Use Of Antiretroviral Drugs Research Articles

Traditional complementary and alternative medicine (TCAM) use among PLHIV on antiretroviral medication

BackgroundTraditional complementary and alternative medicine (TCAM) are products and practices that differ from conventional allopathic medicine. There continues to be an increase in the use of these methods of treatment in developed and developing countries worldwide. This often owes to the perceived ability of these treatment methods to cure chronic medical conditions like HIV. However, TCAM use among PLHIV may be associated with reduced compliance with antiretroviral medications, resulting in poor viral load suppression and increased risk for opportunistic infections. The concomitant use of antiretroviral drugs and TCAM practices may be influenced by some sociodemographic and health-related factors.ObjectiveTo determine the prevalence of TCAM use and examine the sociodemographic and health-related factors associated with its use among PLHIV on antiretroviral medications at the Infectious Disease unit of Korle-Bu Teaching Hospital in Ghana.MethodsA cross-sectional study was conducted among attendants at an adult HIV clinic. 420 study participants were selected by systematic sampling. Data related to TCAM use, sociodemographic and health-related factors were collected using a standardized questionnaire and patient chart review. Multivariate logistic regression model was used to determine the association between TCAM use, sociodemographic and health-related factors.ResultsOf the 420 study participants, majority were female (76.2%) and urban community dwellers (77.9%). 77.4% of participants had been diagnosed with HIV for \\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\:\\ge\\:$$\\end{document} 5 years and had been on anti-retroviral medications for more than 5 years. The prevalence of TCAM use among PLHIV was 25.2%. No sociodemographic or HIV-related health factor was significantly associated with TCAM use in the study population.ConclusionTCAM use was high among PLHIV. No sociodemographic or health-related factor was found to be associated with TCAM use. Further studies employing a qualitative approach using key informant interviews and focused group discussions are needed to explore reasons for its use. Care providers and policy-makers should look beyond sociodemographic and health-related factors in addressing TCAM use among PLHIV.

Femoral head and acetabular necrosis combined with hip subluxation in people with HIV: a case report and literature review

IntroductionHIV is widely prevalent in all regions of the world. The use of antiretroviral drugs has dramatically reduced the mortality rate of HIV-related diseases, but correspondingly increased the incidence of chronic complications in HIV-positive people. Related studies have found that the incidence of osteonecrosis of the femoral head is higher in HIV-positive people, but the co-occurrence of femoral head necrosis, acetabular necrosis and hip joint dislocation in HIV-positive patients is rare.MethodsWe report a 50-year-old man with a 15-month history of progressively worsening right hip pain with movement restriction. According to the CT findings of the other hospital, the patient was admitted to the hospital with femoral head necrosis. After the admission, the relevant X-ray, CT and MRI examinations showed that the right femoral head collapsed and deformed, with the surrounding bone sclerosis, bone fragments, loose body of the joint, right hip subluxation, acetabular marginal osteogeny, and local microcystic degeneration. The left femoral head was in good shape, and cystic degeneration can be seen under the articular surface. The patient was finally diagnosed with femoral head necrosis and acetabular necrosis combined with hip subluxation.ResultsThe pain of the patient was significantly relieved after the operation, and the patient was discharged from the hospital one week after the start of treatment to continue rehabilitation training. During the follow-up one month after the operation, the self-reported pain disappeared completely, and the limitation of activity was significantly improved.

Evidence of Human-designated Antiretroviral (ARV) Drug Residues in Broiler Chicken, Domestic Pigs, and Animal Feeds in Tanzania.

