Number Of HIV-infected Patients Research Articles

HIV-infection in the arctic zone of the republic of Sakha (Yakutia): status, challenges and prospects

The stable increase in morbidity and mortality of the population of the Republic of Sakha (Yakutia) from causes related to HIV infection indicates an unfavorable epidemiological situation in the region. Especially it affects industrial areas and large settlements of Yakutia. In the near future, an increase in the number of HIV-infected patients in the republic is expected, which is alarming. The HIV epidemiological situation is aggravated by the unequal distribution within the region with extremal environmental conditions and underdeveloped transport infrastructure. All this makes it much more difficult to provide medical care to this category of people, some of whom later move outside the territory of the Republic.Aim: Improvement of effective preventive measures and organization of medical care in the Arctic regions of the Republic of Sakha (Yakutia) based on the analysis of morbidity and mortality from HIV infection.Materials and methods: The materials of official statistics of the Department of the Federal Service for Supervision of Consumer Rights Protection and Human Welfare in RS(Ya) and data from official governmental medical reports (forms № 61 and № 4) were used in the work.Results: The number of HIV-infected people on the territory of the Republic of Sakha (Yakutia), including in the Arctic regions, is growing in recent years. Thus, from 1998 to 2022, 77 new cases of HIV infection were detected in the Arctic regions, more than half of which (54.5%) were registered in the period from 2016 to 2022. The tendency of growth of the indigenous population affected by HIV infection, including in remote areas of the region, that dictates the need for mandatory HIV screening of all persons arriving for shift work both from neighboring countries and from other regions of the Russian Federation.Conclusion: Preventive measures, HIV testing and organization of medical care are the basis for effective fight against this disease, especially in remote Arctic regions of the Republic of Sakha (Yakutia).

Opinion: AIDS and some oncological diseases

There is a frequent occurrence of oncological diseases in HIV-induced AIDS. Among this diseases Kaposi’s sarcomas occur in 30% of all cases, malignant lymphomas-in 8 to 10% of patients. Also, they appeared lymphogranulomatosis, Burkitt’s lymphoma, ,histiocytic lymphoma and lung’s adenocarcinomas, myelomas, hepatomas and so on. The number of HIV-infected patients with oncological patients drastically increases. The solution of this problem may bring serious contribution in oncology.

Occult hepatitis B infection in Turkish HIV-infected patients: A multicentre, retrospective, cross-sectional study, Schindler study.

Occult hepatitis B infection (OHBI) appears to have a higher prevalence in populations at high risk for hepatitis B virus (HBV) infection with concomitant liver disease. The aim was to assess the prevalence of OHBI in a sample of human immunodeficiency virus -1 positive and HBV surface antigen-negative (HIV-1+/HBsAg-) Turkish patients. Ten centres in Turkey were included in the study. Patients were selected on the basis of a power calculation with a known population size of HIV-positive patients and a reported prevalence of OHBI. Gender, age, occupation, place of residence, treatment and clinical status, and laboratory results, including immunodeficiency panel, antibody tests, hemogram, biochemistry, and coagulation studies were evaluated retrospectively. The number of HIV-infected patients followed in these centres was 3172 and the sample population numbered 278. All 278 were HBsAg negative. The mean age of the sample was 37.2±13.1years and 235 (84.5%) were male. All but one patient (99.6%) had been treated with antiretroviral therapy. Of the 278 patients, 169 (60.6%) were positive for Anti-HBs and 125 (44.8%) were positive for Anti-HBc IgG. HIV RNA was detected in 203/278 (73%) of the patients. Four HBV DNA (1.4%) were diagnosed with OHBI. There was no significant difference in hemogram, hemoglobin or bilirubin concentrations in those with OHBI compared with the other patients. In a representative sample of HIV+ patients from 10 Turkish centres, the prevalence of OHBI was found to be 1.4%. In HIV positive patients, it is important to identify those with OHBI for optimal clinical management and prognosis.

