Current HIV Research最新文献

Introduction: Toxoplasma gondii is an obligate intracellular protozoan that can infect almost all warm-blooded animals, including humans. Patients with co-infection with toxoplasmosis and HIV have a 30-40% risk of developing toxoplasmosis encephalitis. This study aimed to describe the epidemiology and burden of Toxoplasma gondii in HIV-infected individuals in Iran.

Methods: We searched the five English databases (Science Direct, PubMed, Scopus, Ovid, Embase, and Cochrane) and four Persian databases (Scientific Information Database (SID), Iran Medex, Iran Doc, and Magiran) with the terms of (Toxoplasma gondii OR "toxoplasmosis") AND (HIV OR "AIDS" OR immunodeficiency OR acquired immune deficiency syndrome) AND (Seroprevalence) AND (Seroepidemiologic Studies) AND (Elisa OR IgG) AND (PCR) AND (Iran) by two authors up to Feb 2021. Studies were included if they investigated people with HIV infection and presented data that allowed us to establish the prevalence of Toxoplasma gondii infection in Iran.

Results: According to the inclusion/exclusion criteria, 15 studies were selected. A total number of 2275 HIV-infected individuals were tested and evaluated for toxoplasmosis from 2005 up to 2018 in different regions of Iran. The weighted overall prevalence of toxoplasmosis in HIV-infected individuals with Elisa was obtained using a random-effects model, which was estimated at 47% (95% CI = 31% - 62%). Also, the Weighted overall prevalence of toxoplasmosis in HIV-infected individuals with PCR was obtained using a random-effects model, which was estimated at 7% (95% CI = 3% - 12%).

Conclusion: According to the results of this study, it can be clearly understood that a large population of HIV patients living in Iran have toxoplasmosis. Therefore, due to the high susceptibility of these groups to toxoplasmosis, healthcare professionals must consider measures such as training in the ways of transmission and prevention of the infection to this high-risk group in order to reduce the risk of infection.

Objective: It has been reported that carnitine deficiency is observed in various viral infections and in the follow-up of the prognosis of some diseases. In this cross-sectional study, we aimed to determine how carnitine ester derivatives change in HIV-positive patients.

Materials and methods: In this study, 25 HIV-infected patients who applied to Harran University Faculty of Medicine Education Research and Practice Hospital Infectious Diseases and Clinical Microbiology Outpatient Clinic and who did not receive any antiretroviral treatment, as well as 25 healthy volunteers were included in the study. Carnitine ester levels in serum samples were measured by Liquid Chromatography-Mass Spectrometry/Mass Spectrometry (LC-MS/MS) method (Shimadzu North America, Columbia, MD, USA).

Results: While suberoylcarnitine (C8DC), myristoleylcarnitine (C14:1), tetradecadienoylcarnitine (C14:2), palmitoleylcarnitine (C16:1), and linoleylcarnitine (C18:2) levels in HIV(+) patients were quite low compared to the control group, tiglylcarnitine (C5:1) levels were high (p ≤ 0.05). In addition, C5:1 and C14:2 index parameters according to VIP score, and C5:1 and C14:1/C16 index parameters according to ROC analysis were determined as markers with high potential to distinguish HIV(+) patients from healthy volunteers.

Conclusion: This study showed that levels of acylcarnitine derivatives might be altered in HIV(+) patients, and the results obtained may contribute to a better understanding of carnitine metabolism.

Background: Acquired Immune Deficiency Syndrome (AIDS) remains a nationwide health problem in China; there were a reported 1,045,000 people living with Human immunodeficiency virus (HIV)/AIDS by the end of October 2020, and the proportion of individuals aged 50 years and older living with HIV has also increased from 8% to 24% over the past two decades.

Methods: A cross-sectional study and an 1:2 matched case-control study were conducted from July to August 2016, in Wuxi city, eastern China. A total of 1,000 men aged 50 years and older completed a face-to-face interview regarding their AIDS-related knowledge and attitudes, as well as risk behaviors.

Results: Prevalence was 0.1% for HIV and 2% for syphilis. The awareness rate of AIDS-related knowledge among elderly men was 48.9% (range 40.7%-63.9%). The 1꞉2 matched case-control study indicated that only the AIDS-related attitudes were different between the two groups (χ²=8.726, P=0.013), the conditional logistic regression analysis indicated that scores of AIDS health knowledge were the only significant prognostic factor for the infection (HR=0.754 (0.569- 0.999), P=0.049).

Conclusion: It was crucial to prevent HIV/AIDS and syphilis infections by improving the awareness of AIDS-related knowledge and changing related attitudes among the elderly. Further research aimed at identifying how these factors impact their sexual decision-making can shed valuable insight into further prevention program in this population.