Recent reports have indicated the use of antiretroviral (ARV) drugs to boost animal production in neighboring Uganda, with further reports of use in several African countries. This cross-sectional study was conducted in nine districts in Tanzania, and involved screening for the presence of three first-line ARVs (lamivudine, nevirapine, and efavirenz) residues in the muscle and blood of domestic pigs and broiler chickens, and in sampled animal feed and water. Residues were determined using liquid chromatography and mass spectrometry (LC-MS/MS). The method involved calibration of the lower limit of quantitation (LLOQ) and limit of detection (LOD). ARVs were detected and quantified using the Multiple Reaction Monitoring (MRM) system. 131 (66.8%) of the 196 samples of muscle, blood, and animal feed were found to contain lamivudine residues, with the highest concentration detected in domestic pig blood and muscle (7.58mg/kg) and the lowest concentration (0.01 mg/kg) in broiler chicken feed. There was a significant relationship between the presence of lamivudine by sample type and sample origin (p=0.000). Nevirapine and efavirenz drugs were not detected in any of the collected samples. No ARV residues were detected in water samples (n=37). This study confirms the use of ARVs in animal production in Tanzania as evidenced by the presence of residues in animal feeds. We found lamivudine residues in domestic pigs and broiler chickens at concentrations higher than those recently reported in other East African studies. Farmers living with HIV may be using ARVs from their prescribed medications, which may lead to poor adherence and the emergence of drug resistance. Besides direct human and animal health issues, these residues in animal feeds and animal excreta can lead to environmental contamination leading to several negative impacts. We recommend a total ban on human-designated ARVs in animal production and advocate for comprehensive studies and monitoring systems across African countries to reveal potential societal and other reasons for their use and provide comprehensive solutions using One Health approaches.

The effect of vitamin D supplementation on increasing CD4 levels in human immunodeficiency virus

Introduction: Human immunodeficiency virus (HIV) is a retrovirus infection that attacks the immune system. According to world data in 2016, the number of HIV-infected patients reached 36.7 million, and 10 million people died due to acquired immunodeficiency syndrome (AIDS). Patients with HIV infection are susceptible to decreased levels of vitamin D (25(OH)D) by proinflammatory cytokines or as a result of the use of antiretroviral drugs. Vitamin D plays an important role in immune system, including reducing the production of pro-inflammatory cytokines and increasing the production of cathelicidin that inhibit viral replication. Oral vitamin D supplementation is an effort that can be made to increase vitamin D. To date, the relationship between vitamin D sufficiency and CD4 T cell count remains unclear, although most studies have shown a positive association. This study wanted to determine the effect of oral vitamin D supplementation on increasing CD4 levels in patients with HIV infection. Methods: Literature search was carried out by advanced searching on Pubmed, Cochrane Library, and Science Direct using eligibility criteria determined by the authors. Result: One systematic review and three randomized controlled trials (RCT) met the PICO and eligibility criteria that had been set. Three studies concluded that vitamin D supplementation can increase CD4 levels. One study shows that vitamin D supplementation dose of 5,000 IU daily could not increase CD4 levels. Conclusion: Providing vitamin D supplementation at appropriate dose can increase serum vitamin D levels so that it can increase CD4 levels.

Chronic Liver Enzyme Elevation and Use of Contemporary ARVs Among People With HIV.

While use of some older antiretroviral drugs (ARVs) is associated with chronic liver enzyme elevation (cLEE), the impact of newer ARVs remains unknown. People with HIV enrolled in the RESPOND cohort who started an ARV after January 1, 2012 were included (baseline). The primary outcome was first cLEE individuals were censored at first of cLEE, last visit, death, or December 31, 2021. Incidence rates (IRs; events/1000 person-years) were calculated for each ARV overall and by ARV exposure (6-12 months, 1-2 years, and 2+ years). Poisson regression was used to estimate the incidence rate ratio (IRR) of cLEE and its association with individual ARVs and ARV class. Of 17 106 individuals included contributing 87 924 person-years of follow-up, 1932 (11.3%) experienced cLEE (incidence rate [IR], 22.0; 95% CI, 21.0-23.0). There was no evidence of a cumulative ARV effect on cLEE incidence, (6-12 months: IR, 45.8; 95% CI, 41.4-50.19; 1-2 years: IR, 34.3; 95% CI, 31.5-37.4; and 2+ years: IR, 18.5; 95% CI, 17.4-19.7). Any use (vs no prior use) of non-nucleoside reverse transcriptase inhibitors (NNRTIs) as a class and tenofovir disoproxil fumarate (TDF) was independently associated with an increased IRR of cLEE, and any use of darunavir (DRV) was associated with a decreased risk of cLEE. cLEE is common and more frequent during the first year after initiating new ARVs. With a >5-year median follow-up, we found no short-term liver safety concerns with the use of INSTIs. Use of NNRTIs and TDF was associated with an increased cLEE risk, while DRV was associated with lower risk.

