Comparison of prevention of parent-to-child HIV transmission programme & national biennial HIV sentinel surveillance data for tracking HIV epidemic in India.

Background & objectives: HIV sentinel surveillance (HSS) among antenatal women in India has been used to track the epidemic for many years. However, reliable tracking at the local level is not possible as ANC sentinel sites are limited in number and cover a smaller sample size at each site. Prevention of parent-to-child-transmission (PPTCT) programme data has a potential advantage due to better geographical coverage, which could provide more precise HIV case estimates; therefore, we compared HSS ANC data with PPTCT programme data for HIV tracking. Methods: Out of the 499 surveillance sites, where HSS and PPTCT programme was being conducted in 2015, 210 sites (140 urban and 70 rural) were selected using a stratified random sampling method. HSS (n=72,981) and PPTCT (n=112,832) data records were linked confidentially. The sociodemographic characteristics of HSS and PPTCT attendees were compared. HIV prevalence from HSS ANC was compared with the PPTCT programme data using Chi-square test. State- and site-level correlation of HIV prevalence was also done. Concordance between HSS and PPTCT HIV positivity was estimated using kappa statistics. Results: The age distribution of HSS and PPTCT attendees was similar (range: 23 to 27 yr); however, HSS ANC participants were better educated, whereas PPTCT recorded a higher proportion of homemakers. The correlation of HIV prevalence between HSS and PPTCT was high (r=0.9) at the State level and moderate at the site level (r=0.7). The HIV positivity agreement between HSS ANC and PPTCT was good (kappa=0.633). A similar prevalence was reported across 26 States, whereas PPTCT had a significantly lower prevalence than HSS in three States where PPTCT coverage was low. Overall HIV prevalence was 0.31 per cent in HSS and 0.22 per cent in PPTCT (P<0.001). Interpretation & conclusions: High-quality PPTCT programme data can provide reliable HIV trends in India. An operational framework for PPTCT-based surveillance should be pilot-tested in a phased manner before replacing HSS with PPTCT.

Sociobehavioural matrix and knowledge, attitude and practises regarding HIV/AIDS among female sex workers in an international border area of West Bengal, India.

BACKGROUND: HIV/AIDS is still a big public health challenge of India. Female Sex Workers (FSWs) belong to an important high risk group (HRG) in the transmission of HIV/AIDS. International borders have intermingling of population and also plenty of migrant population. Thus study on FSW s with relation to HIV/AIDS in an international border area is an important area of Research. AIMS: The present study was planned with the objectives of: to determine the sociodemographic profile of the FSW under the study, to assess their knowledge and attitude towards HIV/AIDS and to find out their sexual practices. SETTINGS AND DESIGN: It was a community based descriptive cross sectional study, done at the Indo-Bhutan border town of Jaigaon in Alipurduar District of West Bengal with the help of a Non-governmental organization (NGO) working on Targeted Interventions (TI) for FSW. METHODS AND MATERIAL: Total 90 FSWs were interviewed using predesigned pretested questionnaire. The questionnaires used were prior validated by National AIDS Control Organisation (NACO). STATISTICAL ANALYSIS USED: The data were analysed by SPSS 14.0. RESULTS AND CONCLUSIONS: The analysis revealed that 35 % of the study population were illiterate. It was also found that 81% of respondents had heard about HIV/AIDS; 76.7% had knowledge about its spread through vaginal sex, 67.8% had idea regarding its Mother to Child transmission. 92% felt PLHIV should not be kept away from others, 93% felt they shouldn't be deprived from property. Regarding sexual activity, 76.7% had sexual activity more than 3 times/week and 97.8% used condom persistently in last one year. Coordinated Efforts is required to be taken in this regard to tackle these problems.

Immobilization of a Mesophilic Lipase on Graphene Oxide: Stability, Activity, and Reusability Insights.

Catalyst-mediated bioprocessing at an industrial scale is dependent on the sustained stability and activity of the biocatalyst. Here, we demonstrate that strategy employed to increase the stability and activity of a mesophilic lipase immobilized on graphene oxide (GO). The protein adsorption capacity of GO is much higher than of other large surface area carbonaceous materials. Its structure and physicochemical properties are reported beneficial for enzymatic activity modifications. A purified lipase from Brevibacillus borstelensis NLIP05 immobilized on GO showed remarkable increase in thermostability (at 95°C) over a broad alkaline pH range (pH 7-12) compared to the free enzyme. Thermodynamic analysis of the GO-lip showed decreases in Km and activation energy (Ea) with increased Vmax and deactivation energy (Ed) at both 45 and 95°C. The decrease in decay constant (k) coupled with the increase in t1/2 value with temperature increase were salient features of the GO-lip system. This implies that GO-based immobilization conferred structural stability to the enzyme at higher temperature indicating chaperone like activity. Our findings support suitability of immobilized lipase on GO nanosupport for possible production of value-added materials with varied biological applications in the form of active pharmaceutical substances, synthetic building blocks, and effective synthesis of surfactants. The enhanced stability and activity of lipase indicate major application of GO on an industrial scale.

