Search results for “Immunodeficiency

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27 articles

Human Immunodeficiency Virus Drug Resistance (HIVDR) and Baseline Characteristics among Antiretroviral Therapy (ART) experienced Children and Adolescents under the care of Chidamoyo Christian Hospital in Hurungwe, Zimbabwe

Dec 2023 DOI 10.14302/issn.2324-7339.jcrhap-23-4634
Makura AlfredCorresponding author

Introduction Human Immunodeficiency Virus (HIV) remains a persistent global public health challenge. In 2020, approximately 37.9 million individuals were living with HIV globally, including 1.7 million children <15 years old, with a global HIV prevalence of 0.8% among adults. A larger portion of people living with HIV are found in low-and middle-income countries, and Sub-Saharan Africa (SSA) is home to about 68% of people living with HIV in the world. Strikingly, with increased uptakes in PMTCT, challenges in ART programs, and high viremia among children and adolescents in SSA, the success rate of ART might be quickly compromised, with possible HIVDR emergence, particularly after years of paediatric ART exposure. Therefore, monitoring ART response in children and adolescents in terms of HIVDR patterns and other socio-economic determinants of disease progression might help achieve better treatment outcomes at individual levels. At a programmatic level, this can guide further optimization of treatment options for SSA especially Zimbabwean rural where there is paucity of information on HIVDR prevalence in children and adolescents. Methods We enrolled 89 children and adolescents experiencing virologic failure from Chidamoyo Christian Hospital in Hurungwe. We managed to amplify all the 89 using nested PCR and 32.5% (29) had resistance to at least one ART drug and analysis was done using the 29 samples. Results Among the 89 participants with virologic failure,29 were resistant to at least one of their ART drugs. 39.2% of males and 23.07% of females had HIV-1 with resistance to at least one medication. Among 29 participants with HIVDR mutations, the prevalence of at least one HIVDR mutation to protease inhibitors (PIs), Nucleotide Reverse Transcriptase Inhibitors (NRTI), and Non-Nucleotide Reverse Transcriptase Inhibitors (NNRTI) were 6.47% ,46.76% and 46.76% respectively. Of the 29 participants who had HIVDR 19 (65.5%) had resistance to a drug they were currently taking and they needed to be switched to a better effective ART regimen Conclusion Use of HIVDR testing in guiding and monitoring development of HIVDR at the start of ART or at 1st failure can be very important in treatment options and patient management.

Fungal Diversity Open Access

Saccharomyces Kluyveri Fungemia in a Patient with Human Immunodeficiency Virus Infection

Nov 2018 DOI 10.14302/issn.2766-869X.jfd-18-2276
Cheikhrouhou FatmaCorresponding author Mycology and parasitology Laboratory- Habib Bourguiba hospital 3029 Sfax -Tunisia.

We report a case of a young woman with acquired immune deficiency syndrome admitted with fever and abdominal pain. Saccharomyces kluyveri was isolated in blood culture. She was successfully treated with fluconazole. This case demonstrates the pathogenicity of Saccharomyces Kluyveri in immunocompromised host.

Pattern of Use of Highly Active Antiretroviral Therapy Regimens and Pattern of Occurrence of Adverse Drug Reactions in an Indian Human Immunodeficiency Virus Positive Patients

Jun 2013 DOI 10.14302/issn.2324-7339.jcrhap-12-174
Rajesh RadhakrishnanCorresponding author Radhakrishnan Rajesh M.Pharm, Asst Professor (Senior Grade), Department of Pharmacy Practice, Manipal College of pharmaceutical Sciences, Manipal University, Manipal- 576 104, Karnataka, India.

Background: In India, Human immunodeficiency (HIV) infected patients with highly active antiretroviral therapy (HAART) are at higher risk of developing adverse drug reactions (ADRs). Objectives: The aim of this study was to characterize the pattern of use of HAART, occurrence, incidence, severity and causality of ADRs to HAART in Indian HIV positive patients. Methods: This was a prospective observational study conducted between August 2009 and May 2012. Enrolled HIV positive patients were intensively monitored for ADRs with fixed dose antiretroviral therapy as per National AIDS Control organization (NACO).World Health Organization (WHO) definition of ADR was adopted to detect ADRs to HAART and classified based on WHO adverse reaction terminologies. Naranjo’s scale was used for causality assessment of ADRs. Preventability was assessed using Thornton and Schuman criteria and severity was assessed using the modified Hart wig and Siegel scale. Pattern of ADRs was assessed with patient demographics, ADRs characteristics, and pattern of drug and reaction characteristics. P-value <0.05 was considered as statistically significant. Results: A total of 426 ADRs to HAART were evaluated from 1982 HIV positive patients during the study period. The overall incidence of ADRs to HAART was 21.4%. Significant difference was seen in the incidence of ADRs in the age group of 41-60 years (p <0.001), CD4+T-cell counts of 350-500 cells/µl (p <0.001), females (p <0.001). Three fatal ADRs of with cutaneous drug eruptions of Steven Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) was 1.1%. Anemia (31.7%) accounted for majority of the reports followed by vomiting (15.5%), skin rash (12.9%) and peripheral neuropathy (10.7%). The suspected drug was withdrawn for the management of the ADRs in majority (27.9%) of the reports. Higher incidence rate of ADRs was noted with lamivudine (3TC) + nevirapine (NVP) + stavudine (D4T) (22.9%). In, naranjo's causality assessment, majority of the ADR reports were rated as possible (69%). Symptomatic treatment for ADRs was given in 91.8% of the reports and 86.4% of the reports the patient recovered from the suspected adverse reaction at the time of evaluation. Conclusion: In India, occurrence of ADRs to HAART in HIV infected patients was found to be higher with zidovudine induced anemia (31.7%). The higher percentage of ADRs to HAART was seen with female patients, age 41-60 years; CD4+ T-cell counts 350-500 cells/µl. Physician must focus for monitoring all lab investigations for early detection and prevention of adverse effects associated with HAART.

