Suchergebnisse

Paramount efforts worldwide are seeking to increase understanding of the basic virology of SARS-CoV-2, characterize the spectrum of complications associated with COVID-19, and develop vaccines that can protect from new and recurrent infections with SARS-CoV-2. While we continue learning about this new virus, it is clear that 1) the virus is spread via the respiratory route, primarily by droplets and contact with contaminated surfaces and fomites, as well as by aerosol formation during invasive respiratory procedures; 2) the airborne route is still controversial; and 3) that those infected can spread the virus without necessarily developing COVID-19 (ie, asymptomatic). With the number of SARS-CoV-2 infections increasing globally, the possibility of co-infections and/or co-morbidities is becoming more concerning. Co-infection with Human Immunodeficiency Virus (HIV) is one such example of polyparasitism of interest. This military-themed comparative review of SARS-CoV-2 and HIV details their virology and describes them figuratively as separate enemy armies. HIV, an old enemy dug into trenches in individuals already infected, and SARS-CoV-2 the new army, attempting to attack and capture territories, tissues and organs, in order to provide resources for their expansion. This analogy serves to aid in discussion of three main areas of focus and draw attention to how these viruses may cooperate to gain the upper hand in securing a host. Here we compare their target, the key receptors found on those tissues, viral lifecycles and tactics for immune response surveillance. The last focus is on the immune response to infection, addressing similarities in cytokines released. While the majority of HIV cases can be successfully managed with antiretroviral therapy nowadays, treatments for SARS-CoV-2 are still undergoing research given the novelty of this army.

Nicholas Evans,1 Edgar Martinez,1 Nicola Petrosillo,2 Jacob Nichols,3 Ebtesam Islam,3 Kevin Pruitt,1 Sharilyn Almodovar1 1Texas Tech University Health Sciences Center, Department of Immunology & Molecular Microbiology, Lubbock, TX, USA; 2National Institute for Infectious Diseases L. Spallanzani, IRCCS, Rome, Italy; 3Texas Tech University Health Sciences Center, Department of Internal Medicine, Lubbock, TX, USACorrespondence: Sharilyn AlmodovarTexas Tech University Health Sciences Center, 3601 4th Street, Mail Stop 6591, Lubbock, Texas, 79430 Tel +806 743-1091Email sharilyn.almodovar@ttuhsc.eduAbstract: Paramount efforts worldwide are seeking to increase understanding of the basic virology of SARS-CoV-2, characterize the spectrum of complications associated with COVID-19, and develop vaccines that can protect from new and recurrent infections with SARS-CoV-2. While we continue learning about this new virus, it is clear that 1) the virus is spread via the respiratory route, primarily by droplets and contact with contaminated surfaces and fomites, as well as by aerosol formation during invasive respiratory procedures; 2) the airborne route is still controversial; and 3) that those infected can spread the virus without necessarily developing COVID-19 (ie, asymptomatic). With the number of SARS-CoV-2 infections increasing globally, the possibility of co-infections and/or co-morbidities is becoming more concerning. Co-infection with Human Immunodeficiency Virus (HIV) is one such example of polyparasitism of interest. This military-themed comparative review of SARS-CoV-2 and HIV details their virology and describes them figuratively as separate enemy armies. HIV, an old enemy dug into trenches in individuals already infected, and SARS-CoV-2 the new army, attempting to attack and capture territories, tissues and organs, in order to provide resources for their expansion. This analogy serves to aid in discussion of three main areas of focus and draw attention to how these viruses may cooperate to gain the upper hand in securing a host. Here we compare their target, the key receptors found on those tissues, viral lifecycles and tactics for immune response surveillance. The last focus is on the immune response to infection, addressing similarities in cytokines released. While the majority of HIV cases can be successfully managed with antiretroviral therapy nowadays, treatments for SARS-CoV-2 are still undergoing research given the novelty of this army.Keywords: HIV, AIDS, SARS-CoV-2, COVID-19, ACE-2, remdesivir

