AIDS: is there an answer to the global pandemic? The immune system in HIV infection and control.
ABSTRACT HIV/AIDS continues to spread globally and remains a worldwide pandemic affecting about 40 million people. The prevention of infection remains paramount to vaccine studies. Although the best immune correlates for an efficacious HIV vaccine have not yet been discovered, progress has been made toward developing a vaccine. The identification of an effective antibody-binding site, targeted by a functional neutralizing antibody, and findings confirming that the Gag-specific responses are effective in protecting against disease progression are major advances in this field. This review highlights immunology-based developments in vaccine research and viral and host cell properties that could be employed to curb the spread of HIV.
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ABSTRACT: BACKGROUND: Most HIV-seropositive people who develop AIDS die from an opportunistic infection, such as pulmonary mycosis, rather than the HIV infection itself. Data on the pattern of respiratory mycoses and the immunological profile of HIV-seropositive patients in Nigeria are scarce and uncoordinated, so we investigated respiratory mycosis and CD4 count among HIV-seropositive and AIDS patients attending the antiretroviral clinics at the University of Calabar Teaching Hospital and Lawrence Henshaw Hospital in Calabar, Nigeria. METHOD: From May 2009 to July 2010 we carried out a prospective study of 331 individuals with respiratory symptoms, of whom 272 were HIV seropositive, aged 17-75 years and able to produce sputum and 59 were HIV non-reactive. Relevant samples were collected and subjected to direct microscopy, fungal culture and serology. RESULTS: The overall prevalence of pulmonary mycoses was 36.0%, the most prevalent fungal pathogen being Candida albicans (11.8%). Pneumocystis jirovecii (7.4%) was confirmed as an important opportunistic fungal agent in HIV-infected individuals in Calabar. Patients aged 25-34 years were at the highest risk of pulmonary mycosis (43.9%). HIV-positive patients with mycoses had lower mean CD4 counts (142.3 ± 100.1 cells µl(-1)) than those without mycoses (435.4 ± 249.1 cells µl(-1)) (t = 10.5, p = 0.00). CONCLUSION: Opportunistic pulmonary infections arise more frequently in HIV patients with lower CD4 counts. A more detailed comparative study with other opportunistic infections may help formalize the use of CD4 count as an indicator of HIV/AIDS with opportunistic mycoses.Transactions of the Royal Society of Tropical Medicine and Hygiene 01/2013; DOI:10.1093/trstmh/trs025 · 1.93 Impact Factor
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ABSTRACT: Background: Candidiasis is the commonest opportunistic fungal infection in patients infected with human immunodeficiency virus (HIV). CD4+ lymphocyte counts have been found to be a marker of HIV disease progression. Aim: This study focused on determining the spectrum of Candida isolates in urine, stool, and oral specimens among HIV patients in a tertiary hospital. Methods: A total of 300 subjects comprising of 200 HIV patients and 100 non-HIV subjects were used for this study. Three samples (urine, stool, and oral swab) were collected from each subject. Each specimen was processed using standard microbiological techniques and emergent Candida isolates were identified with CHROMagar™ Candida and sugar fermentation tests. Results: The overall prevalence of Candida colonisation among HIV patients was 52.5%. HAART-naive patients had a significantly higher prevalence (OR = 3.65; 95% CI = 2.03-6.56; p<0.0001) than their counterpart on highly active antiretroviral therapy (HAART) (OR = 1.99; 95% CI = 1.13-3.50; p=0.0232). Female gender was a significant risk factor for acquiring Candida infection (OR = 3.40; 95% CI = 1.14-10.13; p=0.0289). The effect of age on prevalence of candidiasis was observed among HIV patients on HAART (p=0.0161). A CD4+ count <200 cells/µl was a significant risk factor for acquiring candidal infection only among HAART-naive patients (OR = 4.37; 95% CI = 1.60-11.95; p=0.0042). The five species of Candida recovered from this study were C. albicans, C. krusei, C. parapsilosis, C. tropicalis, and C. glabrata. Conclusion: There is a significant relationship between antiretroviral therapy, CD4+ counts, and the prevalence of candidiasis.Libyan Journal of Medicine 03/2013; 8:1-5. DOI:10.3402/ljm.v8i0.20322 · 1.33 Impact Factor
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ABSTRACT: This prospective study was carried out to determine the prevalence of Pneumocystis jirovecii infection among HIV/AIDS patients attending the Antiretroviral Clinics in University of Calabar Teaching Hospital and Lawrence Henshaw Hospital in Calabar, Nigeria. The 14-month study also evaluated the relationship between Pneumocystis infection and CD4 count levels among these subjects on ART. The study population were 272 known HIV seropositive patients aged 17 - 75 years who had respiratory symptoms with ability to produce sputum. Subjects were enrolled after obtaining written consent from the patients and due approval from the Ethical Research Committee, University of Calabar Teaching Hospital, Calabar, Nigeria. Sputum samples were collected and subjected to microscopy by methanamine silver stain. The overall prevalence of Pneumocystis jirovecii infection recorded in this study was 7.4%. The study confirmed that Pneumocystis jirovecii is an important opportunistic fungal agent among HIV infected persons in Calabar. The population at the highest risk of Pneumocystis infection (40.0%) were subjects aged 25-44 years. HIV positive subjects with Pneumocystis infection had lower mean CD4 counts (135±79.9 cells/?l) than those without the infection (360.1±255.2 cells/?l) (t= 4.0, p= 0.0001). Also, Pneumocystis positive subjects on ART 12(60.0%) had lower mean CD4 counts (133.3±65.5 cells/?l) than those who were not on ART 8(40.0%) with (138.7±100.1 cells/?l) (t = 0.15, P = 0.88). In Nigeria there is no access to Pneumocystis pneumonia (PCP) diagnostic testing and patients are treated on empirical bases. Limited facilities and poor manpower capacity make diagnosis of Pneumocystis carinii pneumonia(PCP) difficult. There is an urgent need for training of Laboratory scientists on sensitive investigative techniques used for diagnosing PCP, such as PCR methods