Objective: Improving health-related quality of life (HRQOL) in people living with HIV (PLWH) is one of the critical goals of HIV prevention and control in the following decades, and perceived social support (PSS) has always exhibited a positive influence on patients' HRQOL. This study aims to describe the gap in social support in improving HRQOL between symptomatic and asymptomatic PLWH.

Methods: By analysing secondary data from an online survey, a multicenter, descriptive and crosssectional study was conducted. The correlation trend and differences between PSS and HRQOL among asymptomatic and symptomatic PLWH were determined.

Results: Information from 493 PLWH with ART medication was finally analyzed: 34.89% asymptomatic PLWH and 65.11% symptomatic PLWH. There were significant differences observed between the two groups in terms of family income (χ² = 9.782, P = 0.021), HIV-positive duration (χ² = 19.541, P < 0.001), stage of disease (χ² = 9.617, P = 0.008), and comorbidities (χ² = 26.119, P < 0.001). The mean score of HRQOL of PLWH for the whole domain of the questionnaire was 86.56 (SD = 15.95). In six domains of QOL and PSS, the asymptomatic group had better conditions than the symptomatic group. There was a linear association between PSS and HRQOL, not only in the symptomatic group but also asymptomatic population, after adjusting for potential confounding factors. When the level of PSS was between 60 and 80, the HRQOL of the symptomatic group was similar to that of the asymptomatic group. While the score of PSS exceeded 80, the HRQOL of the symptomatic group was less sensitive to the changes in PSS. The social and environmental status of HRQOL in PLWH was most strongly correlated with their PSS.

Conclusion: The value of PSS on the HRQOL in PLWH is confirmed, especially for asymptomatic subjects. Healthcare providers need a complete understanding of the gap in social support between the asymptomatic and symptomatic populations. The comprehensive strategies, including symptom management, active treatment, and social support, should be more efficient for improving the overall health of symptomatic PLWH.

Background: It has been more than 17 years since the introduction of free ART in India. At this point, it would be prudent to look at the factors associated with the survival of persons living with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) (PLHA) who are already enrolled in the ART program.

Methods: PLHAs enrolled from antiretroviral therapy (ART) centers located in three different cities in India - Delhi, Pune and Kolkata, and were followed up at six monthly intervals monitoring the WHO stage, CD4 counts, complete blood counts, and liver and kidney function tests, for a duration of three years.

Results and discussion: The incidence of mortality among HIV/AIDS patients on ART was 5.0 per 1000 patient-years (21/1410, 1.4%). Age at initiation of ART, being above 35 years, was the only significant predictor of mortality (log-rank p = 0.018). Multivariable analysis showed a significant association of an unfavourable outcome (defined as mortality or development of opportunistic infection during follow-up) with male gender (adjusted odds ratio (AOR) = 5.26, p = <0.01) and being unmarried at ART initiation (AOR = 1.39, p = 0.005).

Conclusion: The survival of PLHA with good adherence to ART is independent of the WHO stage or CD4 counts at the initiation of ART. Initiation of ART after 35 years of age was a significant predictor of mortality.

Background: Acquired immune deficiency syndrome (AIDS) is a serious worldwide public health problem and has become the focus of prevention and control in China, while the student population is the key population for AIDS prevention.

Objective: The purpose of this study was to investigate the effects of cognitive behavioral therapy (CBT) on college students' AIDS-related cognitions, attitudes, and behaviors, and to find programmatic strategies for AIDS prevention in terms of changing college students' cognitions and behaviors.

Methods: In a cluster randomized controlled trial, 233 undergraduate students were assigned to the CBT group (CBT-based intervention, n=92), the TAU group (treatment as usual, n=72), and the CON group (no intervention, n=59). AIDS-related knowledge, attitudes, and behaviors of participants were assessed at pre-intervention, post-intervention, and follow-up.

Results: After one month of the study, AIDS-related knowledge, attitudes, and behaviors improved in both the TAU and CBT groups, while there were no significant changes in the CON group. The intervention effect was more significant and sustainable in the CBT group compared to the TAU group.

Conclusions: The application of CBT in AIDS prevention among college students is feasible, acceptable, and effective. CBT can increase the level of knowledge about AIDS, improve AIDS-related attitudes, and increase willingness to use condoms. CBT is expected to replace traditional health education as an innovative tool for AIDS prevention because of its long-lasting and efficacious nature.

Background: People living with HIV (PLHIV) are at increased risk of COVID-19 death. However, information about whether factors related to the HIV-infection influence the COVID-19 outcome still remains conflicting.

Objective: Here, we evaluate the risk factors for fatal COVID-19 in a cohort of PLHIV from the Moscow region, aged >18 years and diagnosed with COVID-19 between March 2020 and December 2021.

