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Hematologic abnormalities are common in HIV and involve all blood cell lineages. A study on cytopenias, as correlated with disease progression, can be valuable in resource-limited settings. This study aimed to determine the hematologic profile of HIV patients and its association with CD4 count and antiretroviral (ARV) treatment.This is a retrospective cohort study involving adult Filipino HIV patients with complete blood count (CBC) and CD4 count determinations prior to the initiation of ARV treatment and after ≥6 months of ARV treatment. Logistic regression was performed to determine the association between cytopenias and a CD4 count200 cells/µL.The study included 302 patients. Anemia was the most common cytopenia. Anemia and leukopenia were associated with an increased likelihood of having a CD4 count200 cells/µL in ARV-naïve patients. In ARV-treated patients, leukopenia was associated with an increased probability of having a CD4 count200 cells/µL. An increase in hemoglobin, white blood cell (WBC) and platelet counts was observed after ≥6 months of ARV treatment.Anemia and leukopenia can be used as markers of immune status in HIV-infected individuals and improvement in the CBC parameters can be used to assess response to ARV treatment. Routine monitoring of hematologic parameters is recommended.

Over the past few years, neuroimaging studies have been performed in young adults with perinatally acquired HIV (PHIV) to study the impact of HIV infection on the central nervous system (CNS), but no recent review have been published. This review aims to identify brain areas where PHIV eems to have greater impact taking into account demographic, behavioral, and clinical characteristics in PHIV infected patients. For this purpose, PubMed and Medline searches were carried out which included studies from 2010 to April 2020. We performed a systematic review and included 26 articles using structural (brain morphometry and diffusion tensor imaging) and functional magnetic resonance imaging methods involving 1182 PHIV-infected participants. Ample evidence has been provided of HIV effects on underlying brain structure. However, information recorded in the studies is commonly incomplete and results sometimes contradictory. In addition to future improvements and dissemination of tools for the developing brain MRI processing and analysis, the inclusion of data related to HIV infection itself (including clinical and immunovirological characteristics as well as detailed information about antiretroviral treatment such as age at ART initiation) may be of vital importance to the better understanding of the impact of the disease on CNS.

Background: Long-term non-progressors (LTNPs) are small subsets of HIV-infected subjects that can control HIV-1 replication for several years without receiving ART. The exact mechanism of HIV-1 suppression has not yet been completely elucidated. Although the modulatory role of microRNAs (miRNAs) in HIV-1 replication has been reported, their importance in LTNPs is unclear. Objective: The aim of this cross-sectional study was to assess the expression pattern of miR-27b, -29, -150, and -221, as well as their relationship with CD4+ T-cell count, HIV-1 viral load, and nef gene expression in peripheral blood mononuclear cells (PBMCs) of untreated viremic patients and in LTNPs. Methods: MiRNAs expression levels were evaluated with real-time PCR assay using RNA isolated from PBMCs of LTNPs, HIV-1 infected naive patients, and healthy people. Moreover, CD4 T-cell count, HIV viral load, and nef gene expression were assessed. Results: The expression level of all miRNAs significantly decreased in the HIV-1 patient group compared to the control group, while the expression pattern of miRNAs in the LNTPs group was similar to that in the healthy subject group. In addition, there were significant correlations between some miRNA expression with viral load, CD4+ T-cell count, and nef gene expression. Conclusion: The significant similarity and difference of the miRNA expression pattern between LNTPs and healthy individuals as well as between elite controllers and HIV-infected patients, respectively, showed that these miRNAs could be used as diagnostic biomarkers. Further, positive and negative correlations between miRNAs expression and viral/cellular factors could justify the role of these miRNAs in HIV-1 disease monitoring.

Objectives: The objective of this study was to determine the knowledge, perceptions and practices of HIV-infected mothers regarding human immunodeficiency virus (HIV) and infant feeding. Design: A cross-sectional study design was applied. Setting: The study was undertaken at a regional hospital in Bloemfontein. Subjects: A total of 100 mother–infant pairs that were still in hospital after the delivery of the baby were included. All mothers were HIV-infected. Outcome measures: Sociodemographic information, medical history, and knowledge, perceptions and practices related to infant feeding in the context of HIV were noted. Results: The median age of mothers was 31 years, and most mothers reported anti-retroviral therapy (ART) use (93.0%). The median CD4 cell count was 383 cells/mm3, and median haemoglobin level was 11.4 g/dl. Most mothers planned to breastfeed their infant(s) (70.0%). A large percentage of the mothers reported that they did not know or were not aware of the fact that HIV can be transmitted to an infant via breastfeeding (43.0%). Only half of the mothers had been shown how to either breastfeed or formula feed by healthcare staff (depending on their choice). Conclusion: The knowledge, perceptions and practices related to infant feeding were inadequate in mothers included in this study. Providing scientifically based, unbiased information is fundamental during counselling on infant feeding to ensure the success of prevention of mother-to-child transmission (PMTCT) programmes. If women feel confident in their acquired knowledge, they are more likely to be self-empowered and make informed decisions related to infant feeding.

Dengue fever is regarded as an important neglected Arboviral disease worldwide. This study aimed at investigating the prevalence of dengue IgM seroprevalence, malaria parasitaemia and some haematological parameters of HIV infected individuals attending Chukwuemeka Odumegwu Ojukwu Teaching Hospital Amaku, Awka, Nigeria. A cross sectional study consisting of 188 participants was performed. The demographic data and possible risks factors of the subjects were obtained using well-structured questionnaire. Dengue virus IgM was analysed using Enzyme-linked immunosorbent assay (ELISA) techniques, Malaria parasitaemia was determined using microscopy technique while some haematological parameters were evaluated using heamatology auto analyser (PE-6800 fully auto heamatology analyser procan). Statistical analysis was performed using the statistical package for social (spss) version 25. The results of this study showed that the prevalence of Dengue virus was 20.2% while that of Malaria was 37.2%. The co-infection of Dengue virus IgM antibodies and Malaria parasitemia was 8.51%. Plasmodium falciparium was seen as the only specie of malaria parasite present in the study. The results of some haematogical parameters of the Dengue virus seropositive participants as compared with the Dengue virus seronegative participants were statistically significant with neutrophils (p = 0.035), mean cell hemoglobin concentration (MCHC = p

