Stages Of Human Immunodeficiency Virus Infection Research Articles

Alterations in local activity and whole-brain functional connectivity in human immunodeficiency virus-associated neurocognitive disorders: a resting-state functional magnetic resonance imaging study.

Approximately half of human immunodeficiency virus (HIV) patients experience HIV-associated neurocognitive disorders (HAND); however, the neurophysiological mechanisms underlying HAND remain unclear. This study aimed to evaluate changes in functional brain activity patterns during the early stages of HIV infection by comparing local and global indicators using resting-state functional magnetic resonance imaging (rs-fMRI). A total of 165 people living with HIV (PLWH) but without neurocognitive disorders (PWND), 173 patients with asymptomatic neurocognitive impairment (ANI), and 100 matched healthy controls (HCs) were included in the study. A cross-sectional study of the participants was conducted. The metrics of functional segregation and integration were computed, using graph theory to explore differences across methodologies. Brain functional changes in the PWND and ANI groups were assessed, and correlations between the rs-fMRI metrics, clinical data, and cognitive function were examined. As cognitive function declined, changes reflected by regional homogeneity (ReHo) were primarily observed in the default mode network (DMN). In the DMN and visual network (VIS), amplitude of low-frequency fluctuation (ALFF) decreases were mainly observed in the parieto-occipital lobes, while increases were mainly observed in the limbic network (LIM). Reductions in fractional ALFF (fALFF) were mainly observed in the somatomotor network (SMN) and LIM, while increases were observed in the DMN and LIM. Unlike local indicators, global functional connectivity (FC) significantly decreased in both the PWND and ANI groups compared to the HC group. The ANI group showed partial increases in FC compared to the PWND group, with major changes observed in the DMN, VIS, and LIM. Notably, FC between the right insula and right supramarginal gyrus decreased significantly following HIV infection, while FC between the right caudate nucleus and the left middle frontal gyrus declined further in the ANI group. Graph theory further confirmed the significance of the DMN, and revealed changes in the eigenvector centrality mapping (ECM) values of the frontoparietal network (FPN) and dorsal attention network (DAN). HIV patients exhibit complex changes in both local and global brain activity, regardless of cognitive impairment. Widespread abnormalities primarily involve the DMN, VIS, and LIM. Changes in FC along the fronto-striatal pathway may play a crucial role in the decline of cognitive function in individuals with HAND. Our findings provide new insights that may assist in the early detection of brain damage in the early stages of HIV infection. The use of multiple methodologies may offer a more comprehensive and effective approach, enabling the early detection of brain damage in HIV patients.

HIV capsids: orchestrators of innate immune evasion, pathogenesis and pandemicity.

Human immunodeficiency virus (HIV) is an exemplar virus, still the most studied and best understood and a model for mechanisms of viral replication, immune evasion and pathogenesis. In this review, we consider the earliest stages of HIV infection from transport of the virion contents through the cytoplasm to integration of the viral genome into host chromatin. We present a holistic model for the virus-host interaction during this pivotal stage of infection. Central to this process is the HIV capsid. The last 10 years have seen a transformation in the way we understand HIV capsid structure and function. We review key discoveries and present our latest thoughts on the capsid as a dynamic regulator of innate immune evasion and chromatin targeting. We also consider the accessory proteins Vpr and Vpx because they are incorporated into particles where they collaborate with capsids to manipulate defensive cellular responses to infection. We argue that effective regulation of capsid uncoating and evasion of innate immunity define pandemic potential and viral pathogenesis, and we review how comparison of different HIV lineages can reveal what makes pandemic lentiviruses special.

