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Point-of-care testing (POCT) in pediatric primary care is essential for clinicians to make a timely and accurate diagnosis. The COVID-19 pandemic has highlighted the importance of timely and accurate testing strategies to correctly identify the etiology of upper and lower respiratory infections. Additionally, pediatric POCT continues to be important in rural and underserved communities where access to hospital laboratories may be less available. This chapter will focus on seven rapid tests: Group A streptococcus (GAS), influenza A & B, SARS-CoV-2 (COVID-19), human immunodeficiency virus (HIV), C-reactive protein (CRP), human chorionic gonadotropin (hCG), and hemoglobin A1c (HbA1c). © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.
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BackgroundAcetaminophen (APAP = paracetamol) may potentially impact vaccine-associated immune responses as the intake of APAP has been associated with a worse outcome in tumor patients receiving checkpoint inhibitors.[1]Different DMARD regimen have been shown to impair the humoral immune response to mRNA SARS-CoV-2 vaccines in patients with rheumatoid arthritis but the effect of paracetamol has not been explored thus far.ObjectivesTo analyse whether the intake of APAP may interfere with antiviral humoral immune responses following two doses of an anti-SARS-CoV-2 mRNA based vaccine in patients with rheumatoid arthritis (RA) on DMARD therapy.MethodsThe RECOVER trial (Rheumatoid Covid-19 Vaccine Immune Response) was a non-randomised, prospective observational control group trial and enrolled 77 RA patients on DMARD therapy and 21 healthy controls (HC). We performed a posthoc analysis of blood samples taken before the first vaccine dose (T0), two (T1) and three (T2) weeks after the first and second vaccine dose, and at 12 (T3) weeks. APAP intake was measured using ELISA. The antibody response (anti-S) to the receptor binding domain (RBD) within the SARS-CoV-2 S1 protein was measured with the Elecsys Anti-SARS-CoV-2-S (Roche Diagnostics GmbH) test. The neutralizing activity NT50 at week 12 was assessed using an HIV-based pseudovirus neutralization assay against Wuhan-Hu-1.ResultsBaseline characteristics of participants are detailed in Table 1. The immunogenicity analyses were based on 73 RA patients after exclusion of 4 patients with previously unnoticed SARS-CoV-2 infection (positive for anti-nucleoprotein at baseline). APAP was detected in serum samples from 34/73 (25%) RA patients and in 7/21 (33%) HC (least at one timepoint T0, T1 and/or T2). APAP intake in HC did not affect levels of anti-S at any timepoint and all HC developed potent neutralizing activity (NT50 ≥ 250) at week 12. RA patients, who tested positive for APAP at T1, showed comparable anti-S levels at T1, T2 and T3 compared to RA patients not exposed to APAP. The detection of APAP at T2 corresponded to lower anti-S levels at T2 (Figure 1 A, B). The detection of APAP at T2 was associated with a significantly lower SARS-CoV-2 neutralizing activity at week 12 compared to patients without perivaccination APAP exposure (p =0.04) (Figure 1 C).ConclusionA decrease of antiviral humoral immune responses was observed in RA patients (but not in HC) who were exposed to APAP at the time of the second mRNA vaccine dose compared to patients in whom APAP was not detected. Our data suggest that the use of paracetamol within the time period around vaccination may impair vaccine-induced immune responses in patients with an already higher risk for blunted immune responses.Reference[1]Bessede A et al. Ann Oncol 2022;33: 909-915Table 1.Baseline characteristics: RA patients and HC with/without APAP exposureRA APAP – n = 37RA APAP + n = 36p-valueHC APAP – n = 8HC APAP + n = 13p-valueAge (yrs), mean (± SD)62 (13)67 (10)0.07 (NS)45 (12)44 (14)0.90 (NS)Female sex, n (%)24 (65)19 (53)0.29 (NS)2 (25)5 (38)0.53 (NS)Vaccination type/schedulemRNA-1273, n (%)4 (11)8 (22.2)0.19 (NS)0 (0)0 (0)BNT162b2, n (%)33 (89)28 (77.8)0.19 (NS)8 (100)13 (100)RA disease characteristicsACPA ± RF, n (%)17/37 (46)19/36 (53)0.56 (NS)NANANARA disease duration (yrs ± SD)9.2 (9.8)10.2 (8.1)0.67 (NS)NANANADMARD therapycsDMARD-mono, n (%)13/37 (35)9/36 (25)0.35 (NS)NANANAbDMARD-mono/combo, n (%)16/37 (43)16/36 (44)0.92 (NS)NANANAtsDMARDs-mono/combo, n (%)8/37 (22)11/36 (31)0.38 (NS)NANANAPrednisone, n (%)15/37 (41)12/36 (33.3)0.52 (NS)NANANAMean daily dose prednisone (mg ± SD)4.6 ± 1.13.9 ± 2.30.39 (NS)NANANA* APAP = acetaminophenFigure 1.Acknowledgements:NIL.Disclosure of InterestsNone Declared.