Background Short-cycle therapy (SCT) is the administration of ART for 4 or 5 consecutive days a week, followed by 3 or 2 days off therapy. Its benefits include improving patient satisfaction and reducing ART toxicity and costs. Methods In this observational study we included HIV-infected adults with a three-drug ART containing rilpivirine, a history of long-term virological suppression and no evidence of resistance to previous drug regimens. Patients switched to a SCT of 4 days on/3 days off and were followed for 48 weeks with regular check-ups. The primary outcome was virological suppression; secondary outcomes were changes in CD4+ cells and rilpivirine plasma concentration, the occurrence of adverse events and resistance in the case of failure, and patient satisfaction. Results At week 48 no virological failure was observed, with a virological suppression rate of 30/30 (100%). Three patients switched back to continuous therapy for other reasons, with an overall success rate of SCT of 30/33 (90.9%, 95% CI = 81.24% to 100%). The CD4+ mean value increased by +64 cells/mm3 (95% CI = −59 to +187 cells/mm3; P = 0.052). No adverse events were observed and the mean total score in the satisfaction questionnaire was 57.7/60 (96.22%). Rilpivirine plasma concentration was below the efficacy threshold in 71.3% of the samples, suggesting that the patients’ characteristics, more than the drug’s pharmacokinetics, played a role in maintaining virological suppression. Conclusions SCT with rilpivirine-containing regimens could be an effective alternative to continuous therapy in selected HIV-infected patients with previous long-term virological suppression.

This cross-sectional study examined factors affecting Health-related Quality of Life (HRQoL) among 273 HIV-infected key populations. This included, men who have sex with men (MSM), people, who inject drugs (PWID), and sex workers (SW), who were currently receiving antiretroviral therapy (ART) in Myanmar. Participants were recruited from four non-government clinics in four main cities. Overall HRQoL score derived from the WHOQOL-HIV BREF questionnaire was 86.08 ± 10.78. The lowest score was found in the environment domain (13.64 ± 2.06), while the highest score was found in the spirituality domain (15.54 ± 3.04). According to the multiple logistic regression analysis, participants, reported having an adequate income (OR = 3.32, P = 0.006), regularly taking meditation (OR = 3.79, P = 0.009), living in Tachileik (OR = 15.43, P = 0.011), and reported having no symptoms during previous 2 weeks (OR = 14.50, P

Introduction. In most cases, HIV infection in children is accompanied by the development of anemia.Objective: to study the nature of the disturbance of the cellular composition of blood in HIV-infected children on the background of antiretroviral therapy.Materials and methods. In the period from September 2015 to January 2017, 124 patients aged from 0 to 18 years old were examined with a diagnosis of HIV infection at various stages of its development. In all patients in the peripheral blood, the hemoglobin concentration, the absolute number of red blood cells, leukocytes and their varieties in a blood volume unit were determined, the hematocrit value was calculated.Results and discussion. Against the background of ongoing antiretroviral therapy, the formation of hypochromic anemia is associated with a consistent decrease in hemoglobin concentration and the number of circulating red blood cells to 104,86±2,80 g/l and to 3,81–3,67×1012/l, which may be accompanied by a decrease in their content in each erythrocyte and the appearance of macrocytic erythroid forms in circulating blood. Leukopenia develops due to the formation of an absolute deficiency of circulating lymphocytes and neutrophilic granulocytes.Conclusion. The specific assessment of cytopenia depends on the type of primary damage to the blood cells, and the choice of specific treatment depends on the type of disorder. Therefore, timely correction of these disorders could possibly reduce the development of the immunodeficiency state.

The goal is to conduct a comparative analysis of the characteristics of blood counts of pregnant women with HIV living in the subarctic climatic zone of the Khanty-Mansiysk District, as predictors of a systemic inflammatory reaction on the background of infection and pregnancy complicated by preterm delivery.Material and methods. A retrospective analysis of 78 stories of pregnant women with HIV (main group II) was carried out, in 2016–2018. observed in one antenatal clinic in the city of Surgut. Control group (I) comprised 20 histories of pregnant women without HIV. Clinical-anamnestic and blood parameters were compared, including indicators of T-helpers, T-suppressors and viral load, leukocyte intoxication indices, hemoglobin, erythrocytes and platelets by trimesters of pregnancy. The material was processed using the Statistica-10 software system. The critical level of statistical significance was taken at pResults. A comparative analysis of blood counts of pregnant women living in the subarctic region showed a relationship between the preterm labor of patients with HIV with a progressive decrease in the T-cell level of immunity, an increase in the level of lymphocytes and leukocyte blood indices, a decrease of hemoglobin, erythrocytes, platelets, against the background of persisting viral load for the remainder of pregnancy. A decrease of T-lymphocyte counts indicates the development of a systemic inflammatory response on the background of HIV infection, depletion of the immune defense organs and the progression of the disease, while a low level of CD4 lymphocytes stimulates the activation of granulocytes in the blood and indicates further depletion of T-lymphocytes. Activation of a systemic inflammatory response that promotes the release of inflammatory mediators and prostaglandins and, with a high probability, underlies the mechanisms of rejection of the fetus and placenta and the spontaneous preterm labor. The comorbid background of pregnant women with HIV and preterm labor is associated with low adherence to HAART therapy and high detectable viral load throughout gestation.

Background: Tenofovir disoproxil fumarate (TDF) is a major antiretroviral therapy for Thai human immunodeficiency virus (HIV) infected adults. TDF is associated with a decrease in renal function. There is limited data about the use of TDF with the incidence and time to renal impairment and chronic kidney disease (CKD) in Thai HIV-infected adults. Objectives: To study the association of TDF with the incidence rate and duration of renal impairment and CKD in Thai patients. Methods: A retrospective cohort study in Thai naïve HIV-infected adults was conducted to compare the incidence rate and time to renal impairment and CKD in TDF and non-TDF groups. The incidence rate was analyzed by person-time. Time to renal impairment and CKD were analyzed by Kaplan-Meier curves and log-rank tests. Results: A total of 1,400 patients were enrolled. The incidence rates of renal impairment in TDF and non-TDF groups were 27.66/1,000 and 5.54/1,000 person-years. The rate ratio was 4.99 (95% confidence interval [CI] 2.66–9.35). The incidence rates of CKD in both groups were not significantly different. Themean difference of eGFR between the TDF and non-TDF groups was 1.92 ml/min/1.73 m2 (p = 0.022). Time to onset of renal impairment between the TDF and non-TDF groups was found to differ by approximately 20 months. Conclusion: The incidence rate of renal impairment was about five times higher in the TDF group. A rapid decline of eGFR occurred in the first 2–3 years of treatment. Therefore, the renal function of HIV-infected patients should be monitored so that the severity of renal impairment could be evaluated and CKD could be prevented.

