Objective: To take the unpaid blood donors in Wuzhou City as the research object, analyze the characteristics and prevalence of HIV infection, further explore its epidemiological characteristics, and lay a solid found...Objective: To take the unpaid blood donors in Wuzhou City as the research object, analyze the characteristics and prevalence of HIV infection, further explore its epidemiological characteristics, and lay a solid foundation for the recruitment of unpaid blood donors and the safety of blood transfusion, so as to reduce the risk of HIV transmission through blood transfusion. Methods: This paper collected the anti-HIV test results of unpaid blood donors and the confirmation results of reactive samples from 2015 to 2020, and carried out statistical analysis on the relevant information of positive samples. Result: From 2015 to 2020, a total of 233,242 unpaid blood donors were tested, and the positive rate of anti-HIV initial screening was 0.057% (132/233,242), and the positive rate of anti-HIV confirmed was 0.022% (51/233,242);the comparison of positive rates in each year was P < 0.05. Among the total number of infections, 76.47% (39/51) of confirmed positive persons were infected with HIV alone, followed by combined TP infection, accounting for 15.69% (8/51);for the people between 46 and 55 years old, the infection rate was the highest, reaching 37.3%;and more men (90.2%) were infected than women. In terms of education background, junior high school and below were the majority, accounting for 58.83% of the total;in terms of marital status, the number of unmarried people was 27, accounting for 52.9%. In terms of occupation, there were two main groups: farmers and workers, accounting for 66.7% of the total number of infections, and students accounting for 15.7%. Among the confirmed positives, the proportion of first-time blood donors and whole blood donors was higher than that of those who donated blood again or donated component blood. Conclusion: The situation of HIV infection among unpaid blood donors in Wuzhou City was relatively stable from 2015 to 2020, with no significant change in the absolute number of infected people compared to the previous period (the HIV infection rate from 2010 to 2013 was 0.03%), and most of them were males, unmarried people and those with low education. Therefore, attention must be paid to the consultation and recruitment of blood donors before blood donation, as well as the HIV screening in the laboratory after blood donation, so as to ensure the safety of clinical blood use.展开更多
In this paper,Haar collocation algorithmis developed for the solution of first-order ofHIV infection CD4^(+)T-Cells model.In this technique,the derivative in the nonlinear model is approximated by utilizing Haar funct...In this paper,Haar collocation algorithmis developed for the solution of first-order ofHIV infection CD4^(+)T-Cells model.In this technique,the derivative in the nonlinear model is approximated by utilizing Haar functions.The value of the unknown function is obtained by the process of integration.Error estimation is also discussed,which aims to reduce the error of numerical solutions.The numerical results show that the method is simply applicable.The results are compared with Runge-Kutta technique,Bessel collocation technique,LADM-Pade and Galerkin technique available in the literature.The results show that the Haar technique is easy,precise and effective.展开更多
HIV/AIDS is a serious health problem among prisoners and constitutes a big challenge for prison administration services, public health services and governments. <b><span style="font-family:Verdana;"...HIV/AIDS is a serious health problem among prisoners and constitutes a big challenge for prison administration services, public health services and governments. <b><span style="font-family:Verdana;">Aims</span></b><span style="font-family:Verdana;"><strong>:</strong> Determine the prevalence of HIV infection among prisoners and describe associated factors. </span><b><span style="font-family:Verdana;">Population and Methods: </span></b><span style="font-family:Verdana;">This was a descriptive and analytical cross-sectional study conducted from December 2015 to October 2016. A sample of 600 prisoners was randomly interviewed nationwide. They were selected directly from the sample frame from across the country and proportionally from all sites. Pre-established questionnaires providing information on the sociodemographic and biological characteristics of prisoners were used for the collection of data. Data entry and analysis were </span><span style="font-family:Verdana;">performed using EXCEL and SPSS 18 software. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">The survey was</span><span style="font-family:Verdana;"> based on a randomised sample of 600 prisoners, 593 of whom accepted blood extraction for the HIV testing. The series was mainly composed of males (89%). The median age was 33 years (18 -</span><span style="font-family:'';line-height:1.5;"> </span><span style="font-family:'';line-height:1.5;"><span style="font-family:Verdana;">69). The level of education among respondents was 60%. Regarding marital status, the proportion of married prisoners was 51.8%. Almost three-quarters (71.5%) were at their first imprisonment and 51.8% were on preventive detention. The reasons for imprisonment varied and were dominated by drug use (35.3%), while only 4.6% confessed that they continued using drugs while in prison. 97.8% of prisoners have had a sexual experience. Their median age was 19 years at their first sexual intercourse. 20.5% reported using a condom during their first intercourse. Multi </span><span style="font-family:Verdana;">partnership was estimated at 17.8%. The prevalence of HIV infection was high among prisoners (2%), the quadruple of the national rate. This prevalence was associated with female sex (4.5%) (p =</span><span style="font-family:Verdana;"> 0.012) and housewives (12.5%) (p =</span></span><span style="line-height:1.5;font-family:Verdana;"> 0.002). </span><b style="line-height:1.5;"><span style="font-family:Verdana;">Conclusion: </span></b><span style="line-height:1.5;font-family:Verdana;">Prisoners are very vulnerable to HIV infection with a high prevalence compared to the national rate, hence the need for the enforcement of effective HIV prevention and care measures in prisons.</span>展开更多
<strong>Background:</strong> In an age of antiretroviral therapy, the life expectancy of children perinatally infected with Human Immunodeficiency Virus (HIV) has significantly increased. At the same time,...<strong>Background:</strong> In an age of antiretroviral therapy, the life expectancy of children perinatally infected with Human Immunodeficiency Virus (HIV) has significantly increased. At the same time, however, pulmonary pathologies secondary to opportunistic infections have decreased thanks to increased diagnostics and access to antiretroviral therapy (ART). Despite this, in these children an immune dysregulation is maintained due to chronic infection. There is evidence that these patients have increased probability of presenting with abnormalities in pulmonary function, mainly with chronic obstructive clinical pictures (25% - 40% of perinatally infected adolescents display some anomaly in the spirometry), which predisposes them to increased risk of chronic pulmonary disease. Since lung development occurs mainly during infancy, patients perinatally infected with HIV may suffer consequences. This can be secondary to opportunistic infections, chronic inflammation due to the virus, and immunologic effects of ART, mainly in non-industrialized countries, where late diagnosis is frequent. <strong>Methodology:</strong> An analytical, observational, cross-sectional study was conducted at Roosevelt Hospital Pediatric infectious disease clinic, from January to December 2019. A sample of 76 patients was obtained, out of a population of 362 patients. A total of 62 subjects, who met the criterion of reproducibility in the spirometry, were analyzed. Results were analyzed with percentages and the association of variables using the chi-squared test (<em>χ</em><sup>2</sup>). <strong>Results:</strong> A decrease in pulmonary function was found in 34% of patients, mild obstructive pattern (16%) predominating. Significant association between basal viral load greater than 100,000 cp/ml and a decrease in Forced expiratory flow 25 - 75 (FEF 25-75) (<em>p</em> 0.046) and in relationship between forced expiratory volume and forced vital capacity (FEV1/ FVC <em>p</em> = 0.024) was observed, as well as a non-statistically significant relationship between advanced clinical stage at diagnosis and decreased pulmonary function. <strong>Conclusions:</strong> The prevalence of decreased pulmonary function related to advanced clinical stage and elevated basal viral load (>100,000 cps/ml) is higher than that reported in other studies (25%) and has an influence in the long-term decrease in pulmonary function.展开更多
