Revista de SIDA e investigación clínica

Objetivo: Las investigaciones han establecido que el virus de inmunodeficiencia humana (VIH) causa pérdida de audición. Los estudios aún deben evaluar el impacto en la calidad de vida (CV). Este proyecto evalúa el efecto de la pérdida de audición en la CV según el estado serológico respecto del VIH. Métodos: Los participantes del estudio procedían del Estudio de cohorte multicéntrico sobre el sida (MACS) y del Estudio interinstitucional sobre el VIH en mujeres (WIHS). Participaron un total de 248 hombres y 127 mujeres. Se recogieron los umbrales de conducción aérea de tonos puros para cada oído en frecuencias de 250 a 8000 Hz. Los promedios de tonos puros (PTA) para cada oído se calcularon como la media de los umbrales de conducción aérea en frecuencias bajas (es decir, 250, 500, 1000 y 2000 Hz) y frecuencias altas (es decir, 3000, 4000, 6000 y 8000 Hz). Los datos de calidad de vida se recopilaron con la encuesta de salud Short Form 36 y el instrumento Medical Outcome Study (MOS)-HIV en el MACS y WIHS, respectivamente. Se realizó un análisis de regresión de mediana para probar la asociación de PTA con la calidad de vida según el estado de VIH. Resultados: No hubo asociación significativa entre la pérdida auditiva y las puntuaciones de calidad de vida en promedios de tonos puros bajos y altos en individuos VIH positivos y negativos. El estado de VIH, los biomarcadores del VIH y el tratamiento no cambiaron la falta de asociación de promedios de tonos puros bajos y altos con una peor calidad de vida. Conclusión: Aunque no encontramos una asociación estadísticamente significativa de la pérdida auditiva con la calidad de vida según el estado de VIH, la prueba de pérdida auditiva con el envejecimiento y la recomendación de tratamiento pueden compensar cualquier presunto declive en la calidad de vida en la edad adulta.

Parasitic infections are common cause of diarrhea in patients with HIV combined with symptoms such as fatigue, nausea, intestinal cramps and flatulence. In HIV seropositive patients, the disease is often prolonged and severe. Parasites most frequently found in biological samples of HIV infected people are Cryptosporidium spp., Microsporidium and Giardia, Isospora and Cyclospora. The purpose of this study was to know the prevalence of parasitic infections in HIV infected patients and to establish the relationship with CD4 counts and viral load. 109 stool three serial samples from HIV seropositive patients were collected and analyzed by Zinc sulphate centrifugal floatation method and then stained with Ziehl-Neelsen Staining procedure. A “t” distribution analyses was made. A low viral load, CD4 count greater than 500, the absence of diarrhea and the ART treatment are not indicative in all cases of free parasitic infection.

People with disability are at significant risk of becoming Human Immunodeficiency Virus (HIV) infected due to various factors including lack of education and resources to ensure safe sex, risk of violence and rape, stigma and lack of legal protection amongst others. Situation analysis of HIV prevention intervention amongst in-school PWD in the three specials schools in the state show that 48% of the total populations in these schools are hearing impaired, 16% visually impaired and 6% intellectually impaired. To this end, Ekiti State AIDS Control Agency with the funding of the World Bank and in collaboration with a Community Based Organizations (Eyelosun) carried out a two year intervention programme targeted at reaching the PWD population with HIV prevention services. The project community Entry phase activities included Issue Based Advocacy, Selection and Training of PWDs as peer educators, Community dialogue, Interpersonal Communication and Focused Group Discussions. Age peers’ education approach was used to build the capacity of PWDs on HIV prevention. Peer Education manual and IEC materials were produced in Braille and sign language (target group specific communication materials) to ease communication barriers. Thirty five able teachers with specialization in Braille and sign languages were selected and trained as Peer Educator Trainers (Training of Trainers TOT) and 25 PWDs (hearing and visually impaired) were selected and trained by the trained teachers to carry out peer education using the Braille and sign language manuals. The use of Braille and Sign language HIV prevention specific materials to communicate with PWD improved their understanding and knowledge of HIV/AIDS with 80% increase in HIV Counseling and Testing (HCT) uptake and other HIV services. There was active participation of PWD in all the structural interventions including Community dialogues and Anti-AIDS club. However, the intellectually impaired, who are highly sexually active and at risk of HIV remain a neglected population due to communication challenge.