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BackgroundThe exact pathogenesis of fibromyalgia (FM) syndrome is unclear. However, different infections including hepatitis C virus, Human immunodeficiency virus and Lyme disease have already been implicated with the development of FM after their acute phase[1]. Imbalance between pro-inflammatory and anti-inflammatory cytokines has been suggested as a possible mechanism that facilitates the neuropathic pain[2].ObjectivesTo investigate the incidence of FM syndrome among convalesced individuals following hospitalization for Acute Coronavirus Disease-2019 (COVID-19) and to identify possible risk factors.MethodsWe performed a cross-sectional study on patients who were discharged after COVID-19 hospitalization from the Sheba Medical Center, Israel, between July 2020 to November 2020. A phone interview was performed consisting of the following questionnaires: the Fibromyalgia Survey Diagnostic Criteria Questionnaire, Sense of Coherence Questionnaire to evaluate resilience, and the Subjective Traumatic Outlook Questionnaire to assess the associated psychological aspects of the trauma. The incidence of post-COVID FM was calculated and regression models were performed to identify predictors.ResultsThe study population consisted of 198 eligible patients who completed the phone interview. The median age was 64 (52-72) and 37% were women. The median follow-up was 5.2 months (IQR 4.4-5.8). The incidence of FM was 15% (30 patients) and 87% (172 patients) had at least one FM-related symptom. Female gender was significantly associated with post-COVID FM (OR 3.65, p=0.002). In addition, high median Subjective Traumatic Outlook scores and low median Sense of Coherence scores were both significantly associated with post-COVID FM (OR 1.19, p<0.001 and OR 0.92, p<0.001, respectively).ConclusionFM is highly prevalent among COVID-19 convalescent patients. Our finding suggests that a significant subjective traumatic experience and a low resilience are highly associated with post-COVID FM.References[1]Buskila D, Atzeni F, Sarzi-Puttini P. Etiology of fibromyalgia: the possible role of infection and vaccination. Autoimmun Rev. 2008;8: 41-43. https://doi.org/10.1016/j.autrev.2008.07.023[2]Amital M, Ben-Shabat N, Amital H, Buskila D, Cohen AD, Amital D. COVID-19 associated hospitalization in 571 patients with fibromyalgia—A population-based study. PLoS ONE. 2021:16: e0261772. https://doi.org/10.1371/journal.pone.0261772Acknowledgements:NIL.Disclosure of InterestsNone Declared.
