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1.
Medicine (Baltimore) ; 99(9): e19341, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32118769

RESUMO

Hepatitis B virus (HBV) and human immunodeficiency virus (HIV) coinfection is highest in sub-Saharan Africa and results in accelerated clinical outcomes compared with HBV or HIV mono-infection. HBV clearance rates are higher in healthy adults; however, in sub-Saharan Africa, there are limited data on clearance of incident HBV in HIV-infected adults. Therefore, we sought to estimate HBV incidence and HBV surface antigen (HBsAg) clearance in HIV-infected adults in Botswana.This was a retrospective longitudinal study of 442 HIV-1C infected treatment naïve patients enrolled in a previous Botswana Harvard AIDS Institute Partnership study. Archived plasma samples from 435 HIV-infected treatment naïve participants were screened for HBsAg and HBV core antibody (anti-HBc). HBsAg was evaluated annually over a 4-year period, and HBV deoxyribonucleic acid (DNA) levels of HBsAg-positive chronic and incident patients were quantified.Baseline median CD4+ T-cell count was 458 cells/µL [Q1, Q3: 373, 593], and median HIV viral load was 4.15 copies/mL [Q1, Q3: 3.46, 4.64]. Twenty two HBV incident cases occurred, representing an incidence of 3.6/100 person-years [95% CI: 2.2-5.6]. All incident HBV cases with a follow-up sample available for screening (13/22) cleared HBsAg. Detectable HBV viral loads among chronic and incident cases ranged between 5.15 × 10 to 1.4 × 10 IU/L and 1.80 × 10 to 1.7 × 10 IU/mL, respectively.We report high HBV incidence associated with elevated HBV DNA levels despite high CD4+ T-cell counts in HIV-infected patients in Botswana. These incidence cases represent a potential source of HBV transmission in the population. Scaling-up of HIV treatment strategies utilizing antiretroviral therapy regimens with anti-HBV activity coupled with screening for HBV infections in households of the HBsAg-positive cases is recommended.


Assuntos
Infecções por HIV/complicações , Hepatite B/diagnóstico , Adulto , Botsuana/epidemiologia , Feminino , Infecções por HIV/epidemiologia , Infecções por HIV/fisiopatologia , Hepatite B/epidemiologia , Vírus da Hepatite B/genética , Humanos , Hospedeiro Imunocomprometido/genética , Incidência , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
3.
BJOG ; 127(2): 250-259, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31498547

RESUMO

OBJECTIVE: To compare the vaginal microbiota of women living with HIV (WLWH) with the vaginal microbiota of women with recurrent bacterial vaginosis (BV) and healthy women without HIV to determine if there are differences in the vaginal microbiome, what factors influence these differences, and to characterise HIV clinical parameters including viral load and CD4 count in relation to the vaginal microbiome. DESIGN: Observational cohort study. SETTING: Canada. POPULATION: Women aged 18-49 years who were premenopausal and not pregnant were recruited into three cohorts: healthy women, WLWH and women with recurrent BV. METHODS: Demographic and clinical data were collected via interviews and medical chart reviews. Vaginal swabs were collected for Gram-stain assessment and microbiome profiling using the cpn60 barcode sequence. MAIN OUTCOME MEASURES: To compare overall community composition differences, we used compositional data analysis methods, hierarchical clustering and Kruskal-Wallis tests where appropriate. RESULTS: Clinical markers such as odour and abnormal discharge, but not irritation, were associated with higher microbial diversity. WLWH with unsuppressed HIV viral loads were more likely than other groups to have non-Gardnerella-dominated microbiomes. HIV was associated with higher vaginal microbial diversity and this was related to HIV viral load, with unsuppressed women demonstrating significantly higher relative abundance of Megasphaera genomosp. 1, Atopobium vaginae and Clostridiales sp. (all P < 0.05) compared with all other groups. CONCLUSIONS: In WLWH, unsuppressed HIV viral loads were associated with a distinct dysbiotic profile consisting of very low levels of Lactobacillus and high levels of anaerobes. TWEETABLE ABSTRACT: Vaginal microbiomes in WLWH with viral load >50 copies/ml have distinct dysbiotic profiles with high levels of anaerobes.


Assuntos
Infecções por HIV/microbiologia , Infecções por HIV/virologia , Vagina/microbiologia , Vaginose Bacteriana/microbiologia , Carga Viral , Adulto , Anaerobiose , Canadá , Estudos de Coortes , Feminino , Infecções por HIV/fisiopatologia , Humanos , Pessoa de Meia-Idade , Recidiva , Vaginose Bacteriana/fisiopatologia
4.
Medicine (Baltimore) ; 98(49): e18206, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31804344

