Effect of Chocolate and Yerba Mate Phenolic Compounds on Inflammatory and Oxidative Biomarkers in HIV/AIDS Individuals.

Flavonoids in cocoa and yerba mate have a beneficial role on inflammation and oxidative disorders. Their effect on HIV individuals has not been studied yet, despite the high cardiovascular risk of this population. This study investigated the role of cocoa and yerba mate consumption on oxidative and inflammatory biomarkers in HIV+ individuals. A cross-over, placebo-controlled, double-blind, randomized clinical trial was conducted in 92 individuals on antiretroviral therapy for at least six months and at viral suppression. Participants were randomized to receive either 65 g of chocolate or chocolate-placebo or 3 g of yerba mate or mate-placebo for 15 days each, alternating by a washout period of 15 days. At baseline, and at the end of each intervention regimen, data regarding anthropometry, inflammatory, oxidative and immunological parameters were collected. High-sensitivity C-reactive protein, fibrinogen, lipid profile, white blood cell profile and thiobarbituric acid reactive substances were assessed. There was a difference between mean concentrations of HDL-c (ANOVA; p ≤ 0.05) among the different regimens: dark chocolate, chocolate-placebo, yerba mate and mate-placebo. When a paired Student t-test was used for comparisons between mean HDL-c at baseline and after each regimen, the mean concentration of HDL-c was higher after supplementation with dark chocolate (p = 0.008).

Conocimiento, Actitud y Práctica del Nutricionista Panameño sobre la Atención Nutricional a Personas con VIH / Knowledge, attitude and practice in Panamanian nutritionists about HIV nutrition-care

Determinar nivel de conocimiento, actitud y práctica de Nutricionistas en atención a personas con VIH. Métodos: Estudio transversal descriptivo con 49 nutricionistas idóneos (90% femenino) del Ministerio de Salud y Caja de Seguro Social de Panamá. Conocimiento fue medido utilizando las Guías de Atención Nutricional del MINSA 2011; actitud y práctica fueron medidas utilizando escala Likert. Se construyeron índices para conocimiento, actitud y práctica. Se utilizó regresión simple para determinar la relación entre las variables. Resultados: La mediana (rango intercuartílico p75-p25) de edad fue 33(22,4) años; años de experiencia fue 7(15) años; 53% indicó que en su instalación existe una clínica de terapia antirretroviral (CTAR); y 78% no había recibido entrenamiento previo a la entrevista. El conocimiento se relacionó significativamente (p<0,05) con la existencia de CTAR (β e IC95%) 0,96(0,1; 1,8); con años de experiencia -0,05(-0,1; -0,01); y con índice de práctica 0,11(0,1; 0,2). El índice de práctica se relacionó con existencia de CTAR 6,8(2,9; 10,8); con nivel de conocimiento 2,5(1,3; 3,8); y con índice de actitud 0,8(0,3; 1,4). El índice de actitud se relacionó con existencia de CTAR 2,4(0,4; 4,4); con haber recibido entrenamiento previo 2,7(0,3; 5,1); y con índice de práctica 0,2(0,1; 0,3). Conclusión: La existencia de CTAR estuvo relacionada con mejor conocimiento, índice de actitud e índice de práctica. Mayor conocimiento e índice de actitud se relacionaron con un mayor índice de práctica. Entrenamiento previo estuvo relacionado con mayor índice de actitud. Se observó relación negativa entre años de experiencia y nivel de conocimiento...

