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The role of certain viruses in the etiology of some tumors is today indisputable, but there is a lack, however, of annoverview of the relationship between viruses and cancer with amultidisciplinary approach. For this reason, the Health Sciences Foundation has convened a group of professionals from different areas of knowledge to discuss the relationship between viruses and cancer, and the present document is the result of these deliberations. Although viruses cause only 10-15% of cancers, advances in oncology research are largely due to the work done during the last century on tumor viruses. The clearest cancer-inducing viruses are: HPV, HBV, HCV, EBV and, depending on the geographical area, HHV-8, HTLV-1 and HIV. HPVs, for example, are considered to be the causative agents of cervical carcinomas and, more recently, of a proportion of other cancers. Among the Herpes viruses, the association with the development of neoplasms is well established for EBV and HHV-8. Viruses can also be therapeutic agents in certain neoplasms and, thus, some oncolytic viruses with selective tropism for tumor cells have been approved for clinical use in humans. It is estimated that the prophylaxis or treatment of viral infections could prevent at least 1.5 million cancer deaths per year.

In many ways, the coronavirus disease 2019 (COVID-19) pandemic mirrors the challenges, lessons and opportunities of the HIV pandemic. In this article, we argue that global pandemics such as COVID-19 and HIV require a global response. We highlight the HIV Online Provider Education (HOPE) programme as an example of the importance of global communication when combating a pandemic. From both the COVID-19 and HIV pandemics, we have learned that to optimise health worldwide, it is necessary to have effective and efficient means of swiftly sharing experiences, expertise, best practices and guidelines. To prepare for the next public health emergency, clinicians and researchers must put in place and promote effective programmes for global communication.

Antiretroviral treatment has undergone major changes in the last 20 years, from monotherapy, to dual therapy and finally to triple therapy. Lately, more focus has been placed on better, more well-tolerated combinations and formulations. As in most other disciplines in medicine, the development of paediatric HIV dosages and formulations always tends to lag behind adult research. Twenty years ago, it could take several years before data were available to enable the use of life-saving antiretrovirals in children. Paediatricians, being ever resourceful, were not prepared to let their paediatric patients suffer despite the lack of data or formulations and so made a plan. This article describes some of the trials and tribulations that we went through trying to make sure that our paediatric HIV patients not only survived but thrived. Clinicians treating paediatric patients today have it so much easier because of what our colleagues and their patients went through in those early days.

This dataset contains: 1) Binary sequence generated from Wright-Fisher processes, which of source code can be found in the GitHub repository, bartonlab/paper-Bezier-interpolation. 2). HIV nucleotide sequence. The GitHub repository contains source files and data for reproducing the results shown in “B\'ezier interpolation improves the inference of dynamical models from data.” Please see the GitHub repository for more details on the analysis of these data sets. &nbsp

