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Introduction: In this paper, we analyzed the study of a mathematical model of non-linear differential equation on the effect of HIV/AIDS disease among unaware HIV/AIDS-infected population. Material and methods: Population was divided into four categories, including HIV-negative individuals, unaware HIV-positive cases, aware HIV-positive, and AIDS patients. The model was investigated numerically and analytically using fourth-order Runge-Kutta approach and homotopy perturbation method (HPM). Results: We have discussed the parameter variation graphically. Conclusions: Determining the dynamics of HIV prevalence and investigating the effect of each parameter on the governing equation can be simple with analytical solution. [ABSTRACT FROM AUTHOR]

Aspergillus spp. are ubiquitous and cause severe infections in immunocompromised patients. Less is known about its incidence and prognosis in patients with HIV/AIDS. We reviewed the mortality of invasive aspergillosis in HIV/AIDS patients. Pubmed, Embase and Medline databases were used to search for articles. Studies were excluded if they contained other aspergillosis risk factors, no original or patient survival data or were not in English. From 747 articles published, 54 studies and case reports were identified following reading, published between 1985 and 2021, with 54% papers prior to 2000 reporting 853 patients from 16 countries, none from Africa. 707 (83%) patients died with an average time from diagnosis to death of 77.5 days. Postmortem diagnosis was seen in 21% of deaths recorded. A national series from France of 242 cases of invasive aspergillosis diagnosed in life recorded a 3 month mortality of 68% pre-ART, falling to 31% after introduction of ART and voriconazole. CD4 count was recorded in 39 studies and ranged from 2 to >1000 cells/mm3; only 8 patients (1.8%) had a CD4 > 100 cells/mm3. Aspergillosis occurs in patients with HIV/AIDS and associated with high mortality but its slow progression should allow diagnosis and treatment with improved outcome. [ABSTRACT FROM AUTHOR]

Background: People living with HIV (PLWH) are susceptible to social isolation as a result of stigma and discrimination, which not only diminishes adherence to antiretroviral therapy but also heightens the risks of hospital readmission, depression, and mortality. However, there is currently no systematic review addressing the occurrence and impact of social isolation in individuals with HIV. Therefore, this study undertook a comprehensive systematic review and meta-analysis of existing literature to examine the prevalence and influencing factors associated with social isolation among PLWH. Methods and analysis: PubMed, EMBASE, CINAHL, Cochrane Library, Web of Science, Google Scholar, China Science and Technology Journal Database, The China National Knowledge Infrastructure, WanFang Data and Chinese Biomedicine Literature Database will be searched from the establishment of the database to the latest search date. Literature screening, data extraction and literature quality assessment will be done independently by two researchers and results will be cross-referenced. Data analysis will be performed using stata15.1 software. Risk of publication bias will be assessed using Begg's and Egger's methods. Heterogeneity between studies will then be assessed using the I2 index and its 95% CI and Q statistics. Sources of heterogeneity will be accounted for by subgroup and sensitivity analyses. Results: The results may reveal the prevalence of social isolation among PLWH and provide data support for understanding its etiology and prevention. Conclusion: By systematically reviewing the existing literature on social isolation among PLWH, this study aims to provide a comprehensive understanding of the prevalence of social isolation within this population, elucidate the detrimental effects it poses for people affected by HIV, and effectively inform targeted interventions for high-risk groups. Furthermore, these findings offer valuable insights to support evidence-based decision-making in public health policy. Systematic review registration: PROSPERO registration number: CRD42024499044 [ABSTRACT FROM AUTHOR]

In this paper, I aim to show how Swahili literature takes on the responsibility and challenge of creating an environment of co-existence and inclusion between human beings as well as between humans and nature, building upon the concept of “Afro-communitarianism”. This piece of research focuses on the contemporary challenges of African philosophy as a discipline and aims at connecting African philosophical inquiries with the textual medium of Swahili literature. By analysing selected Swahili novels, I will illustrate how literature is not only an instrument of inclusion, but also a device to exemplify the application of contemporary intercultural philosophies. The Swahili novels that will be analysed have been selected thematically, namely: inclusion of people with diseases such as HIV/AIDS; inclusion of people with genetic disorders such as albinism; and co-existence with the ecosystem. [ABSTRACT FROM AUTHOR]

Outliers are common in longitudinal data analysis, and the multivariate contaminated normal (MCN) distribution in model‐based clustering is often used to detect outliers and provide robust parameter estimates in each subgroup. In this paper, we propose a method, the mixture of MCN (MCNM), based on the joint mean‐covariance model, specifically designed to analyze longitudinal data characterized by mild outliers. Our model can automatically detect outliers in longitudinal data and provide robust parameter estimates in each subgroup. We use iteratively expectation‐conditional maximization (ECM) algorithm and Aitken acceleration to estimate the model parameters, achieving both algorithm acceleration and stable convergence. Our proposed method simultaneously clusters the population, identifies progression patterns of the mean and covariance structures for different subgroups over time, and detects outliers. To demonstrate the effectiveness of our method, we conduct simulation studies under various cases involving different proportions and degrees of contamination. Additionally, we apply our method to real data on the number of people infected with AIDS in 49 countries or regions from 2001 to 2021. Results show that our proposed method effectively clusters the data based on various mean progression trajectories. In summary, our proposed MCNM based on the joint mean‐covariance model and MCD of covariance matrices provides a robust method for clustering longitudinal data with mild outliers. It effectively detects outliers and identifies progression patterns in different groups over time, making it valuable for various applications in longitudinal data analysis. [ABSTRACT FROM AUTHOR]

As an interface between health and education, comprehensive sexuality education (CSE) offers a potent tool among other interventions to accelerate healthy transition of adolescents into adulthood. With increasing interest in in-school CSE provision/delivery, young people in out-of-school contexts may be left behind. This study forms part of implementation research to understand if the activities used to train and support the facilitators are feasible, appropriate, acceptable, and effective in enabling them to engage a defined group of young people, deliver CSE to them in the out-of-school context, and assist them in obtaining relevant services. This paper presents findings of mapping of out-of-school CSE interventions in Ghana, ongoing or completed between 2015 and 2020, and then discusses a needs assessment of two purposively selected groups of vulnerable out-of-school youth: young people living with HIV and AIDS (YPLHIV) and those living in detention (YPiD). We conducted 10 interviews with YPLHIV and three focus group discussions with YPiD in November 2020. Qualitative data were analysed thematically using both deductive and inductive approaches. The mapping yielded 29 interventions (18/62% were ongoing) focused extensively on the delivery of CSE-related knowledge and information; none were aimed at building facilitators' capacity and most targeted the northern regions. Among YPLHIV, living positively after diagnosis, disclosure skills and use of HIV/AIDS health services were critical. YpID sought clarification on personal hygiene, consent in sexual relationships, medium/channel to deliver CSE, and issues around same-sex sexual intercourse. Both groups sought skills in dealing with stigmatisation and discrimination. Implications of the findings for our own and other interventions are highlighted. [ABSTRACT FROM AUTHOR]

Pneumocystis pneumonia (PCP) is an opportunity acquired infection, which is usually easy to occur in patients with AIDS, organ transplantation, and immunosuppressive drugs. The prevention and treatment must be necessary for PCP patients with immunocompromise. And the oxidants are currently a typical regimen, including sulfanilamide, dapsone, primaquine, etc. Glucose-6-phosphate dehydrogenase (G6PD) deficiency is an X-linked gene-disease that affects about 400 million people worldwide. The lack of G6PD in this population results in a decrease in intracellular glutathione synthesis and a weakening of the detoxification ability of the oxidants. As a result, oxidants can directly damage haemoglobin in red blood cells, inducing methemoglobin and hemolysis. When patients with G6PD deficiency have low immunity, they are prone to PCP infection, so choosing drugs that do not induce hemolysis is essential. There are no clear guidelines to recommend the drug choice of this kind of population at home and abroad. This paper aims to demonstrate the drug choice for PCP patients with G6PD deficiency through theoretical research combined with clinical cases. [ABSTRACT FROM AUTHOR]

