Search

Neurocognitive disorders are mental health conditions that are caused by medical illnesses and can lead to several acquired cognitive deficits, which represent a decline from a previously attained level of functioning. The principal domains of cognitive functions include complex attention, executive function, learning and memory, language, perceptual–motor function, and social cognition. Studies have shown that people living with human immunodeficiency virus (HIV) are at a heightened risk of experiencing cognitive challenges across multiple domains. Given that, a substantial number of people live in Amhara region, assessing cognitive domains to estimate the current magnitude and factors associated with neurocognitive disorders among HIV/AIDS patients is crucial. An institutional-based cross-sectional study was conducted among 569 participants adults living with HIV attending the city's selected health facilities from March 20 to April 30, 2023. A multistage sampling technique was used. The International HIV Dementia Scale (IHDS) was used to measure the outcome of interest. The data were collected using a structured questionnaire and document review. The data were analyzed using STATA version 14. Multiple binary logistic regressions were used as the final model. A total of 501 individuals, with a response rate of 88.04% participated in the study. The overall proportion of HIV patients with neurocognitive impairment was 54.7% (95% CI 50.62–58.77). Factors associated with the neurocognitive impairment were: being widowed AOR = 3.05 (95% CI 1.47–6.31), divorced AOR = 1.95 (1.16–3.28), rural residence AOR = 2.28 (95% CI 1.02–5.09), CD4 count below 500 cells/dl AOR = 1.61 (95% CI 1.03–2.50), history of opportunistic infection AOR = 2.21 (95% CI 1.42–3.41), being in first-line drug regimen AOR = 2.92 (95% CI 1.22–7.00), being in a first-line regimen with Efavirenz AOR = 4.36 (95% CI 1.07–17.73), and impairment in daily living AOR = 2.64 (95% CI 1.39–4.99). In this study, the proportion of neurocognitive impairment was greater than that in most previous studies conducted in Ethiopia. The factors associated with the disorder were: being widowed or divorced, living in a rural area, having low CD4, having a history of opportunistic infection, receiving a first-line drug regimen, receiving efavirenz-containing drugs, and having impaired daily living. Hence, routine neuropsychological screenings should be integrated into comprehensive ART care by the regional health bureau and implemented by hospitals and health centers. [ABSTRACT FROM AUTHOR]

In the pursuit of achieving better therapeutic outcomes in the treatment of HIV, innovative drug delivery strategies have been extensively explored. Mannose receptors, which are primarily found on macrophages and dendritic cells, offer promising targets for drug delivery due to their involvement in HIV pathogenesis. This review article comprehensively evaluates recent drug delivery system advancements targeting the mannose receptor. We have systematically described recent developments in creating and utilizing drug delivery platforms, including nanoparticles, liposomes, micelles, noisomes, dendrimers, and other nanocarrier systems targeted at the mannose receptor. These strategies aim to enhance drug delivery specificity, bioavailability, and therapeutic efficacy while decreasing off-target effects and systemic toxicity. Furthermore, the article delves into how mannose receptors and HIV interact, highlighting the potential for exploiting this interaction to enhance drug delivery to infected cells. The review covers essential topics, such as the rational design of nanocarriers for mannose receptor recognition, the impact of physicochemical properties on drug delivery performance, and how targeted delivery affects the pharmacokinetics and pharmacodynamics of anti-HIV agents. The challenges of these novel strategies, including immunogenicity, stability, and scalability, and future research directions in this rapidly growing area are discussed. The knowledge synthesis presented in this review underscores the potential of mannose receptor-based targeted drug delivery as a promising avenue for advancing HIV treatment. By leveraging the unique properties of mannose receptors, researchers can design drug delivery systems that cater to individual needs, overcome existing limitations, and create more effective and patient-friendly treatments in the ongoing fight against HIV/AIDS. [Display omitted] [ABSTRACT FROM AUTHOR]

Abstract Neurocognitive disorders are mental health conditions that are caused by medical illnesses and can lead to several acquired cognitive deficits, which represent a decline from a previously attained level of functioning. The principal domains of cognitive functions include complex attention, executive function, learning and memory, language, perceptual–motor function, and social cognition. Studies have shown that people living with human immunodeficiency virus (HIV) are at a heightened risk of experiencing cognitive challenges across multiple domains. Given that, a substantial number of people live in Amhara region, assessing cognitive domains to estimate the current magnitude and factors associated with neurocognitive disorders among HIV/AIDS patients is crucial. An institutional-based cross-sectional study was conducted among 569 participants adults living with HIV attending the city’s selected health facilities from March 20 to April 30, 2023. A multistage sampling technique was used. The International HIV Dementia Scale (IHDS) was used to measure the outcome of interest. The data were collected using a structured questionnaire and document review. The data were analyzed using STATA version 14. Multiple binary logistic regressions were used as the final model. A total of 501 individuals, with a response rate of 88.04% participated in the study. The overall proportion of HIV patients with neurocognitive impairment was 54.7% (95% CI 50.62–58.77). Factors associated with the neurocognitive impairment were: being widowed AOR = 3.05 (95% CI 1.47–6.31), divorced AOR = 1.95 (1.16–3.28), rural residence AOR = 2.28 (95% CI 1.02–5.09), CD4 count below 500 cells/dl AOR = 1.61 (95% CI 1.03–2.50), history of opportunistic infection AOR = 2.21 (95% CI 1.42–3.41), being in first-line drug regimen AOR = 2.92 (95% CI 1.22–7.00), being in a first-line regimen with Efavirenz AOR = 4.36 (95% CI 1.07–17.73), and impairment in daily living AOR = 2.64 (95% CI 1.39–4.99). In this study, the proportion of neurocognitive impairment was greater than that in most previous studies conducted in Ethiopia. The factors associated with the disorder were: being widowed or divorced, living in a rural area, having low CD4, having a history of opportunistic infection, receiving a first-line drug regimen, receiving efavirenz-containing drugs, and having impaired daily living. Hence, routine neuropsychological screenings should be integrated into comprehensive ART care by the regional health bureau and implemented by hospitals and health centers.

Human Immunodeficiency Virus infection and sexually transmitted infections are still a public health problem in the world and in Indonesia. People infected with HIV are still stigmatized, this happens because the level of education in the community is still mostly elementary school graduates. Barriers also occurred when conducting outreach to the community, because it was difficult to gather the community at the same time with reasons for work, school, or free time to be used for rest. This study aims to determine the implementation of HIV/AIDS prevention policies at the Tanjung Morawa Community Health Center. This research is important to do to find out the implementation of HIV/AIDS prevention policies at the Tanjung Morawa Community Health Center. The purpose of this study was to find out how the implementation of HIV/AIDS prevention policies at the Tanjung Morawa Community Health Center. This type of research is a qualitative research using in-depth interview data collection techniques, informants are selected purposively according to research needs, the data obtained in the research is then systematically processed at each stage to get the final results displayed in narrative form. The results showed that the transmission and authority in communication were good, the quantity and quality of resources were good, employee performance was optimal, fragmentation and SOP in the bureaucracy were good, but participation or the community was not optimal.

