We retrospectively reviewed 505 HIV/AIDS patients who attended the Hospital Kuala Lumpur between January 2001 and December 2002. The seroprevalence of toxoplasmosis among these 505 HIV/AIDS patients was 226 (44.8%; 95% CI 42.64 - 51.76): 27 (47.4%) and 199 (44.4%) showed Toxoplasma seropositivity with and without TE, respectively (P < 0.05). We found that the mean age of patients with TE was significantly higher than that of patients without TE (P < 0.05). The majority of them were in the 25 - 34 age group (44 versus 39%), male (86 versus 76%), and Chinese (49 versus 53%), though no statistical significance was found between the two groups. Significant differences were noted between these two groups in terms of marital status, occupa- tion, and present address. A high percentage of patients in both groups were mainly unemployed (75 versus 51%). The majority of patients with TE were single (70%) and resided outside Kuala Lumpur (68%), and that of patients without TE were married (51%) and resided in Kuala Lumpur (57.6%). Heterosexuals demonstrated the most frequent high risk behavior for HIV infection, and accounted for 51% of patients with TE and 59% of patients without TE. Overall, the range of CD4 cell count was from 0 - 1312 with a median of 229 cells/cumm, while the range of CD4 cell count was 0 - 239 with a median of 25 cells/cumm at the time of diagnosis in patients with TE. We also found a significantly relation- ship between CD4 cell count of less than 100 cells/cumm and development of TE (P < 0.05). Our data showed that 260 (51.5%) and 137 (27%) of patients received primary chemo- prophylaxis (cotrimoxazole) and antiretroviral therapy includ- ing HAART before the onset of TE, and only 17/260 (6.5%) and 1/137 (0.7%) of those patients later (at the time of this study) had TE (P < 0.05) as shown in Table 1.
States ever since the outbreak of HIV/AIDS have been using different methods in order to combat the pandemic if possible and to reduce vulnerability. In spite of this, HIV/AIDS continues to be prevalent especially in a less developed countries to the extent that it to be hurdle for development. Criminalization of HIV/AIDS patients is one of the mechanisms that are used in the fight against the deadly disease. However, employing criminalization as prevention and vulnerability reduction strategy poses a question and stimulates a debate. Hence, the main thrust of this article is to identify this challenge and to assess whether criminalization of HIV/AIDS patients reduce vulnerability to HIV/AIDS. This being the aim it will also go on to analyze the role of criminal law in a public health issue. In doing so, the article will discuss experience of countries in criminalization of HIV/AIDS patients along side with international frameworks. At a glance, criminal law through a vehicle of punishment seems to play a role in reducing vulnerability to HIV/AIDS but, the writer based on the analyses of relevant literature and experiences of countries, argues that the use of criminal law to address HIV is inappropriate except in rare cases where a person acts with conscious intent to transmit HIV and does so, and this is because of the high degree of proof required in criminal case and the difficulty of using criminal law in HIV related issue due to the nature of the disease and the absence of technology used for the required proof in the criminal law, i.e. beyond reasonable doubt.
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The replication cycle of HIV begins with the high affinity binding of the gp 120 protein via a portion of its v1 region near the N terminus to its receptor on the host cell surface , the CD4 molecule . It is also expressed on the surface of monocytes / macrophages and dendritic / langerhans cells . Once gp 120 binds to CD4, the gp 120 undergoes a conformational change that facilitates binding to one of a group of co – receptors . The two major co–receptor of HIV -1 are CCR5 and CXCR4.
