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Current HIV research [journal]
- Progress in Prevention of Mother-to-Child Transmission of HIV-1 in Zhejiang Province, China, 2007-2013. [JOURNAL ARTICLE]
- Curr HIV Res 2014 Feb 25.
In this article, a retrospective study was conducted based on surveillance of human immunodeficiency virus type-1 positive pregnant women and their children from 2007-2013 in China's Zhejiang Province. HIV counseling and testing, mother and infant characteristics, and outcomes were reported here. This study compares two principal periods, from 2007-2009 and from 2010-2013. Between the two periods, the rate of HIV counseling among pregnant women rose significantly from 84.87% to 99.08% and the rate of HIV testing rose from 80.60% to 98.58% .However, the HIV-1 prevalence among pregnant women increased slightly, from 0.01% to 0.02%. Over 70% of infected women were migrants and half of these HIV-1 positive pregnant women were 20-30 years old. Variations in the characteristics of HIV-1 positive pregnant women were observed over time, the proportion of women employed increased dramatically from 15.03% during 2007-2009 to 31.34% during 2010-2013 and the proportion of women with high school education increased from 0.52% to 6.51% the same time. 32.53% women were identified prior to pregnancy during 2010-2013, this figure was obviously higher than that (3.11%) during 2007-2009. Sexual contact remained the primary route of transmission route over the years which accounting for half of the infected. But women infected by blood transfusion declined noticeably. The proportion of mothers and children with ART had a big increase over time. The overall mother-to-child transmission rate was 7.14%
- Expansion or Depletion of T Follicular Helper Cells During HIV Infection: Consequences for B Cell Responses. [JOURNAL ARTICLE]
- Curr HIV Res 2014 Feb 25.
HIV infection is characterized by aberrant B cell responses and B cell dysfunction. These dysfunctional responses have been extensively documented in peripheral blood and organized lymphoid tissues such as the lymph nodes. Though the loss of CD4 T cell help has been thought to play a key role in dysfunctional B cell responses, recent studies have implicated a subset of CD4 T helper cells called the T follicular helper (Tfh) cells in this process. Tfh cells interact with B cells and play a key role in mediating the germinal center reaction, and driving the differentiation and maturation of B cells. Why Tfh expand in some HIV infected individuals as compared to their loss in others is still not clear. Here we review some of the recent developments in the field and discuss the implications of Tfh cell dysregulation on B cell responses during HIV infection.
- Genetic Variants of Drug Metabolizing Enzymes and Drug Transporter (ABCB1) as Possible Biomarkers for Adverse Drug Reactions in an HIV/AIDS Cohort in Zimbabwe. [Journal Article]
- Curr HIV Res 2013 Sep; 11(6):481-90.
A study was conducted in an HIV/AIDS Zimbabwean cohort to assess possible associations of pharmacogenetic variants with common adverse drug reactions (ADRs) during anti-retroviral treatment (ART) and/or tuberculosis (TB) treatment. Genotype and allele frequencies for CYP2B6 G516T, CYP2B6 T983C, CYP2A6*17, ABCB1 rs10276036 C>T, NAT2*5 and NAT2*14 were similar to those reported in literature for other African populations. The CYP2B6 516TT genotype and male gender were significantly associated with occurrence of Efavirenz induced central nervous system disorders (OR 20.58, p=0.004) and the ABCB1 rs10276036TT genotype with Nevirapine induced skin hypersensitivity (OR 4.01, p=0.04). For Stavudine, time on treatment was the main factor in development of lipodystrophy (OR 1.06, p<0.0001). For isoniazid, increasing patient age was associated with peripheral neuropathy (OR 1.05, p=0.001). Although genetic polymorphisms may play a role in predicting occurrence of ADRs, this study also indicates that other factors (gender, age, treatment time) are crucial in predicting drug-induced adverse effects.
- Genotypic and Phenotypic Comparison of Enteroaggregative Escherichia Coli Isolates from HIV-Positive and non-HIV Diarrheal Samples. [JOURNAL ARTICLE]
- Curr HIV Res 2014 Feb 7.
