scholarly journals Variations in KIR Genes: A Study in HIV-1 Serodiscordant Couples

2014 ◽  
Vol 2014 ◽  
pp. 1-11 ◽  
Author(s):  
Vijay R. Chavan ◽  
Deepali Chaudhari ◽  
Swati Ahir ◽  
Zakiya Ansari ◽  
Preeti Mehta ◽  
...  
Keyword(s):  
Viral Load ◽  
Hiv Infection ◽  
Indian Population ◽  
Killer Cell ◽  
High Viral Load ◽  
Kir Genes ◽  
Discordant Couples ◽  
Spss Software ◽  
First Time ◽  
Anti Hiv

Background. NK cells have anti-HIV activity mediated through killer cell immunoglobulin-like receptors (KIRs). The current prospective cohort study evaluated whether variation in KIR genes is associated with HIV infection in discordant couples (DCs), where one spouse remains seronegative (HSN) despite repeated exposure to the HIV.Methods. KIR was genotyped using PCR SSP. Viral load and CD4 counts were estimated using commercially available reagents. Data were analyzed using SPSS software.Results. Among the 47 DCs, HSN spouses had significantly (P=0.006) higher frequencies of KIR3DS1. Regression analysis revealed significant (P=0.009) association of KIR2DS1 with low viral load. KIR2DS4 variant was associated (P=0.032) with high viral load. Three pairs of KIR genes were in strong LD in HSNs and two pairs in HSPs. There were 60 KIR genotypes, and 16 are reported the first time in the Indian population. Exclusive genotypes were present either in HSPs (N=22, 11 unique genotypes) or in HSNs (n=27, 9 unique genotypes).Conclusions. This study highlights for the first time in the Indian population an association of KIR genes in HIV infection where presence of exclusive and unique genotypes indicates possible association with either HIV infection or with protection.

scholarly journals HLA-C*18:01 and KIR2DL2+C1 genetic variants are associated with low viral load in cART naïve HIV-infected adult Zimbabweans

2018 ◽  
Vol 12 (12) ◽  
pp. 1105-1111
Author(s):  
Kudakwashe Mhandire ◽  
Mqondisi Tshabalala ◽  
Lynn Sodai Zijenah ◽  
Tommy Mlambo ◽  
Doreen Zvipo Mhandire ◽  
...  
Keyword(s):  
Viral Load ◽  
Hiv Infection ◽  
T Lymphocyte ◽  
Genetic Variants ◽  
Killer Cell ◽  
Human Leukocyte ◽  
Gene Families ◽  
Cd4 Count ◽  
Kir Genes ◽  
Differential Outcomes

Introduction: Polymorphisms in killer cell immunoglobulin-like receptor (KIR) and human leukocyte antigen (HLA) gene families are implicated in differential outcomes of HIV infection. However, research findings on the influence of KIR and HLA-C polymorphism on HIV disease progression remain inconclusive. We thus investigated the association of KIR and HLA-C gene polymorphisms with plasma HIV load (VL) and CD4+ T lymphocyte (CD4) count in 183 chronically HIV-infected, combination antiretroviral therapy (cART) naïve Zimbabweans of Bantu origin. Methodology: The presence or absence of 15 KIR genes were determined using sequence specific primer polymerase chain reaction while HLA-C typing was performed using chain termination DNA sequencing. Plasma VL was determined using the Cavidi Exavir viral load version 3 assay while CD4+ T lymphocytes were enumerated using flow cytometry. VLs and CD4 counts were compared between gene/genotype carriers and non-carriers using Mann-Whitney ranksum test. Results: HLA-C*18:01 allele carriers had a significantly lower median log10 VL (2.87copies/mL [IQR;2.3-3.2]) than the non-C*18:01 carriers (3.33copies/mL [IQR; 2.74-3.9]), p = 0.018. Further, median log10 VL was significantly lower in KIR2DL2+C1 carriers (2.745 [IQR; 2.590-2.745]) than non-KIR2DL2+C1 carriers (3.4 [IQR; 2.746-3.412]), p = 0.041. Comparison of CD4 + T lymphocyte counts between C*08:02 allele carriers and non-C*08:02 carriers showed a significantly higher median CD4 count in C*08:02 carriers (548cells/µL [IQR;410-684]) than in non-carriers (428cells/µL [IQR;388-537]), p = 0.034. Conclusion: We conclude that the HLA-C*18:01 and KIR2DL2+C1 genetic variants are associated with low VL while the C*08:02 is associated with high CD4+ T lymphocyte count among cART naïve Zimbabwean adults with chronic HIV infection.

