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People who use alcohol and other drugs(hereafter "substances") and who are over the age of 40 are now more likely to die of a non‐drug related cause than people who use substances under the age of 40. This population will therefore potentially need greater access to palliative and end of life care services. Initially, the purpose of this rapid evidence assessment (REA), conducted August 2016–August 2017, was to explore the peer‐reviewed evidence base in relation to end of life care for people with problematic substance use. The following databases were searched using date parameters of 1 January 2004–1 August 2016: Amed, Psycharticles, Ovid, Ageinfo, Medline, Ebscohost, ASSIA, Social Care Online, Web of Knowledge, Web of Science, SSCI, Samsha, NIAAA. Data were extracted using a predefined protocol incorporating inclusion and exclusion criteria. Given the dearth of evidence emerging on interventions and practice responses to problematic substance use, the inclusion criteria were broadened to include any peer‐reviewed literature focussing on substance use specifically and end of life care. There were 60 papers that met the inclusion criteria. These were quality assessed. Using a textual thematic approach to categorise findings, papers fell into three broad groups (a) pain management, (b) homeless and marginalised groups, and (c) alcohol‐related papers. In general, this small and diverse literature lacked depth and quality. The papers suggest there are challenges for health and social care professionals in meeting the end of life needs of people who use substances. Addressing issues like safe prescribing for pain management becomes more challenging in the presence of substance use and requires flexible service provision from both alcohol/drug services and end of life care providers. Work is needed to develop models of good practice in working with co‐existing substance use and end of life conditions as well as prevalence studies to provide a wider context for policy development. [ABSTRACT FROM AUTHOR]

The redefining of human immunodeficiency virus (HIV) from an acute disease to a manageable chronic illness has reshaped the focus of care, emphasising clinical outcomes and sidelining the complex social barriers many people living with HIV (PLHIV) still face. This parallels changes in the location of HIV care in Australia, with many PLHIV seeking care from private general practitioners whose ability to address complex social issues is constrained by limitations of time and resources. In response, peer navigation has emerged as a model of care implemented by some HIV‐based community health organisations seeking to support PLHIV's biomedical and psychosocial needs. However, there is limited understanding of how peer navigation operates in community settings or of the way these programmes integrate with primary care. This paper is the first to explore peer navigation from the perspective of general practitioners (GPs), with experience in treating PLHIV, to understand the role they see for peer navigators (PNs) in supporting PLHIV. Semi‐structured in‐depth interviews were conducted with six GPs (11.5% of specialty HIV GPs in Queensland, Australia) to examine their views and experiences of peer navigation in the context of HIV care. GPs highlighted the complexities of care for PLHIV and the need for additional resources and supports for psychosocial care. GPs valued peer navigation as part of a patient support network and bridge to health and social care systems. PNs normalised HIV, alleviating fear and stigma, educating and translating clinical information for patients. However, a key challenge was the absence of direct communication pathways with PNs. Peer navigation has clear potential in supporting the care of PLHIV, to alleviate constraints in GP settings and expand HIV care beyond the clinic. [ABSTRACT FROM AUTHOR]

Hepatitis B and HIV/AIDS coinfections are common globally due to their similar mode of transmission. Since HIV infection modifies the course of HBV infection by increasing the rate of chronicity, prolonging HBV viremia, and increasing liver disease-associated deaths, individuals with coinfection of both diseases have a higher tendency of developing cirrhosis of the liver, higher levels of HBV DNA, reduced rate of clearance of the hepatitis B e antigen (HBeAg), and more likely to die than an individual with a single infection. This nature of HBV-HIV/AIDS coinfection motivated us to conduct this study. In this paper, we proposed and rigorously analyzed a deterministic mathematical model with the aim of investigating the effect of vaccination against hepatitis B virus and treatment for all infections on the transmission dynamics of HBV-HIV/AIDS coinfection in a population. We proved that the solutions of the submodels and the coinfection model are positive and bounded. The models are studied qualitatively using the stability theory of differential equations, and the effective reproduction numbers of the models are derived using the next generation matrix method. Stability of the equilibria of the submodels and the coinfection model is analyzed using Routh-Hurwitz criteria. The disease-free and endemic equilibria of the submodels and the coinfection model are computed, and both local and global asymptotic stability conditions for those equilibria are discussed. We performed a sensitivity analysis to illustrate the influence of different parameters on the effective reproduction number of HBV-HIV/AIDS coinfection model, and we identified the most sensitive parameters are ω B and ω H , which are the effective contact rates for HBV and HIV transmission, respectively. The numerical simulation of the model is done using MATLAB, and the findings from the simulations are discussed. It is observed that if the vaccination and treatment rates are increased, then the number of individuals susceptible to both infections and HBV-HIV/AIDS coinfection decreases and even falls to zero over time. Hence, it is concluded that vaccination against hepatitis B virus infection, treatment of hepatitis B and HIV/AIDS infections, and HBV-HIV/AIDS infection at the highest possible rate is very essential to control the spread of HBV-HIV/AIDS coinfection as an important public health problem. [ABSTRACT FROM AUTHOR]

In the paper, we have considered a nonlinear compartmental mathematical model that assesses the effect of treatment on the dynamics of HIV/AIDS and pneumonia coinfection in a human population at different infection stages. Our model revealed that the disease-free equilibrium points of the HIV/AIDS and pneumonia submodels are both locally and globally asymptotically stable whenever the associated basic reproduction numbers ( R H and R P ) are less than unity. Both the submodel endemic equilibrium points are locally and globally asymptotically stable whenever the associated basic reproduction numbers ( R P and R H ) are greater than unity. The full HIV/AIDS-pneumonia coinfection model has both locally and globally asymptotically stable disease-free equilibrium points whenever the basic reproduction number of the coinfection model R H P is less than unity. Using standard values of parameters collected from different kinds of literature, we found that the numerical values of the basic reproduction numbers of the HIV/AIDS-only submodel and pneumonia-only submodel are 17 and 7, respectively, and the basic reproduction number of the HIV/AIDS-pneumonia coinfection model is max 7 , 17 = 17. Applying sensitive analysis, we identified the most influential parameters to change the behavior of the solution of the considered coinfection dynamical system are the HIV/AIDS and pneumonia transmission rates β 1 and β 2 , respectively. The coinfection model was numerically simulated to investigate the stability of the coinfection endemic equilibrium point, the impacts of transmission rates, and treatment strategies for HIV/AIDS-only, pneumonia-only, and HIV/AIDS-pneumonia coinfected individuals. Finally, we observed that numerical simulations indicate that treatment against infection at every stage lowers the rate of infection or disease prevalence. [ABSTRACT FROM AUTHOR]