Background: Human immunodeficiency virus (HIV) is a retrovirus that causes severe immunodeficiency syndrome in most patients if left untreated. It has been a reportable disease in Taiwan since 1984, and was diagnosed in 41,679 patients until June 2020. However, there is no previous study evaluating aerobic capacity in HIV-infected patient in Taiwan. Case report: A 50-year-old male with HIV infection visited our rehabilitation center for cardiopulmonary exercise testing (CPET) due to dyspnea on exertion sometimes. He received a highly active antiretroviral therapy (HAART) regimen since 2015. He could achieve VO2max during CPET. The maximal aerobic ability was about 91.95% of the predicted, and functional aerobic impairment (FAI) was within normal limit. His VO2 peak was 8.3 MET, equal to 29.05 mL/kg/min. Additionally, VO2 AT was 4.5 MET, equal to 15.75 mL/kg/min. We make recommendations of physical exercise training program according to CPET results. Conclusion: The difference of disease duration, HAART regimen and time of HAART will affect the cardiopulmonary fitness results. However, our HIV-infected patient showed normal aerobic fitness following the CPET, and aerobic capacity did not impair in HIV-infected patient receiving HAART due to personalized life-style modification.

За даними дослідження виявлено нижчий рівень охоплення щепленнями ВІЛ-інфікованих дітей проти дифтерії та правця (63,3 %), ніж загалом у популяції. Велика частка дітей з ВІЛ-інфекцією (79,4 %), щеплених проти цих збудників, не мала протективного рівня антитіл проти дифтерії. Захисний рівень антитіл проти правця був відсутній у 28,8 % ВІЛ-інфікованих дітей, які отримали щеплення проти правця. ВІЛ-інфіковані діти, неімунні проти дифтерії та правця, є групою ризику щодо можливого захворювання на ці інфекції. Основні предиктори наявності імунного захисту проти дифтерії й правця — ранній початок лікування ВІЛ-інфекції (у перші 2 роки життя), вищий рівень CD4+ Т-лімфоцитів на початок антиретровірусної терапії (АРТ) та проведення вакцинації на АРТ. ВІЛ-інфікованим дітям, які отримали щеплення проти дифтерії та правця до початку АРТ, рекомендоване проведення контролю рівня специфічних антитіл, за відсутності захисного рівня антитіл — додаткова ревакцинація проти цих бактеріальних інфекцій.

Influenza is known to cause severe respiratory illness in HIV-infected adults, but there are few data describing the relationship between HIV infection and influenza in West African countries such as Ghana. We conducted a prospective cohort study in the Shai-Osudoku and Ningo Prampram districts of Ghana from 2014 to 2016. Beginning May 2014, 266 HIV-infected and 510 HIV-uninfected participants age 18 to 73 years were enrolled and monitored for 12 months. We observed 4 and 11 laboratory-confirmed influenza cases among HIV-infected and HIV-uninfected persons, respectively. The overall rate of laboratory-confirmed influenza among HIV-infected participants was 15.0 per 1,000 person years (PY) (95% CI, 0.3–29.80 per 1,000 PY), whereas that among HIV-uninfected participants was 21.6 per 1,000 PY (95% CI, 8.8–34.3 per 1,000 PY) (incidence density ratio, 0.70; P = 0.56). Our study found no significant difference in the incidence of laboratory-confirmed influenza-associated illness among HIV-infected and HIV-uninfected individuals in Ghana.

Background: Hepatitis C affects 5–15% of the 38 million people living with HIV globally. Africa which has the second highest prevalence of HIV/HCV co-infection following Asia. This alarming statistics has made it crucial that studies be done to also ascertain the HIV/HCV co-infection prevalence in the country and host factors which may influence the co-infection. Objective: Therefore, this study was conducted to investigate the seroprevalence of HCV infection amongst the HIV population of Rivers state, Nigeria. Study Design: Cross-sectional study. Place and Duration of Study: University of Port Harcourt Teaching Hospital (UPTH), in Rivers State, Nigeria, from February 2017 to September 2019. Methods: In this study, 226 HIV-infected individuals were recruited comprising 105 males and 121 females. These subjects were screened for the presence of HIV and HCV using ELISA and was performed according to the kit manufacturer’s stipulations. The demographic characteristics of the participants were obtained using a questionnaire designed for the study. Results: The presence of antibodies to HIV-1 reconfirmed the HIV status in all the study subject. A seroprevalence rate of 0.0% was observed for HIV/HCV infection. The ratio of females to males was found to be 1.2:1. The ages of the study population ranged from 16 to 70 years with a median age of 42.5 years. A large number (30.5%, n = 69) of the participants were within the age group 40 – 49 years, followed by those within 30 – 39 years (26.1%, n= 59), 50 – 59 years (17.3%, n = 39) and >59 years (13.7%, n = 31). Participants that were within younger age groups had less population; 20 – 29 years (9.7%, n = 22), with those that are

The Human Immunodeficiency Virus (HIV) continues to be a major global public health issue, having claimed more than 35 million lives so far. Antiretroviral therapy, the drug used to treat HIV patients, had been reported to have an adverse effect on patients’ livers. Therefore, this research aims to assess the parameters for measuring liver injury of HIV patients undergoing antiretroviral therapy in Owo and to determine the patients' vulnerability to liver injury. The study sample was divided into five groups comprising Control groups and groups with 6 months, 1 year, 3 years and 5 years’ periods of administration of an antiretroviral drug. Serum was separated from their blood and values of ALT, ALP and BILT were determined. The results of profiling the patients based on values ALT, ALP and BILT indicated that 73%, 71% and 59% of the patients are within the reference range of the parameters, respectively. Further analysis of the percentage of patients likely to have liver diseases indicated that only 3.2% are prone to liver injury. The results of the One-way Analysis of Variance of the mean values of the groups on ALT, ALP and BILT indicated differences in mean values of the groups. It is suggested that a longitudinal study should be carried out to determine the effect of seasonal variation in the value of the studied parameters. It is also suggested that a wider interval of the period for the groups should be used in the future to determine whether there will be a relationship between the period of administration of the drug and the parameters.

