Sullivan, Kathleen M.
Thesis (Ph. D.)--University of Hawaii at Manoa, 2005. / Includes bibliographical references (leaves 207-219).
Epidemiology of HIV-associated risk factors and acquisition of HIV among high-risk women in southern VietnamKomatsu, Ryuichi. January 2004 (has links)
Thesis (Ph. D.)--University of Hawaii at Manoa, 2004. / Includes bibliographical references (leaves 174-184).
Ethnicity and the experience of stress, coping, social support, and depressive symptoms in persons infected with HIV /Cherner, Mariana, January 1997 (has links)
Thesis (Ph. D.)--University of California, San Diego and San Diego State University, 1997. / Vita. Includes bibliographical references (leaves 116-132).
Thesis (M.P.H.)--Georgia State University, 2007. / Title from file title page. Michael Eriksen, committee chair; Betty Apt, Marshall Kreuter, committee members. Electronic text (121 p. : ill. (some col.), col. maps)) : digital, PDF file. Description based on contents viewed Oct. 25, 2007. Includes bibliographical references (p. 109-115).
Epidemiology and prevention of sepsis in young infants and the potential impact of maternal HIV infection on neonatal sepsisCutland, Clare Louise January 2016 (has links)
A thesis submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in fulfillment of the requirements for the degree of Doctor of Philosophy Johannesburg, South Africa 2016 / Introduction: Neonatal infections contribute to 25% of all neonatal deaths, which account for approximately 44% of all under-5 childhood deaths globally. Pathogens responsible for sepsis in neonates and young infants can be acquired vertically prior to or during labour, or from the environment (community or hospital). This project evaluated the burden and aetiology of sepsis in neonates and young infants (≤90 days), and explored this association to in-utero exposure to human immunodeficiency virus. The study also included a specific focus on the epidemiology of invasive Group B Streptococcal disease in young infants. Additionally, we assessed the efficacy of intrapartum chlorhexidine vaginal washes for: (i) preventing early-onset neonatal sepsis; and (ii) vertical transmission of potentially pathogenic bacteria to the newborns. Furthermore, we evaluated risk factors for poor outcomes due to neonatal sepsis. Materials and methods: (i) A bacterial surveillance system was established at Chris Hani Baragwanath Academic Hospital (CHBAH) from 2004-2008 to identify young infants with bacterial sepsis hospitalised in the neonatal and paediatric wards. Medical and microbiological records were utilised to obtain clinical and laboratory data. Maternal HIV results were obtained from antenatal testing records or admission records. (ii) A blinded, randomised, placebo-controlled trial of 0.5% chlorhexidine maternal vaginal intrapartum wipes and newborn skin wipes was conducted at CHBAH between 2004 and 2007. Consented, eligible participants were randomised during labour to receive either chlorhexidine vaginal wipes or water external genitalia wipes. Newborns received either chlorhexidine full-body wipes (intervention arm) or foot wipes (control arm). Maternal and infant participants were followed up for admissions during the first month after delivery/ birth. A subset of 5144 maternal participants had an intrapartum lower vaginal swab collected, and skin swabs were collected from their newborns to assess colonisation with potentially pathogenic bacteria (Group B streptococcus, Escherichia coli and Klebsiella pneumoniae). Results: Group B streptococcus (GBS) was the most commonly isolated bacterial pathogen, causing 35.2% of culture-confirmed sepsis in infants ≤90 days, 41.6% of early-onset disease (EOD, 0-6 days), 40.5% of late-onset neonatal disease (LOD, 7-27 days) and 18.7% of young-infant community-acquired disease (YI-CAD, 28-90 days). Staphylococcus aureus (S. aureus), Escherichia coli (E. coli) and Klebsiella pneumoniae (K. pneumoniae) contribute 16.2%, 12.2% and 3.4% to sepsis in young infants. Overall, incidence (per 1000 live births) of invasive GBS disease was 2.72 (95% confidence interval [95% CI]: 2.46 to 3.01), including an incidence of 1.50 and 1.22, respectively, in infants 0-6 days and 7-90 days of age. HIV-exposed infants were at greater risk of EOD (Relative risk [RR]: 1.69; 95% CI: 1.28-2.24) and LOD (RR= 3.18; 95% CI: 2.34-4.36) than HIV-unexposed infants. GBS serotypes Ia and III caused 84.0% of invasive GBS disease in young infants. Intrapartum chlorhexidine interventional wipes was not efficacious in prevention of any of: (i) vertical transmission of pathogenic bacteria (54% vs. 55%; efficacy -0.05, 95% CI: -9.5 to 7.9) to the newborns; (ii) sepsis in first 3 days of life (3% vs. 4%; p=0.65,); (iii) sepsis in the later neonatal period (both <1%; p=0.4444); or (iv) maternal puerperal sepsis(both <1%; p=0.56). Conclusion: GBS, S. aureus, E. coli and K. pneumoniae are the most commonly isolated bacterial pathogens in neonates and infants ≤90 days old. HIV-exposed infants are at greater risk of GBS sepsis. Intrapartum chlorhexidine intervention was not efficacious in reducing vertical transmission of pathogenic bacteria, neonatal or maternal sepsis. Alternative interventions to prevent sepsis in young infants, including maternal immunisation, need to be investigated in setting such as ours where there is a high prevalence of maternal HIV infection. / MT2017
Effectiveness of HIV preventive intervention programs in China: a systematic review of most recentevidencesHou, Wei Wei. January 2011 (has links)
published_or_final_version / Public Health / Master / Master of Public Health
Tang, Chui-ying., 鄧翠瑩.
