Friday, September 4, 2015

Belief about HIV/AIDS Transmission and Prevention among Pregnant Women in Felege Hiwot Hospital, Northwest Ethiopia

Article Information
Article Type: Research Article
Citation: Beyene Y, Mekonnen H, Geresu B (2015) Belief about HIV/AIDS Transmission and Prevention among Pregnant Women in Felege Hiwot Hospital, Northwest Ethiopia. J HIV AIDS 1(1): http://dx.doi.org/10.16966/jha.105
Copyright: Beyene Y, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Publication history: 
  •  Received date: 19 May 2015

  •  Accepted date: 08 July 2015

  •  Published date: 15 July 2015

    Authors :
      Yeshiwork Beyene1      Hussen Mekonnen2      Berhanu Geresu3*
    1Department of Nursing, College of Medicine and Health Sciences Wollo University, Dessie, Ethiopia2School of Nursing, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia3Department of Pharmacy, College of Medicine and Health Sciences Wollo University, Dessie, Ethiopia
    *Corresponding author: Berhanu Geresu, MSc, Department of Pharmacy, College of Medicine and Health Sciences Wollo University, Dessie, Ethiopia, Tel: +251 913000497; E-mail: berhanu.grs@gmail.com
    Abstract
    Human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) are global health problems. Since AIDS is not only a vital medical problem, but also a socioeconomic complication, increasing people's knowledge and replacing their fatalistic belief by a non-fatalistic belief is important to decrease prevalence of the problems. The objective of the study is to examine beliefs about HIV/AIDS of pregnant women and to study the relationship between their belief and HIV/AIDS prevention behaviors. A cross-sectional structured and semi-structured interview with mixed method approach based survey was used. Convenience sampling technique was used to select study participants. Data was analyzed using SPSS V.15. Our result demonstrated that, out of 422 respondents 336 (79.6%) and 86 (20.4%) had a non-fatalistic and a fatalistic belief, respectively. Majority of the respondents 407 (96.4%) believe that HIV can be transmitted from mother to child and small proportion 15 (3.6%) don’t believe the transmission of HIV from mother to child. The findings showed that 20% of the women were fatalistic and that their beliefs about AIDS may affect prevention behaviors. Fatalistic believe is one of the factors influencing HIV/AIDS prevention behaviors, but it is a vital factor for health professionals to consider when developing future HIV/AIDS prevention strategies among fatalistic people.
    Keywords
    Fatalism; HIV/AIDS; Belief; Pregnant women; Felege Hiwot hospital



    Table 1: Socio-demographic characteristic of pregnant women in Felege Hiwot hospital, Bahir Dar: 2010 (n=422) Note: **significant at 0.05 level


    Table 2: Frequency of prevention indicators among pregnant woman in Felege Hiwot hospital, Bahir Dar: 2010 (n=422) Note: **significance at 0.05 level
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  • Cerebellar Tuberculoma in a HIV Coinfected Patient with Arnold-Chiari I Malformation

    Article Information
    Article Type: Research Article
    Citation: Benabdellah A, Bachir N, Belharane A, Benabadji A, Benchouk S, et al. (2015) Cerebellar Tuberculoma in a HIV Coinfected Patient with Arnold-Chiari I Malformation. J HIV AIDS 1 (1): doi http://dx.doi.org/10.16966/jha.104
    Copyright: © 2015 Benabdellah A, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
    Publication history: 
  •  Received date: 18 May 2015

