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O objetivo do estudo é analisar, com base na da vivência de homens que fazem sexo com homens, quais são os aspectos que influenciam na decisão de usar ou não o preservativo. Trata-se de um estudo qualitativo, de caráter exploratório com 20 homens, atendidos por um Centro de Testagem e Aconselhamento em Porto Alegre. O material foi produzido a partir de entrevistas analisadas sob a perspectiva da análise discursiva. A análise indica que a gestão de risco, do uso e não uso do preservativo, se dá em um contexto de negociação – nem sempre explícita – no qual o valor atribuído ao sexo, ao outro e a si mesmo na cena erótica interfere na decisão do uso do preservativo. Essas negociações e o valor atribuído ao outro e a si operam e se produzem também a partir de marcadores sociais, numa lógica econômica, ainda que não monetária. Neste contexto, a beleza, a aparência, o não ter ‘cara de DST (doenças sexualmente transmissíveis)’, bem como determinadas práticas sexuais e padrões heteronormativos surgem na cena homoerótica, muitas vezes reproduzindo relações de poderes e influenciando na gestão de risco e uso do preservativo. Construir espaços de reflexão sobre a erótica como algo da dimensão não apenas privada, mas também pública e reprodutora de relações de poder, pode ser uma oportunidade de politização da erótica e reflexão sobre a gestão de risco e cuidado.

Helicobacter pylori infection is an infectious disease and should be managed accordingly. Factors that affect patient outcomes, particularly proton inhibitor metabolism, compliance, and antibiotic resistance, are topics of active research. Studies carried out this year aimed to address the above issues by means of comparative studies, meta-analyses, and guidelines. For this year’s review, we have selected studies that are relevant to clinical practice, particularly in the areas of bismuth quadruple therapy (BQT), individualized treatment, high acid suppression therapy, probiotics, barriers to treatment, and factors affecting treatment success. It appears that the globally persistent increasing level of H. pylori antibiotic resistance has led to treatment strategy adaptations, such as prescribing first-line BQT or individualizing first-line treatment based on antimicrobial susceptibility testing. Novel regimens like high-dose dual therapy and vonoprazan-based therapy provide excellent efficacy, while large international studies are still awaited. Compliance should be improved through the awareness of the patient’s concerns and the use of multimedia by the doctor/pharmacist. Future perspectives include making BQT regimens universally available and testing new molecules/regimens.

Binyam Tariku Seboka, Delelegn Emwodew Yehualashet, Getanew Aschalew Tesfa School of Public Health, Dilla University, Dilla, EthiopiaCorrespondence: Binyam Tariku Seboka, School of public health, Dilla University, P.O Box: 419, Dilla University, Dilla, Ethiopia, Tel +251 920612180, Fax +251 46-331-2568, Email bini555tar@gmail.comBackground: Despite the success made in scaling up HIV treatment activities, there remains a tremendous unmet demand for the monitoring of the disease progression and treatment success, which threatens HIV/AIDS treatment and control. This research presented the assessments of viral load and CD4 classification of adults enrolled in ART care using machine learning algorithms.Methods: We trained, validated, and tested eight machine learning (ML) classifier algorithms with historical data, including demographics, clinical, and laboratory data. Data were extracted from the ART registry database of Yirgacheffe Primary Hospital and Dilla University Referral Hospital. ML classifiers were trained to predict virological failure (viral load > 1000 copies/mL) and poor CD4 (CD4 cell count < 200 cells/mL). The model predictive performances were evaluated using accuracy, sensitivity, specificity, precision, f1-score, F-beta scores, and AUC.Results: The mean age of the sample participants was 41.6 years (SD = 10.9). The experimental results showed that XGB classifier ranked as the best algorithm for viral load prediction in terms of sensitivity (97%), f1-score (96%), AUC (0.99), accuracy (96%), followed by RF. The GB classifier exhibited a better predictive capability in predicting participants with a CD4 cell count < 200 cells/mL.Conclusion: In this study, the XGB and RF models had the highest accuracy and outperformed on various evaluation metrics among the models examined for viral load classification. In the prediction of participants CD4, GB model had the highest accuracy.Keywords: artificial intelligence, AI, machine learning, ML, anti-retroviral treatment, ART, viral load, CD4 count, HIV

Aim Substance abuse and concomitant infections are important causes of morbidity and mortality. Yet, the number of epidemiological studies regarding infectious diseases in people with substance abuse are limited in our country. In this study, the aim was to investigate the frequency of illegal alcohol and substance use in an Alcohol and Drug Research, Treatment and Training Centres (AMATEM) clinic in Turkey as well as the HBsAg, anti-HBs, anti-HCV, and anti-HIV parameters between the years of 2016-2021. Material and Method HBsAg, anti-HBs, anti-HCV, and anti-HIV tests were conducted using the ELISA technique in 6881 alcohol and substance use disorder (ASUD). Urine samples from ASUD’s were analyzed for alcohol, cannabis, and cocaine metabolites. The results were evaluated retrospectively. Results All of the 6881 ASUD’s were male with a mean age of 32.18±9.66 years. Of the 6881 ASUD’s included in the study, 4107 (59.7%) were opioid addicts; 1479 (21.5%) were mixed drug addicts; 897 (13%) were alcohol addicts; and the rest were addicts with other types of substance use. The mean age of the alcohol users was 45.33±13.03 and the mean age of opioid users was 29.90±7.13. The percentage of opioid addiction in 2016 was 71.2% which dropped to 28.7% in 2021. Meanwhile, the percentage of alcohol addiction was 13.6% in 2016 and increased to 21.4% in 2021; and the percentage of mixed drug use was 8.7% in 2016 and increased to 36.8% in 2021. HBsAg-positivity in opioid users (56.7%) was higher compared to cannabis users (2.6%) and mixed drug users (22.3%). Anti-HCV positivity of opioid users (69.4%) was found to be higher compared to alcohol (9.4%), cannabis (2%), and mixed drug (16.2%) users, and this finding was statistically significant (p=0.0001). Anti-HBs positivity of opioid users (63.1%) was found to be higher compared to alcohol (9.9%), cannabis (3%), and mixed drug (21%) users, and this finding was statistically significant (p=0.0001). Anti-HIV was determined negative in all ASUD’s. The highest rates of HBsAg, anti-HCV and anti-HBs positivity were found in the 26-30 years of age. Conclusion These findings indicate a high prevalence of intravenous substance abuse in the 26-30 years age group in our region as well as the high HBV and HCV rates in this patient group.