The Effectiveness of a Succinate-Containing Medication in Accompanying Therapy of Comorbid Tuberculosis in a Penitentiary Institution

The aim of the study was to analyze the features of the organization of therapy for patients with HIV-associated tuberculosis (TB/HIV) and the effectiveness of pharmacotherapeutic approaches under the conditions of penitentiary institutions. Materials and methods: the data on the incidence and effectiveness of specialized medical care for TB/HIV patients were analyzed for a ten-year period in the population of penitentiary institutions of the Federal Penitentiary Service of one of the subjects of the Central Federal District of the Russian Federation. Therapy and examination of patients with TB/HIV was carried out in accordance with regulatory documents and using generally accepted diagnostic methods. The patients consulted the staff of the departments of the FSBEI HE KSMU to verify the diagnosis and correct treatment regimens. Results: the analysis showed that, despite the stabilization of the TB epidemic situation, the epidemiological indicators for comorbid TB/HIV are increasing in the penitentiary health sector, which is due to an increase in the number of HIV-infected patients. In order to intensify the treatment of patients with TB/HIV in the population of the penitentiary system, it is necessary to give priority to social and sanitary prevention, primarily in risk groups — HIV-infected and individuals with residual lung changes. The inclusion of Remaxol in the therapy regimens for TB/HIV patients promotes rapid relief of hepatotoxic reactions and, as a consequence, increases the effectiveness of the primary therapy, which is illustrated by clinical observation.

Graves' disease in HIV patient receiving antiretroviral therapy

The article focuses on the clinical case of Graves’ disease in a patient with HIV infection who is receiving antiretroviral therapy. The number of HIV-infected patients has increased significantly in recent decades all over the world. The currently used highly active antiretroviral therapy can significantly improve the prognosis for these patients. However, its use is associated with a number of complications, in particular the development of immune reconstitution syndrome, under which the development of such autoimmune diseases as Graves’ disease, polymyositis and Guillain-Barre syndrome may occur. Therefore, we would like to draw the attention of doctors to the possibility of such a complication in patients receiving antiretroviral therapy. Timely diagnosis and treatment of thyroid disorders will help to avoid the complications associated with an excess or deficit of thyroid hormones.

Cardiovascular Disorders during HIV-AIDS in the Point G University, Hospital Internal Medical Service

The number of HIV-infected patients in the world is estimated at 34 million, including 30.1 million adults with 2.7 million new infections and 1.8 million deaths from HIV according to the 2011 UN AIDS report [1]. The prevalence of HIV infection in the general population of Mali is estimated at 1.1% according to DHSM-V [2]. Cardiovascular manifestations are increasingly encountered during our consultations with patients living with HIV. Thus we initiated this work with the aim of studying the cardiovascular lesions during the HIV-AIDS in the department of internal medicine of the point G. Methods: This retrospective descriptive study was conducted in the Internal Medicine department of the University Hospital Center (CHU) of the Point G from January 2008 to December 2012. Having included all HIV + patients hospitalized in the service with cardiovascular manifestations and who had performed a chest X-ray, cardiac and vascular ultrasound, electrocardiogram and/or cerebral computed tomography. Results: At the end of this work, 20 patients with cardiovascular lesions were identified in 273 hospitalized patients during the study period, i.e. a frequency of 7.3%. The 40 to 50 age group accounted for 45.0% with an average age of 42.4 ± 8.73 years. The most common cardiovascular risk factors were hypertension and active smoking with 31.58% each. Pericarditis accounted for 32% of cases, followed by cardiomyopathies with 23%. Conclusion: In our study, cardiovascular lesions are common in PHAs and etiologies are dominated by pericarditis.

Lung Cancer Surgery in HIV-Infected Patients: An Analysis of Postoperative Complications and Long-Term Survival

Background: The number of HIV-infected patients with non-small-cell lung cancer (NSCLC) undergoing surgical treatment has been increasing recently. However, the risk factors for postoperative complications and reliable predictive factors for long-term survival remain to be unclear. This study aimed to investigate the risk factors of postoperative complications, and reliable prognostic factors in HIV-infected patients with NSCLC. Methods: HIV-infected patients with NSCLC who underwent surgical treatment were retrospectively studied; a single-institutional analysis was conducted from November 2011 to August 2018. Preoperative and postoperative clinical data, including age, gender, smoking history, highly active antiretroviral therapy (HAART), CD4+ cell count, HIV viral load, cancer histology, clinical and pathological stage (P-Stage), surgical result, Glasgow Prognostic Score (GPS), Charlson Comorbidity Index (CCI), survival time and postoperative complications were collected. Results: A total of 33 HIV-infected patients with NSCLC, consisted of 27 men and 6 women, were enrolled. The median age was 56 years (range 30 to 77 years). Of the 33 patients, 18 (54.7%) had preoperative comorbidities; Postoperative complications were observed in 22 (66.7%) patients. Thirty-day mortality was not observed in these patients, median survival time after surgery was 65 months; the MST of P-Stage I patients was 65 months; P-Stage II was unestimable; P-Stage III 21 months; P-Stage I/II was 67 months. Univariate and multivariate analyses showed that HIV viral load (P= 0.009), CCI (P= 0.035) and CD4+ cell count (P=0.045) were associated with postoperative complications; P-Stage were independent prognostic factors for survival time. Conclusion: The risk factors for postoperative complications were HIV viral load, CCI and CD4+ cell count, and that P-stage was the predictive factor for long-term survival in our single-arm retrospective analysis. To strengthen the effective management of HIV-infected patients with NSCLC, the risk factors for postoperative complications and the predictive factor for long-term survival should be considered before surgery. Funding Statement: This research was supported by a grant from the Thirteen-Fifth Mega-Scientific Project on “prevention and treatment of AIDS, viral hepatitis and other infectious diseases” (grant no. 2017ZX10201301-003-002). Declaration of Interests: The authors declare no conflicts of interest. Ethics Approval Statement: This study was approved by the Shanghai public health clinical center's ethics committee (Approval No. [2018] Y038).

