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1.
Acta sci., Health sci ; 44: e56401, Jan. 14, 2022.
Artigo em Inglês | LILACS | ID: biblio-1367453

RESUMO

Blood-borne viruses, includingthe human immunodeficiency virus and hepatitis B virus, have certain common epidemiological characteristics and these viruses infect millions of people worldwide. This study aimed to determine the job satisfaction and the level of knowledge and practices regarding infectious diseases of employees working as hairdressers and barbers.This descriptive and cross-sectional study comprised 1200 hairdressers and barbers. The study sample comprised 628 people who consented to participate in the study. The mean age of the participants who participated in the study was 28, 13 ± 6. 9 years. The mean job satisfaction score of the participants was 3.85 ± 0.58. The job satisfaction score was found to be higher among those with sufficient knowledge of hepatitis B (p < 0.005). Employees should be provided performance trainings to achieve job satisfaction. It is recommended that employees be encouraged to wear gloves and gowns to protect their health and prevent contamination.


Assuntos
Humanos , Masculino , Feminino , Adulto , Barbearia/instrumentação , HIV , Conhecimento , Centros de Embelezamento e Estética , Hepatite B/epidemiologia , Hepatite B/virologia , Vírus da Hepatite B , Doenças Transmissíveis/transmissão , Doenças Transmissíveis/epidemiologia , Saúde Ocupacional/etnologia , Síndrome de Imunodeficiência Adquirida/epidemiologia , Síndrome de Imunodeficiência Adquirida/virologia , Equipamento de Proteção Individual/provisão & distribuição , Equipamento de Proteção Individual/virologia , Satisfação no Emprego , Categorias de Trabalhadores
2.
Sci Rep ; 11(1): 24353, 2021 12 21.
Artigo em Inglês | MEDLINE | ID: mdl-34934097

RESUMO

HIV-associated malignancies are responsible for morbidity and mortality increasingly in the era of potent antiretroviral therapy. This study aimed to investigate the distribution of HIV-associated malignancies among inpatients, the immunodeficiency and the effect of antiretroviral therapy (ART) on spectrum of HIV-associated malignancies. A total of 438 cases were enrolled from 2007 to 2020 in Beijing Ditan Hospital. Demographic, clinical and laboratory data, managements, and outcomes were collected and analyzed retrospectively. Of 438 cases, 433 were assigned to non-AIDS-defining cancers (NADCs) (n = 200, 45.7%) and AIDS-defining cancers (ADCs) (n = 233, 53.2%), 5 (1.1%) with lymphoma were not specified further. No significant change was observed in the proportion of NADCs and ADCs as time goes on. Of NADCs, lung cancer (n = 38, 19%) was the most common type, followed by thyroid cancer (n = 17, 8.5%). Patients with ADCs had lower CD4 counts(104.5/µL vs. 314/µL), less suppression of HIVRNA(OR 0.23, 95%CI 0.16-0.35) compared to those with NADCs. ART did not affect spectrum of NADCs, but affect that of ADCs (between patients with detectable and undetectable HIVRNA). ADCs remain frequent in China, and NADCs play an important role in morbidity and mortality of HIV positive population.


Assuntos
Síndrome de Imunodeficiência Adquirida/complicações , Terapia Antirretroviral de Alta Atividade/métodos , HIV/isolamento & purificação , Pacientes Internados/estatística & dados numéricos , Neoplasias/epidemiologia , Síndrome de Imunodeficiência Adquirida/tratamento farmacológico , Síndrome de Imunodeficiência Adquirida/virologia , China/epidemiologia , HIV/efeitos dos fármacos , Humanos , Neoplasias/virologia , Estudos Retrospectivos , Fatores de Risco
3.
Biomolecules ; 11(12)2021 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-34944448

RESUMO

Acquired immunodeficiency syndrome (AIDS) caused by the human immunodeficiency virus (HIV) continues to be a public health problem. In 2020, 680,000 people died from HIV-related causes, and 1.5 million people were infected. Antiretrovirals are a way to control HIV infection but not to cure AIDS. As such, effective treatment must be developed to control AIDS. Developing a drug is not an easy task, and there is an enormous amount of work and economic resources invested. For this reason, it is highly convenient to employ computer-aided drug design methods, which can help generate and identify novel molecules. Using the de novo design, novel molecules can be developed using fragments as building blocks. In this work, we develop a virtual focused compound library of HIV-1 viral protease inhibitors from natural product fragments. Natural products are characterized by a large diversity of functional groups, many sp3 atoms, and chiral centers. Pseudo-natural products are a combination of natural products fragments that keep the desired structural characteristics from different natural products. An interactive version of chemical space visualization of virtual compounds focused on HIV-1 viral protease inhibitors from natural product fragments is freely available in the supplementary material.