Recent studies have demonstrated that the latent infection is a major obstacle to the viral elimination in HIV infection process. In this paper, we formulate a stochastic HIV infection model to include both latent infection and combination drug therapies. We derive that the model solution is unique and positive, and the solution is global. By constructing appropriate stochastic Lyapunov functions, the existence of an ergodic stationary distribution is obtained when the critical condition is greater than one. Furthermore, through rigorous analysis and deduction, the extinction of the virus is established under certain conditions. Numerical simulations are performed to show that small intensity of white noises can maintain the existence of a stationary distribution, while large intensity of white noises is beneficial to the extinction of the virus. [ABSTRACT FROM AUTHOR]

In this paper, we are concerned with the well-posedness of a fractional model of human immunodeficiency virus infection. Namely, using Grönwall's lemma and Perov's fixed point theorem, we obtain sufficient conditions for which the considered model admits a unique solution. [ABSTRACT FROM AUTHOR]

Purpose. This paper examines the older persons' knowledge of HIV and AIDS and explores the effect of delayed disclosure of HIV status and lack of resources during care. Methods. The study site was health facilities in Thembisile Hani subdistrict, Mpumalanga Province, South Africa. Older persons aged 60 years and above were selected using purposive sampling for in-depth interviews. Thematic analysis was used to analyse the data. Results. Providing physical care to sick adults is labour intensive for the already weak older persons. They undertake the caring role within constraints arising from lack of resource such as gloves, diapers, and soap with which to perform the caring role. Taking care of the sick needed resources for specialized care and money for transport to the health facilities. This put a strain on the finances and rendered the older persons food insecure. Furthermore, disclosure of HIV status was delayed, and some older persons cared for the sick adult children without knowing that they were HIV-infected and had AIDS-related illnesses. The nondisclosure of their HIV status by the sick prevented them from taking precautionary measures to prevent the risk of infection during the provision of care. This was heightened by the limited knowledge of HIV/AIDS of the older persons. Conclusion. Older persons undertake the caring role with diligence under trying conditions due to lack of resources and the nondisclosure of HIV status of the adult children they take care of. Healthcare workers should educate older persons to take preventive precautionary measures when caring for family members even when there is no suspicion of HIV infection. In addition, access to the incapacity grants provided for individuals sick with AIDS-related illnesses could relieve the older persons from financial constraints. [ABSTRACT FROM AUTHOR]

Objective. To evaluate, through a systematic literature review, whether periodontal status in HIV‐infected individuals is different from those non‐HIV‐infected. Materials and Methods. A systematic search for published observational studies within six electronic databases and grey literature was conducted, PROSPERO database number CRD42020160062. Results from studies reporting clinical periodontal parameters: probing pocket depth, bleeding on probing, clinical attachment level, plaque index, and gingival index, in HIV‐ and non‐HIV‐infected individuals were reviewed. The quality of the assessment was evaluated according to the Joanna Briggs Institute Appraise Checklist. Results. Twenty‐three observational studies met the eligibility criteria and were included for analysis. The qualitative analysis indicated similarities in periodontal parameters within both groups, with no significant mean difference (MD) within both groups regarding clinical periodontal parameters; severe heterogeneity was also detected. Conclusions. No significant differences were found in the periodontal profile of HIV‐infected and non‐HIV‐infected individuals. However, the high heterogeneity among the studies calls for caution in interpreting these findings. Further investigations using standardized methods for periodontal evaluation are needed to clarify the association between HIV infection and periodontal conditions. [ABSTRACT FROM AUTHOR]

This paper mainly studies the threshold dynamics of new multicity HIV (Human Immunodeficiency Virus) epidemic models with switching parameters and pulse control. The model's parameters are assumed to be time-varying functions and switching functional forms in time due to seasonal changes. And the susceptible population is assumed to become infected via shared injections or sexual contacts with infected individuals and pre-AIDS patients (following infection with HIV but before the full development of acquired immune deficiency syndrome). New threshold conditions are established to ensure the extinction of the disease by using Razumikhin-type approach. Pulse control strategies are then applied to the multicity epidemic model and analyzed to guarantee their success in eradicating the disease. Numerical examples are performed to support the analytical results. [ABSTRACT FROM AUTHOR]

In this paper a within host mathematical model for Human Immunodeficiency Virus (HIV) transmission incorporating treatment is formulated. The model takes into account the efficacy of combined antiretroviral treatment on viral growth and T cell population in the human blood. The existence of an infection free and positive endemic equilibrium is established. The basic reproduction number R0 is derived using the method of next generation matrix. We perform local and global stability analysis of the equilibria points and show that if R0<1, then the infection free equilibrium is globally asymptotically stable and theoretically the virus is cleared and the disease dies out and if R0>1, then the endemic equilibrium is globally asymptotically stable implying that the virus persists within the host. Numerical simulations are carried out to investigate the effect of treatment on the within host infection dynamics. [ABSTRACT FROM AUTHOR]

Background: Hepatitis D virus (HDV) infection has been considered a serious neglected pandemic, particularly in developing countries. The virus causes a more severe disease than mono infection with hepatitis B virus (HBV). The epidemiology of HDV is not well documented in North Africa, which is known to be endemic for HBV. In this study, we explored the prevalence of HDV infection and also attempted to identify factors associated with hepatitis D positive status among chronic hepatitis B patients in North Africa.Methods: The electronic databases PubMed, Embase, Scopus, Science Direct, Web of Science, and Google Scholar were comprehensively searched for all papers published between January 1, 1998, and December 31, 2017, using appropriate strategies containing all related keywords, including North Africa, names of countries in the region, and all permutations of hepatitis D virus. The estimated prevalence of HDV in North Africa was calculated as an average of the pooled infection prevalence in each country weighted by the ratio of the country's hepatitis D virus population to the study's sample size in the survey data analysis.Findings: A total of 312 studies were identified and 32 were included in this study, with a total sample of 4907 individuals screened for HDV. There was considerable variability in the prevalence estimates of HDV within the countries of the region. The overall prevalence of HDV in the general population of North Africa was 5·01% (95% CI: 1·25-8·27) and in liver disease patients it was 20.7% (95% CI:9.87-44.53). Genotype-1 was the most prominent genotype reported in five published studies. Ten studies reported on HDV RNA in participants who were seropositive for HDV, and four studies highlighted the impact of demographic factors (sex and age). No study showed the impact of risk factors on the prevalence of HDV in North Africa.Interpretation: This review provides a comprehensive assessment of the burden of HDV in Northern Africa. There were significant differences in seroprevalence, study population, and diagnostic testing between the countries in the region. The results presented here will alert health professionals to implement clear policies based on evidence to diminish the burden of HDV infection. Such measures may include but are not restricted to improving the laboratory diagnostic tests and initiating patient data registries and blood screening. Further epidemiological and research studies are needed to explore the risk factors, coinfections, and approaches to increase testing for HDV, particularly in high-risk subpopulations, such as intravenous drug users and immigrants, and to define the consequences of HDV infection in North Africa. [ABSTRACT FROM AUTHOR]