The purpose of our research was to determine the detection frequency of 12 high-risk types of human papillomavirus (HPV) in women with human immunodeficiency virus (HIV) who are planning pregnancy and to assess the results of colposcopy and the state of the cervix in these women, depending on the presence of HPV. Methods and Results: We examined 31 women with HIV infection who sought pregnancy-planning advice at Scientific Center for Family Health and Human Reproduction Problems in Irkutsk during 2014-2015. All HIV-infected women were tested for the presence of high-risk HPV DNA in the epithelium of the cervical canal by PCR. Material for cytological examination (PAP test) was collected during gynecological examination. PAP tests were assessed according to the Bethesda system. All changes were divided into two types: ASCUS and SIL, the last was in its turn divided into two categories: LSIL and HSIL. The frequency of HPV detection in HIV-infected women planning pregnancy was 71%. HPV 16 was found in 16(51.6%) HIV-infected women and ranked first in frequency among 12 types of HPV. HPV 33 and HPV 35 were found in 15(48.4%) and 12(38.7%) HIV-infected women, respectively, and ranked the second and third in frequency among 12 HPV types. We compared abnormal colposcopy results in two groups of patients with HIV infection: Group 1 (n=22) included women with HPV and Group 2 (n=9) included women without HPV. ASCUS was detected in all patients of Group 1 (100%) and in 6(66.7%) women of Group 2. Two women (9.1%) from Group 1 were diagnosed with LSIL and 10(45.5%) women with HSIL. Conclusion: HIV-infected women planning pregnancy and living in Irkutsk form a group at high-risk of HPV infection.

Background: Kenya has a paediatric HIV burden of nearly 140,000 children, of which only 48% of those on antiretroviral therapy (ART) have achieved the desired viral suppression possibly due to vitamin D deficiency. We explored the influence of vitamin D levels on treatment outcome., Method: We performed a cross-sectional study of 196 participants aged 3 - 14 years; among them 98 HIV infected who received treatment between 2019 - 2020 in Jaramogi Oginga Odinga Teaching and Referral Hospital, Kenya. The exposure was vitamin D levels, including deficient (<20 ng/ml), insufficient (≥20 - <30 ng/ml), and sufficient (30 - 50ng/ml). The outcome was optimal immune recovery (CD4 ≥ 500 cells/mm3) and optimal viral suppression (viral load ≤ 200 copies/ml). We compared difference in means for each vitamin D category between HIV infected and uninfected using independent t-test, multiple comparisons of vitamin D levels among age categories using ANOVA and post hoc test and Pearson correlation to correlate vitamin D levels, CD4 and viral load of HIV infected children., Results: Compared with HIV uninfected, HIV infected recorded mean age ± standard deviation of10.65±2.17 years with 39(39.8%) males vs. 6.68±2.81 years with 52(53.1%) males p<0.001; and the difference in vitamin D mean levels was statistically significant [28.21 ± 6.39 infected vs.30.88 ± 6.62 uninfected] t = 2.94, df =194, p = 0.004, 95%CI (0.90 - 4.59). Among age categories, mean vitamin D varied significantly F (2,193) = 10.68, p =0.001; with higher levels observed between 1-4 years category {mean difference 4.64ng/ml, p = 0.02, [95%CI 1.49 - 7.78]} and 5-9 years category {mean difference 4.33ng/ml, p = 0.001, [95%CI 1.89 - 6.38]} as compared to 10 - 14 years respectively.Additionally, children with optimal immune recovery recorded higher proportion of vitamin D deficiency and insufficiency (12.24% and 42.86%) as compared with sub optimally recovered 1.02% and 4.08%); while children with optimal viral suppression recorded higher proportion of vitamin D deficiency and insufficiency (8.16% and 30.61%) as compared with sub optimally suppressed (5.1% and 16.3%)., Conclusion: Infections with HIV suppresses levels of vitamin D, but this has no influence on CD4 counts and viral load status in children receiving ART., Competing Interests: Competing interests The authors declare no competing interests

Background Previously selected lamivudine resistance-associated mutations (RAMs) may remain archived within the proviral HIV-DNA. Objectives To evaluate the ability of proviral DNA genotyping to detect lamivudine RAMs in HIV-1 virologically suppressed participants; the correlation between Sanger and next generation sequencing (NGS); and predictive factors for detection of lamivudine RAMs in proviral DNA. Methods Cross-sectional study of participants on stable antiretroviral therapy and suppressed for ≥1 year. Analysis of proviral DNA was performed by Sanger sequencing in whole blood and by NGS in PBMCs. Results We analysed samples from 102 subjects (52 with and 50 without lamivudine RAMs in historical plasma RNA-genotypes). Among participants with previous lamivudine resistance, Sanger sequencing detected RAMs in 26.9%. Detection rates significantly increased using NGS: 47.9%, 64.6%, 75% and 87.5% with the 20%, 10%, 5% and 1% thresholds, respectively. As for participants without historical lamivudine resistance, Sanger detected the RAMs in 1/49 (2%), and NGS (5% threshold) in 8/45 (17.8%). Multivariate models fitted to the whole population revealed that having a history of lamivudine resistance was a risk factor for detection of lamivudine RAMs by NGS. Among participants with historical lamivudine resistance, multivariate analysis showed that a longer time since HIV diagnosis was associated with persistence of archived mutations by NGS at thresholds of >10% [OR 1.10 (95% CI: 1.00–1.24)] and >5% [OR 1.16 (95% CI: 1.02–1.32)]. Conclusions Proviral DNA Sanger sequencing does not detect the majority of historical lamivudine RAMs. NGS increases the sensitivity of detection at lower thresholds, although the relevance of these minority populations with lamivudine RAMs needs further evaluation.