Aim: Toxoplasma gondii infects about 25-30% of the world population. Toxoplasmosis is generally asymptomatic in immunocompetent individuals, but the infection can be life threatening in congenitally infected children and immunocompromised individuals. In this study, it is aimed to analyse the molecular test results of patients suspected with toxoplasmosis, retrospectively. Material and Method: A total of 647 clinical samples investigated for T. gondii DNA with real-time PCR during the three-year period between 2019 and 2022 were evaluated retrospectively. For the qualitative detection of T. gondii, DNA isolation and DNA amplification were performed using commercial DNA extraction kit (Qiagen, Germany) and real time PCR kit (Sacace Biotechnologies, Italy), respectively. The data on the demographic and clinical parameters of the patients were obtained from the laboratory information management system. Results: Out of 647 patients investigated for T. gondii DNA with real-time PCR, 51.8% were female and the mean age of the patients was 37.03 years. Among all patients, five were positive for T. gondii DNA with real-time PCR and the frequency of a positive PCR result was found 0.8% of all samples analysed. The most frequently positive clinical sample was blood (80%). Among five patients with T. gondii DNA positivity, one was diagnosed with congenital toxoplasmosis, four were HIV-infection. Conclusion: Fast and accurate diagnosis of toxoplasmosis especially in immunosuppressed patients is crucial for rapid and specific treatment. Further studies are needed to understand the importance of molecular tests, in addition to the serological tests, in the diagnosis of toxoplasmosis.

ABSTRACT Objectives: to validate the educational technology “Educational Material on HIV” (INPI - BR 10 2020 003765 0). Methods: a methodological study with 39 expert judges in HIV/AIDS, using a 5-point Likert scale for assessment. Data were tabulated, processed and analyzed through descriptive analysis. Cronbach’s alpha and McDonald’s omega tests were performed to analyze internal consistency, and the Intraclass Correlation Coefficient, for reliability. Agreement was established by a Level Content Validity Index greater than 0.90. Results: the assessment instrument showed high internal consistency (Cronbach’s alpha of 0.89; McDonald’s omega of 0.91) with reliable values. Based on the Intraclass Correlation Coefficient, judges’ answers showed acceptable reliability, mean score 0.89 (p

BackgroundThe risk of hepatotoxicity with antiretroviral therapy (ART) remains unknown. We determined the comparative risk of acute liver injury (ALI) for antiretroviral drugs, classes, and regimens, by viral hepatitis status.MethodsWe followed a cohort of 10 083 human immunodeficiency virus (HIV)-infected persons in Kaiser Permanente Northern California (n = 2099) from 2004 to 2010 and the Veterans Aging Cohort Study (n = 7984) from 2004 to 2012. Within the first year of ART, we determined occurrence of (1) liver aminotransferases >200 U/L and (2) severe ALI (coagulopathy with hyperbilirubinemia). We used Cox regression to determine hazard ratios (HRs) with 95% confidence intervals (CIs) of endpoints among initiators of nucleos(t)ide analogue combinations, antiretroviral classes, and ART regimens, all stratified by viral hepatitis status.ResultsLiver aminotransferases >200 U/L developed in 206 (2%) persons and occurred more frequently among HIV/viral hepatitis-coinfected than HIV-monoinfected persons (116.1 vs 20.7 events/1000 person-years; P < .001). No evidence of differential risk was found between initiators of abacavir/lamivudine versus tenofovir/emtricitabine among coinfected (HR, 0.68; 95% CI, .29-1.57) or HIV-monoinfected (HR, 1.19; 95% CI, .47-2.97) groups. Coinfected patients had a higher risk of aminotransferases >200 U/L after initiation with a protease inhibitor than nonnucleoside reverse-transcriptase inhibitor (HR, 2.01; 95% CI, 1.36-2.96). Severe ALI (30 events; 0.3%) occurred more frequently in coinfected persons (15.9 vs 3.1 events/1000 person-years; P < .001) but was too uncommon to evaluate in adjusted analyses.ConclusionsWithin the year after ART initiation, aminotransferase elevations were infrequently observed and rarely led to severe ALI. Protease inhibitor use was associated with a higher risk of aminotransferase elevations among viral hepatitis-coinfected patients.

The purpose of this series is to highlight a range of rare health conditions. Rare health conditions are those that affect no more and usually fewer than one person in every 2000 and many HCAs and nurses will encounter some of these conditions, given the high number of them. This 57th article will briefly explore four of these conditions: Lassa fever, Laband syndrome, limbic encephalitis and HIV. [ABSTRACT FROM AUTHOR]

Background: People use online personal advertisements (ads) to solicit sexual partners. Data from online ads are often publicly available, allowing researchers to better understand the topics discussed and potential role of online ads in sexual health and risk behaviours. This study aims to examine those research questions.Methods: We collected posts on ClassifiedAds.com from the US (August 2019- February 2020). Gender identity was abstracted from post title, when available. HIV risk-related terms were abstracted from post title and content and were used to dichotomise the following variables: (1) ads describing sexual risk behaviours; (2) ads mentioning concerns over substance use or sexually transmitted infections/HIV; and (3) ads mentioning an interest in substance use. Descriptive analysis and logistic regression were conducted.Results: A total of n =12866 unique ads were posted; 72.4% posted by men. Most posts came from the southern US (34.7%) and from urban areas (89.6%). Few ads contained images (21.9%) or words associated with substance use (1%), while 26% mentioned substance use or STI/HIV concern. Logistic regression models indicated that ads in the South were less likely to contain substance use or STI/HIV concern than ads from the Midwest. Also, women were less likely than men to post about substance use or mention substance use or STI/HIV concern.Conclusions: Personal ads offer a glimpse into Internet-mediated sex encounters and sexual health risks among those who seek sex online. The real-time data collected has potential to highlight elevated prevalence of sexual risk behaviours that may put individuals at risk for STI/HIV or substance use. [ABSTRACT FROM AUTHOR]

Herpes zoster ophthalmicus (HZO) is a neurocutaneous disease caused by reactivation of herpes zoster infection from latent phase after varicella infection in elderly population. It affects ophthalmic division of trigeminal nerve. Common ocular presentation includes conjunctivitis, anterior uveitis, and keratitis. Orbital apex syndrome rarely occurs as a complication of herpes zoster ophthalmicus in young human immunodeficiency virus (HIV)-positive men. A 20-year-old, recently diagnosed HIV-positive man, presented with vesicular skin rashes over right periorbital and forehead area, associated with right eye redness. He was treated as herpetic zoster ophthalmicus with oral antiviral (acyclovir). Three days later, he developed right eye ptosis, reduced visual acuity, anisocoria, and total ophthalmoplegia. An orbit magnetic resonance imaging showed swelling of all rectus muscles of right eye with right optic nerve perineural enhancement. Diagnosis of right eye herpes zoster ophthalmicus with orbital apex syndrome was established, and intravenous acyclovir was initiated. Systemic antiviral acyclovir continued for up to 10 days. Upon discharge, his ocular features improved; however, his visual impairment persisted. Orbital apex syndrome is a rare complication of herpes zoster ophthalmicus. This irreversible sight- threatening complication can be prevented by early diagnosis of HZO and immediate starting of anti­viral treatment.