Knowledge, attitude and practices of medical and health science students on the antiretroviral based HIV post-exposure prophylaxis in an Ethiopian hospital: an institutional based cross-sectional study

BackgroundHIV/AIDS in resource-limited settings poses a high risk of occupational exposure to healthcare workers due to higher number of HIV infected patients. Hence, antiretroviral based post-exposure prophylaxis (PEP) for HIV is very crucial. The aim of the study was to determine the knowledge, attitudes, and practices of medical and Health science students on antiretroviral based HIV PEP in University of Gondar comprehensive specialized hospital (UOGCSH), Northwestern Ethiopia.MethodsAn institutional-based cross-sectional study was conducted among 220 medical and health science graduating students in UOGCSH from May to July 2015. Data were collected using a self-administered pretested questionnaire. The collected data were analyzed using SPSS software version 22. Results were summarized in frequencies, percentages, and means with standard deviations and presented using tables or figures.ResultsAmong the respondents, only sixty-six (30%) of the 220 study participants has had adequate knowledge about HIV PEP. Furthermore, over 90 % of the students had positive attitude towards HIV PEP f. Out of the total respondents, 37/220 (16.8%) were in need of HIV PEP and of these students only 18/37 (48.6%) took PEP. On the other hand, merely 50% of the study subjects completed the full course of HIV PEP, while the rest 50% failed to finish. As to the respondents self-report, the sole reason for starting but failing to complete the full course of HIV PEP was intolerance to the side effects of antiretroviral.ConclusionsAlthough majority of the respondents had poor knowledge and practice, they owned a good attitude towards HIV PEP. Therefore, a pre-service intensive training for all students regarding HIV PEP prior to their clinical attachments is mandatory. In addition, potential side effects of ARTs and its managements should be priory informed to the students so as to prevent the associated non-adherence to ultimately reduce the incidence of drug resistance. Moreover, the habit of needle stick injury reporting was found to be poor that needs due improvement and there has been also a pressing need to supply sufficient protective barriers to the students while planning and rendering services.

Dispanserization monitoring for HIV-infected patients in the Siberian Federal District in 2013–2017

According to UNAIDS, 1.4 million people are living with HIV in Eastern Europe and Central Asia, 75% of them in Russia. International guidelines recommend regular clinical evaluation of HIV-infected patients, which is achieved through follow-up. Purpose of the study: to characterize the quality of follow-up observation of HIV patients in the Siberian Federal District for the five-year period from 2013 to 2017. Materials and methods. A retrospective descriptive-assessment epidemiological study for the period 2013–2017 was conducted in the Siberian Federal District, in which dispensary observation indicators were most affected by improving the epidemiological situation associated with the spread of HIV infection. Results. The HIV infection in the Siberian Federal District increased during the period under review by 62,4% and reached 1328,5 per 100 thousand population. The prevalence of HIV infection at the beginning of 2018 was 679.0 per 100 thousand population (with an average Russian indicator of 430,2). The SFO accounted for 20,7% of all HIV cases (n = 130 595), which were registered at specialized medical organizations in the Russian Federation. The coverage of HIVinfected patients with clinical observation reached the target value and amounted to 88,2%. The number of patients who were examined to determine the immune status and viral load increased almost 2 times. At the same time, the proportion of HIV-infected people receiving antiretroviral therapy was at the level of 39,8%, which is 4,2% lower than the target values. The proportion of patients surveyed for tuberculosis among those who underwent medical examination in 2017 remains at the level of 87,8%, which does not stabilize the incidence of tuberculosis infection. The number of HIV-infected patients with a diagnosis of active tuberculosis increased 1,4 times to 17 610 in 2017 (10,9% of the number of patients). Conclusion. In the context of the continuing increase in the incidence of HIV infection in the population and an increase in the number of patients in need of various types of medical care, additional measures are needed to improve the quality and effectiveness of follow-up observation of patients with HIV infection.

