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  1. HIV-Infected African Parents Living in Stockholm, Sweden: Disclosure and Planning for Their Children's Future

    ERIC Educational Resources Information Center

    Asander, Ann-Sofie; Bjorkman, Anders; Belfrage, Erik; Faxelid, Elisabeth

    2009-01-01

    In Sweden, most HIV-infected parents are of African origin. The present study explored the frequency of HIV-infected African parents' disclosure of their status to their children and custody planning for their children's future to identify support needs among these families. Semistructured interviews were conducted with 47 parents (41 families).…

  2. Targeted interventions required against genital ulcers in African countries worst affected by HIV infection.

    PubMed Central

    O'Farrell, N.

    2001-01-01

    It remains unclear why there is such marked variation in the severity of the human immunodeficiency virus (HIV) epidemic between African countries. The prevalence of HIV infection has reached high levels in many parts of southern Africa but in most countries of West Africa the levels are much lower. Although there is good evidence that sexually transmitted infections (STIs) and genital ulcers in particular facilitate heterosexual transmission of HIV, there is little comparative STI data from the African countries worst affected by HIV infection. A MEDLINE search covering the period 1966 to August 2000 using the keywords "sexually transmitted diseases", "genital ulcers" and "Africa" was performed to identify factors that might be relevant to the spread of HIV infection in countries with the highest prevalences of the virus. In the countries worst affected by HIV infection, the proportions of men and women with STI who had genital ulcers lay in the ranges 45-68% and 13-68%, respectively. The proportions were much lower in countries of West Africa than in those of southern Africa. The African countries worst affected by HIV infection should adopt a more specialized approach to STI control than hitherto and specifically target the high incidence of genital ulceration. Locally, technical STI committees should draw up country-specific guidelines taking into account the prevalence of the various causes of genital ulceration. In these countries, national AIDS control programmes and donor agencies should develop a specific focus for decreasing the incidence of genital ulcer disease. PMID:11436480

  3. Targeted interventions required against genital ulcers in African countries worst affected by HIV infection.

    PubMed

    O'Farrell, N

    2001-01-01

    It remains unclear why there is such marked variation in the severity of the human immunodeficiency virus (HIV) epidemic between African countries. The prevalence of HIV infection has reached high levels in many parts of southern Africa but in most countries of West Africa the levels are much lower. Although there is good evidence that sexually transmitted infections (STIs) and genital ulcers in particular facilitate heterosexual transmission of HIV, there is little comparative STI data from the African countries worst affected by HIV infection. A MEDLINE search covering the period 1966 to August 2000 using the keywords "sexually transmitted diseases", "genital ulcers" and "Africa" was performed to identify factors that might be relevant to the spread of HIV infection in countries with the highest prevalences of the virus. In the countries worst affected by HIV infection, the proportions of men and women with STI who had genital ulcers lay in the ranges 45-68% and 13-68%, respectively. The proportions were much lower in countries of West Africa than in those of southern Africa. The African countries worst affected by HIV infection should adopt a more specialized approach to STI control than hitherto and specifically target the high incidence of genital ulceration. Locally, technical STI committees should draw up country-specific guidelines taking into account the prevalence of the various causes of genital ulceration. In these countries, national AIDS control programmes and donor agencies should develop a specific focus for decreasing the incidence of genital ulcer disease.

  4. Mycobacterium sherrisii visceral disseminated infection in an African HIV-infected adolescent.

    PubMed

    Santoro, Francesco; Santoro, Giulia; Del Giudice, Annalisa; Perna, Rossella; Iannelli, Francesco; Spagnuolo, Maria Immacolata; Bruzzese, Eugenia; Lo Vecchio, Andrea

    2016-04-01

    A case of visceral disseminated infection by Mycobacterium sherrisii in an African HIV-infected adolescent with multiple abdominal abscesses is reported. Despite multiple drug resistance to first-line antibiotics in vitro, long-term treatment with clarithromycin, moxifloxacin, and clindamycin, together with appropriate antiretroviral treatment, resulted in clinical and radiological cure after 19 months of therapy and follow-up. PMID:26903469

  5. Bactericidal Immunity to Salmonella in Africans and Mechanisms Causing Its Failure in HIV Infection

    PubMed Central

    Goh, Yun Shan; Necchi, Francesca; O’Shaughnessy, Colette M.; Micoli, Francesca; Gavini, Massimiliano; Young, Stephen P.; Msefula, Chisomo L.; Gondwe, Esther N.; Mandala, Wilson L.; Gordon, Melita A.; Saul, Allan J.; MacLennan, Calman A.

    2016-01-01

    Background Nontyphoidal strains of Salmonella are a leading cause of death among HIV-infected Africans. Antibody-induced complement-mediated killing protects healthy Africans against Salmonella, but increased levels of anti-lipopolysaccharide (LPS) antibodies in some HIV-infected African adults block this killing. The objective was to understand how these high levels of anti-LPS antibodies interfere with the killing of Salmonella. Methodology/Principal Findings Sera and affinity-purified antibodies from African HIV-infected adults that failed to kill invasive S. Typhimurium D23580 were compared to sera from HIV-uninfected and HIV-infected subjects with bactericidal activity. The failure of sera from certain HIV-infected subjects to kill Salmonella was found to be due to an inherent inhibitory effect of anti-LPS antibodies. This inhibition was concentration-dependent and strongly associated with IgA and IgG2 anti-LPS antibodies (p<0.0001 for both). IgG anti-LPS antibodies, from sera of HIV-infected individuals that inhibit killing at high concentration, induced killing when diluted. Conversely, IgG, from sera of HIV-uninfected adults that induce killing, inhibited killing when concentrated. IgM anti-LPS antibodies from all subjects also induced Salmonella killing. Finally, the inhibitory effect of high concentrations of anti-LPS antibodies is seen with IgM as well as IgG and IgA. No correlation was found between affinity or avidity, or complement deposition or consumption, and inhibition of killing. Conclusion/Significance IgG and IgM classes of anti-S. Typhimurium LPS antibodies from HIV-infected and HIV-uninfected individuals are bactericidal, while at very high concentrations, anti-LPS antibodies of all classes inhibit in vitro killing of Salmonella. This could be due to a variety of mechanisms relating to the poor ability of IgA and IgG2 to activate complement, and deposition of complement at sites where it cannot insert in the bacterial membrane. Vaccine trials

  6. HLA disease association and protection in HIV infection among African Americans and Caucasians.

    PubMed

    Cruse, J M; Brackin, M N; Lewis, R E; Meeks, W; Nolan, R; Brackin, B

    1991-01-01

    In a previous investigation, we demonstrated an increased progression of overt AIDS in the African American population compared to the Caucasian population as reflected by the significantly lower absolute number of CD4+ lymphocytes detected in the African American population in an earlier study. The present study elucidates some of the possible genetic factors which may contribute to disease association or protection against HIV infection. The HLA phenotypes expressed as A, B, C, DR and DQw antigens were revealed by the Amos-modified typing procedure. NIH scoring was utilized to designate positive cells taking up trypan blue. A test of proportion equivalent to the chi 2 approximation was used to compare the disease population (n = 62; 38 African Americans, 24 Caucasians) to race-matched normal heterosexual local controls (323 African Americans, 412 Caucasians). Significant p values were corrected for the number of HLA antigens tested. HLA markers associated with possible protection from infection for African Americans were Cw4 and DRw6, whereas Caucasians expressed none. Disease association markers present in the African American population were A31, B35, Cw6, Cw7, DR5, DR6, DRw11, DRw12, DQw6 and DQw7, whereas in the Caucasian population A28, Aw66, Aw48, Bw65, Bw70, Cw7, DRw10, DRw12, DQw6 and DQw7 were demonstrated. The highest phenotypic frequency for a disease association marker in the study was for HLA-DR5 (62.9%) in the HIV-infected African American population without Kaposi's sarcoma compared to a frequency of 28.9% for the regional control group (p = 0.0012). We conclude that genetic factors do have a role in HIV infection since only 50-60% of those exposed to the AIDS virus will become infected. PMID:1910527

  7. Effect of SLCO1B1 Polymorphisms on Rifabutin Pharmacokinetics in African HIV-Infected Patients with Tuberculosis.

    PubMed

    Hennig, Stefanie; Naiker, Suhashni; Reddy, Tarylee; Egan, Deirdre; Kellerman, Tracy; Wiesner, Lubbe; Owen, Andrew; McIlleron, Helen; Pym, Alexander

    2016-01-01

    Rifabutin, used to treat HIV-infected tuberculosis, shows highly variable drug exposure, complicating dosing. Effects of SLCO1B1 polymorphisms on rifabutin pharmacokinetics were investigated in 35 African HIV-infected tuberculosis patients after multiple doses. Nonlinear mixed-effects modeling found that influential covariates for the pharmacokinetics were weight, sex, and a 30% increased bioavailability among heterozygous carriers of SLCO1B1 rs1104581 (previously associated with low rifampin concentrations). Larger studies are needed to understand the complex interactions of host genetics in HIV-infected tuberculosis patients. (This study has been registered at ClinicalTrials.gov under registration no. NCT00640887.). PMID:26482301

  8. Effect of SLCO1B1 Polymorphisms on Rifabutin Pharmacokinetics in African HIV-Infected Patients with Tuberculosis

    PubMed Central

    Naiker, Suhashni; Reddy, Tarylee; Egan, Deirdre; Kellerman, Tracy; Wiesner, Lubbe; Owen, Andrew; McIlleron, Helen; Pym, Alexander

    2015-01-01

    Rifabutin, used to treat HIV-infected tuberculosis, shows highly variable drug exposure, complicating dosing. Effects of SLCO1B1 polymorphisms on rifabutin pharmacokinetics were investigated in 35 African HIV-infected tuberculosis patients after multiple doses. Nonlinear mixed-effects modeling found that influential covariates for the pharmacokinetics were weight, sex, and a 30% increased bioavailability among heterozygous carriers of SLCO1B1 rs1104581 (previously associated with low rifampin concentrations). Larger studies are needed to understand the complex interactions of host genetics in HIV-infected tuberculosis patients. (This study has been registered at ClinicalTrials.gov under registration no. NCT00640887.) PMID:26482301

  9. Foster care history and HIV infection among drug-using African American female sex workers.

    PubMed

    Surratt, Hilary L; Kurtz, Steven P

    2012-05-01

    Foster care has been associated with increased HIV risk behaviors among youth, yet long-term association with HIV infection has not been examined. This study explored the associations between foster placement, victimization, mental health, onset of sex work and HIV infection among highly vulnerable female sex workers. 562 drug-involved African American women were enrolled into an intervention study to increase health services utilization and reduce HIV risk. Seventeen percent reported a history of foster placement. Foster history was associated with significantly lower educational attainment, higher victimization, and more severe mental health problems. Women with foster histories reported significantly earlier entry into paid sex work, with some 62% active in the sex trade before age 18. Multivariate analyses found that foster care was independently associated with HIV seropositivity, and that early sex work partially mediated this association. The potential long-term health vulnerabilities associated with foster placement are understudied and warrant additional research. PMID:21818654

  10. Foster Care History and HIV Infection among Drug-Using African American Female Sex Workers

    PubMed Central

    Surratt, Hilary L.; Kurtz, Steven P.

    2011-01-01

    Foster care has been associated with increased HIV risk behaviors among youth, yet long-term association with HIV infection has not been examined. This study explored the associations between foster placement, victimization, mental health, onset of sex work and HIV infection among highly vulnerable female sex workers. 562 drug-involved African American women were enrolled into an intervention study to increase health services utilization and reduce HIV risk. Seventeen percent reported a history of foster placement. Foster history was associated with significantly lower educational attainment, higher victimization, and more severe mental health problems. Women with foster histories reported significantly earlier entry into paid sex work, with some 62% active in the sex trade before age 18. Multivariate analyses found that foster care was independently associated with HIV seropositivity, and that early sex work partially mediated this association. The potential long-term health vulnerabilities associated with foster placement are understudied and warrant additional research. PMID:21818654

  11. What African American Male Adolescents Are Telling Us about HIV Infection among Their Peers: Cultural Approaches for HIV Prevention

    ERIC Educational Resources Information Center

    Voisin, Dexter R.; Bird, Jason D. P.

    2009-01-01

    This study explored the beliefs of African American male adolescents concerning the high rates of HIV infection among their peers and their reasons for those beliefs. In-depth interviews were conducted with a sample of 16 male African Americans, and a thematic analysis of the data was conducted. Half of the participants believed that peers were…

  12. Stroke in HIV-infected African Americans: a retrospective cohort study.

    PubMed

    Thakur, Kiran T; Lyons, Jennifer L; Smith, Bryan R; Shinohara, Russell T; Mateen, Farrah J

    2016-02-01

    The risk of having a first stroke is nearly twice as high among African Americans compared to Caucasians. HIV/AIDS is an independent risk factor for stroke. Our study aimed to report the risk factors and short-term clinical outcomes of African Americans with HIV infection and new-onset stroke admitted at the Johns Hopkins Hospitals (2000-2012). Multivariate linear regression was used to examine the association between potential predictors and odds of an unfavorable outcome, defined as a higher modified Rankin Scale (mRS) score on hospital discharge. African Americans comprised 105/125 (84%) of HIV-infected new-onset stroke inpatients (median age 50 years; 69% men; median CD4 140/mL; ischemic 77%; 39% taking highly active antiretroviral therapy). Vascular risk factors were common: hypertension (67%), cigarette smoking (66%), dyslipidemia (42%), hepatitis C (48%), intravenous drug abuse (32%), and prior myocardial infarction (29%). Prior aspirin and statin use were uncommon (18%, 9%). Unfavorable outcome (mRS score 4-6, n = 22 of 90 available records) was noted in 24% of patients, including seven in-hospital deaths. On multivariate analyses, higher CD4 count on hospital admission was associated with a lower mRS (-0.2 mRS points per 1 unit increase in CD4, 95% CI (-0.3, 0), p = 0.03). Intracerebral hemorrhage was also associated with a lower mRS (1.0 points lower, 95% CI (0.2, 1.8) compared to ischemic stroke, p = 0.01) after adjustment for other potential predictors. This underscores the importance of HIV infection on functional stroke outcomes beyond its recognized influence on stroke risk. PMID:26155903

  13. Structural and Sociocultural Factors Associated with Cervical Cancer Screening Among HIV-Infected African American Women in Alabama

    PubMed Central

    Moneyham, Linda; Kempf, Mirjam-Colette; Chamot, Eric; Scarinci, Isabel

    2015-01-01

    Abstract African American women have disproportionately high prevalence rates of HIV and cervical cancer. HIV-infected women are significantly less likely to obtain recommended cervical cancer screenings than HIV-uninfected women. The purpose of this study was to examine sociocultural and structural factors associated with cervical cancer screening among HIV-infected African American in Alabama. The PEN-3 Model and the Health Belief Model were used as theoretical frameworks. In-depth interviews were conducted with twenty HIV-infected African American women to identify perceptions, enablers, and nurturers, perceived susceptibility, perceived severity, and perceived benefits related to cervical cancer and screening. The most common positive perceptions, enablers, and nurturers that contributed to cervical cancer screening included internal motivation and awareness of the importance of HIV-infected women getting Pap tests due to their weakened immune system. Negative perceptions, enablers, and nurturers included lack of knowledge about cervical cancer and screening, and lack of perceived susceptibility to cervical cancer. The results of this study can be used to guide the development of culturally relevant cervical cancer and screening education interventions aimed at increasing cervical cancer screening adherence among HIV-infected African American women. PMID:25514125

  14. Structural and sociocultural factors associated with cervical cancer screening among HIV-infected African American women in Alabama.

    PubMed

    Williams, Michelle; Moneyham, Linda; Kempf, Mirjam-Colette; Chamot, Eric; Scarinci, Isabel

    2015-01-01

    African American women have disproportionately high prevalence rates of HIV and cervical cancer. HIV-infected women are significantly less likely to obtain recommended cervical cancer screenings than HIV-uninfected women. The purpose of this study was to examine sociocultural and structural factors associated with cervical cancer screening among HIV-infected African American in Alabama. The PEN-3 Model and the Health Belief Model were used as theoretical frameworks. In-depth interviews were conducted with twenty HIV-infected African American women to identify perceptions, enablers, and nurturers, perceived susceptibility, perceived severity, and perceived benefits related to cervical cancer and screening. The most common positive perceptions, enablers, and nurturers that contributed to cervical cancer screening included internal motivation and awareness of the importance of HIV-infected women getting Pap tests due to their weakened immune system. Negative perceptions, enablers, and nurturers included lack of knowledge about cervical cancer and screening, and lack of perceived susceptibility to cervical cancer. The results of this study can be used to guide the development of culturally relevant cervical cancer and screening education interventions aimed at increasing cervical cancer screening adherence among HIV-infected African American women.

  15. HIV infection among injecting drug users in north-east Malaysia, 1992.

    PubMed

    Singh, S; Crofts, N

    1993-01-01

    Human immunodeficiency virus (HIV) has spread widely among injecting drug users (IDUs) in countries to the north and west of the 'Golden Triangle' region of South-East Asia; it is likely to have spread southwards to Malaysia as well. In order to assess HIV seroprevalence among IDUs in north-east Malaysia and describe risk factors for HIV infection in this population, we performed a cross-sectional seroepidemiological study among 210 IDUs recruited at the detoxification ward of the General Hospital in the capital city of the north-eastern Malaysian state, Kelantan. Subjects were sequential entrants to the detoxification ward, interviewed about HIV risk behaviour, and tested for antibody to HIV and to syphilis. Nearly a third (62/210, 30%) of these IDUs were HIV seropositive. Three-quarters (159/210) had travelled to Thailand in the preceding 5 years, of whom 32% (51/159) were HIV seropositive; this was associated with injecting in Thailand, but not with sexual contact there. Of those who had not left Malaysia in the preceding 5 years, 26% (11/43) were HIV seropositive, a rate not significantly different from those who had travelled. Travel within Malaysia was common (144/210, 69%) among IDUs interviewed, as was unsafe injecting and unsafe sexual behaviour (20% had shared injecting equipment and 21% had had unprotected intercourse) in other states. In every locale, rates of unsafe injecting behaviour were high (55% sharing in last month), even among those who knew they were HIV infected, and rates of condom usage were low (93% of 160 sexually active IDUs had never used a condom). Syphilis was not associated with HIV infection, but with contact with Thai prostitutes.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8218462

  16. Mortality among blacks or African Americans with HIV infection--United States, 2008-2012.

    PubMed

    Siddiqi, Azfar-e-Alam; Hu, Xiaohong; Hall, H Irene

    2015-02-01

    A primary goal of the National HIV/AIDS Strategy is to reduce HIV-related health disparities, including HIV-related mortality in communities at high risk for human immunodeficiency virus (HIV) infection. As a group, persons who self-identify as blacks or African Americans (referred to as blacks in this report), have been affected by HIV more than any other racial/ethnic population. Forty-seven percent of persons who received an HIV diagnosis in the United States in 2012 and 43% of all persons living with diagnosed HIV infection in 2011 were black. Blacks also experienced a low 3-year survival rate among persons with HIV infection diagnosed during 2003-2008. CDC and its partners have been pursuing a high-impact prevention approach and supporting projects focusing on minorities to improve diagnosis, linkage to care, and retention in care, and to reduce disparities in HIV-related health outcomes. To measure trends in disparities in mortality among blacks, CDC analyzed data from the National HIV Surveillance System. The results of that analysis indicated that among blacks aged ≥13 years the death rate per 1,000 persons living with diagnosed HIV decreased from 28.4 in 2008 to 20.5 in 2012. Despite this improvement, in 2012 the death rate per 1,000 persons living with HIV among blacks was 13% higher than the rate for whites and 47% higher than the rate for Hispanics or Latinos. These data demonstrate the need for implementation of interventions and public health strategies to further reduce disparities in deaths.

  17. Anti-Retroviral Therapy Increases the Prevalence of Dyslipidemia in South African HIV-Infected Patients

    PubMed Central

    Dave, Joel A.; Levitt, Naomi S.; Ross, Ian L.; Lacerda, Miguel; Maartens, Gary; Blom, Dirk

    2016-01-01

    Purpose Data on the prevalence of dyslipidaemia and associated risk factors in HIV-infected patients from sub-Saharan Africa is sparse. We performed a cross-sectional analysis in a cohort of HIV-infected South African adults. Methods We studied HIV-infected patients who were either antiretroviral therapy (ART)-naive or receiving non-nucleoside reverse transcriptase inhibitor (NNRTI)-based or protease inhibitor (PI)-based ART. Evaluation included fasting lipograms, oral glucose tolerance tests and clinical anthropometry. Dyslipidemia was defined using the NCEP ATPIII guidelines. Results The median age of the participants was 34 years (range 19–68 years) and 78% were women. The prevalence of dyslipidemia in 406 ART-naive and 551 participants on ART was 90.0% and 85%, respectively. Low HDL-cholesterol (HDLC) was the most common abnormality [290/406 (71%) ART-naïve and 237/551 (43%) ART- participants]. Participants on ART had higher triglycerides (TG), total cholesterol (TC), LDL-cholesterol (LDLC) and HDLC than the ART-naïve group. Severe dyslipidaemia, (LDLC> 4.9 mmol/L or TG >5.0 mmol/L) was present in <5% of participants. In multivariate analyses there were complex associations between age, gender, type and duration of ART and body composition and LDLC, HDLC and TG, which differed between ART-naïve and ART-participants. Conclusion Participants on ART had higher TG, TC, LDLC and HDLC than those who were ART-naïve but severe lipid abnormalities requiring evaluation and treatment were uncommon. PMID:26986065

  18. Localized spatial clustering of HIV infections in a widely disseminated rural South African epidemic

    PubMed Central

    Tanser, Frank; Bärnighausen, Till; Cooke, Graham S; Newell, Marie-Louise

    2009-01-01

    Background South Africa contains more than one in seven of the world's HIV-positive population. Knowledge of local variation in levels of HIV infection is important for prioritization of areas for intervention. We apply two spatial analytical techniques to investigate the micro-geographical patterns and clustering of HIV infections in a high prevalence, rural population in KwaZulu-Natal, South Africa. Methods All 12 221 participants who consented to an HIV test in a population under continuous demographical surveillance were linked to their homesteads and geo-located in a geographical information system (accuracy of <2 m). We then used a two-dimensional Gaussian kernel of radius 3 km to produce robust estimates of HIV prevalence that vary across continuous geographical space. We also applied a Kulldorff spatial scan statistic (Bernoulli model) to formally identify clusters of infections (P < 0.05). Results The results reveal considerable geographical variation in local HIV prevalence (range = 6–36%) within this relatively homogenous population and provide clear empirical evidence for the localized clustering of HIV infections. Three high-risk, overlapping spatial clusters [Relative Risk (RR) = 1.34–1.62] were identified by the Kulldorff statistic along the National Road (P ≤ 0.01), whereas three low risk clusters (RR = 0.2–0.38) were identified elsewhere in the study area (P ≤ 0.017). Conclusions The findings show the existence of several localized HIV epidemics of varying intensity that are partly contained within geographically defined communities. Despite the overall high prevalence of HIV in many rural South African settings, the results support the need for interventions that target socio-geographic spaces (communities) at greatest risk to supplement measures aimed at the general population. PMID:19261659

  19. Keep them in school: the importance of education as a protective factor against HIV infection among young South African women

    PubMed Central

    Pettifor, Audrey E; Levandowski, Brooke A; MacPhail, Catherine; Padian, Nancy S; Cohen, Myron S; Rees, Helen V

    2008-01-01

    Objective To identify risk factors for HIV infection among young women aged 15–24 years reporting one lifetime partner in South Africa. Design In 2003, we conducted a nationally representative household survey of sexual behaviour and HIV testing among 11 904 young people aged 15–24 years in South Africa. This analysis focuses on the subset of sexually experienced young women with only one reported lifetime sex partner (n = 1708). Methods Using the proximate determinants framework and the published literature we identified factors associated with HIV in young women. The associations between these factors and HIV infection were explored in multivariable logistic regression models. Results Of the young women, 15% reporting one lifetime partner were HIV positive. In multivariable analyses, young women who had not completed high school were more likely to be infected with HIV compared with those that had completed high school (AOR 3.75; 95% CI 1.34–10.46). Conclusions Young South African women in this population were at high risk of HIV infection despite reporting only having one lifetime partner. Few individual level factors were associated with HIV infection, emphasizing the importance of developing HIV prevention interventions that address structural and partner level risk factors. PMID:18614609

  20. Gender Expression and Risk of HIV Infection Among Black South African Men Who Have Sex with Men.

    PubMed

    Sandfort, Theodorus G M; Lane, Tim; Dolezal, Curtis; Reddy, Vasu

    2015-12-01

    To explore demographic, behavioral and psychosocial risk factors for HIV infection in South African MSM we recruited 480 MSM (aged 18 and 44 years) using respondent-driven sampling. Data were collected through individual computer-assisted face-to-face interviews. Participants were tested for HIV. RDS-adjusted HIV prevalence is 30.1 % (unadjusted 35.6 %). Few participants had ever engaged in both receptive and insertive anal sex; sex with women was frequently reported. Independent demographic and behavioral correlates of HIV infection include age, education, number of male sexual partners, ever having been forced to have sex, and ever having engaged in transactional sex; engagement in sex with women was a protective factor. Psychosocial risk factors independently associated with HIV infection were feminine identification, internalized homophobia, and hazardous drinking. Our findings confirm what has been found in other studies, but also suggest that the dynamics and context of sexual transmission among MSM in South Africa differ from those among MSM in Western countries. PMID:25869555

  1. Vitamin D deficiency is associated with coronary artery calcification in cardiovascularly asymptomatic African Americans with HIV infection

    PubMed Central

    Lai, Shenghan; Fishman, Elliot K; Gerstenblith, Gary; Brinker, Jeffrey; Tai, Hong; Chen, Shaoguang; Li, Ji; Tong, Wenjing; Detrick, Barbara; Lai, Hong

    2013-01-01

    Objective Patients with HIV infection are at increased risk for coronary artery disease (CAD), and growing evidence suggests a possible link between vitamin D deficiency and clinical/subclinical CAD. However, the relationship between vitamin D deficiency and coronary artery calcification (CAC), a sensitive marker for subclinical CAD, in those with HIV infection is not well investigated. Methods CAC was quantified using a Siemens Cardiac 64 scanner, and vitamin D levels and the presence of traditional and novel risk factors for CAD were obtained in 846 HIV-infected African American (AA) participants aged 25 years or older in Baltimore, MD, USA without symptoms or clinical evidence of CAD. Results The prevalence of vitamin D deficiency (25-hydroxy vitamin D <10 ng/mL) was 18.7%. CAC was present in 238 (28.1%) of the 846 participants. Logistic regression analysis revealed that the following factors were independently associated with CAC: age (adjusted odds ratio [OR]: 1.11; 95% confidence interval [CI]: 1.08–1.14); male sex (adjusted OR: 1.71; 95% CI: 1.18–2.49); family history of CAD (adjusted OR: 1.53; 95% CI: 1.05–2.23); total cholesterol (adjusted OR: 1.006; 95% CI: 1.002–1.010); high-density lipoprotein cholesterol (adjusted OR: 0.989; 95% CI: 0.979–0.999); years of cocaine use (adjusted OR: 1.02; 95% CI: 1.001–1.04); duration of exposure to protease inhibitors (adjusted OR: 1.004; 95% CI: 1.001–1.007); and vitamin D deficiency (adjusted OR: 1.98; 95% CI: 1.31–3.00). Conclusion Both vitamin D deficiency and CAC are prevalent in AAs with HIV infection. In order to reduce the risk for CAD in HIV-infected AAs, vitamin D levels should be closely monitored. These data also suggest that clinical trials should be conducted to examine whether vitamin D supplementations reduce the risk of CAD in this AA population. PMID:24009422

  2. Blood Group Antigens C, Lub and P1 May Have a Role in HIV Infection in Africans

    PubMed Central

    Motswaledi, Modisa Sekhamo; Kasvosve, Ishmael; Oguntibeju, Oluwafemi Omoniyi

    2016-01-01

    Background Botswana is among the world’s countries with the highest rates of HIV infection. It is not known whether or not this susceptibility to infection is due to genetic factors in the population. Accumulating evidence, however, points to the role of erythrocytes as potential mediators of infection. We therefore sought to establish the role, if any, of some erythrocyte antigens in HIV infection in a cross-section of the population. Methods 348 (346 HIV-negative and 2 HIV-positive) samples were obtained from the National Blood Transfusion Service as residual samples, while 194 HIV-positive samples were obtained from the Botswana-Harvard HIV Reference Laboratory. Samples were grouped for twenty three antigens. Chi-square or Fischer Exact analyses were used to compare the frequencies of the antigens in the two groups. A stepwise, binary logistic regression was used to study the interaction of the various antigens in the light of HIV-status. Results The Rh antigens C and E were associated with HIV-negative status, while blood group Jka, P1 and Lub were associated with HIV-positive status. A stepwise binary logistic regression analysis yielded group C as the most significant protective blood group while Lub and P1 were associated with significantly higher odds ratio in favor of HIV-infection. The lower-risk-associated group C was significantly lower in Africans compared to published data for Caucasians and might partially explain the difference in susceptibility to HIV-1. Conclusion The most influential antigen C, which also appears to be protective, is significantly lower in Africans than published data for Caucasians or Asians. On the other hand, there appear to be multiple antigens associated with increased risk that may override the protective role of C. A study of the distribution of these antigens in other populations may shed light on their roles in the HIV pandemic. PMID:26900853

  3. East African Rift Valley, Kenya

    NASA Technical Reports Server (NTRS)

    1990-01-01

    This rare, cloud free view of the East African Rift Valley, Kenya (1.5N, 35.5E) shows a clear view of the Turkwell River Valley, an offshoot of the African REift System. The East African Rift is part of a vast plate fracture which extends from southern Turkey, through the Red Sea, East Africa and into Mozambique. Dark green patches of forests are seen along the rift margin and tea plantations occupy the cooler higher ground.

  4. HIV Infection and the Epidemiology of Invasive Pneumococcal Disease (IPD) in South African Adults and Older Children Prior to the Introduction of a Pneumococcal Conjugate Vaccine (PCV)

    PubMed Central

    Meiring, Susan; Cohen, Cheryl; Quan, Vanessa; de Gouveia, Linda; Feldman, Charles; Karstaedt, Alan; Klugman, Keith P.; Madhi, Shabir A.; Rabie, Helene; Sriruttan, Charlotte; von Gottberg, Anne

    2016-01-01

    Introduction Streptococcus pneumoniae is the commonest cause of bacteremic pneumonia among HIV-infected persons. As more countries with high HIV prevalence are implementing infant pneumococcal conjugate vaccine (PCV) programs, we aimed to describe the baseline clinical characteristics of adult invasive pneumococcal disease (IPD) in the pre-PCV era in South Africa in order to interpret potential indirect effects following vaccine use. Methods National, active, laboratory-based surveillance for IPD was conducted in South Africa from 1 January 2003 through 31 December 2008. At 25 enhanced surveillance (ES) hospital sites, clinical data, including HIV serostatus, were collected from IPD patients ≥ 5 years of age. We compared the clinical characteristics of individuals with IPD in those HIV-infected and -uninfected using multivariable analysis. PCV was introduced into the routine South African Expanded Program on Immunization (EPI) in 2009. Results In South Africa, from 2003–2008, 17 604 cases of IPD occurred amongst persons ≥ 5 years of age, with an average incidence of 7 cases per 100 000 person-years. Against a national HIV-prevalence of 18%, 89% (4190/4734) of IPD patients from ES sites were HIV-infected. IPD incidence in HIV-infected individuals is 43 times higher than in HIV-uninfected persons (52 per 100 000 vs. 1.2 per 100 000), with a peak in the HIV-infected elderly population of 237 per 100 000 persons. Most HIV-infected individuals presented with bacteremia (74%, 3 091/4 190). HIV-uninfected individuals were older; and had more chronic conditions (excluding HIV) than HIV-infected persons (39% (210/544) vs. 19% (790/4190), p<0.001). During the pre-PCV immunization era in South Africa, 71% of serotypes amongst HIV-infected persons were covered by PCV13 vs. 73% amongst HIV-uninfected persons, p = 0.4, OR 0.9 (CI 0.7–1.1). Conclusion Seventy to eighty-five percent of adult IPD in the pre-PCV era were vaccine serotypes and 93% of cases had recognized risk

  5. The Distribution of Obesity Phenotypes in HIV-Infected African Population.

    PubMed

    Nguyen, Kim Anh; Peer, Nasheeta; de Villiers, Anniza; Mukasa, Barbara; Matsha, Tandi E; Mills, Edward J; Kengne, Andre Pascal

    2016-01-01

    The distribution of body size phenotypes in people with human immunodeficiency virus (HIV) infection has yet to be characterized. We assessed the distribution of body size phenotypes overall, and according to antiretroviral therapy (ART), diagnosed duration of the infection and CD4 count in a sample of HIV infected people recruited across primary care facilities in the Western Cape Province, South Africa. Adults aged ≥ 18 years were consecutively recruited using random sampling procedures, and their cardio-metabolic profile were assessed during March 2014 and February 2015. They were classified across body mass index (BMI) categories as normal-weight (BMI < 25 kg/m²), overweight (25 ≤ BMI < 30 kg/m²), and obese (BMI ≥ 30 kg/m²), and further classified according to their metabolic status as "metabolically healthy" vs. "metabolically abnormal" if they had less than two vs. two or more of the following abnormalities: high blood glucose, raised blood pressure, raised triglycerides, and low HDL-cholesterol. Their cross-classification gave the following six phenotypes: normal-weight metabolically healthy (NWMH), normal-weight metabolically abnormal (NWMA), overweight metabolically healthy (OvMH), overweight metabolically abnormal (OvMA), obese metabolically healthy (OMH), and obese metabolically abnormal (OMA). Among the 748 participants included (median age 38 years (25th-75th percentiles: 32-44)), 79% were women. The median diagnosed duration of HIV was five years; the median CD4 count was 392 cells/mm³ and most participants were on ART. The overall distribution of body size phenotypes was the following: 31.7% (NWMH), 11.7% (NWMA), 13.4% (OvMH), 9.5% (OvMA), 18.6% (OMH), and 15.1% (OMA). The distribution of metabolic phenotypes across BMI levels did not differ significantly in men vs. women (p = 0.062), in participants below vs. those at or above median diagnosed duration of HIV infection (p = 0.897), in participants below vs. those at or above median CD4

  6. The Distribution of Obesity Phenotypes in HIV-Infected African Population

    PubMed Central

    Nguyen, Kim Anh; Peer, Nasheeta; de Villiers, Anniza; Mukasa, Barbara; Matsha, Tandi E.; Mills, Edward J.; Kengne, Andre Pascal

    2016-01-01

    The distribution of body size phenotypes in people with human immunodeficiency virus (HIV) infection has yet to be characterized. We assessed the distribution of body size phenotypes overall, and according to antiretroviral therapy (ART), diagnosed duration of the infection and CD4 count in a sample of HIV infected people recruited across primary care facilities in the Western Cape Province, South Africa. Adults aged ≥ 18 years were consecutively recruited using random sampling procedures, and their cardio-metabolic profile were assessed during March 2014 and February 2015. They were classified across body mass index (BMI) categories as normal-weight (BMI < 25 kg/m2), overweight (25 ≤ BMI < 30 kg/m2), and obese (BMI ≥ 30 kg/m2), and further classified according to their metabolic status as “metabolically healthy” vs. “metabolically abnormal” if they had less than two vs. two or more of the following abnormalities: high blood glucose, raised blood pressure, raised triglycerides, and low HDL-cholesterol. Their cross-classification gave the following six phenotypes: normal-weight metabolically healthy (NWMH), normal-weight metabolically abnormal (NWMA), overweight metabolically healthy (OvMH), overweight metabolically abnormal (OvMA), obese metabolically healthy (OMH), and obese metabolically abnormal (OMA). Among the 748 participants included (median age 38 years (25th–75th percentiles: 32–44)), 79% were women. The median diagnosed duration of HIV was five years; the median CD4 count was 392 cells/mm3 and most participants were on ART. The overall distribution of body size phenotypes was the following: 31.7% (NWMH), 11.7% (NWMA), 13.4% (OvMH), 9.5% (OvMA), 18.6% (OMH), and 15.1% (OMA). The distribution of metabolic phenotypes across BMI levels did not differ significantly in men vs. women (p = 0.062), in participants below vs. those at or above median diagnosed duration of HIV infection (p = 0.897), in participants below vs. those at or above median

  7. African American community leaders' policy recommendations for reducing racial disparities in HIV infection, treatment and care: results from a community-based participatory research project in Philadelphia, PA

    PubMed Central

    Nunn, Amy; Sanders, Julia; Carson, Lee; Thomas, Gladys; Cornwall, Alexandra; Towey, Caitlin; Lee, Hwajin; Tasco, Marian; Shabazz-El, Waheedah; Yolken, Annajane; Smith, Tyrone; Bell, Gary; Feller, Sophie; Smith, Erin; James, George; Dunston, Brenda Shelton; Green, Derek

    2015-01-01

    African Americans account for 45% of new HIV infections in the United States. Little empirical research investigates African American community leaders' normative recommendations for addressing these disparities. Philadelphia's HIV infection rate is five times the national average, nearly 70% of new infections are among African Americans, and 2% of African Americans in Philadelphia are living with HIV/AIDS. Using a community-based participatory research (CBPR) approach, we convened focus groups among 52 African American community leaders from diverse backgrounds to solicit normative recommendations for reducing Philadelphia's racial disparities in HIV infection. Leaders recommended: 1) Philadelphia's city government should raise awareness about HIV/AIDS with media campaigns featuring local leaders; 2) Local HIV prevention interventions should address social and structural factors influencing HIV risks rather than focus exclusively on mode of HIV transmission; 3) Resources should be distributed to the most heavily impacted neighborhoods of Philadelphia; and 4) Faith institutions should play a critical role in HIV testing, treatment and prevention efforts. We developed a policy memo highlighting these normative recommendations for how to enhance local HIV prevention policy. This policy memo led to Philadelphia City Council hearings about HIV/AIDS in October 2010 and subsequently informed local HIV/AIDS prevention policy and development of local HIV prevention interventions. This CBPR case study offers important lessons for effectively engaging community leaders in research to promote HIV/AIDS policy change. PMID:24879446

  8. PEPFAR Funding and Reduction in HIV Infection Rates in 12 Focus Sub-Saharan African Countries: A Quantitative Analysis

    PubMed Central

    Chin, Roger J.; Sangmanee, Domrongphol; Piergallini, Lisa

    2015-01-01

    Background: HIV and AIDS continue to have a calamitous effect on individuals living on the continent of Africa. U.S. President George W. Bush implemented the President’s Emergency Plan for AIDS Relief (PEPFAR) with the objective of committing approximately $15 billion from 2004 through 2008 to assist with the reduction of the HIV pandemic worldwide. The majority of the PEPFAR policy and funding focused on 12 countries in sub-Saharan Africa: Botswana, Cote d’Ivoire, Ethiopia, Kenya, Mozambique, Namibia, Nigeria, Rwanda, South Africa, Tanzania, Uganda, and Zambia. The policy question this research paper seeks to analyze is whether the PEPFAR funding (as a % of Gross Domestic Product (GDP)) allocated to the 12 countries in Africa had any effect on the decrease of HIV infection rates of males and females between the ages of 15 and 49. Methods: A fixed-effects panel regression analysis was conducted to determine if this association exists. This study examined the 12 African countries that received PEPFAR funding over the years 2002 to 2010; even though PEPFAR was only active from 2004 through 2008, this research included two years prior and two years after this timeframe in order to better estimate the effect of PEPFAR funding on HIV reduction. Results: The results illustrate that on average, ceteris paribus, for every 1 percentage point increase in PEPFAR funding per GDP a country received, the country’s HIV infection rate decreased by 0.355 percentage points. Conclusions and Global Health Implications: While the empirical findings in this study suggested that the correlation between PEPFAR funding and HIV reduction is statistically significant, the practical significance is perhaps less obvious. Arguably, the reduction rate should be higher given the extent of funding targeted to this project. The conclusion of this research provides suggestions on future research and the policy implications of PEPFAR.