Introduction: Dermatological manifestations during HIV infection play a diagnostic and prognostic role. They are observed in 83% - 98% of patients at the late stage of AIDS and 58% - 75% at an early stage of AIDS. The...Introduction: Dermatological manifestations during HIV infection play a diagnostic and prognostic role. They are observed in 83% - 98% of patients at the late stage of AIDS and 58% - 75% at an early stage of AIDS. The objective of this study was to determine the prevalence of skin diseases in HIV in children, describes the demographic profile and identify key dermatoses. Material and methods: This was a prospective study of descriptive kind conducted from August 25, 2009 to February 25, 2010. It involved children infected with HIV followed in pediatric services at the University Hospital of Conakry. All children were examined by an experienced dermatologist. The diagnosis of dermatosis was made according to the clinical signs. The stages of HIV infection were determined according to the WHO classification. Each child received retroviral serology rapid tests according to national algorithm. Results: Among 119 HIV-positive children 65 showed mucocutaneous manifestations, there are 34 girls and 31 boys, all HIV-1 infected with 66.16% in stage III disease. The average age was 7 years, ranging from 11 months to 15 years. 66.15% of the children were from married mothers and more than half of the mothers were illiterate. They were all positive for HIV1. Oral candidiasis (38.46%), prurigo (29.23%) and molluscum contagiosum (7.69%) were the most common skin diseases;52.31% had at least two associated dermatoses. The candidiasis-prurigo combination (26.47%) was the most common. Dermatosis was often associated with other conditions: malaria (30.76%), pulmonary tuberculosis (25.61%) and malnutrition (12.30%). Discussion: With 65 cases diagnosed in six months our study shows that skin diseases are common in HIV among children in Guinea. The prevalence and socio-demographic characteristics are close to those reported by sub saharian and North African authors. A special feature of the study is that most mothers are illiterate and are infected with HIV, which would have favored the contamination of these children. Conclusion: In Sub-Saharan Africa where the rate of pediatric HIV infection is increasing, it is important to identify the mucocutaneous manifestations for optimal care.展开更多
This paper mainly targets to deduce an optimal treatment strategy for combined antiretroviral drugs,which can maximize healthy CD4^(+)T cells level with minimum side effects and cost.For this purpose,we consider a wit...This paper mainly targets to deduce an optimal treatment strategy for combined antiretroviral drugs,which can maximize healthy CD4^(+)T cells level with minimum side effects and cost.For this purpose,we consider a within-host treatment model for the HIV infection with two controls incorporating full logistic proliferation of healthy CD4^(+)T cells,cure rate and fusion effect.These two controls represent the effects of reverse transcriptase inhibitors(RTIs)and protease inhibitors(PIs),respectively.The model analysis begins with proving different basic properties like non-negativity,boundedness of the model solutions and calculation of the basic reproduction number of the model under consideration.Then,stability results are obtained for HIV infection-free equilibrium point and also,a critical efficacy for the combined therapies is calculated.After that,the optimal control problem is proposed and solved numerically using a forwardbackward iterative method.Finally,we obtain an optimal treatment strategy that can maximize healthy CD4^(+)T cells count and control the viral load,and HIV-infected CD4^(+)T cells count to an undetectable level resulting in improved health conditions of infected individuals.展开更多
In this paper,we investigate a delayed HIV infection model that considers the homeostatic prolif-eration of CD4^(+)T cells.The existence and stability of uninfected equilibrium and infected equilibria(smaller and larg...In this paper,we investigate a delayed HIV infection model that considers the homeostatic prolif-eration of CD4^(+)T cells.The existence and stability of uninfected equilibrium and infected equilibria(smaller and larger ones)are studied by analyzing the characteristic equation of the system.The intracellular delay does not affect the stability of uninfected equilibrium,but it can change the stability of larger positive equilibrium and Hopf bifurcation appears inducing stable limit cycles.Furthermore,direction and stability of Hopf bifur-cation are well investigated by using the central manifold theorem and the normal form theory.The numerical simulation results show that the stability region of larger positive equilibrium becomes smaller as the increase of time delay.Moreover,when the maximum homeostatic growth rate is very small,the larger positive equilibrium is always stable.On the contrary,when the rate of supply of T cells is very small,the larger positive equilibrium is always unstable.展开更多
In this paper,a neuro-optimized numerical method is presented for approximation of HIV virus progression model in the human body.The model is composed of coupled nonlinear system of differential equations(DEs)containi...In this paper,a neuro-optimized numerical method is presented for approximation of HIV virus progression model in the human body.The model is composed of coupled nonlinear system of differential equations(DEs)containing healthy and infected T-Cells and HIV free virus particles.The coupled system is transformed into feedforward artificial neural network(ANN)with Mexican hat wavelet function in the hidden layers.Two meta-heuristic algorithms based on chaotic particle swarm optimization(CPSO)and its hybrid version with local search technique are exploited to tune the parameters of ANN in an unsupervised manner of error function.A comprehensive testbed is established to observe the virus growth per day with performance metric containing fitness value,computational time complexity and convergence.The proposed solutions are compared with state of art Runge-Kutta method and Legendre Wavelet Collocation Method(LWCM).The core advantages of the proposed scheme are getting the solution on continuous grid,consistent convergence,simplicity in implementation and handling strong nonlinearity effectively.展开更多
Background: The assessment of iron status using a single biomarker of iron metabolism is not enough sensitive and specific to reliably diagnose iron deficiency associated with multiple comorbidities. The objective of ...Background: The assessment of iron status using a single biomarker of iron metabolism is not enough sensitive and specific to reliably diagnose iron deficiency associated with multiple comorbidities. The objective of this study was to describe the iron status of people living with HIV in sub-Saharan Africa using a multi-criteria approach based on the determination of blood ferritin, sTfR, CRP and the calculation of sTfR-F index. Methods: This study was conducted using a retrospective panel of 933 sera/plasmas. We determined serum ferritin concentration, serum sTfR concentration, and C-reactive protein (CRP) by immunoturbidimetry for each subject. The sTfR-F index was determined by calculating the sTfR/log ferritin ratio. The statistical test used was Chi<sup>2</sup>. Results: Regardless of the inflammatory syndrome, we determined 3.80%, 30.29%, and 42.70% iron deficiency based on the separate interpretation of ferritin concentration, sTfR, and sTfR-F calculation, respectively. We used those biomarkers in addition to CRP in an algorithm for the diagnosis of iron deficiency. Subjects without inflammatory syndrome, had iron deficiency of 2.89% (n = 26). Taking into account the presence of an inflammatory syndrome, the frequency obtained was n = 88 (9.78%). Overall, iron deficiency was diagnosed in 114 (12.67%) patients when we used the diagnostic algorithm. Conclusion: The use of diagnostic algorithms combining several biomarkers of iron metabolism and taking into account the presence or absence of an inflammatory syndrome is a good approach to detect a large number of iron deficiencies in a population. Therefore, an assessment of the effectiveness of different diagnostic algorithms is necessary.展开更多
The elimination of vertical transmission of HIV from mother to child is a major global goal. In Senegal, the transmission rate was estimated at 3.2% in 2017. To reduce or even eliminate this transmission, Senegal has ...The elimination of vertical transmission of HIV from mother to child is a major global goal. In Senegal, the transmission rate was estimated at 3.2% in 2017. To reduce or even eliminate this transmission, Senegal has implemented various strategies and programs adopted and applied nationally. Thus access to services for the prevention of mother-to-child transmission of HIV has been extended to the level of the health post (the lowest level of the country’s health pyramid) with a delegation of tasks to paramedical staff (nurse, midwife) in the diagnosis and therapeutic management. Objectives: To describe the epidemiological profile of HIV (Human Immunodeficiency Virus)-positive mothers, to assess the care of children born to HIV-positive mothers, to determine the rate of HIV transmission from mother to child. Patients and Method: We carried out a retrospective, cross-sectional and descriptive study of all live newborns of HIV-positive mothers who gave birth at the Gaspard Kamara Health Center (a level 2 health center in Dakar, Senegal) between January 1, 2015 and December 31, 2018. The data were collected from prevention of mother-to-child transmission (PMTCT) prenatal follow-up registers and files, delivery files and registers, and neonatology and pediatric follow-up files, and exploited using the Epi info 7 software. Results: There were 98 children of seropositive mothers. The epidemiological profile of the HIV-positive woman was that of a young woman aged between 16 and 43 with an average of 31.31 years, pauciparous (>65% of cases) from Dakar center (>75% of cases), housewife with a low socio-economic level (63.1% of cases), married in almost all cases, with HIV profile (in almost all cases) and diagnosed before pregnancy (51.02%). The analysis of the children’s data revealed a predominance of girls (52.04%) with a good birth weight (2964g on average) and a pregnancy carried to term in more than 95% of cases. ARV prophylaxis was almost entirely respected with triple therapy (AZT + 3TC + NVP) in a fixed combination as protocol. Protected breastfeeding (80.21%), including 6 months of exclusive protected breastfeeding, was the rule for the mode of feeding. Three children were diagnosed positive with PCR1 as with serology (3.06%). Discussion and Conclusion: the initiatives and strategies put in place in Senegal have enabled a significant reduction in mother-to-child transmission of HIV and deserve to be supported by insisting on primary prevention, programming and good follow-up of pregnancies, and a good support for HIV-positive women.展开更多