Tolera Ambisa Lamesa,1 Aklilu Getachew Mamo,1 Gebeyaw Arega Berihun,1 Regassa Alemu Kebede,1 Eba Bekele Lemesa,2 Waqtola Cheneke Gebisa1 1School of Medical Laboratory Science, Jimma University, Jimma, Ethiopia; 2Mycobacteriology Research Center, Jimma University, Jimma, EthiopiaCorrespondence: Tolera Ambisa Lamesa, Tel +251937187622, Email toleraambisa@gmail.comBackground: Highly active antiretroviral treatment is beneficial to suppress human immune virus replication in infected individuals. However, dyslipidemia and other metabolic abnormalities have emerged due to antiretroviral treatment. The prevalence of dyslipidemia in children and adolescents on antiretroviral treatment varies from 20% to 70%. The lack of data on children and adolescents in Ethiopia was the rationale for conducting this study. We aimed to determine prevalence of dyslipidemia and nutritional status in children and adolescents on follow-up at Jimma medical center.Materials and Methods: A hospital-based cross-sectional study was conducted with 150 children and adolescents on follow-up at Jimma medical center. A systematic sampling technique was employed. An interview was carried out to collect socioeconomic and demographic data and a review of medical records was carried out to collect patients’ clinical data. Anthropometric data were computed using the CDC growth chart. About 3– 5mL of fasting blood was collected to measure lipid profile. Multivariable logistic regression was performed to find the association between risk factors and lipid profile.Results: The overall prevalence of dyslipidemia in this study was 72%. About 72% and 21.3% of study subjects had low high-density lipoprotein and high triglyceride, respectively. Significant associations were observed between BMI for age ≤ 5% (AOR: 2.02, 95% CI: 1.14– 3.66; P=0.015) and low high-density lipoprotein; greater than 150 months on treatment (AOR: 1.02, 95% CI: 1.00– 1.03; P=0.01) and high triglyceride; and BMI for age ≤ 5% (AOR: 1.86, 95% CI: 1.03– 1.37; P=0.04) and high triglyceride.Conclusion: BMI for age < 5%, treatment duration of greater than 150 months, and parents’ educational level were significantly associated with dyslipidemia, so it is recommended that monitoring of those variables will help to reduce dyslipidemia and its complications in children and adolescents receiving treatment.Keywords: HIV/AIDS, HAART, dyslipidemia, nutritional status, JMC

HIV and AIDS in Ternate City are second ranks after North Halmahera District, especially in North Maluku Province. There were 684 HIV AIDS cases in 2007-April 2022, 24 new cases in 2022 (12 homosexuals, 10 heterosexuals, and 2 IDUs). Early detection of HIV testing is one way of knowing HIV status, especially in people at high risk. The aim is to describe the characteristics of Sex workers in entertainment locations X and Y in their willingness to carry out an HIV test. The study was conducted in July 2022 with a total population of 50 sex workers at entertainment locations X and Y. Samples were taken by total sampling. Data were taken using the IBBS questionnaire and analyzed descriptively. Almost half of the respondents' age group is 30-39 years old (42%), high school education respondents (82%), unmarried respondents (66%), and respondents who have worked in entertainment venues X and Y for 1-5 years (60%). More than half of the respondents had good knowledge (76%), and all respondents received support related to HIV testing from peers, pimps, and health workers as well as the role of health workers who always carried out HIV tests. The better the understanding and knowledge of HIV AIDS, the more motivated they are to be willing to take an HIV test because understanding the condition is a high risk

Abstract Background Prevention of mother-to-child transmission service is a comprehensive package of services planned to reduce the risk of mother-to-child transmission of HIV. It is very crucial to determine the level of quality of PMTCT services in this study area since other studies in our country omitted several variables in each category of the Donobedian model. Therefore, this study aimed to determine the level of quality of option B + PMTCT of HIV services. Methods An institution-based cross-sectional study design with both quantitative and qualitative data collection method was employed. Donabedian’s model was used to assess the level of quality of PMTCT service. A total of 422 pregnant women were used to assess the level of satisfaction of clients. An inventory of resources and direct observation was done to assess the quality of the input and output component of the Donobedian model respectively. In addition to satisfaction items, 12 output-related items were also used to assess quality in the output dimension. Finally, those hospitals that scored above 90% in each component of the Donovedian model were categorized as having good quality. Finally, twelve in-depth interviews were conducted to explore barriers to the quality of option B + PMTCT services. The qualitative data were analyzed using the thematic analysis method and finally, it was presented with the quantitative result through triangulation. Results No hospitals simultaneously met the requirements for good quality in all three dimensions of option B + PMTCT service quality. Only one hospital out of the four hospitals met the requirements for good quality of PMTCT service in the input dimension. Regarding the process and output dimension's quality of PMTCT services, two of the hospitals met the criteria for good quality. One hospital out of the total exhibited poor performance in all three dimensions of service quality for option B + PMTCT services. Conclusion According to this study no hospitals simultaneously met the requirements for good quality in all three dimensions of option B + PMTCT service quality. PMTCT unit performance must be continuously monitored, reviewed, and supervised. To obtain the minimum required resources primary hospitals must be supported.

Background: Prevention of mother-to-child transmission service is a comprehensive package of services planned to reduce the risk of mother-to-child transmission of HIV. It is very crucial to determine the level of quality of PMTCT services in this study area since other studies in our country omitted several variables in each category of the Donobedian model. Therefore, this study aimed to determine the level of quality of option B + PMTCT of HIV services. Methods: An institution-based cross-sectional study design with both quantitative and qualitative data collection method was employed. Donabedian's model was used to assess the level of quality of PMTCT service. A total of 422 pregnant women were used to assess the level of satisfaction of clients. An inventory of resources and direct observation was done to assess the quality of the input and output component of the Donobedian model respectively. In addition to satisfaction items, 12 output-related items were also used to assess quality in the output dimension. Finally, those hospitals that scored above 90% in each component of the Donovedian model were categorized as having good quality. Finally, twelve in-depth interviews were conducted to explore barriers to the quality of option B + PMTCT services. The qualitative data were analyzed using the thematic analysis method and finally, it was presented with the quantitative result through triangulation. Results: No hospitals simultaneously met the requirements for good quality in all three dimensions of option B + PMTCT service quality. Only one hospital out of the four hospitals met the requirements for good quality of PMTCT service in the input dimension. Regarding the process and output dimension's quality of PMTCT services, two of the hospitals met the criteria for good quality. One hospital out of the total exhibited poor performance in all three dimensions of service quality for option B + PMTCT services. Conclusion: According to this study no hospitals simultaneously met the requirements for good quality in all three dimensions of option B + PMTCT service quality. PMTCT unit performance must be continuously monitored, reviewed, and supervised. To obtain the minimum required resources primary hospitals must be supported. [ABSTRACT FROM AUTHOR]

BackgroundThis study aims to evaluate the pharmacokinetics of an increased dose of darunavir (800 mg twice daily) with 100 mg ritonavir during pregnancy and postpartum.MethodsDarunavir (DRV) and ritonavir (RTV; r) intensive pharmacokinetic evaluations were performed at steady state during the second and third trimesters of pregnancy (DRV/r 800/100 mg bid) and 2-3 weeks postpartum (DRV/r 600/100 mg twice daily). Plasma concentrations of darunavir and ritonavir were measured using high-performance liquid chromatography. Target darunavir area under the concentration time curve (AUC) was >70% (43.6 μg × h/mL) of median AUC (62.3 μg × h/mL) in nonpregnant adults on twice daily darunavir-ritonavir 600/100 mg.ResultsTwenty-four women were included in the analysis. Darunavir AUC0-12 was lower with the increased dose during the second {[geometric mean ratio (GMR) of 0.62 (IQR 0.44-0.88); P = 0.055]} and third trimesters [GMR 0.64 (IQR 0.55-0.73); P =

