Cervical cancer is the most common cancer in women in Zimbabwe with approximately 3,000 women being diagnosed and close to 2,000 succumbing to the malignancy annually. HIV remains one of the drivers of cervical cancer in Zimbabwe. In 2019, an estimated 20% of eligible women in Zimbabwe accessed cervical cancer screening services. In collaboration with the Ministry of Health and Child Care, JF Kapnek Zimbabwe, a local NGO, is implementing the Target, Accelerate, Sustain Quality Care for HIV epidemic control, (TASQC program) in six districts in Masvingo province. Visual Inspection with Acetic Acid (VIAC) is offered to women living with HIV targeting the 25 to 49 years age group. Services are provided daily at 20 health care facilities while 150 facilities and health posts are visited quarterly for outreach services. Between April 2022 and August 2024, a total of 86,499 VIAC screenings were done, reaching 119% of the target, which were approximately 2500 per month. Over 40% of all screenings were done at community level with districts like Zaka (62%) and Chivi (57%) doing most of their screening at community level. A total of 115,105 WLHIV were mobilized for VIAC by community volunteers. VIAC positivity at facility level was 6% while at community level was 5%. Treatment coverage of 85% was achieved with most women treated via LEEP followed by thermocoagulation. Treatment was mostly at facility level. The main challenges noted in this program were staff attrition, competing community programs and difficulties accessing some geographical areas, especially in the rainy season. Community based cervical cancer screening can be a way to scale up access to women from hard-to-reach areas. Resources need to be availed to ensure more access to vulnerable women.
Background: An increasing number of first line Anti-retroviral therapy (ART) patients in resource limited countries are experiencing regimen failure and are switched to second line ART. However, predictors of second line ART virologic failure in Cameroon are scarce. This study aimed at investigating the predictors of virologic failure of second line ART regimen amongst adult patients in the Northwest Region of Cameroon. Method: A cross-sectional study was conducted among adults on second line ART between January 2018 and December 2021 at 3 purposefully selected health facilities. Study participants were systematically selected to include participants on second line ART with documented first line and second line viral load information. Data was extracted from clients’ files and analyzed using SPSS version 25. Results: A total of 157 second line ART clients were sampled with majority (69%) being males. The median time to switch to second line ART from the time of first high viral load on first line ART was 18 months (SD=8). The second line ART virologic failure rate was estimated at 16%. Significant predictors of second line ART virologic failure were baseline CD4 >200 copies/ml (AOR: 5.06, 95% CI: 1.54-16.61, p = 0.007) and fair adherence AOR: 19.21, 95% CI: 5-75.37, p = 0.001). Conclusion: Baseline CD4 counts greater than 200 cells/mL and fair adherence were significant predictors of virologic failure of second-line ART. The Midian duration from first high viral load to switch was high at 18 months. Strategies to improve adherence with more attention on the 18-30 years age group will help reduce virologic failure rate of second line ART. Patients on first line ART with high viral load should be closely monitored and provided with treatment support to ensure that those with a persistent high viral load are identified and switched to second line earlier than 12 months to improve their treatment outcomes.
Background: We evaluated for the first time in Cameroon, the performance of a rapid test that detects the presence of specific antibodies to Human Immunodeficiency Virus (HIV) in urine sample, compared to two bloods based rapid tests used for HIV screening in Cameroon. The aim of the study was twofold; [1] to evaluate the diagnostic accuracy (sensitivity and specificity) of the WANTAI HIV URINE rapid test kit (Beijing Wantai), compared to the two blood based rapid antibody tests, Determine HIV 1/2 and Ora Quick HIV-1/2, currently in use in the Cameroon national HIV testing algorithm, and [2] An HIV ‘self-test’ (HIVST) usability study using the WANTAI HIV Self-test by Urine. Method: This was a comparative study where urine and blood specimens were collected simultaneously from each patient, tested for HIV and results of the two tests compared immediately. All interested sexually active adult patients 21yrs and above sent to the hospital laboratory for HIV test and others tests were enrolled in the study after signing an informed consent form. 330 patients opted for the HIV self-testing. All HIV positive and discordant samples were confirmed on western blood and the statistical analysis calculated using Wilson’s method. HIV sub typing was done on all confirmed HIV positive plasma samples. Results: From November 2020 to February 2021, 1000 patients had their urine and blood Specimens tested for HIV. The test performances of both tests were as follows; Determine had a sensitivity of 100%, specificity of 98.72% and a kappa value of 0.860. Meanwhile WANTAI had a sensitivity of 100%, specificity of 99.37% and a kappa value of 0.925. Conclusion: Both Determine and WANTAI have excellent sensitivity (>99%) and specificity (>98%) as per the WHO standards. However, WANTAI showed an overall better performance as compared to Determine, supported by an almost perfect agreement with Western Blot. In a nutshell, WANTAI therefore appears as an outstanding assay for HIV screening. Furthermore, it’s non-invasive/painless approach, its optimal privacy (i.e. reduced stigma/discrimination), and rapidity, accurate and user-friendliness makes it a significantly superior test for scaling-up HIV testing and linkage to care in resource-limited settings.