RESUMO

BACKGROUND: The impaired physical capacity of children and adolescents with HIV can directly influence their physical performance, activities of daily living and social participation. The purpose of this systematic review protocol is to perform a systematic review and meta-analysis on physical fitness (cardiorespiratory capacity, agility, flexibility, strength, and muscular endurance) in children and adolescents with HIV, compared with healthy controls. METHODS: We will be following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis protocol (PRISMA-P) statement guidelines. There will be cross-sectional, longitudinal and case-controlled studies, and there will be no restrictions on language and year of publication in the search. The search strategy will be to use databases including: MEDLINE (via PubMed), EMBASE (via Ovid), Web of Science, Scopus, SportDiscus and CINAHL; The MeSH terms will be: physical fitness, fitness trackers, agility, flexibility, physical endurance, muscle strength, aerobic capacity, human immunodeficiency virus, HIV, children, and adolescents, to discuss and compare physical fitness (cardiorespiratory capacity, agility, flexibility, strength, and muscular endurance) in children and adolescents with HIV and healthy control. The reviewers will independently read the articles, extract the data information and analyze the risk of bias using the Cochrane criteria for observational studies. The Cohen's will be used to calculate the agreement between the revisions. RESULTS: This study will provide a high-quality synthesis of observational studies on the analysis and comparison of physical fitness in children and adolescents with HIV compared with healthy controls. CONCLUSION: This systematic review will be very important for the creation of proposals aimed at providing high quality subsidies in the management of HIV during the development phase of children and adolescents. ETHICS AND DISSEMINATION: Ethics approval is not required because individual patient data and privacy were not involved in this study. PROSPERO REGISTRATION NUMBER: CRD42019140955. PROSPERO REGISTRATION DATE: 23/09/2019.


Assuntos
Infecções por HIV/fisiopatologia , Aptidão Física , Revisão Sistemática como Assunto , Adolescente , Criança , Feminino , Humanos , Masculino , Projetos de Pesquisa
5.
Arch Virol ; 164(12): 3019-3026, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31598843

RESUMO

Polyethyleneimine (PEI) is a chemical compound that used is as a carrier in gene therapy/delivery. Some studies have investigated the microbicidal potential and antiviral activity (prophylactic or therapeutic) of PEI and its derivatives. The aim of this study was to investigate the effect of branched polyethyleneimine (bPEI) on human immunodeficiency virus (HIV) replication. Infected cells were treated with bPEI for 36 hours, and the concentration of the viral protein P24 (as a virus replication marker) was determined in cell culture supernatants. This study indicated that bPEI increased HIV replication and decreased the viability of infected cells through cytotoxicity. The toxicity of bPEI its association with and cell death (apoptosis, autophagy and necrosis) have been reported in several studies. To investigate bPEI-induced cytotoxicity, we examined apoptosis and autophagy in cells treated with bPEI, and a significant increase in HIV viral load, the P24 antigen level, autophagy, and necrosis observed. Thus, treatment with bPEI leads to cytotoxicity and higher HIV virus yield.


Assuntos
Infecções por HIV/virologia , HIV/efeitos dos fármacos , Polietilenoimina/farmacologia , Replicação Viral/efeitos dos fármacos , Autofagia/efeitos dos fármacos , HIV/genética , HIV/fisiologia , Proteína do Núcleo p24 do HIV/genética , Proteína do Núcleo p24 do HIV/metabolismo , Infecções por HIV/fisiopatologia , Humanos , Polietilenoimina/química , Carga Viral/efeitos dos fármacos
6.
Acta Virol ; 63(3): 253-260, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31507190

RESUMO

The human immunodeficiency virus (HIV) envelope, via a key extracellular amino acid sequence, may simulate the functionality of native undecapeptide substance P (SP) acting through the host's neurokinin 1 (SP preferring) receptor (NK-1R). Human monocytes and macrophages express both NK-1Rs and SP. In HIV/AIDS the NK-1R may function as a chemokine-like G-protein coupled co-receptor that: 1) fuses to the outer envelope of HIV; 2) enables intracellular entry of the envelope-capsid-NK-1R complex; 3) co-opts immune defence via its physiological interaction with the SP-like envelope; 4) may contribute to resistance of CD4/chemokine entry inhibitor type drugs; 5) relaxes the blood-brain barrier to support entry of the HIV into the central nervous system, and 6) mediates most of the common clinical sequelae of HIV/AIDS (encephalopathy and AIDS dementia complex). The data support the idea that NK-1R antagonists could be useful to treat HIV/AIDS. Keywords: human immunodeficiency virus; NK-1 receptor; NK-1 receptor antagonist; aprepitant; fusion protein; virus.