Description Of The Usage Of Antiretroviral Medicine With Atc/Ddd Method In The Primary Health Care Centers Of Kediri 2021

AIDS (Acquired Immune Deficiency Syndrome) is a collection of symptoms and infections caused by damage to the human immune system, HIV (Human Immunodeficiency Virus ), a virus that can weaken human immunity. PLWHA patients must undergo antiretroviral virus (ARV) drug therapy, one of the drug use analysis classification systems is using the ATC/DDD system which is a means of researching drug use in an effort to improve the quality of drug use, one of these components is the presentation and comparison of drug consumption levels. international. The aim of this research is to determine the use of antiretroviral drug consumption in primary health care center in the Kediri City area for the 2021 period using the Anatomical Therapeutic Chemical/Defined Daily Dose (ATC/DDD) method. The design of this research is quantitative descriptive, namely describing a particular event systematically and accurately and the treatment of this research is the process of collecting data and evaluating the use of antiretroviral drugs as well as verifying Primary health care center data by interviewing primary health care center pharmacists in the Kediri city area in 2021. Consumption of antiretroviral drugs (ARVs). ) is highest in the Campurejo primary health care center, namely Lamivudine (3TC) as much as 31.71%, Balowerti in primary health care center with Zidovudine (AZT) as much as 29.02% and Pesantren 1 primary health care center with the drug Nevirapine (NVP) as much as 32.62%, while the use of ARV drugs is low. At the Campurejo primary health care center, it was 0.0002% of the drug Dolutegravir (DTG), and at the Balowerti primary health care center, it was 0.0012% of the drug Dolutegravir (DTG), then at Pesantren 1 primary health care center , it was 0.0015% of the drug Dolutegravir (DTG). The incidence of HIV is still high in Indonesia, especially in the city of Kediri.

Synthesis and characterization of tenofovir disoproxil fumarate loaded nanoparticles for HIV‐1 treatment

AbstractThe remarkable ability of the human immunodeficiency virus (HIV) to evade the host's immune system and conventional antiretroviral therapy, has posed significant challenges in achieving complete eradication of the virus in people living with HIV (PLWHIV). However, nanotechnology has emerged as promising avenue for addressing some of the obstacles associated with the use of antiretroviral drugs by modifying drug molecules in nanoscale dimensions. Hence, the present study explores the utilization of poly(epsilon‐caprolactone) (PCL) as a carrier for encapsulating tenofovir disoproxil fumarate (TDF), offering an alternative treatment approach for HIV infection. TDF‐loaded polymeric nanoparticles were successfully prepared using double emulsion solvent evaporation technique and characterized. The characterization of TDF‐loaded polymeric nanoparticles at varied drug to polymer ratios showed that TDF was loaded in PCL with an encapsulation efficiency and drug loading capacity in the range of 23–46% and 4.8–19.9%, respectively. Of note, the neutralization efficacy of TDF‐loaded polymeric nanoparticles was more improved compared to free TDF. Encapsulation of TDF with PCL did not hinder the antiviral activity of TDF against HIV‐1 infection but rather enhanced its potency.

Red light-emitting diode therapy minimizes the functional deleterious effects of the antiretroviral ritonavir on osteoblasts in vitro.

