Current Knowledge on the Role of Monocytes and Macrophages in the Pathogenesis of Non-AIDS Defining Events: Mechanisms, Host Factors, and Therapeutic Implications | Chapter 10 | Medical Science: Updates and Prospects Vol. 4

 

Monocytes and macrophages play a crucial role in the development of HIV infection, contributing not only to viral persistence but also to the development of non-AIDS-defining events (nADEs) in People Living with HIV (PLWH). These innate immune cells serve as long-lived viral reservoirs, driving chronic inflammation through persistent immune activation, oxidative stress, and tissue-specific damage. HIV-infected monocytes infiltrate tissues such as the cardiovascular system, liver, kidneys, and central nervous system, where they differentiate into macrophages and release pro-inflammatory cytokines (e.g., TNF-α, IL-6), reactive oxygen species (ROS), and matrix metalloproteinases (MMPs). These mediators promote endothelial dysfunction, fibrosis, and organ damage, underpinning conditions like atherosclerosis, neurocognitive disorders, and hepatorenal disease. Emerging evidence highlights the importance of macrophage polarisation (M1/M2 imbalance) and epigenetic modifications in sustaining inflammation, even during antiretroviral therapy (ART). Besides persistent immune activation, the ability of these cells to cause tissue-specific damage is significantly influenced by host genetic factors, such as polymorphisms in the APOL1 and CCL2 genes, which can determine the severity of end-organ diseases like HIV-associated nephropathy. Additionally, epigenetic reprogramming of monocytes and macrophages—triggered by HIV proteins and the inflammatory environment—establishes a lasting pro-inflammatory state that remains despite ART. This reprogramming, marked by changes in histone modifications and DNA methylation, sustains mechanisms of tissue damage. Understanding these processes and their interaction with host factors provides critical insights for developing targeted treatments, including immunomodulators, antioxidants, and strategies for reservoir elimination. This review summarises current knowledge on how monocytes and macrophages contribute to the pathogenesis of nADEs. It explores potential new therapeutic approaches to reduce chronic inflammation and enhance clinical outcomes in PLWH.

 

 

Author(s) Details

Samuel Adinoyi Adavba
Kaduna State University, Kaduna, Nigeria.

 

Please see the book here :- https://doi.org/10.9734/bpi/msup/v4/6480

 

Understanding the Impact of Stigma and Discrimination on Adherence to Medication amongst People Living with HIV in Nigeria: A Mixed Method Study | Chapter 2 | Medical Research and Its Applications Vol. 9

 

The present study determines the impact of Stigma and Discrimination amongst People Living with HIV and their Adherence to Medication in North Central Nigeria. Stigma has been and will continue to be one of the factors influencing the prevention and treatment of some diseases in the health sector if adequate measures are not taken to address it. In spite of the identification of stigma as a factor impeding public utilisation of HIV counselling, testing, and treatment services in Nigeria, gaps still exist in knowledge on the impact of stigma, and discrimination on adherence to medication and outcomes amongst people living with HIV (PLWH). It has been observed that even healthcare workers isolate HIV/AIDS patients from other ones, refuse to admit them to the hospital, wear extra cloves when examining them, and charge very high fees for care. This study adopted mixed methods to examine the impact of stigma and discrimination on adherence to medication amongst PLWH in Nigeria. A sample of 1,621 respondents was collected using multi-stage and purposive sampling methods. Structured interviews using questionnaires and in-depth interviews (using a guide) were utilised for data collection. SPSS (version 21) was used for quantitative data analysis while the qualitative data was analysed thematically. There are 46.3% men and 53.7% women respondents. Generally, their income is low, 70.7% are earning less than N25,000 (approximately $125 USD) per month. Some of the HIV patients are stigmatised. In reaction, they avoid public places, and travel long distances away from their immediate community to collect drugs and to avoid being noticed around the centers. They sometimes miss taking drugs regularly as prescribed, suffer depression and die. Those who are alive continue to suffer social exclusion within the communities. Stigma and discrimination impede adherence to medication amongst PLHW in Nigeria. More efforts should be made to create awareness to reduce the stigma and discrimination of HIV patients while augmenting their income to meet up with the challenges of adherence to medication and social acceptability. Policies addressing discrimination of PLWH in the family, marriage and employment domains would be of great help. The overall benefits would be enhanced mechanisms of HIV prevention, treatment and control in the study area.

 

Author(s) Details

Godwin Aondohemba Timiun

Department of Sociology, Benue State University, Makurdi, Benue State, Nigeria and Australian Catholic University, Melbourne, Australia.

 

Please see the book here:- https://doi.org/10.9734/bpi/mria/v9/205

Effect of Pre-exposure Prophylaxis to Reduce the Chances of Human Immuno-Deficiency Virus Infection among the Key Populations | Chapter 1 | Disease and Health Research: New Insights Vol. 3

 

The key populations (KPs) such as female sex workers (FSWs), transgender communities (TGs), persons who inject drugs (PWID), men who have sex with men (MSM), heterosexual groups (HGs) are easily vulnerable to human immunodeficiency virus (HIV) infections. The use of pre-exposure prophylaxis (PrEP) could reduce the chances of HIV infections in the KPs. PrEP can be used as an HIV prevention tool to reduce the infections in HIV burden countries of the world. Awareness and expression of willingness to use PrEP is an additional HIV prevention and works like a complement tool for KPs who are unable to use condoms consistently. PrEP could be used as a main tool in HIV testing and services among the KPs in the Integrated Counselling and Testing Centre (ICTC) and Antiretroviral Therapy (ART) centre. The main determining factors for the use of PrEP are awareness, availability, accessibility, and affordability among the KPs. The most challenging issues such as the burden of stigma and discrimination, noncommunity-friendly therapy dispensing areas and interrupted supply of therapies were identified as key barriers to continuing PrEP. The introduction and recommendation of PrEP into various programs, stakeholders and policymakers could impact HIV prevention among the KPs. However, the use of PrEP as a tool among the KPs is very needful to reduce the burden of new HIV infections.

