Spread Of Human Immunodeficiency Virus Research Articles

Exploring Ways of HIV Transmission in Correctional Facilities in the Democratic Republic of the Congo

The Democratic Republic of Congo (DRC) is one of the few African countries where human immunodeficiency virus (HIV) transmission is still a silent issue. In the context of the DRC, the purpose of this paper was to investigate how HIV is transmitted among inmates within Congolese correctional facilities. It focuses on the ways certain Congolese correctional services‘ cultures facilitate the spread of HIV. The paper argues that incarceration settings allow for the importation of pre-incarceration lifestyles and risky behaviours into prisons; hence increasing the risk of HIV/AIDS (acquired immunodeficiency syndrome) transmission among convicts. Methodologically, the paper followed a qualitative approach based mainly on secondary data. A content analysis was used to analyse the data. The findings of the study indicated that prisoners‘ pre-incarceration lifestyle supplemented by prison culture and settings engendered HIV high-risk behaviour among inmates in Congo‘s prisons. In addition, the paper appealed for the government to pay attention to prison cultures generated by the interaction between prison environments and a quest for a sense of psychological wellbeing inside correctional facilities.

Cell-to-Cell Transmission of HIV-1 and HIV-2 from Infected Macrophages and Dendritic Cells to CD4+ T Lymphocytes.

Macrophages (Mø) and dendritic cells (DCs) are key players in human immunodeficiency virus (HIV) infection and pathogenesis. They are essential for the spread of HIV to CD4+ T lymphocytes (TCD4+) during acute infection. In addition, they constitute a persistently infected reservoir in which viral production is maintained for long periods of time during chronic infection. Defining how HIV interacts with these cells remains a critical area of research to elucidate the pathogenic mechanisms of acute spread and sustained chronic infection and transmission. To address this issue, we analyzed a panel of phenotypically distinct HIV-1 and HIV-2 primary isolates for the efficiency with which they are transferred from infected DCs or Mø to TCD4+. Our results show that infected Mø and DCs spread the virus to TCD4+ via cell-free viral particles in addition to other alternative pathways. We demonstrate that the production of infectious viral particles is induced by the co-culture of different cell populations, indicating that the contribution of cell signaling driven by cell-to-cell contact is a trigger for viral replication. The results obtained do not correlate with the phenotypic characteristics of the HIV isolates, namely their co-receptor usage, nor do we find significant differences between HIV-1 and HIV-2 in terms of cis- or trans-infection. The data presented here may help to further elucidate the cell-to-cell spread of HIV and its importance in HIV pathogenesis. Ultimately, this knowledge is critical for new therapeutic and vaccine approaches.

Access to HIV prevention, treatment, and care services during COVID-19 by men who have sex with men in Zimbabwe, An interpretive phenomenological analysis study.

Key populations are disproportionately affected by the human immunodeficiency virus (HIV) but have less access to HIV prevention and treatment services. The Coronavirus disease-2019 (COVID-19) pandemic is reinforcing health inequities among vulnerable populations, including men who have sex with men (MSM). Therefore, this article presents the findings describing the experiences of MSM in accessing HIV services during COVID-19 in the second largest city of Zimbabwe. An interpretative phenomenological analysis design was applied to gain some insights regarding the lived experiences of MSM in accessing HIV prevention, treatment, and care services during COVID-19 lockdowns era in Zimbabwe. Data were collected from 14 criterion purposively selected MSM using in-depth, one-on-one interviews. Data were analysed thematically guided by the interpretative phenomenological analysis framework for data analysis. The findings demonstrated that during the COVID -19 lockdowns in Zimbabwe, MSM faced several barriers as they tried to access HIV services. Some of the barriers included the need for travel authorisation letters and treatment interruption. The study also found that COVID-19 and related restrictive measures had psychosocial and economic effects that encompassed loss of income, intimate partner violence and psychological effects. Limited access to healthcare services by MSM due to COVID-19 lockdown may negatively affect the viral suppression and fuel the spread of HIV, which may reverse the gains toward the control of HIV epidemic. To sustain the gains toward HIV epidemic control and to ensure continuity of treatment, particularly for members of key populations, it is critical that the health-care delivery system adjusts by taking service to the community through adopting a differentiated service delivery approach.