Assuntos
Produtos Biológicos/síntese química , Inibidores da Protease de HIV/síntese química , HIV-1/enzimologia , Síndrome de Imunodeficiência Adquirida/tratamento farmacológico , Síndrome de Imunodeficiência Adquirida/virologia , Produtos Biológicos/química , Produtos Biológicos/farmacologia , Computadores , Bases de Dados de Produtos Farmacêuticos , Desenho de Fármacos , Inibidores da Protease de HIV/química , Inibidores da Protease de HIV/farmacologia , HIV-1/efeitos dos fármacos , Humanos , Estrutura Molecular , Relação Estrutura-Atividade
5.
Int J Mol Sci ; 22(15)2021 Jul 29.
Artigo em Inglês | MEDLINE | ID: mdl-34360891

RESUMO

Globally, HIV/AIDS and cancer are increasingly public health problems and continue to exist as comorbidities. The sub-Saharan African region has the largest number of HIV infections. Malignancies previously associated with HIV/AIDS, also known as the AIDS-defining cancers (ADCs) have been documented to decrease, while the non-AIDS defining cancer (NADCs) are on the rise. On the other hand, cancer is a highly heterogeneous disease and precision oncology as the most effective cancer therapy is gaining attraction. Among HIV-infected individuals, the increased risk for developing cancer is due to the immune system of the patient being suppressed, frequent coinfection with oncogenic viruses and an increase in risky behavior such as poor lifestyle. The core of personalised medicine for cancer depends on the discovery and the development of biomarkers. Biomarkers are specific and highly sensitive markers that reveal information that aid in leading to the diagnosis, prognosis and therapy of the disease. This review focuses mainly on the risk assessment, diagnostic, prognostic and therapeutic role of various cancer biomarkers in HIV-positive patients. A careful selection of sensitive and specific HIV-associated cancer biomarkers is required to identify patients at most risk of tumour development, thus improving the diagnosis and prognosis of the disease.


Assuntos
Síndrome de Imunodeficiência Adquirida/diagnóstico , Síndrome de Imunodeficiência Adquirida/epidemiologia , HIV-1 , Neoplasias/diagnóstico , Neoplasias/epidemiologia , Síndrome de Imunodeficiência Adquirida/tratamento farmacológico , Síndrome de Imunodeficiência Adquirida/virologia , Terapia Antirretroviral de Alta Atividade/métodos , Biomarcadores Tumorais/classificação , Biomarcadores Tumorais/genética , Biomarcadores Tumorais/metabolismo , Comorbidade , Detecção Precoce de Câncer , Feminino , Humanos , Masculino , Neoplasias/genética , Neoplasias/metabolismo , Vírus Oncogênicos , Medicina de Precisão/métodos , Prevalência , Prognóstico , Medição de Risco , Fatores de Risco , Resultado do Tratamento
6.
Signal Transduct Target Ther ; 6(1): 217, 2021 06 09.
Artigo em Inglês | MEDLINE | ID: mdl-34103473

RESUMO

We examined the safety and efficacy of human umbilical cord mesenchymal stem cell (hUC-MSC) infusion for immune non-responder (INR) patients with chronic HIV-1 infection, who represent an unmet medical need even in the era of efficient antiretroviral therapy (ART). Seventy-two INR patients with HIV were enrolled in this phase II randomized, double-blinded, multicenter, placebo-controlled, dose-determination trial (NCT01213186) from May 2013 to March 2016. They were assigned to receive high-dose (1.5 × 106/kg body weight) or low-dose (0.5 × 106/kg body weight) hUC-MSC, or placebo. Their clinical and immunological parameters were monitored during the 96-week follow-up study. We found that hUC-MSC treatment was safe and well-tolerated. Compared with baseline, there was a statistical increase in CD4+ T counts in the high-dose (P < 0.001) and low-dose (P < 0.001) groups after 48-week treatment, but no change was observed in the control group. Kaplan-Meier analysis revealed a higher cumulative probability of achieving an immunological response in the low-dose group compared with the control group (95.8% vs. 70.8%, P = 0.004). However, no significant changes in CD4/CD8+ T counts and CD4/CD8 ratios were observed among the three groups. In summary, hUC-MSC treatment is safe. However, the therapeutic efficacy of hUC-MSC treatment to improve the immune reconstitution in INR patients still needs to be further investigated in a large cohort study.


