1.  Peer Reviewed Title: Comparison of HIV type 1 sequences from plasma, cell-free breast milk, and cell-associated breast milk viral populations in treated and untreated women in Mozambique. Author: Andreotti M; Galluzzo CM; Guidotti G; Germano P; Altan AD; Pirillo MF; Marazzi MC; Vella S; Palombi L; Giuliano M Source: AIDS Research and Human Retroviruses. 2009 Jul;25(7):707-11. Abstract: We analyzed the sequences of the HIV viral populations obtained from plasma, cell-free breast milk, and breast milk cells of HAART-treated (23) and untreated (30) HIV-infected women to obtain information about the origin of the breast milk virus. Sequence analyses of viruses were performed using the TruGene HIV-1 assay. Direct sequences of the reverse transcriptase (RT) and protease (PR) genes were analyzed using the Phylip 3.68 suite of sequence analysis program and pairwise evolutionary distances were calculated with the Kimura two parameter model for estimation of distances. We found that the genetic distances between the plasma and the cell-free breast milk viruses and between the cell-free and cell-associated breast milk viruses for RT were higher in HAART-receiving women than in untreated women, suggesting viral evolution under selective drug pressure in breast milk. Our data support the hypothesis of the presence of an actively replicating viral population in the breast milk compartment, distinct from that present in plasma. Language: English Keywords: MOZAMBIQUE | RESEARCH REPORT | COMPARATIVE STUDIES | WOMEN | HUMAN MILK | HIV | HIV TESTING | LABORATORY PROCEDURES | TREATMENT | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Studies | Research Methodology | Demographic Factors | Population | Lactation | Maternal Physiology | Physiology | Biology | HIV Infections | Viral Diseases | Diseases | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 342889 |
| 2. Title: Antiretroviral drug resistance surveillance among treatment-naive human immunodeficiency virus type 1-infected individuals in Angola: evidence for low level of transmitted drug resistance. Author: Bartolo I; Rocha C; Bartolomeu J; Gama A; Fonseca M; Mendes A; Cristina F; Thamm S; Epalanga M; Silva PC; Taveira N Source: Antimicrobial Agents and Chemotherapy. 2009 Jul;53(7):3156-8. Abstract: The prevalence of transmitted human immunodeficiency virus type 1 drug resistance in Angola in 2001 in 196 untreated patients was investigated. All subtypes were detected, along with unclassifiable and complex recombinant strains. Numerous new polymorphisms were identified in the reverse transcriptase and protease. Two (1.6%) unrelated patients harbored nucleoside reverse transcriptase inhibitor- and nonnucleoside reverse transcriptase inhibitor-resistant viruses (mutations: M41L, D67N, M184V, L210W, T215Y or T215F, and K103N). Continued surveillance of drug resistance is required for maximization of ART efficacy in Angola. Language: English Keywords: ANGOLA | RESEARCH REPORT | PREVALENCE | PERSONS LIVING WITH HIV/AIDS | CLIENTS | DRUG RESISTANCE | ANTIRETROVIRAL DRUGS | HIV | LABORATORY PROCEDURES | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Measurement | Research Methodology | HIV Infections | Viral Diseases | Diseases | Program Activities | Programs | Organization and Administration | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Laboratory Examinations and Diagnoses | Examinations and Diagnoses Document Number: 342987 |
| 3. Title: Highly divergent subtypes and new recombinant forms prevail in the HIV/AIDS epidemic in Angola: new insights into the origins of the AIDS pandemic. Author: Bartolo I; Rocha C; Bartolomeu J; Gama A; Marcelino R; Fonseca M; Mendes A; Epalanga M; Silva PC; Taveira N Source: Infection, Genetics and Evolution. 2009 Jul;9(4):672-82. Abstract: Angola, located in South-Western Africa, has a remarkably low HIV/AIDS prevalence in the adult population (3.7%). It is bordered in the North by the Democratic Republic of Congo (DRC) and Republic of Congo that are at the origin of human HIV-1 infections. It is, therefore, likely that HIV-1 strains circulating in Angola are genetically diverse and representative of the origin of the HIV/AIDS epidemic. The aim of this work was to investigate in detail the genetic diversity and molecular epidemiology of HIV-1 in Angola. Almost 400 sequences were obtained from the gag (p17), pol (PR and RT) and/or env (C2C3) genes of 159 HIV-1 infected patients living in eight provinces of Angola (Benguela, Cabinda, Cuanza Norte, Luanda, Lunda Norte, Malange, Uige, and Zaire) and their genotype was determined by phylogenetic analyses. Gene regions representing all HIV-1 group M clades were found as well as unclassifiable sequences. In env and pol (RT), two groups of sequences forming distinct sub-clusters within the subtype A radiation were found and may define new A5 and A6 sub-subtypes. Recombinant forms were found in almost half (47.1%) of the patients of which 36.0% were second-generation recombinants. Fifty-eight different patterns of recombination were found. The A subtype, including CRF02_AG, was represented in most recombinant viruses. Epidemiological data suggests that the AIDS epidemic in Angola has probably started as early as 1961, the major cause being the independence war, and spread to Portugal soon thereafter. The extraordinary degree of HIV-1 group M genetic diversity and evolution in Angola may pose unprecedented challenges to diagnostic, treatment and prevention of HIV-1 infection. Language: English Keywords: ANGOLA | RESEARCH REPORT | PREVALENCE | EPIDEMIOLOGY | HIV | LABORATORY PROCEDURES | MANAGEMENT | TREATMENT | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Measurement | Research Methodology | Public Health | Health | HIV Infections | Viral Diseases | Diseases | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Organization and Administration Document Number: 342757 |
| 4. Peer Reviewed Title: The intergenerational impact of the African orphans crisis: a cohort study from an HIV/AIDS affected area. Author: Beegle K; De Weerdt J; Dercon S Source: International Journal of Epidemiology. 2009 Apr;38(2):561-8. Abstract: BACKGROUND: In sub-Saharan Africa, the prevalence of orphanhood among children has been greatly exacerbated by the HIV/AIDS pandemic. If orphanhood harms a child's development and these effects perpetuate into adult life, then the African orphan crisis could seriously jeopardize the continent's future generations. Whether or not there exists an adverse, causal and intergenerational effect of HIV/AIDS on development is of crucial importance for setting medical priorities. This study is the first to empirically investigate the impact of orphanhood on health and schooling using long-term longitudinal data following children into adulthood. METHODS: We examined a cohort of 718 children interviewed in the early 1990s and again in 2004. Detailed survey questionnaires and anthropometric measurements were administered at baseline and during a follow-up survey. Final attained height and education (at adulthood) between children who lost a parent before the age of 15 and those who did not were compared. RESULTS: On average, children who lose their mother before the age of 15 suffer a deficit of around 2 cm in final attained height (mean 1.96; 95% CI 0.06-3.77) and 1 year of final attained schooling (mean 1.01; 95% CI 0.39-1.81). This effect is permanent and the hypothesis that it is causal cannot be rejected by our study. Although father's death is a predictor of lower height and schooling as well, we reject the hypothesis of a causal link. CONCLUSIONS: The African orphan crisis, exacerbated by the HIV/AIDS epidemic will have important negative intergenerational effects. Language: English Keywords: AFRICA | RESEARCH REPORT | COHORT ANALYSIS | PREVALENCE | ORPHANS AND VULNERABLE CHILDREN | CHILD HEALTH | CHILD DEVELOPMENT | HIV | AIDS | HUMAN CAPITAL | IMPACT | Developing Countries | Research Methodology | Measurement | Family and Household | Sociocultural Factors | Health | Biology | HIV Infections | Viral Diseases | Diseases | Human Resources | Economic Factors | Communication Document Number: 341016 |