Background: Renal stone (RS) is a highly prevalent disease in our societies and is mostly secondary to lifestyle habits. HIV<sub>1</sub> patients often experience RS, although specific risk factors are not...Background: Renal stone (RS) is a highly prevalent disease in our societies and is mostly secondary to lifestyle habits. HIV<sub>1</sub> patients often experience RS, although specific risk factors are not known. Despite other priorities, comprehensive work-up should be offered to avoid recurrences (50% risk in 5 years). Purpose and Methods: The aim of the study is to describe how to handle RS in persons living with HIV<sub>1</sub> and to suggest how the understanding of mechanisms involved in stone composition helps customize therapy and prevent recurrences. We prospectively performed a complete work-up in a cohort of 23 prevalent HIV<sub>1</sub> patients referred to our highly-specialized center by HIV physicians. Results: Inclusion was secondary to a colic episode with spontaneous elimination of the stone (74%), bilateral (67%), not obstructive (67%);53% underwent urologic interventions. Mean age was 34 ± 16 years old and BMI was 22.5 ± 3 (one-third with metabolic syndrome). History of RS showed only one episode (22%), >one (74%) or >4 (4%). Estimated GFR was 78 ± 24 ml/min/1.73m<sup>2</sup> (mean Cr 101 ± 24 μmol/L), and 5 were classified CKD stage 3. Stone analysis was only available for 7 patients and in 6/7 patients, and calcium metabolism was fully explored (2 absorptive hypercalciuria, 4 renal primitive hypercalciuria). Retained mechanism for RS was uric acid dependent for one, oxalic acid dependent for three and calcium dependent for three. Very few patients were exposed to known environmental risk factors for RS, 3 were/had been exposed to darunavir and 3 to atazanavir, 1 to efavirenz, 1 to acetazolamide, 2 to allopurinol. Conclusion: RS in HIV<sub>1</sub> patients is mostly not related to ARV. Understanding of renal stone composition is critical to prevent recurrences by offering specific dietetic counselling and therapy. The role of HIV physicians is important due to the high prevalence of RS in the context of HIV disease.展开更多
Since the introduction of antiretroviral therapy, the life expectancy of people living with human immunodeficiency virus (PLWH) has extended. This extension has led to an increase in the aging population in Japan and ...Since the introduction of antiretroviral therapy, the life expectancy of people living with human immunodeficiency virus (PLWH) has extended. This extension has led to an increase in the aging population in Japan and globally. Providing appropriate long-term care (LTC) for PLWH has thus become increasingly critical. Our study aimed to describe LTC setting preferences and related factors among middle-aged and older Japanese people living with HIV. A cross-sectional survey was conducted at two hospitals in Tokyo. One hundred seventy-five outpatients aged 40 years and above participated in this study. Participants completed an anonymous self-administered questionnaire to assess where they wanted to live once they could no longer care for themselves. Approximately 52.0% preferred a designated facility for older adults or LTC, while 30.3% preferred their home or living with family, a partner, or a friend (“familiar housing”). Bivariate analyses revealed that LTC setting preference was significantly associated with marital status, whether or not the participant had at least one child, and household composition. Furthermore, logistic regression analysis revealed that participants living with non-kin were less likely to prefer living in designated housing facilities for older adults or LTC (adjusted odds ratio = 0.17, 95% confidence interval: 0.05 - 0.63). The study findings suggest that family make-up and composition of cohabiters are critical indicators for LTC setting preference in this population. These findings can be the foundation for future care planning and delivery to meet the unique LTC needs and expectations of the aging population with HIV in Japan and similar global settings.展开更多
Objectives:Although effective antiretroviral therapy(ART)has been used for more than two decades,HIV-associated neurocognitive disorder remains prevalent.Thus,whether ART can improve neurocognitive impairment is contr...Objectives:Although effective antiretroviral therapy(ART)has been used for more than two decades,HIV-associated neurocognitive disorder remains prevalent.Thus,whether ART can improve neurocognitive impairment is controversial.This review aims to explore the effects of ART on cognitive impairment in people living with HIV(PLWH).Methods:A systematic literature search was conducted in eight databases(PubMed,Embase,Web of Science,Cochrane Library,CNKI,VIP,China Biology Medicine disc,and WanFang)to identify studies that compare cognitive function between study groups who are administered and not administered ART.We searched for articles published up to April 2019.Article evaluation and data extraction were independently conducted by two reviewers.Results:Sixteen articles(6,694 participants)-14 cross-sectional studies and 2 cohort studies—were included in this meta-analysis.The cross-sectional studies demonstrated that ART group did not perform better than the non-ART group(OR=1.16;95%CI,1.03-1.30).However,the cohort studies reported a significant improvement in cognitive function at three months(OR=4.01;95%CI,2.35-6.85)and six months(OR=9.24;95%CI,1.71-49.96)after ART initiation compared with the baseline data.No significant cognitive improvement was found in participants younger than 55 years old,but the two crosssectional studies showed that ART may improve cognitive function in PLWH under 65 years old with poor physical condition and immune status.Conclusions:ART could improve cognitive function in PLWH with poor physical condition and immune status,but it does not considerably improve cognition in the entire PLWH population.展开更多
<strong>Background:</strong> Sub-Saharan Africa is the region most affected by the Human Immunodeficiency Virus (HIV) with an increasing prevalence of related cognitive impairments. Magnetic Resonance Imag...<strong>Background:</strong> Sub-Saharan Africa is the region most affected by the Human Immunodeficiency Virus (HIV) with an increasing prevalence of related cognitive impairments. Magnetic Resonance Imaging (MRI) plays an important role in the early detection of lesions. This work aimed to describe the MRI aspects of different brain lesions occurred in HIV positive patients in our practice. <strong>Methods:</strong> This was a descriptive cross-sectional study that took place from June 2014 to July 2016 in the medical imaging department of the EL RAPHA private Polyclinic in Libreville, Gabon. It included all patients referred for imaging for the exploration of a Central Nervous System (CNS) lesions at MRI, based on clinical and/or paraclinical arguments. <strong>Results:</strong> Among the 39 patients included, 19 (48.7%) had a previous brain CT scan, 11 of which were normal (28.2%). Thirty-five (89.74%) patients had a pathological MRI. The main etiologies found were toxoplasmosis (37.14%), tuberculosis (17.14%), cerebral atrophy (17.14%) and HIV encephalitis (14.28%). Among the eleven patients with a normal Computer Tomography scan, the MRI found 7 abnormalities including 1 case of toxoplasmosis, 3 cases of HIV encephalitis and 3 cases of Progressive Multifocal Leukoencephalopathy (PML). <strong>Conclusion:</strong> MRI played an important role in the diagnosis of CNS disorders in HIV-infected individuals. It can be used to differentiate and characterize various brain lesions. Improving its accessibility in sub-Saharan Africa should contribute to better care for people living with HIV.展开更多
Background: Despite increased deliverance of antiretroviral therapy (ART), morbidity and mortality from TB are still predominant among HIV/AIDS infected patients in Ethiopia. Thus, current study aimed to determine mag...Background: Despite increased deliverance of antiretroviral therapy (ART), morbidity and mortality from TB are still predominant among HIV/AIDS infected patients in Ethiopia. Thus, current study aimed to determine magnitude and predictors of tuberculosis among cohort of HIV infected patients at Arba Minch General Hospital, Ethiopia, 2015. Methods: Hospital based retrospective follow-up study was conducted among study population which was HIV/AIDS infected individuals registered from September 2007 to 2013. The data were collected using structured data abstraction form and four ART trained nurses were used to abstract the data. The data were checked for completeness, cleaned and entered into Epi Info 7.0 and analyzed using SPSS version (IBM-21). Results were summarized by using table of frequency, graph, and measure of central tendency. Statistical significance was inferred at P-value ≤ 0.05. Adjusted odd ratio (AOR) with 95% confidence interval (CI) was used to determine predictors. Result: Four hundred ninety six patient’s charts were abstracted. Cumulative and incidence density of tuberculosis were 21.4% (95% CI: 21.3, 21.44) and 5.36 per 100 person year respectively. Cigarette smokers (AOR: 2.82, 95% CI (1.27 - 6.27)), household with family size of 3 - 4 (AOR: 2.26, 95% CI (1.14 - 4.50)), baseline WHO clinical stage III (AOR: 20.26, 95% CI (7.09 - 57.6)) and IV (AOR: 22.9, 95% CI (6.91 - 76.4)) and heamoglobin level of <10 (AOR: 2.56, 95% CI (1.22 - 5.33)) were important predictors (risk factors) of tuberculosis among HIV infected patients. Conclusion and recommendation: Relatively high incident tuberculosis cases were established among HIV infected patients and history of cigarette smoking;family size;hemoglobin level and base line WHO clinical stage were responsible for this incidence. Therefore;early initiation of HAARTas per current guideline should get stressed, and the finding that smoking was important predictors for TB in Ethiopia had obvious TB control implication which required high attention focused on fighting against cigarette smoking among HIV infected cohort.展开更多
