Public Health
Design, In Silico, and In vitro Evaluation of Polymer-Based Drug Conjugates Incorporated with Derivative of Cinnamic Acid, Zidovudine, and 4-Aminosalicylic Acid against Pseudo-HIV-1
The incorporation of anti-HIV drugs into polymer to form polymer-drug conjugates has been reported to result in improved therapeutic activity. Zidovudine an anti-HIV drug was explored alone and in combination with known drug molecules using polyamidoamine-based carriers.
Polymer-drug conjugates incorporated with zidovudine cinnamic acid and 4-aminosalicylic acid were prepared and evaluated for their potential efficacy in vitro against pseudo-HIV-1.
Aqueous Michael addition polymerization reaction was employed to prepare the conjugates. The conjugates were incorporated with zidovudine cinnamic acid and 4-aminosalicylic acid. They were characterized by SEM/EDX XRD FTIR NMR LC-MS particle size analysis in vitro analysis computational studies and in silico toxicity predictions.
The conjugates displayed spherically shaped morphology. The in vitro findings showed that polymer-drug conjugates T15 and T16 with a single drug were effective against pseudo-HIV-1 at high concentrations of 111.11 and 333.33 µg/mL respectively. Molecular docking studies supported the in vitro results. Additionally SwissADME ProTox-II and GUSAR (General Unrestricted Structure-Activity Relationships) analyses revealed that these compounds have promising antiviral potential.
The prepared polymer-drug conjugates with a single drug showed promising effects against the Pseudo-HIV-1 and the conjugates displayed features that make them potential anti-HIV therapeutics that require further studies.
MicroRNA Expression in Exosome Extracellular Vesicles as Targets for Personalized Medicine in Diffuse Large B Cell Lymphoma Patients with HIV Infection
Extracellular Vesicles (EVs) more specifically exosomes (xEVs) have been associated with Diffuse Large B-cell Lymphoma (DLBCL). These xEVs contain a variety of biomolecules such as proteins and nucleic acids (e.g. microRNA LncRNA and DNA). The expressions of these vesicles in the setting of Human Immunodeficiency Virus (HIV) have been linked to disease progression. Studies have explored the use of EVs in more practical clinical settings. Several studies have found that biomolecules within xEVs can serve to detect disease progression. The biomolecule content within xEVs is useful in prognostication and has even been associated with mechanisms of resistance for some DLBCL treatment modalities. This review article explores the role of xEV biomolecule content in DLBCL progression in the context of HIV infection and its applied use in practical disease management.
Risk Factors Associated with Osteopenia/Osteoporosis in Antiretroviral Therapy Naive HIV Patients
Different ART (antiretroviral therapy) options may affect the risk of osteopenia/osteoporosis in people living with HIV (PLWH) having increased life expectancy. Current guidelines recommend bone mineral density (BMD) measurement only in patients at risk. In our study we investigated the prevalence of osteopenia/osteoporosis and associated risk factors in naive patients not receiving ART.
This study included 116 newly diagnosed ART naive HIV-positive patients who were studied retrospectively. Vitamin D level BMD measurement CD4 and CD8 count CD4/CD8 ratio HIV RNA level body mass index and other risk parameters of ART naive patients were included in our study.
Of 116 patients 103 were male and 13 female. 47.4% (osteoporosis in 4.3% osteopenia in 43.1%) of patients had osteopenia/osteoporosis. The patients with osteopenia/osteoporosis had older age (39.2±11.0 vs. 32.0±8.6 p=0.0001) lower vitamin D levels (16.0±5.0 vs. 24.4±6.3 p=0.0001) lower BMI (body mass index) (23.0±4.0 vs. 24.6±4.6 p<0.05) lower CD4 and CD8 counts (405.1±885.0 vs. 467.3± 695.1; 849.9570.4 vs. 1012.0±629.4 respectively p<0.05). 41.8% had CD4 count ≤200/µL (vs. 18.0% p=0.005). No statistically significant differences were observed in terms of gender distribution smoking alcohol and drug use comorbidities and additional drug use and HIV RNA >100 000 copies/ml. In multivariate analysis age and vitamin D level were significant and independent (p<0.05) risk factors with osteoporosis/osteopenia.
