Current Issue : April - June Volume : 2013 Issue Number : 2 Articles : 6 Articles
Objective(s): To define the incidence of mental health disorders(MHD)\r\nand risk factors associatedwith incident MHDin anHIV clinic settingwith\r\nunrestricted accessto care and limited confounding due to concomitant\r\ninjection drug use (IDU).\r\nDesign: Retrospective cohortstudy.\r\nMethods: Eligible subjectswereHIV infected adultsfollowed at aUS\r\nmilitary treatmentfacility during the calendar year 2005. Incidence\r\nrates are calculatedper 100person years(py).Coxproportional hazards\r\nregressionwere utilized to identify risk factors associatedwith MHD.All\r\npersons not experiencing MHDwere followed untilstudy completion in\r\nJanuary 2008.\r\nResults: 494 subjects(51%Black, 93% male, medianCD4 count 458)\r\nwere followed for 5200py. 160 subjects developed MHDfor an overall\r\nincidence of 3.1/100py offollowup.The incidence of depression and\r\nanxietywere 2.4/100py and 0.4/100py,respectively. Factors associated\r\nwith a diagnosis ofincident MHDinclude receipt of aprotease inhibitor\r\n(PI)based regimen (HR 2.0,referent- noART), non-Black ethnicity, and\r\nHIV diagnosisin thepostHAART era; male genderwasprotective.\r\nConclusion: In a cohortwith limited confounding, incident MHDwas\r\ncommon.Unlikepriorstudies, non-nucleoside reverse transcriptase\r\ninhibitor(NNRTI) use and MHDassociationwas not observed; instead PI\r\nusewas associatedwith MHD,perhaps due to PI enhanced mitochondrial\r\ntoxicity,signaling need forfurtherresearch.Given the significantburden\r\nof MHDobserved in this cohort, mental health screening shouldbe\r\nconsidered in the management ofHIV infection....
This paper assesses the extent to which HIV prevention interventions for young people in sub-Saharan Africa are grounded\r\nin theory and if theory-based interventions are more effective. Three databases were searched for evaluation studies of HIV\r\nprevention interventions for youth. Additional articles were identified on websites of international organisations and through\r\nsearching references. 34 interventions were included; 25 mentioned the use of theory. Social Cognitive Theory was most prominent\r\n(n = 13), followed by Health Belief Model (n = 7), and Theory of Reasoned Action/Planned Behaviour (n = 6). These cognitive\r\nbehavioural theories assume that cognitions drive sexual behaviour. Reporting on choice and use of theory was low. Only three\r\narticles provided information about why a particular theory was selected. Interventions used theory to informcontent (n = 13), for\r\nevaluation purposes (n = 4) or both (n = 7). No patterns of differential effectiveness could be detected between studies using and\r\nnot using theory, or according to whether a theory informed content, and/or evaluation.We discuss characteristics of the theories\r\nthat might account for the limited effectiveness observed, including overreliance on cognitions that likely vary according to type\r\nof sexual behaviour and other personal factors, inadequately address interpersonal factors, and failure to account for contextual\r\nfactors....
This is a continuation of our efforts to maintain a record of the evolution of HIV-1 infection in Puerto Rico by monitoring\r\nthe expression levels of antiretroviral drug-resistance-associated mutations. Samples from 2,500 patients from 2006ââ?¬â??2010 were\r\nanalyzed using the TruGene HIV-1 genotyping kit and the OpenGene DNA sequencing system. Results show that 58.8% of males\r\nand 65.3% of females had HIV-1 with resistance to at least one medication. The average number of HIVmutations was 6.0 in males\r\nand 6.1 in females. Statistically significant differences between men and women were recorded in the levels of HIV-1 expressed\r\nmutations and antiretroviral drug resistance. The most prevalent antiretroviral medication resistance shifted from zalcitabine to\r\nnevirapine and efavirenz in the five-year period. M184V and L63P were the dominant mutations for the reverse transcriptase and\r\nthe protease genes, respectively, but an increase in the incidence of minority mutations was observed....
