High IL-10 production by aged AIDS patients is related to high frequency of Tr-1 phenotype and low in vitro viral replication.

This work aims to elucidate the effects of age and HIV-1 infection on the frequency and function of T cell subsets in response to HIV-specific and non-specific stimuli. As compared with the younger AIDS group, the frequencies of naive and central memory T cells were significantly lower in aged AIDS patients. Although there was also a dramatic loss of classical CD4(+)FoxP3(+)CD25(+)Treg cells in this patient group, high frequencies of IL-10-producing CD4(+)FoxP3(-) T cells were observed. In our system, the increased production of IL-10 in aged AIDS patients was mainly derived from Env-specific CD4(+)FoxP3(-)CD152(+) T cells. Interestingly, while the blockade of IL-10 activity by monoclonal antibody clearly enhanced the release of IL-6 and IL-1ß by Env-stimulated PBMC cultures from aged AIDS patients, this monoclonal antibody enhanced in vitro HIV-1-replication. In conclusion, HIV infection and aging undoubtedly contribute synergistically to a complex immune dysfunction in T cell compartment of HAART-treated older HIV-infected individuals.

Assessment of vascular function in HIV-infected patients.

PURPOSE: The vascular function in HIV-infected persons under HAART and non-HIV-infected persons was investigated. METHOD: 18 HIV-positive patients and 23 HIV-negative subjects (14 younger group and 9 older group) were evaluated for microvascular vasodilatation during postocclusive reactive hyperemia (PORH) and during prolonged local thermal hyperemia; overall microvascular flux increase induced by iontophoresis of acetylcholine (ACh) and sodium nitroprusside (SNP) and large artery stiffness (SI(DVP)). RESULTS: Cutaneous vascular conductance (CVC) responses to ACh were lower in HIV patients compared to both HIV-negative groups (mean [SEM]) (HIV positive: 878.2 [99.5]; older HIV negative: 1129.3 [231.6]; younger HIV negative: 1366.5 [172.6] % baseline). Regarding SNP iontophoresis, HIV-positive and older HIV-negative groups showed lower CVC responses than younger HIV-negative group (HIV positive: 1043.0 [164.6]; older HIV-negative: 980.8 [108.3]; younger HIV-negative: 1757.3 [245.1] % baseline). Vasodilatation induced by thermal hyperemia (HIV positive: 1.63 [0.11]; older HIV negative: 1.48 [0.08]; younger HIV negative: 1.85 [0.27] perfusion units/mm Hg) and PORH (HIV positive: 0.374 [0.025]; older HIV negative: 0.326 [0.025]; younger HIV negative: 0.326 [0.037] PU/mm Hg) were similar between all groups. SIDVP was greater in HIV and older healthy groups than younger healthy group (HIV positive: 9.17 [0.42]; older HIV negative: 8.19 [0.43]; younger HIV negative: 6.42 [0.22] m/s). CONCLUSION: HIV-infected patients under HAART exhibited slight but nonsignificant lower microvascular reactivity to pharmacological stimuli and increased arterial stiffness compared to age-matched HIV-negative subjects. Comparison of both HIV-positive and older HIV-negative groups with younger HIV-negative subjects suggests that age plays a major role in microvascular reactivity regardless the HIV-infection.

Effects of physical exercise in the perception of life satisfaction and immunological function in HIV-infected patients: Non-randomized clinical trial.

BACKGROUND: there is a lack of research about the relationship between exercise and the psychological well-being of HIV-infected (Human Immunodeficiency Virus) patients. OBJECTIVE: the objective of this study was to investigate the influence of a physical training program on life satisfaction and on the immunological function in HIV-patients. METHODS: a total of 29 HIV-seropositive patients [age: 45 ± 2 yrs; Body Mass Index (BMI): 22.8 ± 1.0 kg/m² ; TCD4: 20.5 ± 2.0%] were allocated to the control (CG, n=10) and to the experimental groups (EG, n=19). The EG participated in an exercise program combining aerobic, strength, and flexibility exercises for a period of 12 weeks [3 times/week of 30 min of aerobic exercise (workload corresponding to 150 bpm-PWC150); 50 min of strength exercises (3 sets of 12 repetitions in 5 exercises at 60-80% 12 RM); and 10 min of flexibility exercises (2 sets of 30 seconds at maximal range of motion of 8 exercises)]. The immunological function was assessed by flow citometry [absolute and relative TCD4 cells counting] and the life satisfaction was assessed by the Life Satisfaction Index (LSI). RESULTS: the analysis of variance (ANOVA) showed no significant differences for relative and absolute CD4 T counts for both groups, however, a slight enhancement trend in the EG [16%, p=0.19] was observed. There was a significant improvement of LSI [approximately 15%; P<0.05] in EG, but not for CG. CONCLUSION: a physical activity program of moderate intensity improved life satisfaction perception in HIV-infected patients with no immunological function impairment.