Pansitopenia as a Marker of Advanced Human Immunodeficiency Virus (HIV) infection: How Often? A Case Study Accompanied by Literature

Pansitopenia is a condition characterized by anemia, thrombocytopenia, and leukopenia. One of the common etiologies of Pansitopenia is HIV infection. In advanced HIV, Pansitopenia may present even without other clinical findings leading to a diagnosis of HIV. This study was conducted as a case study of a 34-year-old man who presented with chief complaints of chronic diarrhea and fever that lasted for one month. Laboratory examination showed Pansitopenia, HIV-rapid reactive and peripheral blood picture indicating Pansitopenia/ aplastic anemia. Data were collected through history taking, physical examination, and a series of laboratory tests. The patient was diagnosed with Pansitopenia suspected to be caused by HIV infection. The chief complaints of chronic diarrhea and fever suggested a chronic disease process due to immune compromise, as seen in the patient's clinical status indicating advanced HIV. The literature suggests that the severity of pansitopenia depends on the severity of HIV disease. Pansitopenia can be an indicator of the advanced stage of HIV infection. Appropriate management and regular monitoring are essential to prevent further complications. Pansitopenia in HIV patients can be considered as an important indicator to assess the severity of the infection. Prompt treatment and antiretroviral therapy are highly recommended to improve the prognosis of patients.

Quantitatively assessed blood leukocyte Epstein–Barr virus in adult HIV-infected patients

Coinfection with the human immunodeficiency virus (HIV) and Epstein–Barr virus (EBV) represents a current biomedical problem. The purpose of the study was to evaluate blood leukocyte EBV detection rate and viral load in adult HIV-infected patients. Materials and methods. There were examined blood leukocytes collected from 138 HIV(+) and 68 HIV(–) individuals aged 20–69 years. Statistical analysis was carried out differentiated according to the stages of HIV infection, the CD4+ T-lymphocyte count, and adherence to antiretroviral therapy. Results. It was shown that EBV DNA was detected significantly more often in HIV(+) vs HIV(–) individuals (70.3±3.9% and 48.5±6.1%, p = 0.008), with EBV viral load comprising 18 [5; 139] versus 2 [1; 3] copies/105 cells (р 0.001), respectively. It has been shown that the group of HIV(+) patients is heterogeneous in the frequency of EBV detection and viral load, with the peak EBV frequency (86.7±6.2%) and DNA (121 [34; 252] copies/105 cells) level observed in “naive” patients with severe immunodeficiency. Among “experienced” patients receiving therapy, the relative risk of detecting EBV DNA with low treatment adherence was significantly higher compared to those who developed high adherence (р 0.05). When the HIV viral load reached undetectable level, EBV DNA concentration was significantly lower where HIV RNA was detectable (1 [0; 8] versus 15 [1; 162] copies/105 cells, р 0.001). Detection of EBV DNA is associated with higher HIV viral load level and lower CD4+ T-lymphocyte count compared to patients with undetected EBV DNA. A relationship has been established between the CD4+ T-lymphocyte count in HIV(+) patients and the likelihood of active EBV infection. A threshold cut-off of 200 cells/μl was determined. CD4+ T-lymphocyte count 200 cells/μl vs ≥ 200 cells/μl (р 0.001) is associated with a 3.3-fold higher risk of detecting active EBV infection. Conclusion. It is necessary to continue interdisciplinary research to improve early diagnostics of EBV-associated diseases in HIV-infected individuals.

Exploring salivary metabolome alterations in people with HIV: towards early diagnostic markers.