  9. PEPFAR Funding and Reduction in HIV Infection Rates in 12 Focus Sub-Saharan African Countries: A Quantitative Analysis

    PubMed Central

    Chin, Roger J.; Sangmanee, Domrongphol; Piergallini, Lisa

    2015-01-01

    Background: HIV and AIDS continue to have a calamitous effect on individuals living on the continent of Africa. U.S. President George W. Bush implemented the President’s Emergency Plan for AIDS Relief (PEPFAR) with the objective of committing approximately $15 billion from 2004 through 2008 to assist with the reduction of the HIV pandemic worldwide. The majority of the PEPFAR policy and funding focused on 12 countries in sub-Saharan Africa: Botswana, Cote d’Ivoire, Ethiopia, Kenya, Mozambique, Namibia, Nigeria, Rwanda, South Africa, Tanzania, Uganda, and Zambia. The policy question this research paper seeks to analyze is whether the PEPFAR funding (as a % of Gross Domestic Product (GDP)) allocated to the 12 countries in Africa had any effect on the decrease of HIV infection rates of males and females between the ages of 15 and 49. Methods: A fixed-effects panel regression analysis was conducted to determine if this association exists. This study examined the 12 African countries that received PEPFAR funding over the years 2002 to 2010; even though PEPFAR was only active from 2004 through 2008, this research included two years prior and two years after this timeframe in order to better estimate the effect of PEPFAR funding on HIV reduction. Results: The results illustrate that on average, ceteris paribus, for every 1 percentage point increase in PEPFAR funding per GDP a country received, the country’s HIV infection rate decreased by 0.355 percentage points. Conclusions and Global Health Implications: While the empirical findings in this study suggested that the correlation between PEPFAR funding and HIV reduction is statistically significant, the practical significance is perhaps less obvious. Arguably, the reduction rate should be higher given the extent of funding targeted to this project. The conclusion of this research provides suggestions on future research and the policy implications of PEPFAR. PMID:27621994

  10. East African Rift

    NASA Technical Reports Server (NTRS)

    2008-01-01

    Places where the earth's crust has formed deep fissures and the plates have begun to move apart develop rift structures in which elongate blocks have subsided relative to the blocks on either side. The East African Rift is a world-famous example of such rifting. It is characterized by 1) topographic deep valleys in the rift zone, 2) sheer escarpments along the faulted walls of the rift zone, 3) a chain of lakes within the rift, most of the lakes highly saline due to evaporation in the hot temperatures characteristic of climates near the equator, 4) voluminous amounts of volcanic rocks that have flowed from faults along the sides of the rift, and 5) volcanic cones where magma flow was most intense. This example in Kenya displays most of these features near Lake Begoria.

    The image was acquired December 18, 2002, covers an area of 40.5 x 32 km, and is located at 0.1 degrees north latitude, 36.1 degrees east longitude.

    The U.S. science team is located at NASA's Jet Propulsion Laboratory, Pasadena, Calif. The Terra mission is part of NASA's Science Mission Directorate.

  11. Pubertal development in HIV-infected African children on first-line antiretroviral therapy

    PubMed Central

    Szubert, Alexander J.; Musiime, Victor; Bwakura-Dangarembizi, Mutsawashe; Nahirya-Ntege, Patricia; Kekitiinwa, Adeodata; Gibb, Diana M.; Nathoo, Kusum; Prendergast, Andrew J.; Walker, A. Sarah

    2015-01-01

    Objectives: To estimate age at attaining Tanner stages in Ugandan/Zimbabwean HIV-infected children initiating antiretroviral therapy (ART) in older childhood and investigate predictors of delayed puberty, particularly age at ART initiation. Design: Observational analysis within a randomized trial. Methods: Tanner staging was assessed every 24 weeks from 10 years of age, menarche every 12 weeks and height every 4–6 weeks. Age at attaining different Tanner stages was estimated using normal interval regression, considering predictors using multivariable regression. Growth was estimated using multilevel models with child-specific intercepts and trajectories. Results: Median age at ART initiation was 9.4 years (inter-quartile range 7.8, 11.3) (n = 582). At the first assessment, the majority (80.2%) were in Tanner stage 1; median follow-up with staging was 2.8 years. There was a strong delaying effect of older age at ART initiation on age at attaining all Tanner stages (P < 0.05) and menarche (P = 0.02); in boys the delaying effect generally weakened with older age. There were additional significant delays associated with greater impairments in pre-ART height-for-age Z-score (P < 0.05) in both sexes and pre-ART BMI-for-age in girls (P < 0.05). There was no evidence that pre-ART immuno-suppression independently delayed puberty or menarche. However, older children/adolescents had significant growth spurts in intermediate Tanner stages, and were still significantly increasing their height when in Tanner stage 5 (P < 0.01). Conclusion: Delaying ART initiation until older childhood substantially delays pubertal development and menarche, independently of immuno-suppression. This highlights that factors other than CD4+, such as pubertal development, need consideration when making decisions about timing of ART initiation in older children. PMID:25710288

  12. Correlates of HIV Infection Among African American Women from 20 Cities in the United States

    PubMed Central

    Miles, Isa; Le, Binh; Paz-Bailey, Gabriela

    2016-01-01

    Little research has been conducted to investigate multiple levels of HIV risk—individual risk factors, sex partner characteristics, and socioeconomic factors—among African American women, who, in 2010, comprised 64 % of the estimated 9,500 new infections in women. Respondent-driven sampling was used to recruit and interview women in 20 cities with high AIDS prevalence in the United States through the National HIV Behavioral Surveillance System. We assessed individual risk factors, sex partner characteristics, and socioeconomic characteristics associated with being HIV-positive but unaware of the infection among African American women. Among 3,868 women with no previous diagnosis of HIV, 68 % had high school education or more and 84 % lived at or below the poverty line. In multivariable analysis, women who were 35 years or older, homeless, received Medicaid, whose last sex partner ever used crack cocaine or was an exchange sex partner were more likely to be HIV-positive-unaware. Developing and implementing strategies that address socioeconomic factors, such as homelessness and living in poverty, as well as individual risk factors, can help to maximize the effectiveness of the public health response to the HIV epidemic. PMID:24077972

  13. Association of Streptococcus pneumoniae common protein antigen (CPA) antibodies and pneumococcal nasopharyngeal colonization in HIV-infected and HIV-uninfected African children.

    PubMed

    Ditse, Z; Adrian, P V; Kuwanda, L; Madhi, S A

    2013-09-13

    Due to the high cost and limited serotype coverage of pneumococcal conjugate vaccines (PCV), pneumococcal common protein antigens (CPAs) are being investigated as potential vaccine candidates. CPAs are likely to be immunogenic in infants and could confer serotype-independent protection. There are limited data on natural antibody kinetics against CPAs in African populations. We aimed to determine the prevalence of naturally acquired antibody titres to 15 CPAs and explore their association to concurrent pneumococcal nasopharyngeal colonization in children aged 4-7 years with and without underlying HIV-infection and/or previous PCV-vaccination. A 15-plex Luminex assay was established to measure serum IgG titres against "cell-wall associated or surface-exposed" proteins (PspA, PspC, LytB, IgA1-proteinase, SP0082, PdB and PcsB), "membrane-associated" proteins (PsaA, SP0609, SP0749, PpmA, SlrA, StkP and SP2194) as well as the hypothetical protein, SP2027. Archived serum samples from HIV-uninfected (n=212) and HIV-infected (n=74) children were analyzed. Concurrent pneumococcal nasopharyngeal colonization was determined with standard microbiological methods. HIV-uninfected children had significantly higher antibody titres against PspA, PspC, PdB, SP0082, LytB, IgA1 proteinase and PcsB compared to HIV-infected children. In contrast, antibody titres against membrane associated proteins (PsaA, SP2027, PpmA and SlrA) were significantly lower in HIV-uninfected compared to HIV-infected children. Higher antibody titres against PdB, and PcsB were associated with the absence of pneumococcal colonization. There was no association between anti-CPA titres and PCV vaccination. In conclusion PdB and PcsB antigens are potential vaccine-candidates which may protect against pneumococcal colonization and consequently pneumococcal disease. PMID:23845819

  14. Decreased sexual risk behavior in the era of HAART among HIV-infected urban and rural South Africans attending primary care clinics

    PubMed Central

    Venkatesh, Kartik K; de Bruyn, Guy; Lurie, Mark N; Mohapi, Lerato; Pronyk, Paul; Moshabela, Mosa; Marinda, Edmore; Gray, Glenda E; Triche, Elizabeth W; Martinson, Neil A

    2011-01-01

    Objective In light of increasing access to highly active antiretroviral treatment (HAART) in sub-Saharan Africa, we conducted a longitudinal study to assess the impact of HAART on sexual risk behaviors among HIV-infected South Africans in urban and rural primary care clinics. Design Prospective observational cohort study. Methods We conducted a cohort study at rural and urban primary care HIV clinics in South Africa consisting of 1544 men and 4719 women enrolled from 2003–2010, representing 19703 clinic visits. The primary outcomes were being sexually active, unprotected sex, and >1 sex partner and were evaluated at six monthly intervals. Generalized estimated equations assessed the impact of HAART on sexual risk behaviors. Results Among 6263 HIV-infected men and women, over a third (37.2%) initiated HAART during study follow-up. In comparison to pre-HAART follow-up, visits while receiving HAART were associated with a decrease in those reporting being sexually active (AOR: 0.86 [95% CI: 0.78–0.95]). Unprotected sex and having >1 sex partner were reduced at visits following HAART initiation compared to pre-HAART visits (AOR: 0.40 [95% CI: 0.34–0.46] and AOR: 0.20 [95% CI: 0.14–0.29], respectively). Conclusions Sexual risk behavior significantly decreased following HAART initiation among HIV-infected South African men and women in primary care programs. The further expansion of antiretroviral treatment programs could enhance HIV prevention efforts in Africa. PMID:20808202

  15. Potential Clinical and Economic Value of Long-Acting Preexposure Prophylaxis for South African Women at High-Risk for HIV Infection

    PubMed Central

    Walensky, Rochelle P.; Jacobsen, Margo M.; Bekker, Linda-Gail; Parker, Robert A.; Wood, Robin; Resch, Stephen C.; Horstman, N. Kaye; Freedberg, Kenneth A.; Paltiel, A. David

    2016-01-01

    Background. For young South African women at risk for human immunodeficiency virus (HIV) infection, preexposure prophylaxis (PrEP) is one of the few effective prevention options available. Long-acting injectable PrEP, which is in development, may be associated with greater adherence, compared with that for existing standard oral PrEP formulations, but its likely clinical benefits and additional costs are unknown. Methods. Using a computer simulation, we compared the following 3 PrEP strategies: no PrEP, standard PrEP (effectiveness, 62%; cost per patient, $150/year), and long-acting PrEP (effectiveness, 75%; cost per patient, $220/year) in South African women at high risk for HIV infection (incidence of HIV infection, 5%/year). We examined the sensitivity of the strategies to changes in key input parameters among several outcome measures, including deaths averted and program cost over a 5-year period; lifetime HIV infection risk, survival rate, and program cost and cost-effectiveness; and budget impact. Results. Compared with no PrEP, standard PrEP and long-acting PrEP cost $580 and $870 more per woman, respectively, and averted 15 and 16 deaths per 1000 women at high risk for infection, respectively, over 5 years. Measured on a lifetime basis, both standard PrEP and long-acting PrEP were cost saving, compared with no PrEP. Compared with standard PrEP, long-acting PrEP was very cost-effective ($150/life-year saved) except under the most pessimistic assumptions. Over 5 years, long-acting PrEP cost $1.6 billion when provided to 50% of eligible women. Conclusions. Currently available standard PrEP is a cost-saving intervention whose delivery should be expanded and optimized. Long-acting PrEP will likely be a very cost-effective improvement over standard PrEP but may require novel financing mechanisms that bring short-term fiscal planning efforts into closer alignment with longer-term societal objectives. PMID:26681778

  16. Increase of Transmitted Drug Resistance among HIV-Infected Sub-Saharan Africans Residing in Spain in Contrast to the Native Population

    PubMed Central

    Yebra, Gonzalo; de Mulder, Miguel; Pérez-Elías, María Jesús; Pérez-Molina, José Antonio; Galán, Juan Carlos; Llenas-García, Jara; Moreno, Santiago; Holguín, África

    2011-01-01

    Background The prevalence of transmitted HIV drug resistance (TDR) is stabilizing or decreasing in developed countries. However, this trend is not specifically evaluated among immigrants from regions without well-implemented antiretroviral strategies. Methods TDR trends during 1996–2010 were analyzed among naïve HIV-infected patients in Spain, considering their origin and other factors. TDR mutations were defined according to the World Health Organization list. Results Pol sequence was available for 732 HIV-infected patients: 292 native Spanish, 226 sub-Saharan Africans (SSA), 114 Central-South Americans (CSA) and 100 from other regions. Global TDR prevalence was 9.7% (10.6% for Spanish, 8.4% for SSA and 7.9% for CSA). The highest prevalences were found for protease inhibitors (PI) in Spanish (3.1%), for non-nucleoside reverse transcriptase inhibitors (NNRTI) in SSA (6.5%) and for nucleoside reverse transcriptase inhibitors (NRTI) in both Spanish and SSA (6.5%). The global TDR rate decreased from 11.3% in 2004–2006 to 8.4% in 2007–2010. Characteristics related to a decreasing TDR trend in 2007-10 were Spanish and CSA origin, NRTI- and NNRTI-resistance, HIV-1 subtype B, male sex and infection through injection drug use. TDR remained stable for PI-resistance, in patients infected through sexual intercourse and in those carrying non-B variants. However, TDR increased among SSA and females. K103N was the predominant mutation in all groups and periods. Conclusion TDR prevalence tended to decrease among HIV-infected native Spanish and Central-South Americans, but it increased up to 13% in sub-Saharan immigrants in 2007–2010. These results highlight the importance of a specific TDR surveillance among immigrants to prevent future therapeutic failures, especially when administering NNRTIs. PMID:22046345

  17. Provider perceptions of key barriers to providing state-of-the-art clinical care for HIV-infected African-American patients.

    PubMed Central

    Lee-Ougo, Wilhelmena; Boekeloo, Bradley O.; Thompson, Estina E.; Funnyé, Alen S.; Jackson, Rudolph E.; ShuTangyie, Gerard; McNeil, J. I.

    2003-01-01

    U.S. AIDS rates have declined among same population groups; however, African-Americans and other ethnic minorities have experienced the least amount of decline. As a result medical and public health authorities are tasked with developing strategies to help eliminate the disparity in HIV/AIDS incidence rate and clinical outcomes. Thus, in 1999, the National Minority AIDS Education and Training Center (NMAETC) was developed to facilitate training, clinical consultation and technical assistance to clinicians that provide care to HIV-infected minority patients. Its initial activities were designed solely to increase providers' clinical capacity to use state-of-art anti-retroviral therapies to treat and manage the disease. However, through focused discussions with target providers and a survey of medical care service sites, the NMAETC confirms that provider' training and assistance needs extend into non-medical domains. PMID:12656428

  18. Bacterial and Respiratory Viral Interactions in the Etiology of Acute Otitis Media in HIV-infected and HIV-uninfected South African Children

    PubMed Central

    Govender, Niresha; Dayal, Kishen; Devadiga, Raghavendra; Van Dyke, Melissa K.; van Niekerk, Nadia; Cutland, Clare Louise; Adrian, Peter V.; Nunes, Marta C.

    2015-01-01

    Background: Bacteria and respiratory viruses are implicated in the pathogenesis of acute otitis media (AOM); however, data from low–middle income countries are sparse. We investigated the etiology of AOM in HIV-infected (HIV+), HIV-uninfected (HIV−) and HIV-exposed clinically asymptomatic for HIV-infection (HEU) South African children. Methods: Children ≥3 months to <5 years of age with AOM were enrolled between May 2009 and April 2010 (NCT01031082). Middle ear fluid samples were cultured for bacteria; antibacterial susceptibility was done and serotyping undertaken for Streptococcus pneumoniae and Haemophilus influenzae. Nasopharyngeal aspirates were analyzed for respiratory viruses using immunofluorescence assay and polymerase chain reaction. Results: Of 260 AOM episodes (HIV+:15; HIV−:182; HEU:63), bacteria were found in 54.6%, including Haemophilus influenzae (30.8%), 98.8% of which were nontypeable, and Streptococcus pneumoniae (20.4%), Staphylococcus aureus (15.8%), Moraxella catarrhalis (5.0%) and Streptococcus pyogenes (1.5%). Nonsusceptibility of Streptococcus pneumoniae to penicillin was 64.2%. Respiratory viruses were detected in 74.2% of cases. Human rhinovirus was most frequently detected (37.7%), followed by adenovirus (14.2%) and human bocavirus (11.5%) overall and irrespective of HIV status. Respiratory viruses were identified concurrently with S. pneumoniae, H. influenzae, M. catarrhalis (76.9–78.8%) and Staphylococcus aureus (63.4%) cultured from middle ear fluid, as well as in 72.0% of episodes negative for any bacteria. Conclusion: The study suggests that respiratory viruses and pathogenic bacteria play an important role in the development of AOM in children. A similar spectrum of pathogens was observed independently of HIV status. Vaccines targeting both nontypeable Haemophilus influenzae and S. pneumoniae may have a broad impact on AOM in South Africa. PMID:25923426

  19. Forced Sexual Experiences as Risk Factor for Self-Reported HIV Infection among Southern African Lesbian and Bisexual Women

    PubMed Central

    Sandfort, Theo G. M.; Baumann, Linda R. M.; Matebeni, Zethu; Reddy, Vasu; Southey-Swartz, Ian

    2013-01-01

    Even though women who have sex with women are usually understood to be at no or very low risk for HIV infection, we explored whether lesbian and bisexual women in a geographical area with high HIV prevalence (Southern Africa) get tested for HIV and whether, among those women who get tested, there are women who live with HIV/AIDS. The study was conducted in collaboration with community-based organizations in Botswana, Namibia, South Africa and Zimbabwe. Data were collected via written surveys of women who in the preceding year had had sex with a woman (18 years and older; N = 591). Most participating women identified as lesbian and black. Almost half of the women (47.2%) reported ever having had consensual heterosexual sex. Engagement in transactional sex (lifetime) was reported by 18.6% of all women. Forced sex by men or women was reported by 31.1% of all women. A large proportion of the women reported to ever have been tested for HIV (78.3%); number of lifetime female and male partners was independently associated with having been tested; women who had engaged in transactional sex with women only or with women and men were less likely to have been tested. Self-reported HIV prevalence among tested women who knew their serostatus was 9.6%. Besides age, the sole independent predictor of a positive serostatus was having experienced forced sex by men, by women, or by both men and women. Study findings indicate that despite the image of invulnerability, HIV/AIDS is a reality for lesbian and bisexual women in Southern Africa. Surprisingly, it is not sex with men per se, but rather forced sex that is the important risk factor for self-reported HIV infection among the participating women. HIV/AIDS policy should also address the needs of lesbian, bisexual and other women who have sex with women. PMID:23326452

  20. Culturally Sensitive Approaches to Identification and Treatment of Depression among HIV Infected African American Adults: A Qualitative Study of Primary Care Providers’ Perspectives

    PubMed Central

    Le, Huynh-Nhu; Hipolito, Maria Mananita S; Lambert, Sharon; Terrell-Hamilton, Flora; Rai, Narayan; McLean, Charlee; Kapetanovic, Suad; Nwulia, Evaristus

    2016-01-01

    Background Major depressive disorder (MDD) is highly prevalent among HIV-infected (HIV+) individuals, and is associated with non-adherence to antiretroviral therapy (ART), and accelerated disease progression. MDD is underdiagnosed and undertreated among low-income African Americans, who are disproportionately impacted by the HIV epidemic. To improve detection and treatment of depression among African Americans living with HIV/AIDS, it is important to understand culturally and contextually relevant aspects of MDD and attitudes about mental health treatment. Methods A focus group session was conducted with seven providers and staff at a primary care center that serves a largely African-American community heavily impacted by the HIV epidemic in Washington, DC. Data were analyzed using an inductive approach to distill prominent themes, perspectives, and experiences among participating providers. Results Five themes emerged to characterize the lived experiences of HIV+ African-American patients: (a) Changes in perceptions of HIV over time; (b) HIV is comorbid with mental illness, particularly depression and substance abuse; (c) Stigma is associated with both HIV and depression; (d) Existing mental health services vary and are insufficient and (e) Suggestions for optimal treatment for comorbid HIV and depression. Limitation This study reflects the views of providers from one clinic in this community. Conclusion Substantial economic disadvantage, pervasive childhood adversity, limited education and limited resources jointly put members of this community at risk for acquisition of HIV and for development of depression and addictions. These contextual factors provide an important reminder that any patient-level depression identification or intervention in this community will have to be mindful of such circumstances. PMID:27347445

  1. Sexual Risk Behaviors Among HIV-Infected South African Men and Women with Their Partners in a Primary Care Program: Implications for Couples-Based Prevention

    PubMed Central

    de Bruyn, Guy; Lurie, Mark N.; Modisenyane, Tebogo; Triche, Elizabeth W.; Gray, Glenda E.; Welte, Alex; Martinson, Neil A.

    2011-01-01

    We studied 1163 sexually-active HIV-infected South African men and women in an urban primary care program to understand patterns of sexual behaviors and whether these behaviors differed by partner HIV status. Overall, 40% reported a HIV-positive partner and 60% a HIV-negative or status unknown partner; and 17.5% reported >2 sex acts in the last 2 weeks, 16.4% unprotected sex in the last 6 months, and 3.7% >1 sex partner in the last 6 months. Antiretroviral therapy (ART) was consistently associated with decreased sexual risk behaviors, as well as with reporting a HIV-negative or status unknown partner. The odds of sexual risk behaviors differed by sex; and were generally higher among participants reporting a HIV-positive partner, but continued among those with a HIV-negative or status unknown partner. These data support ART as a means of HIV prevention. Engaging in sexual risk behaviors primarily with HIV-positive partners was not widely practiced in this setting, emphasizing the need for couples-based prevention. PMID:21476005

  2. Incidence and risk factors of HCV and HIV infections in a cohort of intravenous drug users in the North and East of France.

    PubMed Central

    Lucidarme, D.; Bruandet, A.; Ilef, D.; Harbonnier, J.; Jacob, C.; Decoster, A.; Delamare, C.; Cyran, C.; Van Hoenacker, A. F.; Frémaux, D.; Josse, P.; Emmanuelli, J.; Le Strat, Y.; Desenclos, J. C.; Filoche, B.

    2004-01-01

    In order to evaluate the incidence and risk factors of infection by hepatitis C virus (HCV) among injecting drug users (IDUs), we conducted a prospective cohort study of HCV- and human immunodeficiency virus (HIV)-negative IDUs in the North and East of France. A total of 231 HCV and HIV IDUs who had injected drugs at least once in their lifetime were followed up every 3 months over a 12-month period. Serum anti-HCV and anti-HIV were tested at inclusion in the study and at the end of the follow-up. Data on injecting practices were collected at inclusion and at each visit. Of the 231 participants included, 165 (71.4%) underwent a final HCV and HIV serum test. The incidence was nil for HIV infection and 9/100 person-years (95% CI 4.6-13.4) for HCV infection. In a multivariable analysis, we found that syringe and cotton sharing were the only independent predictive factors of HCV seroconversion. PMID:15310172

  3. Abacavir, zidovudine, or stavudine as paediatric tablets for African HIV-infected children (CHAPAS-3): an open-label, parallel-group, randomised controlled trial

    PubMed Central

    Mulenga, Veronica; Musiime, Victor; Kekitiinwa, Adeodata; Cook, Adrian D; Abongomera, George; Kenny, Julia; Chabala, Chisala; Mirembe, Grace; Asiimwe, Alice; Owen-Powell, Ellen; Burger, David; McIlleron, Helen; Klein, Nigel; Chintu, Chifumbe; Thomason, Margaret J; Kityo, Cissy; Walker, A Sarah; Gibb, Diana M

    2016-01-01

    Summary Background WHO 2013 guidelines recommend universal treatment for HIV-infected children younger than 5 years. No paediatric trials have compared nucleoside reverse-transcriptase inhibitors (NRTIs) in first-line antiretroviral therapy (ART) in Africa, where most HIV-infected children live. We aimed to compare stavudine, zidovudine, or abacavir as dual or triple fixed-dose-combination paediatric tablets with lamivudine and nevirapine or efavirenz. Methods In this open-label, parallel-group, randomised trial (CHAPAS-3), we enrolled children from one centre in Zambia and three in Uganda who were previously untreated (ART naive) or on stavudine for more than 2 years with viral load less than 50 copies per mL (ART experienced). Computer-generated randomisation tables were incorporated securely within the database. The primary endpoint was grade 2–4 clinical or grade 3/4 laboratory adverse events. Analysis was intention to treat. This trial is registered with the ISRCTN Registry number, 69078957. Findings Between Nov 8, 2010, and Dec 28, 2011, 480 children were randomised: 156 to stavudine, 159 to zidovudine, and 165 to abacavir. After two were excluded due to randomisation error, 156 children were analysed in the stavudine group, 158 in the zidovudine group, and 164 in the abacavir group, and followed for median 2·3 years (5% lost to follow-up). 365 (76%) were ART naive (median age 2·6 years vs 6·2 years in ART experienced). 917 grade 2–4 clinical or grade 3/4 laboratory adverse events (835 clinical [634 grade 2]; 40 laboratory) occurred in 104 (67%) children on stavudine, 103 (65%) on zidovudine, and 105 (64%), on abacavir (p=0·63; zidovudine vs stavudine: hazard ratio [HR] 0·99 [95% CI 0·75–1·29]; abacavir vs stavudine: HR 0·88 [0·67–1·15]). At 48 weeks, 98 (85%), 81 (80%) and 95 (81%) ART-naive children in the stavudine, zidovudine, and abacavir groups, respectively, had viral load less than 400 copies per mL (p=0·58); most ART

  4. Incidence of serious morbidity in HIV-infected adults on antiretroviral therapy in a West African care centre, 2003-2008

    PubMed Central

    2013-01-01

    Background In resource-limited settings, scaling-up antiretroviral treatment (ART) has required the involvement of decentralized health facilities with limited equipment. We estimated the incidence of serious morbidity among HIV-infected adults receiving ART in one of these HIV routine care center in sub-Saharan Africa. Methods We conducted a prospective study at the Centre Medical de Suivi des Donneurs de Sang (CMSDS), which is affiliated with the National Centre for Blood Transfusion in Abidjan, Côte d’Ivoire. Adult patients infected with HIV-1 or HIV-1/HIV-2 who initiated ART between January 2003 and December 2008 were eligible for the study. Standardized clinical data were collected at each visit. Serious morbidity was defined as a new episode of malaria, WHO stage 3–4 event, ANRS grade 3–4 adverse event, or any event leading to death or to hospitalization. Results 1008 adults, 67% women, with a median age of 35 years, and a median pre-ART CD4 count of 186/mm3 started ART and were followed for a median of 17.3 months. The overall incidences of loss to follow-up, death, and attrition were 6.2/100 person-years (PY) [95% CI 5.1-7.2], 2.3/100 PY [95% CI 1.6-2.9], and 8.1/100 PY [95% CI 7.0-9.4], respectively. The incidence of first serious event was 11.5/100 PY overall, 15.9/100 PY within the first year and 8.3/100 PY thereafter. The most frequently documented specific diagnoses were malaria, tuberculosis, bacterial septicemia and bacterial pneumonia. Conclusion Among HIV-infected adults followed in routine conditions in a West African primary care clinic, we recorded a high incidence of serious morbidity during the first year on ART. Providing care centers with diagnostic tools and standardizing data collection are necessary steps to improve the quality of care in primary care facilities in sub-Saharan Africa. PMID:24373303

  5. Incidence and predictors of adverse drug events in an African cohort of HIV-infected adults treated with efavirenz

    PubMed Central

    Abah, Isaac Okoh; Akanbi, Maxwell; Abah, Mercy Enuwa; Finangwai, Amos Istifanus; Dady, Christy W; Falang, Kakjing Dadul; Ebonyi, Augustine Odoh; Okopi, Joseph Anejo; Agbaji, Oche Ochai; Sagay, Altiene Solomon; Okonkwo, Prosper; Idoko, John A; Kanki, Phyllis J

    2015-01-01

    Introduction Adverse drug reactions associated with efavirenz (EFV) therapy are poorly described beyond the first year of treatment. We aimed to describe the incidence and predictors of EFV-related adverse drug reactions (ADRs) in a cohort of adult Nigerian HIV-infected patients on antiretroviral therapy (ART). Methods This retrospective cohort study utilized clinical data of HIV-1 infected adults (aged ≥15 years), commenced on efavirenz containing-regimen between January 2004 and December 2011. The time-dependent occurrence of clinical adverse events as defined by the World Health Organization was analyzed by Cox regression analysis. Results A total of 2920 patients with baseline median (IQR) age of 39 (33-46) years, largely made up of men (78%) were included in the study. During 8834 person-years of follow up, 358 adverse drug events were reported; the incidence rate was 40.3 ADRs per 1000 person-years of treatment. Lipodystrophy and neuropsychiatric disorders were the most common ADRs with incidences of 63 and 30 per 1000 patients respectively. About one-third of the neuropsychiatric adverse events were within 12 months of commencement of ART. The risk of neuropsychiatric ADRs was independently predicted for women [adjusted hazard ratio (aHR) 9.05; 95% CI: 5.18-15.82], those aged <40 years (aHR 2.59; 95% CI: 1.50-4.45), advanced HIV disease (WHO stage 3 or 4) [aHR 2.26; 95% CI: 1.37-3.72], and zidovudine [aHR 2.21; 95% CI: 1.27-3.83] or stavudine [aHR 4.22; 95% CI: 1.99-8.92] containing regimen compared to tenofovir. Conclusion Neuropsychiatric adverse drug events associated with efavirenz-based ART had both early and late onset in our clinical cohort of patients on chronic EFV therapy. Continuous neuropsychiatric assessment for improved detection and management of neuropsychiatric ADRs is recommended in resource-limited settings where the use of efavirenz-based regimens has been scaled up. PMID:26405676

  6. Contribution of substance abuse and HIV infection to psychiatric distress in an inner-city African-American population.

    PubMed Central

    Nnadi, C. U.; Better, W.; Tate, K.; Herning, R. I.; Cadet, Jean Lud

    2002-01-01

    We used Symptom Checklist 90-Revised (SCL90-R) to investigate psychiatric symptom severity in African-American drug-abusing individuals. Three hundred and seventeen African-American volunteers (52 control subjects; 265 drug users) were recruited, 19.2% of whom were HIV-positive. The impact of drug of choice or HIV status on mental distress was assessed. Symptomatic HIV-positive participants were excluded. The intake SCL90-R, Addiction Severity Index, and demographic data were subjected to regression analyses. Drug-abusing African Americans reported increased global distress, a finding that remained robust after we adjusted for HIV status, gender, age, and education. Drug of choice had no influence on the severity of global mental distress in our sample. Asymptomatic HIV-positive African Americans who abused drugs reported more distress than the HIV-negative drug users. Levels of global distress were similar in the HIV-negative and the HIV-positive controls. Subscales of the SCL90-R showed more symptom severity among drug-using, compared with nonusing, African Americans. Except for paranoia, anxiety, and obsessive-compulsive subscales, other symptom dimensions were significantly elevated in HIV-positive, compared with HIV-negative, drug abusers. When taken together, these findings suggest that drug abuse can exacerbate the severity of mental distress in HIV-positive patients. Treatment of these patients may be more successful if both sets of needs are addressed with matched interventions. PMID:12069213

  7. Effect of concurrent sexual partnerships on rate of new HIV infections in a high-prevalence, rural South African population: a cohort study

    PubMed Central

    Tanser, Frank; Bärnighausen, Till; Hund, Lauren; Garnett, Geoffrey P; McGrath, Nuala; Newell, Marie-Louise

    2011-01-01

    Summary Background Concurrent sexual partnerships are widely believed to be one of the main drivers of the HIV epidemic in sub-Saharan Africa. This view is supported by theoretical models predicting that increases in prevalence of concurrent partnerships could substantially increase the rate of spread of the disease. However, the effect of concurrent partnerships on HIV incidence has not been appropriately tested in a sub-Saharan African setting. Methods For this population-based cohort study, we used data from the Africa Centre demographic surveillance site in KwaZulu-Natal, South Africa, to try to find support for the concurrency hypothesis. We used a moving-window approach to construct estimates of the geographical variation in reported concurrent and lifetime partners in sexually active men aged 15–55 years (n=2153) across the study area. We then followed up 7284 HIV-negative women (≥15 years of age) in the population and quantified the effect of the sexual behaviour profiles of men in the surrounding local community on a woman's hazard of HIV acquisition. Findings During 5 years' follow-up, 693 new female HIV infections occurred (incidence 3·60 cases per 100 person-years). We identified substantial intercommunity heterogeneity in the estimated point-prevalence of partnership concurrency (range 4·0–76·3%; mean 31·5%) and mean number of lifetime sexual partners (3·4–12·9; mean 6·3) in sexually active men in this population. After adjustment for individual-level sexual behaviour and demographic, socioeconomic, and environmental factors associated with HIV acquisition, mean lifetime number of partners of men in the immediate local community was predictive of hazard of HIV acquisition in women (adjusted hazard ratio [HR] 1·08, 95% CI 1·03–1·14, p=0·004), whereas a high prevalence of partnership concurrency in the same local community was not associated with any increase in risk of HIV acquisition (adjusted HR 1·02, 95% CI 0·95–1·09, p=0

  8. Patient-nominated, community-based HIV treatment supporters: patient perspectives, feasibility, challenges, and factors for success in HIV-infected South African adults.

    PubMed

    Duwell, Monique M; Knowlton, Amy R; Nachega, Jean B; Efron, Anne; Goliath, Rene; Morroni, Chelsea; Maartens, Gary; Chaisson, Richard E

    2013-02-01

    This study aimed to characterize the experience of having a treatment supporter among HIV-infected South African patients enrolled in a randomized controlled trial that compared the efficacy of patient-nominated treatment supporters administering partial directly observed antiretroviral therapy (DOT-ART) versus self-administered ART (Self-ART). Results of the parent study showed no virologic or sustained immunologic differences between groups, but revealed a significant survival benefit among the DOT-ART group. One hypothesis is that this survival benefit may be explained by differences in the training and involvement of the treatment supporters between groups. In the current study, results from a semi-structured exit interview of 172 participants indicate that most participants in both arms maintained a positive, satisfying relationship with a single supporter, typically family member or friend. Most patients (82.6%) perceived supporters as helpful with medication adherence, with no significant difference between groups (p=0.752). Additionally, supporters provided emotional, instrumental, and material support. DOT-ART patients were more likely than Self-ART patients to report that their supporter helped to decrease drug or alcohol use (p=0.03). Patients identified supporter trustworthiness, availability, good communication and reciprocity of support as factors beneficial to a successful relationship. These results suggest: (1) Patient-nominated peers are feasible candidates for ART supporters in this resource-constrained setting; (2) In addition to assistance with medications, treatment supporters have the capacity to promote healthy behaviors and provide other types of support, which may contribute to improved outcomes, particularly with enhanced training; (3) Trustworthiness, availability, good communication, and reciprocity are key factors in a successful patient-supporter relationship.

  9. Could Early Antiretroviral Therapy Entail More Risks than Benefits in sub-Saharan African HIV-Infected Adults? A Model-Based Analysis

    PubMed Central

    Anglaret, Xavier; Scott, Callie A.; Walensky, Rochelle P.; Ouattara, Eric; Losina, Elena; Moh, Raoul; Becker, Jessica E.; Uhler, Lauren; Danel, Christine; Messou, Eugene; Eholié, Serge; Freedberg, Kenneth A.

    2013-01-01

    Background Initiation of antiretroviral therapy (ART) in all HIV-infected adults, regardless of count, is a proposed strategy for reducing HIV transmission. We investigated the conditions under which starting ART early could entail more risks than benefits for patients with high CD4 counts. Methods We used a simulation model to compare ART initiation upon entry to care (“immediate ART”) to initiation at CD4 ≤350 cells/μL (“WHO 2010 ART”) in African adults with CD4 counts >500 cells/μL. We varied inputs to determine the combination of parameters (population characteristics, conditions of care, treatment outcomes) that would result in higher 15-year mortality with immediate ART. Results Fifteen-year mortality was 56.7% for WHO 2010 and 51.8% for immediate ART. In one-way sensitivity analysis, lower 15-year mortality was consistently achieved with immediate ART unless the rate of fatal ART toxicity was >1.0/100PY, the rate of withdrawal from care was >1.2-fold higher or the rate of ART failure due to poor adherence was >4.3-fold higher on immediate ART. In multi-way sensitivity analysis, immediate ART led to higher mortality when moderate rates of fatal ART toxicity (0.25/100PY) were combined with rates of withdrawal from care >1.1-fold higher and rates of treatment failure >2.1-fold higher on immediate ART than on WHO 2010 ART. Conclusions In sub-Saharan Africa, ART initiation at entry into care would improve long-term survival of patients with high CD4 counts, unless it is associated with increased withdrawal from care and decreased adherence. In early ART trials, a focus on retention and adherence will be critical. PMID:22809695

  10. Assessing the contributions of East African and West Pacific warming to the 2014 boreal spring East African drought

    USGS Publications Warehouse

    Funk, Christopher C.; Shukla, Shraddhanand; Hoell, Andrew; Livneh, Ben

    2015-01-01

    Anthropogenic warming contributed to the 2014 East African drought by increasing East African and west Pacific temperatures, and increasing the gradient between standardized western and central Pacific SST causing reduced rainfall, evapotranspiration, and soil moisture.

  11. Is hardship during migration a determinant of HIV infection? Results from the ANRS PARCOURS study of sub-Saharan African migrants in France

    PubMed Central

    Desgrees-du-Lou, Annabel; Pannetier, Julie; Ravalihasy, Andrainolo; Le Guen, Mireille; Gosselin, Anne; Panjo, Henri; Bajos, Nathalie; Lydie, Nathalie; Lert, France; Dray-Spira, Rosemary

    2016-01-01

    Objectives: In Europe, sub-Saharan African migrants are a key population for HIV infection. We analyse how social hardships during settlement in France shape sexual partnerships and HIV risk. Design: PARCOURS is a life-event survey conducted in 2012–2013 in 74 health-care facilities in the Paris region, among three groups of sub-Saharan migrants: 926 receiving HIV care (296 acquired HIV in France), 779 with chronic hepatitis B, and 763 with neither HIV nor hepatitis B (reference group). Methods: Hardships (lack of residence permit, economic resources and housing) and sexual partnerships were documented for each year since arrival in France. For each sex, reported sexual partnerships were compared by group and their associations with hardships each year analysed with mixed-effects logistic regression models. Results: Hardships were frequent: more than 40% had lived a year or longer without a residence permit, and more than 20% without stable housing. Most of the migrants had nonstable and concurrent partnerships, more frequent among those who acquired HIV in France compared with reference group, as were casual partnerships among men (76.7 vs. 54.2%; P = 0.004) and women (52.4 vs. 30.5%; P = 0.02), concurrent partnerships among men (69.9 vs. 45.8%; P = 0.02), and transactional partnerships among women (8.6 vs. 2.3%; P = 0.006). Hardship increased risky behaviours: in women, lacking a residence permit increased casual and transactional partnerships [resp. odds ratio (OR) = 2.01(1.48–2.72) and OR = 6.27(2.25–17.44)]. Same trends were observed for lacking stable housing [OR = 3.71(2.75–5.00) and OR = 10.58 (4.68–23.93)]. Conclusion: Hardships faced by migrants increase HIV risks. Women, especially during the period without stable housing, appear especially vulnerable. PMID:26558722

  12. Cost-effectiveness of first-line antiretroviral therapy for HIV-infected African children less than 3 years of age

    PubMed Central

    Ciaranello, Andrea L.; Doherty, Kathleen; Penazzato, Martina; Lindsey, Jane C.; Harrison, Linda; Kelly, Kathleen; Walensky, Rochelle P.; Essajee, Shaffiq; Losina, Elena; Muhe, Lulu; Wools-Kaloustian, Kara; Ayaya, Samuel; Weinstein, Milton C.; Palumbo, Paul; Freedberg, Kenneth A.

    2015-01-01

    Background: The International Maternal, Pediatric, and Adolescent Clinical Trials P1060 trial demonstrated superior outcomes for HIV-infected children less than 3 years old initiating antiretroviral therapy (ART) with lopinavir/ritonavir compared to nevirapine, but lopinavir/ritonavir is four-fold costlier. Design/methods: We used the Cost-Effectiveness of Preventing AIDS Complications (CEPAC)-Pediatric model, with published and P1060 data, to project outcomes under three strategies: no ART; first-line nevirapine (with second-line lopinavir/ritonavir); and first-line lopinavir/ritonavir (second-line nevirapine). The base-case examined South African children initiating ART at age 12 months; sensitivity analyses varied all key model parameters. Outcomes included life expectancy, lifetime costs, and incremental cost-effectiveness ratios [ICERs; dollars/year of life saved ($/YLS)]. We considered interventions with ICERs less than 1× per-capita gross domestic product (South Africa: $7500)/YLS as ‘very cost-effective,’ interventions with ICERs below 3× gross domestic product/YLS as ‘cost-effective,’ and interventions leading to longer life expectancy and lower lifetime costs as ‘cost-saving’. Results: Projected life expectancy was 2.8 years with no ART. Both ART regimens markedly improved life expectancy and were very cost-effective, compared to no ART. First-line lopinavir/ritonavir led to longer life expectancy (28.8 years) and lower lifetime costs ($41 350/person, from lower second-line costs) than first-line nevirapine (27.6 years, $44 030). First-line lopinavir/ritonavir remained cost-saving or very cost-effective compared to first-line nevirapine unless: liquid lopinavir/ritonavir led to two-fold higher virologic failure rates or 15-fold greater costs than in the base-case, or second-line ART following first-line lopinavir/ritonavir was very ineffective. Conclusions: On the basis of P1060 data, first-line lopinavir/ritonavir leads to longer life

  13. The Offshore East African Rift System

    NASA Astrophysics Data System (ADS)

    Franke, D.; Klimke, J.; Jokat, W.; Stollhofen, H.; Mahanjane, S.