The widespread availability of antiretroviral therapy (ART) for HIV infection in Sub-Saharan Africa (SSA) has resulted in decreased morbidity, mortality, and transmission of HIV. This region, however, still represents the majority of the global burden of HIV. Furthermore, levels of retention in care and medication adherence, critical determinants of ART effectiveness, are currently suboptimal, and, thus, continue to be the target of many interventions. This dissertation is comprised of three chapters related to understanding ART adherence and interventions to improve it.Chapter 1 quantitatively describes and examines the distribution of poor adherence to antiretroviral therapy in a study of HIV-positive patients in Zambia. In a novel application of the Lorenz curve, a tool used commonly in economics, this analysis characterized the concentration of medication non-possession in a network of clinics in order to identify “hotspots” and predictors of poor adherence. Results extend previous studies by revealing that even though average adherence is high, lapses in adherence are common and concentrated among a minority of patients, and also in certain clinics. This concentration and variability varies with time on ART. Furthermore, a small fraction of patients accounts for the majority of days of medication non-possession, with the size of this group increasing with time on ART. This suggests that targeted interventions may represent a preferable overall strategy as compared to those targeting all patients to improve adherence. Furthermore, there was high variability across clinics suggesting that interventions targeting clinic “hotspots” may also represent an efficient use of resources to improve ART adherence. Chapter 2 presents the results of the first qualitative study to examine conditional incentives for ART adherence and their potential pathways of action among people living with HIV. This study was conducted within a study of conditional food and cash transfers to increase retention in care and adherence to ART among HIV-positive food insecure recent adults in Shinyanga, Tanzania. Although financial and in-kind incentives have been shown to improve outcomes along the HIV care cascade, results are mixed, and there is little evidence about the pathways through which incentives work. Results of this qualitative study and analysis revealed that incentives acted through three primary pathways to potentially increase retention in care and adherence to ART: 1) addressing competing needs and offsetting opportunity costs associated with clinic attendance, 2) increasing motivation and 3) alleviating stress associated with attending clinic, worry about providing for oneself and one’s family, and providing hope for a better future. The first pathway was the strongest, which was consistent with field observations and discussions with local clinic staff, research staff, and Ministry of Health officials. Participants did not report any harmful events associated with the incentives, and reported a variety of beneficial spillover effects on household welfare. Understanding these pathways can help improve design and targeting of future food or cash incentive interventions. Chapter 3 focused on intrinsic motivation within the aforementioned study of food and cash transfers for ART adherence in Tanzania. Some critical of incentives argue that incentives can ‘crowd out’ intrinsic motivation, making the individual less likely to engage in the desired behavior after the incentive is removed, potentially leading to limited durability of effect and causing harm in the long term. This hypothesis was examined among recent antiretroviral treatment initiates in Tanzania by comparing participants’ level of intrinsic motivation before receiving transfers to the level once the transfer period ended. The analysis revealed that, not only did intrinsic motivation not decrease after the transfer period ended, but that the level of intrinsic motivation increased overall and within study arms. Furthermore, the change in motivation did not differ by study arms. As the first study to empirically examine the crowding out hypothesis regarding incentives in a real-world, resource-limited setting, these results suggest that incentive interventions in such settings should not be impeded by concerns of crowding out intrinsic motivation.Together these chapters contribute to improving our understanding of antiretroviral adherence and intervention response. The Lorenz curve and medication possession analysis provides a more comprehensive and detailed measurement and illustration of adherence and its variability across individuals and clinics in Zambia. Such information is critical to targeting and designing future interventions. Next, by examining an ongoing intervention to improve adherence in Tanzania, we were able to elucidate and examine the potential pathways of action of food and cash transfers. Furthermore, we found no evidence that these incentives decreased intrinsic motivation. Knowledge gleaned from this deep exploration of the incentives’ mechanism of action in a real-world setting not only informs refinement of the intervention, but also helps to fill the gap in understanding how and when these interventions may work.

The goal of the Ending the HIV Epidemic Initiative is to reduce new infections in the United States by 90% by 2030. Success will require fundamentally changing human immunodeficiency virus (HIV) prevention and care delivery to engage more persons with HIV and at risk of HIV in treatment. While the coronavirus disease 2019 (COVID-19) pandemic reduced in-person visits to care facilities and led to concern about interruptions in care, it also accelerated growth of alternative options, bolstered by additional funding support. These included the use of telehealth, medication delivery to the home, and increased flexibility facilitating access to Ryan White HIV/AIDS Program services. While the outcomes of these programs must be studied, many have improved accessibility during the pandemic. As the pandemic wanes, long-term policy changes are needed to preserve these options for those who benefit from them. These new care paradigms may provide a roadmap for progress for those with other chronic health issues as well.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has revolutionized the practice of ambulatory medicine, triggering rapid dissemination of digital healthcare modalities, including synchronous video visits. However, social determinants of health, such as age, race, income, and others, predict readiness for telemedicine and individuals who are not able to connect virtually may become lost to care. This is particularly relevant to the practice of infectious diseases (ID) and human immunodeficiency virus (HIV) medicine, as we care for high proportions of individuals whose health outcomes are affected by such factors. Furthermore, delivering high-quality clinical care in ID and HIV practice necessitates discussion of sensitive topics, which is challenging over video without proper preparation. We describe the “digital divide,” emphasize the relevance to ID and HIV practice, underscore the need to study the issue and develop interventions to mitigate its impact, and provide suggestions for optimizing telemedicine in ID and HIV clinics.