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ObjectiveTo assess the effectiveness of hydroxychloroquine in patients admitted to hospital with coronavirus disease 2019 (covid-19) pneumonia who require oxygen.DesignComparative observational study using data collected from routine care.SettingFour French tertiary care centres providing care to patients with covid-19 pneumonia between 12 March and 31 March 2020.Participants181 patients aged 18-80 years with documented severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia who required oxygen but not intensive care.InterventionsHydroxychloroquine at a dose of 600 mg/day within 48 hours of admission to hospital (treatment group) versus standard care without hydroxychloroquine (control group).Main outcome measuresThe primary outcome was survival without transfer to the intensive care unit at day 21. Secondary outcomes were overall survival, survival without acute respiratory distress syndrome, weaning from oxygen, and discharge from hospital to home or rehabilitation (all at day 21). Analyses were adjusted for confounding factors by inverse probability of treatment weighting.ResultsIn the main analysis, 84 patients who received hydroxychloroquine within 48 hours of admission to hospital (treatment group) were compared with 89 patients who did not receive hydroxychloroquine (control group). Eight additional patients received hydroxychloroquine more than 48 hours after admission. In the weighted analyses, the survival rate without transfer to the intensive care unit at day 21 was 76% in the treatment group and 75% in the control group (weighted hazard ratio 0.9, 95% confidence interval 0.4 to 2.1). Overall survival at day 21 was 89% in the treatment group and 91% in the control group (1.2, 0.4 to 3.3). Survival without acute respiratory distress syndrome at day 21 was 69% in the treatment group compared with 74% in the control group (1.3, 0.7 to 2.6). At day 21, 82% of patients in the treatment group had been weaned from oxygen compared with 76% in the control group (weighted risk ratio 1.1, 95% confidence interval 0.9 to 1.3). Eight patients in the treatment group (10%) experienced electrocardiographic modifications that required discontinuation of treatment.ConclusionsHydroxychloroquine has received worldwide attention as a potential treatment for covid-19 because of positive results from small studies. However, the results of this study do not support its use in patients admitted to hospital with covid-19 who require oxygen.
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INTRODUCTION: Objectives of this study, as part of a nation-wide HIV pre-exposure prophylaxis (PrEP) evaluation project, were to determine the incidence of infections with HIV, chlamydia, gonorrhea, syphilis, hepatitis A/B/C in persons using PrEP, and to describe the health care funded PrEP use in Germany. Additionally, factors associated with chlamydia/gonorrhea and syphilis infections were assessed. METHODS: Anonymous data of PrEP users were collected at 47 HIV-specialty centers from 09/2019-12/2020. Incidence rates were calculated per 100 person years (py). Using longitudinal mixed models, we analyzed risk factors associated with sexually transmitted infections (STIs). RESULTS: 4620 PrEP users were included: 99.2% male, median age 38 years (IQR 32-45), 98.6% men who have sex with men (MSM). The median duration of PrEP exposure was 451 days (IQR 357-488), totaling 5132 py. Four HIV infections were diagnosed, incidence rate 0,078/100py (95% CI 0.029-0.208). For two, suboptimal adherence was reported and in the third case, suboptimal adherence and resistance to emtricitabine were observed. One infection was likely acquired before PrEP start. Incidence rates were 21.6/100py for chlamydia, 23.7/100py for gonorrhea, 10.1/100py for syphilis and 55.4/100py for any STI and decreased significantly during the observation period. 65.5% of syphilis, 55.6% of chlamydia and 50.1% of gonorrhea cases were detected by screening of asymptomatic individuals. In a multivariable analysis among MSM younger age, PrEP start before health insurance coverage and daily PrEP were associated with greater risk for chlamydia/gonorrhea. Symptom triggered testing and a history of STI were associated with a higher risk for chlamydia/gonorrhea and syphilis. A significantly lower risk for chlamydia/gonorrhea and syphilis was found for observations during the COVID-19 pandemic period. CONCLUSIONS: We found that HIV-PrEP is almost exclusively used by MSM in Germany. A very low incidence of HIV infection and decreasing incidence rates of STIs were found in this cohort of PrEP users. The results were influenced by the SARS-CoV-2 pandemic. Rollout of PrEP covered by health insurance should be continued to prevent HIV infections. Increased PrEP availability to people at risk of HIV infection through the elimination of barriers requires further attention. Investigation and monitoring with a longer follow-up would be of value.