 

Author(s) Details

Sushanta Kumar Barik
Department of Biotechnology, Institute of Biosciences and Technology, Mahatma Gandhi Mission University, Chhatrapati Sambhaji Nagar, Maharashtra, India.

 

Mulay Manjushree Vijay
Department of Microbiology, MGM Institute of Health Sciences - Medical College and Hospital, Chhatrapati Sambhaji Nagar, Maharashtra, India

 

Smita Sitaram Kulkarni
Department of Microbiology, MGM Institute of Health Sciences - Medical College and Hospital, Chhatrapati Sambhaji Nagar, Maharashtra, India.

 

Jyotrimayee Turuk

NRL, TB, ICMR-Regional Medical Research Centre-Bhubaneswar, Odisha, India.

 

 

Keshar Kunja Mohanty
Division of Immunology, HIV/AIDS, ICMR-National JALMA Institute for Leprosy and Other Mycobacterial Diseases, Agra, India.

 

Srikanta Jena
Zoology Department, Ravenshaw University, Odisha, India.

 

Sanjay N. Harke
Department of Biotechnology, Institute of Biosciences and Technology, Mahatma Gandhi Mission University, Chhatrapati Sambhaji Nagar, Maharashtra, India.

 

Ashish S. Deshmukh
Department of Respiratory Medicine, MGM Medical College and Hospital, Chhatrapati Sambhaji Nagar, Maharashtra, India.

 

Sanjay J. Dhoble
Department of Physics, R.T.M. Nagpur University, Nagpur-440033, India.

 

Annasaheb S. Khemnar
Department of Biotechnology, Institute of Biosciences and Technology, Mahatma Gandhi Mission University, Chhatrapati Sambhaji Nagar, Maharashtra, India.

 

Please see the book here:- https://doi.org/10.9734/bpi/dhrni/v3/1251

Clinical Characteristics of HIV/AIDS Central Nervous System Opportunistic Infections in Ecuadorian Patients | Chapter 3 | Disease and Health Research: New Insights Vol. 5

 

Background: Central nervous system (CNS) involvement is reportedly more common in AIDS-related infections. One of the leading causes of illness and death in people infected with the human immunodeficiency virus (HIV) is still infection of the central nervous system (CNS) by different opportunistic pathogens. In HIV immunocompromised patients, the clinical and radiographic pattern of CNS infection might occasionally be used to confirm the diagnosis.

 

Aim: The aim of this study is to describe the distribution of etiologies, clinical parameters, evaluation methods, management and complications in a group of patients treated in a hospital’s AIDS unit in a developing country.

 

Methodology: An observational retrospective analytical study was conducted at Eugenio Espejo Hospital, Quito-Ecuador, between April 2002 and June 2010.

 

Results: The prevalence of CNS infections in HIV patients was 5.9%. The main clinical manifestations were fever, headache and focal neurological deficits. The most common opportunistic infections were Toxoplasmosis 46%, Cryptococcosis 20%, Tuberculosis 19%, Encephalopathy 5%, and Progressive Multifocal Leukoencephalopathy (PML) 5%. In the first decade of the 2000s, antiretroviral therapeutic (ART) regimens were established in 84% of cases, of which 66% followed the guidelines for treatment-naïve patients (AZT/3TC/EFV). The prevalence of mortality throughout the study was 21.31%, being the most common fatal complication lactic acidosis 38%, Systemic Inflammatory Response Syndrome (SIRS) 38%, and Immune Reconstitution Inflammatory Syndrome (IRIS) 23%. The strategies for treatment adherence and reducing the risk of infections, combined with individual commitment, significantly improve both the virological response and ART resistance rates.

 

Conclusion: In Ecuador, until 2005, there were substantial rates of HIV-associated opportunistic CNS infections, which showed a dramatic reduction with the advent and consolidation of highly active antiretroviral therapy (HAART). Since molecular testing is only useful in specific situations and is not always available in developing countries with limited resources, many of the diagnostic methods covered here are still implemented today.

 

Author (s) Details

César Prócel Ramírez
Internal Medicine Department, Hospital Metropolitano, Ecuador and Internal Medicine Department, Eugenio Espejo Hospital, Ecuador.

 

Lucy Baldeón R.
Biomedical Research Institute, Central University of Ecuador, Ecuador and Faculty of Medicine, Central University of Ecuador, Ecuador.

 

Please see the book here:- https://doi.org/10.9734/bpi/dhrni/v5/1723

Dynamics of the Vaginal Microflora during the Menstrual Cycle of HIV-positive and HIV-negative Women in a Sub-urban Community in Kenya | Chapter 8 | Research Perspective on Biological Science Vol. 4

Introduction: Normal vaginal microflora is usually dominated by Lactobacillus species, which play an important role in the maintenance of vaginal health. The dynamism of the vaginal microflora is especially notable as changes that occur during menses. The vaginal micro-environment is dynamic and undergoes changes during the menstrual cycle in women of reproductive age. These changes correlate with the accompanying hormonal changes. Indeed, the vagina is a highly dynamic ecosystem. Studies show that changes occur in the vaginal microflora during the normal menstrual cycle.

