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.
Identification and Analysis of Differentially Expressed Genes Associated with Ferroptosis and HIV in PASMCs Based on Bioinformatics
HIV-associated pulmonary arterial hypertension (HIV-PAH) a rare and fatal condition within the pulmonary arterial hypertension spectrum is linked to HIV infection. While ferroptosis an iron-dependent cell death form is implicated in various lung diseases its role in HIV-PAH development remains unclear.
Leveraging Gene Expression Omnibus data we identified differentially expressed genes (DEGs) in pulmonary arterial smooth muscle cells including HIV-related DEGs (HIV-DEGs) and ferroptosis-related HIV-DEGs (FR-HIV-DEGs). PPI network analysis of FR-HIV-DEGs using CytoHubba in Cytoscape identified hub genes. We conducted functional and pathway enrichment analyses for FR-HIV-DEGs HIV-DEGs and hub genes. Diagnostic value assessment of hub genes utilized ROC curve analysis. Key genes were further screened and external validation was performed. Additionally we predicted a potential ceRNA regulatory network for key genes.
1372 DEGs were found of which 228 were HIV-DEGs and 20 were FR-HIV-DEGs. TP53 IL6 PTGS2 IL1B (downregulated) and PPARG (upregulated) were the five hub genes that were screened. TP53 IL6 and IL1B act as ferroptosis drivers PTGS2 as a ferroptosis marker and PPARG as a ferroptosis inhibitor. Enrichment analysis indicated biological processes enriched in “response to oxidative stress” and pathways enriched in “human cytomegalovirus infection.” Key genes IL6 and PTGS2 exhibited strong predictive value via ROC curve analysis and external validation. The predicted ceRNA regulatory network identified miRNAs (has-mir-335-5p has-mir-124-3p) targeting key genes and lncRNAs (XIST NEAT1) targeting these miRNAs.
This study advances our understanding of potential mechanisms in HIV-PAH pathogenesis emphasizing the involvement of ferroptosis. The findings offer valuable insights for future research in HIV-PAH.
Low Levels of Cortisol are Associated with HIV Infection in Older People: A Hormonal Substudy in the OVER50 Cohort
People with the human immunodeficiency virus (PWH) who were diagnosed long ago are more prone to age-related conditions and comorbidities than the general population. We hypothesized that older PWH have endocrine abnormalities that may influence the patient’s health status.
Mean hormonal values across the thyrotropic somatotropic corticotropic and gonadal axis and percentage of subjects with abnormal values were compared between PWH aged ≥50 years (n=30) and people without HIV (n=30) (Over50 cohort). Clinical factors were also analyzed as independent variables.
PWH had a higher prevalence of comorbidities (36.67% PWH and 20.69% controls had ≥3 comorbidities). Male PWH exhibited lower estradiol levels than male controls (29.75±7.68 pg/mL vs. 35.45 ± 10.04 pg/mL; p = 0.0041). Abnormal concentrations of testosterone were found in 35% of male PWH compared to 55% of male controls (mostly above reference values). Cortisol levels were significantly lower among PWH (9.97 ± 4.33 µg/dL vs. 13.56 ± 3.39 µg/dL; p = 0.002); 16.6% of PWH exhibited abnormally low levels (<5 μg/dL) compared to 0% of controls and 3 PWH met criteria for a definitive diagnosis of adrenal insufficiency (<3.6 μg/dL). For the somatotropic axis growth hormone (GH) levels were significantly lower in male PWH than in controls (p = 0.0394). No significant differences were found in relation to the thyroid axis.
Hormones are generally similar between the chronic PWH who are receiving ART treatment and the general control population except for cortisol in both sexes and testosterone and estradiol in men. Some special attention should be given to cortisol in PWH due to a presumably higher risk of adrenal complications.
Impact of the COVID-19 Pandemic on People Newly Diagnosed with HIV and those Already in -care in Türkiye
COVID-19 has inevitably influenced health systems. HIV testing rates have been reduced and access to antiretroviral treatment has been scaled down. We evaluated the impact of COVID-19 on the management of people living with HIV (PLWH) in Türkiye.
We conducted a cross-sectional study in three tertiary care hospitals. We compared the baseline characteristics at the first visit and viral suppression rates at the 24th week of new HIV diagnoses during the pandemic with those during the previous two years. To observe the effect of the pandemic on people living with HIV who were already in care we compared the metabolic and clinical parameters like weight blood pressure blood lipid levels fasting glucose levels and liver and renal function tests of the same people before and during the pandemic.