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cessfully treated with 6 months short-course therapy, compared to patients with EPT who took a longer time, at least 9 months. This ob- servation is consistent with other studies (Gerard, 2000; Wang et al, 2000). This is due to the fact that extrapulmonary tuberculosis can be rapidly fatal but is a treatable condition, there- fore diagnostic procedures should be imple- mented early and empirical treatment given in suspected cases. We found that nearly half of patients with either PTB or EPT were noncom- pliant with therapy; a slightly higher rate was seen in patients with PTB. The factors that may contribute to nonadherence in this study were being male, having a low socioeconomic status, being single, being an injecting drug user, and having certain racial origins (data were not shown). These findings are supported by other previous investigations (Tansuphaswadikul et al, 1998; Wobeser et al, 1999; Tanguis et al, 2000; Santha et al, 2002). Nonadherence to anti-tubercular therapy has a significant impact on, and is a long- standing problem for involved medical personnel in Malaysia; a country considered to be an inter- mediate zone of tuberculosis burden. Nonadher- ence may contribute to the spread of tuberculo- sis and the emergence of drug resistance, and may increase the cost of treatment (Pablos- Mendez et al, 1997) and relapses (Brucker-Davis et al, 1993). The special problem of prophylaxis of persons exposed to multidrug-resistant tuber- culosis is important (Sepkowitz et al, 1995). DOT programm has been implemented for all TB pa- tients in Malaysia. In TB/HIV-infected patients with history of nonadherence to antitubercular therapy for any cause, closer monitoring is carried out by medical personnel in this center.
Considering the long term introduction and usage of Highly Active Anti-retroviral Therapy (HAART), there is significant reduction in OIs and AIDS related prognosis (Ayyagari et al., 1999; Sun et al., 2006; Habtamu et al., 2015). Although, the type of OIs which affects people living with HIV/AIDS varies from region to region (Sun et al., 2006). Hence, there are significant differences between OIs prevalent in Africa and those prevalent in United States of America and Europe (Mocroft et al., 2013). Of the all HIV/AIDS related infections or diseases, tuberculosis stands most common as seen across geographical boundaries and influencing about one third of the world’s people living with HIV/AIDS (PLWHA) (Sharma et al., 2005). This is may be due its worldwide distribution with endemicity in certain areas and cultures (Mocroft et al., 2013; Habtamu et al., 2015). Therefore, for the road map of HIV/AIDS related morbidity and mortality to be consolidated; their frequency, identification and distribution would play important task (WHO, 2007).
the fact that food insecurity in many situations is due to limited resources available, and the burden of food insecurity remains a global challenge especially among poor nations. This factor is an important risk factor in the HIV progression and deaths among AIDS patients . According to the Food and Agriculture Organization (FAO) of the United Nations report, nearly 870 million people of 7.1 billion or about one-eighth of the world's population are suffering from chronic malnutrition. About 852 million hungry people are living in developing countries with this amount constituting approximately 15% population of these countries. Nearly 16 million people are suffering from malnutrition in developed countries too . Food insecurity during the past two decades has attracted the attention of experts and policymakers as a major public health problem. Food insecurity in Iran has been reported to range from 20 to 60% and it has been reported in 75 to 86% of female- headed households and low-income community respectively . Food insecurity is a key factor in HIV progression globally especially in third world countries and is an important factor for poor health outcomes among people with AIDS. Without food or income, some family members may migrate in search of work, increasing their chances of contracting HIV — and bringing it back home. For others, commercial sex may be their only option to feed and support their family. Food insecurity also leads to malnutrition, which can aggravate and accelerate the progression to AIDS. Likewise, the disease itself can contribute to malnutrition by reducing appetite, interfering with nutrient absorption, and making additional demands on the body's nutritional status . Overall, in the world, 232 studies has been done on the effect of food insecurity on AIDS, and 152 studies showed that there is a relationship between food insecurity and the treatment process of AIDS . Food insecurity has been studied as a key indicator in reduced response to Anti-Retroviral Therapy (ART) treatment in patients with HIV/AIDS. A range of undesirable results in health status have been observed in patients with food insecurity, such as decreasing physical health conditions, reduced viral suppression, reduced immunity, increasing the risk of opportunistic infections . Considering the fact that, no study has been done in this field in Iran and undesirable level of knowledge about the relationship between lifestyle and infection diseases in Iranian people , this study evaluated the effect of food insecurity on the HIV progression among the HIV-infected patients on