 

The recurrent imbalance that occurs in the equilibrium of vaginal microflora favors the overgrowth of bacterial vaginosis (BV)-associated bacteria. The relative depletion of the resident Lactobacilli has been shown to be most profound at the time of menses, indicating that the vaginal microflora become less stable during this event. This phenomenon has generally been attributed to the premenstrual decline in circulating levels of estrogen, which in turn affects the colonisation strength of the vaginal Lactobacilli, for example by limiting their capacity for epithelial adherence. The vaginal Lactobacillus microflora are probably further challenged by the menstrual flooding of the vagina, which is accompanied by a sharply rising pH, further exacerbating the unfavorable conditions for epithelial adherence of the Lactobacilli. Under such conditions, the colonisation resistance offered to BV-associated anaerobes can easily be overcome. Menses possibly also induces a wash-out of Lactobacilli through haemagglutination. These mechanisms might explain why BV is less prevalent in pregnant and postmenopausal women, despite the relative estrogen deficiency, especially in the latter group. To further demonstrate the important role that hormones might play in maintaining the balance in the vaginal ecosystem, a recent longitudinal study found women using hormonal contraceptives to have less prevalence due to greater remission of BV.  The objective of this study was to characterize and explore the changes in the vaginal microflora during the menstrual cycle of HIV positive (HIV+) and HIV negative (HIV-) women in a sub-urban population of Kenya.

 

Methods: In a longitudinal study of 38 premenopausal women, 20 HIV+ and 18 HIV-, high vaginal swabs were taken for genomic DNA extraction. Gram stains were prepared at each of the six visits for each woman. Nugent scores were performed, and quantification of three Lactobacillus spp. (L. crispatus, L. jensenii and L. iners) and Gardnerella vaginalis and Atopobium vaginae carried out by real-time or quantitative PCR (qPCR) technique.

 

Results: Results based on Gram stain category showed a high concentration of L. iners in the normal vaginal microflora. This increases during bacterial vaginosis (BV). There were high levels of L. jensenii in half of the women with BV, while L. Crispatus was absent in BV cases. Concentration of G. vaginalis increased progressively from normal to BV microflora while A. vaginae was absent in normal microflora but was detectable in intermediate gram stain and increased progressively during the BV phase.

 

Analysis based on HIV status showed a high concentration of L. iners and G. vaginalis in both the HIV+ and HIV- groups. Condom use was significantly higher in HIV+ women, but the number of those harbouring the protective L. crispatus was less than in the HIV- group. The concentration of L. crispatus was remarkably lower in the HIV+ group. Atopobium vaginae was present in both groups but L. jensenii was not detectable in the HIV+ women.

 

Based on the phase of the menstrual cycle, analysis showed a high concentration of L. iners and G. vaginalis throughout the cycle. Concentration of L. crispatus increased while concentration of A. vaginae decreased throughout the menstrual cycle. At the initial phase of the menstrual cycle, L. jensenii was comparatively low and not detectable thereafter.

 

Conclusions: The predominant species in normal vaginal microflora in this Kenyan population of women is L. iners, and which increased during BV. Both HIV+ and HIV- groups had high concentrations of L. iners and G. vaginalis. Throughout the menstrual cycle, concentration of L. crispatus increased while concentration of A. vaginae decreased. At the initial phase of the menstrual cycle, L. jensenii was comparatively low and not detectable thereafter.

 

Author (s) Details

Teresa N. Kiama
Department of Human Anatomy& Medical Physiology, University of Nairobi, Kenya.

 

 

Mario Vaneechoutte
Laboratory for Bacteriology Research, Faculty of Medicine and Health Sciences, University of Ghent, Belgium.

 

Paul M. Mbugua
Department of Human Anatomy& Medical Physiology, University of Nairobi, Kenya.

 

Hans Verstraelen
Department of Obstetrics & Gynaecology, Ghent University Hospital, Belgium.

 

Benson Estambale
University of Nairobi Institute of Tropical and Infectious Diseases (UNITID), Kenya.

 

Marleen Temmerman
Department of Obstetrics & Gynaecology, Ghent University Hospital, Belgium.

 

Rita Verhelst
Laboratory for Bacteriology Research, Faculty of Medicine and Health Sciences, University of Ghent, Belgium.

 

Please see the book here:- https://doi.org/10.9734/bpi/rpbs/v4/1438

HIV and Alcohol Synergistically Disrupt Lysosomal Function in Hepatocytes, Driving Extracellular Vesicle Release and Liver Injury | Chapter 11 | Disease and Health: Research Developments Vol. 10

Although the etiologies of hepatic complications among people living with HIV who consume alcohol are multifactorial, alcohol remains a relatively understudied contributor to the progression of HIV-related liver injury. Here, we investigated whether metabolically derived acetaldehyde impairs lysosomes and releases exosomes to enhance HIV-induced hepatotoxicity. Cytochrome P450 2E1 (CYP2E1)-expressing Huh 7.5 (also known as RLW) cells were exposed to an acetaldehyde-generating system (AGS) for 24 h. We then infected (or not) the cells with HIV-1ADA, then exposed them again to AGS for another 48 h. Lysosome damage was assessed by galectin 3/LAMP1 co-localisation and cathepsin leakage. Additionally, we measured the co-localisation of DRAM 1 and Bax in lysosomes, indicating the contribution of HIV-AGS-triggered lysosomal damage to apoptosis induction in hepatocytes. Expression of lysosome biogenesis–transcription factor, TFEB, was measured by its protein levels and in situ immunofluorescence. Exposure of cells to AGS + HIV caused the greatest amount of lysosome leakage and impaired lysosomal biogenesis, leading to intrinsic apoptosis. Furthermore, AGS exposure impaired the microtubule-dependent translocation of TFEB from the cytosol to the nucleus. This appeared to result from the acetylation of α-tubulin.

