<p>Flowcytometric technology has been widely used for measurement of the absolute numbers of T-lymphocytes subsets in Human Immunodeficiency virus (HIV), defining the disease state, monitoring antiviral treatment, and identifying any risk for opportunistic infections. A manual preparing of the samples is required. More recently an automated and enclosed blood cell counting, Celldyn Sapphire has been introduced. In this study the performance of the Flow cytometer EPICS XL as a reference method for analysis of CD3+, CD4+ and CD8 T-lymphocytes was evaluated with blood from 40 individual’s samples. EPICS XL was also compared with Celldyn Sapphire in the analysis of T-lymphocyte subsets in 39 blood samples from patients with low, high and normal lymphocyte counts. The result showed that the precision was high for both EPICS XL (2.5%) and Celldyn (10%). The method was linear over a wide range. Comparisons of CD3+, CD4+, and CD8+ T-lymphocytes analysis showed high coefficients of correlation (r0.9) and agreement (y>0.9x) between two instruments. A lower degree of agreement was observed at low concentration of CD3+ and CD4+ T-lymphocytes (0.757, 0.739). This means that cell counts obtained by Celldyn were 30% lower than those obtained with EPICS XL. This study shows that both EPICS XL and Celldyn Sapphire were suitable for CD4+ and CD8+ T cell counts. It is however preferable to use Flowcytometry for counting of low concentration of CD4+ T-lymphocytes (<200 cells/µL).</p>

The study sought to determine the prevalence and the risk factors for malnutrition in 88 HIV positive children less than 18 months attending Hospital Paediatric ARV Clinic (HPAC). The study used quantitative methods. A questionnaire was administered to the child’s caregiver to assess infant, caregiver and socio-economic risk factors for malnutrition after written consent had been obtained. The history of the patient was extracted from the HIV patient care booklet. Nutritional status was assessed using WHO standard growth charts in children and body mass index (BMI) in adults.

Flowcytometric technology has been widely used for measurement of the absolute numbers of T-lymphocytes subsets in Human Immunodeficiency virus (HIV), defining the disease state, monitoring antiviral treatment, and identifying any risk for opportunistic infections. A manual preparing of the samples is required. More recently an automated and enclosed blood cell counting, Celldyn Sapphire has been introduced. In this study the performance of the Flow cytometer EPICS XL as a reference method for analysis of CD3+, CD4+ and CD8 T-lymphocytes was evaluated with blood from 40 individual’s samples. EPICS XL was also compared with Celldyn Sapphire in the analysis of T-lymphocyte subsets in 39 blood samples from patients with low, high and normal lymphocyte counts. The result showed that the precision was high for both EPICS XL (2.5%) and Celldyn (10%). The method was linear over a wide range. Comparisons of CD3+, CD4+, and CD8+ T-lymphocytes analysis showed high coefficients of correlation (r0.9) and agreement (y&gt;0.9x) between two instruments. A lower degree of agreement was observed at low concentration of CD3+ and CD4+ T-lymphocytes (0.757, 0.739). This means that cell counts obtained by Celldyn were 30% lower than those obtained with EPICS XL. This study shows that both EPICS XL and Celldyn Sapphire were suitable for CD4+ and CD8+ T cell counts. It is however preferable to use Flowcytometry for counting of low concentration of CD4+ T-lymphocytes (&lt;200 cells/µL).

Background: Some studies have suggested that the risk of preeclampsia in HIV positive pregnant women has increased since the use of HAART became routine. There is also a concern that HIV positive women on HAART have a higher risk of adverse fetal outcomes compared to HIV negative women. Methods: In this matched retrospective cohort study, the risk of preeclampsia and adverse fetal outcomes was examined in 91 HIV positive pregnant women receiving HAART and 273 HIV negative pregnant women. Multivariate logistic regression models were used to adjust for confounding factors. Results: The risk of preeclampsia and preterm birth did not differ significantly between HIV positive and HIV negative women. HIV treated with HAART was an independent predictor for giving birth to a low birthweight baby. Conclusions: HIV positive women on HAART do not have a higher risk of preeclampsia. They do however have a higher risk for lower birthweight infants.

Background: Some studies have suggested that the risk of preeclampsia in HIV positive pregnant women has increased since the use of HAART became routine. There is also a concern that HIV positive women on HAART have a higher risk of adverse fetal outcomes compared to HIV negative women. Methods: In this matched retrospective cohort study, the risk of preeclampsia and adverse fetal outcomes was examined in 91 HIV positive pregnant women receiving HAART and 273 HIV negative pregnant women. Multivariate logistic regression models were used to adjust for confounding factors. Results: The risk of preeclampsia and preterm birth did not differ significantly between HIV positive and HIV negative women. HIV treated with HAART was an independent predictor for giving birth to a low birthweight baby. Conclusions: HIV positive women on HAART do not have a higher risk of preeclampsia. They do however have a higher risk for lower birthweight infants.