Since the establishment of HAART, the prognosis of HIV-1 infected individuals and AIDS patients has im- proved significantly. However, treatment failure can oc- cur immunologically, virologically, or clinically, signifi- cant side effects occur and the salvage treatment options are many times restricted (e.g. due to viral cross-resis- tance) or are non-available . HAART is also prob- lematic to pregnant women and children [39,40]. In de- veloping countries HAART may be even more harmful because of the high prevalence of ailments such as ane- mia, malnutrition, and co-infections, such as tuberculosis . Furthermore, since HAART is expensive and needs good infrastructural support and control programs, it is not available to multitude of patients, especially in de- veloping countries . Thus, new, non-expensive, safe, easy to take, alternative or complementary remedies, that can improve the patient’s well-being, are very attractive for the treatment of individuals that fail HAART or anti- retroviral naïve patients that cannot get antiretroviral the- rapy. A food supplement, such as the PHT examined in this study, is extremely inexpensive as compared to HAART. PHT are from a natural source. They have been in the market for several years and have no adverse ef- fects. Also, as opposed to antiretrovirals, since they do not affect directly HIV-1, their uptake with low adher- ence does not result in appearance of drug resistant vi- ruses. Obviously, in order to increase their efficacy high compliance is desired. The regimen used in this study, of 5 pills three times a day is not optimal, as taking 15 pills a day, in addition to usually taking other treatments, is cumbersome to the patients and personnel and may result in low adherence. Better formulations should be devel- oped in the future. Be as it may, it is clear that the ad- ministration of the Phyto V7 improved very dramatically the well-being of the patients. Unfortunately, no viral load or CD4+ T-cell counts were taken from the patients after the 3 months PHT supplementation, so it cannot be determined if there was an improvement in the CD4 counts or reduction of viremia as a consequence of the PHT supplementation. Future studies should carefully examine this.
Results: From the Kaplan–Meier, log-rank test result indicated that there was a significant difference between tuber- culosis comorbidity (P = .000), occupation (P = .027), and WHO clinical stage (P = .012) on the survival experience of patients at 5% statistical significance level. From the Cox regression result, the risk of death for patients who lived with tuberculosis was about 2.872-fold times higher than those patients who were negative. Most of the HIV/AIDS patients on antiretroviral therapy were died in a short period due to tuberculosis comorbidity, began with lower amount of CD4, being underweight, merchant, and being on WHO clinical stage IV.
The different degrees of susceptibility of blood groups (ABO and Rhesus) to different types of blood-borne disease have long been a global issue most especially in consideration of blood transfusion-related consequences of infected blood. This study has revealed the different levels of association of ABO and rhesus blood groups with HIV/AIDS infection. It was found that blood group O was generally more frequent among the participants in this study than other blood groups and this agreed with the earlier report of a study by Maatoghi et al., (9) on ethnicity- related prevalence of blood groups in which they found that blood group O was most prevalent while AB blood had the lowest prevalence. The result also showed that there were more of blood group O victims of HIV/AIDS compared to others, thus confirming the reports of earlier studies by Sayal et al ., (3), Abdulazeez et al., (2), Fatemeh and Aliakbar (10) and Carine et al., (1) undertaken in different parts of the globe, in which they found that Blood group O was more susceptible to HIV/AIDS than other blood groups. Also observed in this study is the fact that rhesus negativity generally recorded highest HIV/AIDS patients of 224(88%) and only 36(12%) rhesus positive blood individuals had HIV/AIDS disease. Even in the different ABO blood groups rhesus negative is tended to be more prevalent among HIV/AIDS infected individuals. From the result shown in table 1, rhesus positivity and negativity distribution has indicated that in blood group A, rhesus A negative (A - ) blood had 67(90.5%) HIV/AIDS patients, in B group, B positive (B - ) accounted for 56(91.8%). Similarly, in AB group, 37(86.5%) HIV/AIDS were
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HIV/AIDS patients, therefore, frequently present with diabetes and metabolic complaints. As treatment of HIV develops, and access to therapy improves, the incidence of HIV-associated diabetes is bound to grow. An inter- national cross-sectional study of 788 HIV-infected adults recruited at 32 centers has studied the metabolic syn- drome prevalence using International Diabetes Federa- tion (IDF) and U.S. National Cholesterol Education Program Adult Treatment Panel III (ATPIII) criteria, relative to body composition (whole-body dual-energy X-ray absorptiometry and abdominal computed tomo- graphy), lipids, glycemic parameters, insulin resistance, leptin, adiponectin, and C-reactive protein (CRP)  .
