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Acquired immune deficiency syndrome is a deadly disease which is caused by human immunodeficiency virus (HIV). This virus attacks patients immune system and effects its ability to fight against diseases. Developing effective medicine requires understanding the life cycle and replication ability of the virus. HIV-1 protease enzyme is used to cleave an octamer peptide into peptides which are used to create proteins by the virus. In this paper, a novel feature extraction method is proposed for understanding important patterns in octamer's cleavability. This feature extraction method is based on data mining techniques which are used to find important relations inside a dataset by comprehensively analyzing the given data. As demonstrated in this paper, using the extracted information in the classification process yields important results which may be taken into consideration when developing a new medicine. We have used 746 and 1625, Impens and schilling data instances from the 746-dataset. Besides, we have performed social network analysis as a complementary alternative method. [ABSTRACT FROM AUTHOR]

Currently, more than one million children suffer from hand, foot and mouth disease (HFMD) every year in China. And there are no effective vaccines or antiviral drugs specifically targeted HFMD. In this paper, a two stage-structured model is constructed to fit the HFMD data from 2009 to 2014 in China and obtain its optimal parameter values by the Chi-square test of statistical inference. Using the parameter values obtained can precisely and reliably forecast the clinical cases. The basic reproduction numbers for each year are more than unit, which suggests that HFMD will persist in China under the current conditions. Sensitivity analysis of the basic reproduction number is conducted to evaluate the effectiveness of HFMD control measures. Using Pontryagins maximum principle, we derive the necessary conditions for optimal control of HFMD. Further, the impact of combinations of the strategies on HFMD transmission is investigated. Finally, we find out the most cost-effective strategy though carrying out cost-effectiveness analysis. [ABSTRACT FROM AUTHOR]

This paper reports on Kganya Motsha Adolescent Centre, an adolescent program specifically established to provide voluntary counseling and testing as well as management of HIV-positive young people in Soweto, South Africa. A retrospective cross-sectional analysis, using clinic records of young people accessing services from 2008 to 2012, was conducted. Of the 11,522 who tested, 7689 (67%) were females. The total number of HIV infections was 410, with an HIV prevalence of 3.6% (95% CI 3.2–3.9%). More females (332, 4% vs. 72, 2%;p< 0.0001) were HIV-infected than males. Of those testing HIV positive, 109 (26.5%) had a median CD4 cell count of 491 (IQR 345–686) cells/mm3. Only 12/410 individuals (2.9%) were eligible for antiretroviral treatment and 10 (2.4%) of those successfully received treatment. The program observed that young people testing HIV positive would not return for follow up blood specimens or confirmatory results. Future programs should consider innovative ways of retaining adolescents in care to reduce potential HIV transmissions that could lead to deteriorating health. [ABSTRACT FROM AUTHOR]

Background: Hepatitis C (HCV) infection is prevalent in the prison setting, with sharing of unsterile injecting equipment the most common mode of transmission in high income countries. Mathematical modelling suggests that HCV treatment scale-up could prevent onward transmission, known as treatment as prevention. Direct-acting antivirals have enabled rapid scale up of HCV treatment, underpinning the first clinical trial of treatment as prevention in the prison setting. The Surveillance and Treatment of Prisoners with hepatitis C (SToP-C) study was carried out in four correctional centres in New South Wales, Australia. This paper utilises Sekhon's Theoretical Framework of Acceptability to examine correctional, prison health, and study personnel's assessments of acceptability of HCV treatment as prevention in the prison setting.Methods: Correctional (n=24) and health personnel (n=17) including officers, nurses (including seven study nurses), and senior administrators across the four prisons where SToP-C was delivered, participated in interviews. This included two maximum security, one minimum security, and one women's medium/minimum security prison. Data analysis was informed by a seven-component theory of acceptability.Results: Participants reported broad acceptability of HCV treatment as prevention in the prison setting across five components of acceptability (affective attitude, burden, ethicality, perceived effectiveness, and self-efficacy). Attributes contributing to acceptability included reduced HCV prevalence within the prison, and public health benefits for the community when people are released without HCV (affective attitude). Elements which may negatively impact on acceptability included limited clinic space (burden) and lack of correctional officers' understanding of availability of equivalent healthcare in the community (ethicality). System-wide prison participation was viewed as necessary for treatment as prevention to be successful (perceived effectiveness), while nonjudgmental care was seen as instrumental to HCV treatment scale up efforts (self-efficacy).Conclusion: Correctional and prison-based health personnel view HCV treatment as prevention as an acceptable health intervention. Overall, environmental issues relating to implementation (i.e., clinic space) were viewed as requiring a strategic approach to support prison-wide HCV treatment scale up. [ABSTRACT FROM AUTHOR]