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Nitsan Chorev's Give and Take is an in-depth and well-researched comparative historical analysis of the kind of foreign aid that facilitated the development and growth of the pharmaceutical industry in East Africa. [...]the decision to purchase locally manufactured drugs for "rations kits” in Kenya, but not in Tanzania or Uganda, was instrumental in the growth of the Kenyan industry and equally detrimental to the fledgling Tanzanian and virtually nonexistent Ugandan pharmaceutical sectors. [...]Chorev shows how this creation of a market, which expands significantly in the wake of HIV/AIDS, was only part of the equation. [...]the remarkable value of Chorev's work has only been amplified since its publication by the highly unequal global distribution of COVID-19 vaccines, particularly in Africa, and a subsequent edition might include a prefatory note on the relevance of Give and Take to the COVID pandemic.
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Following the cancellation of influential contemporary choreographer Bill T. Jones's highly anticipated return to the stage in spring 2020, Jones reflected that COVID-19 was his "second plague." In referencing the AIDS epidemic that upended his career and personal life, Jones located methods of enduring not in the "unprecedented" present, but in the past. This essay considers the irreverent and buoyant Secret Pastures (1984), a work that reemerged as streaming media during the pandemic, as part of Jones's AIDS repertory. I describe how Secret Pastures' artistic and social archives, and the collaboration and friendship among Jones, Arnie Zane, Keith Haring, Peter Gordon, and Willi Smith documented therein, contain crucial practices of queer survival, particularly that of "alongsidedness." The essay argues that contexts for endurance can be found in the allegedly frivolous, glamorous, playful, humorous, and excessive aesthetics of Secret Pastures as much as they can be identified in, and more typically are ascribed to, more formalist, austere, and tonally serious works like D-Man in the Waters (1989) and Still/Here (1994). Modeling a toolkit of perseverance and flourishing, Secret Pastures reorients popular and academic views of minoritarian, particularly Black, and queer art and life as structured through trauma and scarcity. Secret Pastures shows how the onstage performance serves as a context for offstage friendships. Amid the ongoing hostilities of government abandonment, homophobia, white supremacy, and viral attack, art-making functions as a laboratory for modes of relationality that can endure.
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Sexuality educator and author Jane Fleishman discusses the need to focus on sexual pleasure instead of sexual dysfunction for older adults. She exhorts her readers to notice the impact of current political and social upheaval, the pandemic, the recent Dobbs decision, and the concomitant racial violence, climate change, political crises, technological divides, as well as the healthcare system's inconsistencies, which have laid bare disparities, particularly for vulnerable older adults. She encourages scholars, researchers, students, and policy makers to embrace the intersections, develop new tools, and focus on marginalized populations.
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Objective: To look for the factors associated with outcomes in patients managed for invasive fungal infections at the Infectious Diseases Department of a Tertiary Care Hospital Study Design: Comparative cross-sectional study Place and Duration of Study: Department of Infectious Diseases, Pak Emirates Military Hospital, Rawalpindi Pakistan,from Apr 2021 to Sep 2022. Methodology: A total of 90 patients with a different types of invasive fungal infections diagnosed by consultant infectious diseases were recruited. First, they were given standard treatment for fungal infection;they were diagnosed as per guidelines. Then, they were followed up for one month to look for an outcome. Results: Out of 90 patients with invasive fungal infections included in the study, 62(68.8%) had a good outcome, while 28(31.2%) had a poor outcome. The mean age of the patients recruited in our study was 39.54±6.27 years. Of all the participants, 65(72.2%) patients were male, while 25(27.8%) were female. Statistical analysis revealed that poorly controlled diabetes, COVID-19 infection and HIV positive were statistically significantly associated with poor outcomes in our study participants (p-value<0.05). Conclusion: The Considerable number of patients with invasive fungal infections had a poor outcome in our study. The presence of poorly controlled diabetes, COVID-19 infection and being HIV positive were the factors associated with poor outcomes in our study participants.