Evaluation of serum calcitonin gene related peptide (CGRP) Level in HIV infected patients as an indicator of disease activity

Human immunodeficiency virus (HIV) infection is under global attention due to its rapid spread and high rate of morbidity and mortality. HIV gets an access into the mucosa of genital epithelium through binding to Langerhans cells. While viral load and CD4+ cell count are the main parameters to detect disease activity, new biomarkers are introduced as a potential parameter for monitoring of disease activity in HIV infected patients. Calcitonin Gene Related Peptide (CGRP) is a neuropeptide that is secreted by peripheral neurons at genital epithelia and plays an important role in limitation of HIV transmission and spread to infected CD4+ cells through its effect onto Langerhans cells. This study aimed to evaluate the serum level of CGRP in HIV infected patients and to determine whether CGRP can serve as an indicator of HIV infection activity. The study included 104 HIV patients and 24 normal controls. Patients were divided into four groups. Serum levels of CGRP were measured by ELISA and correlated to viral load and CD4+ cells count for patients in the four groups: primary HIV infection (PHI), chronic HIV infection (CHI) before combinational antiretroviral therapy (cART-naïve), chronic HIV infection after one year of cART-initiation, and chronic HIV infection after two years of cART. Serum levels of CGRP were also measured in sera of controls and compared to patients' groups. Serum levels of CGRP were significantly lower in cART naïve PHI and CHI patients in comparison with normal controls (p < 0.05), Also, serum CGRP levels were positively correlated with CD4+ cells count (p < 0.01), but negatively correlated with viral load (p>0.05). In conclusion, CGRP could be proposed as an indicator of disease activity in HIV patients.

Prevalence of unprotected anal intercourse and associated factors among male students who have sex with men in Qingdao, China: A cross-sectional study.

The significant rise of human immunodeficiency virus (HIV) epidemic among young students has become a new feature of acquired immune deficiency syndrome in China, and unprotected anal intercourse (UAI) among male students who have sex with men (SMSM) played a central role in this process. The aim of this study was to investigate the prevalence of UAI, as well as analyze the factors associated with UAI among SMSM in Qingdao, China. From May 2021 to April 2022, men who aged 15 to 30, studied in a high school or college in Qingdao and had anal sex with men in the past 6 months were recruited through snowball method relying on the nongovernmental organization. An anonymous electronic questionnaire was administrated to collect information on socio-demographic characteristics, sexual behaviors, substance use before sex, HIV prevention services and self-esteem. Univariate and multivariate logistic regressions were used to assess factors related to UAI. Among the 341 SMSM included in the study, 40.5% engaged in UAI in the past 6 months. Being migrants from other provinces [odds ratios (OR) = 2.04, 95% confidence intervals (CI): 1.10-3.78], failing to use condoms for the first anal intercourse (OR = 3.38, 95% CI: 1.85-6.18), drinking alcohol before sex (OR = 2.31, 95% CI: 1.25-4.28) and being low level self-esteem (OR = 1.77, 95% CI: 1.09-2.87) were positively associated with UAI. SMSM who had homosexual intercourse more than once a week (OR = 1.76, 95% CI: 1.03-3.00) or had multiple male sex partners (OR = 1.99, 95% CI: 1.20-3.30) were more likely to engage in UAI. Received peer education in the past 12 months (OR = 0.48, 95% CI: 0.27-0.86) was associated with lower odds of UAI. The situation of UAI among SMSM in Qingdao was a public health issue of concern. It is necessary to take targeted measures, such as focusing on first-time sex, advancing sexual health education, expanding peer education, implementing alcohol use screening and maintaining the self-esteem of SMSM, so as to reduce the occurrence of high-risk behaviors among SMSM and curb the spread of HIV on campus.