Objetivo: validar o jogo de tabuleiro “Mural do Risco” sobre prevenção do Vírus da Imunodeficiência Humana/Síndrome da Imunodeficiência Adquirida entre idosos estudantes da Educação de Jovens e Adultos. Método: estudo metodológico desenvolvido no estado de Recife, Brasil, que validou o conteúdo do jogo e do guia de uso entre setembro e novembro de 2020 via e-mail. Participaram 27 juízes da área da saúde e 18 de outras áreas. Dados analisados por estatística descritiva para obtenção do Índice de Validade de Conteúdo e Escore Suitability Assessment of Materials. Resultados: ambos obtiveram Índice de Validade de Conteúdo de 0,90; o Escore Suitability Assessment of Materials foi de 22 pontos e do guia 24. Houve reestruturação das imagens, priorizando clareza, tamanho e relações com o idoso. Conclusão: o jogo e o guia estão adequados e, após o registro, poderão mediar práticas educacionais de prevenção do Vírus da Imunodeficiência Humana/Síndrome da Imunodeficiência Adquirida com idosos no contexto escolar.

No abstract vailable.

Background: We sought to investigate the relationship between tuberculosis (TB) treatment outcomes and its predictors in the KwaMashu region in KwaZulu-Natal (KZN). This area is currently a hotbed for TB and human immunodeficiency virus (HIV) co-infection. Method: A retrospective study design was adopted to characterise adult patients diagnosed with Gene Expert (GXP) positive pulmonary TB from 01 January 2016 to 31 December 2017. Tuberculosis treatment outcomes were assessed after two months and five months according to the standard World Health Organization (WHO) criteria. Multiple logistic regression analysis was used to calculate the odds ratio (OR) of the possible determinants associated with unsuccessful treatment outcomes. Results: Amongst the 596 patients diagnosed, 57.4% (95% confidence interval [CI]: 53.3–61.4; 342 of 596) had successful treatment outcomes. Of these reported cases, 88.89% (85.1–92.0; 304 of 342) were cured. For the unsuccessful treatment outcomes, 52.4% (46.0–58.6; 133 of 254) patients were lost to follow-up, 20.9% (16.0–26.4; 53 of 254) failed treatment, 1.2% (0.2–3.4; 3 of 254) died and 25.6% (20.3–31.4; 65 of 254) of the patients could not be accounted for. Patients with unknown HIV status were more likely to have unsuccessful treatment outcomes (adjusted OR [aOR] = 4.94 [1.83–13.36]). Patients who had sputum conversion at 2 months (aOR = 1.94 [1.27–2.96]) were significantly more likely to exhibit unsuccessful treatment outcomes. Conclusion: Treatment success rate was 57.4% which was below the target set by the WHO. This underscores the urgent need to strengthen treatment adherence strategies to improve outcomes, especially in high HIV burden settings.

Objetivo: analisar estudos referentes à avaliação da qualidade de vida de pessoas vivendo com HIV no Brasil, por meio de uma revisão integrativa da literatura. Método: trata-se de revisão integrativa que incluiu 22 artigos científicos publicados no período de 2011 a 2019. Resultados: os principais instrumentos utilizados na avaliação da qualidade de vida foram o WHOQOL-HIV bref e o HAT-QOL. Os domínios com maiores escores na avaliação foram confiança no médico, psicológico e espiritualidade; as piores avaliações relacionavam-se com os domínios meio ambiente e preocupação com o sigilo. A exposição do diagnóstico impacta negativamente para a qualidade de vida bem como as condições de vida e saúde. Conclusão: a qualidade de vida é um construto multidimensional e subjetivo com implicação direta na saúde e tratamento das pessoas vivendo com HIV, portanto, compreender os fatores que impactam sua avaliação é primordial na elaboração de políticas públicas e melhores condições de vida. ABSTRACT Objective: to analyze studies on evaluating the quality of life of people living with HIV in Brazil, by integrative literature review. Method: this integrative review included 22 scientific articles published from 2011 to 2019. Results: the instruments most used to assess quality of life were the WHOQOL-HIV bref and the HAT-QOL. The highest-scoring domains were trust in the doctor, psychology and spirituality, while the lowest scores related to the environment and confidentiality concerns. Exposing the diagnosis has adverse impacts on both quality of life and conditions of life and health. Final considerations: quality of life is a multidimensional, subjective construct with direct implications for the health and treatment of people living with HIV. Accordingly, in order to develop public policies and improve conditions of life, it is essential to understand the factors that impact on its assessment. RESUMEN Objetivo: analizar estudios sobre la evaluación de la calidad de vida de las personas que viven con el VIH en Brasil, mediante revisión integradora de la literatura. Método: esta revisión integradora incluyó 22 artículos científicos publicados entre 2011 y 2019. Resultados: los instrumentos más utilizados para evaluar la calidad de vida fueron el WHOQOL-HIV bref y el HAT-QOL. Los dominios de mayor puntuación fueron la confianza en el médico, la psicología y la espiritualidad, mientras que las puntuaciones más bajas se relacionaron con el medio ambiente y las preocupaciones de confidencialidad. Exponer el diagnóstico tiene impactos adversos tanto en la calidad de vida como en las condiciones de vida y salud. Consideraciones finales: la calidad de vida es un constructo subjetivo multidimensional con implicaciones directas para la salud y el tratamiento de las personas que viven con el VIH. En consecuencia, para desarrollar políticas públicas y mejorar las condiciones de vida, es fundamental conocer los factores que inciden en su evaluación.

Background and Objectives: The degree of information is not restricted to informative and opportunity issues of knowledge, but also to the development of a conscious individual perception for the adoption of preventive practices. This study aimed to assess the perception and knowledge of medical students about HIV and AIDS. Methods: This is a cross-sectional, observational, and unicentric study, through the application of a structured questionnaire and two referring to the attitude towards HIV and the individual risk perception and knowledge on modes of transmission. Student’s and Pearson’s Chi-Square Tests were applied, with p

Madeleine Touma,1 Line D Rasmussen,2 Raquel Martin-Iguacel,2 Frederik Neess Engsig,3 Nina Breinholt Stærke,4 Mette Stærkind,5 Niels Obel,1 Magnus Glindvad Ahlström1 1Department of Infectious Diseases, Rigshospitalet, Copenhagen University Hospital, Copenhagen, 2Department of Infectious Diseases, Odense University Hospital, Odense, 3Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, 4Department of Infectious Diseases, Aarhus University Hospital, Aarhus, 5Department of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark Background: Human immunodeficiency virus (HIV) infection with advanced immunosuppression predisposes to cryptococcal meningitis (CM). We describe the incidence, clinical presentation, and outcome of CM in HIV-infected individuals during the highly active antiretroviral therapy (HAART) era.Methods: A nationwide, population-based cohort of HIV-infected individuals was used to estimate incidence and mortality of CM including risk factors. A description of neurological symptoms of CM at presentation and follow-up in the study period 1995–2014 was included in this study.Results: Among 6,351 HIV-infected individuals, 40 were diagnosed with CM. The incidence rates were 3.7, 1.8, and 0.3 per 1000 person-years at risk in 1995–1996, 1997–1999, and 2000–2014, respectively. Initiation of HAART was associated with decreased risk of acquiring CM [incidence rate ratio (IRR), 0.1 (95% CI, 0.05–0.22)]. African origin was associated with increased risk of CM [IRR, 2.05 (95% CI, 1.00–4.20)]. The main signs and symptoms at presentation were headache, cognitive deficits, fever, neck stiffness, nausea, and vomiting. All individuals diagnosed with CM had a CD4+ cell count