Research Background : South Jepara Regency is an industrial area that absorbs a lot of labor around the company's establishment. Over time, the incidence of HIV AIDS has increased. Data from the Jepara health office in Pecangaan District in 2018 reached 48 cases, in Mayong District in 2018 it reached 29 cases and in Kalimatan District in 2018 it reached 21 cases. Research Objective: To analyze the impact of industrial estates on the incidence of HIV AIDS. Research Methods: This type of research is qualitative with in-depth interview data collection techniques. Time of data collection in November 2019. The research location is Pecangaan, Kalinyamatan and Mayong Districts, Jepara Regency, Central Java. The number of research informants is 10 people. Miles and Huberman interactive data analysis The results of the study: the positive impact of increasing economic welfare and reducing the number of unemployed, while the negative impact of water pollution, the proliferation of hangouts and the construction of many boarding houses. Conclusion: Industrial growth in the southern part of Jepara Regency, has positive and negative impacts. Industrial environmental conditions as an indirect cause of the increasing incidence of HIV AIDS.

Purpose of Review : Pregnant people living with HIV (PLWH) are at especially high risk for progression from latent tuberculosis infection (LTBI) to active tuberculosis (TB) disease. Among pregnant PLWH, concurrent TB increases the risk of complications such as preeclampsia, intrauterine fetal-growth restriction, low birth weight, preterm-delivery, perinatal transmission of HIV, and admission to the neonatal intensive care unit. The grave impact of superimposed TB disease on maternal morbidity and mortality among PLWH necessitates clear guidelines for concomitant therapy and an understanding of the pharmacokinetics (PK) and potential drug-drug interactions (DDIs) between antitubercular (anti-TB) agents and antiretroviral therapy (ART) in pregnancy. Recent Findings: This review discusses the currently available evidence on the use of anti-TB agents in pregnant PLWH on ART. Pharmacokinetic and safety studies of anti-TB agents during pregnancy and postpartum are limited, and available data on second-line and newer anti-TB agents used in pregnancy suggest that several research gaps exist. DDIs between ART and anti-TB agents can decrease plasma concentration of ART, with the potential for perinatal transmission of HIV. Current recommendations for the treatment of LTBI, drug-susceptible TB, and multidrug-resistant TB (MDR-TB) are derived from observational studies and case reports in pregnant PLWH. Summary: While the use of isoniazid, rifamycins, and ethambutol in pregnancy and their DDIs with various ARTs are well-characterized, there is limited data on the use of pyrazinamide and several new and second-line antitubercular drugs in pregnant PLWH. Further research into treatment outcomes, PK, and safety data for anti-TB agent use during pregnancy and postpartum is urgently needed. [ABSTRACT FROM AUTHOR]

HIV (Human Immunodeficiency Virus) is a virus that attacks the immune system so that it becomes weak in fighting infection, the final stage of HIV infection will develop into Acquired Immunodeficiency Syndrome (AIDS). This study aims to determine the relationship between work and the severity of HIV AIDS in PLWHA in the Aru Islands Regency in 2020. An analytic observational study with the Cross Section Study method. Interviews were conducted on 137 respondents out of a total of 165 who visited and carried out HIV tests at the Mutiara Dobo VCT clinic. To see the relationship between work and the severity of HIV AIDS. Data analysis using chi-quare, univariate analysis, bivariate and multivariate analysis. The results showed that the factors related to the effect of work on the severity of HIV AIDS were employment (p value 0.000) which was a protective variable (prevention) with LL and UL values below the value 1, length of work (p value 0.000). The results of the multivariate analysis showed that the dominant factor affecting the severity of HIV was the length of work variable with the largest odd ratio value, which was 19.873. After knowing that there is a relationship between work and the severity of HIV AIDS, it is necessary to have a program that is able to financially prosper people living with HIV AIDS so that patients are able to maintain their condition. [ABSTRACT FROM AUTHOR]

Penelitian ini bertujuan untuk memberikan gambaran dinamika psikologis remaja HIV-AIDS yang pernah melakukan hubungan seks pranikah di Aceh Utara. Penelitian ini menggunakan pendekatan fenomenologis. Subjek berjumlah empat remaja berusia 14-16 tahun yang sudah terinfeksi HIV AIDS dan pernah aktif melakukan hubungan seks pranikah. Metode pengumpulan data dilakukan dengan cara wawancara dan observasi. Hasil penelitian menunjukkan bahwa Informan mempercayai penyakit ini adalah suatu bentuk hukuman dari Tuhan bagi mereka dan keluarganya. Mereka mengalami rasa bersalah yang mendalam dan rasa malu yang berlebihan. Beberapa subjek juga mengalami harga diri rendah dan takut untuk berhadapan dengan orang banyak. Harga diri rendah membuat mereka melakukan percobaan bunuh diri. Stigma juga dating dari masyarakat yang mengetahui status atau dugaan HIV mereka. Masyarakat menilai mereka yang terkena penyakit ini berasal dari keluarga yang kacau. Remaja yang terdiagnosis HIV ini mengalami beberapa simptom-simptom psikologis yang buruk, yaitu insomnia, agresi, halusinasi, depresi, sulit konsentrasi, dan hilang harapan akan masa depan.

The mother-to-child transmission (MTCT) of the human immunodeficiency virus (HIV) remains a serious public health problem in the Brazilian Rainforest. This study aimed to spatially analyze this type of infection between 2007 and 2018 in Pará, which is the second-largest Brazilian state in the Brazilian Rainforest and also has the highest MTCT of HIV in Brazil. We analyzed the incidence rates of HIV (including the acquired immunodeficiency syndrome (AIDS) by MTCT as the main route of infection in children younger than 13 years old and whose mothers live in Pará. We employed spatial autocorrelation, spatial scanning, and geographic-weighted spatial regression techniques. In the period of this study, 389 new HIV/AIDS were noted, with territorial expansion of the incidence rates in the municipalities in northern and southern Pará having the highest rates. São Francisco do Pará had high spatial risk and high-spatiotemporal risk clusters comprising municipalities in western and south-western Pará between 2013 and 2016. The spatial variability of HIV/AIDS incidence rates was found to be common in the number of men and women with formal jobs; unemployed ≥18 years old people; elementary school pupils; and families enrolled in the “Single Registry for Social Programs”. The social equity approach in Pará guarantee pregnant women access to preventive, diagnostic and treatment health services and their children should be supported to eliminate the MTCT of HIV in Pará.

Neutropenia is a relatively uncommon but notable secondary effect of HIV infection. While the various hematopoietic effects of HIV and AIDS are well-described in the literature, high-quality evidence directly linking neutropenia with mortality in HIV-infected patients remains limited. The multifactorial etiology of neutropenia complicates its diagnosis, particularly when it occurs secondary to HIV. We present the case of a 35-year-old African American male with congenital HIV, who presented with severe neutropenia accompanied by a fever in the context of untreated HIV. The initial differential diagnosis was broad, including benign ethnic neutropenia (given the patient's African American ethnicity), tuberculosis (given the potential for anti-tuberculosis therapy to cause neutropenia and its commonality as a co-infection in HIV patients), sepsis-related neutropenia, and AIDS-related bone marrow suppression. However, through further workup, it became apparent that HIV-related bone marrow suppression ultimately led to pancytopenia. This case highlights how HIV patient non-adherence to antiretroviral therapy (ART) and hematologic abnormalities complicate the diagnosis of hematopoietic abnormalities from HIV. It also discusses how vertical transmission and abrupt ART discontinuation create a new phenotype of HIV patients with delayed presentations of AIDS-related complications. This patient's presentation also provides insight into the consequences of untreated HIV following the self-discontinuation of long-term HIV management therapy due to low healthcare literacy and loss of follow-up. The patient's clinical course, laboratory findings, imaging studies, and treatment outcomes are discussed, emphasizing the need for timely diagnosis and a multidisciplinary approach to care while exploring potential barriers to care in different social contexts., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Huynh et al.)