Moreover, ZKSCAN3, a repressor of lysosome gene activation by TFEB, was amplified by AGS. Both these changes contributed to AGS-elicited disruption of lysosome biogenesis and promoted exosome release from hepatocytes. These results demonstrate that acetaldehyde impairs lysosomal integrity and repair, promotes exosome release, and exacerbates HIV-induced hepatotoxicity, offering mechanistic insight into alcohol’s role as a co-factor in liver damage among people with HIV.

 

Author (s) Details

Moses New-Aaron
Department of Environmental Health, Occupational Health and Toxicology, College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198, USA and Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, Emory University, 615 Michael St. (Suite 205), Atlanta, GA 30322, United States of America.

 

Paul G. Thomes

Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE 68105, USA and Auburn University, Auburn, Alabama, United States of America.

 

Raghubendra Singh Dagur
Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE 68105, USA.

 

Kharbanda K. Kusum
Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE 68105, USA and Research Service, Veterans Affairs Nebraska-Western Iowa Health Care System, Omaha, NE 68105, USA.

 

Larisa Y. Poluektova
Department of Pharmacology and Experimental Neuroscience, University of Nebraska Medical Center, Omaha, NE 68105, USA.

 

Natalia A. Osna
Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE 68105, USA and Department of Pharmacology and Experimental Neuroscience, University of Nebraska Medical Center, Omaha, NE 68105, USA.

 

 

Please see the book here:- https://doi.org/10.9734/bpi/dhrd/v10/5390

Features of Breast Cancer in Women under 50 Years of Age in HIV Positive and Negative Patients in Limpopo Province, South Africa | Chapter 6 | Medical Science: Recent Advances and Applications Vol. 2

Background: Breast cancer and HIV are major global burden of disease among women. There are 39.9 million people globally living with HIV in 2023 and 53% of which were women and girls. Breast cancer is the most diagnosed cancer in women and incidence with 2.3 million comprising 11.6% of all cancer cases in 2022. Breast cancer is commonly occurring in elderly women in Europe and America. However, in Africa, it happens often among younger women.

Objective: Primary objective of the study is to better understand the features of breast cancer (stage, hormonal status, grading and molecular subtype) in women under 50 years and to identify any differences between HIV-positive and negative groups of breast cancer patients.

Methods: A retrospective descriptive quantitative study was designed to analyse the profile of women under 50 years old with breast cancers who attended Mankweng Breast Oncology Clinic from July 2020 to December 2021. Mankweng Breast Cancer Clinic register was used to get patients’ initial data, and the patients’ relevant records were assessed to collect detailed information. The statistical software package SPSS v29 was used for data analysis.

Results: A total of 109 breast cancer patients were evaluated. The mean age was 40.6 years among HIV-negative patients and 39 years among HIV-positive patients. Regarding HIV status, 28 patients (25.7%) were HIV-positive, while 81 patients (74.3%) were HIV-negative.

In the HIV-positive group, the distribution of molecular subtypes was as follows: Luminal A in 5 patients (24%), Luminal B in 8 patients (38%), HER2+ overexpression in 3 patients (14%), and Triple Negative in 5 patients (24%). Regarding disease stage, 6 patients (21%) were diagnosed at an early stage, while 22 patients (79%) presented with late-stage disease. Among the HIV-negative group, the molecular subtypes were distributed as follows: Luminal A in 16 patients (22%), Luminal B in 41 patients (58%), HER2+ overexpression in 7 patients (10%), and Triple Negative in 7 patients (10%). Regarding disease stage, 16 patients (20%) were diagnosed at an early stage, while 65 patients (80%) presented with late-stage breast cancer. Regarding the histological type of breast cancer in this study, all patients both HIV-positive and HIV-negative patients had Invasive ductal carcinoma (no special type).

Conclusion: Mean age of breast cancer in HIV-positive women is slightly younger than HIV-negative. Triple negative molecular subtype was proportionately more in the HIV-positive group in comparison to HIV-negative patients. Majority of breast cancer patients presented in an advanced stage in both HIV-positive and negative groups. Initiative of Routine breast cancer screening should take place on this population of women under 40-year age.

 

Author (s) Details

Mirza Mohamod Zahir Uddin Bhuiyan
Department of General Surgery, Mankweng Academic Hospital, Faculty of Health Sciences, University of Limpopo, Limpopo, South Africa.

Please see the book here:- https://doi.org/10.9734/bpi/msraa/v2/5096

Impact of Community-Based Non-communicable Disease Services on the Quality of Life of People Living with HIV in Uganda: A Randomized Controlled Trial | Chapter 2 | Disease and Health: Research Developments Vol. 6

There was an indication in 2012 that Non Non-communicable diseases (NCDs) were responsible for 38 million (68%) of the world’s 56 million deaths. Almost three-quarters of all NCDs (28 million) and the majority of premature deaths (82%) occur in low and middle-income countries mainly in Asia and Sub-Saharan African (SSA) countries. A comprehensive and culturally applicable community-based Non-Communicable Diseases (NCD) services package was implemented with an aim to test the effectiveness of the community-based NCD services on the Quality of Life (QoL) of people with HIV. The Randomized Controlled Trial (RCT) was conducted to compare the effectiveness of the community-based NCD services as an intervention. The control group received the usual HIV services in the community. Participants were randomly allocated to receive weekly and monthly intervention sessions using the standard care in the community ARV drug distribution points. Paired and independent t-tests were performed to compare changes in the QoL scores at the baseline and the endline. Between November and December 2018, 1076 individuals were screened, of whom 438 were randomly assigned to either the intervention or control group in a ratio of 1:1. The post-intervention results revealed that the community-based NCD services were effective and improved the QoL in all three domains; the physical, environmental and social relationship domains. The study findings further revealed that QoL was higher at the end line across all domains in the treatment group compared to the control group, the mean differences were statistically significant (p = 0.000 < 0.05). Thus, the community-based NCD services were efficacious in improving the QoL of HIV-infected people. Findings could be utilized in regular community service settings for their sustainability and long-term effects. The intervention created an improved understanding of HIV and NCD integration health promotion strategies and community support systems activities by the VHT, ART expert clients and community volunteers. The study recommended that the Government through the Ministry of Health (MOH) review and adopt the transformed community-based HIV and NCD services in the national guidelines for the management of HIV in the communities using the differentiated models.

