Epidemiological data on HIV-infected patients and the importance of education regarding the infection rate. An analytical cross-sectional study

Abstract BACKGROUND: Sexually transmitted diseases (STIs) are an important public health problem in all countries. Knowledge of their relationship with the various socioeconomic levels is necessary for an understanding of their epidemiology and behavior in society. OBJECTIVE: To investigate the epidemiology of human immunodeficiency virus (HIV)-positive patients and to correlate education with history of sexually transmitted diseases, especially for syphilis. DESIGN AND SETTING: Analytical cross-sectional study carried out in the city of Juiz de Fora, Minas Gerais, Brazil. METHODS: The medical records of HIV/acquired immunodeficiency syndrome (AIDS) patients who started antiretroviral therapy (ART) between January 2010 and July 2018 were assessed. These patients were attended at the specialized assistance service for HIV/AIDS) of the Department of Sexually Transmitted Diseases (STD/AIDS) of the city of Juiz de Fora. In total, 335 patients were selected. RESULTS: In our sample, 73.13% were male; 57.36% were aged between 25 and 45 years and 24.23% were over 45 years of age. Regarding sexual orientation, 61.78% were homosexual. Regarding education, 52.88% had "unskilled education", while 47.12% had "qualified education". Analysis on the relationship between schooling and syphilis, a positive relationship between qualified schooling and syphilis was observed: odds ratio = 3.588; 95% confidence interval: 1.090-11.808. CONCLUSION: Homosexual male patients are most affected by HIV. Furthermore, this disease is not limited only to individuals with low education. Syphilis should be suspected in all individuals.

Effect of non-nucleoside reverse transcriptase inhibitors and protease inhibitors on serum levels of myeloperoxidase and C-reactive protein in HIV-infected individuals

Abstract It remains unclear whether increased inflammatory and cardiovascular risk biomarkers differ depending on the class of antiretroviral that is used. This study evaluated the plasma levels of inflammatory and cardiovascular risk biomarkers, such as MPO, hs-CRP, glucose, lipid profile, ALT (GPT), AST (GOT), urea and creatinine, as well as the blood count, of all the 164 participants in the study, either infected or un-infected with HIV. Thirty of the 104 HIV-infected individuals did not receive any antiretroviral; twenty-four of them were treated with non-nucleoside reverse transcriptase inhibitor class; and fifty took protease inhibitors. The control group consisted of sixty non-HIV infected individuals. In the case of the HIV-infected volunteers, the CD4+ T lymphocyte counts and viral load were also analyzed. Regardless of the hematological and biochemical changes resulting from the antiretroviral therapy (ART), the MPO and hs-CRP values significantly increased for the HIV-infected individuals (treated or untreated), irrespective of the class of ART that was used. This is important because these biomarkers are designed to be predictors of the risk of cardiovascular disease. The results of this study provide supporting evidence for the hypothesis that HIV-infected individuals are at increased risk of developing cardiovascular disease related to chronic inflammations, despite virological control with ART, and regardless of the class of ART that is used.

Immune response after inoculation with PPV23 in HIV-infected adults / 上海预防医学

Objective To study the functional antibody and protection effect against pneumonia disease after inoculation with PPV23 in HIV-infected adults. Methods In 2015, 63 HIV-infected adults were randomly selected in Hongkou District of Shanghai, and blood samples were collected before and one month after the inoculation of PPV23.Functional antibodies against 4 serotypes (19F, 19A, 23F, 6B) of Streptococcus pneumoniae were detected by opsonophagocyitosis killing assay (OPA).The incidence of pneumonia after PPV23 inoculation was also determined. Results The GMT of OPA antibodies against 4 serotypes 1 month after inoculation with PPV23 was significantly higher than that before inoculation in HIV-infected subjects.After inoculation, the triple growth rates of OPA antibodies against 4 serotypes in HIV-infected subjects were 50%-91.67%.The protection rate against pneumonia was 100% in 2 years after PPV23 inoculation in HIV-infected subjects when compared with same group before inoculation as well as the control group.The HIV-infected patients who received highly active antiretroviral therapy (HAART) or had CD4 count of≥300/μL showed better response in production of OPA antibodies and obtained protection against community-acquired pneumonia (CAP) after receiving PPV23. Conclusion Routine vaccination of PPV23 is recommended for HIV-infected patients with good basic conditions.