Long-term human immunodeficiency virus (HIV)-infected patients are considered at higher risk for osteoporosis. Among the various causes that lead these patients to lower bone health, there is the use of antiretroviral drugs (ARVs), especially protease inhibitors (PI), such as ritonavir (RTV). In this context, emerge the potential benefits of LED therapy, whose effects on bone cells are currently being extensively studied, showing a modulation in cell differentiation. However, it remains unclear if photobiostimulation might interfere with RTV effects on osteoblast differentiation. In the present study, we investigated the effects of red LED (625nm) irradiation (15 mW/cm2, 0.2J/cm2, and 8 mW/cm2, 0.12J/cm2) on osteoblast cell line MC3T3-E1 treated with RTV (2.5, 5, and 10μg/mL). Our results indicated that red LED irradiation was able to reverse, or at least minimize, the deleterious effects of RTV on the osteoblasts. Neither the ARV treatments 5 and 10μg/mL (104.4% and 95.01%) nor the LED protocols (100.3% and 105.7%) statistically altered cell viability, assessed by the MTT assay. Also, the alkaline phosphatase activity and mineralization showed a decrease in osteoblast activity followed by ARV exposure (39.3-73%), which was attenuated by LED in more than 70% with statistical significance (p < 0.05). In conclusion, photobiostimulation with red LED at 625nm was associated with improved beneficial biological effects as a potential inducer of osteogenic activity on RTV-affected cells. This is the first study that investigated the benefits of red LED irradiation over ARV-treated in vitro osteoblasts.

Perception and barriers to access Pre-exposure Prophylaxis for HIV/AIDS (PrEP) among the MSM (men who have sex with men) Brazilian Amazon: A qualitative study.

Pre-exposure prophylaxis (PrEP) is an effective HIV prevention strategy that consists in the use of antiretroviral drugs by seronegative people at risk of HIV. Negative perceptions, inadequate understanding, and access barriers have been associated with decreased medication adherence. Manaus is the largest city in the Brazilian Amazon, where the incidence of HIV/AIDS is high, and the rates of adherence to the antiretroviral treatment for HIV and PrEP are low. In this qualitative study among PrEP users, mostly MSM, we explored perceptions, knowledge, and access barriers. We conducted 21 in-depth interviews with an intentionally sampled group of participants who had used PrEP at least once in their lifetime, selected through the snowball technique, between April and July 2022. A thematic analysis was conducted with a predominantly inductive approach. We highlight three relevant themes: (i) access to information about PrEP and its influences on users, (ii) access, monitoring, and barriers encountered, and (iii) facilitators for PrEP adherence and sexual behaviors. One of the negative perceptions identified in the study involves a misunderstanding of the association between PrEP users and the HIV/AIDS status. Participants revealed that some non-PrEP users suspect that individuals claiming PrEP usage are concealing an HIV-positive status to engage in unprotected sex. Lack of information by health professionals regarding HIV prevention methods poses significant barriers to PrEP access and adherence. Participants emphasized social media's crucial role in PrEP awareness. The results suggest a need to increase digital outreach regarding PrEP, decentralize PrEP services, and provide comprehensive healthcare training to improve the effectiveness of the preventive measure.

Effect of dolutegravir-based drug combinations on the level of medication adherence and viral load among adolescents living with HIV in resource-limited setting: a pre-post design.

The use of antiretroviral drugs among HIV-infected adolescents has been challenged with poor medication adherence, leading to an unsuppressed viral load and ultimately to drug resistance. Recently, dolutegravir has been approved for use in adolescents with HIV, but the evidence on medication adherence and viral load suppression is limited. The study determined the effect of dolutegravir-based drug regimens on the level of medication adherence and viral load among treatment-experienced adolescents. A longitudinal pre-post design study was done among adolescents living with HIV at a paediatrics clinic in Nigeria. Assessment of medication adherence and viral load testing was done before and at six months of transitioning to dolutegravir-based regimens. McNemar-chi-square was used to determine the effectiveness of the drug on adherence and viral load suppression. Multivariate logistic regression analysis was performed to determine the predictors of drug adherence and viral suppression. The mean age of the participants was 14.7 years (SD=3.2), and 53.3 % were males. The mean duration of ART use was 10.3 years (SD=3.2). Six months after transitioning to dolutegravir, there was a significant decrease in viral load (Z=-7.947, p<0.001) and an increase in medication adherence score (Z=-7.554, p<0.001), among the treatment-experienced adolescents. Viral suppression was 13 times higher among respondents with good medication adherence as compared to those with poor medication adherence (AOR=13.24, CI=3.25-53.90). Dolutegravir is effective in improving medication adherence and viral suppression among Adolescents living with HIV. Thus, the need to transition eligible adolescents to dolutegravir to sustain better treatment outcomes.

