St. Petersburg

There is concern that the widespread use of antiretroviral drugs (ARV) to treat human immunodeficiency virus 1 (HIV-1) infection may result in the emergence of transmission of drug-resistant virus among persons newly infected with HIV-1. Russia is one of a growing number of countries in the world where drug-resistant HIV is becoming a serious health problem because it has the potential to compromise the efficacy of antiretroviral therapy (ART) at the population level.Materials and methods.We performed a genetic analysis of the HIV-1 plasma derived pol gene among the newly diagnosed ART-naïve HIV-1 infected patients during the period from November 2018 to October 2019 in the St. Petersburg Clinical Infectious Diseases Hospital named after S.P. Botkin. We used reverse transcriptase polymerase chain reaction (RT-PCR) followed by direct sequencing of PCR products to determine the prevalence of primary drug resistance (PDR) conferring mutations. HIV-1 genotypes were determined by phylogenetic analysis.Results.The predominant HIV-1 subtype was A1 (87.2%), followed by B (11.8%) and CRF06_cpx (1%). The overall prevalence of PDR was 11%. Virus with known resistance-conferring mutations to any nucleoside reverse transcriptase inhibitors (NRTIs) was found in 8 individuals, to any non NRTIs in 5 subjects, and to any protease inhibitors in 1 case. Multidrug-resistant virus was identified in 2 individuals (2%).Conclusion.The distribution of HIV-1 genotypes in St. Petersburg, Russia is diverse. The emerging prevalence of PDR in ART-naïve patients demonstrates the significance of constant monitoring due to the challenges it presents towards treatment.

Stroke and HIV-associated neurological complications: A retrospective nationwide study.

There is an increased risk of stroke and other neurological complications in human immunodeficiency virus (HIV) infected patients with no large population-based studies in the literature. We aim to evaluate the prevalence of stroke, HIV-associated neurological complications, and identify risk factors associated with poor outcomes of stroke among HIV admissions in the United States. In the nationwide inpatient sample with adult HIV hospitalizations, patients with primary cerebrovascular disease (CeVDs) and HIV-associated neurological complications were identified by ICD-9-CM codes. We performed a retrospective study with weighted analysis to evaluate the prevalence of stroke and neurological complicationsand outcomes of stroke among HIV patients. We included 1,559,351 HIV admissions from 2003 to 2014, of which 22470 (1.4%) patients had CeVDs (transient ischemic attack [TIA]: 3240 [0.2%], acute ischemic stroke [AIS]: 14895 [0.93%], and hemorrhagic stroke [HS]: 4334 [0.27%]), 7781 (0.49%) had neurosyphilis, 29,925 (1.87%) meningitis, 39,190 (2.45%) cytomegalovirus encephalitis, 4699 (0.29%) toxoplasmosis, 9964 (0.62%) progressive multifocal leukoencephalopathy, and 142,910 (8.94%) epilepsy. There is increased overall prevalence trend for CeVDs (TIA: 0.17%-0.24%; AIS: 0.62%-1.29%; HS: 0.26%-0.31%; pTrend < .0001) from 2003 to 2014. Among HIV admissions, variables associated with AIS were neurosyphilis (odds ratio: 4.38; 95% confidence interval: 3.21-5.97), meningitis (4.87 [4.10-5.79]), and central nervous system tuberculosis (6.72 [3.85-11.71]). Toxoplasmosis [4.27 [2.34-7.76]), meningitis (2.91 [2.09-4.06)], and cytomegalovirus encephalitis (1.62 [1.11-2.37]) were associated with higher odds of HS compared to patients without HS. There was an increasing trend of CeVDs over time among HIV hospitalizations. HIV-associated neurological complications were associated with the risk of stroke, together with increased mortality, morbidity, disability, and discharge to long-term care facilities. Further research would clarify stroke risk factors in HIV patients to mitigate adverse outcomes.

Neuroinflammation in HIV-Related Neuropathic Pain.