Survival analysis of HIV-infected patients on antiretroviral therapy during 2006-2019 in Taizhou City / 上海预防医学

Objective:To examine the survival status and explore factors related to death among human immunodeficiency virus （HIV） infected patients receiving antiretroviral therapy （ART） in Taizhou City during 2006‒2019. Methods:A retrospective cohort study was conducted to analyze the data on HIV-infected patients receiving ART in Taizhou during 2006‒2019. Kaplan-Meier （K-M） method was used to calculate the cumulative survival rate and cumulative treatment success rate. Cox regression model was used to determine survival status and factors associated with ART. Results:A total of 2 904 HIV-infected patients was included. The cumulative survival rate after 1， 3， 5， and 8 years of ART were 96.9%， 94.9%， 93.1% and 92.1%， respectively， and the cumulative treatment response rate were 91.3%， 85.3%， 81.8% and 73.8%， respectively. Compared with aged 18-30 years old， baseline CD4+T cell >350 count/μL， normal hemoglobin level， effective ART， no clinical symptom at baseline， and homosexual transmission， we found that aged 51-60 years old（HR=4.94，95%CI：1.66-14.69）， aged over 60 years old（HR=9.14，95%CI：3.14-26.63）， anemia at baseline（HR=2.24，95%CI：1.55-3.23）， baseline CD4+T cell <200 count/μL（HR=4.35，95%CI：2.14-8.86）， ART failure （HR=3.90，95%CI：2.73-5.58）， heterosexual transmission（HR=1.92，95%CI：1.15-3.20）， and signs of symptom at baseline（HR=1.68，95%CI：1.16-2.41） were risk factors of HIV-related death. Conclusion:The effect of ART in Taizhou City is confirmed with a high cumulative survival rate and treatment success. We should pay additional attention to senior HIV-infected patients with anemia at baseline and intensively monitor the effect of ART. Interventions such as “treat after discover” are supposed to be implemented more widely to further reduce HIV-related mortality.

Effectiveness evaluation of peer-group level care and management mode in HIV infected patients / 上海预防医学

Objective To introduce and conduct effectiveness evaluation of peer-group level care and management mode in people living with HIV and AIDS(PLHAs)in Jing'an District, Shanghai. Methods We recruited PLHAs who were managed by Jing'an District and participated in the peer-group care activities from 2015 to 2016, and collected their data of general conditions, behavior, antiretroviral therapy, life quality, social support, mental status and medical modes, and then conducted effectiveness evaluation of the mode by multivariate logistic regression model and linear regression model. Results A total of 300 PLHAs were included with 150 cases in each group. PLHAs in target group had higher proportion of antiretroviral therapy[82.7%(124/150)and 64.7%(97/150)]. In addition, they got higher scores in mental health(48.5±9.2 and 43.9±10.6)and social support(28.7±8.2 and 24.8±6.6), and lower scores in depressive severity index(0.5±0.1)and avoidance of medical modes(16.1±3.0 and 17.0±2.5). Multivariate analysis showed that PLHAs in target group had less sex partners(zero partner, OR = 2.1, 95%CI:1.1-3.9;one partner, OR = 3.6, 95%CI:1.9-6.8)and increased condom use(no sex, OR = 5.3, 95%CI:2.4-11.7;complete use, OR = 10.6, 95%CI:4.7-24.1;random miss, OR = 5.1, 95%CI:1.8-14.8)in the last 12 months. Conclusion The effect of peer-group level care and management mode is significantly good in promoting behavior change, enhancing health concern and increasing antiretroviral therapy.

Prevalence and predictors of undernutrition in HIV-infected children on antiretroviral therapy in Abakaliki, Southeast Nigeria

Background: The introduction of antiretroviral therapy (ART) to HIV medicine has dramatically improved the quality of care of HIV-infected children, translating to better nutritional status and general well-being. However, many HIV-infected children especially in sub-Saharan Africa, despite being on ART are malnourished. Objective: The study was done to determine the prevalence and predictors of undernutrition among HIV-infected children on ART in Abakaliki. Materials and Methods: It was a case–control study with a sample size of 220 (110 HIV infected and 110 HIV negative children as controls) aged 2–17 years. Anthropometric indicators expressed in Z scores were used to define malnutrition: Height for age (stunting) and weight for age (underweight) and weight for height (thinness). A structured questionnaire was used to obtain socio-demographic characteristics and drug adherence. Results: The prevalence rates of underweight and stunting were 24.5% and 20.0% in HIV-infected children as against the prevalence rates of 10.0% and 6.4% for underweight and stunting, respectively, found in HIV negative children. These prevalence rates were statistically significant (P = 0.002 and P = 0.001, respectively). Occupation of caregivers (P = 0.000, P = 0.000), drug adherence (P = 0.001, P = 0.000), and WHO clinical stages of disease (P = 0.002, P = 0.000) were statistically significant predicted the presence of underweight and stunting, respectively, in HIV-infected children on ART. Conclusion: The prevalence of undernutrition is high among children on ART. Nutritional support as well as strengthening adherence to ART is strongly advocated as part of routine care in HIV-infected children on ART.

