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Malignancies are a major cause of morbidity and mortality in human immunodeficiency virus (HIV)- infected patients. With the introduction of an effective combination of antiretroviral therapy, HIV infection has been changed from being a death sentence to a chronic condition. There is renewed clinical interest in the associated morbidities of non-communicable diseases, and most importantly cancers, such as Kaposi’s sarcoma and non-Hodgkin’s lymphoma, due to prolonged survival on antiretrovirals. Available evidence suggests that there is an increasing frequency of cancers associated with bacterial and viral infections among the HIV-infected population. There is also a concern about the etiology of emergence of cancers, risk factors, and viral infections in HIV-infected individuals. The challenge is for the caregivers to develop and implement effective means to screen, treat, and prevent non-AIDS defining cancers (NADCs) in the HIV-infected patients. There is a need for provision of hepatitis B virus and human papillomavirus vaccines for those who are uninfected and the eligible population. Emphasis should be on these non-AIDS defining cancers during health education, in order to create awareness of the morbidity that may encourage screening uptake, thus resulting in healthy living and reduced mortality rates. This brief review aimed to bring to fore the account of NADCs, risk factors, the role of the microbiota, diagnostic methods, and the need for urgent screening and prevention among people living with HIV/AIDS.

In this study we examined potential associations of HPV infection with the cervical microbiota. Cervical samples were collected from 87 HIV-seronegative reproductive-age Black South African women. Microbiota were characterized by Illumina sequencing of the V3-V4 hypervariable regions of the bacterial 16S rRNA gene. Thirty seven (42.5%) and 30 (34.5%) of the women had prevalent HPV and high-risk (HR)-HPV, respectively. Only 23 women (26.4%) had cervical microbiota dominated by a single Lactobacillus species (L. crispatus (2/87 (2.3%)), L. jensenii (2/87 (2.3%)), and L. iners (19/87 (21.8%)). The majority of the women (56/87 (64.4%)) had diverse cervical microbiota consisting of mainly bacterial vaginosis-associated bacteria. The remaining women (8/87 (9.2%)) had microbiota dominated by Aerococcus, Streptococcus, Chlamydia or Corynebacterium. Women with HR-HPV had significantly higher relative abundances of Aerococcaceae, Pseudomonadaceae and Bifidobacteriaceae compared to those with low-risk (LR)-HPV or no HPV-infection (LDA score >2.0, p 2.0, p 0.2). Further investigations of the bacterial taxa significantly enriched in HR-HPV-infected women are warranted., Highlights • Majority of participants (74%) had cervical microbiota not dominated by Lactobacillus. • Lactobacillus was not enriched in HPV-negative women compared to HPV-positive women. • There was no correlation between cervical microbiota diversity and HPV infection.

The standard treatment for bacterial vaginosis (BV) with oral metronidazole is often ineffective, and recurrence rates are high among African women. BV-associated anaerobes are closely associated with genital inflammation and HIV risk, which underscores the importance of understanding the interplay between vaginal microbiota and genital inflammation in response to treatment. In this cohort study, we therefore investigated the effects of metronidazole treatment on the vaginal microbiota and genital cytokines among symptomatic women with BV [defined as Nugent score (NS) ≥4] using 16S rRNA gene sequencing and multiplex bead arrays. Among 56 BV positive women, we observed short-term BV clearance (NS

Introduction:Marsdenia macranthais a crucial source of traditional medicine in Northern Namibia. Its roots are used to treat various health conditions ranging from mouth infections to urinary retention. Despite its medicinal application, there is no known knowledge of its therapeutic properties. Thus, we investigated the phytochemical content and antibacterial activity ofM. macrantha. Methods:M. macrantharoot extracts were obtained using three different solvents (distilled water, methanol and acetone) - in the soxhlet and maceration extraction methods. Total phytochemical (terpenoid, alkaloid and/or flavonoid) content was determined by spectrophotometry. Antibacterial activity against common foodborne pathogens (Staphylococcus aureus,Escherichia coliandSalmonella typhi) was determined by both well and disc diffusion method. Results:we detected the presence of all the tested phytochemicals. Methanol gave the highest percentage yield of extraction (mean: 13.95 ± standard deviation: 0.41%) followed by water (10.92 ± 0.11%) and acetone (6.85 ± 0.23%), F-ratio=326.71 and p