The human immunodeficiency virus (HIV) remains a critical global health issue, with a pressing need for effective diagnostic and monitoring tools. This study explored distinctions in salivary metabolome among healthy individuals, individuals with HIV, and those receiving highly active antiretroviral therapy (HAART). Utilizing LC-MS/MS for exhaustive metabolomics profiling, we analyzed 90 oral saliva samples from individuals with HIV, categorized by CD4 count levels in the peripheral blood. Orthogonal partial least squares-discriminant analysis (OPLS-DA) and other analyses underscored significant metabolic alterations in individuals with HIV, especially in energy metabolism pathways. Notably, post-HAART metabolic profiles indicated a substantial presence of exogenous metabolites and changes in amino acid pathways like arginine, proline, and lysine degradation. Key metabolites such as citric acid, L-glutamic acid, and L-histidine were identified as potential indicators of disease progression or recovery. Differential metabolite selection and functional enrichment analysis, combined with receiver operating characteristic (ROC) and random forest analyses, pinpointed potential biomarkers for different stages of HIV infection. Additionally, our research examined the interplay between oral metabolites and microorganisms such as herpes simplex virus type 1 (HSV1), bacteria, and fungi in individuals with HIV, revealing crucial interactions. This investigation seeks to contribute understanding into the metabolic shifts occurring in HIV infection and following the initiation of HAART, while tentatively proposing novel avenues for diagnostic and treatment monitoring through salivary metabolomics.

Lung infections in HIV-infected children: imaging pattern recognition and its correlation with CD4 counts

ContextChildren with human immunodeficiency virus (HIV) infection frequently present with opportunistic infections of the lung that may be associated with high mortality rate. There is no study, to the best of our knowledge, correlating specific radiographic patterns of chest infections with CD4 levels of immunity in HIV-infected children of Indian subcontinent (where prevalence of respiratory tuberculosis is very high).AimsTo study the radiological patterns of chest infections in HIV-infected children, and to correlate these radiological findings with CD4 cell count and final diagnosis.MethodsForty-five HIV-infected children (1–18 years of age) with suspected chest infections were included in the study. The baseline and the most recent CD4 counts were recorded for each patient. Chest X-ray (CXR) was obtained in all the patients, and multi-detector computed tomography (MDCT) chest was done in 27 patients having clinical suspicion of infection with normal or equivocal findings on CXR. Chest radiographs and MDCT chest were analyzed for different radiological patterns of chest infections. Imaging findings were correlated with CD4 count range for disease spectrum. The final etiopathological diagnosis was achieved in combination with clinico-radiological findings, laboratory data, cytohistopathology and follow-up imaging.ResultsOut of 45 children confirmed to be HIV-infected, 27 (60%) had bacterial infection, 14 (31.11%) had tuberculosis, and four (8.89%) had fungal infection.Consolidation on CXR/CT strongly suggested bacterial etiology (P < 0.05). Mediastinal/hilar lymphadenopathy (with or without necrosis) strongly suggested tubercular etiology (P value < 0.05). Diffuse GGO/haziness on CXR/CT strongly suggested fungal etiology (P value < 0.05).On correlation with CD4 count (cells/mm3), the bacterial infections occurred at early stages of HIV infection when immune status was relatively preserved, and most of the patients with tubercular infection had moderate immunosuppression. On the other hand, all patients of fungal infection showed severe immunosuppression.ConclusionA wide spectrum of pulmonary disease encountered in HIV-infected children warrants an integrated approach of image interpretation. Familiarity with the imaging patterns, combined with relevant clinical/laboratory details, may greatly help to improve the diagnostic confidence and to reach to a more meaningful differential diagnosis.

Basic aspects of pathophysiology, diagnosis and treatment of patients with pulmonary arterial hypertension associated with human immunodeficiency virus infection: what has been achieved and what remains to be achieved?

Human immunodeficiency virus (HIV) infection is characterized by high morbidity and is a significant threat to human health, increasing global mortality. The number of people living with HIV infection is estimated by the United Nations Joint Program on Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (UNAIDS) to be 39 million (33.1-45.7 million) in 2022. With the introduction of highly effective antiretroviral therapy (cART) into clinical practice and the resulting increase in life expectancy in this cohort of patients, HIV-associated complications have come to the forefront, among which the most severe is pulmonary arterial hypertension (PAH), characterized by a progressive increase in pulmonary vascular resistance and pulmonary artery pressure, leading to the development of right ventricular failure. Subsequently, it became evident that this pathology can occur at all stages of HIV infection and, apparently, has no clear relationship with the degree of immunodeficiency, and is an independent predictor of mortality in patients with LAH-HIV, and therefore requires separate, close attention. This article provides an overview covering the basic pathophysiology, clinical manifestations, diagnosis and treatment of HIV-associated LAH (LAHHIV), emphasizing the challenges encountered at each stage. The review also considers current aspects aimed at studying LAH in patients with HIV, including new experimental drug therapies that take into account the interaction of different regimens with LAH-specific drugs.