| 5. Peer Reviewed Title: Barriers to research and capacity building at Hispanic-serving institutions: the case of HIV/AIDS research at the University of Puerto Rico. Author: Bernal G; Ortiz-Torres B Source: American Journal of Public Health. 2009 Apr;99 Suppl 1:S60-5. Abstract: Substantive barriers to research, such as cultural, language, and methodological variables, exist in Hispanic-serving institutions. Historical and contextual variables account for the differences between academic settings with research-intensive centers and those with limited infrastructure for competitive research. We provide a case example to serve as a model for developing and strengthening the research infrastructure in Hispanic-serving institutions and for providing the mentorship Latino investigators may need to compete with other investigators in research-intensive centers. We present recommendations to reduce these barriers. Language: English Keywords: PUERTO RICO | CRITIQUE | RECOMMENDATIONS | CASE STUDIES | EXPERIMENTAL MODELS | HISPANICS | HEALTH PERSONNEL | UNIVERSITIES | RESEARCH ACTIVITIES | HIV | AIDS | CAPACITY BUILDING | CULTURE | LANGUAGE | PARTICIPATION | Caribbean | Americas | Developed Countries | Studies | Research Methodology | Ethnic Groups | Cultural Background | Population Characteristics | Demographic Factors | Population | Delivery of Health Care | Health | Schools | Education | HIV Infections | Viral Diseases | Diseases | Program Sustainability | Programs | Organization and Administration | Sociocultural Factors | Communication | Social Behavior | Behavior Document Number: 330955 |
| 6. Title: Virologic and immunologic responses to antiretroviral therapy among HIV-1 and HIV-2 dually infected patients: case reports from Abidjan, Cote d'Ivoire. Author: Borget MY; Diallo K; Adje-Toure C; Chorba T; Nkengasong JN Source: Journal of Clinical Virology. 2009 May;45(1):72-5. Abstract: In four of five HIV-1 and HIV-2 dually infected patients treated with efavirenz-based therapy, viral load was undetectable for HIV-1 only, with limited increase in CD4+ counts. Both viral loads were undetectable and CD4+ counts increased in one patient treated with protease inhibitor regimen. Specific guidelines for treating HIV-dually infected patients are needed that should avoid the use of non-nucleoside reverse transcriptase inhibitors. Language: English Keywords: COTE D'IVOIRE | RESEARCH REPORT | CASE STUDIES | CLIENTS | PERSONS LIVING WITH HIV/AIDS | HIV | INFECTIONS | ANTIRETROVIRAL THERAPY | CONTRACEPTIVE USE-EFFECTIVENESS | LABORATORY PROCEDURES | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Studies | Research Methodology | Program Activities | Programs | Organization and Administration | HIV Infections | Viral Diseases | Diseases | Contraceptive Effectiveness | Contraception | Family Planning | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 342661 |
| 7. Peer Reviewed Title: Antiretroviral resistance patterns and HIV-1 subtype in mother-infant pairs after the administration of combination short-course zidovudine plus single-dose nevirapine for the prevention of mother-to-child transmission of HIV. Author: Chalermchockcharoenkit A; Culnane M; Chotpitayasunondh T; Vanprapa N; Leelawiwat W; Mock PA; Asavapiriyanont S; Teeraratkul A; McConnell MS; McNicholl JM; Tappero JW Source: Clinical Infectious Diseases. 2009 Jul 15;49(2):299-305. Abstract: BACKGROUND: World Health Organization guidelines for prevention of mother-to-child transmission of human immunodeficiency virus type 1 (HIV-1) recommend administration of zidovudine and single-dose nevirapine (NVP) for HIV-1-infected women who are not receiving treatment for their own health or if complex regimens are not available. This study assessed antiretroviral resistance patterns among HIV-infected women and infants receiving single-dose NVP in Thailand, where the predominant circulating HIV-1 strains are CRF01_AE recombinants and where the minority are subtype B. METHODS: Venous blood samples were obtained from (1) HIV-infected women who received zidovudine from 34 weeks' gestation and single-dose NVP plus oral zidovudine during labor and (2) HIV-infected infants who received single-dose NVP after birth plus zidovudine for 4 weeks after delivery. HIV-1 drug resistance testing was performed using the TruGene assay (Bayer HealthCare). RESULTS: Most mothers and infants were infected with CRF01_AE. NVP resistance was detected in 34 (18%) of 190 women and 2 (20%) of 10 infants. There was a significantly higher proportion of NVP mutations in women with delivery viral loads of >50,000 copies/mL (adjusted odds ratio, 8.5; 95% confidence interval, 2.2-32.8, [Formula: see text] for linear trend) and in those with subtype B rather than CRF01_AE infections (38% vs. 16%; adjusted odds ratio, 3.6; 95% confidence interval, 1.1-11.8; P = .038). CONCLUSIONS: The lower frequency of NVP mutations among mothers infected with subtype CRF01_AE, compared with mothers infected with subtype B, suggests that individuals infected with subtype CRF01_AE may be less susceptible to the induction of NVP resistance than are individuals infected with subtype B. Language: English Keywords: DEVELOPING COUNTRIES | RESEARCH REPORT | WHO | MANUAL | STANDARDS | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | MOTHERS | INFANT | PERSONS LIVING WITH HIV/AIDS | HIV | DRUG RESISTANCE | ANTIRETROVIRAL DRUGS | ANTIRETROVIRAL THERAPY | TREATMENT | LABORATORY PROCEDURES | HIV TESTING | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors | Research Methodology | Disease Transmission Control | Prevention and Control | Diseases | Parents | Family Relationships | Family Characteristics | Family and Household | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | HIV Infections | Viral Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Laboratory Examinations and Diagnoses | Examinations and Diagnoses Document Number: 342429 |
| 8. Peer Reviewed Title: Do men and women with HIV differ in their quality of life? A study from south India. Author: Chandra PS; Satyanarayana VA; Satishchandra P; Satish KS; Kumar M Source: AIDS and Behavior. 2009 Feb;13(1):110-117. Abstract: This paper examined gender differences in Quality of Life (QOL) among people living with HIV/ AIDS in South India using the locally validated version of the WHO Quality of Life Instrument for HIV (WHOQOLHIV 120). Participants (N = 109) were men and women with HIV1 Clade C infection participating in a cohort study. There was no gender difference in CD4 counts or use of antiretroviral therapy. Of the 29 facets of QOL, men reported significantly higher QOL in the following facetspositive feeling, sexual activity, financial resources and transport, while women reported significantly higher QOL on the forgiveness and blame facet. Of the six domains of QOL, men reported better quality of life in the environmental domain while women had higher scores on the spirituality/religion and personal beliefs domain. Understanding these gender differences may provide potentially useful information for tailoring interventions to enhance QOL among people infected with HIV/AIDS. Language: English Keywords: INDIA | RESEARCH REPORT | PERSONS LIVING WITH HIV/AIDS | SEX FACTORS | QUALITY OF LIFE | HIV | Developing Countries | Asia, Southern | Asia | HIV Infections | Viral Diseases | Diseases | Population Characteristics | Demographic Factors | Population | Social Welfare | Economic Factors Document Number: 330154 |