Asia has populated with the second largest number of people living with HIV/AIDS. Under the advancement of transportation, the open up of borders between cities and countries, and the process of globalisation, people move from their place of origin to other places for better living conditions and employment opportunities. Mobile people and migrants are identified as the high risk population of HIV infection. Poverty, discrimination, limited access to healthcare and social services, separation with supports and families, being alienated in resident communities, and gender inequalities are the unfavourable conditions which make the migrant population vulnerable to HIV infection. Existing literatures have investigated and examined the potential risk factors among the mobile population. Inconsistencies were found among research but high risk sexual behaviours and poor knowledge and attitude were observed and reviewed within the migrants. However, literatures which compared the people who migrated with other local people in the same population were not yet reviewed systemically. Therefore, this paper aimed to review the articles which compare the migrant group and the non-migrant group in Asian population to identify the association between migration and the risks of HIV infection. A literature search of five databases (PubMed, Medline, Cochrane, CNKI, Wanfang Med Online) was performed and nine articles were eventually selected for review. The migration status of literature was studied as explanatory variable and compared across studies. Outcome variables of interest were grouped into four categories as: demographic characteristics, sexual practices, awareness towards HIV/AIDS, and disease prevalence. To conclude, compared to people who did not migrate, migrants in Asia were more tend to be less educated, have multiple sex partners, engage in high risk sexual intercourse and commercial sex, but their overall condom usage were lower. Also, they had higher risk of sexually transmitted infections and poorer knowledge in HIV/AIDS. / published_or_final_version / Public Health / Master / Master of Public Health
Distinct vaccine-induced antibody responses and bispecific neutralizing immunoadhesins against SIV/HIV infectionGuo, Jia, 郭佳 January 2013 (has links)
Our research laboratory has recently reported that mucosal priming with a replicating modified vaccinia Tiantan virus (MVTTgpe)-based vaccine elicits durable protection against pathogenic SIVmac239 infection in rhesus monkeys. However, the protective role of vaccine-elicited antibody responses remains poorly understood. Here, a novel yeast surface displayed (YSD) antigen library was established to quantitatively map the antigenic determinants presented by MVTTgpe-based and control vaccines as well as by SIVmac239 infection. The YSD-library allows the mapping of linear and some conformational epitopes as a major technical innovation, as validated by testing SIV-specific mAbs KK65, KK8 and VM-18S. While eight antigenic domains are characterized covering the entire SIVmac239 gp160, the MVTTgpe/Ad5gpe regimen uniquely induces antibody responses against a distinct major antigenic determinant (MAD) in V2 region as compared with the Ad5gpe/Ad5gpe vaccination and SIV infection. This MAD is associated with a higher titer of anti-V2 antibody responses, which inversely correlates with peak viral load. Unexpectedly, the MVTTgpe/Ad5gpe vaccine- challenge. The results showed that instead of recalling B cell memory response to V2, viral infection presents a distinct set of antigenic determinants with anti-V1V2 antibodies primarily directed to V1 region. Moreover, the anti-V1V2 antibody responses disappear in two infected macaques after they enter the stage of simian AIDS. SIVmac239 infection, therefore, can modulate vaccine-elicited B cell immunity by diminishing anti-V2 antibody memory responses in rhesus monkeys. These findings implicated that vaccine efforts with focus on V2 region would require periodic vaccinations to maintain a long-lasting high level of antibody responses for protection. In the absence of an effective vaccine for eliciting HIV-1-specific broadly neutralizing antibodies (bNAbs), passive immunization with bNAbs or Ab-like agents (e.g. immunoadhesin) becomes an attractive alternative for HIV-1 prevention. In this study, we aimed to design, optimize and produce secretory immunoadhesins (IAs) based on gene engineering of existing HIV-1 specific bNAbs for potency and production improvements. IAs are chimeric, antibody-like molecules that combine the functional domain of bNAb with immunoglobulin constant domains, including the hinge and Fc regions. We found that the modified secretory IAs not only preserved the neutralization activity of the parental