Highly active antiretroviral therapy and left ventricular diastolic function in children with human immunodeficiency virus infection

Background In the past, cardiovascular involvement did not seem to be a common complication of HIV, but in recent years it has been described more frequently. With the advent of highly active antiretroviral therapy (HAART), the symptoms of cardiac disease has changed, as the number of HIV-infected patients with abnormal diastolic parameters has increased significantly, often presenting as symptomatic rather than asymptomatic.
 Objective To analyze for a possible correlation between HAART duration and left ventricular diastolic function in HIV-infected children. 
 Methods This cross-sectional study was conducted from December 2016 to December 2017 at the Cardiology and Allergy-Immunology Division/Department of Child Health, Universitas Udayana Medical School/Sanglah Hospital, Denpasar, Bali. Subjects with HAART were collected using a consecutive sampling method. The following data were recorded for each subject: age, sex, current stage of HIV, CD4+ level, as well as HAART regimen and duration of use. Transthoracic echocardiography was performed for tissue doppler imaging (TDI) of diastolic function. Spearman’s test was used to analyze the strength of correlation based on normality test results.
 Results This study involved 53 subjects, 21 of whom had impaired diastolic function. There was no correlation between HAART duration and diastolic function in children with HIV infection (r= -0.03; P=0.82).
 Conclusion Diastolic dysfunction is found in children under HAART treatment, but there is no correlation between HAART treatment duration and diastolic dysfunction.

PG-5 Assessment of knowledge, attitude and practice towards post exposure prophylaxis for HIV among health care workers in Federal Capital Territory, Abuja, Nigeria

Background: HIV/AIDS infection in the health care facility is a major health problem in resource limited settings. Health Care Workers (HCW) are caring for a large number of HIV infected patients. This makes them exposed to HIV infection, warranting the use of Post Exposure Prophylaxis (PEP) for HIV very critical. Here we assess Knowledge, Attitude and Practice of HCW towards PEP for HIV. Methods: This study was cross-sectional and was conducted among health care workers in 20 health care facilities providing primary health care, secondary, tertiary and private care in June 2018 under the US President Emergency Plan For AIDS Relief (PEPFAR). Data was collected using self-administered questionnaire. Results were summarized in percentages, median and Interquartile range (IQR). Results: A total of 195 HCWs completed the survey, 74 (37.9%), 34 (17.4%), 46 (23.6%) and 41 (21.1%) from Primary health care, private, secondary and tertiary health care facilities respectively. Majority of the HCWs were females, 128 (66.7%), 134 (70.2%) were aged 18–39 years and 66 (34.4%) were nurses. The median number of patients seen daily was 28 (IQR 20–50) and the median number of years in practice was 8 (IQR 4–12). One hundred and seventy-seven (92.7%) HCWs had heard of PEP for HIV and 107 (58.5%) had excellent/good knowledge about PEP for HIV. Majority of HCW 168 (92.8%) had good attitude and would recommend PEP for HIV to others; 150 (81.5%) of HCW consider themselves to be at risk and 88 (46.1%), had occupational exposure. Among those exposed, 75 (85.2%) screened for HIV. One hundred and sixty-three (86.7%) of the HCW are aware of hospital policy after occupational exposure and 107 (57.6%) would recommend commencing PEP for HIV within 1–72 hours after exposure; 131 (72.4%) are satisfied with current HIV infection protocol at their facility while 177 (92.7%) feel that more training is required for staff on HIV prevention. Conclusions: Majority of HCW had excellent/good knowledge, favorable attitude and practice towards PEP for HIV. There is need for policy makers in health sector to put policies, guidelines and pogram that will rapidly scale up PEP for HIV services in health care settings. This is much more important given the increased need for staff at these facilities to multitask and can self-expose. Keywords: Health care workers, Post exposure prophylaxis, HIV.