Assuntos
Infecções por HIV , Receptores da Neurocinina-1 , Substância P , Proteínas Virais de Fusão , Dipeptídeos/genética , Dipeptídeos/metabolismo , Proteína gp120 do Envelope de HIV/metabolismo , Infecções por HIV/tratamento farmacológico , Infecções por HIV/fisiopatologia , Humanos , Macrófagos/virologia , Monócitos/metabolismo , Monócitos/virologia , Antagonistas do Receptor de Neuroquinina-1/uso terapêutico , Receptores da Neurocinina-1/metabolismo , Substância P/metabolismo , Proteínas Virais de Fusão/metabolismo
7.
BMC Infect Dis ; 19(1): 708, 2019 Aug 09.
Artigo em Inglês | MEDLINE | ID: mdl-31399063

RESUMO

BACKGROUND: Thymidine analogues (TA) and didanosine (ddI) are associated with long-lasting adipose tissue redistribution. Adiponectin is a widely used marker of adipocyte activity, and adipose tissue density assessed by CT-scan is associated with adipocyte size and function. We hypothesized that prior exposure to TA and ddI was associated with long-lasting adipose tissue dysfunction in people living with HIV (PLWH). Thus, we tested possible associations between markers of adipose tissue dysfunction (adipose tissue density and adiponectin) and prior exposure to TA and/or ddI, years after treatment discontinuation. METHODS: Eight hundred forty-eight PLWH from the COCOMO study were included and stratified according to prior exposure to TA and/or ddI (with, n = 451; without n = 397). Visceral (VAT) and subcutaneous (SAT) adipose tissue area and density were determined by single slice abdominal CT-scan at lumbar 4th level. Venous blood was collected and analyzed for adiponectin. Multivariable linear and logistic regression analyses were used to test our hypotheses. Multivariable models were adjusted for age, sex, smoking, origin, physical activity, BMI, and adipose tissue area (VAT or SAT area, accordingly to the outcome). RESULTS: prior exposure to TA and/or ddI was associated with excess risk of low VAT (adjusted OR (aOR) 1.74 [1.14; 2.67]) and SAT density (aOR 1.74 [1.18; 2.58]), for a given VAT and SAT area, respectively. No association between VAT and SAT density with time since TA and/or ddI discontinuation was found. 10 HU increase in VAT density was associated with higher adiponectin plasma level and this association was not modified by prior exposure to TA and/or ddI. Prior exposure to TA and/or ddI was associated with 9% lower [- 17;-2] plasma adiponectin levels and with excess risk of low adiponectin (aOR 1.74 [1.10; 2.76]). CONCLUSIONS: We described low adipose tissue density and impaired adiponectin production to be associated with prior exposure to TA and/or ddI even years after treatment discontinuation and independently of adipose tissue area. These findings suggest that prior TA and ddI exposure may have long-lasting detrimental effects on adipose tissue function and, consequently, on cardiometabolic health in PLWH.


Assuntos
Adiponectina/sangue , Tecido Adiposo/efeitos dos fármacos , Fármacos Anti-HIV/efeitos adversos , Infecções por HIV/tratamento farmacológico , Tecido Adiposo/patologia , Adulto , Biomarcadores/sangue , Estudos Transversais , Didanosina/efeitos adversos , Feminino , Infecções por HIV/fisiopatologia , Humanos , Gordura Intra-Abdominal/efeitos dos fármacos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Gordura Subcutânea/efeitos dos fármacos , Timidina/análogos & derivados
8.
IEEE Int Conf Rehabil Robot ; 2019: 530-535, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31374684

RESUMO

Robot-based neurorehabilitation strategies often ignore cognitive performance during treatment, but this is a need in populations dealing with a wide variety of cognitive and motor impairments, such as the stroke and HIV populations, for which an association between the two have been established. In this study, we concurrently measure cognitive and motor performance on a robotic cognitive-motor task and quantify cognitive-motor interference. We apply this method to a pilot group of healthy, stroke, and HIV-stroke subjects, and we demonstrate the potential of smoothness and correct response rate as metrics to capture motor and cognitive-related dual-task effects.


Assuntos
Cognição , Infecções por HIV/fisiopatologia , Atividade Motora , Robótica , Acidente Vascular Cerebral/fisiopatologia , Extremidade Superior/fisiopatologia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto
9.
BMC Res Notes ; 12(1): 466, 2019 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-31366401

RESUMO

OBJECTIVE: HIV positive individuals infected with viral hepatitis B (HBV) or C (HCV) are at an increased risk of progression to kidney and liver failures. Therefore, prior to initiation of antiretroviral therapy, early diagnosis and initiation of appropriate treatment protocols are imperative for co-infected individuals. This study evaluated the prevalence of HBV and HCV, and extent of liver and renal dysfunction among 90 newly diagnosed HIV patients attending the Cape Coast Teaching Hospital HIV clinic. RESULTS: Levels of alanine aminotransferase, aspartate-platelet ratio index and estimated glomerular filtration rate were used respectively to diagnose hepatotoxicity, liver fibrosis and chronic kidney disease (CKD). Association analyses were evaluated by Pearson's Chi-square test or Fisher's exact test and considered significant at p < 0.05. Using rapid diagnostic tests, 75.6% (n = 68) had HIV1 mono-infection, 24.4% (n = 22) had HIV1/HBV co-infection while 0.0% (n = 0) had HIV1/HCV co-infection. The prevalence of hepatotoxicity, liver fibrosis, and CKD were 7.8% (n = 7), 2.2% (n = 2), and 15.5% (n = 14) respectively. Similar proportions of HIV1/HBV and HIV1 were diagnosed with liver fibrosis (p = 0.431). In relation to hepatotoxicity Grade, a high proportion of HIV1/HBV were diagnosed with Grade 2 (p = 0.042). Also, severely reduced kidney function (CKD stage 4) was observed in only HIV1/HBV (n = 2, 9.1%, p = 0.053).


