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Coronary artery calcium, HIV and inflammation in Uganda compared with the USA

Source:

Bmj journals- Openheart

Author:

Ben Alencherry, Geoffrey Erem, Grace Mirembe, Isaac Ssinabulya,Chun-Ho Yun, Chung-Lieh Hung, Mark J Siedner,Marcio Bittencourt,Cissy Kityo,Grace A McComsey, Chris T Longenecke.

Abstract:

Objectives: To compare the prevalence of detectable coronary artery calcium (CAC) among higher risk, older people living with HIV (PLWH) and uninfected persons in Uganda versus the USA, and second to explore associations of CAC with HIV-specific variables and biomarkers of inflammation.

Methods: This cross-sectional study of 430 total subjects compared 100 PLWH on antiretroviral therapy and 100 age-matched and sex-matched HIV-uninfected controls in Uganda with 167 PLWH on antiretroviral therapy and 63 uninfected controls in the USA. Multivariable logistic regression was used to examine associations with detectable CAC (CAC >0).

Results: Compared with US subjects, Ugandans were older (mean age 56 vs 52 years) and were more likely to have diabetes (36% vs 3%) and hypertension (85% vs 36%), but were less likely to be male (38% vs 74%) or smokers (4% vs 56%). After adjustment for HIV serostatus, age, sex and traditional risk factors, Ugandans had substantially lower odds of CAC >0 (adjusted OR 0.07 (95% CI 0.03 to 0.17), p<0.001). HIV was not associated with CAC >0 in either country (p>0.1). Among all PLWH, nadir CD4 count was associated with the presence of CAC, and among Ugandans soluble intercellular adhesion molecule (p=0.044), soluble CD163 (p=0.004) and oxidised low-density lipoprotein (p=0.043) were all associated with the presence of CAC.

Conclusions: Ugandans had a dramatically lower prevalence of any coronary calcification compared with US subjects. The role of HIV infection and inflammation as risk factors for subclinical coronary disease in sub-Saharan Africa merits further investigation.

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made.

 

Coronary artery calcium, HIV and inflammation in Uganda compared with the USA

 

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A Review of Risk Behaviors for HIV Infection by Men Who Have Sex With Men Through Geosocial Networking Phone Apps

Source

Journal of the Association of Nurses in AIDS Care, Volume 28, Issue 5, September–October 2017, Pages 807-818

ScienceDirect

Authors

Artur Acelino; Francisco Luz Nunes Queiroz; Álvaro Francisco Lopes de Sousa; Telma Maria Evangelista de Araújo; Francisco Braz Milanez de Oliveira; Maria Eliete Batista Moura; Renata Karina Reis.

Abstract

Aim: Analyze the relationship between the use of geosocial networking phone apps and risk behaviors for HIV infection in men who have sex with men (MSM).

 

A Review of Risk Behaviors for HIV Infection by Men Who Have Sex With Men Through Geosocial Networking Phone Apps

 

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Anthropometric measures of central adiposity are highly concordant with predictors of cardiovascular disease risk in HIV patients

Source

DEDALUS USP

Authorship

Rebeca Antunes Beraldo

ABSTRACT

Body fat redistribution and metabolic abnormalities found in HIV patients receiving highly active antiretroviral therapy (HAART)contribute to an atherogenic profile, increasing cardiovascular disease risk. We aimed to evaluate adiposity measures/indexes and propose cutoffs associated with predictors of cardiovascular disease risk in HIV patients on HAART.

Are women living with HIV prone to osteoporosis in postmenopause? A systematic review : a systematic review

Source

Scientific Electronic Library Online – SciELO.

Authors

Pérsio Yvon Adri Cezarino; Ricardo dos Santos Simões; Edmund Chadat Baracat; José Maria Soares Junior.

Abstract

Aim: To analyze studies that evaluated the loss of bone mass through DEXA in women living with HIV.

 

Are women living with HIV prone to osteoporosis in postmenopause A systematic review a systematic review

 

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Audiological and electrophysiological alterations in HIV-infected individuals subjected or not to antiretroviral therapy

Source

Brazilian Journal of OTORHINOLARYNGOLOGY Otorhinolaryngology.

SciELO – Eletronic Library

Authors

Carla Gentile Matasa , Alessandra Giannella Samellia, Fernanda Cristina Leite Magliaroa e Aluisio Seguradob.