Introduction: Burkitt's lymphoma is an aggressive form of B cell lymphoma generally diagnosed in children and young adults. This tumor has three variants: African (endemic), American (sporadic), and immunodeficiency-associated. Objective: present a case of Burkitt's lymphoma that manifested as a tumor mass in the upper right maxillary region of a patient with AIDS treated at Professor Edgar Santos University Hospital in Salvador, Bahia, Brazil. Clinical case: a male 20-year-old HIV-positive patient was referred from another hospital with a possible odontogenic infection that persisted after drainage and antibiotic therapy. The patient presented a tumor growth in the upper right gingival mucosa. After biopsy, histopathological findings were suggestive of Burkitt's lymphoma. An immunohistochemical panel was positive for CD20 and Bcl6 and negative for CD3, Bcl2, and terminal deoxynucleotidyl transferase antibodies. The Ki67 expression level was 80 %. The final diagnosis was immunodeficiency-associated Burkitt's lymphoma. The patient was successfully treated with cytoreductive chemotherapy (cyclophosphamide, doxorubicin, vincristine, and prednisone), followed by high-dose methotrexate, cyclophosphamide, doxorubicin and vincristine, alternating with high-dose cytarabine, ifosfamide and etoposide. No signs of recurrence have been noted during the follow-up period. Conclusions: Burkitt's lymphoma is an aggressive neoplasia with a rapidly progressing clinical course. Therefore, differential diagnosis from other benign oral diseases is of great importance.

Background: The interaction of human immunodeficiency virus (HIV), host and antiretroviral therapy (ART) causes a range of metabolic disorders that can be characterized as a metabolic syndrome (MetS) that increases the cardiovascular risk. MetS involves central obesity, which can be detected using different anthropometric parameters., Objective: To assess the abilities of different anthropometric parameters in the prediction of MetS in HIV-infected men on ART., Method: The study involved 92 male participants (mean age 44.46±10.38 years), divided into two groups: with and without MetS. All subjects underwent biochemical evaluation (triglycerides, HDL-cholesterol, fasting glucose), blood pressure measurement and anthropometric assessment: body mass, body height, body mass index (BMI), body fat mass, body circumferences (chest, upper arm, forearm, waist, hip, proximal and middle thigh and calf), sagittal abdominal diameter (SAD), skinfold thicknesses (subscapular, anterior and posterior upper arm, anterior and lateral forearm, abdominal, supraspinal, thigh and calf), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), waist-to-thigh ratio (WTR), sagittal abdominal diameter-to-body height ratio (SADH), body adiposity index (BAI) and conicity index. MetS was specified according to IDF criteria., Results: Subjects with MetS had statistically significant higher values of all anthropometric parameters except middle thigh circumference, calf skinfold and body height. According to ROC analysis and Binary Logistic Regression, SAD has been shown as the best predictor of MetS with a predictive value of 21.40 cm (AUC:0.91), followed by WHR with a predictive value of 0.93., Conclusion: Sagittal abdominal diameter is the strongest anthropometric indicator of MetS in HIV-infected patients on ART., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Apresentamos aqui como podem ser obtidos retratos de fase de campos vetoriais bidimensionais lineares e aplicaremos estes conceitos na obtenção do retrato de fase de um modelo não-linear tridimensional utilizado na modelagem do vírus HIV.

Disease intervention specialists (DIS) conduct partner notification for STD and HIV to interrupt the transmission of STD/HIV. In 2016, we collected information from health departments in the United States of America to determine the number of DIS and whether this number was sufficient for STD/HIV prevention. We identified 1610 STD/HIV DIS positions in the USA and 379 DIS supervisory positions. Of DIS positions, 85% were filled indicating potential issues with turnover. Using nationally reportable data from 2016, we found that states with more primary and secondary syphilis cases had more DIS. DIS participated in public health emergencies in 57% of states. Most USA states indicated that the DIS workforce was not sufficient for STD/HIV prevention. Knowledge of information about DIS workload (e.g. number of STD/HIV cases assigned per DIS) would be helpful. [ABSTRACT FROM AUTHOR]

Christelle Domngang Noche,1 Madeleine Singwé-Ngandeu,2 Assumpta Lucienne Bella2 1Université des Montagnes, Yaoundé, Cameroon; 2Université de Yaoundé 1, Yaoundé, Cameroon Introduction: Scleritis and peripheral ulcerative keratitis are ocular manifestations found in many inflammations and infections. Therefore, their association should prompt a search for inflammatory or infectious causes that may be life-threatening, especially in the context of AIDS due to HIV infection. Findings: We report the case of a 37-year-old female, first seen in 2011 with a nodular scleritis in the right eye and a peripheral ulcerative keratitis, a necrotizing scleritis, and a granulomatous anterior uveitis in the left eye, in the context of chronic polyarthropathies that had evolved over 6 months. The patient was diagnosed with AIDS (HIV) in 2008 and was on antiretroviral therapy for the past 2 years. Ophthalmic workup was negative for opportunistic infections and potential causes of scleritis and peripheral ulcerative keratitis, and the patient was unresponsive to topical antibacterial and anti-inflammatory treatment. Ocular lesion resolution and articular swelling improvement was observed less than 6 weeks after sulfasalazine treatment. Based on American College of Rheumatology/European League Against Rheumatism classification criteria, and considering the good response to the treatment (sulfasalazine), diagnosis of rheumatoid arthritis was made in the absence of confirmatory lab tests results. Conclusion: In the context of ocular manifestations associated with polyarthropathies, coexisting pathologies should be considered. Diagnostic workup of chronic inflammatory rheumatism should be carried out, even in the context of HIV/AIDS. Keywords: scleritis, peripheral ulcerative keratitis, anterior uveitis, rheumatoid arthritis, HIV/AIDS

Background Delay discounting has been found to be associated with numerous health-related outcomes, including risky sexual behaviour. To date, it is unclear whether delay discounting measured in different domains is associated within individuals. The goal of this study was to assess the concordance of monetary and sexual delay discounting in men who have sex with men.Methods: Participants completed an online survey, including the Monetary Choice Questionnaire and the Sexual Discounting Task. Linear regression models were used to assess the association between monetary and sexual discount rates.Results: Sexual discount rates did not predict monetary discount rates. There was a substantial amount of clustering of sexual discount rates, requiring sexual discounting data to be categorised.Conclusions: Monetary and sexual delay discounting are distinct processes that are not necessarily associated within individuals, and monetary delay discounting is not an appropriate proxy measure for sexual impulsivity. Data from the Sexual Discounting Task are typically rank-transformed for analysis. These data suggest that this might be an invalid method of analysis. Future studies should investigate the distribution of their data to determine if it is appropriate to analyse sexual discounting data as a continuous measure. [ABSTRACT FROM AUTHOR]