This paper is devoted to develop a nonlocal and time-delayed reaction-diffusion model for HIV infection within host cell-to-cell viral transmissions. In a bounded spatial domain, we study threshold dynamics in terms of basic reproduction number R0 for the heterogeneous model. Our results show that if R0<1, the infection-free steady state is globally attractive, implying infection becomes extinct, while if R0>1, virus will persist in the host environment. [ABSTRACT FROM AUTHOR]

Malaria is one of the three most dangerous infectious diseases worldwide (along with HIV/AIDS and tuberculosis). In this paper we compare the disease dynamics of the deterministic and stochastic models in order to determine the effect of randomness in malaria transmission dynamics. Relationships between the basic reproduction number for malaria transmission dynamics between humans and mosquitoes and the extinction thresholds of corresponding continuous-time Markov chain models are derived under certain assumptions. The stochastic model is formulated using the continuous-time discrete state Galton-Watson branching process (CTDSGWbp). The reproduction number of deterministic models is an essential quantity to predict whether an epidemic will spread or die out. Thresholds for disease extinction from stochastic models contribute crucial knowledge on disease control and elimination and mitigation of infectious diseases. Analytical and numerical results show some significant differences in model predictions between the stochastic and deterministic models. In particular, we find that malaria outbreak is more likely if the disease is introduced by infected mosquitoes as opposed to infected humans. These insights demonstrate the importance of a policy or intervention focusing on controlling the infected mosquito population if the control of malaria is to be realized. [ABSTRACT FROM AUTHOR]

Protease-mediated maturation of HIV-1 virus particles is essential for virus infectivity. Maturation occurs concomitant with immature virus particle release and is mediated by the viral protease (PR), which sequentially cleaves the Gag and Gag-Pol polyproteins into mature protein domains. Maturation triggers a second assembly event that generates a condensed conical capsid core. The capsid core organizes the viral RNA genome and viral proteins to facilitate viral replication in the next round of infection. The fundamental role of proteolytic maturation in the generation of mature infectious particles has made it an attractive target for therapeutic intervention. Development of small molecules that target the PR active site has been highly successful and nine protease inhibitors (PIs) have been approved for clinical use. This paper provides an overview of their development and clinical use together with a discussion of problems associated with drug resistance. The second-half of the paper discusses a novel class of antiretroviral drug termed maturation inhibitors, which target cleavage sites in Gag not PR itself. The paper focuses on bevirimat (BVM) the first-in-classmaturation inhibitor: its mechanism of action and the implications of naturally occurring polymorphisms that confer reduced susceptibility to BVM in phase II clinical trials. [ABSTRACT FROM AUTHOR]

The dynamics of many epidemiological models for infectious diseases that spread in the sexually active population presents a crucial period: the period of the influx or recruitment of susceptible. In this paper, we assume that the recruitment of susceptible is done among the juvenile group. We propose a dynamical system tomodelize the disease spread, and we study the dynamical behavior of this system. Then, the controllability of the system is studied. We prove that the survival rate allows to control the dynamic of the system. Numerical simulations are given to illustrate the results. [ABSTRACT FROM AUTHOR]

This paper presents a case report of an HIV-negative, supraglottic Kaposi’s sarcoma patient. The 80-year-old male patient was admitted with complaints of hoarseness, difficulty in swallowing, and a stinging sensation in his throat for approximately six months. The endoscopic larynx examination revealed a lesion which had completely infiltrated the epiglottis, reached right aryepiglottic fold, was vegetating, pink and purple in color, multilobular, fragile, and shaped like a bunch of grapes, and partially blocked the bleeding airway passage. The case was discussed by the hospital’s head-neck cancer committee and a surgery decision was made. A tracheotomy was performed under local anesthesia before the operation due to respiratory distress and endotracheal intubation difficulty. Direct laryngoscopy showed that the mass was limited in the supraglottic area, had invaded the entire left aryepiglottic fold and one-third of the front right aryepiglottic fold, and completely covered epiglottis. It should be remembered that although rare, Kaposi’s sarcoma may be encountered in larynx malignancy cases. Disease-free survival may be achieved through local excision and postoperative radiotherapy. [ABSTRACT FROM AUTHOR]

In this paper, we proposed and analyzed a realistic compartmental mathematical model on the spread and control of HIV/AIDS-pneumonia coepidemic incorporating pneumonia vaccination and treatment for both infections at each infection stage in a population. The model exhibits six equilibriums: HIV/AIDS only disease-free, pneumonia only disease-free, HIV/AIDS-pneumonia coepidemic disease-free, HIV/AIDS only endemic, pneumonia only endemic, and HIV/AIDS-pneumonia coepidemic endemic equilibriums. The HIV/AIDS only submodel has a globally asymptotically stable disease-free equilibrium if R 1 < 1. Using center manifold theory, we have verified that both the pneumonia only submodel and the HIV/AIDS-pneumonia coepidemic model undergo backward bifurcations whenever R 2 < 1 and R 3 = max R 1 , R 2 < 1 , respectively. Thus, for pneumonia infection and HIV/AIDS-pneumonia coinfection, the requirement of the basic reproduction numbers to be less than one, even though necessary, may not be sufficient to completely eliminate the disease. Our sensitivity analysis results demonstrate that the pneumonia disease transmission rate β 2 and the HIV/AIDS transmission rate β 1 play an important role to change the qualitative dynamics of HIV/AIDS and pneumonia coinfection. The pneumonia infection transmission rate β 2 gives rises to the possibility of backward bifurcation for HIV/AIDS and pneumonia coinfection if R 3 = max R 1 , R 2 < 1 , and hence, the existence of multiple endemic equilibria some of which are stable and others are unstable. Using standard data from different literatures, our results show that the complete HIV/AIDS and pneumonia coinfection model reproduction number is R 3 = max R 1 , R 2 = max 1.386 , 9.69 = 9.69 at β 1 = 2 and β 2 = 0.2 which shows that the disease spreads throughout the community. Finally, our numerical simulations show that pneumonia vaccination and treatment against disease have the effect of decreasing pneumonia and coepidemic disease expansion and reducing the progression rate of HIV infection to the AIDS stage. [ABSTRACT FROM AUTHOR]