  •  Accepted date: 04 June 2015

  •  Published date: 10 June 2015

    Authors :
    Benabdellah A1      Bachir N2      Belharane A2      Benabadji A2      Benchouk S2       Bensaha Z2      Bensaad M2      Brahimi H2      Lakhdori F2      Mahamdaoui F2      Mahmoudi R2      Taleb-Bendiab R2      Allal-Taouli K2      Labdouni MH2      Bensenane M3      Berrada S3 
    1HIV laboratory research, University of Oran, Algeria 2CHU TLEMCEN, University of Oran, Algeria3CHU ORAN, University of Oran, Algeria
    *Corresponding author: Benabdellah Anwar, HIV laboratory research, University of Oran, BP 1524 ELM_Naouer 31000 Oran, Algeria, Tel: +213 (0) 41 58 19 47 /+213 (0) 41 58 19 41; E-mail: benabdellah.anouar@univ-oran.dz
    Abstract
    The four types of Chiari malformations, as described by Dr. Hans Chiari, have neither anatomic nor embryologic correlation. Their only commonality is that they all involve the cerebellum. Chiari I malformation consists of herniation of the cerebellar tonsils into the foramen magnum, thus crowding the craniocervical junction. Chiari II malformation is almost exclusively associated with myelomeningocele and hydrocephalus. It consists of herniation of not only the tonsils but also all the contents of the posterior fossa into the foramen magnum. This herniation involves the brainstem, fourth ventricle, and cerebellar vermis. Chiari III and IV malformations are rare. Chiari III represents an encephalocele (external sac containing brainstem and posterior fossa contents); thus, the cerebellum and brainstem are descending not only into the spine, but also into an external sac. Chiari IV consists of cerebellar hypoplasia. The Chiari I malformation has the latest mean age of clinical presentation. A Chiari type I anomaly presenting in adulthood is the focus of this case report. Surgery is indicated with neurological dysfunction, symptomatic syrinx, or hydrocephalus. Of all Chiari I patients, 15% - 20% will have hydrocephalus. For some of them, the hydrocephalus will resolve with ventriculoperitoneal shunting, alleviating the need for a Chiari decompression. Long-term prognosis for patients with symptomatic Chiari type I malformations who undergo surgical treatment is variable, based on the patients presenting symptoms and spinal cord cyst response.
    Keywords
    Cerebellar tuberculoma; Arnold-Chiari malformation; HIV infection


    Figure 1: Brain magnetic resonance imaging. A hypointense signalmass in the left hemisphere of the cerebellum corresponding to asous-cortical postero-paramedian abscess measuring 13 mm showing unique ringenhancing lesion, surrounded by edema.


    Figure 2:MRI of the head and spine (T2 weighted sagittal view) at time of presentation revealed a T1 hyposignal and hypersignal T2 lesion measuring 13 mm with annular enhancement corresponding to a souscortical postero-median abscess as well as an Arnold-Chiari type 1 malformation with effacement of the citern of posterior fossa and tonsillar herniation in the magnum over 05 mm descending to C2.

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  • Clinical and Immunological Effects of a Reduced Daily Dose of Stavudine among Antiretroviral Naïve HIV-infected Individuals in Dar es Salaam, Tanzania: A Randomized, Controlled Study



    Article Information

    Aritcle Type: Research Article
    Citation: Buma D, Bakari M, Fawzi W, Mugusi F (2015) Clinical and Immunological effects of a Reduced Daily Dose of Stavudine among Antiretroviral Naïve HIV-infected Individuals in Dar es Salaam, Tanzania: A Randomized, Controlled Study. J HIV AIDS 1 (1): doi http://dx.doi.org/10.16966/jha.103
    Copyright: © 2015 Buma D et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
    Publication history: 

  •  Received date: 09 April 2015


  •  Accepted date: 28 May 2015


  •  Published date: 02 June 2015

    Authors :
     Deus Buma1*      Muhammad Bakar2      Wafaie Fawzi3      Ferdinand Mugusi2 
    1Department of Pharmacy, Muhimbili National Hospital (MNH), Dar es Salaam, Tanzania2Departments of Internal Medicine, Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, Tanzania3Department of Global Health and Population, Harvard School of Public Health, Boston, USA
    *Corresponding author: Deus Buma, Muhimbili National Hospital, P.O BOX 65000, Dar es Salaam, Tanzania, Tel: +255787 228282; E-mail: deus.buma@mnh.or.tz, buma70@yahoo.co.uk