Medical literature has long reported evidence of complications associated with cosmetic procedures, including silicone injections. Recent years have seen an increase in case reports involving hypercalcemia resulting from these injections. A common current hypothesis for the development of hypercalcemia associated with silicone injections is granulomatous inflammation against a foreign body.  This report aimed to describe the case of a 44-year-old African American male with human immunodeficiency virus (HIV) and chronic kidney disease (CKD) who presented to our hospital and was diagnosed with calcinosis universalis secondary to a history of silicone injections, as well as to present a literature review of silicone-induced hypercalcemia. This was a case report (n=1) from a large academic medical center for which the patient, who first presented in May 2023, had two inpatient admissions and two outpatient visits before being lost to follow-up. Relevant images, laboratory results, and treatments were included.  The patient's history was significant for HIV, hypertension, CKD, recurrent nephrolithiasis, and tobacco use disorder. Physical examination was positive for flank pain while labs were significant for Na 137 mmol/L, K 2.7 mmol/L, blood urea nitrogen (BUN) 28 mg/dL, creatinine 3.72 mg/dL, calcium 13.4 mg/dL, hemoglobin 9.3 g/dL, white blood cell count 6,700 u/L and platelet count 105,000 u/L. Renal ultrasound revealed bilateral nephrolithiasis and left-sided hydronephrosis. Computerized tomography (CT) upon admission showed hyperlucid deposits in the bilateral gluteal area. Initial management included intravenous (IV) fluids and one dose of IV pamidronate, which resulted in reduced calcium levels during the admission. Subsequent management included outpatient follow-up with endocrinology during which denosumab was prescribed. This case had similar findings to other reports in the literature detailing silicone-induced hypercalcemia, which also reported abnormal imaging or nephrolithiasis, low-normal parathyroid hormone (PTH), normal 25-hydroxyvitamin D, and elevated 1,25-dihydroxyvitamin D. Silicone injection-induced hypercalcemia should be considered as a differential diagnosis in patients presenting with otherwise unexplained elevated serum calcium and a history of past cosmetic procedures. If suspected, the use of imaging techniques (e.g. positron emission tomography (PET) scans or MRI) may help ascertain the diagnosis. Further research is needed to determine the most appropriate therapies for complex patients such as those with immunodeficiency or renal disease., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Mayer et al.)

Introduction India has the second-highest number of people living with human immunodeficiency virus (PLHIV). Despite the national decline in the prevalence of the human immunodeficiency virus (HIV) from 2000 to 2021, regional variations persist, particularly in the northeastern and southern states. High-risk populations, including female sex workers (FSW), men who have sex with men (MSM), and injecting drug users (IDU), significantly contribute to these dynamics. This study focuses on high-prevalence districts in Karnataka. Objectives This study aims to identify socioeconomic and behavioral factors associated with high HIV prevalence in high-burden districts of South Indian states. Methodology A cross-sectional study was conducted using data from Integrated Counseling and Testing Centers (ICTCs) and Designated STI/RTI (sexually transmitted infections/reproductive tract infections) Clinics (DSRCs) across 24 centers in the three districts. The centers were determined using a simple random sampling method. Data from 2501 HIV-positive individuals were analyzed, focusing on demographics, risk behaviors, and treatment history. Results Males constituted the majority of HIV cases, accounting for 448 (56.0%) in Vijayapura, 334 (51.4%) in Bagalkot, and 644 (61.1%) in Belagavi districts, with a significant portion referred by government hospitals. High HIV prevalence was linked to adults aged 25-49 years of age; the number of people with HIV was high among daily wage workers and individuals with multiple sexual partners compared to married and educated people. Newly diagnosed discordant couples ranged from 129 (12.2%) in Belagavi to 133 (18.4%) in Vijayapura districts. Most patients were on first-line antiretroviral therapy (ART), with loss to follow-up attributed to system negligence and poor compliance. Conclusion Key determinants of high HIV prevalence include gender, age, marital status, socioeconomic status, and sexual behavior. Effective interventions require targeted education, improved healthcare services, robust surveillance, and strengthened collaboration among stakeholders., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Shri B. M. Patil Medical College Hospital and Research Centre, BLDE (Deemed to be University) issued approval BLDE(DU)/IEC/846/2022-23. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Pattankar et al.)

We present the case of a young male who was diagnosed with HIV in 2012. However, his initiation of antiretroviral therapy (ART) was delayed until 2018 due to issues related to his acceptance and acknowledgment of the disease. In April 2021, the patient presented with hemoptysis, shortness of breath, and constitutional symptoms. Initial extensive workup for tuberculosis (TB) and other respiratory pathogens returned negative. Despite this, he was treated for smear-negative pulmonary TB and pneumocystis pneumonia (PCP) and was subsequently discharged. He then had recurrent hospital admissions due to worsening respiratory symptoms, with short intervals between recovery and recurrence. Each admission saw an increase in his oxygen requirements. Throughout these hospitalizations, tests for coronavirus disease 2019 (COVID-19) were consistently negative. TB and PCP treatment continued throughout his admissions. Despite various treatments, his condition continued to deteriorate. A DNA polymerase chain reaction (DNA PCR) test for cytomegalovirus (CMV) was eventually conducted. Unfortunately, the patient succumbed to progressive respiratory failure, and the CMV DNA PCR returned positive a week after his death. In the era of COVID-19, this case underscores the importance of early diagnosis and timely antiviral treatment., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Clinical Research Centre (CRC) of Hospital Sultan Abdul Halim and in accordance to Malaysian Research Ethics Committee (MREC) issued approval N/A. Informed consent was obtained from the late patient's family for his information to be published in this article. The design of the work accords to the Malaysian Research Ethics Committee (MREC) and Hospital Sultan Abdul Halim Clinical Research Centre (CRC). Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Krishnasamy Naido et al.)

