HIV/AIDS - Science topic

One of my own algorithms does that. It is called Discrete Probability Detector (DPD). DPD transforms any sequence of symbols into a transition matrix. Please look at the project:

Live: https://gagniuc.github.io/Discrete-Probability-Detector-JS/

It is a rare condition

Bruce Robin Nyamweha

Please also go through the following useful RG links.

Thanks!

It is a discussion sir, not a question. If you have any comment or review after reading the article, please feel free to comment. Thanks

Dear Dr. Anyam!

I consider your question to be a highly important one, so I did search for YOU resources you might value:

1) Meganck, R.M., Baric, R.S. Developing therapeutic approaches for twenty-first-century emerging infectious viral diseases. Nat Med 27, 401–410 (2021). https://doi.org/10.1038/s41591-021-01282-0 Free access:

2) Verguet, S., Hailu, A., Eregata, G.T. et al. Toward universal health coverage in the post-COVID-19 era. Nat Med 27, 380–387 (2021). https://doi.org/10.1038/s41591-021-01268-y Free access: https://www.nature.com/articles/s41591-021-01268-y

3) Fontecha, G., Sánchez, A.L. What Will Happen to Biomedical Research in Low-and-Middle Income Countries in the PostCOVID-19 World?. Curr Trop Med Rep 8, 1–5 (2021). https://doi.org/10.1007/s40475-020-00223-0 Free access:

4) Anser, M.K., Khan, M.A., Zaman, K. et al. Financial development during COVID-19 pandemic: the role of coronavirus testing and functional labs. Financ Innov 7, 9 (2021). https://doi.org/10.1186/s40854-021-00226-4 Free access:

Yours sincerely, Bulcsu Szekely

Hello, Hlelolwenkosi Mlimi

If you are not in a master’s or doctoral program now, then it’s important that you apply to be in one. You might find a supervisor before you enroll in a program or after. Once you are enrolled in a program, it might be easier to make connections with professors with whom you might work, and ideally get funding to do so. Even so, I agree with Sachin Suknunan and Magnolia Cardona that it’s good to be proactive in seeking a supervisor before you even apply, given all of the possible choices of experts in your area of interest and given your geographic restrictions. Then, apply to the institution(s) where those people work. If you develop a rapport with potential mentors before/while you are applying, they may be able to help you in the admissions process, and may even have grant funding to help support you.

In any case, when you are sending queries to potential mentors, I suggest that you tailor your inquiries to show that you have researched their specific areas of expertise, and to show how your interests are a great match with theirs. Tie in your interest in HIV/AIDS with the actual work that they are doing.

I often get queries from students saying they want to work with me and then mentioning topics that are not in line with work that I do. To me, that suggests that they are sending the same query to many people, and that their aim is to find just any opportunity without doing the work to decide who and what might best fit their goals. I am far more likely to respond to someone whose query indicates that he or she knows my work and sincerely wants to work with me because there is a great match between us.

I wish you the best!

Brooke Hallowell

Thank you Dr. Ochomo for your contribution.

I can guess from your name you're from West Africa. You could have applied for a West African Research Grant sponsored by West African Research Association at Boston University

There are several reasons can lead to non-adherence among HIV patients including side effects of antiretroviral, poor quality life, and psychological distress is one of them. You may go through the following thesis for more understanding about the relations between adherence to HIV medications and psychological distress

An excellent explanation of the rationale for early and continuous treatment is given at http://hivmanagement.ashm.org.au/index.php/therapeutics-and-monitoring/antiretroviral-therapy (from paragraph 3). Essentially, this is associated with better clinical outcomes across various measures, as well as prevention of sexual transmission if viral suppression is achieved. Prevention of transmission ("undetectable = untransmittable", see https://www.unaids.org/en/resources/presscentre/featurestories/2018/july/undetectable-untransmittable) assists the public health response and efforts to end the HIV epidemic (for example, UNAIDS targets). Apparently the most recent therapies have fewer side effects, and taking them consistently as prescribed reduces the risk of drug resistance (https://aidsinfo.nih.gov/understanding-hiv-aids/fact-sheets/21/56/drug-resistance).