The clinical significance of serum autoantibodies and HLA-B27 molecule testing in Uygur patients with human immunodeficiency virus infection / 中华内科杂志

Objective@#To explore the clinical value of serum autoantibodies and human leukocyte antigen (HLA-B27) molecular testing in Uygur patients with human immunodeficiency virus (HIV) infection.@*Method@#A total of 727 HIV-infected Uygur patients who visited Kuche infectious diseases hospital during May 2016 to March 2017 were include in this study. The other 390 healthy people were enrolled as controls. Serum antinuclear antibodies (ANA), anti-cyclic citrullinated peptide (CCP) antibody, anti-extractable nuclear antigen (ENAs) antibody and HLA-B27 molecule were tested.@*Result@#Among 727 HIV-infected Uygur patients, 317 were males and 410 were females with mean age (35.52±13.44) years old. The mean duration of disease was (6.34±3.05) years. There were 697 (95.87%) patients receiving highly active antiretroviral therapy (HAART) with mean duration of treatment (5.52±3.47) years. The mean CD4+T cell count was (520±271) cells/μl in 202 HIV-infected patients, and mean virus load was (108 139±20 498) copies/ml in 20 HIV-infected patients. Rheumatic manifestations were recorded in 238 (32.74%) HIV-infected Uygur patients, mainly with dry mouth and dry eye (15.41%) , alopecia (9.90%) , arthralgia (8.94%) , ect. Compared with the health controls, positive ANA was more common in HIV infected Uygur patients (33.43% vs. 17.43%, P<0.001) with low titers (ANA titer:1∶100) . HIV-infected Uygur patients had higher positive anti-u1-RNP antibodies positive rate (1.10%), but lower anti-SSA antibodies positive rate (0.14%) and anti-CCP antibodies positive rate (0.28%). Patients with positive ANA in HAART group were significantly less than that in non-treatment group (32.71% vs. 50.00%, P=0.049). There were no correlations between ANA and duration of HAART, CD4+T cell counts and virus load (r values 0.061, 0.047, 0.121, respectively. P>0.05). Only one female patient was HLA-B27 positive (0.14%), which was significantly lower than that in healthy controls (3.08%) (P<0.001). Also, only one patient was diagnosed with rheumatoid arthritis (RA).@*Conclusion@#Autoimmune manifestations are common in HIV-infected Uygur patients. Several autoantibodies are positive, but the coincidence of rheumatic diseases is rare. It′s noted that patients with autoimmune manifestations should be considered as a differential diagnosis of HIV infection.

High-Resolution Computed Tomography Lung Spectrum In Symptomatic Adult Hiv-Positive Patients In Correlation With Cd-4 Count

Context: Pulmonary disease accounts for 30–40% of the acute hospitalizations of HIV-positive patients. The CD4 count, anindicator of the severity of immune compromise, is of paramount importance for rendering an appropriate differential diagnosis.High-resolution computed tomography (HRCT) of lung provides detailed visualization of lung parenchyma and can characterizediseases according to pattern and distribution which can help in formulating a differential diagnosis.Aims: The aims of this study were as follows: (1) To identify the radiological appearance/pattern of HIV-associated infections.(2) To correlate the radiological findings with CD4 count.Settings and Design: This was a cross-sectional study using sample size of 100 HIV-infected patients conducted at theDepartment of Radiodiagnosis and Imaging, Gandhi Medical College and Hamidia Hospital, Bhopal.Materials and Methods: A total of 100 adult HIV-infected patients were scanned with HRCT chest and findings were documentedand correlated with their CD4+ counts.Statistical Analysis Used: Data analysis was done using SPSS 21.0. Two-tailed P < 0.05 was considered statistically significant.Results: TB (70%) was the most common infection followed by bacterial pneumonia (14%) and Pneumocystis jiroveci pneumonia(6%). Tuberculosis was found in 29% of advance CD4 count patients and 27% of severe CD4 count patients. Consolidation,airspace nodules, miliary nodules, diffuse ground-glass opacity, and pleural effusion showed significant correlation with CD4counts.Conclusions: Incidence of all these manifestations fairly correlates with the decline of CD4 counts. Early and proper diagnosisof these pulmonary complications in patients with HIV infection and lower CD4 counts will help clinicians to develop a focusedtherapeutic approach in their management.