bNAbs, but also had enhanced expression and smaller molecular size that is suitable for antibody gene-based in vivo delivery. Furthermore, we defined the synergistic effects of five IAs against HIV-1 infection and subsequently engineered two types of bi-specific IAs by combining the functional domains of Hu5A8, a humanized anti-CD4 antibody, and the bNAb PGT128. Significantly, one of the bi-specific IA, namely Bi-IA-Mono, neutralized 100% of the 33 viruses tested, including the transmitted/founder viruses and viruses resistant to both parental IAs. The remarkably enhanced neutralization activity of Bi-IA-Mono, either in potency and breadth, indicated the great potential of modified bi-specific IA to provide complete or nearly complete protection against major HIV-1 subtypes. Overall, our results demonstrated that the engineering of IA and bi-specific IA is an attractive way to improve anti-HIV-1 properties of existing bNAbs, which have significant implications for antibody-based prophylactics in blocking diverse HIV-1 transmissions and infections. / published_or_final_version / Microbiology / Doctoral / Doctor of Philosophy
Pong, Chi-him, 龐智謙
Acquired immunodeficiency syndrome (AIDS) is a major problem in our current society. There are over 35 million of the population that are currently living with human immunodeficiency virus (HIV), and the number of HIV-infected patients are still rising every year in spite of our efforts to control it. Furthermore, within the AIDS affected population, opportunistic infection is a major cause of complications and is the number one cause of death. The HIV trans-activator (Tat) protein plays a major role in the AIDS pathogenesis. HIV-1 Tat is known to cause dysregulation of cytokines such as TNF-α, IL-6, and IL-10 in AIDS patients. In this study we recognized a proto-oncogene, c-Myc, could regulate the cytokine dysregulation caused by HIV-1 Tat in primary blood monocyte derived macrophages (PBMac). By knocking down the expression of c-Myc with gene specific small-interfering RNA (siRNA), we demonstrated that c-Myc may be critical for the expression of the pro-inflammatory cytokines TNF-α and IL-6. HIV-1 Tat was subsequently found to regulate the expression of c-Myc via the activation of dsRNA-activated protein kinase (PKR), ERK1/2 and p38 mitogen-activated protein kinase (MAPK). Furthermore, c-Myc regulation of the pro-inflammatory cytokines was demonstrated to have a role in AIDS related opportunistic infections. HIV-1 Tat was shown to increase the intracellular growth of Mycobacteria avium complex (MAC) within PBMac. This increase in MAC growth was in turn found to be regulated by TNF-α expression controlled by c-Myc. HIV-1 Tat was also demonstrated to induce the expression of RIG-I, a common pattern recognition receptor of double stranded RNA viruses, in PBMac. RIG-I is known to activate the viral immune responses such as the type-I interferon (IFN) and pro-inflammatory cytokine pathways. This induction of RIG-I by HIV-1 Tat was found to be regulated by c-Myc, as well as through other signalling kinases such as p38 MAPK and PKR. Tat induction of RIG-I ultimately led to the induction of IFN-α2 and IFN-β through the expression and nuclear translocation of the interferon regulatory factor-7 (IRF-7). This alteration in type-I IFN expression regulated by HIV-1 Tat and RIG-I was also found to play a role against AIDS related opportunistic infections. HIV-1 Tat is known to increase the infectivity of Kaposi’s sarcoma-related herpesvirus (KSHV), a common opportunistic viral infection. We were able to demonstrate that this increase in KSHV infectivity was regulated by RIG-I and type-I IFN induced by HIV-1 Tat. Lastly, this study also demonstrated how HIV-1 Tat was able to manipulate the expression of IL-8 induced by KSHV in PBMac. HIV-1 Tat was able to mediate the production of IL-8 induced by KSHV by altering the phosphorylation of the p38 MAPK and the signal transducer and activator of transcription-1 (STAT-1). Taken together, the results of this study showed how c-Myc and RIG-I may be able to play critical roles in HIV-1 Tat induced cytokine dysregulation. Furthermore, the importance of these pathways is further demonstrated in their roles in regulating the immune responses against opportunistic infections in AIDS patients. / published_or_final_version / Paediatrics and Adolescent Medicine / Doctoral / Doctor of Philosophy
Killebrew, Deirdre Anne
Mode of access: World Wide Web. / Thesis (Ph. D.)--University of Hawaii at Manoa, 2005. / Includes bibliographical references (leaves 158-166). / Electronic reproduction. / Also available by subscription via World Wide Web / xiii, 166 leaves, bound col. ill. 29 cm. +
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