Being over 40 years of age CD4 count ≤200/µL vitamin D level <20 ng/mL and low BMI are the most important risk factors for osteopenia/osteoporosis in ART naive patients. Among these parameters age and vitamin D level were significant and independent risk factors. These factors may guide the determination of the need for dual-energy x-ray absorptiometry (DXA) testing in ART naive patients and drug choices in the treatment plan.
Prevalence and Causes of Vitamin D Deficiency in a Cohort of Greek HIV-Infected Individuals: A Prospective, Single Center, Observational Study
Vitamin D deficiency and/or insufficiency (hypovitaminosis D) has been associated with several disorders including autoimmune diseases like type 1 diabetes mellitus; cardiovascular diseases; neoplasms; obesity; insulin resistance and type 2 diabetes mellitus. This problem is common in southern European countries especially in elderly and institutionalized persons. In HIV-infected individuals hypovitaminosis D has been correlated with various complications like tuberculosis hyperparathyroidism bone mass loss premature atherosclerosis and systemic arterial hypertension deterioration of immune function progression of the disease and overall mortality.
The objective of this study was to examine the prevalence and causes of hypovitaminosis D in a cohort of Greek HIV-infected patients as well as possible complications associated with it.
All patients attending our HIV unit for a period of 5 months were included in this study. Vitamin D status medical anamnes and laboratory tests were obtained at baseline; patients were followed for 3 years and HIV-related complications were noted. No patient received vitamin D supplementation during the follow-up period.
Hypovitaminosis D was common with 83.7% of the patients showing levels below 30 ng/dl and 55.4% below 20 ng/dl. After multivariable analysis age and duration of treatment were the only significant factors for low vitamin D levels. During follow-up 26 patients exhibited a total of 34 HIV-related complications the most common being pneumonocystis jiroveci pneumonia (PCP). Hypovitaminosis D showed a positive correlation with overall complications PCP as well as wasting syndrome.
Overall our study shows that hypovitaminosis D is common in HIV-infected individuals and should probably be treated as soon as possible to protect these patients from serious HIV-related complications like PCP or wasting syndrome.
Genotyping and Antiretroviral Drug Resistance Mutations among HIV Patients in Southern Santa Catarina, Brazil
Therapeutic measures have been successful in increasing survival rates and quality of life of HIV/AIDS-infected people. However some people fail to respond to antiretroviral therapy (HAART) because of viral resistance-associated mutations.
To identify virus genotype and the presence of mutations that alter the susceptibility to HAART and factors associated with the occurrence of these mutations.
A cross-sectional study was conducted on adults living with HIV attending a specialized outpatient clinic in southern Santa Catarina Brazil. The participants were interviewed and had blood samples collected for analysis. Those with detectable viral load were genotyped.
Out of the 629 patients recruited 127 subjects were included due to having a detectable viral load. The most common mutations were M184V and K103N. HIV-1 subtype C was the most prevalent strain. Resistance to HAART was associated with modification in the treatment regimen (p <0.001).
This study concluded that the circulating subtype virus was subtype C and that the mutations K103N and M184V were the most prevalent strains in southern Santa Catarina Brazil.
Associated Factors of Sexual Initiation among Male Vocational High School Students in Zhejiang Province, China: A Cross-sectional Study
This study aims to investigate the factors associated with sexual initiation among male vocational high school students (MVHSS) in Zhejiang Province and provide a scientific basis for preventing unsafe sexual behavior and sexual health issues among adolescents.
The prevalence of sexual behavior among young students has risen significantly in recent years. Contracting HIV poses a serious physical and psychological burden on young individuals and their families. Thus it is imperative to promptly and effectively address the spread of HIV among young people.