The mediating effect of self-consciousness between peer relationship and social anxiety in HIV-infec-ted children / 中华行为医学与脑科学杂志

Objective To explore the relationship among peer relationship,self-consciousness and social anxiety in HIV-infected children. Methods Peer Relationship Scale,Piers-Harris Children's Self-con-cept Scale and Social Anxiety Scale for Children were applied to 126 HIV-infected children. Results The score of peer relationship was 53. 0(45. 0,62. 0),the score of self-concept was 52. 0(42. 0,60. 0),and the score of social anxiety was 6. 0(2. 0,9. 0). Peer relationship was positively correlated with social anxiety( r=0. 196,P=0. 029) and negatively correlated with self-consciousness(r=-0. 628,P<0. 01). Self-conscious-ness was negatively correlated with social anxiety(r=-0. 504,P<0. 01). Bootstrap analysis showed that self-consciousness played a complete mediating role between peer relationship and social anxiety,and the media-ting effect value was 0. 377. Conclusion Peer relationship,self-consciousness and social anxiety are closely related. Furthermore,self-consciousness plays a complete mediating role between peer relationship and social anxiety in HIV-infected children.

Effect of baseline CD4+ T cell count on drop-out of antiretroviral therapy in HIV infected persons in Guangxi Zhuang Autonomous Region, 2008-2015 / 中华流行病学杂志

Objective To investigate the effect of baseline CD4+T cell count (CD4) on drop-out of antiretroviral therapy (ART) in HIV infected persons.Methods Retrospective cohort was conducted in this study.HIV infected persons aged≥ 18 years and receiving free ART for the first time in Guangxi Zhuang Autonomous Region (Guangxi) from 2008 to 2015 were selected from the antiretroviral treatment database of National Comprehensive HIV/AIDS Information System,with follow-up conducted till May 30,2016.Cause-specific Cox proportional hazard models were used to evaluate effect of different CD4 on the drop-out of ART in the HIV infected persons.Results A total of 58 502 eligible study participants were included in this retrospective cohort study.The average drop-out ratio was 4.8/100 person-years.After controlling the following baseline covariates:age,sex,marital status,route of HIV infection,WHO clinical stage before ART,initial/current ART regiment,ART regiment adjustment,and year of initiating ART for potential confounding,the adjusted HR of drop-out for HIV infected persons with 200-cells/μl,351-cells/μl and ≥500 cells/μl were 1.110 (95％CI:1.053-1.171,P＜0.001),1.391 (95％CI:1.278-1.514,P＜0.001) and 1.695 (95％CI:1.497-1.918,P＜ 0.001),respectively,in risk for drop-out compared with those with baseline CD4 ＜200 cells/μ 1.Among the HIV infected persons,56.0％ (1 601/2 861) of drug withdrawal was due to poor compliance with medication.Conclusions With the increase of baseline CD4 when initiating ART,the risk for the drop-out in HIV infected persons increased significantly.To further reduce the drop-out of ART,it is important to take CD4 into account in initiating ART and to strengthen the health education on treatment compliancy and training for healthcare providers.

Effect of baseline CD4+ T cell count on drop-out of antiretroviral therapy in HIV infected persons in Guangxi Zhuang Autonomous Region, 2008-2015 / 中华流行病学杂志

Objective To investigate the effect of baseline CD4+T cell count (CD4) on drop-out of antiretroviral therapy (ART) in HIV infected persons.Methods Retrospective cohort was conducted in this study.HIV infected persons aged≥ 18 years and receiving free ART for the first time in Guangxi Zhuang Autonomous Region (Guangxi) from 2008 to 2015 were selected from the antiretroviral treatment database of National Comprehensive HIV/AIDS Information System,with follow-up conducted till May 30,2016.Cause-specific Cox proportional hazard models were used to evaluate effect of different CD4 on the drop-out of ART in the HIV infected persons.Results A total of 58 502 eligible study participants were included in this retrospective cohort study.The average drop-out ratio was 4.8/100 person-years.After controlling the following baseline covariates:age,sex,marital status,route of HIV infection,WHO clinical stage before ART,initial/current ART regiment,ART regiment adjustment,and year of initiating ART for potential confounding,the adjusted HR of drop-out for HIV infected persons with 200-cells/μl,351-cells/μl and ≥500 cells/μl were 1.110 (95％CI:1.053-1.171,P＜0.001),1.391 (95％CI:1.278-1.514,P＜0.001) and 1.695 (95％CI:1.497-1.918,P＜ 0.001),respectively,in risk for drop-out compared with those with baseline CD4 ＜200 cells/μ 1.Among the HIV infected persons,56.0％ (1 601/2 861) of drug withdrawal was due to poor compliance with medication.Conclusions With the increase of baseline CD4 when initiating ART,the risk for the drop-out in HIV infected persons increased significantly.To further reduce the drop-out of ART,it is important to take CD4 into account in initiating ART and to strengthen the health education on treatment compliancy and training for healthcare providers.