Enteroaggregative Escherichia coli (EAEC) have been isolated from both HIV-positive and non-HIV diarrheal samples. In this study a collection of 18 isolates from these two groups were compared for biofilm formation and antibiotic resistance and for the presence of 14 virulence-related genes. All the HIV-positive and over 66% of the non-HIV strains were PCR-negative for adhesion-related sequences indicating that as yet unknown adhesins may play a role. However, despite some variations, the prevalence rate of the virulence-related genes was not significantly different in the two groups. HIV-positive isolates were biofilm producer but only a single weak biofilm former was observed among the non-HIV strains. The rate of resistance to most of the antibiotics used was higher among the HIV-positive group than the non-HIV isolates, but was significantly higher for amoxicillin-calvulanic acid (100%) and nalidixic acid (55.5%). Pulse field gel electrophoresis of the isolates produced 17 unique profiles reflecting the exiting heterogeneity of the isolates.
- Evaluation of Boosted and Unboosted Atazanavir Plasma Concentration in HIV Infected Patients. [JOURNAL ARTICLE]
- Curr HIV Res 2014 Feb 7.
Objective: The aim of the study was to identify variables that can influence atazanavir plasma concentration. Methods: We retrospectively analysed atazanavir trough concentration of HIV infected patients who performed therapeutic drug monitoring between October 2007 and July 2011. Qualitative variables were compared with χ2 test while continuous ones with Mann-Whitney and Student's t-test. A linear regression model was used to investigate factors influencing atazanavir plasma concentration. Therefore, we analysed the impact of cirrhosis on atazanavir pharmacokinetic variability. Results: 255 plasma samples from 179 patients were analysed. At the univariate analysis female gender (+144.4 ng/mL; p=0.05) and tenofovir (+196.8 ng/mL; p=0.002) were associated with higher atazanavir concentrations. The multivariate model confirmed these two variables (+164.6 ng/mL; p=0.02 and +150.4 ng/mL; p=0.01) as independently associated with higher atazanavir trough concentration. The analysis of cirrhotic population showed an influence of tenofovir (-255.9 ng/mL; p=0.01), increased AST (+95.3 ng/mL; p=0.09), ALT (+67.9 ng/mL; p=0.07) and creatinine (+517.2 ng/mL; p=0.04). The multivariate model confirm that tenofovir was associated with lower atazanavir trough concentration (-284.1 ng/mL; p=0.005) while AST values significantly increased atazanavir concentrations (+114.5 ng/mL; p=0.03). Discussion: Atazanavir is a safe and manageable drug. Our results suggest that female patients tend to have higher atazanavir plasma concentration, while the effect of tenofovir needs to be better clarified.
- HIV-1 Vaccine Strategies Utilizing Viral Vectors Including Antigen-Displayed Inoviral Vectors. [JOURNAL ARTICLE]
- Curr HIV Res 2014 Feb 9.
Antigen-presenting viral vectors have been extensively used as vesicles for the presentation of antigens to the immune system in numerous vaccine strategies. Particularly in HIV vaccine development efforts, two main viral vectors have been used as antigen carriers: (a) live attenuated vectors and (b) virus-like particles (VLPs); the former, although highly effective in animal studies, cannot be clinically tested in humans due to safety issues and the latter have failed to induce broadly neutralizing anti-HIV antibodies. For more than two decades, Inoviruses (non-lytic bacterial phages) have also been utilized as antigen carriers in several vaccine studies. Inoviral vectors are important antigen-carriers in vaccine development due to their ability to present an antigen on their outer architecture in many copies and to their natural high immunogenicity. Numerous fundamental studies have been conducted, which have established the unique properties of antigen-displayed inoviral vectors in HIV vaccine efforts. The recent isolation of new potent anti-HIV broadly neutralizing monoclonal antibodies provides a new momentum in this emerging technology.
- Analysis Of Sexual Behavior In Adolescents. [JOURNAL ARTICLE]
- Curr HIV Res 2014 Jan 28.
The aim of this study was to describe some characteristics of vaginal, anal and oral sexual behavior in Spanish adolescents. It was a cross-sectional descriptive population study conducted using a probabilistic sample survey. The sample was composed of 4,612 male and female adolescents, of whom1,686 reported having penetrative sexual experience. Sample size was established with a 97% confidence level and a 3% estimation error. Data collection took place in secondary education schools. Mean age of vaginal sex initiation was 15 years. Compared to females, males reported an earlier age of anal and oral sex initiation and a larger number of vaginal and anal sexual partners. Males also reported a higher frequency of penetrative sexual relations under the influence of alcohol or other drugs. A higher percentage of females than males reported not using a condom in their first anal sexual experience. This study provides a current overview of the sexual behavior of adolescents that can be useful for the design of future programs aimed at preventing HIV and sexually transmitted infections (STIs).