Here we report that our lead anti-retroviral (ARV) drug candidate Stampidine [2,â��3â��-didehydro-3â��-deoxythymidine- 5â��-(p-bromophenyl methoxy alaninyl phosphate)] results in methylation of a network of HIV-responsive regulatory genes in T-cells, including several genes for HIV-dependency factors (HDFs). Stampidine epigenetically modulates the host transcriptome in a unique manner, silences expression of a distinct set of genes encoding transcription factors and signal transduction molecules, and prevents HIV infection from distorting and disrupting key cellular transcriptional networks. At nanomolar concentrations that are 4-logs lower than those achieved at its non-toxic dose levels in mice, rats, cats, and dogs, Stampidine switched off genes for several HDFs that are required for HIV replication in T-cells. Notably, Stampidine reversed the effects of HIV exposure on the host transcriptome regardless of NRTI-sensitivity or RT mutations of the HIV isolate used and inhibited the replication of 17 NRTI-resistant HIV- 1 strains, including recombinant HIV clones containing common patterns of RT mutations responsible for NRTI resistance, in human peripheral blood mononuclear cells (PBMC) with subnanomolar-nanomolar IC50 values (Mean �± SEM = 12.0 �± 3 .2 nM). Unlike available ARV agents that disrupt a specific step in the life-cycle of HIV, Stampidine has the potential to abrogate all steps in the life cycle of HIV....
Background: Pseudomonas aeruginosa is an opportunistic pathogen in immune-compromised patients.\r\nHowever, reports of infections of Pseudomonas aeruginosa were limited in patients infected with HIV. The aim of the\r\nstudy was to determine the frequency of isolation and sensitivity pattern of P. aeruginosa against the commonly used\r\nantibiotics in HIV-1 positive and negative diarrheic patients.\r\nMethods: Laboratory based cross-sectional study of 312 (199 HIV seropositive and 113 HIV seronegative)\r\ndiarrheic patients of both genders were investigated at University of Gondar Hospital, Gondar, Ethiopia. P. aeruginosa\r\nisolates were isolated from diarrheic stool and identified as per standard methods and tested for antimicrobial\r\nsusceptibility.\r\nResult: Pseudomonas aeruginosa was isolated from 29.5% (92/312) of diarrheic patients, of which 20.5% were\r\nfrom HIV positive subjects. Out of 58 H. zoster positive diarrhoea patients, 47 (81%) were HIV positive and 11 (19%)\r\nwere HIV seronegative (P < 0.002). The proportion of patients with weight loss and P. aeruginosa infection was\r\nsignificantly higher in those with HIV co-infection (P < 0.05). Among P. aeruginosa isolates 96.4%, 78.6%, 73.2%,\r\n71.4%, 68.8% and 62.5% were sensitive to polymyxin B, gentamycin, norfloxacin, kanamycin, ciprofloxacin and\r\nnalidixic acid, respectively. The highest resistance observed was against ampicillin (96.4%), tetracycline (92%),\r\ntrimethoprim-sulphamethoxazole (89.3%) and chloramphenicol (74.1%). One hundred nine (97.3%) out of the 112 P.\r\naeruginosa isolates were found to be multiple drug resistant.\r\nConclusion: Though high proportion of P. aeruginosa strains were reported in HIV seropositive diarrheic\r\npatients, detailed investigation is important to get comprehensive information for better treatment of diarrhoea in\r\nHIV /AIDS patients. In this study, ampicillin, tetracycline, trimethoprim-sulphamethoxazole and chloramphenicol\r\nmay not be used for the treatment of P. aeruginosa infection, unless culture and sensitivity tests are done prior to\r\ntreatment. Effective public health measures such as prevention of infections through quality environmental sanitation\r\nand personal hygiene should be emphasized....
The aim of the present study was to analyse the effect of antiretroviral (ARV) therapy and single antiretroviral drugs on\r\ncerebrospinal fluid (CSF) HIV-RNA burden in HIV-infected patients affected by neurological disorders enrolled in a multicentric\r\nItalian cohort. ARVs were considered ââ?¬Å?neuroactiveââ?¬Â from literature reports. Three hundred sixty-three HIV-positive patients with\r\navailable data from paired plasma and CSF samples, were selected. One hundred twenty patients (33.1%) were taking ARVs at\r\ndiagnosis of neurological disorder. Mean CSF HIV-RNA was significantly higher in naÃ?¨ive than in experienced patients, and in\r\npatients not taking ARV than in those on ARV. A linear correlation between CSF HIV-RNA levels and number of neuroactive\r\ndrugs included in the regimen was also found (r = -0.44, P < 0.001). Low -plasma HIV-RNA and the lack of neurocognitive\r\nimpairment resulted in independently associated to undetectable HIV-RNA. Taking nevirapine or efavirenz, or regimen including\r\nNNRTI, NNRTI plus PI or boosted PI, was independently associated to an increased probability to have undetectable HIV-RNA in\r\nCSF. The inclusion of two or three neuroactive drugs in the ARV regimen was independently associated to undetectable viral load\r\nin CSF. Our data could be helpful in identifying ARV regimens able to better control HIV replication in the CNS sanctuary, and\r\ncould be a historical reference for further analyses....
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