Current Issue : April - June Volume : 2016 Issue Number : 2 Articles : 8 Articles
The HIV/AIDS data from the national surveillance systems of China and the United States\nfrom 1985 to 2014 were compared to characterize the HIV/AIDS epidemic in both countries.\nThe current estimated national HIV prevalence rate in China and the United States are 0.0598%\nand 0.348%, respectively. In the United States, the annual number of new HIV infections has\nremained relatively stable (~50,000 each year) and has shown a downward trend in recent years.\nThe Chinese national HIV prevalence is still low, and new HIV infections have been contained at\na low level (50,000ââ?¬â??100,000 each year). However, the epidemic has showed an increasing trend\nsince 2012. By risk group, in both countries, men who have sex with men (MSM), heterosexual sex,\nand injection drug use (IDU) are the most common modes of transmission of new HIV infections.\nHowever, in the United States, MSM is the dominant transmission route, accounting for >60%\nof new infections; whereas in China, heterosexual sex has now become the dominant route, also\naccounting for >60% of new infections. A rapid increase in the proportion of HIV cases that were\nattributed to MSM and an obvious decrease in the proportion of HIV cases attributed to IDU in\nChina in recent years imply that the Chinaââ?¬â?¢s epidemic is still evolving, to some extent, copying\nwhat was experienced in the United States. By age group, the proportions of HIV cases that were\nattributed to the age group 25ââ?¬â??59 were comparable between the two countries. However, the United\nStates had a higher proportion of cases that were attributed to age groups 15ââ?¬â??19 and 20ââ?¬â??24 than\nChina, indicating that youth account for more infections in the United States. One other fact worth\nnoting: in China there is a significant increase in the number of HIV new infections in individuals\nover 50 years of age, which results in much higher proportion of cases that were attributed to\nage groups 60ââ?¬â??64 and over 65 in China than those in the United States. By race/ethnicity, in the\nUnited States, Blacks/African Americans continue to experience the most severe HIV burden,\nfollowed by Hispanics/Latinos. In China, no official data on race/ethnicity disparities are currently\navailable. Thus, region, risk group, age are important factors in the HIV epidemics in both countries....
Nanometre-sized vesicles, also known as exosomes, are derived from endosomes of diverse cell types and present in multiple\nbiological fluids. Depending on their cellular origins, the membrane-bound exosomes packed a variety of functional proteins\nand RNA species. These microvesicles are secreted into the extracellular space to facilitate intercellular communication. Collective\nfindings demonstrated that exosomes from HIV-infected subjects share many commonalities with Human Immunodeficiency Virus\nType I (HIV-1) particles in terms of proteomics and lipid profiles. These observations postulated that HIV-resembled exosomes\nmay contribute to HIV pathogenesis. Interestingly, recent reports illustrated that exosomes from body fluids could inhibit HIV\ninfection, which then bring up a new paradigm for HIV/AIDS therapy. Accumulative findings suggested that the cellular origin of\nexosomes may define their effects towards HIV-1. This review summarizes the two distinctive roles of exosomes in regulating HIV\npathogenesis. We also highlighted several additional factors that govern the exosomal functions. Deeper understanding on how\nexosomes promote or abate HIV infection can significantly contribute to the development of new and potent antiviral therapeutic\nstrategy and vaccine designs....
This study examined the magnitude and time trends in failure to return (FTR) rates and the relation between FTR and individual\ncharacteristics, tests procedures, waiting period for the results, and HIV test results among people who were screened for HIV in\nthe prevention and voluntary testing and counseling centers (PVTCCs) of six district hospitals of the city of Douala in Cameroon,\nbetween January 2009 and December 2013. It was a retrospective analysis of medical records. Among the 32,020 analyzed records,\nthe failure to return (FTR) rate was 14.3%. Overall, people aged 50 years and over, those tested between 2011 and 2012, and those\ntested in the PVTCC of Bonassama were less likely to return for their results. Significant factors associated with FTR included being\na housewife, having a positive/undetermined/requiring confirmation result, and provider-initiated testing and counseling (PITC).\nThere was an increasing trend for FTR in the PVTCCs of Bonassama, New-Bell, Nylon, and Cit�´e des Palmiers. HIV testing and\ncounseling services in Douala district hospitals must be reorganized such that individuals tested for HIV receive their results on\nthe same day of the test. Also counselors need to better alert clients concerning the importance of returning for their test results....
Background. Anaemia is a common complication of human immunodeficiency virus (HIV) infection. The aim of this study was\nto investigate the impact of HIV infection and zidovudine on red blood cells (RBC) parameters and urine methylmalonic acid\n(UMMA)levels in patients with HIV infection.Material and Methods.Across-sectional study involving 114 subjects, 94 of which are\nHIV-infected non anaemic and 20 HIV negative subjects (Cg) as control. Full blood count parameters and urine methylmalonic acid\n(UMMA) level of each subject were determined. Associations were determined by Chi-square test and logistic regression statistics\nwhere appropriate. Results. Subjects on zidovudine-based ART had mean MCV (93 fL) higher than that of control group (82.9 fL)\nand ART-na�¨�±ve (85.9 fL) subjects and the highest mean RDW. Mean UMMA level, which reflects vitamin B12 level status, was\nhigh in all HIV-infected groups but was significantly higher in ART-na�¨�±ve subjects than in ART-experienced subjects. Conclusion.\nAlthough non-zidovudine therapy may be associated with macrocytosis (MCV > 95 fL), zidovudine therapy and ART naivety may\nnot. Suboptimal level of vitamin B12 as measured by high UMMA though highest in ART-na�¨�±ve subjects was common in all HIV infected\nsubjects....