Background: Mobile health is gradually revolutionizing the way medical care is delivered worldwide. In Mozambique, a country with a high human immunodeficiency virus prevalence, where antiretroviral treatment coverage is 77% accompanied by a 67% of retention rate, the use of mobile health technology may boost the antiretroviral treatment, by delivering care beyond health facilities and reaching underrepresented groups. Leveraging new technologies is crucial to reach the 95–95-95 United Nations target by 2030. The design, development, implementation, and evaluation of a mobile health platform called Infomóvel were covered in this article. Its intended use involves collaboration with community health workers and aims to increase human immunodeficiency virus patient access, adherence, and retention to care. Methods: Using the Design Science Research Methodology, Infomóvel was created, as well as this publication. The explanation of various actions includes everything from problem description to observational study and goal-following for a solution, which results in the design and development of a platform proposal. Before the utility assessment of Infomóvel was conducted to make adjustments, a demonstration phase was conducted in one region of Mozambique. Results: The initial subjects of the Infomóvel flowchart and physical process design were patients receiving antiretroviral medication who were enrolled in the patients tracking system and who had consented to home visits. The case manager examines the file before importing it into the Infomóvel database stored on a cloud server using the website www.commcarehq.org. The case manager application synchronises with the Infomóvel server database, enabling the import of latest data and access to the lists of new patients and community health workers. The community health worker uses his phone to access his application, which allows him to record the geographic coordinates and sort the list of patients by priority and type of visit. Conclusion: Results from Infomóvel add to the growing body of data showing that mobile health techniques are beneficial for managing stable individuals with chronic conditions in Mozambique. These approaches can be scaled up and better utilised. However, additional studies should be conducted to quantify the resources needed to implement on a larger scale. [ABSTRACT FROM AUTHOR]

Crimp may not have been convinced by Edelman's disclaimer, given the overall dense academic tenor of "The Plague of Discourse", and my point is not to suggest that Crimp's uses of Edelman or Watney are erroneous, or necessarily extra-ordinary in scholarly writing practice. In the opening paragraph of the chapter on disco in Before Pictures, Douglas Crimp writes of a folder of miscellaneous project papers he has kept from the 1970s, which includes an old, unpursued book proposal on the topic of contemporary art since Minimalism. In the culminating scene of the series, an emotional Jill confronts Valerie on the seafront of the Isle of Wight, where Ritchie has been taken by his parents to live out his final days; Jill and Roscoe were in hot pursuit, but denied a visit to Ritchie by Valerie before his death. Douglas Crimp, "Mourning and Militancy" (1989), in Melancholia and Moralism: Essays on AIDS and Queer Politics (Cambridge, Mass.: MIT Press, 2002), 128-49 (pp. 136-7) 9. [Extracted from the article]

The significance of opportunistic infections in immunocompromised patients and the enigmatic pathogenicity of Blastocystis directed us to conduct the first global systematic review and meta-analysis on Blastocystis prevalence, odds ratios (ORs), and subtypes distribution in various immunocompromised patients (HIV/AIDS, cancer and hemodialysis patients, as well as transplant recipients). The systematic searching procedure was done in Web of Science, PubMed, Scopus, and Google Scholar databases for relevant published literature until November 11, 2020. Random-effects model was utilized to calculate the weighted estimates and 95% confidence intervals (95% CIs). The computed pooled prevalence of Blastocystis inferred from 118 papers (128 datasets) on immunocompromised patients was 10.3% (95% CI: 8.7–12.2%), with 16.1% (95% CI: 11.3–22.2%), 12.5% (95% CI: 8.5–18%), 8.4% (95 % CI: 6.6–10.6%), and 6% (95% CI: 2.6–13.3%) for hemodialysis patients, cancer patients, HIV/AIDS patients, and transplant recipients, respectively. Based on 50 case-control studies (54 datasets), the highest ORs were associated with cancer [2.81 (95% CI: 1.24–6.38, P = 0.013)] and hemodialysis patients [2.78 (95% CI: 1.19–6.48, P = 0.018)]. The most frequent subtype being found in immunocompromised patients was ST3 [41.7% (95% CI: 31.4–52.7%)], followed by ST1 [31.7% (95% CI: 23.2–41.8%)] and ST2 [23.1% (95% CI: 14.8–34.1%)]. Also, the weighted frequency of Blastocystis in various subgroups (publication year, WHO regions, geographical distribution, continents, and country income) was analyzed separately. In total, the results of the present meta-analysis highlighted that one's immunodeficiency status is probably associated with an increased Blastocystis infection, underpinning strict preventive measures to be taken. [ABSTRACT FROM AUTHOR]

This article discusses a qualitative study conducted in China that explores the experiences of informal caregivers for people living with HIV or AIDS (PLWHA). The study involved 21 informants, including family members, partners, and close friends of PLWHA, and aimed to understand the psychological, physical, economic, and social burdens faced by these caregivers. The findings highlight the need for health services to address the challenges faced by informal caregivers in addition to focusing on the needs of PLWHA. However, the study has some limitations, including a lack of investigation into the duration of care and participants' educational backgrounds, as well as the potential influence of the caregiver's presence during the interview. The article suggests the need for further research to address these limitations and enhance the generalizability of the findings. [Extracted from the article]

Background: Virological failure, drug resistance, toxicities, and other issues make it difficult for ART to maintain long-term sustainability. These issues would force a modification in the patient's treatment plan. The aim of this research was to determine whether first-line antiretroviral therapy is durable and to identify the factors that lead to patients on HAART changing their first highly active antiretroviral therapy regimen. Methods: A retrospective cohort study was conducted from October, 2019—March, 2020 across all regional states including Addis Ababa and Dire Dawa administrative cities. The target population is from all health facilities that have been providing ART service for at least the past 6 months as of October 2019. Multi-stage clustered sampling method was used to select study facilities and participants. Simple random selected ART medical records of patients ever enrolled in ART treatment services. We adopted a multi-state survival modelling (msm) approach assuming each treatment regimen as state. We estimate the transition probability of patients to move from one regimen to another for time to treatment change/switch. We estimated the transition probability, prediction probabilities and length of stay and factor associated with treatment modification of patients to move from one regimen to another. Results: Any of the six therapy combinations (14.4%) altered their treatment at least once during the follow-up period for a variety of reasons. Of the patients, 4,834 (13.26%) changed their treatments just once, while 371 (1.1%) changed it more than once. For 38.6% of the time, a treatment change was undertaken due to toxicity, another infection or comorbidity, or another factor, followed by New drugs were then made accessible and other factors 18.3% of the time, a drug was out of supply; 2.6% of those instances involved pregnancy; and 43.1% involved something else. Highly active anti-retroviral therapy (HAART) combinations TDF + 3TC + NVP, d4T + 3TC + NVP, and TDF + 3TC + EFV were high to treatment alterations in all reasons of treatment modifications, with 29.74%, 26.52%, and 19.52% treatment changes, respectively. Early treatment modification or regime change is one of the treatment combinations that include the d4T medication that creates major concern. The likelihood of staying and moving at the the start of s = 0 and 30-month transitions increased, but the likelihood of staying were declined. For this cohort dataset, the presence of opportunistic disease, low body weight, baseline CD4 count, and baseline TB positive were risk factors for therapy adjustment. Conclusion: Given that the current study took into account a national dataset, it provides a solid basis for ART drug status and management. The patient had a higher likelihood of adjusting their treatment at some point during the follow-up period due to drug toxicity, comorbidity, drug not being available, and other factors, according to the prediction probability once more. Baseline TB positivity, low CD4 count, opportunistic disease, and low body weight were risk factors for therapy adjustment in this cohort dataset. [ABSTRACT FROM AUTHOR]

Background: Poor sleep quality impedes the progression of chronic illnesses, while chronic illnesses themselves are caused by poor sleep quality. Despite this fact, there is no research that has been conducted in Ethiopia that provides a thorough estimate of the self-reported sleep quality among patients with chronic illnesses. In order to present a complete picture of poor sleep quality among diabetes, hypertension, heart failure, cancer, HIV/AIDS and epilepsy patients, this systematic review and meta-analysis was carried out. Methods: Systematic review and meta-analysis was conducted to estimate the quality of sleep among patients with chronic illness in Ethiopia. The Preferred Reporting Items for Systematic Review and Meta Analysis standard was followed in the reporting of this systematic review and meta-analysis. An extensive exploration of digital repositories, including PubMed, EMBASE, Cochrane, Africa Journal of Online, Google Scholar, and an advanced Google search, was conducted to obtain published studies until December 1st, 2023 detailing poor sleep quality of patients with chronic illness. STATA version 17 commands were used to create the pooled estimate. The I2 test and Egger's test, respectively, were used to identify the presence of heterogeneity and publication bias. To manage heterogeneity, a subgroup analysis and random effect model were used. Results: A total 21 articles with a total of 7393 participants were included in the final systematic review and meta-analysis. The pooled estimate of poor sleep quality among patients with chronic illness was 52% (95% of CI: 48%, 59%; I² = 97.26%). In subgroup analysis, the highest pooled estimate of poor sleep quality was observed in cancer patients 63% (95% CI: (95% CI: 45% - 80%). Regarding to data collection period, the highest pooled estimate of poor sleep quality was seen during spring 68% (95% CI: 42% - 94%). Conclusions: Patients with chronic illnesses in Ethiopia had a high pooled estimate of poor sleep quality. Patients with cancer had the highest pooled estimate of poor-quality sleep compared with other patients. Patients with chronic illnesses had trouble sleeping in the spring, according to this systematic review and meta-analysis. Therefore, attention and intervention should be given to enhance the quality of sleep for patients with chronic illnesses. [ABSTRACT FROM AUTHOR]