Please cite this paper as: Regan et al. (2012) Epidemiology of influenza A (H1N1)pdm09-associated deaths in the United States, September-October 2009. Influenza and Other Respiratory Viruses 6(601), e169-e177. Background From April to July 2009, the United States experienced a wave of influenza A (H1N1)pdm09 virus (H1N1pdm09) infection. The majority of the deaths during that period occurred in persons <65 years of age with underlying medical conditions. Objective To describe the epidemiology of H1N1pdm09-associated deaths in the US during the fall of 2009. Methods We collected demographic, medical history, and cause of death information on a nationally representative, stratified random sample of 323 H1N1pdm09-associated deaths that occurred during September 1-October 31, 2009. Results Data were available for 302/323 (93%) deaths. Most cases (74%) were 18-64 years of age and had ≥1 underlying medical condition (72%). Among cases aged <18 years, 16/43 (37%) had a chronic lung disease, and 15/43 (35%) a neurological disorder; among cases aged ≥18 years, 94/254 (37%) had a chronic lung disease and 84/254 (33%) had a metabolic disorder. The median number of days between symptom onset and death was six among children (range, 1-48) and 12 among adults (range, 0-109). Influenza antiviral agents were prescribed for 187/268 (70%) of cases, but only 48/153 (31%) received treatment within 2 days of illness onset. Conclusions The characteristics of H1N1pdm09 deaths identified during the fall of 2009 were similar to those occurring April-July 2009. While most cases had conditions that were known to increase the risk for severe outcomes and were recommended to receive antiviral therapy, a minority of cases received antivirals early in the course of illness. [ABSTRACT FROM AUTHOR]

Please cite this paper as: Borders-Hemphill and Mosholder (2012) U.S. utilization patterns of influenza antiviral medications during the 2009 H1N1 influenza pandemic. Influenza and Other Respiratory Viruses 6(601), e129-e133. Background The 2009 H1N1 influenza pandemic in the United States occurred from April 2009 to April 2010. The 2009 H1N1 influenza virus was susceptible to neuraminidase inhibitors (oseltamivir and zanamivir). Objectives To characterize the 2009 H1N1 influenza pandemic in the United States from April 2009 to April 2010 using weekly influenza antiviral prescription utilization data and the CDC's weekly reports of the number of visits for influenza-like-illnesses by the Influenza Sentinel Provider Surveillance Network. Methods A proprietary outpatient data source used by the FDA, which captures adjudicated U.S. prescription claims for select influenza antiviral drugs, was used to conduct this analysis. Data were extracted weekly and analyzed for surveillance during the pandemic. Results were compiled at the end of the pandemic. Results Oseltamivir has dominated the U.S. influenza antiviral market share of dispensed prescriptions since approval in October 1999 and was the primary influenza antiviral drug used during the 2009 H1N1 influenza pandemic. However, commercial availability of the suspension formulation of oseltamivir was reduced by high demand during the pandemic. Dispensed prescription trends of other influenza antiviral medications studied followed that those of oseltamivir, even antivirals for which the 2009 H1N1 strains showed resistance. Conclusion Weekly prescription utilization of all influenza antivirals used to treat influenza during the seasonal influenza outbreak followed the same trend of weekly reports of the number of visits for influenza-like-illnesses (ILI) by the Influenza Sentinel Provider Surveillance Network. The ILI epidemic curve resembled dispensed antiviral prescription trends (both overall and stratified by age), providing some corroboration for the surveillance data. [ABSTRACT FROM AUTHOR]