    2014-12-01

    Numerous studies have addressed various aspects of the East African Rift system but surprisingly few on the offshore continuation of the south-eastern branch of the rift into the Mozambique Channel. The most prominent article has been published almost 30 years ago by Mougenot et al. (1986) and is based on vintage seismic data. Several studies investigating earthquakes and plate motions from GPS measurements reveal recent deformation along the offshore branch of the East African Rift system. Slip vectors from earthquakes data in Mozambique's offshore basins show a consistent NE direction. Fault plane solutions reveal ~ E-W extensional failure with focal depth clustering around 19 km and 40 km, respectively. Here, we present new evidence for neotectonic deformation derived from modern seismic reflection data and supported by additional geophysical data. The modern rift system obviously reactivates structures from the disintegration of eastern Gondwana. During the Jurassic/Cretaceous opening of the Somali and Mozambique Basins, Madagascar moved southwards along a major shear zone, to its present position. Since the Miocene, parts of the shear zone became reactivated and structurally overprinted by the East African rift system. The Kerimbas Graben offshore northern Mozambique is the most prominent manifestation of recent extensional deformation. Bathymetry data shows that it deepens northwards, with approximately 700 m downthrown on the eastern shoulder. The graben can be subdivided into four subbasins by crosscutting structural lineaments with a NW-SE trend. Together with the N-S striking graben-bounding faults, this resembles a conjugate fault system. In seismic reflection data normal faulting is distinct not only at the earthquake epicenters. The faults cut through the sedimentary successions and typically reach the seafloor, indicating ongoing recent deformation. Reference: Mougenot, D., Recq, M., Virlogeux, P., and Lepvrier, C., 1986, Seaward extension of the East

  14. Microbiome in HIV infection

    PubMed Central

    Salas, January T.; Chang, Theresa L.

    2014-01-01

    HIV primary infection occurs at mucosa tissues, suggesting an intricate interplay between microbiome and HIV infection. Recent advanced technologies of high-throughput sequencing and bioinformatics allow researchers to explore nonculturable microbes including bacteria, virus and fungi and their association with diseases. HIV/SIV infection is associated with microbiome shifts and immune activation that may affect the outcome of disease progression. Similarly, altered microbiome and inflammation are associated with increased risks of HIV acquisition, suggesting the role of microbiome in HIV transmission. In this review, we will focus on microbiome in HIV infection at various mucosal compartments. Understanding the relationship between microbiome and HIV may offer insights into development of better strategies for HIV prevention and treatment. PMID:25439273

  15. Effect of Age at Antiretroviral Therapy Initiation on Catch-Up Growth within the First 24 Months among HIV-Infected Children in the IeDEA West African Pediatric Cohort

    PubMed Central

    Jesson, Julie; Koumakpaï, Sikiratou; Diagne, Ndeye R.; Amorissani-Folquet, Madeleine; Kouéta, Fla; Aka, Addi; Lawson-Evi, Koko; Dicko, Fatoumata; Kouakou, Kouadio; Pety, Touré; Renner, Lorna; Eboua, Tanoh; Coffie, Patrick A.; Desmonde, Sophie; Leroy, Valériane

    2015-01-01

    Background We described malnutrition and the effect of age at antiretroviral therapy (ART) initiation on catch-up growth over 24 months among HIV-infected children enrolled in the IeDEA West African paediatric cohort (pWADA). Methods Malnutrition was defined at ART initiation (baseline) by a Z-score <-2 SD, according to three anthropometric indicators: Weight-for-age (WAZ) for underweight, Height-for-age (HAZ) for stunting, and Weight-for-Height/BMI-for-age (WHZ/BAZ) for wasting. Kaplan-Meier estimates for catch-up growth (Z-score ≥-2 SD) on ART, adjusted for gender, immunodeficiency and malnutrition at ART initiation, ART regimen, time period and country, were compared by age at ART initiation. Cox proportional hazards regression models determined predictors of catch-up growth on ART over 24 months. Results Between 2001 and 2012, 2004 HIV-infected children < 10 years of age were included. At ART initiation, 51% were underweight, 48% were stunted and 33% were wasted. The 24-month adjusted estimates for catch-up growth were 69% (95% confidence interval [CI]: 57;80), 61% (95%CI: 47;70), and 90% (95%CI: 76;95) for WAZ, HAZ, and WHZ/BAZ, respectively. Adjusted catch-up growth was more likely for children <5 years of age at ART initiation compared to children ≥5 years for WAZ, HAZ (P<0.001), and for WHZ/BAZ (P = 0.026). Conclusions Malnutrition among these children is an additional burden that has to be urgently managed. Despite a significant growth improvement after 24 months on ART, especially in children <5 years, a substantial proportion of children still never achieved catch-up growth. Nutritional care should be part of the global healthcare of HIV-infected children in sub-Saharan Africa. PMID:25955835

  16. [Pneumocystosis during HIV infection].

    PubMed

    El Fane, M; Sodqi, M; Oulad Lahsen, A; Chakib, A; Marih, L; Marhoum El Filali, K

    2016-08-01

    Pneumocystosis is an opportunistic disease caused by invasion of unicellular fungus Pneumocystic jirovecii which is responsible for febrile pneumonia among patients with cellular immunodeficiency especially those HIV infected. Despite the decreasing of its incidence due to the introduction of antiretroviral therapy, as well as anti-Pneumocystis prophylaxis among these patients, Pneumocystis pneumonia remains the first AIDS-defining event and a leading cause of mortality among HIV-infected patients. The usual radiological presentation is that of diffuse interstitial pneumonia. The diagnosis is confirmed by the detection of trophozoides and/or cysts P. jirovecii in bronchoalveolar lavage (BAL) samples using several staining techniques. The use of polymerase chain reaction in the BAL samples in conjunction with standard immunofluorescent or colorimetric tests have allowed for more has allowed for more rapid and accurate diagnosis. The standard regimen of treatment is the association of trimethoprim-sulfamethoxazole which has been utilized as an effective treatment with a favourable recovery. Early HIV diagnosis and antiretroviral therapy should reduce the incidence of this dreaded disease. PMID:27349824

  17. High Genotypic Discordance of Concurrent Mycobacterium tuberculosis Isolates from Sputum and Blood of HIV-Infected Individuals

    PubMed Central

    Ssengooba, Willy; Cobelens, Frank G.; Nakiyingi, Lydia; Mboowa, Gerald; Armstrong, Derek T.; Manabe, Yukari C.; Joloba, Moses L.; de Jong, Bouke C.

    2015-01-01

    Background Among HIV-infected individuals with CD4 less than 200 cells/mm3, tuberculosis often has an atypical presentation, is more likely to be disseminated and is diagnostically challenging. We sought to understand the genotypic discordance of concurrent sputum and blood M. tuberculosis (MTB) isolates from HIV-infected individuals. Methods From a prospective diagnostic accuracy study with 182 HIV-infected culture-positive TB adults, isolates were obtained from 51 of 66 participants who were MTB culture-positive by both sputum and blood. Isolates were subjected to susceptibility testing to 1st line drugs, spoligotyping and 24 locus- MIRU-VNTR. Results The median age of the participants was 31 (IQR; 27–38) years and 51% were male. The median CD4 count was 29 (IQR; 10–84) cells/mm3 with 20% taking ART; 8.0% were previously treated for TB, and 63% were AFB smear-negative. The isolates belonged to two of the main global MTB-lineages; East-African-Indian (L3) 17 (16.7%) and Euro-American (L4) 85 (83.3%). We identified 26 (51.0%) participants with discordant MTB-genotypes between sputum and blood, including two patients with evidence of mixed infection in either compartment. Having discordant MTB-genotypes was not predicted by the MTB-lineage in either blood or sputum, CD4 cell count, or any other clinical characteristic. Conclusions There is a high genotypic discordance among M. tuberculosis concurrently isolated from sputum and blood of HIV-infected individuals. These findings suggest that infection with more than one strain of M. tuberculosis occurs in at least half of patients with advanced HIV infection. PMID:26176604

  18. The East African Orogen: Accretion versus Collision

    NASA Astrophysics Data System (ADS)

    Kröner, A.; Muhongo, S.; Sommer, H.; Vogt, M.

    2003-04-01

    The East African Orogen is an extensive Neoproterozoic (Pan-African) orogenic belt extending from Arabia to Mozambique and containing elements of both accretion and collision tectonics. The predominantly upper crustal northern part (Arabian-Nubian Shield, ANS) consists of Neoproterozoic juvenile arc assemblages that accreted onto the African continent along ophiolite-decorated sutures. In contrast, the tectonic evolution of the predominantly middle to lower crustal southern part (Mozambique belt, MB) is still poorly understood, and simple continental collision models as previously applied are not compatible with new isotopic and petrological data. Published Nd isotopic systematics and our new zircon ages demonstrate that large parts of the high-grade MB in Tanzania consists of late Archaean to Palaeoproterozoic granitoid gneisses which may either constitute an extension of the Tanzania craton to the E, reworked during the Pan-African orogeny, or these rocks may constitute a separate terrane, or terranes, tectonically interdigitated with Neoproterozoic gneisses, similar to the situation in Madagascar. Small-scale tectonic interlayering of >1800 Ma and 650-800 Ma gneisses have been documented at several localities, and the amount of pre-Neoproterozoic crust in the MB appears to be ˜70% or more. Relatively small volumes of ˜1000-1100 Ma granitoids have so far only been recorded in southern Tanzania, and their significance in the orogenic evolution and their relation to more extensive rocks of this age in northern Mozambique are not known. High-grade metamorphism in the MB of Tanzania led to granulite and charnockite formation and occurred at 620-640 Ma, slightly earlier than in Mozambique (˜615 Ma) but significantly earlier than in Malawi (˜550-580 Ma) and in Madagascar (˜550-560 Ma). The significance of these age differences is not understood. Petrological data suggest both clockwise and anti-clockwise PT path for the metamorphic assemblages, suggesting that

  19. Prevalence and Correlates of HIV Infection among Street Boys in Kisumu, Kenya

    PubMed Central

    Goldblatt, Ariella; Kwena, Zachary; Lahiff, Maureen; Agot, Kawango; Minnis, Alexandra; Prata, Ndola; Lin, Jessica; Bukusi, Elizabeth A.; Auerswald, Colette L.

    2015-01-01

    Introduction Despite their perceived vulnerability to HIV, East African street youth have been neglected in HIV prevention research. We examined HIV seroprevalence and correlates of HIV infection in a sample of male street youth in Kisumu, Kenya. Methods We enrolled a street-recruited sample of 13–21 year old street youth. Participants completed a survey followed by voluntary HIV counseling and testing. Survey items included demographics, homelessness history, survival activities, sexual behavior and substance use. We examined the relationship between predictor variables, markers of coercion and marginalization and HIV. Results The sample included 296 males. Survival activities included garbage picking (55%), helping market vendors (55%), begging (17%), and working as porters (46%) or domestic workers (4%). Forty-nine percent of participants reported at least weekly use of alcohol and 32% marijuana. Forty-six percent of participants reported lifetime inhalation of glue and 8% fuel. Seventy-nine percent of participants reported lifetime vaginal sex, 6% reported lifetime insertive anal sex and 8% reported lifetime receptive anal sex. Twelve (4.1%; 95% CI: 2.3–7.0) participants tested positive for HIV. Of those, all had been on the street for at least one year and all had engaged in vaginal sex. Occupations placing youth at particular risk of coercion by adults, including helping market vendors (prevalence ratio (PR) = 8.8; 95% CI: 1.2–67.5) and working as domestic workers (PR = 4.6; 95% CI: 1.1–19.0), were associated with HIV infection. Both insertive anal sex (PR = 10.2; 95% CI: 3.6–29.4) and receptive anal sex (PR = 3.9; 95% CI: 1.1–13.4) were associated with HIV infection. Drug use, begging, and garbage picking were not associated with HIV infection. Conclusions Although HIV prevalence in our sample of street youth is comparable to that of similarly-aged male youth in Nyanza Province, our findings highlight behavioral factors associated with HIV

  20. Incidence of WHO Stage 3 and 4 Events, Tuberculosis, and Mortality in Untreated, HIV-Infected Children Enrolling in Care Before 1 Year of Age: An Iedea (International Epidemiologic Databases To Evaluate AIDS) East Africa Regional Analysis

    PubMed Central

    Ciaranello, Andrea; Lu, Zhigang; Ayaya, Samuel; Losina, Elena; Musick, Beverly; Vreeman, Rachel; Freedberg, Kenneth A.; Abrams, Elaine J.; Dillabaugh, Lisa; Doherty, Katie; Ssali, John; Yiannoutsos, Constantin T.; Wools-Kaloustian, Kara

    2014-01-01

    Background Few studies have reported CD4%- and age-stratified rates of WHO Stage 3 (WHO3) events, WHO Stage 4 (WHO4) events, tuberculosis (TB), and mortality in HIV-infected infants before initiation of antiretroviral therapy (ART). Methods HIV-infected children enrolled before 1 year of age in the International Epidemiologic Databases to Evaluate AIDS (IeDEA) East Africa region (10/01/2002-11/30/2008) were included. We estimated incidence rates of earliest clinical event (WHO3, WHO4, and TB), prior to ART initiation per local guidelines, stratified by current age (< or ≥6 months) and current CD4% (<15%, 15–24%, ≥25%). CD4%-stratified mortality rates were estimated separately for children who did not experience a clinical event (“background” mortality) and for children who experienced an event, including “acute” mortality (≤30 days post-event) and “later” mortality (>30 days post-event). Results Among 847 children (median enrollment age: 4.8 months; median pre-ART follow-up: 10.8 months; 603 (71%) with ≥1 CD4% recorded), event rates were comparable for those aged <6 and ≥6 months. Current CD4% was associated with risk of WHO4 events for children <6 months old, and with all evaluated events for children ≥6 months old (p<0.05). “Background” mortality was 3.7–8.4/100py. “Acute” mortality (≤30 days post-event) was 33.8/100py (after TB) and 41.1/100py (after WHO3 or WHO4). “Later” mortality (>30 days post-event) ranged by CD4% from 4.7–29.1/100py. Conclusions In treatment-naïve, HIV-infected infants, WHO3, WHO4, and TB events were common before and after 6 months of age and led to substantial increases in mortality. Early infant HIV diagnosis and treatment are critically important, regardless of CD4%. PMID:24378935

  1. HIV Infection and Adult Vaccination

    MedlinePlus

    ... Resources for Healthcare Professionals HIV Infection and Adult Vaccination Recommend on Facebook Tweet Share Compartir Vaccines are ... percentage is less than 15%. Learn about adult vaccination and other health conditions Asplenia Diabetes Type 1 ...

  2. Pharmacology and immuno-virologic efficacy of once-a-day HAART in African HIV-infected children: ANRS 12103 phase II trial

    PubMed Central

    Nacro, Boubacar; Zoure, Emmanuelle; Hien, Hervé; Tamboura, Hassane; Rouet, François; Ouiminga, Adama; Drabo, Ali; Yameogo, Souleymane; Hien, Alain; Peyriere, Hélène; Mathieu, Olivier; Hirt, Deborah; Treluyer, Jean-Marc; Nicolas, Joëlle; Foulongne, Vincent; Segondy, Michel; van de Perre, Philippe; Diagbouga, Serge

    2011-01-01

    Abstract Objective To assess 12-month survival, pharmacokinetics, immunologic and virologic efficacy, tolerance, compliance and drug resistance in HIV-infected children in Bobo-Dioulasso, Burkina Faso, receiving once-daily highly-active antiretroviral therapy as a combination of didanosine (DDI), lamivudine (3TC) and efavirenz (EFV). Methods In the ANRS 12103 open phase II trial, HIV-infected children were examined at inclusion and monthly thereafter. CD4+ T-lymphocyte (CD4) count, plasma concentration of ribonucleic acid (RNA) of human immunodeficiency virus type 1 (HIV-1) and haematologic and biochemical parameters were measured at baseline and every trimester. HIV-1 resistance testing was performed in case of viral escape. Drug plasma concentrations were determined with high-performance liquid chromatography. Findings From February 2006 to November 2007, 51 children (39% girls) with a mean age of 6.8 years were enrolled and treated for 12 months. At baseline, Z scores for mean weight-for-age and mean height-for-age were −2.01 and −2.12, respectively. Mean CD4% was 9.0. Median plasma HIV-1 RNA viral load was 5.51 log10 copies per millilitre (cp/ml). Two children (3.9%) died and another 11 (22%) suffered 13 severe clinical events. At month 12, mean WAZ had improved by 0.63 (P < 0.001) and mean HAZ by 0.57 (P < 0.001). Mean CD4% had risen to 24 (P < 0.001). Viral load was below 300 RNA cp/ml in 81% of the children; HIV resistance mutations were detected in 11 (21.6%). Conclusion The once-a-day combination of DDI + 3TC + EFV is an alternative first-line treatment for HIV-1-infected children. Dose adjustment should further improve efficacy. PMID:21673861

  3. Trabecular and cortical microarchitecture in postmenopausal HIV-infected women

    PubMed Central

    Yin, Michael T.; Shu, Aimee; Zhang, Chiyuan A.; Boutroy, Stephanie; McMahon, Donald J.; Ferris, David C.; Colon, Ivelisse; Shane, Elizabeth

    2013-01-01

    Objective To assess the effects of HIV infection and antiretroviral therapy (ART) on trabecular and cortical microarchitecture in postmenopausal minority women. Methods A subgroup of 106 (46 HIV-infected, 60 uninfected) postmenopausal Hispanic and African American women from an established cohort had areal bone mineral density (aBMD) measured by dual-energy x-ray absorptiometry, and trabecular and cortical volumetric BMD (vBMD) and microarchitecture measured by high-resolution peripheral quantitative computed tomography (HRpQCT) at the radius and tibia. Results HIV-infected women were slightly younger (58±1 versus 61±1 yrs, p=0.08), and had lower body mass index (BMI, 28±1 versus 32±1 kg/m2, p<0.01). BMI-adjusted aBMD Z scores were lower in HIV-infected women at the lumbar spine, total hip and ultradistal radius. Serum N-telopeptide and C-telopeptide levels were also higher in HIV-infected women. Trabecular and cortical vBMD were similar at the radius, but cortical area (105.5±2.4 versus 120.6±2.0mm2, p<0.01) and thickness (956±33 versus 1075±28 m, p<0.01) at the tibia were approximately 11–12% lower in HIV-infected women. Differences remained significant after adjusting for age, BMI and race/ethnicity. In contrast, cortical porosity was similar in both groups. Conclusion Although HIV-infected postmenopausal women had lower aBMD at the spine, total hip and ultradistal radius and higher levels of bone resorption markers, the only differences detected by HRpQCT were lower cortical thickness and area at the tibia. PMID:23460340

  4. Immunology of Pediatric HIV Infection

    PubMed Central

    Tobin, Nicole H.; Aldrovandi, Grace M.

    2013-01-01

    Summary Most infants born to human immunodeficiency virus (HIV)-infected women escape HIV infection. Infants evade infection despite an immature immune system and, in the case of breastfeeding, prolonged repetitive, exposure. If infants become infected, the course of their infection and response to treatment differs dramatically depending upon the timing (in utero, intrapartum, or during breastfeeding) and potentially the route of their infection. Perinatally acquired HIV infection occurs during a critical window of immune development. HIV’s perturbation of this dynamic process may account for the striking age-dependent differences in HIV disease progression. HIV infection also profoundly disrupts the maternal immune system upon which infants rely for protection and immune instruction. Therefore, it is not surprising that infants who escape HIV infection still suffer adverse effects. In this review, we highlight the unique aspects of pediatric HIV transmission and pathogenesis with a focus on mechanisms by which HIV infection during immune ontogeny may allow discovery of key elements for protection and control from HIV. PMID:23772619

  5. Antibacterial activity of East African medicinal plants.

    PubMed

    Fabry, W; Okemo, P O; Ansorg, R

    1998-02-01

    In an ethnopharmacological survey, extracts of the six East African medicinal plants Entada abyssinica (stem bark), Terminalia spinosa (young branches), Harrisonia abyssinica (roots), Ximenia caffra (roots), Azadirachta indica (stem bark and leaves), and Spilanthes mauritiana (roots and flowers) were tested against 105 strains of bacteria from seven genera (Staphylococcus, Enterococcus, Pseudomonas, Escherichia, Klebsiella, Salmonella, Mycobacterium). The minimum inhibitory concentration reached by 50% (MIC50%) and 90% (MIC90) of the strains for the extracts of E. abyssinica, T. spinosa, X. caffra, and A. indica (stem bark) ranged from 0.13-8 mg/ml and from 0.5 to > 8 mg/ml, respectively. Their minimum bactericidal concentration by 50% (MBC50%) and MBC90% were all between 0.5 and > 8 mg/ml. H. abyssinica, A. indica (leaves), and S. mauritiana (roots and flowers) had MIC and MBC values > or = 8 mg/ml. Mycobacteria were not inhibited at extract concentrations of 0.5-2 mg/ml. It is concluded that plant extracts with low MIC and MBC values may serve as sources for compounds with therapeutic potency. PMID:9533435

  6. Successes and Challenges in East African Conservation Education

    ERIC Educational Resources Information Center

    Johnson-Pynn, Julie S.; Johnson, Laura R.

    2005-01-01

    Environmental education (EE) programs that include service-learning components have great potential to positively impact East African youth, their communities, and their ecology. This exploratory study describes 2 programs in East Africa, The Jane Goodall Institute's Roots & Shoots (R&S) and Wildlife Clubs of Uganda (WCU). The authors studied…

  7. [Microbiological diagnosis of HIV infection].

    PubMed

    López-Bernaldo de Quirós, Juan Carlos; Delgado, Rafael; García, Federico; Eiros, José M; Ortiz de Lejarazu, Raúl

    2007-12-01

    Currently, there are around 150,000 HIV-infected patients in Spain. This number, together with the fact that this disease is now a chronic condition since the introduction of antiretroviral therapy, has generated an increasing demand on the clinical microbiology laboratories in our hospitals. This increase has occurred not only in the diagnosis and treatment of opportunistic diseases, but also in tests related to the diagnosis and therapeutic management of HIV infection. To meet this demand, the Sociedad de Enfermedades Infecciosas y Microbiología Clinica (Spanish Society of Infectious Diseases and Clinical Microbiology) has updated its standard Procedure for the microbiological diagnosis of HIV infection. The main advances related to serological diagnosis, plasma viral load, and detection of resistance to antiretroviral drugs are reviewed in this version of the Procedure.

  8. A Census Tract–Level Examination of Social Determinants of Health among Black/African American Men with Diagnosed HIV Infection, 2005–2009—17 US Areas

    PubMed Central

    Gant, Zanetta; Gant, Larry; Song, Ruiguang; Willis, Leigh; Johnson, Anna Satcher

    2014-01-01

    Background HIV disproportionately affects black men in the United States: most diagnoses are for black gay, bisexual, and other men who have sex with men (collectively referred to as MSM). A better understanding of the social conditions in which black men live and work may better explain why HIV incidence and diagnosis rates are higher than expected in this population. Methods Using data from the National HIV Surveillance System and the US Census Bureau's American Community Survey, we examined the relationships of HIV diagnosis rates and 5 census tract–level social determinants of health variables for 21,948 black MSM and non-MSM aged ≥15 years residing in 17 areas in the United States. We examined federal poverty status, marital status, education level, employment status, and vacancy status and computed rate ratios (RRs) and prevalence odds ratios (PORs), using logistic regression with zero-inflated negative binomial modeling. Results Among black MSM, HIV diagnosis rates decreased as poverty increased (RR: 0.54). At the time of HIV diagnosis, black MSM were less likely than black non-MSM to live in census tracts with a higher proportion below the poverty level (POR: 0.81) and with a higher proportion of vacant houses (POR: 0.86). In comparison, housing vacancy was positively associated with HIV diagnosis rates among black non-MSM (RR: 1.65). HIV diagnosis rates were higher for black MSM (RR: 2.75) and non-MSM (RR: 4.90) whose educational level was low. Rates were significantly lower for black MSM (RR: 0.06) and non-MSM (RR: 0.26) as the proportion unemployed and the proportion married increased. Conclusions This exploratory study found differences in the patterns of HIV diagnosis rates for black MSM and non-MSM and provides insight into the transmission of HIV infection in areas that reflect substantial disadvantage in education, housing, employment, and income. PMID:25268831

  9. Preventing HIV Infection in Women

    PubMed Central

    Adimora, Adaora A.; Ramirez, Catalina; Auerbach, Judith D.; Aral, Sevgi O.; Hodder, Sally; Wingood, Gina; El-Sadr, Wafaa; Bukusi, Elizabeth Anne

    2014-01-01

    Although the number of new infections has declined recently, women still constitute almost half of the world's 34 million people with HIV infection, and HIV remains the leading cause of death among women of reproductive age. Prevention research has made considerable progress during the past few years in addressing the biological, behavioral and social factors that influence women's vulnerability to HIV infection. Nevertheless, substantial work still must be done in order to implement scientific advancements and to resolve the many questions that remain. This article highlights some of the recent advances and persistent gaps in HIV prevention research for women and outlines key research and policy priorities. PMID:23764631

  10. Common oral lesions associated with HIV infection.

    PubMed

    Navazesh, M; Lucatorto, F

    1993-09-01

    More than 40 different lesions involving head and neck areas have been associated with HIV infection. The oral cavity may manifest the first sign of HIV infection. Early detection of these conditions can lead to early diagnosis of HIV infection and subsequent appropriate management. Signs, symptoms and management of the most common HIV-associated oral lesions are discussed.

  11. Middle East and North African Oil.

    ERIC Educational Resources Information Center

    Al-Quazzaz, Ayad

    1981-01-01

    Traces the history of oil and natural gas in the Middle East and relates the importance of the Middle East's current stores of oil to economic development. Information is presented on the relationship of major oil companies and local governments, OPEC, rate of production, and the impact of oil on the societies of the Middle East and North Africa.…

  12. Prevalence of Lipodystrophy and Metabolic Abnormalities in HIV-infected African Children after 3 Years on First-line Antiretroviral Therapy

    PubMed Central

    Bwakura-Dangarembizi, Mutsawashe; Szubert, Alexander J.; Prendergast, Andrew J.; Gomo, Zvenyika A.; Thomason, Margaret J.; Musarurwa, Cuthbert; Mugyenyi, Peter; Nahirya, Patricia; Kekitiinwa, Adeodata; Gibb, Diana M.; Walker, Ann S.; Nathoo, Kusum

    2015-01-01

    Background: Most pediatric lipodystrophy data come from high-income/middle-income countries, but most HIV-infected children live in sub-Saharan Africa, where lipodystrophy studies have predominantly investigated stavudine-based regimens. Methods: Three years after antiretroviral therapy (ART) initiation, body circumferences and skinfold thicknesses were measured (n = 590), and fasted lipid profile assayed (n = 325), in children from 2 ARROW trial centres in Uganda/Zimbabwe. Analyses compared randomization to long-term versus short-term versus no zidovudine from ART initiation [unadjusted; latter 2 groups receiving abacavir+lamivudine+non-nucleoside-reverse-transciptase-inhibitor (nNRTI) long-term], and nonrandomized (confounder-adjusted) receipt of nevirapine versus efavirenz. Results: Body circumferences and skinfold thicknesses were similar regardless of zidovudine exposure (P > 0.1), except for subscapular and supra-iliac skinfolds-for-age which were greater with long-term zidovudine (0.006 < P < 0.047). Circumferences/skinfolds were also similar with efavirenz and nevirapine (adjusted P > 0.09; 0.02 < P < 0.03 for waist/waist-hip-ratio). Total and high-density lipoprotein (HDL)-cholesterol, HDL/triglyceride-ratio (P < 0.0001) and triglycerides (P = 0.01) were lower with long-term zidovudine. Low-density lipoprotein (LDL)-cholesterol was higher with efavirenz than nevirapine (P < 0.001). Most lipids remained within normal ranges (75% cholesterol, 85% LDL and 100% triglycerides) but more on long-term zidovudine (3 NRTI) had abnormal HDL-cholesterol (88% vs. 40% short/no-zidovudine, P < 0.0001). Only 8/579(1.4%) children had clinical fat wasting (5 grade 1; 3 grade 2); 2(0.3%) had grade 1 fat accumulation. Conclusions: Long-term zidovudine-based ART is associated with similar body circumferences and skinfold thicknesses to abacavir-based ART, with low rates of lipid abnormalities and clinical lipodystrophy, providing reassurance where national programs now

  13. Are WHO/UNAIDS/UNICEF-recommended replacement milks for infants of HIV-infected mothers appropriate in the South African context?

    PubMed Central

    Papathakis, P. C.; Rollins, N. C.

    2004-01-01

    OBJECTIVE: Little is known about the nutritional adequacy and feasibility of breastmilk replacement options recommended by WHO/UNAIDS/UNICEF. The study aim was to explore suitability of the 2001 feeding recommendations for infants of HIV-infected mothers for a rural region in KwaZulu Natal, South Africa specifically with respect to adequacy of micronutrients and essential fatty acids, cost, and preparation times of replacement milks. METHODS: Nutritional adequacy, cost, and preparation time of home-prepared replacement milks containing powdered full cream milk (PM) and fresh full cream milk (FM) and different micronutrient supplements (2 g UNICEF micronutrient sachet, government supplement routinely available in district public health clinics, and best available liquid paediatric supplement found in local pharmacies) were compared. Costs of locally available ingredients for replacement milk were used to calculate monthly costs for infants aged one, three, and six months. Total monthly costs of ingredients of commercial and home-prepared replacement milks were compared with each other and the average monthly income of domestic or shop workers. Time needed to prepare one feed of replacement milk was simulated. FINDINGS: When mixed with water, sugar, and each micronutrient supplement, PM and FM provided <50% of estimated required amounts for vitamins E and C, folic acid, iodine, and selenium and <75% for zinc and pantothenic acid. PM and FM made with UNICEF micronutrient sachets provided 30% adequate intake for niacin. FM prepared with any micronutrient supplement provided no more than 32% vitamin D. All PMs provided more than adequate amounts of vitamin D. Compared with the commercial formula, PM and FM provided 8-60% of vitamins A, E, and C, folic acid, manganese, zinc, and iodine. Preparations of PM and FM provided 11% minimum recommended linoleic acid and 67% minimum recommended alpha-linolenic acid per 450 ml mixture. It took 21-25 minutes to optimally prepare

  14. International travel and HIV infection.

    PubMed Central

    von Reyn, C. F.; Mann, J. M.; Chin, J.

    1990-01-01

    Although human immunodeficiency virus (HIV) infection is a worldwide problem, its prevalence and pattern vary from country to country. Accordingly, the risk to international travellers of acquiring HIV infection also varies widely in different parts of the world, and depends principally on their behaviour. The risk of sexual acquisition of HIV infection can be virtually eliminated by avoiding penetrative sexual intercourse with intravenous drug users and persons who have had multiple sexual partners (such as prostitutes) or reduced by the use of condoms. The risk of parenteral exposure to HIV can be reduced by avoiding parenteral drug use and behaviour that is likely to lead to injury (with its attendant risk of requiring blood transfusion) and by seeking medical facilities with adequate capabilities to screen blood donors for HIV and to sterilize instruments. HIV screening of international travellers is an ineffective, costly, and impractical public health strategy for limiting the worldwide spread of HIV infection. Travellers infected with HIV require specialized advice regarding health precautions, prophylactic medications, and immunization. PMID:2194689

  15. Tuberculosis and HIV infection worldwide.

    PubMed

    Murray, J F

    1995-12-01

    The incidence of HIV-associated tuberculosis is increasing worldwide and will continue to increase during the foreseeable future, especially in developing countries. HIV infection appears to increase the opportunity for M. tuberculosis to succeed in causing infection after inhalation into the lungs. Moreover, there is persuasive evidence that in the presence of HIV infection, new-onset tuberculous infection will progress rapidly to clinically significant disease and the likelihood that latent tuberculous infection will reactivate is enormously increased. The accelerating and amplifying influence of HIV infection is contributing to the increasing incidence of disease caused by multidrug-resistant strains of M. tuberculosis. Neither clinical or radiographic features reliably distinguish the majority of patients with HIV-associated tuberculosis from those who are non-HIV-infected. The remainder, however, may have atypical manifestations and be difficult to diagnose. Six months of chemotherapy with conventional antituberculosis drugs cures most patients, but many die during or after treatment of other AIDS-related complications.

  16. Troubled Adolescents and HIV Infection.

    ERIC Educational Resources Information Center

    Woodruff, John O., Ed.; And Others

    This report on adolescents, Acquired Immune Deficiency Syndrome (AIDS), and Human Immune Virus (HIV) infection had its beginning in the Knowledge Development Workshop "Issues in the Prevention and Treatment of AIDS Among Adolescents with Serious Emotional Disturbance," held June 9-10, 1988 in the District of Columbia. These papers are included:…

  17. HIV Infection and Homeless Adolescents.

    ERIC Educational Resources Information Center

    Athey, Jean L.

    1991-01-01

    A literature review reveals that homeless adolescents are at extremely high risk for acquiring HIV infection. Sexual and drug use behaviors that put these adolescents at risk are described. New models of social, health, and mental health services for these youth are outlined. (GLR)

  18. HIV Infection Presenting with Dementia.

    PubMed

    Narayanan, K; Gupta, Avneet; Manoj, S; Seshadri, Kp

    2015-08-01

    We present a case of dementia in a young healthy individual. On evaluation he was detected to have HIV infection with low CD4 count and a high viral load. He had no opportunistic infections or any other AIDS defining illnesses. He recovered fully within 3 months of antiretroviral therapy. PMID:27604445

  19. Spatiotemporal dynamics of HIV infection

    NASA Astrophysics Data System (ADS)

    Strain, Matthew Carl

    Mathematical models of the dynamics of infection with the human immunodeficiency virus (HIV) have contributed to tremendous advances over the past 20 years. This thesis extends this previous work by exploring the importance of spatial heterogeneity in HIV infection both in vitro and in vivo in patients treated with highly-active antiretroviral therapy. Viral infections propagate locally in space, yet HIV infection has been widely regarded as equilibrated over the entire body of an infected patient. This dissertation constructs and explores a cellular automata model of viral spread at the cellular level. Coupling the automata to a blood compartment represented by a differential equation leads to a whole-body model of HIV infection that explicitly includes spatial effects at both the cellular and tissue levels. These models are tested by comparison with experimental data. A central prediction of the spatial model is that, due to competition between Brownian motion and viral lability, HIV infectivity increases with target cell density. This production is verified in a series of in vitro experiments in cell culture. The predicted independence of inhibitory concentrations of antiretoviral agents is verified for nevirapine, but azidothymidine inhibits HIV replication less efficiently in more dense cultures. These in vitro results suggest that systems allowing cell concentrations closer to tissue densities would better reflect virus replication kinetics, although standard measures of relative drug susceptibility may accurately reflect in vivo conditions. The coupled spatial model of in vivo dynamics is compared with novel mathematical analysis of experiments in HIV-infected patients. These analyses indicate that HIV DNA provides a useful marker of the size of long-lived cellular reservoirs of HIV. Levels of HIV DNA in peripheral blood are predictive of the average rate of residual virus production after years of treatment, regardless of whether patients initiate therapy

  20. African-American Adolescents' Knowledge, Health-Related Attitudes, Sexual Behavior, and Contraceptive Decisions: Implications for the Prevention of Adolescent HIV Infection.

    ERIC Educational Resources Information Center

    St. Lawrence, Janet S.

    1993-01-01

    African-American adolescents (n=195) completed measures on Acquired Immune Deficiency Syndrome (AIDS) knowledge, condoms, health locus of control, vulnerability to human immunodeficiency virus, peer sexual norms, sexual behavior, and contraceptive preferences. Girls were more knowledgeable about AIDS, reported fewer sexual partners, held more…

  1. Radiocarbon dating of East african lake levels.

    PubMed

    Butzer, K W; Isaac, G L; Richardson, J L; Washbourn-Kamau, C

    1972-03-10

    The fluctuations of the key East African lakes discussed are summarized in Fig. 4 which also includes the available evidence from Lake Rukwa (42) and Lake Chad (43) Exceot for Lake Victoria, all of these now lack surface outlets and are situated in much drier climates than the major lakes of the Western Rift Valley, which remain filled to their overflow levels. The apparent differendes among the fluctuations of the lakes are partly due to differendes in the nature of the evidence or the intensity of research or both, although there must also have been important local differences in the histories of the lakes Yet the consistencies are far more striking, most notably the coincidence of early Holocene high stands. Between 10,000 and 8,000 years ago, it seems that lakes in many parts of tropical Africa were greatly enlarged. Where evidence for the previous span of time is well resolved, it appears that transgressions leading to this high stand began about 12,000 years ago, and evidende from three basins (Victoria, Nakuru, and Chad) indicates a pause or minor recession just at or before 10,000 years ago. Wherever information is available for the period preceding 12,000 years ago, it can consistentlybe shown that lakes were much small-er . Several basins (Rudolf, Nakuru, and Chad) also show traces of much earlier phases of lake expansion. which are not yet well dated but which all occurred more then 20,000 years ago. The Holocene record subsequent to the maximum of 10,00 to 8,000 years ago is more complex. Three basins (Rudolf, Nakuru, and Chad) show an apparently concordant, positive oscillation at some point between 6000 and 4000 years ago, but it is uncertain how widely this episode is represented. Although many of these lakes that are now closed filled to overflowing at least once during the late Quaternary, it is evident from Fig. 4 that the periods of expansion were short-lived compared with phases of contraction to levels near those of today. This pattern may be

  2. Radiocarbon dating of East african lake levels.

    PubMed

    Butzer, K W; Isaac, G L; Richardson, J L; Washbourn-Kamau, C

    1972-03-10

    The fluctuations of the key East African lakes discussed are summarized in Fig. 4 which also includes the available evidence from Lake Rukwa (42) and Lake Chad (43) Exceot for Lake Victoria, all of these now lack surface outlets and are situated in much drier climates than the major lakes of the Western Rift Valley, which remain filled to their overflow levels. The apparent differendes among the fluctuations of the lakes are partly due to differendes in the nature of the evidence or the intensity of research or both, although there must also have been important local differences in the histories of the lakes Yet the consistencies are far more striking, most notably the coincidence of early Holocene high stands. Between 10,000 and 8,000 years ago, it seems that lakes in many parts of tropical Africa were greatly enlarged. Where evidence for the previous span of time is well resolved, it appears that transgressions leading to this high stand began about 12,000 years ago, and evidende from three basins (Victoria, Nakuru, and Chad) indicates a pause or minor recession just at or before 10,000 years ago. Wherever information is available for the period preceding 12,000 years ago, it can consistentlybe shown that lakes were much small-er . Several basins (Rudolf, Nakuru, and Chad) also show traces of much earlier phases of lake expansion. which are not yet well dated but which all occurred more then 20,000 years ago. The Holocene record subsequent to the maximum of 10,00 to 8,000 years ago is more complex. Three basins (Rudolf, Nakuru, and Chad) show an apparently concordant, positive oscillation at some point between 6000 and 4000 years ago, but it is uncertain how widely this episode is represented. Although many of these lakes that are now closed filled to overflowing at least once during the late Quaternary, it is evident from Fig. 4 that the periods of expansion were short-lived compared with phases of contraction to levels near those of today. This pattern may be

  3. HIV infection of the penis

    PubMed Central

    Anderson, Deborah; Politch, Joseph A.; Pudney, Jeffrey

    2010-01-01

    The penile foreskin, shaft, glans/corona, meatus and urethral introitus are all potential sites of HIV-1 acquisition in men. Circumcision decreases HIV infection in heterosexual men by 50–60%, indicating that the foreskin plays an important role, but that other sites are also involved. HIV target cells have been described throughout the male genital epithelium, but appear to be more accessible in the inner foreskin and urethral introitus, both of which are mucosal (wet) epithelia and infectable with HIV in vitro. Sexually transmitted co-infections can increase the risk of HIV infection at these and other sites by eroding the protective epithelial layer and by attracting and activating HIV target cells in the mucosal epithelium. The moist subpreputial cavity hosts a unique microbiome that may also play a role in HIV infection. Both innate and adaptive immune defense mechanisms are operative in the lower male genital region. The penile urethral mucosa contains accumulations of IgA+ plasma cells and T lymphocytes, and may provide a responsive target for future mucosal vaccines to prevent HIV sexual transmission. PMID:21214659

  4. Innovative tephra studies in the East African Rift System

    NASA Astrophysics Data System (ADS)

    WoldeGabriel, Giday; Hart, William K.; Heiken, Grant

    Geosciences investigations form the foundation for paleoanthropological research in the East African Rift System. However, innovative applications of tephra studies for constraining spatial and temporal relations of diverse geological processes, biostratigraphic records, and paleoenvironmental conditions within the East African Rift System were fueled by paleoanthropological investigations into the origin and evolution of hominids and material culture. Tephra is a collective, size-independent term used for any material ejected during an explosive volcanic eruption.The East African Rift System has become a magnet for paleoanthropological research ever since the discovery of the first hominids at Olduvai Gorge, in Tanzania, in the 1950s [Leakey et al., 1961]. Currently, numerous multidisciplinary scientific teams from academic institutions in the United States and Western Europe make annual pilgrimages for a couple of months to conduct paleoanthropological field research in the fossil-rich sedimentary deposits of the East African Rift System in Ethiopia, Kenya, and Tanzania. The field expedition consists of geological, paleontological, archaeological, and paleoenvironmental investigations.