Background and Aim(S): This study retrospectively assessed the prevalence of TB and human immunodeficiency virus (HIV)/AIDS coinfection among patients that attended the Directly Observed Treatment Short‐course (DOTS) centers in Anambra State, Southeast, Nigeria, between 2013 and 2017. Methods: The study adopted a descriptive and retrospective epidemiological survey design. A total of 1443 case files of patients aged 15−60 who were treated in DOTS centers selected from Anambra State's 21 Local Government Areas between 2013 and 2017 were investigated. The uniform data form, a standardized instrument used in Anambra State's health facilities for data collection, was used to collect data from case files of all those identified as coinfected with TB and HIV/AIDS. Results: The mean prevalence rate of TB and HIV/AIDS coinfection in the state during the 5‐year period (2013–2017) was 20.00%. The highest annual prevalence of TB and HIV/AIDS coinfection was recorded in 2014 (23.84%). The state's prevalence of TB and HIV/AIDS coinfection increased dramatically from 13.17% in 2013 to 23.84% in 2014, followed by a slight downward trend to 22.80% in 2015, 20.17% in 2016, and 20.03% in 2017. In terms of gender, age, marital status, and occupation, females (59.5%), those aged 15 to 25 years (30.7%), married people (43.90%), and traders/business owners (50.7%), respectively, had the highest rates of tuberculosis and HIV/AIDS coinfection during the study period. Conclusion: The findings of this study show that young people, females, married people, and traders/business owners appear to be the most vulnerable groups affected by TB and HIV/AIDS coinfection, accounting for the majority of the disease burden in the state. To address the high prevalence of TB and HIV/AIDS coinfection in the Anambra State, novel intervention and control programs should be developed and implemented, and existing intervention frameworks should be strengthened. [ABSTRACT FROM AUTHOR]

Candida albicans species can cause severe morbidity and mortality in Human Immunodeficiency Virus (HIV) patients when they become systemically involved, known as candidemia. Mangrove (Aegiceras corniculatum) is a plant that is commonly distributed and has been shown to have several advantages to be used as phytotherapy. Objective to investigate the anti-fungal ability of Mangrove Ethanol Extract (MEE) (A.corniculatum) to Candida albicans isolated from Oral Candidiasis HIV/AIDS patient in vitro. The fresh mangrove leaf (A. corniculatum) was extracted by means of maceration methods. There were 5 groups, each with 4 samples: (1) control negative group (2) control doxycycline group, (3) MEE (A. corniculatum) concentration 25%, (3) 50% concentration group, (4) 75% concentration group, and (5) 100% concentration group. C. albicans isolated from stadium HIV/AIDS patients who were assessed clinically but did not seek fungal infection therapy. Saboraoud dextrose agar (SDA) containing the tested C. albicans suspension was poured into a petri dish around the paper disk. Observation of the inhibition zone around the well and then measuring the diameter of the inhibition zone horizontally and vertically using a digital scale ruler. It was discovered that 100%, 75%, 50%, and 25% MEE (A corniculatum) had no antifungal efficacy against C. albicans isolated from HIV/AIDS with no significant difference in inhibitory zone (p>0.05). MEE (A. corniculatum) did not have an inhibitory zone against C. albicans isolated from HIV/AIDS patients in vitro. [ABSTRACT FROM AUTHOR]

The goal of a traditional Markov decision process (MDP) is to maximize the expectation of cumulative reward over a finite or infinite horizon. In many applications, however, a decision maker may be interested in optimizing a specific quantile of the cumulative reward. For example, a physician may want to determine the optimal drug regime for a risk-averse patient with the objective of maximizing the 0.10 quantile of the cumulative reward; this is the cumulative improvement in health that is expected to occur with at least 90% probability for the patient. In "Quantile Markov Decision Processes," X. Li, H. Zhong, and M. Brandeau provide analytic results to solve the quantile Markov decision process (QMDP) problem. They develop an efficient dynamic programming procedure that finds the optimal QMDP value function for all states and quantiles in one pass. The algorithm also extends to the MDP problem with a conditional value-at-risk objective. The goal of a traditional Markov decision process (MDP) is to maximize expected cumulative reward over a defined horizon (possibly infinite). In many applications, however, a decision maker may be interested in optimizing a specific quantile of the cumulative reward instead of its expectation. In this paper, we consider the problem of optimizing the quantiles of the cumulative rewards of an MDP, which we refer to as a quantile Markov decision process (QMDP). We provide analytical results characterizing the optimal QMDP value function and present a dynamic programming-based algorithm to solve for the optimal policy. The algorithm also extends to the MDP problem with a conditional value-at-risk objective. We illustrate the practical relevance of our model by evaluating it on an HIV treatment initiation problem, in which patients aim to balance the potential benefits and risks of the treatment. [ABSTRACT FROM AUTHOR]

We assessed predictive models (PMs) for diagnosing Pneumocystis jirovecii pneumonia (PCP) in AIDS patients seen in the emergency room (ER), aiming to guide empirical treatment decisions. Data from suspected PCP cases among AIDS patients were gathered prospectively at a reference hospital's ER, with diagnoses later confirmed through sputum PCR analysis. We compared clinical, laboratory, and radiological data between PCP and non-PCP groups, using the Boruta algorithm to confirm significant differences. We evaluated ten PMs tailored for various ERs resource levels to diagnose PCP. Four scenarios were created, two based on X-ray findings (diffuse interstitial infiltrate) and two on CT scans ("ground-glass"), incorporating mandatory variables: lactate dehydrogenase, O2sat, C-reactive protein, respiratory rate (> 24 bpm), and dry cough. We also assessed HIV viral load and CD4 cell count. Among the 86 patients in the study, each model considered either 6 or 8 parameters, depending on the scenario. Many models performed well, with accuracy, precision, recall, and AUC scores > 0.8. Notably, nearest neighbor and naïve Bayes excelled (scores > 0.9) in specific scenarios. Surprisingly, HIV viral load and CD4 cell count did not improve model performance. In conclusion, ER-based PMs using readily available data can significantly aid PCP treatment decisions in AIDS patients. [ABSTRACT FROM AUTHOR]

Purpose: The assessment of tear film and ocular surface conditions in patients with acquired immunodeficiency syndrome (AIDS) has been poorly studied thus far. We aim to assess tear film parameters, ocular surface characteristics, and dry eye disease (DED) symptoms of patients with AIDS who did not undergo highly active antiretroviral treatment (HAART). Methods: This case-control study included 154 age-, sex-, and ethnicity-matched healthy controls and patients with AIDS. All participants underwent comprehensive ocular surface assessment and subjective DED symptomology evaluation. Data were collected between March 2022 and July 2022. Results: HAART-naïve patients with AIDS had a shorter noninvasive tear film breakup time (median 3.76 vs. 8.54 s), thinner tear film lipid layer thickness (median 73.00 vs. 91.00 nm), and lower Schirmer I test values (median 5.00 mm/5 min vs. 12.00 mm/5 min) (all P < 0.001). Moreover, higher corneal fluorescein staining scores (median 1.00 vs. 0.00) and higher upper, lower, and total meibomian gland grades were observed in AIDS patients (all P < 0.05). Negative correlations between the blood viral load and the Ocular Surface Disease Index score (r = -3.50, P = 0.027) and the Schirmer I test score (r = -0.374, P = 0.017) were detected in patients with AIDS. Conclusion: Altered tear film status was observed in individuals with HAART-naïve AIDS, even when there were no other ocular symptoms present. Therefore, patients with AIDS should be encouraged to undergo comprehensive ocular surface examinations to detect any subclinical tear film alterations occurring. [ABSTRACT FROM AUTHOR]