Assuntos
Síndrome de Imunodeficiência Adquirida/terapia , Doença Enxerto-Hospedeiro/terapia , Infecções por HIV/terapia , Cordão Umbilical/transplante , Síndrome de Imunodeficiência Adquirida/patologia , Síndrome de Imunodeficiência Adquirida/virologia , Adulto , Contagem de Linfócito CD4 , Estudos de Coortes , Feminino , Seguimentos , Doença Enxerto-Hospedeiro/patologia , Doença Enxerto-Hospedeiro/virologia , Infecções por HIV/patologia , Infecções por HIV/virologia , Humanos , Fatores Imunológicos/genética , Fatores Imunológicos/imunologia , Masculino , Transplante de Células-Tronco Mesenquimais/efeitos adversos , Células-Tronco Mesenquimais/citologia , Pessoa de Meia-Idade , Cordão Umbilical/virologia
7.
BMC Infect Dis ; 21(1): 448, 2021 May 18.
Artigo em Inglês | MEDLINE | ID: mdl-34006230

RESUMO

BACKGROUND: In the era of anti-retroviral therapy (ART), the plasma HIV viral load (VL) is an important primary indicator for monitoring the HIV treatment response. To optimize the clinical management of HIV/AIDS patients, we investigated VL high-risk events related to virological failure (VF) and further explored the preventive factors of VL high-risk events. METHODS: The data were derived from China's HIV/AIDS Comprehensive Response Information Management System. HIV infected patients who initiated or received ART in Guangxi between 2003 and 2019 were included. The contributions of VL after 6 months of ART to VF and AIDS-related death were analysed by Kaplan-Meier curves, log-rank tests and Cox regression analyses. Both descriptive analyses and bivariate logistic regression were employed to further explore the preventive factors related to VL high-risk events of VF. RESULTS: The cumulative rates of VF in the high low-level viremia group (high LLV) (χ2 = 18.45; P <  0.001) and non-suppressed group (χ2 = 82.99; P <  0.001) were significantly higher than those in the viral suppression (VS) group. Therefore, the VL high-risk events of VF was defined as highest VL > 200 copies/ml after 6 months of ART. Compared with the VS group, the adjusted hazard risk was 7.221 (95% CI: 2.668; 19.547) in the high LLV group and 8.351 (95% CI: 4.253; 16.398) in the non-suppressed group. Compared with single patients, married or cohabiting (AOR = 0.591; 95% CI: 0.408, 0.856) and divorced or separated (AOR = 0.425, 95% CI: 0.207, 0.873) patients were negatively associated with VL high-risk events. So were patients acquired HIV homosexually (AOR = 0.572; 95% CI: 0.335, 0.978). However, patients who had ART modification were 1.728 times (95% CI: 1.093, 2.732) more likely to have VL high-risk events, and patients who used cotrimoxazole during ART were 1.843 times (95% CI: 1.271, 2.672) more likely to have VL high-risk events. CONCLUSIONS: A VL greater than 200 copies/ml is a VL high-risk event for VF. Intervention measurements should be adopted to optimize the surveillance of ART in patients who are single or widowed, who have ART modification, and who use cotrimoxazole during ART.


Assuntos
Síndrome de Imunodeficiência Adquirida/tratamento farmacológico , Antirretrovirais/uso terapêutico , HIV-1/fisiologia , Síndrome de Imunodeficiência Adquirida/epidemiologia , Síndrome de Imunodeficiência Adquirida/mortalidade , Síndrome de Imunodeficiência Adquirida/virologia , Adulto , China/epidemiologia , Feminino , HIV-1/isolamento & purificação , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Taxa de Sobrevida , Falha de Tratamento , Carga Viral
8.
J Virol ; 95(15): e0034221, 2021 07 12.
Artigo em Inglês | MEDLINE | ID: mdl-33980600

RESUMO

After human immunodeficiency virus type 1 (HIV-1) was identified in the early 1980s, intensive work began to understand the molecular basis of HIV-1 gene expression. Subgenomic HIV-1 RNA regions, spread throughout the viral genome, were described to have a negative impact on the nuclear export of some viral transcripts. Those studies revealed an intrinsic RNA code as a new form of nuclear export regulation. Since such regulatory regions were later also identified in other viruses, as well as in cellular genes, it can be assumed that, during evolution, viruses took advantage of them to achieve more sophisticated replication mechanisms. Here, we review HIV-1 cis-acting repressive sequences that have been identified, and we discuss their possible underlying mechanisms and importance. Additionally, we show how current bioinformatic tools might allow more predictive approaches to identify and investigate them.