| 9. Peer Reviewed Title: CD4+ response and subsequent risk of death among patients on antiretroviral therapy in Lusaka, Zambia. Author: Chi BH; Giganti M; Mulenga PL; Limbada M; Reid SE; Mutale W; Stringer JS Source: Journal of Acquired Immune Deficiency Syndromes. 2009 Sep 1;52(1):125-31. Abstract: INTRODUCTION: Where virologic monitoring is not routinely available, immunologic criteria are commonly used to determine treatment failure while on antiretroviral therapy (ART). However, few have studied CD4+ response and its relationship to subsequent clinical outcomes in a programmatic setting. METHODS: We analyzed cohort data from Zambia to investigate whether 6- and 12-month CD4+ response after ART initiation was associated with later mortality. We used Cox proportional hazards models that accounted for different strata of baseline CD4 counts and adjusted for age, sex, clinical stage, tuberculosis coinfection, baseline hemoglobin, initial ART regimen, and adherence behavior. RESULTS: We analyzed data from 2 cohorts, from 6 months onward (n = 24,366; median follow-up = 467 days, interquartile range 222-791) and from 12 months onward (n = 17,920; median follow-up = 423 days, interquartile range 191-689). In the post-6-month analysis, hazard for death was significantly higher when absolute CD4+ response was <100 cells per microliter [adjusted hazard ratio (AHR) = 2.25, 95% confidence interval (CI): 1.91 to 2.64], relative response was <10% above baseline (AHR = 2.60, 95% CI: 2.12 to 3.19), and absolute CD4+ count was <100 per microliter (AHR = 2.79, 95% CI: 2.26 to 3.45). In the post-12 month analysis, mortality was associated with rise in absolute CD4+ cell count <200 per microliter (AHR = 2.41, 95% CI: 1.83 to 3.17), relative rise in CD4+ cell count of <10% above baseline (AHR = 3.41, 95% CI: 2.51 to 4.64), and absolute CD4+ count at 12 months <100 per microliter (AHR = 4.11, 95% CI: 2.96 to 5.68). CONCLUSION: Commonly used definitions for immunologic treatment failure are associated with elevated mortality risk among patients on ART. Language: English Keywords: ZAMBIA | RESEARCH REPORT | COHORT ANALYSIS | CLIENTS | PERSONS LIVING WITH HIV/AIDS | DEATH RATE | HIV | MORTALITY | TREATMENT | ANTIRETROVIRAL THERAPY | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Research Methodology | Program Activities | Programs | Organization and Administration | HIV Infections | Viral Diseases | Diseases | Population Dynamics | Demographic Factors | Population | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 342891 |
| 10. Peer Reviewed Title: Comparison of laboratory methods for analysis of non-nucleoside reverse transcriptase inhibitor resistance in Ugandan infants. Author: Church JD; Huang W; Parkin N; Marlowe N; Guay LA; Omer SB; Musoke P; Jackson JB; Eshleman SH Source: AIDS Research and Human Retroviruses. 2009 Jul;25(7):657-63. Abstract: Detailed comparisons of HIV drug resistance assays are needed to identify the most useful assays for research studies, and to facilitate comparison of results from studies that use different methods. We analyzed nonnucleoside reverse transcriptase inhibitor (NNRTI) resistance in 40 HIV-infected Ugandan infants who had received nevirapine (NVP)-based prophylaxis using the following assays: an FDA-cleared HIV genotyping assay (the ViroSeq HIV-1 Genotyping System v2.0), a commercially available HIV genotyping assay (GeneSeq HIV), a commercially available HIV phenotyping assay (PhenoSense HIV), and a sensitive point mutation assay (LigAmp). ViroSeq and GeneSeq HIV results (NVP resistance yes/no) were similar for 38 (95%) of 40 samples. In 6 (15%) of 40 samples, GeneSeq HIV detected mutations in minor subpopulations that were not detected by ViroSeq, which identified two additional infants with NVP resistance. LigAmp detected low-level mutations in 12 samples that were not detected by ViroSeq; however, LigAmp testing identified only one additional infant with NVP resistance. GeneSeq HIV and PhenoSense HIV determinations of susceptibility differed for specific NNRTIs in 12 (31%) of the 39 samples containing mixtures at relevant mutation positions. PhenoSense HIV did not detect any infants with NVP resistance who were not identified with GeneSeq HIV testing. In this setting, population sequencing-based methods (ViroSeq and GeneSeq HIV) were the most informative and had concordant results for 95% of the samples. LigAmp was useful for the detection and quantification of minority variants. PhenoSense HIV provided a direct and quantitative measure of NNRTI susceptibility. Language: English Keywords: UGANDA | RESEARCH REPORT | DATA ANALYSIS | COMPARATIVE STUDIES | RESEARCH METHODOLOGY | INFANT | PERSONS LIVING WITH HIV/AIDS | HIV | POPULATION GENETICS | LABORATORY PROCEDURES | HIV TESTING | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Studies | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | Genetics | Biology | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 342880 |
| 11. Title: Variations in the frequencies of torque teno virus subpopulations during HAART treatment in HIV-1-coinfected patients. Author: Devalle S; Rua F; Morgado MG; Niel C Source: Archives of Virology. 2009;154(8):1285-91. Abstract: Sera from 15 patients coinfected with TTV and HIV-1, collected before and at two times after introduction of highly active anti-retroviral therapy (HAART), were tested for TTV load and the presence of the five highly divergent TTV phylogenetic groups. Seven patients showed a 1-5 log TTV load decrease during HAART, while the others did not show significant variations. A decrease in the number of coinfecting TTV genogroups was detected in 12 of 15 patients, with the mean number of TTV genogroups/patient decreasing from 2.33 before HAART to 1.47 at the last collect. All five genogroups were less frequently found after introduction of HAART. Three hundred sixty-seven TTV clones from four different genogroups, derived from two patients, were sequenced. Noticeable fluctuations in TTV subpopulation frequencies were observed in both patients analyzed. In conclusion, HAART tends to reduce the number of TTV genotypes/genogroups and may affect the balance between different TTV isolates coinfecting single individuals. Language: English Keywords: BRAZIL | RESEARCH REPORT | CLIENTS | PERSONS LIVING WITH HIV/AIDS | ANTIRETROVIRAL THERAPY | HIV TESTING | HIV | LABORATORY PROCEDURES | South America, Eastern | South America | Latin America | Americas | Developing Countries | Program Activities | Programs | Organization and Administration | HIV Infections | Viral Diseases | Diseases | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 342971 |