The discovery of the 32-bp deletion allele of the chemokine receptor gene CCR5 showed that homozygous carriers display near-complete resistance to HIV infection, irrespective of exposure. Algorithms of molecular evolutionary theory suggested that the CCR5-Δ32 mutation occurred but once in the last millennium and rose by strong selective pressure relatively recently to a ~10% allele frequency in Europeans. Several lines of evidence support the hypothesis that CCR5-Δ32 was selected due to its protective influence to resist Yersinia pestis, the agent of the Black Death/bubonic plague of the 14th century. Powerful anti-AIDS entry inhibitors targeting CCR5 were developed as a treatment for HIV patients, particularly those whose systems had developed resistance to powerful anti-retroviral therapies. Homozygous CCR5-Δ32/Δ32 stem cell transplant donors were used to produce HIV-cleared AIDS patients in at least five "cures" of HIV infection. CCR5 has also been implicated in regulating infection with Staphylococcus aureus, in recovery from stroke, and in ablation of the fatal graft versus host disease (GVHD) in cancer transplant patients. While homozygous CCR5-Δ32/32 carriers block HIV infection, alternatively they display an increased risk for encephalomyelitis and death when infected with the West Nile virus. [ABSTRACT FROM AUTHOR]

Background: WHO statistics show that someone attempts suicide every three seconds and commits suicide every 40 seconds somewhere in the world. There is a scarcity of aggregate evidence in Ethiopia. The aim of this review was to assess the pooled prevalence of suicidal ideation, attempts, and associated factors among adult HIV/AIDS patients in Ethiopia to fill this gap. Methods: We extensively searched the bibliographic databases of PubMed, MEDLINE, Scopus, Google Scholar, and the Web of Science to obtain eligible studies. Further screening for a reference list of articles was also done. The Microsoft Excel Spreadsheet was used to extract data, and Stata 17 was used for analysis. To check heterogeneity, the Higgs I2 and Cochran's Q tests were employed. Sensitivity and subgroup analysis were implemented. To detect publication bias, Egger's test and funnel plots were used. Results: The pooled prevalence of suicidal ideation and attempts among adult HIV/AIDS patients in Ethiopia was 20.3 with a 95% CI (14, 26.5) and 11.1 with a 95% CI (6.6, 15.5), respectively. Living alone (AOR 4.98; 95% CI: 2.96–8.37), having comorbidity or other opportunistic infection (AOR 4.67; 95% CI: 2.57–8.48), female sex (AOR 2.86; 95% CI: 1.76, 4.62), having WHO clinical stage III of HIV (AOR 3.69; 95% CI: 2.15, 6.32), having WHO clinical stage IV of HIV (AOR 5.43; 95% CI: 2.81, 10.53), having co-morbid depression (AOR 5.25; 95% CI: 4.05, 6.80), having perceived HIV stigma (AOR 2.53; 95% CI: 1.67, 3.84), and having family history of suicidal attempt (AOR 2.79; 95% CI: 1.38, 5.66) were significantly associated with suicidal ideation. Being female (AOR 4.33; 95% CI: 2.36, 7.96), having opportunistic infections (AOR 2.73; 95% CI: 1.69, 4.41), having WHO clinical stage III of HIV (AOR 3.78; 95% CI: 2.04, 7.03), having co-morbid depression (AOR 3.47; 95% CI: 2.38, 5.05), having poor social support (AOR 3.02; 95% CI: 1.78, 5.13), and having WHO clinical stage IV (AOR 7.39; 95% CI: 3.54, 15.41) were significantly associated with suicidal attempts. Conclusion: The pooled magnitude of suicidal ideation and attempt was high, and factors like opportunistic infection, WHO clinical stage III of HIV, WHO clinical stage III of HIV, and co-morbid depression were related to both suicidal ideation and attempt. Clinicians should be geared towards this mental health problem in HIV patients during management. [ABSTRACT FROM AUTHOR]

Background: An estimated 301 million people worldwide suffer from anxiety disorders. People living with HIV/AIDS (PLWHA) are particularly prone to anxiety disorders that could interfere with the important developmental process in an individual's development and ultimately result in a wide range of negative mental, physical, and psychosocial consequences, as well as poor quality of life in those population groups. Early intervention for anxiety disorders can reverse some of the physical damage caused by anxiety. However, based on systematic reviews and meta-analyses, the specific prevalence of anxiety disorders in PLWHA remains unknown. Method: We conducted a literature search on PubMed, Embase, and Web of Science up to 22 October 2022. A random-effects meta-analysis was used to pool prevalence rates from the included studies. Sensitivity and subgroup analyses were performed to identify the possible sources of heterogeneity and to compare the prevalence estimates across groups. The Joanna Briggs Institute's Quality Assessment Checklist was used to assess the quality of the included studies. Cochran's Q and I² tests were used to assess the betweenstudy heterogeneity. Results: Ten studies with a total of 238,570 cases were included for the final analysis. Results showed that 15.5% of HIV/AIDS patients had anxiety disorders. The prevalence was higher in females (20.8%) than males (20.7%). The mean age of PLWHA with anxiety disorders was 46.58 ± 11.15 years in these included studies. The subgroup analyses showed significant higher prevalence in non-heterosexual (32.1%). Conclusion: We attempted to quantify literature that could allow for stronger inferences to be made regarding the significantly higher prevalence of anxiety disorders in PLWHA, a finding that suggests the imperativeness of intervention strategies to alleviate suffering and reduce the probable negative ramifications. [ABSTRACT FROM AUTHOR]

Objectives: Cytomegalovirus (CMV) is frequently detected in lung and/or blood samples of patients with Pneumocystis jirovecii pneumonia (PJP), although this co-detection is not precisely understood. We aimed to determine whether PJP was more severe in case of CMV detection. Methods: We retrospectively included all patients with a diagnosis of PJP between 2009 and 2020 in our centre and with a measure of CMV viral load in blood and/or bronchoalveolar lavage (BAL). PJP severity was assessed by the requirement for intensive care unit (ICU) admission. Results: The median age of the 249 patients was 63 [IQR: 53–73] years. The main conditions were haematological malignancies (44.2%), solid organ transplantations (16.5%), and solid organ cancers (8.8%). Overall, 36.5% patients were admitted to ICU. CMV was detected in BAL in 57/227 patients; the 37 patients with viral load ≥3 log copies/mL were more frequently admitted to ICU (78.4% vs 28.4%, p<0.001). CMV was also detected in blood in 57/194 patients; the 48 patients with viral load ≥3 log copies/mL were more frequently admitted to ICU (68.7% vs 29.4%, p<0.001). ICU admission rate was found to increase with each log of BAL CMV viral load and each log of blood CMV viral load. Conclusions: PJP is more severe in the case of concomitant CMV detection. This may reflect either the deleterious role of CMV itself, which may require antiviral therapy, or the fact that patients with CMV reactivation are even more immunocompromised. [ABSTRACT FROM AUTHOR]

Introduction: Behavioral skills of people living with HIV/AIDS (PLWHA) in consuming antiretrovirals (ARV) can reduce their morbidity and mortality; however, behavioral skills in ARV therapy are still low. Motivational factor is considered to have an effect on behavior skills. The purpose of this study was to explain the influence of motivational factors on behavioral skills of PLWHA. Material and methods: Descriptive correlational cross-sectional approach was applied as study design. One hundred respondents, who met inclusion criteria were selected through simple random sampling method, and were requested to fill out a questionnaire. Results were analyzed using descriptive analysis and logistic regression test, with a significance value of p = 0.05. Results: In general, there is a significant effect of personal motivation (p = 0.000) and social motivation (p = 0.016) on behavioral skills. Personal motivation is based on attitudes towards preventive behavior, perceptions of disease susceptibility, benefits, and barriers to preventive behavior, while social motivation is a support provided by family and/ or friends as an assistance during treatment. Conclusions: Behavioral skills of PLWHA consisting of taking medication skills and managing information, are influenced by personal and social motivation. Support from family and friends is an important value that can play a role in achieving optimal motivation for treatment. [ABSTRACT FROM AUTHOR]