 

Author (s) Details

Christopher Ddamulira
Bugema University Graduate School, Kampala, Uganda.

 

Frank Pio Kiyingi
Bugema University Graduate School, Kampala, Uganda.

 

Eria Muwanguzi
Bugema University Graduate School, Kampala, Uganda.

 

Stephen S Kizza
Bugema University Graduate School, Kampala, Uganda.

 

Please see the book here:- https://doi.org/10.9734/bpi/dhrd/v6/4402

Diagnostic and Management Strategies for Altered Sensorium in HIV/AIDS Patients: A Syndromic Approach | Chapter 7 | Medicine Essentials in Clinical Practice

Managing altered sensorium in individuals with HIV and AIDS is a vital aspect of clinical practice, given the multifaceted factors contributing to cognitive changes in this group. Altered sensorium, which involves disruptions in consciousness, cognition, and perception, can arise from diverse causes such as opportunistic infections, malignancies, metabolic imbalances, or the direct impact of HIV on the central nervous system. Early detection and a thorough evaluation are critical for effective management. The initial workup should include a detailed medical history, comprehensive physical examination, and focused diagnostic tests such as neuroimaging, lumbar puncture, and pertinent laboratory assessments. Common infectious etiologies like cryptococcal meningitis, toxoplasmosis, and cytomegalovirus encephalitis should be considered, as well as non-infectious conditions such as HIV-associated neurocognitive disorders (HAND), primary CNS lymphoma, and progressive multifocal leukoencephalopathy (PML). Treatment plans must be customized based on the underlying cause, incorporating optimized antiretroviral therapy (ART), targeted antimicrobial regimens, and supportive interventions.

A multidisciplinary approach, involving neurologists, infectious disease specialists, and other healthcare providers, is essential for comprehensive care. Moreover, addressing psychosocial factors, ensuring adherence to ART, and regularly monitoring for neurocognitive changes are integral to long-term management.

With advancements in HIV treatment and the increasing age of individuals living with HIV, continued research into the mechanisms, prevention, and management of altered sensorium is vital. Such efforts aim to improve clinical outcomes, enhance quality of life, and mitigate the neurocognitive burden associated with HIV and AIDS.

 

Author (s) Details

 

Rohit Raina
Department of General Medicine, AIIMS Bathinda, Punjab- 151001, India.

 

Preeti Singh Dhoat
Department of General Medicine, AIIMS Bathinda, Punjab- 151001, India.

 

Amandeep Kaur
Department of General Medicine, AIIMS Bathinda, Punjab- 151001, India.

 

P Arun Kumar
Department of General Medicine, AIIMS Bathinda, Punjab- 151001, India.

 

Please see the book here:- https://doi.org/10.9734/bpi/mono/978-93-49238-92-3/CH7

The Impact of CD4 Count Level on Patterns of Respiratory Tract Infections of HIV-Infected Patients: A Study in Western India | Chapter 3 | Medical Science: Trends and Innovations Vol. 7

Background: The World Health Organisation has estimated that 25 million people have died of HIV/AIDS, including 2 million people who died in 2007. A significant proportion of these deaths were due to opportunistic pneumonias. The majority of new HIV infections are in adults aged 20 to 39 years old. Individuals with HIV infection are at increased risk for tuberculosis (TB) and other respiratory tract infections (RTIs). The altered CD4 T-cell homeostasis induced by HIV infection may play a key role in the development of respiratory tract infections in HIV-infected patients.

Aim: The aim of the study is to find out of mean CD4 count of HIV patients at which they were at higher risk of developing various RTIs and accordingly when HAART is to be started in this part of the world.

Materials and Methods: The present prospective study was conducted between 9th August 2009 to 23rd January 2012. All the 961 HIV-infected patients and 300 HIV seronegative patients’ three early morning sputum were screened for routine bacterial and fungal pathogens and even examined for AFB and few of the samples were even cultured on LJ medium. All sputum samples’ smears were also examined for Poly Morpho Nuclear Leucocytes (PMNLs) in Gram staining.

Results: Out of all these 961 HIV patients, those with probable viral respiratory tract infections (RTIs) (349 patients) had a mean CD4 count of 474.62 ± 114.89, followed by mixed polymicrobial RTI (80 patients) with mean CD4 about 392.26 + 87.14. For the patients with pure fungal etiology (66), the mean CD4 count was found to be 377.29 + 268.29 followed by 466 patients with pure monomicrobial bacterial RTI the mean CD4 count was about 223.07 + 83.21.

Conclusion: A very vague co-relationship between the pattern of RTIs and CD4 counts has been attempted. Only Fungal and Bacterial RTIs were seen first to establish in even HIV-infected patients at very high mean CD4 counts of about 377 + 268.29 and 223.07 + 83.21 respectively, but in both very high prevalence rates were observed when compared with HIV non-infected patients with probability values of <0.05 and <0.001 respectively. The probable viral etiology of RTI was significantly high in HIV-non infected subjects when compared to HIV-infected RTI patients with a probability value of P < 0.001.