The first group included 380 cases (127 diagnosed during the pandemic and 253 diagnosed during the previous year). The demographic characteristics were similar. The newly diagnosed PLWH during the pandemic had significantly higher baseline HIV RNA levels (p=0.005) a lower number of clinical visits (p=0.0005) and a lower number of cases with undetectable viral loads at 24 weeks of treatment (p=0.0005) than those diagnosed during the pre-pandemic period.
The second group included 261 individuals with a mean follow-up duration of 24.7 (SD± 3.5; min- max 12-144) months. The comparison of laboratory parameters revealed that in the post-pandemic period virologic suppression was maintained at 90.1% body mass index (p=00001) total cholesterol (p=00001) and LDL levels (p=00001) increased significantly and creatinine levels decreased significantly (p=00001).
Our study showed that COVID-19 deteriorated the HIV management of PLHIV. Strengthening the medical infrastructure of basic services for PLWH is critical for future crises.
A Step Towards Optimization of Amide-Linked Coumarin Pharmacophore: As an Anti-HIV Agent
The aim of the present investigation is to identify effective anti-HIV drugs through the in-silico virtual screening of the coumarin pharmacophore with or without substituents. Virtual screening started with target identification through computation docking and interactions binding affinity through molecular dynamics and the ADMET profile through the use of various enzymes. The target study suggests that the target is involved in various stages of HIV replication and in determining the ways in which non-nucleoside reverse transcriptase inhibitors (RTIs) influence it. The interaction pattern and simulation study conclude the specific affinity of coumarin pharmacophore to the HIV's reverse transcriptase enzyme especially 3HVT. Moreover the amide linkage worked as a synergistic bridge to provide more interaction to the pharmacophore. The initial results led to the determination of 83 virtual amide-like molecules which were screened through docking and MD studies (100 ns) on the best-suited enzyme HIV's reverse transcriptase enzyme such as PDB ID “3HVT”. The virtual screening study revealed the high affinity of compounds 7d and 7e with the lowest IC50 values of 0.729 and 0.658 μM; moreover their metabolism pattern study toxicity and QED values in a range of 0.31-0.40 support a good drug candidate. The two compounds were also synthesized and characterized for future in vitro and in vivo studies. The in silico-based descriptor of compounds 7d and 7e indicates the potential future and provides the best two molecules and their synthetic route for the development of a more effective drug to combat HIV/AIDS epidemics.
Prediction Models for HIV Infection in Infants: Analysis of Scoring Systems on Maternal, Infants, and Mode of Delivery Risk Factors
Diagnosis for HIV in infants is hard to determine particularly in limited-resource areas. A delay in the diagnosis of HIV-infected infants will lead to high morbidity and mortality. The purpose of this project is to construct a model of an HIV-positive infant and develop a useful and practical scoring system to estimate the likelihood of mother-to-child transmission that can be applied in the field.
A cross-sectional study on 100 subjects through medical records of infants born to HIV-infected mothers was conducted at four hospitals and one community health center. Several models of risk prediction scores of HIV-infected infants were then made. Furthermore the performed validation was performed on 20 subjects of infants born to mothers with HIV in three hospitals by comparing the scoring system and the result of the PCR RNA examination performed at the age of 6 weeks old.
The risk of HIV-infected infants was higher in mothers who did not receive ARV through PMTCT programs (OR 33.6; 95% CI 4.0 to 282.2) pulmonary TB infection (OR 5.1; IK95% 1.6 to 16.0) and vaginal delivery (OR 9.2; IK95 2.2 to 38.0%). Two models can predict the occurrence of infected HIV infants effectively. Model 1 consists of maternal age maternal ARVs lung TB infection gestational age mode of delivery and sex of the infants with sensitivity and specificity of 78.9% and 70.8% (AUC=0.817 [95% CI 0.709 to 0.926]) and likelihood ratio score of 4. Model 2 consists of ARVs to the mother pulmonary TB infection and mode of delivery with sensitivity and specificity of 73.7% and 86.1%; AUC value of 0.812 (95% CI 0.687 to 0.938) and likelihood ratio of 5. External Validation gave similar results to the Model 2 scoring system with PCR RNA.