<p>Background-Namibia has a high HIV and malnutrition burden. HIV increases the risk of&nbsp / malnutrition and malnutrition results in rapid progression of the disease and worsening malnutrition. Nutrition plays an important role in the management of an HIV positive child. Optimal nutrition delays disease progression, improves immune function and the effectiveness of antiretroviral drugs thereby improving the quality of life of the child. Early identification of children at risk of malnutrition is therefore essential to prevent malnutrition in HIV positive children. Methodology-The study sought to determine the prevalence and the risk factors for malnutrition in 88 HIV positive children less than 18 months attending Hospital Paediatric ARV Clinic (HPAC). The study used quantitative methods. A questionnaire was administered to the child&rsquo / s caregiver to assess infant, caregiver and socio-economic risk factors for malnutrition after written consent had been obtained. The history of the patient was extracted from the HIV patient care booklet. Nutritional status was assessed using WHO standard growth charts in children and body mass index (BMI) in adults. Results- The study showed that 56.8% of children were wasted (14.8% had severe wasting), 52.3% were stunted (18.2% had severe stunting) and 69.3% underweight (20.5% were severely underweight). This level of malnutrition is much higher than the rates of 8% wasting, 29% stunting and 17% underweight in the general paediatric population. Malnutrition in children was associated with fewer number of working adults per family, frequent illnesses in the child, low level of caregiver education, caregiver unemployment, low household income and lack of adequate food in the family. Children of malnourished caregiver were more likely to be underweight. Conclusions- The results showed a high prevalence of malnutrition (56.8%wasting, 52.3%stunting and 69.3% underweight) among HIV positive infants attending the HPAC. The study showed that poverty and food insecurity were strongly associated with malnutrition in children. This therefore&nbsp / highlights the urgent need to address poverty to reduce malnutrition in the community. Although the study did not show any statistically significant association between feeding practices and malnutrition in children, health workers should encourage HIV positive mothers to breastfeed their infants as per the WHO and Namibian antiretroviral therapy guidelines (2010). Recommendations - There is need to train health workers to identify and manage malnourished children early. Linkages with social services must be improved and strengthened to help reduce poverty in the community.</p>

<p>Many studies have reported low cure rates for multidrug-resistant tuberculosis (MDRTB) patients and MDR-TB patients co-infected with human immunodeficiency virus (HIV). However, little is&nbsp / known about the effect of HIV infection and antiretroviral therapy on the treatment outcomes of MDR-TB in South Africa. Therefore, the objectives of the study are: to find out whether HIV infection&nbsp / and interactions between ARVs and second line anti-TB drugs have an impact on the following MDR-TB treatment outcomes: cure rate and treatment failure at Brewelskloof Hospital. MDR-TB&nbsp / patients were treated for 18-24 months. The study was designed as a case-control retrospective study comparing MDR-TB treatment outcomes between HIV positive (cases) and HIV negative&nbsp / patients (controls). Patients were included in the study only if they complied with the following criteria: sensitivity to second line anti-TB drugs, MDR-TB infection, co-infection with HIV (for some&nbsp / of them), male and female patients, completion of treatment between 1 January 2006 and 31 December 2008. Any patients that presented with extreme drug-resistant tuberculosis (XDR-TB)&nbsp / were excluded from the study. Data were retrospectively collected from each patient&rsquo / s medical records. There were a total of 336 patients of which 242 (72%) were MDR-TB patients and 94&nbsp / (27.9%) MDRTB co-infected with HIV patients. Out of the 242 MDR-TB patients, 167 (69.2%) were males and 75 (30.7%) were females. Of the 94 patients with MDR-TB co-infected with HIV, 51&nbsp / (54.2%) males and 43 (45.7%) females. Patients with multidrug-resistant tuberculosis co-infected with HIV who qualify for antiretroviral therapy were treated with stavudine, lamivudine and&nbsp / efavirenz while all MDR-TB patients were given kanamycin, ethionamide, ofloxacin, cycloserine and pyrazinamide. The cure rate of MDR-TB in HIV (+) patients and in HIV (-) patients is 34.5%&nbsp / and 30 % respectively. There is no significant difference between both artes (pvalue = 0.80). The MDR-TB cure rate in HIV (+) patients taking antiretroviral drugs and in HIV (+) patients without&nbsp / antiretroviral therapy is 35% and 33% respectively. The difference between both rates is not statistically significant. The study shows that 65 (28.0%) patients completed MDR-TB treatment but&nbsp / could not be classified as cured or failure, 29 (12.5%) patients failed, 76 (32.7%) defaulted, 18 (7.7%) were transferred out and 44 (18.9%) died. As far as treatment completed and defaulted is concerned,&nbsp / there is no significant statistical difference between HIV (+) and HIV (-) The number of patients who failed the MDR-TB treatment and who were transferred out is significantly higher in the HIV (-)&nbsp / group than in the HIV (+) group. Finally the number of MDR-TB patients who died is significantly higher in the HIV (+) group). The median (range) duration of antiretroviral therapy before starting&nbsp / anti-tuberculosis drugs is 10.5 (1-60) months. According to this study results, the MDR-TB treatment cure rate at Brewelkloof hospital is similar to the cure rate at the national level. The study also&nbsp / hows that HIV infection and antiretroviral drugs do not influence any influence on MDR-TB treatment outcomes.</p>