  5. A preliminary evaluation of the cognitive and motor effects of pediatric HIV infection in Zairian children.

    PubMed

    Boivin, M J; Green, S D; Davies, A G; Giordani, B; Mokili, J K; Cutting, W A

    1995-01-01

    Fourteen asymptomatic HIV-infected Zairian children under 2 years of age displayed social and motor developmental deficits on the Denver Developmental Screening Test when compared with 20 HIV-negative cohorts born to HIV-infected mothers and 16 control children. In a second study, 11 infected children over 2 years of age had sequential motor and visual-spatial memory deficits on the Kaufman Assessment Battery for Children and motor development deficits on the Early Childhood Screening Profiles. HIV infection affects central nervous system structures mediating motor and spatial memory development, even in seemingly asymptomatic children. Furthermore, maternal HIV infection compromises the labor-intensive provision of care in the African milieu and undermines global cognitive development in even uninfected children. PMID:7737068

  6. Associations among correlates of schedule adherence to antiretroviral therapy (ART): a path analysis of a sample of crack cocaine using sexually active African-Americans with HIV infection.

    PubMed

    Atkinson, J S; Schönnesson, L Nilsson; Williams, M L; Timpson, S C

    2008-02-01

    Adherence to HIV medication regimens is a function of multiple dimensions including psychological functioning, social support, adherence self-efficacy and optimism regarding treatment. Active substance use can also negatively affect adherence. An understanding of the nature of the associations among the correlates of adherence can better inform the design of interventions to improve adherence. This study developed an exploratory path model of schedule adherence using data from a sample 130 African-American HIV-positive crack cocaine users on highly active antiretroviral therapy (ART). This model was based on the Transactional Model of Stress and Coping developed by Lazarus and Folkman. Following the theory, the effects of psychological distress on schedule adherence were mediated by patients' relationship with their doctor and optimism towards antiretroviral treatment. Adherence was also associated with patients' self-efficacy regarding their medical regimen which, in turn, was associated with their social support.

  7. Vaccination in HIV-Infected Adults

    PubMed Central

    Wallace, Mark R.

    2014-01-01

    Abstract Vaccines are critical components for protecting HIV-infected adults from an increasing number of preventable diseases. However, missed opportunities for vaccination among HIV-infected persons persist, likely due to concerns regarding the safety and efficacy of vaccines, as well as the changing nature of vaccine guidelines. In addition, the optimal timing of vaccination among HIV-infected adults in regards to HIV stage and receipt of antiretroviral therapy remain important questions. This article provides a review of the current recommendations regarding vaccines among HIV-infected adults and a comprehensive summary of the evidence-based literature of the benefits and risks of vaccines among this vulnerable population. PMID:25029589

  8. Specific Antibody Production by Blood B Cells is Retained in Late Stage Drug-naïve HIV-infected Africans

    PubMed Central

    Béniguel, Lydie; Bégaud, Evelyne; Cognasse, Fabrice; Gabrié, Philippe; Mbolidi, Christophe D.; Marovich, Mary A.; Cazorla, Céline; Lucht, Frédéric; Genin, Christian; Garraud, Olivier

    2004-01-01

    Unseparated peripheral blood mononuclear cells (PBMCs) obtained from drug-naïve African individuals living in a context of multi-infections and presenting with high viral load (VL), were cultured in vitro and tested for their ability to produce antibodies (Abs) reacting with HIV-1 antigens. Within these PBMCs, circulating B cells were differentiated in vitro and produced IgG Abs against not only ENV, but also GAG and POL proteins. Under similar experimental conditions, HAART treated patients produced Abs to ENV proteins only. The in vitro antibody production by drug-naïve individuals' PBMCs depended on exogenous cytokines (IL-2 and IL-10) but neither on the re-stimulation of reactive cells in cultures by purified HIV-1-gp 160 antigen nor on the re-engagement of CD40 surface molecules. Further, it was not abrogated by the addition of various monoclonal Abs (mAbs) to co-stimulatory molecules. This suggests that the in vitro antibody production by drug-naïve individuals' PBMCs resulted from the maturation of already envelope and core antigen-primed, differentiated B cells, presumably pre-plasma cells, which are not known to circulate at homeostasy. As in vitro produced Abs retained the capacity of binding antigen and forming complexes, this study provides pre-clinical support for functional humoral responses despite major HIV- and other tropical pathogen-induced B cell perturbations. PMID:15330447

  9. Ocular manifestations of HIV infection.

    PubMed Central

    Jabs, D A

    1995-01-01

    OBJECTIVE: To evaluate the frequency of ocular complications and the clinical outcomes of these complications in patients with various stages of HIV infection. METHODS: Retrospective review of all HIV-infected patients seen in an AIDS ophthalmology clinic from November 1983 through December 31, 1992. RESULTS: Eleven-hundred sixty-three patients were seen for ophthalmologic evaluation. Of these, 781 had the acquired immune deficiency syndrome (AIDS), 226 had symptomatic HIV infection (AIDs-related complex [ARC]), and 156 had asymptomatic HIV infection. Non-infectious HIV retinopathy was the most common ocular complication, affecting 50% of the patients with AIDS, 34% of the patients with ARC, and 3% of the patients with asymptomatic HIV infection. Cytomegalovirus (CMV) retinitis was the most common opportunistic ocular infection, affecting 37% of the patients with AIDS. Other opportunistic ocular infections, including ocular toxoplasmosis, varicella zoster virus retinitis, and Pneumocystis choroidopathy were all much less common, each occurring in < or = 1% of the patients with AIDS. Treatment of CMV retinitis with either foscarnet or ganciclovir was successful in initially controlling the retinitis. However, relapse represented a significant problem and required frequent re-inductions. As a consequence of the retinal damage associated with relapse, loss of visual acuity occurred. The median time to a visual acuity of 20/200 or worse for all eyes with CMV retinitis was 13.4 months, and the median time to a visual acuity of 20/200 or worse in the better eye was 21.1 months. At last follow-up, 75% of the patients had a final visual acuity of 20/40 or better in at least one eye. Retinal detachments were a frequent ophthalmologic complication of CMV retinitis with a cumulative probability of a retinal detachment in at least one eye of 57% at 12 months after the diagnosis of CMV retinitis. Herpes zoster ophthalmicus developed in 3% of the overall series and was seen in

  10. Parotid manifestations of HIV infection.

    PubMed

    Zeitlen, S; Shaha, A

    1991-08-01

    A lump in the parotid region is generally a salivary tumor unless proved otherwise. Recently with an epidemic of acquired immune deficiency syndrome (AIDS) and AIDS-related complex (ARC), a large number of pathologies are noticed in the parotid region. These conditions generally involve the intraparotid and periparotid lymph nodes. Hyperplastic lymphadenopathy and the benign lymphoepithelial lesions are the most common variants. Our knowledge regarding these new conditions is just evolving. There remains a therapeutic dilemma starting from observation only to local excision and superficial or total parotidectomy. These lesions must be kept in mind when we evaluate a patient with risk factors for human immunodeficiency virus (HIV) infection.

  11. Monitoring East African vegetation using AVHRR data

    NASA Technical Reports Server (NTRS)

    Justice, C. O.; Holben, B. N.; Gwynne, M. D.

    1986-01-01

    NOAA Advanced Very High Resolution Radiometer satellite data are applied to regional vegetation monitoring in East Africa. Normalized Difference Vegetation Index (NDVI) data for a one-year period from May 1983 are used to examine the phenology of a range of vegetation types. The integrated NDVI data for the same period are compared with an ecoclimatic zone map of the region and show marked similarities. Particular emphasis is placed on quantifying the phenology of the Acacia Commiphora bushlands. Considerable variation was found in the phenology of the bushlands as determined by the satellite NDVI, and is explained through the high spatial variability in the distribution of rainfall and the resulting green-up of the vegetation. The relationship between rainfall and NDVI is further examined for selected meteorological stations existing within the bushland. A preliminary estimate is made of the length of growing season using an NDVI thresholding technique.

  12. Rainfall variability over the East African coast

    NASA Astrophysics Data System (ADS)

    Gamoyo, Majambo; Reason, Chris; Obura, David

    2015-04-01

    The coastal region of Kenya and Tanzania experiences two rainy seasons per year (October-November-December (OND) and March-April-May (MAM)) and has an economy that is highly dependent on and vulnerable to the amounts and timing of rainfall during these seasons. Most of the interannual variability in OND seasonal rainfall totals relate to El Niño Southern Oscillation (ENSO) and Indian Ocean Dipole (IOD) events. While these relationships are fairly well documented and understood, there is a relatively poor understanding of the timing and intensity of the rainfall during ENSO/IOD seasons. In an attempt to improve understanding on this topic, daily rainfall station data, dekad and seasonal satellite rainfall estimates and Normalized Difference Vegetation Index (NDVI) imagery are analyzed for two recent OND seasons with El Niño conditions. These are OND 2006 which was characterized by devastating floods over the region and 2009 when the magnitude and spatial extent of the above average rainfall patterns were smaller. Daily rainfall data for the Tanzanian coastal stations showed that Tanga and Dar es Salaam (north and central coast) experienced few dry spells and several relatively intense wet spells during OND 2006 whereas at Mtwara, on the south coast, there were two very intense wet spells and a number of dry spells during the season. In OND 2009, only the north coast (Tanga) experienced above average rainfall, comprised of three wet spells with the one about a month after the beginning of the season being very intense. These data highlight the complexity of the rainfall distributions in the coastal region. A shift of the Walker circulation over coastal East Africa with strong uplift there seemed to be responsible for the very wet conditions during OND 2006. The marine air mass being advected from the western tropical Indian Ocean towards East Africa contained more moisture than average. Similar, but weaker, horizontal circulation anomalies occurred in OND 2009

  13. West Indian Ocean variability and East African fish catch.

    PubMed

    Jury, M; McClanahan, T; Maina, J

    2010-08-01

    We describe marine climate variability off the east coast of Africa in the context of fish catch statistics for Tanzania and Kenya. The time series exhibits quasi-decadal cycles over the period 1964-2007. Fish catch is up when sea surface temperature (SST) and atmospheric humidity are below normal in the tropical West Indian Ocean. This pattern relates to an ocean Rossby wave in one phase of its east-west oscillation. Coastal-scale analyses indicate that northward currents and uplift on the shelf edge enhance productivity of East African shelf waters. Some of the changes are regulated by the south equatorial current that swings northward from Madagascar. The weather is drier and a salty layer develops in high catch years. While the large-scale West Indian Ocean has some impact on East African fish catch, coastal dynamics play a more significant role. Climatic changes are reviewed using 200 years of past and projected data. The observed warming trend continues to increase such that predicted SST may reach 30 degrees C by 2100 while SW monsoon winds gradually increase, according to a coupled general circulation model simulation with a gradual doubling of CO(2). PMID:20471674

  14. East African and Kuunga Orogenies in Tanzania - South Kenya

    NASA Astrophysics Data System (ADS)

    Fritz, H.; Hauzenberger, C. A.; Tenczer, V.

    2012-04-01

    Tanzania and southern Kenya hold a key position for reconstructing Gondwana consolidation because here different orogen belts with different tectonic styles interfere. The older, ca. 650-620 Ma East African Orogeny resulted from the amalgamation of arc terranes in the northern Arabian-Nubian Shield (ANS) and continental collision between East African pieces and parts of the Azania terrane in the south (Collins and Pisarevsky, 2005). The change form arc suturing to continental collision settings is found in southern Kenya where southernmost arcs of the ANS conjoin with thickened continental margin suites of the Eastern Granulite Belt. The younger ca. 570-530 Ma Kuunga orogeny heads from the Damara - Zambesi - Irumide Belts (De Waele et al., 2006) over Tanzania - Mozambique to southern India and clashes with the East African orogen in southern-central Tanzania. Two transitional orogen settings may be defined, (1) that between island arcs and inverted passive continental margin within the East African Orogen and, (2) that between N-S trending East African and W-E trending Kuungan orogenies. The Neoproterozoic island arc suites of SE-Kenya are exposed as a narrow stripe between western Azania and the Eastern Granulite belt. This suture is a steep, NNW stretched belt that aligns roughly with the prominent southern ANS shear zones that converge at the southern tip of the ANS (Athi and Aswa shear zones). Oblique convergence resulted in low-vorticity sinstral shear during early phases of deformation. Syn-magmatic and syn-tectonic textures are compatible with deformation at granulite metamorphic conditions and rocks exhumed quickly during ongoing transcurrent motion. The belt is typified as wrench tectonic belt with horizontal northwards flow of rocks within deeper portions of an island arc. The adjacent Eastern Granulite Nappe experienced westward directed, subhorizontal, low-vorticity, high temperature flow at partly extreme metamorphic conditions (900°C, 1.2 to 1.4 GPa

  15. HIV infection in females dependent on drugs.

    PubMed

    Wai, B H; Singh, S; Varma, S L

    1996-03-01

    One hundred and seventy-one drug-dependent females in a drug rehabilitation centre were studied to estimate the prevalence of HIV infection among them. Twenty-four (14%) were positive on the Western Blot test. The presence of HIV infection was significantly correlated with syphilis (p < 0.03) and age (p < 0.001); 83% of those who were HIV positive were intravenous drug users. The need for harm reduction programmes to prevent spread of HIV infection among injecting drug users is stressed. PMID:8867206

  16. The Prevalence of Motor Delay among HIV Infected Children Living in Cape Town, South Africa

    ERIC Educational Resources Information Center

    Ferguson, Gillian; Jelsma, Jennifer

    2009-01-01

    Children living with HIV often display delayed motor performance owing to HIV infection of the central nervous system, the effects of opportunistic infections and, indirectly, owing to their social environments. Although these problems have been well documented, the impact of the virus on the development of South African children is less well…

  17. Trends and variability in East African rainfall and temperature observations

    NASA Astrophysics Data System (ADS)

    Seregina, Larisa; Ermert, Volker; Fink, Andreas H.; Pinto, Joaquim G.

    2014-05-01

    The economy of East Africa is highly dependent on agriculture, leading to a strong vulnerability of local society to fluctuations in seasonal rainfall amounts, including extreme events. Hence, the knowledge about the evolution of seasonal rainfall under future climate conditions is crucial. Rainfall regimes over East Africa are influenced by multiple factors, including two monsoon systems, several convergence zones and the Rift Valley lakes. In addition, local conditions, like topography, modulate the large-scale rainfall pattern. East African rainfall variability is also influenced by various teleconnections like the Indian Ocean Zonal Mode and El Niño Southern Oscillation. Regarding future climate projections, regional and global climate models partly disagree on the increase or decrease of East African rainfall. The specific aim of the present study is the acquirement of historic data from weather stations in East Africa (Kenya, Tanzania, Ruanda and Uganda), the use of gridded satellite (rainfall) products (ARC2 and TRMM), and three-dimensional atmospheric reanalysis (e.g., ERA-Interim) to quantify climate variability in the recent past and to understand its causes. Climate variability and trends, including changes in extreme events, are evaluated using ETCCDI climate change and standardized precipitation indices. These climate indices are determined in order to investigate the variability of temperature and rainfall and their trends with the focus on most recent decades. In the follow-up, statistical and dynamical analyses are conducted to quantify the local impact of pertinent large-scale modes of climate variability (Indian Ocean Zonal Mode, El Niño Southern Oscillation, Sea Surface Temperature of the Indian Ocean).

  18. HIV Infection Seems to Affect Nervous System

    MedlinePlus

    ... is a clinical fellow in the department of neurology at the University of California, San Francisco (UCSF). " ... early [HIV] infection." Valcour is a professor of neurology at UCSF. "Additionally, the ubiquity of symptoms in ...

  19. Vaccinations for Adults with HIV Infection

    MedlinePlus

    Vaccinations for Adults with HIV Infection The table below shows which vaccinations you should have to protect your health if ... sure you and your healthcare provider keep your vaccinations up to date. Vaccine Do you need it? ...

  20. Emerging landscape degradation trends in the East African Horn

    NASA Astrophysics Data System (ADS)

    Pricope, N. G.; Michaelsen, J.; Husak, G. J.; Funk, C. C.; Lopez-Carr, D.

    2012-12-01

    Increasing climate variability along with declining trends in rainfall represent major risk factors affecting food security in many regions of the world. We identify Africa-wide regions where significant rainfall decreases from 1979-2011 are coupled with significant human population density increases. The rangelands of the East African Horn remain one of the world's most food insecure regions with significantly increasing human populations predominantly dependent on pastoralist and agro-pastoralist livelihoods. Widespread vegetation degradation is occurring, adversely impacting fragile ecosystems and human livelihoods. Using MODIS land cover and normalized difference vegetation index (NDVI) data collected since 2000, we observe significant changes in vegetation patterns and productivity over the last decade across the East African Horn and demonstrate that these two products can be used concurrently at large spatial scales to monitor vegetation dynamics at decadal time scales. Results demonstrate that a near doubling of the population in pastoral regions is linked with hotspots of degradation in vegetation condition. The most significant land cover change and browning trends are observed in areas experiencing drying precipitation trends in addition to increasing population pressures. These findings have serious implications for current and future regional food security monitoring and forecasting and for mitigation and adaptation strategies in a region where population is expected to continue increasing against a backdrop of drying climate trends.Fig.1(a)Change in standardized precipitation index in Africa between 1979-2010 (b)Change in population density at continental scale using the GRUMPv1 1990 and 2000 and AfriPop 2010 population density datasets Fig.2 Land cover change trajectories based on 2001-2009 MOD12Q1 Land Cover product for the East African Horn overlaid over aggregated FEWS Net Livelihoods Zones.

  1. HIV Infection and High Density Lipoprotein Metabolism

    PubMed Central

    Rose, Honor; Hoy, Jennifer; Woolley, Ian; Tchoua, Urbain; Bukrinsky, Michael; Dart, Anthony; Sviridov, Dmitri

    2008-01-01

    HIV infection and its treatment are associated with dyslipidemia, including hypoalphalipoproteinemia, and increased risk of cardiovascular disease. Parameters of HDL metabolism in HIV-positive patients were investigated in a cross-sectional study. The following groups of subjects were selected: i) 25 treatment-naïve HIV-infected patients or HIV-infected patients on long therapy break, ii) 28 HIV-infected patients currently treated with protease inhibitors, and iii) 33 HIV-negative subjects. Compared to the HIV-negative group, all groups of HIV-infected patients were characterized by significantly elevated triglyceride and apolipoprotein B levels, mass and activity of lecithin cholesterol acyl transferase and cholesteryl ester transfer protein (p<0.01). Total and LDL cholesterol was lower in treatment-naïve HIV-infected group only. HDL cholesterol and preβ1-HDL were significantly lower in all HIV-infected groups (p<0.05), while mean levels of apolipoprotein A-I (apoA-I) and ability of plasma to promote cholesterol efflux were similar in all groups. We found a positive correlation between apoA-I and levels of CD4+ cells (r2 = 0.3, p<0.001). Plasma level of phospholipid transfer protein was reduced in the group on antiretroviral therapy. Taken together these results suggest that HIV infection is associated with modified HDL metabolism re-directing cholesterol to the apoB-containing lipoproteins and likely reducing the functionality of reverse cholesterol transport. PMID:18054941

  2. Current oral manifestations of HIV infection.

    PubMed

    Navazesh, M

    2001-02-01

    The oral manifestations of human immunodeficiency virus infection have changed drastically since the introduction of the highly active anti-retroviral therapy (HAART) in developed countries. Recent studies have documented significant reductions in morbidity and mortality rates among HIV-infected patients on HAART. This article focuses on the latest information about the oral manifestations of HIV infection and will discuss the impact of HAART.

  3. Severe Malaria among British Troops in the East African Campaign

    PubMed Central

    Keyworth, W. D.

    1928-01-01

    (1) A study of the East African Campaign shows how helpless we are on field service as regards prevention of malaria in a malarious country. (2) Not only prophylaxis but also the symptoms, diagnosis and treatment of the disease are modified by the conditions of field service. (3) The accounts given of the disease in its different aspects do not represent any scientific advance but are included merely to illustrate the points considered under (1) and (2) and to show the responsible and difficult nature of the work that medical officers on field service may be called upon to do. PMID:19986719

  4. Lactase persistence alleles reveal partial East African ancestry of southern African Khoe pastoralists.

    PubMed

    Breton, Gwenna; Schlebusch, Carina M; Lombard, Marlize; Sjödin, Per; Soodyall, Himla; Jakobsson, Mattias

    2014-04-14

    The ability to digest milk into adulthood, lactase persistence (LP), as well as specific genetic variants associated with LP, is heterogeneously distributed in global populations. These variants were most likely targets of selection when some populations converted from hunter-gatherer to pastoralist or farming lifestyles. Specific LP polymorphisms are associated with particular geographic regions and populations; however, they have not been extensively studied in southern Africa. We investigate the LP-regulatory region in 267 individuals from 13 southern African populations (including descendants of hunter-gatherers, pastoralists, and agropastoralists), providing the first comprehensive study of the LP-regulatory region in a large group of southern Africans. The "East African" LP single-nucleotide polymorphism (SNP) (14010G>C) was found at high frequency (>20%) in a strict pastoralist Khoe population, the Nama of Namibia, suggesting a connection to East Africa, whereas the "European" LP SNP (13910C>T) was found in populations of mixed ancestry. Using genome-wide data from various African populations, we identify admixture (13%) in the Nama, from an Afro-Asiatic group dating to >1,300 years ago, with the remaining fraction of their genomes being from San hunter-gatherers. We also find evidence of selection around the LCT gene among Khoe-speaking groups, and the substantial frequency of the 14010C variant among the Nama is best explained by adaptation to digesting milk. These genome-local and genome-wide results support a model in which an East African group brought pastoralist practices to southern Africa and admixed with local hunter-gatherers to form the ancestors of Khoe people.

  5. Lactase persistence alleles reveal partial East African ancestry of southern African Khoe pastoralists.

    PubMed

    Breton, Gwenna; Schlebusch, Carina M; Lombard, Marlize; Sjödin, Per; Soodyall, Himla; Jakobsson, Mattias

    2014-04-14

    The ability to digest milk into adulthood, lactase persistence (LP), as well as specific genetic variants associated with LP, is heterogeneously distributed in global populations. These variants were most likely targets of selection when some populations converted from hunter-gatherer to pastoralist or farming lifestyles. Specific LP polymorphisms are associated with particular geographic regions and populations; however, they have not been extensively studied in southern Africa. We investigate the LP-regulatory region in 267 individuals from 13 southern African populations (including descendants of hunter-gatherers, pastoralists, and agropastoralists), providing the first comprehensive study of the LP-regulatory region in a large group of southern Africans. The "East African" LP single-nucleotide polymorphism (SNP) (14010G>C) was found at high frequency (>20%) in a strict pastoralist Khoe population, the Nama of Namibia, suggesting a connection to East Africa, whereas the "European" LP SNP (13910C>T) was found in populations of mixed ancestry. Using genome-wide data from various African populations, we identify admixture (13%) in the Nama, from an Afro-Asiatic group dating to >1,300 years ago, with the remaining fraction of their genomes being from San hunter-gatherers. We also find evidence of selection around the LCT gene among Khoe-speaking groups, and the substantial frequency of the 14010C variant among the Nama is best explained by adaptation to digesting milk. These genome-local and genome-wide results support a model in which an East African group brought pastoralist practices to southern Africa and admixed with local hunter-gatherers to form the ancestors of Khoe people. PMID:24704072

  6. Tuberculosis and HIV infection: global perspectives.

    PubMed

    Murray, J F

    1997-09-01

    This paper reviews the epidemiological and clinical aspects of the interaction between Mycobacterium tuberculosis and HIV infection. The incidence of HIV-associated tuberculosis is increasing worldwide and is expected to increase further, especially in Africa and parts of Asia. HIV infection appears to increase the likelihood that tuberculous infection will occur after tubercle bacilli are inhaled into the lungs. Moreover, there is persuasive evidence that in the presence of HIV infection, new-onset tuberculous infection will progress rapidly to clinically significant disease and the probability that latent tuberculous infection will reactivate is enormously increased. The accelerating and amplifying influence of HIV infection is also contributing to the increasing incidence of disease caused by multidrug-resistant strains of M. tuberculosis. Neither clinical nor radiographic features reliably distinguish the majority of patients with HIV-associated tuberculosis from those who are non-HIV-infected. Some HIV-infected patients, however, have atypical manifestations and are difficult to diagnose. Chemotherapy for 6 months with conventional antituberculosis drugs cures most patients, but many died during or after treatment of other AIDS-related complications. HIV is contributing heavily to the worldwide increase in tuberculosis. There is also mounting evidence that tuberculosis accelerates the course of co-existing HIV disease.

  7. Identifying HIV-Infected Women’s Psychosocial Stressors: Findings from a Qualitative Study

    PubMed Central

    Brown, Jennifer L.; Vanable, Peter A.; Naughton, Jessie D.; Carey, Michael P.

    2015-01-01

    To inform future psychosocial interventions for HIV-infected women, five focus groups were conducted with 29 HIV-infected women (72% African-American). Sessions were audio-recorded, transcribed, and coded by two raters. HIV-specific stressors included difficulties with serostatus disclosure, HIV medication adherence, and HIV-related discrimination. Stressors not directly linked to HIV were described as more concerning and included mental health or substance use problems, relationship challenges, caretaking for children or grandchildren, and financial difficulties. Participants suggested that interventions provide social support from other HIV-infected women, consistent case management and social work services, and forums to acquire additional information about HIV and treatment options. PMID:26834511

  8. Gender and HIV infection in the context of alcoholism in Kenya.

    PubMed

    Muturi, Nancy

    2015-01-01

    Women in sub-Saharan Africa account for more than half (58%) of people living with the HIV and it is the only continent where HIV prevalence is higher for women than for men. Studies have attributed alcoholism with the high rates of HIV infection due to its impact on sexual behaviour and arousal. African countries with high rates of alcoholism also reportedly have higher rates of HIV infection. This study explores rural communities' perspectives on the risk factors for HIV infection among women who are in alcohol discordant relationships where the man drinks alcohol excessively. Data were gathered through focus group discussions in rural central Kenya where alcoholism has reached epidemic levels. Key findings indicate the perceived severity of alcoholism, the perceived impact of alcoholism on men's reproductive health and the unmet sexual and reproductive needs of women in alcohol discordant relationships. Women engage in risky sexual behaviours in an attempt to meet these needs. Such risky behaviour in addition to alcohol-related sexual violence and low response-efficacy for safer sexual practices make them vulnerable to HIV infection and enhances the spread of HIV within communities. The study concludes that in preventing HIV infection among women in alcohol communities affected by alcohol, it is important to focus on their response efficacy. Intervention programmes that focus on HIV prevention among older married women and that integrate alcohol and HIV prevention are long overdue.

  9. Gender and HIV infection in the context of alcoholism in Kenya.

    PubMed

    Muturi, Nancy

    2015-01-01

    Women in sub-Saharan Africa account for more than half (58%) of people living with the HIV and it is the only continent where HIV prevalence is higher for women than for men. Studies have attributed alcoholism with the high rates of HIV infection due to its impact on sexual behaviour and arousal. African countries with high rates of alcoholism also reportedly have higher rates of HIV infection. This study explores rural communities' perspectives on the risk factors for HIV infection among women who are in alcohol discordant relationships where the man drinks alcohol excessively. Data were gathered through focus group discussions in rural central Kenya where alcoholism has reached epidemic levels. Key findings indicate the perceived severity of alcoholism, the perceived impact of alcoholism on men's reproductive health and the unmet sexual and reproductive needs of women in alcohol discordant relationships. Women engage in risky sexual behaviours in an attempt to meet these needs. Such risky behaviour in addition to alcohol-related sexual violence and low response-efficacy for safer sexual practices make them vulnerable to HIV infection and enhances the spread of HIV within communities. The study concludes that in preventing HIV infection among women in alcohol communities affected by alcohol, it is important to focus on their response efficacy. Intervention programmes that focus on HIV prevention among older married women and that integrate alcohol and HIV prevention are long overdue. PMID:25920984

  10. [HIV infection : Test and treatment].

    PubMed

    Rockstroh, J K; Wasmuth, J-C

    2016-08-01

    In Europe depending on the country 15-80 % of all individuals infected with human immunodeficiency virus (HIV) are either not aware of the diagnosis or are diagnosed later. An early HIV diagnosis could, however, considerably improve the prognosis of individuals infected with HIV and decrease the risk of new infections; therefore, in the presence of indicator diseases, such as sexually transmitted diseases, oral thrush, herpes zoster and lymphoma, the performance of a HIV test is of utmost importance. A newly diagnosed HIV infection represents an indication for starting antiretroviral combination therapy independent of the clinical stage or CD4 cell count. A decline of the viral burden to below the limit of detection and subsequent continuous suppression of viral replication can prevent transition from HIV to acquired immune deficiency syndrome (AIDS) and if started early enough a normal life expectancy can be achieved. Challenges which remain in HIV therapy are the lifelong daily intake of medication and the complex long-term adverse effects. PMID:27368530

  11. East African coast overlooked. [Oil and gas potential of the east African coast

    SciTech Connect

    Not Available

    1994-09-01

    This paper reviews the petroleum and gas potential of the Tanzania-Mozambique basinal areas. It discusses the locations of the various sedimentary basins in the onshore and near offshore areas, including the central African rift zone. The paper describes the structure, stratigraphy, and petroleum geology of these basins. Finally the paper reviews the exploration history and the outlook for the future of these basins.

  12. Environmental health impacts of East African Rift volcanism.

    PubMed

    Davies, T C

    2008-08-01

    The East African Rift Valley (EARV) is a structure of a major order in the Earth's crust. Accompanying volcanic activity has influenced greatly the nature of the soils and the geochemistry of ground and surface waters, an influence that is reflected in water and food quality. Direct volcanic impacts result from the up-welling of volatile, potentially harmful elements (PHE), such as F, As, and Hg, that dissolve directly into groundwaters. Intense tropical weathering results in clear redistribution of all but the most refractory elements to form distinct zones of micronutrient deficiencies and PHE excesses. Of concern, too, is human exposure to volcanic materials such as dust and clay-enriched soil fractions. Further alteration of the landscape geochemistry is being brought about by pollution from human activities, with increasing health concerns in many ecosystems of the region. This review shows that the unique distribution pattern of trace elements, imprinted by the East African Rift volcanism and modified by weathering and anthropogenic factors, correlates with a number of geochemical diseases in man and animals. It is submitted that accurate diagnoses of these diseases and associated health conditions, and prescription of appropriate remedies, must be founded upon a fundamental understanding of how the elements were naturally distributed in the first place. This can only be realised through the construction of complete geochemical databases for the region.

  13. Yellow fever, Asia and the East African slave trade.

    PubMed

    Cathey, John T; Marr, John S

    2014-05-01

    Yellow fever is endemic in parts of sub-Saharan Africa and South America, yet its principal vectors--species of mosquito of the genus Aedes--are found throughout tropical and subtropical latitudes. Phylogenetic analyses indicate that yellow fever originated in Africa and that its spread to the New World coincided with the slave trade, but why yellow fever has never appeared in Asia remains a mystery. None of several previously proposed explanations for its absence there is considered satisfactory. We contrast the trans-Atlantic slave trade, and trade across the Sahara and to the Arabian Peninsula and Mesopotamia, with that to Far East and Southeast Asian ports before abolition of the African slave trade, and before the scientific community understood the transmission vector of yellow fever and the viral life cycle, and the need for shipboard mosquito control. We propose that these differences in slave trading had a primary role in the avoidance of yellow fever transmission into Asia in the centuries before the 20(th) century. The relatively small volume of the Black African slave trade between Africa and East and Southeast Asia has heretofore been largely ignored. Although focal epidemics may have occurred, the volume was insufficient to reach the threshold for endemicity.

  14. Yellow fever, Asia and the East African slave trade.

    PubMed

    Cathey, John T; Marr, John S

    2014-05-01

    Yellow fever is endemic in parts of sub-Saharan Africa and South America, yet its principal vectors--species of mosquito of the genus Aedes--are found throughout tropical and subtropical latitudes. Phylogenetic analyses indicate that yellow fever originated in Africa and that its spread to the New World coincided with the slave trade, but why yellow fever has never appeared in Asia remains a mystery. None of several previously proposed explanations for its absence there is considered satisfactory. We contrast the trans-Atlantic slave trade, and trade across the Sahara and to the Arabian Peninsula and Mesopotamia, with that to Far East and Southeast Asian ports before abolition of the African slave trade, and before the scientific community understood the transmission vector of yellow fever and the viral life cycle, and the need for shipboard mosquito control. We propose that these differences in slave trading had a primary role in the avoidance of yellow fever transmission into Asia in the centuries before the 20(th) century. The relatively small volume of the Black African slave trade between Africa and East and Southeast Asia has heretofore been largely ignored. Although focal epidemics may have occurred, the volume was insufficient to reach the threshold for endemicity. PMID:24743951

  15. The pace of East African monsoon evolution during the Holocene

    NASA Astrophysics Data System (ADS)

    Weldeab, Syee; Menke, Valerie; Schmiedl, Gerhard

    2014-03-01

    African monsoon precipitation experienced a dramatic change in the course of the Holocene. The pace with which the African monsoon shifted from a strong early to middle to a weak late Holocene is critical for our understanding of climate dynamics, hydroclimate-vegetation interaction, and shifts of prehistoric human settlements, yet it is controversially debated. On the basis of planktonic foraminiferal Ba/Ca time series from the eastern Mediterranean Sea, here we present a proxy record of Nile River runoff that provides a spatially integrated measure of changes in East African monsoon (EAM) precipitation. The runoff record indicates a markedly gradual middle to late Holocene EAM transition that lasted over 3500 years. The timing and pace of runoff change parallels those of insolation and vegetation changes over the Nile basin, indicating orbitally forced variation of insolation as the main EAM forcing and the absence of a nonlinear precipitation-vegetation feedback. A tight correspondence between a threshold level of Nile River runoff and the timing of occupation/abandonment of settlements suggests that along with climate changes in the eastern Sahara, the level of Nile River and intensity of summer floods were likely critical for the habitability of the Nile Valley (Egypt).

  16. Signatures of positive selection in East African Shorthorn Zebu: a genome-wide SNP analysis

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The small East African Shorthorn Zebu is the main indigenous cattle across East Africa. A recent genome wide SNPs analysis has revealed their ancient stable African taurine x Asian zebu admixture. Here, we assess the presence of candidate signature of positive selection in their genome, with the aim...

  17. Seismicity of the Earth 1900-2013 East African Rift

    USGS Publications Warehouse

    Hayes, Gavin P.; Jones, Eric S.; Stadler, Timothy J.; Barnhart, William D.; McNamara, Daniel E.; Benz, Harley M.; Furlong, Kevin P.; Villaseñor, Antonio; Hayes, Gavin P.; Jones, Eric S.; Stadler, Timothy J.; Barnhart, William D.; McNamara, Daniel E.; Benz, Harley M.; Furlong, Kevin P.; Villaseñor, Antonio

    2014-01-01

    Rifting in East Africa is not all coeval; volcanism and faulting have been an ongoing phenomenon on the continent since the Eocene (~45 Ma). The rifting began in northern East Africa, and led to the separation of the Nubia (Africa) and Arabia plates in the Red Sea and Gulf of Aden, and in the Lake Turkana area at the Kenya-Ethiopia border. A Paleogene mantle superplume beneath East Africa caused extension within the Nubia plate, as well as a first order topographic high known as the African superswell which now includes most of the eastern and southern sectors of the Nubia plate. Widespread volcanism erupted onto much of the rising plateau in Ethiopia during the Eocene-Oligocene (45–29 Ma), with chains of volcanoes forming along the rift separating Africa and Arabia. Since the initiation of rifting in northeastern Africa, the system has propagated over 3,000 km to the south and southwest, and it experiences seismicity as a direct result of the extension and active magmatism.

  18. Breast feeding and HIV infection.

    PubMed

    Cutting, W A

    1992-10-01

    There are considerable data suggesting that breast milk and colostrum transmit HIV. The European Collaborative Study shows the risk of transmission of HIV from breast milk to infant to be about 28%. A study in Rwanda indicates that transmission is more likely to take place during viremia which occurs during primary HIV infection and later with progression to AIDS. Postnatal transmission in this study stood at about 60%. Breast feeding protects against diarrhea and respiratory infections. A study in Brazil demonstrates that infants who were not breast fed were at 14.2 and 3.6 higher risk of death from diarrhea and respiratory infections, respectively, than breast-fed infants. These risks are especially great where poverty, inadequate sanitation, and poor hygiene predominate. A study in Malaysia shows that infants living in a household with no piped water and no toilet and were not breast-fed faced a 5-fold risk of death after 1 week of age than breast-fed infants living under the same conditions. This risk continued to be high (2.5) for non-breast-fed infants living in a household with piped water and a toilet. In developed countries, affordable formula, clean water, and adequate facilities for sterilizing bottles allows HIV positive mothers to bottle feed their infants which should reduce the vertical transmission rate. In developing countries, however, bottle feeding is expensive and hazardous. Governments often cannot provide potable water and sanitation services. In addition, mathematical models demonstrate that for HIV positive mothers, the risk of infant death is lower in infants who breast feed than in those who do not. Thus, in those areas of the world where infectious diseases and malnutrition are the leading causes of infant death, health workers should promote breast feeding regardless of HIV status of the mothers. PMID:1422355

  19. Immunotherapeutic restoration in HIV-infected individuals.

    PubMed

    Kim, June Myung; Han, Sang Hoon

    2011-02-01

    While the development of combined active antiretroviral therapy (cART) has dramatically improved life expectancies and quality of life in HIV-infected individuals, long-term clinical problems, such as metabolic complications, remain important constraints of life-long cART. Complete immune restoration using only cART is normally unattainable even in cases of sufficient plasma viral suppression. The need for immunologic adjuncts that complement cART remains, because while cART alone may result in the complete recovery of peripheral net CD4+ T lymphocytes, it may not affect the reservoir of HIV-infected cells. Here, we review current immunotherapies for HIV infection, with a particular emphasis on recent advances in cytokine therapies, therapeutic immunization, monoclonal antibodies, immune-modulating drugs, nanotechnology-based approaches and radioimmunotherapy.

  20. [Bacillary epithelioid angiomatosis in advanced HIV infection].

    PubMed

    Hettmannsperger, U; Soehnchen, R; Gollnick, H; Detmar, M; Orfanos, C E

    1993-12-01

    A patient with advanced HIV infection developed multiple angiomatous papules and nodules on the upper chest within a few days. At first sight the lesions resembled disseminated Kaposi's sarcoma; the differential diagnosis, however, included eruptive haemangiomas and pyogenic granulomas. Such distinct clinical characteristics as the collarette-like desquamation at the borders of the tumours led to the suspicion of bacillary epithelioid angiomatosis in HIV infection, which was then confirmed by histology and ultrastructural demonstration of bacillary colonies within the lesions. Under systemic antibiotic treatment, marked regression of the lesions was quickly observed within 1 week and complete regression occurred after 4 weeks. It is important to consider bacillary angiomatosis in HIV infection in the differential diagnosis of Kaposi's sarcoma, and it is a separate entity in the form of angioproliferation caused by bacteria.

  1. Hypogonadism in the HIV-infected man.

    PubMed

    Rochira, Vincenzo; Guaraldi, Giovanni

    2014-09-01

    Androgen deficiency occurs frequently in men with human immunodeficiency virus (HIV) infection. Antiretroviral treatments had reduced the prevalence of male hypogonadism. The pathogenesis of testosterone (T) deficiency in HIV is multifactorial. Several mechanisms have been proposed; among them, drugs, fat redistribution, and a poor health status could explain the mechanism leading to gonadotropins inhibition and hypogonadotropic hypogonadism. The diagnosis of hypogonadism in HIV-infected men should be made based on clinical symptoms and a specific workup including T measurement. The interpretation of the results of biochemical testing is more difficult in men with HIV due to several confounding factors. T treatment should be offered to HIV-infected men with documented clinical hypogonadism and symptoms, especially if they are losing lean mass. PMID:25169563

  2. Modeling East African tropical glaciers during the Last Glacial Maximum

    NASA Astrophysics Data System (ADS)

    Doughty, Alice; Kelly, Meredith; Russell, James; Jackson, Margaret; Anderson, Brian; Nakileza, Robert

    2016-04-01

    The timing and magnitude of tropical glacier fluctuations since the last glacial maximum could elucidate how climatic signals transfer between hemispheres. We focus on ancient glaciers of the East African Rwenzori Mountains, Uganda/D.R. Congo, where efforts to map and date the moraines are on-going. We use a coupled mass balance - ice flow model to infer past climate by simulating glacier extents that match the mapped and dated LGM moraines. A range of possible temperature/precipitation change combinations (e.g. -15% precipitation and -7C temperature change) allow simulated glaciers to fit the LGM moraines dated to 20,140±610 and 23,370±470 years old.

