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HIV Test

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55521. Identification of accessory mutations associated with high-level resistance in HIV-1 reverse transcriptase. (Abstract)

Identification of accessory mutations associated with high-level resistance in HIV-1 reverse transcriptase. To identify accessory mutations associated with high levels of resistance to reverse transcriptase inhibitors (RTI).HIV pol sequences from routine resistance tests from over 3000 patients who were treatment experienced and infected with subtype B HIV-1 were analysed. Changes relative to the wild-type amino acid for codons 1-400 of reverse transcriptase were determined in two series: (i

2007 AIDS

55522. Executive summary and recommendations from the WHO/UNAIDS/IAVI expert group consultation on 'Phase IIB-TOC trials as a novel strategy for evaluation of preventive HIV vaccines', 31 January-2 February 2006, IAVI, New York, USA. (Abstract)

Vaccine Initiative. The consultation discussed issues related to the design and implementation of phase IIB 'test of concept' trials (phase IIB-TOC), also referred to as 'proof of concept' trials, in evaluating candidate HIV vaccines and their implications for future approval and licensure. The results of a single phase IIB-TOC trial would not be expected to provide sufficient evidence of safety or efficacy required for licensure. In many instances, phase IIB-TOC trials may be undertaken relatively (...) Executive summary and recommendations from the WHO/UNAIDS/IAVI expert group consultation on 'Phase IIB-TOC trials as a novel strategy for evaluation of preventive HIV vaccines', 31 January-2 February 2006, IAVI, New York, USA. This report summarizes the discussions and recommendations from a consultation held in New York City, USA (31 January-2 February 2006) organized by the joint World Health Organization-United Nations Programme on HIV/AIDS HIV Vaccine Initiative and the International AIDS

2007 AIDS

55523. Is the increased risk of liver enzyme elevation in patients co-infected with HIV and hepatitis virus greater in those taking antiretroviral therapy? (Abstract)

Is the increased risk of liver enzyme elevation in patients co-infected with HIV and hepatitis virus greater in those taking antiretroviral therapy? To investigate if the risk of liver enzyme elevation (LEE) in HIV/hepatitis B or C (HBV, HCV) co-infection is altered by HAART (two or more drugs).Analysis comprised HIV-positive patients in the ICoNA study without acute hepatitis who had >or= 1 positive HCV antibody test and > 1 positive HBV surface antigen test. LEE was defined as > 5x baseline (...) [adjusted relative risk (RR), 1.19; 95% confidence interval (CI), 0.81-1.75; P = 0.37]. Co-infection increased the risk of LEE (adjusted RR, 5.07; 95% CI, 3.47-7.48; P < 0.001), with no significant differences if taking HAART (adjusted RR, 4.99; 95% CI, 3.38-7.37) or not (adjusted RR, 6.02; 95% CI, 2.02-17.98) (P = 0.74 for interaction). Females were at lower risk of LEE than males (adjusted RR, 0.59; 95% CI, 0.42-0.83; P = 0.02).HIV and HBV/HCV co-infection per se is associated with increased risk

2007 AIDS

55524. Hepatitis C virus infection is associated with insulin resistance among older adults with or at risk of HIV infection. Full Text available with Trip Pro

Hepatitis C virus infection is associated with insulin resistance among older adults with or at risk of HIV infection. To determine the associations of hepatitis C virus (HCV) infection with insulin resistance and abnormal glucose tolerance in a cohort of older adults with or at risk of HIV infection.A cross-sectional study of 267 HIV-infected and 179 at-risk-uninfected adults without a history of diabetes mellitus.HCV antibody assays and RNA levels were performed to assess HCV status (...) . Antiretroviral use, family history of diabetes, sedentary behavior, and sociodemographic data were obtained using standardized interviews. Fasting insulin levels and oral glucose tolerance tests were performed to assess two outcomes, the homeostasis model assessment of insulin resistance and abnormal glucose tolerance [impaired glucose tolerance (IGT) or diabetes].Of 446 participants, 265 (59%) were HCV seropositive; of these, 199 (75%) had detectable HCV-RNA levels. Insulin resistance was greater among HCV

2007 AIDS

55525. Survival from HIV-1 seroconversion in Southern Africa: a retrospective cohort study in nearly 2000 gold-miners over 10 years of follow-up. (Abstract)