Objective: This secondary data analysis determined how far the eight South African metropolitan municipalities have progressed in the expansion of HIV treatment. The framework of HIV care cascades (HCC) was used. Methods: We collated data sources to understand the HCC in metro and non-metro populations including demographic, HIV prevalence and laboratory data (2014-2015) that we linked to unique individuals using a probabilistic matching algorithm. We defined the HCC using: number of persons living with HIV (PLHIV); total remaining on ART; numbers with a CD4 count and viral load (VL) test results in the past year and the number of suppressed VL tests. Results: 37% of South Africa’s PLHIV live in metros. Progress along the HCC for metro and non-metro populations was 53% of PLHIV in care and 45% on ART for both populations and 27% of metro/26% of non-metro populations virally suppressed. Achievement varied widely by metro, 35%-63% of PLHIV were on ART, 21%-48% of ART clients were virally suppressed. The largest treatment gap was in Ekurhuleni metro. The metros spend approximately US$383 million per year on ART. Annual VL testing of all ART clients in the eight metros would amount to approximately US$ 42 million or 11% of ART programme cost. Conclusion: South Africa sees rapid growth of its urban centres which are chiefly affected by HIV. There are currently large gaps in the metro’s 90-90-90 level of achievements. The District Implementation Plans offer a mechanism to focus investment on ART scale-up. Supporting factors are the existing expertise, service integration and infrastructure for largescale ART, the close network of service delivery sites and service delivery solutions. Ensuring scale and quality of the HIV treatment programmes is vital for the metros’ economic prosperity - and for South Africa as a whole.

Objective: The spectrum of neuropsychiatric illness (NI) associated with the Human Immunodeficiency Virus (HIV) and/or the Hepatitis C Virus (HCV) is far reaching and significantly impacts the clinical presentation and outcome of infected persons; however, the etiological and pathophysiological background remains partially understood. The present work was aimed to investigate the potential significance of formin binding protein 1 (FNBP-1)-dependent pathways in NI-pathogenesis by elaborating on previous microarray-based research in HIV and/or HCV-infected patients receiving interferon-? (IFN-?) immunotherapy via a rigorous data mining procedure. Methods: Using microarray data of peripheral whole blood (PB) samples obtained from HCV mono-infected persons (n=25, Affymetrix? HG-U133A_2) 12 h before and after the 1st dose of pegylated IFN-? (PegIFN-?), we reapplied the same analytical algorithm that we had developed and published in an earlier study with HIV/HCV coinfected subjects (N=28, Affymetrix? HG-U133A), in order to evaluate reproducibility of potential NI-related molecular findings in an independent cohort. Results: Among 28 gene expression profiles (HIV/HCV: N=9 vs. HCV: N=19) selected by applying different thresholds (a Mean Fold Difference value (MFD) in gene expression of ? 0.38 (log2) and/or P value from <0.05 to ? 0.1) FNBP-1 was identified as the only overlapping marker, which also exhibited a consistent upregulation in association with the development of NI in both cohorts. Previous functional annotation analysis had classified FNBP-1 as molecule with significant enrichment in various brain tissues (P<0.01). Conclusion: Our current findings are strongly arguing for intensifying research into the FNBP-1-related mechanisms that may be conferring risk for or resistance to HIV- and/or HCV-related NI.