Quantitative structure-activity relationships were constructed for 107 inhibitors of HIV-1 reverse transcriptase that are derivatives of 1-[(2-hydroxyethoxy)methyl]-6-(phenylthio)thymine (HEPT). A combination of a support vector machine (SVM) and oscillating search (OS) algorithms for feature selection was adopted to select the most appropriate descriptors. The application was optimized to obtain an SVM model to predict the biological activity EC50 of the HEPT derivatives with a minimum number of descriptors (SpMax4 Bh (e) MLOGP MATS5m) and high values of R2 and Q2 (0.8662, 0.8769). The statistical results showed good correlation between the activity and three best descriptors were included in the best SVM model. The values of R2 and Q2 confirmed the stability and good predictive ability of the model. The SVM technique was adequate to produce an effective QSAR model and outperformed those in the literature and the predictive stages for the inhibitory activity of reverse transcriptase by HEPT derivatives. [ABSTRACT FROM AUTHOR]

Introdução: No contexto das doenças crônicas transmissíveis, a pandemia da aids vem gerando discussões em âmbito internacional sobre as formas de controlar seu avanço, inclusive na população idosa, a qual apresenta incidência considerável de casos. Objetivo: Investigar o conhecimento e verificar a percepção de risco de idosos quanto à contaminação por Infecções Sexualmente Transmissíveis (IST) e HIV. Métodos: Trata-se de estudo descritivo de natureza quantitativa realizado com 55 idosos participantes de grupos em duas unidades de saúde da família interligadas à rede-escola. Resultados: A maioria dos idosos era entre 60–70 anos, sexo masculino, casados, católicos, com o nível fundamental incompleto. Além disso, 40% dos idosos citaram o uso do preservativo como principal método de prevenção às infecções sexuais, 21,9% responderam que o HIV é transmitido de uma pessoa para outra por meio do contato sexual e 38,2% citaram que a doença não tem cura. Sobre a percepção de risco, 76,4% referiram que não tinham nenhuma possibilidade de adquirir Infecções Sexualmente Transmissíveis ou HIV. Tal fator pode contribuir para que essa população se considere pouco vulnerável à contaminação ou não se perceba em risco, o que os torna susceptíveis ao perigo da infecção, favorecendo o aumento do índice de idosos infectados no cenário nacional. Conclusão: Cabe aos organismos governamentais e não governamentais investir em práticas educativas, onde idosos possam ser inseridos em um ambiente que aborde a sexualidade, proporcionando maior segurança e qualidade de vida aos nossos cidadãos.

One of the factors causing treatment failure in cryptococcosis is the resistance of Cryptococcus spp. to antifungal drugs, which has motivated the susceptibility assessment of isolates from patients with cryptococcosis, different clinical conditions and infections outcomes. Clinical isolates of Cryptococcus spp. from three different groups of patients were studied in the present investigation: 19 HIV-positive patients with relapsing and/or refractory meningitis (Group 1), 30 HIV-positive patients who experienced a single and limited episode of cryptococcosis (Group 2), and 19 HIV-negative patients with cryptococcosis (Group 3). Eighty C. neoformans var. grubii isolates and 7 C. gattii isolates were studied. The minimum inhibitory concentration (MIC) of amphotericin B, azole drugs and flucytosine was determined for Cryptococcus spp. by broth microdilution test and E-test. The MIC50 and MIC90 were 0.25 and 0.50 μg/mL for amphotericin B, 4.0 and 8.0 μg /mL for fluconazole, 0.06 and 0.25 μg/mL for itraconazole, 0.25 and 0.50 μg/mL for voriconazole, and 8.0 and 16.0 μg/mL for flucytosine, respectively. Amphotericin B and itraconazole showed higher MICs for C. neoformans var. grubii and C. gattii, respectively. The MICs of fluconazole and itraconazole obtained with the E-test were higher than those obtained with broth microdilution. Isolates from non-HIV coinfected were less sensitive to the azoles. There was no difference in the susceptibility of C. neoformans var. grubii isolates from patients with a favorable or unfavorable outcome or along the episodes of relapsing and/or refractory meningitis. [ABSTRACT FROM AUTHOR]

Objetivo: Conhecer os saberes, significados e vivências de gestantes sobre o teste sorológico anti-HIV no período gestacional. Métodos: Pesquisa exploratória e qualitativa realizada em cinco Unidades Básicas de Saúde de Iguatu, Ceará; com 20 gestantes mediante entrevista semi-estruturada em dezembro de 2010 e janeiro de 2011, após assinatura do termo de anuência. Utilizou-se a técnica de análise de conteúdo e os resultados foram analisados conforme literatura. Resultados: As gestantes tinham entre 18 e 41 anos; 13 eram multíparas; a maioria apresentava relação estável, escolaridade e renda baixas. O conhecimento sobre a finalidade do exame encontrava-se limitado por algumas, mas atribuíram significados representando instinto materno, responsabilidade social e prevenção de transmissão vertical. Todas realizaram a sorologia sem dificuldades de acesso, apesar de que algumas não queriam fazê-lo por medo da descoberta da doença. Conclusão: Considera-se que o exame sorológico seja sempre ofertado para minimizar a transmissão vertical do vírus HIV. Descritores: Gravidez, Conhecimento, HIV.

Introduction: The posterior reversible encephalopathy syndrome (PRES) is a neurological entity characterized by magnetic resonance imaging (MRI) evidence of bilateral subcortical edema in the occipital regions of the brain. Case report: We report the case of a female patient with AIDS, pulmonary aspergillosis, CMV infection, and acute renal failure due to Clostridium difficile diarrhea. Her clinical course was complicated by seizures and hypertension. MRI findings were consistent with PRES. The patient was treated with anticonvulsants and antihypertensive agents with clinical improvement. Discussion and conclusions: Few cases of PRES in HIV-infected patients have been described, and it is not clear whether HIV infection is a predisposing factor for this syndrome. The article reviews the literature on PRES in HIV and discusses the role of HIV-associated endothelial damage in the pathogenesis of this syndrome.

Objectives: To assess the knowledge of interns on standard precautions and post-exposure prophylaxis for HIV, and identify the gap between knowledge and practice relating to standard precautions, as well as determining the perceived barriers against adherence to standard precautions.Methods: The study was conducted on 130 interns of 2010-11 batch from a government-run medical college in Kolkata, India. All participants completed a self-administered questionnaire with items relating to basic components of standard precautions and post-exposure prophylaxis for HIV. The questionnaire also included open ended questions relating to reasons for non-adherence to the practice of standard precautions along with additional space for specific comments, if any.Results: Poor adherence in the use of personal protective equipment, hand washing, safe handling and disposal of needles and sharp objects were found to be among the practices for which the interns expressed correct knowledge. While the main reasons for non-adherence were found to be clumsiness in handling needles, wearing gloves, feeling uncomfortable when wearing aprons, impracticality of regular hand-washing and non-availability of equipment. Although the majority of the respondents (84.6%) expressed awareness of washing sites of injured with soap and water, approximately 32.3% did not know that antiseptics could cause more damage. Also, only 63.8% expressed awareness of reporting any incidence of occupational exposure, while knowledge on post-exposure prophylaxis regimens was generally found to be poor.Conclusion: The considerable gap between knowledge and practice of standard precautions and inadequate knowledge of post-exposure prophylaxis emphasizes the need for continuous onsite training of interns with supportive supervision and monitoring of their activities.

