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HIV Test

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55501. HIV drug resistance acquired through superinfection. (Abstract)

HIV drug resistance acquired through superinfection. HIV interclade B superinfection has previously been described in individuals initially infected with drug resistant virus who then become superinfected by a drug susceptible strain. We report an individual initially infected with a drug-sensitive clade B strain of HIV who was superinfected with another clade B strain resistant to two classes of antiretroviral drugs.To differentiate superinfection from possible co-infection we applied three (...) with a decrease of 150 x CD4 T cells/mul over the next 6 months. The greater in vivo fitness of the second virus was not supported by the replication capacity assay. Furthermore, superinfection negatively impacted this individual's treatment course. It was not known that he had acquired a drug resistant strain before entering a treatment study, and he had an incomplete response to therapy most likely because the superinfecting viral strain had a decreased susceptibility to two of the prescribed

2005 AIDS

55502. Effectiveness of a city-wide program to prevent mother-to-child HIV transmission in Lusaka, Zambia. Full Text available with Trip Pro

facility in Lusaka were included in the study. The main outcome measure was population NVP coverage, defined as the proportion of HIV-infected women and HIV-exposed infants in the population that ingested NVP.Of 8787 women in the surveillance population, 7204 (82%) had been offered antenatal HIV testing, of which 5149 (71%) had accepted, and of which 5129 (99%) had received a result. Overall, 2257 of 8787 (26%) were cord seropositive. Of the 1246 (55%) cord blood seropositive women who received (...) an antenatal HIV test result, 1112 (89%) received a positive result; the other 134 comprise seroconverters and clerical errors. Only 751 of 1112 (68%) women who received a positive antenatal test result and a NVP tablet for ingestion at labor onset had NVP detected in the cord blood (i.e., maternal non-adherence rate was 32%). A total of 675 infants born to 751 adherent mothers (90%) received NVP before discharge. Thus, only 675 of 2257 (30%) seropositive mother-infant pairs in the surveillance population

2005 AIDS

55503. Anal intraepithelial neoplasia in the highly active antiretroviral therapy era among HIV-positive men who have sex with men. (Abstract)

was introduced. We characterized the prevalence of AIN among HIV-positive MSM and examined the association between AIN and various factors including use of HAART.A baseline point-prevalence analyses in a prospective cohort study of AIN was performed at a university-based research clinic. A total of 357 HIV-positive MSM with no history of anal cancer completed a questionnaire detailing behaviors and medical history, anal cytology and human papillomavirus (HPV) testing, and high-resolution anoscopy with biopsy (...) Anal intraepithelial neoplasia in the highly active antiretroviral therapy era among HIV-positive men who have sex with men. The incidence of anal cancer among men who have sex with men (MSM) has continued to increase since the introduction of highly active antiretroviral therapy (HAART). The prevalence of the putative anal cancer precursor, anal intraepithelial neoplasia (AIN) was high among HIV-positive MSM prior to the availability of HAART but little is known about AIN since HAART

2005 AIDS

55504. Amphetamine use is associated with increased HIV incidence among men who have sex with men in San Francisco. (Abstract)

Amphetamine use is associated with increased HIV incidence among men who have sex with men in San Francisco. We examined the association between amphetamine use and HIV incidence for 2991 men who have sex with men (MSM) who tested anonymously for HIV in San Francisco. HIV incidence among 290 amphetamine users was 6.3% per year (95% CI 1.9-10.6%), compared with 2.1% per year (95% CI 1.3-2.9%) among 2701 non-users (RR 3.0, 95% CI 1.4-6.5). HIV prevention programmes in San Francisco should include

2005 AIDS

55505. Increased HIV incidence among men who have sex with men in Rome. (Abstract)

Increased HIV incidence among men who have sex with men in Rome. Among 976 men who have sex with men (MSM) who had undergone repeat HIV testing between 1984 and 2003 at a sexually transmitted infection clinic in Rome, Italy, we observed a dramatic increase in HIV incidence in 2002 and 2003, with the cumulative incidence for 2000-2003 being twice as high as that for 1984-1995, and significantly higher than that for 1996-1999. This trend suggests the need for interventions aimed at encouraging