HIV infection aggravates the progression of liver damage in HCV-coinfected patients, with the underlying pathogenesis being\nmultifactorial. Although high level of oxidative stress has been observed frequently in patients infected with HIV or HCV, the\nstatus of oxidative stress in HIV/HCV coinfection and its contribution to HCV liver damage have not been determined. This\nstudy involved 363 HBsAg-negative, anti-HCV-positive former blood donors recruited from a village in central China in July\n2005; of these, 140 were positive for HIV. Of these 363 subjects, 282 were successfully followed up through July 2009. HIV/HCVcoinfected\nsubjects had higher rates of end-stage liver disease-related death than those monoinfected with HCV. Liver ultrasound\nmanifestations were poor in HIV-positive than in HIV-negative individuals, in both chronic HCV carriers and those with resolved\nHCV. Serum concentrations of total glutathione (tGSH), malondialdehyde (MDA), glutathione peroxidase (GSH-Px), GSSG, and\nreduced GSH were higher in HIV-positive than HIV-negative subjects. GSSG concentrations were higher in HIV-infected subjects\nwith abnormal ALT/AST levels than in those with normal ALT/AST levels and were associated with poorer liver ultrasound\nmanifestations. These finding indicated that HIV infection accelerated HCV-associated liver damage in HIV/HCV-coinfected\nindividuals. Increased oxidative stress, induced primarily by HIV coinfection, may contribute to aggravated liver damage....
Introduction. Proper implementation of prevention of mother-to-child transmission (PMTCT) services requires adequate\nknowledge and appropriate attitudes and practices on the part of the health care providers especially in rural areas where access to\nhealth care delivery is very limited in Oyo State. Materials and Methods.This is a descriptive cross-sectional survey of 350 health\ncare workers in a two-stage sampling technique. Data was obtained using interviewer-administered, pretested, semistructured\nquestionnaires.The datawas analyzed using Epi Info software version 7. Results.The knowledge of PMTCT of HIV was poor among\nthe health care workers (69.1%). However, more than half (58.3%) had good attitudes towards PMTCT of HIV/AIDS. Predictors\nof good knowledge of PMTCT were religion [AOR = 1.6, 95% CI (1.1ââ?¬â??2.6)], cadre of occupation [AOR = 10.2, 95% CI (2.9ââ?¬â??35.1)],\nand length of service [AOR = 4.3, 95% CI (2.3ââ?¬â??19.4)]. Predictors of good attitude towards PMTCT were length of service in the\ncurrent hospital [AOR = 2.8, 95% CI (1.5ââ?¬â??5.2)] and cadre of occupation [AOR = 3.9, 95% CI (1.28ââ?¬â??11.9)]. Conclusion. Despite poor\nknowledge of PMTCT of HIV/AIDS among the health care workers, the attitude towards PMTCT of HIV/AIDS was good.There is\nneed for the involvement of the stakeholders in bridging the gap between knowledge of and attitude towards prevention of MTCT\nof HIV/AIDS among health care workers in the rural areas....
Background. In Ethiopia, little is known regarding the distribution and the in vitro antifungal susceptibility profile of yeasts.\nObjective. This study was undertaken to determine the spectrum and the in vitro antifungal susceptibility pattern of yeasts isolated\nfrom HIV infected patients with OPC. Method. Oral pharyngeal swabs taken from oral lesions of study subjects were inoculated\nonto Sabouraud Dextrose Agar. Yeasts were identified by employing conventional test procedures and the susceptibility of yeasts to\nantifungal agents was evaluated by disk diffusion assay method. Result. One hundred and fifty-five yeast isolates were recovered of\nwhich 91 isolates were from patients that were not under HAART and 64 were from patients that were under HAART. C. albicans was\nthe most frequently isolated species followed by C. glabrata, C. tropicalis, C. krusei, C. kefyr, Cryptococcus laurentii, and Rhodotorula\nspecies. Irrespective of yeasts isolated and identified, 5.8%, 5.8%, 12.3%, 8.4%, 0.6%, and 1.3% of the isolates were resistant to\namphotericin B, clotrimazole, fluconazole, ketoconazole, miconazole, and nystatin, respectively. Conclusion. Yeast colonization\nrate of 69.2% and 31% resistance to six antifungal agents was documented. These highlight the need for nationwide study on the\nepidemiology of OPC and resistance to antifungal drugs....
Antiretroviral therapy (ART) has transformed the clinical profile of human immunodeficiency virus (HIV) froman acute infection\nwith a highmortality into a treatable, chronic disease. As a result, the clinical sequelae of HIV infection are changing as patients live\nlonger. HIV-associated cardiomyopathy (HIVAC) is a stage IV, HIV-defining illness and remains a significant cause ofmorbidity and\nmortality among HIV-infected individuals despite ART. Causes and clinical manifestations of HIVAC depend on the degree of host\nimmunosuppression. Myocarditis from direct HIV toxicity, opportunistic infections, and nutritional deficiencies are implicated\nin causing HIVAC when HIV viral replication is unchecked, whereas cardiac autoimmunity, chronic inflammation, and ART\ncardiotoxicity contribute to HIVAC in individuals with suppressed viral loads. The initiation of ART has dramatically changed\nthe clinical manifestation of HIVAC in high income countries from one of severe, left ventricular systolic dysfunction to a pattern\nof subclinical cardiac dysfunction characterized by abnormal diastolic function and strain. In low and middle income countries,\nhowever, HIVAC is the most common HIV-associated cardiovascular disease. Clear diagnostic and treatment guidelines for HIVAC\nare currently lacking but should be prioritized given the global burden of HIVAC....
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