To determine the level of knowledge, attitude and practice on HIV nutrition-care in Panamanian nutritionists. Methods: A cross-sectional study was made among 49 nutritionists who were enrolled in health centers. Knowledge was measured according to MoH HIV Nutrition-Care Guide 2011; attitude and practice were obtained using a Likert scale. Indices were constructed for knowledge, attitude and practice. Simple linear regression models were performed to determine the relation among variables. Results: Median (iqr) age was 33(22,4); for year of experiences was 7(15). 49% reported work in the Minister of Health; 53% reported no anti-retroviral therapy clinic (ARTC) at place of work; 78% no having any previous training on HIV Nutrition Care. knowledge was significantly associated (p<.05) with the existence of a ARTC β(CI95%) 0.96(0.1;1.8); years of experience -0.05(-0.1;-0.01), and practice 0.11(0.1;0.2); practice was associated with ARTC 6.8(2.9;10.8); knowledge 2.5(1.3;3.8); and attitude 0.8(0.3;1.4); and attitude was associated with ARTC 2.4(0.4;4.4); prior training 2.7(0.3;5.1); and practice 0.2(0.1;0.3). Conclusion: ARTC was associated with knowledge, attitude and practice. Better knowledge and attitude were associated with practice. Previous training was associated with attitude; and a negative association was observed between years of experience and knowledge...

Nutritional care, time period since diagnosis, demographics and body mass index in HIV/AIDS patients.

BACKGROUND: Nutritional status and nutritional care have long been ignored among HIV/AIDS patients. Furthermore, in Mexico there is no information on potential factors favoring weight increase in such population. OBJECTIVE: To assess the association between the time period since diagnosis, demographics and BMI in different categories of patients with HIV/AIDS in Monterrey, Mexico. In addition, to provide information on overweight/obesity prevalence and nutritional care referral. MATERIAL AND METHODS: This was a cross-sectional study of HIV/AIDS positive patients receiving outpatient secondary care (n = 231). Nutritional care referral, time period since diagnosis and demographic data were obtained by interview. A standardized and registered dietitian collected anthropometrics measures. Binary multiple logistic regression was used to evaluate the association between increasing BMI categories and variables of interest. RESULTS: Mean patient age was 40.6 ± 11.2 years, 87% were male, 79.2% were economically active, 65% were single and 60% had less than a college education. The average time since diagnosis was 6.5 ± 5.4 years. Overweight and obesity prevalence were 35.8% and 12.5%, respectively. Only 18% of patients had ever been referred for nutritional care. The time period since diagnosis, the sum of skinfold measurements and the waist-to-hip ratio, were significantly predictive of the BMI category (normal/underweight vs. overweight/obese), when controlling for nutritional care referral and daily carbohydrate intake; age and marital status were not associated with BMI category. CONCLUSIONS: Identification of predisposing factors to overweight/obesity among HIV/AIDS patients constitutes a significant step for providing nutritional care, of the same importance as the load or CD4+ count, especially nowadays, with more common increased survival rates and consequently, longer lives with the disease.

Sialic acid associated with αvß3 integrin mediates HIV-1 Tat protein interaction and endothelial cell proangiogenic activation.

Sialic acid (NeuAc) is a major anion on endothelial cells (ECs) that regulates different biological processes including angiogenesis. NeuAc is present in the oligosaccharidic portion of integrins, receptors that interact with extracellular matrix components and growth factors regulating cell adhesion, migration, and proliferation. Tat is a cationic polypeptide that, once released by HIV-1(+) cells, accumulates in the extracellular matrix, promoting EC adhesion and proangiogenic activation by engaging α(v)ß(3). By using two complementary approaches (NeuAc removal by neuraminidase or its masking by NeuAc-binding lectin from Maackia amurensis, MAA), we investigated the presence of NeuAc on endothelial α(v)ß(3) and its role in Tat interaction, EC adhesion, and proangiogenic activation. α(v)ß(3) immunoprecipitation with biotinylated MAA or Western blot analysis of neuraminidase-treated ECs demonstrated that NeuAc is associated with both the α(v) and the ß(3) subunits. Surface plasmon resonance analysis demonstrated that the masking of α(v)ß(3)-associated NeuAc by MAA prevents Tat/α(v)ß(3) interaction. MAA and neuraminidase prevent α(v)ß(3)-dependent EC adhesion to Tat, the consequent FAK and ERK1/2 phosphorylation, and EC proliferation, migration, and regeneration in a wound-healing assay. Finally, MAA inhibits Tat-induced neovascularization in the ex vivo human artery ring sprouting assay. The inhibitions are specific because the NeuAc-unrelated lectin from Ulex europaeus is ineffective on Tat. Also, MAA and neuraminidase affect only weakly integrin-dependent EC adhesion and proangiogenic activation by fibronectin. In conclusion, NeuAc is associated with endothelial α(v)ß(3) and mediates Tat-dependent EC adhesion and proangiogenic activation. These data point to the possibility to target integrin glycosylation for the treatment of angiogenesis/AIDS-associated pathologies.