The epidemic of human immunodeficiency virus continues impacting negativelyhealth of women and children worldwide. Currently, the course of the entity can bemodified through programs that provide antiretroviral prophylaxis and treatment.Preconception counseling and family planning are tools that still have low presencein the general population and especially in couples who are HIV positive. One ofthe objectives of management of the pregnant woman with HIV is the prevention of perinatal transmission. National and international guidelines address themanagement of different clinical scenarios in which you can find a woman ofchildbearing age with HIV. These guidelines should be permanently available inclinics, emergency rooms, delivery rooms and operating rooms, to be applied properlyand promptly. Health professionals should be aware of drugs and dosages. Themanagement of HIV positive pregnant women should be multidisciplinary.RESUMEN:La epidemia del virus de inmunodeficiencia humana continúa impactando negativamentela salud de mujeres y niños a nivel mundial. Actualmente el curso de la entidad puedemodificarse a través de programas que ofrecen profilaxis y tratamiento antirretroviral.La consejería preconcepcional y la planificación familiar son herramientas que todavíatienen baja presencia dentro de la población en general y en especial dentro de las parejasque son VIH positivas. Dentro de los objetivos del manejo de la mujer embarazadacon VIH se encuentra la prevención de la transmisión perinatal. Las guías nacionalese internacionales denominan escenarios clínicos a las posibles situaciones en las quese puede encontrar una mujer en edad fértil con VIH, ya sea que esté planificando oesté embarazada, y la mejor forma de manejarla. Estas guías deben estar disponiblespermanentemente en consultorios, salas de urgencias, salas de parto y salas de cirugía,para que sean aplicadas correcta y oportunamente. Los profesionales de la salud debenconocer los fármacos, sus presentaciones comerciales y las dosificaciones. El manejo delas mujeres con VIH positivo debe ser multidisciplinario.

Background and Objectives: Patients with major ß-Thalassaemia-due to their constant need for blood transfusion-are at the risk of blood-transmitted diseases such as hepatitis B, C and HIV. Moreover, the residual risk of blood-transmittable viruses in window period during blood donation remains un-detected in antibody screening test. In the study the prevalence of hepatitis B, C and HIV were examined in patients with major ß-thalassaemia.Methods: This descriptive study was performed on 142 patients with major ß-thalassaemi in city of Qom in 2007. At first, a questionnaire was filled by each patient. It elicited demographic ،information including age, sex, frequency of blood transfusion per year, time of diagnosis, history of vaccination and….. Then blood samples of patients were tested to detect serum markers including HBsAg, Anti-HCV, Anti-HIV with Eliza method. Positive EIA results of HBSAg and Anti-HCV were confirmed respectively with neutralization, RIBA and Blot tests.Results: Out of 142 patients with major ß–thalasseamia in this study, 76(53.5%) were male and 66 (46.5%) female. The average age of patients was 14.3 years and 3% of patients were married. The average age of diagnosis of disease was 10/9 years. 63% of patients had received the vaccine. Among 142 patients, one was seropositive for HBSAg and 19 for anti HCV. There was no case of HIV positive. Conclusion: The results showed the prevalence of hepatitis C in patients with major ß-Thalassemia in Qom to be relatively low (13.38%), but it seems that screening the blood donors effectively decreases the prevalence and incidence of infection.

Background: Malnutrition is a public health problem in the entire world, particularly in the developing countries. The effect of Spiruline supplement in the weight recovery of HIV-negative and HIV-infected undernourished children has been largely demonstrated. The aim of this study is to determine the effect of Spiruline on the immune status of 46 HIV-infected undernourished children, aged 15 ± 5 months, and of 23 undernourished HIV-negative children, aged 14 ± 6 months.Methodology: The duration of this study was eight weeks. To assess immune functions a count of CD4 lymphocyte subpopulation was performed before and after introducing the Spiruline supplement.Results: The degree of anemia improved in all the children, but the effect was less evident among HIV-infected children; in fact, 81% of HIV-negative versus 62% of HIV-infected children showed signs of improvement. The mean values of CD4 lymphocyte subpopulation showed a consistent increment in HIV-negative children [from 1257 (range 531-2301) to 1562 (range 798-2552) mm3] while they showed an irregular increase in HIV-infected children [from 1339 (152-4000) to 2088 (244-4214) mm3].Conclusions: The improvement of the immunological status due to Spiruline treatment might represent an effective barrier against infectious diseases, which both cause and result from malnutrition in underdeveloped countries.

Human immune-virus (HIV) infection is the most significant risk factor for progression of latent mycobacterium tuberculosis (MTB) infection to active tuberculosis. Tuberculosis reactivation among human immunodeficiency virus (HIV) infected cases can be prevented by anti tubercular chemoprophylaxis. This randomized controlled study compared the efficacy of 2 months of daily rifampicin and pyrazinamide and 6 months of daily rifampicin and isoniazid drug regimes in preventing active tuberculosis in HIV seropositives. It is observed that 2 months of daily rifampicin in combination with pyrazinamide is not only efficacious as that of 6 months of daily rifampicin and isoniazid combination in preventing active tuberculosis in HIV seropositives but has the advantage of better compliance, lesser side effects and prolonged post prophylactic preventive effect.

In The actions of prevention to the HIV AIDS, in the prenatal lens the advising of women infected bythe HIV about the risk from the vertical transmission causing to prohibition from the lactation and from the breastfeedingcrossed. Objective it identify joined the pregnants HIV positive the main worries as regards the impedimentfrom the breast-feeding natural and evaluate the individual educational needs of activities as form alternative to theaffectionate and psychic emotional support to the pregnant. Methodology treats itself of a boarding qualitative, theywere interviewed pregnants soropositivas inscription in the outpatient clinic of prenatal of high risk, of a PublicHospital, in Goiânia GO. Analyzing the facts: them interviewed were unanimous in affirm that to pregnancy wasnot planned. It be pregnant and uncover that they are bearers of the virus HIV brought bigger expectationsregarding the pregnancy: fear, insecurity, anguish and doubts are emotions by them related. And, they stood outthat the specific groups permit bigger liberty for argument and change of experiences, the work helps to pregnantreact to the consequences of the virus HIV. Like this being, we understand that the aid to the pregnantsoroposotive, in the institution studied attends a standard quality, however, is important thing systematize thespecific formation of groups of pregnant soropositives for HIV.