Introduction: Prevention of acquired immune deficiency syndrome (AIDS) requires proper awareness and attitude towards the disease, and ways of transmission and prevention. This study aimed to investigate the awareness and attitude of students at Kurdistan University of Medical Sciences and University of Kurdistan towards AIDS in 2020. Material and methods: This was cross-sectional, descriptive-analytical study. The study population was students at Kurdistan University of Medical Sciences (MUK) and University of Kurdistan (UOK) in 2020. 369 students were selected based on relative sampling. Data collection tool was international AIDS questionnaire (IAQ). Independent t-test and analysis of variance were applied for analysis. Results: The total IAQ score among students of MUK (75.38 ± 7.66) was higher than that of UOK students (71.17 ± 8.52) (p = 0.023). Although the total score in men (74.04 ± 8.14) was slightly higher than women (72.71 ± 8.50), there was no significant difference (p = 0.13). The difference in the scores of students living in single house with students living with their parents (p = 0.002) and students living in dormitories (p = 0.006) was statistically significant. The average score of undergraduates was the lowest, and doctorates the highest (p = 0.035). Conclusions: In light of the need to increase the awareness of ways of AIDS transmission, and appropriate attitudes towards people living with HIV/AIDS, with a focus on non-medical students, schemes should be designed and implemented to raise awareness and attitudes among people. [ABSTRACT FROM AUTHOR]

HIV-related spatial analysis studies in China are relatively few, and Jiangsu Province has not reported the relevant data in recent years. To describe the spatial distribution and molecular linkage characteristics of HIV-infected patients, this article combined descriptive epidemiology, spatial analysis, and molecular epidemiology methods to analyze patient reporting, patient mobility information, and HIV sequence information simultaneously. The results showed that HIV reporting profiles differed among Jiangsu cities, with the reporting rate in southern Jiangsu being above average. There was a spatial autocorrelation (Global Moran I = 0.5426, p < 0.05), with Chang Zhou showing a High–High aggregation pattern. Chang Zhou and Wu Xi were identified as hotspots for HIV reporting and access to molecular transmission networks. Some infected individuals still showed cross-city or even cross-province mobility after diagnosis, and three were linked with individuals in the destination cities within the largest molecular transmission cluster, involving 196 patients. The cross-city or cross-province mobility of patients may result in a potential HIV transmission risk, suggesting that combining timely social network surveys, building an extensive transmission network across cities and provinces, and taking critical regions and key populations as entry points could contribute to improved prevention and control efficiency and promote achievement of the 95-95-95 target and cascade. [ABSTRACT FROM AUTHOR]

Reviews of intimate partner violence (IPV) have primarily focused on women and same-sex relationships, but little is known about the global epidemiology of IPV among people living with HIV/AIDS (PLWHA). This review employed meta-analytic approaches to determine the worldwide prevalence and factors related to different forms of IPV among PLWHA. Databases including PubMed, Cochrane review, EMBASE, Scopus, PsycINFO, CINAHL, ProQuest, and registers, were systematically reviewed until November 5, 2021. The meta-analysis was conducted using the metafor package in R software. The Newcastle Ottawa Scale and Cochrane Risk of Bias Tool version 1 were used to assess the study quality and risk of bias, respectively. A total of 49 published articles and 42,280 participants, were included in the meta-analysis. Over their lifetime, four in ten PLWHA have experienced some type of IPV. Over a quarter have experienced physical, emotional, or psychological IPV. One in five PLWHA experienced at least one form of IPV during the recall period of last year, with emotional IPV being the most prevalent. Rates of physical and any types of IPV differed substantially between IPV measurements. IPV rates also varied significantly by the study design, with physical (29%) and sexual (18%) IPV rates being more prevalent in cross-sectional studies. Public health measures are critical for preventing and combating IPV among PLWHA. Additional cross-national research using robust sampling methods is required to obtain more representative samples and thus a more reliable prevalence estimate of IPV prevalence. [ABSTRACT FROM AUTHOR]

Concurrent infections caused by multiple fungal pathogens in immunocompromised patients can pose diagnostic and treatment challenges. Here, we presented the first reported case in Taiwan of an AIDS patient who had concurrent infection with Cryptococcus neoformans meningitis and Talaromyces amestolkiae lymphadenopathy. The patient presented with an enlarged inguinal lymph node and was diagnosed with T. amestolkiae lymphadenitis. The species T. amestolkiae was identified using DNA sequencing, which had the capability of differentiating it from other Talaromyces species. The patient was discharged from the hospital following treatment with amphotericin B and subsequent administration of voriconazole. This case highlights the importance of maintaining a suspicion of co-infections and utilizing appropriate diagnostic tools, such as DNA sequencing, to identify possible pathogens. Further studies are needed to determine the optimal treatment for T. amestolkiae and other co-infecting fungal pathogens. [ABSTRACT FROM AUTHOR]

Cutaneous disorders are one of the most common complications of patients with Human Immunodeficiency Virus (HIV) infections and acquired immunodeficiency syndrome (AIDS). The clinical manifestation of these cutaneous disorders' ranges from infections, malignancies, and other inflammatory conditions that can be distinguished based on the severity of infection through assessment of the number of CD4 lymphocyte cells. The misdiagnosis rate of these cutaneous disorders is high, particularly in patients with unclear HIV status or undiagnosed HIV infections. Papular pruritic eruption (PPE) is one of the cutaneous manifestations of HIV that occur mostly in patients with a low count of lymphocyte CD4 cells (<200 cells/uL). We report a case of a 49-yearold male patient with PPE that was initially diagnosed with prurigo nodularis with no improvement after topical potent corticosteroid treatment. A more thorough history taking, physical examination, and confirmation through histopathology examination revealed that the patient was an undiagnosed AIDS patient with a total lymphocyte CD4 cell count of 45 cells/uL with PPE. The patient was successfully treated using a combination of antiretroviral (ARV), oral antihistamines, and topical corticosteroids with significant clinical improvements, prompting physicians to be more aware of the possibility of PPE when faced with unspecific dermatitis/prurigo-like clinical manifestation with no improvement after conventional corticosteroid treatment. [ABSTRACT FROM AUTHOR]

Mathematical modeling techniques have been used extensively during the human immunodeficiency virus (HIV) epidemic. Drug injection causes increased HIV spread in most countries globally. The media is crucial in spreading health awareness by changing mixing behavior. The published studies show some of the ways that differential equation models can be employed to explain how media awareness programs influence the spread and containment of disease (Greenhalgh et al. Appl Math Comput. 2015;251:539–563). Here we build a differential equation model which shows how disease awareness programs can alter the HIV prevalence in a group of people who inject drugs (PWIDs). This builds on previous work by Greenhalgh and Hay (1997) and Liang et al. (2016). We have constructed a mathematical model to describe the improved model that reduces the spread of the diseases through the effect of awareness of disease on sharing needles and syringes among the PWID population. The model supposes that PWIDs clean their needles before use rather than after. We carry out a steady state analysis and examine local stability. Our discussion has been focused on two ways of studying the influence of awareness of infection levels in epidemic modeling. The key biological parameter of our model is the basic reproductive number R0$$ {R}_0 $$. R0$$ {R}_0 $$ is a crucial number which determines the behavior of the infection. We find that if R0$$ {R}_0 $$ is less than one then the disease‐free steady state is the unique steady state and moreover whatever the initial fraction of infected individuals then the disease will die out as time becomes large. If R0$$ {R}_0 $$ exceeds one there is the disease‐free steady state and a unique steady state with disease present. We also showed that the disease‐free steady state is locally asymptotically stable if R0$$ {R}_0 $$ is less than one, neutrally stable if R0$$ {R}_0 $$ is equal to one and unstable if R0$$ {R}_0 $$ exceeds one. In the last case, when R0$$ {R}_0 $$ is greater than one the endemic steady state was locally asymptotically stable. Our analytical results are confirmed by using simulation with realistic parameter values. In nontechnical terms, the number R0$$ {R}_0 $$ is a critical value describing how the disease will spread. If R0$$ {R}_0 $$ is less than or equal to one then the disease will always die out but if R0$$ {R}_0 $$ exceeds one and disease is present the disease will sustain itself and moreover the numbers of PWIDs with disease will tend to a unique nonzero value. [ABSTRACT FROM AUTHOR]