HIV Serodiscordance: Diagnosis Problem in the Douentza Heath District

Summary: Human immunodeficiency virus (HIV) is an infection that attacks the body's immune system. The most advanced stage of HIV infection is acquired immunodeficiency syndrome (AIDS). HIV is spread through the body fluids of an infected person, including blood, breast milk, semen, and vaginal fluids. Observation: These were 2 patients who had been consulted for a transfusion during which routine screening was carried out. Faced with divergent results, the hypothesis of a serodiscordance was raised. Series of tests carried out came back sometimes Negative and sometimes positive. It was the result of the PCR which made it possible to conclude that it was negative for HIV infection. These results had an impact on the psychological state of donors and could contribute to raising questions on the quality, specificity and/or sensitivity of current tests? On the interaction of one or more viral markers of another unknown viral pathology? And on the other hand on a possible genetic predisposition of these blood donors? Conclusion: HIV is a preventable disease. Awareness campaigns and promotion of early detection are effective ways to reduce transmission.

Profile of Syphilis Risk Factors in The Productive Age Group at Dermatology and Venereology Clinic RSUD DR. Saiful Anwar, Malang Indonesia

Syphilis is a sexually transmitted infection that has the potential to cause serious complications and is closely related to the human immunodeficiency virus (HIV) infection, thus making syphilis a major public health problem. Understanding the characteristics of risk factors could be used to prevent future transmission and occurrences of syphilis. This study aimed to determine the demographic data and risk factors of syphilis in productive age at the Dermatology and Venereology Clinic, RSUD. DR. Saiful Anwar, Malang, Indonesia. This study used a descriptive approach using secondary data from the medical records of syphilis patients from January to December 2021. Sample collection was carried out using a total sampling technique. Twenty medical records that met the inclusion criteria were included, all of which belonged to the productive age group. The majority of the sample were male (70%), aged 17-25 years (45%) and 26-35 years (45%), had a high school education (55%), were private sector workers (40%), were unmarried (70%), had anogenital sexual activity (50%), never used condoms (50%), had more than one sexual partner (85%), were in the primary stage of syphilis (35%), and were HIV positive. Among male patients with syphilis-HIV coinfection, 80% of cases were homosexual. The risk factors for syphilis at a productive age include anogenital intercourse, irregular condom use, multiple sexual partners, the primary stage of syphilis, HIV infection, and homosexuality. A program focused on detecting and treating syphilis among people living with HIV/AIDS, especially those in high-risk populations such as men who have sex with men (MSM), is needed.

Intestinal Microbiota Dysbiosis Promotes Mucosal Barrier Damage and Immune Injury in HIV-Infected Patients

The intestinal microbiota is an “invisible organ” in the human body, with diverse components and complex interactions. Homeostasis of the intestinal microbiota plays a pivotal role in maintaining the normal physiological process and regulating immune homeostasis. By reviewing more than one hundred related studies concerning HIV infection and intestinal microbiota from 2011 to 2023, we found that human immunodeficiency virus (HIV) infection can induce intestinal microbiota dysbiosis, which not only worsens clinical symptoms but also promotes the occurrence of post-sequelae symptoms and comorbidities. In the early stage of HIV infection, the intestinal mucosal barrier is damaged and a persistent inflammatory response is induced. Mucosal barrier damage and immune injury play a pivotal role in promoting the post-sequelae symptoms caused by HIV infection. This review summarizes the relationship between dysbiosis of the intestinal microbiota and mucosal barrier damage during HIV infection and discusses the potential mechanisms of intestinal barrier damage induced by intestinal microbiota dysbiosis and inflammation. Exploring these molecular mechanisms might provide new ideas to improve the efficacy of HIV treatment and reduce the incidence of post-sequelae symptoms.