In cryctococcus meningits the treatment is, as you say Amphotericin B plus Flucytosin, then Fluconazole

Am somehow sceptical that Fluconazole as exclusive treatment is sufficient. No chance to get Amphotericin B and Flucytosin?

Age appropriate information must be divulged to every student without any discrimination. Simple jingles based basic idea of the disease should be imparted. Primary rather primordial prevention is the need of hour. It is our duty to give accurate, reliable, appropriate, adequate and timely information to one and all. In my opinion, as early as we start disseminating the information better it will be...!!

Yes I'm interested share your mail

I think the current burden depends really on the contexts. It is obvious that the challenges living with HIV in rural sub-Saharan Africa will be different from living in London with the disease. So health systems, healthcare delivery, social determinants, persisting issues of stigma and social exclusion, employment related issues, access to medicine, regular monitoring of CD4 count etc. This will really depend on the location of the individual.

Thank you so much Nordirali and Imadeddin for your help.

You might be interested in this article on HIV, Stigma and discrimination in Ireland - Foreman, M. & Ni Rathaille, N., Not just another long term chronic illness - Social Work and HIV in Ireland, Practice: Social Work in Action, 28, 12, 2016, 97 - 114 . You can download a copy via this link http://hdl.handle.net/2262/75536. I wrote it with Neans Ní Rathaille, the Senior Medical Social Worker in Ireland's largest HIV clinic. It's based on research we conducted with people living with HIV as well as with social workers and HIV counsellors.

Thanks for showing your interest in this project and for sending articles, these articles are really helpful.

Regards !!

Hi Mohsen,

you can make you own idea about potential use of CRISPR/Cas9 towards a cure for HIV by starting with this recent review article; DOI link below.

Good luck!

Nicolas

A disease that means it was caused by once genetic default by either onco- protein or viral- onco protein. .At first, the DNA/RNA confirmation is very important. The treatment arm should be consider on last symptom.

The last symptom that means a RNA virus /its viral protein or RNA cell-proteins in our cells are randomly (location based) virulent and would be affected to the DNA stranded "proteins". So, subsequently the last symptom will pave way the confirmation either RNA or DNA symptoms.

Dear Obed

thanks for your question.

in this paper you can find good answers to your question:

If HIV gets into the bloodstream from a needle stick directly into a vien or artery, then there might be just one or ten or 100 virions in the blood at the time of the event. But if HIV gets into the bloodstream from a mucosal surface and then replicates in germinal centers and lymph nodes for days or weeks before entering the blood it is a very different situation. But anyway, post-exposure prophylaxis can work in many cases, but not all cases. Some drugs leave the bloodstream and enter different tissues at different rates than other drugs.

Dear ,

I hope you are fine.this is to ask you if there is any research done so far on ''clinical.humanistic and economic outcome of admitted HIV patients.'' also comment on feasibility and measurement parameters to be used.thanks in advance!

Hi Gorky. These articles might interest you:

Edwards, R. W., Jumper-Thurman, P., Plested, B. A., Oetting, E. R., & Swanson, L. (2000). Community readiness: Research to practice. Journal of community psychology, 28(3), 291-307.

Thurman, P. J., Plested, B. A., Edwards, R. W., Foley, R., & Burnside, M. (2003). Community readiness: The journey to community healing. Journal of Psychoactive Drugs, 35(1), 27-31.

Take a look here:

You can also USSD to automate them. My candidate is looking for an app for the patients to have on their own mobiles which will be more interactive. Thanks for your response.

ok send me your relevant data  

The CD4:CD8 ratio is useful since it determines the recovery of the Helper T cells (the main target of HIV) over the Cytotoxic T cells. An early recovery, >1, represents a qualitative gain in the functionality of the immune system, see C Mussini et al. in Lancet HIV.

Thank you all so much. Your advise was so helpful - finally got published - http://www.tandfonline.com/doi/abs/10.1080/00224499.2016.1255702?journalCode=hjsr20. Thanks!

The first thing you must do (if you haven't done so already) is find a recent systematic review of of the efficacy of HIV testing and counseling (HTC)  in preventing HIV and STIs in youth in sub-Saharan Africa. Ideally, the review should also assess evidence quality. If there is no quite recent review, you may need to conduct your own. After you know the relative risk of incident infection in youth receiving HTC, compared to those who don't, you will have a basis for your cost-effectiveness analysis. Without knowing this, you cannot do a cost-effectiveness analysis.