Background: With the availability of highly active antiretroviral therapy, more HIV-infected children have lived longer. Many children are at the age that they should know the diagnosis. Aim: To identify the prevalence and patterns of disclosure of HIV/AIDS diagnosis to HIV-infected children. Methods: A cross-sectional study was conducted among 103 main care givers of HIV-infected children aged ≥6 years who received highly active antiretroviral therapy at Chiang Mai University and Sanpatong district hospitals, northern Thailand. Results: One-third (30.1%) of the children knew their HIV/AIDS status at an average age of 9.2 years. The care givers’ understanding of ‘knowing’ did not always mean that the children were told the name of ‘HIV’ or ‘AIDS’. Many of those care givers (84.3%) who reported that the child did not know their diagnosis had inaccurately explained to the child that he or she had some kind of disease such as allergy, lung, or liver disease. The most common reason for non-disclosure was the fear that disclosure might have negative psychological consequences to the child (53.4%). Almost all (88.7%) agreed that they should tell the children their diagnosis in the future but half needed health-care providers to help them at the event. Conclusion: There is a need for the development of disclosure guide-lines and models for health-care providers and care givers as there was a high rate of inaccurate disclosure and, in addition, care givers expressed their need for assistance from health-care providers for the future disclosure. [ABSTRACT FROM AUTHOR]

The use of pharmacologic doses of the conditionally-essential nutrient L-carnitine ( LC) has been associated with positive effects on the immune system. We have recently suggested that this property of LC could be mediated through activation of the glucocorticoid receptor alpha. Human immunodeficiency virus (HIV)-infected individuals, especially those on antiretroviral therapy, may become LC-deficient. This evidence, together with the immunomodulatory properties of LC, its known major role in lipid and energy metabolisms, and its proposed antiapoptotic and neuroprotective actions, have encouraged the use of LC supplementation as a potential treatment for HIV-related disorders, such as lipodystrophy and peripheral neuropathy. Preliminary results, mostly from small-scale uncontrolled studies are conflicting, whilst larger controlled trials are warranted. [ABSTRACT FROM AUTHOR]

Background: Few studies have examined the factors associated with depression in informal caregivers of HIV-infected persons.Objective: To investigate the relationship between depression and caregiver burden among informal caregivers of HIV-infected individuals.Design: Cross-sectional study using baseline data from an ongoing randomized trial of a supportive telephone intervention.Participants: One hundred seventy-six dyads of HIV patients and their informal caregiver.Measurements: Depression was defined as a Beck Depression Inventory >10. A Caregiver Strain Index >6 identified informal caregivers with a high caregiver burden. We used logistic regression to identify characteristics that were associated with depression in the informal caregiver.Results: Informal caregivers were 42 years old (SD, 13), 53% female, 59% nonwhite, and 30% had education beyond high school. Forty-seven percent of informal caregivers were the patient's partner, 18% a friend, and 35% a family member. Twenty-seven percent of informal caregivers had a high caregiver burden, and 50% were depressed. We found significantly greater odds of informal caregiver depression with high caregiver burden (OR, 6.08; 95% CI, 2.40 to 15.4), informal caregiver medical comorbidity besides HIV (OR, 2.32; 95% CI, 1.09 to 4.92), spending all day together (OR, 3.92; 95% CI, 1.59 to 9.69), having to help others besides the HIV patient (OR, 2.55; 95% CI, 1.14 to 5.74), and duration of the HIV patient's diagnosis (OR, 1.01 per month; 95% CI, 1.00 to 1.01).Conclusions: High caregiver burden was strongly associated with depression among HIV-infected individuals' informal caregivers, who themselves had difficult life circumstances. Informal caregivers of HIV patients may be in need of both mental health services and assistance in caregiving. [ABSTRACT FROM AUTHOR]

HIV-1 protease is a pivotal enzyme in the later stages of the viral life cycle which is responsible for the processing and maturation of the virus particle into an infectious virion. As such, HIV-1 protease has become an important target for the treatment of AIDS, and efficient drugs have been developed. However, negative side effects and fast emerging resistance to the current drugs have necessitated the development of novel chemical entities in order to exploit different pharmacokinetic properties as well as new interaction patterns. We have used X-ray crystallography to decipher the structure–activity relationship of fluoro-substitution as a strategy to improve the antiviral activity and the protease inhibition of C2-symmetric diol-based inhibitors. In total we present six protease–inhibitor complexes at 1.8–2.3 Å resolution, which have been structurally characterized with respect to their antiviral and inhibitory activities, in order to evaluate the effects of different fluoro-substitutions. These C2-symmetric inhibitors comprise mono- and difluoro-substituted benzyloxy side groups in P1/P1′ and indanoleamine side groups in P2/P2′. The ortho- and meta-fluorinated P1/P1′-benzyloxy side groups proved to have the most cytopathogenic effects compared with the nonsubstituted analog and related C2-symmetric diol-based inhibitors. The different fluoro-substitutions are well accommodated in the protease S1/S1′ subsites, as observed by an increase in favorable Van der Waals contacts and surface area buried by the inhibitors. These data will be used in the development of potent inhibitors with different pharmacokinetic profiles towards resistant protease mutants. [ABSTRACT FROM AUTHOR]

The Internet is an emerging research tool that may be useful for contacting and working with rural men who have sex with men (MSM). Little is known about HIV risks for rural men and Internet methodological issues are only beginning to be examined. Internet versus conventionally recruited samples have shown both similarities and differences in their demographic characteristics. In this study, rural MSM from three sizes of town were recruited by two methods: conventional (e.g. face-to-face/snowball) or Internet. After stratifying for size of city, demographic characteristics of the two groups were similar. Both groups had ready access to the Internet. Patterns of sexual risk were similar across the city sizes but varied by recruitment approach, with the Internet group presenting a somewhat higher HIV sexual risk profile. Overall, these findings suggest the Internet provides a useful and low cost approach to recruiting and assessing HIV sexual risks for rural White MSM. Further research is needed on methods for recruiting rural minority MSM. [ABSTRACT FROM AUTHOR]

The prevalence and differentiation of dendritic cells (DC) in lymphoid tissue of simian immunodeficiency virus (SIV)-infected cynomolgus monkeys was studied during disease progression. Lymph node biopsies were consecutively obtained from clinical rapid and slow progressors until the development of disease consistent with simian acquired immunodeficiency syndrome (sAIDS) occurred. Quantitative evaluation of CD1a+ DC and the expression of DC antigens related to maturation (CD83, DC-LAMP and S100b) were performed at the single cell level by in situ image analysis. Despite a persistent prevalence of CD1a+ DC in lymphoid tissue during disease progression, there was a subsequent drop of mature CD83+, DC-LAMP+ and S100b+ DC, correlating with the decline of CD4+ T cells in blood. Thus, disease progression to sAIDS was associated with impaired maturation of DC, and lack of CD83, DC-LAMP and S100b expression. [ABSTRACT FROM AUTHOR]

