Predictors of HIV positivity among pregnant women presenting for obstetric care in South India - a case-control study.

Feminization of the HIV epidemic in India has increasingly burdened the public health infrastructure to provide prevention of mother-to-child transmission (PMTCT) services. A mere 20% of pregnant women in the country receive HIV counseling and testing. One of the strategies, for expansion of PMTCT services is to ascertain an accurate identification of HIV-positive pregnant women. Thus, we sought to characterize a demographic profile of pregnant women at high-risk for HIV infection. We performed a retrospective case-control study. We included as cases, all HIV-positive women identified in a PMTCT program implemented in 23 charitable faith-based hospitals in four states in South India over a period of 75 months, starting in January 2003. Thus a total of 320 HIV-positive cases were frequency matched using stratified random sampling to 365 HIV-negative pregnant women presenting for antenatal care during the same time period. Cases and controls were compared using Chi-square test for categorical variables and Student's t-test for continuous variables. Multivariate step-wise logistic regression analysis was performed. On multivariate analysis, following factors were independently predictive of HIV positivity: age ≤25 years (odds ratio [OR] 0.50; confidence interval [CI] 0.33-0.76; p = 0.001); illiteracy (OR 4.89; CI 2.79-8.57; p <0.0001); woman holding a service and/or professional job (OR 0.27; CI 0.14-0.53; p <0.0001); spouses holding a service or higher job (OR 3.13; CI 2.13-4.59; p <0.0001); being married ≤5 years (OR 2.89; CI 1.68-4.95; p <0.0001); late gestational age at presentation (OR 3.06; CI 2.04-4.59; p <0.0001); history of fetal and/or live born loss (OR 2.36; CI 1.51-3.67; p <0.0001). To our knowledge this is the first large study to evaluate factors predictive of HIV positivity among women presenting for antenatal care in the Indian setting. This type of profiling of HIV-positive pregnant women may help expand PMTCT services in a focused and cost-effective manner in India.

A relationship between CD4 count and oral manifestations of human immunodeficiency virus-infected patients on highly active antiretroviral therapy in urban population.

INTRODUCTION: Human immunodeficiency virus (HIV) infection gradually destroys the body's immune system, which makes it harder for the body to fight infections. HIV infection causes a quantitative and qualitative depletion of CD4 lymphocyte count, which increases the risk of opportunistic infections. Thus, CD4 count is one of the key factors in determining both the urgency of highly active antiretroviral therapy (HAART) initiation and the need of prophylaxis for opportunistic infections. AIM: This study aims to evaluate the prevalence and variations in the oral manifestations of HIV/acquired immune deficiency syndrome patients on HAART therapy in urban population and their association with CD4 count. MATERIALS AND METHODS: A study was conducted by screening eighty patients who were HIV positive in an urban location. Both adult and pediatric patients were screened for oral manifestations and simultaneously CD4 count was also evaluated. Patients with HIV infection for variable time period who are under HAART were considered. STATISTICAL ANALYSIS: Measures of central tendency were used to analyse the data. RESULTS: HIV infection destroys the immune system of an individual, making the patient susceptible to various infections and malignancies. With the advent of antiretroviral therapy, the scenario has changed drastically. We have observed that patients with CD4 counts between 164 and 1286 show relatively few oral manifestations. Long-term HAART therapy causes pigmentation, xerostomia and angular cheilitis but is taken up quite well by the patients. CONCLUSION: In this study, eighty patients with HAART from urban population showed very minimal oral findings because of good accessibility for treatment and awareness about HIV infections. The patients who were on long-standing HAART treatment also showed minimal oral manifestation such as pigmentation and xerostomia. Hence, we conclude that recognition, significance and treatment of these lesions in patients with HIV infection do not require elaborate setup and can be treated with basic primary health care.

A Descriptive Study on the Users and Utility of HIV/AIDS Helpline in Karnataka, India.

BACKGROUND: Globally, Telephone help-lines have proved their utility in several crisis situations. They were introduced in India for helping persons in need of counseling or emergency care such as victims of suicide, cardiac arrests, etc. The utility of such help-lines in HIV/AIDS has not been established .Hence this study done in ASHA Foundation, Bangalore. OBJECTIVES: To determine the characteristics of persons who access the HIV/AIDS helpline. To determine the reasons for calling the helpline. To identify the gaps in the provision of this service. MATERIALS AND METHODS: Details on all calls received on ASHA Foundation's HIV/AIDS help line during the period January 2007 to December 2008, were entered on MS excel worksheet and analyzed using the SPSS software. RESULTS: Majority of callers are male, are in the age group of 20-39 years and educated. The most common reasons for calling the helpline were for HIV testing, information about HIV/AIDS, care and support services and referrals to other services not linked to HIV/AIDS. Reasons for calling were linked to risk ( HIV testing, condom use etc) in younger persons, and to avail of care and support services in the older age-group. CONCLUSIONS: The main users of the HIV/AIDS helpline are urban ,young, educated males.

Retinol enhances differentiation of the gastric parietal cell lineage in developing rabbits.

In the gastric glands, parietal cells are the targets for anti-ulcer drugs because they contain the proton pump or HK-ATPase responsible for acid secretion. Little is known about factors influencing developmental expression and activity of HK-ATPase. In this study, the parietal cell lineage was investigated in rabbits at post-natal days 0 (P0) to P60 by using morphological and biochemical methods. Immunohistochemical and ultrastructural studies show that the HK-ATPase-expressing cells that appear at P0 and P3 are pre-parietal cells. However, terminally differentiated, mature parietal cells make their appearance at P7. These data correlate with the activity of HK-ATPase, measured as K(+)-dependent hydrolysis of p-nitrophenyl phosphate. Three-day-retinol treatment of P3-P30 rabbits induced an increase in the (i) production of parietal cells, (ii) intensity of the HK-ATPase immunostaining per cell, (iii) activity of HK-ATPase and (iv) amount of HK-ATPase protein measured by Western blotting. In conclusion, retinol upregulates the development of HK-ATPase in rabbits, perhaps due to precocious acceleration of the differentiation program of parietal cell lineage.