scholarly journals Acute HIV Infection in Pregnancy: The Case for Third Trimester Rescreening

2011 ◽  
Vol 2011 ◽  
pp. 1-5
Author(s):  
Jocelyn Wertz ◽  
Jason Cesario ◽  
Jennifer Sackrison ◽  
Sean Kim ◽  
Chi Dola
Keyword(s):  
Viral Load ◽  
Hiv Infection ◽  
Late Pregnancy ◽  
First Trimester ◽  
Acute Hiv Infection ◽  
Hiv Rna ◽  
Increased Risk ◽  
Acute Hiv ◽  
Anti Hiv ◽  
In Pregnancy

Combination testing with anti-HIV Elisa and Western blot is both sensitive and specific for diagnosis of established HIV-1 infection but could not detect acute HIV infection (AHI). AHI is a time of extremely high viral load, which may correlate to increased risk of horizontal or vertical transmission. Thus, early identification of AHI could allow for interventions to decrease transmission. However, recognition of AHI can be challenging as symptoms could be absent or nonspecific, therefore, AHI is often not detected, particularly in pregnancy. We present a case report of AHI in a pregnant woman who presented with headache and fever. She tested negative for HIV in the first trimester and at time of AHI at 26 3/7 weeks by anti-HIV Elisa, but was diagnosed with AHI based on an HIV RNA viral load of 434,000 copies/mL. This report presents a case for improved awareness of AHI in pregnancy, and the need for repeat HIV testing in late pregnancy, and highlighted that early detection of AHI might be possible with adding HIV RNA testing at time of standard anti-HIV Elisa screening test in pregnancy. Novel laboratory approaches including pooling of sera for HIV RNA could reduce the cost of HIV RNA testing.

scholarly journals What Determines Do-Not-Resuscitate Status in Critically Ill HIV Patients?

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S435-S435
Author(s):  
Shannon L Turvey ◽  
Anne Gregory ◽  
Sean Bagshaw ◽  
Wendy I Sligl
Keyword(s):  
Viral Load ◽  
Hiv Infection ◽  
Critically Ill ◽  
Severity Of Illness ◽  
Cd4 Count ◽  
Apache Ii Score ◽  
Do Not Resuscitate ◽  
Hiv Patients ◽  
Icu Admission ◽  
First Time

Abstract Background Mortality and morbidity of people living with HIV have declined in the era of combination antiretroviral therapy (cART). However, Intensive Care Unit (ICU) admission rates remain high. In this study, we identified predictors of Do-Not-Resuscitate (DNR) status in critically ill HIV patients. Methods Retrospective cohort study of all first-time admissions of HIV-infected patients to five ICUs in Edmonton, Alberta from 2002 to 2014. Data collected included demographics, comorbidities, markers of HIV disease severity and control, admission diagnoses, severity of illness, organ failure, and DNR status. Multivariable logistic regression analysis was performed to identify factors associated with DNR status. Results During the study period, 282 patients were admitted to the ICU for the first time. Mean (SD) age was 44 (±10) years, 169 (60%) were male, 134 (48%) aboriginal, 153 (55%) co-infected with hepatitis C virus, and 184 (65%) had a history of polysubstance use. Median (IQR) CD4 count and viral load were 125 (30–300) cells/mm3and 28,000 (110–270,000) copies/mL, respectively. Only 98 (35%) patients were receiving cART at the time of admission while 45 (16%) were newly diagnosed in the ICU. Most common admission diagnosis was sepsis 189 (64%), 213 (76%) received mechanical ventilation, 133 (47%) vasopressor support and 35 (12%) renal replacement therapy. Sixty-seven (24%) patients were DNR and support was withdrawn in 42 (15%). In multivariable analysis, APACHE II score (adjusted odds ratio [aOR] 1.13; 95% CI, 1.08–1.19, P < 0.001), coronary artery disease (CAD) (aOR 5.7; 95% CI, 1.2–27.8, P = 0.03), prior opportunistic infection (OI) (aOR 2.6; 95% CI, 1.2–5.6, P = 0.015) and duration of HIV infection (aOR 1.07 per year; 95% CI, 1.01–1.14, P = 0.025) were independently associated with DNR status. Other factors such as ethnicity, HIV risk factor(s), CD4 count and viral load were not associated with DNR status. Conclusion In this relatively young cohort, one in four patients had DNR status during ICU admission. DNR designation was associated with severity of illness, along with CAD, prior OI, and duration of HIV infection. Future work should characterize the timing of patient DNR orders relative to ICU admission and describe patient and provider-specific factors that may influence decision-making towards DNR status. Disclosures All authors: No reported disclosures.

