RESUMEN
HIV-1 prevalence was studied in 1,890 metamphetamine users from Thanyarak Hospital from 1999 to 2000. 64.8 per cent positive urine metamphetamine and 2.3 per cent positive urine opiate were observed. The most common route of the drug intake was 93.92 per cent inhalation. HIV-1 prevalence was 2.44 per cent (95% Confidence interval; 1.65-3.18%). 44 out of 46 HIV-1 infected cases were typeable as 32 (72.73%) subtype E and the rest of subtype B'. Active opiate users had a higher rate of HIV-1 infection, 15.91 per cent, compared to 2.11 per cent of the non-opiate users (Fisher's exact test p=0.0002). This group of metamphetamine users is important to public health and more attention on intervention efforts towards HIV infection is urgently needed.
Asunto(s)
Adolescente , Adulto , Distribución por Edad , Comorbilidad , Femenino , Infecciones por VIH/diagnóstico , Seronegatividad para VIH , Seropositividad para VIH , VIH-1/aislamiento & purificación , Humanos , Masculino , Metanfetamina/efectos adversos , Persona de Mediana Edad , Vigilancia de la Población , Prevalencia , Factores de Riesgo , Distribución por Sexo , Trastornos Relacionados con Sustancias/diagnóstico , Tailandia/epidemiologíaRESUMEN
CCR5, a chemokine receptor, is the principal coreceptor for macrophage-tropic HIV-1 which is the most important variant for viral transmission. It has been demonstrated that a homozygous genotype of a 32-bp deletion in CCR5 gene (delta32CCR5) shows a high degree of resistance to HIV-1 infection. To demonstrate that delta32CCR5 does exist in Thai natives, the CCR5 genotypes and allelic frequencies in 860 Thai injecting drug users (IDUs) were determined by PCR and DNA sequencing. Of these, six (0.7%) were CCR5/delta32CCR5 heterozygotes and no homozygote was found. The overall delta32CCR5 allelic frequency was 0.0035 and in HIV-1 seronegative (n = 490) and seropositive (n = 370) IDUs were 0.0051 and 0.0004, respectively, which were not significantly different (p = 0.3776). Here we report that the delta32CCR5 does exist in Thai IDUs as it is present in other human races. Such low allelic frequency may indicate that this mutation does not attribute a significant role in HIV-1 transmission in Thai IDUs.
Asunto(s)
Adulto , Alelos , Estudios de Cohortes , Estudios Transversales , Femenino , Genotipo , Infecciones por VIH/epidemiología , Seronegatividad para VIH , Seropositividad para VIH/genética , VIH-1 , Heterocigoto , Humanos , Masculino , Mutación , Prevalencia , Receptores CCR5/genética , Abuso de Sustancias por Vía Intravenosa/genética , Tailandia/etnologíaRESUMEN
A study on how to apply PCR as a diagnostic test for the infants born to HIV-1 infected mothers is described. All steps including clinical care, blood sampling, specimen processing and PCR analysis were carried out using native facilities and personnel. An open cohort of 130 children was evaluated at birth, 1, 6, 9, 15, and 18 months of age. Definite infection status was assessed by clinical and serological data during an 18 months of follow up period. PCR results were reported as positive or negative when at least 2 concordant data were denoted. This in-house PCR, compared to known infection status, gave 100% sensitivity and 94.4% specificity within 6 months after birth. On the other hand, clinical diagnosis could identify only the infected infants at 9 months of age. The HIV-1 transmission rate from mother to infant was 23.2%. Though this PCR was not at an optimal level of specificity, it was still beneficial to identify uninfected infants in the first year of their lives and avoid unnecessary medical care. Here, we report an in-house PCR that offers good performance at low cost for the diagnosis of HIV-1 vertical transmission.