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5 The authors are cautious about drawing too-easy parallels between the two pandemics, citing, for example, Marc Arthur's point that "there was never a race for a cure or vaccine to end AIDS like there is for COVID-19" (Anderson and Ybarra;Nereson);they also emphasize that the HIV and AIDS pandemic is ongoing.6 But the callousness on vivid display in the United States over the past two years, which ensured that COVID-19 has disproportionately impacted Black, Indigenous, Latinx, Asian American and Pacific Islander communities, the elderly, the immunocompromised, the incarcerated, and the poor, recalls the cruelty of public health policies during the first wave of HIV and AIDS. The issue opens with Anderson's and Ybarra's essay.11 It triangulates the first wave of the HIV and AIDS epidemic in the 1980s, performance theory, and the COVID-19 pandemic to trace how the legacies of queer care that emerged in response to HIV and AIDS circulate powerfully in our discipline today. "12 Anderson and Ybarra "contend that it is not merely coincidental that performance theory would elaborate such a claim within the context of the first wave of the HIV/AIDS epidemic … not because they have a causal or direct connection, but because they point to the same urgent question: 'Someone is dying in front of your eyes. What are you going to do about it?'" They go on to trace the complex legacies of queer care as practiced (and refused) at the 2022 American Society of Theatre Research annual conference in San Diego.
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The study estimates the usability and attitude assessment of users for India's first approved rapid antigen self-test kit;the CoviSelf™. India approved its first AI-powered self-test for Covid-19 in April 2021 a few weeks after the first approval in the US. We present here a study on usability and attitude assessment of users of India's first approved rapid antigen self-test kit;the CoviSelf™. The study evaluates participants' understanding of and performance of test procedure and interprets the results. Analysis revealed that more than 90% study participants followed steps correctly as illustrated in the user's manual. Age group and gender-based analysis showed comparable scores for usability of the test kit suggesting users of different age groups has same ease in using the test kit. What we learnt from this study could be start of self-test revolution, where rapid tests could expand the access of diagnostics for hundreds of diseases including HIV, HPV, and dengue to millions of people who could not get access to diagnostics because we lacked manpower or facility to conduct tests. Self-testing could break the barriers for diagnostics that Internet did for information.
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This essay examines queer responses to the first wave of the HIV/AIDS epidemic alongside public health practices at a recent ASTR conference held during the COVID-19 pandemic. The authors focus especially on the period between the identification of the HIV virus in 1983 and the first availability of protease inhibitors in 1996. Within this period, queer practices of care in the face of government neglect engaged with performance, and in retrospect were themselves a form of performance theory that literalized performance studies' fixation on liveness and mortality. As the authors revisit archives, including public health videos, memoirs, congressional hearings, and queer criticism from the 1980s and '90s, they reconsider the work of Cindy Patton, David Román, Douglas Crimp, Eric Michaels, Gary Fisher, Herbert Blau, and Reza Abdoh in the elaboration of performance as vital to the collective project of public health.
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OBJECTIVES/GOALS: COVID-19 disproportionately affects patients with prior health conditions and those living at a lower socioeconomic status. Persons living with HIV (PLWH) are infected with SARS-CoV-2 at a higher rate than seronegative patients. Risk factors and incidence of post-COVID-19 comorbidities in PLWH, specifically, are still unknown METHODS/STUDY POPULATION: We will study PLWH enrolled in the Emory Centers for AIDS Research (CFAR) Registry who receive care at the Grady Ponce de Leon Center in Atlanta, Georgia to 1) investigate the incidence of, and 2) identify risk factors that predispose PLWH to post-COVID-19 comorbidities. All PLWH with documented COVID-19 (by positive SARS-CoV-2 PCR or antigen test) between March 1, 2020, and September 30, 2021, with a clinic visit within 12 months will be included. We will identify comorbidities using problem list diagnoses and ICD9/10 codes. With a predicted sample size of 395, we will use a Cox proportional hazards model for time-to-detection of comorbidity, and bivariate and multivariate logistic regression models to identify predictors of incident comorbidity within 12 months of COVID-19. RESULTS/ANTICIPATED RESULTS: o Previous work demonstrated that in PLWH, age and non-AIDS comorbidities, but not HIV-related factors, were associated with hospitalization for COVID-19 in a dose dependent fashion.18 We anticipate that rate of incident comorbidities will be significantly higher in PLWH after COVID-19 compared to PLWH without a history of COVID-19. We also expect that pre-existing comorbidities including obesity and cardiovascular disease, male sex, Black race, and older age are associated with higher incidence of post-COVID-19 comorbidities in PLWH. When stratifying by organ system, we also anticipate that prior comorbidities of an organ system will predispose patients to later complications of that same system. DISCUSSION/SIGNIFICANCE: By understanding the incidence and risk factors associated with developing post-COVID-19 comorbiditieswe can improve guidelines for treatment of groups experiencing the disproportionate impact of co-infection with HIV and SARS-CoV-2.