The result showed that the willingness to associate with HIV/AIDS-infected person, interest in HIV/AIDS educations, the knowledge of HIV/AIDS transmission modes and understanding HIV/AIDS risk behavior, was higher on national level athletes but lower on the willingness to practice safe sex. Overall, all the skill categories of athletes showed a very low level of willingness to practice safe sex. Since condoms considered as the only method to prevent AIDS/HIV or safe sex, condom companies in Malaysia should play an important role to promote it. The prevention of AIDS among athletes depends on the usage of condoms. Condom companies in Malaysia should use this result to play an important role in promoting condoms to all skilled athletes. Elements that compose promotion strategy of condoms among athletes are advertising, publicity, activities and inducements in sports event, public relations, personal selling and sponsorship.
Globally, 34.0 million (31.4-35.9 million) people were living with HIV at the end of 2011. Worldwide, the number of people newly infected continues to fall: the number of people (adults and children) acquiring HIV infection in 2011 was 20% lower than in 2001. The number of people dying from AIDS-related causes began to decline in the mid-2000s because of the steady decline in HIV incidence and scaled-up antiretroviral therapy since the peak in 1997. Antiretroviral therapy reached 8 million people by the end of 2011—a 20-fold increase since 2003. Since 1995, antiretroviral therapy has added 14 million life-years in low- and middle-income countries. 1 Twenty-five years after the discovery of the antiviral effect of AZT (Broder, 2010; Mitsuya et al, 1985), there are 25 approved single
gives us an amplification rate higher than 85% for the two regions. This difference in amplification was also observed in various conditions; samples are more easily amplified on the Reverse Transcriptase than the protease because of the size of the gene of interest [19,20]. Amplification failures can be due to the high diversity of the amplification site of HIV type 1 variants that exist in Kinshasa . They can also be caused by low Viral loads (VL) or under the detection limit [15,19]. Indeed, all 7 samples (4.6%) who had a VL less than 3.0 log 10 RNA copies/ml did not give any amplification.
Coreceptor usage strikingly differed between those two cell systems. On GHOST cells 95% of SI-isolates were dual tropic (R5X4). On PBMCs, strains obtained at acute infection were predominantly R5X4 (75%), while 70% of SI HIV-1 from chronic stages was X4. In addition, four V3- loop-sequence-based algorithms were applied to the previously mentioned isolates in order to classify them as R5 or X4/R5X4 variants (the net charge, 11/25 rule, PSSM and geno2pheno). Only 66% of SI isolates were classified as X4 using the bioinformatic algorithms. Our study demonstrated that computational algorithms were notoriously inaccurate in predicting tropism of SI-isolates, particularly for those obtained at primary infection since half of them were misclassified as R5 variants by three of the V3-sequence-based phenotype-predictor algorithms. In conclusion, SI variants coreceptor usage may vary according to the method used. Tropism determination of SI strains on PBMCs may more closely indicate the viral behavior in vivo since we use the natural virus target. Differences along the course of infection, such as predominance of dual-R5X4 tropic in the acute stage and prevalence of X4 variants in chronic infection, probably reflect the evolution of coreceptor usage of SI variants during pediatric infection. We also provide strong evidence suggesting that coreceptor usage of HIV-1 should be carefully determined before CCR5 blockers were implemented, particularly in pediatric infection.