Assuntos
Transporte Ativo do Núcleo Celular/genética , Regulação Viral da Expressão Gênica/genética , HIV-1/crescimento & desenvolvimento , HIV-1/genética , Replicação Viral/genética , Síndrome de Imunodeficiência Adquirida/patologia , Síndrome de Imunodeficiência Adquirida/virologia , Algoritmos , Biologia Computacional/métodos , Genoma Viral/genética , Humanos , RNA Viral/genética , Produtos do Gene env do Vírus da Imunodeficiência Humana/genética , Produtos do Gene gag do Vírus da Imunodeficiência Humana/genética , Produtos do Gene pol do Vírus da Imunodeficiência Humana/genética
9.
Curr Opin Virol ; 48: 57-64, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33901736

RESUMO

HIV-1 is the causative agent of acquired immunodeficiency syndrome (AIDS), a global pandemic that has claimed 32.7 million lives since 1981. Despite decades of research, there is no cure for the disease, with 38 million people currently infected with HIV. Attractive therapeutic targets for drug development are mature HIV-1 capsids, immature Gag polyprotein assemblies, and Gag maturation intermediates, although their complex architectures, pleomorphism, and dynamics render these assemblies challenging for structural biology. The recent development of integrative approaches, combining experimental and computational methods has enabled atomic-level characterization of structures and dynamics of capsid and Gag assemblies, and revealed their interactions with small-molecule inhibitors and host factors. These structures provide important insights that will guide the development of capsid and maturation inhibitors.


Assuntos
Proteínas do Capsídeo/química , Proteínas do Capsídeo/metabolismo , HIV-1/fisiologia , Montagem de Vírus/fisiologia , Síndrome de Imunodeficiência Adquirida/virologia , Capsídeo/metabolismo , HIV-1/genética , Humanos , Integração Viral , Produtos do Gene gag do Vírus da Imunodeficiência Humana/química , Produtos do Gene gag do Vírus da Imunodeficiência Humana/metabolismo
10.
Molecules ; 26(7)2021 Mar 31.
Artigo em Inglês | MEDLINE | ID: mdl-33807292

RESUMO

Acquired immune deficiency syndrome (AIDS) has prevailed over the last 30 years. Although highly active antiretroviral therapy (HAART) has decreased mortality and efficiently controlled the progression of disease, no vaccine or curative drugs have been approved until now. A viral inactivator is expected to inactivate cell-free virions in the absence of target cells. Previously, we identified a gp120-binding protein, mD1.22, which can inactivate laboratory-adapted HIV-1. In this study, we have found that the gp41 N-terminal heptad repeat (NHR)-binding antibody D5 single-chain variable fragment (scFv) alone cannot inactivate HIV-1 at the high concentration tested. However, D5 scFv in the combination could enhance inactivation activity of mD1.22 against divergent HIV-1 strains, including HIV-1 laboratory-adapted strains, primary HIV-1 isolates, T20- and AZT-resistant strains, and LRA-reactivated virions. Combining mD1.22 and D5 scFv exhibited synergistic effect on inhibition of infection by divergent HIV-1 strains. These results suggest good potential to develop the strategy of combining a gp120-binding protein and a gp41-binding antibody for the treatment of HIV-1 infection.


Assuntos
Síndrome de Imunodeficiência Adquirida/virologia , Proteínas de Transporte/farmacologia , Proteína gp120 do Envelope de HIV/antagonistas & inibidores , Proteína gp41 do Envelope de HIV/antagonistas & inibidores , Inibidores da Fusão de HIV/farmacologia , Proteínas Recombinantes/farmacologia , Vírion/efeitos dos fármacos , Anticorpos Antivirais/imunologia , Sítios de Ligação , Linhagem Celular , HIV-1/imunologia , Humanos , Anticorpos de Cadeia Única/imunologia
11.
Curr Top Med Chem ; 21(12): 1052-1066, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33845745

RESUMO

With the introduction of antiretroviral therapy, the worldwide AIDS-related deaths have decreased, and life expectancy has increased, including the prevalence of AIDS-related neurological disorders or neuroAIDS. HIV-associated neurocognitive disorders such as mild neurocognitive disorder and asymptomatic neurocognitive impairment have largely remained stable or increased among the HIV-infected individuals in the combination antiretroviral therapy era. The emerging evidence that antiretrovirals with high CNS penetration effectiveness score contribute to the neurotoxicity and HIV-associated neurocognitive disorders has ushered the search for natural, nontoxic bioactive constituents having pre-established neuroprotective, anti-inflammatory, and restorative neurocognitive activity. In this review, we have highlighted the probable mechanism of neuroAIDS infection, the problem with the existing antiretroviral therapy, along with various bioactive constituents with in vivo, in vitro, or ex vivo evidence of their neuroprotective activity that can be used as an adjuvant with the current combination antiretroviral therapy regimen or can even serve as an alternate to the antiretrovirals for treatment of HIV associated neurocognitive disorder.