Evaluation of Direct Cost of Adverse Drug Reactions to Highly Active Antiretroviral Therapy in Indian Human Immunodeficiency Virus Positive Patients

Dec 2012 DOI 10.14302/issn.2324-7339.jcrhap-12-71
Rajesh RadhakrishnanCorresponding author Radhakrishnan Rajesh M.Pharm, Asst Professor (Senior Grade), Department of Pharmacy Practice, Manipal College of pharmaceutical Sciences, Manipal University, Manipal- 576 104, Karnataka, India.

In India, interruptions to highly active antiretroviral therapy (HAART) are due to adverse drug reactions (ADRs) and no reports on the direct cost incurred in the management of ADRs to HAART are available. There is a need to study direct cost incurred with ADRs to HAART to explore the high economic cost burden imposed by ADRs to HAART in HIV/AIDS patients. This study was aimed to evaluate the direct cost incurred in the management of ADRs to HAART in Indian HIV positive patients. This prospective study was conducted at a Medicine department in a South Indian tertiary care teaching hospitals were ADRs reporting system exist. HIV-positive hospitalized in-patients were identified and intensively monitored for ADRs to HAART. The World Health Organization (WHO) probability scale was used for causality assessment of ADRs. Modified Hart wig and Siegel scale was used for severity assessment of ADRs.Pearson chi-square test identified association of mean direct cost between ADRs and without ADRs by investigating total mean direct cost. The overall direct cost per ADRs to HAART was found to be higher in the context of expenditure on health care cost in India.

Characterization of People Receiving 2-Drug Regimens (2DR) for HIV Management in Italy

Mar 2026 DOI 10.14302/issn.2994-6743.ijstd-26-6060
Francesco Amadeo PierCorresponding author

Objective To describe the clinical features and real-world treatment of people living with human immunodeficiency virus (PLHIV) using fixed-dose or free combinations of 2-drug regimens (2DR) of antiretroviral therapy (ART). Design Italian retrospective cohort study. Methods Data were extracted from PLHIV who initiated or switched to 2DR: Group 1 (fixed dose), Group 2 (free combination). Results Group 1 was younger and more predominantly male, and had shorter time from AIDS-defining diagnosis to 2DR-ART and from diagnosis to baseline, a lower prevalence of resistance, and fewer comorbidities than Group 2. Median baseline viral load was <50 copies/mL in both groups, but Group 1 had a higher mean due to outliers. The most common ART classes before switching to 2DR were Integrase Strand Transfer Inhibitor (INSTI)-based (48.97%), Non-Nucleoside Reverse Transcriptase Inhibitor (NNRTI)-based (22.73%), and Protease Inhibitor (PI)-based (16.53%). Distribution varied: Group 1: INSTI-based (53.13%), NNRTI-based (24.31%), and PI-based (15.04%); Group 2: INSTI-based (29.41%), PI-based (23.53%), and NNRTI-based (15.29%). After switching, Group 1 was on dolutegravir/lamivudine (79,33%) and dolutegravir/rilpivirine (20,67%); Group 2 mostly on INSTI-PI (52.81%), followed by NNRTI combinations, mainly with doravirine (19.10%). Duration of ART after switching was shorter in Group 1. Conclusion Italian PLHIV on 2DR fixed-dose combinations were younger, virologically suppressed individuals at baseline, with a shorter lead time from diagnosis, lower prevalence of resistance and lower comorbidity rate compared to those on free combinations. These findings underscore an unmet need for 2DR fixed-dose combinations, as the free combinations were predominantly utilized for more challenging populations.

Recruitment Strategies and Challenges in a Pilot HIV Prevention Study among Cisgender Black Women in Houston, Texas

Dec 2025 DOI 10.14302/issn.2324-7339.jcrhap-25-5715
Couture LucyCorresponding author

Recruitment for research studies focused on communicable diseases such as HIV (Human Immunodeficiency Virus) has historically been challenging, particularly among populations who have been underrepresented in media messaging, yet maintain a significant vulnerability to new HIV cases, like Black women. This study examines the recruitment strategies utilized in Aim 2 of pilot study at the University of Texas Health Science Center (UTHealth) in Houston, Texas that was funded by the Ujima Mentoring Program to develop, implement, and evaluate a video log (vlog)-based intervention. The overarching goal of the pilot study was to promote the uptake of pre-exposure prophylaxis (PrEP) among cisgender Black women in Harris County, Texas. Aim 2 involved the creation of a culturally relevant vlog for use in Aim 3, which sought to educate and motivate participants to consider PrEP as an HIV prevention strategy. With the growing role of digital platforms in public health outreach, social media was employed alongside traditional recruitment methods such as flyers and word-of-mouth referrals. Despite an expanded online reach, engagement remained low, and participation rates did not increase proportionally to the number of individuals who viewed recruitment materials. The reluctance to participate was largely attributed to stigma surrounding HIV and concerns about being publicly associated with an HIV prevention study based on participants feedback to the research team. Even the availability of research incentives to encourage participation did not significantly improve recruitment accrual goals, particularly among healthcare providers who experienced limitations with eligibility due to institutional policies. This study underscores the need to better understand the social and cultural barriers that prevent Black women and healthcare providers from engaging in HIV prevention research. While digital recruitment strategies can enhance visibility to a larger audience, they must be supported with trust-building efforts, community partnerships, and culturally competent messaging to encourage meaningful participation. These findings point to the critical need for multi-faceted recruitment strategies that go beyond social media campaigns and actively build trust within communities, ensuring that HIV prevention research and interventions are both accessible and culturally resonant.