| 12. Title: CD4 validation for the World Health Organization classification and clinical staging of HIV/AIDS in a developing country. Author: Edathodu J; Ali B; Alrajhi AA Source: International Journal of Infectious Diseases. 2009 Mar;13(2):243-6. Abstract: OBJECTIVES: To validate the World Health Organization (WHO) clinical staging and classification of HIV/AIDS using CD4+ T-lymphocyte counts in the setting of a developing country. METHODS: This was a retrospective chart review of HIV-infected adults at the national HIV referral clinic in the Kingdom of Saudi Arabia. Four hundred HIV-infected individuals were reviewed. All individuals under the age of 15 years and those who had received antiretroviral therapy were excluded. WHO clinical stage at presentation was determined by a single reviewer. The first CD4+ T-lymphocyte count within 6 months of diagnosis of HIV infection was then abstracted by a different reviewer. The main outcome measure was the comparison of the WHO clinical stages of HIV/AIDS at the time of diagnosis and the CD4+ T-lymphocyte counts. RESULTS: Data were available for 191 individuals, of whom 123 were men and 68 were women. The mean CD4+ T-lymphocyte count was 281/mm(3) in the men and 425/mm(3) in the women. The distribution of individuals at the WHO clinical stages was 110 at stage I, 10 at stage II, 36 at stage III, and 35 at stage IV. Mean CD4+ T-lymphocyte counts were 457, 337, 188, and 86/mm(3) at the respective stages. The difference between the mean CD4+ T-lymphocyte count in patients at stage IV and at each of the other stages was significant; p<0.0001. The correlation between the stages and the mean CD4+ T-lymphocyte counts was -0.65. CONCLUSION: The WHO clinical staging and classification of HIV/AIDS correlates well with CD4+ T-lymphocyte counts. Language: English Keywords: SAUDI ARABIA | RESEARCH REPORT | WHO | VALIDITY | HIV | AIDS | TESTING | IMMUNITY | Middle East | Developing Countries | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors | Measurement | Research Methodology | HIV Infections | Viral Diseases | Diseases | Immune System | Physiology | Biology Document Number: 341557 |
| 13. Title: Seroprevalence of human immunodeficiency virus and syphilis in blood donors of Delhi [letter] Author: Ekadashi R; Langer S Source: Indian Journal of Medical Microbiology. 2009 Apr-Jun;27(2):167-8. Abstract: Transfusion of blood and blood products is a life saving measure that benefits numerous patients worldwide. At the same time it is an important mode of infection to the recipients. In up to 15% of the total patients infected with human immunodeficiency virus (HIV), blood transfusion has been the route of transmission. Syphilis positivity varies from 0.8% in voluntary donors to more than 15% in paid commercial donors. Although HIV infection has been reported in all groups of blood donors in Delhi, it is particularly high among replacement donors. Concealing the medical history by professional or replacement donors pose a great threat to safe blood supply. Problems are also due to the prevalence of asymptomatic carriers in the society, blood donations during the window period, genetic variability in the viral strains and laboratory errors. Only few reports are available regarding the trend of HIV seropositivity and syphilis serology, particularly in blood donors from northern India. In this study, we aimed to assess the prevalence and trend of HIV and syphilis over 4 years, 2004-2007, among blood donors of Central Delhi. A total of 13,672 blood units were collected from blood donors during the period from January 1 2004 to December 31 2007 at the blood bank of Delhi Heart and Lung Institute in New Delhi, India. This is a tertiary care level hospital super specializing in heart and lung ailments. Blood donors were either replacement or voluntary. Care was taken to exclude professional donors by taking appropriate history and examination. (excerpt) Language: English Keywords: INDIA | CRITIQUE | BLOOD DONORS | HIV TRANSMISSION | SYPHILIS | HIV | LABORATORY PROCEDURES | SCREENING | SAFETY | PREVENTION AND CONTROL | Asia, Southern | Asia | Developing Countries | Blood Supply | Equipment and Supplies | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | HIV Infections | Viral Diseases | Diseases | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Public Health Document Number: 341204 |
| 14. Peer Reviewed Title: "When in the body, it makes you look fat and HIV negative": the constitution of antiretroviral therapy in local discourse among youth in Kahe, Tanzania. Author: Ezekiel MJ; Talle A; Juma JM; Klepp K Source: Social Science and Medicine. 2009 Mar;68(5):957-964. Abstract: Antiretroviral therapy (ART) is becoming increasingly more accessible within the health care system in Tanzania. However, the impact of the increased availability of ART on local conceptions about medicines, health and physical wellbeing has not been fully explored. In this article we examine how ART is constituted within local discourses about treatment and healing. Based on 21 focus group discussions with young people aged 14-24 years in a rural area (Kahe), we examine how local terms and descriptions of antiretroviral therapy relate to wider definitions about the body, health, illness and drug efficacy. Findings illustrate how local understandings of ART draw on a wider discourse about the therapeutic functions of medicines and clinical dimensions of HIV/AIDS. Therapeutic efficacy of antiretroviral medication appeared to overlap and sometimes contradict locally shared understandings of the clinical functions of medicines in the body. Implications of ART on bodily appearance and HIV signs may influence conceptions about sick role, perpetuate stigma and affect local strategies for HIV prevention. Structural inequities in access, limited information on therapeutic efficacy of ART and perceived difficulties with status disclosure appear to inform local conceptions and possible implications of ART. Policy and programme interventions to foster public understanding and acceptability of ART should emphasize treatment education about the benefits and limitations of therapy and increased access to ART in rural areas, and should integrate voluntary status disclosure and HIV prevention. (author's) Language: English Keywords: TANZANIA | RESEARCH REPORT | FOCUS GROUPS | RURAL AREAS | YOUTH | ANTIRETROVIRAL THERAPY | HIV INFECTIONS | HIV | STIGMA | SELF-PERCEPTION | TREATMENT | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Data Collection | Research Methodology | Geographic Factors | Population | Age Factors | Population Characteristics | Demographic Factors | Viral Diseases | Diseases | Social Problems | Sociocultural Factors | Perception | Psychological Factors | Behavior | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 325348 |
| 15. Peer Reviewed Title: The integration of STD/HIV services with contraceptive services for young women in the United States. Author: Farr SL; Kraft JM; Warner L; Anderson JE; Jamieson DJ Source: American Journal of Obstetrics and Gynecology. 2009 May 28; Abstract: OBJECTIVE: The purpose of this study was to estimate the national prevalence and predictors of sexually transmitted disease/human immunodeficiency virus (STD/HIV) service receipt in the preceding year among young women who received contraceptive services. STUDY DESIGN: Weighted self-reported data from the 2002 National Survey of Family Growth was used to estimate the prevalence and multivariable odds ratios for the receipt of STD/HIV services among 1009 unmarried, sexually active 15- to 24-year-old women who received contraceptive services. RESULTS: Of the women who received contraceptive services, 35% (2.7 million) did not receive STD/HIV services. Predictors of the receipt of STD/HIV services included younger age at first sexual intercourse (/= 2 partners in the past year (aOR, 2.6), receipt of a pregnancy test or abortion in the past year (aOR, 2.3), and having visited a Title X clinic in the last 12 months (aOR, 3.3). CONCLUSION: Interventions are needed to help integrate contraceptive and STD/HIV services. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | ADOLESCENTS | YOUTH | WOMEN | CONTRACEPTION | HIV | REPRODUCTIVE HEALTH | HEALTH SERVICES | SEXUALLY TRANSMITTED DISEASES | Developed Countries | North America | Americas | Age Factors | Population Characteristics | Demographic Factors | Population | Family Planning | HIV Infections | Viral Diseases | Diseases | Health | Delivery of Health Care | Reproductive Tract Infections | Infections Document Number: 341571 |