Our review (conducted in 2011 to inform WHO's 2013 adolescent HTC guidelines) found mostly very low quality, very indirect evidence that such interventions are efficacious. However, several years have passed and new, more directly-applicable research may have been done since that time.

 There are tremendous researchers that were conducted and ongoing researches on HIV. One of the focus of the rigorous HIV researches targets to eradicate and/or prevent HIV from the face of the globe. For this serious purpose we all need to explore what had been already done and find what shall be done in the future with you, me, and others. Since I am two weeks break, I am trying to explore such research gaps. When I become to know HIV health issues for new studies I will share to you and I believe you will do the same.

Thank you very much

I am sending you the citations of two references I found on PubMed. Unfortunately was not able to get the full text.

1.Crişan A, Tudorache V, Nicoară E, Laza R. [AIDS patient with pneumocystosis

and pulmonary alveolar proteinosis]. Pneumologia. 2009 Apr-Jun;58(2):121-4.

Romanian. PubMed PMID: 19637766.

2: Nachajon RV, Rutstein RM, Rudy BJ, Collins MH. Pulmonary alveolar proteinosis

in an HIV-infected child. Pediatr Pulmonol. 1997 Oct;24(4):292-5. PubMed PMID:

9368264.

Dear Dr. De Socio

let me suggest an answer citing Maggi P. et al In "Novel antiretroviral drugs and renal function monitoring of HIV patients" (PMID: 25102336):

Rilpivirine, cobicistat, and dolutegravir reduce the tubular secretion of creatinine, inducing a decrease of estimated glomerular filtration rate according to creatinine. Rilpivirine and dolutegravir block the uptake of creatinine from the blood, inhibiting organic cation transporter 2, and cobicistat interacts with the efflux inhibiting multidrug and toxin extrusion protein 1. This effect can then be considered a "reset" of the estimated glomerular filtration rate according to creatinine. However, clinicians should carefully monitor renal function in order to identify possible alterations suggestive of a true renal functional impairment".

Moreover there are some evidences of interactions between DLT and metformin (plasma levels of metformin could be significantly increased) so they should not be co-administrated.

Thus in my opinion ART should be modified according to previous  pharmacoresistance  tests (e.g. PI/r + NRTI such as ABC alone?). 

Best wishes,

Cinzia Puzzolante

Thank you , The Drugs cost are covered through the Public Medical care and International Support, Free of Charge , However , they tend to be Bug-down with Protocol because of Underlying protection of Interest in-terms of cost.

While I agree with my earlier position that a combination of both methods are necessary, I will beg to disagree that qualitative methods alone cannot give you the right information. Why researchers in recent times are agitating for both quantitative and qualitative methods in development and gender research is that, quantitative tend to give you only figurative information which may not necessarily mean what the figures reflect in true situation. This is always as a result of design error. You are interested in looking at rural development, what constitute rural development? most beginners in the field find it difficult to really tel you what they mean by rural development, but an experienced researcher will give your measurable parameters or indicators to measure rural development, these are the data that you must collect in order to measure rural development. how do you measure rural development? is it the no of carrugated iron roofs, is it hospitals, health centers, security, motorable roads, portable drinking water, presence of police station, banks etc, after this, you can now know how to gather the information and the type of information to collect.

For Quantitative research, it is difficult to translate most of the information into analytical form, most often, researchers have to listen to hear say and as humans, Hurtton's effect sets in, in this situation, objectivity is near absence. another is that emotion normally sets in, by right researchers should be empathetic and not sympathetic, this is another disadvantage of qualitative research design. The best bait is to use a combination of both designs.

The first set of TALC slides on basic virology and transmission, in a summarised version attached. It was all about story-telling to raise HIV / AIDS awareness...

This is a very important question and very nice points from Shabani.

I would add that in Mozambique we managed to see a small improvement of adherence to medicine and a slight 12 months retention among patients newly ART initiated on urban sites. However, somewhere at month 9-11 month the effect vanish very rapidly. It seems people got tired of receiving such messages and we received complains about SMS.

