Factors associated with neurocognitive impairment in treatment experienced HIV+ Adults: A perspective from a Tertiary Care Center in Ethiopia: factors associated with HAND in Ethiopia

Background: Given the improvement in life expectancy of people living with HIV (PLWH) in sub-Saharan Africa, the risk of asymptomatic HIV-associated neurocognitive disorder (HAND) has increased. The study objectives were to investigate the prevalence of HAND and associated factors among treatment experienced adults in Ethiopia. Methods: A single-center observational cross-sectional study was conducted between December 2019 and June2020 to investigate HAND. International HIV dementia scale (IHDS) was used to screen for the disorder. Both descriptive and analytical statistics were used to analyze the data. Results: Total of 324 PLWH (63% females) who were on combination antiretroviral therapy for median of 144months (IQR: 108-168) were investigated. The mean age was 42.5 years (1SD=12.2). The prevalence of HAND was 75.3% and the difference was significantly more in those above 40 years of age (65.8% vs. 80.7%, p=0.003). Age is the only risk factor identified with multivariable logistic regression analysis. A linear decrement in the total score of cognitive performance was observed as the patient's age increase; age was responsible for 9.4% variation observed in IHDS score (r= -0.31, R2=0.094, p<0.0001). Although statistically not-significant, the trend for cardio-metabolic and behavioral risk factors (hypertension, diabetes mellitus, dyslipidemia, smoking, alcohol and khat use) was higher in the group diagnosed with HAND. Conclusion: The occurrence of neurocognitive impairment was more pronounced in individuals aged 40 years and above who were HIV positive, compared to those below 40 years. Age was found to be an independent predictor of HAND. Cardiovascular and behavioral risk factors were observed more among patients with HAND compared to no-HAND

Functions of HIV-1 Tat and its association with diseases / 中国生物制品学杂志

@#Acquired immune deficiency syndrome,or AIDS,has been a major infectious disease that troubles the public health in a global scale. Human immunodeficiency virus type 1(HIV-1)is the causative reagent responsible for AIDS development. Even though the highly active anti-retroviral therapy(HAART,or the cocktail therapy)that has been widely applied could effectively suppress the infection and replication of HIV-1,the infected people suffer from other related diseases,such as the HIV-associated neurocognitive disorder(HAND). This paper mainly focused on the function of an important regulatory protein of HIV-1,trans-activator of transcription(Tat),and its correlation with HIV-1 replication and HAND development,so as to clarify the importance of developing anti-AIDS drugs targeting Tat protein

Incomplete recovery of the CD4+/CD8+ ratio is associated with the late introduction of antiretroviral therapy among people living with HIV infection

ABSTRACT Despite being subject to lower AIDS-related mortality rates and having a higher life expectancy, patients with HIV are more prone to develop non-AIDS events. A low CD4+/CD8+ ratio during antiretroviral therapy identifies people with heightened immune senescence and increased risk of mortality. In clinical practice, finding determinants of a low CD4+/CD8+ ratio may be useful for identifying patients who require close monitoring due to an increased risk of comorbidities and death. We performed a prospective study on the evolution of the CD4+/CD8+ ratio in 60 patients infected with HIV (80% males), who were subjected to two different antiretroviral regimens: early and deferred therapy. The initial CD4+/CD8+ ratio was ≤1 for 70% of the patients in both groups. Older age, CD4+ cell count at inclusion, Nadir CD8+T-cell count, and Initial CD4+/CD8+ ratio ≤ 1 were risk factors for lack of ratio recovery. In the multivariate analysis, a CD4+/CD8+ ratio > 1 at the start of the treatment was found to be a determinant factor in maintaining a CD4+/CD8+ ratio > 1. The nadir CD4+T-cell count was lower in the deferred therapy group (p=0.004), and the last CD4+/CD8+ ratio ≤1 was not associated with comorbidities. Ratio recovery was not associated with the duration of HIV infection, time without therapy, or absence of AIDS incidence. A greater improvement was observed in patients treated early (p=0.003). In contrast, the slope of increase was slower in patients who deferred treatment. In conclusion, the increase in the CD4+/CD8+ ratio occurred mostly for patients undergoing early strategy treatment and its extension did not seem to be related to previous HIV-related factors.