Background: Barriers to Human Immunodeficiency Virus (HIV) and Hepatitis C (HCV) testing and care persist, especially among high-risk populations in medically underserved areas, where limited testing accessibility, stigma, and systemic inequities hinder early diagnosis and treatment. In Southern New Jersey, substance use and mental health treatment facilities serve populations with increased vulnerability to HIV and HCV, yet testing and retention of care remain suboptimal. To address these challenges, we developed a “Group Risk Reduction and Testing” (GRREAT) Model, an interdisciplinary, group-based approach integrating harm reduction counseling, peer support, and rapid testing to enhance screening rates, reduce stigma, and improve patient engagement with care. Unlike traditional individual testing models, the GRREAT Model leverages group therapy principles to create a supportive environment that facilitates knowledge sharing, increases testing uptake, and fosters open conversations surrounding risk behaviors. Methods: From June 2023 to September 2024, weekly group testing sessions were conducted at residential treatment facilities in medically underserved areas of Southern New Jersey, evaluated using a mixed-methods approach. Participants received educational presentations, rapid HIV and optional HCV antibody testing, and individualized results counseling. Quantitative data included surveys measuring satisfaction, comfort, and perceptions of privacy and confidentiality, which were then interpreted using ender-stratified analyses involving descriptive statistics and chi-square tests. Qualitative feedback was analyzed thematically. Results: A total of 452 participants completed surveys (348 men, 104 women). Participants were predominantly male (77%) and gender differences were the primary focus of the analysis, as data on other demographic factors such as age and ethnicity were not collected. Participants reported high satisfaction, with 95% of women and 74% of men rating their care as “Excellent.” A statistically significant gender difference was observed in overall care ratings (p=0.007, Cohen’s d=0.303), with women reporting higher levels of overall satisfaction. A smaller but statistically significant difference was noted in preferences for privacy in counseling (p=0.034, Cohen’s h=-0.100), though men and women reported similar levels of comfort and confidence in confidentiality. Thematic analysis of participant comments identified key themes, including “Trust and Emotional Safety,” “Interpersonal dynamics,” “Program Impact and Effectiveness,” and “Value Recognition” of the program. Conclusions: The GRREAT Model demonstrated strong acceptability among participants and effectiveness in improving perceptions of HIV/HCV testing and harm reduction counseling respective of patient gender. This peer-supported, group-based intervention not only allows for increased testing rates but also fosters open discussions around HIV, harm reduction strategies, and sobriety treatment adherence. Given the high satisfaction ratings and minimal gender differences, this scalable approach holds promise for broader implementation in diverse medical settings. Future research should explore long-term impact, refine strategies for balancing privacy in group settings, and assess how this model can be adapted to different populations to maximize its effectiveness in reducing health disparities.