This paper is based on data collected in 2009 for the international Stigma Index Study which measured the experiences of stigma among participants living with HIV in the UK. Data were collected using a self-completed survey questionnaire and focus group discussions. Quantitative data were analysed using SPSS, while qualitative data were subjected to thematic analysis. The Stigma Index attempts to establish a baseline for documenting the experience of stigma and discrimination by people living with HIV while also acting as an advocacy tool whose power lay in the involvement of people living with HIV in the design of study instruments and data collection. Participants were recruited through collaborations with a broad range of UK HIV support organisations. The ethics protocols used were those described in the Stigma Index guidebook. A total of 867 people living with HIV took part, of whom 276 described themselves as 'immigrants'. Most of this 'migrant' subsample (70%) was women. Nearly, all (91%) identified as heterosexual, while 9% were attracted to someone of the same sex as them. Socioeconomic deprivation was a key theme and they reported other stigmatised chronic conditions in addition to HIV. It is not possible to ascertain from the questionnaire, the migrants' countries of origin and length of stay in the UK. Control of information about HIV was critically managed, with respect to family and partners. Felt stigma increased anxieties about personal safety, particularly among men. Strategies for safeguarding against the negative impact of stigma included avoiding social gatherings, intimacy, and clinical and HIV social care settings. Most participants were unaware of policies and declarations that protected them as persons living with HIV. Specific recommendations include creating awareness about rights as enshrined in various legal frameworks that protect the right of people living with HIV, which has been reconfigured as a 'disability'. [ABSTRACT FROM AUTHOR]

Background. People living with HIV (PLHIV) are at a high-risk of developing AIDS-defining cancers (ADCs) and non-AIDS-defining cancers (NADCs). This review is aimed at exploring available evidence regarding the trends of ADCs and NADCs and the associated risk factors among adult PLHIV. Methods. We conducted a comprehensive search of PubMed, Web of Science, and EBSCO host databases to identify articles published between 2010 and 2023 that reported incidence and mortality rates of cancer, including ADCs and NADCs among PLHIV. We compared trends and rates in PLHIV with HIV-negative adults and further assessed related risk factors. Results. A total of 1886 potentially eligible articles were screened, and of these, 36 were included in this study. More than 50% (n = 20) of these were based in high-income countries. Seventeen studies reported a higher prevalence of NADCs compared to ADCs, with twelve of these conducted in high-income countries. Conversely, eight out of twelve studies reporting a higher prevalence of ADCs versus NADCs were from low-and-middle and upper-middle-income countries. Ten studies indicated a higher incidence of ADCs (6 studies) and NADCs (4 studies) among PLHIV compared to HIV-negative individuals. In contrast, only two studies observed an increase in NADCs among the HIV-negative population. In comparing mortality, seven out of nine studies showed elevated NADC-related deaths compared to ADCs. The main risk factors identified for any cancer, NADCs, and related mortality were advancing age, and longer duration of HIV infection, while lower CD4 cell counts (<200 cells/μl), was associated with both ADC and NADC occurrences. Conclusion. Chronic HIV infection combined with advancing age in PLHIV taking antiretroviral therapy appears to have contributed to increasing cancer burden, particularly the incidence of NADCs and associated mortality. These findings stress the importance of screening for high-risk cancers among PLHIV for early detection and treatment to ensure improved outcomes. [ABSTRACT FROM AUTHOR]

It is crucial to understand the specificity of HIV-1 protease for designing HIV-1 protease inhibitors. In this paper, a new feature selection method combined with neural network structure optimization is proposed to analyze the specificity of HIV-1 protease and find the important positions in an octapeptide that determined its cleavability. Two kinds of newly proposed features based on Amino Acid Index database plus traditional orthogonal encoding features are used in this paper, taking both physiochemical and sequence information into consideration. Results of feature selection prove that p2, p1, p1′, and p2′ are the most important positions. Two feature fusion methods are used in this paper: combination fusion and decision fusion aiming to get comprehensive feature representation and improve prediction performance. Decision fusion of subsets that getting after feature selection obtains excellent prediction performance, which proves feature selection combined with decision fusion is an effective and useful method for the task of HIV-1 protease cleavage site prediction. The results and analysis in this paper can provide useful instruction and help designing HIV-1 protease inhibitor in the future. [ABSTRACT FROM AUTHOR]

This paper analyses data from a 3-year prospective study to understand the factors associated with becoming a caregiver to a person with a chronic illness and examines the dynamics among caregivers over time. A total of 1485 participants were drawn from a study conducted in the slums of Nairobi, Kenya. Two waves of data collected in 2006 for the baseline and a follow-up in 2009 were used. Information on the demographic, self-reported health and socioeconomic characteristics such as education, sources of livelihood and employment status was used. Age was a significant factor in becoming a caregiver, but there were no significant differences by gender or marital status. New caregivers and those with more than one care-giving episode had a higher socioeconomic position than non-caregivers. Caregivers also had poorer health compared with non-caregivers, highlighting the association between being a caregiver and negative health outcomes. Additionally, having cared for someone with a HIV-related illness compared with other chronic conditions increased the likelihood of subsequently caring for another person in need of long-term care. This may be due to the heterosexual mode of HIV transmission in sub-Saharan Africa, hence clustering of infection within family or married couples. This finding draws attention to the need to provide timely interventions to caregivers for people with HIV-related illness who are likely to end up providing care to multiple care recipients. Furthermore, there is a need to enhance the indispensable contribution of informal caregivers through incorporating their role within the continuum of care for effective HIV and AIDS management. Overall, informal caregivers to persons with chronic illnesses perform the tasks of care-giving without any formal support from health or social services. Therefore, it is crucial to initiate policies and programmes to ease the burden of care that is borne by informal caregivers. [ABSTRACT FROM AUTHOR]

Aim This paper describes perceptions of the end users on quality of antiretroviral therapy ( ART) in public health facilities in Nigeria. Background Health care services in Nigeria face challenges of meeting end users' requirements and expectations for quality ART service provision. Method A qualitative design was followed. Unstructured focus group discussions were conducted with end users ( n = 64) in six locations across the six geopolitical zones of Nigeria. Results The findings indicate that end users were satisfied with uninterrupted antiretroviral drug supplies, courtesy treatment, volunteerism of support group members and quality counselling services. Conclusion End users expect effective collaboration between healthcare providers and support group members, to enhance the quality of life of people living with HIV. Implications for nursing management A best practice guideline for the provision of end user focused ART service provision was developed for nurse managers. [ABSTRACT FROM AUTHOR]