Early drug-induced hepatotoxicity in newly diagnosed HIV-positive patients on ARV therapy: A retrospective follow-up study of liver function profiles

Antiretroviral therapy (ART) is a primary therapeutic modality for managing individuals with Human Immunodeficiency Virus (HIV) infection, and its efficacy has been established. However, the safety profiles of ART need to be continually monitored, including early elevated liver function test (LFT) after antiretroviral (ARV) initiation. This study aimed to assess the incidence of abnormal LFT among HIV-positive patients receiving initial ARV and to identify factors associated with abnormal LFT. A retrospective cohort study without a control group summarised medical records from Dr Sardjito General Hospital, Yogyakarta between January 2014 and December 2021. The study subjects were adult HIV patients taking their first ARV and underwent follow-up visits for at least two weeks. Study outcomes were LFT levels, abnormal LFT, and factors associated with abnormal LFT during follow-up visits at 2 wk, 6 mo, and 12 mo. Univariate and multivariate analyses will be performed with a significance level of p&lt;0.05. A total of 137 subjects with 203 visits were retrieved from medical records. The subjects' mean age was 33.4 years, predominantly male, younger, unmarried, in the early stage of HIV infection, and without comorbidities. The findings showed a significant increase in alanine transaminase (ALT) at all three follow-up visits: 2 wk (p=0.02), 6 mo (p=0.003), 12 mo (p=0.001) and an increase in aspartate aminotransferase (AST) after 6 mo (p=0.007) and 12 mo (p=0.04). Abnormal LFT levels (AST and/or ALT) were observed in 23.4% of patients after a normal baseline, with ALT increase being more common. Furthermore, homosexuality was identified as a significant independent factor associated with abnormal LFT (AOR=3.1; 95% CI 1.27-7.51; p=0.01). The findings indicate exceptionally elevated LFT levels and the occurrence of abnormal LFTs among HIV-positive patients initiating ARVs. The increase in abnormal LFTs was significantly associated with patients identifying as homosexual, where hepatitis co-infection may be a contributing factor. The limited study design and measured variables warrant further investigation.

New Potential MicroRNA Biomarkers in Human Immunodeficiency Virus Elite Controllers, Human Immunodeficiency Virus Infections, and Coinfections with Hepatitis B Virus or Hepatitis C Virus

Introduction: This research aimed to evaluate the specific microRNA (miRNA) including miR-17-5p, miRN-140-3p miR-191-5p, miR-200c-3p, and miR-N367 and cellular factors (p21, SDF-1, XCL1, CCL-2, and IL-2) in controlling replication of human immunodeficiency virus (HIV) in ECs. Methods: The expression of miRNAs was assessed between healthy control groups and patient groups including ART-naïve HIV, HIV ART, ECs, and coinfection (HIV-HBV and HIV-HCV) via real-time PCR technique. Besides, the expression level of the nef gene and cellular factors were assessed by the ELISA method. The differences in the level of cellular factors and selected miRNAs between study groups were analyzed using the Kruskal-Wallis H or one-way ANOVA test. In addition, the potential of selected miRNAs as biomarkers for discriminating study groups was assessed by the receiver-operator characteristic (ROC) curve analysis. Results: Some miRNAs in ECs, HIV ART, and healthy controls have similar expression patterns, whereas a miRNA expression profile of patient groups significantly differed compared to EC and control groups. According to ROC curve analyses, the miR-17-5p, miR-140-3p miR-191-5p, miR-200c-3p, and miR-N367 can be served as biomarkers for discriminating ECs from ART-naïve HIV-infected groups. There was a significant correlation between some miRNAs and cellular factors/the viral load as well. Conclusion: This report demonstrated a differentiation in the expression of selected immunological factors and cellular/viral miRNAs in ECs compared to other patient groups. Some miRNAs and cellular factors are involved in the viral replication control, immune response/modulation and can be used as biomarkers for diagnosis of ECs and differentiation with other groups. Differential expression of these miRNAs and cellular factors in different stages of HIV infection can help in finding novel ways for infection control.