Introduction: Key populations have disproportionately higher HIV prevalence rates than the general population.Objective: To determine the level of virologic suppression and associated factors in female Commercial Sex Workers (CSW) who completed six months of ART and compare with the female general population (GP).Methods: Clinical records of CSW and GPs who initiated ART between December 2014 to December 2016 from seven urban clinics were analyzed to determine virologic suppression (viral load < 1000 copies/ml) and associated factors.Results: We identified 218 CSW and 182 female GPs. CSW had median age of 28 (IQR 25-31) vs 31 (IQR 26-37); median baseline CD4 446 (IQR 308-696) vs 352 (IQR 164-493) cells/microL; and optimal ART adherence levels at 70.6% vs 92.8% respectively, compared to GP. Virologic suppression in CSW and GPs was 85.7% and 89.6% respectively, P=0.28. Overall virologic suppression in CSW was 55% while Retention in care after 6 months of ART was 77.5%. Immediate ART initiation (

Background: Malaria parasite has been observed to be a common infection in Human Immunodeficiency virus (HIV), an increase malaria infection in adults. Objective: This experimental study is sets to determine the prevalence and density of malaria parasitaemia in Warri com- munity, South-Southern Nigeria. Methods and Results: A total of 600 participants were screened for Human immunodeficiency virus and malaria parasite using WHO systems two and Geimsa staining technique for thick and thin blood films and absolute parasite counts done respectively. The prevalence rate of 38% and 39% were obtained for malaria parasite infection among HIVSP and HIV/ span>SN respectively. The difference in malaria parasite infection was not statistically significant (P>0.05) between HIVSP and HIVSN. However, the mean parasite density in HIVSP was significant (P

Background CD4+ T cell counts in certain human immunodeficiency virus (HIV)-infected patients called immunological non-responders (INRs) could not return to a normal level even with sustained antiretroviral therapy (ART) because of persistent immune activation, which is associated with pro-inflammatory cytokines production and an altered intestinal microbiome profile. Changes in gut bacterial composition have been linked to low CD4+ T cell counts in HIV-infected individuals. However, the association between CD4+ T cell counts and gut microbiota community composition and cytokines levels in INRs (CD4+ T cell counts Methods To address this issue, we carried out a cross-sectional study of 34 HIV-infected INRs. The patients were divided into CD4 count > 200 cells/μL group and CD4 count 16S rRNA gene sequencing. We also compared CD8+ T cell counts, pro-inflammatory cytokines levels, and nutritional status between the two groups. Results Compared to INRs with CD4 count > 200 cells/μL, those with CD4 count Ruminococcaceae was less abundant in the CD4 count 200 cells/μL group, and difference in alpha diversity was observed between the two groups. Moreover, CD4+ T cell counts were negatively associated with TNF-α and IL-1α levels and positively associated with the relative abundance of Ruminococcaceae. Conclusions Our study demonstrated that lower CD4+ T cell counts in INRs are associated with a reduced abundance of Ruminococcaceae in the gut and elevated serum pro-inflammatory cytokines levels. Thus, interventions targeting gut microbiota to increase CD4+ T cell counts are a potential strategy for promoting immune reconstitution in HIV-infected INRs.

Background: Dolutegravir (DTG) plus lamivudine (2-DR) is suggested as an initial and switch option in HIV-1 treatment. Objective: To analyze the effectiveness, durability, and safety of 2-DR compared with DTG plus abacavir/lamivudine (3-DR). Methods: This was an observational, ambispective study that included all treatment-naïve (TN) and treatment-experienced (TE) patients who started 2-DR or 3-DR between July 1, 2018, and November 30, 2020. The primary end point was noninferiority, at 24 and 48 weeks, of 2-DR versus 3-DR regarding the percentage of patients with viral load (VL)≥50 and 200 copies/mL in TN (4% margin) and VLResults: 242 patients were included (53 TN and 189 TE). Two TN patients on 2-DR had VL≥50 copies/mL and 1 had VL≥200 copies/mL at week 24. In TE patients on 2-DR, 90.2% achieved VLConclusion and Relevance: Our results did not show noninferiority in terms of virological effectiveness. Nevertheless, all effectiveness measures support the use of 2-DR in a real-life cohort of TN and TE. Additionally, durability and safety of 2-DR were confirmed to be similar to that of 3-DR.

Relevance. The question about HIV-infected people as a risk group of morbidity and severe course of COVID-19 is still open.Aim of our scientific work is to determine the prevalence and severity of COVID-19` clinical course in HIV-infected people in comparison with the general population.Materials and methods. The information resources of COVID-19 registration in HIV-infected and HIV-negative people in Perm Region were studied for 2020.Results. The prevalence of COVID-19 among HIV-infected people is lower than among HIV-negative people. There were no significant differences in the severity of COVID-19 clinical course in HIV-infected and HIV-negative people. There was no statistically significant dependence of the severity of COVID-19 clinical course in HIV-infected patients on the number of CD4 + T cells and the degree of viral load.Conclusion. HIV-infected people are not a risk group of morbidity and severe course of COVID-19.

Background Human immunodeficiency virus (HIV) infection induces epigenetic age acceleration (EAA), but it remains unclear whether epigenetic aging continues to accelerate during successful antiretroviral therapy (ART) and prolonged virological suppression. Methods We longitudinally analyzed 63 long-term aviremic HIV-infected adults. Using blood DNA methylation patterns, we calculated EAA measures based on 3 epigenetic clocks (Horvath’s clock, PhenoAge, and GrimAge). We recorded the emergence of serious AIDS-related and non-AIDS-related events throughout the study to assess its association with EAA. Results All participants were on stable ART and were virologically suppressed. After 4 years of follow-up, PhenoAge-EAA and GrimAge-EAA showed no differences, whereas Horvath-EAA slightly decreased (median difference, –0.53 years; P = .015). Longitudinal changes in EAA measures were independent of changes in CD4 cell counts, the ART regimen, or other HIV-related factors. Nineteen percent of participants experienced a serious clinical event during the study. Horvath-EAA was significantly higher at baseline in participants with clinical events (P = .027). After adjusting for confounders, we found a trend toward an association of higher levels of all EAA measures at baseline with serious clinical events. Conclusions Epigenetic aging did not accelerate in long-term aviremic HIV-infected adults after 4 years of successful ART. EAA measures deserve further study as potential tools for predicting clinical events.