Background: Electronic patient-reported outcomes (PRO) provide quick and usually reliable assessments of patients’ health-related quality of life (HRQL). Objective: An electronic version of the Patient-Reported Outcomes Quality of Life-human immunodeficiency virus (PROQOL-HIV) questionnaire was developed, and its face validity and reliability were assessed using standard psychometric methods. Methods: A sample of 80 French outpatients (66% male, 52/79; mean age 46.7 years, SD 10.9) were recruited. Paper-based and electronic questionnaires were completed in a randomized crossover design (2-7 day interval). Biomedical data were collected. Questionnaire version and order effects were tested on full-scale scores in a 2-way ANOVA with patients as random effects. Test-retest reliability was evaluated using Pearson and intraclass correlation coefficients (ICC, with 95% confidence interval) for each dimension. Usability testing was carried out from patients’ survey reports, specifically, general satisfaction, ease of completion, quality and clarity of user interface, and motivation to participate in follow-up PROQOL-HIV electronic assessments. Results: Questionnaire version and administration order effects (N=59 complete cases) were not significant at the 5% level, and no interaction was found between these 2 factors ( P =.94). Reliability indexes were acceptable, with Pearson correlations greater than .7 and ICCs ranging from .708 to .939; scores were not statistically different between the two versions. A total of 63 (79%) complete patients’ survey reports were available, and 55% of patients (30/55) reported being satisfied and interested in electronic assessment of their HRQL in clinical follow-up. Individual ratings of PROQOL-HIV user interface (85%-100% of positive responses) confirmed user interface clarity and usability. Conclusions: The electronic PROQOL-HIV introduces minor modifications to the original paper-based version, following International Society for Pharmacoeconomics and Outcomes Research (ISPOR) ePRO Task Force guidelines, and shows good reliability and face validity. Patients can complete the computerized PROQOL-HIV questionnaire and the scores from the paper or electronic versions share comparable accuracy and interpretation. [J Med Internet Res 2014;16(4):e115]

Although gender mainstreaming has been long recognized as a strategy for addressing gender inequalities and associated negative health outcomes; its implementation has remained a challenge, even in the area of prevention of mother to child transmission of HIV (PMTCT). Despite recognition of gender in Tanzania’s political arena and prioritization of PMTCT by the health sector, there is very little information on how well gender has been mainstreamed into National PMTCT guidelines and organizational practices at service delivery level. Using a case study methodology, we combined document review with key informant interviews to assess gender mainstreaming in PMTCT on paper and in practice in Tanzania. We reviewed PMTCT policy/strategy documents using the WHO’s Gender Responsive Assessment Scale (GRAS). The scale differentiates between level 1 (gender unequal), 2 (gender blind), 3 (gender sensitive), 4 (gender specific), and 5 (gender transformative). Key informant interviews were also conducted with 26 leaders purposively sampled from three government health facilities in Mwanza city to understand their practices. The gender responsiveness of PMTCT policy/strategy documents varies, with some being at GRAS level 3 (gender sensitive) and others at GRAS level 4 (gender specific). Those which are gender sensitive indicate gender awareness, but no remedial action is developed; while those which are gender specific go beyond indicating how gender may hinder PMTCT to highlighting remedial measures, such as the promotion of couple counselling and testing for HIV. In addition, interviews on organizational processes and practices suggested that there has been little attention to the holistic integration of gender in the delivery of PMTCT services. The study has revealed limited integration of gender concerns in PMTCT policy documents. Similarly, health facility leader responses indicate perspectives and practices that pay little attention to the holistic integration of gender in the delivery PMTCT services.