Objective. This study is to investigate the difference in HIV-1 RNA pol gene expression in AIDS patients before and after antiviral treatment and its effect on the expression level of CD4+/CD8+ T cells in peripheral blood. Methods. The participants included 200 AIDS patients who had undergone antiviral medication, and the quantity of HIV-1 RNA pol gene was determined using nested polymerase chain reaction (nPCR). The levels of CD3+, CD4+, and CD8+ T lymphocytes in peripheral blood were measured by flow cytometry before and after therapy. The receiver operating characteristics (ROC) curve was used to assess the impact of HIV-1 RNA pol gene expression and the CD4+/CD8+ ratio on the prognosis of AIDS patients. Results. After three months of therapy, the levels of HIV-1 RNA and viral load in the patients showed a drastic decline, while the levels of CD4+/CD8+ were markedly elevated (P < 0.05). Logistic analysis revealed that patients' viral loads were positively correlated with HIV-1 RNA and negatively correlated with CD4+/CD8+ (P < 0.05). The alanine aminotransferase (ALT), white blood cell (WBC) count, Serum creatinine (Cr), total cholesterol (TC), triglyceride (TG), and platelet (PLT) levels significantly increased following a 24-month therapy, while no significant changes were observed in the level of aspartate aminotransferase (AST), red blood cell (RBC), and neutrophil (NEU) (%). (P > 0.05). Conclusion. Antiviral drugs significantly inhibit the HIV-1 RNA POL gene expression and viral load in AIDS patients but upregulate the expression level of CD4+/CD8+ T cells in peripheral blood. [ABSTRACT FROM AUTHOR]

Antiretroviral therapy (ART) has improved survival and clinical course amongst HIV/AIDS patients. CD4 cell count is one of the most critical indicators of the disease progression. With respect to the dynamic nature of CD4 cell count during the clinical history of HIV/AIDS, modeling the CD4 cell count changes, which represents the likelihood of disease progression, is of interest to establish or revise treatment strategies and, specifically, to determine the stage at which giving ART is more clinically effective. In this historical cohort study on 917 HIV/AIDS patients in the Iranian "National Registry of HIV/AIDS Care" database, we used the Markov chain model to predict the effectiveness of the ART based on the transition probability of CD4 cell count, measured before and after initiating ART. We found that when the ART was initiated in the earlier stages of HIV infection, good prognosis might be more accessible; that is, after initiating ART at state CD 4 ≥ 500 , the probability of staying at this state was statistically increased than before the treatment (P < 0.001). Also, it was found that initiating ART significantly decreased the probability of CD4 cell count transition to the lower counts ( P CD 4 ≥ 500 ‐ to ‐ 350 ≤ CD 4 < 500 < 0.001 , P 350 ≤ CD 4 < 500 ‐ to ‐ 200 ≤ CD 4 < 350 < 0.001 , and P 200 ≤ CD 4 < 350 ‐ to ‐ CD 4 < 200 < 0.001). In addition, initiating ART showed a statistically significant increase in the probability of CD4 cell count transition from a lower state (350 ≤ CD 4 < 500) to a higher state (CD 4 ≥ 500) (P = 0.009). Furthermore, When CD4 count reaches under 200, even after the initiation of therapy, the probability of CD4 cell count transition to higher levels was not significant (P > 0.05). In summary, these results have a message for primary healthcare organizations to extensively identify HIV patients and initiating ART as early as possible. [ABSTRACT FROM AUTHOR]

Objective: Cryptococcal meningitis (CM) threatens people's health and is the main cause of opportunistic fungus-related death in acquired immune deficiency syndrome (AIDS) patients. Herein, we investigate the clinical characteristics and prognostic factors of AIDS patients with Cryptococcus neoformans in Wenzhou, Zhejiang Province, China. Methods: Our study enrolled AIDS patients diagnosed with Cryptococcus neoformans infection who were hospitalised in our hospital. They were divided into Group A (32 patients with CM) and Group B (28 patients without CM) according to their diagnosis. The differences between the two groups of patients' clinical symptoms, imaging examinations and laboratory examinations were observed. Statistical methods were used to analyse the difference in prognosis between the two groups. Results: Headache and fever were the most common clinical characteristics for patients with CM, while respiratory symptoms and fever were the most common clinical characteristics for patients without CM. The positive rate of cryptococcal capsular antigen, India ink staining and culture in the cerebrospinal fluid examination was higher in the CM patients than in the non-CM patients. The overall morbidity and mortality rate after systemic antifungal therapy was higher in the CM patients than in the non-CM patients. A higher incidence of headache, impaired consciousness, nuchal rigidity, first intracranial pressure > 200 mmH2O and mortality was observed in the CM patients than in the non-CM patients. Multifactorial logistic regression analysis showed that headache risk factors affecting the patient's prognosis at 12 weeks. Conclusion: Patients with AIDS diagnosed with Cryptococcus neoformans infection have insidious clinical symptoms in the early stage, and their manifestation is often non-specific, resulting in poor prognosis and high mortality among CM patients compared to patients without CM. Therefore, early identification and timely antifungal therapy before the disease progresses to meningitis are of great value in improving the survival rate of patients. [ABSTRACT FROM AUTHOR]

Introduction: This was a cross-sectional study conducted to determine the relationship between stigmatizing attitudes towards HIV/AIDS patients in relation to job satisfaction of nurses and midwives in Yazd, Eastern Iran. Cases of HIV/AIDS have not been studied. Material and methods: A total of 399 nurses and midwives were enrolled into the study using a multistage cluster method; all participants completed two standard questionnaires regarding health personnel attitudes towards HIV and job satisfaction on their own. Pearson's correlation coefficient and multiple regression analysis were applied to investigate the relationship between stigmatizing attitude and job satisfaction, and to control the effect of confounding variables. Analyzes were evaluated using STATA software, version 11.0. Results: The mean (standard deviation) of stigmatizing attitude score was 17.34 (8.6), which was equal to the mean number (score, 34), and showed the average level of stigmatizing attitudes of midwives and nurses. In total, 24.5%, 52.9%, and 22.6% of the participants presented non-stigmatizing attitude (n < 30), somewhat stigmatizing (n: 39-30), and stigmatizing (n > 39) attitudes towards HIV, respectively. Additionally, the overall mean score of job satisfaction was 53.89, which indicated the average level (38 to 57) of job satisfaction of nurses and midwives. In addition, the overall job satisfaction score was significantly inversely related to the stigmatized attitude of individuals, so that in return for increasing the job satisfaction score in staff, their stigmatizing attitude score decreased (ß = 0.10, p = 0.001). Conclusions: The findings showed an inverse and indirect relationship between job satisfaction and attitude. Accordingly, since nurses and midwives play a key role in the care, diagnosis, and treatment of people living with HIV, it is necessary for health managers and policy-makers to highlight the factors affecting job satisfaction of nurses and midwives. [ABSTRACT FROM AUTHOR]

Background Oral candidiasis (OC) develops in most HIV/AIDS patients. Increasing resistance to antifungals leads to searches for alternative treatment for OC. This study evaluated the in vitro activity of rosemary (Rosmarinus officinalis L.) essential oil compared to fluconazole against Candida spp. Methods The rosemary essential oil used in this study is a commercial product (Young Living Ltd.). This essential oil and fluconazole were tested by broth microdilution assay against 40 isolates of Candida spp. (20 C. albicans and 20 C. non-albicans) obtained from HIV/AIDS patients with OC. Results Against C. albicans, MIC and MFC of rosemary essential oil were 6.25% and 25%, and fluconazole were 100% and >100%. Against C. non-albicans, MIC and MFC of rosemary essential oil were 12.5% and 25%, and fluconazole were 100% and >100%. Conclusion Rosemary essential oil was a potential antifungal candidate showing higher antifungal activity compared to fluconazole. It was fungistatic against C. albicans but fungicidal against C. non-albicans, suggesting its potential role in the treatment of OC due to C. non-albicans. Further studies are needed to determine safety and toxicity of this essential oil prior to human use especially in immunocompromised patients. [ABSTRACT FROM AUTHOR]