<strong>Background: </strong>The Sustainable Development Goals commitment to Ending HIV/AIDS by 2030 requires sustained adequate investment. This study sought to examine the association between HIV/AIDS sp...<strong>Background: </strong>The Sustainable Development Goals commitment to Ending HIV/AIDS by 2030 requires sustained adequate investment. This study sought to examine the association between HIV/AIDS spending and outcomes in Thailand between 2008 and 2019. <strong>Methods: </strong>A quantitative secondary data analysis with time-series was conducted using a retrospective dataset of HIV spending and some selected outcomes including the number of people living with HIV (PLHIV), incidence and prevalence of HIV/AIDS, the prevention of mother-to-child transmission (PMTCT) and AIDS-related deaths. Data were obtained from a diverse set of sources. Descriptive statistics and univariate regression model were used to analyze HIV expenditure and outcomes. <strong>Results: </strong>HIV spending per PLHIV rose by two folds from $347 in 2008 to more than $600 in 2019, mostly financed by domestic sources. This increase of domestic resources per PLHIV was significantly associated with better HIV-related outcomes especially in the reduction of PLHIV and AIDS-related deaths through increased number of people receiving antiretroviral therapy (ART). However, the spending per PLHIV varied across the three public health insurance schemes. Comparison of HIV expenditure and health outcomes across upper-middle-income countries shows Thailand is not highly ranked in terms of spending efficiency despite having made good progress. <strong>Conclusion: </strong>Domestic financing for HIV programs is indispensable for achieving the goal of ending AIDS. Despite significant improvement in HIV-related outcomes, challenges remain in achieving the 90-90-90 goal. The redesigning of payment methods should be considered to increase the efficiency of HIV financing. Other factors related to strengthening the health system should not be overlooked.展开更多
Context: The Human Immunodeficiency Virus (HIV) continues to be the main public health challenge in Gabon. The latest studies highlight a high rate of virological failure and HIV drug resistance in semi-rural Gabon. I...Context: The Human Immunodeficiency Virus (HIV) continues to be the main public health challenge in Gabon. The latest studies highlight a high rate of virological failure and HIV drug resistance in semi-rural Gabon. In Libreville, virological failure data is sparse, data on HIV drug resistance for the former first line and new first-line regimen is lacking. Methods: Between January 28<sup>th</sup>, 2019, and January 31<sup>st</sup>, 2020, we received patient living with HIV (PLWHA) for CD4 counts, HIV-1 viral load, and/or genotyping of HIV-1 mutation drug resistance. We used the BD FACSPresto for CD4 count, the Biocentric Generic HIV viral load test for HIV-1 quantification, and the HIV-1 drug resistance mutation genotyping (ARNS protocol). Results: A total of 1129 HIV-1 patients have been enrolled for this study. The median age was 46 years old and the median of CD4 was 386 cells per cubic millimeter. The virological suppression success was observed at 62.7% of patients on the former first line regimen and 70.6% of the patient on DBR. We successfully amplified and analyzed 76 sequences and noticed the presence of the nineteen different subtypes with the predominance of the subtypes CRF02-AG (37.95%), followed by subtype A (22.3%). For HIV drug resistance analyses, 108 (65.1%) had resistance mutation to nucleoside reverse transcriptase inhibitors (NRTIs);of these, 91 (84%) present M184V/I. When looking for NNRTI mutations, 119 (71.7%) sequences had at least one mutation. Of these, 82 had K103N (68.9%), representing the main NNRTI mutations. The pattern showing the high level of resistance (HLR) in all molecules of NRTIs and NNRTIs, except for the TDF (intermediate resistance) was M41L-E44DL74I-M184-L210W-T215Y-K101P-K103N-V106I. Conclusion: This report paints a picture of a relatively female-dominated HIV-infected Gabonese population with a low level of immunity. The level of drug resistance with the former first-line regimen suggests the need to monitor the drug Dolutegravir resistance.展开更多
<b><span style="font-family:Verdana;">Background: </span></b><span style="font-family:Verdana;">Haematological abnormalities are strong independent predictors of morbi...<b><span style="font-family:Verdana;">Background: </span></b><span style="font-family:Verdana;">Haematological abnormalities are strong independent predictors of morbidity and mortality in HIV infection.</span><span style="font-family:;" "=""> </span><b><span style="font-family:Verdana;">Objectives of the Study:</span></b><span style="font-family:Verdana;"> This study was carried out to assess the pattern of the changes in the baseline peripheral blood cell counts among adult HIV positive patients. To also determine the </span><span style="font-family:;" "=""><span style="font-family:Verdana;">CD4</span><sup><span style="font-family:Verdana;">+</span></sup></span><span style="font-family:Verdana;"> T</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">cell levels and its correlation with the changes in the baseline cell counts of the patients using HIV negative blood donors as controls.</span><span style="font-family:;" "=""> </span><b><span style="font-family:Verdana;">Methods</span></b><b><span style="font-family:Verdana;">:</span></b><span style="font-family:Verdana;"> This was a case controlled prospective study. The subjects were antiretroviral therapy naive adult HIV positive patients and HIV negative blood donor controls. Five milliliters (5</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">mls) of venous blood was collected from the cubitus of every consecutive consenting subject. Blood sample was analysed for baseline complete blood cell counts and the </span><span style="font-family:;" "=""><span style="font-family:Verdana;">CD4</span><sup><span style="font-family:Verdana;">+</span></sup></span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">T lymphocyte levels using Sysmex and Cyflow R Counter autoanalysers respectively. Obtained data was analysed with the statistical package for the social scientist (SPSS version 20.0). The Erythrocyte sedimentation rate of subjects was measured by the manual standard Westergreen method. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">Of 300 subjects, there were 139 (46.3%) males and 161 (53.7%) females in the study. Anaemia was found in 72</span></span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">(29.2%), leucopenia in 20</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">(8%) and thrombocytopenia in 6</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">(2.4%) of the patients. The mean erythrocyte sedimentation rates of the subjects were 81.88</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">mm/hr and 9.46</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">mm/hr (p = 0.000) for the patients and the controls respectively. The mean </span><span style="font-family:;" "=""><span style="font-family:Verdana;">CD4</span><sup><span style="font-family:Verdana;">+</span></sup></span><span style="font-family:Verdana;"> T lymphocyte cell counts were 293</span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">cells/μl and 750 cells/μl (p = 0.000) for the patients and controls respectively. </span><b><span style="font-family:Verdana;">Conclusion</span></b></span><b><span style="font-family:Verdana;">:</span></b><b><span style="font-family:;" "=""> </span></b><span style="font-family:Verdana;">Anaemia, leucopenia and thrombocytopenia were more prevalent among the studied HIV positive patients.</span>展开更多
Background: The diagnosis of deep vein thrombosis (DVT) requires an etiological research of HIV infection. The objective was to identify the characteristics of patients with DVT of limbs without other risk factors in ...Background: The diagnosis of deep vein thrombosis (DVT) requires an etiological research of HIV infection. The objective was to identify the characteristics of patients with DVT of limbs without other risk factors in our context. Methods: We performed a comparative retrospective study from January 2005 to December 2012. We identified 162 cases of patients hospitalized in Medicine Department of Institute of Cardiology of Abidjan with 124 HIV-negative and 38 HIV positive patients. Results: DVT is more common in HIV positive young patients (57.8 ± 15.6 years vs 39.3 ± 10.6 years, p = 0.0001). The traditional risk factors were found in HIV negative patients. HIV positive patients had no predisposing factor for thrombosis. The ankle-femoral popliteal location (29% vs 73.7% p = 0.05) was most frequent in HIV positive patients. There was no significant difference in anticoagulant therapy: UFH (60.5% vs 52.6%;p > 0.05), LMWH (20.2% vs 7.9%;p > 0.05), AVK relay (99.2% vs 100%;p > 0.05) and general measures (elevation MI). (70.2% vs 65.8%;p > 0.05). None of the patients in both groups had worn stockings in hospitalization. The stockings were prescribed on discharge (70% vs 64.7%;p > 0.05). Conclusion: DVT may be the mode of revelation of HIV infection. The etiological research with HIV infection should be systematic in?young patients suffering from DVT in the absence of risk factors of thrombosis.展开更多