The study explores how HIV-positive couples negotiate and make reproductive and sexually related decisions. The broader aim of the paper is to understand how men and women with HIV make decisions about contraception and reproduction and what those decisions indicate about the realities of HIV-positive relationships. In line with the study's aim to explore meanings related to the decision making process, a qualitative research approach was adopted. In-depth interviews were conducted with 15 couples in which at least one of them was HIV-positive. A critical interpretive analysis of the data was adopted in order to gain insight into decision making among the HIV-positive couples. The results indicate that decisions made were usually a result of negotiation and compromise between partners. However, women's fertility and sexual preferences were found to be a major factor in determining the outcome of the decision making process. Couples who intended to have a child were found to be active decision makers while those who only desired or did not desire to have a child were mainly passive decision makers. The study concludes that women exercise significant power over contraceptive and reproductive decisions among both active and passive decision makers. [ABSTRACT FROM AUTHOR]

The preventative effects of antiretroviral therapy for people with HIV have been debated since they were first raised. Models commenced studying the preventive effects of treatment in the 1990s, prior to initial public reports. However, the outcomes of the preventive effects of antiretroviral use were not consistent. Some outcomes of dynamic models were based on unfeasible assumptions, such as no consideration of drug resistance, behavior disinhibition, or economic inputs in poor countries, and unrealistic input variables, for example, overstated initiation time, adherence, coverage, and efficacy of treatment. This paper reviewed dynamic mathematical models to ascertain the complex effects of ART on HIV transmission.This review discusses more conservative inputs and outcomes relative to antiretroviral use in HIV infections in dynamic mathematical models. ART alone cannot eliminate HIV transmission. [ABSTRACT FROM AUTHOR]

This paper analyzes the implications of HIV and AIDS prevention, treatment, and care programmes on the health system in Zimbabwe. The programmes have been spearheaded by various stakeholders that include the public and private sectors, nongovernmental organizations, formal and informal institutions, and intergovernmental organizations. There has been a tremendous increase of the programmes as they adapt to local contexts, accommodate new funders, and changes in population attitudes, and expectations in the country. Through a comprehensive literature review, this paper focuses on Behaviour Change, the Antiretroviral Therapy, Home-Based Care, Prevention to Mother To Child Transmission and Voluntary Counselling and Testing programmes and services in relation to the components of the health system that include health service delivery, human resources, finance, leadership and governance, and the medical products and technologies. Thus far, the implications are uneven throughout the health system and there is need to integrate the HIV and AIDS programmes within the health system in order to achieve positive heath outcomes. [ABSTRACT FROM AUTHOR]

Individuals infected with human immunodeficiency virus (HIV) frequently demonstrate metabolic syndrome (MS) associated with increased incidence of cardiovascular disorders. Characteristics of HIV infection, such as immunodeficiency, viral load, and duration of the disease, in addition to the highly active antiretroviral therapy (HAART) have been suggested to induce MS in these patients. It is well documented that MS involves a number of traditional cardiovascular risk factors, like glucose, lipids, and arterial blood pressure abnormalities, leading to extensive atherogenic arterial wall changes. Nevertheless, the above traditional cardiovascular risk factors merely explain the exacerbated cardiovascular risk in MS. Nowadays, the adipose-tissue derivatives, known as adipokines, have been suggested to contribute to chronic inflammation and the MS-related cardiovascular disease. In view of a novel understanding on how adipokines affect the pathogenesis of HIV/HAART-related MS and cardiovascular complications, this paper focuses on the interaction of the metabolic pathways and the potential cardiovascular consequences. Based on the current literature, we suggest adipokines to have a role in the pathogenesis of the HIV/HAART-related MS. It is crucial to understand the pathophysiology of the HIV/HAART-related MS and apply therapeutic strategies in order to reduce cardiovascular risk in HIV patients. [ABSTRACT FROM AUTHOR]

TNPO3, transportin-SR2 or Tnp3, a member of the karyopherin ß superfamily of proteins, is important for the ability of human immunodeficiency virus (HIV-1) to achieve productive infection, as TNPO3 depletion in human cells leads to a dramatic reduction of infection. Here we describe and discuss recent findings suggesting that TNPO3 assists HIV-1 replication in the nucleus and in fact that TNPO3 may assist PIC maturation in the nucleus. In addition, the viral determinant for the requirement of TNPO3 in HIV-1 infection is discussed. This paper summarizes the most significant recent discoveries about this important host factor and its role in HIV-1 replication. [ABSTRACT FROM AUTHOR]

During the retrotranscription process, characteristic of all retroviruses, the viral ssRNA genome is converted into integrationcompetent dsDNA. This process is accomplished by the virus-coded reverse transcriptase (RT) protein, which is a primary target in the current treatments for HIV-1 infection. In particular, in the approved therapeutic regimens two classes of drugs target RT, namely, nucleoside RT inhibitors (NRTIs) and nonnucleoside RT inhibitors (NNRTIs). Both classes inhibit the RT-associated polymerase activity: the NRTIs compete with the natural dNTP substrate and act as chain terminators, while the NNRTIs bind to an allosteric pocket and inhibit polymerization noncompetitively. In addition to these two classes, other RT inhibitors (RTIs) that target RT by distinct mechanisms have been identified and are currently under development. These include translocationdefective RTIs, delayed chain terminators RTIs, lethalmutagenesis RTIs, dinucleotide tetraphosphates, nucleotide-competing RTIs, pyrophosphate analogs, RT-associated RNase H function inhibitors, and dual activities inhibitors. This paper describes the HIV-1 RT function and molecular structure, illustrates the currently approved RTIs, and focuses on the mechanisms of action of the newer classes of RTIs. [ABSTRACT FROM AUTHOR]

Understanding the nuances of RNA structure as they pertain to biological function remains a formidable challenge for retrovirus research and development of RNA-based therapeutics, an area of particular importance with respect to combating HIV infection. Although a variety of chemical and enzymatic RNA probing techniques have been successfully employed for more than 30 years, they primarily interrogate small (100-500 nt) RNAs that have been removed from their biological context, potentially eliminating long-range tertiary interactions (such as kissing loops and pseudoknots) that may play a critical regulatory role. Selective 2' hydroxyl acylation analyzed by primer extension (SHAPE), pioneered recently by Merino and colleagues, represents a facile, user-friendly technology capable of interrogating RNA structure with a single reagent and, combined with automated capillary electrophoresis, can analyze an entire 10,000-nucleotide RNA genome in a matter of weeks. Despite these obvious advantages, SHAPE essentially provides a nucleotide "connectivity map," conversion of which into a 3-D structure requires a variety of complementary approaches. This paper summarizes contributions from SHAPE towards our understanding of the structure of retroviral genomes, modifications to which technology that have been developed to address some of its limitations, and future challenges. [ABSTRACT FROM AUTHOR]