    Abstract

    Objectives: To compare the immunological and clinical effects of a further reduction of stavudine dose to 30 mg once-daily with that of a standard zidovudine containing antiretroviral therapy (ART) regimen in a prospective, open-label randomized controlled study.
    Methods: Naïve HIV infected patients were equally randomized to receive either stavudine 30 mg once-daily or a standard dose zidovudine containing regimen. CD4+ T-cell counts, Haemoglobin (Hb), alanine aminotransferase (ALT), Body Mass Index (BMI), WHO stage and patients’ morbidity at baseline, three and six months were determined. Changes between baseline and three as well as six months follow-up were compared within-and between-groups.
    Results: Five hundred and twenty patients aged ≥ 18 years were included. Males were 159 (30.6%), with the mean (SD) age of 39 (9) years. Within group comparison indicated that there were statistically significant increases in mean CD4+ cell counts, BMI, and Hb (p<0.0001) at 3 and 6 months from the values at baseline in both groups, but there were not significantly different between groups. Furthermore, there was no statistically significant difference between groups in terms of occurrence of opportunistic infections (OIs) however, there was significant decrease of OIs for subsequent follow up time points compared to baseline status. The overall median adherence rate was 94% (IQR 94%, 98%) in both groups, but patients in the stavudine group had better adherence compared to those in the zidovudine group, p<0.0001. Additionally, liver damage at 6 months, as indicated by elevated ALT, was more likely with the zidovudine based regimen, p <0.0001. There was no statistically significant difference in ALT elevations between the groups at 3 months.
    Conclusion: The immunological and clinical outcomes following a regimen employing a reduced dose of stavudine to 30 mg once-daily were similar to those of a standard zidovudine-based antiretroviral regimen.

    Keywords

    Stavudine; Zidovudine; CD4+cell counts; Adherence



    Figure 2:Change in the number of Opportunistic Infections over time


    Figure 1:Study Patients Flow
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  • Coreceptor Usage of Syncytium-InducingHIV-1 Isolates Depends on the Target Cell and Evolves during Pediatric Infection

    Article Information

    Aritcle Type: Research Article
    Citation: Crudeli CM, Corró G, Rocco CA, Beltramone N, Marino SA, et al. (2015) Coreceptor Usage of Syncytium-Inducing- HIV-1 Isolates Depends on the Target Cell and Evolves during Pediatric Infection. J HIV AIDS Volume1.1: http:// dx.doi.org/10.16966/jha.102
    Copyright: © 2015 Crudeli CM et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
    Publication history: 
  •  Received date: 13 March, 2015

  •  Accepted date: 27 April, 2015

  •  Published date: 01 May, 2015.

    Authors :
     Cintia M Crudeli,1.2#      Guillermo Corró,1,2*#      Carlos A Rocco,1      Natalia Beltramone,1      Silvia A Marino,1       Luisa Sen,1,2   
    1Laboratorio Biología Celular y Retrovirus, Hospital de Pediatría “Prof. Dr. Juan P. Garrahan”, Buenos Aires, Combate de los Pozos 1881 (C1245AAL) Buenos Aires, Argentina
    2Consejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET), Buenos Aires, Combate de los Pozos 1881 (C1245AAL) Buenos Aires, Argentina 
    #These two authors have equally contributed to this work
    *Corresponding author: Guillermo Corró, Hospital de Alta Complejidad “Cepernic-Kirchner” SAMIC, Avda Jorge Newbery 453 (9405) El Calafate, Santa Cruz, Argentina, Tel: +54 2966 9 729443; E-mail: gcorro2@gmail.com

    Abstract

    Comparisons between different phenotypic and sequence-based bioniformatic methods for coreceptor usage prediction were performed to establish the role and variation of syncytium-inducing (SI) HIV-1 phenotype on CCR5 and CXCR4 coreceptor usage along the course of vertical infection.
    Thirty-one SI HIV-1 isolates were studied (12 from the acute and 19 from the chronic stage). Infection capacity dependent on CXCR4 only (X4) or on both CXCR4 and CCR5 (R5X4) was determined by re-infection on two cell systems: PHA-activated PBMCs and GHOST coreceptorransfected cells using CXCR4 blockers when necessary.
    Coreceptor usage strikingly differed between those two cell systems. On GHOST cells 95% of SI-isolates were dual tropic (R5X4). On PBMCs, strains obtained at acute infection were predominantly R5X4 (75%), while 70% of SI HIV-1 from chronic stages was X4. In addition, four V3- loop-sequence-based algorithms were applied to the previously mentioned isolates in order to classify them as R5 or X4/R5X4 variants (the net charge, 11/25 rule, PSSM and geno2pheno). Only 66% of SI isolates were classified as X4 using the bioinformatic algorithms. Our study demonstrated that computational algorithms were notoriously inaccurate in predicting tropism of SI-isolates, particularly for those obtained at primary infection since half of them were misclassified as R5 variants by three of the V3-sequence-based phenotype-predictor algorithms. In conclusion, SI variants coreceptor usage may vary according to the method used. Tropism determination of SI strains on PBMCs may more closely indicate the viral behavior in vivo since we use the natural virus target. Differences along the course of infection, such as predominance of dual-R5X4 tropic in the acute stage and prevalence of X4 variants in chronic infection, probably reflect the evolution of coreceptor usage of SI variants during pediatric infection. We also provide strong evidence suggesting that coreceptor usage of HIV-1 should be carefully determined before CCR5 blockers were implemented, particularly in pediatric infection.