The impact of integrating food supplementation, nutritional education and HAART (Highly Active Antiretroviral Therapy) on the nutritional status of patients living with HIV/AIDS in Mozambique: results from the DREAM Programme.

DREAM (Drug Resources Enhancement against AIDS and Malnutrition) is a multiregional health program active in Mozambique since 2002 and provides free of charge an integrating package of care consisting of peer to peer nutritional and health education, food supplementation, voluntary counseling and testing, immunological, virological, clinical assessment and HAART (Highly Active AntiRetroviral Treatment). The main goals of this paper are to describe the state of health and nutrition and the adequacy of the diet of a sample of HIV/AIDS patients in Mozambique on HAART and not. A single-arm retrospective cohort study was conducted. 106 HIV/AIDS adult patients (84 in HAART), all receiving food supplementation and peer-to-peer nutritional education, were randomly recruited in Mozambique in two public health centres where DREAM is running. The programme is characterized by: provision of HAART, clinical and laboratory monitoring, peer to peer health and nutritional education and food supplementation. We measured BMI, haemoglobin, viral load, CD4 count at baseline (T0) and after at least 1 year (T1). Dietary intake was estimated using 24h food recall and dietary diversity was assessed by using the Dietary Diversity Score (DDS) at T1. Overall, the patients'diet appeared to be quite balanced in nutrients. In the cohort not in HAART the mean BMI values showed an increases but not significant (initial value: 21.9 ± 2.9; final value: 22.5 ± 3.3 ) and the mean haemoglobin values (g/dl) showed a significant increases (initial value: 10.5+ 2.1; final value: 11.5 ± 1.7 p< 0.024) . In the cohort in HAART, both the mean of BMI value (initial value: 20.7 ± 3.9; final value: 21.9 ± 3.3 p< 0.001) and of haemoglobin (initial value: 9.9 ± 2.2; final value: 10.8 ± 1.7 p< 0.001) showed a higher significant increase. The increase in BMI was statistically associated with the DDS in HAART patients. In conclusion nutritional status improvement was observed in both cohorts. The improvement in BMI was significant and substantially higher in HAART patients because of the impact of HAART on nutritional status of AIDS patients. Subjects on HAART and with a DDS > 5, showed a substantial BMI gain. This association showed an additional expression of the synergic effect of integrating food supplementation, nutritional education and HAART on the nutritional status of African AIDS patients and also highlights the complementary role of an adequate and diversified diet in persons living with HIV/AIDS in resources limited settings.

Perfil nutricional e bioquímico dos pacientes HIV positivos em atendimento no ambulatório de infectologia do Hospital Universitário Antonio Pedro em Niterói - RJ / Biochemical and nutritional profile of HIV-positive patients in the outpatient clinic of infectious diseases at the University Hospital Antonio Pedro in Niterói - RJ

Desde 1980, ano da identificação do primeiro caso de aids no Brasil, mais de meio milhão de novos casos foram notificados no país. A região Sudeste foi a mais atingida com mais de 300 mil casos. No estado do Rio de Janeiro foram identificados 81.606 casos da doença, 48.061 dos quais na capital apenas...Este estudo foi aprovado pelo Comitê de Ética em Pesquisa do HUAP. Num período de 13 meses, foram estudados 235 pacientes, sendo a maioria do sexo masculino(55,3%). A média de idade dos pacientes foi de 43,1 anos, com o predomínio de raça não branca (50,6%). Em relação ao estado nutricional 5,5% da população estudada apresentava baixo peso , 54,4% apresentavam classificação normal, 26% sobrepeso e 11,1% obesidade. Os exames de glicemia de jejum estavam alteradas em 13,7% dos indivíduos, o colesterol total em 40,8%, o LDL em 33,5% e o HDL em 47,9% deles. Este estudo mostra elevado sobrepeso e obesidade na população com HIV/aids, identificando a necessidade em se conhecer o perfil nutricional desses pacientes e tomando as medidas necessárias para o seu controle precoce.