Background: Post-exposure prophylaxis (PEP) is the use of short-term Antiretroviral Therapy (ART) to reduce the risk of acquiring the Human Immunodeficiency Virus (HIV) infection following exposure. Frontline Healthcare Workers (HCWs) are at a higher risk of contracting HIV. This study investigated the factors influencing the intention to practice of HIV-PEP among front line HCWs in the Volta region of Ghana using the theory of planned behavior as the conceptual framework. Methods: This study adopted a quantitative cross-sectional design in November 2023, collecting data from a multistage sample of 243 participants and analyzing them using STATA version 17 at p<0.05 and 95% confidence interval. Findings: The intention to practice HIV-PEP was 92.2%, with nurses being 10 times more likely to have the intention than doctors [adjusted odds ratio (aOR)=9.63(1.74-53.49), p=0.010]. Subjective norm was significantly associated with the intention to practice HIV PEP with those who disagreed that important people in their lives would approve of them taking HIV PEP being less likely to use PEP compared to those who agreed [aOR=0.16(CI: 0.29- 0.83), p=0.029], and those who disagreed that they would follow the recommended protocols for PEP being less likely to practice HIV PEP compared to those who agreed [aOR=0.04(CI: 0.00-0.63), p=0.022]. Perceived behavioural control was significantly associated with the intention to practice HIV PEP, with those who disagreed that they were confident to use HIV PEP any time they were exposed to HIV being less likely to have intention to use PEP if exposed [aOR=0.10(CI: 0.01-0.75), p=0.026]. Conclusion: The overall intention to practice HIV PEP was high. Nurses were more likely to have the intention to take PEP for HIV compared to doctors. Strategies to increase the intention to practice HIV PEP should focus on subjective norms and perceived behavioural control and should also target medical doctors.
Background: Loss to Follow-Up (LTFU) among HIV positive children and adolescents greatly contributes to sub-optimal retention in HIV prevention and treatment program outcomes. This can be worse among conflict affected areas of the country. LTFU threatens efforts to ensure longevity and survival of children and adolescents living with HIV. In the context of the ongoing socio-political crises and instability in the Northwest and Southwest Regions of Cameroon, we investigated reasons for LTFU among children and adolescents enrolled on ART. Methods: We conducted a qualitative study, nested within a larger cohort study (2018-2022) on assessing the incidence of LTFU among children and adolescents in two regions of Cameroon. The data collection was done from November 2021 to January 2022.We traced and interviewed 25caregivers of children and adolescent’s LTFU. Recorded interviews were transcribed, translated and then analyzed using Atlas-ti Version 9. Results: The following reasons were reported as the main contributing factors of LTFU: Socio-political crises/displacement, long distances/cost of transportation, lack of partner/family support, refusal/dating/marriage among adolescents, poverty/competitive life activities, stigma, shortage of ARVs/poor efficacy, alternative forms of health care and negative attitudes of healthcare providers. Conclusion: Our study found multiple factors at personal, family, community and health system levels, which contribute to poor retention of children and adolescents in HIV care with the leading reason postulated being displacements and constant roadblocks due to the current sociopolitical crises. The impact of the socio-political crisis on HIV services therefore cannot be neglected.
Tuberculosis (TB) remains a leading cause of global mortality and is the most common opportunistic infection in individuals with Human Immunodeficiency Virus (HIV). Among its severe manifestations, Tuberculosis Meningitis (TBM) presents a significant clinical challenge due to its high mortality rate and the complexities of treatment. This case report presents a 33-year-old Middle Eastern male diagnosed simultaneously with human immunodeficiency virus/acquired immune deficiency syndrome and disseminated tuberculosis including tuberculosis meningitis. Initial management included anti-tuberculosis treatment and prophylactic steroid, followed by the initiation of antiretroviral therapy five weeks later. Despite these interventions, the patient developed Immune Reconstitution Inflammatory Syndrome (IRIS). The case highlights the challenges in managing opportunistic infections in advanced human immunodeficiency virus cases, emphasizing the need for new strategies to reduce the incidence of immune reconstitution inflammatory syndrome and its complications while identifying the most effective approach in managing such cases.
