Current Issue : April - June Volume : 2012 Issue Number : 2 Articles : 8 Articles
Recently, it has been shown that human ejaculate enhances human immunodeficiency virus 1 (HIV-1) infectivity.\r\nEnhancement of infectivity is conceived to be mediated by amyloid filaments from peptides that are proteolytically\r\nreleased from prostatic acid phosphatase (PAP), termed Semen-derived Enhancer of Virus Infection (SEVI). The aim\r\nof this study was to test the range of HIV-1 infectivity enhancing properties of a large number of individual semen\r\nsamples (n = 47) in a TZM-bl reporter cell HIV infection system. We find that semen overall increased infectivity to\r\n156% of the control experiment without semen, albeit with great inter- and intraindividual variability (range -53%-\r\n363%). Using transmission electron microscopy, we provide evidence for SEVI fibrils in fresh human semen for the\r\nfirst time. Moreover, we confirm that the infectivity enhancing property can be inhibited by the major green tea\r\ningredient epigallocatechin-3-gallate (EGCG) at non-toxic concentrations. The median inhibition of infection by\r\ntreatment with 0.4 mM EGCG was 70.6% (p < 0.0001) in our cohort. Yet, there were substantial variations of\r\ninhibition and in a minority of samples, infectivity enhancement was not inhibited by EGCG treatment at all. Thus,\r\ntopical application of EGCG may be a feasible additional measure to prevent the sexual transmission of HIV.\r\nHowever, the reasons for the variability in the efficacy of the abrogation of semen-mediated enhancement of HIV-1\r\ninfectivity and EGCG efficacy have to be elucidated before therapeutic trials can be conducted....
Background: Several lines of evidence suggest that retinoids (retinol-ROL or vitamin A, and its active metabolites,\r\nretinoic acids-RAs) play important pathogenic roles in HIV infection and combination antiretroviral therapy (cART)-\r\nrelated events. We previously reported that antiretrovirals alter RAs synthesis in vitro. We hypothesised that in vivo\r\nserum retinoid concentrations are affected by both cART and HIV infection. This might explain several clinical and\r\nlaboratory abnormalities reported in HIV-infected patients receiving cART.\r\nMethods: The effects of optimal cART and chronic HIV on serum retinoids were firstly assessed longitudinally in 10 HIVinfected\r\nadults (group1 = G1): twice while on optimal cART (first, during long-term and second, during short term cART)\r\nand twice during 2 cART interruptions when HIV viral load (VL) was detectable. Retinoid concentrations during optimal\r\nlong term cART in G1 were compared with cross-sectional results from 12 patients (G2) with suboptimal cART\r\n(detectable VL) and from 28 healthy adults (G3). Serum retinoids were measured by HPLC with ultraviolet detection.\r\nRetinoid concentrations were correlated with VL, CD4 T- cell count and percentages, CD8? fluorescence,\r\ntriglycerides, cholesterol and C-peptide serum levels.\r\nResults: During optimal cART, G1 participants had drastically reduced RAs (0.5 �± 0.3 �µg/dL; P < 0.01) but the\r\nhighest ROL (82 �± 3.0 �µg/dL) concentrations. During cART interruptions in these patients, RAs slightly increased\r\nwhereas ROL levels diminished significantly (P < 0.05). G3 had the highest RAs levels (7.2 �± 1.1 �µg/dL) and serum\r\nROL comparable to values in North Americans. Serum ROL was decreased in G2 (37.7 �± 3.2 �µg/dL; P < 0.01). No\r\ncorrelations were noted between RA and ROL levels or between retinoid concentrations and CD4 T- cell count,\r\nCD8? fluorescence, VL. ROL correlated with triglycerides and cholesterol in G1 (rs = 0.8; P = 0.01).\r\nConclusions: Serum RAs levels are significantly diminished by cART, whereas ROL concentrations significantly\r\ndecreased during uncontrolled HIV infection but augmented with optimal cART. These alterations in retinoid\r\nconcentrations may affect the expression of retinoid-responsive genes involved in metabolic, hormonal and\r\nimmune processes and be responsible for some adverse events observed in HIV-infected persons treated with\r\nantiretrovirals. Further studies should assess concomitant serum and intracellular retinoid levels in different clinical\r\nsituations in larger, homogenous populations....