Assuntos
Infecções por HIV/fisiopatologia , Hepatite B/fisiopatologia , Hepatite C/fisiopatologia , Rim/fisiopatologia , Cirrose Hepática/fisiopatologia , Fígado/fisiopatologia , Insuficiência Renal Crônica/fisiopatologia , Adulto , Alanina Transaminase/sangue , Ácido Aspártico/sangue , Plaquetas/patologia , Coinfecção , Estudos Transversais , Feminino , Gana/epidemiologia , Taxa de Filtração Glomerular , Infecções por HIV/diagnóstico , Infecções por HIV/epidemiologia , Infecções por HIV/virologia , Hepatite B/diagnóstico , Hepatite B/epidemiologia , Hepatite B/virologia , Hepatite C/diagnóstico , Hepatite C/epidemiologia , Hepatite C/virologia , Humanos , Rim/metabolismo , Rim/virologia , Fígado/metabolismo , Fígado/virologia , Cirrose Hepática/diagnóstico , Cirrose Hepática/epidemiologia , Cirrose Hepática/virologia , Testes de Função Hepática , Masculino , Pessoa de Meia-Idade , Prevalência , Insuficiência Renal Crônica/diagnóstico , Insuficiência Renal Crônica/epidemiologia , Insuficiência Renal Crônica/virologia
10.
BMJ Case Rep ; 12(8)2019 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-31451457

RESUMO

Kaposi sarcoma (KS) is an angioproliferative disorder that is commonly associated with human herpes virus 8 as well as the HIV. In fact, KS is one of the most common AIDS-defining illnesses. KS typically presents with diffuse, violaceous cutaneous nodules, and may have concomitant visceral involvement. However, visceral involvement rarely occurs without skin manifestations. A rare case of localised bronchopulmonary KS without skin involvement is described in a patient with previously undiagnosed HIV. This atypical presentation represents a challenge for modern-day physicians in developed countries where the prevalence of AIDS-related diseases is decreasing.


Assuntos
Síndrome de Imunodeficiência Adquirida , Infecções por HIV , Neoplasias Pulmonares , Oseltamivir/administração & dosagem , Sarcoma de Kaposi , Síndrome de Imunodeficiência Adquirida/diagnóstico , Síndrome de Imunodeficiência Adquirida/etiologia , Antivirais/administração & dosagem , Lavagem Broncoalveolar/métodos , Contagem de Linfócito CD4/métodos , Deterioração Clínica , Confusão/diagnóstico , Confusão/etiologia , Desidratação/complicações , Desidratação/diagnóstico , Desidratação/terapia , Diagnóstico Diferencial , Evolução Fatal , Hidratação/métodos , Infecções por HIV/complicações , Infecções por HIV/diagnóstico , Infecções por HIV/fisiopatologia , Infecções por HIV/terapia , Humanos , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/fisiopatologia , Masculino , Sarcoma de Kaposi/patologia , Sarcoma de Kaposi/fisiopatologia , Tomografia Computadorizada por Raios X/métodos , Carga Viral/métodos
11.
Int J Mol Sci ; 20(15)2019 Jul 30.
Artigo em Inglês | MEDLINE | ID: mdl-31366152

RESUMO

Purpose of the review: This review highlights the role of angiogenesis, lymphangiogenesis, and immune markers in human immunodeficiency virus (HIV)-associated preeclamptic (PE) pregnancies in an attempt to unravel the mysteries underlying the duality of both conditions in South Africa. Recent findings: Studies demonstrate that HIV-infected pregnant women develop PE at a lower frequency than uninfected women. In contrast, women receiving highly active anti-retroviral therapy (HAART) are more inclined to develop PE, stemming from an imbalance of angiogenesis, lymphangiogenesis, and immune response. Summary: In view of the paradoxical effect of HIV infection on PE development, this study examines angiogenesis, lymphangiogenesis, and immune markers in the highly HIV endemic area of KwaZulu-Natal. We believe that HAART re-constitutes the immune response in PE, thereby predisposing women to PE development. This susceptibility is due to an imbalance in the angiogenic/lymphangiogenic/immune response as compared to normotensive pregnant women. Further large-scale studies are urgently required to investigate the effect of the duration of HAART on PE development.