| 16. Peer Reviewed Title: HIV prevalence and mortality among children undergoing treatment for severe acute malnutrition in sub-Saharan Africa: a systematic review and meta-analysis. Author: Fergusson P; Tomkins A Source: Transactions of the Royal Society of Tropical Medicine and Hygiene. 2009 Jun;103(6):541-8. Abstract: This systematic review and meta-analysis explored HIV prevalence and mortality in children undergoing treatment for severe acute malnutrition (SAM) in sub-Saharan Africa. It included all studies reporting on HIV infection within a sample of children with SAM where HIV status was assessed using a blood test and SAM was defined using the WHO, Gomez, Wellcome or Waterlow definitions. Children from 17 studies were included in the analysis (n=4891), of whom 29.2% were HIV-infected. HIV-infected children were significantly more likely to die than HIV-uninfected children (30.4% vs. 8.4%; P<0.001; relative risk=2.81, 95% CI 2.04-3.87). HIV-negative children treated within community-based therapeutic care (CTC) programmes had lower mortality (4.3%) than those treated within an inpatient nutrition rehabilitation unit (NRU) (15.1%). There was no significant difference in mortality for HIV-infected children with SAM treated in the CTC (30.0%) or NRU (31.3%) settings. HIV prevalence is high in children with SAM in sub-Saharan Africa, and HIV-infected children are at significantly increased risk of mortality. There is an urgent need to integrate HIV testing and treatment into care for children with SAM in regions of high HIV prevalence. Language: English Keywords: AFRICA | RESEARCH REPORT | PREVALENCE | CHILD | CHILD MORTALITY | MALNUTRITION | HIV INFECTIONS | HIV TESTING | TESTING | HIV | RISK FACTORS | TREATMENT | Developing Countries | Measurement | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Mortality | Population Dynamics | Nutrition Disorders | Diseases | Viral Diseases | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 342751 |
| 17. Title: Staged introduction of antiretroviral therapy into a family with multiple HIV-infected members. Author: Fielder JF; Kwatampora L Source: Journal of the International Association of Physicians in AIDS Care. 2009 Jan-Feb;8(1):68-72. Abstract: Children and families bear a significant burden of human immunodeficiency virus disease globally, particularly in sub-Saharan Africa. Care of severely affected families can be adversely impacted by high medication burdens and overwhelmed caregivers, who themselves may be human immunodeficiency virus infected. Family-centered care involving joint clinic days, treatment preparation, adherence counseling, and community-based follow-up may improve the care of family units. We describe the successful treatment of a single family composed of 6 infected members living in a rural African setting. Language: English Keywords: AFRICA | RESEARCH REPORT | PERSONS LIVING WITH HIV/AIDS | NUCLEAR FAMILY | HIV | ANTIRETROVIRAL THERAPY | USER COMPLIANCE | Developing Countries | HIV Infections | Viral Diseases | Diseases | Family Characteristics | Family and Household | Sociocultural Factors | Behavior Document Number: 331332 |
| 18. Peer Reviewed Title: Role of breastfeeding cessation in mediating the relationship between maternal HIV disease stage and increased child mortality among HIV-exposed uninfected children. Author: Fox MP; Brooks DR; Kuhn L; Aldrovandi G; Sinkala M; Kankasa C; Horsburgh R; Thea DM Source: International Journal of Epidemiology. 2009 Apr;38(2):569-76. Abstract: BACKGROUND: Maternal CD4 count predicts child mortality in HIV-uninfected children born to HIV-infected women. METHODS: To explore the mediating role of breastfeeding cessation in this relationship, we compared marginal structural models of maternal CD4 count on child death with and without adjustment for breastfeeding. RESULTS: In crude analyses, children of mothers with CD4<200 during pregnancy were 3.2 times more likely to die by 18 months (CI 1.3-8.1) as children whose mothers had CD4>500. Earlier breastfeeding cessation was also associated with low CD4 (HR 1.8; CI 1.2-2.7). After adjusting for breastfeeding and low birth weight using a marginal structural model, the low CD4 count-child mortality association through 18 months was reduced 17%. The change was overestimated using a traditional Cox proportional hazards model (35% reduction in HR from 3.4 to 2.5). CONCLUSIONS: Our analysis suggests that only a small part of the effect of low vs high CD4 count on child mortality through 18 months is mediated through breastfeeding cessation. Our results must be taken into account when deciding whether or not to recommend breastfeeding for infants of HIV-infected mothers. Language: English Keywords: AFRICA | RESEARCH REPORT | DATA ANALYSIS | CHILDREN | CHILD MORTALITY | BREASTFEEDING | INFANT MORTALITY | HIV | RESEARCH METHODOLOGY | Developing Countries | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Mortality | Population Dynamics | Infant Nutrition | Nutrition | Health | HIV Infections | Viral Diseases | Diseases Document Number: 341015 |
| 19. Peer Reviewed Title: Population-level effect of potential HSV2 prophylactic vaccines on HIV incidence in sub-Saharan Africa. Author: Freeman EE; White RG; Bakker R; Orroth KK; Weiss HA; Buve A; Hayes RJ; Glynn JR Source: Vaccine. 2009 Feb 5;27(6):940-6. Abstract: Herpes simplex virus type-2 (HSV2) infection increases HIV transmission. We explore the impact of a potential prophylactic HSV2 vaccination on HIV incidence in Africa using STDSIM an individual-based model. A campaign that achieved 70% coverage over 5 years with a vaccine that reduced susceptibility to HSV2 acquisition and HSV2 reactivation by 75% for 10 years, reduced HIV incidence by 30-40% after 20 years (range 4-66%). Over 20 years, in most scenarios fewer than 100 vaccinations were required to avert one HIV infection. HSV2 vaccines could have a substantial impact on HIV incidence. Intensified efforts are needed to develop an effective HSV2 vaccine. Language: English Keywords: AFRICA, SUB SAHARAN | RESEARCH REPORT | INCIDENCE | HIV | HIV INFECTIONS | HIV PREVENTION | VACCINES | Africa | Developing Countries | Measurement | Research Methodology | Viral Diseases | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 330823 |