Persons living with human immunodeficiency virus (HIV) and others receiving antiretrovirals are at risk for medication errors during hospitalization and at transitions of care. These errors may result in adverse effects or viral resistance, limiting future treatment options. A range of interventions is described in the literature to decrease the occurrence or duration of medication errors, including review of electronic health records, clinical checklists at care transitions, and daily review of medication lists. To reduce the risk of medication-related errors, antiretroviral stewardship programs (ARVSPs) are needed to enhance patient safety. This call to action, endorsed by the Infectious Diseases Society of America, the HIV Medicine Association, and the American Academy of HIV Medicine, is modeled upon the success of antimicrobial stewardship programs now mandated by the Joint Commission. Herein, we propose definitions of ARVSPs, suggest resources for ARVSP leadership, and provide a summary of published, successful strategies for ARVSP that healthcare facilities may use to develop locally appropriate programs., Persons receiving antiretrovirals are at risk for medication-related errors in the inpatient setting. This joint policy paper endorses antiretroviral stewardship and antiretroviral stewardship programs, designed to improve patient safety

We propose to use Twitter data as social-spatial sensors. This study deals with the question whether research papers on certain diseases are perceived by people in regions (worldwide) that are especially concerned by these diseases. Since (some) Twitter data contain location information, it is possible to spatially map the activity of Twitter users referring to certain papers (e.g., dealing with tuberculosis). The resulting maps reveal whether heavy activity on Twitter is correlated with large numbers of people having certain diseases. In this study, we focus on tuberculosis, human immunodeficiency virus (HIV), and malaria, since the World Health Organization ranks these diseases as the top three causes of death worldwide by a single infectious agent. The results of the social-spatial Twitter maps (and additionally performed regression models) reveal the usefulness of the proposed sensor approach. One receives an impression of how research papers on the diseases have been perceived by people in regions that are especially concerned by these diseases. Our study demonstrates a promising approach for using Twitter data for research evaluation purposes beyond simple counting of tweets.

Research with nonhuman primates (NHPs) – monkeys for the most part – has led to critical health advances that have saved or improved millions of human lives. While NHPs account for just one-half of one percent of animals in current medical research, it is no exaggeration to say they are essential to our ability to find cures for cancer, AIDS, Alzheimer’s, Parkinson’s, obesity/diabetes, and dozens of other diseases that cause human suffering and death.

Non-Hodgkin Lymphoma (NHL) is a neoplasm associated with a group of malignancies called AIDs-Defining Malignancies (ADMs) in Human-Immunodeficiency Virus (HIV) -patients. Similar to the case of NHL in Latin America, particularly in Peru, the amount of research done on others ADMs is limited, especially in the case of Kaposi’s Sarcoma (KS). Prior investigations have talked about the great potential risk that represents this illness in latin american population, but topics as prognosis factors are yet to be well defined. In this letter, we address the importance of investigation in this area and include previously reported data that may enlighten the current national standpoint.

South Africa has the biggest HIV epidemic in the world and the HIV rates among youth are especially alarming. In 2016 there were 110 000 new cases of HIV among 15 to 24-year-olds. The aim of this study is to describe and analyse perceptions of HIV and HIV prevention among Xhosa youth in the township of Langa, Cape Town. In order to study this, I focus on the organisation loveLife and their employed peer educators called groundBREAKERs (gBs). To gain knowledge on what fuels the HIV epidemic in this setting I will examine their thoughts and notions of HIV/AIDS, sexuality and sexual behaviour in relation to the information that is available to them. Examining the socio-cultural context of HIV/AIDS is important to understand the spread and why HIV is not declining sufficiently in response to HIV preventative efforts. This thesis is based on ten weeks of fieldwork at loveLife’s Y-Centre in Langa. The material was gathered through semi-structured interviews and participant observation. To analyse the drivers for the spread of HIV among Xhosa youth an analytical tool of gender roles, with a main focus on masculinity, has been utilized.