2005 AIDS

55506. Effect of HIV on work-related injury rates in South African gold miners. (Abstract)

the rate of work-related injuries overall (adjusted rate ratio, 1.3; 95% confidence interval, 1.1-1.4), but had less effect on severe injuries. Injury rates in HIV-positive men prior to the first positive test were similar to those in HIV-negative men. The injury rate rose soon after the first HIV positive test. After seroconversion there was only weak evidence of an increase in injury rates by duration of infection.This is the first study to demonstrate an increase in injury rates in HIV-positive (...) Effect of HIV on work-related injury rates in South African gold miners. Work-related injuries have severe, well-documented economic and social impacts, and injury is a leading cause of death in working adults. As adults of working age are one of the groups most affected by the HIV epidemic, the interaction between work-related injuries and HIV is important. The objective was to calculate the effect of HIV on the rate and severity of work-related injuries by duration of infection.A large

2005 AIDS

55507. Indirubin-3'-monoxime, a derivative of a Chinese antileukemia medicine, inhibits P-TEFb function and HIV-1 replication. (Abstract)

and RT-PCR analysis of viral transcripts. The antiviral effect of IM was investigated in cells from HIV-1 infected individuals as well as in cell lines, primary lymphocytes and monocyte-derived macrophages. The antiviral activity of IM was also tested against drug-resistant HIV-1.IM inhibits the kinase activity of CDK9 [50% inhibitory concentration (IC50) of 0.05 microM], the catalytic subunit of Positive transcription elongation factor b (P-TEFb). Inhibition of CDK9 activity by IM results (...) Indirubin-3'-monoxime, a derivative of a Chinese antileukemia medicine, inhibits P-TEFb function and HIV-1 replication. To evaluate the effects of the cyclin dependent kinase (CDK) inhibitor Indirubin-3'-monoxime (IM) on Tat-mediated transactivation function, a step of the HIV-1 cycle that is not currently targeted in antiviral therapy.The effects of IM on CDK implicated in HIV-1 Tat transactivation function were evaluated by kinase assays, transfection experiments, RNase protection assay

2005 AIDS

55508. Determinants of HIV drug resistance mutations in plasma virus after treatment interruption. (Abstract)

Determinants of HIV drug resistance mutations in plasma virus after treatment interruption. This study examines the utility of resistance testing during treatment interruption, making comparisons with the current IAS guidelines. A total of 188/1279 tests (14%) were performed during treatment interruption; 69/188 tests (36.7%) demonstrated key mutations. Time off therapy and the total number of previous drugs were both significantly associated with the presence of mutations. We conclude (...) that resistance testing is of value up to 3 months after treatment interruption, and may convey some benefit up to 12 months.

2005 AIDS

55509. Early induction of leukemia inhibitor factor (LIF) in acute HIV-1 infection. (Abstract)

who did not achieve a similar control (> 9000 HIV-1 RNA copies/ml plasma) of HIV-1 replication.Consecutively obtained HIV plasma samples were collected from primary HIV-1 infected subjects. A group of acutely Epstein-Barr virus-infected subjects and a group of HIV-1-seronegative healthy individuals served as controls. All samples were tested by ELISA for LIF and sgp130, the soluble form of LIF's signalling receptor.LIF and sgp130 plasma levels were significantly increased in primary HIV-1-infected (...) Early induction of leukemia inhibitor factor (LIF) in acute HIV-1 infection. Leukemia inhibitor factor (LIF) is thought to play a substantial role in protecting CD4 T cells in lymphoid tissues (LT) from infection by HIV-1.To investigate whether primary HIV-1 infected subjects with sustained virological control (< 1000 HIV-1 RNA copies/ml plasma) post-cessation antiretroviral therapy (ART) had a higher initial LIF response during primary HIV-1 infection (PHI) as compared with those individuals

2006 AIDS

55510. The impact of transmitted drug resistance on the natural history of HIV infection and response to first-line therapy. (Abstract)

The impact of transmitted drug resistance on the natural history of HIV infection and response to first-line therapy. Transmission of drug-resistant HIV-1 is well recognized. However, the impact of such transmission on natural history of infection remains unknown.Three hundred HIV-1-infected, antiretroviral-naive individuals, recruited between 1987 and 1993, and with resistance tests undertaken within 18 months of infection were assessed. We estimated the impact of transmitted drug resistance (...) (TDR) on subsequent CD4 cell count decline in the absence of treatment. We also used Kaplan-Meier methods to assess the response to antiretroviral therapy based on the number of active drugs utilized (according to genotypic resistance results).Infection with any form of drug-resistant HIV-1 was associated with a steeper decline of CD4 cell count over the first year of infection. Estimated rates of decline in the first year were 5.0 [95% confidence interval (CI), 2.8-7.3] and 1.7 (95% CI, 0.8-2.6