 

Author (s) Details

 

Rajeev Ramanlal Shah
Microbiology Department, Shree Aurobindo Medical College and PG Institute Indore, Madhya Pradesh, India.

 

Please see the book here:- https://doi.org/10.9734/bpi/msti/v7/4269

Application of Apri and Fib_4 Biomarkers in Stratifying the Degree of Hepatic Involvement in HIV-HCV Coinfection | Chapter 8 | Advanced Concepts in Medicine and Medical Research Vol. 10

Acquired immune deficiency syndrome/Hepatitis C co-infections are accepted and represent main public health problems as it influences between 2 and 3 heap people general This study developed located onnon-invasive tests utilizing biomarkers was conducted on victims co-infected with Immunological disorder and HCV. This chapter focuses on judging the degree of hepatic connection using APRI and FIB 4 scores in liver damage in those co-polluted with Disease given through sexual relations/HCV in Côte d'Ivoire. This study qualitative pattern of semi-directive interviewing was used to interview that was attended from September 2019 to November 2019Serological tests were performed to resolve the data. APRI and FIB 4 scores were deliberate for each patient from organic data acquired by COBAS C311 (Roche Hitachi, Japan). Mathematical analyses were performed utilizing GraphPad and MED-CALC software.The study complicated 30 patients (husbands) of middle age (25 - 52 age), with limits ranging from 0.67 to 8 for APRI and 0.201 to 22 for FIB 4. A predicting APRI and FIB4 score of significant hepatic fibrosis was observed in 23% of victims; however, 46% and 54% of sufferers for the APRI and FIB 4 score, respectively, would not have meaningful fibrosis. An APRI and FIB4 score not included in the categorization limits of the type of fibrosis hepatitis was observed in 31% and 23% of sufferers, respectively. The findings concerning this study revealed that APRI and FIB-4 good prejudicial capacity in the disease of liver cirrhosis in people endure hepatitis C in accordance with additional research.The study showed that APRI or FIB 4 score illustrated good discriminatory capacity to categorize patients into the various stages of liver fibrosis, as about 70 and 77%, respectively, of the patient state could be top-secret in the stages of hepatitis C fibrosis based on the understanding of their criteria.

Author(s) Details:

Serge Kouakou Kouassi,
Biology and Health Laboratory, Félix Houphouët-Boigny University, Abidjan, Côte d’Ivoire.

Doumbia Moussa,
Department of Bacteriology-Virology, Bacterial and Viral Serology Unit, Institut Pasteur of Côte d’Ivoire, Abidjan, Côte d’Ivoire.

Alexis Bahi,
Department of Medical and Fundamental Biochemistry, Institut Pasteur of Côte d’Ivoire, Abidjan, Côte d’Ivoire.

Carole N’Guessan Djaman Obouayeba,
Biology and Health Laboratory, Félix Houphouët-Boigny University, Abidjan, Côte d’Ivoire.

Françis Adou Yapo,
Biology and Health Laboratory, Félix Houphouët-Boigny University, Abidjan, Côte d’Ivoire.

Joseph Allico Djaman,
Biology and Health Laboratory, Félix Houphouët-Boigny University, Abidjan, Côte d’Ivoire and Department of Medical and Fundamental Biochemistry, Institut Pasteur of Côte d’Ivoire, Abidjan, Côte d’Ivoire.

Please see the link here: https://stm.bookpi.org/ACMMR-V10/article/view/12822

A Study on Intimate Partner Violence among HIV Positive Women at Kericho County Referral Hospital Comprehensive Care Centre in Kericho, Kenya | Chapter 14 | Novel Research Aspects in Medicine and Medical Science Vol. 6

 The basic goal concerning this study was to examine by means of what HIV positive women accompanying the Kericho County Referral Hospital Comprehensive Care Centre respond to household abuse. Available data display that 55% of women and 20% of men endure HIV infection knowledge intimate partner intensity (IPV) and that 24% of daughters experience abuse by their partners subsequently disclosing their HIV serostatus. IPV increases the risk of HIV purchase and often interferes accompanying victims' date in and adherence to HIV care. A descriptive cross-localized research design was utilized. Between May and July 2013, 230 HIV positive girls over the age of 15 were systematically sampled. To get qualitative and all-inclusive data, interview schedules and focus group conversations were employed. To decide frequencies and ideas, content analysis was acted, and SPSS 20.0 and Microsoft Excel were used to enter and evaluate the dossier. Intimate partner intensity (IPV) was experienced by 156 of the 230 daughters questioned. According to the survey, material abuse (57.8%) was the most prevalent type of IPV, while sex crime (4.9%) was the least prevailing. Furthermore, 25.6% of the women consulted reported an increase in violence subsequently being diagnosed accompanying HIV. The majority of persecutes individuals (45.5%) abandoned and talked to a friend (21.2%) in answer to IPV. As a result, HIV and IPV are syndemic concerns that must be addressed orderly for an HIV program to be profitable. IPV was shown to have a solid impact on HIV positive women accompanying Kericho District Hospital (KDH). There is a pressing necessity for IPV screening and administration techniques expected included into the HIV prevention program at KDH, in addition to IPV training for strength practitioners. The CCC's fitness treatment bear include trauma-cognizant care.

Author(s) Details:

Dorcas Bii,
University of Kabianga, P.O. Box 2030 – 20200, Kericho, Kenya.

Simon Kiprono Ruttoh,
Moi University, P.O. Box 4606-30100, Eldoret, Kenya.