| 20. Title: Incidence of common opportunistic infections in HIV-infected individuals in Pune, India: analysis by stages of immunosuppression represented by CD4 counts. Author: Ghate M; Deshpande S; Tripathy S; Nene M; Gedam P; Godbole S; Thakar M; Risbud A; Bollinger R; Mehendale S Source: International Journal of Infectious Diseases. 2009 Jan;13(1):e1-8. Abstract: BACKGROUND: Opportunistic infections (OIs) influence the morbidity and mortality due to HIV infections. Data from India on the incidence of OIs among HIV-infected individuals by stages of immunodeficiency are scarce. METHODS: Between September 2002 and November 2004, HIV-infected individuals were enrolled in a prospective study in Pune. They were clinically and immunologically evaluated quarterly. Incidence rates of specific OIs were calculated. RESULTS: Median CD4 counts in HIV-infected male and female patients at baseline were 197/mm(3) and 413/mm(3), respectively. Tuberculosis was the most common OI with an incidence of 15.4 (95% CI 12.2-19.2) per 100 person-years, followed by oral candidiasis 11.3 (95% CI 8.6-14.5), herpes zoster 10.1 (95% CI 7.6-13.1), and cryptococcal meningitis 1.7 (95% CI 0.8-3.1) per 100 person-years. Patients with baseline CD4 counts of <200/mm(3) were six times more likely to develop OIs compared to those with CD4 counts of >350/mm(3) (p<0.001). CONCLUSIONS: The high incidence of commonly reported OIs in Indian HIV-infected individuals highlights the need for early screening and also the need to increase awareness in healthcare providers, in order to improve decisions regarding prophylaxis for prevention and appropriate therapeutic intervention. Emphasis needs to be given to the early diagnosis and management of tuberculosis in HIV-infected individuals. Language: English Keywords: INDIA | RESEARCH REPORT | INCIDENCE | PERSONS LIVING WITH HIV/AIDS | HIV INFECTIONS | HIV | IMMUNOLOGIC FACTORS | LABORATORY PROCEDURES | Developing Countries | Asia, Southern | Asia | Measurement | Research Methodology | Persons Living With HIV/AIDS | Viral Diseases | Diseases | Immunity | Immune System | Physiology | Biology | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 329688 |
| 21. Peer Reviewed Title: Calicivirus and Giardia lamblia are associated with diarrhea in human immunodeficiency virus-seropositive patients from southeast Brazil. Author: Goncalves AC; Gabbay YB; Mascarenhas JD; Yassaka MB; Moran LC; Fraga VD; Castro E; Franco C; Machado RL; Rossit AR Source: American Journal of Tropical Medicine and Hygiene. 2009 Sep;81(3):463-6. Abstract: To study enteropathogens, 100 fecal samples were collected from a Brazilian human immunodeficiency virus (HIV)-seropositive population, with or without diarrhea. Giardia lamblia and calicivirus were significantly associated with diarrhea as were severe immunosuppression and the presence of at least one enteropathogen. No sample was positive for rotavirus and only one asymptomatic individual carried the astrovirus. We concluded that there is a great diversity of pathogens and opportunistic infections in the studied population, with a high prevalence of mixed colonization/infection. Our findings pave the way for future molecular studies related to the expression of virulence factors and to the possibility of pathogen-pathogen interactions, especially between G. lamblia and calicivirus. These findings are relevant to the improvement of therapies and controlling diarrhea in the HIV-seropositive population. Language: English Keywords: BRAZIL | RESEARCH REPORT | LABORATORY PROCEDURES | HIV | ROTAVIRUS | DIARRHEA | TREATMENT | PREVENTION AND CONTROL | South America, Eastern | South America | Latin America | Americas | Developing Countries | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | HIV Infections | Viral Diseases | Diseases Document Number: 342873 |
| 22. Peer Reviewed Title: Universal voluntary HIV testing with immediate antiretroviral therapy as a strategy for elimination of HIV transmission: a mathematical model. Author: Granich RM; Gilks CF; Dye C; De Cock KM; Williams BG Source: Lancet. 2009 Jan 3;373(9657):48-57. Abstract: BACKGROUND: Roughly 3 million people worldwide were receiving antiretroviral therapy (ART) at the end of 2007, but an estimated 6.7 million were still in need of treatment and a further 2.7 million became infected with HIV in 2007. Prevention efforts might reduce HIV incidence but are unlikely to eliminate this disease. We investigated a theoretical strategy of universal voluntary HIV testing and immediate treatment with ART, and examined the conditions under which the HIV epidemic could be driven towards elimination. METHODS: We used mathematical models to explore the effect on the case reproduction number (stochastic model) and long-term dynamics of the HIV epidemic (deterministic transmission model) of testing all people in our test-case community (aged 15 years and older) for HIV every year and starting people on ART immediately after they are diagnosed HIV positive. We used data from South Africa as the test case for a generalised epidemic, and assumed that all HIV transmission was heterosexual. FINDINGS: The studied strategy could greatly accelerate the transition from the present endemic phase, in which most adults living with HIV are not receiving ART, to an elimination phase, in which most are on ART, within 5 years. It could reduce HIV incidence and mortality to less than one case per 1000 people per year by 2016, or within 10 years of full implementation of the strategy, and reduce the prevalence of HIV to less than 1% within 50 years. We estimate that in 2032, the yearly cost of the present strategy and the theoretical strategy would both be US$1.7 billion; however, after this time, the cost of the present strategy would continue to increase whereas that of the theoretical strategy would decrease. INTERPRETATION: Universal voluntary HIV testing and immediate ART, combined with present prevention approaches, could have a major effect on severe generalised HIV/AIDS epidemics. This approach merits further mathematical modelling, research, and broad consultation. Language: English Keywords: GLOBAL | SOUTH AFRICA | RESEARCH REPORT | INCIDENCE | MATHEMATICAL MODEL | PERSONS LIVING WITH HIV/AIDS | ANTIRETROVIRAL THERAPY | HIV TESTING | HIV PREVENTION | HIV | TREATMENT | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Measurement | Research Methodology | Theoretical Models | HIV Infections | Viral Diseases | Diseases | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 329719 |
| 23. Title: Factors associated with increased prevalence of human papillomavirus infection in a cohort of HIV-infected Brazilian women. Author: Grinsztejn B; Veloso VG; Levi JE; Velasque L; Luz PM; Friedman RK; Andrade AC; Moreira RI; Russomano F; Pilotto JH; Bastos FI; Palefsky J Source: International Journal of Infectious Diseases. 2009 Jan;13(1):72-80. Abstract: OBJECTIVES: Human papillomavirus (HPV) infection is a major risk factor for cervical disease. Using baseline data from the HIV-infected cohort of Evandro Chagas Clinical Research Institute at Fiocruz, Rio de Janeiro, Brazil, factors associated with an increased prevalence of HPV were assessed. METHODS: Samples from 634 HIV-infected women were tested for the presence of HPV infection using hybrid capture II and polymerase chain reaction. Prevalence ratios (PR) were estimated using Poisson regression analysis with robust variance. RESULTS: The overall prevalence of HPV infection was 48%, of which 94% were infected with a high-risk HPV. In multivariate analysis, factors independently associated with infection with high-risk HPV type were: younger age (<30 years of age; PR 1.5, 95% confidence interval (CI) 1.1-2.1), current or prior drug use (PR 1.3, 95% CI 1.0-1.6), self-reported history of HPV infection (PR 1.2, 95% CI 0.96-1.6), condom use in the last sexual intercourse (PR 1.3, 95% CI 1.1-1.7), and nadir CD4+ T-cell count <100cells/mm(3) (PR 1.6, 95% CI 1.2-2.1). CONCLUSIONS: The estimated prevalence of high-risk HPV-infection among HIV-infected women from Rio de Janeiro, Brazil, was high. Close monitoring of HPV-related effects is warranted in all HIV-infected women, in particular those of younger age and advanced immunosuppression. Language: English Keywords: BRAZIL | RESEARCH REPORT | LABORATORY PROCEDURES | PREVALENCE | MULTIVARIATE ANALYSIS | WOMEN | PERSONS LIVING WITH HIV/AIDS | HPV | HIV | AGE FACTORS | Developing Countries | South America, Eastern | South America | Latin America | Americas | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Measurement | Research Methodology | Data Analysis | Demographic Factors | Population | Persons Living With HIV/AIDS | HIV Infections | Viral Diseases | Diseases | Population Characteristics Document Number: 329678 |