Background: Behaviour change which is highly influenced by risk perception is a major challenge that HIV\r\nprevention efforts need to confront. In this study, we examined the validity of self-reported likelihood of HIV\r\ninfection among rural and urban reproductive age group Nigerians.\r\nMethods: This is a cross-sectional study of a nationally representative sample of Nigerians. We investigated the\r\nconcordance between self-reported likelihood of HIV and actual results of HIV test. Multivariate logistic regression\r\nanalysis was used to assess whether selected respondents� characteristics affect the validity of self-reports.\r\nResults: The HIV prevalence in the urban population was 3.8% (3.1% among males and 4.6% among females) and\r\n3.5% in the rural areas (3.4% among males and 3.7% among females). Almost all the respondents who claimed\r\nthey have high chances of being infected with HIV actually tested negative (91.6% in urban and 97.9% in rural\r\nareas). In contrast, only 8.5% in urban areas and 2.1% in rural areas, of those who claimed high chances of been\r\nHIV infected were actually HIV positive. About 2.9% and 4.3% from urban and rural areas respectively tested\r\npositive although they claimed very low chances of HIV infection. Age, gender, education and residence are factors\r\nassociated with validity of respondents� self-perceived risk of HIV infection.\r\nConclusion: Self-perceived HIV risk is poorly sensitive and moderately specific in the prediction of HIV status. There\r\nare differences in the validity of self-perceived risk of HIV across rural and urban populations....
Background: Little is known about HIV-1 subtype distribution in Morocco. Some data suggest an emergence of\r\nnew HIV subtypes. We conducted phylogenetic analysis on a nationally representative sample of 60 HIV-1 viral\r\nspecimens collected during 2004-2005 through the Morocco national HIV sentinel surveillance survey.\r\nResults: While subtype B is still the most prevalent, 23.3% of samples represented non-B subtypes, the majority of\r\nwhich were classified as CRF02_AG (15%). Molecular clock analysis confirmed that the initial introduction of HIV-1B\r\nin Morocco probably came from Europe in the early 1980s. In contrast, the CRF02_AG strain appeared to be\r\nintroduced from sub-Saharan Africa in two separate events in the 1990s.\r\nConclusions: Subtype CRF02_AG has been emerging in Morocco since the 1990s. More information about the\r\nfactors introducing HIV subtype-specific transmission will inform the prevention strategy in the region....
Background: Partners In Health (PIH) works with the Ministry of Health to provide comprehensive health services\r\nin Haiti. Between 1994 and 2009, PIH recommended exclusive formula feeding in the prevention of mother-tochild\r\ntransmission (PMTCT) of HIV program and provided support to implement this strategy. We conducted this\r\nstudy to assess HIV-free survival and prevalence of diarrhea and malnutrition among infants in our PMTCT program\r\nin rural Haiti where exclusive formula feeding was supported.\r\nMethods: We reviewed medical charts of PMTCT mother-infant pairs at PIH between November 2004 and August\r\n2006 through a retrospective longitudinal study and cross-sectional survey. We performed household surveys for\r\neach pair and at control households matched by infant�s age and gender.\r\nResults: 254 mother-infant pairs were included. 15.3% of infants were low birth weight; most births occurred at\r\nhome (68.8%). 55.9% of households had no latrine; food insecurity was high (mean score of 18; scale 0-27, SD =\r\n5.3). HIV-free survival at 18 months was 90.6%. Within the cohort, 9 children (3.5%) were HIV-infected and 17 (6.7%)\r\ndied. Community controls were more likely to be breastfed (P = 0.003) and more likely to introduce food early (P =\r\n0.003) than PMTCT-program households. There was no difference in moderate malnutrition (Z score = 2 SD)\r\nbetween PMTCT and community groups after controlling for guardian�s education, marital status, and food\r\ninsecurity (OR = 1.05; 95% CI: 0.67, 1.64; P = 0.84). Diarrhea was 2.9 times more prevalent among community\r\nchildren than PMTCT infants (30.3% vs. 12.2%; P < 0.0001).\r\nConclusions: In a PIH-supported program in rural Haiti that addressed socioeconomic barriers to ill-health, breast\r\nmilk substitution was safe, acceptable and feasible for PMTCT for HIV-infected women choosing this option....