Deficiency of Adenosine Deaminase Type 2 (ADA2) DADA2 Masquerade as Lupus

Aug 2023
Almabadi BayanCorresponding author

DADA2 (deficiency of adenosine deaminase type 2) is an autoinflammatory autosomal recessive disease resulting from biallelic loss of function mutations in ADA2 gene. Clinical presentation and age of onset vary widely even among related patients, and variability of symptoms and severity manifestations include bone marrow failure, autoinflammation, immunodeficiency and vasculitis. Here, we report a case of young male with adult onset DADA2, who presented with fever, lower limbs skin rash, joint pain, and anemia resembling systemic lupus erythematous (SLE). DADA2 has an extremely variable clinical phenotype. It was described into three categories: inflammatory/vascular, immune dysregulation, and hematologic. However, the data is scant in describing autoimmunity phenotype in DADA2 and further studies are required to investigate the clinical correlation and presence of autoantibodies. We recommend genetic testing in cases with lupus-like disease especially if there is consanguinity between parents and family history of vasculitis.

Predictors of Adherence to Pre-Exposure Prophylaxis among Female Sex Workers in South-Western Nigeria

Jul 2022 DOI 10.14302/issn.2324-7339.jcrhap-22-4204
Samson Jegede OluwatosinCorresponding author LAUTECH Teaching Hospital, Ogbomoso, Nigeria

Introduction Pre-exposure prophylaxis (PrEP) is an element of the biomedical interventions of Human Immunodeficiency virus (HIV) prevention. The level of protection is strongly correlated to PrEP drug adherence. In Nigeria, the prevalence of HIV among female sex workers (FSW) is 15.5%. The 2020 integrated biological and behavioral surveillance survey did not report on PrEP adherence among FSW. This study therefore assessed the level of adherence to PrEP and its predictors among FSW in South-Western Nigeria. Methodology This cross-sectional analytical study was conducted in 2021. Study population were brothel-based FSW at Gambari Ogbomoso and Lagos, Nigeria. A total of 156 FSW participated in the study. Data was collected using interviewer-administered semi-structured questionnaire and analyzed using IBM SPSS Version 25. Results One hundred and forty-nine properly completed questionnaires were analyzed. Ninety-nine respondents (66.4%) have been working for more than 5years as a FSW and 65(43.6%) had initiation of sex work before 18 years of age. Respondents’ sexual behavior showed that 55 (36.9%) of total respondents had consistent use of condom. One hundred and thirty-four respondents (89.9%) had good knowledge of PrEP, 97 (65.1%) had good attitude towards PrEP while 111 (74.5%) had good perception of risk of HIV infection. One hundred and thirty-two (88.6%) reported to be taking PrEP and 119 (79.9%) had good adherence to PrEP. Predictors of adherence to PrEP were educational status, age of commencement of sex work and monthly income. It was found that educated sex workers were 2.67 times more likely to adhere to PrEP (OR=2.67, 95% CI=1.280-5.591, p=0.019). Those who commenced sex work after clocking 18 years of age were 75% times less likely to adhere to PrEP (OR=0.251, 95% CI=0.106-0.597, p=0.001) while those with average monthly income more than #10,000 were 1.65 times more likely to adhere to PrEP (OR=1.65, 95% CI=0.674-4.042, p=0.0275. Discussion and Recommendation The level of adherence to PrEP is considerably high and underscores a positive effect of the efforts of the Government of Nigeria in controlling HIV as a threat by 2030. Further studies would be useful to understand the behavioral factors associated with low adherence to PrEP among FSW who have spent more than 5 years in sex work.

Human Health Research Open Access

HIV and Homosexuality: In the Light of Therapeutic Interventions

May 2022 DOI 10.14302/issn.2576-9383.jhhr-21-3994
Yadav RavinderCorresponding author Medical Social Welfare Officer Department of Medical Record Government Medical College and Hospital, Sector-32, Chandigarh, India

In this article the author reviews research on high risk factor of Human Immunodeficiency Virus in homosexuals and how lack of awareness & unprotected anal sex contribute substantially to new infections among this population. current HIV prevention efforts by providing insight into the patterns of Indian MSM behavior and sexual partnerships, and the specific cultural, social inequality, the gaps and lack of knowledge and psychological context in which HIV risk is occurring. And the need to develop effective awareness programs for well-functioning prevention of HIV and considerable understanding of the logistical and socio-cultural barriers MSM experience while accessing HIV prevention services. And in last will put light on therapeutic interventions for Human Immunodeficiency Virus, behavioral interventions that are socially and culturally appropriate for the population or community being prioritized and addressing multilevel psychosocial factors, including skills building and strategies to foster self-acceptance and increased social support for MSM. At the same time, prevention messages need to be designed and adapted to the knowledge level and culture of people.