Introduction: Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) is a major global health emergency that affects all regions of the world, countries, races, and different groups of people causing millions of deaths and suffering. This study aimed to determine ARV therapy adherence among patients using community pharmacies and Eleta Hospital in Ibadan, Nigeria. Methods: A cross-sectional study that employed quantitative data collection methods from 373 patient records at 10 community pharmacies and 227 patients’ records at Eleta secondary facility were conducted. Descriptive statistics and inferential statistics, including Chi-square and logistic regression analysis, were used to find adherence rates to Antiretroviral Therapy (ARV). Results: The median age of the participants was 37.35 and 393 (65.5%) were females. The study revealed that the default rates were higher in community pharmacies (17%) than in the secondary facility (6%). Those who utilized community pharmacies were 265 (71.2%) while 128 (56.4%) used the general hospital. Male patients had significantly higher odds (approximately four times) of HIV medication adherence compared to female patients (AOR = 4.082, p < 0.001). When considering community and secondary health facility data, male patients had significantly higher odds (approximately 2.43 times) of adherence than female patients (AOR = 2.426, p = 0.002). Conclusion: Both community-based and facility-based pick-up centers have the potential of improving adherence rates. These insights can be used to develop comprehensive strategies aimed at reducing the burden of HIV/AIDS.
Analyses of the factors involved in HIV/AIDS transmission have generally focused mainly on the risks that individuals face through their sexual networks. This study looks instead at the risks posed by the behaviour of each partner in the couple to the other. This helps us to understand the reciprocal consequences that the fulfilment of the marital duty now has on the health of both partners. The analysis is based on data from the fifth Burkina Faso Demographic and Health Survey of 2021, which provides a nationally representative sample of 4,697 couples. For polygamous households, the husband was matched to each of his wives. On this basis, we found that the vast majority of couples (87.2%) can be considered risk-free, as neither partner is involved in an unprotected extramarital relationship. However, in 40 couples both partners had had unprotected sex outside their regular union. In 292 couples only the man was in this situation and in 270 couples only the woman was concerned. Although men are more responsible for the couple’s risk, women make a significant contribution. Other factors include being young, belonging to the Lobi/Dagara ethnic group, being animist, being polygamous, having a higher education level and having a greater degree of autonomy. These are pillars on which a targeted risk reduction approach should be focused.
Background: Globally, Human Immunodeficiency Virus (HIV) continues to be a major public health burden. Transmission occurs by several means including the transmission from mother to child mostly happening during labor and delivery. The objective of this study was to determine the prevalence and factors associated with HIV infection in women who delivered at Soroti Teaching/Regional Referral Hospital. Methods: A cross-sectional study was conducted from April to June 2023. A total of 422 mothers who delivered in Soroti Regional Referral and Teaching Hospital were sampled by systematic random sampling. A structured data extraction tool was developed and data were collected using the Kobo Collect mobile application. Data was analyzed using STATA 15 and modified Poisson regression model was used for inferential statistics. Statistical significance was accepted for a value of p < 0.05. Results: The average age of the population was 26 years (SD = 0.5). The HIV prevalence was 5.3%. Associated factors were Gravidity ≥ 5 (PR- 95% CI = 1.54 to 1.57, P = 0.007), previous miscarriage ≥ 3 (PR = 0,266 (0.11, 0.642) CI 95%, P = 0.003), Hepatitis B PR-19.429 (2.613, 144.43) CI 95% p = 004 and residing in a rural setting (PR = 2.506 (1.05, 1.593) CI 95% p = 0.038). Conclusion: HIV prevalence among women who delivered at Soroti Teaching Hospital during the study period was 5.3%. Gravidity above 7, Hepatitis B infection, miscarriages more than or equal to 3 and living in a rural setting were significantly associated with HIV infection. Prevention of subsequent pregnancies and sexually transmitted diseases like hepatitis B are key factors in the prevention of HIV.