Efavirenz: History, Development and Future

Efavirenz (Sustiva®) is a first-generation non-nucleoside reverse transcriptase inhibitor (NNRTI) used to treat human immunodeficiency virus (HIV) type 1 infection or to prevent the spread of HIV. In 1998, the FDA authorized efavirenz for the treatment of HIV-1 infection. Patients formerly required three 200 mg efavirenz capsules daily, which was rapidly updated to a 600 mg tablet that only required one tablet per day. However, when given 600 mg once daily, plasma efavirenz concentrations were linked not only to poor HIV suppression but also to toxicity. Clinical data suggested that the standard dose of efavirenz could be reduced without compromising its effectiveness, resulting in a reduction in side effects and making the drug more affordable. Therefore, ENCORE1 was performed to compare the efficiency and safeness of a reduced dose of efavirenz (400 mg) with the standard dose (600 mg) plus two NRTI in antiretroviral-naïve HIV-infected individuals. Nowadays, due to the emergence of integrase strand transfer inhibitors (INSTIs), some consider that it is time to stop using efavirenz as a first-line treatment on a global scale, in the parts of the world where that is possible. Efavirenz has been a primary first-line antiviral drug for more than 15 years. However, at this moment, the best use for efavirenz could be for pre-exposure prophylaxis (PrEP) and repurposing in medicine.

Scenario of HIV infection in Pakistan

Human immunodeficiency virus (HIV) infection, which was previously lethal, has evolved into a chronic disease that may be treated and well-managed. HIV levels in the bloodstream may become undetectable with antiretroviral therapy (ART). All those providing care for people living with HIV should be aware of the risk factors, transmission, diagnosis, and treatment, acute HIV infection, possible opportunistic infections, and malignancies. Preexposure and postexposure prophylaxis regimens allow for preventive treatment. Home healthcare specialists can help people follow their drug schedules, assess the effectiveness of their treatments, and identify HIV problems and ART side effects. The ability to support, inform, and counsel people living with HIV and their families is most crucial [1].&#x0D; Approximately 38.9 million people worldwide were living with HIV, 25.4 million had access to antiretroviral therapy (ART), 1.7 million had just recently contracted the virus, and 690,000 had passed away from AIDS-related illnesses, according to a Joint United Nations Program on HIV/AIDS 2020 report. Although Pakistan's national HIV/AIDS control program was established in 1987, the number of new HIV/AIDS cases has been rising quickly ever since. In Pakistan, 160,000 people were living with HIV/AIDS as of 2018, yet only 10% of them were receiving ART. 3 Increasing people with HIV/AIDS' access to ART has a number of positive effects, including delaying the advancement of the disease, extending life expectancy, and enhancing people's quality of life and mental health [2].&#x0D; "More than 1,000 new HIV cases are reported each month from all four provinces, including the capitol city Islamabad, Azad Kashmir, and Gilgit Baltistan. This demonstrates unequivocally that homosexuals, persons who inject drugs, male, female, and transgender sex workers, and other critical demographics are now spreading HIV to the broader community. During the final 10 months of 2022, 9,773 people in Pakistan had HIV tests that were positive, casting significant doubt on HIV preventive and control initiatives and amply demonstrating the spread of HIV from important populations to the general public. New HIV infections account for a sizable portion of low-risk males, females, and clients of critical communities, showing an increase in HIV transmission to bridging populations [3].&#x0D; The increased rate of HIV in Pakistan pose a risk to a healthy population, blood recipients etc. Therefore, surrounding communities should also be checked for HIV. The government should direct public education campaigns in coordination with NGOs. To prevent any future epidemics, barbers and unlicensed health professionals in remote regions should receive training.

Building a model and assessing the level of morbidity during the epidemic

The article considers the effectiveness of methods of mathematical models and control over the spread of human immunodeficiency virus (HIV) in Kazakhstan. Data were obtained for a 10-year period of the incidence of HIV infection, a distribution schedule for the morbidity of the population was created and analyzed using the Statistica application software package. A model of HIV spread is considered taking into account the social adaptation of the population,a scheme of a probabilistic model is constructed and a system of probabilistic differential equations is used. The current direction of the strategy for combating HIV infection is largely determined by a scientifically based system for assessing the epidemiological state of HIV infection using mathematical models that can determine the patterns of the epidemiological process with great confidence and predict the expected level of morbidity. Currently, according to scientists, there are about 150 different forecasting methods, but in practice 15-20 types of these methods are most often used. One of the methods used in the majority are expert assessment, extrapolation, mathematical modeling, mixed forecasts. To date, the problem of HIV infection is one of the most important Kazakhstan consistently implements steps to curb the spread of HIV infection. The problems of combating HIV infection are included in the state program of healthcare development of the Republic of Kazakhstan for 2020-2025.