The use of highly active antiretroviral therapy (HAART) involves combinations of drugs to achieve maximal virological response and reduce the potential for the emergence of antiviral resistance. There are two broad classes of reverse transcriptase inhibitors, the nucleoside reverse transcriptase inhibitors (NRTIs) and nonnucleoside reverse transcriptase inhibitors (NNRTIs). Since the first classes of such compounds were developed, viral resistance against them has necessitated the continuous development of novel compounds within each class. This paper considers the NRTIs and NNRTIs currently in both preclinical and clinical development or approved for second line therapy and describes the patterns of resistance associated with their use, as well as the underlying mechanisms that have been described. Due to reasons of both affordability and availability, some reverse transcriptase inhibitors with low genetic barrier are more commonly used in resource-limited settings. Their use results to the emergence of specific patterns of antiviral resistance and so may require specific actions to preserve therapeutic options for patients in such settings. More recently, the advent of integrase strand transfer inhibitors represents another major step forward toward control of HIV infection, but these compounds are also susceptible to problems of HIV drug resistance. [ABSTRACT FROM AUTHOR]

Today, HIV-infected children who have access to treatment face a chronic rather than a progressive and fatal disease. As a result, new challenges are emerging in the field. Recent lines of evidence outline several factors that can differently affect the ability of the immune system to fully reconstitute and to mount specific immune responses in children receiving HAART. In this paper, we review the underlying mechanisms of immune reconstitution after HAART initiation among vertically HIV-infected children analyzing the possible causes of suboptimal responses. [ABSTRACT FROM AUTHOR]

Treatment of HIV-infected patients with highly active antiretroviral therapy (HAART) usually results in diminished viral replication, increasing CD4+ cell counts, a reversal of most immunological disturbances, and a reduction in risk of morbidity and mortality. However, approximately 20% of all HIV-infected patients do not achieve optimal immune reconstitution despite suppression of viral replication. These patients are referred to as immunological nonresponders (INRs). INRs present with severely altered immunological functions, including malfunction and diminished production of cells within lymphopoetic tissue, perturbed frequencies of immune regulators such as regulatory T cells and Th17 cells, and increased immune activation, immunosenescence, and apoptosis. Importantly, INRs have an increased risk of morbidity and mortality compared toHIV-infected patients with an optimal immune reconstitution. Additional treatment to HAART that may improve immune reconstitution has been investigated, but results thus far have proved disappointing. The reason for immunological nonresponse is incompletely understood. This paper summarizes the known and unknown factors regarding the incomplete immune reconstitution in HIV infection, including mechanisms, relevance for clinical care, and possible solutions. [ABSTRACT FROM AUTHOR]

An individual's subjective judgment about his or her Human Immunodeficiency Virus status depends on certain factors, behavioral, health, and sociodemographic alike. This paper aims to develop a model with good accuracy for predicting subjective HIV infection status using the random forest approach. A total of 12,796 responses of Malawians over a 12-year period were assessed. Fourteen risk factors including behavioral, health, and sociodemographic information were analysed as potential predictors of subjective Human Immunodeficiency Virus infection status in the general population and thirteen behavioral, health, and sociodemographic information were analysed among males and females. The random forest approach was adopted to build a comprehensive model comprising 14 risk factors in Malawi. It was revealed that age, worries about infection, and health rate were the most significant predictors as compared to use of condoms, marital status, and education which were the least important predictors of subjective Human Immunodeficiency Virus status in Malawi. However, the importance of infidelity on the part of a spouse and marital status as predictors of subjective Human Immunodeficiency Virus status alternated among males and females. The importance of infidelity and marital status was relatively high among females than among males. The model achieved a prediction accuracy of about 97%–99% measured by c-statistic with jack-knife cross validation and verified by Mathews correlation coefficient. As a result, RF based model has great potential to be an effective approach for analysing subjective health status. [ABSTRACT FROM AUTHOR]

Curcumin, a low-molecular-weight natural polyphenol mainly found in the plant Curcuma longa (turmeric), is widely used as a food colorant and as a potential protective agent against several chronic diseases including cancer, HIV-infection, neurological, cardiovascular, and skin diseases. Moreover, evidences from long-term use process and preclinical trials have demonstrated low toxicity of curcumin, even at relatively high doses. However, it has been well known that the application of curcumin was limited owing to its water insolubility, instability, and poor bioavailability. For decades, many attempts have been made to compensate for these disadvantages, with the development of improved delivery platforms as the feasible approaches. The past ten years witnessed the encouraging progress in the use of nanoscale drug delivery systems on curcumin such as loading curcumin into liposomes or nanoparticles, forming self-microemulsifying drug delivery systems (SMEDDS), cyclodextrin inclusions, and solid dispersions, as well as the latest reported technologies such as nadodisks and nanotubes. This paper summarizes the recent works on the design and development of nanoscale delivery systems of curcumin, with the goal of harnessing the true difficulties of this multifunctional agent in the clinical arena. [ABSTRACT FROM AUTHOR]

Hodgkin's lymphoma (HL) occurs with increasing frequency in human-immunodeficiency-virus-(HIV-) infected individuals. The natural history and behaviour of HIV-HL is different, being more atypical and aggressive. The association between HIV and HL appears to be primarily EBV driven. HAART use does not significantly impact on the incidence of HL. Indeed, the risk of HL has increased in the post-HAART era. However, the advent of HAART has brought renewed hope, allowing standard therapeutic options to be usedmore optimally, with better treatment outcomes. Despite the renewed optimism, the overall survival of HIV-HL patients remains less favourable than that in HIV-seronegative patients. This is particularly true in sub-Saharan Africa, where there is a significant burden of HIV/AIDS and where more than half the patients are HAART naive at diagnosis of HL. The similarities and differences of a South African cohort of HIV-HL are presented in this paper. [ABSTRACT FROM AUTHOR]

Stigma is not a new concept; however, it remains highly significant in the context of HIV/AIDS in South Africa. There is wide consensus that HIV/AIDS-related stigma compromises the well-being of people living with the disease. This paper is part of a larger study that seeks to understand the social and cultural complexity related to the provision and outcomes of antiretroviral therapy (ART) in South Africa. It explores and analyses how patients on ART perceived and experienced stigma and how it has shaped their behaviour towards, as well as their understanding of the epidemic. The data have been collected by means of in-depth face-to-face interviews, conducted between June and November 2007, with a sample of 44 patients in an HIV/AIDS clinic in a resource-limited setting in Johannesburg, South Africa. The findings reveal that the level of felt and anticipated stigma is intense and affects all dimensions of living with HIV/AIDS, particularly disclosure and treatment. Stigma permeates the experience of HIV-positive people on ART who participated in this study. The intensity of HIV/AIDS-related stigma can threaten to compromise the value of ART, thus impacting on the daily lives of people living with HIV/AIDS (PLWHA). This study suggests that three decades into the epidemic, stigmatisation remains a core feature of the patient experience of HIV/AIDS. In the clinic in which this research was conducted, HIV/AIDS was regarded as a chronic condition increasingly manageable by ongoing access to ART. However, this approach was not shared by many family members, neighbours and employers who held highly stigmatised views. [ABSTRACT FROM AUTHOR]