Management mode of HIV infection and antiviral therapy adherence in Jing'an District, Shanghai / 上海预防医学

[Objective]To ascertain the status and related factors of antiretroviral therapy adherence and analyze the influence of management mode on adherence in HIV infected patients in Jing' an District, Shanghai. [Methods]We recruited 150 HIV infected patients who participated in the "peer group care"activities (target group) and those from another 150 patients who did not (control group) but received antiviral treatment during the period from 2015 to 2016 (221 cases in total) into the study. We collected data on general conditions, behavioral way, antiretroviral therapy adherence, life quality, social support, mental status and medical coping modes, and analyzed the related factors of antiretroviral therapy adherence by linear regression model. [Results]The 221 HIV infected patients were included, with 124 in target group and 97 in control group. The proportion of good antiretroviral therapy adherence was 86.0％, with 91.9％ in target group and 78.4％ in control group. Multiple analysis showed that the related factors of antiretroviral therapy adherence were management mode (β = 1.871, P < 0.001) , disposable income per month (β = 0.600, P = 0.001) , social support utilization (β = 0.174, P = 0.044) and yield attitude of medical coping modes (β =-0.153, P = 0.003). [Conclusion]Antiretroviral therapy adherence of HIV infected patients in Jing'an District should be further improved. "Peer group level care and management mode"could effectively promote the increase of antiretroviral therapy adherence; however, it should be improved and perfected in the aspects of its coverage and content.

Moxibustion combined with highly active antiretroviral therapy for CDand γ chain cytokines of HIV infected patients / 中国针灸

<p><b>OBJECTIVE</b>To compare the effects of moxibustion combined with highly active antiretroviral therapy (HAART) and simple HAART for human immunodeficiency virus (HIV) infected patients.</p><p><b>METHODS</b>A total of 100 patients with HIV receiving HAART were randomized into an observation group and a control group, 50 cases in each one. In the observation group, moxibustion was used at Zusanli (ST 36), Guanyuan (CV 4) and Sanyinjiao (SP 6), etc. combined with HAART of zidovudine, lamivudine, nevirapine and efavirenzone, etc. Simple HAART was used in the control group. The patients were observed for 18 months. The indexes were CD, CD/CD, interleukin 2 (IL-2), interleukin 7 (IL-7), the incidence of side effects and the score of quality of life.</p><p><b>RESULTS</b>After treatment, CD, CD/CD, serum IL-2 and the scores of quality of life (physiological, psychological, social relation fields and comprehensive score) increased and serum IL-7 decreased compared with those before treatment in the two groups (<0.01,<0.05), with better results except CDin the observation group (<0.01,<0.05). The incidences of gastrointestinal side effects and total side effects in the observation group were lower than those in the control group (14% (7/50) vs 32% (16/50), 58% (29/50) vs 80% (40/50), both<0.05).</p><p><b>CONCLUSION</b>Moxibustion combined with HAART for HIV infected patients could reduce the incidence of side effects, improve medication compliance, CD/CD, IL-2, IL-7 and the quality of life.</p>

Control de embarazo y postparto en mujeres infectadas por HIV / Pregnancy and postpartum control in HIV infected women