In the management of human immunodeficiency virus (HIV) infection around the world, chronic complications are becoming a new problem along with the prolonged life expectancy. Chronic pain is widespread in HIV infected patients and even affects those with a low viral load undergoing long-term treatment with antiviral drugs, negatively influencing the adherence to disease management and quality of life. A large proportion of chronic pain is neuropathic pain, which defined as chronic pain caused by nervous system lesions or diseases, presenting a series of nervous system symptoms including both positive and negative signs. Injury caused by HIV protein, central and peripheral sensitization, and side effects of antiretroviral therapy lead to neuroinflammation, which is regarded as a maladaptive mechanism originally serving to promote regeneration and healing, constituting the main mechanism of HIV-related neuropathic pain. Gp120, as HIV envelope protein, has been found to be the major toxin that induces neuropathic pain. Particularly, the microglia, releasing numerous pro-inflammatory substances (such as TNFα, IL-1β, and IL-6), not only sensitize the neurons but also are the center part of the crosstalk bridging the astrocytes and oligodendrocytes together forming the central sensitization during HIV infection, which is not discussed detailly in recent reviews. In the meantime, some NRTIs and PIs exacerbate the neuroinflammation response. In this review, we highlight the importance of clarifying the mechanism of HIV-related neuropathic pain, and discuss about the limitation of the related studies as future research directions.

COMMON OPPORTUNISTIC PULMONARY PARASITES IN HIV PATIENTS AND THEIR IMPACT ON ORGAN TRANSPLANTATION

HIV (human immunodeficiency virus) is a virus that attacks the body's immune system, If not treatedwould lead to AIDS (acquired immunodeficiency syndrome). The HIV infection is acquired fromcontact with infected blood, semen, or vaginal fluids. Most patients get HIV by having unprotectedsex with someone who has HIV. Another common way is by sharing drug needles with HIV infectedpatient. Most patients develop a pulmonary complication during the history of HIV infection. Lungis the most frequently affected site by the bacterial, fungal, viral and parasitic diseases.

Prevalence, Severity and Relationship of Anaemia with Immune Status and Use of Highly Active Antiretroviral Therapy among Human Immunodeficiency Virus-Infected Adults in South-eastern Nigeria

Objective: Anaemia is a significant complication of human immunodeficiency infection, causing life-threatening symptoms and impairing quality of life. This study aimed to assess the prevalence, severity and associations of anaemia, with cluster of differentiation 4 (CD4+) cell count and use of highly active antiretroviral therapy (HAART), in human immunodeficiency virus-infected patients. Material and Methods: Haemoglobin concentration, CD4+ count, HAART use and other factors were assessed in 372, adult HIV-infected out-patients; enrolled at a tertiary hospital in South-Eastern Nigeria. Anaemia was defined according to World Health Organisation criteria. Independent predictors were determined using bivariate analysis and enter method logistic regression analysis, at a p-value&lt;0.05.Results: Prevalence of anaemia was 76.3% overall; 79.9% in females and 67.6% in males. Median CD4+ cell count was 609.50 (interquartile range 379) cells per microlitre (cells/μl). Females were more likely to be anaemic than males [odds ratio (OR)=1.88, 95% confidence interval (CI) 1.07, 3.31; p-value=0.011]. Furthermore, the odds of being anaemic were higher in participants 50 years or older (OR 3.79, 95% CI 1.36, 10.55; p-value=0.023). A CD4+ count &lt;200 cells/μl. Not being on cotrimoxazole preventive therapy and a low monthly household income were associated with higher odds of anaemia. Tenofovir- and abacavir-based regimens were associated with lower odds of anaemia compared to zidovudine. Conclusion: Gender and the age of patients were independent predictors of anaemia. Pre-treatment screening, and close follow-up monitoring for anaemia as well as increased access to less haematotoxic HAART regimens are needed.

High Prevalence of Anemia among Human Immunodeficiency Virus-Infected Patients: A Cross-sectional Study in Bali-Indonesia

Anemia is a common condition found among Human Immunodeficiency Virus (HIV)-infected patients. T-cells that are infected with HIV virus can directly suppress the growth of progenitor cells in the bone marrow so that affecting the hemopoiesis resulted in anemia. These hematological abnormalities could potentially cause serious clinical implications. This study was conducted to determine the prevalence of anemia in HIV-infected patients in Bali. It was ahospital based cross-sectional studyconducted at two public hospital in Bali-Indonesia. A total of 243 medical record data from HIV-infected patients atWangaya Hospital Denpasar Bali and Sanjiwani Hospital Gianyar Bali between 2009 -2017 were included in analysis. Prevalence of anemia in antiretroviral (ART)-naïve patients and in patients on ART were 60.8% and 40.3%, respectively. Leucopenia and thrombocytopenia were found 8.2% and 9.4%, respectively, in ART-naïve group. While in patients with ART group leucopenia and thrombocytopenia were accounted for 6.9% and 4.3%, respectively. There was a significant difference in prevalence of anemia between ART-naïve patients and patients on ART (60.8% vs. 40.3%; p &lt; 0.05). Although the prevalence of anemia was lower in patients on ART, but anemia continues to be common in a substantial portion of HIV-infected persons. Another studies are still needed to addressing the impact of anemia on HIV-infected individuals, as well as treatment strategies and future research directions.