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Mathematical modeling techniques have been used extensively during the human immunodeficiency virus (HIV) epidemic. Drug injection causes increased HIV spread in most countries globally. The media is crucial in spreading health awareness by changing mixing behavior. The published studies show some of the ways that differential equation models can be employed to explain how media awareness programs influence the spread and containment of disease (Greenhalgh et al. Appl Math Comput. 2015;251:539–563). Here we build a differential equation model which shows how disease awareness programs can alter the HIV prevalence in a group of people who inject drugs (PWIDs). This builds on previous work by Greenhalgh and Hay (1997) and Liang et al. (2016). We have constructed a mathematical model to describe the improved model that reduces the spread of the diseases through the effect of awareness of disease on sharing needles and syringes among the PWID population. The model supposes that PWIDs clean their needles before use rather than after. We carry out a steady state analysis and examine local stability. Our discussion has been focused on two ways of studying the influence of awareness of infection levels in epidemic modeling. The key biological parameter of our model is the basic reproductive number R0$$ {R}_0 $$. R0$$ {R}_0 $$ is a crucial number which determines the behavior of the infection. We find that if R0$$ {R}_0 $$ is less than one then the disease-free steady state is the unique steady state and moreover whatever the initial fraction of infected individuals then the disease will die out as time becomes large. If R0$$ {R}_0 $$ exceeds one there is the disease-free steady state and a unique steady state with disease present. We also showed that the disease-free steady state is locally asymptotically stable if R0$$ {R}_0 $$ is less than one, neutrally stable if R0$$ {R}_0 $$ is equal to one and unstable if R0$$ {R}_0 $$ exceeds one. In the last case, when R0$$ {R}_0 $$ is greater than one the endemic steady state was locally asymptotically stable. Our analytical results are confirmed by using simulation with realistic parameter values. In nontechnical terms, the number R0$$ {R}_0 $$ is a critical value describing how the disease will spread. If R0$$ {R}_0 $$ is less than or equal to one then the disease will always die out but if R0$$ {R}_0 $$ exceeds one and disease is present the disease will sustain itself and moreover the numbers of PWIDs with disease will tend to a unique nonzero value.