As Shabani said, besides the SMS content, things like electricity (is the health facility with power to feed the SMS system?) and network outages are critical to send SMS; Local expertise to keep the system running; Literacy (we sent text SMS), played key role.

Dear Rafael

Thank you for taking the time to answer this, i really appreciate it. I will take a look at your research group.

All best wishes

Nigel

In simple explanation, HIV RNA copies is a measure of the virus itself, while CD4 count targets the T lymphocytes population.A reduction in HIV RNA copies population is an indication of suppression of viral replication while an increase in CD4 count population is an indication of improvement of immune system.CD4 count is for T lymphocyte while HIV RNA copies is for the virus itself.

Hope this also helps you.Best regards.

Thanks Parismita Kalita...

Adolescence is a phase of many emotional and hormonal changes  and rebelliousness  is common . However , when this starts affecting a drug regime , in this case , ART , the situation becomes a little more  complex and has to be handled sensitively .

The fear factors of stigma and gossip can be dealt with  , by first sensitising  the  local community  and  giving them ownership   . Role plays , street plays , poster education should be done  to spread awareness . 

In parallel , counselling of the girls should be done  and they should be told  kindly but firmly that the drugs are meant for their benefit . Parents also should be given emotional and socio-economic support  . 

Follow these links for further readings:

A survey of 11th to 12th  students with questionnaire may give some information.

Hello Tsegaye,

Have you attempted writing to Martin Duracinsky, (e-mail: martin.duracinsky@bct.aphp.fr) to ask him directly?

Else, he is also on Researchgate.net at www.researchgate.net/profile/Martin_Duracinsky

I will suggest the interested readers to go through page 223 of "Biosafety in Microbiological and Biomedical Laboratories" 5th Edition - HHS publication no. (CDC) 21-1112 downoladable from CDC website. 

Bill & Melinda Gates Foundation

Commonwealth Foundation

Elton John AIDS Foundation

European Union

Global Fund to Fight AIDS, Tuberculosis and Malaria

Hewlett Foundation

International HIV/AIDS Alliance

Government of the Netherlands

The Abbott Fund

US President’s Emergency Plan for AIDS Relief (PEPFAR)

UK Department for International Development (DFID)

UNAIDS

United States Agency for International Development (USAID)

United Nations Development Programme

World Health Organization

NACO, 9th Floor, Chanderlok Bldg., 36 Janpath,

New Delhi-110001 Tel: 23325337

Rajiv Gandhi Foundation

Rajendra Prasad Road

New Delhi - 110 001, India

Tel.: +91 11 2375 5117

Fax: +91 11 2375 5119

The Foundation supports HIV training programs for health professionals working with NGOs to treat the underprivileged throughout India. It also supports education, prevention and direct services programs for PLWHA as well as capacity-building grants for CBOs working in this area.

Vasavya Mahila Mandali

Benz Circle, Vijayawada - 520 010

Andhra Pradesh, India

Tel.: +91 86 6247 0966

Fax: +91 86 6247 3056

Vasavya is an intermediary for international and national

funders and governments. It supports home and community-based HIV/AIDS care and prevention programs.

MAMTA MAMTA

Health

Institute for Mother and Child

B-5, Greater Kailash Enclave-II

New Delhi, India 110048

Tel.: +91 11 2922 0210

Fax: +91 11 2922 0575

MAMTA is an intermediary for international and national funders and governments. It supports HIV/AIDS programs focusing on direct care, advocacy, and training throughout the country.

Palmyrah Workers Development Society (PWDS PWDS PWDS )

Crystal Street, Marthandam – 629165

Kanyakumari District

Tamil Nadu, India

Tel.: +91 46 5127 0241

Fax: +91 46 5127 0138

PWDS is an intermediary for international and national funders and governments. It supports CBOs and NGOs working with AIDS orphans as well as organizations providing community-based care and support programs for PLWHA.

LEPRA

Society

Post Box No. 1518

West Marredpally, Secunderabad

Andhra Pradesh, India

Tel.: +91 040 2780 2139

Fax: +91 040 2780 1391

LEPRA is an intermediary for international and national funders and governments. It supports a wide range of HIV/AIDS projects from direct care to advocacy to education and vocational programs throughout the country.