The rate of spontaneous preterm-birth among pregnant women living with HIV on antiretroviral therapy (ART) is 3- to 4-fold higher when compared to HIV-negative women. The pathophysiology of preterm-birth related to HIV or ART remains unknown, especially as women living with HIV are often excluded from preterm birth studies. This review discusses the currently available evidence on the prediction and prevention of preterm-birth in pregnant women living with HIV. A review of the literature was conducted of primary articles between 2005 and 2021 measuring the association or lack thereof between combination ART and preterm birth, as well as of other predisposing factors to preterm birth in women living with HIV, including cervical length, vaginal microbiome, and cervico-vaginal biomarkers. Further research into the effect of ART exposure on preterm-birth risk is critical, and development of preterm-birth predictive tools in this population should be a priority. Vaginal progesterone supplementation deserves further investigation as a therapeutic option to prevent recurrent preterm birth in pregnant women living with HIV. The ProSPAR study, a multicenter randomized controlled trial studying progesterone supplementation in pregnant women on protease inhibitor-based regimens, has been designed but is not yet recruiting patients. [ABSTRACT FROM AUTHOR]

Aims: The objective of this study was to determine relationship between xerostomia and quality of life of HIV person's living in prison. Materials and Methods: an observational study using cross sectional design was done among 68 HIV AIDS person in prison in Jakarta, but only 54 could be analyzed because of incomplete data. We used the xerostomia inventory questionnaire to assess xerostomia, and for salivary flow rate was measured by the spitting method without stimulation. Quality of life was assessed using questionnaire of the Oral Health Impact Profile (OHIP-14). Results: Quality of life of HIV AIDS patient, only 55.6% was good. There was a significant relationship between xerostomia and quality of life with Prevalence Ratio 3.16. From 11 questions regarding xerostomia there were 4 questions that were significantly related to quality of life (P < 0.05), namely dry mouth when eating, need water when swallowing food, dry eyes, dry nose. In conclusion many HIV AIDS patient experienced xerostomia which affects their quality of life. Conclusion: Xerostomia was a risk factor of having low quality of life, it showed on Prevalence ratio in most of items of OHIP. [ABSTRACT FROM AUTHOR]

The 2018 national prevalence of HIV/AIDSwas 301.959 cases. The 2016 East Java had an HIV/AIDS prevalence was 6.315 cases,the prevalence of HIV/AIDS in Madiun of 2002-2009 amounted to 343 cases. The prevalence in Dagangan was 46 cases. The HIV/AIDS cases in Dagangan was small, but peoples stigma on HIV/AIDS fall in high category, one in the BanjarsariWetan village. Therefore, the purpose of this studied to identify the impact of Public Health Promotion had on peoples stigma in HIV/AIDS sufferers. The kind of this research used experimental methods of epidemiology, and used pre-experimental design (one group pretest and posttest design). The population of this studied about 1,326 people and the numbers of samples were 171 respondents. The results of pre-test and post -test studies, means 96 respondents have dropped the stigma on HIV/AIDS sufferers from pre test to posttest scores. The result of the ties' value was 59, so there is a similar value between the pre test and the post test for those who develop the stigma on HIV/AIDS. Based on wilcoxon's test analysis, the value of p=0,000 can be concluded that a significant impact can be noted between the stigma on society's intervention and the promotion of health care for those with HIV/AIDS in pre-test and post-test values. Increased tools and information infrastructure to increase public knowledge about HIV/AIDS are urgently needed.

HIV attacks the sufferer's immune system and if coupled with prolonged psychosocial spiritual stress will accelerate the occurrence of AIDS, and even increase the mortality rate. AIDS is incurable. Giving ARV is to suppress the amount of virus (viral load). The purpose of the study was to motivate parents with parental compliance in giving their children anti-HIV drugs. This research is a quantitative method with used purposive sampling, cross sectional technique, 41 respondents were parents or caregivers of children with HIV patients who were taking ARV treatment. The results showed that the level of motivation of parents or caregivers in giving ARV drugs was sufficient 60.98% and Parental Compliance with HIV Drugs was compliant with 73.17%. Based on the Spearman Rank statistical test, the correlation value (r) is 0.372 and the p value is 0.017. P value < (0.05. It is hoped that the officers will improve the provision of health education about treatment and the impact of stopping treatment for patients with the method of giving leaflets to each respondent who comes to take medication so that it can be spread evenly. [ABSTRACT FROM AUTHOR]

Acquired immune deficiency syndrome (AIDS)-associated cholangiopathy is a biliary tract condition seen in AIDS patients who are severely immunosuppressed, contributing to significant mortality in this population, even in developed countries with access to highly active antiretroviral therapy (HAART).  We discuss a thirty-six-year-old human immunodeficiency virus (HIV)-positive male, non-compliant with HAART therapy, who presented with a one-year history of weight loss, persistent fatigue, and chronic diarrhea, which had worsened significantly in the past few weeks. Routine laboratory studies on presentation indicated elevated liver enzymes and alkaline phosphatase, a CD4 count of 2 cells/mm 3 , and a high HIV RNA count of 8.8 million. Imaging via CT of the abdomen and pelvis and ultrasound of the abdomen both displayed thickening and edema in the gallbladder without evidence of gallstones, raising concerns of acalculous cholecystitis. The patient subsequently decompensated, requiring intravenous vasopressors to maintain hemodynamic stability, broad-spectrum antibiotics, and resumption of antiretroviral therapy. Biliary fluid drainage was performed, and Cryptosporidium and cytomegalovirus (CMV) were detected via polymerase chain reaction (PCR) testing. The diagnosis of AIDS cholangiopathy was established; however, the patient's diarrhea worsened upon the introduction of tube feeds. Despite ongoing antimicrobial treatment, the patient developed a fever of 101.4°F, became asystolic and subsequently passed away. This case highlights the diagnostic, management, and therapeutic challenges of AIDS cholangiopathy. Also, it underscores the importance of thorough investigation into even mild or intermittent diarrhea and abnormal liver function tests in all HIV-infected patients, particularly in severely immunosuppressed patients. AIDS cholangiopathy should be considered in AIDS patients with diarrhea and abnormal liver function tests, irrespective of age, due to its associated morbidity across all age groups. Laboratory investigations often reveal markedly elevated alkaline phosphatase, gamma-glutamyltransferase, and mild to moderate liver enzyme elevations as hallmark findings of AIDS cholangiopathy. Ultrasonography is the first-line screening modality of AIDS cholangiopathy. Cryptosporidium parvum is the most common infectious etiology of AIDS cholangiopathy and can be identified by DNA-based polymerase chain reaction (PCR) testing of the stool or biliary fluid or acid-fast staining of stool specimens. Early detection of HIV infection and the prompt initiation and adherence to highly active antiretroviral therapy (HAART), which helps with maintaining a normal CD4 count and a low HIV viral load through HAART therapy, thereby significantly reducing the risk of developing AIDS cholangiopathy in HIV patients., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Alsharif et al.)

Tuberculosis (TB) is still one of the most challenging infectious diseases worldwide. Coinfection with HIV increases the likelihood of extrapulmonary involvement, including the tuberculosis of the central nervous system (CNS-TB). CNS-TB often presents as tuberculomas or tuberculous meningitis. Although tuberculomas can be single or multiple, asymptomatic carriage of numerous tuberculomas is seldom reported. We present a case of a 55-year-old man who carried at least 34 tuberculomas of different sizes asymptomatically before developing and succumbing to tuberculous meningitis. Furthermore, we highlight several possible public health challenges that might have complicated his clinical course, suggesting that future studies also focus on these variables alongside more traditional clinical issues., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Alavidze et al.)

Polyneuropathy, organomegaly, endocrinopathy, M-protein, and skin changes (POEMS) syndrome is a multisystem paraneoplastic disorder due to an underlying plasma cell neoplasm, and its occurrence among HIV patients is extremely rare. The diagnosis of POEMS syndrome can be challenging in this context, particularly if its disabling polyneuropathy is misdiagnosed as neuropathy related to HIV. Herein, we report the case of a female patient with treated HIV who later developed POEMS syndrome. After a misdiagnosis of chronic inflammatory demyelinating polyneuropathy related to HIV and unsuccessful corticosteroids and cyclophosphamide therapies, the correct diagnosis of POEMS syndrome was made. The patient achieved significant hematological and neurological improvement after six cycles of lenalidomide. Autologous stem cell transplantation was then scheduled to prevent eventual relapses., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Belkhribchia et al.)