Incorporation of awareness programs into a model of the spread of HIV/AIDS among people who inject drugs

AbstractMathematical modeling techniques have been used extensively during the human immunodeficiency virus (HIV) epidemic. Drug injection causes increased HIV spread in most countries globally. The media is crucial in spreading health awareness by changing mixing behavior. The published studies show some of the ways that differential equation models can be employed to explain how media awareness programs influence the spread and containment of disease (Greenhalgh et al. Appl Math Comput. 2015;251:539–563). Here we build a differential equation model which shows how disease awareness programs can alter the HIV prevalence in a group of people who inject drugs (PWIDs). This builds on previous work by Greenhalgh and Hay (1997) and Liang et al. (2016). We have constructed a mathematical model to describe the improved model that reduces the spread of the diseases through the effect of awareness of disease on sharing needles and syringes among the PWID population. The model supposes that PWIDs clean their needles before use rather than after. We carry out a steady state analysis and examine local stability. Our discussion has been focused on two ways of studying the influence of awareness of infection levels in epidemic modeling. The key biological parameter of our model is the basic reproductive number . is a crucial number which determines the behavior of the infection. We find that if is less than one then the disease‐free steady state is the unique steady state and moreover whatever the initial fraction of infected individuals then the disease will die out as time becomes large. If exceeds one there is the disease‐free steady state and a unique steady state with disease present. We also showed that the disease‐free steady state is locally asymptotically stable if is less than one, neutrally stable if is equal to one and unstable if exceeds one. In the last case, when is greater than one the endemic steady state was locally asymptotically stable. Our analytical results are confirmed by using simulation with realistic parameter values. In nontechnical terms, the number is a critical value describing how the disease will spread. If is less than or equal to one then the disease will always die out but if exceeds one and disease is present the disease will sustain itself and moreover the numbers of PWIDs with disease will tend to a unique nonzero value.

Common factors in HIV/AIDS prevention success: lessons from Thailand

BackgroundThailand has achieved global acclaim for its response to HIV/AIDS. However, the success of some of the country’s most well-known initiatives was by no means a foregone conclusion. Policy entrepreneurs on the periphery of power had to achieve buy-in from stakeholders in state and society to scale and mainstream their ideas. This paper offers a comparative and historical understanding the process by which three of the country’s most well-known initiatives came into being: a civil society campaign to promote condom usage; a Ministry of Public Health program that aimed to prevent the spread of Human Immunodeficiency Virus (HIV) by targeting high-risk populations (the 100% condom program); and a universal Prevention of Mother-To-Child Transmission (PMTCT) program.MethodsThe research relied on existing literature and interviews with high-ranking ministerial officials, representatives from international and non-governmental organizations, professors, and philanthropic organizations, in addition to a review of the existing literature. Taking a comparative and historical approach that is common within political science and sociology, we analysed the in-depth qualitative interviews in relation to the literatures and used an inductive cross-case analysis aimed to draw out critical features that the initiatives shared in common.ResultsCommon factors in HIV/AIDS prevention that cut across the three key cases include policy entrepreneurs who championed the programs, successful demonstration projects that produced a credible evidence base for policy adoption, and a diverse set of institutional partners that played critical roles in helping to mainstream their initiatives into national HIV/AIDS policy and scale programs nationally. The findings from this comparative research project have implications not only for the building of understanding related to one single project, but for broader theoretical understanding related to the mainstreaming of health policy from peripheral spaces of power.ConclusionsThis analysis draws out the role that demonstration projects played in building a credible evidence base for policy adoption and the role that a diverse set of institutional partners played in elevating the profile of policy entrepreneurs’ ideas and helping to scale them nationally as state policy. Success was contingent on entrepreneurs first identifying and then taking advantage of different political opportunities that arose during each of the historical periods. Over time, these initiatives have evolved from vertical programs into an integrated program, in parallel with the evolution of the HIV/AIDS landscape at the global level.

Could Vhavenda initiation schools be a panacea for HIV and AIDS management in the Vhembe district of South Africa?

