Articles Related to HIV

Background: Despite their good efficacy, antiretroviral drugs often induce adverse effects, in particular hypersensitivity reactions (HSR) which cause significant discomfort leading to the abandonment of treatment and then to therapeutic failure in some HIV-positive patients. Therefore, in this study, we aimed to assess the association between immune responses and hypersensitivity reactions (HSR) induced by antiretroviral treatment in people who living with HIV-1 (PLHIV-1), through the distribution of immune cells and cytokine profiles.

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Introduction: Tanzania aims for 95% of persons living with HIV (PLHIV) to know their serostatus by 2023. Methods: An uncontrolled before-after study design was conducted between March 2018 (pre-intervention phase) and July 2018 (post-intervention phase). A total of 183 participants (males=89; females=94) were recruited for this study. Data were collected at baseline and at the one-month and three-month follow-ups using a pre-and post-test semi-structured questionnaire. Descriptive data are presented using measures of central tendency and their respective measures of dispersion. No comparative statistical analysis was performed.

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According to the UNAIDS 2022 report, 52% of the HIV positive children between 0-14 years were able to access treatment and of these 68% attain viral suppression. CCR5 promoter genotype specifically single nucleotide polymorphisms have been linked to modulate patient virological status. However, the few studies that have studied the association in infants have utilized allele-specific PCR a genotypic method limited to detecting already known SNPs. By using Sanger sequencing, we explored the association taking into account novel mutations.

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Before the development of highly active antiretroviral medication, AIDS and related illnesses caused a great deal of suffering and death. All of the AIDS-related morbidities and mortality have considerably decreased thanks to modern medication, especially in industrialized nations. However, this accomplishment is still elusive in underdeveloped nations, particularly in those in sub-Saharan Africa. This failure can be attributed to a number of factors. Poverty, ignorance about the treatment, and inadequate therapy adherence are at the top of this list.

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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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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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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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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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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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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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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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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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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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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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