Assuntos
Terapia Antirretroviral de Alta Atividade/efeitos adversos , Citocinas/sangue , Infecções por HIV/fisiopatologia , Neovascularização Fisiológica/efeitos dos fármacos , Pré-Eclâmpsia/fisiopatologia , Complicações Infecciosas na Gravidez/fisiopatologia , Feminino , Infecções por HIV/tratamento farmacológico , Infecções por HIV/imunologia , Humanos , Sistema Linfático/efeitos dos fármacos , Pré-Eclâmpsia/imunologia , Pré-Eclâmpsia/virologia , Gravidez , Complicações Infecciosas na Gravidez/tratamento farmacológico , Complicações Infecciosas na Gravidez/imunologia
12.
Rev. neurol. (Ed. impr.) ; 69(4): 152-158, 16 ago., 2019. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-184073

RESUMO

Objetivo. Analizar los hallazgos clínicos, exámenes complementarios y pronóstico de los pacientes con leucoencefalopatía multifocal progresiva (LMP) atendidos en nuestra institución, comparando las poblaciones con y sin virus de la inmunodeficiencia humana (VIH) asociado. Pacientes y métodos. Estudio retrospectivo de historias clínicas de pacientes con LMP probable o definitiva. Se analizaron variables clínicas, estudios complementarios (líquido cefalorraquídeo, resonancia magnética cerebral) y variables pronósticas. Mediante pruebas estadísticas no paramétricas se realizó la comparación entre las poblaciones con y sin VIH. Resultados. Se incluyó a 14 pacientes con diagnóstico de LMP definitiva y uno probable. Nueve pacientes presentaron LMP asociada a VIH; cinco, otras condiciones de inmunoafectación (dos, leucemia linfática crónica; uno, esclerosis múltiple; uno, neuromielitis óptica; y uno, neurosarcoidosis); y uno, sin condición inmunosupresora evidente. La población con VIH presentó con mayor frecuencia lesiones de la sustancia blanca heterogéneas de aspecto «sucio» (77,7% frente a 16,67%; p = 0,0247) en la resonancia magnética cerebral. No se identificaron otras diferencias significativas en las restantes variables analizadas. Conclusión. El VIH/sida es la patología más frecuente asociada a LMP. Con el uso de fármacos inmunomoduladores se describe su aparición en una variedad de otras enfermedades. Las lesiones de la sustancia blanca heterogéneas de aspecto «sucio» fueron significativamente más frecuentes en pacientes con VIH


Aim. To analyse the clinical findings, complementary examinations and prognosis of patients with progressive multifocal leukoencephalopathy (PML) treated in our institution, comparing populations with and without associated human immunodeficiency virus (HIV). Patients and methods. A retrospective study of the medical records of patients with probable or definite PML was carried out. Clinical variables, complementary studies (cerebrospinal fluid, magnetic resonance imaging of the brain) and prognostic variables were analysed. Non-parametric statistical tests were used to compare HIV-positive and HIV non-positive populations. Results. Fourteen patients with definite and one probable diagnosis of PML were included. Nine patients had PML associated with HIV; five had other immunosuppressive conditions (two, chronic lymphatic leukaemia; one, multiple sclerosis; one, neuromyelitis optica; and one, neurosarcoidosis); and one, no obvious immunosuppressive condition. The population with HIV presented heterogeneous dirty-appearing white matter lesions more frequently (77.7% versus 16.67%; p = 0.0247) in the cerebral MRI. No other significant differences were identified in the remaining variables analysed. CONCLUSION. HIV/AIDS is the pathology most frequently associated with PML. With the use of immunomodulator drugs its appearance is reported in a variety of other diseases. Heterogeneous dirty-appearing white matter lesions were significantly more common in HIV patients


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Leucoencefalopatia Multifocal Progressiva/fisiopatologia , Infecções por HIV/fisiopatologia , Leucoencefalopatia Multifocal Progressiva/diagnóstico por imagem , Estudos Retrospectivos , Imagem por Ressonância Magnética
13.
PLoS One ; 14(7): e0213222, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31291243

RESUMO

OBJECTIVE: To evaluate the psychometric properties of the HIV Disability Questionnaire (HDQ) among people living with HIV (PLHIV) in London, United Kingdom (UK). METHODS: This is a cross-sectional measurement study. We recruited and administered the self-reported HDQ, seven criterion measures, and a demographic questionnaire with adults living with HIV accessing HIV care. We determined median and interquartile ranges (IQR) for disability presence, severity and episodic scores (range 0-100). We calculated Cronbach's alpha (α) Kuder-Richardson-20 (KR-20) statistics for disability and episodic scores respectively (internal consistency reliability), smallest detectable change (SDC) for each HDQ severity item and domain (precision), and tested 36 a priori hypotheses assessing correlations between HDQ and criterion scores (construct validity). RESULTS: Of N = 243 participants, all were male, median age 40 years, 94% currently taking antiretroviral therapy, and 22% living with ≥2 concurrent health conditions. Median HDQ domain scores ranged from 0 (IQR: 0,7) (difficulties with day-to-day activities domain) to 27 (IQR: 14, 41) (uncertainty domain). Cronbach's alpha for the HDQ severity scale ranged from 0.85 (95% Confidence Interval (CI): 0.80-0.90) in the cognitive domain to 0.93 (95%CI: 0.91-0.94) in the mental-emotional domain. The KR-20 statistic for the HDQ episodic scale ranged from 0.74 (95%CI: 0.66-0.83) in the cognitive domain to 0.91 (95%CI: 0.89-0.94) in the uncertainty domain. SDC ranged from 7.3-15.0 points on the HDQ severity scale for difficulties with day-to-day activities and cognitive symptoms domains, respectively. The majority of the construct validity hypotheses (n = 30/36, 83%) were confirmed. CONCLUSIONS: The HDQ possesses internal consistency reliability and construct validity with varied precision when administered to males living with HIV in London, UK. Clinicians and researchers may use the HDQ to measure the nature and extent of disability experienced by PLHIV in the UK, and to inform HIV service provision to address the health-related challenges among PLHIV.