Abstract

Introduction:

The Human Immunodeficiency Virus (HIV) and infections related to it can affect multiple sites in the hearing system. The use of High Activity Anti-Retroviral Therapy (HAART) can cause side effects such as ototoxicity. Thus, no consistent patterns of hearing impairment in adults with Human Immunodeficiency Virus / Acquired Immune Deficiency Syndrome have been established, and the problems that affect the hearing system of this population warrant further research.

Objectives:

This study aimed to compare the audiological and electrophysiological data of Human Immunodeficiency Virus-positive patients with and without Acquired Immune Deficiency Syndrome, who were receiving High Activity Anti-Retroviral Therapy, to healthy individuals.

Methods:

It was a cross-sectional study conducted with 71 subjects (30-48 years old), divided into groups: Research Group I: 16 Human Immunodeficiency Virus-positive individuals without Acquired Immunodeficiency Syndrome (not receiving antiretroviral treatment); Research Group II: 25 Human Immunodeficiency Virus-positive individuals with Acquired Immunodeficiency Syndrome (receiving antiretroviral treatment); Control Group: 30 healthy subjects. All individuals were tested by pure-tone air conduction thresholds at 0.25-8 kHz, extended high frequencies at 9-20 kHz, electrophysiological tests (Auditory Brainstem Response, Middle Latency Responses, Cognitive Potential).

Results:

Research Group I and Research Group II had higher hearing thresholds in both conventional and high frequency audiometry when compared to the control group, prolonged latency of waves I, III, V and interpeak I-V in Auditory Brainstem Response and prolonged latency of P300 Cognitive Potential. Regarding Middle Latency Responses, there was a decrease in the amplitude of the Pa wave of Research Group II compared to the Research Group I.

Conclusions:

Both groups with Human Immunodeficiency Virus had higher hearing thresholds when compared to healthy individuals (group exposed to antiretroviral treatment showed the worst hearing threshold) and seemed to have lower neuroelectric transmission speed along the auditory pathway in the brainstem, subcortical and cortical regions.

 

Audiological and electrophysiological alterations in HIV-infected individuals subjected or not to antiretroviral therapy

 

 

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Ceftriaxone versus ceftriaxone plus a macrolide for community-acquired pneumonia in hospitalized patients with HIV/AIDS : a randomized controlled trial

Source

Journal ‘Clinical Microbiology and Infection’ – Editora Elsevier

Authors

Claudia Figueiredo-Mello, Pontus Naucler, Marinella Della Negra e Anna S. Levin

Abstract

Objectives:To evaluate if treatment with ceftriaxone and a macrolide, improved patient outcome whencompared with monotherapy with ceftriaxone, in hospitalized patients with human immunodeficiencyvirus/acquired immunodeficient syndrome (HIV/AIDS) with community-acquired pneumonia (CAP).Methods:Adult patients with HIV hospitalized due to suspected CAP were randomized to receive one oftwo regimens, ceftriaxone plus macrolide or ceftriaxone plus placebo, at a 1:1 proportion (BrazilianClinical Trials Registry: RBR-8wtq2b). The primary outcome was in-hospital mortality and the secondaryoutcomes were mortality within 14 days, need for vasoactive drugs, need for mechanical ventilation,time to clinical stability and length of hospitalization.Results:A total of 227 patients were randomized, two were excluded after randomization; 225 patientswere analysed (112 receiving ceftriaxone plus placebo and 113 receiving ceftriaxone plus macrolide). Thefrequency of the primary outcome, in-hospital mortality, was not statistically different between theregimens: 12/112 (11%) patients who received ceftriaxone plus placebo and 17/113 (15%) who receivedceftriaxone plus macrolide died during hospitalization (hazard ratio 1.22, 95% CI 0.57e2.59). We did notfind differences between the regimens for any of the secondary outcomes, including mortality within14 days, which occurred in 5/112 (4%) patients with ceftriaxone plus placebo and in 12/113 (11%) patientswith ceftriaxone plus macrolide (relative risk 2.38, 95% CI 0.87e6.53).Conclusions:Among hospitalized patients with HIV/AIDS with CAP, treatment with ceftriaxone and amacrolide did not improve patient outcomes, when compared with ceftriaxone monotherapy.

