scholarly journals High seroprevalence of Leishmania infantum is linked to immune activation in people with HIV: a two-stage cross-sectional study in Bahia, Brazil

Author(s):  
Laise de Moraes ◽  
Luciane Amorim Santos ◽  
Liã Bárbara Arruda ◽  
Maria da Purificação Pereira da Silva ◽  
Márcio de Oliveira Silva ◽  
...  

Background: Visceral leishmaniasis is an opportunistic disease in HIV-1 infected individuals, although not yet recognized as a determining factor for AIDS diagnosis. The growing geographical overlap of HIV-1 and Leishmania infections is an emerging challenge worldwide, as co-infection increases morbidity and mortality for both. Here, we determined the prevalence of people living with HIV (PWH) with a previous or ongoing infection by Leishmania infantum in Bahia, Brazil and investigated the virological and immunological factors associated with co-infection. Methodology and Principal Findings: We adopted a two-stage cross-sectional cohort (CSC) design (CSC-I, n=5,346 and CSC-II, n=317) of treatment-naïve HIV-1-infected individuals in Bahia, Brazil. In CSC-I, samples collected at the time of HIV-1 diagnosis between 1998 and 2013 were used for serological screening for leishmaniasis by an in-house immunoassay (ELISA) with SLA (Soluble Leishmania Antigen), resulting in a prevalence of previous or ongoing infection of 16.27%. Next, 317 PWH were prospectively recruited from July 2014 to December 2015 with collection of sociodemographic and clinical data. Serological validation by two different immunoassays confirmed a prevalence of 15.46% and 8.20% by anti-SLA, and anti-HSP70 serology, respectively, whereas 4.73% were double-positive (DP). Stratification of these 317 individuals in DP and double-negative (DN) revealed a significant reduction of CD4+ counts and CD4+/CD8+ ratios and a tendency of increased viral load in the DP group, as compared to DN. No statistical differences in HIV-1 subtype distribution were observed between the two groups. However, we found a significant increase of CXCL10/IP-10 (p=0.0076) and a tendency of increased CXCL9/MIG (p =0.061) in individuals with DP serology for L. infantum, demonstrating intensified immune activation in this group. These findings were corroborated at the transcriptome level in independent Leishmania- and HIV-1-infected cohorts (Swiss HIV Cohort and Piaui Northeast Brazil Cohort), indicating that CXCL10 transcripts are shared by the IFN-dominated immune activation gene signatures of both pathogens and positively correlated to viral load in untreated PWH. Conclusions/Significance: This study demonstrated a high prevalence of PWH with L. infantum seropositivity in Bahia, Brazil, linked to IFN-mediated immune activation and a significant decrease in CD4+ levels. Our results highlight the urgent need to increase awareness and define public health strategies for the management and prevention of HIV-1 and L. infantum co-infection.

2020 ◽  
Author(s):  
Aude Christelle Ka'e ◽  
Samuel Martin Sosso ◽  
Joseph Fokam ◽  
Rachel Kamgaing Simo ◽  
Sara Riwom Essama ◽  
...  

Abstract Background: Toxoplasmosis remains a neglected common opportunistic infection in immunocompromised individuals, who are mainly people living with HIV (PLWHIV) in whom reactivation of toxoplasmosis may occur with advanced HIV conditions in resource-limited settings (RLS). Our objective was to evaluate the correlation between the anti-toxoplasmic IgG (Tg-IgG) concentration and the immuno-virological status of PLWHIV.Methods : A prospective and cross-sectional study was conducted among PLWHIV aged>18 years from February to November 2018 at the Chantal BIYA international Reference Centre. Blood samples were collected from eligible consenting PLWHIV; Tg-IgG level was assessed by quantitative ELISA, CD4-T lymphocytes counts were measured by flow cytometry and HIV-1 plasma viral load (PVL) measurement by real-time-PCR. Data were analysed using Excel and Graph Pad softwares; with p<0.05 considered statistically significant.Results : A total of 100 PLWHIV were enrolled: 56% seropositive for IgG anti- Toxoplasma gondii, 33% seronegative and 11% indeterminate results. According to viremia, 100% (19/19) of those with PVL>1000 copies/mL were seropositive to Tg-IgG versus 52.85% (37/70) of those with PVL<1000 copies/mL (median [IQR] IgG concentration 152.78 [139.24-444.43] versus 34.44 [13.04-36.47] IU/mL, respectively); p<0.0001. According to CD4, 100% (11/11) of those with T-CD4<200 cells/µL were seropositive to Tg-IgG versus 57.69% (45/78) of those with T-CD4>200 cells/µL (median IgG [IQR] 432.92 [145.06-450.47] versus 35.01 [15.01-38.01] IU/mL, respectively); p<0.0001. Interestingly, there were moderate-positive and strong-negative correlations respectively with HIV-1 PVL (r = 0.54; p<0.0001) and T-CD4 (r = -0.70; p<0.0001) as compared to Tg-IgG concentration. After adjusting for age, gender, immune status and PVL in logistic regression, only poor immune status (T-CD4<200 cells/µL) was independently associated to Tg-IgG seropositivity (p=0.0004).Conclusion : In a typical RLS like Cameroon, about half of PLWHIV might be seropositive to Tg-IgG. Of relevance, decreasing immunity appears with risk of increasing IgG anti- T gondii concentration, which suggests a relapse of toxoplasmosis. Thus, in the context of immunodeficiency, routine quantification of Tg-IgG would alleviate the programmatic burden of this opportunistic infection in RLS with generalized HIV epidemics.