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OBJECTIVES/GOALS: Despite highly effective antiretroviral therapy, people living with HIV (PLWH) experience chronic immune activation and inflammation which may influence the progression of infections such as SARS-CoV-2. Here, we explore the immune response and clinical outcomes in HIV(+) and HIV(-) individuals experiencing acute COVID-19 and long COVID (LC). METHODS/STUDY POPULATION: We performed flow cytometric analyses on peripheral blood mononuclear cells from the following: 1) HIV(-) individuals experiencing acute COVID-19, 2) PLWH experiencing acute COVID-19, and 3) pre-COVID-19 pandemic PLWH. Additionally, we will perform similar analyses for the following: 1) PLWH experiencing LC, 2) PLWH previously infected with SARS-CoV-2 who recovered, 3) pre-COVID-19 pandemic PLWH, and 4) HIV(-) individuals experiencing LC. Flow cytometry panels include surface markers for immune cell populations, activation and exhaustion surface markers (with and without SARS-CoV-2-specific antigen stimulation), and intracellular cytokine staining. We will also analyze how chronic HIV infection and other clinical and demographic factors (e.g., age, CD4 %) impact persistent symptomatic burden. RESULTS/ANTICIPATED RESULTS: Acute COVID-19 results–Overall, PLWH had higher baseline expression of activation markers OX40 and CD137 on CD4+ and CD8+ T cells, along with increased levels of TNFa producing CD8+ T cells. Interestingly, PLWH had increased expression of exhaustion markers PD1 and TIGIT but decreased expression of TIM3 on CD4+ and CD8+ T cells. Additionally, PLWH had decreased levels of IL-2 and IFNg producing CD4+ T cells which suggests functional exhaustion. Long COVID-19 expected results–we hypothesize that the activation and inflammation seen in chronic HIV infection will lead to more immune dysregulation and subsequently worsened symptomatic burden. Additionally, we hypothesize that PLWH may have different frequencies of certain LC manifestations, such as increased rates of neurocognitive impairment. DISCUSSION/SIGNIFICANCE: Our findings suggest that chronic HIV infection influences acute immune response during SARS-CoV-2 infection, and that PLWH have variable expression of exhaustion markers which warrants further study. Additionally, our findings in the LC cohort will aid in characterizing clinical manifestations and immunologic mechanisms of LC in PLWH.
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Kajian ini bertujuan meneroka pengetahuan mahasiswa tentang risiko jangkitan HIV/AIDS, faktor keterlibatan dalam hubungan romantik dan ketertarikan seks sesama jantina. Masih kurang kajian yang memberi tumpuan kepada amalan hubungan romantik dan ketertarikan seks sesama jantina serta kesedaran mahasiswa tentang HIV/AIDS impak daripada tingkah laku seks berisiko ini. Banyak kajian terdahulu lebih menumpu kepada faktor keterlibatan dalam hubungan romantik dan ketertarikan seks sesama jantina tanpa mengaitkannya dengan kesedaran mahasiswa gay terhadap jangkitan HIV. Kajian ini menggunakan pendekatan kajian kes dan direkabentuk bersesuaian kaedah kajian kualitatif. Seramai empat informan dalam kalangan mahasiswa Institusi Pengajian Tinggi di Malaysia yang membuat pengakuan identiti gay telah terlibat dalam kajian ini. Pemilihan informan adalah menggunakan teknik Persampelan Snow Ball. Pengumpulan data telah dijalankan secara atas talian dengan menggunakan medium Google Meet. Semua informan ditemubual dalam talian secara konferen video. Data temu bual dianalisis menggunakan analisis tematik. Hasil analisis menunjukkan terdapat empat faktor risiko keterlibatan mahasiswa dalam hubungan romantik dan tingkah laku seksual sesama jantina iaitu (i) pengalaman menjadi mangsa gangguan seksual semasa kecil, (ii) faktor naluri semulajadi, (iii) pengaruh rakan/komuniti berisiko gay dan (iv) pengaruh negatif daripada media sosial dan internet. Informan juga mempunyai pengetahuan asas tentang risiko jangkitan HIV. Walau bagaimanapun, kesemua informan percaya tingkah laku mereka mempunyai risiko rendah dan tidak mudah untuk dijangkiti HIV. Salah faham tentang risiko jangkitan HIV bagi seks tidak selamat dan seks luar tabi' dipercayai mendorong amalan hubungan seks sesama jantina dilakukan tanpa rasa takut dan menurunnya keprihatinan kepada seks selamat dalam kalangan mahasiswa gay. Kajian mencadangkan salah faham tentang risiko jangkitan HIV sebagai faktor baharu penyebab amalan seks sesama jantina yang berterusan dalam kalangan informan yang dikaji. Intervensi perlu dibentuk bersesuaian faktor risiko hubungan romantik dan tingkah laku seksual sesama jantina agar ia dapat dibendung daripada menular dalam kalangan mahasiswa gay.Alternate :This study aims to explore the knowledge of HIV/AIDS infection risk and the factors that contribute to same-sex romantic relationship involvement and same-sex sexual attractions among university students. Less studies have been done focusing on same-sex romantic relationships and same-sex sexual attraction among self-identified