Background To date, the microbiota of the human penis has been studied mostly in connection with circumcision, HIV risk and female partner bacterial vaginosis (BV). These studies have shown that male circumcision reduces penile anaerobic bacteria, that greater abundance of penile anaerobic bacteria is correlated with increased cytokine levels and greater risk of HIV infection, and that the penile microbiota is an important harbour for BV-associated bacteria. While circumcision has been shown to significantly reduce the risk of acquiring human papillomavirus (HPV) infection, the relationship of the penile microbiota with HPV is still unknown. In this study, we examined the penile microbiota of HPV-infected men as well as the impact of HIV status. Results The penile skin microbiota of 238 men from Cape Town (South Africa) were profiled using Illumina sequencing of the V3-V4 hypervariable regions of the 16S rRNA gene. Corynebacterium and Prevotella were found to be the most abundant genera. Six distinct community state types (CSTs) were identified. CST-1, dominated by Corynebacterium, corresponded to less infections with high-risk HPV (HR-HPV) relative to CSTs 2–6. Men in CST-5 had greater relative abundances of Prevotella, Clostridiales, and Porphyromonas and a lower relative abundance of Corynebacterium. Moreover, they were significantly more likely to have HPV or HR-HPV infections than men in CST-1. Using a machine learning approach, we identified greater relative abundances of the anaerobic BV-associated bacteria (Prevotella, Peptinophilus, and Dialister) and lower relative abundance of Corynebacterium in HR-HPV-infected men compared to HR-HPV-uninfected men. No association was observed between HIV and CST, although the penile microbiota of HIV-infected men had greater relative abundances of Staphylococcus compared to HIV-uninfected men. Conclusions We found significant differences in the penile microbiota composition of men with and without HPV and HIV infections. HIV and HR-HPV infections were strongly associated with greater relative abundances of Staphylococcus and BV-associated bacterial taxa (notably Prevotella, Peptinophilus and Dialister), respectively. It is possible that these taxa could increase susceptibility to HIV and HR-HPV acquisition, in addition to creating conditions in which infections persist. Further longitudinal studies are required to establish causal relationships and to determine the extent of the effect.

BackgroundLactobacillusspp. are common bacteria in the cervical and vaginal microbiota (CVM) and are thought to represent a “healthy” cervicovaginal state. Several studies have found an independent association between ethnicity/race and cervical and vaginal microbiota (CVM) composition. Women of sub-Saharan African descent appear to be significantly more likely to have non-Lactobacillus-dominated CVM compared to women of European descent. The factors contributing to these differences remain to be fully elucidated. The CVM of Black South African women and factors influencing their CVM remain understudied. In this study, we characterized the cervical microbiota of reproductive-age South African women and assessed the associations of these microbiota with participants’ metadata.MethodsThe cervical microbiota from cervical DNA of 62 reproductive-age women were profiled by Ion Torrent sequencing the V4 hypervariable region of the bacterial 16S ribosomal RNA (rRNA) gene and analyzed with the Quantitative Insights Into Microbial Ecology (QIIME), UPARSE, and metagenomeSeq tools. Associations between cervical microbiota and participants’ metadata were assessed using GraphPad Prism, R packages and an in-house script.ResultsThe cervical microbiota clustered into three distinct community state types (CSTs):Lactobacillus iners-dominated cervical microbiota (CST I (38.7%, 24/62)), unclassifiedLactobacillus-dominated cervical microbiota (CST II (4.8%, 3/62)), and diverse cervical microbiota (CST III (56.5%, 35/62)) with an array of heterogeneous bacteria, predominantly the bacterial vaginosis (BV)-associatedGardnerella,Prevotella,Sneathia, andShuttleworthia. CST III was associated with BV (p = 0.001). Women in CST I were more likely to be on hormonal contraception, especially progestin-based, compared to women in CST III (odds ratio: 5.2 (95% CI [1.6–17.2]);p = 0.005). Women on hormonal contraception had a significantly lower alpha (Shannon indices: 0.9 (0.2–1.9) versus 2.3 (0.6–2.3);p = 0.025) and beta (permutational multivariate analysis of variance (PERMANOVA) pseudo-F statistic =4.31,p = 0.019) diversity compared to non-users. There was no significant difference in the alpha (Shannon indices: 1.0 (0.3–2.2) versus 1.9 (0.3–2.2);p = 0.483) and beta (PERMANOVA pseudo-Fstatistic = 0.89,p = 0.373) diversity in women with versus without human papillomavirus infection.ConclusionsThe majority of Black women in our study had non-Lactobacillus-dominated cervical microbiota. Additional studies are needed to examine whether such microbiota represent abnormal, intermediate or variant states of health. Lastly, the association of hormonal contraception withL. inersdominance requires further in-depth research to confirm this association, determine its biological mechanism and whether it has a beneficial effect on the cervicovaginal health.