Nutritional Status of Inmates in the Central Prison of Mbuji-Mayi, Democratic Republic of Congo

Sep 2021 DOI 10.14302/issn.2379-7835.ijn-21-3926
Patoka Guillaume Kalonji MuasaCorresponding author University of Liège, Department of Public Health Sciences, Belgium

Background The nutritional situation in prisons of developing countries and the health status of inmates remain a major human rights concern. The objective of the study was to assess the nutritional status of inmates jailed in a prison of the Democratic Republic of Congo (DRC). Methods This cross-sectional study was conducted over a 4-month period in the Central Prison of Mbuji-Mayi, DRC. Three hundred inmates were selected according to the Malnutrition Universal Screening Tool (MUST). Severe malnutrition was defined according to Buzby index and Nutritional Risk Index (NRI). Data were analyzed by Stata™ (version12.0). Results The inmates were aged between 18 and 70 years and primarily males (88.7%). Of them, 24% were suffering from severe malnutrition and 62% of moderate malnutrition as based on the NRI. At the time of study, 88% of inmates were incarcerated for more than 6 months. Multivariate logistic regression analysis showed that factors independently associated with severe malnutrition were incarceration of more than 6 months (OR=5.1; 95% CI (1.5-17.4)), origin of food (prison vs. family or NGO) (OR=4.7; 95% CI (1.6-13.8)) presence of tuberculosis, human immunodeficiency virus and/or intestinal infections (OR=2.6; 95% CI (1.4-4.7)). Conclusions The nutritional situation in the Central Prison of Mbuji-Mayi is precarious. There is urgent need to supply enough nutrient-rich food to improve health of inmates.

Risk Reduction Intervention Services for In-school Adolescents in the rural Areas of Abia State of Nigeria

Feb 2021
E.E. Enwereji,Corresponding author College of Medicine Abia State University, Uturu, Nigeria.

Introduction Risk reduction intervention is meant to provide enhanced and desirable interventions for HIV prevention among adolescents especially the in-school. Adolescents have been identified as the most vulnerable groups that can easily acquire human immunodeficiency virus (HIV) and other sexually transmitted diseases (STDs). Therefore, adolescents are the appropriate target for HIV prevention efforts. Most interventions for adolescents focus on providing AIDS-related education with the assumption that improving knowledge would enable adolescents to protect themselves from sexually transmitted infections. Numerous studies have shown that using class-room education alone is insufficient in reducing adolescents’ risky sexual behaviours. Therefore, this study used role-plays and peer facilitation for the study. Materials and Method The study used role-play and peer facilitation for the intervention strategy. The theme of the role-play was ‘My Future is My Choice’ (MFMC) intervention which was aimed to reduce HIV risk behaviours among sexually inexperienced adolescents. The role-play was carried out by 4 peer leaders who were trained in the theoretical framework of role-plays and peer facilitation by a consultant. With mastery and experience they carried out the role play in a regular classroom section for over 3 class periods, co-facilitated with the assistance of a volunteer teacher. A unique feature of this intervention was the dual focus on strategies that influenced both individual risk factors (i.e., attitudes, behavioural skills) and social environments (e.g., peer resources). A school was chosen by simple random sampling for the intervention. In the school chosen, a total sample of 65 students in senior secondary classes 2&3 ( SS2&3) were included in the study. These were the students considered to be sexually active who can respond to the questions in the questionnaire. Self-administered pre-and post-questionnaire were completed by the students. The results were analysed using frequency tables, descriptive and inferential statistics. Results The students studied were between the ages of 13-18 years. There was evidence that the role play ‘My Future is My Choice’ (MFMC) intervention created positive effects on reduction of HIV risk behaviours among the sexually inexperienced participants aged 13–18. Perceptions on methods of preventing risk reduction behaviours were also positively impacted by the intervention as 12(18.5%) and 34(52.3 %) of the respondents realized after post- intervention that having sex with someone outside marriage and being transfused with infected blood respectively Will constitute risk to HIV infection. Conclusion The role play which used the theme ‘My Future is My Choice’ (MFMC) intervention provided safer choices for reducing one or more measures of sexual risk behaviours among the sexual inexperienced respondents. It created the opportunity for the students to recognize that engaging in unprotected sex constitutes high risk for HIV, other sexually transmitted infections and pregnancy.

Overview of HIV Prevention among In-school Adolescents in the Rural Areas of Abia State of Nigeria

Jan 2021 DOI 10.14302/issn.2324-7339.jcrhap-20-3633
E.E Enwereji,Corresponding author College of Medicine and Health Sciences, Abia State University, Uturu Abia State.

Introduction HIV prevention services to in-school adolescents need good planning and management. HIV risk reduction interventions are geared toward measuring sexual risk behaviour outcomes of adolescents that predispose them to HIV infection. The sexual behaviour of adolescents, especially in-school adolescents should be assessed in the process. Adolescents have been identified as the most vulnerable group for acquiring human immunodeficiency virus (HIV) and other sexually transmitted diseases (STDs) and as such, measures should be taken to prevent them from infection. One important reason for higher HIV prevalence among adolescents, especially girls, is the frequent practice of age-discrepant partnering, where older men, who are more likely to be infected with HIV, form sexual partners with younger girls. The objective of this study is to assess the knowledge and sexual behaviour of in-school adolescents in the prevention of HIV and AIDs in rural areas of Abia State. Materials and Methods This is a descriptive cross-sectional survey that was conducted between January and March 2020. Information was collected from 66 students of a community secondary school in the state. Participants were selected by a multi-stage sampling method and data were obtained using a semi-structured pre-tested questionnaire. Results Respondents consisted of 40(60.6%) females and 26(39.4%) males with ages ranging from 13 to 19. Some of the respondents 28 (42.4%), are living with parents while 24(36.4%) live with close relatives. A good number of the respondents 39(59.1%), accepted that their friends are HIV positive. Majority of them 49(74.2%) have not been approached for sexual relationships. About 17(25.8%) of the respondents accepted that they have boyfriends and girlfriends. Out of this number, 12(18.2%) of them said they have been approached for sex and only 2(3%) of them accepted having sexual relationships with the opposite sex. Finding showed that only 1(1.5%) of the respondents claimed to have ever used condoms during sex. Of the sexually active respondents, 49(74.2%) of them are aware that HIV is a virus infection caused by having multiple sex partners while 14(21.2%) were not sure whether HIV is a virus or bacterial infection. Conclusion The study revealed a gap in the knowledge of HIV prevention as well as inappropriate sexual behaviour among the respondents. Therefore, meaningful strategies that will be culturally sensitive to modify adolescent sexual risk behaviours should be adopted.