Introduction: In recent years, a reduction in the life expectancy gap between people living with HIV (PLWH) and the general population has been observed, irrespective of CD4 lymphocyte count, due to widespread access to antiretroviral treatment. The increase in the life expectancy of PLWH has increased awareness of both the ageing process and gender discrepancies in immune restoration and survival. Materials and Methods: Longitudinal data were collected for 2240 patients followed up at the Hospital for Infectious Diseases in Warsaw, Poland (n = 1482), and the Department of Acquired Immunodeficiency, Pomeranian Medical University, Szczecin, Poland (n = 758). Immune restoration was measured from the time of starting combination antiretroviral therapy until achieving 500 CD4 lymphocytes/μL, 800 CD4 lymphocytes/μL, and CD4/CD8 lymphocyte ratios of > 0.8 and > 1.0. Full recovery was achieved when the patient was restored to both 800 CD4 lymphocytes/μL and a CD4/CD8 lymphocyte ratio > 1.0. Results: For all endpoints, immune restoration had a protective effect by reducing mortality. Patients who achieved immune restoration had a greater chance of reduced mortality than those who did not achieve immune restoration: for CD4 count > 500 cells/μL, HR = 5.4 (interquartile range: 3.09–9.41), p < 0.001; for CD4 > 800 cells/μL, HR = 5.37 (2.52–11.43), p < 0.001; for CD4/CD8 ratio > 0.8, HR = 3.16 (1.81–5.51), p < 0.001; for CD4/CD8 ratio > 1.0, HR = 2.67 (1.49–5.24), p = 0.001, and for full immune recovery, HR = 3.62 (1.63–8.04), p = 0.002. Conclusions: Immune restoration remains a powerful factor in improving the survival of PLWH, regardless of the speed of recovery. [ABSTRACT FROM AUTHOR]

The estimated prevalence rate of adults living with HIV infection in MENA is one of the lowest in the world. To date, no data on the genetic characteristics of Cryptosporidium isolates from HIV/AIDS patients in Algeria were available. This study aimed to identify Cryptosporidium species and subtype families prevalent in Algerian HIV-infected patients and contribute to the molecular epidemiology mapping of Cryptosporidium in the MENA region. A total of 350 faecal specimens from HIV/AIDS patients were analysed using microscopy, and a Cryptosporidium infection was identified from 33 samples, with 22 isolates successfully sequencing and confirming species and subtypes. Based on sequence analysis, 15 isolates were identified as C. parvum with family subtypes IIa (n = 7) and IId (n = 8), while five were identified as C. hominis (family subtypes Ia (n = 2) and Ib (n = 3)) and two as C. felis. The C. parvum subtype families IIa and IId predominated, suggesting potential zoonotic transmission. More extensive sampling of both humans and farm animals, especially sheep, goats and calves, as well as a collection of epidemiological data are needed for a better understanding of the sources of human C. parvum infections in Algeria. [ABSTRACT FROM AUTHOR]

Posttraumatic growth (PTG) among people living with HIV (PLWH) remains an understudied and controversial topic, and several research gaps need to be filled. In our study, we focused on one such gap by implementing parallel assessment of positive (PTG) and negative changes (posttraumatic depreciation [PTD]) following trauma related to HIV diagnosis, along with measurement of resilience and HIV/AIDS stigma and socio-medical data. The study sample comprised 509 PLWH, which completed the standardized psychometric inventories measuring the study variables. The results showed an unexpected positive relationship between PTG and PTD among participants. In addition, following the person-centered approach, we observed specific PTG/PTD clusters in the study sample with different resilience and HIV/AIDS stigma levels. Our study may shed some light on understanding PTG/PTD processes among PLWH and inspire planning for effective psychological help adjusted to patients' specific needs. [ABSTRACT FROM AUTHOR]

A 22-year-old woman with uncontrolled advanced human immunodeficiency virus (HIV) infection was persistently infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) beta variant for 9 months, the virus accumulating >20 additional mutations. Antiretroviral therapy suppressed HIV and cleared SARS-CoV-2 within 6 to 9 weeks. Increased vigilance is warranted to benefit affected individuals and prevent the emergence of novel SARS-CoV-2 variants. [ABSTRACT FROM AUTHOR]

We describe the opportunistic infections (OIs) of HIV/AIDS to understand the spectrum, mortality, and frequency of multiple coinfected OIs among HIV/AIDS patients in southern China, where OIs are severe. We carried out a retrospective cohort study of hospitalized HIV-infected individuals at the Fourth People's Hospital of Nanning, Guangxi, China, from Jan. 2011 to May. 2019. The chi-square test was used to analyze cross-infection; the Kaplan‒Meier analysis was used to compare mortality. A total of 12,612 HIV-infected patients were admitted to this cohort study. Among them, 8982 (71.2%) developed one or more OIs. The overall in-hospital mortality rate was 9.0%. Among the patients, 35.6% coinfected one OI, and 64.4% coinfected more than two OIs simultaneously. Almost half of the patients (60.6%) had CD4 + T-cell counts < 200 cells/μL. Pneumonia (39.8%), tuberculosis (35.3%), and candidiasis (28.8%) were the most common OIs. Coinfected cryptococcal meningitis and dermatitis are the most common combined OIs. The rate of anaemia (17.0%) was highest among those common HIV-associated complications. Multiple OIs are commonly found in hospitalized HIV/AIDS patients in southwestern China, which highlights the need for improved diagnosis and treatment. [ABSTRACT FROM AUTHOR]

Disabled activists in the United States brought unique expertise to HIV/AIDS in the 1980s and '90s, including understanding social stigma and health as social justice issues and approaching information as a complex access problem. Disproportionately affected Deaf communities mounted a response that carefully blended face-to-face caring practices with mediated information by and for deaf people grappling with HIV. San Francisco's Deaf AIDS Information Center (DAIC) advocated for wider access to Telecommunications Device for the Deaf (TDD) in the AIDS service sector while also marking this text and modem-based machine's inadequacies as a substitute for the high-touch, one-to-one interpretive work needed by many ASL users. Crossovers among media, AIDS, and disability justice histories are underdocumented and risk seeming minor. Through our analysis of the DAIC, we argue that this intersection is key to advancing knowledge of how HIV left an imprint on emerging communication technologies and how sexuality and disability factor in technological cultures. [ABSTRACT FROM AUTHOR]

Migrants experience several challenges en route to or in their host country. Current legislation in Russia imposes a permanent ban on international migrants with HIV obtaining a residence permit in Russia. Using qualitative methodology, we conducted semi-structured interviews with 15 international migrants who have lived with HIV in Russia and 12 interviews with healthcare providers in Russia. With the help of Bonnington's temporal framework, the study finds that the HIV-positive status of migrants becomes a biographical event that interrupts their migration cycle, thereby leading to the disruption of their normal life course which results in 'short term planning' and instability. Although most people living with HIV face similar challenges, Russian law concerning international migrants living with HIV worsens their living experience in Russia. International migrants living with HIV further face social exclusion, serious stigma and discrimination. The results show that the country's demand for migrants with HIV to leave the country to reduce the spread of HIV in Russia is counterproductive: it does not mobilise heath-seeking behaviour among migrants. Therefore, such legislation has to be amended to encourage international migrants living with HIV to access adequate HIV services. [ABSTRACT FROM AUTHOR]

What is Known and Objective: Except for the transmitted drug resistance (TDR)'s standard sampling and monitoring protocol, China's HIV‐1 pretreatment drug resistance (PDR) and acquired drug resistance (ADR) results vary widely due to the studies' diverse background. This meta‐analysis was conducted to comprehensively understand the drug resistance profiles of Chinese HIV/AIDS patients and compare the drug resistance differences among groups to provide a reference for the further improvement of treatment protocols. Methods: Data sources for this study were WANFANG, VIP, CNKI, SinoMed, PubMed and Web of Science databases from January 1, 2010 to January 13, 2022. Data extracted from the literature were analyzed by R and Stata to evaluate the profile and changing trend of drug resistance in Chinese HIV/AIDS patients. Results and Discussion: One hundred twenty‐one literature were included. The combined PDR and ADR in the Chinese HIV/AIDS patients was 5.56% (95% CI: 4.77%–6.41%) and 51.33% (95% CI: 47.57%–55.38%), respectively. The time trend analysis shows the upward trend of PDR. There were significate differences in ADR among different sample sources, the ADR in the central region were higher than those in all other regions. The PDR in men who have sex with men (MSM) was lower the whole population, while the MSM's ADR was much higher than whole population. What is New and Conclusion: PDR in China showed an upward trend and exceeded the 5% warning line but is still at a low level worldwide. ADR is stable and below the middle level globally; the comprehensively promoted free ART in China still has lasting effects. MSM is the high‐risk drug resistance population, targeted treatment strategies should be used. [ABSTRACT FROM AUTHOR]