Efeito do exercício físico na percepção de satisfação de vida e função imunológica em pacientes infectados pelo HIV: Ensaio clínico não randomizado / Effects of physical exercise in the perception of life satisfaction and immunological function in HIV-infected patients: Non-randomized clinical trial

CONTEXTUALIZAÇÃO: Os estudos sobre a relação entre prática de exercícios e bem-estar psicológico de pacientes com vírus da imunodeficiência humana (HIV) são raros. OBJETIVO: Investigar a influência de programa de condicionamento físico sobre a satisfação com a própria vida e sobre a função imunológica. MÉTODOS: Para tal análise, 29 pacientes soropositivos (idade: 45±2 anos; índice de massa corporal (IMC): 22,8±1,0 kg/m2; TCD4: 20,5±2,0 por cento), foram divididos em grupo controle (GC, n=10) e grupo experimental (GE, n=19). O GE participou durante 12 semanas de programa de exercícios que combinavam exercícios aeróbios, força e flexibilidade (três vezes/semana; aeróbio-30min: carga em watts equivalente a 150bpm-PWC150; força-50min: três séries de 12 repetições em cinco exercícios a 60-80 por cento 12 RM; flexibilidade-10min: duas séries de 30s na máxima amplitude em oito exercícios). A função imunológica foi avaliada por contagem absoluta e relativa das células TCD4 (citometria de fluxo),e a satisfação de vida, por meio do Índice de Satisfação de Vida (ISV). RESULTADOS: A análise de variância (ANOVA) não identificou alteração significativa para os linfócitos TCD4 em ambos os grupos, apesar da tendência à elevação no GE (16 por cento, p=0,19). Houve melhora significativa no ISV (≈15 por cento, P<0,05) para o GE, mas não para o GC. CONCLUSÃO: Um programa de condicionamento físico de intensidade moderada melhorou a percepção de satisfação de vida dos pacientes com HIV observados, sem acarretar prejuízos imunológicos.

BACKGROUND: There is a lack of research about the relationship between exercise and the psychological well-being of HIV-infected (Human Immunodeficiency Virus) patients. OBJECTIVE: The objective of this study was to investigate the influence of a physical training program on life satisfaction and on the immunological function in HIV-patients. METHODS: A total of 29 HIV-seropositive patients [age: 45±2 yrs; Body Mass Index (BMI): 22.8±1.0 kg/m² ; TCD4: 20.5±2.0 percent] were allocated to the control (CG, n=10) and to the experimental groups (EG, n=19). The EG participated in an exercise program combining aerobic, strength, and flexibility exercises for a period of 12 weeks [3 times/week of 30 min of aerobic exercise (workload corresponding to 150 bpm-PWC150); 50 min of strength exercises (3 sets of 12 repetitions in 5 exercises at 60-80 percent 12 RM); and 10 min of flexibility exercises (2 sets of 30 seconds at maximal range of motion of 8 exercises)]. The immunological function was assessed by flow citometry [absolute and relative TCD4 cells counting] and the life satisfaction was assessed by the Life Satisfaction Index (LSI). RESULTS: The analysis of variance (ANOVA) showed no significant differences for relative and absolute CD4 T counts for both groups, however, a slight enhancement trend in the EG [16 percent, p=0.19] was observed. There was a significant improvement of LSI [approximately 15 percent; P<0.05] in EG, but not for CG. CONCLUSION: A physical activity program of moderate intensity improved life satisfaction perception in HIV-infected patients with no immunological function impairment.

A 3-year follow-up of a brazilian AIDS patient with protracted diarrhea caused by Enterocytozoon bieneusi

Enterocytozoon bieneusi e o mais comum microsporidio agente de infeccoes gastrointestinais que ocorre predominantemente em pessoas com AIDS. Em todo o mundo os microsporidios sao reconhecidos como importantes patogenos oportunistas, entretanto poucos casos ja foram diagnosticados no Brasil, provavelmente devido ao pouco conhecimento do quadro clinico que os agentes produzem ou a dificuldades no diagnostico laboratorial. No presente trabalho relatamos o caso de um paciente brasileiro HIV-positivo acompanhado durante 3 anos, em que foram detectados esporos de microsporidios nas fezes, identificados como Enterocytozoon bieneusi por microscopia eletronica e PCR. O paciente apresentava diarreia cronica, contagem de linfocitos CD4 abaixo de 100/mm3 e fez uso de albendazol em diferentes ocasioes com melhora transitoria da diarreia, que reaparecia logo que a droga era suspensa...