TEST Foundation

4, Sathalvar Street

Mugappair West

Chennai, India 600037

Tel.: +91 044 2624 4100

Fax: +91 044-2625 0315

TEST is both an operating foundation, running its own programs including home-based care and a hospice for AIDS patients, and a grantmaking

There is no indication they biologically transmit the virus.  No molecular or immunological studies found any virus binding sites in the midgut for example of mosquitoes.

Insects are really not very good vectors of almost any virus (with a few exceptions).  The shear number of viruses out there is astronomical and insects are not shown or even implicated in most.  The only exception are the arboviruses and to be truthful if you look at the biology of these viruses you will find that even susceptible vectors are really not that good at transmitting most of them.  The viruses end up getting blocked by midgut or salivary gland barriers or there just are not enough in a blood meal to even infect a vector.

Dear Ayyanna,

1) You may also consider HIV Research Trust (http://www.hivresearchtrust.org.uk/), for your early/mid-career HIV physicians, nurses, scientists and other health care professionals.

2) EDCTP also has some opportunities, especially if you have African collaborators (http://www.edctp.org/funding-opportunities/calls/).

3) The Collaborative Initiative for Paediatric HIV Education and Research (CIPHER) of the International AIDS Society (IAS) is another opportunity aimed at optimizing clinical management and delivery of services to infants, children and adolescents affected by HIV in resource-limited settings through advocacy and research promotion. 

Thanks Nouhoum.

I think that this link may be useful for you.

Pathogenesis of human cytomegalovirus infection and ...

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de G Gerna - ‎2004 - ‎Cité 93 fois - ‎Autres articles

In acquired immunodeficiency syndrome patients with human cytomegalovirus (HCMV), disseminated infection, and end-organ disease, autopsy findings show ...

Please review the following:

 Frias M(1), Rivero-Juarez A(1), Gordon A(1), Camacho A(1), Cantisan S(1),

Cuenca-Lopez F(1), Torre-Cisneros J(1), Peña J(2), Rivero A(1).

OBJECTIVE: A prospective analysis of the distribution of NK subsets and natural cytotoxicity receptors (NKp30/NKp46) in HIV patients with long-term HAART use and sustained virological and immunological response.

METHODS: The main inclusion criteria were: at least 3 years' receipt of HAART; current CD4+ count ≥ 500 cells/mm3; undetectable viral load for at least 24 months; no hepatotropic virus co-infection. Percentages of CD56dim, CD56bright NK cells and CD56neg CD16+ cells were obtained. Expression of the NCRs, NKp30 and NKp46 was analysed in CD56+ cells. Thirty-nine infected patients and sixteen healthy donors were included in the study.

RESULTS: The percentages of total CD56+ and CD56dim NK cells were significantly lower in HIV-infected patients than in healthy donors (70.4 vs. 50.3 and 80.9 vs. 66.1 respectively). The percentage of total CD56+ NK cells expressing NCR receptors was lower in HIV patients than in healthy donors (NKp30: 25.20 vs. 58.63; NKp46: 24.8 vs. 50.59). This was also observed for CD56dim and CD56bright NK cells. Length of time with undetectable HIV viral load was identified as an independent factor associated with higher expression of NKp30 and NKp46. 

CONCLUSION: Despite the prolonged and effective use of HAART, HIV-infected patients do not fully reconstitute the distribution of NK cells. Length of time with an undetectable viral load was related to greater recovery of Kp30/NKp46 receptors.

 Della Chiesa M(1), Marcenaro E(1), Sivori S(1), Carlomagno S(1), Pesce S(1),

Moretta A(2).