HIV pathogenesis is known to cause a progressive depilation of CD4+ T-cell cell population in close association with progressive impairment of cellular immunity and increase the susceptibility to infection. This new study is giving a new explanation about the mode of action of this virus. We assume that there is an alteration in the physiological behavior of CD4+ T-cells causing it to mutate to CD8+ T-cells and that CD4+ T-cell are neither destroyed nor lost during the infection. Twelve consenting adults took part in a randomized control trail, six were tested positive for HIV and had never received any antiretroviral therapy while the other six were tested negative. Blood samples withdrawn from participants were tested for total CD4+ T-cells and CD8+ T-cells .Infected cells from HIV positive patients were stimulated with a purified recombinant HIV-1 p17 matrix as a viral protein along with other immunological assays. The collected data showed that the sum of both CD4+ T-cells and CD8+ T-cells did not change in HIV positive patients, although there were a decrease in CD4+ T-cells and an increase in CD8+ T-cell count. Our study confirms that CD8+ T-cells is responsible for the increase in scope of HIV and the susceptibility to (OI), we assumed that this resulted from the duplication in cell signals of both newly formed (mutant) and originally found CD8+ T-cells causing a complete cellular discrepancy. According to our findings a new area of medications could arise to be a promising therapeutical modality for treating HIV-1 infection.

Objective: HIV and AIDS have adverse effects on the livelihood of adolescents especially when parents die or are poor due to ill health. Mildmay Uganda has an apprenticeship programme that helps such adolescents acquire skills in order to improve their quality of life. The aim of this study was to examine the role of apprenticeship in improving the livelihood of HIV-positive adolescents who prematurely dropped out of school. Methods: A retrospective review of data of all adolescents who had been enrolled on the apprenticeship programme from January 2012 to January 2014 was done to document their progress and any lessons learnt. A vulnerability index tool was used to assess vulnerability levels and at same time to measure the progress and improvement of livelihood. Results: A total of twenty (20) adolescents were enrolled on the apprenticeship programme during the stated period. Sixty percent were male and were in the age range of 17-24 years. Sixteen out of the 20 (80%) were able to use the acquired skills through apprenticeship to improve their livelihood. The other four adolescents completed apprenticeship, but did not practice their acquired skills. One male opted to venture into another business and three females abandoned their vocations when they got married. The vulnerability level assessment outcome showed a graduation from extremely poor to poor. Adolescents were able to meet their basic needs, keep clinic appointments and were emotionally stable by end of period of review. Conclusion: Apprenticeship is one way that can be used successfully to improve the livelihood of adolescents who prematurely drop out of school.

HIV counseling and testing remains a fundamental entry point of care in limiting transmission of HIV/AIDS. Community outreaches serves the dual function of improving access to service and outcome of care through early linkages and subsequent initiation of Anti-Retroviral Therapy (ART). Gender and socio-cultural factors affects uptake of screening services and ultimately early treatment. This study therefore assessed gender-related HIV counseling and testing uptake and linkage to care among those who were tested. A review of data from 423 community outreaches conducted between August 2012 to July 2015 by AHF Nigeria in which information on socio-demographic characteristics, HIV counseling and testing and time to accessing care was obtained. Means and proportions were used to document the results. With a monthly Mean of 2650 [male 68.8% female 38%] clients counselled, tested and received results, 2.6% (SD 0.7) were positive; male 33.5% (SD 10) female 60.8% (SD 9). An average of 64% of positive clients were linked to care; male 40% (SD 10) female 60% (SD 10). Male predominance in testing uptake with more female positive results and early linkage to care forms a persisting trend. HIV testing activities aimed at increasing female participation by addressing social and cultural barriers limiting their participation through advocacy and community dialogue approaches would increase case detection and early linkages to care and help reduce gaps in prevention and treatment in HIV.

