Use of betapropiolactone to disinfect fresh tissue without impairing antigenicity: method applicable to human immunodeficiency virus (HIV) positive tissue.

Abstract Background The number of human immunodeficiency virus (HIV) positive adolescents in secondary school has increased over the years. Little is known on how the students cope to the pressures and demands of their academic and health lives in the boarding secondary schools. This study explored the factors surrounding their anti-retroviral therapy adherence as well as their experiences. Methods We did a qualitative study that employed in-depth interviews amongst purposively selected 19 HIV positive adolescent students in boarding secondary school and seven key informants. Key informants were members of boarding secondary school staff directly taking care of the adolescents living with human immune virus and had spent at least two academic terms in that school. The study participants were recruited from four health facilities in Bushenyi district, southwestern Uganda, and key informants from five boarding secondary schools in Bushenyi. These were engaged in in-depth interviews using an interview guide. Data was transcribed, coded and the content analyzed thematically. Results Adolescents living with human immunodeficiency virus in boarding secondary school face challenges similar to adolescents outside boarding school settings. However, some challenges are unique to them. Students faced numerous barriers which made it difficult to adhere to their medication. Stigmatization in its different forms was also a major challenge amongst students. Willingness disclosure of serostatus was beneficial to the students since it guaranteed support while at school; facilitating adherence and better living. However, students were uneasy to disclose their status. Some students adopted negative coping mechanisms such as telling lies, escaping from school, and class to access medication. Conclusions Adolescents in boarding secondary schools face similar challenges as compared to their counterparts with some being unique to them. Few school mechanisms help these students to cope while at school. Limited disclosure has proven useful but some adolescents have opted not to disclose their status and hence used negative coping mechanisms. These challenges need to be addressed and a safe environment to encourage limited disclosure should be made.

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Pneumocystis carinii infection in bilateral aural polyps in a human immunodeficiency virus-positive patient

The Journal of Laryngology & Otology ◽

10.1258/0022215021910555 ◽

2002 ◽

Vol 116 (4) ◽

pp. 288-290 ◽

Cited By ~ 7

Author(s):

C. V. Praveen ◽

R. M. Terry ◽

M. Elmahallawy ◽

C. Horsfield

Keyword(s):

Human Immunodeficiency Virus ◽

Opportunistic Infection ◽

Pneumocystis Carinii ◽

Lymphatic Vessels ◽

Blood Stream ◽

Positive Patient ◽

Hiv Positive ◽

Immunodeficiency Virus ◽

History Of ◽

Pneumocystis Carinii Infection

Pneumocystis carinii is an opportunistic infection found in patients with impaired immunity. Under favourable conditions the parasite can spread via the blood stream or lymphatic vessels and cause extrapulmonary dissemination. We report a case of P carinii infection presenting as bilateral aural polyps, otitis media and mastoiditis in human immunodeficiency (HIV)-positive patient with no history of prior or concomitant P carinii infection.

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Abstract WP426: Subarachnoid Hemorrhage in patients infected with Human Immunodeficiency Virus

Stroke ◽

10.1161/str.44.suppl_1.awp426 ◽

2013 ◽

Vol 44 (suppl_1) ◽

Author(s):

Haralabos Zacharatos ◽

Malik M Adil ◽

Ameer E Hassan ◽

Sarwat I Gilani ◽

Adnan I Qureshi

Keyword(s):