Several human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) prevention strategies have been implemented to counteract the impact of the disease, including the use of condoms, social marketing, testing, voluntary counselling and education programmes. One of the platforms which has not been fully explored is that of traditional initiation schools. This study aimed to explore and discuss Vhavenda traditional initiation schools, which can be used as panacea for HIV and AIDS management in the Vhembe district of South Africa. This ethnographic study was conducted in the Vhembe district of South Africa, among nine purposively sampled key informants drawn from a cohort of Vhavenda traditional healers and leaders. Data were collected using semistructured face-to-face interviews and analysed using ethnographic content analysis. The results indicate that Vhavenda traditional initiation schools positively affect the management of HIV and AIDS. Initiation schools are centres for cultural education and the formation of a cultural identity. During the initiation process, initiates are taught social norms, customs and values which will serve them well in adulthood. They are also taught matters of sexuality, courtship, marriage and respect for others. The positive attributes of Vhavenda initiation schools should be accommodated and implemented in curricula from the primary school level up to the tertiary level to reduce and curb the spread of HIV infection.Contribution:Improved expertise at the initiation schools will aid the Department of Health and Education and Training to develop and implement suitable cultural contextualised HIV and AIDS prevention strategies.

Evasion of cGAS and TRIM5 defines pandemic HIV

Of the 13 known independent zoonoses of simian immunodeficiency viruses to humans, only one, leading to human immunodeficiency virus (HIV) type 1(M) has become pandemic, causing over 80 million human infections. To understand the specific features associated with pandemic human-to-human HIV spread, we compared replication of HIV-1(M) with non-pandemic HIV-(O) and HIV-2 strains in myeloid cell models. We found that non-pandemic HIV lineages replicate less well than HIV-1(M) owing to activation of cGAS and TRIM5-mediated antiviral responses. We applied phylogenetic and X-ray crystallography structural analyses to identify differences between pandemic and non-pandemic HIV capsids. We found that genetic reversal of two specific amino acid adaptations in HIV-1(M) enables activation of TRIM5, cGAS and innate immune responses. We propose a model in which the parental lineage of pandemic HIV-1(M) evolved a capsid that prevents cGAS and TRIM5 triggering, thereby allowing silent replication in myeloid cells. We hypothesize that this capsid adaptation promotes human-to-human spread through avoidance of innate immune response activation.

The technology of intelligent analysis in predicting the epidemiological situation of hiv infection in the west kazakhstan region

The article uses the main directions of development of mathematical modeling of control and spread of human immunodeficiency virus (HIV infection), dynamic and structural classification of the epidemic process. Statistical data on the West Kazakhstan region for the period 2010-2020 were taken from the regional center for the prevention and control of AIDS of the health department of the Akimat of the West Kazakhstan region, with a description of the spread of the virus, depending on the available data and tasks in the world and in the Republic of Kazakhstan, a retrospective, cluster analysis of HIV-infected people was carried out. The characteristics of the morbidity schedule are given, the risk is identified, statistical forecasts of morbidity are checked. In scientific and practical studies, the prevalence of criteria and observations of the epidemic was considered from the information technology side. Examples are given using a forecasting system and existing intelligent mathematical model systems. One of the important directions is the prediction of the consequences of the HIV epidemic, the study of immunological dynamics within one organism, the problem of predicting the development of the epidemic situation at the population level. Data Mining classification methods were used to process HIV-infected people and analyze the situation by age characteristics. The prognosis of the morbidity of the West Kazakhstan region by the age group of HIV-infected people over a 10-year period was carried out using the Statistica application software package.

Exploring Projections for HIV Infection with Pre-Exposure Prophylaxis Usage in a High-Risk Population

Prevention of type-1 human immunodeficiency virus (HIV) infections has primarily been through condom usage, abstinence, and behavioral and risk awareness programs. Pre-exposure prophylaxis (PrEP) medications became approved for infection prevention in 2012. Mathematical models exploring the projections and impacts of PrEP on the spread of HIV are sparse. This study develops an epidemiological model for type-1 HIV infection accounting for both PrEP and condom usage. We utilized CDC surveillance data on HIV/AIDS statistics to develop a susceptible, infected, AIDS numerical model containing PrEP, condoms, and the combination of both. We explore projections with the percentages of PrEP usage held constant and the impact of average annual sexual partners. We find when 70% of the high-risk population uses PrEP properly with an average of 2 sexual partners per year, the eventual infected percentage drops to about 15%. In contrast, when PrEP is not used correctly and with 4 partners per year the total eventual infected percentage rises to 59%. PrEP can be a highly effective mitigator for the spread of HIV. However, an increased average number of sexual partners per year with improper PrEP usage can minimize the long-term effectiveness of PrEP.