  3. Activity of east African medicinal plants against Helicobacter pylori.

    PubMed

    Fabry, W; Okemo, P; Ansorg, R

    1996-01-01

    The activity of extracts from the East African medicinal plants Entada abyssinica (stem bark), Terminalia spinosa (young branches), Harrisonia abyssinica (roots), Ximenia caffra (roots), Azadirachta indica (leaves and stem bark) and Spilanthes mauritiana (roots and flowers) were evaluated against 12 strains of Helicobacter pylori. The most active extracts were those derived from T. spinosa with an MIC50 of 125 micrograms/ml, an MIC90 of 250 micrograms/ml and an MIC range of 62.5-500 micrograms/ml. An MIC50 of 250 micrograms/ml and an MIC90 of > 4,000 micrograms/ml was reached by H. abyssinica with a range of 125-->4,000 micrograms/ml and by X. caffra with a range of 62.5-->4,000 micrograms/ml, respectively. It is concluded that these plants contain compounds with antimicrobial activity against H. pylori. PMID:8874968

  4. Climate Change Affects the East African Rift Valley Lakes

    NASA Astrophysics Data System (ADS)

    O'Reilly, C. M.; Plisnier, P.; Cohen, A. S.

    2004-12-01

    Over the last 100 years, air temperatures in eastern African have been warming consistent with the global average temperature increase. This has led to warmer water temperatures in the East African Rift Valley lakes, increasing the stability of the water column. Subsequently, there has been a reduction in the upwelling of deep nutrient-rich waters that are the primary source of nutrients for most of these lakes. There were decreases in surface water N and P and increases in the Si:P ratio over the past 70 years for Lakes Malawi, Tanganyika, Edward, and Albert. The lower nutrient concentrations in the surface waters were associated with reduced algal biomass and increased water clarity. The consistent, regional-scale changes among these lakes provide strong evidence that climate warming may be having a large negative affect on these unique tropical lakes. A decrease in primary productivity of 20% has been indicated for Lake Tanganyika, which would be associated with a 30% decrease in fisheries yields. The human implications of such subtle, but progressive, environmental changes are potentially dire in this densely populated region of the world, where these large lakes are an important nutritional and economic resource.

  5. [Is it possible to cure HIV infection?].

    PubMed

    Gutiérrez, Carolina; Madrid, Nadia P; Moreno, Santiago

    2015-09-01

    Antiretroviral therapy has significantly improved the life expectancy in HIV-infected people, but it cannot cure the disease by itself. Several barriers have been identified for the cure of HIV infection, including a reservoir of latently infected cells, persistent viral replication in tissues, and anatomical sanctuaries. The main strategy proposed for the cure of HIV consists on the administration of drugs that, through the reactivation of latent HIV, would eliminate the cell reservoir. Ongoing clinical trials have shown the proof of concept, but the efficacy of these drugs in decreasing the reservoir size has not been proved so far.

  6. [Is it possible to cure HIV infection?].

    PubMed

    Gutiérrez, Carolina; Madrid, Nadia P; Moreno, Santiago

    2015-09-01

    Antiretroviral therapy has significantly improved the life expectancy in HIV-infected people, but it cannot cure the disease by itself. Several barriers have been identified for the cure of HIV infection, including a reservoir of latently infected cells, persistent viral replication in tissues, and anatomical sanctuaries. The main strategy proposed for the cure of HIV consists on the administration of drugs that, through the reactivation of latent HIV, would eliminate the cell reservoir. Ongoing clinical trials have shown the proof of concept, but the efficacy of these drugs in decreasing the reservoir size has not been proved so far. PMID:26365737

  7. HIV infection and the gastrointestinal immune system

    PubMed Central

    Brenchley, JM; Douek, DC

    2009-01-01

    There has recently been a resurgence of interest in the gastrointestinal pathology observed in patients infected with HIV. The gastrointestinal tract is a major site of HIV replication, which results in massive depletion of lamina propria CD4 T cells during acute infection. Highly active antiretroviral therapy leads to incomplete suppression of viral replication and substantially delayed and only partial restoration of gastrointestinal CD4 T cells. The gastrointestinal pathology associated with HIV infection comprises significant enteropathy with increased levels of inflammation and decreased levels of mucosal repair and regeneration. Assessment of gut mucosal immune system has provided novel directions for therapeutic interventions that modify the consequences of acute HIV infection. PMID:19079157

  8. Cancer prevention in HIV-infected populations.

    PubMed

    Goncalves, Priscila H; Montezuma-Rusca, Jairo M; Yarchoan, Robert; Uldrick, Thomas S

    2016-02-01

    People living with human immunodeficiency virus (HIV) are living longer since the advent of effective combined antiretroviral therapy (cART). While cART substantially decreases the risk of developing some cancers, HIV-infected individuals remain at high risk for Kaposi sarcoma, lymphoma, and several solid tumors. Currently HIV-infected patients represent an aging group, and malignancies have become a leading cause of morbidity and mortality. Tailored cancer-prevention strategies are needed for this population. In this review we describe the etiologic agents and pathogenesis of common malignancies in the setting of HIV, as well as current evidence for cancer prevention strategies and screening programs. PMID:26970136

  9. When to consider acute HIV infection in the differential diagnosis.

    PubMed

    Grimes, Richard M; Hardwicke, Robin L; Grimes, Deanna E; DeGarmo, D Sean

    2016-01-16

    Patients presenting with fever, pharyngitis, and lymphadenopathy are likely to have mononucleosis; however, patients with acute HIV infection may present with similar symptoms. Acute HIV infection should be considered as a differential diagnosis if test results for mononucleosis are negative. This article describes when to order HIV testing and discusses the importance of early intervention for acute HIV infection. PMID:26678418

  10. The genetics of East African populations: a Nilo-Saharan component in the African genetic landscape.

    PubMed

    Dobon, Begoña; Hassan, Hisham Y; Laayouni, Hafid; Luisi, Pierre; Ricaño-Ponce, Isis; Zhernakova, Alexandra; Wijmenga, Cisca; Tahir, Hanan; Comas, David; Netea, Mihai G; Bertranpetit, Jaume

    2015-01-01

    East Africa is a strategic region to study human genetic diversity due to the presence of ethnically, linguistically, and geographically diverse populations. Here, we provide new insight into the genetic history of populations living in the Sudanese region of East Africa by analysing nine ethnic groups belonging to three African linguistic families: Niger-Kordofanian, Nilo-Saharan and Afro-Asiatic. A total of 500 individuals were genotyped for 200,000 single-nucleotide polymorphisms. Principal component analysis, clustering analysis using ADMIXTURE, FST statistics, and the three-population test were used to investigate the underlying genetic structure and ancestry of the different ethno-linguistic groups. Our analyses revealed a genetic component for Sudanese Nilo-Saharan speaking groups (Darfurians and part of Nuba populations) related to Nilotes of South Sudan, but not to other Sudanese populations or other sub-Saharan populations. Populations inhabiting the North of the region showed close genetic affinities with North Africa, with a component that could be remnant of North Africans before the migrations of Arabs from Arabia. In addition, we found very low genetic distances between populations in genes important for anti-malarial and anti-bacterial host defence, suggesting similar selective pressures on these genes and stressing the importance of considering functional pathways to understand the evolutionary history of populations.

  11. The genetics of East African populations: a Nilo-Saharan component in the African genetic landscape

    PubMed Central

    Dobon, Begoña; Hassan, Hisham Y.; Laayouni, Hafid; Luisi, Pierre; Ricaño-Ponce, Isis; Zhernakova, Alexandra; Wijmenga, Cisca; Tahir, Hanan; Comas, David; Netea, Mihai G.; Bertranpetit, Jaume

    2015-01-01

    East Africa is a strategic region to study human genetic diversity due to the presence of ethnically, linguistically, and geographically diverse populations. Here, we provide new insight into the genetic history of populations living in the Sudanese region of East Africa by analysing nine ethnic groups belonging to three African linguistic families: Niger-Kordofanian, Nilo-Saharan and Afro-Asiatic. A total of 500 individuals were genotyped for 200,000 single-nucleotide polymorphisms. Principal component analysis, clustering analysis using ADMIXTURE, FST statistics, and the three-population test were used to investigate the underlying genetic structure and ancestry of the different ethno-linguistic groups. Our analyses revealed a genetic component for Sudanese Nilo-Saharan speaking groups (Darfurians and part of Nuba populations) related to Nilotes of South Sudan, but not to other Sudanese populations or other sub-Saharan populations. Populations inhabiting the North of the region showed close genetic affinities with North Africa, with a component that could be remnant of North Africans before the migrations of Arabs from Arabia. In addition, we found very low genetic distances between populations in genes important for anti-malarial and anti-bacterial host defence, suggesting similar selective pressures on these genes and stressing the importance of considering functional pathways to understand the evolutionary history of populations. PMID:26017457

  12. Prevalence and incidence of pulmonary hypertension among HIV-infected people in Africa: a systematic review and meta-analysis

    PubMed Central

    Bigna, Jean Joel R; Nansseu, Jobert Richie N; Um, Lewis N; Noumegni, Steve Raoul N; Simé, Paule Sandra D; Aminde, Leopold Ndemngue; Koulla-Shiro, Sinata; Noubiap, Jean Jacques N

    2016-01-01

    Objective Patients infected with HIV have a direly increased risk of developing pulmonary hypertension (PH), and of dying from the condition. While Africa carries the greatest burden of HIV infection worldwide, there is unclear data summarising the epidemiology of PH among HIV-infected people in this region. Our objective was to determine the prevalence and incidence of PH among HIV-infected people living across Africa. Design A systematic review and meta-analysis. Participants HIV-infected African people residing in Africa. Outcome Prevalence and incidence of PH diagnosed through echocardiography or right heart catheterisation. Data sources Articles published in PubMed/MEDLINE, EMBASE, African Journals Online and African Index Medicus between 1 January 1980 and 30 June 2016, without any language restriction. Results Overall, 121 studies were screened; 3 were included in this review: 1 from Southern Africa (South Africa), 1 from Eastern Africa (Tanzania) and 1 from Central Africa (Cameroon). These studies included HIV-infected adult patients selected based on presentation with cardiovascular symptoms. No study reported PH incidence or PH incidence/prevalence among children and adolescents. The quality assessment yielded moderate risk of bias. Ages of participants ranged between 18 and 78 years, and the proportion of females varied between 52.3% and 68.8%. The prevalence of PH in the pooled sample of 664 patients was 14% (95% CI 6%–23%). Limitations Only 3 studies were found eligible from 3 regions of the African continent. Conclusions The prevalence of PH among HIV-infected people in Africa seems very high. Further studies are urgently warranted to determine the incidence of HIV-induced PH, which must include all subregions of Africa. Trial registration number Review registration number PROSPERO CRD42016033863. PMID:27554104

  13. Tuberculosis and HIV infection: a global perspective.

    PubMed

    Murray, J F

    1998-01-01

    The incidence of HIV-associated tuberculosis has been increasing worldwide since the beginning of the AIDS epidemic, and is expected to increase even further during the foreseeable future, especially in developing countries. There is no doubt now that, in the presence of HIV infection, new-onset tuberculous infection progresses rapidly to clinically significant disease and the likelihood that latent tuberculous infection progresses rapidly to clinically significant disease and the likelihood that latent tuberculous infection will reactivate is enormously increased. The accelerating and amplifying influence of HIV infection is contributing to the increasing incidence of disease caused by multidrug-resistant strains of Mycobacterium tuberculosis. Neither clinical features nor radiographic abnormalities reliably distinguish the majority of patients with HIV-associated tuberculosis from those without HIV infection. Some persons with HIV infection, however, present with atypical manifestations of tuberculosis and these patients may be difficult to diagnose. Six months of daily or thrice weekly chemotherapy with the usual regimen of 4 then 2 antituberculosis drugs cures most patients, but many die during or after treatment of other AIDS-related complications.

  14. Pediatric HIV Infection and Developmental Disabilities.

    ERIC Educational Resources Information Center

    Seidel, John F.

    This paper presents an overview of the developmental disabilities associated with pediatric Human Immunodeficiency Virus (HIV) infection, and examines efficacious practices for assessment and intervention programming. The focus population is early childhood into school age. The paper describes the complex array of challenges presented by these…

  15. Public Opinion, Public Policy, and HIV Infection.

    ERIC Educational Resources Information Center

    West, Jane

    1989-01-01

    A four-stage framework for considering the development of public policy in regard to the issue of HIV (Human Immunodeficiency Virus) infection is offered. The phases are denial, irrationality, acceptance, and the development of a rational response. Federal antidiscrimination policies which include persons with HIV infections as disabled are…

  16. Contraception for HIV-Infected Adolescents.

    PubMed

    Kourtis, Athena P; Mirza, Ayesha

    2016-09-01

    Access to high-quality reproductive health care is important for adolescents and young adults with HIV infection to prevent unintended pregnancies, sexually transmitted infections, and secondary transmission of HIV to partners and children. As perinatally HIV-infected children mature into adolescence and adulthood and new HIV infections among adolescents and young adults continue to occur in the United States, medical providers taking care of such individuals often face issues related to sexual and reproductive health. Challenges including drug interactions between several hormonal methods and antiretroviral agents make decisions regarding contraceptive options more complex for these adolescents. Dual protection, defined as the use of an effective contraceptive along with condoms, should be central to ongoing discussions with HIV-infected young women and couples wishing to avoid pregnancy. Last, reproductive health discussions need to be integrated with discussions on HIV care, because a reduction in plasma HIV viral load below the level of detection (an "undetectable viral load") is essential for the individual's health as well as for a reduction in HIV transmission to partners and children. PMID:27573084

  17. Children Who Acquire HIV Infection Perinatally Are at Higher Risk of Early Death than Those Acquiring Infection through Breastmilk: A Meta-Analysis

    PubMed Central

    Becquet, Renaud; Marston, Milly; Dabis, François; Moulton, Lawrence H.; Gray, Glenda; Coovadia, Hoosen M.; Essex, Max; Ekouevi, Didier K.; Jackson, Debra; Coutsoudis, Anna; Kilewo, Charles; Leroy, Valériane; Wiktor, Stefan Z.; Nduati, Ruth; Msellati, Philippe; Zaba, Basia; Ghys, Peter D.; Newell, Marie-Louise

    2012-01-01

    Background Assumptions about survival of HIV-infected children in Africa without antiretroviral therapy need to be updated to inform ongoing UNAIDS modelling of paediatric HIV epidemics among children. Improved estimates of infant survival by timing of HIV-infection (perinatally or postnatally) are thus needed. Methodology/Principal Findings A pooled analysis was conducted of individual data of all available intervention cohorts and randomized trials on prevention of HIV mother-to-child transmission in Africa. Studies were right-censored at the time of infant antiretroviral initiation. Overall mortality rate per 1000 child-years of follow-up was calculated by selected maternal and infant characteristics. The Kaplan-Meier method was used to estimate survival curves by child's HIV infection status and timing of HIV infection. Individual data from 12 studies were pooled, with 12,112 children of HIV-infected women. Mortality rates per 1,000 child-years follow-up were 39.3 and 381.6 for HIV-uninfected and infected children respectively. One year after acquisition of HIV infection, an estimated 26% postnatally and 52% perinatally infected children would have died; and 4% uninfected children by age 1 year. Mortality was independently associated with maternal death (adjusted hazard ratio 2.2, 95%CI 1.6–3.0), maternal CD4<350 cells/ml (1.4, 1.1–1.7), postnatal (3.1, 2.1–4.1) or peri-partum HIV-infection (12.4, 10.1–15.3). Conclusions/Results These results update previous work and inform future UNAIDS modelling by providing survival estimates for HIV-infected untreated African children by timing of infection. We highlight the urgent need for the prevention of peri-partum and postnatal transmission and timely assessment of HIV infection in infants to initiate antiretroviral care and support for HIV-infected children. PMID:22383946

  18. Reframing women's risk: social inequalities and HIV infection.

    PubMed

    Zierler, S; Krieger, N

    1997-01-01

    Social inequalities lie at the heart of risk of HIV infection among women in the United States. As of December, 1995, 71,818 US women had developed AIDS-defining diagnoses. These women have been disproportionately poor, African-American, and Latina. Their neighborhoods have been burdened by poverty, racism, crack cocaine, heroin, and violence. To explain which women are at risk and why, this article reviews the epidemiology of HIV and AIDS among women in light of four conceptual frameworks linking health and social justice: feminism, social production of disease/political economy of health, ecosocial, and human rights. The article applies these alternative theories to describe sociopolitical contexts for AIDS' emergence and spread in the United States, and reviews evidence linking inequalities of class, race/ethnicity, gender, and sexuality, as well as strategies of resistance to these inequalities, to the distribution of HIV among women.

  19. Thymic function in HIV-infection.

    PubMed

    Kolte, Lilian

    2013-04-01

    This thesis is based on seven previously published articles. The work was performed during my employment at The Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, as a scholarship student from 2000-2001 and as a research assistant in the period 2004-2010. HIV-infection is characterized by CD4+ cell depletion. The differences between patients in the degree of CD4+ cell recovery upon treatment with highly active antiretroviral therapy (HAART) may in part be due to differences in the supply of naïve CD4+ cells from the thymus. The thymus atrophies with increasing age for which reason the adult thymus was previously assumed to be without function. The aim of these investigations was to examine the role of the thymus in different aspects of HIV-infection: In adult HIV-infected patients, during HIV-positive pregnancy, and in HIV-exposed uninfected (HIV-EU) children born to HIV-infected mothers. Thymic size and output were determined in 25 adult HIV-infected patients receiving HAART and in 10 controls. Larger thymic size was associated with higher CD4 counts and higher thymic output. Furthermore, patients with abundant thymic tissue seemed to have broader immunological repertoires, compared with patients with minimal thymic tissue. The study supports the mounting evidence of a contribution by the adult thymus to immune reconstitution in HIV-infection. In a follow-up study conducted till 5 years of HAART, the importance of the thymus to the rate of cellular restoration was found to primarily lie within the first two years of HAART. The effect of recombinant human growth hormone (rhGH) was then investigated in a randomized, double-blinded placebo controlled trial in 46 adult HIV-infected patients on HAART. Daily treatment with a low dose of rhGH of 0.7mg for 40 weeks stimulated thymopoiesis as expressed by thymic size, density, and output strongly supporting the assumption that rhGH possesses the potential to stimulate the ageing thymus, holding

  20. A Screen-and-Treat Strategy Targeting Visceral Leishmaniasis in HIV-Infected Individuals in Endemic East African Countries: The Way Forward?

    PubMed Central

    van Griensven, Johan; Diro, Ermias; Lopez-Velez, Rogelio; Ritmeijer, Koert; Boelaert, Marleen; Zijlstra, Ed E.; Hailu, Asrat; Lynen, Lutgarde

    2014-01-01

    In the wake of the HIV epidemic, visceral leishmaniasis (VL), a disseminated protozoan infection caused by the Leishmania donovani complex, has been re-emerging, particularly in North Ethiopia where up to 40% of patients with VL are co-infected with HIV. Management of VL in HIV co-infection is complicated by increased drug toxicity, and high treatment failure and relapse rates with all currently available drugs, despite initiation of antiretroviral treatment. Tackling L. donovani infection before disease onset would thus be a logical approach. A screen-and-treat approach targeting latent or the early stage of infection has successfully been implemented in other HIV-associated opportunistic infections. While conceptually attractive in the context of VL–HIV, the basic understanding and evidence underpinning such an approach is currently lacking. Prospective cohort studies will have to be conducted to quantify the risk of VL in different risk groups and across CD4 cell count levels. This will allow developing clinical prognostic tools, integrating clinical, HIV and Leishmania infection markers. Interventional studies will be needed to evaluate prophylactic or pre-emptive treatment strategies for those at risk, ideally relying on an oral (combination) regimen. Issues like tolerability, emergence of resistance and drug interactions will require due attention. The need for maintenance therapy will have to be assessed. Based on the risk–benefit data, VL risk cut-offs will have to be identified to target treatment to those most likely to benefit. Such a strategy should be complemented with early initiation of antiretroviral treatment and other strategies to prevent HIV and Leishmania infection. PMID:25101627

  1. Identification of Germinal Center B Cells in Blood from HIV-infected Drug-naive Individuals in Central Africa

    PubMed Central

    Béniguel, Lydie; Bégaud, Evelyne; Cognasse, Fabrice; Gabrié, Philippe; Mbolidi, Christophe D.; Sabido, Odile; Marovich, Mary A.; deFontaine, Christiane; Frésard, Anne; Lucht, Frédéric; Genin, Christian; Garraud, Olivier

    2004-01-01

    To better understand the pathophysiology of B cell populations—the precursors of antibody secreting cells—during chronic human immunodeficiency virus (HIV) infection, we examined the phenotype of circulating B cells in newly diagnosed Africans. We found that all African individuals displayed low levels of naive B cells and of memory-type CD27+ B cells, and high levels of differentiated B cells. On the other hand, HIV-infected African patients had a population of germinal center B cells (i.e. CD20+, sIgM-, sIgD+, CD77+, CD138±), which are generally restricted to lymph nodes and do not circulate unless the lymph node architecture is altered. The first observations could be linked to the tropical environment whereas the presence of germinal center B cells may be attributable to chronic exposure to HIV as it is not observed in HIV-negative African controls and HAART treated HIV-infected Europeans. It may impact the management of HIV infection in countries with limited access to HIV drugs and urges consideration for implementation of therapeutic vaccines. PMID:15154608

  2. Early limited antiretroviral therapy is superior to deferred therapy in HIV-infected South African infants: results from the CHER (Children with HIV Early antiRetroviral) Randomized Trial

    PubMed Central

    Cotton, Mark F; Violari, Avy; Otwombe, Kennedy; Panchia, Ravindre; Dobbels, Els; Rabie, Helena; Josipovic, Deirdre; Liberty, Afaff; Lazarus, Erica; Innes, Steve; van Rensburg, Anita Janse; Pelser, Wilma; Truter, Handre; Madhi, Shabir A; Handelsman, Edward; Jean-Philippe, Patrick; McIntyre, James A; Gibb, Diana M; Babiker, Abdel G

    2014-01-01

    Background Interim results from the CHER trial showed that early antiretroviral therapy (ART) was life-saving for HIV-infected infants. Given limited options and potential for toxicity with life-long ART, CHER compared early limited ART with deferred ART. Methods CHER was an open 3-arm trial in HIV-infected asymptomatic infants aged <12 weeks with CD4% ≥25%. Infants were randomized to deferred (ART-Def) or immediate ART for 40weeks (ART-40W) or 96weeks (ART-96W), followed by interruption. Criteria for ART initiation in ART-Def and re-initiation after interruption were CD4% <25% in infancy; otherwise <20% or CDC severe stage B or stage C disease. Lopinavir-ritonavir, zidovudine, lamivudine was the first-line regimen at ART initiation and re-initiation. The primary endpoint was time-to-failure of first-line ART (immunological/clinical/virological) or death. Comparisons were by intent-to-treat, using time-to-event methods. Findings 377 infants were enrolled: median age 7.4weeks; CD4% 35% and HIV RNA log 5.7copies/ml. Median follow-up was 4.8 years; 34 (9%) were lost-to-follow-up. Median time to ART initiation in ART-Def was 20 (IQR 16–25) weeks. Time to restarting ART after interruption was 33 (26–45) weeks in ART-40W and 70 (35–109) weeks in ART-96W; at trial end 19% and 32% respectively, remained off ART. Proportions of follow-up time spent on ART were 81%, 70% and 69% in ART-Def, ART-40W and ART-96W arms. 48/125(38%), 32/126(25%) and 26/126(21%) children reached the primary endpoint; hazard ratio (95%CI), relative to ART-Def, was 0.59(0.38-0.93, p=0.02) for ART-40W and 0.47(0.27-0.76, p=0.002) for ART-96W. Seven children (3 ART-Def, 3 ART-40W, 1 ART-96W) switched to second-line ART. Interpretation Early limited ART had superior clinical/immunological outcome with no evidence of excess disease progression during subsequent interruption and less overall ART exposure than deferred ART. Longer time on primary ART permits longer subsequent interruption with

  3. Ambient noise tomography of the East African Rift in Mozambique

    NASA Astrophysics Data System (ADS)

    Domingues, Ana; Silveira, Graça; Ferreira, Ana M. G.; Chang, Sung-Joon; Custódio, Susana; Fonseca, João F. B. D.

    2016-03-01

    Seismic ambient noise tomography is applied to central and southern Mozambique, located in the tip of the East African Rift (EAR). The deployment of MOZART seismic network, with a total of 30 broad-band stations continuously recording for 26 months, allowed us to carry out the first tomographic study of the crust under this region, which until now remained largely unexplored at this scale. From cross-correlations extracted from coherent noise we obtained Rayleigh wave group velocity dispersion curves for the period range 5-40 s. These dispersion relations were inverted to produce group velocity maps, and 1-D shear wave velocity profiles at selected points. High group velocities are observed at all periods on the eastern edge of the Kaapvaal and Zimbabwe cratons, in agreement with the findings of previous studies. Further east, a pronounced slow anomaly is observed in central and southern Mozambique, where the rifting between southern Africa and Antarctica created a passive margin in the Mesozoic, and further rifting is currently happening as a result of the southward propagation of the EAR. In this study, we also addressed the question concerning the nature of the crust (continental versus oceanic) in the Mozambique Coastal Plains (MCP), still in debate. Our data do not support previous suggestions that the MCP are floored by oceanic crust since a shallow Moho could not be detected, and we discuss an alternative explanation for its ocean-like magnetic signature. Our velocity maps suggest that the crystalline basement of the Zimbabwe craton may extend further east well into Mozambique underneath the sediment cover, contrary to what is usually assumed, while further south the Kaapval craton passes into slow rifted crust at the Lebombo monocline as expected. The sharp passage from fast crust to slow crust on the northern part of the study area coincides with the seismically active NNE-SSW Urema rift, while further south the Mazenga graben adopts an N-S direction

  4. Model, Proxy and Isotopic Perspectives on the East African Humid Period

    NASA Technical Reports Server (NTRS)

    Tierney, Jessica E.; Lewis, Sophie C.; Cook, Benjamin I.; LeGrande, Allegra N.; Schmidt, Gavin A.

    2011-01-01

    Both North and East Africa experienced more humid conditions during the early and mid-Holocene epoch (11,000-5000yr BP; 11-5 ka) relative to today. The North African Humid Period has been a major focus of paleoclimatic study, and represents a response of the hydrological cycle to the increase in boreal summer insolation and associated ocean, atmosphere and land surface feedbacks. Meanwhile, the mechanisms that caused the coeval East African Humid Period are poorly understood. Here, we use results from isotopeenabled coupled climate modeling experiments to investigate the cause of the East African Humid Period. The modeling results are interpreted alongside proxy records of both water balance and the isotopic composition of rainfall. Our simulations show that the orbitally-induced increase in dry season precipitation and the subsequent reduction in precipitation seasonality can explain the East African Humid Period, and this scenario agrees well with regional lake level and pollen paleoclimate data. Changes in zonal moisture flux from both the Atlantic and Indian Ocean account for the simulated increase in precipitation from June through November. Isotopic paleoclimate data and simulated changes in moisture source demonstrate that the western East African Rift Valley in particular experienced more humid conditions due to the influx of Atlantic moisture and enhanced convergence along the Congo Air Boundary. Our study demonstrates that zonal changes in moisture advection are an important determinant of climate variability in the East African region.

  5. Present-day kinematics of the East African Rift

    NASA Astrophysics Data System (ADS)

    Saria, E.; Calais, E.; Stamps, D. S.; Delvaux, D.; Hartnady, C. J. H.

    2014-04-01

    The East African Rift (EAR) is a type locale for investigating the processes that drive continental rifting and breakup. The current kinematics of this ~5000 km long divergent plate boundary between the Nubia and Somalia plates is starting to be unraveled thanks to a recent augmentation of space geodetic data in Africa. Here we use a new data set combining episodic GPS measurements with continuous measurements on the Nubian, Somalian, and Antarctic plates, together with earthquake slip vector directions and geologic indicators along the Southwest Indian Ridge to update the present-day kinematics of the EAR. We use geological and seismological data to determine the main rift faults and solve for rigid block rotations while accounting for elastic strain accumulation on locked active faults. We find that the data are best fit with a model that includes three microplates embedded within the EAR, between Nubia and Somalia (Victoria, Rovuma, and Lwandle), consistent with previous findings but with slower extension rates. We find that earthquake slip vectors provide information that is consistent with the GPS velocities and helps to significantly reduce uncertainties of plate angular velocity estimates. We also find that 3.16 Myr MORVEL average spreading rates along the Southwest Indian Ridge are systematically faster than prediction from GPS data alone. This likely indicates that outward displacement along the SWIR is larger than the default value used in the MORVEL plate motion model.

  6. Hybridization in East African swarm-raiding army ants

    PubMed Central

    2011-01-01

    Background Hybridization can have complex effects on evolutionary dynamics in ants because of the combination of haplodiploid sex-determination and eusociality. While hybrid non-reproductive workers have been found in a range of species, examples of gene-flow via hybrid queens and males are rare. We studied hybridization in East African army ants (Dorylus subgenus Anomma) using morphology, mitochondrial DNA sequences, and nuclear microsatellites. Results While the mitochondrial phylogeny had a strong geographic signal, different species were not recovered as monophyletic. At our main study site at Kakamega Forest, a mitochondrial haplotype was shared between a "Dorylus molestus-like" and a "Dorylus wilverthi-like" form. This pattern is best explained by introgression following hybridization between D. molestus and D. wilverthi. Microsatellite data from workers showed that the two morphological forms correspond to two distinct genetic clusters, with a significant proportion of individuals being classified as hybrids. Conclusions We conclude that hybridization and gene-flow between the two army ant species D. molestus and D. wilverthi has occurred, and that mating between the two forms continues to regularly produce hybrid workers. Hybridization is particularly surprising in army ants because workers have control over which males are allowed to mate with a young virgin queen inside the colony. PMID:21859477

  7. The water balance of the East African Great Lakes

    NASA Astrophysics Data System (ADS)

    Yin, Xungang

    The East African Great Lakes are important indicators of climatic and environmental change in an area where standard meteorological data are scarce. Three large lakes, Lakes Victoria, Tanganyika and Malawi are studied in order to build water balance relations between lake level and over-lake rainfall. By analyzing the satellite observations, the characteristics of the regional and mesoscale circulations are studied through analysis of convective activity and cloudiness over the lakes. Using a regression approach, the relationship between catchment rainfall and cold cloud frequency is found. Assuming the same convective mechanism operates for each lake and its catchment, the over-lake rainfall is calculated using the catchment rainfall, which has long records. Evaporation is estimated for each lake by energy-budget and Penman methods and a sensitivity study is also carried out. The available tributary inflow and lake outflow data of Lake Victoria are expressed by rainfall and lake level terms. For Lake Victoria, the water balance model is reformulated as a lake level model. The model is first used to predict the lake level changes as a validation. Then it is inverted so that the over-lake rainfall can be reconstructed from known lake levels in both modern times and historical times. In modern times, the precision is on the order of 1% for the calculated mean rainfall and a few percent for the calculated annual rainfall.

  8. Cage experiments in an East African mangrove forest: a synthesis

    NASA Astrophysics Data System (ADS)

    Schrijvers, J.; Vincx, M.

    1997-12-01

    The impact of epibenthos on endobenthos has frequently been investigated for temperate saltmarsh regions by using cage exclusion experiments. Although the insight into the function of the endobenthos of mangrove forests is crucial for their management, very few cage experiments have so far been carried out in such areas. The present paper summaries the results of such experiments in a typical East African mangrove forest at Gazi Bay about 60 km south of Mombasa, Kenya. Epibenthic animals were excluded for one year in two mangrove zones which differed in forest morphology and intertidal position ( Ceriops tagal and Avicennia marina). Environmental factors and meiobenthic and macrobenthic densities were followed in a randomised block design, and procedural and exclusion effects were statistically detected. In confronting the separate responses of all faunal groups in the two mangrove zones, this synthesis gives a better insight into the tropho-dynamical interactions than the earlier separate reports on the same experiment. The ecosystem of the mangrove zones and the competitive interactions within this system provided an ideal opportunity to discover the existence of two food systems. This confirmed a strong involvement of the majority of the endobenthos in an isolated decompositional pathway in the mangrove sediment. It became clear that this exploitative competition was more important than the epibenthic predation in structuring and regulating the global endobenthic community. This synthesis therefore both demonstrates the decisive role of the endobenthos as regenators of mangrove material, and suggests that endobenthos plays a minor role as prey for the demersal or pelagic carnivores.

  9. Obesity Among HIV-Infected Adults Receiving Medical Care in the United States: Data From the Cross-Sectional Medical Monitoring Project and National Health and Nutrition Examination Survey.

    PubMed

    Thompson-Paul, Angela M; Wei, Stanley C; Mattson, Christine L; Robertson, McKaylee; Hernandez-Romieu, Alfonso C; Bell, Tanvir K; Skarbinski, Jacek

    2015-07-01

    Our objective was to compare obesity prevalence among human immunodeficiency virus (HIV)-infected adults receiving care and the U.S. general population and identify obesity correlates among HIV-infected men and women.Cross-sectional data was collected in 2009 to 2010 from 2 nationally representative surveys: Medical Monitoring Project (MMP) and National Health and Nutrition Examination Survey (NHANES).Weighted prevalence estimates of obesity, defined as body mass index ≥30.0 kg/m, were compared using prevalence ratios (PR, 95% confidence interval [CI]). Correlates of obesity in HIV-infected adults were examined using multivariable logistic regression.Demographic characteristics of the 4006 HIV-infected adults in MMP differed from the 5657 adults from the general U.S. population in NHANES, including more men (73.2% in MMP versus 49.4% in NHANES, respectively), black or African Americans (41.5% versus 11.6%), persons with annual incomes <$20,000 (64.5% versus 21.9%), and homosexuals or bisexuals (50.9% versus 3.9%). HIV-infected men were less likely to be obese (PR 0.5, CI 0.5-0.6) and HIV-infected women were more likely to be obese (PR1.2, CI 1.1-1.3) compared with men and women in the general population, respectively. Among HIV-infected women, younger age was associated with obesity (<40 versus >60 years). Among HIV-infected men, correlates of obesity included black or African American race/ethnicity, annual income >$20,000 and <$50,000, heterosexual orientation, and geometric mean CD4+ T-lymphocyte cell count >200 cells/μL.Obesity is common, affecting 2 in 5 HIV-infected women and 1 in 5 HIV-infected men. Correlates of obesity differ for HIV-infected men and women; therefore, different strategies may be needed for the prevention and treatment. PMID:26166086

  10. Programmatic Implications of Acute and Early HIV Infection.

    PubMed

    Suthar, Amitabh B; Granich, Reuben M; Kato, Masaya; Nsanzimana, Sabin; Montaner, Julio S G; Williams, Brian G

    2015-11-01

    Human immunodeficiency virus (HIV) infection includes acute, early, chronic, and late stages. Acute HIV infection lasts approximately 3 weeks and early HIV infection, which includes acute HIV infection, lasts approximately 7 weeks. Many testing and blood screening algorithms detect HIV antibodies about 3 weeks after HIV infection. Incidence estimates are based on results of modeling, cohort studies, surveillance, and/or assays. Viral load is the key modifiable risk factor for HIV transmission and peaks during acute and early HIV infection. Empirical evidence characterizing the impact of acute and early HIV infection on the spread of the HIV epidemic are limited. Time trends of HIV prevalence collected from concentrated and generalized epidemics suggest that acute and early HIV infection may have a limited role in population HIV transmission. Collectively, these data suggest that acute and early HIV infection is relatively short and does not currently require fundamentally different programmatic approaches to manage the HIV/AIDS epidemic in most settings. Research and surveillance will inform which epidemic contexts and phases may require tailored strategies for these stages of HIV infection.

  11. Bloodstream infections in HIV-infected patients.

    PubMed

    Taramasso, Lucia; Tatarelli, Paola; Di Biagio, Antonio

    2016-04-01

    In the combined antiretroviral therapy era, HIV-infected patients remain a vulnerable population for the onset of bloodstream infections (BSI). Worldwide, nontyphoid salmonellae, Streptococcus pneumoniae, Escherichia coli, Staphylococcus aureus and coagulase negative staphylococci are the most important pathogens. Intravenous catheter associated infection, skin-soft tissue infection and endocarditis are associated with Gram-positive bacteremia. Among the Gram-negative, nontyphoidal Salmonella have been previously correlated to sepsis. Other causes of BSI in HIV-infected patients are mycobacteria and fungi. Mycobacteria constitute a major cause of BSI in limited resource countries. Fungal BSI are not frequent and among them Cryptococcus neoformans is the most common life-threatening infection. The degree of immunosuppression remains the key prognostic factor leading to the development of BSI. PMID:26950194

  12. CD4 immunophenotyping in HIV infection

    PubMed Central

    Barnett, David; Walker, Brooke; Landay, Alan; Denny, Thomas N.

    2009-01-01

    The ability to rapidly identify immune cell subsets such as CD4 cells, which became possible around the same time as the onset of the HIV/AIDS pandemic, was one of the greatest advances in clinical and diagnostic immunology. The evolution of this global pandemic and the subsequent development of treatment strategies to prolong the life of infected individuals mean that it is now more crucial than ever that we develop affordable, reliable and accurate methods for the enumeration of CD4 cells. Here, we provide an overview of the historical developments in CD4 enumeration technologies that are related to HIV infection, and summarize the current technological challenges that must be overcome to meet the needs of those living with HIV infection. PMID:18923413

  13. Motor slowing in asymptomatic HIV infection.

    PubMed

    Fitzgibbon, M L; Cella, D F; Humfleet, G; Griffin, E; Sheridan, K

    1989-06-01

    To examine neuropsychological deficits associated with the human immunodeficiency virus (HIV), 25 asymptomatic homosexual men and sexual partners of intravenous drug users and 25 seronegative homosexual men and nonhigh-risk heterosexuals were assessed on measures of fine motor control, visual scanning, attention, depression, and global psychological functioning. Analysis suggested that HIV infection is associated with reduced fine motor control. Seropositivity is associated with elevated depression and global psychological maladjustment. When depression and global adjustment were analyzed as covariates, motor slowing was evident in the seropositive group. These findings suggest an association between motor slowing and HIV infection in asymptomatic subjects and point to the necessity of measuring affect at least as a control variable. Further study is needed to determine whether the fine motor deficit evident in this sample is limited to distinct subgrouping of the over-all sample. PMID:2762096

  14. HIV Infection and Osteoarticular Tuberculosis: Strange Bedfellows.

    PubMed

    Hodkinson, B; Osman, N; Botha-Scheepers, S

    2016-01-01

    We report the case of a 47-year-old female patient with rheumatoid arthritis and HIV infection presenting with a 3-week history of a painful swollen knee, increased serum inflammatory markers, and a low CD4 lymphocyte count. The diagnosis of TB arthritis was made by synovial fluid culture, GeneXpert/PCR, and confirmed by histopathology of a synovial biopsy. A mini literature review suggests that although HIV infection is associated with extrapulmonary TB, osteoarticular TB is a relatively unusual presentation in an HIV positive patient. The diagnostic utility of the GeneXpert test is explored. We also describe the patient's good response to an intra-articular corticosteroid injection in combination with standard anti-TB therapy. PMID:27366339

  15. Mannose-binding lectin in HIV infection

    PubMed Central

    Eisen, Sarah; Dzwonek, Agnieszka; Klein, Nigel J

    2010-01-01

    Infection with HIV represents a significant global health problem, with high infection rates and high mortality worldwide. Treatment with antiretroviral therapy is inaccessible to many patients and efficacy is limited by development of resistance and side effects. The interactions of HIV with the human immune system, both innate and humoral, are complex and complicated by the profound ability of the virus to disable the host immune response. Mannose-binding lectin, a component of the innate immune system, has been demonstrated to play a role in host-virus interactions. This protein may have a key role in determining host susceptibility to infection, pathogenesis and progression of disease, and may contribute to the extensive variability of host response to infection. Further understanding and manipulation of the mannose-binding lectin response may represent a target for immunomodulation in HIV infection, which may, in conjunction with highly active antiretroviral therapy, allow development of a novel therapeutic approach to HIV infection. PMID:21218140

  16. Cryptococcal Disease in HIV-Infected Children.

    PubMed

    Kao, Carol; Goldman, David L

    2016-09-01

    Cryptococcus neoformans is an encapsulated fungal pathogen that is remarkable for its tendency to cause meningoencephalitis, especially in patients with AIDS. While disease is less common in children than adults, it remains an important cause of morbidity and mortality among HIV-infected children without access to anti-retroviral therapy. This review highlights recent insights into both the biology and treatment of cryptococcosis with a special emphasis on the pediatric literature. PMID:27443557

  17. Mental health aspects of HIV infection.

    PubMed Central

    Hunter, J.