Background: We continue the previously described prospective cohort study of ritonovir-boosted lopinavir (LPV/r)\r\nmonotherapy for second-line therapy in HIV-infected patients with prior failure and extensive resistance to\r\nnucleoside reverse transcriptase inhibitors (NRTIs) and non-nucleoside reverse transcriptase inhibitors (NNRTIs), with\r\nthe objective being to determine the three-year treatment responses.\r\nFindings: There were 40 patients with a mean �± SD age of 37 �± 8 years. Median (IQR) baseline CD4 was 123 (37-\r\n245) cells/mm3 and median (IQR) HIV-1 RNA was 55,800 (9,670-100,000) copies/mL. All patients received twice daily\r\nLPV/r 400/100 mg and recycled lamivudine 150 mg. By intend-to-treat analysis at 144 weeks, 26 (65%) and 22\r\n(56%) patients achieved HIV-1 RNA at < 400 and < 50 copies/mL, respectively. In as-treated analysis, the\r\ncorresponding rates were 26 of 28 (93%) and 22 of 28 (78%), respectively. Low-level viral rebound (HIV-1 RNA 50-\r\n400 copies/mL) was found in 6 (15%), 6 (15%), and 4 (10%) patients at week 48, 96 and week 144, respectively.\r\nMedians CD4 at week 48, 96, and 144 were 351, 481, and 584 cells/mm3 and significantly changed from baseline\r\n(all, P < 0.05). There were increments of mean triglycerides at 48 weeks and 144 weeks from baseline (P < 0.05). No\r\nmajor protease resistance-associated mutations emerged after virologic failure.\r\nConclusion: LPV/r monotherapy with recycled lamivudine can maintain long-term virologic suppression in a\r\nrelatively small proportion of patients failing NNRTI-based regimen and having limit option for active NRTI. More\r\nantiretroviral classes are needed be accessible in resource-limited countries....
Background: There have been few reports of long-term survival of HIV-infected patients on antiretroviral therapy\r\n(ART) in Africa managed under near normal health service conditions.\r\nMethods: Participants starting ART between February 2005 and December 2006 in The AIDS Support (TASO) clinic\r\nin Jinja, Uganda, were enrolled into a cluster-randomised trial of home versus facility-based care and followed up\r\nto January 2009. The trial was integrated into normal service delivery with patients managed by TASO staff\r\naccording to national guidelines. Rates of survival, virological failure, hospital admissions and CD4 count over time\r\nwere similar between the two arms. Data for the present analysis were analysed using Cox regression analyses.\r\nResults: 1453 subjects were enrolled with baseline median count of 108 cells/�µl. Over time, 119 (8%) withdrew\r\nand 34 (2%) were lost to follow-up. 197/1453 (14%) died. Mortality rates (95% CI) per 100 person-years were 11.8\r\n(10.1, 13.8) deaths in the first year and 2.4 (1.8, 3.2) deaths thereafter. The one, two and three year survival\r\nprobabilities (95% CI) were 0.89 (0.87 - 0.91), 0.86 (0.84 - 0.88) and 0.85 (0.83 - 0.87) respectively. Low baseline CD4\r\ncount, low body weight, advanced clinical condition (WHO stages III and IV), not being on cotrimoxazole\r\nprophylaxis and male gender were associated independently with increased mortality. Tuberculosis, cryptococcal\r\nmeningitis and diarrhoeal disease were estimated to be major causes of death.\r\nConclusion: Practical and affordable interventions are needed to enable earlier initiation of ART and to reduce\r\nmortality risk among those who present late for treatment with advanced disease....
Background: Use of dietary supplements is common among people living with HIV/AIDS. Because dietary\r\nsupplements are used in the context of other health behaviors, they may have direct and indirect health benefits.\r\nHowever, supplements may also be associated with vulnerability to medical misinformation and unfounded health\r\nclaims. We examined use of dietary supplements among people living with HIV/AIDS (PLWH) and the association\r\nbetween use of dietary supplements and believing medical misinformation.\r\nMethods: A convenience sample of 268 men and 76 women living with HIV was recruited from AIDS services and\r\nclinics in Atlanta, GA. Participants completed measures of demographic and health characteristics, dietary\r\nsupplement use, beliefs about dietary supplements, internet use, and an internet evaluation task designed to assess\r\nvulnerability to medical misinformation.\r\nResults: One out of four PLWH currently used at least one dietary supplement product excluding vitamins. Dietary\r\nsupplement use was associated with higher education and greater use of the internet for health-related\r\ninformation. Dietary supplement users also endorsed greater believability and trust in unfounded claims for HIV\r\ncures.\r\nConclusions: Dietary supplement use is common among PLWH and is associated with a broad array of health\r\ninformation seeking behaviors. Interventions are needed to reduce the vulnerability of PLWH, particularly dietary\r\nsupplement users, to medical misinformation propagated on the internet....
Loading....