    Keywords

    HIV-1; Coreceptors; Children

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  • Genetic Diversity and Antiretroviral Drug Resistance among Drug-Naïve HIV Type 1 Infected Patients attending Clinics in Kinshasa, Democratic Republic of Congo

    Article Information

    Article Type: Research Article
    Citation: Kamangu EN, Chatte A, Susin F, Boreux R, Kalala RL, et al. (2015) Genetic Diversity and Antiretroviral Drug Resistance among Drug-Naïve HIV Type 1 Infected Patients attending Clinics in Kinshasa, Democratic Republic of Congo. J HIV AIDS Volume1.1: http://dx.doi.org/10.16966/jha.101
    Copyright: © 2015 Kamangu EN et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
    Publication history: 
  •  Received date: 18 March, 2015

  •  Accepted date: 16 April, 2015

  •  Published date: 21 April, 2015

    Authors :
    Erick Ntambwe Kamangu,1*      Adawaye Chatté,2      Fabrice Susin,3      Raphael Boreux,4      Richard Lunganza Kalala,1      Georges Lelo Mvumbi,1      Patrick De Mol,4      Dolores Vaira,3       Marie-Pierre Hayette,3,4
    1Molecular Biology Unit, Department of Basic Sciences, Faculty of Medicine, University of Kinshasa (UNIKIN), Kinshasa, Democratic Republic of Congo (DRC)
    2 University Institute of Sciences and Technologies of Abéché, Abéché, Tchad
    3AIDS Reference Laboratory (ARL), Centre Hospitalier Universitaire-Université de Liège (CHU-Lg), Liège, Belgique
    4Clinical MicrobiologyLaboratory, Centre Hospitalier Universitaire-Université de Liège (CHU-Lg), Liège, Belgique
    Corresponding author: Erick Ntambwe Kamangu, Molecular Biology Unit, Department of Basic Sciences, Faculty of Medicine, University of Kinshasa (UNIKIN), Kinshasa, Democratic Republic of Congo (DRC); E-mail: erick.kamangu@unikin.ac.cd or erickamangu@gmail.com

    Abstract

    Background
    The massive use of antiretroviral (ARV) created the emergence of mutant strains resistant to treatment. Thus, the World Health Organization (WHO) recommends epidemiological monitoring for newly infected patients with the Human Immunodeficiency Virus (HIV). The objective of this study is to determine the genetic diversity of HIV Type 1 and the prevalence of mutations associated with resistance to ARV in treatment-naïve patients in Kinshasa. The massive use of antiretroviral (ARV) created the emergence of mutant strains resistant to treatment. Thus, the World Health Organization (WHO) recommends epidemiological monitoring for newly infected patients with the Human Immunodeficiency Virus (HIV). The objective of this study is to determine the genetic diversity of HIV Type 1 and the prevalence of mutations associated with resistance to ARV in treatment-naïve patients in Kinshasa.
    Methods
    One hundred fifty-three subjects diagnosed positive for HIV Type 1 voluntarily participated in this study. They were recruited in different centers in Kinshasa. The inclusions were conducted from August 2013 to February 2014. Five milliliters (5 ml) of blood were collected in a tube with anticoagulant EDTA. Five hundred microliter of plasma was sent for analysis to the AIDS Reference Laboratory of the University Hospital of Liège (CHU-Liège) in Belgium. RNA was extracted from 140 µl of plasma using the QIAamp RNA Mini Kit (QIAGEN®). A Reverse Transcriptase PCR and Nested PCR enabled amplification of the regions of interest on the Protease and Reverse Transcriptase (RT) for subsequent sequencing.
    Results
    The mean age of patients was 37 years, ranging from 18 to 65 years. The median values of Viral Loads (VL) and rate of CD4 lymphocytes were respectively 5.68 log10 RNA copies/ml and 180 cells/ml. Protease and RT were amplified and sequenced, respectively, for 130 (84.9%) and 145 (94.8%) patients out of 153. Subtype A was dominant with 35 cases (22.9%); followed by CRF02_AG (11.1%), C (9.8%), G (9.8%), K (9.8%), D (7.8%), H (7.8%) and J (5.0%).
    Conclusion
    The results of our study confirm the high diversity of HIV Type 1 in Kinshasa. It reveals the heterogeneity and the dynamic of the virus, and the presence of transmitted resistance associated with antiretroviral drugs.