Tropical infectious diseases diagnosis and surveillance are often hampered by difficulties of sample collection and transportation. Filter paper potentially provides a useful medium to help overcome such problems. We reviewed the literature on the use of filter paper, focusing on the evaluation of nucleic acid and serological assays for diagnosis of infectious diseases using dried blood spots (DBS) compared with recognized gold standards. We reviewed 296 eligible studies and included 101 studies evaluating DBS and 192 studies on other aspects of filter paper use. We also discuss the use of filter paper with other body fluids and for tropical veterinary medicine. In general, DBS perform with sensitivities and specificities similar or only slightly inferior to gold standard sample types. However, important problems were revealed with the uncritical use of DBS, inappropriate statistical analysis, and lack of standardized methodology. DBS have great potential to empower healthcare workers by making laboratory-based diagnostic tests more readily accessible, but additional and more rigorous research is needed.

A method for detection of proviral human immunodeficiency virus DNA in dried blood spots on filter paper by direct polymerase chain reaction (PCR) has been developed. To develop the method, a standard system was used which was prepared from cells each containing a single integrated provirus and titrated with normal donor blood. This rapid procedure provides virtually quantitative yields of nuclear DNA and exploits most of the standard methodology described for blood specimens. A nested PCR using SK38-SK39 gag as the internal primer pair was also designed; this PCR detected a single copy of provirus per filter at near theoretical frequency with SK19 probe. The utility of the procedure was demonstrated with clinical specimens. Blood spot filters from human immunodeficiency virus-infected and uninfected individuals were readily and unequivocally discriminated. The method is designed for ultimate use with large (1.5-ml) sample preparation tubes that are compatible as PCR tubes with thermal cyclers. This will permit convenient, direct single-tube PCR of dried blood specimens on filters. It should be adaptable to analysis of dried blood spots for a variety of infectious or genetic diseases.

Despite the importance of early diagnosis and treatment of HIV, only a small fraction of HIV-exposed infants in low- and middle-income countries are tested for the disease. The gold standard for early infant diagnosis, DNA PCR, requires resources that are unavailable in poor settings, and no point-of-care HIV DNA test is currently available. We have developed a device constructed of layers of paper, glass fiber, and plastic that is capable of performing isothermal, enzymatic amplification of HIV DNA. The device is inexpensive, small, light-weight, and easy to assemble. The device stores lyophilized enzymes, facilitates mixing of reaction components, and supports recombinase polymerase amplification in five steps of operation. Using commercially available lateral flow strips as a detection method, we demonstrate the ability of our device to amplify 10 copies of HIV DNA to detectable levels in 15 minutes. Our results suggest that our device, which is designed to be used after DNA extraction from dried-blood spots, may serve in conjunction with lateral flow strips as part of a point-of-care HIV DNA test to be used in low resource settings.

O presente artigo questiona o papel da mídia diante da epidemia do HIV/Aids. Toda a discussão é travada à luz da bioética, tentando sempre apreender os dilemas morais subjacentes nas mensagens de prevenção do HIV/Aids. Pautar se a mídia considerou os rumos da epidemia na medida em que essa ia se modificando; refletir se as campanhas educativas do HIV/Aids ponderavam as assimetrias de gênero, a sexualidade e os processos de socialização.The present article tries to question the mission of the media before the epidemic of HIV/AIDS. The whole discussion is supposed, in the light of the bioethics, to try to apprehend the tenor of the messages transmitted in the context of the disease. To discuss if the media had considered the different ways of the epidemic while they were being modified; to think if the HIV/AIDS educative campaigns had considered the gender differences, the sexuality and the socialization process.

Despite increased access to highly active antiretroviral therapy (HAART) in South Africa, there remains a high risk of people living with HIV (PLHIV) developing a wide range of disabilities. Physiotherapists are trained to rehabilitate individuals with the disabilities related to HIV. Not only can South African physiotherapists play a significant role in improving the lives of PLHIV, but by responding proactively to the HIV epidemic they can reinforce the relevance and value of the profession in this country at a time when many newly qualified therapists are unable to secure employment. This paper offers recommendations that may help to fuel this response. These ideas include enhancing HIV curricula at a tertiary level, designing and attending continuing education courses on HIV and researching Southern African rehabilitation interventions for HIV at all levels of practice. Furthermore, it is vital that physiotherapists are at the forefront of directing multi-disciplinary responses to the rehabilitation of PLHIV in order to influence stakeholders who are responsible for health policy formulation. It is hoped that this paper stimulates discussion and further ideas amongst physiotherapists and other health professionals in order to improve the quality and access to care available to PLHIV in South Africa.