Invasive-squamous-cell-cancer (ISCC) of the anal canal is an uncommon disease. Human papillomavirus (HPV) is the etiological agent of most of types of ISCC. The incidence of ISCC has been increasing in HIV-infected in...Invasive-squamous-cell-cancer (ISCC) of the anal canal is an uncommon disease. Human papillomavirus (HPV) is the etiological agent of most of types of ISCC. The incidence of ISCC has been increasing in HIV-infected individuals, even after the introduction of highly active antiretroviral therapy. The aim of this study was to analyze biopsy specimens from patients diagnosed with ISCC at a tertiary hospital from 1983 to 2012 in order to detect HPV-DNA. Methods: Formaldehyde-fixed, paraffin-embedded specimens from patients with ISCC underwent HPV-DNA genotyping using multiplex PCR assay. Results: A total of 31 cases were collected;10 were HIV-infected (9 men, 1 woman) and 21 non-HIV-infected (11 men, 10 women). HPV infection was detected in 87.5% (7/8) of the HIV-infected patients (DNA from 2 biopsies was degraded) and 76.2% (16/21) of non-HIV-infected individuals. Multiple-type infections were only found in 28.6% (2/7) of the HIV-infected patients (no multiple-type infections in non-HIV-infected individuals). The most prevalent type was HPV-16: 50% (4/8) in the HIV-infected group (57% [4/7] of the HPV-positive samples) and 66.7% (14/21) in the non-HIV-infected group (87.5% (14/16) of the HPV-positive samples). Remarkably, 37.5% (3/8) of the HIV-infected group had high-risk HPV types not included in the vaccines (HPV-33, 51, 52, and 66) compared with 4.8% in the non-HIV-infected group (1/21, HPV-52). All cases of anal ISCC in HIV-infected patients were recorded in the highly active antiretroviral therapy era. Conclusion: HIV-infected patients presented anal ISCC with a higher proportion of high-risk HPV types not covered by the conventional vaccines than non-HIV-infected individuals.展开更多
文摘Objective: To take the unpaid blood donors in Wuzhou City as the research object, analyze the characteristics and prevalence of HIV infection, further explore its epidemiological characteristics, and lay a solid foundation for the recruitment of unpaid blood donors and the safety of blood transfusion, so as to reduce the risk of HIV transmission through blood transfusion. Methods: This paper collected the anti-HIV test results of unpaid blood donors and the confirmation results of reactive samples from 2015 to 2020, and carried out statistical analysis on the relevant information of positive samples. Result: From 2015 to 2020, a total of 233,242 unpaid blood donors were tested, and the positive rate of anti-HIV initial screening was 0.057% (132/233,242), and the positive rate of anti-HIV confirmed was 0.022% (51/233,242);the comparison of positive rates in each year was P < 0.05. Among the total number of infections, 76.47% (39/51) of confirmed positive persons were infected with HIV alone, followed by combined TP infection, accounting for 15.69% (8/51);for the people between 46 and 55 years old, the infection rate was the highest, reaching 37.3%;and more men (90.2%) were infected than women. In terms of education background, junior high school and below were the majority, accounting for 58.83% of the total;in terms of marital status, the number of unmarried people was 27, accounting for 52.9%. In terms of occupation, there were two main groups: farmers and workers, accounting for 66.7% of the total number of infections, and students accounting for 15.7%. Among the confirmed positives, the proportion of first-time blood donors and whole blood donors was higher than that of those who donated blood again or donated component blood. Conclusion: The situation of HIV infection among unpaid blood donors in Wuzhou City was relatively stable from 2015 to 2020, with no significant change in the absolute number of infected people compared to the previous period (the HIV infection rate from 2010 to 2013 was 0.03%), and most of them were males, unmarried people and those with low education. Therefore, attention must be paid to the consultation and recruitment of blood donors before blood donation, as well as the HIV screening in the laboratory after blood donation, so as to ensure the safety of clinical blood use.
文摘In this paper,Haar collocation algorithmis developed for the solution of first-order ofHIV infection CD4^(+)T-Cells model.In this technique,the derivative in the nonlinear model is approximated by utilizing Haar functions.The value of the unknown function is obtained by the process of integration.Error estimation is also discussed,which aims to reduce the error of numerical solutions.The numerical results show that the method is simply applicable.The results are compared with Runge-Kutta technique,Bessel collocation technique,LADM-Pade and Galerkin technique available in the literature.The results show that the Haar technique is easy,precise and effective.
文摘HIV/AIDS is a serious health problem among prisoners and constitutes a big challenge for prison administration services, public health services and governments. <b><span style="font-family:Verdana;">Aims</span></b><span style="font-family:Verdana;"><strong>:</strong> Determine the prevalence of HIV infection among prisoners and describe associated factors. </span><b><span style="font-family:Verdana;">Population and Methods: </span></b><span style="font-family:Verdana;">This was a descriptive and analytical cross-sectional study conducted from December 2015 to October 2016. A sample of 600 prisoners was randomly interviewed nationwide. They were selected directly from the sample frame from across the country and proportionally from all sites. Pre-established questionnaires providing information on the sociodemographic and biological characteristics of prisoners were used for the collection of data. Data entry and analysis were </span><span style="font-family:Verdana;">performed using EXCEL and SPSS 18 software. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">The survey was</span><span style="font-family:Verdana;"> based on a randomised sample of 600 prisoners, 593 of whom accepted blood extraction for the HIV testing. The series was mainly composed of males (89%). The median age was 33 years (18 -</span><span style="font-family:'';line-height:1.5;"> </span><span style="font-family:'';line-height:1.5;"><span style="font-family:Verdana;">69). The level of education among respondents was 60%. Regarding marital status, the proportion of married prisoners was 51.8%. Almost three-quarters (71.5%) were at their first imprisonment and 51.8% were on preventive detention. The reasons for imprisonment varied and were dominated by drug use (35.3%), while only 4.6% confessed that they continued using drugs while in prison. 97.8% of prisoners have had a sexual experience. Their median age was 19 years at their first sexual intercourse. 20.5% reported using a condom during their first intercourse. Multi </span><span style="font-family:Verdana;">partnership was estimated at 17.8%. The prevalence of HIV infection was high among prisoners (2%), the quadruple of the national rate. This prevalence was associated with female sex (4.5%) (p =</span><span style="font-family:Verdana;"> 0.012) and housewives (12.5%) (p =</span></span><span style="line-height:1.5;font-family:Verdana;"> 0.002). </span><b style="line-height:1.5;"><span style="font-family:Verdana;">Conclusion: </span></b><span style="line-height:1.5;font-family:Verdana;">Prisoners are very vulnerable to HIV infection with a high prevalence compared to the national rate, hence the need for the enforcement of effective HIV prevention and care measures in prisons.</span>
文摘<strong>Background:</strong> In an age of antiretroviral therapy, the life expectancy of children perinatally infected with Human Immunodeficiency Virus (HIV) has significantly increased. At the same time, however, pulmonary pathologies secondary to opportunistic infections have decreased thanks to increased diagnostics and access to antiretroviral therapy (ART). Despite this, in these children an immune dysregulation is maintained due to chronic infection. There is evidence that these patients have increased probability of presenting with abnormalities in pulmonary function, mainly with chronic obstructive clinical pictures (25% - 40% of perinatally infected adolescents display some anomaly in the spirometry), which predisposes them to increased risk of chronic pulmonary disease. Since lung development occurs mainly during infancy, patients perinatally infected with HIV may suffer consequences. This can be secondary to opportunistic infections, chronic inflammation due to the virus, and immunologic effects of ART, mainly in non-industrialized countries, where late diagnosis is frequent. <strong>Methodology:</strong> An analytical, observational, cross-sectional study was conducted at Roosevelt Hospital Pediatric infectious disease clinic, from January to December 2019. A sample of 76 patients was obtained, out of a population of 362 patients. A total of 62 subjects, who met the criterion of reproducibility in the spirometry, were analyzed. Results were analyzed with percentages and the association of variables using the chi-squared test (<em>χ</em><sup>2</sup>). <strong>Results:</strong> A decrease in pulmonary function was found in 34% of patients, mild obstructive pattern (16%) predominating. Significant association between basal viral load greater than 100,000 cp/ml and a decrease in Forced expiratory flow 25 - 75 (FEF 25-75) (<em>p</em> 0.046) and in relationship between forced expiratory volume and forced vital capacity (FEV1/ FVC <em>p</em> = 0.024) was observed, as well as a non-statistically significant relationship between advanced clinical stage at diagnosis and decreased pulmonary function. <strong>Conclusions:</strong> The prevalence of decreased pulmonary function related to advanced clinical stage and elevated basal viral load (>100,000 cps/ml) is higher than that reported in other studies (25%) and has an influence in the long-term decrease in pulmonary function.