The objectives of this study are to investigate the demographic characteristics of male vocational high school students (MVHSS) who have engaged in sexual activity and to identify associated factors such as sexual attitudes and lifestyle that may influence sexual initiation among this population and to offer recommendations for interventions and policy development aimed at promoting healthy sexual behaviors among MVHSS.
A survey was conducted among vocational high school students in grades one and two in Zhejiang Province. Variables that were statistically significantly associated with sexual initiation in bivariate analyses were included in a multivariate logistic regression model which adopted a backward elimination procedure with a p-value > 0.10 as the exclusion criterion. Odds ratios (ORs) and 95% confidence intervals (CIs) were used to describe the relationship between dependent and outcome variables.
Of the 1032 male participants 17.4% had initiated sexual behavior. The multivariate analysis results indicated that those who were frequent smokers (adjusted OR[AOR] =4.89 95% CI: 2.36–10.13) those who reported having been in love (AOR=2.86 95% CI: 1.84–4.44) those currently in love (AOR=4.47 95% CI: 2.68–7.45) those willing to have sex with a high school student (AOR =2.63 95% CI: 3.31–6.50) those willing to pay for sex (AOR =1.90 95% CI: 1.10–3.27) and those who had received sex education and STDs/AIDS prevention education in school (AOR =2.21 95% CI: 1.53–3.18) were more likely to initiate sexual behavior.
Sexual attitudes among MVHSS are liberal and the prevalence of sexual initiation is high. Interventions targeted at improving sexual safety education reducing the rate of early initiation of sexual behavior and promoting condom use among students must be implemented to reduce the risk of HIV infections and STDs among sexually active MVHSS.
Frequency of Human Leukocyte Antigen-B*57:01 Allele Carriers in People Living with HIV/AIDS in Türkiye
Abacavir is among the first-line initial antiretroviral regimens for most patients living with HIV/AIDS (PLWHA). Although well tolerated it is associated with hypersensitivity reaction (HSR) which is treatment-limiting and potentially life-threatening. HSR was shown to be associated with the class I MHC allele HLA-B*57:01. In this study we aimed to evaluate the prevalence of HLA-B*57:01 in PLWHA in Istanbul Türkiye.
Five HIV treatment centers in Istanbul included all sequential treatmentnaïve ≥ 18 years adult PLWHA between December 2017- December 2021. Demographic clinical and laboratory data were collected at baseline and during treatment. HLA-B* 57:01 genotyping was determined with PCR-SSP.
Eight hundred sixty-seven PLWHA were included (male:91% mean age 39.6±11.1 years). 1.6% of patients were found to be HLA-B*57:01 positive. Among HLA-B*57:01 positive patients 4 were initially given abacavir-containing treatment; they were switched to non-abacavir treatment upon the allele found to be positive.
Although previous studies reported the HLA-B*57:01 prevalence of PLWHA in Türkiye as 3-3.6% we have found the prevalence to be 1.6%. The current study includes higher numbers of patients than the previous studies. Furthermore patients from all over the country apply to the centers in Istanbul; compared to the other studies which involve patients limited to the relevant regions. It can be assumed that the number in our cohort is more representative of the country. In conclusion the prevalence of the HLA-B*57:01 allele in PLWHA in this study is relatively low. With evident benefit in preventing abacavir HSR HLA-B*57:01 should be screened in planning antiretroviral therapy.
Handgrip Strength and Clinical Evolution of People Living with HIV: A Mini Narrative Review
HIV infection is a worldwide epidemic. Antiretroviral therapy allows people living with HIV (PLHIV) increased longevity and a better quality of life. Among the various ways of monitoring the clinical evolution of PLHIV handgrip strength (HGS) is a promising strategy as this test can be used to assess the health condition quickly and at a low cost. In this sense the present study aims to describe through a literature review the relationship between HGS and the clinical evolution of PLHIV especially with morbimortality. Initially it is highlighted that aging HIV infection and excess body fat are related to the loss of HGS in PLHIV. Furthermore PLHIV is more likely to present cardiometabolic diseases that can be aggravated by reduced HGS. Thus in people without positive HIV serology low HGS indirectly through the presence of risk factors or cardiometabolic diseases or directly increases the chance of mortality. In conclusion the lack of studies on this topic for PLHIV is highlighted and more longitudinal studies including control groups are needed.