The aim: to conduct a constitutional and legal analysis of the legal regulation of medical secrecy protection for HIV-infected Russian citizens.Materials and methods. The analysis was carried out on the basis of Russian and foreign legislation and scientific literature published on this topic over the past 7 years, including in Pubmed. The study used dialectical and logical methods, which created the basis for a comprehensive and complete study of the limits of admissibility of protecting medical secrets of HIV-infected; the use of the systemicstructural method allowed to study it in conjunction with constitutional guarantees of human rights.Results. Some problems in the legal regulation of medical secrecy protection of HIV-infected Russian citizens have been identified. It is noted that in Russia there are specific circumstances and reasons requiring disclosure of the positive status of HIV-infected citizens. They hide their diagnosis when entering into intimate relationships with healthy people and even in marriage. The current criminal liability for contracting another person’s HIV infection does not ensure the suppression of infringements on the health of others. Based on the analysis of judicial practice, the excessive protection of medical secrets of HIV-infected is noted. Conclusion. It is concluded that in order to effectively protect the health of Russian citizens, it is necessary to limit in some aspects the protection of personal secrets of HIV-infected persons to ensure the safety of all people in contact with them.

espanolObjetivos. Argentina ha informado de altos niveles de farmacorresistencia transmitida (TDR), en mujeres embarazadas infectadas por el VIH por secuenciacion poblacional. Nuestro objetivo fue describir, en pacientes con TDR, el porcentaje de cuasiespecies que albergan mutaciones de resistencia (RAM) y la carga mutacional (ML). Pacientes y metodos. Estudio retrospectivo en una cohorte de 40 mujeres embarazadas VIH positivas naive, cuyas muestras pretratamiento habian sido genotipificadas por TRUGENE (periodo 2008-2014). Las muestras se genotipificaron por secuenciacion ultraprofunda y se calculo la ML considerando la carga viral multiplicada por la frecuencia de las cuasiespecies que albergan RAMs. Resultados. La TDR para ITINN, ITIAN e IP fue del 17,5% (n=7 pacientes), 10% (n=4), 12,5% (n=5) respectivamente. Las RAMs ITINN predominantes fueron K103N (n=4; 10%) y G190A/E/ S (n=3; 7,5%). Para los ITINN, el 78% de los RAM estaban presentes en >93,5% de la poblacion viral y la ML fue >1000 copias/ml (c/mL) para el 89%, con una mediana (IQR) de 8330 c/ml (7738-29796). Se describieron los siguientes RAM de ITIAN (% de cuasiespecies, ML): T215I (99,7%, 11014 c/ml); D67G (1,28%, 502 c/ml); M41L (79,8%, 88578 c/mL) y M184I (1,02%, 173 c/mL). Las IP-RAMs mas frecuentes fueron I85V, M46I, I50V y L90M (n=2, 5% cada una). Para los IP, las cuasiespecies con RAMs fueron Conclusion. Los ITINN-RAMs son predominantes dentro de la poblacion viral, por lo general superan el umbral de 1000 c/mL, que indicaria un riesgo potencial mas alto de transmision perinatal. Por el contrario, las mutaciones de IP aparecen principalmente como variantes minoritarias, con un riesgo menor de transmision. Para ITIAN, las cuasiespecies que albergan RAM y los valores de ML fueron variables. EnglishObjective. Argentina has reported high levels of transmitted drug resistance (TDR), in HIV-infected pregnant women by population sequencing. We aimed to describe, in patients with TDR, the percentage of quasispecies harboring resistance mutations (RAMs) and mutational load (ML). Patients and Methods. Retrospective study in a cohort of 40 naive HIV-infected pregnant women, whose pretreatment samples had been genotyped by TRUGENE (period 2008-2014). Samples were re-sequenced with Ultra-deep Sequencing and ML was calculated considering baseline HIV-1 RNA load multiplied by the frequency of quasispecies harboring RAMs. Results. TDR for NNRTIs, NRTIs and PIs was 17.5% (n=7 patients), 10% (n=4), 12.5% (n=5) respectively. Predominant NNRTI RAMs were K103N (n=4; 10%) and G190A/E/S (n=3; 7.5%). For NNRTIs, 78% of RAMs were present in >93.5% of viral population and ML was >1000 copies/mL (c/mL) for 89%, with a median (IQR) of 8330 c/ml (7738-29796). The following NRTI RAMs were described (per patient: % of quasispecies, ML): T215I (99.7%, 11014 c/ml); D67G (1.28%, 502 c/mL); M41L (79.8%, 88578 c/mL) and M184I (1.02%, 173 c/mL). Most frequent PI-RAMs were I85V, M46I, I50V and L90M (n=2, 5% each). For PIs, quasispecies with RAMs were Conclusion. NNRTI-RAMs are predominant within the viral population, usually exceeding the threshold of 1000 c/mL, indicating potential higher risk of perinatal transmission. Conversely, PI mutations appear mostly as minority variants, with potential lower risk of transmission. Among NRTI, quasispecies harboring RAMs and ML values were variable.