Recent advances in HIV antiretroviral therapy and the availability of prophylaxis for opportunistic infections, combined with the opportunity to prevent perinatal HIV infection, underscores the value of early diagnosis of HIV infection. HIV antibody home test kits offer individuals the opportunity to collect a blood sample, send it anonymously to a laboratory, and receive counseling and referral over the phone. Home HIV testing may reduce barriers to testing that have precluded individuals from learning their HIV serostatus, and if seropositive, from taking advantage of efficacious therapeutic and preventive regimens. This study employed a randomized-controlled prospective field trial design to determine if the availability of home testing increased HIV testing relative to traditional counseling and testing among injecting drug users in three HIV prevention/drug treatment contexts; methadone maintenance, hospital-based detoxification, and syringe exchange. Theoretical correlates to HIV testing were also evaluated. Multivariate analyses demonstrated that participants randomized to home testing were 2.2 times more likely than those randomized to traditional counseling and testing to test for HIV antibodies in this study after controlling for demographic, HIV risk, and theoretical variables. No differences were observed between testing methods with regard to obtaining HIV test results. The relationship between HIV testing and test type was moderated by drug treatment context and history of homeless, with home testing resulting in increased testing among methadone participants and persons without a history of homelessness. Analyses of theoretical variables suggested that prevention education stressing the benefits of HIV testing, personal risk of HIV infection, and efficacy of available treatments could increase HIV testing among injecting drug users. Participants randomized to home testing were more satisfied with testing and telephone-based counseling than were those receiving traditional testing and face-to-face counseling. Home testing was associated with increased testing perhaps due to reduced barriers to testing. To further reduce barriers to testing and to increase testing among injecting drug users, consideration should be given to incorporating oral fluid testing and rapid result capability in home test kits. Counseling could be made available as needed, delivered by telephone, and contingent upon the volitional control of the testing consumer.

Human Immunodeficiency Virus (HIV) has become a global pandemic with at least 25 million deaths and no cure. One of the most important targets to inhibit this virus is HIV-1 protease (PR), which is required to cleave the viral proteins needed for maturation of the virus after it invades and replicates in the host cell. There are nine protease inhibitors that are used in AIDS treatment. The virus loses susceptibility to these inhibitors by drug resistance due to mutations. The goal of the project is to examine the highly drug resistant HIV PR P51 in its complex with inhibitors. In this experiment we expressed and purified HIV PR P51 protein. We performed protein crystallization with inhibitors Tipranavir, Amprenavir, Darunavir, and Saquinavir to obtain the structure of the protease and the inhibitors in their complexes. Future analysis of the crystal structures will help with the development of successful therapeutic inhibitors.

Abstract The purpose of this study was to investigate the drug-using behavioral patterns, drug abusers¡¦ cognition and inner-containment, the causes of HIV infection, the relationship between drug abuse and HIV infection, and the acceptable degree of the government¡¦s harm reduction program. This study adopted quantitative research design. A total number of 1083 (37.2% samples had HIV-infected) male drug abusers, whom sampled correctional institutions, including the drug treatment center, prison and detention house in Taiwan, were surveyed with self-reported questionnaire. Statistical methods, including descriptive analysis, Chi-square, t-test, Pearson correlation analysis and one-way ANOVA, were applied to proof the hypothesis of this study. The findings were as follows: I. The proportion of drug-using kin of drug abusers was up to 23.8%. According to the analysis, the proportion of drug-using siblings was 10.2%, cousins was 4.9%. II. Non-injecting drug users (NIDUS) had lower tendency in drug craving than injecting drug users (IDUS), but had higher tendency in inner-containment than IDUS. Therefore, increasing IDUS¡¦ confidence and coping skills to deal with craving is important element of relapse prevention program. IDUS had lower ability of abstinence, so they should be the prior client of harm reduction program to decrease the harm from drug injection. III. 52% samples used to needle-sharing would still have needle-sharing behaviors when facing drug craving. The key factor of sharing behaviors was they don¡¦t know how to resist the craving and urge of using drugs. Correcting drug users¡¦ irrational belief could aid in decreasing the craving for drug. Therefore, drug abusers whom don¡¦t have strong coping response and concept about the damage of drug abuse should be instructed stress management abilities and cognitive modification in drug treatment to effectively prevent relapse.