2006 AIDS

55511. Changes in sexual behavior and risk of HIV transmission after antiretroviral therapy and prevention interventions in rural Uganda. (Abstract)

-infected adults were enrolled and followed in a home-based ART program that included prevention counselling, voluntary counseling and testing (VCT) for cohabitating partners and condom provision. At baseline and follow-up, participants' HIV plasma viral load and partner-specific sexual behaviors were assessed. Risky sex was defined as inconsistent or no condom use with partners of HIV-negative or unknown serostatus in the previous 3 months. The rates of risky sex were compared using a Poisson (...) Changes in sexual behavior and risk of HIV transmission after antiretroviral therapy and prevention interventions in rural Uganda. The impact of antiretroviral therapy (ART) on sexual risk behavior and HIV transmission among HIV-infected persons in Africa is unknown.To assess changes in risky sexual behavior and estimated HIV transmission from HIV-infected adults after 6 months of ART.A prospective cohort study was performed in rural Uganda. Between May 2003 and December 2004 a total of 926 HIV

2006 AIDS

55512. No benefit of a structured treatment interruption based on genotypic resistance in heavily pretreated HIV-infected patients. (Abstract)

No benefit of a structured treatment interruption based on genotypic resistance in heavily pretreated HIV-infected patients. To evaluate the potential benefits of a tailored antiretroviral treatment interruption with duration based on the observed reversion of resistance mutations.In this open single-arm pilot study, 23 patients with multiple treatment failure interrupted therapy and underwent longitudinal genotypic resistance testing. Salvage gigatherapy was started when resistance mutations (...) to at least two antiretroviral drug classes reverted. The primary endpoint was a fall in viral load by > 1 log10 copies/ml after 12 weeks of salvage therapy.Baseline median viral load was 5.14 log copies/ml and CD4 cell count 43 x 10 cells/l. Genotypic resistance testing showed a median of six, two and nine resistance mutations to nucleoside analogue reverse transcriptase inhibitors, non-nucleoside analogue reverse transcriptase inhibitors and protease inhibitors, respectively; viral strains were

2005 AIDS

55513. Neuropsychological functioning in a cohort of HIV- and hepatitis C virus-infected women. (Abstract)

Neuropsychological functioning in a cohort of HIV- and hepatitis C virus-infected women. To evaluate the neurocognitive function in 220 women enrolled in the Women's Interagency HIV Study (WIHS), a study of disease progression in women living with HIV/AIDS and in HIV-negative controls.We evaluated the prevalence of abnormal neuropsychological (NP) results in hepatitis C virus (HCV)-positive compared with HCV-negative women in combination with HIV serostatus.NP impairment was significantly (...) abnormalities in HCV-infected patients was only slightly reduced (ORs above 1.9). After testing for an interaction between age and infection status, we conducted age-stratified analysis and showed a significant effect of infection status for those aged under 40 years.The effect of aging on co-infected populations will require further study. This study has demonstrated the association of HCV with the risk of neurocognitive impairment in women living with HIV/AIDS and suggests that co-infection has

2005 AIDS

55514. The incidence and prevalence of orphanhood associated with parental HIV infection: a population-based study in Rakai, Uganda. (Abstract)

in Rakai District, Uganda. Census data were collected on all resident members in 10,657 households, including survival of parents of resident children in 1996/1997. Consenting adults were interviewed, provided blood for HIV testing, and were followed up 10 months later to determine parental death and incident orphanhood. The incidence rate ratio (IRR) of orphanhood associated with parental HIV-infection was estimated by Poisson multivariate regression.A total of 22,712 children aged 0-14 years were (...) The incidence and prevalence of orphanhood associated with parental HIV infection: a population-based study in Rakai, Uganda. There are limited empirical data on the prevalence and incidence of orphanhood due to parental HIV infection.To assess the prevalence and incidence of orphanhood, and the population attributable fraction (PAF) of incident orphanhood associated with parental HIV infection, in a rural population with a 14.8% adult HIV prevalence.The data are derived from a community cohort

2005 AIDS

55515. Evaluation of the anti-HIV activity of statins. (Abstract)

Evaluation of the anti-HIV activity of statins. Recent data suggest that statins block HIV-1 replication, which may have important implications for an alternative treatment for AIDS. We tested different statins in cell culture against HIV and conducted a pilot study in HIV-positive patients receiving simvastatin. No anti-HIV activity was detected at subtoxic concentrations and simvastatin did not induce a significant change in the mean viral load or CD4 cell count in study patients. We caution

2005 AIDS

55516. The potential impact of enhanced diagnostic techniques for tuberculosis driven by HIV: a mathematical model. Full Text available with Trip Pro