ContextHIV‐1 is a neurotropic virus. In a resource‐limited country such as India, large populations of affected patients now have access to adequate chemoprophylaxis for opportunistic infections (OIs), allowing them to live longer. Unfortunately the poor availability of highly active antiretroviral therapy (HAART) has allowed viral replication to proceed unchecked. This has resulted in an increase in the debilitating neurologic manifestations directly mediated by the virus.ObjectiveThe main objective of this study was to identify and describe in detail the direct neurologic manifestations of HIV‐1 in antiretroviral treatment (ART)‐naive, HIV‐infected patients (excluding the neurologic manifestations produced by opportunistic pathogens).DesignThree hundred successive cases of HIV‐1 infected, ART‐naive patients with neurologic manifestations were studied over a 3‐year period. Each case was studied in detail to identify and then exclude manifestations due to opportunistic pathogens. The remaining cases were then analyzed specially in regard to their occurrence and the degree of immune suppression (CD4+ cell counts).Setting and PatientsThe study was carried out in an apex, tertiary, referral care center for HIV/AIDS in India. All patients were admitted for a detailed analysis.No interventions were carried out, as this was an observational study.ResultsOf the 300 cases, 67 (22.3%) had neurologic manifestations due to the direct effects of HIV‐1. The HIV infection involved the neuroaxis at all levels. The distribution of cases showed that the region most commonly involved was the brain (50.7%). The manifestations included stroke syndromes (29.8%), demyelinating illnesses (5.9%), AIDS dementia complex (5.9%), and venous sinus thrombosis (4.4%). The other manifestations seen were peripheral neuropathies (35.8% of cases), spinal cord pathologies (5.9% of cases), radiculopathies (4.4% of cases), and a single case of myopathy. The onset of occurrence of these diseases and their progression were then correlated with the CD4+ cell counts.ConclusionHIV infection is responsible for a large number of nonopportunistic neurologic manifestations that occur across a large immune spectrum. During the early course of the disease, the polyclonal hypergammaglobulinemia induced by the virus results in demyelinating diseases of the central‐ and peripheral nervous systems (CNS and PNS). As the HIV infection progresses, the direct toxic effects of the virus unfold, directly damaging the CNS and PNS, resulting in protean clinical manifestations.

Purpose. To explore the feasibility of engaging community businesses in human immunodeficiency virus (HIV) prevention. Design. Randomly selected business owners/managers were asked to display discreetly wrapped condoms and brochures, both of which were provided free-of-charge for 3 months. Assessments were conducted at baseline, mid-program, and post-program. Customer feedback was obtained through an online survey. Setting. Participants were selected from a San Diego, California neighborhood with a high rate of acquired immune deficiency syndrome. Participants. Fifty-one business owners/managers who represented 10 retail categories, and 52 customers. Measures. Participation rates, descriptive characteristics, number of condoms and brochures distributed, customer feedback, business owners'/managers' program satisfaction, and business owners'/managers' willingness to provide future support for HIV prevention were measured. Analysis. Kruskal-Wallis, Mann-Whitney U, Fisher's exact, and McNemar's tests were used to analyze data. Results. The 20 business owners/managers (39%) who agreed to distribute condoms and brochures reported fewer years in business and more employees than those who agreed only to distribute brochures (20%) or who refused to participate (41%; p < .05). Bars were the easiest of ten retail categories to recruit. Businesses with more employees and customers distributed more condoms and brochures (p < .05). More than 90% of customers supported distributing condoms and brochures in businesses, and 96% of business owners/managers described their program experience as positive. Conclusion. Businesses are willing to distribute condoms and brochures to prevent HIV. Policies to increase business participation in HIV prevention should be developed and tested.

Abstract

Introduction:
Effective educational interventions to knowledge, attitude, and prevention of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) may limit the spread of the disease. However, the relevance of HIV knowledge to followers of religions is unknown. We assessed the 2015–2016 Demographic and Health Survey (DHS) data from India to investigate the levels of knowledge of HIV/AIDS among Hindus, Muslims, Sikhs, Christians, and Buddhists in relation to standard sociodemographic variables in India.


Methods:
We used the individual and household level data from the internationally and temporally harmonized cross-sectional DHS. These data were representative of the national population and were collected from January 2015 to December 2016.


Results:
The age range of the population was 15–54 years (n = 224,531). We found the highest level of knowledge of HIV/AIDS among Sikh men (than the followers of other religions (80.4%–92.7%). Conversely, Muslims and Hindus were least knowledgeable of HIV/AIDS (80.4% and 81.2%). Younger participants (82.5%), residents of urban areas (90.6%), more educated (98.6%), never married (84.9%), wealthier (95.5%), and having more access to mass media (90.4%–96.7%) were more aware of HIV/AIDS-related knowledge. Among various religions, Sikhs were more educated (16.1% with higher education), wealthier (59.5% in the top quintile), with higher exposure to communication means than Muslims, Hindus, and Christians.