Background: According to the ECDC’s latest report, Portugal has the highest incidence of HIV/AIDS and late diagnosis (lymphocyte TCD4+ count <350 cells/µL) in the European Union. Late diagnosis can significantly impact an individual’s health outcomes and the effectiveness of treatment interventions, interfering with overall health outcomes and quality of life. Objectives: Evaluate evolution of HIV diagnosis between 1998-2022 in a district Hospital comparing demographic, epidemiological, AIDS defining illnesses and mortality data. And evaluating the COVD-19 pandemic years regarding the late diagnosis impact, in this matter comparing 2020, 2021 and 2022 with 2017, 2018 and 2019. Methods: Retrospective study of HIV patients (pts) with TCD4+ <350 cells/µL at 1st visit between 1998-2018, divided into group A: TCD4+ <200 cells/ µL; group B: TCD4+ 200-350 cells/µL. Statistical analysis by Excel® from Microsoft 365®, by using the chi-squared test (χ²). Results: From a total of 1175 pts in IDS database, 649 met the criteria but due the lack of data, only 590 were admitted. From these, 63,73% (N=376) in group A and 36,27% (N=214) in B. Demographic and epidemiological characterization revealed (A vs B): male predominance of 79,52% vs 66.82% (p<0,0001); age at diagnosis<50 years 76,59% vs 84,11% (p<0,0001); transmission by heterosexual contact in 53,45% vs 50,93% (p<0,0001). At first health care encounter, 59,84% of group A had an AIDS defining illness-most commonly tuberculosis (33,33%). In a group analysis the percentage of pts in group A raised from 31,4% in 2018 to 32% in 2022. Analysis of mortality showed a death rate of 26,86% in group A versus 16,36% in group B (p<0,0001), with a mean duration from HIV diagnosis to death of 2208 days versus 2940 (p<0,0001). On average, time from first Infectious Diseases (ID) consultation to death was 1441 days in group A and 2308 in group B (p<0,0001). Analyzing before (2017-2019) and during COVID-19 (2020-2022), the prevalence of late presenters (<350 TCD4+/μl) went from 3.90% to 8.81% globally; an increase of 55.77% (23 to 52 pts), maintaining proportion of genders. During COVID-19 an increase in overall mortality was observed 26.86% vs 16.36% (group A vs B pre-pandemic) to 28.86% vs 18.92% (group A vs B pandemic) not due COVID infection. Conclusion: This study highlights the persistent challenge of late HIV diagnosis and its profound impact on patient outcomes. The demographic and epidemiological characterization underscores the need for targeted interventions to address disparities in testing and care access. The observed increase in late presenters and mortality rates during the COVID-19 pandemic underscores the importance of maintaining HIV care services amidst public health crises. Timely diagnosis, early intervention, and comprehensive care remain imperative to improve outcomes and advance towards the goal of ending AIDS as a public health threat by 2030.
Introduction: Dual Antiretroviral Therapy (DT) has been evaluated as a successful treatment approach in various patient populations, including treatment-naïve and suppressed individuals. However, its effectiveness in experienced patients who become nonadherent due to pill burden, dosing frequency, and/or associated toxicities and develop resistance to it is uncertain. Objectives and Methods: This study aimed to assess the therapeutic efficacy of DT involving dolutegravir (DTG), doravirine (DOR), and darunavir/ cobicistat (DRV/c) or darunavir/ritonavir (DRV/r 600/100 bid) in multi-experienced patients, both suppressed and unsuppressed. For patients experiencing treatment failure, genotypic resistance testing was conducted to evaluate drug efficacy. In cases without treatment failure, regimen selection was based on considerations such as previous toxicities, drug interactions, and clinical history. Results: A total of 72 multi-experienced patients were studied (one with more than one treatment) between 2015 and 2023, mostly men (64%), with ages between 37 and 73 (average 54 ± 9) and a time of infection between 4 and 24 years (median or mean 16 ± 5). The major risk for infection was heterosexual (63%), followed by intravenous drug users (23%). All of them presented with more than one therapeutic drug class resistance, and the most previously used regime was RAL+LPV/R in 18 patients (24%). The most frequent reason for switching was the development of resistance in 30 (41%) of the patients, followed by simplification of the number of doses or tablets in 31 (42%) patients. At the switch, DTG+DRV/c were used in 46 (62%) patients, followed by DTG+DRV/R 600 in 19 (26%) patients. At the end of follow-up, 82% had a viral load of less than 200 cps/mL, 79% less than 100 cps/mL, and 67% had complete viral suppression. Twelve patients were lost for follow-up; seven patients were off medications; and of these, three died with AIDS-defining illnesses. Four additional patients died of non-HIV-related causes, all virally suppressed. Conclusion: The extended evaluation period (6 years) demonstrated that the simplification for dual therapy in patients who were treatment experienced with prior adherence failure with consequent multi-resistant drug patterns is associated with a high degree of efficacy (82%). Many (18%) still dropped out, consistent with findings from other studies. The reduction of pill burden and toxicities are factors that, by promoting a higher adherence rate to treatment, may have contributed to this success.