Assuntos
Avaliação da Deficiência , Infecções por HIV/psicologia , Inquéritos e Questionários , Adulto , Idoso , Estudos Transversais , Infecções por HIV/tratamento farmacológico , Infecções por HIV/fisiopatologia , Humanos , Londres , Masculino , Pessoa de Meia-Idade , Psicometria , Reprodutibilidade dos Testes , Autorrelato/estatística & dados numéricos , Inquéritos e Questionários/estatística & dados numéricos
14.
Braz J Infect Dis ; 23(4): 211-217, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31344351

RESUMO

BACKGROUND: Several tools have been developed to evaluate HIV health-related quality of life (HRQoL) during and after antiretroviral therapy (ART). Few longitudinal studies evaluated the effect of ART on the quality of life of HIV patients. OBJECTIVE: To evaluate changes in HRQoL in HIV-infected individuals one year after initiating ART. METHODS: A prospective study was conducted from May 2016 to July 2018. Data on clinical and sociodemographic characteristics of 91 HIV-infected patients were collected prior to initiation of ART and one year thereafter. Demographic and clinical data were collected and the questionnaires 36-item Short Form Health Survey (SF-36) and HIV/AIDS-targeted quality of life (HAT-QoL) were administered in both periods. Asymptomatic individuals, aged ≥18 years, were included in the study. Patients who discontinued treatment were excluded. The association between predictors of physical and mental HRQoL was analyzed by multiple linear regression analysis. RESULTS: Patients were predominantly male (78.0%), mean age 35.3 ±â€¯10.7 years, with no stable relationship (80.2%), and no comorbidities (73.6%). Most of the SF-36 domains improved after one year, particularly Physical Function (p = 0.0001), General Health (p = 0.0001), Social Functioning (p = 0.0001), Mental Health (p = 0.001), and Mental Component Summary (p = 0.004). HAT-QoL domains improved in the Overall Function (p = 0.0001), Life Satisfaction (p = 0.0001), Provider Trust (p = 0.001), and Sexual Function (p = 0.0001) domains. Sex (p = 0.032), age (p = 0.001), income (p = 0.007), and stable relationship (p = 0.004) were good predictors of the Physical Component Summary. Sex (p = 0.002) and stable relationship (p = 0.038) were good predictors of the Mental Component Summary. SF-36 and HAT-QoL scales presented strong correlations, except for Medication Concerns (0.15-0.37), HIV Mastery (0.18-0.38), Disclosure Worries (-0.15 to 0.07), and Provider Trust (-0.07 to 0.15). CONCLUSIONS: ART improved HRQoL after one year of use. The HAT-QoL and SF-36 correlated well and are good tools to evaluate HRQoL in HIV-infected patients on ART.


Assuntos
Terapia Antirretroviral de Alta Atividade/métodos , Infecções por HIV/tratamento farmacológico , Qualidade de Vida , Adulto , Brasil , Feminino , Infecções por HIV/fisiopatologia , Infecções por HIV/psicologia , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores Socioeconômicos , Inquéritos e Questionários , Resultado do Tratamento , Carga Viral
15.
Chin Med J (Engl) ; 132(14): 1639-1644, 2019 Jul 20.
Artigo em Inglês | MEDLINE | ID: mdl-31268908

RESUMO

BACKGROUND: Unprotected anal intercourse (UAI) has previously been associated with human immunodeficiency virus (HIV) infection. Male students who have sex with men (SMSM) are at increased exposure to experience UAI. The aim of this study was to investigate the status of UAI and related factors among SMSM in three northern regions of China. METHODS: From November 2018 to January 2019, SMSM, 18 years or older, studying or living in Beijing, Tianjin, or Shijiazhuang, who had anal sex in the past 6 months were recruited by community-based organizations to participate in an unmatched, case-control study. Detailed demographic and behavioral information were collected via self-administrated electronic questionnaires and factors related to UAI were assessed using uni- and multivariate logistic regression analyses. RESULTS: Among the 511 SMSM included in the study, 210 (41.1%) reported UAI in the past 6 months. SMSM who had sexual partners at least 10 years older than themselves (odds ratio [OR] = 2.277, 95% confidence interval [CI]: 1.380-3.756), used vacant capsules before sexual activity (OR = 3.858, 95% CI: 1.472-10.106), had a self-perceived moderate-HIV risk (OR = 2.128, 95% CI: 1.403-3.227), and unprotected, first anal intercourse (OR = 2.236, 95% CI: 1.506-3.320) had increased odds of UAI. CONCLUSIONS: Factors associated with increased odds of engaging in UAI in the past 6 months among SMSM included having older sexual partners, using vacant capsules, having a self-perceived moderate risk of HIV, and unprotected, first anal intercourse. Continuing education on risk reduction, including improving condom decision making in age-discordant relationships could help address the sexual risk behaviors among SMSM.