Progressive multifocal leukoencephalopathy (PML) is a rare, demyelinating infectious disease of the central nervous system, primarily affecting immunosuppressed individuals, such as those with acquired immunodeficiency syndrome (AIDS) or undergoing immunosuppressive therapy. The causative agent is the dormant John Cunningham (JC) polyomavirus, which reactivates in immunocompromised patients. PML is diagnosed through clinical observations, imaging, and polymerase chain reaction (PCR) analysis, detecting JC virus deoxyribonucleic acid (DNA) in the cerebrospinal fluid (CSF). Here, we report a case of a 42-year-old male, recently diagnosed with human immunodeficiency virus (HIV), who presented with slurred speech, difficulty articulating, tingling in both feet, difficulty walking, and significant weight loss. Examination revealed absent reflexes, coordination impairment, and diminished vibration sense. Blood tests showed anemia, elevated D-dimer, and HIV-1 positivity with a low CD4 count. CSF analysis indicated a lymphocytic profile with elevated protein and marginally increased adenosine deaminase (ADA). Autoantibody testing was positive for antinuclear antibodies (ANA), but CSF culture and India ink staining were negative. Magnetic resonance imaging (MRI) of the brain revealed hyperintense lesions on T2-weighted and fluid-attenuated inversion recovery (FLAIR) images in the left peritrigonal and parietal white matter, suggesting demyelination. The diagnosis of PML was confirmed by a positive JC virus PCR result from the CSF. The patient was started on combination antiretroviral therapy (cART) and supportive measures to improve immune status. This case underscores the importance of considering PML in patients with new-onset neurological symptoms and immunosuppression., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Adapa et al.)

Histoplasma capsulatum is a dimorphic fungus that grows in nature as a mold or in culture but converts to a small yeast during cellular invasion. While most histoplasmosis infections are primarily asymptomatic or mildly symptomatic, disseminated histoplasmosis is a relentlessly progressive granulomatous disease that can mimic other granulomatous diseases, such as tuberculosis, sarcoidosis or coccidioidomycosis, more so in the proper context of immunosuppression. The current global migrant crisis, particularly the United States migrant crisis conversation is mostly socio-political; however, it also has a public health implication as exemplified by the case of a 35-year-old male who migrated from Haiti via Chile and Mexico to the United States. He presented with a four-day history of fever, generalized body aches, and cough. This case underscores the importance of entertaining a myriad of differentials and avoiding the tendency for anchoring, especially when initial therapy yields little clinical response., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Akanmode et al.)

This case emphasizes the significance of recognizing and managing Brevibacterium species. Here, we present a unique case of Brevibacterium species isolated from the cerebrospinal fluid of a 60-year-old female with recently diagnosed human immunodeficiency virus (HIV) and small cell carcinoma of the lung. Management involved a two-week course of intravenous vancomycin. Brevibacterium species are infrequently encountered in clinical practice. Sharing this case report aims to enhance the limited understanding of Brevibacterium species infections and encourages discussion among healthcare professionals regarding its diagnosis and management., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Nguyen et al.)

The development of Hodgkin's lymphoma (HL) is a known complication in patients with human immunodeficiency virus (HIV) infection. Extranodal involvement, specifically primary bone marrow Hodgkin's lymphoma (PBMHL) is a rare manifestation that has been reported in HIV-positive patients and may represent a distinct entity from HIV-associated HL. We present a case of PBMHL presenting with hemophagocytic lymphohistiocytosis (HLH) in an HIV-positive patient. The 55-year-old male with HIV/AIDS presented with abdominal pain, diarrhea, and fever, leading to hospital admission. Despite initial treatment, he deteriorated, prompting re-admission and investigation revealing pancytopenia and elevated inflammatory markers, suggestive of HLH. Subsequent bone marrow biopsy unexpectedly revealed PBMHL. Treatment with HLH-directed therapy and the HLH-94 protocol resulted in significant clinical improvement. This case underscores the importance of recognizing atypical lymphoproliferative presentations in HIV/AIDS patients and the need for interdisciplinary collaboration in complex cases., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Navarrete et al.)

Pneumocystis jirovecii pneumonia (PCP) is a life-threatening condition found in immunocompromised individuals, especially in human immunodeficiency virus (HIV) positive patients. Here, we report a case of PCP in a presumably immunocompetent 25-year-old male patient who presented with a one-month history of chest pain, dyspnea, and a nonproductive cough with recent development of night sweats. The patient recently immigrated to the United States without any known medical or family history. A chest radiograph revealed moderate pneumothorax for which a chest tube was placed. A chest computed tomography (CT) scan revealed diffuse lung disease with multiple thin- and thick-walled cystic lesions on a background of diffuse ground-glass opacities. Based on these radiologic findings and subsequent positive HIV serology, there was a high suspicion of PCP. Bronchoalveolar lavage was performed, and PCR for Pneumocystis jirovecii was positive. Appropriate treatment was initiated, and the patient recovered well. Through this report, we aim to highlight the importance of recognizing the various clinical and radiologic findings of PCP even in patients with no overt risk factors. Prompt and targeted treatment could mitigate morbidity and mortality associated with this opportunistic pathogen., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Bui et al.)

It is known that there are several clinical forms that diseases can take when presented in patients living with HIV, especially those in the AIDS phase. Here, we present a case that demonstrates the peculiar capacity of diseases to assume the most varied forms, highlighting the limited research on neglected infectious parasitic diseases. This study aimed to underscore the ability of these diseases to mimic other pathologies, emphasizing the importance of infectious diseases as differential diagnoses in the most diverse clinical entities, as is the case of visceral leishmaniasis., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Santos-Oliveira et al.)

We present a 45-year-old African American male with a medical history of advanced-stage HIV/AIDS (CD4 count: 1 cell/μL) and poor adherence to highly active antiretroviral therapy (HAART), who presented with symptoms of diarrhea, weakness, and respiratory distress. Upon admission, duodenal and colonic biopsies revealed a diffuse histiocytic infiltrate consistent with Mycobacterium avium complex (MAC), and a cecal biopsy was positive for Kaposi sarcoma (KS). Further workup showed consolidation and a right pleural effusion on chest X-ray, suggesting a pneumonia infection. The patient's hypoglycemic state and lung consolidation raised concerns for sepsis, despite negative blood cultures for the first 24 hours. The patient was initiated on HAART and treated with azithromycin, rifabutin, and ethambutol for disseminated MAC. Despite the aggressive immunotherapy, the patient's condition did not improve, and he eventually expired. This case uniquely highlights the wide range of opportunistic infections and malignancies that can present in individuals with advanced-stage HIV/AIDS, underscoring the importance of early recognition and treatment. This susceptible demographic warrants further research due to the non-solidified prognosis of individuals with severe immunodeficiency., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Carpintieri et al.)