 

Ceftriaxone versus ceftriaxone plus a macrolide for community-acquired pneumonia in hospitalized patients with HIV/AIDS : a randomized controlled trial

 

 

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Cerebellar degeneration and progressive ataxia associated with HIV-virus infection

Source

Editora Elsevier

Revista Científica ‘Parkinsonism and Related Disorders’

Authors

Jose Luiz Pedroso, Thiago Cardoso Vale, Maria Thereza Drumond Gama, Gustavo Ribas, Julio C.G. Kristochik, Francisco M.B. Germiniani, Maria Cristina Domingues da Silva Fink, Augusto Cesar Penalva de Oliveira, Helio A.G. Teive e Orlando G. Barsottini.

Abstract

Introduction
The spectrum of neurologic disorders associated with HIV infection is very broad, resulting from direct virus invasion, opportunistic infections, malignancies and toxic effects of drugs.

Methods
Among a large cohort of ataxia patients (N = 1050) evaluated between 2008 and 2017, we detected four patients with HIV-infection who developed a pure progressive cerebellar ataxia syndrome combined with cerebellar atrophy.

Results
Adverse drug effects, opportunistic infections and malignancies as well as immune-reconstitution syndrome were ruled out based on history and laboratory data. The exact pathophysiological mechanisms of ataxia in HIV patients is not very clear, but seems to be immune-mediated or a direct neurotoxic virus effect leading to apoptosis of Purkinje and granular cells.

Conclusion
HIV infection should be investigated in adult patients with undetermined sporadic progressive pure ataxia with cerebellar atrophy.

 

Cerebellar degeneration and progressive ataxia associated with HIV-virus infection

 

 

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Depression, self-concept, future expectations and hope of people with HIV

Fonte:

Revista Brasileira de Enfermagem.

Autoria:

Anna Cláudia Freire de Araújo Patrício,Ingrid Bergmam do Nascimento Silva, Milenna Azevedo Minhaqui Ferreira, Brenda Feitosa Lopes Rodrigues, Rôseane Ferreira da Silva, João Agnaldo do Nascimento, Richardson Augusto Rosendo da Silva.

Resumo:

Objective: To analyze conditions of depression, self-concept, future expectations and hope in people with HIV/AIDS. Method: Cross-sectional survey of 108 individuals living with HIV/AIDS, carried out in a reference hospital for the treatment of infectious diseases in Northeast Brazil. The following instruments were employed: sociodemographic data, and questionnaires for ascertaining participants’ emotions, including scales for selfconcept, hope, depression (HAMD-D), and future expectations. Descriptive statistics using the following tests were performed: Mann–Whitney, Kruskal–Wallis, chi-square, and t-test—considered significant when p ≤ 0.05. Results: 31.5% presented mild depression and 21.3% presented moderate depression; 63% reported difficulty in obtaining decent employment; 52.8% considered life a failure; 52.8% felt worthless. Fear, guilt and loneliness influenced self-concept (p ≤ 0.05). Loneliness influenced hope (p ≤ 0.05). Conclusion: It is necessary to raise the attention of nursing professionals and healthcare managers to the importance of providing health services that consider the mental health of people with HIV/AIDS, contributing to treatment adherence and well-being.

 

0034-7167-reben-72-05-1288

 

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Detection and genotyping of human papillomavirus (HPV) in HIV-infected women and its relationship with HPV/HIV co-infection.

Source:

Wolters Kluwer- Medicine

Authors:

Rodolfo Miglioli Badial, MSa, Marina Carrara Dias, MSa, Bruna Stuqui, PhDa,
Patrícia Pereira dos Santos Melli, MDb, Silvana Maria Quintana, MDc, Caroline Measso do Bonfim, PhDa,
José Antônio Cordeiro, PhDd, Tatiana Rabachini, PhD, Marilia de Freitas Calmon, PhDa,
Paola Jocelan Scarin Provazzi, PhDa, Paula Rahal, PhDa.