Conclusion:
We report that Sikh men are most knowledgeable of HIV compared to Sikh women and followers of other religions. Our findings may help formulate public health strategies targeting various religious groups to reduce the incidence of HIV/AIDS.

Purpose of the studyVitamin D deficiency in the adults could produce osteomalacia, secondary hyperparathyroidism with bone loss and increased risk of fractures. An increased prevalence of osteopenia, osteoporosis, decreased bone density, vitamin D deficiency and increased risk of fracture was found in HIV‐positive patients. A study performed in Buenos Aires, Argentina that included non‐HIV‐infected adult patients showed 15% prevalence of vitamin D deficiency in winter and 0% prevalence in summer. There is no local data published of vitamin D deficiency in HIV‐positive populations. The aim of the study is to determinate the prevalence of vitamin deficiency in our HIV‐positive population receiving HAART.MethodsAn observational, retrospective study was performed. We reviewed the clinical charts of the HIV‐positive adult patients attending the infectious disease clinic. We collected data of vitamin D, parathormone and beta cross laps value; we recorded if the test was performed in winter or summer. We considered vitamin D deficiency if<10 ng/ml. We recorded age, sex, comorbidities (diabetes mellitus, renal failure, hepatic failure, HBV and/or HCV coinfection, menopause, malignancy and metabolic syndrome), months since HIV diagnosis, CD4 count, viral load and HAART.Summary of results60 patients were included, 49 (65%) of whom were male. Mean age was 49.15 years. Mean time from diagnosis was 112 months. Mean CD4 count was 548 cells/mm3 and 6.6% presented CD4 <200; 83.3% had viral load <50 copies/mm3. All patients were on HAART; 50% received efavirenz, 65% received tenofovir and 11.6% recived atazanavir. Mean vitamin D value was 23.58 ng/ml (5–66.5 ng/ml). In winter, 15.3% of the patients had <10 ng/ml of vitamin D and mean value was 24.16 ng/ml (10–40 ng/ml). Although the mean value in summer was 25.8 ng/ml (11.6–66 ng/ml) 10% of the patients had vitamin D deficiency. PTH value was abnormal in 31.6% of patients and beta cross laps was abnormal in 10% of patients.ConclusionsAlthough the small number of patient included, we observed a high prevalence of vitamin D deficiency even in summer. A systematic assessment of vitamin D must be included in HIV positive patient care.

CONTEXT: Sexually transmitted infections (STIs) have a well-established synergistic relationship with human immunodeficiency virus (HIV) infection. Coinfection with HIV and STI can increase the probability of HIV transmission to an uninfected partner by increasing HIV concentrations in genital lesions, genital secretions, or both. Concurrent HIV infection alters the natural history of the classic STIs. AIMS: The aim was to study the current scenario of STIs with HIV co-infection, and to recognize different manifestations of STIs than the classical presentation in people living with HIV/AIDS (PLHIV). SETTINGS AND DESIGN: It was an open, cross-sectional, descriptive study carried out in the setting of state government hospital with attached antiretroviral therapy referral center. SUBJECTS AND METHODS: The sample size of the study was duration based (30 months). INCLUSION CRITERIA: All PLHIV presenting to the department of dermatology with STIs were included in the study. EXCLUSION CRITERIA: Non-STI causes of genital ulceration were excluded in the study. RESULTS: The study includes total (n = 484) patients living with HIV/AIDS, prevalence of different STIs was in the following order, herpes simplex virus infections 24.17%, human papillomavirus infections 8.88%, molluscum contagiosum 7.43%, secondary syphilis 4.33%, gonorrhea 1.85%, chancroid 1.44%, and granuloma inguinale 0.41%. Of all the patients with herpes simplex virus infections, 45.6% (n = 57) had multiple recurrences (>6/year). The incidence of mixed STI was 17.29% in the present study. CONCLUSIONS: The study represents decreasing trends in bacterial STIs and the rise of viral STIs. Atypical presentations of classic STIs were more frequent than non-HIV-infected individuals.