Assessments of viral load and haematological parameters in HIV patients on HAART in Ilorin, Kwara state

Human immune deficiency virus (HIV) infection represents the most common cause of acquired immune deficiency and leads to clinical disease referred to as Acquired Immune Deficiency Syndrome (AIDS). Highly active antiretroviral therapies (HAART) are the gold standard for the management of HIV disease. Viral load indicates that treatment is effective. A high viral load in a person on treatment indicates either that the medication is not being taken properly or that the virus is becoming resistant to the medication. This is a comparative study aimed at assessing the Viral load count and haematological parameters. 120 HIV positive individual and 40 HIV negative subjects were recruited for this study,while haematological parameters were carried out using Sysmex KX-21 analyser. Results was analyzed using SPSS version 20. .Our result shows the following mean absolute counts of haematological parameters; lymphocyte count of HIV positive persons to be 1.42±1.82, Neutrophil 1.64±2.80, Monocyte 0.07±0.08, Basophil 0.05±0.06 Eosinophil 1.71±3.42 while the mean value of TWBC 5.130±1.43, RBC 3.97±0.48, HB 11.41±1.65, MCV 87.054±15.59 and MCHC MCHCf/l, compared to 0.78±0.08, 1.10±0.32, 0.06±0.02, 0.01±0.01 and 1.14±3.42 respectively among the HIV negative individual. In conclusion, we found that the use of antiretroviral drugs could positively or negatively affect haematological parameters, depending on the choice of combination used.

HIV pre-exposure prophylaxis and incidence of sexually transmitted infections in Brazil, 2018 to 2022: An ecological study of PrEP administration, syphilis, and socioeconomic indicators.

Human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP) is one of the pillars of a combination prevention strategy for reducing the risk of new infections caused by HIV. The daily use of antiretroviral drugs by individuals who are not infected with HIV is required to prevent infection. Although its efficacy has been well established in the literature, in recent years, the decreased supply of antiretroviral drugs has been associated with an increase in the incidence of sexually transmitted infections (STI) and changes in the social determinants of health. An ecological study was conducted covering a five-year period (2018-2022), starting from the year of initiation of PrEP administration in Brazilian state capitals. Descriptive analysis was performed, and the spatial distribution of study data was taken into account. Correlation analysis was used to assess the association between PrEP administration, the incidence and detection rate of STI, and socioeconomic data. The southern region showed the highest incidence rates of STI, but the northern and northeastern regions demonstrated the worst socioeconomic indicators, especially those related to illiteracy and basic sanitation. PrEP administration was significantly correlated with illiteracy (ρ = -0.658), per capita income (ρ = 0.622), public garbage collection (ρ = 0.612), syphilis (ρ = 0.628) and viral hepatitis (ρ = 0.419) incidences. Further, all STI were significantly associated with illiteracy and per capita income. Our findings highlight the need to continue exploring PrEP use and rising syphilis rates. In terms of policy, PrEP administration appears to be inversely associated with regions of greater social vulnerability. Further efforts should focus on the social determinants and health needs of this population to improve access to PrEP and reduce social disparities.