HIV-associated lipodystrophy: epidemiological analysis of a Plastic Surgery Service in Brazil / Lipodistrofia associada ao HIV: análise epidemiológica de um Serviço de Cirurgia Plástica no Brasil

Introduction: Lipodystrophy is an important complication of HIV and has different clinical manifestations, such as lipoatrophy of the face, buttocks, and limbs and accumulation of fat in the abdominal and cervical regions. Lipodystrophy has aesthetic and psychosocial consequences, stigmatizing and affecting patients' quality of life. The objective is to evaluate the epidemiology and treatments performed in patients treated at the HIV-related Lipodystrophy Outpatient Clinic at Hospital das Clínicas da Faculdade de Medicina de Botucatu. Method: The study was conducted retrospectively, with port analysis of patients treated between June 2012 and December 2019, at Hospital das Clínicas da Faculdade de Medicina de Botucatu, in Botucatu, SP, Brazil. Results: The medical records of 153 individuals were analyzed, 79 male and 74 female patients. The mean age was 45.6 years. The referrals came from 48 cities in four states. Caucasian patients accounted for 74.5% of the consultations. The complaint of facial lipodystrophy was reported by 52.9% of the patients. The most common invasive procedure was facial filling with polymethylmethacrylate (PMMA) in 62 patients. Gluteal implants were the most common surgery on six occasions. Conclusion: The data found show a higher proportion of female patients with complaints of lipodystrophy when compared to general data of patients with HIV. The white race was predominant, and the main complaint of lipodystrophy was facial atrophy. Facial filling with PMMA was the most common procedure.

Introdução: A lipodistrofia é uma importante complicação do HIV e apresenta diferentes manifestações clínicas, como lipoatrofia de face, glúteos e membros, e acúmulo de gordura em região abdominal e cervical. A lipodistrofia apresenta consequências estéticas e psicossociais, que são estigmatizantes e afetam a qualidade de vida dos pacientes. O objetivo é avaliar a epidemiologia e os tratamentos realizados nos pacientes atendidos no Ambulatório de Lipodistrofia relacionada ao HIV do Hospital das Clínicas da Faculdade de Medicina de Botucatu. Método: O estudo foi realizado de maneira retrospectiva, com análise de portuário dos pacientes atendidos entre junho de 2012 e dezembro de 2019, no Hospital das Clínicas da Faculdade de Medicina de Botucatu, em Botucatu, SP, Brasil. Resultados: Os prontuários de 153 indivíduos foram analisados, sendo 79 pacientes do sexo masculino e 74 do sexo feminino. A média de idade foi 45,6 anos. Os encaminhamentos tiveram origem de 48 cidades, de quatro estados. Pacientes da raça branca totalizaram 74,5% dos atendimentos. A queixa de lipodistrofia de face foi referida por 52,9% dos pacientes. O procedimento invasivo mais realizado foi o preenchimento facial com polimetilmetacrilato (PMMA), em 62 pacientes. A inclusão de implantes glúteos foi a cirurgia mais realizada, em seis ocasiões. Conclusão: Os dados encontrados mostram maior proporção de pacientes do sexo feminino com queixa de lipodistrofia, quando comparados a dados gerais de pacientes com HIV. A raça branca foi predominante e a principal queixa de lipodistrofia foi a atrofia facial. O preenchimento facial com PMMA foi o procedimento mais realizado

Impact of strength training on bone mineral density in HIV-positive patients / Impacto do treinamento de força na densidade mineral óssea em pacientes HIV positivo

Abstract Introduction: Highly active antiretroviral therapy (HAART) transformed HIV from a fatal disease to a chronic one, but it has adverse effects, such as the lipodystrophy syndrome, characterized by morphological and metabolic changes, such as reduced bone mineral density (BMD), potentiating morbidities and mortality. Strength training (ST) aims to increase BMD, due to the osteogenic effect. Objective: To verify the impact of strength training on BMD in people with HIV. Methods: This is a quasi-experimental study, which included 40 people with a mean age of 50 ± 6 years, separated into trained group (TG, n = 20) and control group (CG, n = 20), with reduction in BMD, HIV-positive, using HAART and without exercising. BMD was assessed by DEXA in the lumbar spine, femoral neck and distal 1/3 of the radius, before and after 12 weeks, with the GT submitted to 36 ST and the CG without physical training in the DEXA evaluation in the same time interval. Results: TG had a significant increase with great effect on BMD in all segments: lumbar spine (p = 0.001; ES: 1.87), femoral neck (p = 0.003; ES: 2.20) and 1/3 distal of the radius (p = 0.001; ES: 1.81). Meanwhile, CG group showed a significant reduction with great effect on the femoral neck (p = 0.020; ES: 2.56) and 1/3 distal of the radius (p = 0.015; ES: 2.93), while the lumbar spine showed a great effect to reduce BMD (p = 0.293; ES: 1.78). Conclusion: ST can be used as a therapeutic resource to increase BMD in people with HIV, contributing to the advancement in the search for non-drug therapeutic practices.