Human Immunodeficiency Virus ◽

Subarachnoid Hemorrhage ◽

Blood Transfusion ◽

Hospital Mortality ◽

Hiv Infection ◽

The United States ◽

Hiv Positive ◽

Published Data ◽

Immunodeficiency Virus ◽

Hiv Negative

Background: There is limited data regarding the unique attributes of ischemic stroke among patients infected with human immunodeficiency virus (HIV). There is no published data regarding the occurrence and outcomes of subarachnoid hemorrhage (SAH) among HIV infected persons. Methods: The largest all-payer Nationwide Inpatient Sample (NIS 2002-2010) data was used to identify and analyze all patients presenting with the primary diagnosis of SAH in the United States. Among this cohort, we identified the patients who were not HIV positive and those who were HIV positive. Patient demographics, medical co-morbidities, in-hospital complications, in-hospital procedures, and discharge disposition were compared between the two groups. The association between HIV infection and outcomes was evaluated in multivariate analysis after adjusting for potential confounders. Results: Of the 351,491 patients admitted with SAH, 1367 (0.39%) were infected with HIV. HIV infected patients were younger, mean age [±SD] of 45 ±14.2 years versus those who were not 58±19 years, (p<0.0001). The rate of blood transfusion [27,286 (7.8%) versus 245.6 (18%), p=0.0003], mechanical ventilation [51,199 (14.6%) versus 316.1(23.1%), p=0.008], and sepsis [14,644 (4.2%) versus 236.1 (17.3%), p<0.0001] was significantly higher among HIV infected patients. After adjusting for age, gender, hypertension, coagulopathy, atrial fibrillation, renal failure, and dyslipidemia, HIV negative patients had a significantly higher rate of discharge to home (odds ratio [OR] 1.9, 95% CI: 1.4-2.6, p<0.0001) and lower in-patient mortality (OR 0.4, 95% CI: 0.3-0.5, p<0.001). Further adjustment for blood transfusion and sepsis reduced the odds of discharge to home for the HIV negative patients, from 1.9 to 1.7 but did not affect in-hospital mortality. Conclusion: The in-hospital mortality in HIV infected patients with SAH is higher despite these patients being younger than non-HIV infected patients. We believe that this study provides a nationwide perspective which may have some important implications for early recognition and diagnosis of HIV-infection in SAH patients.

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Antimalarial drug resistance markers in human immunodeficiency virus (HIV)-positive and HIV-negative adults with asymptomatic malaria infections in Port Harcourt, Nigeria

Transactions of the Royal Society of Tropical Medicine and Hygiene ◽

10.1093/trstmh/trab061 ◽

2021 ◽

Author(s):

Ifeyinwa Chijioke-Nwauche ◽

Mary C Oguike ◽

Chijioke A Nwauche ◽

Khalid B Beshir ◽

Colin J Sutherland

Keyword(s):

Human Immunodeficiency Virus ◽

Drug Resistance ◽

Drug Susceptibility ◽

Blood Film ◽

University Hospital ◽

Hiv Positive ◽

Asymptomatic Malaria ◽

Immunodeficiency Virus ◽

Before And After ◽

Hiv Negative

Abstract Background In Nigeria, indiscriminate use of antimalarial drugs may contribute to the threat of drug resistance, but this has not been evaluated among people living with human immunodeficiency virus (HIV). Methods HIV-positive adults attending a university hospital HIV clinic and HIV-negative adult volunteers from the university hospital community with a positive blood film were treated with artemether–lumefantrine. Parasite DNA from before and after treatment was polymerase chain reaction amplified to identify molecular markers of drug susceptibility. Results The pfcrt76T genotype was prevalent among both HIV-positive and HIV-negative participants (78.6% and 68.2%, respectively). Three new mutations in the pfmdr1 gene—F73S, S97L and G165R—and the uncommon pfdhps S436F variant were detected, whereas pfdhps K540E and pfdhfr I164L were absent. The A437G allele of pfdhps predominated (62/66 [94%]). The I431 V mutation was found in 19 of 66 pretreatment pfdhps sequences (28.8%). The pfmdr1 86N allele was significantly more common at day 3 post-treatment than at baseline (odds ratio 8.77 [95% confidence interval 1.21 to 380]). Conclusions We found evidence of continued chloroquine use among HIV-positive individuals. Selection for the pfmdr1 86N after artemether–lumefantrine treatment was observed, indicating a possible threat to antimalarial efficacy in the study area. The complexity of pfdhps haplotypes emphasises the need for careful monitoring of anti-folate susceptibility in Nigeria.