- PrEP Awareness and Perceived Barriers Among Single Young Men who have Sex with Men. [JOURNAL ARTICLE]
- Curr HIV Res 2014 Jan 28.
Pre-exposure prophylaxis (PrEP) has the potential to help reduce new HIV infections among young men who have sex with men (YMSM). Using a cross-sectional survey of YMSM (N=1,507; ages 18-24), we gauged YMSM's PrEP awareness and PrEP-related beliefs regarding side effects, accessibility, and affordability. Overall, 27% of the sample had heard about PrEP; 1% reported ever using PrEP prior to sex. In a multivariate logistic regression, we found that YMSM were more likely to have heard about PrEP if they were older more educated were residentially unstable in the prior 30 days had insurance or reported having at least one sexually transmitted infection in their lifetime We found no differences by race/ethnicity, history of incarceration, or recent sexual risk behavior. In multivariate linear regression models, Black and Latino YMSM were more likely than Whites to state they would not use PrEP because of side effect concerns. YMSM were more likely to indicate that they would not be able to afford PrEP if they did not have insurance or if they had a prior sexually transmitted infection PrEP rollout may be hindered due to lack of awareness, as well as perceived barriers regarding its use. We propose strategies to maximize equity in PrEP awareness and access if it is to be scaled up among YMSM.
- State of the Evidence: Intimate Partner Violence and HIV/STI Risk Among Adolescents. [JOURNAL ARTICLE]
- Curr HIV Res 2014 Jan 28.
This paper provides a critical narrative review of the scientific literature on intimate partner violence (IPV) and risky sexual behavior as well as sexually transmitted infections (STIs) among adolescents, aged 14-24 years. Intimate partner violence has been associated with a number of high risk sexual behavior, including inconsistent condom use, multiple sexual partners, earlier sexual debut, consuming substances while engaging in sexual behavior, and sexually transmitted infections among adolescents. An electronic search of the literature was performed using PubMed/MEDLINE, PsycINFO, and Web of Science and articles from January 2000 - June 2013 were reviewed. Search terms included a combination of keywords for IPV, HIV/STI risk, and adolescents. The findings from the review indicated that IPV was associated with inconsistent condom use, STIs, early sexual debut, multiple sexual partners, and other HIV/STI-associated risk factors among adolescents. HIV/STI interventions for female adolescents often focus on increasing behavioral and cognitive skills, specifically condom negotiation. However, within the context of an abusive relationship, it becomes challenging for adolescents to enact these skills, where this behavior could potentially place them at greater risk. Components that address violence are necessary within HIV prevention programming. Additionally, integration of IPV screening within healthcare settings is important along with a combined approach that merges resources from healthcare, social, and community-level settings.
- Power Dynamics in Adolescent Couple Relationships and Risk of Sexually Transmitted Infections and HIV. [JOURNAL ARTICLE]
- Curr HIV Res 2014 Jan 28.
The aim of this study was to determine whether there are differences in power distribution between males and females in couple relationships, and whether these differences are associated with risky sexual behaviour in a representative sample of Spanish adolescents. The study also examined the influence of partner's age on the power dynamics that occur in a relationship. The sample comprised 1,223 adolescents attending state and private schools in the 17 autonomous regions in Spain. All adolescents included in the sample were involved in a heterosexual relationship (for at least one month) at the time of evaluation. Relationship control and decision-making dominance were evaluated using the Spanish version of the Sexual Relationship Power Scale. Two further questionnaires were administered to collect sociodemographic data, and data on sexual behaviour. Females showed greater relationship control and greater control over decision-making than males. In the female group, participants with partners five or more years older than them were found to have less control over decision-making, while greater control over decision-making was linked to less exposure to risk. In the male group, participants with partners older than them were found to have greater control over decision-making, while relationship control was found to be negatively related to exposure to sexual risk. These results highlight the importance of taking power distribution and gender inequalities in couple relationships into consideration for STI and HIV prevention.