Introduction: Monitoring and characterization of infection with pandemic (H1N1nv) 2009 is an essential part of monitoring the evolution, epidemiology and severity of a pandemic. The aim of this paper is to describe and analyze the clinical characteristics and risk factors of patients admitted to our hospital the 2010-2011 season. Methods: Detection of influenza A H1N1nv virus in 266 respiratory specimens (242 patients with suspected infection) and descriptive and comparative analysis of data collected from each patient: age, sex, service, reason for admission, risk factors and treatment with antivirals. Results: The most common reason for admission (52.47%) was the presence of clinical respiratory signs. 69.4% of patients had risk factors, with chronic respiratory disease (CRD), the most frequent (20.2%). 14.2% were pediatric patients. The infection of Influenza A H1N1nv was confirmed in 26,4% of patients. The mean age among the infected patients was 36 years versus 44.85 years in non-infected. This difference was statistically significant (p = 0.011). 75% of infected patients had risk factors. Of these, 68.7% had CRD only factor being predominant. 6% of patients with infection were vaccinated. Conclusion: The positivity rate was similar to that observed in the previous season. There was a greater involvement among young-adult population. The CRD is the most common risk factor. Vaccine coverage was low. [ABSTRACT FROM AUTHOR]

Early identification and management of treatment failure on highly active antiretroviral therapy (HAART) is crucial in maintaining a sustained response to therapy in HIV infection. However, HIV viral load (VL) and resistance testing, and second-line HAART regimens, are unaffordable to many patients in India, leaving them with limited treatment options. Predictors and reasons for antiretroviral switching, therefore, are likely to differ in settings of varying resources. A one-year, observational study of patients receiving antiretroviral therapy was conducted in a private, non-profit hospital in Bangalore. This paper examines the predictors and consequences of antiretroviral treatment switching in this setting and explores reasons for switching in a subset of patients. Data on demographics, drug regimens, adherence, and physical and psychosocial outcomes were collected quarterly. Tests of VL and CD4 cell counts were performed every six months. One-third of the patients switched therapy during the study period. Baseline predictors of switching included lower CD4 cell counts and more physical symptoms. Contrary to studies in other settings, a high VL did not predict treatment switching, and only a minority of those experiencing drug failure were switched to second-line regimens. Both groups (switchers and non-switchers) improved significantly over time with respect to CD4 counts and psychological well-being, and showed a reduction in physical and depressive symptoms. Any differences between the groups were no longer significant at the end of the study, once we controlled for baseline levels. Clinical, policy, and research implications of these findings are discussed within the context of resource-limited settings. [ABSTRACT FROM AUTHOR]

Background: Hepatitis C is a global health problem and represents a major cause of liver disease and socioeconomic burden. Effective antiviral therapy may prevent these complications, but the current treatment for patients with chronic hepatitis C virus (HCV) infection does not produce sustained virologic response. Therefore, identification of the determinants of response to treatment is a high priority. A number of host and viral factors have been associated with treatment outcomes. Objectives: To assess the associations of single nucleotide polymorphisms (SNP) of the IL28B and sustained virologic response (SVR) of patients with chronic hepatitis C to PEG-interferon/ribavirin therapy. Materials and Methods: We searched PubMed, Medline and Chochrane Library, and found 7 eligible papers involved in this study. Then we performed a meta-analysis comparing the SVR rate at SNP of the IL28B in individuals with PEG-interferon/ribavirin therapy. Meanwhile, the SVR rate between different races and HCV genotypes was studied. Results: The sustained virologic response rate was higher in patients with the rs12979860 CC and rs8099917 IT alleles in the IL28B SNP, comparing with the rs12979860 CT, or TT and rs8099917 TG or GG. Futhermore, a higher SVR was observed in the Caucasians than in Afro-Americans (OR = 3.85, 95% CI: 3.06-4.83); the percentage of rs12979860 CC genotype was higher in Caucasians than that of Afro-Americans (OR=3.45, 95% CI = 2.68-4.44). Between different HCV genotypes, the SVR was much lower in those with HCV genotype 1 than those with genotype 2/3 (OR=0.16, 95% CI: 0.11-0.24). Conclusions: IL28B is significantly associated with response to PEG-interferon/ribavirin therapy of patients with chronic HCV infection. Both the rs12979860 and rs8099917 alleles could be used as independent predictors of the treatment response. The rs12979860 allele in particular, is more important from our study. The polymorphism even explains part the difference in response rate between different ethnic groups and HCV genotypes. [ABSTRACT FROM AUTHOR]