 NK cells represent important effectors of the innate immunity in the protection

of an individual from microbes. During an NK-mediated anti-microbial response,

the final fate (survival or death) of a potential infected target cell depends

primarily on the type and the number of receptor/ligand interactions occurring at

the effector/target immune synapse. The identification of an array of receptors

involved in NK cell triggering has been crucial for a better understanding of the

NK cell biology. In this context, NCR play a predominant role in NK cell

activation during the process of natural cytotoxicity. Regarding the NK-mediated

pathogen recognition and NK cell activation, an emerging concept is represented

by the involvement of TLRs and activating KIRs. NK cells express certain TLRs in

common with other innate cell types. This would mean that specific TLR ligands

are able to promote the simultaneous and synergistic stimulation of these innate

cells, providing a coordinated mechanism for regulating the initiation and

amplification of immune responses. Evidences have been accumulated indicating

that viral infections may have a significant impact on NK cell maturation,

promoting the expansion of phenotypically and functionally aberrant NK cell

subpopulations. For example, during chronic HIV-infection, an abnormal expansion

of a dysfunctional CD56neg NK cell subset has been detected that may explain, at

least in part, the defective NK cell-mediated antiviral activity. An analogous

imbalance of NK cell subsets has been detected in patients receiving HSCT to cure

high risk leukemias and experiencing HCMV infection/reactivation. Remarkably, NK

cells developing after CMV reactivation may contain "memory-like" or "long-lived"

NK cells that could exert a potent anti-leukemia effect.

 Jacobson A(1), Bell F, Lejarcegui N, Mitchell C, Frenkel L, Horton H.

 BACKGROUND: Neonatal Natural Killer (NK) cells show functional impairment and expansion of a CD56 negative population of uncertain significance.

METHODS: NK cells were isolated from cord blood and from adult donors. NK subpopulations were identified as positive or negative for the expression of CD56 and characterized for expression of granzyme B and surface markers by multi-parameter flow cytometry. Cell function was assessed by viral suppression and cytokine production using autologous lymphocytes infected with HIV. Activating (NKp30, NKp46) and inhibitory (Siglec-7) markers in healthy infants and adults were compared with viremic HIV-infected adults.

RESULTS: Cord blood contained increased frequencies of CD56 negative (CD56neg) NK cells with reduced expression of granzyme B and reduced production of IFNγ and the CC-class chemokines RANTES, MIP1α and MIP1β upon stimulation. Both CD56pos and CD56neg NK subpopulations showed impaired viral suppression in cord blood, with impairment most marked in the CD56neg subset. CD56neg NK cells from cord blood and HIV-infected adults shared decreased inhibitory and activating receptor expression when compared with CD56pos cells.

CONCLUSIONS: CD56neg NK cells are increased in number in normal infants and these effectors show reduced anti-viral activity. Like the expanded CD56neg population described in HIV-infected adults, these NK cells demonstrate functional impairments which may reflect inadequate development or activation.

Have you attempted to make contact with any of these research centers?

We use IFNa2a in our study described in the attached paper at 2500 U/ml for 24h on fresh human monocytes but I've seen both IFNalpha and beta used anywhere between 10 to 10000 u/ml.  In the end, it depends on the sensitivity of the cell type used and your endpoint or readout.

Contact Valerian Delega, Department of Psychology, Old Dominion University, in Norfolk VA (USA).  He's an expert on aspects of your topic.

The key is to outreach the population. In Guatemala, we're building an experience to increase coverage in MSM. Is important to mention that in Guatemala isn't an unfreandly legal system for LGBTI, however stigma is a major concern in our context.

The close work with a community based organization, and promotion through social network as Facebook, Twitter; and "gay apps" such as Grindr and Manhunt; are an important strategy to contact MSM. 

Also, Mpowerment model 

Here are some publications that may help you:

Goldenberg T, McDougal JS, Sullivan SP, Stekler DJ, Stephenson R. Preferences for a Mobile HIV Prevention App for Men Who Have Sex With Men. JMIR mHealth uHealth [Internet].

Young SD, Szekeres G, Coates T. The Relationship between Online Social Networking and Sexual Risk Behaviors among Men Who Have Sex with Men (MSM). PLoS One. 2013;8(5):15–8.

Usher D, Frye V, Shinnick J, Greene E, Baez E, Benitez J, et al. Recruitment by a Geospatial Networking Application for Research and Practice: The New York City Experience. JAIDS J Acquir Immune Defic Syndr [Internet]. 2014;67(5).

Suthar AB, Ford N, Bachanas PJ, Wong VJ, Rajan JS, Saltzman AK, et al. Towards Universal Voluntary HIV Testing and Counselling: A Systematic Review and Meta-Analysis of Community-Based Approaches. PLoS Med. 2013;10(8).