    Keywords
    HIV-1; Genetic Diversity; ARV Resistance; Naïve patients; Kinshasa


    Figure 1: Distribution of HIV Type 1 subtypes among drug-naïve patients in Kinshasa.

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  • The Genetic Variability of HIV-1 in Kyrgyzstan: The Spread of CRF02_AG and Subtype A1 Recombinants

    Article Information
    Article Type: Research Article
    Citation: Laga V, Lapovok I, Kazennova E, Ismailova A, Beisheeva N, et al. (2015) The Genetic Variability of HIV-1 in Kyrgyzstan: The Spread of CRF02_AG and Subtype A1 Recombinants. J HIV AIDS 1(2): http://dx.doi.org/10.16966/jha.106
    Copyright: © 2015 Laga V, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
    Publication history: 
  •  Received date: 12 June 2015

  •  Accepted date: 28 July 2015

  •  Published date: 03 Aug 2015

    Authors : Vita Laga : Ivanovsky Institute of Virology, Moscow, RussiaIlya Lapovok : Ivanovsky Institute of Virology, Moscow, RussiaElena Kazennova : Ivanovsky Institute of Virology, Moscow, RussiaAikul Ismailova : Kyrgyz Republican AIDS Centre, Ministry of Health, Bishkek, Kyrgyzstan
    Nurgul Beisheeva : Kyrgyz Republican AIDS Centre, Ministry of Health, Bishkek, Kyrgyzstan
    Nazgul Asybalieva : Kyrgyz Republican AIDS Centre, Ministry of Health, Bishkek, Kyrgyzstan
    Nataliya Glushchenko : Ivanovsky Institute of Virology, Moscow, RussiaMarina Bobkova : Ivanovsky Institute of Virology, Moscow, Russia 
    Corresponding author: Marina Bobkova, Laboratory of T-lymphotropic Viruses, Ivanovsky Institute of Virology, 123098 Moscow, Russia, Gamaleya 16, Tel: +7 (499) 190 30 63; Fax: +7 (499) 190 30 63; E-mail: mrbobkova@mail.ru
    Abstract
    To evaluate HIV-1 variability and drug resistance, a cross-sectional study involving 57 naïve patients was carried out in Kyrgyzstan, Central Asia, between 2009 and 2010. Most of the patients were men (77.2%), and most of them were injecting drug users (97.7%). To analyze the HIV-1 genetic variability, DNA sequencing in both the PR-RT and gag genome regions was performed.
    The study identified complex HIV-1 molecular epidemiological patterns in Kyrgyzstan with the co-circulation of multiple subtypes, including currently circulating and unique recombinant forms. CRF02_AG was the predominant genetic form (45.6%; 26/57), and the second-most prevalent HIV-1 genetic variant was subtype A1 (IDU-A) (40.4%; 23/57). The phylogenetic analysis results indicate a link between the HIV epidemic in Kyrgyzstan and Russia and Ukraine on the one hand and other Central Asian FSU countries on the other hand. The simultaneous analysis of pol and gag regions allowed the identification of seven unique recombinant forms (12.3%) formed by two major variants (CRF02_AG/A1), each having a specific PR-RT structure. The analysis of drug resistance mutations found NRTI mutations M184I and K65R and NNRTI mutations Y181C, K103N, and G190S in four sequences; no mutations in the PR region were detected.
    The representativeness of this study was limited both in terms of collection size and in terms of the incomplete representation of different population groups. Further studies are needed to better understand the evolution of HIV-1 genetic variants and drug resistance in Kyrgyzstan and Central Asia.
    Keywords

    HIV-1; Subtype; Recombinant; Variability; Kyrgyzstan

    Figure 1: A map of Kyrgyzstan and its bordering countries in central Asia. The dashed lines show some common drug trafficking routes.

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