A Case Report on Challenging Management of Multiple Neoplasms in Elderly

Dec 2020 DOI 10.14302/issn.2474-7785.jarh-20-3628
Syiao Wei NgCorresponding author Hospital Sultanah Aminah, Jalan Persiaran Abu Bakar Sultan, 80100 Johor Bahru, Johor, Malaysia

Multiple primary malignancies especially in the head and neck region is no longer a rare occurrence and the prevalence is increasing. They were described as synchronous when the malignancies present within 6 months of another or metachronous tumors if the subsequent malignancy presents 6 months later. Many etiologies had been hypothesised including similar carcinogens exposure, genetic susceptibility and mutation, immunodeficiency or treatment of the index tumor. Among the hypotheses, the most accepted theory was field cancerisation in which the occurrence of multiple primaries in the aerodigestive tract was due to persistent exposure of similar carcinogens through inhalation or oral intake . However the co-incidence of thyroid and aerodigestive malignancies is relatively low. Hereby we would like to report a case of a 74 years old lady with known esophageal squamous cell carcinoma presented with metachronous laryngeal squamous cell carcinoma and papillary micro carcinoma of thyroid.

The Prevalence of Osteoporosis in Hiv Infected Patient and its Correlation with Cd4 Count/Clinical Staging in Indian Population

Aug 2020 DOI 10.14302/issn.2324-7339.jcrhap-20-3003
Kant Tiwari SatyaCorresponding author Department of Internal Medicine, All India Institute of Medical Sciences, India

Human immunodeficiency virus (HIV) is a retroviral disease in which the viruses copy their genetic material into the genetic material of the human beings. Infected cells remain infected for the whole of their life. First discovered in the year 1981, Human immunodeficiency virus infections is considered to be a pandemic by the World Health organization.

Perspectives of Health Care Providers Working with HIV Positive Clients on Nutritional Challenges Among People Living with HIV/AIDS in Kigali, Rwanda

Mar 2020 DOI 10.14302/issn.2641-4538.jphi-20-3261
Dzinamarira TafadzwaCorresponding author Department of Public Health, Mount Kenya University Rwanda, Kigali, Rwanda

Efforts to control the Human Immunodeficiency Virus epidemic in Rwanda have seen remarkable success over the years. Effective antiretroviral therapy has played great role in improving longevity among people living with HIV/AIDS (PLWH). While this is the case, there are various nutritional challenges, which are often faced, among PLWH. Guided by the Rwanda country guidelines for nutritional management for PLWH and WHO recommendations, this study aimed to explore the perspectives of health care providers (HCPs) working with PLWH on nutritional challenges faced by their clients in Kigali, Rwanda. We conducted a qualitative study using in-depth interviews to collect data. A non-probability purposive sampling was employed to recruit HCPs. Data analysis was based on the naturalistic paradigm. We followed the hybrid approach in conducting thematic analysis. Three themes were identified. First, HCPs had good knowledge on nutritional requirements for PLWH. They demonstrated good communication skills and adequate counseling skills that were necessary for addressing concerns on nutrition from their clients. Secondly, it emerged that HCPs perceived a lack of resources to be the major challenge faced in nutritional management of their clients. From theme three, it emerged that, from HCPs experiences, food insecurity and lack of feeding supplements were the main causes of malnutrition among PLWH in Kigali, Rwanda. From the HCPs perspective, there is a need to improve healthcare institutions capacity to manage nutritional challenges faced by PLWH. To achieve this, policy makers need to channel adequate resources for this cause.

Docking Studies of HIV-1 Reverse Transcriptase and HIV-1 Protease with Phytocompounds of Carissa Carandas L.

May 2019 DOI 10.14302/issn.2324-7339.jcrhap-19-2847
Sharma BechanCorresponding author Department of Biochemistry, Faculty of Science, University of Allahabad, Allahabad-211002, UP, India.

Background Carissa carandas L. is a well-known wild fruit plant distributed through-out the India and also present in other countries. The fruits are rich in nutrients and minerals. A number of medicinally important phytochemicals such as carrisone, carindone, carandinol, lupeol, scopoletin, stigmasterol, β-sitosterol, myo-inositol, β-amyrin, Des-n-methylnoracronycine etc. have been reported from the extract of this plant. Being safe and cost effective molecules, the activity of phytochemicals against HIV-1 enzymes needs to be screened. Objective The aim of this study was to screen the potent phytocompound of C. carandas against human immunodeficiency virus-1 using docking method. Methods Total nine compounds viz. carandinol, caridone, carrisone, lupeol, p-coumaric acid, gallic acid, rutin, scopoletin and ursolic acid were used for in-silico study towards drug development against human immunodeficiency virus-1 reverse transcriptase (HIV-1RT; PDB ID: 1REV) and human immunodeficiency virus-1 protease (PDB ID:1EBY) using Autodock software. Results The qualitative characterization of the extracts showed the presence of a number of phytochemicals such as phenolics, flavonoids, alkaloids, terepnoids, terpenes, steroids, glycosides etc. Carandinol was observed as most effective anti-HIV-1 molecule having lowest binding energy and small inhibition coefficient. Another compound, p-coumaric acid, showed least effectiveness against human immunodeficiency virus- 1 reverse transcriptase or human immunodeficiency virus-1 protease showing highest binding energy and inhibition coefficients among all the evaluated phytocompounds. Conclusion The in-silico study demonstrated that some phytoconstituents of C. carandas exhibit potential anti-human immunodeficiency virus -1 activity and hence can be optimized to develop as a drug candidate in future.