Assuntos
Síndrome de Imunodeficiência Adquirida/tratamento farmacológico , Antirretrovirais/farmacologia , Produtos Biológicos/farmacologia , Transtornos Neurocognitivos/tratamento farmacológico , Neurônios/efeitos dos fármacos , Síndrome de Imunodeficiência Adquirida/patologia , Síndrome de Imunodeficiência Adquirida/virologia , Antirretrovirais/química , Antirretrovirais/isolamento & purificação , Produtos Biológicos/química , Produtos Biológicos/isolamento & purificação , Humanos , Transtornos Neurocognitivos/patologia , Transtornos Neurocognitivos/virologia , Neurônios/patologia , Neurônios/virologia
12.
Dis Mon ; 67(9): 101168, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33640175

RESUMO

Human immunodeficiency virus-infected patients have depleted CD4 lymphocyte counts and are susceptible to a plethora of infections of bacterial, viral, and fungal etiology. In addition to a wide range of systemic manifestations, human immunodeficiency virus-infected patients also display several characteristic oral manifestations. Studies have shown a correlation between some of the oral manifestations and CD4 lymphocyte counts which in turn is an independent prognostic indicator. To tackle the human immunodeficiency virus numerous drugs have been discovered and implemented. To overcome any potential resistance, human immunodeficiency virus patients are prescribed highly active antiretroviral therapy, wherein a combination of antiretroviral regimens are used. Studies have shown that in addition to controlling the viral activity, the treatment regimen, has a significant effect on the oral manifestations of the human immunodeficiency virus-infected patients. The present paper highlights the effects of highly active antiretroviral therapy on periodontal diseases in human immunodeficiency virus-infected individuals.


Assuntos
Terapia Antirretroviral de Alta Atividade , Infecções por HIV , Doenças Periodontais , Síndrome de Imunodeficiência Adquirida/complicações , Síndrome de Imunodeficiência Adquirida/tratamento farmacológico , Síndrome de Imunodeficiência Adquirida/virologia , Fármacos Anti-HIV/farmacologia , Fármacos Anti-HIV/uso terapêutico , Contagem de Linfócito CD4 , HIV , Infecções por HIV/complicações , Infecções por HIV/tratamento farmacológico , Humanos , Doenças Periodontais/complicações , Periodonto/efeitos dos fármacos
13.
Dis Mon ; 67(9): 101169, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33640178

RESUMO

Human immunodeficiency virus has plagued mankind since the 1980's when the first case was documented. Human immunodeficiency virus-induced immunocompromised state can lead to several systemic and local manifestations, which often culminates in mortality. Oral candidiasis was one of the most prevalent opportunistic infections noted in human immunodeficiency virus-infected patients. The advent of highly active antiretroviral therapy has led to a significant reduction in both the mortality and the morbidity of infected patients. The combined antiretroviral therapy has also led to a decrease in the incidence of opportunistic infections including oral candidiasis. Thus, the presence of well-established oral candidiasis in human immunodeficiency virus-infected patients under highly active antiretroviral therapy could be considered as an indicator of potential treatment failure. The present manuscript aims to review the published literature assessing the effect of highly active antiretroviral therapy on the incidence of oral candidiasis in human immunodeficiency virus-infected patients.


Assuntos
Fármacos Anti-HIV/uso terapêutico , Terapia Antirretroviral de Alta Atividade , Candidíase Bucal , Infecções por HIV , Infecções Oportunistas Relacionadas com a AIDS/microbiologia , Síndrome de Imunodeficiência Adquirida/complicações , Síndrome de Imunodeficiência Adquirida/tratamento farmacológico , Síndrome de Imunodeficiência Adquirida/virologia , Candidíase Bucal/etiologia , Candidíase Bucal/prevenção & controle , HIV , Infecções por HIV/complicações , Infecções por HIV/tratamento farmacológico , Humanos , Boca/efeitos dos fármacos , Boca/microbiologia
14.
Dis Mon ; 67(9): 101167, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33640179

RESUMO

Acquired immunodeficiency syndrome a disease with high mortality rates is caused by the well-known human immunodeficiency virus. The disease is characterized by several opportunistic infections owing to the decreased CD4 lymphocyte counts. Oral manifestations of human immunodeficiency virus are vital as they are one of the early manifestations of the disease. Also, they serve as prognostic markers as they correlate with the CD4 lymphocyte counts of the affected individuals. Human immunodeficiency virus is not only common in the adult population but also can affect pediatric patients through vertical transmission. The initial therapeutic strategy for the management of the virus was only the prevention of opportunistic infections. Later in the mid-1990s, antiretroviral therapy was introduced but there was no significant improvement in prognosis. After the advent of combination therapy or the use of three antiretroviral drugs also known as highly active antiretroviral therapy, there has been a marked reduction in human immunodeficiency virus-associated mortality rates. The highly active antiretroviral therapy has several effects on the oral manifestations of the human immunodeficiency virus. The present paper aims to review the oral pigmented lesions associated with human immunodeficiency virus with an emphasis on the effect of highly active antiretroviral therapy.