Intestinal helminth infections in HIV-infected patients in Savannakhet after establishment of an HIV registration network in Lao People\u2019s Democratic Republic

BackgroundIn Lao People’s Democratic Republic (PDR), which borders China, Vietnam, Cambodia, Thailand, and Myanmar, the number of HIV-infected patients has increased in recent years. HIV-infected patients diagnosed in Lao PDR are enrolled in a registration network and receive antiretroviral therapy (ART) covered by governmental financial support. Based on the registration network, we investigated intestinal helminth infections and coinfection with HTLV-1 in HIV-infected patients treated with an early intervention using ART in Lao PDR.MethodsThis cross-sectional study of all 252 HIV-infected patients at Savannakhet Provincial Hospital, located in the southern part of Lao PDR, was conducted between February and March 2018. Socioepidemiological information and clinical information were collected from a registration network database and by questionnaire administered to participants. Microscopic examination of intestinal helminth infections in stool samples and particle agglutination for anti-HTLV-1 antibody in plasma were performed.ResultsThe median age of all 252 participants was 39 years old (range, 18–59). Based on the registration network database, there were 156 (61.9%) HIV-infected patients with a CD4-positive cell count ≥ 200 cells/μL and 146 (57.9%) with an HIV viral load < 250 copies/mL. Among 212 stool samples, 75 (35.4%) were found to contain one or more intestinal helminth species, including Opisthorchis viverrini (16.5%), Strongyloides stercoralis (10.8%), hookworm (10.4%), and Taenia saginata (3.3%). This rate of intestinal helminth infections was lower than that of a previous report conducted before the establishment of the registration network for HIV-infected patients in Lao PDR. There was no significant association between intestinal helminth infections and a lower CD4-positive T cell count or higher HIV viral load. HIV-infected patients with anti-HTLV-1 antibody positivity were not found in this cohort.ConclusionThe registration network and an early intervention using ART may provide good medical care and improve the clinical course of HIV-infected patients in Lao PDR. However, the incidence of intestinal helminth infections remains high at 35.4%. The development of a specific medical care system for helminth infection for HIV-infected patients is necessary.

EPIDEMOILOGY, DIAGNOSIS, AND TREATMENT OF HIV-ASSOCIATED NON-HODGKIN LYMPHPOMAS

The objective of the study was to analyze clinical, immunological and morphological features of malignant non-Hodgkin lymphpomas (MNHL) in HIV-infected patients, evaluate the options and the results of the treatment for the patients in oncohematological hospital environment. Materials and methods. The study evaluated the data from Original Medical Records of 185 HIVinfected patients (mean age 36–40 years) with MNHL that was detected during the period from 1994 to 2017. The results of clinical, laboratory, morphological and immunohistochemical methods used for the study in HIV-infected patients with MNHL were represented. Results. During the period from 1994 to 2017, increasing in the number of HIV-infected patients with MNL, mean age of which was less than 40 years, had been marked. Duration of HIV-infection up to the time of detection the MNHL was 7 years but in 23% of cases the HIV-infection and tumor disease were diagnosed at the same time. Low number of CD4 lymphocyte cells (132 cells/μL) and high number of RNA HIV (more than 550 000 copies/μL) were detected in the blood of the patients. The following distribution was among morphological types of MNHL: diffuse large B-cell lymphoma (DLBCL) — 42%, Burkitt's lymphomas — 32%, plasmablastic lymphomas — 26%. Clinical lymphomas with the extranodal manifestations accompanied with large quantity of complications and opportunistic infections directly resulted from immunosuppression severity (p&lt;0,05) were predominant (76%). Evaluation of combined chemoimmunotherapy effectiveness in HIV-infected patients and in the patients with MNHL showed comparable results in contrast with the population of seronegative HIV-infected patients under using standard polychemotherapy regimens with rituximab, antiretroviral therapy, prevention of infectious complications and immune reconstitution syndrome. Conclusion. Malignant non-Hodgkin lymphpomas represent the group of oncological diseases, which is predominant in HIV-infected patients. These diseases require team approach in early detection, current treatment, prevention of complications in the multidisciplinary team that will significantly improve disease outcome.