A cross-sectional study of socio-demographic and clinical profile of HIV patients at ART plus centre, Sawai Man Singh Hospital, Jaipur, India

Background: This study aimed to understand the regional variation in the socio-demographic and clinical profile of human immunodeficiency virus (HIV) infected patients at antiretroviral therapy plus centre of Sawai Man Singh (SMS) hospital, Jaipur, India. &#x0D; Methods: A descriptive cross-sectional study was conducted on HIV patients from January to December 2019. The HIV-positive patients of all age groups and all categories were included in the study. The socio-economic status was assessed by BG Prasad classification-based consumer price index. However, the clinical staging was done according to the World Health Organization (WHO) classification of HIV/AIDS. Data were expressed as mean ± standard deviation.&#x0D; Results: Among 525 HIV patients 59.16% were males, 40.26% females and 0.57% intersex. About half (51.0%) in the reproductive age group with mean age 36 ±13 years. The commonest mode of HIV transmission was heterosexual (89.77%). Maximum belonged to social class I (57.84%) and class II (26.05 %) of BG Prasad's socioeconomic status. Each of the non-agricultural laborers and semi-skilled workers constitutes 18.0%, and the housewives were 23.6%. At the time of presentation, baseline CD4+Tcell count was &lt;350 /mm3 in 55.0% of HIV patients. Pulmonary tuberculosis and skin involvement were the most predominant secondary opportunistic infections accounting for 24.8% and 7.8%, respectively. More than half (52.09%) of patients were in WHO clinical stage I of HIV disease.&#x0D; Conclusion: Socio-demographic and clinical profile of study participants reflect an impact of early case detection and timely institution of highly active antiretroviral therapy.

Prevalence of Hepatitis B Virus coinfection among Human Immunodeficiency Virus positive patients in Yola, Adamawa State, Nigeria

Background: Hepatitis B virus (HBV) and human immunodeficiency virus (HIV) confection has been reported to impair negatively on the health of the patients because it impacts directly on the outcome of HBV infection, considerably complicating its natural history, diagnosis and management. This study was aimed at determining the incidence and distribution of HBV/HIV coinfection in the study area. Methods: The sera people living with HIV/AIDS were screened for hepatitis B surface antigen (HBsAg) and cluster of differentiation 4 (CD4) cell counts using the Becton Dickinson Fluorescence Activated Cell Sorter procedure. Results: The prevalence of HBV co-infection among people living with HIV/AIDS in this study was 11% with the coinfection being higher in males (14.3%) compared to the 9.7% among females. The coinfection was highest among people ages 25-39 yr. (12.9%) while least occurrence of coinfection was observed in ages above 53 yr. (8.3%). The CD4 counts of HBV and HIV coinfected persons showed that 18.2% of coinfected persons had CD4 counts above 700-1000 cells/mm3 while 12.1% had CD4 counts between 501-700 cells/mm3. Conclusion: The relatively high prevalence of HBV infection in HIV patients confirms the need for baseline screening for these markers in HIV-infected patients, as this could affect the choice of highly active antiretroviral therapy (HAART) regimen for the patients.

Demographic, clinical and pathological characterisation of patients with colorectal and anal cancer followed between 2013 and 2016 at Maputo Central Hospital, Mozambique.

PurposeThe aim of this study was to investigate colorectal cancer (CRC) data and anal cancer data from Maputo Central Hospital (MCH), the largest hospital and a reference for oncological diseases in Mozambique, with the aim of characterising the disease profile in view to define an appropriate control programme.MethodsMCH records from the Pathology and Surgery Services and MCH Cancer Registry database were assessed to obtain retrospective clinical and pathologic data of patients with CRC or anal cancer admitted to and treated between 13 December 2013 and 23 March 2016.ResultsThe female gender was more prevalent (54.8%), even when anal cancers were excluded. Median age was 54 years (20–99). Most patients (51.6%) lived in the city of Maputo. The most common presenting symptom was found to be rectal bleeding. Adenocarcinoma was the most frequent histological type, and the most prevalent anatomical site was the rectum. Most of the cases were diagnosed at MCH in advanced stages. Colostomy was the most frequent surgical procedure and performed in 38.7% of the patients. Most cases of anal cancer occurred in human immunodeficiency virus-infected patients. Most patients had a poor prognosis due to advanced stage at first diagnosis.ConclusionWe observed an increase in cases of CRC and anal cancer in Mozambique and mostly diagnosed at advanced stages, which anticipates a dismal prognosis. Our data supports the urgent need of a comprehensive public health programme dedicated to solving this growing concern.