Presentamos los datos de un estudio descriptivo observacional retrospectivo realizado con el objetivo de evaluar las características de las mujeres embarazadas infectadas por HIV, analizar el nivel de control del embarazo y evaluar la adherencia al tratamiento y las pérdidas de seguimiento posterior al parto. Analizamos los datos informados de 104 embarazos, 32.7% de mujeres menores de 25 años. El diagnóstico se realizó durante el control del embarazo en 36.5% de ellos. La terapia antirretroviral (TARV) se inició antes de la semana 24 en 70% de los embarazos. El régimen utilizado incluyó 2 nucleós(t)idos + 1 inhibidor de la proteasa potenciado con ritonavir (IPr) en 84.5% de los casos. La cesárea electiva fue el modo mas frecuente de parto. La carga viral luego de la semana 32 de embarazo estaba disponible en el 82.7% de las pacientes siendo menor a 1000 copias/ml en 78 (75%) y menor a 200 en 70 (67.3%), no hallándose disponible en 18 (17.3%) de los casos. Observamos una alta frecuencia de fallos de adherencia y pérdidas de seguimiento posteriores al parto. Los datos comunicados deben alertar a los programas y centro de atención sobre la necesidad de implementar estrategias que promuevan el control temprano del embarazo e incrementen la adherencia y la retención en cuidado, especialmente en el período posterior al parto.

We present data from a retrospective observational descriptive study with the objective of evaluating characteristics of HIV-infected pregnant women, analyze the level of control of pregnancy and assess adherence to treatment and loss of follow up after delivery. We analyzed reported data of 104 pregnancies, 32.7% of them under 25 years old. The diagnosis was performed as part of pregnancy control in 36.5% of women. TARV started before 24 weeks of pregnancy in 70% of them and a regimen with 2 nucleos(t)ides and 1 ritonavir potenciated protease inhibitor (PIr) was prescribed in 84.5%. Elective c-section was the most frequent mode of delivery. The viral load after 32 weeks of pregnancy was available in 82.7%, being less than 1000 cop/ml in 78 (75%), less than 200 cop/ml in 70 (67.3%) and not available in 18 (17.3%) of cases. We observed a considered high rate of adherence failure and loss of follow up after delivery. Reported data should alert programs on the need to implement strategies to promote early pregnancy control and increase adherence and retention in care, especially in the postpartum period.

Frequency and molecular epidemiology of Panton-Valentine leukocidin gene in Staphylococcus aureus colonising HIV-infected patients

Background: HIV-infected patients pose a high risk of contracting skin and soft tissue infections caused by Staphylococcus aureus. Those who are colonized with methicillin-resistant S. aureus (MRSA) that carry Panton-Valentine leukocidin (PVL) are predisposed to severe infections that could lead to necrotic skin infections. However the association of S. aureus specifically methicillin sensitive S. aureus carrying PVL gene in HIV patients has not been widely reported. Here, we study the prevalence and the molecular epidemiology of PVL-producing S. aureus in HIV-infected patients. Methods: Swabs from four body sites of 129 HIV-infected patients were cultured for S. aureus and identified by standard microbiological procedures. The isolates were subjected to antimicrobial susceptibility testing by disk diffusion against penicillin, erythromycin, clindamycin, and cotrimoxazole. PCR was used to detect the PVL gene and genetic relationship between the isolates was determined by using pulse field gel electrophoresis. Results: A total of 51 isolates of S. aureus were obtained from 40 (31%) of the patients. The majority (43.1%) of the isolates were obtained from the anterior nares. Thirteen (25.5%) of all the isolates were resistant to more than one category of antibiotics, with one isolate identified as MRSA. Thirty-eight (74.5%) isolates (including the MRSA isolate) carried PVL gene where the majority (44.7%) of these isolates were from the anterior nares. A dendogram revealed that the isolates were genetically diverse with 37 distinct pulsotypes clustered in 11 groups. Conclusion: S. aureus obtained from multiple sites of the HIV patients were genetically diverse without any clonality observed.

Large adrenal leiomyoma presented as adrenal incidentaloma in an AIDS patient: A rare entity

The literature on adrenal gland tumour in HIV-infected patients is scarce. We report a 46-year-old Malay man with HIV and Hepatitis C infection presenting with a large nonfunctioning adrenal tumour. Computed tomography showed a large right adrenal tumour with heterogeneous enhancement and central necrosis. A high index of suspicion of a malignant tumour or pheochromocytoma led us to surgical removal of the adrenal gland. In this case report, we highlight important features to look for during pre-op evaluation of a large adrenal mass. Appropriate action should be taken when there is a suspicion of a pheochromocytoma or malignancy.