Resumo Introdução: A terapia antirretroviral altamente ativa (HAART) transformou o HIV em uma doença crônica, apresentando efeitos adversos como a síndrome da lipodistrofia, caracterizada por alterações morfológicas e metabólicas, como redução da densidade mineral óssea (DMO), potencializando morbidades e mortalidades. O treinamento de força (TF) tem como proposta aumentar a DMO, devido ao efeito osteogênico. Objetivo: Verificar o impacto do TF na DMO em pessoas com HIV. Métodos: Trata-se de um estudo quase-experimental que incluiu 40 pessoas com idade média de 50 ± 6 anos, separadas em grupo treinado (GT, n = 20) e grupo controle (GC, n = 20), com redução na DMO, HIV positivo, usando HAART e sem praticar exercícios físicos. A DMO foi avaliada pelo DEXA na coluna lombar, colo do fêmur e 1/3 distal do rádio, antes e após 12 semanas, com o GT submetido a 36 sessões de TF e o GC sem exercício durante o mesmo período. Resultados: O GT teve aumento significante com grande efeito em todos os segmentos: coluna lombar (p = 0,001; ES: 1,87), colo do fêmur (p = 0,003; ES: 2,20) e 1/3 distal do rádio (p = 0,001; ES: 1,81), enquanto o GC apresentou redução significante com grande efeito no colo do fêmur (p = 0,020; ES: 2,56), 1/3 distal do rádio (p = 0,015; ES: 2,93) e apenas grande efeito na coluna lombar (p = 0,293; ES: 1,78). Conclusão: O TF pode ser utilizado como recurso terapêutico para aumentar a DMO em pessoas com HIV, contribuindo para o avanço nas buscas de práticas terapêuticas não medicamentosas.

HIV, cirurgia plástica e Brasil: uma revisão narrativa / HIV, plastic surgery and Brazil: a narrative review

RESUMO Introdução: O Brasil apresenta um dos melhores programas de combate ao HIV do mundo e uma das características dessa abordagem é a multidisciplinaridade, onde a cirurgia plástica está envolvida. Objetivo: Realizar uma revisão não sistemática do que já foi publicado sobre HIV por cirurgiões plásticos brasileiros, analisando os principais temas estudados. Métodos: Pesquisas no PubMED, EMBASE, MEDLINE, LILACS, SciELO, Revista Brasileira de Cirurgia Plástica com os seguintes termos: "plastic surgery HIV", "plastic surgery AIDS", "HIV cirurgia plástica", "AIDS cirurgia plástica", "HIV" e "AIDS. Resultados: No total encontramos 862 artigos e após selecionar os escritos por cirurgiões plástico brasileiros, chegamos a um número final de 15, produzidos por 10 instituições de 5 estados brasileiros. O tema mais abordado foi lipodistrofia em 13 publicações. Discussão: Dos artigos selecionados, fica clara a concentração na região Sudeste. O tema mais abordado foi a lipodistrofia e os artigos sobre este foram publicados posteriores à Portaria GM/MS 2582. Áreas como neoplasia cutânea, genética e cirurgia para mudança de sexo não foram alvos de publicações, embora em outros países já haja conteúdo relacionado a HIV e cirurgia plástica produzido. Conclusão: Apesar de publicações de qualidade ainda há áreas em que a pesquisa da cirurgia plástica brasileira necessita explorar em relação ao HIV/AIDS.