Immunogenicity and safety of two doses of catch-up immunization with Haemophilus influenzae type b conjugate vaccine in Indian children living with HIV.

BACKGROUND: Children living with HIV are at increased risk of disease from Haemophilus influenzae type b (Hib). Data are limited on the immunogenicity of a two-dose, catch-up schedule for Hib conjugate vaccine (HibCV) among HIV-infected children accessing antiretroviral therapy (ART) late. OBJECTIVES: The objectives of the study were to: (1) evaluate baseline immunity to Hib and the immunogenicity and safety of two doses of HibCV among HIV-infected Indian children; and (2) document the threshold antibody level required to prevent Hib colonization among HIV-infected children following immunization. METHODS: We conducted a prospective cohort study among HIV-infected children 2-15 years of age and HIV-uninfected children 2-5 years of age. HIV-infected children received two doses of HibCV and uninfected children received one. Serum anti-Hib PRP IgG antibodies were measured at baseline and two months after immunization in the HIV-infected children. Nasopharyngeal (NP) swabs were collected at baseline and follow-up. RESULTS: 125 HIV-infected and 44 uninfected children participated. 40% of HIV-infected children were receiving ART and 26% had a viral load >100,000 copies/mL. The geometric mean concentration of serum anti-Hib PRP antibody increased from 0.25 µg/mL at baseline to 2.65 µg/mL after two doses of HibCV, representing a 10.6-fold increase (p<0.0001). 76% percent of HIV-infected children mounted an immune response. Moderate or severe immune suppression, trimethoprim/sulfamethoxazole prophylaxis, and lower baseline antibody levels were associated with lower post-vaccine serum anti-Hib PRP IgG antibodies. A serum anti-Hib PRP IgG antibody level ≥ 3.3 µg/mL was protective against Hib NP colonization. There were no differences in adverse events between HIV-infected and uninfected children. CONCLUSION: Including a catch-up immunization schedule for older HIV infected children in countries introducing Hib vaccines is important. Older HIV-infected children with delayed access to ART and without suppressed viral loads mounted an adequate immune response following two doses of HibCV.

Burden and Correlates of HIV among Men Who Have Sex with Men in West Bengal, India: Analysis of Sentinel Surveillance Data.

BACKGROUND: Little is known about the socio-behavioral risk factors for HIV acquisition among hard-to-reach men who have sex with men (MSM) population in India, particularly from the densely populated eastern part. Thus to measure the burden and correlates of HIV among MSM in West Bengal state of eastern India, a cross-sectional analysis of the national HIV Sentinel Surveillance (HSS) data was conducted. METHODS: In 2011, between July and September, involving all sentinel sites of the state, 1237 consenting MSM were anonymously interviewed and tested for HIV following national guidelines. Using a short, structured questionnaire, information was collected on socio-behavioral factors along with sexual practices and was analyzed to determine burden of HIV and the role of its socio-behavioral correlates on HIV acquisition. RESULTS: Among participants, mean age was 23.4 years, 44.55% were "Kothis" (usually receptive partner) and 25.1% admitted receiving money for sex with man. HIV sero-positivity was 5.09%. Using logistic regression method, for both bivariate and multivariate (with saturated model) analyses, transport-workers [adjusted odds ratio (AOR)=8.95, 95% confidence interval (95%CI): 1.09-73.71), large business-owners/self-employed (AOR=8.46, 95%CI: 1.25-57.49), small business-owners/cultivators (AOR=7.90, 95%CI: 1.67-37.38), those who visited the sentinel site for official purposes (AOR=7.60, 95%CI: 1.21-47.83) and paying money for having sex with men (AOR=3.03, 95%CI: 1.10-8.33) were strongly associated with higher HIV sero-positivity with than their counterparts. Using the parsimonious model for multivariate analysis, Kothis (AOR=4.64, 95%CI: 1.03-20.89), paying (AOR=2.96, 95%CI: 1.15-7.58) or receiving (AOR=2.06, 95%CI: 1.06-3.99) money for having sex with a man were associated with higher risk of HIV. CONCLUSIONS: Focused intervention targeting the high risk MSM subgroups including Kothis, transport-workers, business-owners/self-employed and those who exchanged money for having sex with men, seemed to be the need of the hour for preventing the spread of HIV infection within and from this understudied population.