Assuntos
Terapia Antirretroviral de Alta Atividade , Infecções por HIV , Doenças da Boca , Infecções Oportunistas Relacionadas com a AIDS , Síndrome de Imunodeficiência Adquirida/complicações , Síndrome de Imunodeficiência Adquirida/tratamento farmacológico , Síndrome de Imunodeficiência Adquirida/virologia , Fármacos Anti-HIV/farmacologia , Fármacos Anti-HIV/uso terapêutico , Contagem de Linfócito CD4 , HIV , Infecções por HIV/complicações , Infecções por HIV/tratamento farmacológico , Humanos , Boca/efeitos dos fármacos , Doenças da Boca/complicações
15.
PLoS One ; 16(2): e0247421, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33617557

RESUMO

BACKGROUND: HIV is a major global public health challenge, claiming the lives of over 32 million people so far. The satisfaction of HIV-affected clients with the quality of their HIV services at treatment centres is crucial for quality improvement. This article assesses clients' satisfaction with different aspects of the overall care experience and seeks to determine if the type of health facility ownership is a predictor of satisfaction. METHODS: A cross-sectional study involving 430 respondents was conducted between September and October 2019. Purposeful and convenient sampling techniques were used to select health facilities and potential respondents, respectively. A pre-tested, interviewer-administered questionnaire was used to collect data. Binary logistic regression was used to assess the association between type of health facility and clients' satisfaction based on the six assessed aspects of care, and p˂0.05 was considered statistically significant. RESULTS: The general clients' satisfaction with HIV/AIDS services at care and treatment centres was 92.3%. Respondents from public health facilities were most satisfied with privacy and confidentiality (100%), physical environment (100%), counseling (99.5%) and drug availability (99.5%); respondents from private health facilities were most satisfied with the time spent in the facility (95.9%); while respondents from faith-based health facilities were most satisfied with staff-patient communication (99.2%). However, after adjusting for confounders, only one aspect of care, that of "time spent in the facility," showed significant association with the type of health facility. CONCLUSION: Generally, clients' satisfaction with HIV/AIDS services at care and treatment centres in the Ubungo District, Dar es Salaam was high. This finding should encourage health care providers to maintain high-quality services to sustain clients' satisfaction.


Assuntos
Síndrome de Imunodeficiência Adquirida/tratamento farmacológico , Síndrome de Imunodeficiência Adquirida/psicologia , Infecções por HIV/tratamento farmacológico , Infecções por HIV/psicologia , HIV/efeitos dos fármacos , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Satisfação do Paciente/estatística & dados numéricos , Síndrome de Imunodeficiência Adquirida/virologia , Adulto , Atitude do Pessoal de Saúde , Confidencialidade/psicologia , Aconselhamento , Estudos Transversais , Feminino , Pessoal de Saúde/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Satisfação Pessoal , Privacidade/psicologia , Qualidade da Assistência à Saúde , Inquéritos e Questionários , Tanzânia
16.
Lancet HIV ; 8(2): e106-e113, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33539757

RESUMO

Ending the AIDS epidemic by 2030 will require addressing stigma more systematically and at a larger scale than current efforts. Existing global evidence shows that stigma is a barrier to achieving each of the 90-90-90 targets; it undermines HIV testing, linkage to care, treatment adherence, and viral load suppression. However, findings from both research studies and programmatic experience have helped to inform the growing body of knowledge regarding how to reduce stigma, leading to key principles for HIV stigma reduction. These principles include immediately addressing actionable drivers of stigma, centring groups affected by stigma at the core of the response, and engaging opinion leaders and building partnerships between affected groups and opinion leaders. Although there is still room to strengthen research on stigma measurement and reduction, in particular for intersectional stigma, the proliferation of evidence over the past several decades on how to measure and address stigma provides a solid foundation for immediate and comprehensive action.


Assuntos
Síndrome de Imunodeficiência Adquirida/prevenção & controle , Síndrome de Imunodeficiência Adquirida/psicologia , Epidemias/prevenção & controle , Medo/psicologia , Estigma Social , Síndrome de Imunodeficiência Adquirida/diagnóstico , Síndrome de Imunodeficiência Adquirida/virologia , Fármacos Anti-HIV/uso terapêutico , Feminino , HIV/efeitos dos fármacos , HIV/crescimento & desenvolvimento , HIV/patogenicidade , Teste de HIV/ética , Humanos , Masculino , Cooperação do Paciente/psicologia , Cooperação do Paciente/estatística & dados numéricos , Isolamento Social/psicologia , Cooperação e Adesão ao Tratamento/psicologia , Cooperação e Adesão ao Tratamento/estatística & dados numéricos , Carga Viral/efeitos dos fármacos
17.
Arch Virol ; 166(5): 1273-1282, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33507389