    1993-01-01

    Of the multiple causes of mental disturbance in HIV infection, it is generally safest to consider organic causes first, including opportunistic infections, tumours, medications, and HIV encephalopathy. The psychological stress of the illness will cause different or overlapping presentations that include anxiety and depression. When managing these situations, one should also pay attention to the effects of stress on the social network of the infected person. PMID:8324410

  18. HIV Infection in the Elderly: Arising Challenges

    PubMed Central

    2016-01-01

    Globally there is an increase in the number of people living with HIV at an advanced age (50 years and above). This is mainly due to prolonged survival following the use of highly active antiretroviral therapy. Living with HIV at an advanced age has been shown to be associated with a number of challenges, both clinical and immunological. This minireview aims at discussing the challenges encountered by elderly HIV-infected patients. PMID:27595022

  19. HIV Infection in the Elderly: Arising Challenges.

    PubMed

    Mpondo, Bonaventura C T

    2016-01-01

    Globally there is an increase in the number of people living with HIV at an advanced age (50 years and above). This is mainly due to prolonged survival following the use of highly active antiretroviral therapy. Living with HIV at an advanced age has been shown to be associated with a number of challenges, both clinical and immunological. This minireview aims at discussing the challenges encountered by elderly HIV-infected patients. PMID:27595022

  20. Levamisole-Contaminated Cocaine Use in HIV-Infected and Uninfected Unstably Housed Women.

    PubMed

    Riley, Elise D; Kral, Alex H; Cohen, Jennifer; Dilworth, Samantha E; Shumway, Martha; Lynch, Kara L

    2016-09-01

    A growing number of case reports cite serious health complications linked to the cocaine adulterant, levamisole and women are disproportionately affected; however, the clinical effects are not well established. Between April and October of 2010, we conducted a cross-sectional study among 222 homeless and unstably housed women (116 human immunodeficiency virus [HIV]-infected and 106 HIV-uninfected). Immune markers and behavioral factors were compared in separate models by cocaine and levamisole exposure. Overall, 63% of participants were toxicology positive for cocaine/benzoylecgonine, 85% of whom also tested positive for levamisole. Differences in immune markers did not reach levels of significance among HIV-uninfected persons. Compared to HIV-infected persons who were negative for both cocaine and levamisole, the adjusted odds of low white blood cell count were significantly higher among HIV-infected persons positive for both (p = 0.03), but not for those positive for cocaine only. Neutrophil count and HIV viral load did not differ by cocaine and levamisole status among HIV-infected persons. In a separate model, the adjusted odds of testing positive for levamisole were higher among African American women compared to Caucasian and Asian women (p = 0.02). In the context of high levamisole prevalence, results suggest that decreased immune function as a result of levamisole exposure occurs mainly in individuals who are already immune compromised (e.g., HIV-positive), and race/ethnicity appears to be an important factor in understanding levamisole exposure among cocaine-using women. While larger and geographically diverse studies are needed to elucidate these initial findings, results suggest that levamisole may be one mechanism of immune dysfunction in HIV-infected cocaine-using women. PMID:27203838

  1. Fosamprenavir calcium plus ritonavir for HIV infection.

    PubMed

    Torres, Harrys A; Arduino, Roberto C

    2007-06-01

    Fosamprenavir is a protease inhibitor (PI) approved for the treatment of HIV-1 infection. Fosamprenavir is a prodrug of amprenavir developed to reduce the pill burden yet maintain the unique resistance pattern and efficacy associated with amprenavir. In a head-to-head, noninferiority trial in antiretroviral treatment-naive HIV-infected patients, the antiviral efficacy and tolerability of ritonavir-boosted fosamprenavir was not inferior to ritonavir-boosted lopinavir, when the PIs were combined with two other nucleoside reverse transcriptase inhibitors. There are fewer studies published about fosamprenavir use in antiretroviral treatment-experienced HIV-infected patients. The high genetic barrier to the development of resistance to fosamprenavir and the low level of cross-resistance between ritonavir-boosted fosamprenavir and other PI regimens are notable. As with amprenavir, gastrointestinal disturbance and rash are the most frequent short-term treatment-limiting events with fosamprenavir. Treatment with ritonavir-boosted fosamprenavir can produce a durable response. To date, fosamprenavir is one of the recommended preferred PI components for the treatment of antiretroviral-naive HIV-infected patients.

  2. Projection of HIV infection in Calcutta.

    PubMed

    Basu, A; Basu, S; Chakraborty, M S; Dewanji, A; Ghosh, J K; Majumder, P P

    1998-04-01

    Starting with the base year of 1991, the HIV infection projection for 1992-99 for the total, as well as various high-risk sub-populations of Calcutta, the first of its kind is provided. These projections are based on statistical methodology developed in this paper. Our methodology for spread of HIV infection takes into account various social interactions and practices and also uses available data. Rates of these interactions and practices and estimates of demographic parameters used in making projections were obtained primarily from surveys and census data. Since one of these estimated rates, that of HIV transmission rate through heterosexual encounters between an infected and an uninfected had a large range, we have provided two sets of projections based on the largest of these rates (worst-case scenario) and another that is consistent with the available data. The total projection of the number of HIV infected cases in Calcutta for 1999 is between 49,000 and 1,26,000. Separate projections are also provided for high-risk sub-groups. Among these, the sex workers expectedly will continue to manifest the highest numbers of newly infected cases. The temporal rate of increase in prevalence is projected to be alarmingly higher in the general population than even among sex workers, although the actual prevalence will continue to be the lowest in the general population compared to all other sub-groups of the population. PMID:9604543

  3. Variations in enamel thickness and structure in East African hominids.

    PubMed

    Beynon, A D; Wood, B A

    1986-06-01

    Tooth fragments are an appreciable but neglected proportion of fossil hominid specimens. The present study on 47 naturally fractured enamel surfaces of premolar and molar teeth of Plio-Pleistocene East African hominids measured enamel thickness, slope of incremental lines (striae of Retzius), and the morphology of Hunter Schreger bands (HSBs). Specimens allocated to three categories--"robust" australopithecines (EAFROB), "early Homo" (EAFHOM), and "unknown"--were photographed in ethanol with polarised light. Enamel thickness was measured on the occlusal (OT), cuspal (CT), and lateral (LT) aspects. The angle of intersection of striae of Retzius (D) with the enamel-dentine junction (EDJ) was recorded, together with the degree of curvature and width of Hunter-Schreger bands (HSB). Absolute measurements of enamel thickness were scaled by using two allometry correction factors. Absolute thicknesses of all enamel measurements were significantly greater in the EAFROB (OT 3.1 mm; CT 3.3 mm; LT 2.4 mm) compared with EAFHOM (OT 1.4 mm; CT 1.6 mm; LT 1.6 mm) categories. Correction for size reduces the mean difference between the two taxa, but CT and OT thickness remain significantly different (P less than 0.05). HSBs in EAFROB were relatively straight and narrower (means = 52.8 micron) than in EAFHOM, which are more curved and wider (means = 62.0 micron), suggesting greater enamel prism decussation in early Homo. The slope of striae was less in EAFROB permanent molars (means = 23 degrees) compared with EAFHOM (means = 31 degrees), indicating faster rates of coverage during crown formation in "robust" australopithecines. We conclude that the study of fractured enamel surfaces can contribute to our understanding of the systematic relationships and patterns of enamel growth of early hominids.

  4. Crustal thinning between the Ethiopian and East African Plateaus from modeling Rayleigh wave dispersion

    SciTech Connect

    Benoit, M H; Nyblade, A A; Pasyanos, M E

    2006-01-17

    The East African and Ethiopian Plateaus have long been recognized to be part of a much larger topographic anomaly on the African Plate called the African Superswell. One of the few places within the African Superswell that exhibit elevations of less than 1 km is southeastern Sudan and northern Kenya, an area containing both Mesozoic and Cenozoic rift basins. Crustal structure and uppermost mantle velocities are investigated in this area by modeling Rayleigh wave dispersion. Modeling results indicate an average crustal thickness of 25 {+-} 5 km, some 10-15 km thinner than the crust beneath the adjacent East African and Ethiopian Plateaus. The low elevations can therefore be readily attributed to an isostatic response from crustal thinning. Low Sn velocities of 4.1-4.3 km/s also characterize this region.

  5. Transition to Parenthood and HIV Infection in Rural Zimbabwe

    PubMed Central

    Piccarreta, Raffaella; Gregson, Simon; Melegaro, Alessia

    2016-01-01

    Background The relationship between the risk of acquiring human immunodeficiency virus (HIV) infection and people’s choices about life course events describing the transition to parenthood–sexual debut, union (in the form of marriage, cohabitation, or long-term relationship), and parenthood–is still unclear. A crucial role in shaping this relationship may be played by the sequence of these events and by their timing. This suggests the opportunity to focus on the life courses in their entirety rather than on the specific events, thus adopting a holistic approach that regards each individual’s life course trajectory as a whole. Methods We summarise the individual life courses describing the transition to parenthood using ordered sequences of the three considered events. We aim to (i) investigate the association between the sequences and HIV infection, and (ii) understand how these sequences interact with known mechanisms for HIV transmission, such as the length of sexual exposure and the experience of non-regular sexual partnerships. For this purpose, we use data from a general population cohort study run in Manicaland (Zimbabwe), a Sub-Saharan African area characterised by high HIV prevalence. Results For both genders, individuals who experienced either premarital or delayed childbearing have higher HIV risk compared to individuals following more standard transitions. This can be explained by the interplay of the sequences with known HIV proximate determinants, e.g., a longer exposure to sexual activity and higher rates of premarital sex. Moreover, we found that people in the younger birth cohorts experience more normative and safer sequences. Conclusions The shift of younger generations towards more normative transitions to parenthood is a sign of behaviour change that might have contributed to the observed reduction in HIV prevalence in the area. On the other hand, for people with less normative transitions, targeted strategies are essential for HIV

  6. New Regimens to Prevent Tuberculosis in Adults with HIV Infection

    PubMed Central

    Martinson, Neil A.; Barnes, Grace L.; Moulton, Lawrence H.; Msandiwa, Reginah; Hausler, Harry; Ram, Malathi; McIntyre, James A.; Gray, Glenda E.; Chaisson, Richard E.

    2012-01-01

    BACKGROUND Treatment of latent tuberculosis in patients infected with the human immunodeficiency virus (HIV) is efficacious, but few patients around the world receive such treatment. We evaluated three new regimens for latent tuberculosis that may be more potent and durable than standard isoniazid treatment. METHODS We randomly assigned South African adults with HIV infection and a positive tuberculin skin test who were not taking antiretroviral therapy to receive rifapentine (900 mg) plus isoniazid (900 mg) weekly for 12 weeks, rifampin (600 mg) plus isoniazid (900 mg) twice weekly for 12 weeks, isoniazid (300 mg) daily for up to 6 years (continuous isoniazid), or isoniazid (300 mg) daily for 6 months (control group). The primary end point was tuberculosis-free survival. RESULTS The 1148 patients had a median age of 30 years and a median CD4 cell count of 484 per cubic millimeter. Incidence rates of active tuberculosis or death were 3.1 per 100 person-years in the rifapentine–isoniazid group, 2.9 per 100 person-years in the rifampin–isoniazid group, and 2.7 per 100 person-years in the continuous-isoniazid group, as compared with 3.6 per 100 person-years in the control group (P>0.05 for all comparisons). Serious adverse reactions were more common in the continuous-isoniazid group (18.4 per 100 person-years) than in the other treatment groups (8.7 to 15.4 per 100 person-years). Two of 58 isolates of Mycobacterium tuberculosis (3.4%) were found to have multidrug resistance. CONCLUSIONS On the basis of the expected rates of tuberculosis in this population of HIV-infected adults, all secondary prophylactic regimens were effective. Neither a 3-month course of intermittent rifapentine or rifampin with isoniazid nor continuous isoniazid was superior to 6 months of isoniazid. PMID:21732833

  7. [the epidemiology of HIV infection].

    PubMed

    Chêne, G

    1999-10-15

    By the end of 1998, estimates indicate that 33.4 millions people were infected with Human Immunodeficiency Virus. Over two-thirds of these people live in Sub-Saharian Africa, where HIV has mostly spread through sex between men and women. Today, the epidemic is spreading rapidly in the southern countries of Africa. One-fifth of infected people live in South and South-East Asia, where the epidemic was identified from 1992, mostly in intra-venous drug injectors, sex workers and their clients. In Latin America (4% of infected people), men who have sex with men and drug injectors are the transmission categories mostly concerned. Countries of North America and western Europe concentrated 2.7% of infected people. HIV incidence is stable and AIDS cases in many industrialized countries are falling. AIDS is one of the ten first causes of death in the world; early testing and prevention should remain a high priority in all countries over the world.

  8. Serotonin-Related Gene Polymorphisms and Asymptomatic Neurocognitive Impairment in HIV-Infected Alcohol Abusers

    PubMed Central

    Villalba, Karina; Dévieux, Jessy G.; Rosenberg, Rhonda; Cadet, Jean Lud

    2016-01-01

    HIV-infected individuals continue to experience neurocognitive deterioration despite virologically successful treatments. While the cause remains unclear, evidence suggests that HIV-associated neurocognitive disorders (HAND) may be associated with neurobehavioral dysfunction. Genetic variants have been explored to identify risk markers to determine neuropathogenesis of neurocognitive deterioration. Memory deficits and executive dysfunction are highly prevalent among HIV-infected adults. These conditions can affect their quality of life and HIV risk-taking behaviors. Single nucleotide polymorphisms in the SLC6A4, TPH2, and GALM genes may affect the activity of serotonin and increase the risk of HAND. The present study explored the relationship between SLC6A4, TPH2, and GALM genes and neurocognitive impairment in HIV-infected alcohol abusers. A total of 267 individuals were genotyped for polymorphisms in SLC6A4 5-HTTLPR, TPH2 rs4570625, and GALM rs6741892. To assess neurocognitive functions, the Short Category and the Auditory Verbal Learning Tests were used. TPH2 SNP rs4570625 showed a significant association with executive function in African American males (odds ratio 4.8, 95% CI, 1.5–14.8; P = 0.005). Similarly, GALM SNP rs6741892 showed an increased risk with African American males (odds ratio 2.4, 95% CI, 1.2–4.9; P = 0.02). This study suggests that TPH2 rs4570625 and GALM rs6741892 polymorphisms may be risk factors for HAND. PMID:27069689

  9. Fatal haemorrhage following liver biopsy in patients with HIV infection.

    PubMed Central

    Churchill, D R; Mann, D; Coker, R J; Miller, R F; Glazer, G; Goldin, R D; Lucas, S B; Weber, J N; De Cock, K M

    1996-01-01

    A retrospective review of all 248 liver biopsies performed in patients with HIV infection at two referral centres in London over a 12 year period revealed five cases of major bleeding following biopsy, with four deaths. The risk of major bleeding was 2.0%, and mortality was 1.6% following liver biopsy. The risk of bleeding as much higher than in published series of biopsies done in patients without HIV infection, owing in part to the high prevalence of thrombocytopaenia and clotting abnormalities in patients with HIV infection. HIV infection per se may also increase the risk of bleeding following liver biopsy. PMID:8655172

  10. Low-level Viremia Early in HIV Infection

    PubMed Central

    Chen, Iris; Cummings, Vanessa; Fogel, Jessica M.; Marzinke, Mark A.; Clarke, William; Connor, Matthew B.; Griffith, Sam; Buchbinder, Susan; Shoptaw, Steven; del Rio, Carlos; Magnus, Manya; Mannheimer, Sharon; Wheeler, Darrell P.; Mayer, Kenneth H.; Koblin, Beryl A.; Eshleman, Susan H.

    2014-01-01

    HIV RNA levels are usually high early in HIV infection. In the HPTN 061 study, men were tested for HIV infection every six months; six (21.4%) of 28 men who acquired HIV infection during the study had low or undetectable HIV RNA at the time of HIV diagnosis. Antiretroviral drugs were not detected at the time of HIV diagnosis. False-negative HIV test results were obtained for two men using multiple assays. Antiretroviral drug resistance mutations were detected in HIV from one man. Additional studies are needed to identify factors associated with low HIV RNA levels during early HIV infection. PMID:25140905

  11. Poverty, risky sexual behaviour, and vulnerability to HIV infection: evidence from South Africa.

    PubMed

    Booysen, Frederik le R; Summerton, Joy

    2002-12-01

    This paper explores the relationship among poverty, risky sexual behaviour, and vulnerability to HIV infection, using data from the 1998 South African Demographic and Health Survey. Asset index was employed as proxy of socioeconomic status. Inequalities in health were measured using concentration index. Women in poorer households were slightly less knowledgeable about HIV/AIDS, while the socioeconomic inequalities in risky sexual behaviour were negligible. These small health gradients may reflect the limitations of population-based surveys in collection of information on sexual behaviour. The results may also mean that women in general are equally at risk of HIV infection, which means that more work is required to establish how factors other than knowledge on HIV/ AIDS and socioeconomic status stand to enhance the vulnerability of women to HIV/AIDS.

  12. Multidecadal variability in East African hydroclimate controlled by the Indian Ocean.

    PubMed

    Tierney, Jessica E; Smerdon, Jason E; Anchukaitis, Kevin J; Seager, Richard

    2013-01-17

    The recent decades-long decline in East African rainfall suggests that multidecadal variability is an important component of the climate of this vulnerable region. Prior work based on analysing the instrumental record implicates both Indian and Pacific ocean sea surface temperatures (SSTs) as possible drivers of East African multidecadal climate variability, but the short length of the instrumental record precludes a full elucidation of the underlying physical mechanisms. Here we show that on timescales beyond the decadal, the Indian Ocean drives East African rainfall variability by altering the local Walker circulation, whereas the influence of the Pacific Ocean is minimal. Our results, based on proxy indicators of relative moisture balance for the past millennium paired with long control simulations from coupled climate models, reveal that moist conditions in coastal East Africa are associated with cool SSTs (and related descending circulation) in the eastern Indian Ocean and ascending circulation over East Africa. The most prominent event identified in the proxy record--a coastal pluvial from 1680 to 1765--occurred when Indo-Pacific warm pool SSTs reached their minimum values of the past millennium. Taken together, the proxy and model evidence suggests that Indian Ocean SSTs are the primary influence on East African rainfall over multidecadal and perhaps longer timescales.

  13. Multidecadal variability in East African hydroclimate controlled by the Indian Ocean.

    PubMed

    Tierney, Jessica E; Smerdon, Jason E; Anchukaitis, Kevin J; Seager, Richard

    2013-01-17

    The recent decades-long decline in East African rainfall suggests that multidecadal variability is an important component of the climate of this vulnerable region. Prior work based on analysing the instrumental record implicates both Indian and Pacific ocean sea surface temperatures (SSTs) as possible drivers of East African multidecadal climate variability, but the short length of the instrumental record precludes a full elucidation of the underlying physical mechanisms. Here we show that on timescales beyond the decadal, the Indian Ocean drives East African rainfall variability by altering the local Walker circulation, whereas the influence of the Pacific Ocean is minimal. Our results, based on proxy indicators of relative moisture balance for the past millennium paired with long control simulations from coupled climate models, reveal that moist conditions in coastal East Africa are associated with cool SSTs (and related descending circulation) in the eastern Indian Ocean and ascending circulation over East Africa. The most prominent event identified in the proxy record--a coastal pluvial from 1680 to 1765--occurred when Indo-Pacific warm pool SSTs reached their minimum values of the past millennium. Taken together, the proxy and model evidence suggests that Indian Ocean SSTs are the primary influence on East African rainfall over multidecadal and perhaps longer timescales. PMID:23325220

  14. Tomography of the East African Rift System in Mozambique

    NASA Astrophysics Data System (ADS)

    Domingues, A.; Silveira, G. M.; Custodio, S.; Chamussa, J.; Lebedev, S.; Chang, S. J.; Ferreira, A. M. G.; Fonseca, J. F. B. D.

    2014-12-01

    Unlike the majority of the East African Rift, the Mozambique region has not been deeply studied, not only due to political instabilities but also because of the difficult access to its most interior regions. An earthquake with M7 occurred in Machaze in 2006, which triggered the investigation of this particular region. The MOZART project (funded by FCT, Lisbon) installed a temporary seismic network, with a total of 30 broadband stations from the SEIS-UK pool, from April 2011 to July 2013. Preliminary locations of the seismicity were estimated with the data recorded from April 2011 to July 2012. A total of 307 earthquakes were located, with ML magnitudes ranging from 0.9 to 3.9. We observe a linear northeast-southwest distribution of the seismicity that seems associated to the Inhaminga fault. The seismicity has an extension of ~300km reaching the Machaze earthquake area. The northeast sector of the seismicity shows a good correlation with the topography, tracing the Urema rift valley. In order to obtain an initial velocity model of the region, the ambient noise method is used. This method is applied to the entire data set available and two additional stations of the AfricaARRAY project. Ambient noise surface wave tomography is possible by computing cross-correlations between all pairs of stations and measuring the group velocities for all interstation paths. With this approach we obtain Rayleigh wave group velocity dispersion curves in the period range from 3 to 50 seconds. Group velocity maps are calculated for several periods and allowing a geological and tectonic interpretation. In order to extend the investigation to longer wave periods and thus probe both the crust and upper mantle, we apply a recent implementation of the surface-wave two-station method (teleseismic interferometry - Meier el al 2004) to augment our dataset with Rayleigh wave phase velocities curves in a broad period range. Using this method we expect to be able to explore the lithosphere

  15. Hydrothermal vents is Lake Tanganyika, East African Rift system

    SciTech Connect

    Tiercelin, J.J.; Pflumio, C.; Castrec, M.

    1993-06-01

    Sublacustrine hydrothermal vents with associated massive sulfides were discovered during April 1987 at Pemba and Cape Banza on the Zaire side of the northern basin of Lake Tanganyika, East African Rift system. New investigations by a team of ten scuba divers during the multinational (France, Zaire, Germany, and Burundi) TANGANYDRO expedition (August-October 1991) found hydrothermal vents down to a depth of 46 m along north-trending active faults bounding the Tanganyika rift on the western side. Temperatures from 53 to 103 {degrees}C were measured in hydrothermal fluids and sediments. Veins of massive sulfides 1-10 cm thick (pyrite and marcasite banding) were found associated with vents at the Pemba site. At Cape Banza, active vents are characterized by 1-70-cm-high aragonite chimneys, and there are microcrystalline pyrite coatings on the walls of hydrothermal pipes. Hydrothermal fluid end members show distinctive compositions at the two sites. The Pemba end member is a NaHCO{sub 3}-enriched fluid similar to the NaHCO{sub 3} thermal fluids form lakes Magadi and Bogoria in the eastern branch of the rift. The Cape Banza end member is a solution enriched in NaCl. Such brines may have a deep-seated basement origin, as do the Uvinza NaCl brines on the eastern flank of the Tanganyika basin. Geothermometric calculations have yielded temperatures of fluid-rock interaction of 219 and 179 {degrees}C in the Pemba and Cape Banza systems, respectively. Abundant white or reddish-brown microbial colonies resembling Beggiatoa mats were found surrounding the active vents. Thermal fluid circulation is permitted by opening of cracks related to 130{degrees}N normal-dextral faults that intersect the north-south major rift trend. The sources of heat for such hydrothermal systems may relate to the existence of magmatic bodies under the rift, which is suggested by the isotopic composition of carbon dioxide released at Pemba and Cape Banza. 21 refs., 2 figs.

  16. The neuropathology of adult HIV infection.

    PubMed

    Bell, J E

    1998-12-01

    Since the onset of the acquired immune deficiency syndrome (AIDS) epidemic fifteen years ago, much has been learned about the effects of the human immunodeficiency virus (HIV) in the nervous system. This review summarizes the pathology findings in the central nervous system (CNS). There is now abundant evidence that HIV can infect the CNS directly, leading to a characteristic HIV encephalitis (HIVE) which occurs in 10-50 p. 100 of AIDS autopsy series. Multinucleated giant cells are the pathognomonic feature of HIVE and are found predominantly in the central white matter and deep grey matter. Evidence of productive HIV infection in the CNS is confined to cells of the microglial/macrophage lineage, from which the giant cells are almost certainly derived. These cells are known to express both CD4 and beta-chemokine receptors, which act in conjunction to permit HIV entry. Restricted infection of astrocytes has also been identified by a variety of methods. HIVE is frequently associated with white matter damage ranging from inflammatory (microglia, macrophages and sparse lymphocytes) to degenerative (myelin loss and axonal damage) pathology. Although giant cells are seen less frequently in neocortical grey matter, significant neuronal loss has been established in a number of studies. Recent investigations using markers of apoptosis, (including TUNEL, Bcl-2 and BAX), have established the presence of DNA damage in some neurons and in other cell types. Axonal damage has also been confirmed by evidence of amyloid precursor protein expression. The CNS is also vulnerable to opportunistic infections and high grade B-cell lymphomas as a result of the immune suppression of advanced HIV infection. Cytomegalovirus (CMV) infection is reported in 10-30 p. 100 of AIDS cases at autopsy, toxoplasma in 10-25 p. 100, progressive multifocal leucoencephalopathy in about 5 p. 100 and lymphomas, usually primary, in up to 10 p. 100. A wide variety of other infections has also been reported

  17. Effect of Cocaine on HIV Infection and Inflammasome Gene Expression Profile in HIV Infected Macrophages

    PubMed Central

    Atluri, Venkata Subba Rao; Pilakka-Kanthikeel, Sudheesh; Garcia, Gabriella; Jayant, Rahul Dev; Sagar, Vidya; Samikkannu, Thangavel; Yndart, Adriana; Nair, Madhavan

    2016-01-01

    We have observed significantly increased HIV infection in HIV infected macrophages in the presence of cocaine that could be due to the downregulation of BST2 restriction factor in these cells. In human inflammasome PCR array, among different involved in inflammasome formation, in HIV infected macrophages in the presence of cocaine, we have observed significant upregulation of NLRP3, AIM2 genes and downstream genes IL-1β and PTGS2. Whereas negative regulatory gene MEFV was upregulated, CD40LG and PYDC1 were significantly downregulated. Among various NOD like receptors, NOD2 was significantly upregulated in both HIV alone and HIV plus cocaine treated cells. In the downstream genes, chemokine (C-C motif) ligand 2 (CCL2), CCL7 and IL-6 were significantly up regulated in HIV plus cocaine treated macrophages. We have also observed significant ROS production (in HIV and/or cocaine treated cells) which is one of the indirect-activators of inflammasomes formation. Further, we have observed early apoptosis in HIV alone and HIV plus cocaine treated macrophages which may be resultant of inflammasome formation and cspase-1 activation. These results indicate that in case of HIV infected macrophages exposed to cocaine, increased ROS production and IL-1β transcription serve as an activators for the formation of NLRP3 and AIM2 mediated inflammasomes that leads to caspase 1 mediated apoptosis. PMID:27321752

  18. Magmatic Versus Amagmatic Rifting in the East African Rift System from Pn and Sn Tomography

    NASA Astrophysics Data System (ADS)

    O'Donnell, J. P.; Nyblade, A.

    2014-12-01

    Geodynamic models of rifting currently rely on the mechanism of hot mantle upwelling and decompressional melting to weaken lithospheric rock to the degree that rifting can initiate. However, many rift segments worldwide are apparently amagmatic. The East African Rift System is a prime example, with large sections of the system subaerially amagmatic. We seek to address the question of whether these apparently amagmatic rift segments merely lack a surficial expression of magmatism which exists at depth, or whether rifting is genuinely amagmatic. Based on regional earthquakes recorded by the Tanzania Broadband Seismic Experiment, the Kenya Broadband Seismic Experiment, the AfricaArray East African Seismic Experiment and several permanent GSN stations, we probe for uppermost mantle melt signatures along the East African Rift System using P- and S-wave speed ratios derived from Pn and Sn tomography. Pn- and Sn-velocity models, and their ratio which can be diagnostic of the presence of fluids, will be presented.

  19. Humanized Mouse Models of HIV Infection

    PubMed Central

    Denton, Paul W.; Garcia, J. Victor

    2013-01-01

    Because of the limited tropism of HIV, in vivo modeling of this virus has been almost exclusively limited to other lentiviruses such as SIV that reproduce many important characteristics of HIV infection. However, there are significant genetic and biological differences among lentiviruses and some HIV-specific interventions are not effective against other lentiviruses in non-human hosts. For these reasons much emphasis has recently been placed on developing alternative animal models that support HIV replication and recapitulate key aspects of HIV infection and pathogenesis in humans. Humanized mice, CD34+ hematopoietic progenitor cell transplanted immunodeficient mice and in particular mice also implanted with human thymic/liver tissue (BLT mice) that develop a functional human immune system, have been the focus of a great deal of attention as possible models to study virtually all aspects of HIV biology and pathogenesis. Humanized mice are systemically reconstituted with human lymphoid cells offering rapid, reliable and reproducible experimental systems for HIV research. Peripheral blood of humanized mice can be readily sampled longitudinally to assess reconstitution with human cells and to monitor HIV replication permitting the evaluation of multiple parameters of HIV infection such as viral load levels, CD4+ T cell depletion, immune activation, as well as the effects of therapeutic interventions. Of high relevance to HIV transmission is the extensive characterization and validation of the reconstitution with human lymphoid cells of the female reproductive tract and of the gastrointestinal tract of humanized BLT mice that renders them susceptible to both vaginal and rectal HIV infection. Other important attributes of all types of humanized mice include: 1) their small size and cost that make them broadly accessible; 2) multiple cohorts of humanized mice can be made from multiple human donors and each cohort has identical human cells, permitting control of

  20. The stochastic dance of early HIV infection

    NASA Astrophysics Data System (ADS)

    Merrill, Stephen J.

    2005-12-01

    The stochastic nature of early HIV infection is described in a series of models, each of which captures aspects of the dance of HIV during the early stages of infection. It is to this highly variable target that the immune response must respond. The adaptability of the various components of the immune response is an important aspect of the system's operation, as the nature of the pathogens that the response will be required to respond to and the order in which those responses must be made cannot be known beforehand. As HIV infection has direct influence over cells responsible for the immune response, the dance predicts that the immune response will be also in a variable state of readiness and capability for this task of adaptation. The description of the stochastic dance of HIV here will use the tools of stochastic models, and for the most part, simulation. The justification for this approach is that the early stages and the development of HIV diversity require that the model to be able to describe both individual sample path and patient-to-patient variability. In addition, as early viral dynamics are best described using branching processes, the explosive growth of these models both predicts high variability and rapid response of HIV to changes in system parameters.In this paper, a basic viral growth model based on a time dependent continuous-time branching process is used to describe the growth of HIV infected cells in the macrophage and lymphocyte populations. Immigration from the reservoir population is added to the basic model to describe the incubation time distribution. This distribution is deduced directly from the modeling assumptions and the model of viral growth. A system of two branching processes, one in the infected macrophage population and one in the infected lymphocyte population is used to provide a description of the relationship between the development of HIV diversity as it relates to tropism (host cell preference). The role of the immune

  1. Risk management information for HIV infection.

    PubMed

    Edwards, A J

    1990-01-01

    This article discusses HIV infection in terms of the risk manager's information needs in the health care environment. The malpractice problem, increasing workman's compensation suits, the greater role of the ombudsman, implementation of the National Practitioner Data Bank, and the Joint Commission on Accreditation of Health Care Organizations' (JCAHO) emphasis on clinical excellence are conditions which have given greater importance to the risk manager's position. Included in this article are hedges to retrieve various components of risk management and a select bibliography from AIDSLINE.

  2. Use of Machine Learning Techniques for Identification of Robust Teleconnections to East African Rainfall Variability

    NASA Technical Reports Server (NTRS)

    Roberts, J. Brent; Robertson, F. R.; Funk, C.

    2014-01-01

    Hidden Markov models can be used to investigate structure of subseasonal variability. East African short rain variability has connections to large-scale tropical variability. MJO - Intraseasonal variations connected with appearance of "wet" and "dry" states. ENSO/IOZM SST and circulation anomalies are apparent during years of anomalous residence time in the subseasonal "wet" state. Similar results found in previous studies, but we can interpret this with respect to variations of subseasonal wet and dry modes. Reveal underlying connections between MJO/IOZM/ENSO with respect to East African rainfall.

  3. Primary cutaneous plasmablastic lymphoma revealing clinically unsuspected HIV infection.

    PubMed

    Marques, Silvio Alencar; Abbade, Luciana P Fernandes; Guiotoku, Marcelo Massaki; Marques, Mariangela Esther Alencar

    2016-01-01

    Plasmablastic lymphoma is a rare subtype of diffuse large B-cell lymphoma more frequently diagnosed in immunosuppressed patients, mainly HIV-infected. Primary cutaneous plasmablastic lymphoma is extremely rare, and in this patient it was the first clinical manifestation of unsuspected HIV-infection. PMID:27579749

  4. The Presence of Psychiatric Disorders in HIV-Infected Women.

    ERIC Educational Resources Information Center

    Taylor, Elizabeth R.; And Others

    1996-01-01

    Many women of low socioeconomic status who have contracted HIV qualify for individual, dual, and multiple psychiatric diagnoses that predate their knowledge of their HIV infection. Earlier intervention addressing these problems might have prevented the onset of psychiatric disorders as well as high-risk behaviors that lead to HIV infection. (FC)

  5. Primary cutaneous plasmablastic lymphoma revealing clinically unsuspected HIV infection*

    PubMed Central

    Marques, Silvio Alencar; Abbade, Luciana P. Fernandes; Guiotoku, Marcelo Massaki; Marques, Mariangela Esther Alencar

    2016-01-01

    Plasmablastic lymphoma is a rare subtype of diffuse large B-cell lymphoma more frequently diagnosed in immunosuppressed patients, mainly HIV-infected. Primary cutaneous plasmablastic lymphoma is extremely rare, and in this patient it was the first clinical manifestation of unsuspected HIV-infection. PMID:27579749

  6. High osteoporosis risk among East Africans linked to lactase persistence genotype.

    PubMed

    Hilliard, Constance B

    2016-01-01

    This ecological correlation study explores the marked differential in osteoporosis susceptibility between East and West Africans. African tsetse belt populations are lactase non-persistent (lactose intolerant) and possess none of the genetic polymorphisms carried by lactase persistent (lactose tolerant) ethnic populations. What appears paradoxical, however, is the fact that Niger-Kordofanian (NK) West African ethnicities are also at minimal risk of osteoporosis. Although East Africans share a genetic affinity with NK West Africans, they display susceptibility rates of the bone disorder closer to those found in Europe. Similar to Europeans, they also carry alleles conferring the lactase persistence genetic traits. Hip fracture rates of African populations are juxtaposed with a global model to determine whether it is the unique ecology of the tsetse-infested zone or other variables that may be at work. This project uses MINITAB 17 software for regression analyses. The research data are found on AJOL (African Journals Online), PUBMED and JSTOR (Scholarly Journal Archive). Data showing the risk of osteoporosis to be 80 times higher among East Africans with higher levels of lactase persistence than lactase non-persistence West Africans are compared with global statistics. Hip fracture rates in 40 countries exhibit a high Pearson's correlation of r=0.851, with P-value=0.000 in relation to dairy consumption. Lower correlations are seen for hip fracture incidence vis-à-vis lactase persistence, per capita income and animal protein consumption. Ethnic populations who lack lactase persistence single-nucleotide polymorphisms may be at low risk of developing osteoporosis.

  7. High osteoporosis risk among East Africans linked to lactase persistence genotype.

    PubMed

    Hilliard, Constance B

    2016-01-01

    This ecological correlation study explores the marked differential in osteoporosis susceptibility between East and West Africans. African tsetse belt populations are lactase non-persistent (lactose intolerant) and possess none of the genetic polymorphisms carried by lactase persistent (lactose tolerant) ethnic populations. What appears paradoxical, however, is the fact that Niger-Kordofanian (NK) West African ethnicities are also at minimal risk of osteoporosis. Although East Africans share a genetic affinity with NK West Africans, they display susceptibility rates of the bone disorder closer to those found in Europe. Similar to Europeans, they also carry alleles conferring the lactase persistence genetic traits. Hip fracture rates of African populations are juxtaposed with a global model to determine whether it is the unique ecology of the tsetse-infested zone or other variables that may be at work. This project uses MINITAB 17 software for regression analyses. The research data are found on AJOL (African Journals Online), PUBMED and JSTOR (Scholarly Journal Archive). Data showing the risk of osteoporosis to be 80 times higher among East Africans with higher levels of lactase persistence than lactase non-persistence West Africans are compared with global statistics. Hip fracture rates in 40 countries exhibit a high Pearson's correlation of r=0.851, with P-value=0.000 in relation to dairy consumption. Lower correlations are seen for hip fracture incidence vis-à-vis lactase persistence, per capita income and animal protein consumption. Ethnic populations who lack lactase persistence single-nucleotide polymorphisms may be at low risk of developing osteoporosis. PMID:27408710

  8. Group Counseling with Traumatized East African Refugee Women in the United States: Using the "Kaffa" Ceremony Intervention

    ERIC Educational Resources Information Center

    Loewy, Michael I.; Williams, DiAnna Toliver; Keleta, Aster

    2002-01-01

    The Kaffa ceremony is a unique, culturally appropriate, group counseling intervention for female East African refugees. A counseling group is described in which the Kaffa ceremony was instrumental in helping to bridge the gap between Western counseling and East African culture, providing a context for the group members to resolve long-held trauma.…

  9. Fuzzy Modeling and Control of HIV Infection

    PubMed Central

    Zarei, Hassan; Kamyad, Ali Vahidian; Heydari, Ali Akbar

    2012-01-01

    The present study proposes a fuzzy mathematical model of HIV infection consisting of a linear fuzzy differential equations (FDEs) system describing the ambiguous immune cells level and the viral load which are due to the intrinsic fuzziness of the immune system's strength in HIV-infected patients. The immune cells in question are considered CD4+ T-cells and cytotoxic T-lymphocytes (CTLs). The dynamic behavior of the immune cells level and the viral load within the three groups of patients with weak, moderate, and strong immune systems are analyzed and compared. Moreover, the approximate explicit solutions of the proposed model are derived using a fitting-based method. In particular, a fuzzy control function indicating the drug dosage is incorporated into the proposed model and a fuzzy optimal control problem (FOCP) minimizing both the viral load and the drug costs is constructed. An optimality condition is achieved as a fuzzy boundary value problem (FBVP). In addition, the optimal fuzzy control function is completely characterized and a numerical solution for the optimality system is computed. PMID:22536298

  10. HIV Infection Legal Issues: An Introduction for Developmental Services. Technical Report on Developmental Disabilities and HIV Infection, Number 2.

    ERIC Educational Resources Information Center

    Harvey, David C.; Decker, Curtis L.

    As agencies and programs serving individuals with developmental disabilities are called upon to serve a new population of individuals with human immunodeficiency virus (HIV) infection, they will be forced to confront complex legal questions. This paper discusses the legal frameworks in which individuals with HIV infection are considered eligible…

  11. AIDS, HIV infection, and illicit drug use within inner-city families and social networks.

    PubMed Central

    Pivnick, A; Jacobson, A; Eric, K; Doll, L; Drucker, E

    1994-01-01

    OBJECTIVES. Drug use is commonly depicted and treated as an individual problem. This study describes the extent of drug use, human immunodeficiency virus (HIV) infection, and acquired immunodeficiency syndrome (AIDS) among drug users' sexual partners and family and household members in order to broaden considerations of risk. METHODS. Social network charts and structured interviews were administered to 126 women (predominantly African American and Latino) enrolled in methadone treatment. The charts elicited the prevalence of drug use and HIV infection among subjects' family and household members. RESULTS. Drug use and HIV/AIDS permeated subjects' sexual, familial, and household relationships. More than half of the women who resided with a sexual partner reported that their partners currently used drugs. Almost one third of the subjects' siblings were drug users. Of the 715 total siblings (all subjects plus their siblings), 69 (9.7%) were known to be HIV positive or to have an AIDS diagnosis. CONCLUSIONS. The sexual, familial, and household expressions of drug use underscore the notion that drug use and attendant risks, including but not limited to HIV infection, might be usefully viewed and treated as an inter- and intracommunity problem rather than as an exclusively individual one. PMID:8296952

  12. Knowledge of specific HIV transmission modes in relation to HIV infection in Mozambique

    PubMed Central

    Brewer, Devon D

    2012-01-01

    Background: In prior research, Africans who knew about blood-borne risks were modestly less likely to be HIV-infected than those who were not aware of such risks. Objectives/Methods: I examined the association between knowledge of specific HIV transmission modes and prevalent HIV infection with data from the 2009 Mozambique AIDS Indicator Survey. Results: Respondents displayed high awareness of blood exposures and vaginal sex as modes of HIV transmission. However, only about half of respondents were aware of anal sex as a way HIV can be transmitted. After adjustments for demographics and sexual behaviors, respondents who knew that HIV could spread by contact with infected blood or by sharing injection needles or razor blades were less likely to be infected than those who did not know about these risks. Respondents who knew about sexual risks were as, or more, likely to be HIV infected as those who did not know about sexual risks. Also, children of HIV-uninfected mothers were less likely to be infected if their mothers were aware of blood-borne HIV risks than if their mothers were unaware. Conclusion: HIV education campaigns in Mozambique and elsewhere in sub-Saharan Africa should include a focus on risks from blood exposures and anal sex. PMID:24358833

  13. The meteorology of the Western Indian Ocean, and the influence of the East African Highlands.

    PubMed

    Slingo, Julia; Spencer, Hilary; Hoskins, Brian; Berrisford, Paul; Black, Emily

    2005-01-15

    This paper reviews the meteorology of the Western Indian Ocean and uses a state-of-the-art atmospheric general circulation model to investigate the influence of the East African Highlands on the climate of the Indian Ocean and its surrounding regions. The new 44-year re-analysis produced by the European Centre for Medium range Weather Forecasts (ECMWF) has been used to construct a new climatology of the Western Indian Ocean. A brief overview of the seasonal cycle of the Western Indian Ocean is presented which emphasizes the importance of the geography of the Indian Ocean basin for controlling the meteorology of the Western Indian Ocean. The principal modes of inter-annual variability are described, associated with El Nino and the Indian Ocean Dipole or Zonal Mode, and the basic characteristics of the subseasonal weather over the Western Indian Ocean are presented, including new statistics on cyclone tracks derived from the ECMWF re-analyses. Sensitivity experiments, in which the orographic effects of East Africa are removed, have shown that the East African Highlands, although not very high, play a significant role in the climate of Africa, India and Southeast Asia, and in the heat, salinity and momentum forcing of the Western Indian Ocean. The hydrological cycle over Africa is systematically enhanced in all seasons by the presence of the East African Highlands, and during the Asian summer monsoon there is a major redistribution of the rainfall across India and Southeast Asia. The implied impact of the East African Highlands on the ocean is substantial. The East African Highlands systematically freshen the tropical Indian Ocean, and act to focus the monsoon winds along the coast, leading to greater upwelling and cooler sea-surface temperatures.