Does Maternal HIV Infection Affect Neonatal Outcomes?
Pregnancy among women infected with HIV is classified as a high-risk pregnancy. While previous research has indicated an elevated likelihood of preterm birth low birth weight and early gestational age in infants born to mothers with HIV the correlation between maternal HIV infection and different neonatal results remains unclear.
This study aims to investigate the impact of maternal HIV infection on after-birth neonatal outcomes using machine learning (ML) and statistical methods.
A case-control study is conducted through a three-stage process: Initially the outcomes among newborns from HIV-positive mothers are identified through a combination of literature review and expert survey. Subsequently data are paired at a 1:2 ratio based on gestational age with infants from HIV-positive mothers (n=48) compared to HIV-negative mothers (n=96) as the control group. Finally filter wrapper and embedded based feature selection techniques are applied to identify outcomes that exhibit significant differences between the two groups. feature selection techniques are applied to identify outcomes that exhibit significant differences between the two groups.
The statistical analysis showed that the rate of addiction among HIV-positive mothers is higher than that of the HIV-negative group. The need for mechanical ventilation and duration of ventilator-assisted breathing in infants born to HIV-positive mothers are significantly higher than in infants born to HIV-negative mothers. Moreover based on feature selection methods increasing the need for mechanical ventilation and reducing surfactant administration were two important outcomes.
To investigate the impact of maternal HIV infection on neonatal outcomes various statistical and machine learning-based feature selection techniques were implemented and the results showed that the presented methods can be utilized to examine the potential impacts of different diseases contracted by the mother on the infant.
Knowledge about HIV and Stigmatizing Attitudes of Medical Students in Saudi Arabia Towards Patients with HIV/AIDS: A Cross-Sectional Nationwide Study
The Human Immunodeficiency Virus (HIV) and the social stigma directed toward patients with HIV are serious public health issues. We aimed to evaluate the HIV knowledge base and stigmatizing attitudes toward patients with HIV among students enrolled in medical schools in Saudi Arabia.
This cross-sectional study included students at medical colleges in Saudi Arabia and was conducted between February and March 2023. We used non-random convenience sampling with an online chain referral via a validated Arabic questionnaire composed of 35 questions. Data were analyzed using descriptive and comparative statistics.
A total of 1213 medical students (women: 56.6%) participated in the study. Students in clinical years had a higher level of HIV knowledge than their pre-clinical colleagues. Logistic regression analysis revealed that participants who gave incorrect answers to questions related to mother-to-child and casual contact HIV transmission had a higher likelihood of harboring a negative attitude towards patients with HIV. Conversely those who correctly answered queries on prevention and treatment were less likely to have stigmatizing attitudes. A significant proportion of this cohort harbored negative attitudes toward patients with HIV with the sex and geographic location of participants being significant predictors of negative attitudes.
Our data have revealed a significant percentage of medical students in Saudi Arabia to have misconceptions about HIV transmission and prevention and stigmatizing attitudes toward patients with HIV indicating a need for targeted interventions to enhance the HIV knowledge base in this population of future caregivers.