Abstract:

HPV have been identified as high-risk and low-risk, depending on their association with the development of cancer. HPV infections can be facilitated by co-infection with HIV. Here, we investigated HPV prevalence and genotypes and the risk factors affecting HPV/HIV co-infection. Forty HIV-positive patients had 80 cervical swab samples collected in 2 consecutive years. Polymerase chain reaction and DNA direct sequencing were used to perform HPV genotyping. Statistical analyses were performed regarding risk factors for HPV/HIV co-infection and the occurrence of cervical lesions. HPV DNA was detected in 59 samples (73.75%), and high-risk HPVs were predominant (59.3%). The most prevalent type was HPV56 (17%), followed by HPV16 (15.3%). Patient age did not affect the risk of cervical cancer (P = .84) or HPV prevalence in different years (P = .25/P = .63). CD4 count also did not affect the risk for cervical lesions in the tested samples (P = .15/P = .28). Although the HIV viral load was not correlated with an increase in cervical lesion detection in the first group of analyzed samples (P = .12), it did affect cervical cancer risk in the group of samples analyzed in the following year (P = .045). HIV-infected patients presented a high prevalence of HPV co-infection, and HPV16 and HPV56 were the most prevalent genotypes. Considering this, it is possible that immunodeficiency can contribute to increased susceptibility to HPV56 infection in HIV-infected patients. The association between HIV viral load and the lesions also confirmed the importance of monitoring HIV/HPV co-infected patients with high HIV viral loads.

 

Detection_and_genotyping_of_human_papillomavirus.47

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Detection of HIV-1 infections in blood donors during the pre-seroconversion window period in São Paulo, Brazil

Source

Observatório da Produção Intelectual (OPI).

Revista da Sociedade Brasileira de Medicina Tropical, v.52, n.0, p.e20180432, 2019

Authors

SALLES, Nanci Alves; NISHIYA, Anna Shoko; FERREIRA, Suzete Cleusa; ROCHA, Vanderson Geraldo; MENDRONE-JUNIOR, Alfredo.

Abstract

Aim: To determine the HIV NAT-yield and to describe.

 

Detection of HIV-1 infections in blood donors during the pre-seroconversion window period in São Paulo, Brazil

 

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Evaluation of outpatient services in the Brazilian Unified National Health System for persons living with HIV : a comparison of 2007 and 2010.

Source:

Caderno de saúde pública- SciElo

Authors:

Ana Paula Loch,Maria Ines Battistella Nemes, Maria Altenfelder Santos, Ana Maroso Alves, Regina Melchior, Cáritas Relva Basso, Joselita Maria de Magalhães Caraciolo, Maria Teresa Seabra Soares de Britto e Alves, Elen Rose Lodeiro Castanheira, Wania Maria do Espírito Santo Carvalho, Ruth Terezinha Kehrig, Aline Aparecida Monroe.

Abstract:

Health services play a crucial role in reaching the 90-90-90 target of controlling the HIV epidemic. This study evaluates the organization of Brazilian health services in improving, monitoring, and retention in HIV care and adherence support. Percentage variation (PV) was used to compare the responses by services to an evaluation questionnaire on organizational quality (Qualiaids) in 2007 and 2010. The study analyzed the 419 services that completed the questionnaire in 2007 (83.1% of respondents) and 2010 (63.6%). Management actions of retention and support although increased in the period, but remained at low rates, for example: systematic meetings for case discussion (32.7% in 2010; PV = 19.8%) and recording of missed medical appointments (35.3%; PV = 36.8%). Patient care actions related to adherence to ART remained largely exclusive to the attending physician. The supply of funds and resources from the Federal Government (medicines and specific HIV tests) remained high for the vast majority of the services (~90%). It will not be possible to achieve a significant decrease in HIV transmission as long as retention in treatment is not a priority in all the health services.

 

Evaluation of outpatient services in the Brazilian Unified National Health System for persons living with HIV a comparison of 2007 and 2010.

 

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HIV vulnerability of men who have sex with men users of geossocial dating applications.

Source

Biblioteca Digital de Teses e Dissertações – USP

Authors

Queiroz, Artur Acelino Francisco Luz Nunes

Abstract

Aim: Analyze the vulnerabilities of men who have sex with men, users of geossocial applications against HIV infection.

 

HIV vulnerability of men who have sex with men users of geossocial dating applications

 

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HIV/AIDS care : analysis of actions and health services integration.

Source:

Escola Anna Nery

Authors:

Gabriela Tavares Magnabosco, Lívia Maria Lopes, Rubia Laine de Paula Andrade, Maria Eugênia Firmino Brunello, Aline Aparecida Monroe Tereza Cristina Scatena Villa

Abstract:

Objective: To analyze the integration of actions and health services in care provided by Specialized Services (SS) in Ribeirão Preto/SP in people living with HIV/AIDS (PLWHA) perception.