Subarachnoid hemorrhage and diffuse vasculopathy in an adult infected with HIV

2007 ◽  
Vol 106 (3) ◽  
pp. 478-480 ◽  
Author(s):  
D. Kojo Hamilton ◽  
Neal F. Kassell ◽  
Mary E. Jensen ◽  
Aaron S. Dumont
Keyword(s):  
Viral Load ◽  
Subarachnoid Hemorrhage ◽  
Hiv Infection ◽  
Ct Scanning ◽  
Undetectable Viral Load ◽  
High Viral Load ◽  
Acute Onset ◽  
Vascular Involvement ◽  
Vascular Abnormalities ◽  
Infected Adult

✓This 34-year-old man with a 10-year history of HIV infection presented with an acute onset of severe headache, fever, nausea, vomiting, and left-sided weakness. Computed tomography (CT) scanning demonstrated diffuse subarachnoid hemorrhage (SAH), and subsequent CT angiography revealed multiple large and giant intracranial aneurysms with diffuse vasculopathy. The patient's CD4-positive cell count was low, although he had been receiving combination antiret-roviral therapy and his viral load was undetectable. The preponderance of the literature on HIV-infected patients with intracranial vascular involvement has concerned children in whom there is a high viral load. In such children, appropriate antiretroviral therapy may result in the complete resolution of these vascular abnormalities. In the present study, the authors report on the unique case of an HIV-infected adult patient who presented with SAH, diffuse intracranial vasculopathy, and multiple giant and fusiform aneurysms, despite having received adequate antiretroviral treatment and demonstrating an undetectable viral load. Intracranial vascular involvement in these patients may become increasingly common as the management of HIV infection continues to improve and afflicted patients survive for longer periods.

Specific features of pregnancy and delivery in HIV-infected women

2021 ◽  
Vol 70 (3) ◽  
pp. 103-113
Author(s):  
Olga L. Mozalyova ◽  
Anna V. Samarina
Keyword(s):  
Viral Load ◽  
Hiv Infection ◽  
Placental Abruption ◽  
Opportunistic Infections ◽  
High Viral Load ◽  
Chronic Viral Hepatitis ◽  
International Studies ◽  
Confounding Factors ◽  
Pregnancy And Delivery ◽  
Hiv Negative

HIV-infected women have a higher risk of complications during pregnancy and delivery (chronic placental insufficiency, anemia, placental abruption, preterm birth) compared with HIV-negative women, especially in case of opportunistic infections, immunodeficiency and a high viral load in the blood. The obstetrical pathologies are hard to study in these women because the above conditions are associated with a range of confounding factors that are not directly related to HIV infection but are often present, such as drug addiction, weight deficit, and chronic viral hepatitis coinfection. The literature review provides data from domestic and international studies on the correlation between HIV infection and the frequency of complications during pregnancy, delivery and the postpartum period, as well as the effect of the infection on the condition of newborns. The article cites current recommendations on the choice of delivery types for HIV-infected women.

scholarly journals Clinical and laboratory characterictic of acute HIV-infection in adult residents of Novosibirsk region