Synthesis and biological activity of Wuweizisu C and analogs.

Lignans are widely distributed in nature. The earliest recorded medicinal use of lignans dated back to over 1000 years ago. Lignan-rich plant products were also active ingredients in Chinese and Japanese folk medicines for the treatment of various diseases. The dried root and stem of this plant are listed in the Chinese pharmacopoeia for the treatment of rheumatoid arthritis, gastric, duodenal ulcers and many other diseases. This review highlights synthetic strategies for the Wuweizisu C analogs and the important pharmacological activities as well as therapeutic findings related to the treatment of HBV and other diseases. Notably a significant and ongoing project on Wuweizisu C and its analogs has led to the discovery and development of two potent derivatives alpha-DDB and BICYCLOL which are currently in clinical trials against HBV, especially in lowering elevated SGPT levels. Further design, synthesis, and evaluation of Wuweizisu C analogs are discussed.

[Impact of micronutrients on immunocyte and microelements status among people living with HIV].

OBJECTIVE: To explore the impact of micronutrients supplement on immunocyte and microelements status in HIV positive people. METHODS: Volunteers aged 25-49 years old were randomly selected and distributed into two groups. Supplement and placebo were given to the two groups. At the beginning of the trial, data on physical examination, immunocyte and microelements level in serum of the two groups were collected and showed no significant difference (P > 0.05). RESULTS: After 6 months, the amount of immunocyte (CD4+, CD8+, CD3+) were (2078 +/- 108) mm3, (582 +/- 75) mm3, (1287 +/- 97) mm3 in the study group while they were (1436 +/- 105) mm3, (472 +/- 61) mm3, (998 +/- 84) mm3 in the control group, with statistically significant difference (P < 0.05). Amounts of serum Zn, Ca, Mg, Fe showed (144.89 +/- 9.78) micromol/L, (1.89 +/- 0.19) micromol/L, (1.68 +/- 0.12) micromol/L, (152.61 +/- 8.94) micromol/L in the study group and they were (102.67 +/- 5.45) micromol/L, (1.13 +/- 0.07) micromol/L, (0.85 +/- 0.05) micromol/L, (89.24 +/- 3.91) micromol/L in the control group, with statistically significant difference (P < 0.05). CONCLUSION: Supplementation of micronutrients could increase the levels of Zn, Ca, Mg, Fe so as to increase the immune function in people living with HIV.

Malnutrición y VIH / Malnutrition and HIV

El Síndrome de Inmunodeficiencia Adquirida (SIDA) es el estadio avanzado de la infección por el Virus de Inmunodeficiencia Humana (VIH), considerándose en este momento una enfermedad emergente por el incremento de los casos en los últimos dos decenios Esta pandemia ha causado efectos catastróficos en la seguridad alimentaría de los países aumentando el grado de miseria y escasez de alimentos La desnutrición entonces es una amenaza real para todos aquellos que viven con el VIH /SIDA desde los primeros momentos de infestarse. La alimentación en los pacientes de SIDA es un tema que aún no se ha estudiado con gran profundidad, aunque desde los comienzos de la historia de esta enfermedad se pensara que podía tener cierta relevancia por tratarse de un virus que ataca directamente al sistema inmune, relacionado en gran medida con el estado general del individuo y su nutrición. En esta revisión vemos los diferentes aspectos de la vinculación VIH/SIDA con la malnutrición y su corrección(AU)

