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Articles Related to HIV

Trend of HIV/AIDS Reported Cases in Morocco Between 1986 and 2019: A Time Series Analysis

Background: Morocco is a low endemic country of HIV/AIDS that achieved the goal of the second and third 90-90-90 targets in 2019 while still 78% of people living with HIV know their HIV status. The aim of this study was to analyze time trends of HIV/AIDS reported cases during the last 33 years taking into consideration the implementation of voluntary HIV counseling and testing (HCT) services in primary health care facilities. Methodology: This was a time series of HIV/AIDS reported cases at national level between 1986 and 2019. Variable collected for each year were HIV/AIDS reported per 100000 H, age category, gender, origin, CD4 count and route of transmission. Trend of HIV/AIDS reported cases was assessed by Joinpoint Regression Analysis. Annual percentage changes (APCs) were estimated to identify the years (joinpoint) when significant changes occurred in the trend. We therefore examined trends in HIV/AIDS reported cases according to epidemiological variables. Results: Cumulative HIV/AIDS reported cases during the study period was of 17 000. Joinpoint regression showed an increase in HIV/AIDS reported cases between 1986 and 2019. The APC for the period 1986-2012 was of 13.4 (95% CI: 12.0 to 14.8, p <0.05) and the APC from 2012 to 019 was of 5.4 (95% CI: 2.5 to 8.5, p<0.05) with a significant break in the same joinpoint year than HCT implementation in primary health care settings. In stratified analysis, HIV/AIDS reported cases increased but not significantly after joinpoint. A significant decrease was noted in 2015 in urban areas (APC = -10.0, 95% CI: -17.0 to -2.3, p<0.05). Conclusions: HIV/AIDS reported cases were increasing over 33 years, with a significant rise after 2012by 5% per year, corresponding to HCT integration into primary health care setting. Furthermore, Morocco is may be on the right way to eliminate HIV/AIDS in urban areas.
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Level of Adherence to Antiretroviral Therapy Among People Living with HIV/AIDS in Ekiti State

Introduction: The use of anti-retroviral drugs slows down disease progression in Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) and this has improved the quality of life and life expectancy of Persons Living with HIV/AIDS (PLWHA). However, optimum use of antiretroviral drugs (adherence) by PLWHA is the key to achieving viral load suppression and preventing drug resistance in them. Objective: This study determined the level of adherence to Anti-Retroviral Therapy (ART) among PLWHA in Ekiti State. Methodology: A cross-sectional study was conducted on 320 PLWHA in Ekiti State University Teaching Hospital, Ado-Ekiti and 300 PLWHA in Federal Teaching Hospital, Ido-Ekiti aged 18 years and above using ARV for at least six months prior to the study. Quantitative data were collected from the participants using a structured questionnaire while sixteen in-depth interviews were conducted among purposively selected PLWHA in both study centres to further elicit qualitative information on determinants of adherence. Quantitative data were analyzed with SPSS 22 using descriptive statistics while content analysis was used for qualitative data. Regression analysis was done to identify determinants of adherence at p value < 0.05. Results: About 60% of the PLWHA had high level of ART adherence while 18.9% had low adherence. Most of the respondents were female (66.0%), married (76.1%) and Christians (89.4%) and had post-secondary education (43.4%). Respondents’ age (X2=32.483), educational status (X2=2.473), marital status (X2=40.083), occupation (X2=57.951) and distance from the clinic (X2=13.181) significantly influenced the level of adherence. Patient factors such as forget timing of the medication, pill burden and feeling better, psychosocial factors like stigmatization, non-disclosure of status and depression; and healthcare factors such as long clinic waiting time and absence of support are some of the barriers to optimum ART adherence. Conclusion: Counseling on drug adherence and psycho-social support to PLWHA will further improve their level of adherence to medication.
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The Presence of Minority HIV Drug Resistance Variants in The Protease and Gag Regions Confers Poor Response to Therapy Among Subtype A And D Patients