Prevalence of Risk Factors Associated With Poor Quality of Sleep in People Living with HIV and the Correlation between Quality of Sleep and Cd4+ T Lymphocyte Reconstitution: A Cross-Sectional Study from Turkey
Introduction: The prevalence of sleep disorders in people living with HIV (PLWH) is higher than in the general population. Even if viral suppression is achieved with Antiretroviral Therapy (ART) the chronic immune activation and increased inflammation due to immune reconstitution persist. The aim of our study was to determine the prevalence of poor quality of sleep (QoS) and associated risk factors in PLWH and to investigate the relationship between poor QoS and CD4 T lymphocyte count and CD4 reconstitution. Methods: PLWH ≥18 years old attending for routine HIV monitoring were recruited. PLWH with conditions that may affect their QoS (pregnant hospitalized malignancy substance-alcohol abuse psychiatric disease or treatment sleeping pill) were excluded. Pittsburgh Sleep Quality Index (PSQI score ≥5 indicates poor QoS) Epworth Sleepiness Scale (ESS score ≥11 indicates daytime sleepiness) and Beck Depression Scale (BDS score ≥10 indicates clinical depression) were applied. CD4+ T lymphocyte reconstitution (current-baseline CD4+ count) and CD4+ T lymphocyte reconstitution rate [(current-baseline CD4+ count)/duration of HIV infection in years] were calculated for PLWH on ART. Student t-test and Pearson’s chi-squared test were used for analysing the data and p<0.05 was considered significant. Results: A total of 131 (15 newly diagnosed 116 on ART for at least six months) PLWH were enrolled. Poor QoS was detected in 60.3% of PLWH. When compared the ratio was higher in newly diagnosed PLWH (vs PLWH on ART p>005). Daytime sleepiness in PLWH with poor Qos (p=0.04) was significantly increased (vs good QoS). Clinical depression (p=0.001) was significantly more common in PLWH with poor QoS (vs good QoS). Although statistically nonsignificant (p>005) younger age female sex being single homosexüel sexual preference high income and living with the family were associated with poor QoS. No association was found between the ART regime and QoS. PLWH with poor QoS had a higher CD4+ T lymphocyte count (p>005) a higher number of CD4+ T lymphocyte reconstitution (p<0.05) and a higher reconstitution rate than PLWH with good QoS (p<0.05). Conclusion: Prevalence of poor QoS was high in our cohort. Poor QoS was associated with CD4+ T lymphocyte reconstitution and reconstitution rate.
Impact of Metabolic Syndrome and Cardiovascular Risk on the Quality of Life of People Living with HIV
Background: The time elapsed since HIV infection diagnosis (TdiagHIV) affects the quality of life (QoL) and can get worse when chronic illnesses start. Objective: The aim of this study was to analyze the impact of metabolic syndrome (MetS) and cardiovascular risk (CVR) on the QoL of people living with HIV (PLHIV). Methods: Cross-sectional study with 60 PLHIV followed at a Reference Center in the city of Jataí Goiás Brazil. Data collection involved sociodemographic clinical CVR MetS and QoL information. The data were analyzed using descriptive and inferential statistics with the BioEstat 5.3 program adopting p<0.05. Results: There was a predominance of men (61.7%) aged ≤38 years (53.3%) with a TdiagHIV of 97.88±85.65 months and use of antiretroviral therapy (ART) of 80.13±69.37 months. The worst domain of QoL was concern about confidentiality (40 points) and the best was medication concerns (95 points). MetS predominated at 18.3% and a moderate CVR at 11.7%. MetS was positively associated with age >38 years the female sex with the lowest score in QoL for general function and the highest for TdiagHIV and the use of ART (p<0.05). A moderate CRV was positively related to higher TdiagHIV and ART use and low HDL-c and the lowest score for QoL was found for trust in a professional (p<0.05). Conclusion: PLHIV who are older have a higher TdiagHIV and use ART are more likely to develop MetS and moderate CVR. The presence of these diseases in PLHIV causes impairment in areas of QoL.