Factors associated with perceived ease of access to syringes in Appalachian North Carolina.

To examine associations between perceived ease of syringe access, syringe sources, injection behaviors, and law enforcement (LE) interactions among people who inject drugs (PWID) in rural Appalachian North Carolina (NC). Using respondent-driven sampling, a diverse sample of 309 self-reported PWID were recruited from rural Appalachian NC. Data were collected via audio computer-assisted self-interview technology from February 2019 through March 2020. Respondents reported demographics, sources of syringes, LE interactions, and injection behaviors. Univariate, bivariate, and linear regression analyses were performed. Respondents most often obtained syringes from pharmacies and syringe service programs (SSPs). Twenty-one percent disagreed that it was easy to obtain sterile syringes, with 28% reporting low or no access to an SSP. PWID who reported longer physical distances to an SSP had greater difficulty accessing syringes (P<.001). PWID who reported greater ease of access to syringes reported engaging in receptive syringe sharing less often (P<.01). PWID who were stopped and searched by LE more often reported injecting drugs somebody else prepared with nonsterile supplies more often (P<.01). Participants shared used injection supplies more than twice as often than they shared used syringes. These results underscore the importance of SSPs to mitigate the spread of human immunodeficiency virus and viral hepatitis in rural areas. Supporting mobile SSP services in rural areas could increase access to sterile syringes and injection supplies. SSPs should educate PWID about the importance of not sharing injection supplies. Pharmacies could increase syringe access in areas where SSPs do not operate.

Sex Differences in Injection Drug Risk Behaviors Among Hospitalized Persons.

As opioid use increases, it remains important to assess factors that contribute to injection drug risk behaviors, as sharing needles and other drug use equipment contributes to the spread of human immunodeficiency virus and hepatitis C virus. Such risks may differ by sex and injecting with others. The current study examined factors that contribute to increased injection drug risk separately for men and women. People who inject drugs were recruited at an academic safety-net hospital that reported recent injection drug use. Two main injection outcomes were assessed: (1) human immunodeficiency virus drug risk behaviors as assessed by the Risk Assessment Battery and (2) the number of times participants injected drugs with a needle used by someone else. For each outcome, different models for women and men were conducted to detect differences by sex. Both men and women were more likely to inject with a needle used by someone else if they used drugs within a sexual relationship (incidence rate ratio (IRR) = 14.61, P < 0.01; IRR = 7.17, P < 0.05). Being employed was associated with lower risk assessment battery scores among men, and lower mean rates of using a needle used by someone else among women (IRR = 0.22, P < 0.05). Women with post-traumatic stress disorder (PTSD) and men with higher depression scores had higher rates of injecting with a needle used by someone else. People who inject drugs who are in intimate relationships report higher injection drug risk behaviors. We found benefits to employment among both men and women. Identifying factors associated with increased injection risk behaviors can be useful for creating interventions tailored by sex.

Factors associated with treatment outcome of multidrug-resistant tuberculosis patients co-infected with human immunodeficiency virus in a Drug Resistant Tuberculosis Centre

Background: Tuberculosis is one of the major public health problem, further complicated by the relentless spread of human immunodeficiency virus (HIV). The incidence of drug resistant TB among HIV patients is now increasing. Treatment outcomes in multidrug-resistant tuberculosis (MDR-TB) patients co-infected with HIV is poorly documented. Objectives: Assessed the treatment outcome of MDR-TB co-infected with HIV treated under programmatic management of drug resistant tuberculosis. Methods: The study was conducted in Department of Respiratory Medicine, Princess Krishnajammanni Tuberculosis and Chest Diseases (PK TB &amp; CD) Hospital, Mysore Medical College and Research Institute (MMCRI), Mysore. It is a retrospective study done on patients who were admitted in DRTB center of PK TB &amp; CD hospital, Mysore for initiation of treatment from January 2013 to December 2019. Results: Among the 63 patients studied, 26 patients (41.3%) had a favorable outcome with cure and treatment completed. 25 patients (39.7%) had an unfavorable outcome with death, 9 patients (14.3%) defaulted during the treatment and 2 patients (3.2%) had failure of therapy. Conclusion: Early recognition and treatment of HIV with ART and the clinical stage of the disease during presentation affect the treatment outcome in patients with MDR-TB. Keywords: tuberculosis; HIV; outcome; multidrug resistance; ART

Two strains and drug adherence: An HIV model in the paradigm of community transmission.