2017 ◽  
Vol 9 (1) ◽  
pp. 2017049 ◽  
Author(s):  
Lassina TRAORE ◽  
Ouéogo NIKIEMA ◽  
Abdoul Karim OUATTARA ◽  
Tegwindé Rébéca COMPAORE ◽  
Serge Théophile SOUBEIGA ◽  
...  

Epstein Barr Virus (EBV) and Human Herpes Virus 6 (HHV-6) are responsible for severe diseases, particularly in immunocompromised persons. There are poor data on the infection with these opportunistic viruses in Burkina Faso.The purpose of this study is to characterize EBV and HHV-6 subtypes and to assess their impact on CD4 T cell count, HIV-1 viral load and antiretroviral treatment in people living with HIV-1.The study population consisted of 238 HIV-positive patients with information on CD4 count, HIV-1 viral load and HAART. Venous blood samples collected on EDTA tubes were used for EBV and HHV-6 Real Time PCR subtyping.An infection rate of 6.7% (16/238) and 7.1% (17/238) were found respectively for EBV and HHV-6 in the present study. Among EBV infections, similar prevalences were noted for both subtypes (3.9% [9/238] for EBV-1 vs 4.6% [11/238] for EBV-2) with 2.1% (5/238) of co-infection. HHV-6A infection represented 6.3% (15/238) of the study population against 5.0% (12/238) for HHV-6B. . EBV-2 infection was significantly higher in patients with CD4 count ≥ 500 compared to those with CD4 count less than 500 cells (1.65% vs 8.56%, p = 0,011). The prevalence of EBV and HHV-6 infections were almost similar in HAART-naive and HAART-experienced patients.The present study provides information on the prevalence of EBV and HHV-6 subtypes in people living with HIV-1 in Burkina Faso. The study also suggests that HAART treatment has no effect on infection with these opportunistic viruses in people living with HIV-1.


2011 ◽  
Vol 8 (1) ◽  
pp. 33 ◽  
Author(s):  
Eric Pefura Yone ◽  
Awa Betyoumin ◽  
André Kengne ◽  
François Kaze Folefack ◽  
Jeanne Ngogang

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Alhanoof Alohaly ◽  
Adriana Campa ◽  
Leslie Seminario ◽  
Marianna Baum

Abstract Objectives HIV infection and cocaine use contribute to oxidative stress; persistent oxidative stress leads to rapid rates of glutathione (GSH) consumption. GSH is an abundant intracellular antioxidant and is synthesized from its precursor amino acids. HIV promotes changes in the components of the antioxidant defense system, resulting in GSH depletion and may cause DNA damage, and is associated with chronic inflammatory diseases. Therefore, the aim is to assess oxidative stress, and biomarkers of inflammation in HIV-infected individuals from the Miami Adult Studies on HIV (MASH) cohort, on stable antiretroviral therapy (ART), with controlled HIV viral load. Methods A cross-sectional study of participants in the MASH cohort in Miami. Participants were consented and blood was collected for C-reactive protein (CRP), oxidized glutathione and % of reduced to oxidized glutathione (GSH: GSSG). Anthropometrics included body fat measured by the bioimpedance analysis machine. Results Mean age was 54.6 ± 6.3 years, 67% were male, and 50% used cocaine, mean BMI was 26.2 ± 3.1, CRP was 7.1 ± 12.4, oxidized glutathione was 34.4 ± 32.4 mmol, and the ratio of GSH: GSSG 4.86 ± 4.7. All participants had undetected viral load and were mainly overweight (70%) with a mean fat% of 28.0 ± 7.1. Cocaine use was strongly related with CRP (r = 401, P = 0.014) and GSH: GSSG (r = −389, P = 0.017) ; BMI was lower with age (r = −0.502, P = 0.024); and fat contain was lower in males (r = −0.474, P = 0.004); males also had significantly higher oxidized glutathione (r = 0.384, P = 0.018); age was inversely correlated with BMI (r = −0.335, P = 0.027). A nutritional supplementation with antioxidants with a longitudinal follow-up of outcomes is in progress. Conclusions Our findings suggest that cocaine use is significantly associated with markers of inflammations and oxidative stress in people living with HIV who are already at risk for these conditions, and interventions with antioxidants and detoxification interventions are important for these participants. Funding Sources National Institute on Drug Abuse.