Evaluation of HIV and Syphilis Co-infected Cases, Data from a University Hospital
Background: HIV and syphilis are sexually transmitted infections with overlapping risk factors potentially leading to increased HIV transmission and treatment challenges. Understanding the clinical management of syphilis co-infection among people living with HIV is crucial for public health interventions. Objective: This retrospective cohort study aimed to assess the prevalence of syphilis co-infection clinical characteristics treatment response and public health implications among people living with HIV in southern Turkey. Methods: Records of 1352 people living with HIV 18 years and older followed at a tertiary infectious diseases clinic between 2013 and 2023 were analyzed. Data on demographics clinical stage of syphilis and HIV/AIDS laboratory parameters treatment response and co-infections were collected. Statistical analyses were performed using SPSS 20.0 software. Results: Among the people living with HIV 103 (7.6%) were diagnosed with syphilis. Most cases were male (97.1%) with a median age of 33 (IQR 28-49) years. Heterosexual transmission was predominant (60.2%) with a history of condomless sexual intercourse in 90.3% of cases. The majority (88.3%) were asymptomatic with latent syphilis. Syphilis was diagnosed concurrently with HIV in 77.7% of cases. Serological response to syphilis treatment was observed in 46.8% of patients while 53.2% showed a serofast reaction. Neurosyphilis was rare diagnosed in only one patient. Co-infections with hepatitis B and C were detected in 3.9% and 1.9% of patients respectively. Conclusion: Syphilis co-infection among people living with HIV is a significant public health concern in southern Turkey. Routine screening for syphilis along with comprehensive education on sexually transmitted infection prevention is essential for early detection and optimal management. Further research is needed to improve treatment outcomes and address emerging challenges in HIV-syphilis co-infection management.
Feasibility of a Mobile Health Intervention for Providing a Continuum of HIV Services for MSM: Pilot Study of the WeTest Program in 3 Cities in China
Background: Men who have sex with men (MSM) in China have a high risk for HIV infection but experience suboptimal rates of HIV testing and service engagement due to various social and structural barriers. We developed a mobile health (mHealth) intervention entitled “WeTest-Plus” (WeTest+) as a user-centered “one-stop service” approach for delivering access to comprehensive information about HIV risk HIV self-testing behavioral and biomedical prevention confirmatory testing treatment and care. Objective: The goal of the current study was to investigate the feasibility of WeTest+ to provide continuous HIV services to high-risk MSM. Methods: Participants completed a 3-week pilot test of WeTest+ to examine acceptability feasibility and recommendations for improvement. Participants completed a structured online questionnaire and qualitative exit interviews facilitated by project staff. “Click-through” rates were assessed to examine engagement with online content. Results: 28 participants were included and the average age was 27.6 years (standard deviation = 6.8). Almost all participants (96.4%) remained engaged with the WeTest+ program over a 3-week observational period. The majority (92.9%) self-administered the HIV self-test and submitted their test results through the online platform. Overall click-through rates were high (average 67.9%). Participants provided favorable comments about the quality and relevance of the WeTest+ information content the engaging style of information presentation and the user-centered features. Conclusion: This pilot assessment of WeTest+ supports the promise of this program for promoting HIV self-testing and linkage to in-person services for MSM in China. Findings underscore the utility of a user-centered approach to mHealth program design.
Pill Burden: A Major Barrier to HAART Adherence and Fixed Dose Combinations (FDCS) as its Solution - A Mini-Review
HIV/ AIDS is a global pandemic one of the most challenging; with no cure for the disease various therapies available in the form of regimens as Highly Active Anti-Retroviral Therapy (HAART) or simply Anti-Retroviral Therapy (ART) are the only way to manage the disease. The Fixed Dose Combinations (FDCs) concept has been a well-recognised improvement in pharmacotherapy for the treatment of a variety of chronic maladies like hypertension diabetes HIV/AIDS and several FDC products consisting of HIV drugs are approved. These single-tablet regimens have been essential in streamlining ART lowering pill burden and increasing adherence. Adherence to HAART is the most vital factor to ensure medication success and virologic suppression. However adherence is faced with several barriers including adverse effects of drugs the complexity of ART social-cultural factors and pill burden among others. This writing reviews the concept of adherence to ART and its barriers while stressing pill burden as a significant one which we suggest would be solved by using Fixed Dose Combinations (FDCs).