RESUMO

In 2006 we discovered a new type of mucosal vaccine against simian immunodeficiency virus (SIV) in Chinese macaques. Here, we review 15 years of our published work on this vaccine, which consists of inactivated SIVmac239 particles adjuvanted with Bacillus Calmette-Guérin, Lactobacillus plantarum, or Lactobacillus rhamnosus. Without adjuvant, the vaccine administered by the intragastric route induced the usual SIV-specific humoral and cellular immune responses but provided no protection against intrarectal challenge with SIVmac239. In contrast, out of 24 macaques immunized with the adjuvanted vaccine and challenged intrarectally with SIVmac239 or SIVB670, 23 were sterilely protected for up to five years, while all control macaques were infected. This protection was confirmed by an independent group from the Pasteur Institute. During the past 15 years, we have identified the mechanism of action of the vaccine and discovered that the vaccinated macaques produced a previously unrecognized class of MHC-Ib/E-restricted CD8+ T cells (which we refer to as tolerogenic CD8+ T cells) that suppressed the activation of SIV-RNA-infected CD4+ T cells and thereby inhibited the (activation-dependent) reverse transcription of the virus, which in turn prevented the establishment of SIV infection. Importantly, we discovered also that the tolerogenic CD8+ T cell subset observed in vaccinated Chinese macaques could also be found in human elite controllers, a small group of HIV-infected patients in whom these tolerogenic CD8+ T cells were shown to naturally suppress viral replication. Given that SIV and HIV require activated immune cells in which to replicate, the specific prevention of activation of SIV-RNA-containing CD4+ T cells by a tolerogenic vaccine approach offers an exciting new avenue in HIV vaccine research.


Assuntos
Vacinas contra a AIDS/imunologia , Síndrome de Imunodeficiência Adquirida/imunologia , Infecções por HIV/imunologia , Vírus da Imunodeficiência Símia/imunologia , Vacinas contra a AIDS/administração & dosagem , Síndrome de Imunodeficiência Adquirida/prevenção & controle , Síndrome de Imunodeficiência Adquirida/virologia , Animais , Linfócitos T CD4-Positivos/imunologia , Linfócitos T CD4-Positivos/virologia , Linfócitos T CD8-Positivos/imunologia , Infecções por HIV/prevenção & controle , Infecções por HIV/virologia , Humanos , Macaca mulatta , Vírus da Imunodeficiência Símia/fisiologia , Replicação Viral
18.
BMC Infect Dis ; 21(1): 71, 2021 Jan 13.
Artigo em Inglês | MEDLINE | ID: mdl-33441089

RESUMO

BACKGROUND: Understanding the demographic characteristics of people living with HIV/AIDS (PLWHA) infected through commercial heterosexual contact (CHC) or nonmarital noncommercial heterosexual contact (NMNCHC) is important for HIV/AIDS prevention and control. METHODS: Cases reported through the Chinese HIV/AIDS Case Reporting System (CRS) from 2015 to 2018 were analyzed. A descriptive and preliminary inferential analysis were performed for those demographic characteristics deemed of interest. RESULTS: Overall, 523,121 identified PLWHA between 2015 and 2018 in the CRS were analyzed. The constituent ratio of heterosexual transmission increased from 66.25% in 2015 to 71.48% in 2018. The proportion of CHC heterosexual transmission decreased from 40.18% in 2015 to 37.99% in 2018, while that of NMNCHC increased from 46.33% in 2015 to 49.02% in 2018. PLWHA infected through NMNCHC were significantly younger than those who were infected through CHC (Student's t test, P < 0.0001), with an average age gap ranging from 5.63 (2015) to 7.46 (2018) years, and the average age of both groups increased annually. The frequency of newly identified PLWHA who were infected through CHC had a remarkable increase among the ages of 65 and above. Gender distribution was significantly different between CHC and NMNCHC (χ2 = 8909.00(2015), 9941.90(2016), 11,004.00 (2017), 12,836.00(2018), all P < 0.0001), and the ratio of men to women in the NMCHC group was 1.50:1 (2015), 1.51:1 (2016), 1.54:1 (2017), and 1.52:1 (2018), while in the commercial heterosexual contact (CHC) group, these ratios were 11.45:1 (2015), 12.08:1 (2016), 12.53:1 (2017), and 13.28:1 (2018). Marital status was significantly different between CHC and NMNCHC (χ2 = 94.67 (2015), 109.88(2016), 58.18(2017), 152.38(2018), all P < 0.0001). As the educational level improved, the proportion of NMNCHC also increased (Cochran - Armitage test, P < 0.0001). CONCLUSIONS: We found that heterosexual transmission was the primary mode of HIV transmission in China from 2015 to 2018. PLWHA infected through CHC and NMNCHC had different characteristics in age, gender, marital status, and educational level. The frequency of PLWHA infected through CHC increased substantially in the age group of 65 and above. This study provides useful baseline data for future studies on the heterosexual transmission of HIV in China.