Survival from HIV-1 seroconversion in Southern Africa: a retrospective cohort study in nearly 2000 gold-miners over 10 years of follow-up. To obtain robust estimates of survival with HIV in individuals with known dates of seroconversion in Africa in the pre-antiretroviral era.Mortality rates were estimated in men from four South African gold mines in a retrospective cohort study with 10-year follow-up. HIV testing was carried out with counselling and consent, in random surveys in the early (...) 1990s and in clinics. A total of 1950 HIV-positive men with seroconversion intervals < 3 years were compared with 6164 HIV-negative men with no subsequent evidence of HIV. Unique industry numbers were used to link medical records to demographic and occupational information. Follow-up after leaving the mine was conducted through employment offices across southern Africa, and using South African death registration data.Follow-up was complete for 85% of those who seroconverted. Median survival was 10.5

2007 AIDS

55526. Evolution of drug resistance in HIV-infected patients remaining on a virologically failing combination antiretroviral therapy regimen. (Abstract)

Evolution of drug resistance in HIV-infected patients remaining on a virologically failing combination antiretroviral therapy regimen. To estimate the extent of drug resistance accumulation in patients kept on a virologically failing regimen and its determinants in the clinical setting.The study focused on 110 patients of EuroSIDA on an unchanged regimen who had two genotypic tests performed at two time points (t0 and t1) when viral load was > 400 copies/ml.Accumulation of resistance between t0

2007 AIDS

55527. Prevalence and determinants of HIV infection in South India: a heterogeneous, rural epidemic. (Abstract)

collection and testing for HIV, syphilis, and herpes simplex virus type 2 (HSV-2) on a 25% sub-sample.HIV prevalence was 2.9% overall, 2.4% in urban areas and 3.6% in rural areas [odds ratio (OR), 0.65; 95% confidence interval (CI), 0.45-0.95]. Significant differences in HIV prevalence were seen between the three sub-districts, with prevalences of 1.1, 3.0 and 6.4% (P < 0.05), and HIV prevalence in the 10 villages ranged from 0 to 8.2%. Reported multiple sexual partners, receiving money for sex (...) Prevalence and determinants of HIV infection in South India: a heterogeneous, rural epidemic. To assess the prevalence and determinants of HIV infection in the general population in Bagalkot district, a largely rural district in the southern Indian state of Karnataka.Approximately 6700 individuals aged 15-49 years were randomly sampled from 10 villages and six towns, from three of Bagalkot's six sub-districts. Each consenting respondent was administered a questionnaire, followed by blood

2007 AIDS

55528. Arginine methylation of the HIV-1 nucleocapsid protein results in its diminished function. (Abstract)

Arginine methylation of the HIV-1 nucleocapsid protein results in its diminished function. The HIV-1 nucleocapsid protein (NC) is involved in transfer RNA3 annealing to the primer binding site of viral genomic RNA by means of two basic regions that are similar to the N-terminal portion of the arginine-rich motif (ARM) of Tat. As Tat is known to be asymmetrically arginine dimethylated by protein arginine methyltransferase 6 (PRMT6) in its ARM, we investigated whether NC could also act (...) as a substrate for this enzyme.Arginine methylation of NC was demonstrated in vitro and in vivo, and sites of methylation were determined by mutational analysis. The impact of the arginine methylation of NC was measured in RNA annealing and reverse transcription initiation assays. An arginine methyltransferase inhibitor (AMI)3.4 was tested for its effects on viral infectivity and replication in vivo.NC is a substrate for PRMT6 both in vitro and in vivo. NC possesses arginine dimethylation sites in each

2007 AIDS

55529. Prevalence of the HIV-1 protease mutation I47A in clinical practice and association with lopinavir resistance. (Abstract)

Prevalence of the HIV-1 protease mutation I47A in clinical practice and association with lopinavir resistance. Mutation proI47A has recently been associated with lopinavir/ritonavir (LPV/r) resistance. Only four out of 1859 specimens (0.2%) sent for drug resistance testing (219 drug-naive and 1650 antiretroviral-experienced) showed I47A. All belonged to patients failing LPV/r. The prevalence among protease inhibitor-experienced patients was 0.6%. Phenotypic testing showed that proI47A caused

2006 AIDS

55530. Potential for HIV transmission through unsafe injections. (Abstract)

Potential for HIV transmission through unsafe injections. We tested for HIV in discarded needles and syringe washes from 191 HIV-infected patients receiving injections in rural Cameroon. HIV-1 RNA was amplified from 34 of 103 intravenous injection syringes and two of 88 intramuscular injection syringes. All 36 strains were HIV-1 group M. The majority belonged to the circulating recombinant form CRF02 (IbNg). Our data support a role for unsafe injections in the spread of HIV-1 in Africa

2006 AIDS

55531. Immunosuppression and GB virus C-RNA detection among HIV-infected patients in Cambodia. Full Text available with Trip Pro