文摘Introduction: Dermatological manifestations during HIV infection play a diagnostic and prognostic role. They are observed in 83% - 98% of patients at the late stage of AIDS and 58% - 75% at an early stage of AIDS. The objective of this study was to determine the prevalence of skin diseases in HIV in children, describes the demographic profile and identify key dermatoses. Material and methods: This was a prospective study of descriptive kind conducted from August 25, 2009 to February 25, 2010. It involved children infected with HIV followed in pediatric services at the University Hospital of Conakry. All children were examined by an experienced dermatologist. The diagnosis of dermatosis was made according to the clinical signs. The stages of HIV infection were determined according to the WHO classification. Each child received retroviral serology rapid tests according to national algorithm. Results: Among 119 HIV-positive children 65 showed mucocutaneous manifestations, there are 34 girls and 31 boys, all HIV-1 infected with 66.16% in stage III disease. The average age was 7 years, ranging from 11 months to 15 years. 66.15% of the children were from married mothers and more than half of the mothers were illiterate. They were all positive for HIV1. Oral candidiasis (38.46%), prurigo (29.23%) and molluscum contagiosum (7.69%) were the most common skin diseases;52.31% had at least two associated dermatoses. The candidiasis-prurigo combination (26.47%) was the most common. Dermatosis was often associated with other conditions: malaria (30.76%), pulmonary tuberculosis (25.61%) and malnutrition (12.30%). Discussion: With 65 cases diagnosed in six months our study shows that skin diseases are common in HIV among children in Guinea. The prevalence and socio-demographic characteristics are close to those reported by sub saharian and North African authors. A special feature of the study is that most mothers are illiterate and are infected with HIV, which would have favored the contamination of these children. Conclusion: In Sub-Saharan Africa where the rate of pediatric HIV infection is increasing, it is important to identify the mucocutaneous manifestations for optimal care.
文摘This paper mainly targets to deduce an optimal treatment strategy for combined antiretroviral drugs,which can maximize healthy CD4^(+)T cells level with minimum side effects and cost.For this purpose,we consider a within-host treatment model for the HIV infection with two controls incorporating full logistic proliferation of healthy CD4^(+)T cells,cure rate and fusion effect.These two controls represent the effects of reverse transcriptase inhibitors(RTIs)and protease inhibitors(PIs),respectively.The model analysis begins with proving different basic properties like non-negativity,boundedness of the model solutions and calculation of the basic reproduction number of the model under consideration.Then,stability results are obtained for HIV infection-free equilibrium point and also,a critical efficacy for the combined therapies is calculated.After that,the optimal control problem is proposed and solved numerically using a forwardbackward iterative method.Finally,we obtain an optimal treatment strategy that can maximize healthy CD4^(+)T cells count and control the viral load,and HIV-infected CD4^(+)T cells count to an undetectable level resulting in improved health conditions of infected individuals.
基金supported by the National Natural Science Foundation of China(Nos.11871235,11901225)the Natural Science Foundation of Hubei Province(2019CFB189)+1 种基金the Fundamental Research Funds for the Central Universities(Nos.CCNU19TS030,CCNU18XJ041)by the Japan Society for the Promotion of Science“Grand-in-Aid 20K03755”。
文摘In this paper,we investigate a delayed HIV infection model that considers the homeostatic prolif-eration of CD4^(+)T cells.The existence and stability of uninfected equilibrium and infected equilibria(smaller and larger ones)are studied by analyzing the characteristic equation of the system.The intracellular delay does not affect the stability of uninfected equilibrium,but it can change the stability of larger positive equilibrium and Hopf bifurcation appears inducing stable limit cycles.Furthermore,direction and stability of Hopf bifur-cation are well investigated by using the central manifold theorem and the normal form theory.The numerical simulation results show that the stability region of larger positive equilibrium becomes smaller as the increase of time delay.Moreover,when the maximum homeostatic growth rate is very small,the larger positive equilibrium is always stable.On the contrary,when the rate of supply of T cells is very small,the larger positive equilibrium is always unstable.
基金supported by the National Natural Science Foundation of China[11527801,41706201].
文摘In this paper,a neuro-optimized numerical method is presented for approximation of HIV virus progression model in the human body.The model is composed of coupled nonlinear system of differential equations(DEs)containing healthy and infected T-Cells and HIV free virus particles.The coupled system is transformed into feedforward artificial neural network(ANN)with Mexican hat wavelet function in the hidden layers.Two meta-heuristic algorithms based on chaotic particle swarm optimization(CPSO)and its hybrid version with local search technique are exploited to tune the parameters of ANN in an unsupervised manner of error function.A comprehensive testbed is established to observe the virus growth per day with performance metric containing fitness value,computational time complexity and convergence.The proposed solutions are compared with state of art Runge-Kutta method and Legendre Wavelet Collocation Method(LWCM).The core advantages of the proposed scheme are getting the solution on continuous grid,consistent convergence,simplicity in implementation and handling strong nonlinearity effectively.
文摘Background: The assessment of iron status using a single biomarker of iron metabolism is not enough sensitive and specific to reliably diagnose iron deficiency associated with multiple comorbidities. The objective of this study was to describe the iron status of people living with HIV in sub-Saharan Africa using a multi-criteria approach based on the determination of blood ferritin, sTfR, CRP and the calculation of sTfR-F index. Methods: This study was conducted using a retrospective panel of 933 sera/plasmas. We determined serum ferritin concentration, serum sTfR concentration, and C-reactive protein (CRP) by immunoturbidimetry for each subject. The sTfR-F index was determined by calculating the sTfR/log ferritin ratio. The statistical test used was Chi<sup>2</sup>. Results: Regardless of the inflammatory syndrome, we determined 3.80%, 30.29%, and 42.70% iron deficiency based on the separate interpretation of ferritin concentration, sTfR, and sTfR-F calculation, respectively. We used those biomarkers in addition to CRP in an algorithm for the diagnosis of iron deficiency. Subjects without inflammatory syndrome, had iron deficiency of 2.89% (n = 26). Taking into account the presence of an inflammatory syndrome, the frequency obtained was n = 88 (9.78%). Overall, iron deficiency was diagnosed in 114 (12.67%) patients when we used the diagnostic algorithm. Conclusion: The use of diagnostic algorithms combining several biomarkers of iron metabolism and taking into account the presence or absence of an inflammatory syndrome is a good approach to detect a large number of iron deficiencies in a population. Therefore, an assessment of the effectiveness of different diagnostic algorithms is necessary.
文摘The elimination of vertical transmission of HIV from mother to child is a major global goal. In Senegal, the transmission rate was estimated at 3.2% in 2017. To reduce or even eliminate this transmission, Senegal has implemented various strategies and programs adopted and applied nationally. Thus access to services for the prevention of mother-to-child transmission of HIV has been extended to the level of the health post (the lowest level of the country’s health pyramid) with a delegation of tasks to paramedical staff (nurse, midwife) in the diagnosis and therapeutic management. Objectives: To describe the epidemiological profile of HIV (Human Immunodeficiency Virus)-positive mothers, to assess the care of children born to HIV-positive mothers, to determine the rate of HIV transmission from mother to child. Patients and Method: We carried out a retrospective, cross-sectional and descriptive study of all live newborns of HIV-positive mothers who gave birth at the Gaspard Kamara Health Center (a level 2 health center in Dakar, Senegal) between January 1, 2015 and December 31, 2018. The data were collected from prevention of mother-to-child transmission (PMTCT) prenatal follow-up registers and files, delivery files and registers, and neonatology and pediatric follow-up files, and exploited using the Epi info 7 software. Results: There were 98 children of seropositive mothers. The epidemiological profile of the HIV-positive woman was that of a young woman aged between 16 and 43 with an average of 31.31 years, pauciparous (>65% of cases) from Dakar center (>75% of cases), housewife with a low socio-economic level (63.1% of cases), married in almost all cases, with HIV profile (in almost all cases) and diagnosed before pregnancy (51.02%). The analysis of the children’s data revealed a predominance of girls (52.04%) with a good birth weight (2964g on average) and a pregnancy carried to term in more than 95% of cases. ARV prophylaxis was almost entirely respected with triple therapy (AZT + 3TC + NVP) in a fixed combination as protocol. Protected breastfeeding (80.21%), including 6 months of exclusive protected breastfeeding, was the rule for the mode of feeding. Three children were diagnosed positive with PCR1 as with serology (3.06%). Discussion and Conclusion: the initiatives and strategies put in place in Senegal have enabled a significant reduction in mother-to-child transmission of HIV and deserve to be supported by insisting on primary prevention, programming and good follow-up of pregnancies, and a good support for HIV-positive women.