Background: Toxoplasma gondii infection (toxoplasmosis) has the potential to cause a serious disease in immunocompromised patients and can be fatal in this population. We conducted a systematic review and meta-analysis to assess comprehensively the pooled seroprevalence of toxoplasmosis among immunocompromised patients including HIV/AIDS patients, cancer patients, and transplant recipients in Iran. Methods: PubMed, Web of Science, Scopus, Embase, and Google Scholar databases (international) and Scientific Information Database (SID), Magiran, IranMedex, and IranDoc databases (national) were systematically searched for all reports that possibly contained data for T. gondii prevalence in different immunocompromised populations in Iran between 2013 and 2022. Results: Overall, IgG seroprevalence rate of toxoplasmosis in Iranian immunocompromised patients was 45.1% (95% confidence interval (CI), 37.4-52.9). IgG seroprevalence rate of toxoplasmosis in 12 studies that included 2279 cancer patients, 19 studies that included 2565 HIV/AIDS patients and in 3 studies that included 200 transplant recipients was 43.6% (95% CI, 30.2-57.0), 45.9% (95% CI, 34.8-57.1) and 45.8% (95% CI, 32.5-59.0), respectively. Moreover, IgM seroprevalence rate in the 26 studies was 2.6% (95% CI, 1.4-3.7). Conclusion: Our findings represent a high seroprevalence rate of Toxoplasma IgG among immunocompromised patients. Health improvement and education toward prevention of toxoplasmosis is of great importance for these susceptible populations. [ABSTRACT FROM AUTHOR]

Talaromyces marneffei is a thermally dimorphic fungus that affects multiple organs and frequently invades immunocompromised individuals. However, only a few studies have reported the presence of intestinal infection associated with T. marneffei. Herein, we reported a case of intestinal T. marneffei infection in a man who complained of a 1-month history of intermittent fever, abdominal pain, and diarrhea. The result of the human immunodeficiency virus antibody test was positive. Periodic acid-Schiff and Gomorrah's methylamine silver staining of the intestinal biopsy tissue revealed T. marneffei infection. Fortunately, the patient's symptoms rapidly resolved with prompt antifungal treatment. In addition, we summarized and described the clinical characteristics, management, and outcomes of patients with intestinal T. marneffei infection. A total of 29 patients were identified, the majority of whom (65.52%) were comorbid with acquired immunodeficiency syndrome. The main clinical features included anemia, fever, abdominal pain, diarrhea, weight loss, and lymphadenopathy. The transverse and descending colon, ileocecum, and ascending colon were the most common sites of lesions. A considerable number of patients (31.03%) developed intestinal obstruction, intestinal perforation, and gastrointestinal bleeding. Of the 29 patients, six underwent surgery, 23 survived successfully with antifungal treatment, five died of T. marneffei infection, and one died of unknown causes. T. marneffei intestinal infection should be considered when immunodeficient patients in endemic areas present with non-specific symptoms, such as fever, abdominal pain, and diarrhea. Appropriate and timely endoscopy avoids delays in diagnosis. Early aggressive antifungal therapy improves the clinical outcomes of patients. [ABSTRACT FROM AUTHOR]

Background: Patients with acquired immunodeficiency syndrome (AIDS) tend to suffer from several central nervous system (CNS) infections due to hypoimmunity. However, CNS aspergillosis (CNSAG) is extremely rare and difficult to diagnose. Thus, it is easily misdiagnosed. Case presentation: We reported a 47-year-old male AIDS patient with ghosting vision and anhidrosis on the left head and face. He was accordingly diagnosed with Toxoplasma gondii encephalitis (TE) at other hospitals, for which he received regular anti-Toxoplasma gondii and anti-human immunodeficiency virus (anti-HIV) treatment. Then, the patient was transferred to our hospital due to a lack of any improvement with the prescribed treatment. The patient's neurological examination revealed no abnormalities at admission, only a slight change in the cerebrospinal fluid. His cranial magnetic resonance imaging (MRI) revealed multiple abnormal signals in the brain parenchyma, and his blood was positive for Toxoplasma gondii IgG antibody. The initial diagnosis at our hospital was also TE. Considering the poor efficacy of anti-TE treatment, cerebrospinal fluid metagenomics next-generation sequencing (mNGS) was performed, but no pathogenic bacteria were detected. However, Aspergillus fumigatus was detected in the cerebrospinal fluid via targeted next-generation sequencing (tNGS) and bronchoalveolar alveolar lavage fluid via mNGS. The diagnosis was accordingly revised to CNSAG combined with his other clinical manifestations. After administering voriconazole antifungal therapy, the patient's symptoms were relieved, with improved absorption of the intracranial lesions. Conclusions: The present case experience indicates the need for clinicians to strengthen their understanding of CNSAG. Moreover, for patients with diagnostic difficulties, early mNGS and tNGS (using biological samples with only a few pathogens) are helpful for early diagnosis and treatment, potentially allowing patients to achieve favorable outcomes. [ABSTRACT FROM AUTHOR]

Oral manifestations are early and important clinical indicators of Human Immunodeficiency Virus (HIV) infection since they can occur in up to 50% of HIV-infected patients and in up to 80% of patients at the AIDS stage (<200 CD4+ T lymphocytes). Oral health is related to physical and mental well-being because the presence of some lesions can compromise dental aesthetics, and alter speech, chewing, and swallowing, thus impacting the quality of life of patients. For this reason, it is necessary to integrate, as part of the medical treatment of HIV-positive patients, the prevention, diagnosis, and control of oral health. It is essential that health professionals have the power to identify, diagnose, and treat oral pathologies through clinical characteristics, etiological agents, and risk factors, both local and systemic. A diagnosis at an early stage of injury allows optimizing and prioritizing oral treatments, especially in acute pathologies, such as gingivitis and necrotizing periodontitis. In this group of patients, the development of strategies for the prevention, control, and reduction of these pathologies must be prioritized in order to reduce morbidity and mortality in this group of patients. [ABSTRACT FROM AUTHOR]

Risk compensation—the phenomenon positing that people adjust their risky behaviours in response to changes in perceived risks—could have the adverse effect of worsening health outcomes. Consequently, understanding potential behavioural responses is critical for designing effective public policies. This study examines the relationship between improved human immunodeficiency virus (HIV) therapy and subsequent risky sexual behaviour. Using a field experiment in South Africa, I estimate the causal effects of improved HIV therapy adherence on subsequent risky sexual behaviour among HIV-positive patients. I find that access to HIV therapy induces a substantial increase in the demand for unsafe sex. [ABSTRACT FROM AUTHOR]

Human immunodeficiency virus (HIV) infection and acquired immune deficiency syndrome (AIDS) are worldwide problems that lead to high rates of morbidity and mortality. Malignancies are important causes of death among patients; lymphoma and Kaposi sarcoma are the most common malignancies in HIV-positive and AIDS patients, but concurrence of these cancers in the same patient has rarely been reported. We present a 33-year-old female patient who had been diagnosed with an AIDS-related high-grade central nervous system lymphoma, based on results of stereotactic biopsy, and had undergone radiotherapy and combined antiretroviral therapy. She was referred to our center with a productive cough, bilateral lung nodules, and skin lesion. Computed tomography-guided biopsies of skin lesion and pulmonary nodules were compatible with Kaposi sarcoma. Patient's pulmonary nodules and skin lesion resolved over the course of therapy, based on imaging findings; her brain lesions did not progress. These findings suggest that dual malignancies related to HIV infection can occur in patients who are receiving antiretroviral therapy and have virologic suppression. To our knowledge, concomitant malignancies in HIV-positive or AIDS patients are rare, and the authors would like to advocate the assessment of dual cancers among these patients to optimize therapeutic course and outcome. [ABSTRACT FROM AUTHOR]

Peer support interventions for people living with HIV and AIDS (PLWHA) are effective, but their associated time and material costs for the recipient and the health system make them reachable for only a small proportion of PLWHA. Internet-based interventions are an effective alternative for delivering psychosocial interventions for PLWHA as they are more accessible. Currently, no reviews are focusing on internet-based interventions with peer support components. This scoping review aims to map the existing literature on psychosocial interventions for PLWHA based on peer support and delivered through the internet. We conducted a systematic scoping review of academic literature following methodological guidelines for scoping reviews, and 28 articles met our criteria. We summarized the main characteristics of the digital peer support interventions for PLWHA and how they implemented peer support in a virtual environment. Overall the reported outcomes appeared promising, but more robust evidence is needed. [ABSTRACT FROM AUTHOR]