Paul Kizito,
University of Kabianga, P.O. Box 2030 – 20200, Kericho, Kenya.

Please see the link here: https://stm.bookpi.org/NRAMMS-V6/article/view/12152

Samos Syndrome, Women with Borderline Personality Disorder and Risk for Sexually Transmitted Infections and HIV: Their Role During Pandemics | Chapter 2 | Current Innovations in Disease and Health Research Vol. 7

 The author (CL) found the Samos Syndrome when researchers investigated reason certain crowd refuse to take precautionary measures even when aware of universal risks. Samos Syndrome suggests that universal and primary prevention can only happen if people care about staying athletic and avoiding able to be contracted illnesses. When faced accompanying risky inherited diseases, individuals either uphold themselves or welcome them. This last is what takes place in Samos Syndrome. The syndrome is a kind of pathophilia (crowd attracted by illnesses). As inexact personality disorder, in the direction of Samos Syndrome, becomes more common, so will crowd who scrap primary protection from spreading diseases and health behaviour as their choice. Therefore, we cannot halt universal outbursts. Pandemics would sinisterly draw pathophilies and split individuals the one wish to avoid sickness from remainder of something who would waves the risk caused by pandemics to harm themselves for private, interpersonal, and mental reasons.

Author(s) Details:

Carlo Lazzari,
International Centre for Healthcare and Medical Education, London, United Kingdom.

Please see the link here: https://stm.bookpi.org/CIDHR-V7/article/view/12040

Motivations for Sexual Relationships, Sero-discordant Partnerships and the Spread of HIV amongst Tiv People of Benue State, North Central Nigeria | Chapter 1 | Current Innovations in Disease and Health Research Vol. 6

 Despite the knowledge created on the styles of HIV transmission through intercourse behaviour change intervention programmes, the incidence rates of HIV contaminations remain significantly high in Nigeria, accompanying a figure of 227,518 cases in 2014. The present study examines the ambitions for sexual relationships, sero-conflicting partnerships and the spread of HIV among Tiv People of Benue State, Nigeria. A sample of 1,621 respondents was composed using multi-stage and beneficial sampling methods. Structured and meticulous interviews were used for dossier collection. SPSS (story 21) was used for all-inclusive data analysis.  The desire for inclination, place to live, favours, love and their combined belongings, age; and levels of education are considerably associated with sero-conflicting partnerships. The inspiration factors for sero-discordant intercourse relationships will need expected addressed, while guaranteeing access to character education, if significant decline in the incidence rates of HIV is expected achieved among the Tiv People of North Central Nigeria.

Author(s) Details:

Godwin Aondohemba Timiun,
Australian Catholic University, 115 Victoria Parade, Fitzroy Vic 3065, Melbourne, Australia and Department of Sociology, Benue State University, Makurdi, Benue State, West Africa, Nigeria.

Please see the link here: https://stm.bookpi.org/CIDHR-V6/article/view/11835

Determination of Antifungal Susceptibility of Isolated Candidal Strains for Fluconazole and Voriconazole: An in vitro Study | Chapter 2 | Current Innovations in Disease and Health Research Vol. 2

This branch highlights to detect the predominance of asymptomatic Candidal colonization with HIV-positive and Healthy individuals and assess antifungal drug susceptibleness for Candida species by Fluconazole and Voriconazole.Human immunodeficiency bacterium (HIV) infection is a worldwide fitness problem, that affects in both cultivating and developed nations. The oral lesions caused on account of this disease can intensely change the life of the patient, in terms of value. The present Case-control study was conducted all the while 2008-2010, among 50 HIV-positive patients as cases the one were admitted to the society care center of Acharya Vinoba  Bhave Rural Hospital, Wardha, India. Oral swabs were collected from the tongue and bias, Candidal species were isolated and antifungal susceptibleness testing had transported based on disk spread procedures.Prevalence of Candidal settlement of area was 52% among the cases which was considerably higher than the healthful control (8%) (p=0.00001). There is no association between asymptomatic Candidal settlement on the tongue and partiality with decreasing CD4 T lymphocyte count statistically (P=0.3454, P=0.7279). Fungal contaminations are caused on account of eukaryotic organisms which results in more troublesome therapeutic questions than bacterial infections. During the initial scenes of oral Candidiasis topical antifungal situation is useful, but most victims suffer multiple scenes,d fluconazole or itraconazole can help in the management. Antifungal susceptibleness, among cases, Candidal colonization, 78.8% and 71.1% were delicate and 17.3% and 26.9% were resistant individually. To Fluconazole and Voriconazole.The frequency of Candidal colonisation was particularly extreme in HIV-positive people. The CD4 T- lymphocyte count is independent to oral Candidal colonisation in asymptomatic individuals. Antifungal cure sensitivity experiment is necessary.  Due to the rising rise of resistance to azoles, these powers should be used tentatively and should be continued for severe candidiasis or clinically symptomatic subjects.

Author(s) Details:

Monal M. Kukde,
Department of Oral Medicine and Radiology, Sri Sai Dental College, Srikakulum, Andhra Pradesh, India.

Deepak S. Selokar,
Health Services-Leprosy Chandrapur, India.

Rahul R. Bhowate,
Department of Oral Medicine and Radiology, Sharad Pawar Dental College, Sawangi (Meghe), Wardha, India.

Silpi Basak,
Department of Microbiology, Jawaharlal Nehru Medical College, Sawangi (Meghe), Wardha, India.

Shirish S. Degwekar,
Department of Oral Medicine and Radiology, Sharad Pawar Dental College, Sawangi (Meghe), Wardha, India.