How has the cost of antiretroviral therapy changed over the years? A database analysis in Italy

BackgroundThe number of human immunodeficiency virus (HIV)-related hospitalizations has decreased worldwide in recent years, due to the availability of combined antiretroviral therapies (cART). The present analysis aimed to analyse the economic, and clinical burden of HIV management, after the introduction of systematic use of cART.MethodsData from HIV-infected patients, treated at Policlinico San Martino Hospital in Genova (Italy) were retrospectively collected. A comparison between years 2009 and 2015 was performed. HIV-related admissions were identified by using the Diagnosis-Related Group (DRG) codes. The resource consumption of outpatient services was derived by using a modelling approach. Expenditure for drugs was also analysed, as aggregate data.ResultsThe number of HIV-infected patients was 898 in 2009 and 1006 in 2015. Overall, the virological success rate improved from 2009 to 2015, as the percentage of patients with HIV-RNA < 50 copies/mL increased from 79 to 89% (P < 0.05). The average incidence of hospitalizations per-patient decreased from 0.30 in 2009, to 0.13 in 2015. Average expenditure per-patient decreased from €10,107 in 2009 to €9063 in 2015.ConclusionsThe present analysis confirmed the role of cART in controlling HIV viral load and, consequently, in reducing hospitalizations, admissions to day-hospital and the use of outpatient services.Clinical improvements and economic savings more than compensated the investments required to treat HIV-infected patients with cART. Health Authorities should invest in modern cART supply and universal treatment, to use at best the available resources and obtain a cost-effective improvement of health in people living with HIV. Additional research, with the involvement of different centers and the use of patient-specific data, are recommended to consolidate the findings of this analysis.

BARTONELLOSIS (CAT-SCRATCH DISEASE) IN CHILDREN

Bartonelloses are a group of human diseases caused by gram-negative, aerobic, facultative intracellular bacteria, which only grow in the presence of blood or erythrocyte cleavage products. The diseases are characterized with multiple forms of clinical manifestations due to by systemic damage to internal organs. The clinical case presented by the authors demonstrates the difficulties of the bartonellosis diagnosis in children. The purpose of the demonstration is making aware of the problem of bartonellosis not only specialists in infectious diseases, but also pediatricians. It should be kept in mind that any atypical manifestation of the disease is the reason to rule out infectious pathology. In view of high prevalence of Bartonella among both domestic and wild animals, general immunodeficiency of the population, an increase in the number of HIV-infected patients, an unfavourable environmental and migration situation, the problem of Bartonellosis acquires great social importance for the population of Russia.

GENE-CELL THERAPY OF HIV AND HEMATOLOGICAL MALIGNANCES BASED ON HEMATOPOIETIC STEM CELL TRANSPLANTATION AND SITE-SPECIFIC GENOME EDITING

Based on the annual UNAIDS reports the number of HIVinfected patients is continually growing since 1983. Antiretroviral Therapy (ART) allows to prolong life expectancy, but the problem of life quality and overall survival is still remaining. Nowadays, in the era of ART, one of the main cause of mortality in HIV-infected patients is malignancies. Lymphomas play one of the key roles in this group of diseases. The treatment of lymphomas includes combined regiments of chemotherapy with a curative potential. High dose chemotherapy with autologous hematopoietic stem cell transplant (auto-HSCT) is the main path of the treatment for relapsed / refractory lymphomas. In the last few years with a development of the genome editing technology auto-HSCT is becoming one of the most promising methods of HIV treatment. The case of “Berlin patient” when allogeneic HSCT from donor with mutation CCR5-delta32 lead to cure from HIV and proof of concept the efficacy of the gene therapy for HIV based on HSCT. Hematopoietic stem cell transplantation with edited autologous HSC (CCR5 knockout by site-specific genome editing tools with engineering nucleases) is a comprehensive treatment for this cohort of patients. On one hand, high dose chemotherapy with auto-HSCT cures the malignancy; on the other hand auto-HSCT works as a delivery method for the edited cells and creates an environment for the HIV eradication. This review is dedicated to HIV and oncology, methods of treatment of hematological malignancies and HIV-infection using genome editing technology based on HSCT.

慢性透析療法を受けているHIV陽性患者数―HIV/エイズ拠点病院の最新データに基づく調査―

慢性透析療法を受けているHIV陽性患者数―HIV/エイズ拠点病院の最新データに基づく調査―

Rates and drivers of progression to pre-diabetes and diabetes mellitus among HIV-infected adults on antiretroviral therapy: a global systematic review and meta-analysis protocol.