ABSTRACT Introduction: Brazil presents one of the best HIV programs globally, and one of the characteristics of this approach is multidisciplinarity, where plastic surgery is involved. Objective: To conduct a non-systematic review of what has already been published on HIV by Brazilian plastic surgeons, analyzing the main themes studied. Methods: Research at PubMed, EMBASE, MEDLINE, LILACS, SciELO, Revista Brasileira de Cirurgia Plástica with the following terms: "plastic surgery HIV", "plastic surgery AIDS", "HIV plastic surgery", "AIDS plastic surgery", "HIV" and "AIDS. Results: We found 862 articles, and after selecting those written by Brazilian plastic surgeons, we reached a final number of 15, produced by 10 institutions from 5 Brazilian states. The most addressed theme was lipodystrophy in 13 publications. Discussion: From the selected articles, it is clear the concentration in the Southeast region. The most addressed theme was lipodystrophy, and the articles on it were published after ordinance GM/MS 2582. Areas such as skin cancer, genetics and surgery for gender reassignment have not been published, although there is already content related to HIV and plastic surgery in other countries. Conclusion: Despite quality publications, there are still areas in which Brazilian plastic surgery research needs to explore concerning HIV/AIDS.

High prevalence of HIV-associated neurocognitive disorders (HAND) in São Paulo City, Brazil / Alta prevalência de desordem neurocognitiva associada ao HIV (HAND) na Cidade de São Paulo, Brazil

INTRODUCTION: HIV-associated neurocognitive disorders (HAND) are the subject of many studies, some of them reporting a prevalence of up to 50 percent. OBJECTIVES: To determine the prevalence and factors associated with HIV neurocognitive disorders (HAND) in a cohort of HIV-1-infected patients in São Paulo city, Brazil. METHODOLOGY: Descriptive cross-sectional study including 106 HIV-1-infected patients, employing direct interview and neuropsychological tests, applied by trained neuro-psychologists with expertise in the tests. Other, similar assessment tools we used were Brief Neurocognitive Questionnaire, International HIV Dementia Scale, Lawton Instrumental Activities of Daily Living, Hospital Anxiety and Depression Scale, Social Support Scale for People with HIV/Aids, Assessment of Adherence to Antiretroviral Therapy Questionnaire, and a complex neuropsychological assessment. RESULTS: We included 106 patients from May 2015 to April 2018. We found a high prevalence of HAND in our patients (45%), with 27.5% presenting asymptomatic neurological impairment (ANI) and 17.5% mild neurological dysfunction (MND); only one patient presented HIV-associated dementia (HAD) (0.9%). Women were more likely to have MND (52.9%) and the only case of HAD was also female. The high prevalence of neurocognitive disorders was independent of the immunological status, use of efavirenz, or virological control. CONCLUSIONS: This study may mirror the national and international scenarios, showing a high prevalence of HAND (45%) and the prevalence of some risk factors, in special among women

INTRODUÇÃO: As doenças neurocognitivas associadas ao HIV (HAND), são o assunto de muitos estudos, alguns deles relatando uma prevalência de até 50 por cento. OBJETIVOS: Determinar a prevalência e os fatores associados aos distúrbios neurocognitivos do HIV (HAND) em uma coorte de pacientes infectados pelo HIV-1 na cidade de São Paulo, Brasil. METODOLOGIA: Estudo transversal descritivo incluindo 106 pacientes infectados pelo HIV-1, utilizando entrevista direta e testes neuropsicológicos, aplicados por neuropsicólogos treinados com experiência nos testes. Foram utilizados também: Questionário Neurocognitivo Breve, Escala Internacional de Demência do HIV, Atividades Instrumentais de Vida Diária de Lawton, Escala Hospitalar de Ansiedade e Depressão, Escala de Apoio Social para Pessoas com HIV / Aids, Avaliação da Adesão à Terapia Antiretroviral Questionário e uma bateria de avaliação neuropsicológica complexa. RESULTADOS: Foram avalaidos 106 pacientes de maio de 2015 a abril de 2018. Foi observado uma alta prevalência de HAND em nossos pacientes (45%), com 27,5% apresentando comprometimento neurológico assintomático (ANI) e 17,5% comprometimento cognitive leve (MND); apenas um paciente apresentou demência associada ao HIV (DAH) (0,9%). As mulheres eram mais propensas a ter MND (52,9%) e o único caso de HAD também era do sexo feminino. A alta prevalência de distúrbios neurocognitivos foi independente do estado imunológico, uso de efavirenz ou controle virológico. CONCLUSÕES: Este estudo pode espelhar o cenário nacional e internacional, mostrando uma alta prevalência de HAND (45%) e a prevalência de alguns fatores de risco, em especial entre as mulheres

SBi4211 alleviates gp120-induced central nervous system injury / 南方医科大学学报

OBJECTIVE@#To explore the protective effect of SBi4211 (heptamidine), an inhibitor of S100B, against central nervous system injury induced by HIV-1 envelope protein gp120.@*METHODS@#In an @*RESULTS@#In the cell co-culture system, SBi4211 treatment significantly inhibited gp120-induced expression of S100B, RAGE and GFAP in U251 cells (@*CONCLUSIONS@#SBi4211 can protect neurons from gp120-induced neurotoxicity possibly by inhibiting the S100B/ RAGE-mediated signaling pathway.