Preclinical development and pharmacokinetic assessment in macaques of a multipurpose long-acting injectable suspension containing medroxyprogesterone acetate for contraception and rilpivirine for HIV prevention

Depot injections comprising aqueous drug suspensions are widely marketed for long-acting administration of contraceptive progestins and antipsychotics. In recent years, there has been considerable interest in developing similar long-acting injectable products containing antiretroviral drugs for treatment or prevention of HIV infection, culminating in 2020/2021 with the approval of Cabenuva® (which combines the integrase strand transfer inhibitor cabotegravir with the non-nucleoside reverse transcriptase inhibitor rilpivirine for treatment of HIV infection) and Apretude (a cabotegravir extended-release injectable suspension for HIV prevention). Here, we describe formulation and preclinical development of a new multipurpose prevention technology product based on a long-acting injectable aqueous suspension formulation combining micronized medroxyprogesterone acetate (the progestin used in the long-acting injectable contraceptive product Depo-Provera®) and a rilpivirine nanosuspension for HIV prevention. Through the application of an extensive range of analytical methods, we have demonstrated that the resulting combination suspension formulation had a bimodal particle distribution, was stable, was sterilised by gamma irradiation, and provided sustained systemic and vaginal exposure of both drugs over at least one month following intramuscular injection in macaques. Further formulation development will be needed to sustain drug concentrations in the systemic/vaginal compartments over longer time periods, and to consider options for use of alternate antiretroviral drugs.

The new profile of psychiatric disorders in patients with HIV infection.

Nowadays, HIV infection is largely considered as a chronic condition rather than a deadly disease, given that effective antiretroviral treatment allows almost complete and persistent suppression of viral replication and restoration of nearly normal CD4+ T-cell counts. Being HIV a "condition", we imply that other illnesses are more frequently seen in persons living with HIV (PLHIV), among which mental health disorders are particularly common. Despite very successful antiretroviral therapy, HIV infection may still cause a wide range of neurocognitive dysfunctions and accelerated brain ageing. Beyond direct viral effects, at least another five causes of neurological damage are more frequent among PLHIV. First, the use of neurochemical substances as sexual boosters (chemsex) has become popular in this population. Second, the rate of sexually transmitted infections as syphilis, which may affect the central nervous system, is more prevalent among PLHIV. Third, the use of certain antiretroviral drugs, such as efavirenz, has been associated with changes in mood and/or psychotic symptoms. Fourth, an increased rate of mental disorders has been reported in PLHIV, either as predisposing conditions or following the recognition of HIV diagnosis (i.e., major depression). Finally, psychosocial factors such as loneliness, isolation and stigmatization are more frequent in PLHIV and worsen their mental health. Given that the life expectancy of PLHIV has increased significantly, a new and much broader spectrum of psychiatric disorders has emerged in PLHIV. Early diagnosis and adequate management, including education and preventative interventions are warranted.

Sleep deficiency among people living with human immunodeficiency virus: A growing challenge.

The purpose of this narrative review is to consolidate and summarize the existing literature on sleep deficiency among people living with human immunodeficiency virus (HIV; PLWH), to discuss the potential impact of antiretroviral therapy on sleep deficiency and to identify priorities for future research in this area. Three important domains of sleep deficiency include alterations in sleep quality (including sleep disorders), duration and timing. The existing HIV and sleep deficiency literature, which is robust for sleep quality but sparser for sleep duration or sleep timing, has identified epidemiological correlates and outcomes associated with sleep deficiency including sociodemographic factors, HIV-specific factors, aspects of physical and mental health and cognition. Sleep deficiency is a common problem among PLWH and is likely underdiagnosed, although more high-quality research is needed in this area. Sleep quality has received the most attention in the literature via methodologies that assess subjective/self-reported sleep quality, objective sleep quality or both. There is significantly less research on sleep duration and minimal research on sleep timing. Use of certain antiretroviral therapy drugs may be associated with sleep deficiency for some individuals. Future research should utilize larger, longitudinal studies with consistent, comprehensive and validated methods to assess both subjective and objective measures of sleep deficiency to better understand the prevalence, correlates and clinical implications of sleep deficiency in PLWH.