A 34-year-old male with a history of peripheral vascular disease and multifactorial anemia presented with red blotches on his face, trunk, and extremities, multiple large bumps prominent on the lower extremities that burst at times with yellow pus and blood, swelling in the ankles, extremely dry feet, a chronic ulcer on the foot, and a dry, flaky, and irritated left middle finger. The patient was human immunodeficiency virus (HIV) positive, viral load undetectable. Endovenous laser ablation therapy was performed to correct venous insufficiency. A balloon was placed in the common iliac vein to treat May-Thurner syndrome. The bumps on the lower extremities were biopsied and found to be Kaposi's sarcoma (KS) and were removed by both wide excisions and shave removals, and further treatment with doxorubicin was performed successfully. The foot ulcer was found to be positive for methicillin-resistant Staphylococcus aureus (MRSA) and was treated with sulfamethoxazole-trimethoprim, metronidazole, and a chlorhexidine topical liquid. The patient noted that the treatments on his leg were working very well, and he was clearing up., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Minick et al.)

Antiretroviral therapy (ART) has significantly improved immune health and survival rates in HIV, but these outcomes rely on near perfect adherence. While many psychosocial factors are related to sub-optimal adherence, effectiveness of associated interventions are modest or inconsistent. The Psychological Flexibility (PF) model underlying Acceptance and Commitment Therapy (ACT) identifies a core set of broadly applicable transdiagnostic processes that may be useful to explain and improve non-adherence. However, PF has not previously been examined in relation to ART adherence. Therefore, this cross-sectional study (n = 275) explored relationships between PF and intentional/unintentional ART non-adherence in people with HIV. Adults with HIV prescribed ART were recruited online. Participants completed online questionnaires assessing self-reported PF, adherence and emotional and general functioning. Logistic regressions examined whether PF processes were associated with intentional/unintentional non-adherence. Fifty-eight percent of participants were classified as nonadherent according to the Medication Adherence Rating Scale, of which 41.0% reported intentional and 94.0% unintentional non-adherence. Correlations between PF and adherence were small. PF did not significantly explain intentional/unintentional non-adherence after controlling for demographic and disease factors. Further clarification of the utility of PF in understanding ART non-adherence is warranted using prospective or experimental designs in conjunction with more objective adherence measures. [ABSTRACT FROM AUTHOR]

Introduction The World Health Organization states that almost all cervical cancer cases are linked to infection with high-risk human papillomaviruses transmitted through sexual contact. Implementing effective surveillance and preventive measures would enable the prevention of most cervical cancer cases, especially in HIV-infected women. Every year, about 12,000 women in Nigeria are diagnosed, with almost 8,000 deaths. HPV cervical cancer testing capacity is low in Nigeria. Testing scale-up and sensitization efforts across health facilities, including cervical tissue sample collection, are needed to reduce the cases of cervical cancer. This study aimed to assess the genotype-specific prevalence of clinically relevant high-risk HPV among women living with HIV in Nigeria. Methods A descriptive, cross-sectional study was conducted among adult HIV-infected women attending health facilities in four Nigerian states. From August to October 2022, cervical tissue was collected into PCR cell media, transported to the Nigerian Institute of Medical Research, and assayed for HPV presence and genotype using the Cobas 6800 System (Roche Diagnostics). Statistical analysis was conducted with Stata 2. Results A total of 4423 cervical swab samples were tested. The ages of women ranged from 18 to 72 years (mean 36.61±8.61). In our study, we found that 16.3% of participants tested positive for HPV. Among the high-risk HPV genotypes detected, HPV16 was present in 1.44% of participants, HPV18 in 1.29%, and other high-risk HPV (OHR-HPV) in 11.35%. Additionally, co-infections were observed, with 0.98% of participants testing positive for both HPV16 and OHR-HPV, 1.12% for HPV18 and OHR-HPV, and 0.12% for HPV16, HPV18, and OHR-HPV concurrently. However, 7.4% of the total results were deemed invalid. Conclusion OHR-HPV is prevalent among HIV-infected women across the north and west geopolitical zones of Nigeria. Policies and interventions geared towards curtailing the incidence of cervical cancer are fervently solicited., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Okwuraiwe et al.)

There is a need to establish consensus for harmonization in antiretroviral (ARV) therapy (ART) switch treatment strategy and address the dilemma that exists in terms of subpar immune response to therapy or an immunologic deterioration while on therapy. The purpose of this review is to identify the factors that contribute to ARV treatment failure, such as insufficient dosage, drug interactions, poor adherence, drug resistance, and poor medication absorption. It is crucial to adopt a more efficient strategy to address this challenging dilemma. After ARV treatment failure, the aim of therapy is virologic suppression, which targets plasma viral load below the limits of detection as assessed by very sensitive tests with lower limits of quantification of 20 to 75 RNA copies/ml. The therapeutic objectives when complete virologic suppression is not possible, should be to maintain or restore immunologic function, stop the progression of the clinical illness, and minimize the emergence of new drug resistance that could further restrict the options for ARV drugs. Treatment history and drug-resistance testing, including the findings of previous and ongoing resistance tests, should be considered while selecting ARV regimens. Hence, the treatment approach post-ARV failure can be personalized based on clinical, immunologic, virologic, or as a mix of the three domains on a case-to-case basis. The evaluation of projected ARV activity should be based on treatment history and previous resistance test findings., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Sharma et al.)

Background In 2018, the World Health Organisation (WHO) released interim guidelines, advising a change of regimens to dolutegravir-based first- and second-line antiretroviral therapy (ART), based on which, in 2021, the National Aids Control Organisation (NACO) updated its guidelines to include the tenofovir + lamivudine + dolutegravir (TLD) regimen as a first line of therapy for all people living with HIV (PLHIV) and second- and third-line regimens to dolutegravir-based regimens. Considering this change of regimen, the adverse drug reaction (ADR) profiling and longitudinal prescription pattern of antiretroviral and concomitant medications in adult patients at the ART centre of a tertiary care hospital were assessed in this study. Methods Ninety-seven PLHIV out of all the patients who attended the ART centre from September 2021 to July 2022 were enrolled and followed up for six months. The ADRs that occurred during this period were collected along with details of prescription patterns and analyzed by descriptive statistics. Causality assessment for ADR was done using the World Health Organisation-Uppsala Monitoring Centre (WHO-UMC) scale. Results Seventy-eight percent (n=76 out of 97) of patients experienced at least one ADR, and 128 ADRs were seen in 97 patients. The most common ADRs were increased alkaline phosphatase (39.0%, n=128), dyslipidaemia (12.5%, n=128), and nephrotoxicity (10.1%, n=128). The drug most suspected of causing ADRs was dolutegravir (27.5%, n=342). The most common therapeutic regimen was TLD (71.2%, n=97). The most prescribed drug was lamivudine (30.6%, n=1183). The most prescribed concomitant medication was cotrimoxazole (15%, n=312). Conclusions Dolutegravir-based regimens have been implemented for PLHIV in a phased-out manner from previous non-dolutegravir-based ART regimens, which is in line with the recent NACO guidelines. However, it has also led to an increase in dolutegravir-associated ADRs like increased alkaline phosphatase, dyslipidaemia, and nephrotoxicity. Continuous monitoring of prescriptions and ADRs can add to our knowledge regarding their use and ADRs., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Sekar et al.)