Effects of HIV-1 Vpr protein on cell viability and cell cycle of mouse neuroblastoma N2a cells / 中华实验和临床病毒学杂志

Objective@#To investigate the toxic effect of HIV-1 Vpr protein on neurons.@*Methods@#HIV-1 vpr gene was amplified by nested PCR in four parts of peripheral spleen (SPL) and central nervous tissue meninges (MG) of HIV-associated dementia (HAD) patients and non-HAD patients. Eukaryotic expression vector pEGFP-N1-vpr was constructed. The gene sequence and key amino acid sites were analyzed by BLAST and MEGA6. The expression of Vpr protein in N2a cells was detected by Western-blotting. The effects of Vpr proteins from different sources on the activity and cell cycle of N2a cells were studied by flow cytometry.@*Results@#HIV-1 vpr gene was successfully amplified by PCR. Sequence analysis showed that the vpr gene sequence belonged to HIV-1B subtype. There were amino acid mutations at C-terminal 84, 86 and 87 sites of central Vpr protein from HAD and non-HAD patients. Vpr protein could inhibit the activity of nerve cells, leading to G2 phase arrest. Different sources of Vpr had different intensity of action. Compared with other groups, Vpr protein from the meninges of HAD patients showed stronger inhibition of cell activity and G2 phase arrest ability.@*Conclusions@#Variations in key amino acid sites of Vpr protein could cause significant changes in its biological functions, and its significance in the pathogenesis of HAD remains to be further studied.

Human Immunodeficiency Virus Infection and the Endocrine System

In the current era of effective antiretroviral therapies (ARTs), human immunodeficiency virus (HIV) infection became a chronic disorder that requires long term follow-up. Among other medical issues, these patients may develop endocrine problems, specific to HIV infection and its treatment. The purpose of this review is to give an overview of common endocrine complications associated with HIV infection, and to propose diagnostic and therapeutic strategies. HIV can affect the endocrine system at several levels. Adrenal and gonadal dysfunction, osteoporosis with increased fracture risk, dyslipidemia with increased cardiovascular risk, are some of the endocrine disorders prevalent in HIV-infected patients that may negatively influence quality of life, and increase morbidity and mortality. While ARTs have dramatically increased life expectancy in the HIV-infected population, they are not devoid of adverse effects, including endocrine dysfunction. Physicians caring for HIV-infected patients should be knowledgeable and exercise a high index of suspicion for the diagnosis of endocrine abnormalities, and in particular be aware of those that can be life threatening. Endocrine evaluation should follow the same strategies as in the general population, including prevention, early detection, and treatment.

Comparison between the Mini-Mental State Examination and Montreal Cognitive Assessment as a Cognitive Screening Tool in Patients with Human Immunodeficiency Virus-Associated Neurocognitive Disorders

Abstract INTRODUCTION: The number of human immunodeficiency virus-associated neurocognitive disorders has increased, reaching more than 50% of the cases. However, there are currently no substantial data on the screening methods for this disease. This study aimed to evaluate and compare the Mini-Mental State Examination to the Montreal Cognitive Assessment in human immunodeficiency virus-infected patients. METHODS: This was an observational study comprising 82 human immunodeficiency virus-positive individuals with and without cognitive complaints. RESULTS: Positive correlation (p<0.001) between the Mini-Mental State Examination and the Montreal Cognitive Assessment test scores was observed, but the mean scores revealed that the Mini-Mental State Examination showed worse performance for trails (p<0.001), cube copying (p<0.001), and clock drawing (p<0.001) than the Montreal Cognitive Assessment. CONCLUSIONS: The Mini-Mental State Examination and the Montreal Cognitive Assessment tests should be used concomitantly for the assessment of human immunodeficiency virus-associated neurocognitive disorders, but visuoexecutive and visuospatial dysfunctions are better evaluated using the Montreal Cognitive Assessment test than the Mini-Mental State Examination.