Background There are limited data exploring antiretroviral therapy (ART) changes and time to change among South Africa young people living with HIV/AIDS. Objective We describe the time to first drug switch, which includes ART regimen change (three drug switch) and substitutions (single drug switch). We describe common reasons for ART switch among young people aged 10 to 24 years in South Africa. Methods We conducted a retrospective cohort study at a primary health care clinic in Cape Town, South Africa, providing ART to HIV-infected adolescents and adults since 2002. Those aged 10 to 24 years at ART initiation, who accessed care clinic between September 2002 and April 2019. Data was retrieved from electronic information systems: ART regimens, ART changes, dates for initiation or stop of each drug/regimen, laboratory results (viral loads, haemoglobin, liver enzyme results, and creatinine to support the reason for ART switch. From written records, we abstracted reason for single drug switch or regimen change, as well as socio demographic and clinical data. We fitted cox regression models to determine factors associated with ART switch (Having a change in one or more drugs in ART combination) and the rate of occurrence. Results Of 2601 adolescents included, 605 (24.9%) adolescents switched ART over 5090.5 person years at risk (PYAR), a rate of 11.9 /100PYAR. Median follow-up time was 4.4 (± 3.2) years. At multivariable analysis, the older age group was protective of the risk of ART switch: adjusted Hazard Ratio [aHR] 0.78, 95% CI 0.62–0.98, transfer status [transferred out 1.42 [1.11–1.82]. The hazard of ART switch increased with more severe HIV-disease at ART start, as observed by increasing WHO clinical stage or reduced CD4 count at baseline. The primary reasons for ART switch were side effects (20.0%), virological failure (17.9%) and formulation switch (27.8%). Others reasons included pregnancy, Hepatitis B, tuberculosis and psychosis. Conclusion ART switches are frequent and occur at a consistent rate across 7.5 years from initiation. The main reasons for ART switch were virological failure and drug side effects.

Objective Human immunodeficiency virus (HIV) infection and antiretroviral therapy (ART) have been associated with reduced bone mineral density (BMD) in persons with HIV (PWH). BMD provides information only about bone mineral quantity. Trabecular bone score (TBS) is a noninvasive tool that estimates bone microarchitecture. The aim of this study is to measure BMD and TBS of Chinese PWH after one-year ART. Methods We designed a retrospective study of adult Chinese PWH. Patients with a dual-energy X-ray absorptiometry (DXA) scan prior to ART initiation, and again 48 weeks later were included. Information regarding demographic and clinical history, HIV treatment history, BMD and TBS were collected. We analyzed differences in BMD and TBS over 48 weeks and associations between key risk factors and changes in BMD and TBS. Results Our study included 233 ​PWH (mean age ​= ​36.6 ​± ​11.1 years). Before ART initiation, 19.3% of PWH had normal BMD but abnormal TBS. Both BMD and TBS decreased after one-year ART. TDF and LPV/r-containing regimens were associated with greater declines in BMD at different site. Traditional risk factors such as old age, low BMI and female sex were associated with lower baseline TBS. Greater change in TBS over one year was associated with lower BMI and lower baseline CD4+ cell count, but unlike BMD measures, it was not correlated with treatment with TDF and LPV/r in our study population. Conclusions We present the first longitudinal analysis of change in TBS over 48 weeks compared with BMD among Asian PWH receiving ART. Before ART initiation, approximately 20% of PWH with impaired bone microarchitecture would not have been identified if DXA were used alone to assess for bone damage. Both BMD and TBS decreased after one-year ART. Change in TBS was not associated with different antiretroviral agents. The translational potential of this article The trabecular microarchitecture measured indirectly by TBS may provide clinicians additional information about bone damage in PWH.

Background Primary analysis at 24 weeks showed that switching to rilpivirine plus darunavir/cobicistat was non-inferior to continuing a standard three-drug antiretroviral regimen in virologically suppressed people with HIV. We present efficacy and safety data from the 48-week analysis. Methods PROBE 2 is a randomized, open-label trial. Adults who were on a three-drug therapy and had had Findings 160 participants were recruited and randomized. At week 48, 70 (87.5%) in the early switch group and 76 (94.8%) in the late switch group maintained HIV-RNA Interpretation The combination of rilpivirine plus darunavir/cobicistat sustained virological suppression, was associated with a low frequency of virological failure, and had a favorable safety profile, which support its use as a nucleoside reverse transcriptase inhibitor-sparing and integrase inhibitor-sparing alternative to three-drug regimens.

HIV/AIDS is an increasingly important cause of cardiovascular (CVD) morbidity world-wide. We sought to evaluate the prevalence of CVD risk factors in HIV positive (HIV+) adults and assessment of these risks using the Framingham risk score (FRS). A cross-sectional study of adult clients of the HIV clinic at Jos University Teaching Hospital. One hundred and fifty HIV+ selected randomly with 50 (age and sex matched) HIV negative (HIV-) participants were enrolled. Relevant history, physical examination and biochemical investigations and 12-lead electrocardiography were performed. Data was analyzed using Epi-info 7.2 statistical software and P value < 0.05 was considered significant. The prevalent major CVD risk factors were dyslipidaemia (30.0% versus 6.0%), hypertension (34.0% versus 10.0%) and diabetes mellitus (10.0% versus 2.0%) among the HIV+ and HIV- participants respectively. The FRS of the HIV+, 3 (IQR 3-28) were statistically significantly higher than that of the HIV- participants, 2 (IQR 1-13); P=0.001. Furthermore, 32% of the HIV+ had moderate-high FRS compared to 2% of HIV- participants. CD4 count ≤ 200 cells/ml, use of anti-retroviral (ART), ART use ≥ 2 years and use of protease inhibitors (PI) emerged as predictors of moderate-high FRS among the HIV+ participants. In conclusion, a high prevalence of CVD risk factors exists among HIV+ population in our local environment. These risk factors can be identified early by baseline/periodic cardiovascular work-up which should include use of CVD risk tools. Early diagnosis and treatment will significantly reduce morbidity and mortality in these patients.

Objective To molecularly characterise the relationship between Epstein-Barr virus (EBV) genotypes and Pashtun ethnicity. Methods The cross-sectional study was conducted from November 2018 to December 2019 after approval from the Gomal University, Dera Ismail Khan, Pakistan, and comprised blood samples from transgender sex workers who were seropositive for human immunodeficiency virus-1 and seronegative for human immunodeficiency virus residing in two cities of Khyber Pakhtunkhwa province and Islamabad, the federal capital. Formalin-fixed paraffin-embedded (FFPE). Samples were collected from the partner institute along with the patients data, but without any follow-up from the study subjects which was purely on the basis of physical availability. β-globin gene and EBER-1(EBV encoded small RNA-1) were amplified for qualitative assessment and existence of Epstein-Barr virus. Characterisation of EBNA-2 (EBV Nuclear Antigen-2 was done through nested polymerase chain reaction. Results Of the 80 subjects, 40(50%) each were seropositive and seronegative individuals. The overall mean age was 28±6.917 years. Among the seropositive group, 38(95%) were homosexual and 2(5%) were heterosexual. Among the seropositive group, 16(40%) had Epstein-Barr virus genotype 1 and 6(15%) had genotype 2, while co-infections were found in 2(5%) subjects. In the seronegative group, 36(90%) subjects had Epstein-Barr virus genotype 1, while there was no case of genotype 2 or co-infection. EBV-2 genotypes with HIV seropositivity showed strong association (p=0.005). Amplification for the EBER-1 gene was done in all the 80(100%) samples. Conclusions Epstein-Barr virus EBV genotype 1 was found to be the most frequent type, while genotype 2 and co-infections were detected in only seropositive samples.