Please see the link here: https://stm.bookpi.org/CIDHR-V2/article/view/11190

Detection of IgG and IgM Antibodies Anti- T. gondii and Associated Risk Factor in Pregnant Women in Bangui, Central African Republic| Chapter 10 | Current Progress in Medicine and Medical Research Vol. 3

 Objective: The objective concerning this study was to determine the immune response right gondii and associated risk determinant in pregnant wives in Bangui.Materials and Methods: This study used backward-looking analysis to review the records of pregnant girls who had fetal consultations in the maternity custody of the Bangui Community Hospital between January 2019 and December 2019. From January to June 2021, sociodemographic facts, laboratory data (IgM and IgG answers to T. gondii), and HIV serology results were assembled. Chi2 analysis was approved.Results: In this chapter, A total of 307 pregnant wives were analyzed. The average age of the daughters included was 28 (±6) age. The average parity of the complete sample was 2.18 (±1.93). The infection rate of toxoplasmosis was 14.65%. Women with a certain IgM reaction clarified 17.58%, while those with a definite IgG response justified 42.99%. 5.86% of patients tested helpful for HIV. Patients aged 20 to 29 had a serological sketch that indicated a likely ongoing infection (p = 0.010). With no statistically significant dissimilarity (p = 0.23), the paucipares were more represented. Pregnant mothers were not substantially more inclined contract toxoplasmosis (p = 0.96). Immunized and unimmunized patients were unprotected in the same way [OR = 0.97; CI 95% 0.4 = 6 - 2.05]. Conclusion: Toxoplasmosis is especially hazardous during pregnancy. Seroprevalence was considerably greater between those aged 20 to 24. Whether or either women were inoculated, they were likewise exposed. This makes necessary the establishment of a distinguishing illness prevention program.

Author(s) Details:

Wilfrid Sylvain Nambei,

Department of Science Biomedical, Faculty of Health Science, University of Bangui, Bangui, Central African Republic.

Junior Ouefio Nguerenam,

Department of Science Biomedical, Faculty of Health Science, University of Bangui, Bangui, Central African Republic.

Edwige Régina Kodia-Lenguetama,

National Center of Blood Donor’s, Ministry of Public Health, Bangui, Central African Republic.

Arsène Gbamonza,

Community Hospital of Bangui, Bangui, Central African Republic.


Please see the link here: https://stm.bookpi.org/CPMMR-V3/article/view/11243

'Is We Carnival Culture; is We Caribbean Thing; is We Life!': Demystifying Gendered Relations and the Taboo of Sex and HIV and AIDS among West Indian Women | Chapter 7 | Recent Trends in Arts and Social Studies Vol. 3

 This study covers the detracting and interconnected functions of several socio-educational issues in the Caribbean: Patriarchy, sex commercialisation, fathers having sexuality with brothers, violence, and conscientious practices - all providing to HIV and AIDS risk. By doing so, the item promotes knowledge of the harsh realisms of Caribbean women's intercourse lives and how Caribbean breeding disproportionately exposes ruling class to HIV and AIDS risk. The report concludes accompanying a need for more research into the crucial socio-enlightening factors that unfavorably influence male-female relationships and their effect on HIV and AIDS risk in the Caribbean.

Author(s) Details:

Shivaughn Hem-Lee-Forsyth,
St. George's University, St. George's, Grenada.

Please see the link here: https://stm.bookpi.org/RTASS-V3/article/view/10901

Lipid Profile among Art Treated and Untreated Patients in HIV Positive Cases: A Comparative Study | Chapter 15 | Research Highlights in Disease and Health Research Vol. 7

 This affiliate aims to find out the lipid sketch pattern in treated HIV victims after shorter magnitude with ART (First line of situation i.e. zidovudine, lamuvudine and Nevirapine) and equating them against HIV contaminated untreated things and controls within our locality. HIV Seropositive subjects on HAART or untreated have dyslipidaemia. In not cooked HIV infection, the plurality of the ATP is used in the reverse copy process to achieve host container morphism. The dyslipidaemia in ART untreated or in ART discussed HIV infected individuals is an main factor in heart failure risk factors in HIV polluted individuals.  Subject field of HIV Seropositive cases (n=84) and age and sexuality matched active non-HIV cases as controls (n=47). Comparison between the HIV infected (n=42), HIV contaminated ART treated (n=42) and controls were meaningful (p 0.000) for fasting cholesterol, triacylglycerols (p 0.000) and HDLc (p 0.000) and LDLc (p 0.000). When TAG distinguished controls to HIV-infected ART-prepared individuals, the dissimilarities were negligible. Statistical significance in middle from two points sexes within prepared patients' lipid sketch in HDLc (35 ± 3.8 against 37.4 ± 3.5) and LDLc (48.0 ± 8.3 against 38.0 ± 7.2). ART treated or prepared in HIV Seropositive subjects accompanied altered lipid description when compared to apparently healthful controls in our report.  HIV-positive individuals endure be routinely restrained for lipid abnormalities either they are receiving ART a suggestion of correction, and a careful anti-retroviral situation plan should be recommended. This will unquestionably aid from now on management of dyslipidemia in HIV seropositive victims.

Author(s) Details:

Doddigarla Zephy,
Department of Biochemistry, Hi-Tech Medical College and Hospital, Rourkela,Orissa, India

Lingidi Jhansi Lakshmi,
Department of Biochemistry, Hi-Tech Medical College and Hospital, Rourkela,Orissa, India.

Muhamed Faizal,
Srinivasan Medical College and Hospital, Trichi, Tamil Nadu, India.

Please see the link here: https://stm.bookpi.org/RHDHR-V7/article/view/10580