文摘Background: Renal stone (RS) is a highly prevalent disease in our societies and is mostly secondary to lifestyle habits. HIV<sub>1</sub> patients often experience RS, although specific risk factors are not known. Despite other priorities, comprehensive work-up should be offered to avoid recurrences (50% risk in 5 years). Purpose and Methods: The aim of the study is to describe how to handle RS in persons living with HIV<sub>1</sub> and to suggest how the understanding of mechanisms involved in stone composition helps customize therapy and prevent recurrences. We prospectively performed a complete work-up in a cohort of 23 prevalent HIV<sub>1</sub> patients referred to our highly-specialized center by HIV physicians. Results: Inclusion was secondary to a colic episode with spontaneous elimination of the stone (74%), bilateral (67%), not obstructive (67%);53% underwent urologic interventions. Mean age was 34 ± 16 years old and BMI was 22.5 ± 3 (one-third with metabolic syndrome). History of RS showed only one episode (22%), >one (74%) or >4 (4%). Estimated GFR was 78 ± 24 ml/min/1.73m<sup>2</sup> (mean Cr 101 ± 24 μmol/L), and 5 were classified CKD stage 3. Stone analysis was only available for 7 patients and in 6/7 patients, and calcium metabolism was fully explored (2 absorptive hypercalciuria, 4 renal primitive hypercalciuria). Retained mechanism for RS was uric acid dependent for one, oxalic acid dependent for three and calcium dependent for three. Very few patients were exposed to known environmental risk factors for RS, 3 were/had been exposed to darunavir and 3 to atazanavir, 1 to efavirenz, 1 to acetazolamide, 2 to allopurinol. Conclusion: RS in HIV<sub>1</sub> patients is mostly not related to ARV. Understanding of renal stone composition is critical to prevent recurrences by offering specific dietetic counselling and therapy. The role of HIV physicians is important due to the high prevalence of RS in the context of HIV disease.
文摘Since the introduction of antiretroviral therapy, the life expectancy of people living with human immunodeficiency virus (PLWH) has extended. This extension has led to an increase in the aging population in Japan and globally. Providing appropriate long-term care (LTC) for PLWH has thus become increasingly critical. Our study aimed to describe LTC setting preferences and related factors among middle-aged and older Japanese people living with HIV. A cross-sectional survey was conducted at two hospitals in Tokyo. One hundred seventy-five outpatients aged 40 years and above participated in this study. Participants completed an anonymous self-administered questionnaire to assess where they wanted to live once they could no longer care for themselves. Approximately 52.0% preferred a designated facility for older adults or LTC, while 30.3% preferred their home or living with family, a partner, or a friend (“familiar housing”). Bivariate analyses revealed that LTC setting preference was significantly associated with marital status, whether or not the participant had at least one child, and household composition. Furthermore, logistic regression analysis revealed that participants living with non-kin were less likely to prefer living in designated housing facilities for older adults or LTC (adjusted odds ratio = 0.17, 95% confidence interval: 0.05 - 0.63). The study findings suggest that family make-up and composition of cohabiters are critical indicators for LTC setting preference in this population. These findings can be the foundation for future care planning and delivery to meet the unique LTC needs and expectations of the aging population with HIV in Japan and similar global settings.
文摘Objectives:Although effective antiretroviral therapy(ART)has been used for more than two decades,HIV-associated neurocognitive disorder remains prevalent.Thus,whether ART can improve neurocognitive impairment is controversial.This review aims to explore the effects of ART on cognitive impairment in people living with HIV(PLWH).Methods:A systematic literature search was conducted in eight databases(PubMed,Embase,Web of Science,Cochrane Library,CNKI,VIP,China Biology Medicine disc,and WanFang)to identify studies that compare cognitive function between study groups who are administered and not administered ART.We searched for articles published up to April 2019.Article evaluation and data extraction were independently conducted by two reviewers.Results:Sixteen articles(6,694 participants)-14 cross-sectional studies and 2 cohort studies—were included in this meta-analysis.The cross-sectional studies demonstrated that ART group did not perform better than the non-ART group(OR=1.16;95%CI,1.03-1.30).However,the cohort studies reported a significant improvement in cognitive function at three months(OR=4.01;95%CI,2.35-6.85)and six months(OR=9.24;95%CI,1.71-49.96)after ART initiation compared with the baseline data.No significant cognitive improvement was found in participants younger than 55 years old,but the two crosssectional studies showed that ART may improve cognitive function in PLWH under 65 years old with poor physical condition and immune status.Conclusions:ART could improve cognitive function in PLWH with poor physical condition and immune status,but it does not considerably improve cognition in the entire PLWH population.
文摘<strong>Background:</strong> Sub-Saharan Africa is the region most affected by the Human Immunodeficiency Virus (HIV) with an increasing prevalence of related cognitive impairments. Magnetic Resonance Imaging (MRI) plays an important role in the early detection of lesions. This work aimed to describe the MRI aspects of different brain lesions occurred in HIV positive patients in our practice. <strong>Methods:</strong> This was a descriptive cross-sectional study that took place from June 2014 to July 2016 in the medical imaging department of the EL RAPHA private Polyclinic in Libreville, Gabon. It included all patients referred for imaging for the exploration of a Central Nervous System (CNS) lesions at MRI, based on clinical and/or paraclinical arguments. <strong>Results:</strong> Among the 39 patients included, 19 (48.7%) had a previous brain CT scan, 11 of which were normal (28.2%). Thirty-five (89.74%) patients had a pathological MRI. The main etiologies found were toxoplasmosis (37.14%), tuberculosis (17.14%), cerebral atrophy (17.14%) and HIV encephalitis (14.28%). Among the eleven patients with a normal Computer Tomography scan, the MRI found 7 abnormalities including 1 case of toxoplasmosis, 3 cases of HIV encephalitis and 3 cases of Progressive Multifocal Leukoencephalopathy (PML). <strong>Conclusion:</strong> MRI played an important role in the diagnosis of CNS disorders in HIV-infected individuals. It can be used to differentiate and characterize various brain lesions. Improving its accessibility in sub-Saharan Africa should contribute to better care for people living with HIV.
文摘Background: Despite increased deliverance of antiretroviral therapy (ART), morbidity and mortality from TB are still predominant among HIV/AIDS infected patients in Ethiopia. Thus, current study aimed to determine magnitude and predictors of tuberculosis among cohort of HIV infected patients at Arba Minch General Hospital, Ethiopia, 2015. Methods: Hospital based retrospective follow-up study was conducted among study population which was HIV/AIDS infected individuals registered from September 2007 to 2013. The data were collected using structured data abstraction form and four ART trained nurses were used to abstract the data. The data were checked for completeness, cleaned and entered into Epi Info 7.0 and analyzed using SPSS version (IBM-21). Results were summarized by using table of frequency, graph, and measure of central tendency. Statistical significance was inferred at P-value ≤ 0.05. Adjusted odd ratio (AOR) with 95% confidence interval (CI) was used to determine predictors. Result: Four hundred ninety six patient’s charts were abstracted. Cumulative and incidence density of tuberculosis were 21.4% (95% CI: 21.3, 21.44) and 5.36 per 100 person year respectively. Cigarette smokers (AOR: 2.82, 95% CI (1.27 - 6.27)), household with family size of 3 - 4 (AOR: 2.26, 95% CI (1.14 - 4.50)), baseline WHO clinical stage III (AOR: 20.26, 95% CI (7.09 - 57.6)) and IV (AOR: 22.9, 95% CI (6.91 - 76.4)) and heamoglobin level of <10 (AOR: 2.56, 95% CI (1.22 - 5.33)) were important predictors (risk factors) of tuberculosis among HIV infected patients. Conclusion and recommendation: Relatively high incident tuberculosis cases were established among HIV infected patients and history of cigarette smoking;family size;hemoglobin level and base line WHO clinical stage were responsible for this incidence. Therefore;early initiation of HAARTas per current guideline should get stressed, and the finding that smoking was important predictors for TB in Ethiopia had obvious TB control implication which required high attention focused on fighting against cigarette smoking among HIV infected cohort.
文摘<strong>Background: </strong>The Sustainable Development Goals commitment to Ending HIV/AIDS by 2030 requires sustained adequate investment. This study sought to examine the association between HIV/AIDS spending and outcomes in Thailand between 2008 and 2019. <strong>Methods: </strong>A quantitative secondary data analysis with time-series was conducted using a retrospective dataset of HIV spending and some selected outcomes including the number of people living with HIV (PLHIV), incidence and prevalence of HIV/AIDS, the prevention of mother-to-child transmission (PMTCT) and AIDS-related deaths. Data were obtained from a diverse set of sources. Descriptive statistics and univariate regression model were used to analyze HIV expenditure and outcomes. <strong>Results: </strong>HIV spending per PLHIV rose by two folds from $347 in 2008 to more than $600 in 2019, mostly financed by domestic sources. This increase of domestic resources per PLHIV was significantly associated with better HIV-related outcomes especially in the reduction of PLHIV and AIDS-related deaths through increased number of people receiving antiretroviral therapy (ART). However, the spending per PLHIV varied across the three public health insurance schemes. Comparison of HIV expenditure and health outcomes across upper-middle-income countries shows Thailand is not highly ranked in terms of spending efficiency despite having made good progress. <strong>Conclusion: </strong>Domestic financing for HIV programs is indispensable for achieving the goal of ending AIDS. Despite significant improvement in HIV-related outcomes, challenges remain in achieving the 90-90-90 goal. The redesigning of payment methods should be considered to increase the efficiency of HIV financing. Other factors related to strengthening the health system should not be overlooked.