The prediction score of HIV-infected infants in Model 2 can be used in newborns of HIV-positive mothers as an effective and practical risk screening tool for HIV-infected infants before the gold standard examination by PCR.
Identification of Two HIV-1 CRF01_AE/B Recombinant Forms and a CRF01_AE/B/C Recombinant Form in Hebei Province, China
In the Hebei province Human Immunodeficiency Virus type one (HIV-1) recombinant strains of subtypes B C and CRF01_AE are emerging very rapidly and diversely.
In order to confirm the characteristics of novel recombination forms we aimed to analyze HIV-1 Near-full-length Genome sequences (NFLGs) obtained from three Men who have Sex with Men (MSM) in this study.
Phylogenetic trees were constructed and breakpoints analysis were performed based on the NFLGs and each gene fragment to examine the gene recombination patterns of three new HIV-1 NFLGs.
HIV-1 subtypes CRF01_AE and B were combined to generate the recombinant structures of the NFLGs 610 and 687. CRF01_AE B and C were combined to generate the recombinant structures of the NFLG 825. According to the NFLG phylogenetic tree the NFLG 825 clustered with CRF65_cpx and the NFLGs 610 and 687 clustered with CRF68_01B. The recombination breakpoints analysis revealed that the recombination pattern of the NFLGs 610 and 687 was the insertion of subtype B fragment into the CRF01_AE backbone. Subregions I II and III were derived from CRF01_AE subtype B and CRF01_AE respectively. The recombination pattern of the NFLG 825 contained ten fragments of subtypes CRF01_AE C and B. Finally the above factors were formed using phylogenetic trees and breakpoints analysis which were combined to get two CRF68_01B forms and one CRF65_cpx form.
Our findings have suggested that it is crucial to keep an eye on the genetic diversity of HIV-1 in Hebei province.
Rates of Viral Non-Suppression and Acquired HIV-1 Drug Resistance Emergence among Children during the Sociopolitical Crisis in the Northwest Region of Cameroon: A Call for Improved Monitoring Strategies
Virological failure (VF) among children remains concerning with high risks of HIV drug resistance (HIVDR) emergence and increased disease progression. Therefore monitoring of viral non-suppression and emerging HIVDR is crucial especially in the frame of sociopolitical unrest.
The study sought to determine the prevalence of VF and evaluate the acquired HIVDR and viral genetic diversity among children in the Northwest region of Cameroon during the ongoing sociopolitical crisis.
A cross-sectional facility-based study was conducted among HIV-infected children aged ≤18 years receiving antiretroviral therapy (ART) in urban and rural settings of Northwest Cameroon from November 2017 through May 2018. Viral load (VL) was done using the Abbott m2000RealTime. Unsuppressed VL was defined as viral load ≥1000 copies/ml. HIVDR testing was performed by sequencing of HIV-1 protease-reverse transcriptase at the Chantal Biya International Reference Center (CIRCB) using an in-house protocol. Drug resistance mutations (DRM) were interpreted using Stanford HIVdbv8.5 and phylogeny using MEGAv.6. Data were compared between urban and rural areas with p<0.05 considered statistically significant.
A total of 363 children were recruited average age of 12 years (urban) and 8 years (rural). VL coverage was 100% in the urban setting and 77% in the rural setting. Overall VF was 40.5% (39% [130/332] in the urban setting and 41% (13/31) in the rural setting; p=0.45). Overall viral undetectability (defined as VL<40 copies/ml) was 45.5% (46% (urban) and 45% (rural); p=0.47). Among those experiencing confirmed virological failure and who were successfully sequenced (n=35) the overall rate of HIVDR was 100% (35/35). By drug class HIVDR rates were 97.1% (34/35) for non-nucleoside reverse transcriptase inhibitors (NNRTIs) 97.1% (34/35) for NRTIs and 17.1% (6/35) for protease inhibitors (22.7% (5/22) in the urban setting and 7.7% [1/13] in the rural setting). CRF02_AG was the most prevalent viral clade (75%) followed by other recombinants (09_cpx 11_cpx 13_cpx 22_01A1 37_cpx) and pure subtypes (A1 F2 G H).
In this population of children and adolescents living with HIV in a context of socio-political instability in the North-West region of Cameroon rates of viral non-suppression are high and accompanied by HIVDR selection. Our findings suggest the need for a more differentiated care of these CAHIV especially those in these regions faced with significant socio-economic and health impacts due to the ongoing crisis.
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.