Whole genome sequencing based differentiation between re-infection and relapse in Indian patients with tuberculosis recurrence, with and without HIV co-infection

IntroductionDifferentiation between relapse and reinfection in cases with tuberculosis (TB) recurrence has important implications for public health, especially in patients with human immunodeficiency virus (HIV) co-infection. We compared Mycobacterial Interspersed Repeat Unit (MIRU) typing and spoligotyping with whole genome sequencing (WGS) to differentiate between relapse and reinfection in patients (HIV-positive and HIV-negative) with TB recurrence. We also assessed the value of WGS to track acquired drug resistance in those with relapse after successful treatment. MethodForty-one paired M. tuberculosis isolates collected from 20 HIV-positive and 21 HIV-negative patients were subjected to WGS in addition to spoligotyping and MIRU typing. Phylogenetic and Single Nucleotide Substitution (SNP) clustering analyses were performed to determine whether recurrences were due to relapse or re-infection. ResultsComparison of M. tuberculosis genomes indicated that 95% of TB recurrences in the HIV-negative cohort were due to relapse, while the majority of TB recurrences (75%) in the HIV-positive cohort was due to reinfection (P = 0.0001). New drug resistance mutations were acquired in 5/24 cases (20.8%) that experienced relapse. ConclusionsWGS provided increased resolution, but differentiation between relapse and reinfection was broadly consistent with MIRU and spoligotyping. The high contribution of reinfection among HIV infected patients experiencing TB recurrence warrants further study to explore risk factors for TB exposure.

ELISA versus Nested PCR for Detection of Hepatitis B Co-infection in HIV-infected People in Bandung Indonesia

The number of Human Immunodeficiency Virus infected patients in Bandung is increasing. HIV patients are often suffering from Hepatitis B Virusco-infection. The co-infection status must be detected using the accurate method. This study aims to compare the accuracy of Enzyme-Linked Immunosorbent Assay and nested Polymerase Chain Reaction in detecting HIV-HBV co-infection in Bandung. The research method used is experimental. The sample used in this study was 50 people. All samples had met the inclusion criteria. The presence of hepatitis B surface antigen in the serum was detected using a qualitative ELISA Wantai kit, while sHBsAg gene in the whole blood was amplified using 2 pairs of the specific primary. The results obtained from both methods were analyzed to determine sensitivity, specificity, and accuracy values. The result of Hepatitis B detection using ELISA method showed that 15 samples (30%) were positive, 1 sample (2%) was a false positive, and 3 samples (6%) were the false negative. Moreover, the nested PCR method showed that 18 samples (36%) were positive without false positive or false negative result. These results showed that ELISA has a sensitivity value of 83.33%, specificity of 96.87%, and the accuracy of 92%, while Nested PCR has a value of 100% for all three parameters. Therefore, it can be concluded that the Nested PCR method was more accurate than ELISA to detect Hepatitis B co-infection in HIV patients in Bandung.The Nested PCR can be recommended for detecting the other co-infection cases.&#x0D; &#x0D; Keywords: accuracy, HBsAg, co-infection, sensitivity, specificity

Intestinal mucosal microbiota composition of patients with acquired immune deficiency syndrome in Guangzhou, China.