Methods: Exploratory descriptive study, survey type in which 253 PLWHA were interviewed using a structured questionnaire. The data were analyzed by indicators (classified as unsatisfactory-average from 1 to 2.5; regular-between 2.6 and 3.5; satisfying-3.6 to 5) and multiple correspondence analysis.

Results: The integration of health care actions had an average 3.7 (SD = 1.7) classified as satisfactory. The horizontal integration was satisfactory regarding the use of medical records, and the vertical one regarding the referral to other health services. The low utilization of Basic Care and Emergency Care services was also identified.

Conclusion: Despite of the satisfactory rating on the integration of assistance to PLWHA, challenges still be done, highlighting the need for greater empowerment of individuals and strengthening reference mechanisms with support of SCS to other points of attention in HIV/AIDS specificities

 

HIVAIDS care analysis of actions and health services integration.

 

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HIV/AIDS case definition criteria and association between sociodemographic and clinical aspects of the disease reported in the State of Minas Gerais from 2007 to 2016

Source

Scientific Electronic Library Online – SciELO

Authors

Sybelle de Souza Castro; Lúcia Marina Scatena; Alfredo Miranzi; Almir Miranzi Neto; Fernanda Carolina Camargo; Altacílio Aparecido Nunes.

Abstract

Aim: Verify the geographic distribution of human immunodeficiency virus/acquired immunodeficiency syndrome and analyze the association between case definition criteria, sociodemographic data, and clinical aspects of the disease in the State of Minas Gerais between 2007 and 2016.

 

HIV AIDS case definition criteria and association between sociodemographic and clinical aspects of the disease reported in the State of Minas Gerais from 2007 to 2016

 

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HLA-C downregulation by HIV-1 adapts to host HLA genotype.

Source:

Plos Pathogens

Authors:

Nathaniel D. Bachtel,Gisele Umviligihozo, Suzanne Pickering, Talia Mota,Hua Liang, Gregory Q. Del Prete, Pramita Chatterjee, Guinevere Q. Lee,Rasmi Thomas, Mark A. Brockman, Stuart Neil, Mary Carrington, Bosco Bwana, David R. Bangsberg,  Jeffrey N. Martin, Esper G. Kallas, Camila Sunaitis Donini, Natalia B. Cerqueira,Una T. O’Doherty, Beatrice H. Hahn, R. Brad Jones, Zabrina L. Brumme , Douglas F. Nixon , Richard Apps.

Abstract:

HIV-1 can downregulate HLA-C on infected cells, using the viral protein Vpu, and the magnitude of this downregulation varies widely between primary HIV-1 variants. The selection pressures that result in viral downregulation of HLA-C in some individuals, but preservation of surface HLA-C in others are not clear. To better understand viral immune evasion targeting HLA-C, we have characterized HLA-C downregulation by a range of primary HIV-1 viruses. 128 replication competent viral isolates from 19 individuals with effective anti-retroviral therapy, show that a substantial minority of individuals harbor latent reservoir virus which strongly downregulates HLA-C. Untreated infections display no change in HLA-C downregulation during the first 6 months of infection, but variation between viral quasispecies can be detected in chronic infection. Vpu molecules cloned from plasma of 195 treatment naïve individuals in chronic infection demonstrate that downregulation of HLA-C adapts to host HLA genotype. HLA-C alleles differ in the pressure they exert for downregulation, and individuals with higher levels of HLA-C expression favor greater viral downregulation of HLA-C. Studies of primary and mutant molecules identify 5 residues in the transmembrane region of Vpu, and 4 residues in the transmembrane domain of HLA-C, which determine interactions between Vpu and HLA. The observed adaptation of Vpu-mediated downregulation to host genotype indicates that HLA-C alleles differ in likelihood of mediating a CTL response that is subverted by viral downregulation, and that preservation of HLA-C expression is favored in the absence of these responses. Finding that latent reservoir viruses can downregulate HLA-C could have implications for HIV-1 cure therapy approaches in some individuals.

 

HLA-C downregulation by HIV-1 adapts to host HLA genotype.

 

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Impact of antiretroviral resistance and virological failure on HIV-1 informational entropy.

Source:

Journal of Antimicrobial chemotherapy.

Authors:

Elidamar Nunes de Carvalho Lima, Jose  Roberto Castilho Piqueira, Michelle Camargo, Juliana Galinskas,  Maria Cecilia Sucupira and Ricardo Sobhie Diaz.