  14. Louse-borne relapsing fever among East African refugees in Europe.

    PubMed

    Antinori, Spinello; Mediannikov, Oleg; Corbellino, Mario; Raoult, Didier

    2016-01-01

    Louse-borne relapsing fever a neglected and forgotten disease by western physicians has recently re-emerged among East African migrants seeking asylum in Europe. We review here the cases observed so far together with a critical reappraisal of several issues regarding clinical presentation, diagnosis and treatment. PMID:26872415

  15. Detection of east/central/south African genotype of chikungunya virus in Myanmar, 2010.

    PubMed

    Tun, Mya Myat Ngwe; Thant, Kyaw Zin; Inoue, Shingo; Nabeshima, Takeshi; Aoki, Kotaro; Kyaw, Aung Kyaw; Myint, Tin; Tar, Thi; Maung, Kay Thwe Thwe; Hayasaka, Daisuke; Morita, Kouichi

    2014-08-01

    In 2010, chikungunya virus of the East Central South African genotype was isolated from 4 children in Myanmyar who had dengue-like symptoms. Phylogenetic analysis of the E1 gene revealed that the isolates were closely related to isolates from China, Thailand, and Malaysia that harbor the A226V mutation in this gene.

  16. African American Students in East Baton Rouge Parish: How Have They Fared in Desegregated Schools?

    ERIC Educational Resources Information Center

    Fossey, Richard

    Three generations of children have passed through the Baton Rouge (Louisiana) school system since the "Brown" decision (1954) and one generation since the federal court's 1981 desegregation order. The impact of school desegregation on African American children was studied in the East Baton Rouge School District. For the student body as a whole,…

  17. Characteristics of soils in selected maize growing sites along altitudinal gradients in East African highlands

    PubMed Central

    Njuguna, Elijah; Gathara, Mary; Nadir, Stanley; Mwalusepo, Sizah; Williamson, David; Mathé, Pierre-Etienne; Kimani, Jackson; Landmann, Tobias; Juma, Gerald; Ong’amo, George; Gatebe, Erastus; Ru, Bruno Le; Calatayud, Paul-andré

    2015-01-01

    Maize is the main staple crop in the East African Mountains. Understanding how the edaphic characteristics change along altitudinal gradients is important for maximizing maize production in East African Highlands, which are the key maize production areas in the region. This study evaluated and compared the levels of some macro and micro-elements (Al, Ca, Fe, K, Mg, Mn, Na and P) and other soil parameters (pH, organic carbon content, soil texture [i.e. % Sand, % Clay and % Silt], cation exchange capacity [CEC], electric conductivity [EC], and water holding capacity [HC]). Soil samples were taken from maize plots along three altitudinal gradients in East African highlands (namely Machakos Hills, Taita Hills and Mount Kilimanjaro) characterized by graded changes in climatic conditions. For all transects, pH, Ca, K and Mg decreased with the increase in altitude. In contrast, % Silt, organic carbon content, Al and water holding capacity (HC) increased with increasing altitude. The research provides information on the status of the physical–chemical characteristics of soils along three altitudinal ranges of East African Highlands and includes data available for further research. PMID:26509187

  18. The impact of the geologic history and paleoclimate on the diversification of East african cichlids.

    PubMed

    Danley, Patrick D; Husemann, Martin; Ding, Baoqing; Dipietro, Lyndsay M; Beverly, Emily J; Peppe, Daniel J

    2012-01-01

    The cichlid fishes of the East African Great Lakes are the largest extant vertebrate radiation identified to date. These lakes and their surrounding waters support over 2,000 species of cichlid fish, many of which are descended from a single common ancestor within the past 10 Ma. The extraordinary East African cichlid diversity is intricately linked to the highly variable geologic and paleoclimatic history of this region. Greater than 10 Ma, the western arm of the East African rift system began to separate, thereby creating a series of rift basins that would come to contain several water bodies, including the extremely deep Lakes Tanganyika and Malawi. Uplifting associated with this rifting backponded many rivers and created the extremely large, but shallow Lake Victoria. Since their creation, the size, shape, and existence of these lakes have changed dramatically which has, in turn, significantly influenced the evolutionary history of the lakes' cichlids. This paper reviews the geologic history and paleoclimate of the East African Great Lakes and the impact of these forces on the region's endemic cichlid flocks.

  19. Detection of East/Central/South African Genotype of Chikungunya Virus in Myanmar, 2010

    PubMed Central

    Tun, Mya Myat Ngwe; Thant, Kyaw Zin; Inoue, Shingo; Nabeshima, Takeshi; Aoki, Kotaro; Kyaw, Aung Kyaw; Myint, Tin; Tar, Thi; Maung, Kay Thwe Thwe; Hayasaka, Daisuke

    2014-01-01

    In 2010, chikungunya virus of the East Central South African genotype was isolated from 4 children in Myanmyar who had dengue-like symptoms. Phylogenetic analysis of the E1 gene revealed that the isolates were closely related to isolates from China, Thailand, and Malaysia that harbor the A226V mutation in this gene. PMID:25062511

  20. The Impact of the Geologic History and Paleoclimate on the Diversification of East African Cichlids

    PubMed Central

    Danley, Patrick D.; Husemann, Martin; Ding, Baoqing; DiPietro, Lyndsay M.; Beverly, Emily J.; Peppe, Daniel J.

    2012-01-01

    The cichlid fishes of the East African Great Lakes are the largest extant vertebrate radiation identified to date. These lakes and their surrounding waters support over 2,000 species of cichlid fish, many of which are descended from a single common ancestor within the past 10 Ma. The extraordinary East African cichlid diversity is intricately linked to the highly variable geologic and paleoclimatic history of this region. Greater than 10 Ma, the western arm of the East African rift system began to separate, thereby creating a series of rift basins that would come to contain several water bodies, including the extremely deep Lakes Tanganyika and Malawi. Uplifting associated with this rifting backponded many rivers and created the extremely large, but shallow Lake Victoria. Since their creation, the size, shape, and existence of these lakes have changed dramatically which has, in turn, significantly influenced the evolutionary history of the lakes' cichlids. This paper reviews the geologic history and paleoclimate of the East African Great Lakes and the impact of these forces on the region's endemic cichlid flocks. PMID:22888465

  1. Louse-borne relapsing fever among East African refugees in Europe.

    PubMed

    Antinori, Spinello; Mediannikov, Oleg; Corbellino, Mario; Raoult, Didier

    2016-01-01

    Louse-borne relapsing fever a neglected and forgotten disease by western physicians has recently re-emerged among East African migrants seeking asylum in Europe. We review here the cases observed so far together with a critical reappraisal of several issues regarding clinical presentation, diagnosis and treatment.

  2. Positive association between dietary iron intake and iron status in HIV-infected children in Johannesburg, South Africa.

    PubMed

    Kruger, Herculina S; Balk, Lisanne J; Viljoen, Michelle; Meyers, Tammy M

    2013-01-01

    Anemia is a common complication of pediatric HIV infection and is associated with suboptimal cognitive performance and growth failure. Routine iron supplementation is not provided to South African HIV-infected children. We hypothesized that dietary iron intake without supplementation is sufficient to protect against iron deficiency (ID) in HIV-infected children receiving highly active antiretroviral therapy. In this prospective study, the difference between dietary intakes of iron-deficient children (soluble transferrin receptor >9.4 mg/L) and iron-sufficient children after 18 months on highly active antiretroviral therapy was examined. The association between iron intake and hemoglobin (Hb) concentration was also assessed. Longitudinal data collected for 18 months from 58 HIV-infected African children were assessed by generalized estimation equations, with adjustment for demographic information, dietary intakes, growth parameters, and CD4%. After adjustment for covariates, the longitudinal association between dietary iron intake and Hb concentration remained significant. This association shows that for every 1-mg increase in iron intake per day, Hb increases by 1.1 g/L (P < .001). Mean Hb increased significantly after 18 months of follow-up (106 ± 14 to 129 ± 14 g/L, P < .01), but soluble transferrin receptor also increased (7.7 ± 2.7 to 8.9 ± 3.0 mg/L, P < .01). The incidence of ID increased from 15.2% at baseline to 37.2% after 18 months. Children with animal protein intakes greater than >20 g/d had significantly lower odds for ID at 18 months than did children with lower intakes (odds ratio, 0.40; 95% confidence interval, 0.21-0.77). Dietary iron intake was insufficient to protect against ID, pointing to a need for low-dose iron supplementation for iron-deficient HIV-infected children and interventions to increase the consumption of animal protein.

  3. The kidney in HIV infection: beyond HIV-associated nephropathy.

    PubMed

    Wyatt, Christina M

    2012-01-01

    Acute kidney injury (AKI) and chronic kidney disease (CKD) are more common in HIV-infected persons than in the general population. AKI is associated with poor health outcomes, including increased risk of heart failure, cardiovascular events, end-stage renal disease (ESRD), and mortality. The most common causes of AKI in HIV-infected persons are systemic infections and adverse drug effects. The prevalence of CKD is rising in the HIV-infected population and CKD is increasingly likely to be caused by comorbid conditions, such as diabetes and hypertension, that frequently cause CKD in the general population. Guidelines for CKD screening in HIV-infected patients are being revised. It is currently recommended that all patients be screened for creatinine-based estimates of glomerular filtration rate and for urine protein at the time of HIV diagnosis. Annual screening is recommended for high-risk patients. Hemodialysis, peritoneal dialysis, and kidney transplantation are all options for treating ESRD in HIV-infected patients. Hemodialysis and peritoneal dialysis offer similar survival in HIV-infected patients with ESRD. In selected patients with well-controlled HIV infection, kidney transplantation is associated with survival intermediate between that in the overall transplant population and that among transplant recipients older than 65 years. This article summarizes a presentation by Christina M. Wyatt, MD, at the IAS-USA continuing medical education program held in Chicago in May 2012, describing AKI and CKD using case illustrations.

  4. HIV Infection Affects Streptococcus mutans Levels, but Not Genotypes

    PubMed Central

    Liu, G.; Saxena, D.; Chen, Z.; Norman, R.G.; Phelan, J.A.; Laverty, M.; Fisch, G.S.; Corby, P.M.; Abrams, W.; Malamud, D.; Li, Y.

    2012-01-01

    We report a clinical study that examines whether HIV infection affects Streptococcus mutans colonization in the oral cavity. Whole stimulated saliva samples were collected from 46 HIV-seropositive individuals and 69 HIV-seronegative control individuals. The level of S. mutans colonization was determined by conventional culture methods. The genotype of S. mutans was compared between 10 HIV-positive individuals before and after highly active antiretroviral therapy (HAART) and 10 non-HIV-infected control individuals. The results were analyzed against viral load, CD4+ and CD8+ T-cell counts, salivary flow rate, and caries status. We observed that S. mutans levels were higher in HIV-infected individuals than in the non-HIV-infected control individuals (p = 0.013). No significant differences in S. mutans genotypes were found between the two groups over the six-month study period, even after HAART. There was a bivariate linear relationship between S. mutans levels and CD8+ counts (r = 0.412; p = 0.007), but not between S. mutans levels and either CD4+ counts or viral load. Furthermore, compared with non-HIV-infected control individuals, HIV-infected individuals experienced lower salivary secretion (p = 0.009) and a positive trend toward more decayed tooth surfaces (p = 0.027). These findings suggest that HIV infection can have a significant effect on the level of S. mutans, but not genotypes. PMID:22821240

  5. HIV infection, bone metabolism, and fractures.

    PubMed

    Güerri-Fernández, Robert; Villar-García, Judit; Díez-Pérez, Adolfo; Prieto-Alhambra, Daniel

    2014-07-01

    With the advent of high active antiretroviral therapy there was a significant improvement on HIV subjects survival. Thus, bone changes related to HIV became an important aspect of these individuals. HIV affects bone remodeling causing bone fragility. In addition, antiretroviral therapy may also negatively affect bone metabolism. Several studies describe an increased incidence of fractures in these patients when compared with controls without the disease. The European Society of AIDS (EACS), and other societies, have included guidance on management of osteoporosis in HIV-infected patients emphasizing the identification of patients with low bone mass. Supplementation of calcium and vitamin D and the use of alendronate in these individuals should be recommended on a case base. PMID:25166038

  6. Insulin resistance and diabetes in HIV infection.

    PubMed

    Das, Satyajit

    2011-09-01

    Insulin resistance is an important and under recognized consequence of HIV treatment. Different studies have yielded widely varying estimates of the prevalence of impaired glucose metabolism in people on highly active antiretroviral therapy (HAART). The risk increases further with hepatitis C co infection. Although Protease inhibitors (PIs) are the main drug class implicated in insulin resistance, some studies have shown an association of increased risk of diabetes with cumulative exposure of nucleoside reverse transcriptase inhibitors (NRTIs). The effect of switching to other antiretrovirals has not been fully determined and the long-term consequences of insulin resistance in this population are not known. Treatment of established diabetes mellitus should generally follow existing guidelines. It is therefore reasonable to recommend general measures to increase insulin sensitivity in all patients infected with HIV, such as regular aerobic exercise and weight reduction for overweight persons. The present review article has the information of some recent patents regarding the insulin resistance in HIV infection. PMID:21824074

  7. Is fluoride-induced hyperthyroidism a cause of psychosis among East African immigrants to Scandinavia?

    PubMed

    Zachariassen, Karl Erik; Flaten, Trond Peder

    2009-05-01

    East African immigrants to Scandinavia are admitted to mental hospitals far more frequently than native Scandinavians. Most of these patients are admitted for psychosis, commonly ascribed to problems adapting to the new culture. However, psychosis is also known to be associated with hyperthyroidism, and the high frequency of psychosis among East Africans in Scandinavia may at least in part be due to hyperthyroidism rather than cultural problems. Large areas in East Africa are notorious for high natural concentrations of fluoride in water and plants. Fluoride inhibits the production of thyroid hormones. To maintain normal thyroxin levels the body increases the capacity for thyroxin production. Goitre is caused by such a compensatory mechanism, and endemic goitre is widespread in many high-fluoride areas, even where dietary access to iodine is adequate. When people from such areas arrive in a low-fluoride area, their elevated capacity to produce thyroid hormones may lead to hyperthyroidism and subsequently to psychosis. PMID:19201548

  8. A mathematical approach to HIV infection dynamics

    NASA Astrophysics Data System (ADS)

    Ida, A.; Oharu, S.; Oharu, Y.

    2007-07-01

    In order to obtain a comprehensive form of mathematical models describing nonlinear phenomena such as HIV infection process and AIDS disease progression, it is efficient to introduce a general class of time-dependent evolution equations in such a way that the associated nonlinear operator is decomposed into the sum of a differential operator and a perturbation which is nonlinear in general and also satisfies no global continuity condition. An attempt is then made to combine the implicit approach (usually adapted for convective diffusion operators) and explicit approach (more suited to treat continuous-type operators representing various physiological interactions), resulting in a semi-implicit product formula. Decomposing the operators in this way and considering their individual properties, it is seen that approximation-solvability of the original model is verified under suitable conditions. Once appropriate terms are formulated to describe treatment by antiretroviral therapy, the time-dependence of the reaction terms appears, and such product formula is useful for generating approximate numerical solutions to the governing equations. With this knowledge, a continuous model for HIV disease progression is formulated and physiological interpretations are provided. The abstract theory is then applied to show existence of unique solutions to the continuous model describing the behavior of the HIV virus in the human body and its reaction to treatment by antiretroviral therapy. The product formula suggests appropriate discrete models describing the dynamics of host pathogen interactions with HIV1 and is applied to perform numerical simulations based on the model of the HIV infection process and disease progression. Finally, the results of our numerical simulations are visualized and it is observed that our results agree with medical and physiological aspects.

  9. Solid organ transplants in HIV-infected patients.

    PubMed

    Harbell, Jack; Terrault, Norah A; Stock, Peter

    2013-09-01

    There is a growing need for kidney and liver transplants in persons living with HIV. Fortunately, with the significant advances in antiretroviral therapy and management of opportunistic infections, HIV infection is no longer an absolute contraindication for solid organ transplantation. Data from several large prospective multi-center cohort studies have shown that solid organ transplantation in carefully selected HIV-infected individuals is safe. However, significant challenges have been identified including prevention of acute rejection, management of drug-drug interactions and treatment of recurrent viral hepatitis. This article reviews the selection criteria, outcomes, and special management considerations for HIV-infected patients undergoing liver or kidney transplantation.

  10. Spatial working memory in asymptomatic HIV-infected subjects.

    PubMed

    Grassi, B; Garghentini, G; Campana, A; Grassi, E; Bertelli, S; Cinque, P; Epifani, M; Lazzarin, A; Scarone, S

    1999-01-01

    Many clinical and research findings converge to indicate that frontal lobe, basal ganglia, and related neuronal connections are primarily involved in human immunodeficiency virus (HIV) infection; frontal lobe, mainly the prefrontal cortex, has a specialized role in working memory processes. This study focused on neuropsychological evaluation of the spatial component of working memory in a sample of 34 asymptomatic HIV-infected subjects as compared with 34 age- and sex-matched seronegative control subjects. A computer-administered test assessing spatial working memory was used for the neuropsychological evaluation. The findings did not show any spatial working memory impairment during the asymptomatic phase of HIV infection.

  11. Nutritional Assessment of Newborns of HIV Infected Mothers.

    PubMed

    Gangar, J

    2009-04-01

    Nutritional status of 50 newborns born to HIV infected mothers in a tertiary care hospital was compared with that of babies born to HIV seronegative mothers, as assessed by birthweight, mid arm circumference to head circumference ratio (MAC/HC), ponderal index (PI), and clinical assessment of nutritional status (CAN) score. The incidence of malnutrition in babies born to HIV infected mothers was 36%, 82%, 20%, and 44% using birth weight, MAC/HC, PI, and CAN scores, respectively, compared to 10%, 56%, 8%, and 22% incidence in babies born to HIV seronegative mothers, respectively. Rate of fetal malnutrition was significantly more in babies born to HIV infected mothers. PMID:19213988

  12. Initiation of the western branch of the East African Rift coeval with the eastern branch

    NASA Astrophysics Data System (ADS)

    Roberts, E. M.; Stevens, N. J.; O'Connor, P. M.; Dirks, P. H. G. M.; Gottfried, M. D.; Clyde, W. C.; Armstrong, R. A.; Kemp, A. I. S.; Hemming, S.

    2012-04-01

    The East African Rift System transects the anomalously high-elevation Ethiopian and East African plateaux that together form part of the 6,000-km-long African superswell structure. Rifting putatively developed as a result of mantle plume activity that initiated under eastern Africa. The mantle activity has caused topographic uplift that has been connected to African Cenozoic climate change and faunal evolution. The rift is traditionally interpreted to be composed of two distinct segments: an older, volcanically active eastern branch and a younger, less volcanic western branch. Here, we show that initiation of rifting in the western branch began more than 14 million years earlier than previously thought, contemporaneously with the eastern branch. We use a combination of detrital zircon geochronology, tephro- and magnetostratigraphy, along with analyses of past river flow recorded in sedimentary rocks from the Rukwa Rift Basin, Tanzania, to constrain the timing of rifting, magmatism and drainage development in this part of the western branch. We find that rift-related volcanism and lake development had begun by about 25million years ago. These events were preceded by pediment development and a fluvial drainage reversal that we suggest records the onset of topographic uplift caused by the African superswell. We conclude that uplift of eastern Africa was more widespread and synchronous than previously recognized.

  13. Recent seismicity of the East African Rift system and its implications

    NASA Astrophysics Data System (ADS)

    Kebede, Fekadu; Kulhánek, Ota

    1991-09-01

    The seismicity of the East African Rift system and southern Red Sea is studied here. Location of earthquake epicenters in East Africa shows that there is a seismicity gap in space and time between the Main Ethiopian Rift system and the eastern rift. However, distribution of earthquake epicenters together with the energy mapping suggest a continuity of seismic activity or stress field from the Main Ethiopian Rift system to the western rift system via the southernmost rifts of Ethiopia. In general (except for some earthquakes which occurred at different complex tectonics regions) mechanisms of earthquakes studied here show dominantly normal faulting suggesting that the rift system is an extensional zone on the continent. The presence of greater focal depth earthquakes to the southern part of the rift system may indicate that softer materials at a shallower depth are present in Afar and neighboring regions than in the remaining part of the East African Rift system. This interpretation is supported by other geophysical studies (low electrical resistivity and gravity data) performed in Afar. It is also supported by low and high stress drops found for the northern part (Afar depression) and southern part of the East African Rift system, respectively.

  14. [Gonadotrophic axis dysfunction in men with HIV-infection/aids].

    PubMed

    Ponte, Clarisse Mourão Melo; Gurgel, Maria Helane Costa; Montenegro, Renan Magalhães

    2009-11-01

    Gonadotrophic axis dysfunction is commonly observed in HIV-infected patients. The pathogenesis is multifactorial and related to duration of HIV infection, direct cytopathic effects of viruses, use of drugs, opportunistic infections, malignancies, and malnutrition, among other factors. In men, reduced levels of testosterone is associated with loss of muscle mass and strength, decreased bone mineral density, lipodystrophy, depression, asthenia, fatigue and sexual dysfunction. In HIV-infected patients with hypogonadism, numerous studies have shown the beneficial effects of testosterone replacement on the metabolic profile and distribution of body fat, with increased body mass weight, and promote better quality of life, reduce the bone mass loss and the rates of depression. Thus, this review aimed to present a brief update of epidemiologic data, pathophysiology aspects and treatment strategies for the major abnormalities of male gonadotrophic axis associated with HIV infection and its treatment.

  15. An Epigenetic Clock Measures Accelerated Aging in Treated HIV Infection.

    PubMed

    Boulias, Konstantinos; Lieberman, Judy; Greer, Eric Lieberman

    2016-04-21

    In this issue of Molecular Cell, Gross et al. (2016) find a CpG DNA methylation signature in blood cells of patients with chronic well-controlled HIV infection that correlates with accelerated aging. PMID:27105110

  16. Pan-African granulites of central Dronning Maud Land and Mozambique: A comparison within the East-African-Antarctic orogen

    USGS Publications Warehouse

    Engvik, A.K.; Elevevold, S.; Jacobs, J.; Tveten, E.; de Azevedo, S.; Njange, F.

    2007-01-01

    Granulite-facies metamorphism is extensively reported in Late Neoproterozoic/Early Palaeozoic time during formation of the East-African-Antarctic orogen (EAAO). Metamorphic data acquired from the Pan-African orogen of central Dronning Maud Land (cDML) are compared with data from northern Mozambique. The metamorphic rocks of cDML are characterised by Opx±Grt-bearing gneisses and Sil+Kfs-bearing metapelites which indicate medium-P granulite-facies metamorphism. Peak conditions, which are estimated to 800-900ºC at pressures up to 1.0 GPa, were followed by near-isothermal decompression during late Pan-African extension and exhumation. Granulite-facies lithologies are widespread in northern Mozambique, and Grt+Cpx-bearing assemblages show that high-P granulite-facies conditions with PT reaching 1.55 GPa and 900ºC were reached during the Pan-African orogeny. Garnet is replaced by symplectites of Pl+Opx+Mag indicating isothermal decompression, and the subsequent formation of Pl+amphibole-coronas suggests cooling into amphibolite facies. It is concluded that high-T metamorphism was pervasive in EAAO in Late Neoproterozoic/Early Paleozoic time, strongly overprinting evidences of earlier metamorphic assemblages.

  17. Seventy years of the East African Medical Journal towards safe motherhood.

    PubMed

    Ojwang, S B

    1993-06-01

    Obstetrical and gynaecological articles related to safe motherhood published in the East African Medical Journal between 1924 and 1989 were reviewed. A total of 133 topics were published. Out of these, 84 (63.2%) were obstetrical and 49 (36.8%) gynaecological. Out of the obstetrical topics, 66 were pregnancy related, 12 were public health and the rest medical topics. A rapid increase in the number of the relevant topics is seen especially after 1970. This is probably due to the increase in the number of of obstetricians training locally in the African region and the international nature of the Journal during the last two decades. PMID:8261963

  18. Multimodality evoked potentials in HIV infected subjects: a longitudinal study.

    PubMed

    Cazzullo, C L; Gala, C; Ducati, A; Landi, A; Donati, R; Russo, R; Rossini, M; Nicolosi, A

    1990-10-01

    18 subjects with symptomless HIV infection were investigated with multimodal evoked potentials for possible CNS involvement and again after an 8-12 month interval. 13 subjects showed neuropsychological changes, which were confirmed at the second examination. The 5 subjects found normal remained so at the second examination. On WAIS assessment the only patient to earn pathological scores was the one with the greatest evoked potentials changes. Thus the evoked potentials procedure proved capable of identifying early CNS involvement by HIV infection.

  19. Intermuscular Adipose Tissue and Metabolic Associations in HIV Infection

    PubMed Central

    Scherzer, Rebecca; Shen, Wei; Heymsfield, Steven B.; Lewis, Cora E.; Kotler, Donald P.; Punyanitya, Mark; Bacchetti, Peter; Shlipak, Michael G.; Grunfeld, Carl

    2013-01-01

    Intermuscular adipose tissue (IMAT) is associated with metabolic abnormalities similar to those associated with visceral adipose tissue (VAT). Increased IMAT has been found in obese human immunodeficiency virus (HIV)-infected women. We hypothesized that IMAT, like VAT, would be similar or increased in HIV-infected persons compared with healthy controls, despite decreases in subcutaneous adipose tissue (SAT) found in HIV infection. In the second FRAM (Study of Fat Redistribution and Metabolic Change in HIV infection) exam, we studied 425 HIV-infected subjects and 211 controls (from the Coronary Artery Risk Development in Young Adults study) who had regional AT and skeletal muscle (SM) measured by magnetic resonance imaging (MRI). Multivariable linear regression identified factors associated with IMAT and its association with metabolites. Total IMAT was 51% lower in HIV-infected participants compared with controls (P = 0.003). The HIV effect was attenuated after multivariable adjustment (to −28%, P < 0.0001 in men and −3.6%, P = 0.70 in women). Higher quantities of leg SAT, upper-trunk SAT, and VAT were associated with higher IMAT in HIV-infected participants, with weaker associations in controls. Stavudine use was associated with lower IMAT and SAT, but showed little relationship with VAT. In multivariable analyses, regional IMAT was associated with insulin resistance and triglycerides (TGs). Contrary to expectation, IMAT is not increased in HIV infection; after controlling for demographics, lifestyle, VAT, SAT, and SM, HIV+ men have lower IMAT compared with controls, whereas values for women are similar. Stavudine exposure is associated with both decreased IMAT and SAT, suggesting that IMAT shares cellular origins with SAT. PMID:20539305

  20. Evaluation of Olfactory and Gustatory Function of HIV Infected Women.

    PubMed

    Fasunla, Ayotunde James; Daniel, Adekunle; Nwankwo, Ukamaka; Kuti, Kehinde Mobolanle; Nwaorgu, Onyekwere George; Akinyinka, Olusina Olusegun

    2016-01-01

    Background. Compliance with medication requires good sense of smell and taste. Objective. To evaluate the olfactory and gustatory function of HIV infected women in Ibadan, Nigeria. Methods. A case control study of women comprising 83 HIV infected women and 79 HIV uninfected women. Subjective self-rating of taste and smell function was by visual analogue scale. Olfactory function was measured via olfactory threshold (OT), olfactory discrimination (OD), olfactory identification (OI), and TDI using "Sniffin' sticks" kits and taste function (Total Taste Strips (TTS) score) measurement was by taste strips. Results. The mean age of the HIV infected women was 43.67 years ± 10.72 and control was 41.48 years ± 10.99. There was no significant difference in the self-reported assessment of smell (p = 0.67) and taste (p = 0.84) of HIV infected and uninfected women. Although the mean OT, OD, OI, TDI, and TTS scores of HIV infected and uninfected women were within the normosmic and normogeusic values, the values were significantly higher in the controls (p < 0.05). Hyposmia was in 39.7% of subjects and 12.6% of controls while hypogeusia was in 15.7% of subjects and 1.3% of controls. Conclusions. Hyposmia and hypogeusia are commoner among the HIV infected women than the HIV uninfected women and the risk increases with an increased duration of highly active antiretroviral therapy. PMID:27047688

  1. Evaluation of Olfactory and Gustatory Function of HIV Infected Women

    PubMed Central

    Kuti, Kehinde Mobolanle; Nwaorgu, Onyekwere George; Akinyinka, Olusina Olusegun

    2016-01-01

    Background. Compliance with medication requires good sense of smell and taste. Objective. To evaluate the olfactory and gustatory function of HIV infected women in Ibadan, Nigeria. Methods. A case control study of women comprising 83 HIV infected women and 79 HIV uninfected women. Subjective self-rating of taste and smell function was by visual analogue scale. Olfactory function was measured via olfactory threshold (OT), olfactory discrimination (OD), olfactory identification (OI), and TDI using “Sniffin' sticks” kits and taste function (Total Taste Strips (TTS) score) measurement was by taste strips. Results. The mean age of the HIV infected women was 43.67 years ± 10.72 and control was 41.48 years ± 10.99. There was no significant difference in the self-reported assessment of smell (p = 0.67) and taste (p = 0.84) of HIV infected and uninfected women. Although the mean OT, OD, OI, TDI, and TTS scores of HIV infected and uninfected women were within the normosmic and normogeusic values, the values were significantly higher in the controls (p < 0.05). Hyposmia was in 39.7% of subjects and 12.6% of controls while hypogeusia was in 15.7% of subjects and 1.3% of controls. Conclusions. Hyposmia and hypogeusia are commoner among the HIV infected women than the HIV uninfected women and the risk increases with an increased duration of highly active antiretroviral therapy. PMID:27047688

  2. Women and HIV infection: the makings of a midlife crisis.

    PubMed

    Santoro, Nanette; Fan, Maria; Maslow, BatSheva; Schoenbaum, Ellie

    2009-11-20

    With the advent of highly active antiretroviral agents, women with HIV infection can expect to live longer than ever before. This increased survival has led to concerns about the long-term implications of HIV disease and its treatment. Women with HIV infection appear to lose ovarian function earlier in life than women without HIV infection. They also have evidence of reduced bone mineral density and increased cardiovascular risk. Moreover, many of these increases in risk factors are present even prior to the menopausal transition. All of these risks, present at midlife, augur poorly for future health and describe a substantially increased burden of disease likely to accrue to HIV-infected women as they enter older age groups. Further compounding the adversity faced by the HIV infected, the demographics of women most vulnerable to this disease include adverse social and economic influences, both of which worsen their long-term prognosis. For example, drug use and poverty are related to more severe menopausal symptoms and chronic stress is related to worse psychological and cardiovascular risk. An understanding of how menopause interacts with HIV infection is therefore most important to alert the clinician to perform surveillance for common health problems in postmenopausal women, and to address directly and appropriately symptomatology during the menopausal transition. PMID:19783389

  3. Effects of tobacco smoking on HIV-infected individuals.

    PubMed

    Calvo, Marta; Laguno, Montserrat; Martínez, María; Martínez, Esteban

    2015-01-01

    A longer life expectancy and a high prevalence of tobacco smoking among HIV patients have led to an increasing cumulative exposure to tobacco in this community. Clinical recommendations for smoking cessation in HIV patients are mainly based on the body of evidence from the general population plus few available data from HIV cohort studies. The assumption that the pathophysiology of tobacco-related diseases in HIV-infected patients is similar to that in the general population may be questionable. This article reviews the pathophysiological mechanisms underlying health problems attributable to tobacco in HIV patients, and how these mechanisms may interact with those of HIV infection. Tobacco smoking exerts a greater health impact on HIV-infected patients than on uninfected smokers. Components of tobacco smoke and HIV infection induce complex interrelated pathophysiological changes through different pathways, affecting various organ systems with a cumulative or synergistic effect. This review supports the contention that HIV infection may confer an increased susceptibility to the harmful effects of smoking. Tobacco-related harm in the setting of HIV infection is still underestimated. A better understanding of the pathophysiological interaction between tobacco smoking and HIV will help to promote smoking cessation in this specific population.

  4. Substance Use in Older HIV-Infected Patients

    PubMed Central

    Edelman, E. Jennifer; Tetrault, Jeanette M.; Fiellin, David A.

    2014-01-01

    Purpose of the Review Substance use may persist throughout the life course and has a substantial impact on health outcomes globally. As HIV-infected individuals are disproportionately impacted by substance use and living longer, it is critical that providers and researchers alike understand the impact of substance use on older, HIV-infected patients and potential treatment options. To this end, we conducted a review of the literature focusing on the most commonly used substances to outline the epidemiology, health consequences, treatment options and latest research relevant to older, HIV-infected patients. Recent Findings Substance use impacts older, HIV-infected patients with regards to HIV-related and non-HIV related outcomes. Counseling strategies are available for marijuana and stimulant use disorders. Brief counseling is useful alongside medications for alcohol, tobacco and opioid use disorders. Many medications for alcohol, tobacco, and opioid use disorders are safe in the setting of antiretroviral therapy. Unfortunately, few interventions targeting substance use in older, HIV-infected patients have been developed and evaluated. Summary As older, HIV-infected patients continue to experience substance use and its related health consequences, there will be a growing need for the development of safe and effective interventions which address the complex needs of this population. PMID:24824888

  5. Spatial Distributions of HIV Infection in an Endemic Area of Western Kenya: Guiding Information for Localized HIV Control and Prevention.

    PubMed

    Hoshi, Tomonori; Fuji, Yoshito; Nzou, Samson Muuo; Tanigawa, Chihiro; Kiche, Ibrahim; Mwau, Matilu; Mwangi, Anne Wanjiru; Karama, Mohamed; Hirayama, Kenji; Goto, Kensuke; Kaneko, Satoshi

    2016-01-01

    HIV is still a major health problem in developing countries. Even though high HIV-risk-taking behaviors have been reported in African fishing villages, local distribution patterns of HIV infection in the communities surrounding these villages have not been thoroughly analyzed. The objective of this study was to investigate the geographical distribution patterns of HIV infection in communities surrounding African fishing villages. In 2011, we applied age- and sex-stratified random sampling to collect 1,957 blood samples from 42,617 individuals registered in the Health and Demographic Surveillance System in Mbita, which is located on the shore of Lake Victoria in western Kenya. We used these samples to evaluate existing antibody detection assays for several infectious diseases, including HIV antibody titers. Based on the results of the assays, we evaluated the prevalence of HIV infection according to sex, age, and altitude of participating households. We also used Kulldorff's spatial scan statistic to test for HIV clustering in the study area. The prevalence of HIV at our study site was 25.3%. Compared with the younger age group (15-19 years), adults aged 30-34 years were 6.71 times more likely to be HIV-positive, and the estimated HIV-positive population among women was 1.43 times larger than among men. Kulldorff's spatial scan statistic detected one marginally significant (P = 0.055) HIV-positive and one significant HIV-negative cluster (P = 0.047) in the study area. These results suggest a homogeneous HIV distribution in the communities surrounding fishing villages. In addition to individual behavior, more complex and diverse factors related to the social and cultural environment can contribute to a homogeneous distribution pattern of HIV infection outside of African fishing villages. To reduce rates of transmission in HIV-endemic areas, HIV prevention and control programs optimized for the local environment need to be developed.

  6. Spatial Distributions of HIV Infection in an Endemic Area of Western Kenya: Guiding Information for Localized HIV Control and Prevention.

    PubMed

    Hoshi, Tomonori; Fuji, Yoshito; Nzou, Samson Muuo; Tanigawa, Chihiro; Kiche, Ibrahim; Mwau, Matilu; Mwangi, Anne Wanjiru; Karama, Mohamed; Hirayama, Kenji; Goto, Kensuke; Kaneko, Satoshi

    2016-01-01

    HIV is still a major health problem in developing countries. Even though high HIV-risk-taking behaviors have been reported in African fishing villages, local distribution patterns of HIV infection in the communities surrounding these villages have not been thoroughly analyzed. The objective of this study was to investigate the geographical distribution patterns of HIV infection in communities surrounding African fishing villages. In 2011, we applied age- and sex-stratified random sampling to collect 1,957 blood samples from 42,617 individuals registered in the Health and Demographic Surveillance System in Mbita, which is located on the shore of Lake Victoria in western Kenya. We used these samples to evaluate existing antibody detection assays for several infectious diseases, including HIV antibody titers. Based on the results of the assays, we evaluated the prevalence of HIV infection according to sex, age, and altitude of participating households. We also used Kulldorff's spatial scan statistic to test for HIV clustering in the study area. The prevalence of HIV at our study site was 25.3%. Compared with the younger age group (15-19 years), adults aged 30-34 years were 6.71 times more likely to be HIV-positive, and the estimated HIV-positive population among women was 1.43 times larger than among men. Kulldorff's spatial scan statistic detected one marginally significant (P = 0.055) HIV-positive and one significant HIV-negative cluster (P = 0.047) in the study area. These results suggest a homogeneous HIV distribution in the communities surrounding fishing villages. In addition to individual behavior, more complex and diverse factors related to the social and cultural environment can contribute to a homogeneous distribution pattern of HIV infection outside of African fishing villages. To reduce rates of transmission in HIV-endemic areas, HIV prevention and control programs optimized for the local environment need to be developed. PMID:26862764

  7. Spatial Distributions of HIV Infection in an Endemic Area of Western Kenya: Guiding Information for Localized HIV Control and Prevention

    PubMed Central

    Hoshi, Tomonori; Fuji, Yoshito; Nzou, Samson Muuo; Tanigawa, Chihiro; Kiche, Ibrahim; Mwau, Matilu; Mwangi, Anne Wanjiru; Karama, Mohamed; Hirayama, Kenji; Goto, Kensuke; Kaneko, Satoshi

    2016-01-01

    HIV is still a major health problem in developing countries. Even though high HIV-risk-taking behaviors have been reported in African fishing villages, local distribution patterns of HIV infection in the communities surrounding these villages have not been thoroughly analyzed. The objective of this study was to investigate the geographical distribution patterns of HIV infection in communities surrounding African fishing villages. In 2011, we applied age- and sex-stratified random sampling to collect 1,957 blood samples from 42,617 individuals registered in the Health and Demographic Surveillance System in Mbita, which is located on the shore of Lake Victoria in western Kenya. We used these samples to evaluate existing antibody detection assays for several infectious diseases, including HIV antibody titers. Based on the results of the assays, we evaluated the prevalence of HIV infection according to sex, age, and altitude of participating households. We also used Kulldorff’s spatial scan statistic to test for HIV clustering in the study area. The prevalence of HIV at our study site was 25.3%. Compared with the younger age group (15–19 years), adults aged 30–34 years were 6.71 times more likely to be HIV-positive, and the estimated HIV-positive population among women was 1.43 times larger than among men. Kulldorff’s spatial scan statistic detected one marginally significant (P = 0.055) HIV-positive and one significant HIV-negative cluster (P = 0.047) in the study area. These results suggest a homogeneous HIV distribution in the communities surrounding fishing villages. In addition to individual behavior, more complex and diverse factors related to the social and cultural environment can contribute to a homogeneous distribution pattern of HIV infection outside of African fishing villages. To reduce rates of transmission in HIV-endemic areas, HIV prevention and control programs optimized for the local environment need to be developed. PMID:26862764

  8. Lung cancer in HIV-infected patients

    PubMed Central

    Palacios, R; Lebrón, J; Guerrero-León, M; Del Arco, A; Colmenero, J; Márquez, M; Santos, J

    2012-01-01

    Purpose Several studies have shown that HIV patients are at higher risk of lung cancer. Our aim is to analyse the prevalence and features of lung cancer in HIV-infected patients. Methods The clinical charts of 4,721 HIV-infected patients seen in three hospitals of southeast Spain (study period 1992–2012) were reviewed, and all patients with a lung cancer were analysed. Results There were 61 lung cancers, giving a prevalence of 1.2%. There was a predominance of men (82.0%), and smokers (96.6%; mean pack-years 35.2), with a median age of 48.0 (41.7–52.9) years, and their distribution according to risk group for HIV was: intravenous drug use 58.3%, homosexual 20.0%, and heterosexual 16.7%. Thirty-four (56.7%) patients were Aids cases, and 29 (47.5%) had prior pulmonar events: tuberculosis 16, bacterial pneumonia 9, and P. jiroveci pneumonia 4. The median nadir CD4 count was 149/mm3 (42–232), the median CD4 count at the time of diagnosis of the lung cancer was 237/mm3 (85–397), and 66.1%<350/mm3. 66.7% were on ART, and 70% of them had undetectable HIV viral load. The most common histological types of lung cancer were adenocarcinoma and epidermoid, with 24 (40.0%) and 23 (38.3%) cases, respectively. There were 49 (80.3%) cases with advanced stages (III and IV) at diagnosis. The distribution of treatments was: only palliative 23 (39.7%), chemotherapy 14 (24.1%), surgery and chemotherapy 8 (13.8%), radiotherapy 7 (12.1%), surgery 4 (6.9%), and other combined treatments 2 (3.4%). Forty-six (76.7%) patients died, with a median survival time of 3 months. The Kaplan-Meier survival rate at 6 months was 42.7% (at 12 months 28.5%). Conclusions The prevalence of lung cancer in this cohort of HIV-patients is high. People affected are mainly men, smokers, with transmission of HIV by intravenous drug use, and around half of them with prior opportunistic pulmonary events. Most patients had low nadir CD4 count, and were immunosuppressed at the time of diagnosis. Adenocarcinoma

  9. Persisting high prevalence of pneumococcal carriage among HIV-infected adults receiving antiretroviral therapy in Malawi: a cohort study

    PubMed Central

    Heinsbroek, Ellen; Tafatatha, Terence; Phiri, Amos; Ngwira, Bagrey; Crampin, Amelia C.; Read, Jonathan M.; French, Neil

    2015-01-01

    Objective: HIV-infected adults have high rates of pneumococcal carriage and invasive disease. We investigated the effect of antiretroviral therapy (ART) on pneumococcal carriage in HIV-infected adults prior to infant pneumococcal conjugate vaccine (PCV) rollout. Design: Observational cohort study. Methods: We recruited HIV-infected adults newly attending a rural HIV clinic in northern Malawi between 2008 and 2010. Nasopharyngeal samples were taken at baseline and after 6, 12, 18 and 24 months. We compared pneumococcal carriage by ART status using generalized estimated equation models adjusted for CD4+ cell count, sex, seasonality, and other potential confounders. Results: In total, 336 individuals were included, of which 223 individuals started ART during follow-up. Individuals receiving ART had higher pneumococcal carriage than individuals not receiving ART (25.9 vs. 19.8%, P = 0.03) particularly for serotypes not included in PCV13 (16.1 vs. 9.6% P = 0.003). Following adjustment, increased carriage of non-PCV13 serotypes was still observed for individuals on ART, but results for all serotypes were nonsignificant [all serotypes: adjusted risk ratio (aRR) 1.22 (0.95–1.56); non-PCV13 serotypes: aRR 1.72, 95% CI 1.13–2.62]. Conclusion: Pneumococcal carriage in HIV-infected adults in Malawi remained high despite use of ART, consistent with failure of mucosal immune reconstitution in the upper respiratory tract. There was evidence of increased carriage of non-PCV13 serotypes. HIV-infected adults on ART could remain an important reservoir for pneumococcal diversity post infant pneumococcal vaccine introduction. Control of pneumococcal disease in African HIV remains a priority. PMID:26218599

  10. East African wetland-catchment data base for sustainable wetland management

    NASA Astrophysics Data System (ADS)

    Leemhuis, Constanze; Amler, Esther; Diekkrüger, Bernd; Gabiri, Geofrey; Näschen, Kristian

    2016-10-01

    Wetlands cover an area of approx. 18 Mio ha in the East African countries of Kenya, Rwanda, Uganda and Tanzania, with still a relative small share being used for food production. Current upland agricultural use intensification in these countries due to demographic growth, climate change and globalization effects are leading to an over-exploitation of the resource base, followed by an intensification of agricultural wetland use. We aim on translating, transferring and upscaling knowledge on experimental test-site wetland properties, small-scale hydrological processes, and water related ecosystem services under different types of management from local to national scale. This information gained at the experimental wetland/catchment scale will be embedded as reference data within an East African wetland-catchment data base including catchment physical properties and a regional wetland inventory serving as a base for policy advice and the development of sustainable wetland management strategies.