Kegeles SM, Hays RB, Coates TJ. The Mpowerment project: A community-level HIV prevention intervention for young gay men. Am J Public Health. 1996;86(8 I):1129–36.

Kahn JG, Kegeles SM, Hays R, Beltzer N. Cost-Effectiveness of the Mpowerment Project, a Community-Level Intervention for Young Gay Men. JAIDS J Acquir Immune Defic Syndr [Internet]. 2001;27(5)

The best options at this stage would be to either continue with a PI (such as darunavir) or switch to efavirenz. The British HIV Association still advocates one of these two options even in early pregnancy. I suspect Raltegravir or even Dolutegravir would be good options but there is not much information at the moment to promote their use in pregnancy.

I would personally try boosted darunavir and see how she goes.

I am attaching link to the British guidance on HIV treatment in pregnancy (2014 update):

The risk reduction model looks appropriate to behavioral change in HIV/AIDS, for the model integrates human behavior: valuing being healthy, understanding the actions to be taken to remain healthy, developing self efficacy and self esteem. The model promotes individuals to assess their behavioral practices that make them vulnerable to HIV infection, understanding the severity of the disease, and knowledge on prevention and transmission of the disease. The model is designed to help target people to understand the severity of the illness; the practice to healthy way of life; and the path to be followed for behavior change such as abandoning practices that expose them to the infection through  change in life style. The target people should be able to see a better, healthy and enjoyable life as they transform to the new life practices that do not expose them to HIV infection. Since knowledge of HIV/AIDS is conditioned in the new practices, agents of change have to reinforce the new mode of life. Health educators, teachers, families, communities, religious and other players and their respective institutions  are agents in the creation of knowledge and reinforcement of knowledge based practices in HIV prevention.

Thank you all. Paul, I will look into contacting Dr. Travers. I have been conducting focus groups with folks living with HIV whose viral loads are suppressed and have had interesting conversations regarding engagement, retention in care and dropping out of care. Thank you for your connection.

Hi,

With regards.

Attached implications of my study:

Nurses, who represent 65% of human resources in the Bolivian health system structure, must actively participate in the design of culturally adapted prevention programmes and health education interventions. In this regard, governmental health authorities, NGOs and international organisations should be actively engaged and aware of our study’s results, particularly highlighting the importance of local agents to promote their capacitation as well as the empowerment of indigenous populations. Nursing could develop programmes and interventions based on the transcultural care theory, preserving healthy cultural practices, negotiating the adaptation of others and remodelling those which support risk behaviours. Without an in-depth knowledge of this population’s cultural framework, any attempt at an intervention runs the risk of being done in vain.

Hi Oliver,

the time individual computers started being used in a whitespread fashion (and, thus: 'easy data collecting' emerged) stretches from the beginning 90'ies in the industrialized world and a bit later in African countries. Hence, before that decade, there was virtually nothing  in this respect, at least not in a representative fashion and/or the amount you are intending to obtain here. Sorry to say, the only slim chance would be to contact the respective officers at WHO.

good luck for your endeavour!

Sibylle

Nelson - a somewhat broad question -  but one that can be answered 'in parts' - so you may get quite a few responses in this thread. I would 'start' by suggesting that, despite your lack of experience in grant writing, you are best to consider the nature and scope of your team initially. It may well not be a good idea to put yourself forward as Chief Investigator (CI) or Principle Investigator (PI). Grant proposal reviewers need to assess the ability of the investigators in the research team to undertake the research. Therefore, proposals require some information about the research team (e.g. name, qualifications, employment position) as a minimum. In some instances (e.g. NHMRC grants), a short biography (research track record) and publications list are necessary for each investigator. All authors on the research team should provide intellectual capital to the research project in a 'ranked order'; that is, they must actively participate in the project and contribute to the generation of knowledge. Following some unfortunate episodes of ‘honorary authorship’ to persons in authority who provided no academic input to the research and related publications, there are now guidelines on authorship, sponsorship and accountability, issued by, among others, the International Committee of Medical Journal Editors (ICMJE) (Halperin et al. 2005), and Universities Australia http://www.universitiesaustralia.edu.au/. These types of resources may well assist in working through the grant process

HIV KQ 45 is a validated HIV knowledge scale and HIV KQ 18 is a shortened version. For attitude AIDS Attitude Scale (AAS) is a validated scale.