Flow cytometry (FCM) is widely used in health research and in treatment for a variety of tasks, such as in the diagnosis and monitoring of leukemia and lymphoma patients, providing the counts of helper-T lymphocytes needed to monitor the course and treatment of HIV infection, the evaluation of peripheral blood hematopoietic stem cell grafts, and many other diseases. In practice, FCM data analysis is performed manually, a process that requires an inordinate amount of time and is error-prone, nonreproducible, nonstandardized, and not open for re-evaluation, making it the most limiting aspect of this technology. This paper reviews state-of-the-art FCM data analysis approaches using a framework introduced to report each of the components in a data analysis pipeline. Current challenges and possible future directions in developing fully automated FCM data analysis tools are also outlined. [ABSTRACT FROM AUTHOR]

In this paper we map the location and distribution of HIV service providers across Toronto neighbourhoods. Our analysis identified an uneven distribution of services across Toronto and a number of communities that are less accessible to HIV-related services. We subsequently identified three neighbourhood-level characteristics of the populations living within these communities (i.e. concentrated economic disadvantage, concentrated immigration, and residential instability). Our findings suggest a significant overlap in the location of HIV service providers and the clustering of neighbourhood-level demographic and socioeconomic factors. Some inaccessible neighbourhoods overlap with clusters of neighbourhoods with higher levels of concentrated disadvantage, immigration and percentage of black Canadians. Accessible neighbourhoods are located within the downtown core of Toronto and overlap with clusters of highly dense, younger neighbourhoods (with a high proportion of 15- to 34-year-olds who are unmarried). Our findings point to the need for policy-makers to integrate spatial analytic techniques into their examination of the types of neighbourhoods, and subsequently the community members that live within those neighbourhoods, that are potentially underserved with respect to health and social services. [ABSTRACT FROM AUTHOR]

In this study, Caputo fractional derivative model of HIV and COVID-19 infections is analyzed. Moreover, the well-posedness of a model is verified to depict that the developed model is mathematically meaningful and biologically acceptable. Particularly, Mittag Leffler function is incorporated to show that total population size is bounded whereas fixed point theory is applied to show the existence and uniqueness of solution of the constructed Caputo fractional derivative model of HIV and COVID-19 infections. The study depicts that as the order of fractional derivative increase the size of the infected variable decrease as time increase. Additionally, memory effects correspond to order of derivative in the reduction of a number of populations infected both with HIV and COVID-19 infections. Numerical simulations are performed using MATLAB platform. [ABSTRACT FROM AUTHOR]

HIV is one of the major causes of deaths, especially in Sub-Saharan Africa. In this paper, an in vivo deterministic model of differential equations is presented and analyzed for HIV dynamics. Optimal control theory is applied to investigate the key roles played by the various HIV treatment strategies. In particular, we establish the optimal strategies for controlling the infection using three treatment regimes as the system control variables. We have applied Pontryagin’s Maximum Principle in characterizing the optimality control, which then has been solved numerically by applying the Runge-Kutta forth-order scheme. The numerical results indicate that an optimal controlled treatment strategy would ensure significant reduction in viral load and also in HIV transmission. It is also evident from the results that protease inhibitor plays a key role in virus suppression; this is not to underscore the benefits accrued when all the three drug regimes are used in combination. [ABSTRACT FROM AUTHOR]

We propose a fractional order model in this paper to describe the dynamics of human immunodeficiency virus (HIV) infection. In the model, the infection transmission process is modeled by a specific functional response. First, we show that the model is mathematically and biologically well posed. Second, the local and global stabilities of the equilibria are investigated. Finally, some numerical simulations are presented in order to illustrate our theoretical results. [ABSTRACT FROM AUTHOR]

Persistent low-level viremia (PLLV) of 200-999 copies/ml has been reported as a risk factor for HIV virologic failure (VF). This retrospective study was aimed at characterizing patients with PLLV, determining factors associated with VF, and determining the effect of regimen change. Data were extracted from electronic medical records for HIV care and treatment. Patients' characteristics (N = 705) were as follows: a mean age of 42 years, majority female (55%), and 51% married. A majority (78.7%) had a history of opportunistic infections in their ART lifetime. To determine factors associated with VF, 187 records on patients who maintained PLLV and 12 on deceased patients at the time of data review were eliminated from the analysis, leaving 506 patient records. Out of the 506, 89% (451/506) suppressed VL to nondetectable levels while 11% (55/506) had VF, and the difference was significant (P = 0.0001). Virologic failure was significantly associated with ages 10-30 years (P < 0.05). Baseline VL ≥ 1000 (OR 3.929; P = 0.002) and 200-999 copies/ml (OR 4.062; P = 0.004) were associated with VF. During PLLV, factors associated with VF included the following: PLLV of 200-999 copies/ml (P < 0.05), viral blips (OR 4.545; P = 0.0001), mean maximum VL (P < 0.05), and age (P = 0.043). Married marital status was inversely associated with VF (OR 0.318; P = 0.026). Regimen change was not significantly associated with virologic outcomes. However, patients who switched regimens to the second line had a high risk of VF (P = 0.028 ; OR 3.203). Regimen change was significantly high (P < 0.05) among adolescents and patients with a start regimen of 2NRTI+1NNRTI. Most of the PLLV patients (89%) achieved nondetectable VL after their continued ART monitoring for at least 12 months. Therefore, PLLV was not an indicator of VF. However, a consistent VL of ≥200-999 copies/ml at baseline and more than 12 months of ART care and treatment were significantly associated with VF. Patients with VL 200-999 copies/ml, adolescents, and young adults require intensive ART monitoring and support. [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]