Introduction: The aims of the current study are to report on preliminary epidemiological data of pregnant women with human immunodeficiency virus (HIV).Material and methods: HIV tests of 4653 pregnant women from Săo José do Rio Preto, Brazil between May 1995 and May 1997 were assessed, and the following epidemiological aspects were noted: age ethnic background, number of gestations, marital status, type of delivery, and the patients’ knowledge about the disease including: forms of transmission, diseases associated with positive cases, and the difficulties in and evolution of the approach to the disease in Brazil. Statistical analysis used percentages with means and standard deviation.Results: HIV tests were positive in 48 (1.03%) of the pregnant women. The mean age was 24.3±0.6 years. 35 (72.9%) of the individuals were married and 13 (27.1%) had been pregnant one to four times previously. 52.0% knew they were HIV positive and in 23 (48.0%), diagnoses was made during the consultations for this pregnancy. In 25 (52.0%) the form of transmission was unknown; events and gravid diseases occurred in 4 (31.2%) cases. In 38 (79.2%) cases delivery occurred before the 36th week of gestation, with delivery being vaginal in 38 (79.2%) cases, and there were puerperal complications in 8 (16.7%).Conclusions: The routine examination to test for HIV during pregnancy allows the identification of women who are unaware of infection by the virus and performance of medicinal prevention for these pregnant.

In the 1980s, most Western countries decided to opt for a new public health approach based on learning strategies to fight HIV/AIDS. Within the new public health paradigm, every sexually active person protects him-/herself, whereas it is the infected people that bear the burden of prevention according to old public health. The paper begins with a clear statement for the new public health approach that includes self-protection and the protection of civil rights. It argues that this approach is still valid under the changing circumstances due to combination therapies and the developments related to them, such as the introduction of routine HIV screening in some countries. On this background, the paper examines from an ethical perspective to what extent people with HIV have a responsibility in HIV prevention. The paper argues that a person with HIV has a responsibility to protect his/her partner in the case of a relationship of love. On the other hand, in the case of "purely" sexual encounters, each person is responsible for his/her own security and should not rely on the other. This position also helps to clarify prevention messages. In conclusion, the paper shows how morality evolves into ethical positions and then translates into the law. It finally claims for stronger obligations for sex businesses to support HIV prevention.

Blood spot residues on filter paper circles from which antibodies have been eluted remain suitable for follow-up polymerase chain reaction to detect human immunodeficiency virus (HIV) provirus. A method has been developed for specimen processing and nested polymerase chain reaction amplification with a single tube. HIV-positive specimens can be detected by simple, direct electrophoresis of amplified material to a single copy of provirus. The procedure is particularly suited for survey purposes to estimate rates of vertical transmission of virus among HIV antibody-positive newborns, in whom virus loads may be low.

O presente artigo questiona o papel da mídia diante da epidemia do HIV/Aids. Toda a discussão é travada à luz da bioética, tentando sempre apreender os dilemas morais subjacentes nas mensagens de prevenção do HIV/Aids. Pautar se a mídia considerou os rumos da epidemia na medida em que essa ia se modificando; refletir se as campanhas educativas do HIV/Aids ponderavam as assimetrias de gênero, a sexualidade e os processos de socialização. The present article tries to question the mission of the media before the epidemic of HIV/AIDS. The whole discussion is supposed, in the light of the bioethics, to try to apprehend the tenor of the messages transmitted in the context of the disease. To discuss if the media had considered the different ways of the epidemic while they were being modified; to think if the HIV/AIDS educative campaigns had considered the gender differences, the sexuality and the socialization process.