AIDS Prevention Initiative in Nigeria Department, Jos University Teaching Hospital, Jos, Nigeria. HIV-research Laboratory, Kenya Medical Research Institute, Kisumu, Kenya. Department of Pediatrics, University of Jos, Jos, Nigeria. Department Medicine, University of Jos, Jos, Nigeria. Department Family Medicine, University of Jos, Jos Nigeria. Medical Research Council Unit, Fajara, Banjul, The Gambia. Department of Obstetrics and Gynaecology University of Jos, Jos, Nigeria. Department of Microbiology, Ahmadu Bello University Zaria, Nigeria. Department of Medical Laboratory Science, University of Jos, Nigeria. Director General, National Agency for Control of AIDS, Abuja, Nigeria.

HIV-1 transmitted drug resistance (TDR) is of increasing public health concern in sub-Saharan Africa with the rollout of antiretroviral (ARV) therapy. Such data are, however, limited in Kenya, where HIV-1 drug resistance testing is not routinely performed. From a population-based household survey conducted between September and November 2012 in rural western Kenya, we retrospectively assessed HIV-1 TDR baseline rates, its determinants, and genetic diversity among drug-naïve persons aged 15-59 years with acute HIV-1 infections (AHI) and recent HIV-1 infections (RHI) as determined by nucleic acid amplification test and both Limiting Antigen and BioRad avidity immunoassays, respectively. HIV-1 pol sequences were scored for drug resistance mutations using Stanford HIVdb and WHO 2009 mutation guidelines. HIV-1 subtyping was computed in MEGA6. Eighty seven (93.5%) of the eligible samples were successfully sequenced. Of these, 8 had at least one TDR mutation, resulting in a TDR prevalence of 9.2% (95% CI 4.7-17.1). No TDR was observed among persons with AHI (n = 7). TDR prevalence was 4.6% (95% CI 1.8-11.2) for nucleoside reverse transcriptase inhibitors (NRTIs), 6.9% (95% CI 3.2-14.2) for non- nucleoside reverse transcriptase inhibitors (NNRTIs), and 1.2% (95% CI 0.2-6.2) for protease inhibitors. Three (3.4% 95% CI 0.8-10.1) persons had dual-class NRTI/NNRTI resistance. Predominant TDR mutations in the reverse transcriptase included K103N/S (4.6%) and M184V (2.3%); only M46I/L (1.1%) occurred in the protease. All the eight persons were predicted to have different grades of resistance to the ARV regimens, ranging from potential low-level to high-level resistance. HIV-1 subtype distribution was heterogeneous: A (57.5%), C (6.9%), D (21.8%), G (2.3%), and circulating recombinant forms (11.5%). Only low CD4 count was associated with TDR (p = 0.0145). Our findings warrant the need for enhanced HIV-1 TDR monitoring in order to inform on population-based therapeutic guidelines and public health interventions.

Background: Minor mutations to protease inhibitors often occur as polymorphisms in the protease gene in non-B human immunodeficiency virus (HIV)-1 subtype among antiretroviral (ARV) treatment-naive patients. Aims: This study sought to determine the prevalence of minor mutations occurring in the protease gene among ARV naive HIV-1 infected patients in Jos, Nigeria. Settings and Design: We retrospectively analyzed specimen of 105 patients recruited between October 2010 and April 2011 at the HIV clinic, Jos University Teaching Hospital, Nigeria. Materials and Methods : Genotypic testing was done using an in-house genotyping system at the Kenya Medical Research Institute HIV-Research Laboratory in Kisumu, Kenya; HIV-1 viral resistance mutations assessed using Stanford HIV drug resistance database and classified using International acquired immunodeficiency syndrome (AIDS) Society (IAS)-USA list of mutations. In additional, viral subtypes were determined using REGA subtyping tool v.2.0 and CD4 levels by flow cytometry. Statistical analysis: Prevalence of mutations was computed and participants' baseline clinical and biological properties summarized by percentages for categorical variables and mean/median for quantitative variables. Results: Of the 105 samples, 100 were successfully amplified. HIV-1 subtypes identified were circulating recombinant form (CRF) - CRF02_AG (48.0%), G (41.0%), CRF06_cpx (6.0%) and A1 (5.0%). The most prevalent minor mutations among the patients occurred at positions L89M (96%), M36I (93%), K20I (77%), V82I (39%), E35Q (29%), L63P (25%) and polymorphisms at I13V (99%), R41K (86%), H69K (86%), K14R (67%). One sample presented with a major PI resistance mutation (Q58E). Conclusions: We found high rates of minor mutations and polymorphisms in circulation, possibly reflecting the drug naivety of participants. In addition, there was an evidence of transmitted drug resistance, hence targeted genetic resistance testing should be considered in national treatment guidelines.