Dear Hentrich,

it is hard to find published medical research to answer your question. Whether or not an injection at pH 0.05 would be lethal depends on several factors and variables. Firstly, the amount of fluid/substance you plan to inject. Secondly, the mode of administration; subcutaneous, intravenously, i.m, and so on. Furthermore, the chemical composition and active ingredients in the substance will also play a role in this matter, as will the clinical condition of each patient be equally important.

Hope this was helpful, and best of luck in your research.

You can, may be draw examples from the Indian model, although not completely integrated in its true sense currently. The National AIDS Control program nevertheless has worked progressively towards integration and now envisages to integrate the AIDS program completely in to the national health mission. Integration as I understand occurs at various levels and for various program components of the AIDS program. If your question is about the prevention and treatment component of HIV/AIDS then the answer would be yes it can be integrated one hundred percent. For example, testing for HIV can occur at any general laboratory, in most cases it would not require specialised training or equipment that is not manageable by a certified general laboratory technician. Now the larger problem I assume could be when we talk of the treatment component. If PLHIV have access to ARV medications provided by the government then it could be challenging, in terms of the capacities of the medical officers to provide standardized care based on the guidelines and also the laboratory support for periodic CD4 testing. Our experience in India is that integration is a slow drawn process especially for a concentrated epidemic such as ours. And, most off it depends on the existing public health infrastructure.

From your question, you indicate that adherence to HIV and AIDS medicines in Nigeria is high and there are some factors that have been shown to contribute to that, i believe you want to establish which factors may be adapted into strategies for sustained high adherence.

Since you want to conduct a qualitative research, interview with the patients, health care providers, managers, caregivers and community organization representatives (such as support groups and home based care groups)  may be the way to go. You could use semi-structured questionnaires and focused group discussions and your questions should include some of the factors identified to result in high adherence and seek from the participants what they should be done. In your interviews you should have representation in terms of gender, age and if possible, duration on therapy. 

Our experiences shows that more inter active is more effective .Side effects of ART and how to cope with it is very important for patients' adherence, other important based on our study is family stigma that should be targeted by IEC approaches.

Personally, I think it is case dependent. First, it has to be determined whether its an unmasking or paradoxical IRIS. Starting steroids in under-controlled infections can be detrimental. 

A student once asked me that question, very interesting indeed. The whole point of the "AIDS defining illness/condition" I believe is to assist in the clinical diagnosis of AIDS and to be able to predict a prognosis. There are more than 800 AIDS related conditions, the CDC and WHO came up with a list of AIDS defining illnesses which is composed of the most common clinical conditions that are associated with AIDS.  Of course these can also occur in non AIDS cases, but their appearance merits further investigation and ruling out of AIDS as a causative factor.

HIV-1 envelope glycoprotein is synthesized as a precursor glycoprotein, gp160, and is then processed into gp120 and gp41. As Mohamed has mentioned, these are lab designed variants used for a successful vaccine development and for various neutralizing assays. gp140 is created by deleting trans-membrane and cytoplasmic domain namely gp140L, which contained the complete membrane-proximal external region (MPER), and gp140S, which lacks the distal half of MPER. Moreover, it has also been observed the neutralization sensitivity of gp120, gp140, and gp41 are distinct. Hope it clarifies your doubt.

Look at this site belonging to Sigma Research - London School of Tropical Medicine

http://www.sigmaresearch.org.uk/gay or just search PEP on their site.

Try IL-7 for 2-3 days and Il-7/IL-15 from DAY 3 onwards if you want to drive out the cells a little more. I find IL-2 works but can also cause cellular death in this short time period. IL-7 works for me.

I have recently published a paper that might be of interest. It focuses on how issues of medication side effects and compliance are raised as topics and dealt with in conversations between staff and patients in a Therapeutic Community. http://www.ncbi.nlm.nih.gov/pubmed/24053481

I found interesting the conclusions of a recent paper in J Acquir Immune Defic Syndr (2014;66:140–147) : Intensified 5-drug cART initiated during early infection fails to significantly further impact virologic or immunologic responses beyond those achieved with standard 3-drug PI based cART.