Introduction: Tuberculosis (TB) is a non-degenerative disease, which has a high negative health impact on both developed as well as developing countries. HIV, AIDS has increased the chance of TB occurrence.
Introduction: HIV-Associated Neurocognitive Disorder (HAND) is frequently reported even in patients undergoing Antiretroviral Therapy (ART), however, its severity, the main affected domains, and its relationship with ART are not well understood.
Elite Controllers (ECs) are a less frequent but distinct group of HIV infected patients. Recent treatment guidelines encourage ART initiation in all HIV-infected individuals as early as 2 possible to control the infection and prevent transmission. Initiating ART in ECs remains controversial, although there are multiple hypothetical benefits. Currently, there is evidence that ECs must be initiated on ART in order to prevent non-AIDS related comorbidities associated with immune activation. Clinicians are to weigh the risks and benefits of initiating ART as well as monitor the patients for effective therapy. In this case report, we present an HIV management dilemma of an EC, a middle-class South African woman from the Limpopo province.
INTRODUCTION:Mitochondrial dysregulation is a key event in HIV-1 infection. Recent studies have suggested that age-related neurodegenerative disorders are associated with increased mitochondrial DNA (mtDNA) damage. As accelerated ageing was found in HIV-1 patients, we hypothesized that HIV-1 infection or HIV-1 proteins can lead to mtDNA damage. Unrepaired mtDNA impairs mitochondrial function, which can lead to oxidative stress and cell death. Investigations of mechanisms of mtDNA damage are limited by the lack of available human models.METHODS:We compared mtDNA or nDNA (nuclear DNA) damage in human cortical neurons and PBMC cells. Primary neuronal cultures were incubated with conditioned media from HIV-1 infected PBMC, or HIV-1 viral proteins Tat or Vpr. Total genomic DNA (nuclear and mtDNA) was isolated using the QIAamp Kit. Nuclear and mtDNA were amplified using the long q-PCR/Gene Amp XL Kit. Real-Time RT-PCR using mitochondrial energy metabolism array was performed to assess mitochondrial energy metabolism markers. Superoxide dismutase (SOD) activity in neuronal cells was measured by the OxiSelect SOD Activity Assay. Reactive oxygen species (ROS) were determined by the confocal microscopy. ATP levels were analyzed using ATP determination biochemical assay. Mitochondrial, cytoplasmic and nuclear proteins were studied by quantitative western-blot assay.RESULTS:We show that both treatment of neuronal cells with HIV-1 conditioned media, or infection of PBMC with HIV-1 increase mtDNA damage in cells. mtDNA damage was also seen in neuronal cells, incubated with HIV-1 proteins, Tat and Vpr. Next, we confirmed that mtDNA damage was also increased in neuronal cells transfected by Tat expressing plasmids. We showed that mtDNA was not damaged in neuronal cells following treatment with heat inactivated HIV-1 or Tat protein. Further, we demonstrated that HIV-1 or Tat caused more mtDNA damage compared to nuclear DNA damage in neuronal cells. Finally, we showed that Tat dysregulates RNA expression of several genes regulating mitochondrial energy metabolism, suggesting involvement of Tat in mitochondrial bioenergetics in human neurons. Finally, our hypothesis was confirmed by qWestern analysis of mitochondrial and apoptotic proteins demonstrating the accumulation of apoptotic Bax and Bad proteins in mitochondrial fraction of Tat-treated neuronal cells, suggesting toxic effects of Tat on mitochondrial survival.CONCLUSION:We showed an increase of mtDNA damage in primary neurons, treated with HIV-1 proteins and in PBMC, infected with HIV-1. Increased mtDNA damage can lead to neurodegeneration, and cause neuronal apoptosis. Our system presents a suitable model to study mtDNA changes during HIV-1 infection.