The potential impact of enhanced diagnostic techniques for tuberculosis driven by HIV: a mathematical model. To explore the potential impact of enhanced tuberculosis (TB) diagnostic techniques as a TB control strategy in an adult population with high HIV prevalence.A compartmental difference-equation model of TB/HIV was developed using parameter estimates from the literature.The impact of five TB control interventions (rapid molecular testing, mycobacterial culture, community-wide and HIV (...) -targeted active case finding, and highly active antiretroviral therapy) on TB incidence, prevalence, and mortality was modeled in a steady-state population with an HIV prevalence of 17% and annual TB incidence of 409 per 100 000. Sensitivity analyses assessed the influence of each model parameter on the interventions' mortality impact.Enhanced diagnostic techniques (rapid molecular testing or culture) are each projected to reduce TB prevalence and mortality by 20% or more, an impact similar

2006 AIDS

55517. Advanced immunosuppression at entry to HIV care in the southeastern United States and associated risk factors. (Abstract)

indicate an urgent need to increase HIV testing for earlier diagnosis in the southeastern USA. (...) Advanced immunosuppression at entry to HIV care in the southeastern United States and associated risk factors. In this study we characterized factors associated with the late initiation of HIV care in the southeastern United States. At initiation of care, antiretroviral therapy was indicated for 75% of patients, 50% had a CD4 cell count of less than 200 cells/mul, and 27% presented with an AIDS-defining illness. Male sex was an independent predictor in multivariable analysis. These results

2006 AIDS

55518. The effects of hepatitis C, HIV, and methamphetamine dependence on neuropsychological performance: biological correlates of disease. (Abstract)

The effects of hepatitis C, HIV, and methamphetamine dependence on neuropsychological performance: biological correlates of disease. To determine the effects of hepatitis C virus (HCV) infection on neuropsychological (NP) performance.Cross-sectional analysis of a prospectively enrolled cohort.A total of 239 HIV-seropositive and 287 HIV-seronegative subjects enrolled in prospective cohort studies at a single center. Subjects underwent standardized assessments, including comprehensive (...) neuropsychological testing, substance use inventory neuromedical examination, venipuncture, and lumbar puncture. HCV antibody was measured in serum. In seropositive individuals, HCV RNA was measured in plasma and cerebrospinal fluid (CSF).HCV-seropositive subjects performed worse on neuropsychological testing and were almost twice as likely to be diagnosed as globally impaired, compared with those who were HCV seronegative. In a multivariate analysis, HCV, HIV, and methamphetamine dependence were independently

2005 AIDS

55519. Primary HIV-1 infection sets the stage for important B lymphocyte dysfunctions. (Abstract)

cell activation at diagnosis of PHI was shown in five patients tested. These parameters normalized after 6 months of therapy.B cell dysfunctions found in chronic HIV-1 infection appear during PHI and initiation of antiretroviral therapy early during infection may help to preserve the B cell compartment. (...) Primary HIV-1 infection sets the stage for important B lymphocyte dysfunctions. To investigate the effects of primary HIV-1 infection (PHI) and of two antiretroviral therapies [highly active antiretroviral therapy (HAART) or reverse transcriptase inhibitors (RTI)] on activation, differentiation and survival of B cells.Naive and memory B cells from three groups [PHI (31), chronic infection (26) and healthy donors (12)] were studied for surface expression of Fas, LAIR-1, CD70, intracellular

2005 AIDS

55520. GB virus C and HIV-1 RNA load in single virus and co-infected West African individuals. (Abstract)

GB virus C and HIV-1 RNA load in single virus and co-infected West African individuals. Investigations on the impact of GB virus C (GBV-C) co-infection on HIV disease progression relied essentially on clinical follow-up but not on virologic parameters.To detect and quantify GBV-C RNA in West African populations co-infected or not with HIV-1 and to correlate the RNA load of HIV-1 and GBV-C in co-replicating patients with different clinical conditions.Three Ghanaian populations (blood donors (...) , pregnant women and HIV-infected patients) were subdivided into six groups according to HIV-1 and clinical status and GBV-C and HIV-1 RNA load was tested by quantitative real time reverse transcriptase-polymerase chain reaction. In one population with HIV-1 disease, CD4+ cell count was also measured.Prevalence of GBV-C markers in HIV-1-infected groups and HIV-1 non-infected pregnant women were significantly higher than in healthy blood donors. Similar levels and distribution of GBV-C RNA load were found

2006 AIDS

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