文摘Context: The Human Immunodeficiency Virus (HIV) continues to be the main public health challenge in Gabon. The latest studies highlight a high rate of virological failure and HIV drug resistance in semi-rural Gabon. In Libreville, virological failure data is sparse, data on HIV drug resistance for the former first line and new first-line regimen is lacking. Methods: Between January 28<sup>th</sup>, 2019, and January 31<sup>st</sup>, 2020, we received patient living with HIV (PLWHA) for CD4 counts, HIV-1 viral load, and/or genotyping of HIV-1 mutation drug resistance. We used the BD FACSPresto for CD4 count, the Biocentric Generic HIV viral load test for HIV-1 quantification, and the HIV-1 drug resistance mutation genotyping (ARNS protocol). Results: A total of 1129 HIV-1 patients have been enrolled for this study. The median age was 46 years old and the median of CD4 was 386 cells per cubic millimeter. The virological suppression success was observed at 62.7% of patients on the former first line regimen and 70.6% of the patient on DBR. We successfully amplified and analyzed 76 sequences and noticed the presence of the nineteen different subtypes with the predominance of the subtypes CRF02-AG (37.95%), followed by subtype A (22.3%). For HIV drug resistance analyses, 108 (65.1%) had resistance mutation to nucleoside reverse transcriptase inhibitors (NRTIs);of these, 91 (84%) present M184V/I. When looking for NNRTI mutations, 119 (71.7%) sequences had at least one mutation. Of these, 82 had K103N (68.9%), representing the main NNRTI mutations. The pattern showing the high level of resistance (HLR) in all molecules of NRTIs and NNRTIs, except for the TDF (intermediate resistance) was M41L-E44DL74I-M184-L210W-T215Y-K101P-K103N-V106I. Conclusion: This report paints a picture of a relatively female-dominated HIV-infected Gabonese population with a low level of immunity. The level of drug resistance with the former first-line regimen suggests the need to monitor the drug Dolutegravir resistance.
文摘<b><span style="font-family:Verdana;">Background: </span></b><span style="font-family:Verdana;">Haematological abnormalities are strong independent predictors of morbidity and mortality in HIV infection.</span><span style="font-family:;" "=""> </span><b><span style="font-family:Verdana;">Objectives of the Study:</span></b><span style="font-family:Verdana;"> This study was carried out to assess the pattern of the changes in the baseline peripheral blood cell counts among adult HIV positive patients. To also determine the </span><span style="font-family:;" "=""><span style="font-family:Verdana;">CD4</span><sup><span style="font-family:Verdana;">+</span></sup></span><span style="font-family:Verdana;"> T</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">cell levels and its correlation with the changes in the baseline cell counts of the patients using HIV negative blood donors as controls.</span><span style="font-family:;" "=""> </span><b><span style="font-family:Verdana;">Methods</span></b><b><span style="font-family:Verdana;">:</span></b><span style="font-family:Verdana;"> This was a case controlled prospective study. The subjects were antiretroviral therapy naive adult HIV positive patients and HIV negative blood donor controls. Five milliliters (5</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">mls) of venous blood was collected from the cubitus of every consecutive consenting subject. Blood sample was analysed for baseline complete blood cell counts and the </span><span style="font-family:;" "=""><span style="font-family:Verdana;">CD4</span><sup><span style="font-family:Verdana;">+</span></sup></span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">T lymphocyte levels using Sysmex and Cyflow R Counter autoanalysers respectively. Obtained data was analysed with the statistical package for the social scientist (SPSS version 20.0). The Erythrocyte sedimentation rate of subjects was measured by the manual standard Westergreen method. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">Of 300 subjects, there were 139 (46.3%) males and 161 (53.7%) females in the study. Anaemia was found in 72</span></span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">(29.2%), leucopenia in 20</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">(8%) and thrombocytopenia in 6</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">(2.4%) of the patients. The mean erythrocyte sedimentation rates of the subjects were 81.88</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">mm/hr and 9.46</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">mm/hr (p = 0.000) for the patients and the controls respectively. The mean </span><span style="font-family:;" "=""><span style="font-family:Verdana;">CD4</span><sup><span style="font-family:Verdana;">+</span></sup></span><span style="font-family:Verdana;"> T lymphocyte cell counts were 293</span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">cells/μl and 750 cells/μl (p = 0.000) for the patients and controls respectively. </span><b><span style="font-family:Verdana;">Conclusion</span></b></span><b><span style="font-family:Verdana;">:</span></b><b><span style="font-family:;" "=""> </span></b><span style="font-family:Verdana;">Anaemia, leucopenia and thrombocytopenia were more prevalent among the studied HIV positive patients.</span>
文摘Background: The diagnosis of deep vein thrombosis (DVT) requires an etiological research of HIV infection. The objective was to identify the characteristics of patients with DVT of limbs without other risk factors in our context. Methods: We performed a comparative retrospective study from January 2005 to December 2012. We identified 162 cases of patients hospitalized in Medicine Department of Institute of Cardiology of Abidjan with 124 HIV-negative and 38 HIV positive patients. Results: DVT is more common in HIV positive young patients (57.8 ± 15.6 years vs 39.3 ± 10.6 years, p = 0.0001). The traditional risk factors were found in HIV negative patients. HIV positive patients had no predisposing factor for thrombosis. The ankle-femoral popliteal location (29% vs 73.7% p = 0.05) was most frequent in HIV positive patients. There was no significant difference in anticoagulant therapy: UFH (60.5% vs 52.6%;p > 0.05), LMWH (20.2% vs 7.9%;p > 0.05), AVK relay (99.2% vs 100%;p > 0.05) and general measures (elevation MI). (70.2% vs 65.8%;p > 0.05). None of the patients in both groups had worn stockings in hospitalization. The stockings were prescribed on discharge (70% vs 64.7%;p > 0.05). Conclusion: DVT may be the mode of revelation of HIV infection. The etiological research with HIV infection should be systematic in?young patients suffering from DVT in the absence of risk factors of thrombosis.
基金from Red de Investigacion en SIDA (RIS)ART AIDS Foundation+2 种基金Gilead SciencesObra Social Caixa Sabadell Gala contra la SIDA Barcelona 2011
文摘Invasive-squamous-cell-cancer (ISCC) of the anal canal is an uncommon disease. Human papillomavirus (HPV) is the etiological agent of most of types of ISCC. The incidence of ISCC has been increasing in HIV-infected individuals, even after the introduction of highly active antiretroviral therapy. The aim of this study was to analyze biopsy specimens from patients diagnosed with ISCC at a tertiary hospital from 1983 to 2012 in order to detect HPV-DNA. Methods: Formaldehyde-fixed, paraffin-embedded specimens from patients with ISCC underwent HPV-DNA genotyping using multiplex PCR assay. Results: A total of 31 cases were collected;10 were HIV-infected (9 men, 1 woman) and 21 non-HIV-infected (11 men, 10 women). HPV infection was detected in 87.5% (7/8) of the HIV-infected patients (DNA from 2 biopsies was degraded) and 76.2% (16/21) of non-HIV-infected individuals. Multiple-type infections were only found in 28.6% (2/7) of the HIV-infected patients (no multiple-type infections in non-HIV-infected individuals). The most prevalent type was HPV-16: 50% (4/8) in the HIV-infected group (57% [4/7] of the HPV-positive samples) and 66.7% (14/21) in the non-HIV-infected group (87.5% (14/16) of the HPV-positive samples). Remarkably, 37.5% (3/8) of the HIV-infected group had high-risk HPV types not included in the vaccines (HPV-33, 51, 52, and 66) compared with 4.8% in the non-HIV-infected group (1/21, HPV-52). All cases of anal ISCC in HIV-infected patients were recorded in the highly active antiretroviral therapy era. Conclusion: HIV-infected patients presented anal ISCC with a higher proportion of high-risk HPV types not covered by the conventional vaccines than non-HIV-infected individuals.