Abstract:

Objectives: The present study investigated the relationship between genomic variability and resistance of HIV-1sequences in protease (PR) and reverse transcriptase (RT) regions of thepolgene. In addition, we analysed the resistance among 651 individuals presenting antiretroviral virological failure, from 2009 to 2011, in the state ofS~ao Paulo, Brazil.

Methods: The genomic variability was quantified by using informational entropy methods and the relationship between resistance and replicative fitness, as inferred by the residual viral load and CD4!T cell count.

Results: The number of antiretroviral schemes is related to the number of resistance mutations in the HIV-1PR (a”0.2511,P”0.0003,R2″0.8672) and the RT (a”0.7892,P”0.0001,R2″0.9141). Increased informa-tional entropy rate is related to lower levels of HIV-1 viral loads (a”#0.0121,P”0.0471,R2″0.7923), lower levels of CD4!T cell counts (a”#0.0120,P”0.0335,R2″0.8221) and a higher number of antiretroviral resistance-related mutations.

Conclusions: Less organized HIV genomes as inferred by higher levels of informational entropy relate to lesscompetent host immune systems, lower levels of HIV replication and HIV genetic evolution as a consequence of antiretroviral resistance.

 

Impact of antiretroviral resistance and virological failure on HIV-1 informational entropy.

 

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Is the telomere length associated with neurocognitive disabilities in HIV-1-infected subjects?

Fonte

Revista  do Instituto medicina tropical de São Paulo

Scientific Electronic Library Online ( SciELO)

 

Autoria

Marilia Ladeira de Araújo, Wellington Duarte, Augusto César Penalva de Oliveira, Maria Rita Polo Gascón ,Luiz Augusto Marcondes Fonseca,Raquel de Melo Alves Paiva, Bárbara Santana,Rodrigo Tocantins Calado Jorge Casseb

 

Resumo

Objective: We evaluated the association between cognitive deficits and leukocyte telomere
length (LTL) in HIV-1-infected individuals. Design: 73 HIV-1-infected patients undergoing
neuropsychological evaluation and 91 healthy controls were included in this study. Fifteen
HIV-1 positive patients did not have cognitive disorders whereas 26 had asymptomatic
neurocognitive disorder (ANI), 13 presented mild to moderate neurocognitive disorder
(MND), and 10 had HIV-associated dementia (HAD). Methods: DNA from the peripheral
blood of HIV-1-infected patients was used for measurement of telomere length by real-time
PCR. HIV-1 viral load was determined in blood. Results: LTL decreased with age in healthy
controls (p=0.0001). Regardless of the HIV status, age-matched LTL from HIV patients,
including those with ANI and MND, were shortened in comparison to the healthy control
group (p=0.0073); however, no association was found among the HIV-1-infected individuals
with cognitive deficits (p=0.01). In addition, no gender-related association with LTL was
observed (p=0.80), smoking, physical exercise, and plasma viral load were not correlated to
telomere length (p=0.66). Conclusions: We concluded that leukocyte telomere length may
not be a marker of cellular senescence in individuals with HIV infection and neurocognitive
disorders.

 

Is the telomere length associated with neurocognitive

 

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Lipodystrophy diagnosis in people living with HIV/AIDS: prediction and validation of sex-specific anthropometric models

Source

BMC Public Health

Author

 André Pereira dos Santos, Navarro, Anderson Marliere, Schwingel, Andiara Alves, Thiago C. Abdalla, Pedro P. Venturini, Ana Claudia R. Santana, Rodrigo de Carvalho Machado e Dalmo Roberto Lopes.