Immunosuppression and GB virus C-RNA detection among HIV-infected patients in Cambodia. In this survey, 213 patients in an antiretroviral treatment programme in Phnom Penh, Cambodia, were tested for GB virus C (GBV-C) RNA before treatment initiation. Most had advanced HIV infection, only 34 having CD4 cell counts > 200 cells/microl. GBV-C-RNA was detected in 35 patients. The proportion with positive GBV-C-RNA decreased dramatically with CD4 cell counts < 100 cells/microl. In multivariate

2006 AIDS

55532. The efficiency of R5 HIV-1 infection is determined by CD4 T-cell surface CCR5 density through G alpha i-protein signalling. (Abstract)

The efficiency of R5 HIV-1 infection is determined by CD4 T-cell surface CCR5 density through G alpha i-protein signalling. The intensity of replication of CCR5-using HIV-1 strains is highly dependent on the number of CCR5 molecules on the surface of CD4-positive T cells. The molecular mechanisms responsible for this phenomenon remained so far unclear. As CCR5 co-receptors are coupled to G alpha i and G alpha q proteins, we tested the hypothesis that the activation triggered through (...) these proteins secondary to the interaction between the viral envelope and CCR5 could account for the effect of the level of CCR5 expression on HIV-1 production.We transduced the wild-type or a G-protein signalling-defective CCR5 gene into CD4/CCR5 HOS cells and peripheral blood mononuclear cells. The effect on cell activation in presence of a CCR5-binding chemokine and on HIV infection was monitored by measuring calcium mobilization and p24 antigen production, respectively. The role of G alpha i protein

2006 AIDS

55533. Grey nails predict low CD4 cell count among untreated patients with HIV infection in Malawi. (Abstract)

Grey nails predict low CD4 cell count among untreated patients with HIV infection in Malawi. Alternative criteria for initiating antiretroviral therapy to CD4 testing or clinical illness are needed in Malawi.We tested if grey nails could be used to identify patients with a CD4 cell count less than 200 cells/microl who had not yet presented with AIDS-defining illnesses.Using a set of 242 photographs we showed good inter-observer agreement for grey nails (kappa = 0.66; P < 0.0001 (...) ) and the positive predictive value of grey nails for a CD4 cell count of less than 200 cells/microl was 81% (chi < 0.0001).Grey nails have been associated with HIV infection and we have shown significant correlation of this sign with a low CD4 cell count. For clinicians working in sub-Saharan Africa without access to CD4 cell count testing, grey or DB nails represent an additional staging sign to help identify a sub-group of patients likely to benefit from ART.

2006 AIDS

55534. Co-infection with HIV and hepatitis C virus in former plasma/blood donors: challenge for patient care in rural China. Full Text available with Trip Pro

Co-infection with HIV and hepatitis C virus in former plasma/blood donors: challenge for patient care in rural China. Illegal commercial plasma donation in the late 1980s and early 1990s caused blood-borne infections in China.To estimate the prevalence of HIV and hepatitis C virus (HCV) infections and to identify associated risk factors in central China with a history of illegal plasma collection activities.A cross-sectional study was carried out in 2004, in which all adult residents in four (...) villages in rural Shanxi Province were invited for a questionnaire interview and testing of HIV and HCV antibodies.Of 3062 participating villagers, 29.5% reported a history of selling whole blood or plasma. HIV seropositivity was confirmed in 1.3% of subjects and 12.7% were HCV positive. Their co-infection rates were 1.1% among all study subjects, 85% among HIV-positive subjects, and 8.7% among HCV-positive subjects. Selling plasma [odds ratio (OR), 22.5; 95% confidence interval (CI), 16.1-31.7; P

2006 AIDS

55535. Assessment of automated genotyping protocols as tools for surveillance of HIV-1 genetic diversity. Full Text available with Trip Pro

Assessment of automated genotyping protocols as tools for surveillance of HIV-1 genetic diversity. The routine use of drug resistance testing provides an abundant source of HIV-1 sequence data. However, it is not clear how reliable standard genotyping of these sequences is for describing HIV-1 genetic variation and for detecting novel genetic variants and epidemiological trends.To compare assignment of HIV-1 resistance test sequences to reference strains across commonly used genotyping (...) protocols.Subtype assignments were compared across three standard genotyping protocols for 10 537 resistance test sequences, representing approximately one-fifth of all reported infections in the United Kingdom. Sequences that were inconsistently genotyped across methods, or that were unassigned by at least one method, were examined for evidence of recombination using sliding-window-based approaches.Although agreement across methods was high for subtypes B, C and H, it was generally much lower (< 50%) for other