In Vietnam, ARV access has been scaled up since 2005 in high HIV prevalence areas in order to meet increasing demands for HIV treatment. This paper aims to estimate ARV unmet need and its associated socio-demographic characteristics among HIV-positive women in Haiphong, Vietnam. A cross-sectional study using structured questionnaires and CD4 cell count was conducted with 353 HIV-positive women recruited from groups of people living with HIV/AIDS (PLWHA), by snowball technique through member of PLWHA groups and the local AIDS management system (Provincial AIDS Center (PAC)). The percentage of HIV-positive women having an unmet ARV need was estimated to be 40%, particularly high among women who were not registered at PAC. Having an unmet ARV need was associated with not participating in PLWHA groups (OR 6.5; 2.4-17.2) and being younger than 30 years old (OR 2.9; 1.1-7.3). [ABSTRACT FROM AUTHOR]

erlen j.a., cha e.s., kim k.h., caruthers d. & sereika s.m. (2010) The HIV Medication Taking Self-efficacy Scale: psychometric evaluation. Journal of Advanced Nursing 66(11), 2560-2572. Aim. This paper is a report of an examination of the psychometric properties of the HIV Medication Taking Self-efficacy Scale. Background. Self-efficacy is a critically important component of strategies to improve HIV medication-taking; however, valid and reliable tools for assessing HIV medication-taking self-efficacy are limited. Method. We used a cross-sectional, correlational design. Between 2003 and 2007, 326 participants were recruited from sites in Pennsylvania and Ohio in the United States of America. Six self-report questionnaires administered at baseline and 12 weeks later during 'Improving Adherence to Antiretroviral Therapy' were used to examine the variables of interest. Means and variances, reliability, criterion, and construct validity of the HIV Medication Taking Self-efficacy Scale were assessed. Findings. Participants reported high self-confidence in their ability to carry out specific medication-related tasks (mean = 8·31) and in the medication's ability to effect good outcomes (mean = 8·56). The HIV Medication Taking Self-efficacy Scale and subscales showed excellent reliability (α = 0·93∼0·94). Criterion validity was well-established by examining the relationships between the HIV Medication Taking Self-efficacy Scale and selected physiological and psychological factors, and self-reported medication adherence ( r = −0·20∼0·58). A two-factor model with a correlation between self-efficacy belief and outcome expectancy fitted the data well (model χ2 = 3871·95, d.f. = 325, P < 001; CFA = 0·96; RMSEA = 0·046). Conclusion. The HIV Medication Taking Self-efficacy Scale is a psychometrically sound measure of medication-taking self-efficacy for use by researchers and clinicians with people with HIV. The findings offer insight into the development of interventions to promote self-efficacy and medication adherence in persons with HIV. [ABSTRACT FROM AUTHOR]

Responses to the HIV epidemic leading to an increase in the number of residential care facilities for children across sub-Saharan Africa have prompted concerns that large numbers of orphaned children are being placed in institutional care. There is little empirical research into the role that institutions are playing in the provision of care to children affected by HIV in the region. This paper draws on an exploratory study of the provision of residential care for children in the context of the HIV epidemic in South Africa. The analysis characterises the population of children in a small sample of residential care facilities in four provinces, and, after identifying a disproportionate number of HIV-positive children in care, examines the circumstances that led to their admission and the nature of HIV-related interventions in the facilities. The analysis reveals missed opportunities for non-institutional placements for HIV-positive children and identifies important gaps in the HIV prevention, treatment, care, and support interventions within the facilities. The article argues that a global and local preoccupation with orphans as being the children most severely affected by HIV, and as the primary category of children requiring alternative care as a result of the HIV epidemic, may have diverted attention away from the extent to which HIV-positive children populate institutions in South Africa. Furthermore, we suggest that adjustments are required to both decisionmaking regarding placement of HIV-positive children requiring alternative care and the provision of HIV-related interventions in residential facilities in order to ensure an adequate response to children's health and wellbeing. [ABSTRACT FROM AUTHOR]