The HIV epidemic has been the most significant public health crisis of the last 2 decades. Although Experimental Social Innovation and Dissemination (ESID) principles have been used by many HIV prevention researchers, the clearest application is the series of model- building and replication experiments conducted by Kelly and colleagues. The model mobilized, trained, and engaged key opinion leaders to serve as behavior change and safe-sex endorsers in their social networks. This paper illustrates how ESID principles were used to develop, test, and disseminate an innovative social model and discusses the challenges of applying ESID methodology in the midst of a public health emergency. [ABSTRACT FROM AUTHOR]

Intravenous drug users often have many health conditions in addition to their drug addiction, yet may be isolated from conventional sources of care. They have never before been examined for their use of complementary and alternative medicine (CAM) therapies. Our purpose was to study the prevalence and predictors of CAM use among persons with a history of intravenous drug use through a cross-sectional survey of intravenous drug users examining their utilization of health services, including CAM therapies. A total of 548 persons with a history of intravenous drug use, recruited from a needle-exchange program and a methadone maintenance clinic, both in Providence, Rhode Island, participated. Overall prevalence of any CAM use in the past 6 months, frequency of use of individual named CAM therapies and domains, and demographic and clinical characteristics associated with CAM users, reasons for CAM use and self-perceived effectiveness of CAM were also measured. Of the 548 participants, 45% reported use of at least one CAM therapy. The top three therapies--religious healing, relaxation techniques, and meditation--were all from the mind-body domain. Having a higher education and lower self-rated health were the two strongest predictors of CAM use, followed by having a regular doctor or clinic, being white and younger. There was a high level of self-perceived effectiveness of CAM therapies (4.1 on a scale of 1-5), and CAM users were likely to use CAM for reasons related to their addiction. [ABSTRACT FROM AUTHOR]

IV drug use is a risk factor for the spread of Hepatitis B-C and HIV infections. The aim of this study is to determine the rate of the seropositivity of those agents in an inpatient sample and to evaluate sociodemographic and clinical correlates related to this issue. The sex ratio in the study group was 7.5 % (n=8) as female, 92.5 % (n=99) as male. The mean age of group was 28.9 years (±6.9); the mean length of time of iv heroin use was 1.9 years (±1.8). The rate of sharing injector was 48.6 % (n=53). The distribution of serologic test results were as follows; HbsAg 2.8% (n=3), Anti-HBs 29.9% (n=32), Anti-HCV 44.9% (n=48), Anti-HIV I-II 4.7 % (n=5). The rate of seropositivity with HBV, HCV, HIV is found higher than general population. For viral hepatitis and HIV infections are growing health problems in Turkey, educational and preventive interventions should be planned especially for high risk groups throughout the country. [ABSTRACT FROM AUTHOR]

Dipeptidyl peptidase IV-β (DPP IV-β) is a novel protein which shows a peptidase activity similar to the T-cell-activation antigen CD26. To further characterize this DPP IV-β and confirm its cell surface expression, we have developed a purification strategy using the CD26- cell line C8166. The purification process includes biotinylation of cell surface proteins before preparation of cell extracts and processing by gel-filtration, ion-exchange and lectin chromatographies. Consistent with the molecular mass of DPP IV-β estimated by gel-filtration chromatography, the final purified fraction, manifesting a typical DPP IV activity, showed a major biotinylated 75-80-kDa band in SDS/PAGE, thus suggesting the monomeric nature of this enzyme. Kinetic parameters of DPP IV-β and the sensitivity to a new family of irreversible DPP IV inhibitors, were studied in comparison to CD26. Both enzymes followed a Michaelis kinetics with different Km values for Gly-Pro-NH-Np (NH-Np, para-nitroanilide) hydrolysis (0.28 ± 0.05 mM and 0.12 ± 0.02 mM). More significant differences were observed in the sensitivity to inhibitors, which exerted a much higher activity on CD26 than on DPP IV-β. These differences permitted us to study DPP IV-β expression in CD26-expressing cells, showing the expression of this new enzyme in all lymphoid cells tested, and a rapid enhancement in phytohemagglutinin-stimulated or protein-A-stimulated peripheral blood mononuclear cells. Our results indicate that, although DPP IV-β and CD26 are coexpressed and manifest a typical DPP IV activity, there are distinct features in their catalytic activities that may confer to each enzyme a complementary role in peptide processing. [ABSTRACT FROM AUTHOR]

This was a retrospective study to evaluate the prevalence and impact of hepatitis G virus (HGV) infection in hepatitis C virus (HCV)-positive drug addicts, according to the serological status of hepatitis B virus (HBV) and human immunodeficiency virus (HIV) co-infection. Two hundred and thirty-five randomly selected intravenous drug addicted patients (147 French, 88 Italian) were studied. All patients were positive for antibodies to HCV (anti-HCV). HGV RNA positivity was measured by reverse transcriptase–polymerase chain reaction (RT–PCR). Comparisons of HCV RNA positivity rate, and biological and histopathological variables, were made between HGV RNA-positive and negative patients, according to their HBV and HIV status. HGV prevalence was around 30% in both French and Italian groups. No clear association between HGV infection and a particular HCV genotype was observed. The rate of HCV RNA positivity did not differ between HGV-positive and HGV-negative patients after stratification for hepatitis B surface antigen (HBsAg) and HIV positivity. Histological severity of the underlying chronic hepatitis did not differ according to the HGV status; however, in HIV-positive HBsAg-negative patients, the hepatitis activity was moderately increased in HGV-positive patients. A striking negative influence of HBsAg positivity on HCV replication was observed in HIV-negative patients: an HCV RNA-positive rate of 25% was found in HBsAg-positive patients vs 86% in HBsAg-negative patients; similar significant results were observed in HIV-positive patients, although to a lesser extent. The underlying chronic hepatitis was significantly more severe in HBsAg-positive than in HBsAg-negative HIV-negative patients. Hence, HGV infection is highly prevalent in anti-HCV positive drug addicts but the co-infection with HCV does not seem to influence HCV replication nor to worsen the underlying chronic hepatitis, in HIV-negative patients at least. Reciprocal influence between... [ABSTRACT FROM AUTHOR]

Latency of the Human Immunodeficiency Virus (HIV) has been demonstrated in both helper T-Lymphocytes and cells of the macrophage/monocyte series. Although mitogen-dependent amplification of HIV infection within lymphocytes and monocytes/macrophages has been demonstrated to occur in vitro, in vivo evidence of such a phenomenon has been lacking. We have performed electron microscopic and immunocytochemical evaluation of skin biopsies from a patient with the Acquired Immunodeficiency Syndrome (AIDS) with chronic erythroderma. These biopsies provided evidence of proliferation of HIV in macrophages interacting with activated lymphocytes (CD3+). These macrophages were undergoing morphologic changes characteristic of cytopathicity and contained numerous viral particles, many of which were actively budding from plasma membranes. Cutaneous macrophages which were not interacting with lymphocytes did not demonstrate cytopathicity or evidence of viral multiplication. These in vivo data substantiate the concept that activation of cells which harbour latent HIV promotes viral replication as well as subsequent cytopathicity. [ABSTRACT FROM AUTHOR]