Introduction: Novel plant DING proteins (full-length 38 kDa p38SJ, and 27 kDa p27SJ) exhibit phosphatase activity and modulate HIV-1 gene transcription. Previously, we demonstrated that DING regulates HIV-1 gene transcription by dephosphorylation and inactivation of CTD RNA polymerase II, the major elongating factor of HIV-1 Long Terminal Repeats (LTR). Because the transcription of HIV-1 is controlled by several viral and cellular factors, including p65/p50 subunits of NF-κB, we hypothesized that DING phosphatase can also affect the phosphorylation and activity of p65 NF-κB, in addition to C-terminal Domain (CTD) of RNA Polymerase II (RNAPII), to suppress HIV-1 gene transcription and inhibit HIV-1 infection. Methods: Here, we describe the inhibition of HIV-1 infection and the p65/p50 NF-κB phosphorylation by DING protein, analyzed by ELISA and northern-blot assays, western-blot assays, cell fractionation, and promoter-reporter assays in DING-expressing cells, using a pTet-on inducible system. Results: Results from HIV-1 infection assays demonstrate a strong inhibition of HIV-1 and HIV-LTR RNA expression by DING protein, determined by p24 ELISA and by northern blot assay. Results from the western blot assays and cell fractionation assays show that there is an increase in the level of hypo-phosphorylated form of p65 NF-κB in DING-expressing cells. Both fractions of p65/p50, nuclear or cytoplasmic, are affected by DING phosphatase, but more cytoplasmic accumulation of p65 NF-κB was found in the presence of DING, suggesting that subsequent activation and nuclear import of active NF-κB is affected by DING. The major portion of nuclear p65 was dephosphorylated in DING-expressing cells. The promoter-reporter assay demonstrated that DING-mediated dephosphorylation and dysregulation of NF-κB p65 lead to the suppression of its binding to HIV-1 LTR, and resulted in the inhibition of p65-mediated activation of LTR transcription. Mapping of the region within LTR that was affected by DING revealed that both, NF-κB and CTD RNA Polymerase II binding sites were important, and cooperativity of these cellular factors was diminished by DING. In addition, mapping of the region within DING-p38SJ that affected LTR transcription, revealed that phosphate-binding domain is essential for this inhibitory activity. Conclusion: We have demonstrated the effect of DING phosphatases on HIV-1 infection, phosphorylation of p65 NF-κB, and transcription of HIV-1 LTR. Our studies suggest that one possible mechanism by which DING can regulate the expression of HIV-1 LTR can be through dysregulation of the transcription factor NF-κB p65 by preventing its phosphorylation and translocation to the nucleus and binding to the HIV-1 LTR, an action that could contribute to the utility of DING p38SJ as an antiviral agent. Importantly, DING not only inhibits HIV-1 LTR gene transcription in the presence of increased p65 NF-κB, but also suppresses HIV-1 infection. DING protein improved inhibitory effects of the known anti-retroviral drugs, Tenofovir (TFV) and Emtricitabine (FTS) on HIV-1, since in the combination with these drugs; the suppression of HIV-1 by DNG was significantly higher when it was in combination with these drugs, compared to controls or cases without DING. Thus, our data support the use of neuroprotective DING proteins as novel therapeutic antiviral drugs that suppress HIV-1 LTR transcription by interfering with the function of NF-κB.
Objective: Metabolic disturbances such as dyslipidemia and liver enzymes changes may be associated with the risk for developing cardiac disorder as well as liver toxicity in PLWH having HAART. This study investigated the biological pattern of PLWH on effective antiretroviral therapy in the Democratic Republic of Congo.
Aim: Since the early 1980s, sexual risk behaviors have become a severe public health concern in preventing the prevalence of HIV infection, especially among minority young adults. In the United States, minority young adults have higher than expected HIV infection than other racial groups. The spread of HIV infection among this vulnerable population has created a need to identify risk and protective factors, disease, and evidence-based prevention strategies to reduce disease transmission. The Comprehensive, Integrated HIV Prevention Program (CIHPP), is based on a derivative of the ecological epistemology framework that views risk factors as a multilevel concentric, including the individual, family, community, and societal levels. The framework asserts that any meaningful prevention strategy should examine these different levels and the effects on the population of interest. This study aims to assess the effectiveness of CIHPP in increasing sexual risk practice and reducing risky sexual behavior among minority young adults.
Background: Human Immunodeficiency Virus (HIV) infection may alter antibody responses against periodontopathic bacteria, increasing the susceptibility for gingival and periodontal disorders in HIV-infected individuals. We describe the oral health of HIV-infected individuals receiving stable Antiretroviral Therapy (ART) and determine their association with serum anti-periodontopathic bacteria antibody level.