Research on expression of NKG2 C/NKG2 A receptors on T cells in HIV infected individuals and relationship with disease progression / 中国免疫学杂志

Objective:To study the changes of NKG2C/NKG2A expressed on T cells in HIV chronically infected individuals and HAART-treatment AIDS patients and the relationship with disease progression of HIV. Methods: We collected peripheral blood from HIV chronically infected individuals,HAART-treatment AIDS patients and healthy human and used the flow cytometry by staining fluorescent antibody to detect the NKG2C/NKG2A receptors expressed on T cells. Results:NKG2C+,NKG2A+ and NKG2C+NKG2A-expressed on T cells in HIV chronically infected individuals were significantly higher than the healthy control group ( P=0. 025,P=0. 032,P=0. 029),while in HAART-treatment AIDS patients were significantly lower than that in HIV chronically infected individuals (P=0. 033,P=0. 037,P=0. 018),returned to the normal levels with no significant difference compared with the healthy control group. The absolute number of peripheral blood CD4+ T lymphocytes in HIV chronically infected individuals was negative correlation with T cells which expressing NKG2A+,NKG2C+NKG2A+ and NKG2C-NKG2A+( r=-0. 697,P<0. 000 1;r=-0. 463,P=0. 015;r=-0. 693,P<0. 000 1). What was more,the absolute number of peripheral blood CD4+ T lymphocytes had positive correlation with the ratio of NKG2C and NKG2A expressed on T cells receptor in HIV chronically infected individuals(r=0. 476,P=0. 012). Conclusion:Studying the expression of NKG2C and NKG2A receptors on T cell has great significance in HIV infected individuals, which may provide a scientific basis for clinical prognosis of HIV infection.

Analysis of anti -HIV confirmed positive blood of 27 voluntary blood donors / 中国基层医药

Objective In order to understand the characteristics and the distribution of HIV infection among voluntary blood donation population by analyzing the result about anti -HIV confirmed positive blood of the blood donors.Methods In the study,researchers used ELISA three and four generations of reagents to carry out anti -HIV blood test,and used the Western Blot to confirm the result.Results 176 024 cases of blood collected from voluntary blood donors had been made anti -HIV blood test,between June 1999 and June 2014.The result showed that 274 cases were testing positive,accounting for 0.16%,and 27 cases were confirmed positive,accounting for 0.015%. All the confirmed positive bloods were HIV -1 type virus infection.In the confirmed positive,23 male patients accounted for 85.2%,and it was greater than the proportion of women;age ranged from 19 to 30 years (16 cases, accounting for 59.3% of the total number;professional farmers in 13 cases accounted for 48.2% and it was bigger than other occupations;The cultural degree was less than college level;The regional distribution was mainly in Yuci in 9 cases,each of the remaining counties each accounted for 1 ~2 cases,3 cases in the field of mobile staff,students, migrant workers in 1 case.Conclusion The number of confirmed positive is rising up year by year,and the distribution of HIV infection population is widespread and spread from high -risk groups to the general population. According to the recent situation,the author suggests to ensure the blood safety,it is necessary to do that increasing the publicity and recruitment about the voluntary blood donation,and strengthening blood screening efforts.

Viral suppression and adherence among HIV-infected children and adolescents on antiretroviral therapy: results of a multicenter study / Supressão viral e adesão entre crianças e adolescentes vivendo com HIV na terapia antirretroviral: resultados de um estudo multicêntrico

OBJECTIVE: To evaluate treatment adherence among perinatally-infected pediatric human immunodeficiency virus (HIV) patients followed in pediatric centers in Brazil. METHODS: This was a cross-sectional multicenter study. Medical records were reviewed and adherence scale, assessment of caregivers' quality of life (WHOQOL-BREF), anxiety, depression, and alcohol/substances use/abuse were assessed. Outcomes included self-reported 100% adherence in the last three days and HIV viral load (VL) < 50 copies/mL. Statistical analyses included contingency tables and respective statistics, and multivariable logistic regression. RESULTS: 260 subjects were enrolled: 78% children and 22% adolescents; 93% of caregivers for the children and 77% of adolescents reported 100% adherence; 57% of children and 49% of adolescents had VL < 50 copies/mL. In the univariate analyses, HIV diagnosis for screening due to maternal infection, lower caregiver scores for anxiety, and higher scores in physical and psychological domains of WHOQOL-BREF were associated with 100% adherence. Shorter intervals between pharmacy visits were associated with VL < 50 copies/mL (p ≤ 0.01). Multivariable regression demonstrated that caregivers who did not abuse alcohol/other drugs (OR = 0.49; 95% CI: 0.27-0.89) and median interval between pharmacy visits < 33 days (OR = 0.97; 95% CI: 0.95-0.98) were independently associated with VL < 50 copies/mL; whereas lower caregiver scores for anxiety (OR = 2.57; 95% CI: 1.27-5.19) and children's HIV diagnosis for screening due to maternal infection (OR = 2.25; 95% CI: 1.12-4.50) were found to be independently associated with 100% adherence. CONCLUSIONS: Pediatric HIV programs should perform routine assessment of caregivers' quality of life, and anxiety and depression symptoms. In this setting, pharmacy records are essential to help identify less-than-optimal adherence. .