HIV Stigma, Sexual Identity Stigma and Online Coping Strategy of Gay, Bisexual and Queer People Living with HIV: A Moderated Mediation Study
Introduction: Living with HIV/AIDS is more difficult for gay bisexual and queer (GBQ) people as they face stigma on both the disease and sexuality which puts significant stress on coping with stressors and online platforms have become an alternative coping channel. Methods: This study investigated the use of online coping strategies in moderating the HIV stigma mediated by sexual identity stigma on mental health in Malaysia. 123 GBQ people living with HIV between the ages of 20 and 39 participated in the study responding to the HIV Stigma - Short Form Scale adapted China MSM Stigma Scale Online Coping Inventory and DASS-21. Result: Results were analyzed using OLS and logistic regression path modeling showed a statistically significant indirect effect of sexual identity stigma mediating HIV stigma on depressive (ab = 0.1362) anxiety (ab = 0.1259) and stress (ab = 0.1636) levels. Problem-focused online coping strategy was found to moderate the indirect association between HIV stigma and depression levels via sexual identity stigma at low (β = 0.2110 SE = 0.0741 p<.05) and moderate levels (β = 0.1168 SE = 0.0465 p>.05). The findings demonstrated the compounding link between HIV and sexual identity stigmas on mental health and how online coping strategies can be used as a helpful coping resource to manage depressive symptoms for this community and mental health practitioners. Conclusion: These findings can be beneficial to generate a better understanding of how double stigmas play a role in mental health and the types of online coping strategies adopted to process the stressors for GBQ individuals living with HIV in Malaysia.
Evaluating the Relationship between Various Risk Factors and COVID-19 Incidence in People Living with HIV: A Cross-Sectional Study
Introduction: People living with HIV (PLWH) are more susceptible to acquiring and having serious consequences from COVID-19. The objective of this study was to examine the correlation between COVID-19 infection and other risk factors in these patients. Methods: This is a descriptive-analytical study recruiting 160 PLWH referred to the Behavioral Disease Counselling Centre of Imam Khomeini Hospital in Tehran in 2021. The patients were selected through convenient sampling. A checklist was used to collect the necessary data. Descriptive statistical tests such as mean and standard deviation were employed alongside inferential statistics including chi-square Fisher independent t-tests and logistic regression all evaluated at a significance level of p<0.05 using the R software. Results: The patients' average age was 43.15 ± 11.23. Forty-four women and 116 men were present. A notable association was observed between the incidence of COVID-19 and variables such as hepatitis C and the duration of time since HIV diagnosis (p<0.001). Moreover a strong correlation was found between the amount of COVID-19 vaccination doses given to patients and their probability of acquiring the disease. The first vaccination dose was linked to a 5.45 percent increase in COVID-19 incidence in patients whereas the second and third doses (t=2.95 t=7.57) reduced the risk of getting COVID-19. Furthermore no discernible link (p>0.05) was found between the use of various antiretroviral medications and COVID-19 infection. Conclusion: This study finds that vaccine type does not impact COVID-19 outcomes in HIV-positive patients but receiving more doses decreases the probability of occurrence of COVID-19 advocating for multiple vaccinations. However PLWH especially those non-compliant with antiretrovirals need strict adherence to health protocols due to heightened vulnerability to viral illnesses.
Assessment of Knowledge and Concern of People Living with HIV Regarding Human Mpox and Vaccination
Introduction: Mpox virus is an orthopoxvirus that causes the zoonotic infectious disease known as mpox. The disease can also spread from humans to humans. It can be transmitted through contact with bodily fluids lesions on the skin or internal mucosal surfaces. Method: The number of mpox cases increased during the COVID-19 pandemic. Early diagnosis and prompt management of mpox are critical in people living with HIV (PLHIV). In this study a cross-sectional survey was conducted among PLHIV followed at the outpatient clinic between 20 April–20 August 2023. A questionnaire was used to assess the knowledge and anxiety levels of patients as well as their opinions about vaccination against mpox. The severity of symptoms in the past two weeks was assessed using the Generalised Anxiety Disorder 7-item scale. A total of 203 PLHIV were interviewed for this survey study. Result: The mean age was 39.37±11.93. The majority of them were male (86.7%) and 41.4% were men who have sex with men (MSM). Only 21 of the surveyed participants (10.4%) had a “good knowledge” score about mpox. The mean knowledge score on human Mpox was 2.05 (min:0-max:8) and 107 (52.7%) had a score of 0. Conclusion: The future study should focus on continuous education promoting awareness through programs and establishing measures to successfully overcome identified variables that contribute to mpox pandemic understanding and attitudes. Applying the lessons learned from the COVID-19 pandemic will help the management of mpox virus.