Estimation of Serum Levels of AST, LDH, CKMB AND TCK Among HIV Patients on HAART, HAART Naïve and Controls

Human Immunodeficiency virus (HIV) infection is associated with increased of developing heart disease. Information on the cardiac status of HIV-infected Nigerians is lacking. HIV/AIDS infection is a global pandemic and poses a serious health challenge in sub-Saharan Africa, Nigeria inclusive. The cardiac disease may occur at any stage of HIV infection, but important manifestations are more frequent with advanced immunodeficiency. Moreover, it has been reported that complications from HIV infection include arrhythmias, heart failure myocardial infarction and coronary heart disease. This study aimed to estimate serum levels of AST, LDH, CKMB and TCK among HIV patients on HAART, HAART naïve and controls subjects attending Bauchi State Tertiary hospital, Nigeria. The results showed that the mean serum total Creatine kinase, CK-MB, LDH and AST were significantly higher in HIV participants not on HAART compared with HIV participants on HAART at P&lt;0.05 respectively. Similarly, the mean serum total Creatine kinase, CK-MB, LDH and AST were significantly higher in symptomatic HIV participants not on HAART compared with HIV seronegative control subjects at P&lt;0.05 in each case. Once again, the mean serum total Creatine kinase, CK-MB, LDH and AST were significantly higher in asymptomatic HIV participants compared with HIV seronegative control subjects at P&lt;0.05 respectively. Increased levels of some cardiac markers were seen in HIV-infected participants. The study reveals that there is a need to monitor these parameters to prevent sudden cardiovascular complications in HIV seropositive patients. Hence, it is recommended that more investigations need to be carried out to further evaluate the levels of CK-MB (cardiac-specific) isoenzyme of CK and other cardiac biomarkers such as troponins I and T, and myoglobin, among others.

Correlation of Whole Blood Zinc Levels, CD4 Cell Count, Disease Stage, and Dermatologic Manifestations Among HIV Patients: A Single Center Experience in Philippines

Objective: Zinc deficiency is the most common micronutrient abnormality seen in human immunodeficiency virus (HIV) infection. Depletion of CD4 cells is a hallmark of HIV infection. The study aims to determine the association between whole blood zinc levels and CD4 cell count and stage of HIV infection among patients in a tertiary hospital in the Philippines. Methods: Sixty-five newly diagnosed HIV-positive patients of the institution were recruited. Demographic profile, whole blood zinc levels, CD4 cell count level, HIV disease stage, and presence of any dermatologic manifestations were noted. Prevalence of zinc deficiency and correlation between whole blood zinc levels and CD4 cell count were determined. The data were analyzed by chi-square and pearson correlation analysis. Results: Among the 65 patients, overall zinc deficiency was noted at 33.8%. Low CD4 count and HIV disease stage IV participants had the highest percentage of zinc deficiency at 54.6% and 50%, respectively. A correlation coefficient at r = 0.3364 was noted between whole blood zinc levels and CD4 cell count (P = 0.006). Twenty-nine patients presented with dermatologic manifestations, with 10 patients being zinc deficient. Conclusion: A weak positive correlation was seen between zinc levels and CD4 count. There is an increasing frequency of zinc level deficiency with a higher HIV disease stage. Dermatologic manifestations of HIV may be present in both patients with normal and deficient zinc levels.