2019 ◽  
Vol 12 (1) ◽  
Author(s):  
Alex Durand Nka ◽  
Samuel Martin Sosso ◽  
Joseph Fokam ◽  
Yagai Bouba ◽  
Georges Teto ◽  
...  

Abstract Objective Thrombocytopenia is an abnormal decrease in blood platelets, which can affect the prognosis of people living with HIV (PLHIV). In order to assess the burden of this haematological disorder, we evaluated the frequency of thrombocytopenia according to antiretroviral drug combinations, viremia and the immune status of PLHIV. Results A cross-sectional and analytical study was conducted from June to November 2016 among 310 PLHIV at the “Chantal BIYA” International Reference Centre, Yaoundé, Cameroon. Overall rate of thrombocytopenia was 19.0% (59/310). The rate of thrombocytopenia was 64.6% (42/65) versus 6.9% (17/245) in ART-naïve versus ART-treated patients respectively, p < 0.0001. Following viral load, rate of thrombocytopenia was 15.8% (20/130) in those with undetectable viral load, and 34.1% (27/79) with viral loads > 3 log10 RNA/ml (p = 0.03). As concerns CD4-count, rate of thrombocytopenia was 16.2% (42/259) in those with ≥ 200 CD4/mm3 versus 33.3% (17/51) with < 200 CD4/mm3 (p = 0.0003). After adjusting for sex, ART, viral load and CD4, Viral load and ART exposure were significantly associated with decreased risk of thrombocytopenia (p < 0.05). Thrombocytopenia occurs especially among ART-naïve, high viremia and severe immune-compromised patients. Interestingly, ART coverage appears as an independent factor in preventing the occurrence of thrombocytopenia.


Author(s):  
Henrik Friis ◽  
Exnevia Gomo ◽  
Norman Nyazema ◽  
Patricia Ndhlovu ◽  
Henrik Krarup ◽  
...  

2021 ◽  
Vol 15 (10) ◽  
pp. 1481-1488
Author(s):  
Thaisa Fernanda Lourenção Tauyr ◽  
Luciano Garcia Lourenção ◽  
Maria Amélia Zanon Ponce ◽  
Francisco Rosemiro Guimarães Ximenes Neto ◽  
Maria de Lourdes Sperli Geraldes Santos ◽  
...  

Introduction: Human immunodeficiency virus (HIV) infection affects the lesbian, gay, bisexual, transvestite, and transsexual (LGBT) population. We aimed to identify the indidual vulnerability profile of the LGBT population ling with H/acquired immunodeficiency syndrome (AIDS) and correlate it with the treatment situation. Methodology: This cross-sectional study included 510 LGBT people living with HIV (PLHIV)/AIDS who attended the Complex of Chronic Communicable Diseases of the municipality of São José do Rio Preto, São Paulo, Brazil, between 2008 and 2015. Results: There was a predominance of indiduals who were white (70.2%), male (98.4%), single (87.1%), aged 25–44 years (70.0%), educated up to high school (47.7%), economically acte (91.2%), under treatment (80.8%), having CD4 > 350 cells/mm3 (77.1%), and having undetectable viral load (53.3%). HIV transmission was mainly sexual (97.0%) and most people used drugs (76.5%). There was a weak correlation between the variables ‘in treatment’ and acte occupation (r = 0.148, p = 0.001), single marital status (r = 0.128, p = 0.004), white race/colour (r = 0.117, p = 0.008), high school education (r = 0.111, p = 0.012), sexual transmission (r = 0.222, p = 0.000), drug use (r = 0.087, p = 0.049), and CD4 > 350 cells/mm3 (r = 0.118, p = 0.008); and strong correlation between the variables ‘in treatment’ and undetectable viral load (r = -0.937, p = 0.113). Conclusions: The characteristics of the indidual vulnerability of LGBT people involve, among other aspects, issues of gender and social exclusion, a situation that is part of the daily life of PLHIV/AIDS in many scenarios and territories. This can be alleviated with a network of social and health support and effecte and efficient, protecte, attitudinal, and behavioural public policies.


PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0255834
Author(s):  
Bogusz Jan Aksak-Wąs ◽  
Miłosz Parczewski ◽  
Anna Urbańska ◽  
Małgorzata Hackiewicz ◽  
Justyna D. Kowalska

Background The life expectancy of people living with HIV (PLWH) remains shorter than that of the general population, despite significant improvement in the recent years. Mortality in HIV-infected individuals may be associated with a higher viral load at of diagnosis, a lower CD4 count, or clinical variables such as sex or route of transmission. This article investigated the role of the HLA-B*5701 varian on mortality among PLWH. Methods Material for the analysis consist of the data of 2,393 patients for whom the HLA-B*57 variant was known. Those patients were followed under the care of the Infectious Diseases Hospital in Warsaw (n = 1555) and the Clinic of Acquired Immunodeficiency of the Pomeranian Medical University in Szczecin (n = 838). Factors such as age, gender, date of HIV diagnosis, route of transmission, date of death, baseline HIV viral load and baseline CD4 counts, were collected, and end-point cross-sectional analyses were marked at 60, 120, 180 and 240 month of observation. Results HLA-B*5701 allele was found in 133 (5.5%) analyzed cases. Median age was notably higher for HLA-B*5701 positive patients [32.7 (28.3–41.3) vs. 31.6 (26.8–38.3)years p = 0.02]. HLA-B*5701 was associated with lower baseline viral load [4.21 (3.5–4.8) vs. 4.79 (4.2–5.3)log copies/ml p<0.001] and higher CD4count [448 (294.5–662) vs. 352 (176–514) cells/μl p<0.001]. There were no association between HLA-B*5701 and survival for any given end-point. Higher mortality was associated to male gender, intravenous drug users, lower CD4 count at baseline and higher baseline viral load. Conclusions In our study, the presence of HLA-B*5701 allel was not associated with mortality rate of HIV infected patients, irrespective of being associated with both higher baseline CD4 + cell count and lower baseline HIV viral load.


2019 ◽  
Author(s):  
Alex Durand NKA ◽  
Samuel Martin Sosso ◽  
Joseph Fokam ◽  
Bouba Yagai ◽  
Georges Teto ◽  
...  

Abstract Background Thrombocytopenia is an abnormal decrease in blood platelets, which can affect the prognosis of people living with HIV (PLHIV). In order to limit the occurrence of this haematological disorder, we evaluated the frequency of thrombocytopenia according to antiretroviral drug combinations, viremia and the immune status of PLHIV. Methods A cross-sectional and analytical study was conducted from June-November 2016 among 310 PLHIV at the “Chantal BIYA” International Reference Centre for research on HIV/AIDS prevention and management (CIRCB), Yaoundé, Cameroon. Thrombocytopenia was assessed by blood count on Mindray BC 3000 plus, then categorized as mild (50,000-149,999 platelets/μL), moderate (20,000-49,999) and severe <20,000; HIV-1 viremia was measured by Abbott m2000RT and CD4 by BD Facs Calibur; treatment history was retrieved from medical records. Data were analysed using Graph Pad Prism.6, with p<0.05 considered statistically significant. Results Median age was 40 [IQR: 33-49] years with, and 60.9% of participants being female. Up to 79.0% (245) were receiving antiretroviral therapy (ART); 54.5% had CD4 counts <500 cells/mm3 and 25.4% had viremia >3log10 RNA/ml. Overall rate of thrombocytopenia was 19.0% (59/310), with 17.4% (54/310) mild, 1.6% (5/310) moderate and 0.0% severe. Following ART-exposure, rate of thrombocytopenia was 64.6% (42/65) versus 6.9% (17/245) in naïve versus treated patients respectively, p<0.0001. Following ART regimens, rate of thrombocytopenia was 64.7% (11/17) versus 35.3% (6/17) among AZT-containing versus AZT-sparing regimens, p=0.02. Following viral load ranges, rate of thrombocytopenia was 15.8% (20/130) in those with undetectable viral load, 11.0% (12/101) with viral loads 1.60-3.0 log10 RNA/ml and 34.1% (27/79) with viral loads >3 log10 RNA/ml (p=0.03; r=-0.12). As concerns CD4-count, rate of thrombocytopenia was 16.2% (42/259) in those with ≥200 CD4/mm3 versus 33.3% (17/51) with <200 CD4/mm3 (p=0.0003; r=0.21). After adjusting for age, sex, ART, viral load and CD4, only ART exposure was significantly associated with decreased risk of thrombopenia (p<0.0001). Conclusions Thrombocytopenia occurs generally at mild-level among PLHIV in Cameroon, especially among ART-naïve, AZT-treated, high viremia and severe immune-compromised patients. Interestingly, ART coverage appears as an independent factor in preventing the occurrence of thrombocytopenia, especially for AZT-sparing treatment combinations in countries with similar features like Cameroon.


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