Assuntos
Homossexualidade Masculina/estatística & dados numéricos , Comportamento Sexual/fisiologia , Adulto , Estudos de Casos e Controles , Infecções por HIV/fisiopatologia , Humanos , Masculino , Análise Multivariada , Razão de Chances , Assunção de Riscos , Parceiros Sexuais , Inquéritos e Questionários , Sexo sem Proteção , Adulto Jovem
16.
BMC Res Notes ; 12(1): 424, 2019 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-31311574

RESUMO

OBJECTIVE: The objective of this study is to quantify and compare the effect of excess dietary salt on immune cell activation and blood pressure in HIV versus HIV negative individuals. RESULTS: Salt-sensitivity is associated with increased immune cell activation in animal studies. This concept has not been tested in people living with HIV. This study will therefore add more information in elucidating the interaction between HIV infection and/or anti-retroviral therapy (ART), immune-activation/inflammation and hypertension.


Assuntos
Antirretrovirais/uso terapêutico , Infecções por HIV/tratamento farmacológico , Hipertensão/fisiopatologia , Sistema Imunitário/imunologia , Cloreto de Sódio na Dieta/administração & dosagem , Adulto , Pressão Sanguínea/efeitos dos fármacos , Pressão Sanguínea/fisiologia , Feminino , Infecções por HIV/fisiopatologia , Infecções por HIV/virologia , Humanos , Hipertensão/etiologia , Sistema Imunitário/citologia , Sistema Imunitário/efeitos dos fármacos , Masculino , Estudos Prospectivos , Projetos de Pesquisa , Cloreto de Sódio na Dieta/efeitos adversos , Adulto Jovem , Zâmbia
17.
Nat Rev Cardiol ; 16(12): 745-759, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31182833

RESUMO

Antiretroviral therapy has largely transformed HIV infection into a chronic disease condition. As such, physicians and other providers caring for individuals living with HIV infection need to be aware of the potential cardiovascular complications of HIV infection and the nuances of how HIV infection increases the risk of cardiovascular diseases, including acute myocardial infarction, stroke, peripheral artery disease, heart failure and sudden cardiac death, as well as how to select available therapies to reduce this risk. In this Review, we discuss the epidemiology and clinical features of cardiovascular disease, with a focus on coronary heart disease, in the setting of HIV infection, which includes a substantially increased risk of myocardial infarction even when the HIV infection is well controlled. We also discuss the mechanisms underlying HIV-associated atherosclerotic cardiovascular disease, such as the high rates of traditional cardiovascular risk factors in patients with HIV infection and HIV-related factors, including the use of antiretroviral therapy and chronic inflammation in the setting of effectively treated HIV infection. Finally, we highlight available therapeutic strategies, as well as approaches under investigation, to reduce the risk of cardiovascular disease and lower inflammation in patients with HIV infection.


Assuntos
Doença das Coronárias/complicações , Infecções por HIV/complicações , Fármacos Anti-HIV/uso terapêutico , Aterosclerose/etiologia , Doença das Coronárias/epidemiologia , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , Infecções por HIV/fisiopatologia , Humanos , Fatores de Risco
18.
PLoS One ; 14(6): e0218024, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31211789

RESUMO

BACKGROUND: Little is known on how the interaction between Sickle Cell Disease (SCD) and renal insults caused by other coexisting conditions in Sub Saharan Africa such as urinary schistosomiasis, malnutrition and HIV affect the prevalence of renal dysfunction in children with SCD. OBJECTIVES: To determine the prevalence and factors associated with renal dysfunction among children with SCD aged 6 months to 12 years attended at a tertiary hospital in Northwestern Tanzania. METHODS: A cross sectional hospital-based study with a short follow up component of 3 months for 153 children with SCD was done to document demographics, clinical characteristics and features of renal dysfunction including urine dipstick albuminuria (>20mg/l) and eGFR (<60ml/ml/min/1.73m2). Other potential renal insults such as HIV infection and Schistosomiasis were also evaluated. RESULTS: At enrollment, 48/153(31.37%) children had renal dysfunction declining to 31(20.3%) at 3 months follow up. Acute chest syndrome (OR 3.04, 95% CI [1.08-8.96], p = 0.044), severe anemia (OR 0.44, 95% CI [0.26-0.76],p = 0.003), urinary schistosomiasis (OR 7.43, 95% CI [2.10-26.32] p<0.002) and acute malnutrition (OR 4.92, 95% CI [1.29-18.84], p = 0.020). were associated with renal dysfunction. CONCLUSION: Where prevalent, urinary schistosomiasis and acute malnutrition increase the risk for renal dysfunction in children with SCD. We recommend albuminuria routine screening in children with SCD especially those presenting with acute chest syndrome, severe anemia and features of acute malnutrition for early detection of renal dysfunction among children with SCD.