Background: The COVID-19 pandemic profoundly affected healthcare services, including HIV patient care. This study assessed the impact of the pandemic on diverse aspects of care for individuals living with HIV (PLWH)., Methods: Patient data from 2019 to 2021 were collected using the Cascades template, provided by the New York State Department of Health, focusing on viral testing and suppression outcomes. Age, ethnicity, sex, and race were considered variables and analyzed via chi-square analysis, logistic regression model, and F test., Results: The pandemic significantly reduced viral testing in 2020 due to restrictions and closures, but telemedicine and tele-pharmacy helped maintain care. Age was a crucial factor, predicting higher viral testing and suppression odds for older individuals, but no significant differences were observed between patient gender, race, or ethnicity in obtaining viral testing or achieving suppression., Conclusions: While limitations existed, this study provides insights into sustaining care during crises, highlighting the importance of innovative healthcare delivery methods and age-sensitive approaches for PLWH., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Lewis et al.)

Recently, there has been interest in using viruses as cancer treatments. Oncolytic virology was founded by scientists who noticed that viruses might preferentially lyse cancer cells over healthy ones. Oncolytic virotherapy has similar obstacles as other treatment approaches, gaining entry into the specific tumour cell, encountering antiviral immune responses, off-target infection and many other unfavourable circumstances in the tumour microenvironment, and a lack of unique therapeutic and predictive biomarkers. However, oncolytic viruses have emerged as the main players in the biological treatment for cancer with the use of vectors such as human adenoviruses in oncolytic virotherapy. Recent large-scale research has shown that other viruses, such as the measles virus and the herpes simplex virus (HSV), may potentially be viable options for cancer treatment. The FDA has cleared T-VEC, an HSV-based oncolytic virus, for use in biological cancer treatment after its successful completion of human clinical trials. Furthermore, the measles virus vaccine strain has shown remarkable outcomes in pre-clinical and clinical testing. The use of such modified viruses in biological cancer treatment holds promise for groundbreaking discoveries in the field of cancer research because of their therapeutic effectiveness, fewer side effects, and safety. Several other newer approaches have been used in recent years. HIV-encoded proteins are also hypothesized to promote mitochondrial homeostasis causing bystander-induced apoptosis. We provide an overview of the most recent developments in the clinical use of oncolytic virus-based biological cancer treatment in this study. This evaluation also assesses the advantages and disadvantages of the viral candidates and provides insight into their potential in the future., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Balakrishnan et al.)

ABSTRACT Introduction: HIV AIDS is a disease with CD4 as the main target and frequently accompanied by lymphadenopathy symptoms. Most lymphadenopathy is caused by tuberculosis. The prevalence of limphadenitis in HIV TB is 40-80%. Cytological features of TB lymphadenitis in HIV AIDS and non-HIV have differences and associated with lower CD4 counts. Case: Male, 58 years old with complaints of right and left neck mass since 1 month. It was enlarged since 1 week, not accompanied by pain and injury. Patient also complained fever, night sweats, weight loss, white spots in the mouth. On physical examination, found right neck mass of 7x6 cm and left of 5x4 cm, flat surface elastic solid mass, difficult to move, no tenderness and inflammation. VCT result of three methods was reactive, absolute CD4 cell count 81.8 cells/UL and 6.13 log copies/mL viral load. Cytology result was hypocellular smears containing large necrotic areas with lymphocyte cells, histiocytes, PMN without signs of malignancy, conclusion: TB lymphadenitis. Patients received anti TB category one and ARV 2 weeks after TB treatment. Discussion: Lymphadenopathy symptoms in HIV AIDS from many etiologies are almost same so a cytological examination is needed. In TB lymphadenitis cytology, there are 3 groups of typical features are granuloma, granuloma with necrosis and only necrosis then it was confirmed ZN staining (smear bacilli). In HIV AIDS is more found necrosis without granuloma except CD4>100. This is because T cell function which is important in the formation of epithelioid granuloma is decreased. At an advanced stage with CD4 decreases, there is no epithelioid cell formation but rather foamy macrophage formation. Conclusion: HIV AIDS patient with CD4 81.8 and cervical tuberculosis lymphadenitis has different cytological features with large necrotic areas without granulomas.

Penelitian ini bertujuan untuk mengetahui persepsi perempuan pekerja seks terhadap keseriusan HIV-AIDS. Metode penelitian kualitatif dengan desain deskriptif fenomenologi. Partisipan utama adalah perempuan pekerja seks yang berada di kota Yogyakarta sebanyak 7 partisipan dan 2 partisipan pendukung dalam penelitian ini adalah konselor VCT dan manager klinik PKBI DIY. Pemilihan partisipan dilakukan dengan tehnik snow ball sampling. Hasil penelitian ini menunjukkan bahwa persepsi keseriusan terkena HIV-AIDS yang dirasakan partisipan mengakibatkan daya tahan tubuh menurun, lemas, sering batuk-batuk, sesak, bintik-bintik merah, mencret, pilek, rambut rontok, bau, panas, kadang juga tidak bisa dideteksi sampai akhirnya meninggal.

Human Immuno-deficiency Virus (HIV) is a virus that affects the immune system and causes Acquired Immunodeficiency Syndrom (AIDS). In 2014, new cases of HIV in Indonesia reached 32.711 cases and increased to 41.250 cases in 2016. One of many groups that tend to be infected with HIV was commercial sex workers. This study was to describe kinds of support from Primary Health Care Service in preventing sexually transmitted diseases and decreasing the transmission of HIV AIDS to commercial sex workers. This study was a qualitative research using phenomenological approach. Seven participants were involved, consist of five commercial sex workers, one procurer, and one of a health worker as informants. Data were collected using the in-depth interview. This study was done in Sexually Transmitted Infection Clinic in Gambilangu localization. The result of the study showed the kinds of support in preventing HIV AIDS transmission were routine screening, delivery of condoms and medications, and sustainable education to commercial sex workers. There was an obstacle in performing the support, such as no policies for the consumer to wear a condom. Therefore, the government and community should be involved in implementing the policies as an effort to prevent HIV AIDS transmission.

HIV (Human Immunodeficiency Virus) adalah virus penyebab penyakit AIDS (Acquired Immunodeficiency Syndrome) yang ditemukan di bali pada tahun 1987, kasus HIV dan AIDS menyebar hampir di seluruh provinsi Indonesia dan mengalami peningkatan jumlah penderita setiap tahunnya. Pada paper ini dibahas model matematika untuk penyebaran penyakit HIV-AIDS [1]. Model merupakan sistem dinamik non linier tiga dimensi yang menggambarkan Interaksi tiga populasi yaitu Susceptible, Infected, dan AIDS Cases. Analisis kestabilan dari titik kesetimbangan endemik menggunakan metode Kriteria Routh Hurwitz. Bilangan reproduksi dasar digunakan untuk menganalisis keendemikan penyakit HIV-AIDS yang diperoleh menggunakan next generation matrix [2]. Hasil analisis memberikan informasi bahwa semakin besar nilai bilangan reproduksi dasar maka penyebaran penyakit HIV-AIDS di dalam suatu populasi akan semakin cepat dan dalam waktu yang lama penyakit tersebut akan tetap ada. Berdasarkan analisis sensitivitas diketahui parameter-parameter yang berpengaruh terhadap bilangan reproduksi dasar yaitu tingkat kontak Susceptible dengan Infected, peluang sukses terjadinya transmisi virus HIV dari Infected ke Susceptible, tingkat kontak Susceptible dengan AIDS Cases, peluang sukses terjadinya transmisi virus HIV dari AIDS Cases ke Susceptible, tingkat kematian yang disebabkan oleh penyakit AIDS, dan tingkat penjangkitan virus HIV.