Prevalence of Hiv Infection Among Pregnant Women Attending Ajiko Medical Clinic, Damaturu, Nigeria

May 2019 DOI 10.14302/issn.2324-7339.jcrhap-19-2746
Khanam SabinaCorresponding author Department of Biological Sciences, Yobe State University, Nigeria

Human immunodeficiency viruses causes HIV infection in humans belongs to two species of Lentivirus. It damages the cells of immune system which leads to weak immune system and the ability to fight from infections and diseases. This study was conducted to investigate the prevalence rate of HIV infection among pregnant women of different age groups attending Ajiko medical clinic, Damaturu, Nigeria. The prevalence rate was maximum (12.5%) in 36-45 age group and minimum (5%) in 26-35 age group but their was no HIV infection in 15-25 age group. The overall prevalence rate among pregnant women was 4%. General knowledge , training and campaigns of HIV prevention need to be tailored towards older women of age group 36-45 because of high prevalence rate.

Knowledge about Sexual and Reproductive Health among School Enrolled Adolescents in Tololar, Nicaragua, A Cross-Sectional Study

Dec 2018 DOI 10.14302/issn.2641-4538.jphi-18-2464
Källestal CarinaCorresponding author International Maternal and Child Health, Department of Women's and Children's Health, Uppsala University, Uppsala University Hospital, SE 75185, Sweden.

Background Nicaragua has the highest prevalence of teenage pregnancies in Latin America. Knowledge regarding sexual and reproductive health plays an integral part in sexual behavior. The objective was to assess school going adolescents' knowledge about sexual and reproductive health and possible factors affecting it in the semi-rural community of Tololar, Nicaragua. Methods A cross-sectional study with a self-administered questionnaire on tablets was used for data collection. All 253 registered students at the school present at the time of fieldwork who gave written informed consent were deemed eligible for the study. A total of 225 participants in the ages of 11-19 years were included. Simple linear regression and multiple linear regression were performed analyzing the outcome knowledge. A p-value <0.05 was considered significant. Results The general knowledge about sexual and reproductive health was moderate; however, knowledge gaps were found such as prevailing myths and poor knowledge regarding human immunodeficiency virus (hiv) transmission and contraceptive methods. Being female and single were significant negative determinants of knowledge (p-value < 0.01) and knowledge increased significantly with age (p-value < 0.05). School teachers, websites, social networks, and TV were the most frequently chosen sources of information on the topic. Conclusions Increased education on sexual and reproductive health with new interventions particularly for young females is recommended. Using IT-based materials as a complement may be an effective way to reach out to adolescents.

Perspective for Methicillin-resistant Staphylococcus Aureus colonization, Antibiotic Susceptibility Patterns and Risk factors for Colonization among People Living with HIV at Nyenga Hospital, Buikwe District, in Central Uganda

Jul 2018 DOI 10.14302/issn.2690-4837.ijip-18-2238
MugishaTaremwa IvanCorresponding author Clarke International University, Kampala, Uganda

Background Colonization with methicillin-resistant Staphylococcus aureus (MRSA) is recognized as an association towards development of infections that may cause of morbidity among people living with Human Immunodeficiency Virus (PLWHIV). We report on the prevalence, antibiotic susceptibility pattern and risk factors associated with MRSA carriage among PLWHIV at Nyenga hospital, Buikwe district in central Uganda. Materials and Methods We conducted a cross-sectional study among PLWHIV attending Nyenga hospital anti-retroviral therapy (ART) clinic. Nasopharyngeal swab was collected from each participant, cultured to isolate Staphylococcus aureus, and drug susceptibility testing (DST) performed. Sociodemographic data and medical history was recorded. Results We enrolled 219 PLWHIV; of these, 58.4% (N=128) were females. The majority of participants (95.0%) were on ART. Ninety-eight (44.75%) of the nasopharyngeal swabs had growth, of which 41 (41.84%) were S. aureus. Of these, 11 (5.02%, 95% confidence interval: 3.67-7.02) were MRSA. Of 41 isolated S. aureus strains, only 8 (19.51%) were susceptible to all antibiotics tested. A total of three (7.32%) were multi-drug resistant (MDR), while one1 (2.43%) was a possible extensively drug resistant (XDR) strain. Deteriorating immunologic state as indicated by a low CD4 count showed a significant association with the MRSA colonization. Conclusion These results are reassuring that MRSA colonization is high among PLWHIV. As most of the antibiotics in use were resistant, it raises concerns of intricate clinical management in a low resource set up.

Non-Hodgkin Lymphoma of External Auditory Canal – Uncommon Location and Related Risk Factors

Feb 2018 DOI 10.14302/issn.2641-5518.jcci-17-1880
A D Mettias BassemCorresponding author ENT Department, Fayoum University, Egypt.

Objective: Presentation of rare case report of primary non-Hodgkin Lymphoma of temporal bone secondary to immunodeficiency after prolonged steroid administration in a diabetic patient. Then review the literature of similar case reports. Method: 49 years old female presented with hearing loss, facial paralysis and otalgia. Biopsy revealed high grade non Hodgkin’s B-lymphoma. She underwent chemotherapy and had remarkable response. Result: Rapidly progressive deafness, facial paralysis and otalgia are common presentations of external canal Non-Hodgkin lymphoma. The disease is common in middle age, females and has a fair response to chemotherapy, good to radiotherapy. Surgery is an alternative method in isolated lesions or recurrent cases. Conclusion: High dose steroid and type II diabetes are potential risks for acquired immunodeficiency. External Auditory canal lymphoma is uncommon sequel. Chemotherapy is very effective in treatment of isolated cases without B symptoms

Squamous Cell Carcinoma of the Conjunctiva (Scc) and Human Immunodefisciency Virus (Hiv): What Reality in Ivory Coast Through 23 Cases?