Abstract

Background: Body composition alterations, or lipodystrophy, can lead to serious health problems in people living with HIV/AIDS (PLWHA). The objectives of this study are to predict and validate sex-specific anthropometric predictive models for the diagnosis of lipodystrophy in PLWHA. Methods: A cross-sectional design was employed to recruit 106 PLWHA (men = 65 and women = 41) in Brazil during 2013–2014. They were evaluated using dual-energy X-ray absorptiometry, and 19 regions of body perimeters and 6 skinfold thicknesses were taken. Sex-specific predictive models for lipodystrophy diagnosis were developed through stepwise linear regression analysis. Cross-validations using predicted residual error sum of squares was performed to validate each predictive model. Results: Results support the use of anthropometry for the diagnosis of lipodystrophy in men and women living with HIV/AIDS. A high power of determination with a small degree of error was observed for lipodystrophy diagnosis for men in model six (r2 = 0.77, SEE = 0.14, r2 PRESS = 0.73, SEE PRESS = 0.15), that included ratio of skinfold thickness of subscapular to medial calf, skinfold thickness of thigh, body circumference of waist, formal education years, time of diagnosis to HIV months, and type of combined antiretroviral therapy (cART) (with protease inhibitor “WI/PI = 1” or without protease inhibitor “WO/PI = 0”); and model five for women (r2 = 0.78, SEE = 0.11, r2 PRESS = 0.71, SEE PRESS = 0.12), that included skinfold thickness of thigh, skinfold thickness of subscapular, time of exposure to cART months, body circumference of chest, and race (Asian) (“Yes” for Asian race = 1; “No” = 0). Conclusions: The proposed anthropometric models advance the field of public health by facilitating early diagnosis and better management of lipodystrophy, a serious adverse health effect experienced by PLWHA

 

81 s12889-018-5707-z

 

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Natural experiment of syphilis treatment with doxycycline or benzathine penicillin in HIV-infecte

Source:

Wolters Kluwer Health- AIDS

Author:

Antonio, Marilia B.; Cuba, Gabriel T.; Vasconcelos, Ricardo P.; Alves, Ana Paula P.S.; da Silva, Bruna Oliveira; Avelino-Silva, Vivian Iida.

Abstract:

Background: Although doxycycline is widely used as an alternative to benzathine
penicillin for the treatment of early and late latent syphilis, data on serological response
following treatment with doxycycline among HIV-infected patients are limited.
Methods: In this study, we analysed serological response to syphilis treatment with
doxycycline among HIV-infected patients treated during a benzathine penicillin
shortage period and compared with treatment response among patients treated with
benzathine penicillin. Cases with neurosyphilis and those treated with suboptimal
doses or with concurrent medications in association with benzathine penicillin or
doxycycline were excluded.
Results: Fifty patients treated with doxycycline from September 2014 to December 2016
were compared with 115 patients treated with benzathine penicillin for early, late latent or
latent syphilis of unknown duration. Patients treated with doxycycline were slightly older
[(median 49 years old, 95%confidence interval (95%CI) 43–56] than those in the penicillin
group (median 44 years old, 95% CI 37–50; P¼0.007). Groups had no statistically
significant differences regarding sex, HIV suppression under treatment and syphilis stages.
Serological response to treatment, defined as a nonreagent Venereal Disease Research
Laboratory (VDRL) or at least a four-fold reduction in VDRL titres measured 6–12 months
after treatment, was seen in 72% (95% CI 58–84) of patients treated with doxycycline and
70% (95% CI 60–78) of patients treated with penicillin (P¼0.753).
Conclusion: We found no statistically significant differences in serological response to
treatment with doxycycline or benzathine penicillin among HIV-infected patients with
early, late latent or latent syphilis of unknown duration. Our findings suggest that
doxycycline is an acceptable treatment to HIV-infected patients with nontertiary stages
of syphilis.

 

Natural_experiment_of_syphilis_treatment_with.8

 

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Opinion: Paracoccidioidomycosis and HIV Immune Recovery Inflammatory Syndrome

Source

DEDALUS USP

Authors

Renata Buccheri
Gil Benard

Abstract

Two distinct patterns of immune recovery inflammatory syndrome (IRIS) are recognized, paradoxical and unmasking IRIS. Here we raise some concerns regarding the first case of neuroPCM-IRIS published to date, as recently proposed by Almeida and Roza for a patient originally described by Silva-Vergara et al. taking in account the different case definitions for IRIS and the cases of neuroparacoccidioidomycosis already described in the literature.

Osteonecrosis of the femoral head in people living with HIV : anatomopathological description and p24 antigen test.

Source:

DovePress

Authors:

Ana lucia l Munhoz lima,Priscila Rosalba Oliveira,Vladimir C Carvalho,Alexandre leme godoy-Santos,leandro ejnisman,Claudia R Oliveira1David e Uip,Maria Irma S Duarte.