A two-strain model, comprising of drug-sensitive and drug-resistant strains, is proposed for the dynamics of Human Immunodeficiency Virus (HIV) spread in a community. A treatment model is introduced by taking drug adherence into account. The treatment-free model is analyzed for the effect of treatment availability and drug adherence on disease dynamics. The analysis revealed that for the treatment-free model, at least one strain faces competitive exclusion, and co-existence of both strains is not possible. On the contrary, both strains may co-exist in presence of treatment. The analysis carried out was both local, as well as global. A comprehensive bifurcation analysis showed periodic behaviour and all solutions approached a stable limit cycle for a wide range of parametric values. Overall, we concluded that the treatment availability and drug adherence play a significant role in determining the dynamics of HIV spread. Numerical simulations are performed to validate the analytical results using MATLAB.

The role of nonprescription syringe sales in ending the human immunodeficiency virus epidemic

In 2019, the executive branch of the United States released “Ending the Human Immunodeficiency Virus (HIV) Epidemic: A Plan for America” (EHE). EHE proposes to end the HIV epidemic in the United States by 2030. To do so requires a multifaceted effort from all health care providers addressing every possible avenue of HIV transmission. An important aspect of this mission is to increase access to sterile syringes for people who inject drugs (PWID). For many PWID, access to Syringe Service Programs is limited because of hours, location, and state laws. Pharmacies are able to provide clean syringes in a safe, clean, climate-controlled atmosphere with access to a health professional. Although published research shows pharmacist ambivalence toward the nonprescription sales of syringes, pharmacist involvement in states with established guidance and support from departments of health suggests that pharmacists are interested in this public health effort. However, without proper support from departments of health and access to training on the dignified delivery of services, pharmacies will continue to be an ineffective avenue for prevention of HIV spread through the provision of sterile syringes.

The Analysis of Transfusion Transmitted Infections (TTIs) in Thalassemia Patients

Objective: To find out the analysis of transfusion transmitted infections (TTIs) in β-thalassemia patients at a tertiary care hospital of South Punjab, Pakistan. Study Design: A cross-sectional study. Place and Duration of the Study: The Department of Hematological Disorder, Thalassemia and Bone Marrow Transplantation Centre, and Department of Biochemistry, “Bahawal Victoria Hospital, Quaid e Azam Medical College”, Bahawalpur, Pakistan from February January 2020 to December 2021. Methodology: Patients of blood transfusion-dependent 𝛽-thalassaemia of both genders and aged 5 to 12 years were analyzed. Blood was collected from patients aseptically and serum separated in Eppendorf tubes and stored at –200C. Screening for hepatitis C virus (HCV), hepatitis B virus (HBV), syphilis and human immunodeficiency virus (HIV) were performed through Chemiluminescence Immunoassay (CLIA) technique. Results: In a total of 1212 patients, 745 (61.5%) were male. Overall, mean age was calculated to be 8.7±4.6 years while 874 (72.1%) patients were below 10 years of age. There were 866 (71.5%) patients who belonged to rural areas of residence. Parental consanguineous marriages were reported in 951 (78.5%) cases. There were 205 (16.9%) patients who were found to have TTIs. Out of these 205 patients, 169 (13.9%) were having HCV, 11 (0.9%) HBV, 20 (1.7%) syphilis whereas HIV was noted in 5 (0.4%) patients. Conclusion: Prevalence of TTIs was found to be high among multi-transfused patients of β-thalassemia. Most common types of TTIs were HCV which is consistent to what has previously been reported in the local literature. Identification of HIV in 0.5% cases in the present study is pointing towards disturbing development regarding spread of HIV in our region. Keywords: β-thalassemia, blood transfusion, hepatitis C, hepatitis B, human immunodeficiency virus.