Heterologous DNA Prime/Protein Boost Immunization Targeting Nef-Tat Fusion Antigen Induces Potent T-cell Activity and in vitro Anti-SCR HIV-1 Effects
Background: Heterologous combinations in vaccine design are an effective approach to promote T cell activity and antiviral effects. The goal of this study was to compare the homologous and heterologous regimens targeting the Nef-Tat fusion antigen to develop a human immunodeficiency virus-1 (HIV-1) therapeutic vaccine candidate. Methods: At first the DNA and protein constructs harboring HIV-1 Nef and the first exon of Tat as linked form (pcDNA-nef-tat and Nef-Tat protein) were prepared in large scale and high purity. The generation of the Nef-Tat protein was performed in the E. coli expression system using an IPTG inducer. Then we evaluated and compared immune responses of homologous DNA prime/ DNA boost homologous protein prime/ protein boost and heterologous DNA prime/protein boost regimens in BALB/c mice. Finally the ability of mice splenocytes to secret cytokines after exposure to single-cycle replicable (SCR) HIV-1 was compared between immunized and control groups in vitro. Results: The nef-tat gene was successfully subcloned in eukaryotic pcDNA3.1 (-) and prokaryotic pET-24a (+) expression vectors. The recombinant Nef-Tat protein was generated in the E. coli Rosetta strain under optimized conditions as a clear band of ~ 35 kDa detected on SDS-PAGE. Moreover transfection of pcDNA-nef-tat into HEK-293T cells was successfully performed using Lipofectamine 2000 as confirmed by western blotting. The immunization studies showed that heterologous DNA prime/protein boost regimen could significantly elicit the highest levels of Ig- G2a IFN-γ and Granzyme B in mice as compared to homologous DNA/DNA and protein/protein regimens. Moreover the secretion of IFN-γ was higher in DNA/protein regimens than in DNA/DNA and protein/protein regimens after exposure of mice splenocytes to SCR HIV-1 in vitro. Conclusion: The chimeric HIV-1 Nef-Tat antigen was highly immunogenic especially when applied in a heterologous prime/ boost regimen. This regimen could direct immune response toward cellular immunity (Th1 and CTL activity) and increase IFN-γ secretion after virus exposure.
Outcomes of Total Hip Arthroplasty Performed for HIV-Associated Osteonecrosis in China: A Retrospective Cohort Study
Background: In the post-epidemic era Acquired Immune Deficiency Syndrome (AIDS) remains one of the most prevalent and detrimental infectious diseases worldwide. The incidence of osteonecrosis of the femoral head (ONFH) in AIDS patients is 100 times higher than that in healthy individuals. Although Total Hip Arthroplasty (THA) is ultimately necessary for most patients there is still a dearth of evidence regarding its safety and efficacy in Chinese AIDS patients. Methods: The clinical data of 49 patients who met the inclusion and exclusion criteria were retrospectively analyzed. Simultaneously we categorized patients whose hemoglobin and albumin met a specific threshold as the optimized group and performed group comparisons. Results: There are statistical differences in Harris score and VAS score pre- and post-operation with a low overall complication rate. Notably no disparities were observed between the optimized group and the partial optimized group in terms of overall conditions laboratory examination indicators severity of ONFH surgical outcomes surgical complications pain perception or functional limitations. Furthermore no correlation was found between CD4+ T lymphocytes and hemoglobin levels albumin levels white blood cell count or platelet count. Conclusion: THA is safe and effective in Chinese AIDS patients with ONFH. However optimal treatment has limited efficacy in AIDS patients undergoing THA for ONFH. The reconsideration and evaluation of the predictive value of CD4+ T lymphocytes for postoperative complications in joint replacement procedures is warranted.