Assuntos
Anemia Falciforme/epidemiologia , Rim/fisiopatologia , Insuficiência Renal/epidemiologia , Esquistossomose/epidemiologia , Albuminúria/complicações , Albuminúria/epidemiologia , Albuminúria/fisiopatologia , Instituições de Assistência Ambulatorial , Anemia Falciforme/complicações , Anemia Falciforme/fisiopatologia , Criança , Pré-Escolar , Feminino , Taxa de Filtração Glomerular , Infecções por HIV/complicações , Infecções por HIV/epidemiologia , Infecções por HIV/fisiopatologia , Humanos , Lactente , Masculino , Insuficiência Renal/complicações , Insuficiência Renal/fisiopatologia , Esquistossomose/complicações , Esquistossomose/fisiopatologia , Tanzânia/epidemiologia , Centros de Atenção Terciária
19.
Turk J Med Sci ; 49(3): 899-906, 2019 06 18.
Artigo em Inglês | MEDLINE | ID: mdl-31192547

RESUMO

Background/aim: This study aimed to evaluate the stiffness of the liver, spleen, and kidneys in HIV-monoinfected children via shear wave elastography (SWE). Materials and methods: Twenty-one HIV-monoinfected children and 37 healthy subjects were included in this study. Livers, spleens, and kidneys of the participants were examined via ultrasound and SWE. Patients were divided into two groups according to the presence of pathologic ultrasonographic findings. Routine laboratory tests were also recorded. Stiffness of these organs was compared between patients and control groups. Results: Liver transaminases, blood urea, and creatinine levels were normal in all subjects. Ultrasonographic examination revealed hepatosplenomegaly (n = 1, 4.7%), grade 1 hepatosteatosis (n = 1, 4.7%), and hepatosteatosis and minimal heterogeneity of the liver (n = 1, 4.7%). Ultrasonographic features were normal in 18 patients. Stiffness of the liver, spleen, and kidneys of all HIV-monoinfected children with normal laboratory parameters was significantly higher than in healthy subjects. Eighteen patients with normal ultrasonographic findings also had higher stiffness values when compared to control subjects. Conclusion: Stiffness of the liver, spleen, and kidneys in HIV-monoinfected children was increased. SWE can be used in the detection of early parenchymal changes even in patients with normal laboratory parameters and ultrasonographic findings.


Assuntos
Técnicas de Imagem por Elasticidade/métodos , Infecções por HIV , Rim , Fígado , Baço , Adolescente , Criança , Pré-Escolar , Estudos de Coortes , Feminino , Infecções por HIV/diagnóstico por imagem , Infecções por HIV/fisiopatologia , Humanos , Lactente , Rim/diagnóstico por imagem , Rim/fisiopatologia , Fígado/diagnóstico por imagem , Fígado/fisiopatologia , Masculino , Baço/diagnóstico por imagem , Baço/fisiopatologia
20.
Echocardiography ; 36(6): 1123-1131, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31038789

RESUMO

BACKGROUND: Pulmonary hypertension (PH) is one of the complications of human immunodeficiency virus (HIV) infection. Despite the emergence of effective therapies, pulmonary arterial hypertension is commonly seen, especially at advanced stages. At the time of diagnosis, a majority of patients are at New York Heart Association-Functional Class III or IV. Many of the current screening modalities are dependent on detecting a rise in pulmonary arterial pressure (PAP). However, high capacitance of the pulmonary circulation implies that early microcirculation loss is not accompanied by a change in resting PAP. Therefore, we aimed to demonstrate early changes in pulmonary vascular disease in HIV-infected patients with a new echocardiographic parameter, called as pulmonary arterial stiffness (PAS). METHODS AND RESULTS: Thirty-six HIV-infected patients and 36 age- and sex-matched healthy control subjects were enrolled in this study. PAS was calculated echocardiographically by using maximal frequency shift and acceleration time of the pulmonary artery flow trace. There was no significant difference in diastolic functions, right ventricular diameters, systolic PAP, inferior vena cava widths, right atrial area, and tricuspid annular plane systolic excursion values between the two groups. However, PAS was calculated as 24.3 ± 6.4 Hz/msn in HIV-infected patients and 19.3 ± 3.1 Hz/msn in healthy control group (P < 0.001). Increase in PAS was correlated with duration of HIV infection (P < 0.05). CONCLUSION: Our results suggest that HIV infection affects pulmonary vascular bed starting early onset of disease and this can be demonstrated by an easy-to-measure echocardiographic parameter.


Assuntos
Ecocardiografia/métodos , Infecções por HIV/fisiopatologia , Artéria Pulmonar/diagnóstico por imagem , Artéria Pulmonar/fisiopatologia , Rigidez Vascular/fisiologia , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
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