2019 ◽  
Vol 11 (2) ◽  
pp. 40-44
Author(s):  
Ya. S. Ulyanova ◽  
N. M. Gashnikova ◽  
V. V. Ivlev ◽  
E. I. Krasnova ◽  
N. I. Khokhlova ◽  
...  
Keyword(s):  
Viral Load ◽  
Hiv Infection ◽  
High Viral Load ◽  
Acute Hiv Infection ◽  
Novosibirsk Region ◽  
Medical Institutions ◽  
Atypical Cells ◽  
Acute Hiv ◽  
Subtype A ◽  
Hiv 1

Purpose of the study. To study the characteristics of acute HIV infection in adults in the Novosibirsk region in 2017– 2018.Materials and methods. 200 patients with acute HIV infection, residents of the Novosibirsk region, aged 15 to 74 years, hospitalized in 2017–2018, 104 men and 96 women were examined. The diagnosis was verified by detecting antibodies to HIV in ELISA with a negative or doubtful result of the immunoblot, as well as by determining the quantitative content of HIV RNA in the blood by PCR. The hemogram, the content of CD4 + lymphocytes in the blood were determined. In addition, HIV-1 was studied in 71 patients for belonging to a genetic group.Results. Patients of 20–40 years old prevailed – 70.5%. The sexual way was dominant in women (69.0%), injecting psychoactive substances was more often in men (32.2%). Frequent symptoms were fever (99%), exanthema (65.5%), polylimfoadenopathy (54.0%). Less common were diarrhea (36.0%), pharyngotonsillitis (23.0%), aphthous stomatitis (6.5%), hepatomegaly or hepatosplenomegaly (8.5%). Secondary diseases were revealed in 26.5% of patients. Leukopenia was recorded in 63.0%, thrombocytopenia in 62.5%, lymphocytosis and atypical cells of the lymphoid series in 14.0%. All patients had a high “viral load” – from 23,000 to 10,000,000 or more copies / ml, a decrease in the number of CD4 + less than 350 cells – in 38.0%. From among 71 patients, 19.7% had HIV-1 subtype A, and 76.0% had recombinant HIV-1 CRF63_02A. In the latter, “viral load” of more than 10,000,000 copies / ml was more often recorded (67.8% vs. 33.4%, p = 0.004).Conclusion. A significant number of cases of acute HIV infection were reported in the Novosibirsk region in 2017– 2018. Its detection is possible by examination of all febrile patients who apply to medical institutions. Early initiation of antiretroviral therapy with the appointment of well-tolerated regimens contributes to the formation of a high commitment to therapy.

scholarly journals Subclinical atherosclerosis and endothelial dysfunction in patients with HIV infection: is there any new diagnostic test?

2021 ◽  
Author(s):  
Francisco Arnaiz de las Revillas ◽  
Vicente Gonzalez-Quintanilla ◽  
Jose Antonio Parra ◽  
Enrique Palacio ◽  
Claudia Gonzalez-Rico ◽  
...  
Keyword(s):  
Viral Load ◽  
Endothelial Dysfunction ◽  
Hiv Infection ◽  
Subclinical Atherosclerosis ◽  
Calcium Score ◽  
High Viral Load ◽  
Breath Holding ◽  
Hiv Positive ◽  
Cd4 Cells ◽  
Immunodeficiency Virus

Abstract Introduction: To analyze the association between human immunodeficiency virus (HIV) infection, and the presence of subclinical atherosclerosis and endothelial dysfunction. Methods Prospective cohort study of HIV positive patients who underwent to intimate thickness (IMT) determination and coronary artery calcium score to determine subclinical atherosclerosis. To detect endothelial dysfunction breath holding index, flow mediated dilation and concentration of endothelial progenitor cells (EPC) were measured. Results Patients with an IMT ≥ 0.9 mm had an average of 559.3 ± 283.34 CD4/µl and those with an IMT < 0.9 mm 715.4 ± 389.92 CD4/µl (p = 0.04). Patients with a low calcium score had a significantly higher average of CD4 cells value and lower zenith viral load than those with a higher score (707.7 ± 377.5 CD4/µl vs 477.23 ± 235.7 CD4/µl (p = 0.01)) and (7x104 ± 5x104 c/ml vs 23.4 x 104 ± 19 x 104 c /ml (p = 0.02). Early EPCs concentration in patients with a CD4 nadir < 350/ul was lower than concentration among those presenting a CD4 nadir ≥ 350 (p = 0.03). Conclusion In HIV positive patients low CD4 cells levels and high viral load were associated to a higher risk of developing subclinical atherosclerosis.HIV patients with less CD4 cells may have fewer early EPCs.