Sep 2017 DOI 10.14302/issn.2324-7339.jcrhap-17-1694
Coulibaly R BereteCorresponding author Ophthalmology Department of University Hospital of Treichville

Introduction: Squamous cell carcinomas of the conjunctiva (SCC) are rare neoplasia but have a high rate of increase and a high rate of mortality, especially when they occur in the context of Human Immunodeficiency Virus (HIV) infection. The objective of this study was to establish an epidemiological and clinical profile of SCC in patients living with HIV and to assess its evolutionary characteristics. Patients and Methods: this was a descriptive cross-sectional study carried out over a period of 5 years in the ophthalmology department of the University Hospital of Treichville. The data collected focused on epidemiological, clinical, pathological, therapeutic and evolutionary elements. Twenty tree eyes of 23 patients were examined during this period. Results: The average age of our patients was 45 years with extremes ranging from 31 to 60 years. A female predominance was observed with a sex ratio of 0.92. The average consultation period was 18 months with extremes ranging from 6 to 60 months. Physically, 35% of our eyes (08 eyes) presented a functional loss of the eye. All our patients had a HIV positive status with 16 cases of HIV1 infection, 4 cases of HIV 2 infection and 3 cases of HIV 1 and 2 co-infection. Lymphocyte typing was performed for 15 patients out of the 23 With CD4 cell counts ˂ 200 in 30.43% of cases, between 200 and 500 in 34.78% of cases. All our tumors had had biopsy excision with pathological examination. A postoperative adjuvant topical chemotherapy in 6 cases. The average follow-up period of our patients was 29 months. In all cases, it was invasive differentiated squamous cell carcinoma. Discussion: HIV infection is a risk factor for the occurrence of conjunctival squamous cell carcinoma, but it is also an aggravating factor especially in the case of low CD4 cell count, particularly in sub-Saharan Africa, where the fight against infection, although boosted in these recent years, is far to achieve all objectives Conclusion: HIV seroprevalence is very often associated with opportunistic infections which include carcinogenic processes such as squamous cell carcinomas of the conjunctiva

Medical Management of Sexual Assault Survivors at an Academic Medical Center

Dec 2016 DOI 10.14302/issn.2381-862X.jwrh-15-846
Rafie SallyCorresponding author UC San Diego Health

Sexual assault is a serious problem in the United States. It is crucial that the medical management of these patients is adequate. The Centers for Disease Control and Prevention (CDC) provides guidelines for appropriate management of these patients. The purpose of this study is to evaluate medical management of survivors of sexual assault at an academic medical center and identify opportunities for improvements in care. We conducted a retrospective, chart review study of patients aged 12 years and older presenting at an academic medical center following sexual assault or rape between 2009 and 2013. Descriptive statistical tests were used to analyze the data. A total of 29 females and 5 males were identified. The majority of patients presented to the medical center within 24 hours of sexual assault or rape and typically presented to the emergency department. Empiric treatment for infections were 8.8% for Hepatitis B, 29.4% for human immunodeficiency virus, 20.6% for gonorrhea, 17.6% for chlamydia, and 8.8% for trichomonas. Among women of reproductive age, 28.0% were provided with emergency contraception. This study found inconsistency in the medical management of sexual assault survivors. Among this small sample size, many patients were not provided with recommended medical treatments. With this knowledge, the medical center plans to implement institutional guidelines and a corresponding order set in the computerized prescriber order entry system to standardize the medical management of sexual assault survivors and educate healthcare professionals. Future studies are warranted to evaluate the impact of standardized guidelines and order set implementation.

Undergraduate Student’s Perception of HIV/AIDS.A Case of Obafemi Awolowo University Ile-Ife, NIGERIA

Jan 2016 DOI 10.14302/issn.2324-7339.jcrhap-13-180
Okumdi Muoghalu CarolineCorresponding author Department of Sociology and Anthropology, Obafemi Awolowo University, Ile-Ife.

Perception of Human Immunodeficiency Virus has been topical due to its central place in determining attitudes and care for people living with HIV/AIDS and having implications for the containment of the epidemic. People living with HIV/AIDS face social stigmatization due partly to misconception in the perception of the disease and people living with it and students are not left out in this stigmatization and discrimination. This study aimed at exploring the perception of HIV/AIDS by the students of Obafemi Awolowo University. The study utilized quantitative methodology –questionnaires to elicit information from 160 students on their perception of the disease. The sampling technique was quota sampling technique in which 40 students were randomly selected from each hostel out of the 4 selected hostels. The findings were that majority of the respondents view the disease and people living with it negatively (53.9) and dangerous (30.9) and 66.4 percent of the respondents did not see themselves being vualnerable to contracting the virus. The result further showed a significant association between knowledge and perception of the disease. It was also revealed that there was no significant relationship between perception of the disease and socio-economic status of students. This negative perception has serious implications for students living with HIV/AIDS in the University. In conclusion, the negative students’ perception of the disease and people living with it has serious implications for the containment of the epidemic in that people living with HIV/AIDS would hide their sero-positive status to avoid stigma and would in turn infect others. There is therefore need for intervention to change student perception to positive in the university.