Methods: Demographic, clinical and laboratory data were compared between different COVID-19 outcomes. To analyze the risk factors associated with COVID-19 death, we employed the logistic regression method. A total of 566 PLHIV were included in the analysis.

Results: The majority of individuals, 338 (59.7%), were male; 194 (34.3%) were on antiretroviral therapy; 296 (52.3%) had a comorbidity; 174 (30.7%) of patients had drug and/or alcohol dependence; 160 (33.1%) patients had CD4 counts <200 cells/μl; 253 (51.9%) had undetectable viral load. Our analysis revealed that PLHIV >55 years old (OR, 12.88 [95% CI, 2.32-71.62]), patients with a viral load of more than 1000 copies/ml (OR, 2.45 [95%CI, 1.01-5.98]) and with CD4 counts <200 cell/μl (OR, 2.54 [95%CI, 1.02-6.28]), as well as with a history of cachexia (OR, 3.62 [95%CI, 1.26-10.39]) and pneumocystis pneumonia (OR, 2.47 [95%CI, 1.03-5.92]), and drug/alcohol dependence (OR, 2.70 [95%CI, 1.36-5.39]) were significantly more likely to die from COVID-19.

Conclusion: These data show that people with advanced HIV-1 infection have an increased risk of fatal COVID-19 outcomes and that there is a need to improve this population's access to health services and, hence, increase their survival rates.

Background: Multilocular thymic cysts (MTCs) in adults with human immunodeficiency virus (HIV) are rarely reported.

Case presentation: We describe a case of symptomatic MTC in a male with untreated HIV. A presumptive diagnosis was established based on radiographic imaging and biopsy. Pathologic diagnosis and exclusion of malignancy were ultimately confirmed following thymectomy. In conjunction with starting antiretroviral therapy, the patient recovered well post-operatively with a resolution of his presenting symptoms.

Conclusion: Our case report and review of the literature serve to highlight MTCs as an important clinical entity occurring in persons with HIV.

Background: Rates of cardiovascular disease are higher in people living with HIV. Early detection of high-risk subjects (applying cardiovascular risk equations) would allow preventive actions. D:A:D, ASCVD, and FRS:CVD equations are the most recommended. However, controversies surround these equations and cut-points, which have the greatest capacity to discriminate high-risk subjects.

Objectives: The study aims (i) to assess the association/agreement between cardiovascular risk levels obtained with D:A:D and fifteen other cardiovascular risk equations, (ii) to detect cardiovascular risk equation's capability to detect high-risk subjects, and (iii) to specify the optimal cardiovascular risk equation´s cut points for the prediction of carotid plaque presence, as a surrogate of high cardiovascular risk.

Methods: 86 adults with HIV were submitted to the clinical, laboratory, and cardiovascular risk evaluation (including carotid ultrasound measurements). Cardiovascular risk was evaluated through multiple risk equations (e.g., D.A.D, ASCVD, and FRS equations). Association and agreement between equations (Correlation, Bland-Altman, Williams´test) and equation's capacity to detect plaque presence (ROC curves, sensitivity, specificity) were evaluated.

Results: Cardiovascular risk equations showed a significant and positive correlation with plaque presence. Higher high-cardiovascular risk detection capability was obtained for ASCVD and D:A:D. Full D:A:D5y>0.88 %, ASCVD>2.80 %, and FRS:CVD>2.77 % correspond to 80 % sensitivity.

Conclusion: All cardiovascular risk equations underestimate the true risk in HIV subjects. The cut-- points for high cardiovascular risk were found to vary greatly from recommended in clinical guidelines.

Background: Entry inhibitors prevent the binding of human immunodeficiency virus protein to the chemokine receptor CXCR4 and are used along with conventional anti-HIV therapy. They aid in restoring immunity and can prevent the development of HIV-TB co-infection.

Aims: In the present study, various thiazolidinone-pyrazine derivatives earlier studied for NNRT inhibition activity were gauged for their entry inhibitor potential.

Objective: The objective of the study is to perform molecular docking, ADME, toxicity studies of some thiazolidinone-pyrazine derivatives as entry inhibitors targeting CXCR4 co-receptors.

Methods: In-silico docking studies were performed using AutoDock Vina software and compounds were further studied for ADME and toxicity using SwissADME and pkCSM software, respectively.

Results: Taking into consideration the docking results, pharmacokinetic behaviour and toxicity profile, four molecules (compounds 1, 9, 11, and 16) have shown potential as entry inhibitors.

Conclusion: These compounds have shown potential as both NNRTI and entry inhibitors and hence can be used in management of immune compromised diseases like TB-HIV coinfection.