scholarly journals PREDICTORS OF CHRONICKIDNEY DISEASEINHUMAN IMMUNODEFICIENCY VIRUS PATIENTS

2018 ◽  
pp. 32-37
Author(s):  
M.O. Andrushchak
Keyword(s):  
Viral Load ◽  
Hiv Infection ◽  
Clinical Stage ◽  
High Viral Load ◽  
Kidney Damage ◽  
Average Amount ◽  
Hiv Rna ◽  
Immunodeficiency Virus ◽  
The Difference ◽  
Cd4 Lymphocytes

Purpose: to determine the frequency of diagnosis and predictors of renal disease in HIV-infected patients. Patients and methods. 292 HIV-infected patients, who were on an outpatient screening at the Chernivtsi Regional AIDS Center, were screened. Results CKD was diagnosed in 153 out of292 (52.4%) of the examined patients. among which 105 (36.0%) patients were diagnosed with isolated albuminuria/proteinuria, 48 (16.4%) patients had albuminuria /proteinuria, in combination with a decrease in glomerular filtration rate. It has been established that the presence of proteinuria in HIV infection is accompanied by a significantly higher level of HIV RNA compared to patients without this symptom (p < 0.01). At the same time, the average amount of CD4+-lymphocytes in blood serum in patients with proteinuria is significantly lower than in HIV-infected individuals who did not show kidney damage. The difference between the values of the ratios of CD4+/CD8+-lymphocytes in the analyzed groups (p < 0,05) is also significant. In most patients who were in the III-IV clinical stage of HIV infection, antiretroviral therapy (ART) was effective and reduced the viral load. Therefore, it is obvious that the amount of HIV-RNA in the blood of these individuals was significantly lower compared to patients who did not receive such treatment. At the same time, the burden of HIV, as well as the number of CD4+-lymphocytes in the representatives of the comparable groups did not differ (p > 0.05). Conclusion. The main predictors of kidney damage in HIV-infected are: high viral load, decrease in absolute numbers. CD4+-lymphocytes less than 200. Co-infection with hepatitis B and/ or C viruses does not affect the level of proteinuria and GFR in HIV-infected patients.

Update in management of hepatitis B in pregnancy and prevention of mother to child hepatitis B transmission

2018 ◽  
Vol 1 (3) ◽  
pp. 1-8
Author(s):  
Naichaya Chamroonkul
Keyword(s):  
Chronic Hepatitis ◽  
Viral Load ◽  
Hepatitis B ◽  
Chronic Hepatitis B ◽  
High Viral Load ◽  
World Population ◽  
Hepatitis B Infection ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Mother To Child

Even with two decades of widespread using hepatitis B vaccination, chronic hepatitis B remains a major global health problem. In Thailand, the prevalence of chronic hepatitis B infection was down from 8 - 10% in last decade to 5% recently. Failure to control mother to child transmission is one of the important barriers to the total elimination of hepatitis B infection from world population. In the majority, vertical transmission can be prevented with a universal screening program, immunoprophylaxis by administration of hepatitis B vaccine and hepatitis B immunoglobulin (HBIg) for babies born to mothers with HBV. However, in mothers with a high viral load, the chance of immunoprophylaxis failure remains high. To date, there are standard recommendations by all international liver societies including AASLD, EASL and APASL suggest introducing an antiviral agent during the third trimester to CHB pregnant women with a high viral load. Previous US FDA pregnancy category B agents such as Tenofovir and Telbivudine are allowed through all trimesters of pregnancy and are effective for prevention of mother to child transmission. Breastfeeding for patients who receive antiviral agents can be allowed after a risk-benefit discussion with the patient and family.

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