Fibrillary glomerulonephritis in a human immunodeficiency virus-positive, hepatitis C-negative Indian patient: Expanding the profile of renal involvement in human immunodeficiency virus infection

Highly active anti retroviral therapy (HAART) has dramatically improved life expectancy of human immunodeficiency virus (HIV) infected patients, converting HIV infection into a chronic illness with associated changes in its attendant renal complications. The past two decades have witnessed a decrease in the prevalence of HIV associated nephropathy (HIVAN), traditionally considered to be the hall mark of renal involvement in HIV infection. Simultaneously a host of other glomerular and tubulo-interstitial diseases have emerged, expanding the spectrum of HIV associated renal diseases, predominant among which is HIV associated immune complex mediated kidney diseases (HIVICK). Of the diverse glomerular diseases constituting HIVICK, fibrillary glomerulonephritis (FGN) remains a rarity, with only two existing reports to date, confined to patients co-infected with Hepatitis C virus (HCV). The pathogenetic role of HIV in these patients remains under a cloud because of previously well established association of HCV infection and FGN. We report a case of FGN in a HIV seropositive, HCV negative Indian patient, highlighting the diagnostic electron microscopy (EM) findings of FGN and strengthening the causal association of HIV with FGN. In view of increasing heterogeneity of renal complications in HIV infection, the diagnostic utility of a comprehensive renal biopsy evaluation inclusive of EM is emphasized for appropriate selection of treatment modalities.

Effects of HIV-1 Tat derived from central nervous system of a HIV-associated dementia patient on the activity of human umbilical vein endothelial cells / 中华实验和临床病毒学杂志

Objective@#BG-derived HIV-1 Tat protein from an HIV-associated dementia (HAD) patient was expressed in E. coli BL21(DE3) and purified in order to research the effects on human umbilical vein endothelial cells (HUVECs) activity.@*Methods@#The recombinant plasmid pGEX-KG-tat with HIV-1 tat stored in our laboratory was amplified by PCR. The PCR product was cloned into pET-32a-tat. The recombinant plasmid pET-32a-tat was transfected into E. coli, and Tat protein was expressed in BL21(DE3), which was induced by IPTG. Then it was purified by Ni-chelating chromatography column and gel filtration preloaded column, and identified by SDS-PAGE and Western blot(WB). The concentration was determined by BCA Kit. Different concentrations of Tat were added into HUVECs to detect their effects on cell activity by cck-8.@*Results@#The Tat with high purity was efficiently expressed in BL21 (DE3) and obtained by using the Ni-chelating chromatography column and gel filtration preloaded column. The concentration was 0.47 mg/ml by using BCA Kit. As the concentration of Tat increased, HUVECs activity decreased. There was no significant difference in cells viability between negative control with 100 ng/ml and 200 ng/ml group (P>0.05). There was significant difference in cells viability between negative control with 300 ng/ml, 400 ng/ml, 500 ng/ml and 1000 ng/ml group (P<0.05). But the difference between 300 ng/ml, 400 ng/ml, 500 ng/ml and 1000 ng/ml group was not statistically significant (P>0.05).@*Conclusions@#The HIV-1 Tat with biological activity was efficiently expressed in BL21 (DE3), and the activity of HUVECs was significantly decreased when the concentration reached 300 ng/ml.

Altered White Matter Integrity in Human Immunodeficiency Virus-Associated Neurocognitive Disorder: A Tract-Based Spatial Statistics Study

OBJECTIVE: Human immunodeficiency virus (HIV) infection has been known to damage the microstructural integrity of white matter (WM). However, only a few studies have assessed the brain regions in HIV-associated neurocognitive disorders (HAND) with diffusion tensor imaging (DTI). Therefore, we sought to compare the DTI data between HIV patients with and without HAND using tract-based spatial statistics (TBSS). MATERIALS AND METHODS: Twenty-two HIV-infected patients (10 with HAND and 12 without HAND) and 11 healthy controls (HC) were enrolled in this study. A whole-brain analysis of fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), and axial diffusivity was performed with TBSS and a subsequent 20 tract-specific region-of-interest (ROI)-based analysis to localize and compare altered WM integrity in all group contrasts. RESULTS: Compared with HC, patients with HAND showed decreased FA in the right frontoparietal WM including the upper corticospinal tract (CST) and increased MD and RD in the bilateral frontoparietal WM, corpus callosum, bilateral CSTs and bilateral cerebellar peduncles. The DTI values did not significantly differ between HIV patients with and without HAND or between HIV patients without HAND and HC. In the ROI-based analysis, decreased FA was observed in the right superior longitudinal fasciculus and was significantly correlated with decreased information processing speed, memory, executive function, and fine motor function in HIV patients. CONCLUSION: These results suggest that altered integrity of the frontoparietal WM contributes to cognitive dysfunction in HIV patients.