Introducción: La infección por el virus de la inmunodeficiencia humana es un problema de salud grave. En 2014, alrededor de 36,9 millones de personas vivían con el virus de la inmunodeficiencia humana en todo el mundo. Los saudíes perciben el SIDA como una enfermedad moral. La brecha entre la actitud y el conocimiento adecuados de los médicos y dentistas sobre el SIDA ha influido negativamente en la calidad de la atención sanitaria relacionada con el VIH. Nuestro objetivo para este estudio es evaluar el conocimiento y la actitud de los médicos y dentistas hacia la infección por el virus de la inmunodeficiencia humana en nuestra sociedad. Método: Se diseñó un estudio transversal para recopilar datos utilizando un cuestionario estructurado y autoadministrado de médicos y dentistas. Se distribuyó entre ellos en días y horarios específicos en un centro de atención terciaria ubicado en Riad, Arabia Saudita. Resultados: El estudio incluyó un total de 201 médicos y dentistas, de los cuales 189 eran médicos y 19 eran dentistas. La mayoría de ellos (69%) son saudíes. Alrededor del 99% de los participantes saben que el SIDA es de etiología viral. Alrededor de 127 (63%) de ellos conocen correctamente la probabilidad estimada de transmisión del VIH a partir de una herida por pinchazo de aguja. Además, todos los médicos y dentistas creen que la confidencialidad es importante para los pacientes con SIDA. Aproximadamente 36 (18%) piensan que el SIDA es una enfermedad curable. Conclusión: Existe un nivel aceptable de información y conocimiento sobre la infección por VIH entre nuestros médicos y dentistas. Sin embargo, la asistencia educativa regular por parte de especialistas sería beneficiosa para mejorar la percepción actual. Este resultado puede brindarnos algunos conocimientos para futuros estudios con el fin de promover la concienciación relacionada con el VIH entre los trabajadores de la salud y la comunidad.

Se han producido numerosos anticuerpos ampliamente neutralizantes (bNAbs) contra el virus de inmunodeficiencia humana-1 (VIH-1) y los detalles de su generación, evolución y estructura proporcionan un modelo para una vacunación eficaz. Los avances recientes en las tecnologías de secuenciación de próxima generación (NGS) han permitido la caracterización de alta resolución del repertorio de anticuerpos y han hecho posible la caracterización exhaustiva de muchos bNAbs del VIH-1. Estos bNAbs identificaron epítopos conservados que pueden usarse para diseñar nuevas vacunas y proporcionaron nuevas herramientas para la profilaxis y la terapia de la enfermedad del VIH-1. En esta revisión, resumimos el avance en el descubrimiento y la maduración de los bNAbs del VIH-1 y describimos con más detalle las aplicaciones emergentes en el diseño de vacunas.

Antecedentes: El VIH/SIDA es una enfermedad de gran importancia para la salud pública a nivel mundial. Nigeria es el segundo país con mayor incidencia de esta enfermedad en el mundo y, en la actualidad, aproximadamente el 3,4% de la población general es VIH positiva. Objetivo del estudio: El objetivo del estudio es comprender las causas del estigma y la discriminación contra las personas que viven con el VIH/SIDA (PVVS) y los efectos del estigma y la discriminación en la vida de estas personas. Métodos: El estudio se llevó a cabo mediante debates grupales centrados en personas que viven con el VIH/SIDA y que asisten regularmente a una clínica de ARV. Los participantes fueron seleccionados en función de los años que llevaban tomando ARV y de si habían sufrido alguna forma de discriminación. Las entrevistas se transcribieron textualmente y se aplicó un análisis de contenido manifiesto y latente para analizar los textos. Resultados: Tras el análisis, surgieron dos temas principales del estudio: (1) La ruptura de una relación y la falta de divulgación son consecuencias del estigma y la discriminación, (2) La información deficiente contribuye en gran medida al estigma y la discriminación. Estos dos temas permitieron poner de manifiesto la causa y el efecto del estigma y la discriminación en la vida de las personas que viven con el VIH. Conclusión: El estigma y la discriminación han contribuido a la ruptura de relaciones y promueven la no divulgación del estado serológico a las parejas sexuales y la disolución de las familias en Nigeria. La falta de información adecuada sobre la enfermedad y la escasa educación e información entre el público en general y, en especial, entre los trabajadores sanitarios empeoran el estigma y la discriminación.