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A High Prevalence Rate of a Positive Screen for Cognitive Impairment in Patients With Human Immunodeficiency Virus Attending an Irish Clinic

Open Forum Infectious Diseases ◽

10.1093/ofid/ofw242 ◽

2016 ◽

Vol 4 (1) ◽

Cited By ~ 2

Author(s):

Patricia H. McNamara ◽

Robert Coen ◽

Janice Redmond ◽

Colin P. Doherty ◽

Colm Bergin

Keyword(s):

Human Immunodeficiency Virus ◽

Cognitive Impairment ◽

Large Scale ◽

Screening Program ◽

Cross Sectional Study ◽

Hiv Positive ◽

Study Cohort ◽

Cross Sectional ◽

Positive Screen ◽

Immunodeficiency Virus

Abstract Background Human immunodeficiency virus (HIV)-associated neurocognitive disorders occurs in 20%–50% of HIV-positive patients. We undertook this study to assess the prevalence of a positive screen for cognitive impairment in the clinic population at our institution and to demonstrate the feasibility of implementing a screening program in routine clinical encounters. Methods This was a cross-sectional study, and patients were recruited prospectively between December 2010 and February 2013. Inclusion criteria were as follows: patients were HIV positive, over the age of 18, capable of giving informed consent, and had sufficient ability to communicate in English. Patients were screened for cognitive impairment using the Brief Neurocognitive Screen. Results A total of 604 patients were recruited, and 51.5% had a positive screen for cognitive impairment. The majority of the study cohort were male (78.8%), mean age was 40.9 (standard deviation, 10.2) years, 70.9% were Irish, the most common mode of transmission was men who have sex with men (49.3%), 83% were on antiretroviral therapy, and 88.7% were virally suppressed. Logistic regression showed that the main factors predictive of a positive screen for cognitive impairment were the endorsement of cognitive symptoms (P = .024), being born in Africa (P < .000001), the use of benzodiazepines (P = .00341), being unemployed (P = .008), and consumption of more than 40 units of alcohol weekly (P = .035). There was a positive screen for depression in 9.1% and a positive screen for anxiety in 24.5%. Conclusions The study highlights the necessity for a structured, prospective, large-scale screening program for cognitive impairment across countries with limited resources and demonstrates the feasibility of easily implementing this with minimal training.

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Impact of Next-generation Sequencing Defined Human Immunodeficiency Virus Pretreatment Drug Resistance on Virological Outcomes in the ANRS 12249 Treatment-as-Prevention Trial

Clinical Infectious Diseases ◽

10.1093/cid/ciy881 ◽

2018 ◽

Vol 69 (2) ◽

pp. 207-214 ◽

Cited By ~ 23

Author(s):

Anne Derache ◽

Collins C Iwuji ◽

Kathy Baisley ◽

Siva Danaviah ◽

Anne-Geneviève Marcelin ◽

...

Keyword(s):

Human Immunodeficiency Virus ◽

Clinical Trials ◽

Transcriptase Inhibitor ◽

Hiv Positive ◽

Treatment As Prevention ◽

Kwazulu Natal ◽

Immunodeficiency Virus ◽

Virological Outcomes ◽

Reverse Transcriptase Inhibitor ◽

Generation Sequencing

Abstract Background Previous studies in human immunodeficiency virus (HIV)-positive individuals on thymidine analogue backbone antiretroviral therapy (ART) with either nevirapine or efavirenz have suggested poorer virological outcomes in the presence of pretreatment drug resistance (PDR). We assessed the impact of PDR on virological suppression (VS; <50 copies/mL) in individuals prescribed primarily tenofovir/emtricitabine/efavirenz in rural KwaZulu-Natal within a treatment-as-prevention trial. Methods Among 1557 HIV-positive individuals who reported no prior ART at study entry and provided plasma samples, 1328 individuals with entry viral load (VL) >1000 copies/mL had next-generation sequencing (NGS) of the HIV pol gene with MiSeq technology. Results were obtained for 1148 individuals, and the presence of PDR was assessed at 5% and 20% detection thresholds. Virological outcome was assessed using Cox regression in 837 of 920 ART initiators with at least 1 follow-up VL after ART initiation. Results PDR prevalence was 9.5% (109/1148) and 12.8% (147/1148) at 20% and 5% thresholds, respectively. After a median of 1.36 years (interquartile range, 0.91–2.13), mostly on fixed-dose combination tenofovir/emtricitabine/efavirenz, presence of both nonnucleoside reverse transcriptase inhibitor (NNRTI)/nucleoside reverse transcriptase inhibitor PDR vs no PDR was associated with longer time to VS (adjusted hazard ratio [aHR], 0.32; 95% confidence interval [CI], 0.12–0.86), while there was no difference between those with only NNRTI PDR vs no PDR (aHR, 1.05; 95% CI, 0.82–1.34) at the 5% threshold. Similar differences were observed for mutations detected at the 20% threshold, although without statistical significance. Conclusions NGS uncovered a high prevalence of PDR among participants enrolled in trial clinics in rural KwaZulu-Natal. Dual-class PDR to a mainly tenofovir/emtricitabine/efavirenz regimen was associated with poorer VS. However, there was no impact of NNRTI PDR alone. Clinical Trials Tegistration NCT01509508; South African National Clinical Trials Register: DOH-27-0512-3974.