This study investigated drug-resistant tuberculosis (DR-TB) in the Yi ethnic group. The study was designed to identify risk factors for DR-TB and its relationship with HIV/AIDS. To establish the resistance to antituberculosis drugs, whole-genome sequencing (WGS) was performed using culture-positive Mycobacterium tuberculosis samples collected from people of the Yi ethnic group from March 2019 to March 2021. Baseline characteristics were obtained from China's tuberculosis surveillance system. A total of 116 M. tuberculosis strains were included in the final analysis. Lineage 2.2 (75.86%) was the dominant sublineage, followed by lineage 4.5 (18.97%) and lineage 4.4 (5.17%). The rates of rifampicin-resistant (RR-TB), multidrug-resistant (MDR-TB), and preextensively drug-resistant TB (pre-XDR-TB) were 18.97%, 10.34%, and 6.03%, respectively. Drug-resistant strains were not found in the elderly (age ≥ 65 years). The proportions of RR/MDR-TB and pre-XDR-TB cases among re-treatment patients were higher than those among new patients ( χ 2 = 12.155 , P = 0.003 ; χ 2 = 22.495 , P = 0.001 , respectively). The pre-XDR-TB case proportions were higher among female patients than among males and higher among referred patients ( χ 2 = 5.456 , P = 0.032 ; χ 2 = 15.134 , P = 0.002 , respectively). The rates of RR/MDR-TB and pre-XDR-TB did not differ appreciably among groups with different HIV infection statuses nor lineage populations. DR-TB poses a serious challenge to the Yi ethnic group. Re-treatment patients, women, and referred patients were at high risk of MDR/RR-TB or pre-XDR-TB while HIV and lineage 2 had negligible association with drug resistance. Whole-genome sequencing should be used to guide the design of treatment regimens and to tailor public interventions. [ABSTRACT FROM AUTHOR]

People experiencing homelessness (PEH) have high rates of acute and chronic health conditions, complex support needs and often face multiple barriers to accessing health services. Financial incentive (FI) interventions have been found effective in improving service engagement and health outcomes for a range of health conditions, populations and settings, but little is known about their impact on PEH. We conducted a scoping review to explore the impact of FI interventions on treatment retention, adherence and other health outcomes of PEH. We searched seven electronic databases from inception to September 2021 to identify peer‐reviewed published English language studies that used FI interventions with adult PEH. A scoping review methodology was used to chart relevant data uniformly. Descriptive statistics and narrative syntheses were used to describe outcomes. Thirty‐three quantitative articles related to 29 primary studies were published between 1990 and 2021 and met inclusion criteria. Studies targeted three areas of health behaviour change: decreasing substance use or increasing abstinence rates, preventing or treating infectious diseases or promoting lifestyle/general health goal attainment. A variety of FIs were used (cash/non‐cash, escalating/fixed schedule, larger/smaller amounts, some/all behaviours rewarded, certain/uncertain reward) across studies. Twenty‐six of the primary studies reported significantly better outcomes for the participants receiving FI compared to controls. There were mixed findings about the efficacy of cash versus non‐cash FIs, non‐cash FIs versus other interventions and higher versus lower value of incentives. Furthermore, there was limited research about long‐term outcomes and impacts. FIs have promise in increasing abstinence from substances, engagement in infectious disease treatment, retention in health services and general lifestyle modifications for PEH. Future research should examine long‐term impacts and the contribution of co‐interventions and intermediary lifestyle behaviour changes. [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]

Advancements in antiretroviral therapy have drastically increased the life expectancy for those infected with HIV. Today, a new subgroup of older patients with long-term controlled HIV exists, and its populace is continuously mounting. Therefore, it is essential to understand the enduring effects of chronic suppressed HIV infection in order to further improve HIV management in these patients. This paper will examine the role of HIV in chronic inflammation and immune dysfunction, the dynamic interaction that exists between comorbidity and HIV, and the potential consequences of long-term antiretroviral therapy in an effort to provide the best management options for the virally suppressed HIV patient. [ABSTRACT FROM AUTHOR]

An optimal control on the treatment of the transmission of tuberculosis-HIV coinfection model is proposed in this paper. We use two treatments, that is, anti-TB and antiretroviral, to control the spread of TB and HIV infections, respectively. We first present an uncontrolled TB-HIV coinfection model. The model exhibits four equilibria, namely, the disease-free, the HIV-free, the TB-free, and the coinfection equilibria. We further obtain two basic reproduction ratios corresponding to TB and HIV infections. These ratios determine the existence and stability of the equilibria of the model. The optimal control theory is then derived analytically by applying the Pontryagin Maximum Principle. The optimality system is performed numerically to illustrate the effectiveness of the treatments. [ABSTRACT FROM AUTHOR]

Monitoring antiretroviral therapy using measurements of viral load (VL) and the genotyping of resistance mutations is not routinely performed in low- to middle-income countries because of the high costs of the commercial assays that are used. The analysis of dried plasma spot (DPS) samples on filter paper may represent an alternative for resource-limited settings. Therefore, we evaluated the usefulness of analyzing DPS samples to determine VL and identify drug resistance mutations (DRM) in a group of HIV-1 patients. The VL was measured from 22 paired plasma and DPS samples. In these samples, the average VL was 4.7 log10 copies/mL in liquid plasma and 4.1 log10 copies/mL in DPS, with a correlation coefficient of R = 0.83. A 1.1 kb fragment of HIV pol could be amplified in 14/22 (63.6%) of the DPS samples and the same value was amplified in plasma samples. A collection of ten paired DPS and liquid plasma samples was evaluated for the presence of DRM; an excellent correlation was found in the identification of DRM between the paired samples. All HIV-1 pol sequences that were obtained corresponded to HIV subtype B. The analysis of DPS samples offers an attractive alternative for monitoring ARV therapy in resource-limited settings. [ABSTRACT FROM AUTHOR]

Sub‐Saharan Africa carries the highest burden of HIV, with approximately 70% of all people living with HIV (PLWH) globally living in this region. The provision of antiretroviral treatment (ART) significantly affects already overburdened health systems, which need to accommodate large volumes of ART patients while facing a shortage of professional health workers, infrastructure challenges and medical resources. Finding alternative ways to provide routine services to PLWH has become significantly more urgent. Multi‐month dispensing (MMD) of ART aims to improve access to treatment for PLWH, while also improving the efficiency of the health system. This study explores the experienced benefits and challenges of community‐based MMD in order to make recommendations for future implementation efforts. Twenty focus group discussions were conducted with members of community ART refill groups (CARGs) who received 3‐monthly or 6‐monthy MMD. Individual interviews were also conducted with health providers. All interviews and focus group discussions took place between April and June 2019 conducted by research nurses in English, Shona or Ndebele. Multiple benefits of community‐based MMD were reported, including decreased congestion in health facilities, improved service delivery, decline in staff burnout and increased time availability for CARG members due to less time spent at clinics, improved ART adherence and social support experienced amongst members of CARGs. Identified challenges included the possibility of being exposed to HIV‐related stigma when belonging to a CARG, and low levels of medical supplies and ART stock at clinics. Recommendations were made by CARG members and health care workers on how CARGs could be improved and sustained in the future. Results from this study show that the implementation of community‐based MMD holds multiple benefits at an individual and health facility level. Future recommendations include evaluating the feasibility of MMD among other vulnerable populations. [ABSTRACT FROM AUTHOR]