Double-Exponential-X Family of Distributions: Properties and Applications

A new family of distribution named Double-Exponential-X family is proposed. The proposed family is generated from the double exponential distribution. The forms of the probability densities and hazard functions of two distinct subfamilies of the proposed family are examined and reported. Generalproperties such as moment, survival, order statistics, probability weighted moments and quartile functions of the models are investigated. A sub family of the developed family of double –Exponential-X family of the distribution known as double-Exponential-Pareto distribution was used to fit a real life data on the use of antiretroviral drugs. Molecular simulation of efficacy of antiretroviral drugs is conducted to evaluate the performance of the model. The models were tested using some models diagnostic tests and it was revealed that the proposed model was better than the ones proposed before it from the same family and also, stochastic dominance method was used to affirm the best antiretroviral drugs used in the study.

Effect of aerobic and resistance exercise training on anthropometric parameters of human immunodeficiency virus-positive individuals

Background: The use of antiretroviral drugs has made human immunodeficiency virus (HIV)/AIDS a chronic disease with adverse anthropometric changes as one of its complications. Objectives: This study investigated the effects of aerobic and resistance exercise training on anthropometric parameters of HIV-positive individuals. The study examined the influence of aerobic and resistance exercises on body mass index (BMI), waist-to-hip ratio (WHR), percentage body fat and visceral fat of persons living with HIV/AIDS in a tertiary health institution in South–South zone of Nigeria. Methods: A randomised control trial design was employed in this study. Eighty-eight HIV-seropositive patients in stages 1 and 2 participated in the study. Randomisation was done into the control and aerobic exercise group and resistance exercise group. The experimental groups exercised thrice a week for 10 weeks and the non-experimental group received usual antiretroviral drugs and counselling. Initial intensity of the exercise was 60% HRmax and 1-RM and progression was by 10% every 3 weeks. Anthropometric parameters were recorded initially and on termination of 10 weeks for all three groups. Frequency, mean, standard deviation, and analysis of covariance (ANCOVA) were used for the data analysis. The Bonferroni pairwise comparison was used as post hoc test to identify the source of differences. Results: The outcome of this research showed that aerobic and resistance exercises resulted in significant alterations in anthropometric parameters of BMI (f = 13.617; Sig = 0.000), percentage body fat (f = 10.074; Sig = 0.000), WHR (f = 11.070; Sig = 0.000) and visceral fat (f = 10.286; Sig = 0.000). Conclusion: It was, therefore, concluded that aerobic and resistance are beneficial to HIV-seropositive persons and recommended that exercise should be prescribed for HIV-infected persons to enhance their anthropometric parameters resulting in improved health.

Contemporary Anti-Retroviral Drugs (ARVDs) Disrupt Follicular Development in Female Wistar Rats.

There are genuine concerns that long-term use of anti-retroviral drugs may be associated with reproductive complications in females. This study aimed to ascertain the effect of highly active anti-retroviral drugs on the ovarian reserve and reproductive potential of female Wistar rats and by extension to HIV-positive human females. A total of 25 female Wistar rats, weighing between 140g and 162g, were randomly allotted into non-intervention and intervention groups, receiving the anti-retroviral drugs, Efavirenz (EFV), Tenofovir Disoproxil Fumarate (TDF), Lamivudine (3TC), and a fixed-dose combination (FDC). The dosage was administered orally at 8 am daily for 4 weeks. Serum concentrations of anti-Mullerian hormone (AMH), follicle-stimulating hormone (FSH), luteinising hormone (LH), and estradiol were measured using standard biochemical techniques (ELISA). Follicular counts were made on fixed ovarian tissue from the sacrificed rats. The mean AMH level for the control group and the EFV, TDF, 3TC, and FDC groups were 11.20, 6.75, 7.30, 8.27, and 6.60 pmol/L, respectively. The EFV and FDC groups had the lowest AMH, compared to the other groups, but there was no statistically significant difference in AMH across the groups. The mean count of antral follicles was significantly lower in the group that received EFV when compared to the other groups. The corpus luteal count was significantly higher in the control group than in the intervention groups. The study demonstrated a disruption in the reproductive hormones of female Wistar rats receiving anti-retroviral regimens containing EFV. Clinical studies are required to determine if these changes are seen in women receiving EFV-based treatment, as this may compromise reproductive function and predispose them to early menopause.