Objective: To determine the prevalence of minority drug resistance variants in the protease and Gag regions among patients failing a protease inhibitor (PI) based regimen with or without a susceptible genotype based on Sanger sequencing technology. Methods: Samples were obtained from patients who were failing on a protease inhibitor-based regimen (n = 500). Sanger based sequencing was performed as part of the standard of care. Mutation analysis was performed using the Stanford HIV drug Resistance database. A subset of these patient samples was grouped into two categories: those failing a PI based with mutations in the protease region (n = 100) and those failing on a PI based regimen without mutations in the protease region (n = 128). These samples were then analyzed in the protease and Gag regions using Next Generation Sequencing (NGS) technology and analysis of the drug resistance mutations was performed at the 20% and 1% cutoffs. Results: An initial analysis of the protease region for patients failing with drug resistance mutations revealed that most patients harbored mutations that confer resistance to Lopinavir and Atazanavir, but these mutations had little effect on Darunavir. Furthermore, NGS revealed that in patients failing with and without drug resistance mutations, minority drug resistance mutations were present at each of the drug resistance codons and at codons that confer multi-drug resistance to protease inhibitors. Further analysis of the Gag gene revealed more genetic diversity among patients failing with no mutations in the protease as evidenced by the proportion of polymorphisms at each codon. Conclusion: Based on Sanger sequencing, a proportion of patients fail a PI based regimen with a susceptible genotype. However, these patients harbor minority variants in the protease and numerous polymorphisms in the Gag region which when combined these could explain their poor response to therapy. Therefore, in order to improve patient care in low resource settings, there is need to adapt NGS as the standard genotyping technique so that minority variants are captured much earlier. In addition, since mutations in the Gag region also play a role in response to PIs, this region should be included in the routine monitoring for response to therapy in patients on a PI based regimen.
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Liquorice-Induced Pseudohyperaldosteronism with Severe Hypokalaemia in a Young Patient Living with HIV: A Rare Case Presentation and Literature Review

HIV-1 infection treatment has greatly improved with the availability of combined antiretroviral therapy (cART). Unlike Tenofovir Disoproxil Fumarate, Tenofovir Alafenamide has a more favourable renal profile, even if proximal tubulopathy and electrolyte disturbances have been reported. As earlier as 4000 years ago, liquorice root was used for some medical treatments. Excessive liquorice intake is described to cause a state of mineralocorticoid excess. However, liquorice-induced hypokalaemia usually occurs with mild clinical manifestations and a severe presentation is rare.
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The Clinical, Bacteriological and Therapeutic Characteristics of Tuberculosis in Patients Infected with HIV (about 42 Cases)

Tuberculosis still remains a public health priority, especially with the emergence of HIV. It is more and more revealing of the HIV infection. The objective of this study is to analyze the clinical, epidemiological, and therapeutic aspect of tuberculosis in patients infected with HIV.
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Two-Years Follow-Up in a Multidrug-Resistant HIV-1-Infected Woman Treated with Ibalizumab

Diarrhoea is a common and diverse aetiology problem in HIV infected patients that can cause deterioration in the quality of life, malnutrition and failure of antiretroviral therapy (ART). Ibalizumab (IBA), a humanized monoclonal antibody that binds to domain 2 of CD4 T lymphocytes receptor, has been recently approved for treating adults infected with multidrug-resistant HIV-1 infection for whom it is otherwise not possible to construct a suppressive antiviral regimen.
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Enteric Pathogens in Patients with Acquired Immunodeficiency Syndrome from Porto Velho City, Rondonia State, Western Amazon, Brazil

Patients with human immunodeficiency virus (HIV), mainly those who live under poor sanitary and socioeconomic conditions, are often diagnosed with Gastrointestinal (GI) tract diseases. The lowest CD4+ T-cell counts are not found in the plasma, but in the GI tract, the biggest HIV source, thus allowing opportunistic infections. Therefore, the aim of the present study was to identify the epidemiological factors of GI infections and the prevalent pathogens in HIV patients from Porto Velho City, Rondônia State.
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HIV Screening Scenarios and Targets to Achieve 90% Sero-Status Knowledge Over 2021-2025 in Morocco – Pioneer Use Case of the Goals HIV Testing Strategies Model in a Concentrated Epidemic