IntroductionWith the new ‘test and treat’ policy of the WHO, it is obvious that the number of HIV-infected patients taking antiretroviral therapy (ART) will grow exponentially, with consequential increase in the burden of diabetes mellitus (DM). Our aim is to summarise existing data on the incidence of pre-diabetes and DM, and associated risk factors among HIV-infected adults.Methods and analysisThis systematic review will include cohort studies reporting the incidence of pre-diabetes and/or DM, and associated risk factors among HIV-infected adults on ART, with these patients being free of any impaired glucose metabolism at study baseline. We will perform electronic searches in PubMed, Excerpta Medica Database (EMBASE), Web of Science and WHO Global Health Library, supplemented with manual searches. Articles published from 1 January 2000 to 31 July 2016, in English or French languages, and without any geographical restriction will be eligible for inclusion. 3 authors will independently screen, select studies, extract data and assess the risk of bias with discrepancies resolved by consensus. We will assess clinical heterogeneity by examining the study design and setting, criteria and cut-offs used to define pre-diabetes or DM, process of calculation of incidence and outcomes in each study. We will also assess statistical heterogeneity using the χ2 test of homogeneity and quantify it using the I2 statistic. A random effects meta-analysis will be used to estimate the overall cumulative incidence of pre-diabetes/DM and risk factors.Ethics and disseminationThis systematic review will use data from published studies and does not require ethics approval. Its results are expected to help putting in place action plans and preventive measures to curb the growing burden of DM in the HIV population on ART. Findings will be published in a peer-reviewed journal and presented at scientific conferences.PROSPERO registration numberCRD42016039651.

End-of-life care for HIV-infected patients with malignancies: A questionnaire-based survey

Background: The number of HIV-infected patients who require palliative or end-of-life care is increasing, and the status of end-of-life care for HIV patients with malignancies is unclear. Aim: This study aimed to evaluate the end-of-life care provided to HIV patients with malignancies in Japan. Design: National cross-sectional questionnaire-based survey. Setting/participants: Questionnaires were delivered to the medical staff of 378 regional core hospitals/core hospitals for AIDS and 285 palliative care units in Japan. Data were collected between August and October 2013. Results: Overall, 226 regional core hospitals/core hospitals for AIDS (59.8%) responded. A total of 55 institutions (24.3%) provided end-of-life care to HIV patients with malignancies. Regarding the place of death of the patients, 69.1% died at the institution whereas 18.2% were transferred to palliative care units. The requests of 16 (29.1%) institutions to transfer patients to palliative care units were rejected. Of the 378 palliative care units, 179 (62.8%) responded. While 13 palliative care units (4.6%) provided care to hospitalized HIV patients with malignancies, 20 (11.2%) refused to accept these patients for treatment because of a lack of experience in treating these patients and a lack of knowledge regarding HIV infection. Conclusion: Our findings suggest that in Japan, HIV patients with malignancies have difficulties obtaining hospitalization at a palliative care unit, which is likely due to a lack of experience among the professionals in treating such patients as well as a lack of knowledge about HIV.

Cancer incidence in HIV patients under HAART therapy in a HIV-1 F1 subtype endemic area

Abstract Cancers have been recognized as a major health problem in patients with HIV. The first cases reported, before the existence of the virus was proven, involved patients with immunosuppression and a history of illness characterized by fever, weight loss and/or lymphadenopathy lasting weeks of months. As the population grows older, a consequence of better and largely available treatments, the impact of non-AIDS-defining cancers (NADC) is having a greater impact on the management of HIV infected patients. Studies of different subtypes of HIV-1 in Romania show a very high prevalence of subtype F1, with values between 70% - 90% or the patients being infected with this strain. The study of HIV infected population in Romania is important for identifying particularities of the subtype F1 evolution. We conducted a prospective study on HIV positive patients under HAART treatment from the Constanta Regional Centre, for a period of eight years, between 2007-2015. All causes of new discovered cancers were recorded with the occasion of subsequent visits that are done on a regular basis. For comparison we used official data from of new diagnosed cancers from reports on health status for Constanta County for the same time period. The adjusted incidence ratio is 955.18/100000patient-years (95% CI 446.58 – 1463.75/100000 patient-years). As observed in similar studies conducted. HIV patients that undergo HAART treatment have an increased risk of all cancers significantly higher than what is observed in the general population. Considering this, better screening programs have to be developed and implemented for this population. Also, because of the suspicioned high number of HIV infected patients that are not diagnosed, a screening program for HIV should be implemented for all newly diagnosed patients with any type of malignancy.