Curriculum management can only be effective when the curriculum content and expected learning outcomes are clearly stated for the actual implementers. The implementers on their side espe- cially the teachers and the school administration must ensure that the stated contents, instruc- tional methodologies and the time lines are followed appropriately. This paper examines the ex- tent at which the HIV/AIDS curriculum is being implemented at the Secondary School level in Kenya. The key objectives were to identify the policy dimensions of HIV/AIDS education curricu- lum and to determine the level of implementation of HIV/AIDS education curriculum in public secondary schools. Structured questionnaire, observation and in-depth interviews were used for data collection from selected school students and the curriculum implementers. The study con- cluded that HIV/AIDS aspects are taught in public secondary schools through infusion and inte- gration into carrier subjects, though not allocated any specific time in the curriculum. The level at which these aspects are taught is very low, and when taught lecture method, which is a rather pas- sive way of teaching, is the predominant method employed by the teachers. It is recommended that the teachers should be more creative and devise other forums that would ensure that these aspects are amply taught. Also the teachers should collect and avail more learning materials to their learners, including use of the internet to supplement what is provided in the text books.
The medications prescribed for the treatment of NCDs were collected from patient files in both HIV positive and HIV negative groups and were categorized using the Anatomical Therapeutic Chemical (ATC) classification in which the drugs are divided into different groups based on therapeutic indication . The analysis con- sidered the prevalence of the six most frequently pre- scribed classes other than ART with particular regards of cardiovascular active agents including statins, beta- blocker, ACE-inhibitors, anti-hypertensives and acetyl- salicylic acid (ASA) and psychoactive agents including benzodiazepines (BDZ).
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The government’s efforts to change behavior through information, education, and communication have focused mainly on involving non- governmental agencies in training, support, outreach, and on preparing materials for the mass media. These efforts appear to be having an impact. Out of 422 (100%) respondents, 20.4% respondents had fatalistic belief about HIV/AIDS and 79.6% respondents believed non-fatalistically women who are grade 9 and above had a non-fatalistic belief than illiterate people. When educational status increases belief about HIV/ AIDS becomes non fatalistic . Exposing for education was preventive for believing fatalistically. Formal education may make people feel more in control of their lives because of the knowledge they have gained or from exposure to different ways of thinking and behaving. This finding is in agreement with the study conducted in Mali on fatalism and HIV/AIDS beliefs in Rural Mali .
In addition to the beneficial effects on body weight, liraglutide appears to significantly lower certain lipid parameters such as TC, LDL-C, and TG . In the current study, we found that in obese+DM subjects, liraglutide treatment tended to lower non-HDL-C, and log (TG/HDL-C). It also had a beneficial effect on lipid profile in obese-DM subjects with a significant reduction in TC and tendency to lower LDL-C, non-HDL-C, TG, TC/ HDL-C, and log (TG/HDL-C). The differences between our study and others may be due to the dose and duration of treatment with liraglutide, concomitant use of other lipid-lowering medication, or changes in lifestyle. In HIV-infected patients, there was a trend in improvement in some of the lipid parameters including TC and non-HDL-C in HIV+DM group
Peripheral mononuclear blood cells (PBMCs) were separated, frozen and kept in a local laboratory at -70°C until transported to analytical lab using cold chain delivery service. Each participant provided informed consent following approval from the Russian governmental ethical review committee (FWA00000621). None of the patients received ART prior to the date of sample collection, and no data on the viral load were available. The proviral DNA extracted from the sampled PBMCs was analyzed using an in-house set of primers ; as a result, sequences from the PR (protease, 2253-2550 nucleotides with HXB2 strain as the reference) and RT (reverse transcriptase, 2551-2922 nucleotides) genes in the pol region and gag gene (1620-2040 nucleotides) sequences were obtained.
The current stavudine label suggests that toxicity can be reduced by administering even lower doses but given twice daily, that is 60 mg in a day. In all studies so far, the effectiveness of once-daily administration of 30 mg stavudine in combination with other antiretroviral drugs against HIV infected individuals is lacking. It is unclear if administration of the drug as a once-daily reduced dose will have similar outcomes as standard regimens. To address this question, we assessed the non-inferiority of stavudine based regimen at aforementioned low dose of 30 mg compared to a standard dose zidovudine (AZT)-based regimen on immunological and clinical outcomes at 24 weeks. Stavudine was compared to zidovudine rather than tenofovir because, during the study period zidovudine was the default drug in the initiation of antiretroviral therapy (ART) in Tanzania.