Human immunodeficiency virus animal models and related neuropathy study / 中国药理学通报

Human immunodeficiency virus(HIV) infection may result in serious impairment of the immune system in HIV-posi-tive patients. Both HIV productions and highly active antiretrovi-ral therapy (HAART) drugs can cause neuropathy, including the HIV associated neurocognitive disorders (HAND) and the peripheral neuropathy. Several animal models have been devel-oped in an attempt to study the mechanisms of HIV relative neu-ropathies. This review focuses on researching HIV-1 associated neuropathies by application of HIV-1 animal models.

Impacto na qualidade de vida em pacientes usuários de medicação retroviral e submetidos à gluteoplastia: estudo de coorte histórica / Gluteal contour restoration in antiretroviral users and its quality-of-life related impacts: a historical cohort study

INTRODUÇÃO: Desde a introdução do tratamento do HIV com uso da terapia antirretroviral altamente ativa, a mortalidade por essa doença foi reduzida drasticamente em todo o mundo. Um dos parefeitos relacionados à utilização desses fármacos é a lipodistrofia glútea. O objetivo deste trabalho é verificar o impacto da correção dessa deformidade na qualidade de vida de pacientes com HIV. MÉTODOS: Foi conduzido um estudo de coorte histórica com 23 pacientes submetidos à gluteoplastia com implante intramuscular, entre janeiro de 2010 e dezembro de 2014, avaliando a qualidade de vida por meio do em Nottingham Health Profile em. As informações foram coletadas de julho a agosto de 2015. A análise estatística foi feita utilizando-se o em Related-Samples McNemar Test em. RESULTADOS: strong Houve diferença significativa entre o pré-operatório e pós-operatório em 19 das 38 perguntas. CONCLUSÃO: É possível afirmar que a reconstrução glútea melhora a qualidade de vida de pacientes HIV positivos acometidos por lipodistrofia glútea relacionada a antirretrovirais.

INTRODUCTION: Since the introduction of highly active antiretroviral therapy for the treatment of human immunodeficiency virus (HIV), disease mortality has been dramatically reduced worldwide. One related side effect from the use of these drugs is gluteal lipodystrophy. The aim of this study is to assess the quality-of-life impact of correcting this deformity in HIV patients. METHODS: A historical cohort study was conducted between January 2010 and December 2014 with 23 patients, assessing the quality of their lives using the Nottingham Health Profile. A statistical analysis was performed using the McNemar test for related samples. RESULTS: There was a significant difference between preoperative and postoperative response in 19 of the 38 questions. CONCLUSION: We may say that gluteal reconstruction plays a role in improving quality of life for HIV patients who have been affected by antiretroviral related gluteal lipodystrophy.

Manifestaciones de la cavidad bucal por infección del virus de la inmunodeficiencia humana: reporte de caso clínico / Oral manifestations of the HIV virus: report of a clinical case

Las manifestaciones orales por la infección del virus de la inmunode-ficiencia humana son en ocasiones el primer signo de la enfermedad yen muchos casos un indicador de la progresión de la infección hacia elsíndrome de inmunodeficiencia adquirida. Las ulceraciones indoloras,diferentes tipos de gingivitis agresivas y la leucoplasia vellosa, se desarrollan muy fácilmente en individuos cuyo sistema inmunológico está comprometido, como el de los pacientes que sufren del virus deinmunodeficiencia adquirida.

Oral manifestations caused by the human immunodefi ciency virusare often the fi rst indication that the person is infected and oftenan indicator of its progression into AIDS. Painless ulcers, assortedtypes of aggressive gingivitis, and hairy leukoplakia develop easilyin individuals whose immune system is compromised, such as thoseinfected with HIV.