Acquired immune deficiency syndrome, caused by the human immunodeficiency virus (HIV), has been associated with intestinal dysbiosis, which includes an increase in the number of mucosa-associated pathobionts. In the present study, the intestinal mucosal microbiota patterns of HIV-infected patients were compared with those of healthy individuals in a population from Guangzhou, China. The gut microbiota of intestinal mucosal samples from 12 patients with HIV (transmission routes included sex and intravenous drug abuse) was compared with that of 12 healthy age- and sex-matched controls. Gut microbial communities were profiled via sequencing of the bacterial 16S ribosomal RNA genes. Dysbiosis in HIV-infected individuals was characterized by decreased α-diversity, decreased levels of Firmicutes and increased levels of Proteobacteria. Furthermore, low mean counts of Lachnoclostridium, Roseburia, Thauera, Dorea and Roseburia inulinivorans, and high mean counts of Halomonas and Shewanella bacteria, were indicated to be HIV-associated mucosal bacterial alterations. The relative abundance of Fusobacterium and Lachnoclostridium was significantly decreased, while that of Halomonas and Shewanella was significantly increased in patients with sexually transmitted HIV-infection compared with healthy controls. Alterations of the gut microbiota during HIV infection were also indicated to be associated with the route of HIV transmission. Certain bacteria may be potential biomarkers for HIV infection in patients from Guangzhou, China.

Distribution of CCR5 Δ32 HIV-1 resistance allele frequency at Zanjan province in Iran

Introduction: The CC chemokine receptor 5 (CCR5) is known as the main co-receptor in human immunodeficiency virus (HIV) infection. Accumulating evidence verified 32bp deletion in both alleles of CCR5 provides natural resistance to HIV infection. Accordingly, recent therapeutic approaches are based on gene and cell therapies by inducing this resistance. Allogeneic transplantation of stem cells with CCR5Δ32 homozygous to HIV infected people has been considered as an efficient strategy. Objectives: The aim of this study was to determine CCR5 Δ32 mutation frequency in healthy and HIV-infected individuals in Zanjan province, in Iran and also detecting appropriate candidate for future therapeutic approaches. Patients and Methods: In this study, blood samples were collected from 102 HIV infected patients and 204 healthy controls in ethylene diamine tetra-acetic acid (EDTA) pre-coated tubes. DNA extraction was performed and analyzed for CCR5Δ32 mutation by GAP-PCR in both groups and followed by 2% gel agarose electrophoresis. The Δ32 genotype frequency was statistically determined. Results: Our finding demonstrated that 3 HIV infected patients displayed CCR5 mutation, while 204 healthy controls showed one CCR5 Δ32/Δ32 homozygote mutation. We observed that Δ32 mutation frequency is 0.82% in Zanjan province (χ2 =47.58, P&lt;0.001). Conclusion: Reduction in CCR5 mutation frequency as well as the other polymorphisms related to HIV resistance, can lead to the development of HIV infection epidemiology. Migration, natural selection and genetic admixture can elucidate various distribution of Δ32 allele frequency in different populations, like as north Europeans that reduce gradually to south. The result of this study can facilitate the presentation of suitable Δ32 donors to HIV infected patients in therapeutic approaches.

Derangement in Enzymatic and Non-Enzymatic Markers of Liver Function in Human Immunodeficiency Virus (HIV) Infected Patients in Makurdi, North Central Nigeria

Liver disease has emerged as a critical issue in the management of human immunodeficiency virus (HIV) victims. This study was carried out to investigate the derangement in indices of liver function in HIV-infected patients in Makurdi, North Central Nigeria. One hundred and fifty males and females adults within the age range of 21- 50 years were enrolled for this study. One hundred of these participants were confirmed HIV positive, out of which fifty were on various antiretroviral drugs including the nucleoside / nucleotide reverse transcriptase inhibitors and the non-nucleoside transcriptase inhibitors classes of antiretroviral drugs. The remaining fifty persons who were HIV- negative served as the control group. Blood samples from the studied persons were analysed for alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, total protein, albumin, total bilirubin and conjugated bilirubin using automated clinical chemistry analyser, Hitachi 902 (Roche Diagnostic GMBH, Germany). The HIV- patients with or without antiretroviral drugs had their serum levels of alanine aminotransferase, aspartate aminotransferase and alkaline phosphatase significantly raised (p&lt; 0.05) compared with the control subjects. A significant rise (p&lt; 0.05) was observed in serum level of total protein in the HIV patients who were yet to commence antiretroviral drugs when compared to the control subjects. However, the albumin levels of the HIV patients on the antiretroviral drugs and those who were yet to commence the antiretroviral drugs decreased significantly (p&lt; 0.05) when compared with that of the control. The total bilirubin level of the HIV patients on antiretroviral drugs showed significant increase (p&lt; 0.05) compared with the control subjects and the HIV patients who were not on antiretroviral drugs. This study reveals that both HIV infection itself and the antiretroviral drugs cause hepatic malfunction