Abstract:

Objective: To examine the presence of HIV in bone tissue of people living with HIV (PLWHIV) with osteonecrosis of femoral head and describe clinical and anatomopathological findings.Design: This is a case series which included 44 PLWHIV with osteonecrosis of femoral head who underwent total hip arthroplasty.Methods: Clinical data were obtained through analysis of the patients’ medical records. Bone tissue obtained during total hip arthroplasty was retrieved and sent for conventional and immuno-histochemical analysis. Monoclonal antibodies were used to mark the p24 (HIV), CD31 (vascular endothelial cells), CD68 (macrophages), and D240 (cells of the lymphatic endothelium) antigens.Results: Dyslipidemia was found in 48% of the patients and lipodystrophy in 31%. Histological analysis showed similar characteristics for the entire sample. Degeneration of joint cartilage was visualized with the presence of fissures and fibrillations, as well as subchondral sclerosis and necrosis of the subchondral cancellous bone tissue. Lymphoplasmocytic inflammatory reaction was observed, with the presence of macrophages containing a foamy, vacuolated cytoplasm, as well as the presence of ceroid pigment and occasional granulation tissue. The reaction with the monoclonal anti-p24 antibody was negative in the samples from all 44 PLWHIV undergoing hip arthroplasty. Reactions with the anti-CD31 and anti-D240 antibodies were negative. Stain-ing with CD68 antibody confirmed that the cells visualized with foamy, vacuolated cytoplasm were macrophages.Conclusion: p24 HIV antigen was not detected in the bone tissue of PLWHIV and osteone-crosis. The most frequent anatomopathological findings were extensive necrosis of bone tissue, large vacuoles filled with fat cells, inflammatory lymphoplasmocytic reaction with macrophages containing vacuolated cytoplasm, and the presence of ceroid pigment.

 

Osteonecrosis of the femoral head in people living with HIV anatomopathological description and p24 antigen test.

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Poly(I:C) Potentiates T Cell Immunity to a Dendritic Cell Targeted HIV-Multiepitope Vaccine

Source:

Frontiers in immunology

Authors:

Juliana de Souza Apostólico Victória Alves Santos Lunardelli ,Marcio Massao Yamamoto, Edecio Cunha-Neto, Silvia Beatriz Boscardin and Daniela Santoro Rosa.

Abstract:

Cellular immune responses are implicated in resistance to HIV and have been considered for the development of an effective vaccine. Despite their safety profile, subunit vaccines need to be delivered combined with an adjuvant. In the last years, in vivo antigen targeting to dendritic cells (DCs) using chimeric monoclonal antibodies (mAb) against the DC endocytic receptor DEC205/CD205 was shown to support long-term T cell immunity. Here, we evaluated the ability of different adjuvants to modulate specific cellular immune response when eight CD4+ HIV-derived epitopes (HIVBr8) were targeted to DEC205+ DCs in vivo. Immunization with two doses of αDECHIVBr8 mAb along with poly(I:C) induced Th1 cytokine production and higher frequency of HIV-specific polyfunctional and long-lived T cells than MPL or CpG ODN-assisted immunization. Although each adjuvant elicited responses against the 8 epitopes present in the vaccine, the magnitude of the T cell response was higher in the presence of poly(I:C). More over, poly(I:C) up regulated the expression of costimulatory molecules in both cDC1 and cDC2 DCs subsets. In summary, the use of poly(I:C) in a vaccine formulation that targets multiple epitopes to the DEC205 receptor improved the potency and the quality of HIV-specific responses when compared to other vaccine-adjuvant formulations. This study highlights the importance of the rational selection of antigen/adjuvant combination to potentiate the desired immune responses.

Poly(IC) Potentiates T Cell Immunity to a Dendritic Cell Targeted HIV-Multiepitope Vaccine

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Power to the people

Authorship

UNAIDS

Year of publication

2019

Abstract

This report argues that power in fact rests in the hands of the people, as can be seen in countless local, national and international movements to redistribute power and bring greater attention to neglected issues.

 

2019 UNAIDS Poder para as Pessoas

 

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Production and Characterization of Pulchellin A chain conjugated to HIV mAbs, and study its selective cytotoxicity against cells expressing HIV envelope

Source

Biblioteca Digital de Teses e Dissertações – USP

Authors

Sadraeian, Mohammad

Abstract

Aim: Propose to use anti-HIV immunotoxins to eliminate infected cells that serve as the persistent virus reservoir.

 

Production and Characterization of Pulchellin A chain conjugated to HIV mAbs, and study its selective cytotoxicity against cells expressing HIV envelope

 

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