gay university students and their awareness of the HIV/AIDS impact due to risky sexual behaviour. Many previous studies were found to focus only on gay students' romantic relationships and samesex sexual attraction involvement factors without relating these factors with their awareness of HIV infection. This study uses a case study approach and is designed following qualitative research methods. Four students who self-identified as gay were selected as informants. Snow Ball Sampling is used as the informants' selection technique. Data collection was conducted online using the Google Meet platform. All informants were interviewed online via video conference. The thematic analysis has been used to analyse the interview data. The study analysis demonstrated four risk factors conduce to a same-sex romantic relationship and samesex sexual behaviours among gay students: (i) sexual abuse experienced during childhood;(ii) same-sex sexual attraction as an instinct factor;(iii) gay friends/community influenced and (iv) internet and social media negative influence. All informants are identified to have basic HIV risk infection knowledge. However, those in a same-sex relationship believe same-sex romantic relationships and same-sex sexual practices have a low risk of HIV infection. The misunderstanding of HIV infection in same-sex sexual practices and unsafe sex is believed to contribute to a consistent no fear of same-sex sexual practices and less concern towards safe sex among ay students. This study suggests a misunderstanding of HIV infection as the new factor contributing to continuous same-sex sexual practices among studied informants. Intervention needs to be developed tailored to the same-sex romantic relationship and same-sex sexual attraction risk factors to curb the spread among gay students.
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This report describes a case of a newly diagnosed 49-year-old HIV patient, who presented with decreased visual acuity and retinal lesions characterized by ischemia at the level of the deep retinal capillary plexus, documented with optical coherence tomography (OCT), OCT angiography, fluorescein angiography, and visual fields testing. These lesions closely resembled the morphologic and clinical characteristics of late paracentral acute middle maculopathy. The presence of these lesions suggests that HIV microangiopathy can potentially affect both superficial and deep retinal capillary plexuses.
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The menace of infectious diseases has constantly been a reason of concern for humankind since time immemorial. As evident by the name, infectious diseases can infect a huge population within a short period, leading to an eruption of pandemics and epidemics. The present human era is fortunate enough to have a wide array of readily available drugs that help cure and prevent various diseases. Moreover, the scientific community has always responded to the needs of society through its drug discovery and development programs. The co-existence of multiple diseases calls forth the scientific community to design and develop drugs that could have a broad spectrum of activity. In this perspective, our goal was to investigate the potential of reported MbtA inhibitors (antitubercular molecules) in inhibiting HIV-1 RT and nCovid-19-RdRp and eventually leading to the identification of a multi-targeted ligand (triple co-infection inhibitor). In this study, the primary success was attained by capitalizing on the structure-based virtual screening drug discovery approach. Results were quite promising. Molecular docking results showed that GV17 interacted strongly with the active site residues of both the target proteins (HIV-1 RT and nCOVID-19-RdRp). Moreover, the docking score of GV17 was more than that of the internal ligands of both the target proteins, which indicates a firm binding. Molecular dynamics further validated these results as identical amino acid residues were observed in the protein's docked pose with the ligand. The detailed atomic interactions of ligand GV17 with the protein residues have been discussed. Overall, the protein–ligand complexes remained stable throughout the simulation, and the system's backbone fluctuations were modest. MM-GBSA analysis revealed free binding energy of − 72.30 ± 7.85 kcal/mol and − 65.40 ± 7.25 kcal/mol for 1RT2 and 7BV2, respectively. The more negative binding energy indicates a stronger affinity of GV17 with both the receptors. GV17 also gave satisfactory predictive in silico ADMET results. Overall, this computational study identified GV17 as a potential HIT molecule and findings can open up a new avenue to explore and develop inhibitors against nCOVID-19-HIV-TB triple-infections.
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Molecular-dynamics simulations together with virtual high-throughput screening provide a means of quick evaluation of existing drugs for antiviral activity. The authors explain how these methods serve in the quest for drugs to treat Covid-19.