| 24. Peer Reviewed Title: Adherence to anti retroviral therapy (ART) during Muslim Ramadan fasting. Author: Habib AG; Shepherd JC; Eng MK; Babashani M; Jumare J; Yakubu U; Gebi UI; Saad M; Ibrahim H; Blattner WA Source: AIDS and Behavior. 2009 Feb;13(1):42-45. Abstract: Annual fasting during the month of Ramadan is observed in Muslim countries, some of which have widespread HIV infection. We studied treatment adherence and customary practices among 142 fasting 'FT' and 101 nonfasting 'NFT' patients on anti-retroviral therapy (ART) in Nigeria. Adherence on ART among FT and NFT patients was similar during Ramadan, 96% and 98%, and ever since commencement of ART, 80% and 88%, respectively. FT patients altered their typical daily behaviors by advancing morning and delaying evening doses thereby prolonging dosing intervals, eating heavier meals pre-dawn and on breakfast at sunset (78%), and changing or reducing their sleeping and waking times (40%). This preliminary study suggests that adherence and drug taking frequency appear uncompromised in FT HIV infected patients on ARVs. Language: English Keywords: ETHIOPIA | KENYA | NIGERIA | SOMALIA | SOUTH AFRICA | TANZANIA | UGANDA | RESEARCH REPORT | PERSONS LIVING WITH HIV/AIDS | ISLAM | HIV | ANTIRETROVIRAL THERAPY | USER COMPLIANCE | RELIGION | CULTURE | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Africa, Western | Africa, Southern | HIV Infections | Viral Diseases | Diseases | Sociocultural Factors | Behavior Document Number: 330156 |
| 25. Peer Reviewed Title: Performance of clinical algorithms for HIV-1 diagnosis and antiretroviral initiation among HIV-1-exposed children aged less than 18 months in Kenya. Author: Inwani I; Mbori-Ngacha D; Nduati R; Obimbo E; Wamalwa D; John-Stewart G; Farquhar C Source: Journal of Acquired Immune Deficiency Syndromes. 2009 Apr 15;50(5):492-8. Abstract: BACKGROUND: Ninety percent of HIV-1-infected children live in sub-Saharan Africa. In the absence of diagnosis and antiretroviral therapy, approximately 50% die before 2 years. METHODS: We evaluated sensitivity and specificity of clinical algorithms for diagnosis of HIV-1 infection and antiretroviral therapy initiation among HIV-1-exposed children aged less than 18 months. Children were identified with routine HIV-1 testing and assessed using 3 sets of criteria: (1) Integrated Management of Childhood Illnesses (IMCI), (2) World Health Organization Presumptive Diagnosis (WHO-PD) for HIV-1 infection, and (3) CD4 T-lymphocyte cell subsets. HIV-1 infection status was determined using DNA polymerase chain reaction testing. FINDINGS: A total of 1418 children (median age 5.4 months) were screened for HIV-1 antibodies, of whom 144 (10.2%) were seropositive. Of these, 134 (93%) underwent HIV-1 DNA testing and 80 (60%) were found to be HIV-1 infected. Compared with HIV-1 DNA testing, sensitivity and specificity of the IMCI criteria were 19% and 96% and for WHO-PD criteria 43% and 88%, respectively. Inclusion of severe immune deficiency determined by CD4% improved sensitivity of IMCI and WHO-PD criteria to 74% and 84%, respectively; however, specificity declined to 43% and 41%, respectively. INTERPRETATION: Diagnosis of HIV-1 infection among exposed children less than 18 months in a high-prevalence resource-limited setting remains a challenge, and current recommended algorithms have low sensitivity. This underscores the need for rapid scale-up of viral assays for early infant diagnosis. Language: English Keywords: KENYA | RESEARCH REPORT | CLINICAL RESEARCH | INFANT | HIV | EXAMINATIONS AND DIAGNOSES | EXPOSURE | LABORATORY PROCEDURES | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Risk Factors | Laboratory Examinations and Diagnoses Document Number: 331222 |
| 26. Title: Heterosexual transmission of human immunodeficiency virus type 1 subtype C: Macrophage tropism, alternative coreceptor use, and the molecular anatomy of CCR5 utilization. Author: Isaacman-Beck J; Hermann EA; Yi Y; Ratcliffe SJ; Mulenga J; Allen S; Hunter E; Derdeyn CA; Collman RG Source: Journal of Virology. 2009 Aug;83(16):8208-20. Abstract: Human immunodeficiency virus type 1 transmission selects for virus variants with genetic characteristics distinct from those of donor quasispecies, but the biological factors favoring their transmission or establishment in new hosts are poorly understood. We compared primary target cell tropisms and entry coreceptor utilizations of donor and recipient subtype C Envs obtained near the time of acute infection from Zambian heterosexual transmission pairs. Both donor and recipient Envs demonstrated only modest macrophage tropism, and there was no overall difference between groups in macrophage or CD4 T-cell infection efficiency. Several individual pairs showed donor/recipient differences in primary cell infection, but these were not consistent between pairs. Envs had surprisingly broad uses of GPR15, CXCR6, and APJ, but little or no use of CCR2b, CCR3, CCR8, GPR1, and CXCR4. Donors overall used GPR15 better than did recipients. However, while several individual pairs showed donor/recipient differences for GPR15 and/or other coreceptors, the direction of the differences was inconsistent, and several pairs had unique alternative coreceptor patterns that were conserved across the transmission barrier. CCR5/CCR2b chimeras revealed that recipients as a group were more sensitive than were donors to replacement of the CCR5 extracellular loops with corresponding regions of CCR2b, but significant differences in this direction were not consistent within pairs. These data show that sexual transmission does not select for enhanced macrophage tropism, nor for preferential use of any alternative coreceptor. Recipient Envs are somewhat more constrained than are donors in flexibility of CCR5 use, but this pattern is not universal for all pairs, indicating that it is not an absolute requirement. Language: English Keywords: ZAMBIA | RESEARCH REPORT | HIV TRANSMISSION | HETEROSEXUALS | GENETICS | HIV | LABORATORY PROCEDURES | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | HIV Infections | Viral Diseases | Diseases | Sex Behavior | Behavior | Biology | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 342733 |
| 27. Peer Reviewed Title: Molecular phylogenetics of nearly full-length HIV type 2 envelope gene sequences from West India. Author: Jadhav S; Tripathy S; Kulkarni S; Agnihotri K; Risbud A; Paranjape R Source: AIDS Research and Human Retroviruses. 2009 Jan;25(1):115-21. Abstract: Abstract While infection with HIV-1 has become a pandemic, the presence of HIV-2 is also of concern in certain regions of the world. We have characterized the gp105 region of the envelope gene of HIV-2 isolates from Western India. Phylogenetic analysis of all 18 sequences revealed that these sequences were closely related to each other as well as to published African and European HIV-2 group A sequences, with an overall genetic divergence of 10.9% (range 2-14%). Our study sequences showed close relatedness with West African HIV-2 group A (CAM group) sequences from Guinea Bissau with 89% homology. This was further confirmed by SimPlot as well as RIP analysis. Accordingly, the sequences presented here demonstrate the predominance of HIV-2 group A infection and show no evidence of HIV-2 recombination in Western India. Language: English Keywords: INDIA | GUINEA-BISSAU | RESEARCH REPORT | CLINICAL RESEARCH | EPIDEMIOLOGIC METHODS | GENETIC TECHNIQUES | PERSONS LIVING WITH HIV/AIDS | HIV | GENETICS | PREVALENCE | Developing Countries | Asia, Southern | Asia | Africa, Western | Africa, Sub Saharan | Africa | Research Methodology | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Persons Living With HIV/AIDS | HIV Infections | Viral Diseases | Diseases | Biology | Measurement Document Number: 330229 |