Intimate partner violence (IPV) has been highlighted as one of the challenges to the effectiveness of the Prevention of Mother-to-Child Transmission of HIV (PMTCT) programs in rural areas in South Africa. This study aimed at assessing the prevalence of prenatal and postnatal physical as well as psychological IPV, and corresponding time-invariant and time-varying predictors, among HIV-positive women attending PMTCT services in rural South Africa. The Conflict Tactics Scale (CTS) was used to assess IPV at four time points prenatal and postnatal. This study highlighted high levels of physical and psychological IPV experienced by HIV-infected women during pregnancy and in the first year after childbirth. Time-invariant predictors and time-varying predictors of physical IPV and psychological IPV were individual, social, and behavioral factors. Multi-dimensional evidence-based interventions are needed to deal with the high levels of prenatal and postnatal physical as well as psychological IPV experienced by these women.

Introduction: Among HIV infected children, skin disorders are vital as they give a clue to diagnosis of the HIV disease. Various factors are associated with occurrence of skin disorders among HIV infected children. Objectives: To determine the factors associated with prevalence of skin disorders among HIV infected children in Aminu Kano Teaching Hospital (AKTH) Kano, Nigeria. Materials and Methods: It was a cross-sectional study conducted to determine the factors affecting skin disorders among HIV infected children attending Paediatric Infectious Disease Clinic of Aminu Kano Teaching Hospital, Kano, Nigeria. A total of 223 HIV infected participants aged 6weeks to14 years were recruited for this study. Chi-square test or Fishers exact test where necessary were used to determine the difference between proportions of categorical variables and level of significance was set at 0.05. Multivariate analysis was used to further analyse significant relationships from the univariate analysis. The confidence level was set at 95% and a p-value less than 0.05 was considered statistically significant Results: There were 110 (49.3%) males and 113 females (50.7%). The male to female ratio was found to be 1:1.1. Seventy-eight percent (78%) of the children had skin disorder. A multivariate analysis showed that only age, social class and immune status were significantly associated with the occurrence of skin disorders. Conclusion: Among the HIV infected children, age, socioeconomic class and immune status were the factors found to determine the Prevalence of skin disorders.

Young people perinatally infected with HIV (pHIV) are at risk of a lowered health-related quality of life (HRQOL). Previous evaluation of the NeurOlogical, VIsual and Cognitive performance in HIV-infected Children (NOVICE)-cohort showed no difference in HRQOL between pHIV and matched HIV-uninfected controls (HIV-), yet a higher percentage of pHIV had impaired HRQOL. The aim of this study is to compare the change over time in HRQOL of pHIV to HIV- over a 5-year period. We used the Pediatric Quality of Life Inventory (PedsQL)™ 4.0 to repeat HRQOL assessment. High PedsQL scores indicate good HRQOL. Fifteen/33 (45.5%) pHIV and 17/37 (45.9%) HIV- completed both assessments. At the first assessment, the mean age was 13.1 years (range 8.0–18.4). PHIV scored higher than HIV- on Emotional functioning and on Total scale score. After five years, the mean age was 17.6 years (range 12.1–22.8). PHIV scored higher than HIV- on all scales, except Social functioning. PHIV did not differ significantly from the Dutch norm on either time-point. LMEM showed no difference in change over time for any of the PedsQL scales. In this study, young people with pHIV receiving high-quality health care, including monitoring of HRQOL, remain to experience a good HRQOL.

BACKGROUND Tuberculosis is often more difficult to diagnose and more complicated to treat among people who are human immunodeficiency virus (HIV) positive. This study was conducted to assess the clinical, microbiological, laboratory and radiological spectrum of tuberculosis (TB) in HIV seropositive patients, and explore its possible correlation with their CD4 count. METHODS A total of 104 patients who were western blot positive for HIV and co-infected with tuberculosis were studied in Salem district of Tamil Nadu. A detailed history was obtained and patients were examined clinically. CD4 count, sputum smear for acid fast bacilli (AFB), chest x-ray, and tuberculin test, were done along with other relevant investigations. The relationship between CD4 count, and the type of tuberculosis, sputum smear, chest x-ray, and tuberculin test, were analysed statistically, and P < 0.05 was considered significant. RESULTS Most of the patients were between 30 to 39 years. Males (84.6 %) outnumbered females (15.4 %). Pulmonary tuberculosis alone was seen in 47 patients, while extra pulmonary tuberculosis in 36 cases, and both pulmonary and extra pulmonary occurred in 21 cases. They had a mean CD4 count of 237.7 cells / μL, 135.2 cells / μL and 120.9 cells / μL respectively. Extrapulmonary tuberculosis and combined forms were associated with lower CD4 counts (P-value 0.005). The mean CD4 count of sputum positive, sputum negative, and multiple drug resistant (MDR) tuberculosis were 294.2, 168.3 and 90.2 cells / μL respectively. Lower CD4 count was associated with sputum - ve TB (P < 0.041). Lower CD4 counts were associated with atypical chest X-ray findings (P < 0.006) and negative tuberculin test (P < 0.001). CONCLUSIONS Sputum smear positivity for AFB decreases as CD4 count reduces. Involvement of lungs tend to be atypical in immunocompromised patients. The diagnosis of TB in HIV positive individuals is complex and a high index of suspicion is needed. KEYWORDS HIV, Tuberculosis, CD4 Cell Count, Sputum Smear for AFB, Chest X-Ray