Assuntos
Síndrome de Imunodeficiência Adquirida/epidemiologia , Síndrome de Imunodeficiência Adquirida/transmissão , HIV/isolamento & purificação , Heterossexualidade , Trabalho Sexual , Síndrome de Imunodeficiência Adquirida/virologia , Adolescente , Adulto , Idoso , China/epidemiologia , Estudos Transversais , Escolaridade , Feminino , Humanos , Masculino , Estado Civil , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos , Autorrelato , Adulto Jovem
19.
Science ; 371(6526): 284-288, 2021 01 15.
Artigo em Inglês | MEDLINE | ID: mdl-33446556

RESUMO

The ability for viruses to mutate and evade the human immune system and cause infection, called viral escape, remains an obstacle to antiviral and vaccine development. Understanding the complex rules that govern escape could inform therapeutic design. We modeled viral escape with machine learning algorithms originally developed for human natural language. We identified escape mutations as those that preserve viral infectivity but cause a virus to look different to the immune system, akin to word changes that preserve a sentence's grammaticality but change its meaning. With this approach, language models of influenza hemagglutinin, HIV-1 envelope glycoprotein (HIV Env), and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Spike viral proteins can accurately predict structural escape patterns using sequence data alone. Our study represents a promising conceptual bridge between natural language and viral evolution.


Assuntos
Síndrome de Imunodeficiência Adquirida/imunologia , COVID-19/imunologia , HIV-1/genética , Vírus da Influenza A/genética , Influenza Humana/imunologia , SARS-CoV-2/genética , Síndrome de Imunodeficiência Adquirida/virologia , Sítios de Ligação , COVID-19/virologia , Evolução Molecular , Glicoproteínas de Hemaglutininação de Vírus da Influenza/química , Glicoproteínas de Hemaglutininação de Vírus da Influenza/genética , Humanos , Influenza Humana/virologia , Mutação , Domínios Proteicos , Glicoproteína da Espícula de Coronavírus/química , Glicoproteína da Espícula de Coronavírus/genética , Produtos do Gene env do Vírus da Imunodeficiência Humana/química , Produtos do Gene env do Vírus da Imunodeficiência Humana/genética
20.
Curr Drug Metab ; 22(4): 280-286, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-32964821

RESUMO

BACKGROUND: Human immunodeficiency virus (HIV)/AIDS is one of the principal concerns contributing to the global burden and the accompanying deleterious outcomes could not be left unattended. Despite significant advances and innovative research being conducted throughout the globe in order to improve the therapeutic profile of conventionally available antiretroviral (ARV) drugs in the eradication of HIV virus reservoirs, its penetration across the blood-brain barrier (BBB) is still a formidable mission. This makes the central nervous system a dominant and vulnerable site for virus propagation, which ultimately affects the therapeutic potential of the drug administered. Therefore there is an upsurge in the prerequisite of novel technologies to come into play, paving the way for nanotechnology. METHODS: This review primarily provides a comprehensive outline and emphasizes on the nanotechnological techniques employed for the delivery of ARV drugs and their stupendous advantages in overcoming the hurdles associated with the same. RESULTS: The nanotechnological approach bears the potential of site-specific delivery across the BBB via targeting explicit transport processes and provides a sustained release mechanism. Furthermore, different routes of administration explored have also yielded beneficial outcomes for the delivery of ARV drugs. CONCLUSION: The futuristic holistic nanotechnology methods, however, should focus on increasing drug trafficking and permeability across the BBB to ameliorate the therapeutic effect of ARV drugs. Additionally, the domain warrants clinical studies to be undertaken to make the technology commercially viable and a success to deal with the problems of the treatment strategy.


Assuntos
Síndrome de Imunodeficiência Adquirida/tratamento farmacológico , Fármacos Anti-HIV/administração & dosagem , Barreira Hematoencefálica/efeitos dos fármacos , Viroses do Sistema Nervoso Central/tratamento farmacológico , Sistemas de Liberação de Fármacos por Nanopartículas/farmacologia , Síndrome de Imunodeficiência Adquirida/complicações , Síndrome de Imunodeficiência Adquirida/imunologia , Síndrome de Imunodeficiência Adquirida/virologia , Fármacos Anti-HIV/farmacocinética , Barreira Hematoencefálica/metabolismo , Viroses do Sistema Nervoso Central/imunologia , Viroses do Sistema Nervoso Central/virologia , HIV-1/efeitos dos fármacos , HIV-1/imunologia , Humanos , Sistemas de Liberação de Fármacos por Nanopartículas/química , Nanomedicina Teranóstica/métodos , Nanomedicina Teranóstica/tendências , Distribuição Tecidual , Resultado do Tratamento
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