The Role of Nuclear Medicine in the Staging and Management of Human Immune Deficiency Virus Infection and Associated Diseases / 대한핵의학회잡지

Human immune deficiency virus (HIV) is a leading cause of death. It attacks the immune system, thereby rendering the infected host susceptible to many HIV-associated infections, malignancies and neurocognitive disorders. The altered immune system affects the way the human host responds to disease, resulting in atypical presentation of these disorders. This presents a diagnostic challenge and the clinician must use all diagnostic avenues available to diagnose and manage these conditions. The advent of highly active antiretroviral therapy (HAART) has markedly reduced the mortality associated with HIVinfection but has also brought in its wake problems associated with adverse effects or drug interaction and may even modulate some of the HIV-associated disorders to the detriment of the infected human host. Nuclear medicine techniques allow non-invasive visualisation of tissues in the body. By using this principle, pathophysiology in the body can be targeted and the treatment of diseases can be monitored. Being a functional imaging modality, it is able to detect diseases at the molecular level, and thus it has increased our understanding of the immunological changes in the infected host at different stages of the HIV infection. It also detects pathological changes much earlier than conventional imaging based on anatomical changes. This is important in the immunocompromised host as in some of the associated disorders a delay in diagnosis may have dire consequences. Nuclear medicine has played a huge role in the management of many HIV-associated disorders in the past and continues to help in the diagnosis, prognosis, staging, monitoring and assessing the response to treatment of many HIV-associated disorders. As our understanding of the molecular basis of disease increases nuclear medicine is poised to play an even greater role. In this review we highlight the functional basis of the clinicopathological correlation of HIV from a metabolic view and discuss how the use of nuclear medicine techniques, with particular emphasis of F-18 fluorodeoxyglucose, may have impact in the setting of HIV. We also provide an overview of the role of nuclear medicine techniques in the management of HIV-associated disorders.

Fatores associados ao uso de polimetilmetacrilato na lipoatrofia facial em pacientes tratados com antirretrovirais / Associated factors to use of polymethylmethacrylate in facial lipoatrophy in patients treated with antiretrovirals

Objetivos: Identificar fatores associados ao uso do polimetilmetacrilato em pacientes HIV positivos sob tratamento antirretroviral em Santa Catarina e definir o perfil dos pacientes que buscam o tratamento para lipoatrofia facial. Métodos: Estudo transversal com 219 pacientes elaborado a partir de registros no SINAN (Sistema de Informação de Agravos de Notificação) e concomitantemente no serviço realizador da intervenção para lipoatrofia facial no âmbito do Sistema Único de Saúde no Estado de Santa Catarina, no período de 2008 a 2011, em que foram avaliados possíveis fatores de risco em variáveis sóciodemográficas e clínicas relacionadas à doença e à intervenção. Resultados: Os pacientes tinham em média 48 anos variando de 30 a 74 anos, sendo predominantemente do sexo masculino (70,8%). Foi encontrada associação significativa entre hipertensão arterial sistêmica (p=0,0006), sexo masculino (p=0,0010), realização de transfusão sanguínea (p=0,013), pacientes não etilistas (p=0,014) e portadores de HIV há mais de 5 anos (p=0,049) e a maior aplicação de polimetilmetacrilato. Em média, o grupo homossexual necessitou de quase 0,6 intervenções a mais do que o grupo heterossexual para uso de metacrilato, assim como maior volume (6,16mL). Conclusão: Pacientes do sexo masculino, homossexuais, hipertensos, que realizaram transfusão sanguínea, não etilistas e que possuem diagnóstico da doença há mais de 5 anos fizeram aplicação de maior volume de polimetilmetacrilato.

Objectives: Identify factors associated with use of polymethylmetacrylate HIV-infected patients in with treatment on antiretroviral in Santa Catarina and define the profile of patients seeking treatment for lipoatrophy. Methods: Cross-sectional study with 219 patients compiled from records in SINAN (Information System for Notifiable Diseases) and concurrently director of the service intervention for facial lipoatrophy in the SUS in the state of Santa Catarina, from 2008 to 2011, where they were assessed possible risk factors in clinical and sociodemographic variables related to illness and intervention. Results: Patients had an mean of 48 years ranging from 30 to 74 years, predominantly male (70.8%). There was use of higher volume of polymethyl methacrylate in the face of patients with hypertension (p = 0.0006), male gender (p = 0.0010), performance of blood transfusion (p = 0.013), non-alcoholic patients (p = 0.014) and HIV for over 5 years (p = 0.049). On mean, the homosexual group interventions needed almost 0.6 more than the heterosexual group for use methacrylate as well as higher volume (6.16 mL). Conclusion: Homossexual men, hypertensive, patients who underwent blood transfusion, nondrinkers as well as who have a diagnosis of the disease for more than 5 years showed increased risk for higher volume of polymethyl methacrylate in the face male patients.