| 28. Title: Virological response to highly active antiretroviral therapy in patients infected with human immunodeficiency virus type 2 (HIV-2) and in patients dually infected with HIV-1 and HIV-2 in the Gambia and emergence of drug-resistant variants. Author: Jallow S; Alabi A; Sarge-Njie R; Peterson K; Whittle H; Corrah T; Jaye A; Cotten M; Vanham G; McConkey SJ; Rowland-Jones S; Janssens W Source: Journal of Clinical Microbiology. 2009 Jul;47(7):2200-8. Abstract: Drug design, antiretroviral therapy (ART), and drug resistance studies have focused almost exclusively on human immunodeficiency virus type 1 (HIV-1), resulting in limited information for patients infected with HIV-2 and for those dually infected with HIV-1 and HIV-2. In this study, 20 patients, 12 infected with HIV-2 and 8 dually infected with HIV-1 and HIV-2, all treated with zidovudine (ZDV), lamivudine (3TC), and lopinavir-ritonavir (LPV/r), were followed up longitudinally for about 3 years. For 19/20 patients, viral loads were reduced to undetectable levels; the patient whose viral load remained detectable reported adverse effects associated with LPV/r that had caused him to stop taking all the drugs. HIV-2 strains containing mutations in both the protease and the reverse transcriptase gene that may confer drug resistance were observed in two patients with viral rebound, as early as 130 days (4.3 months) after the initiation of therapy. We conclude that the combination of ZDV, 3TC, and LPV/r is able to provide efficient and durable suppression of HIV-1 and HIV-2 for as long as 3 years in HIV-2-infected and dually infected patients. However, the emergence of HIV-1 and HIV-2 strains containing drug-resistant mutations can compromise the efficacy of this highly active ART. Language: English Keywords: GAMBIA | RESEARCH REPORT | LONGITUDINAL STUDIES | CLIENTS | PERSONS LIVING WITH HIV/AIDS | HIV | ANTIRETROVIRAL THERAPY | ANTIRETROVIRAL DRUGS | DRUG RESISTANCE | TREATMENT | CONTRACEPTIVE USE-EFFECTIVENESS | Africa, Western | Africa, Sub Saharan | Africa | Developing Countries | Studies | Research Methodology | Program Activities | Programs | Organization and Administration | HIV Infections | Viral Diseases | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Contraceptive Effectiveness | Contraception | Family Planning Document Number: 342659 |
| 29. Peer Reviewed Title: Factors associated with tuberculosis treatment default among HIV-infected tuberculosis patients in Thailand. Author: Kittikraisak W; Burapat C; Kaewsa-ard S; Watthanaamornkiet W; Sirinak C; Sattayawuthipong W; Jittimanee S; Pobkeeree V; Varma JK Source: Transactions of the Royal Society of Tropical Medicine and Hygiene. 2009 Jan;103(1):59-66. Abstract: Ensuring completion of tuberculosis (TB) treatment remains a major public health problem. In HIV-infected patients, TB is the most common severe opportunistic infection. Few studies have evaluated risk factors for TB treatment default in HIV-infected patients. We conducted a prospective, observational study of HIV-infected TB patients in Thailand. Patients underwent standardised evaluations at the beginning of TB treatment, at the end of the intensive phase and at the end of TB treatment. TB treatment outcomes were assessed according to WHO guidelines. The analysis was limited to patients who defaulted or who had treatment success. Of the 554 patients analysed, 61 (11%) defaulted. In multivariate analysis, factors associated with TB treatment default included incarceration history [adjusted odds ratio (AOR) 2.0, 95% CI 1.1-3.7), smoking (AOR 2.3, 95% CI 1.3-4.1) and having a symptom complaint score >15 (AOR 3.4, 95% CI 1.4-8.0); one marker of wealth, namely owning a refrigerator, was protective (AOR 0.4, 95% CI 0.2-0.8). Default during TB treatment was a significant problem in HIV-infected patients. Reducing default may require enhancing services for patients with a history of incarceration or smoking and designing patient-centred systems to address poverty and patient wellness. Language: English Keywords: THAILAND | RESEARCH REPORT | RISK ASSESSMENT | PERSONS LIVING WITH HIV/AIDS | HIV | AIDS | TUBERCULOSIS | DIRECTLY OBSERVED THERAPY SHORT-COURSE (DOTS) | Developing Countries | Asia, Southeastern | Asia | Evaluation | HIV Infections | Viral Diseases | Diseases | Infections | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 330836 |
| 30. Title: Mother to child transmission of HIV-1 in a Thai population: role of virus characteristics and maternal humoral immune response. Author: Kittinunvorakoon C; Morris MK; Neeyapun K; Jetsawang B; Buehring GC; Hanson CV Source: Journal of Medical Virology. 2009 May;81(5):768-78. Abstract: The objective of this study was to investigate factors influencing mother to child transmission of HIV-1 in Thailand, where HIV-1 CRF01_AE, the major subtype in Southeast Asia, predominates. Samples from 84 HIV-1 infected, anti-retroviral treatment-naive, non-breast feeding mothers, 28 who transmitted HIV-1 to their babies (transmitters) and 56 who did not (non-transmitters), were studied for maternal humoral immune response and virus characteristics. Maternal humoral immune response was measured by lymphocyte phenotyping; neutralizing antibodies to laboratory HIV-1 MN strain and two clinical isolates; peptide binding antibody to gp41 and V3 from strains CRF01_AE, B, and MN; autologous antibodies; and quasispecies diversity. Virus characteristics studied were viral load, co-receptor usage, and viral replication capacity. No significant difference between transmitters and non-transmitters was found for any parameter of maternal humoral immune response. However, viral load and viral replication capacity were significantly higher in transmitters versus non-transmitters and were not correlated with each other. This suggests that viral replication capacity may be a transmission factor independent of viral load, which is already well established as a risk factor for transmission of HIV-1. All except four viral isolates used the CCR5 co-receptor. This is one of few studies of vertical transmission in a population where HIV-1 CRF01_AE predominates. The data suggest that in this population the maternal humoral immune response was not important in preventing transmission at parturition, but that virus characteristics were key factors, and that viral replication capacity may contribute to birth-associated mother to child transmission of HIV-1. Language: English Keywords: THAILAND | RESEARCH REPORT | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | HIV | AUTOIMMUNE RESPONSE | HIV TRANSMISSION | Developing Countries | Asia, Southeastern | Asia | Disease Transmission Control | Prevention and Control | Diseases | HIV Infections | Viral Diseases | Antibodies | Immunologic Factors | Immunity | Immune System | Physiology | Biology Document Number: 341024 |
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