Cardiovascular pathology in HIV infection

Currently, there are indications of an increase in the incidence of cardiovascular pathology in patients with HIV infection in comparison with population data and a higher mortality rate from cardiovascular diseases. The problem of detecting the pathology of the cardiovascular system in patients infected with the human immunodeficiency virus (HIV) is relevant due to the increase in the number of HIV-positive individuals and the established effect of HIV infection on the circulatory organs. In order to identify cardiovascular pathology, two patients with stages III and IV of HIV infection were extensively examined. The examination was carried out using electrocardiography, echocardiography and ultrasound dopplerography. Both clinical cases are presented below, in which pronounced cardiovascular pathology was detected in both cases. As factors influencing the development of pathology of the cardiovascular system, based on the presented clinical examples, drug addiction (long-term intravenous use of surfactants) and pathologies of other internal organs in the development of HIV-mediated opportunistic diseases are considered. Analysis of the course of the disease showed that the lesion can develop in various stages of HIV infection, more often infectious endocarditis is the main diagnosis in patients in stage 3 of HIV infection (the first clinical example), and dilated cardiomyopathy in the late stages of HIV infection and is considered as a concomitant pathology due to lung and kidney damage (the second clinical example).

Significance of initiating antiretroviral therapy in the early stage of HIV infection.

A growing number of guidelines now recommend that human immunodeficiency virus (HIV) infected patients should be given early antiretroviral therapy (ART), especially in acute HIV infection. ART during early infection can limit viral reservoirs and improve immune cell function. From a societal prospect, early-infected individuals who achieve a state of viral suppression through ART can reduce the chance of HIV transmission and reduce the acquired immunodeficiency syndrome (AIDS)-related disease burden. However, there are many problems in the early diagnosis and treatment of HIV infection, including personal and social factors, which hinder the implementation and development of early treatment. It is recommended that initiating ART in the early stage of HIV infection, combined with other treatment strategies, so as to achieve functional cure.

HIV Infection Predisposes to Increased Chances of HBV Infection: Current Understanding of the Mechanisms Favoring HBV Infection at Each Clinical Stage of HIV Infection.

Human immunodeficiency virus (HIV) selectively targets and destroys the infection-fighting CD4+ T-lymphocytes of the human immune system, and has a life cycle that encompasses binding to certain cells, fusion to that cell, reverse transcription of its genome, integration of its genome into the host cell DNA, replication of the HIV genome, assembly of the HIV virion, and budding and subsequent release of free HIV virions. Once a host is infected with HIV, the host’s ability to competently orchestrate effective and efficient immune responses against various microorganisms, such as viral infections, is significantly disrupted. Without modern antiretroviral therapy (ART), HIV is likely to gradually destroy the cellular immune system, and thus the initial HIV infection will inexorably evolve into acquired immunodeficiency syndrome (AIDS). Generally, HIV infection in a patient has an acute phase, a chronic phase, and an AIDS phase. During these three clinical stages, patients are found with relatively specific levels of viral RNA, develop rather distinctive immune conditions, and display unique clinical manifestations. Convergent research evidence has shown that hepatitis B virus (HBV) co-infection, a common cause of chronic liver disease, is fairly common in HIV-infected individuals. HBV invasion of the liver can be facilitated by HIV infection at each clinical stage of the infection due to a number of contributing factors, including having identical transmission routes, immunological suppression, gut microbiota dysbiosis, poor vaccination immune response to hepatitis B immunization, and drug hepatotoxicity. However, there remains a paucity of research investigation which critically describes the influence of the different HIV clinical stages and their consequences which tend to favor HBV entrenchment in the liver. Herein, we review advances in the understanding of the mechanisms favoring HBV infection at each clinical stage of HIV infection, thus paving the way toward development of potential strategies to reduce the prevalence of HBV co-infection in the HIV-infected population.

Arsenic: a Culpable Element and a Possible Menace for HIV/AIDS Patients.