2006 AIDS

55536. Cohort- and time-specific associations of CTLA4 genotypes with HIV-1 disease progression. (Abstract)

) from another cohort (REACH) of mixed ethnicity. Single nucleotide polymorphisms in CTLA4 promoter (-1147C/T, -658C/T, -318C/T), coding sequence (49A/G) and the 3' untranslated region (CT60A/G) were resolved by PCR-based techniques. Repeated measures and survival analyses were used to test allelic and haplotypic associations with HIV-1 viral load (VL) and time to AIDS, respectively.Individuals carrying -318T or the (-1147) T-(-318) T haplotype had elevated HIV-1 VL in MACS and REACH but reduced VL (...) Cohort- and time-specific associations of CTLA4 genotypes with HIV-1 disease progression. CTLA4 in the chromosome 2q33 region encodes cytotoxic T-lymphocyte (CTL) associated antigen 4, which downregulates CTL responses. We examined the relationships between common CTLA4 variants and several outcomes of HIV-1 infection in adults and adolescents.We studied 765 HIV-1-infected persons: 558 Caucasian seroconverters from three cohorts (MACS, ACS, and DCG) and 207 infected adolescents (mostly female

2006 AIDS

55537. Routine surveillance for the detection of acute and recent HIV infections and transmission of antiretroviral resistance. Full Text available with Trip Pro

Routine surveillance for the detection of acute and recent HIV infections and transmission of antiretroviral resistance. To estimate the rate of acute and recent HIV infections and the prevalence of primary antiretroviral resistance.A consecutive sample of individuals presenting for HIV testing at the San Francisco municipal sexually transmitted diseased (STD) clinic in 2004 (n = 3789).HIV antibody-positive specimens were screened by BED IgG capture enzyme immunoassay to identify recent (...) infections. HIV antibody-negative specimens were screened by nucleic acid amplification testing (NAAT) to detect acute infections. Newly detected infections were genotyped to detect primary antiretroviral resistance.There were 11 acute and 44 recent HIV infections among the total 136 newly detected cases. NAAT increased case identification by 8.08% over standard antibody testing. Acute HIV infections were associated with having a known HIV-positive partner, and a history of hepatitis B, syphilis

2006 AIDS

55538. Population-based surveillance for cryptococcosis in an antiretroviral-naive South African province with a high HIV seroprevalence. (Abstract)

cryptococcal latex agglutination test or a positive histopathology specimen from a Gauteng resident. Cases were identified prospectively at all laboratories in Gauteng. Case report forms were completed using medical record review and patient interview where possible.Between 1 March 2002 and 29 February 2004, 2753 incident cases were identified. The overall incidence rate was 15.6/100 000. Among HIV-infected persons, the rate was 95/100 000, and among persons living with AIDS 14/1000. Males and children (...) Population-based surveillance for cryptococcosis in an antiretroviral-naive South African province with a high HIV seroprevalence. To measure the burden of disease and describe the epidemiology of cryptococcosis in Gauteng Province, South Africa.The study was an active, prospective, laboratory-based, population-based surveillance. An incident case of cryptococcosis was defined as the first isolation by culture of any Cryptococcus species from any clinical specimen, a positive India ink

2006 AIDS

55539. Predictors of HIV sero-status among drug injectors at three Ukraine sites. (Abstract)

Predictors of HIV sero-status among drug injectors at three Ukraine sites. To assess the HIV serostatus of injection drug users (IDU) in Ukraine, as well as associations between serostatus and selected demographic and risk factors.IDU were recruited from the streets in Kiev, Odessa and Makeevka/Donesk. Participants were interviewed using an HIV risk behavior assessment and tested for HIV with a finger-stick rapid test. Multiple logistic regression was used to identify determinants of HIV (...) infection.Of the 891 IDUs surveyed, one-third came from each site and 22% were female. Their mean age was 29 years and on average they had been injecting for slightly more than 10 years. Seven hundred and seventy-eight of the total sample did not know their HIV status when first interviewed; they are the participants in this investigation. Overall, 33% tested positive for HIV, including 34% in Kiev, 51% in Odessa and 17% in Makeevka/Donesk. Independent predictors of HIV included injecting a sedative/opiate

2006 AIDS

55540. Persistence of a sexually transmitted highly resistant HIV-1: pol quasispecies evolution over 33 months in the absence of treatment. (Abstract)

Persistence of a sexually transmitted highly resistant HIV-1: pol quasispecies evolution over 33 months in the absence of treatment. The evolution of a sexually transmitted multiresistant HIV-1 in a linked transmission chain was followed for 33 months to assess its potential to persist in the absence of treatment. The multiresistant HIV reverted slowly to wild type in reverse transcriptase (positions 44, 67, 74, 118) rendering the virus only susceptible to lamivudine/emtricitabine. Persistence (...) of the replication-competent resistant HIV increases its potential to spread further and strengthens the importance of resistance testing in newly infected patients.

2006 AIDS

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