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Intracranial Arterial Dissection Related to HIV Infection

Interventional Neuroradiology ◽

10.1177/159101990501100413 ◽

2005 ◽

Vol 11 (4) ◽

pp. 387-391 ◽

Cited By ~ 6

Author(s):

D. Lefeuvre ◽

L. Liebenberg ◽

A. Taylor

Keyword(s):

Human Immunodeficiency Virus ◽

Subarachnoid Haemorrhage ◽

Vessel Wall ◽

False Aneurysm ◽

Hiv Positive ◽

Pathological Study ◽

Hiv Virus ◽

Immunodeficiency Virus ◽

The Right ◽

Wall Injury

There are many reasons for patients infected with human immunodeficiency virus (HIV) to develop cerebrovascular disease. The HIV virus itself however may be a cause of vessel wall pathology. We present a clinical and pathological study of a patient who was HIV positive and presented with a subarachnoid haemorrhage. Cerebral angiography and later histology confirm that there was extensive vessel wall injury with dissection and a false aneurysm of the right middle cerebral artery.

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Human Immunodeficiency Virus Status in Malnourished Children seen at Lagos

10.1101/357608 ◽

2018 ◽

Author(s):

EO Temiye ◽

OF Adeniyi ◽

IB Fajolu ◽

AA Ogbenna ◽

TA Ladapo ◽

...

Keyword(s):

Human Immunodeficiency Virus ◽

Total Protein ◽

Protein Energy Malnutrition ◽

World Health ◽

Full Blood Count ◽

Hiv Positive ◽

Hiv Status ◽

Malnourished Children ◽

Immunodeficiency Virus ◽

Oral Thrush

AbstractIntroductionHuman immunodeficiency virus and protein energy malnutrition are still prevalent in Nigeria and the occurrence of the two conditions together confers a poor prognosis. The aim of this study was to determine the current categories of malnutrition amongst under 5 children in Lagos, document their HIV status and determine any peculiarities in the clinical features, haematological and some biochemical profile in these children.MethodsThe study was a prospective crossectional study conducted at the Paediatric department of the Lagos University Teaching Hospital and the Massey Street Children’s Hospital over a 6 month period. All the subjects had anthropometry, HIV testing, full blood count and serum proteins done. The factors associated with HIV status were determined with the logistic regression analysis.ResultsTwo hundred and fourteen (214) malnourished children ≤5 years were recruited into the study and 25(11.7%) were HIV positive. One hundred and five (49.1%) of the participants had moderate malnutrition while 25.2% had severe forms of malnutrition. Fever, cough and diarrhea were the commonest symptoms. Severe wasting, oral thrush, dermatoses and splenomegaly were seen more commonly in the HIV positive subjects. The haematological indices were comparable in the two groups, however, the total protein was significantly higher in the HIV positive subjects compared to the negative group (p=0.042). Multivariate analysis showed that the total protein (p=0.001) and platelet count (p=0.016) could significantly predict the occurrence of HIV in the malnourished childrenConclusionThe presence of severe wasting, oral thrush, diarrhea, splenomegaly, thrombocytopenia and high total proteins in malnourished children should heighten the suspicion of possible underlying associated HIV infection. This study reinforces the recommendation by the World Health Organisation (WHO) that all malnourished children should have mandatory HIV screening.

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