OBJETIVO: Avaliar a adesão ao tratamento antirretroviral entre portadores de HIV acompanhados em centros pediátricos. MÉTODOS: Trata-se de estudo transversal multicêntrico. Os prontuários ambulatoriais foram revistos e aplicadas escala de adesão, avaliação de qualidade de vida (WHOQOL-BREF), ansiedade, depressão e uso indevido de álcool/substâncias entre cuidadores. Os desfechos incluíram autorrelato 100% de adesão nos últimos três dias e carga viral do HIV (CV) < 50 cópias/mL. RESULTADOS: 260 indivíduos foram incluídos, 79% crianças e 21% adolescentes; 93% das crianças e 77% dos adolescentes relataram 100% de adesão; 57% das crianças e 49% dos adolescentes tinham CV < 50 cópias /mL. Na análise univariada, diagnóstico do HIV por triagem devido à infecção materna, cuidador com pontuação menor para ansiedade e maior nos domínios físico e psicológico do WHOQOL-BREF se mostraram independentemente associados a 100% de adesão. Intervalos mais curtos entre visitas de farmácia foram associados com CV < 50 cópias /mL (p ≤ 0,01). Regressão multivariada mostrou que os cuidadores sem abuso de álcool/outras drogas (OR = 0,49; IC95% 0,27-0,89) e o intervalo médio entre visitas de farmácia < 33 dias (OR = 0,97; IC95% 0,95-0,98) foram associados com CV < 50 cópias/mL; cuidador com menores escores para ansiedade (OR = 2,57; IC95% 1,27-5,19) e diagnóstico de crianças por triagem devido à infecção materna (OR = 2,25; IC95% 1,12-4,50) foram associados com 100% de adesão. CONCLUSÕES: Programas de HIV pediátrico devem avaliar qualidade de vida e sintomas de ansiedade e depressão dos cuidadores. Registros de farmácia são essenciais na identificação de adesão ...

High Prevalence of Hypocholesterolaemia among Antiretroviral Therapy-naive HIV-infected Children in Makurdi, Nigeria: A Retrospective Study.

Aim: To determine the abnormalities in total cholesterol (TC) levels and the potential risk factors in ART–naive, HIV-infected Nigerian children. Study Design: A retrospective and cross-sectional study. Place and Duration of Study: Paediatric antiretroviral therapy (ART) clinic of the Federal Medical Centre, Makurdi, between June 2010 and June 2012. Methods: Electronic data of 429 HIV-infected ART-naive children, aged 1–15 years, including 223 males and 206 females, were analysed to get the relevant information for the study. Abnormal un-fasted TC levels and the association with potential risk factors were tested in bivariate regression analyses. Abnormal lipid level was defined as hypercholestrolaemia when the TC was>200mg/dL and hypocholesterolaemia when TC was ˂160mg/dl. Normal TC was value between 160 and 200mg/dl. P-value less than 0.05 was significant. Results: The median age was 5.00 years with an interquartile range of 3.0 to 8.0 years. The TC ranged from 32 to 196 mg/dl with a mean value of 116±34.98mg/dl. Hypocholesterolaemia was the prominent finding in 88.3% (379/429) of the children. Hypercholestrolaemia was not found (0%). In bivariate analyses, no factor was found to significantly impact on hypocholesterolaemia, although a greater proportion of hypocholesterolaemia was seen in children: within 2-15 years age group (92.1%, 349/379); male gender (52.0%): HIV/AIDS stages 1&2 (82.6%); CD4 count>200 cell/mm3(81.5%); viral load>10,000 copies/ml (69.1%); hemoglobin˂10g/dl (61.7%); stunting (55.4%, 102/207) and undernourishment with body mass index (BMI)˂18.5 (83.7%, 164/222). Multivariate analysis was not done. Conclusion: A high prevalence of hypocholesterolaemia was found among the ARTnaive, HIV-infected Children, in Makurdi. The study could serve as a stimulus for our centre and other paediatric ART programmes in Nigeria to undertake an elaborate lipid profile of HIV infected children at diagnosis and on follow-up on ART.