The Acquired Immunodeficiency Syndrome is the advanced stage of the Human Immunodeficiency Virus. In this moment it is considered an emergent disease because of the increase of the cases in the last two decades. This pandemics has caused catastrophic effects on the alimentary security of many countries, increasing the level of misery and the scarcity of food. Then, malnutrition is a real menace for all those people living with the Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome since the first moments after getting infected. Nutrition of Acquired Immunodeficiency Syndrome patients is a theme that has not been studied deeply, although since the beginning of this disease history, everybody thought that it could have certain relevance because it is a virus directly attacking the immune system, related with the general status of the individual and its nutrition. In this review we deal with the different aspects relating Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome and malnutrition and its correction(AU)

Effect of a liquid nutritional supplement on viral load and haematological parameters in HIV-positive/AIDS patients.

The effect of a nutritional supplement on the immune status and haematological parameters of HIV-positive/AIDS patients is tested using standard procedures. This clinical trial of 35 patients consists of a baseline visit and three months of supplementation from April to September 2003. Results showed that viral load decreased significantly (P<0.002) with time following supplementation. Mean cell volume (MCV) and mean cell haemoglobin concentration (MCHC) increased significantly (P<0.002 and P<0.0002, respectively), reflecting the positive effect of the supplement on these haematological parameters. Supplementation had no effect on CD4+ T-cell count, which decreased significantly with disease progression. Owing to certain limitations of the study (small sample size, short duration and the late stage of HIV infection), further studies are needed to confirm the effect attributed to the supplement.

Improving dietary habits in disadvantaged women with HIV/AIDS: the SMART/EST women's project.

There is a lack of information on whether brief nutrition education can succeed in improving longer-term dietary patterns in disadvantaged populations with HIV/AIDS. In the SMART/EST II Women's Project 466 disadvantaged women with HIV/AIDS were randomized to one of four groups and received a two-phase training consisting of a coping skills/stress management and nutrition education provided either in a group or individually. At baseline the majority of participants had excessive fat and sugar consumption and suboptimal intakes of vegetables, fruits, calcium-rich foods and whole grains. Dietary patterns for all participants improved after the nutrition intervention primarily due to decreases in high fat and high sugar foods such as soda and fried foods and were still significantly better 18 months later. There were only short-term differences in improvements between the four groups. These findings support the value of even brief nutrition education for disadvantaged women living with HIV/AIDS.

Hablemos del VIH - SIDA / Lo que los y las adolescentes queremos saber / Let us speak of the HIV - AIDS

Da a conocer cual es la diferencia entre una persona seropositiva y una persona con SIDA, las creencias, conocimientos y actitudes antes las personas que padecen de la enfermedad. Aborda la historia como se desarrollo esta enfermedad, asi como cuales son sus etapas de desarrollo, la forma de transmisión y algunas orientaciones de como prevenirla. También orienta sobre el Virus de Inmunodeficiencia Humana

How HIV-1 causes AIDS: implications for prevention and treatment.

HIV-1 encodes for one of the human glutathione peroxidases. As a consequence, as it is replicated, its genetic needs cause it to deprive HIV-1 seropositive individuals not only of glutathione peroxidase, but also of the four basic components of this selenoenzyme, namely selenium, cysteine, glutamine, and tryptophan. Eventually this depletion process causes severe deficiencies of all these substances. These, in turn, are responsible for the major symptoms of AIDS which include immune system collapse, greater susceptibility to cancer and myocardial infarction, muscle wasting, depression, diarrhea, psychosis and dementia. As the immune system fails, associated pathogenic cofactors become responsible for a variety of their own unique symptoms. Any treatment for HIV/AIDS must, therefore, include normalization of body levels of glutathione, glutathione peroxidase, selenium, cysteine, glutamine, and tryptophan. Although various clinical trials have improved the health of AIDS patients by correcting one or more of these nutritional deficiencies, they have not, until the present, been addressed together. Physicians involved in a selenium and amino-acid field trial in Botswana, however, are reporting that this nutritional protocol reverses AIDS in 99% of patients receiving it, usually within three weeks.