Arsenic contamination has long been recognized as one of the most harmful environmental pollutants resulting from anthropogenic activity. Apart from being an environmental toxicant or pollutant, this culpable heavy metal also has detrimental effects on human health. People throughout the world are exposed to arsenic (As) mostly through polluted drinking water. Acute inorganic arsenic (iAs) poisoning causes nausea, vomiting, stomach discomfort, and severe diarrhea. As on long-term exposure is a potent carcinogen, characterized by IARC (International Agency for Research on Cancer). As levels are high mainly in Gangetic regions due to which the people living around are suffering the consequences. The carcinogenicity of As is well established but the immunotoxicity caused by it is still unknown. Some animal model supports the toxicity of As in the immune system as well, but in humans, mainly suffering from human immunodeficiency virus (HIV), it is not well established. iAs suppresses the immune system by acting on different targets and exacerbating infections. Although animal studies have demonstrated that arsenic trioxide (As2O3) reduces viral rebound and restores CD4 + count in vivo when coupled with antiretroviral medications, elemental AS may have devastating effects on the immune system of HIV patients, making them more prone to opportunistic infections (OIs). It is well known that in later stages of HIV infection, neurological problems also complicate the conditions such as cognitive impairment and AIDS dementia complex (ADC). Along with immunotoxicity, As has the potential to damage HIV patients' brains. This article addresses theimmunotoxicity of arsenic and exacerbations caused by it, along with the neurotoxicity, particularly in HIV patients residing near the Gangetic belt.

The relationship of antibodies detected in the Western Blot test with clinical and immunological stages in HIV-infected patients

Background/Aim: The laboratory diagnosis of human immunodeficiency virus (HIV) infection is based on detection of anti-HIV antibodies in an initial ELISA (enzyme-linked immunosorbent assay) test and its confirmation with the Western Blot (WB) procedure. Even though the specificity of WB is high for the detection of antibodies against various viral proteins, there are important differences in the timing of the appearance of antibody bands and intensities in different stages of HIV infection. The aim of this study was to evaluate antibodies detected in WB testing and the relationship to clinical and immunological stages in HIV-infected patients. Methods: Newly diagnosed 78 patients with HIV/AIDS (Acquired Immunodeficiency Syndrome) in our outpatient department between April 2009 and September 2012 were included in the study as a retrospective cohort. Age, gender, complaints, clinical signs, CD4+ T lymphocyte counts and HIV RNA level at diagnosis were collected retrospectively from medical records. WB band patterns obtained from the reference laboratory of the Istanbul Public Health Center were examined retrospectively. Results: Of the 78 HIV/AIDS cases, 68 (87.2%) were male. Mean age was 38.87(13.09) years (range, 17-83 years). Median CD4+ T lymphocyte count at diagnosis was 410.2 /mm³ (range, 3-1114). Mean HIV RNA level at diagnosis was 592.894 copies/ml. Rare band profiles were seen in 29.4% (23/78). According to World Health Organization (WHO) clinical staging, 59 (75.6%) patients were at stage I, 4 at stage II, 10 at stage III and 5 at stage IV. Gp120, gp160 and gp41, known as envelope glycoproteins in WB band antibodies, were seen in all patients. There was determined to be a decrease in the p17, p51, p55 and p39 bands in WB tests of the advanced grade (Grade IV) of HIV infection. Conclusions: Reduction of p17, p51, p55, p39 antibodies in advanced stages were related with the progression of HIV infection. This shows that WB test is an important parameter not only in the diagnosis of HIV infection, but also in the follow-up of clinical progression in the absence of these antibodies.

An Overview of HIV on World AIDS Day: A Short Commentary

Acquired immunodeficiency syndrome (AIDS) is caused by Human immunodeficiency virus (HIV). HIV infections cause a gradual decrease in CD4+ cells and these cells are an indicator of the immune system including the body’s natural defense system against pathogens and illness.1 AIDS is defined as the advanced stage of HIV infection with CD4 cell count less than 200/mm3. AIDS is characterized by immunosuppression which can result in several opportunistic infections, tumors, and cancers.