АНАЛИЗ КЛИНИЧЕСКИХ СЛУЧАЕВ ОСТРОГО ПАНКРЕАТИТА НА ФОНЕ КОМОРБИДНЫХ ПАТОЛОГИЙ

The article collects and analyzes the available information on the pathogenesis, features of diagnosis and course of acute pancreatitis in patients with HIV and COVID-19 based on cited scientific papers. Patients with HIV/AIDS can be affected to a wide range of factors for the development of acute pancreatitis, such as opportunistic infections, neoplasms and metabolic changes due to the use of antiretroviral drugs. Morphological changes in the pancreas, including its endocrine, exocrine apparatus and interstitial tissue, as well as the ductal system, observed in about 20% of HIV-infected patients. Pathological and morphological changes in the pancreas during autopsy detected in 90% of cases. With the introduction of combined antiretroviral drugs, new metabolic disorders appeared, such as liver steatosis and lactic acidosis, which also have a toxic effect on the pancreas. COVID-19 can cause severe complications from the heart, lungs, brain, kidneys, blood vessels and other vital human systems and organs. Scientists associate the effect of the virus on pancreatic cells with the placement of ACE-2 receptors in the organ. The presence of ACE-2 in non-respiratory organs has a positive effect on the functioning of these tissues. As is known, COVID-19 infection was caused by the SARS-CoV-2 virus. This virus actively replicates using intracellular ARF-2 and then destroys the host cell when it enters the extracellular space [1]. Although COVID-19 refers to respiratory infections, doctors recognize that the disease is multisystem, in other words, it can affect any organ [2]. During the period of COVID-19 disease, the human excretory system ceases to cope with its functions due to oxygen starvation, blood detoxification does not occur. Against this background, multiple organ failure and numerous edemas of the tissues of internal organs develop. The organs of the endo- and exocrine systems suffer, including the organ of mixed secretion – the pancreas. The study of the impact of the new coronavirus infection is the most relevant nowadays, from that moment this infection is relatively young and poorly studied. By analyzing rare clinical cases, we can predict the consequences of the disease and anticipate late complications. The analysis was made on the basis of laboratory and morphological features. Comparison of pancreatitis in patients with HIV and COVID-19 has been conducted. As a result, the most relevant questions on this topic have been formed.

Differences in adoption of COVID-19 pandemic related preventive behaviour by viral load suppression status among people living with HIV during the first wave of the pandemic

BackgroundAdherence to antiretroviral therapy and COVID-19 preventive behaviours among people living with HIV during the pandemic has received little attention in the literature. To address this gap in knowledge, the present study assessed the associations between viral load, adherence to antiretroviral therapy and the use of COVID-19 prevention strategies during the first wave of the COVID-19 pandemic. This was a secondary analysis of data generated through an online survey recruiting participants from 152 countries. Complete data from 680 respondents living with HIV were extracted for this analysis.ResultsThe findings suggest that detectable viral load was associated with lower odds of wearing facemasks (AOR: 0.44; 95% CI:0.28–0.69; p < 0.01) and washing hands as often as recommended (AOR: 0.64; 95% CI: 0.42–0.97; p = 0.03). Also, adherence to the use of antiretroviral drugs was associated with lower odds of working remotely (AOR: 0.60; 95% CI: 0.38–0.94; p = 0.02). We found a complex relationship between HIV positive status biological parameters and adherence to COVID-19 preventive measures that may be partly explained by risk-taking behaviours. Further studies are needed to understand the reasons for the study findings.