Morocco applied the Goals testing model, projecting alternative testing scale-up scenarios, varying coverage targets for 13 adult populations. The model was calibrated using program service delivery, spending and surveillance data (2015-2019), integrated bio-behavioural surveys, and national HIV estimates. It projects annual diagnoses by target group from undiagnosed prevalence and testing coverage, allowing for HIV-infected people self-selecting for testing, retesting and transitions between groups. Scenarios were evaluated for knowledge status improvement and cost, focusing on 2023-2025.
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Development of Chronic Obstructive Pulmonary Disease (COPD) in Patients Infected with Human Immunodeficiency Virus (HIV)

Chronic Obstructive Pulmonary Disease (COPD) is considered a public health problem and its prevalence increases over the years, in Brazil. Currently, 37 million people are living with HIV and 4 million of these patients infected with the virus may have COPD. However, many of these cases may be underreported. In Brazil, these two clinical situations (HIV infection and COPD) have a high incidence, which causes a great expense for the public health, increased morbidity and mortality of these patients. We observed that, in the national literature, there is a gap on the association between these two scenarios.
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Indeterminate HIV Status during Pregnancy and Delivery: The Perinatal Dilemma

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Determinants of Mother to Child Transmission of HIV Among Infants Born from HIV Positive Women in North Wollo Zone, North East Ethiopia: 2018, Case Control Study

HIV infection has a pandemic aspect and is extremely severe, making it one of the most important current public health problems.
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Multiplicity of HIV Related Risk Behaviour among Injecting Drug Users in South Asian Countries Evidence from Nepal, Bangladesh, and India

Interface of drug abuse, needle sharing and high-risk-sex are potential menace multiplying HIV risk.
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HIV-Associated Oral Kaposi Sarcoma: Case Report and Literature Review

Kaposi sarcoma (KS) is an angioproliferative polymorfic disorder that might be associated with human immunodeficiency virus (HIV) infection. In this clinical form, oral manifestation is particularly common and, sometimes, the first manifestation of the retroviral infection. In those cases, KS diagnosis is fundamental as the treatment is based in HIV infection control through an advisable multidisciplinary approach.
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Tumour or Fungus? A Diagnostic Conundrum

Candida, a commensal of the oral and the vaginal cavity, sometimes turns invasive, in immunosuppressed individuals. The resultant lesion, known as invasive or aggressive candidiasis, can be extremely refractory to treatment. This is a case report of an ulcero proliferative lesion in the hard palate that mimicked an intra-oral neoplasm. The clinical picture was confused by the fact that the patient was a chain smoker, and also because the initial MRI images were strongly suggestive of an invasive malignancy. When clinical and radiological signs exactly mimic a malignancy, the picture is confusing.
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Stimulation of IL-16 Release by Cells Exposed to HIV Virion Proteins

The pathogenesis and immune response to a chronic viral infection is multifaceted especially for HIV infection. The effect of HIV on the systemic immunoenvironment of the infected individual is profound and triggered by multiple stimuli. While replication competent viral infection induces a large spectrum of immune responses, such as cytokine release, we focused on what happens when cells are exposed to replication incompetent virions and their components.
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Editorial Board Members Related to HIV

Walter Royal

Professor
Department of Neurology
University of Maryland
United States

JUAN CARLOS SALAZAR

Professor and Chair, Department of Pediatrics
University of Connecticut School of Medicine
Physician in Chief Connecticut Children’s Medical Center
Academic Director, Division of Pediatric Infectious Diseases and
Director of the Pediatric and Youth HIV Program
United States

Xiaodong Ma

Associate professor
College of Pharmacy
Dalian Medical University
China

SANJEEV KUMAR SINGH

Professor
Department of Bioinformatics
Alagappa University
India

Diego Andrés Chiappetta

Associate Professor
Department of Pharmaceutical Technology
University of Buenos Aires
Argentina

GEORGE E. WOODY

Professor
Department of Psychiatry
University of Pennsylvania and Treatment Research Institute
United States

Gregory H. Taylor

Associate Professor
Department of Family Medicine
University of Maryland School of Medicine
United States

Bechan Sharma

Professor
Department of Biochemistry
University of Allahabad
India

RAJNISH S. DAVE

Associate Scientist
Department of Neuroscience
Temple University
United States

LEONID B. MARGOLIS

Visiting Professor
Ilia University
Republic of Georgia
Georgia
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