HIV/AIDS Knowledge, Attitudes and Practices among Truck Drivers in Burkina Faso.

May 2015 DOI 10.14302/issn.2324-7339.jcrhap-14-416
Gnimbar PODA GhislainCorresponding author National Council of HIV/AIDS (SP/CNLS-IST), Ouagadougou, Burkina Faso.

Objective: Human immunodeficiency virus (HIV) /acquired immune deficiency syndrome (AIDS) affect all levels of society and drivers are considered as vectors of HIV transmission because of the mobility of their work. The aim of this study was to assess struck drivers’ knowledge, attitudes and practices on HIV and AIDS in Burkina Faso. Methods: Quantitative method and cross-sectional survey using questionnaire with Cronbach’s alpha 0.76 were used in this study. SPSS, version 18.0 was used for analysis. P-values ≤ 0.05 were considered statistically significant. Results: 150 truck drivers participated in the study with a mean age of 38.71 years (SD=8.87), and ranged from 25 to 68 years old. It was observed that misconceptions about HIV transmission are quite prevalent among truck drivers. About 61 (40.7%) felt that AIDS can be transmitted by sharing meals, 35 (23.3%) stated that it can be spread by mosquito bite and 65 (43.3%) were of the opinion that AIDS can be transmitted by using same toilet and cloths. High-risk behavior was established in the study. 78% have other sexual partners besides their wives and 34% often visit sex workers in which 26 % had unprotected sex with sex workers. Alcohol seems to have a big role in their sexual behavior; thus 22 % of truck drivers declare drink alcohol before sex. There were significant association in demographic factors and knowledge, attitude and practice. Conclusion: The study findings underline the negative risk behaviors of truck drivers. Safe sex and use of condom have to be promoted through education program among truck drivers in Burkina Faso.

Report of a False Positive Rapid HIV Test Due to Hepatitis A in a U.S. Army Soldier

Oct 2014 DOI 10.14302/issn.2324-7339.jcrhap-14-541
S. Berry-Cabán CristóbalCorresponding author Department of Clinical Investigation, Womack Army Medical Center, Fort Bragg, NC, USA

A 25 year old, single, active duty soldier presented to a clinic in Afghanistan complaining of malaise, fatigue, acholic stools, and mild jaundice over a 5- to 7-day period. He had significantly elevated liver transaminase levels approaching 5000 U/L and a positive rapid human immunodeficiency (HIV) 1 antibody test. Ultimately, the patient was found to have a false positive rapid HIV-1 antibody test due to acute hepatitis A virus infection. This case report describes his evaluation and outcome, in addition to exploring possible causes of false positive HIV screening.

Sociocultural Issues as Barriers to HIV-Infected Orphan Care in Southern Africa

Jun 2014 DOI 10.14302/issn.2324-7339.jcrhap-13-239
Lehmann CorinneCorresponding author University of Cincinnati, College of Medicine, Department of Pediatrics

As advances in treatment and prevention are starting to decrease the magnitude of the Acquired Immunodeficiency Syndrome (AIDS) epidemic in Sub-Saharan Africa, the number of orphans and children surviving Human Immunodeficiency Virus (HIV) infection is growing. To date, little research has been conducted in the care of HIV-infected children in orphanages in Sub-Saharan Africa. In this qualitative study, managing personnel in 10 programs caring for HIV-infected children were interviewed to ascertain perceived barriers to care of these children. While all programs commented on medical infrastructure barriers, respondents felt sociocultural issues were more pressing. After analysis of transcribed interviews, three major themes of poverty, denial/stigma, and cultural differences with outsiders emerged. These findings have implications for international programs that both serve and seek to serve the needs of HIV-infected children and orphans in Africa. Outside funding organizations will need to address local poverty, stigma, and African “ownership” of HIV-positive orphans to ultimately ensure the best care of these vulnerable children.

Cardiovascular Risk Factors Among People Being Treated for HIV in Nepal: A Cross-Sectional Study

Feb 2014 DOI 10.14302/issn.2324-7339.jcrhap-12-157
Aryal NirmalCorresponding author Division of Applied Health Sciences, Forester Hill Campus, University of Aberdeen, Aberdeen, Scotland, UK

Background: Human Immunodeficiency Virus (HIV) and antiretroviral therapy (ART) are found to be strongly associated with cardiovascular diseases. Data are sparse on the prevalence and distribution of cardiovascular risk factors among people being treated for HIV in South Asia region. Methods: A cross-sectional study of 103 HIV patients (51 women and 52 men) attending routine follow-up consultations at the largest ART centre in Nepal was conducted. Data on several cardiovascular risk factors were collected through interview questionnaires, biophysical measurements and consulting medical records. Results: The most common cardiovascular risk factors observed were central obesity 34.6% 95% Confidence Interval (CI): 25.3% to 43.9%, chronic kidney disease {20.7% (95% CI: 11.6% to 29.7%)} and tachycardia {20.6% (95% CI: 12.7% to 28.5%)}. Females were significantly more likely to have central obesity (male 9.8% vs. female 60%, p=0.016) and chronic kidney disease (male 15.4% vs. female 26.3%, p=0.003) as compared to the males. Participants were fairly active but a large proportion, especially men, had smoked {65% (95% CI: 57%-72.3%)}, used tobacco products {66% (95% CI: 56.4%-74.4%)} or drugs (53.8% of the men) and consumed alcohol {60.2% (95% CI: 50.5%-69.1%)}. Conclusion: A high prevalence of several cardiovascular risk factors was observed among patients being treated for HIV in Nepal. Further larger studies are warranted to better understand the relevance and public health impact of cardiovascular risk factors in this region.

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