  11. A new brachypterous scarab species, Orphnus longicornis (Coleoptera: Scarabaeidae: Orphninae), from the East African Rift.

    PubMed

    Frolov, Andrey; Akhmetova, Lilia

    2015-11-05

    The Afrotropical Region is the center of the diversity of the scarab beetle genus Orphnus MacLeay, 1819 (Coleoptera: Scarabaeidae: Orphninae), with 94 species occurring from Sahel in the north to Little Karoo in the south (Paulian, 1948; Petrovitz, 1971; Frolov, 2008). The East African Rift is one of the richest regions of the Afrotropics housing more than 20 species of Orphnus (Paulian, 1948; Frolov, 2013), most of which are endemic to this region. Yet the scarab beetle fauna of the East African Rift, and especially the Eastern Arc Mountains, is still inadequately studied. Examination of the material housed in the Museum of Natural History of Humboldt-Universität, Berlin, Germany (ZMHUB), revealed a series of brachypterous Orphnus beetles belonging to an undescribed species. The new species is described and illustrated below.

  12. Feasibility of interactive videodisc technology to teach minority youth about preventing HIV infection.

    PubMed

    Schinke, S P; Orlandi, M A; Schilling, R F; Parms, C

    1992-01-01

    Hispanic and African American adolescents are more likely than white Anglo youth to harbor misconceptions about acquired immunodeficiency syndrome (AIDS) and are also more likely to engage in intravenous drug use and sexual intercourse. This paper describes the development of an AIDS prevention curriculum that uses an interactive videodisc program to teach skills for interventions. Focus group and expert panel studies yielded suggests for intervention vignettes and scenes relevant to Hispanic and African American adolescents. The authors then developed and produced a sample curriculum, specifically designed for Hispanic youth. Content was designed to build knowledge, attitudes, and skills in handling situations where young persons are at risk for human immunodeficiency virus (HIV) infection. The feasibility of the finished pilot product was tested with adolescents and with professionals who serve ethnic and racial minority youth. Adults and Hispanic adolescent viewers rated the videodisc as enjoyable, interesting, and likely to achieve positive effects with the intended target population. Findings suggest that the interactive videodisc is a useful way to interest and help Hispanic adolescents learn ways of reducing their risk of contracting and spreading HIV infection through lifestyle practices. This developmental research in the use of interactive videodisc also provides a basis for further investigation. PMID:1375760

  13. Latitudinal Hydrologic Variability Along the East African Rift, Over the Past 200 Kyr

    NASA Astrophysics Data System (ADS)

    Scholz, C. A.

    2014-12-01

    Within the deep sediments of the large lakes of Africa's Great Rift Valley are continuous environmental records of remarkable antiquity and fidelity. Not only do stratigraphic sections from these basins extend back millions of years, many of the intervals represented contain high-resolution material of decadal resolution or better. East African lake basins remain sparsely sampled however, with only a few long and continuous records available. Our ability to image the lakes using seismic reflection methods greatly exceeds our opportunities for coring and drilling however; assessing stratal relationships observed in the geophysical data permits powerful inferences about past hydrologic changes. With intensive hydrocarbon exploration work underway in East Africa, industry well data can also help constrain and ground truth basin histories. Substantial spatio-temporal hydrologic variability is observed in East African basins over the past 200 kyr. Paleohydrological changes in the late Pleistocene and early Holocene are now well constrained in the northern hemisphere East African topics, with widespread aridity and in some cases lake desiccation observed during Heinrich Event 1. A climate recovery followed in the northern hemisphere East African tropics, with the early Holocene African Humid Period a time of positive water balance across most of the rift valley. The paleohydrology of southern hemisphere tropical East Africa is more equivocal, for instance with negligible draw-down of Lake Malawi at HE1. Whereas these late Pleistocene events represent substantial climate reorganizations, severe droughts during the middle-late Pleistocene (150-65 kyr BP) were far more intense, and produced much more severe drawdowns of Lakes Malawi and Tanganyika. Scientific drill cores, kullenberg cores, and extensive seismic reflection data sets from Lakes Malawi and Tanganyika provide indisputable evidence for lowstands of -500m and -600 m respectively. Climate changes that lowered the

  14. Predicting and attributing recent East African Spring droughts with dynamical-statistical climate model ensembles

    NASA Astrophysics Data System (ADS)

    Funk, C. C.; Shukla, S.; Hoerling, M. P.; Robertson, F. R.; Hoell, A.; Liebmann, B.

    2013-12-01

    During boreal spring, eastern portions of Kenya and Somalia have experienced more frequent droughts since 1999. Given the region's high levels of food insecurity, better predictions of these droughts could provide substantial humanitarian benefits. We show that dynamical-statistical seasonal climate forecasts, based on the latest generation of coupled atmosphere-ocean and uncoupled atmospheric models, effectively predict boreal spring rainfall in this area. Skill sources are assessed by comparing ensembles driven with full-ocean forcing with ensembles driven with ENSO-only sea surface temperatures (SSTs). Our analysis suggests that both ENSO and non-ENSO Indo-Pacific SST forcing have played an important role in the increase in drought frequencies. Over the past 30 years, La Niña drought teleconnections have strengthened, while non-ENSO Indo-Pacific convection patterns have also supported increased (decreased) Western Pacific (East African) rainfall. To further examine the relative contribution of ENSO, low frequency warming and the Pacific Decadal Oscillation, we present decompositions of ECHAM5, GFS, CAM4 and GMAO AMIP simulations. These decompositions suggest that rapid warming in the western Pacific and steeper western-to-central Pacific SST gradients have likely played an important role in the recent intensification of the Walker circulation, and the associated increase in East African aridity. A linear combination of time series describing the Pacific Decadal Oscillation and the strength of Indo-Pacific warming are shown to track East African rainfall reasonably well. The talk concludes with a few thoughts linking the potentially important interplay of attribution and prediction. At least for recent East African droughts, it appears that a characteristic Indo-Pacific SST and precipitation anomaly pattern can be linked statistically to support forecasts and attribution analyses. The combination of traditional AGCM attribution analyses with simple yet

  15. Toxoplasmosis in HIV infection: An overview

    PubMed Central

    Basavaraju, Anuradha

    2016-01-01

    Toxoplasma gondii is an obligate intracellular protozoan parasite presenting as a zoonotic infection distributed worldwide. In HIV-positive individuals, it causes severe opportunistic infections, which is of major public health concern as it results in physical and psychological disabilities. In healthy immunocompetent individuals, it causes asymptomatic chronic persistent infections, but in immunosuppressed patients, there is reactivation of the parasite if the CD4 counts fall below 200 cells/μl. The seroprevalence rates are variable in different geographic areas. The tissue cyst or oocyst is the infective form which enters by ingestion of contaminated meat and transform into tachyzoites and disseminate into blood stream. In immunocompetent persons due to cell-mediated immunity the parasite is transformed into tissue cyst resulting in life long chronic infection. In HIV-infected people opportunistic infection by T. gondii occurs due to depletion of CD4 cells, decreased production of cytokines and interferon gamma and impaired cytotoxic T-lymphocyte activity resulting in reactivation of latent infection. The diagnosis can be done by clinical, serological, radiological, histological or molecular methods, or by the combination of these. There is various treatment regimen including acute treatment, maintenance therapy should be given as the current anti T. gondii therapy cannot eradicate tissue cysts. In HIV patients, CD4 counts <100; cotrimoxazole, alternately dapsone + pyrimethamine can be given for 6 months. Hence, early diagnosis of T. gondii antibodies is important in all HIV-positive individuals to prevent complications of cerebral toxoplasmosis. PMID:27722101

  16. Post-treatment control of HIV infection

    SciTech Connect

    Conway, Jessica M.; Perelson, Alan S.

    2015-04-13

    Antiretroviral therapy (ART) for HIV is not a cure. However, recent studies suggest that ART, initiated early during primary infection, may induce post-treatment control (PTC) of HIV infection with HIV RNA maintained at <50 copies per mL. We investigate the hypothesis that ART initiated early during primary infection permits PTC by limiting the size of the latent reservoir, which, if small enough at treatment termination, may allow the adaptive immune response to prevent viral rebound (VR) and control infection. We use a mathematical model of within host HIV dynamics to capture interactions among target cells, productively infected cells, latently infected cells, virus, and cytotoxic T lymphocytes (CTLs). Analysis of our model reveals a range in CTL response strengths where a patient may show either VR or PTC, depending on the size of the latent reservoir at treatment termination. Below this range, patients will always rebound, whereas above this range, patients are predicted to behave like elite controllers. As a result, using data on latent reservoir sizes in patients treated during primary infection, we also predict population-level VR times for non-controllers consistent with observations.

  17. Post-treatment control of HIV infection

    DOE PAGES

    Conway, Jessica M.; Perelson, Alan S.

    2015-04-13

    Antiretroviral therapy (ART) for HIV is not a cure. However, recent studies suggest that ART, initiated early during primary infection, may induce post-treatment control (PTC) of HIV infection with HIV RNA maintained at <50 copies per mL. We investigate the hypothesis that ART initiated early during primary infection permits PTC by limiting the size of the latent reservoir, which, if small enough at treatment termination, may allow the adaptive immune response to prevent viral rebound (VR) and control infection. We use a mathematical model of within host HIV dynamics to capture interactions among target cells, productively infected cells, latently infectedmore » cells, virus, and cytotoxic T lymphocytes (CTLs). Analysis of our model reveals a range in CTL response strengths where a patient may show either VR or PTC, depending on the size of the latent reservoir at treatment termination. Below this range, patients will always rebound, whereas above this range, patients are predicted to behave like elite controllers. As a result, using data on latent reservoir sizes in patients treated during primary infection, we also predict population-level VR times for non-controllers consistent with observations.« less

  18. Nanotechnology and the Treatment of HIV Infection

    PubMed Central

    Parboosing, Raveen; Maguire, Glenn E. M.; Govender, Patrick; Kruger, Hendrik G.

    2012-01-01

    Suboptimal adherence, toxicity, drug resistance and viral reservoirs make the lifelong treatment of HIV infection challenging. The emerging field of nanotechnology may play an important role in addressing these challenges by creating drugs that possess pharmacological advantages arising out of unique phenomena that occur at the “nano” scale. At these dimensions, particles have physicochemical properties that are distinct from those of bulk materials or single molecules or atoms. In this review, basic concepts and terms in nanotechnology are defined, and examples are provided of how nanopharmaceuticals such as nanocrystals, nanocapsules, nanoparticles, solid lipid nanoparticles, nanocarriers, micelles, liposomes and dendrimers have been investigated as potential anti-HIV therapies. Such drugs may, for example, be used to optimize the pharmacological characteristics of known antiretrovirals, deliver anti-HIV nucleic acids into infected cells or achieve targeted delivery of antivirals to the immune system, brain or latent reservoirs. Also, nanopharmaceuticals themselves may possess anti-HIV activity. However several hurdles remain, including toxicity, unwanted biological interactions and the difficulty and cost of large-scale synthesis of nanopharmaceuticals. PMID:22590683

  19. HIV infection and intervention: the first decade.

    PubMed

    Beck, E J

    1991-01-01

    Integrated intervention strategies, appropriate to the specific socioeconomic context, are required to address the needs of the 18 million adults projected to be infected with the human immunodeficiency virus (HIV) by the year 2000. Such interventions must operate on two levels. The first is aimed at minimizing the devastating effects of HIV and acquired immunodeficiency syndrome (AIDS) on individuals, while the second is geared toward halting HIV transmission in populations. The median two-year survival time for people with AIDS had doubled from 10 months before 1987 to 20 months in 1990, primarily because of treatments such as zidovudine that slow down the rate of virus replication, but AIDS patients who survive longer develop more intractable opportunistic infections than in the past. Viral transmission throughout populations can be halted only through a comprehensive strategy that addresses agent, host, and environmental factors in a complementary manner. For example, whether or not high-risk individuals will be willing and able to adopt safer sex practices depends, in large part, on the social, economic, and psychological forces acting on and within those individuals. Finally, public attitudes toward sexuality, drug use, and racial discrimination comprise the moral context in which AIDS prevention strategies must be implemented. The mass media, which have already created public awareness of the problem and corrected many misconceptions, must continue to motivate individuals to adopt behavioral changes that reduce the risk of HIV infection.

  20. HIV infection in traditional rural communities.

    PubMed

    Carwein, V L; Sabo, C E; Berry, D E

    1993-03-01

    The challenge to rural nurses to deliver knowledgeable and skilled nursing and health care to individuals with HIV infection and AIDS is indeed tremendous. Isolation of rural communities and health care facilities coupled with limited resources, financial concerns, conservative values of many traditional rural communities, and the tendency to exclude those who do not conform to community norms make it difficult to integrate the individual with HIV disease into the rural health care delivery system fully. Issues of particular concern to the rural nurse include maintenance of client confidentiality, obtaining and maintaining current knowledge and skills necessary to the provision of quality HIV nursing care, management of complex client health care problems, and provision of appropriate support services. Rural nurses must be innovative and creative in developing mechanisms to deal with these concerns. In addition, because rural nurses are well respected by the community and viewed as possessing a great deal of expertise in the delivery of health care, they are well positioned to provide leadership to the community in developing educational and care strategies to more effectively provide HIV care. Indeed, the delivery of high-quality HIV care in rural areas across the United States will likely depend on the expertise and leadership provided by rural nurses. PMID:8451211

  1. Zidovudine and Lamivudine for HIV Infection

    PubMed Central

    Anderson, Peter L.; Rower, Joseph E.

    2010-01-01

    Zidovudine and lamivudine (ZDV and 3TC) are long-standing nucleoside analog-reverse transcriptase inhibitors (NRTIs) with extensive clinical experience in a wide spectrum of patients from in utero through childhood and adult ages. The safety profiles of both drugs are well-known and side effects for ZDV most commonly include nausea/vomiting, fatigue, anemia/neutopenia, and lipoatrophy; while 3TC is well-tolerated. ZDV-3TC is currently a viable alternative NRTI backbone for initial three-drug therapy of HIV infection when tenofovir disoproxil fumarate-emtricitabine (TDF-FTC) cannot be used because of a relative or absolute contraindication. ZDV-3TC continue to be viable alternatives for children, pregnant women and in resource limited settings where other recommended options are not readily available. ZDV-3TC penetrate the Central Nervous System (CNS) well, which makes ZDV-3TC attractive for use in patients with HIV-associated neurological deficits. Additional benefits of these drugs may include the use of ZDV in combination with certain NRTIs to exert selective pressure to prevent particular drug resistance mutations from developing, and giving a short course of ZDV-3TC to prevent resistance after prophylactic single dose nevirapine. PMID:20953318

  2. A case of symptomatic primary HIV infection.

    PubMed

    Kobayashi, Satomi; Segawa, Satoko; Kawashima, Makoto; Itoda, Ichiro; Shima, Takako; Imai, Mitsunobu

    2005-02-01

    A 30-year-old homosexual Japanese man had fourteen days of fever, malaise, appetite loss, sore throat, and four days of diarrhea and slightly congested eyes before he developed a skin eruption. He presented with measles-like exanthems on his face, trunk, and extremities. Deep red enanthems were seen on his left buccal mucosa opposite the premolar teeth, and whitish enanthems were seen on the buccal and gingival mucosa. HIV RNA was detected at the high concentration of 5.8 x 10(6) copies /ml in his serum. Cerebrospinal fluid examination revealed aseptic meningitis with 5,488 copies /ml of HIV RNA. Anti-HIV 1 antibodies against Gp160 and p24 tested by Western blot assay showed seroconversion on day 5 of his admission, seven days after he developed the skin eruptions. The fever lasted for three weeks from the initial onset, and the skin eruptions lasted for twelve days. Histopathologically, a mononuclear cell infiltration was seen mainly in the upper dermis surrounding small vessels and sweat ducts, with CD8+ cytotoxic T lymphocytes predominant. Additionally, CD1a+ putative interdigitating dendritic cells had also infiltrated perivascularly, and were surrounded by CD8+ and CD4+ T cells. In situ hybridization study failed to detect HIV products in skin biopsy specimens. Our findings suggested that CD8+ T cells and their interaction with CD1a+ dendritic cells in the skin may be important in inducing skin manifestations in acute HIV infections. PMID:15906546

  3. Trends and variability of East African rainfall and its relationship to the Mascarene High pressure system

    NASA Astrophysics Data System (ADS)

    Seregina, Larisa; Pinto, Joaquim G.; Fink, Andreas H.; Ermert, Volker

    2016-04-01

    In the recent decades, East Africa needs to deal with strong fluctuations in seasonal rainfall including precipitation extremes. In context of climate change, such extremes can become more frequent in the future. However, regional climate projections are uncertain about the future development of seasonal precipitation in the region. Rainfall regimes over East Africa are influenced by multiple factors, including two monsoon systems, several convergence zones and the Rift Valley lakes. In addition, local conditions, like topography, modulate the large-scale rainfall pattern. East African rainfall variability is also influenced by various teleconnections like the Indian Ocean Zonal Mode and El Niño Southern Oscillation. The study of past climate variability in East Africa requires sufficient observational data coverage in the region. As East Africa does not have a dense observational network of meteorological stations, satellite rainfall observations gain on importance in studies on climate variability in the region. The specific aim of the present study is the analysis of historic data from weather stations in East Africa (Kenya, Tanzania, Ruanda and Uganda), the use of gridded satellite products, and three-dimensional atmospheric reanalysis (e.g., ERA-Interim) to quantify climate variability in the recent past and to understand its causes. Climate variability and trends, including changes in extreme events, are evaluated using ETCCDI climate change and standardized precipitation indices. These climate indices are determined in order to investigate the variability of rainfall and its trends with the focus on recent decades. For seasonal trend analysis, an independent and non-calendaric rainfall onset criterion is introduced. In the follow-up, statistical and dynamical analyses are conducted to quantify the local impact of Mascarene High as a part of the Subtropical High Pressure Ridge on East African seasonal rainfall. Possible connections to pertinent large

  4. Investigating "mass hysteria" in early postcolonial Uganda: Benjamin H. Kagwa, East african psychiatry, and the Gisu.

    PubMed

    Pringle, Yolana

    2015-01-01

    In the early 1960s, medical officers and administrators began to receive reports of what was being described as "mass madness" and "mass hysteria" in Tanganyika (now Tanzania) and Uganda. Each epidemic reportedly affected between three hundred and six hundred people and, coming in the wake of independence from colonial rule, caused considerable concern. One of the practitioners sent to investigate was Benjamin H. Kagwa, a Ugandan-born psychiatrist whose report represents the first investigation by an African psychiatrist in East Africa. This article uses Kagwa's investigation to explore some of the difficulties facing East Africa's first generation of psychiatrists as they took over responsibility for psychiatry. During this period, psychiatrists worked in an intellectual climate that was both attempting to deal with the legacy of colonial racism, and which placed faith in African psychiatrists to reveal more culturally sensitive insights into African psychopathology. The epidemics were the first major challenge for psychiatrists such as Kagwa precisely because they appeared to confirm what colonial psychiatrists had been warning for years-that westernization would eventually result in mass mental instability. As this article argues, however, Kagwa was never fully able to free himself from the practices and assumptions that had pervaded his discipline under colonial rule. His analysis of the epidemics as a "mental conflict" fit into a much longer tradition of psychiatry in East Africa, and stood starkly against the explanations of the local community.

  5. Post-Pan-African tectonic evolution of South Malawi in relation to the Karroo and recent East African rift systems

    NASA Astrophysics Data System (ADS)

    Castaing, C.

    1991-05-01

    Structural studies conducted in the Lengwe and Mwabvi Karroo basins and in the basement in South Malawi, using regional maps and published data extended to cover Southeast Africa, serve to propose a series of geodynamic reconstructions which reveal the persistence of an extensional tectonic regime, the minimum stress σ3 of which has varied through time. The period of Karroo rifting and the tholeiitic and alkaline magmatism which terminated it, were controlled by NW-SE extension, which resulted in the creation of roughly NE-SW troughs articulated by the Tanganyika-Malawi and Zambesi pre-transform systems. These were NW-SE sinistral-slip systems with directions of movement dipping slightly to the Southeast, which enabled the Mwanza fault to play an important role in the evolution of the Karroo basins of the Shire Valley. The Cretaceous was a transition period between the Karroo rifting and the formation of the Recent East African Rift System. Extension was NE-SW, with some evidence for a local compressional episode in the Lengwe basin. Beginning in the Cenozoic, the extension once more became NW-SE and controlled the evolution in transtension of the Recent East African Rift System. This history highlights the major role of transverse faults systems dominated by strike-slip motion in the evolution and perpetuation of the continental rift systems. These faults are of a greater geological persistence than the normal faults bounding the grabens, especially when they are located on major basement anisotropies.

  6. Will "Combined Prevention" Eliminate Racial/Ethnic Disparities in HIV Infection among Persons Who Inject Drugs in New York City?

    PubMed

    Des Jarlais, Don; Arasteh, Kamyar; McKnight, Courtney; Feelemyer, Jonathan; Hagan, Holly; Cooper, Hannah; Campbell, Aimee; Tross, Susan; Perlman, David

    2015-01-01

    It has not been determined whether implementation of combined prevention programming for persons who inject drugs reduce racial/ethnic disparities in HIV infection. We examine racial/ethnic disparities in New York City among persons who inject drugs after implementation of the New York City Condom Social Marketing Program in 2007. Quantitative interviews and HIV testing were conducted among persons who inject drugs entering Mount Sinai Beth Israel drug treatment (2007-2014). 703 persons who inject drugs who began injecting after implementation of large-scale syringe exchange were included in the analyses. Factors independently associated with being HIV seropositive were identified and a published model was used to estimate HIV infections due to sexual transmission. Overall HIV prevalence was 4%; Whites 1%, African-Americans 17%, and Hispanics 4%. Adjusted odds ratios were 21.0 (95% CI 5.7, 77.5) for African-Americans to Whites and 4.5 (95% CI 1.3, 16.3) for Hispanics to Whites. There was an overall significant trend towards reduced HIV prevalence over time (adjusted odd ratio = 0.7 per year, 95% confidence interval (0.6-0.8). An estimated 75% or more of the HIV infections were due to sexual transmission. Racial/ethnic disparities among persons who inject drugs were not significantly different from previous disparities. Reducing these persistent disparities may require new interventions (treatment as prevention, pre-exposure prophylaxis) for all racial/ethnic groups.

  7. Misclassified maternal deaths among East African immigrants in Sweden.

    PubMed

    Elebro, Karin; Rööst, Mattias; Moussa, Kontie; Johnsdotter, Sara; Essén, Birgitta

    2007-11-01

    Western countries have reported an increased risk of maternal mortality among African immigrants. This study aimed to identify cases of maternal mortality among immigrants from the Horn of Africa living in Sweden using snowball sampling, and verify whether they had been classified as maternal deaths in the Cause of Death Registry. Three "locators" contacted immigrants from Somalia, Eritrea, and Ethiopia to identify possible cases of maternal mortality. Suspected deaths were scrutinised through verbal autopsy and medical records. Confirmed instances, linked by country of birth, were compared with Registry statistics. We identified seven possible maternal deaths of which four were confirmed in medical records, yet only one case had been classified as such in the Cause of Death Registry. At least two cases, a significant number, seemed to be misclassified. The challenges of both cultural and medical competence for European midwives and obstetricians caring for non-European immigrant mothers should be given more attention, and the chain of information regarding maternal deaths should be strengthened. We propose a practice similar to the British confidential enquiry into maternal deaths. In Sweden, snowball sampling was valuable for contacting immigrant communities for research on maternal mortality; by strengthening statistical validity, it can contribute to better maternal health policy in a multi-ethnic society.

  8. Use of dental care by HIV-infected medical patients.

    PubMed

    Coulter, I D; Marcus, M; Freed, J R; Der-Martirosian, C; Cunningham, W E; Andersen, R M; Maas, W R; Garcia, I; Schneider, D A; Genovese, B; Shapiro, M F; Bozzette, S A

    2000-06-01

    Although increasing attention has been paid to the use of dental care by HIV patients, the existing studies do not use probability samples, and no accurate population estimates of use can be made from this work. The intent of the present study was to establish accurate population estimates of the use of dental services by patients under medical care. The study, part of the HIV Cost and Services Utilization Study (HCSUS), created a representative national probability sample, the first of its kind, of HIV-infected adults in medical care. Both bivariate and logistic regressions were conducted, with use of dental care in the preceding 6 months as the dependent variable and demographic, social, behavioral, and disease characteristics as independent variables. Forty-two percent of the sample had seen a dental health professional in the preceding 6 months. The bivariate logits for use of dental care show that African-Americans, those whose exposure to HIV was caused by hemophilia or blood transfusions, persons with less education, and those who were employed were less likely to use dental care (p < 0.05). Sixty-five percent of those with a usual source of care had used dental care in the preceding 6 months. Use was greatest among those obtaining dental care from an AIDS clinic (74%) and lowest among those without a usual source of dental care (12%). We conclude that, in spite of the high rate of oral disease in persons with HIV, many do not use dental care regularly, and that use varies by patient characteristics and availability of a regular source of dental care. PMID:10890713

  9. Predicting East African spring droughts using Pacific and Indian Ocean sea surface temperature indices

    NASA Astrophysics Data System (ADS)

    Funk, C.; Hoell, A.; Shukla, S.; Bladé, I.; Liebmann, B.; Roberts, J. B.; Robertson, F. R.; Husak, G.

    2014-12-01

    In eastern East Africa (the southern Ethiopia, eastern Kenya and southern Somalia region), poor boreal spring (long wet season) rains in 1999, 2000, 2004, 2007, 2008, 2009, and 2011 contributed to severe food insecurity and high levels of malnutrition. Predicting rainfall deficits in this region on seasonal and decadal time frames can help decision makers implement disaster risk reduction measures while guiding climate-smart adaptation and agricultural development. Building on recent research that links more frequent East African droughts to a stronger Walker circulation, resulting from warming in the Indo-Pacific warm pool and an increased east-to-west sea surface temperature (SST) gradient in the western Pacific, we show that the two dominant modes of East African boreal spring rainfall variability are tied to SST fluctuations in the western central Pacific and central Indian Ocean, respectively. Variations in these two rainfall modes can thus be predicted using two SST indices - the western Pacific gradient (WPG) and central Indian Ocean index (CIO), with our statistical forecasts exhibiting reasonable cross-validated skill (rcv ≈ 0.6). In contrast, the current generation of coupled forecast models show no skill during the long rains. Our SST indices also appear to capture most of the major recent drought events such as 2000, 2009 and 2011. Predictions based on these simple indices can be used to support regional forecasting efforts and land surface data assimilations to help inform early warning and guide climate outlooks.

  10. Neurospirochætosis in the East African

    PubMed Central

    Gordon, H. L.

    1934-01-01

    (1) An inquiry was made at the Mathari Mental Hospital, Nairobi, into the validity in Kenya of the common belief that syphilitic infection of the nervous system is rare amongst Africans in their own environment. (2) The difficulties encountered by the inquiry are discussed, especially: (a) That arising from the presence of both yaws and syphilis in the colony; (b) that due to apparent unreliability of the Wassermann reaction under local conditions. (3) The incidence of a positive serum reaction in the general population was estimated. (4) The whole of the male adults in the hospital were selected for the inquiry. (5) The results are presented in tables showing: (a) Mental state and neurological and other signs; (b) serum reactions; (c) cerebrospinal fluid examination results, including those from the Lange colloidal gold reaction. (6) The post-mortem reports on four of the series who died during the inquiry are given. (7) The inquiry appears to allow the general conclusion that spirochœtal infection of the nervous system of the Kenya native is not uncommon. (8) Insufficient evidence is forthcoming for a decision as to whether the infection found was syphilitic, frambœsial, or from an unknown source. (9) The question has much more than medical importance in view of the possibility that unchecked spirochætal infection in the past may have been an environmental influence contributing to the present degree of cerebral deficiency found in the native by Dr. F. W. Vint and the writer, and reported elsewhere. (To the Eugenics Society on November 7, 1933, by the writer, and in the next issue of the Journal of Anatomy, by Dr. Vint.) PMID:19989630

  11. Monitoring wetland changes with remote sensing: An East African example

    NASA Astrophysics Data System (ADS)

    Haack, Barry; Messina, Joe

    1997-01-01

    Environmental managers need current, accurate information upon which to base decisions. Viable information, especially in developing countries, is often unavailable. Satellite remote sensing is an appropriate and effective data source for mapping the surface of the earth including a variety of environmental features. Remote sensing derived information is enhanced by being one component within a Geographic Information System (GIS). These techniques were employed to study an expanding delta in East Africa. The Omo River flows from the Ethiopian Highlands into the northern end of Lake Turkana creating a large delta extending between Ethiopia and Kenya. This isolated and unique wetland feature has expanded by over 500 sq. km in the last fifteen years as measured by spaceborne remote sensing techniques and corroborated by low altitude aircraft reconnaissance flights. The growth of the delta appears to be a function of both increased sedimentation and decreased lake levels and river flows. Within the delta there has been a selective decline in wildlife and an increase in human activity, both pastoral and agricultural. The uniqueness of this isolated delta suggests that consideration be given to its possible protection and management.

  12. Monitoring wetland changes with remote sensing: An East African example

    NASA Astrophysics Data System (ADS)

    Haack, Barry

    1996-05-01

    Environmental managers need current, accurate information upon which to base decisions. Viable information, especially in developing countries, is often unavailable. Satellite remote sensing is an appropriate and effective data source for mapping the surface of the earth, including a variety of environmental features. Remote-sensing-derived information is enhanced by being one component within a geographic information system (GIS). These techniques were employed to study an expanding delta in East Africa. The Omo River flows from the Ethiopian Highlands into the northern end of Lake Turkana, creating a large delta extending between Ethiopia and Kenya. This isolated and unique wetland feature has expanded by over 500 sq km in the last 15 years as measured by space-borne remote sensing techniques and corroborated by low-altitude aircraft reconnaissance flights. The growth of the delta appears to be a function of both increased sedimentation and decreased lake levels and river flows. Within the delta there has been a selective decline in wildlife and an increase in human activity, both pastoral and agricultural. The uniqueness of this isolated delta suggests that consideration be given to its possible protection and management.

  13. Gender attitudes and fertility aspirations among young men in five high fertility East African countries.

    PubMed

    Snow, Rachel C; Winter, Rebecca A; Harlow, Siobán D

    2013-03-01

    The relationship between women's attitudes toward gender equality and their fertility aspirations has been researched extensively, but few studies have explored the same associations among men. Using recent Demographic and Health Survey data from five high fertility East African countries, we examine the association between young men's gender attitudes and their ideal family size. Whereas several DHS gender attitude responses were associated with fertility aspirations in select countries, men's greater tolerance of wife beating was consistently associated with higher fertility aspirations across all countries, independent of education, income, or religion. Our findings highlight the overlapping values of male authority within marriage and aspirations for large families among young adult males in East Africa. Total lifetime fertility in East Africa remains among the highest worldwide: thus, governments in the region seeking to reduce fertility may need to explicitly scrutinize and address the reproduction of prevailing masculine values.

  14. The 1990 to 1991 Sudan earthquake sequence and the extent of the East african rift system.

    PubMed

    Girdler, R W; McConnell, D A

    1994-04-01

    One of the largest earthquakes ever recorded in Africa (surface wave magnitude M(s) = 7.2) occurred about 50 kilometers east of the Upper River Nile on 20 May 1990. Four days later, two more large earthquakes (M(s) = 6.4 and 7.0) occurred about 50 kilometers to the northwest in the Nile Valley. In the following months, a further 60 events were recorded by seismic stations worldwide. The earthquakes are associated with two fault systems: one east of the Nile with azimuth southeast and one along the Nile Valley with azimuth north-northeast. The activity alternated between the two fault systems and indicates that the northern extremity of the western branch of the East African Rift System extends at least 350 kilometers north of Lake Albert.

  15. Glacial/interglacial climate controls on east African interannual rainfall variability

    NASA Astrophysics Data System (ADS)

    Timmermann, A.; Wolff, C.; Haug, G. H.; Sinninghe Damsté, J. S.; Brauer, A.; Sigman, D. M.; Cane, M. A.; Verschuren, D.

    2011-12-01

    Interannual rainfall variations in equatorial East Africa are tightly linked to the El Niño Southern Oscillation (ENSO), with more rain and flooding during El Niño and droughts in La Niña years, both having severe impacts on water stress and food security. Here we report evidence from an annually laminated lake-sediment record from southeastern Kenya for inter-annual to centennial-scale changes in ENSO-related rainfall variability during the last three millennia, abrupt changes in variability between the Medieval Climate Anomaly and the Little Ice Age, and an overall reduction in East African rainfall and its variability during the Last Glacial period. A suite of CCSM3 climate model experiments for LGM, present-day and future CO2-doubling conditions supports forward extrapolations from these lake-sediment data that future Indian Ocean warming will intensify East Africa's hydrological cycle during the short rainy season in September to November.

  16. Multi-model trends in East African rainfall associated with increased CO2

    NASA Astrophysics Data System (ADS)

    McHugh, Maurice J.

    2005-01-01

    Nineteen coupled ocean-atmosphere general circulation models participating in the Coupled Model Intercomparison Program (CMIP) were used to analyze future rainfall conditions over East Africa under enhanced CO2 conditions. 80 year control runs of these models indicated that four models produced mean annual rainfall distributions closely resembling climatological means and all four models had normalized root mean square errors well within the bounds of observed variability. East African (10°N-20°S, 25°-50°E) rainfall data from transient 80 year experiments which featured CO2 increases of 1% per year were compared with 80 year control simulations. Results indicate enhanced annual and seasonal rainfall rates, and increased extreme wet period frequency. These results indicate that East Africa may face a future in which mosquito-borne diseases such as malaria and Rift Valley fever proliferate resulting from increased CO2.

  17. Gender attitudes and fertility aspirations among young men in five high fertility East African countries.

    PubMed

    Snow, Rachel C; Winter, Rebecca A; Harlow, Siobán D

    2013-03-01

    The relationship between women's attitudes toward gender equality and their fertility aspirations has been researched extensively, but few studies have explored the same associations among men. Using recent Demographic and Health Survey data from five high fertility East African countries, we examine the association between young men's gender attitudes and their ideal family size. Whereas several DHS gender attitude responses were associated with fertility aspirations in select countries, men's greater tolerance of wife beating was consistently associated with higher fertility aspirations across all countries, independent of education, income, or religion. Our findings highlight the overlapping values of male authority within marriage and aspirations for large families among young adult males in East Africa. Total lifetime fertility in East Africa remains among the highest worldwide: thus, governments in the region seeking to reduce fertility may need to explicitly scrutinize and address the reproduction of prevailing masculine values. PMID:23512871

  18. Impact of Mascarene High variability on the East African `short rains'

    NASA Astrophysics Data System (ADS)

    Manatsa, Desmond; Morioka, Yushi; Behera, Swadhin K.; Matarira, Caxston H.; Yamagata, Toshio

    2014-03-01

    The interannual variability of East African `short rains' (EASR) and its link with the Mascarene High (MH) variation are explored, using observations and reanalysis data. Correlation and composite analyses for flood and drought events reveal that the EASR variability is strongly linked to the MH zonal displacement, in particular, the zonal movement of the MH eastern ridge. When the MH eastern ridge is anomalously displaced to the west (east) of its normal position, the south east (SE) trade winds over the South Indian Ocean (SIO) anomalously strengthen (weaken). This enhances (reduces) the relatively cool and dry SE trade winds and induces cold (warm) sea surface temperature anomaly in the SIO. As a result, convection over the western equatorial SIO is suppressed (enhanced) and leads to rainfall deficits (excess) over East Africa. Droughts in East Africa are associated with a westward migration of the MH eastern ridge, while the relationship is less clear for flood events and their link to an eastward migration of the MH. Therefore, the zonal migration of the MH eastern ridge provides a novel indicator for the EASR extremes especially droughts. This revelation has immense social application for rainfall forecast over East Africa where rainfall deficits have become more prevalent against the background of deteriorating conventional forecasts for EASR droughts.

  19. Orogen styles in the East African Orogen: A review of the Neoproterozoic to Cambrian tectonic evolution

    NASA Astrophysics Data System (ADS)

    Fritz, H.; Abdelsalam, M.; Ali, K. A.; Bingen, B.; Collins, A. S.; Fowler, A. R.; Ghebreab, W.; Hauzenberger, C. A.; Johnson, P. R.; Kusky, T. M.; Macey, P.; Muhongo, S.; Stern, R. J.; Viola, G.

    2013-10-01

    The East African Orogen, extending from southern Israel, Sinai and Jordan in the north to Mozambique and Madagascar in the south, is the world´s largest Neoproterozoic to Cambrian orogenic complex. It comprises a collage of individual oceanic domains and continental fragments between the Archean Sahara-Congo-Kalahari Cratons in the west and Neoproterozoic India in the east. Orogen consolidation was achieved during distinct phases of orogeny between ∼850 and 550 Ma. The northern part of the orogen, the Arabian-Nubian Shield, is predominantly juvenile Neoproterozoic crust that formed in and adjacent to the Mozambique Ocean. The ocean closed during a protracted period of island-arc and microcontinent accretion between ∼850 and 620 Ma. To the south of the Arabian Nubian Shield, the Eastern Granulite-Cabo Delgado Nappe Complex of southern Kenya, Tanzania and Mozambique was an extended crust that formed adjacent to theMozambique Ocean and experienced a ∼650-620 Ma granulite-facies metamorphism. Completion of the nappe assembly around 620 Ma is defined as the East African Orogeny and was related to closure of the Mozambique Ocean. Oceans persisted after 620 Ma between East Antarctica, India, southern parts of the Congo-Tanzania-Bangweulu Cratons and the Zimbabwe-Kalahari Craton. They closed during the ∼600-500 Ma Kuungan or Malagasy Orogeny, a tectonothermal event that affected large portions of southern Tanzania, Zambia, Malawi, Mozambique, Madagascar and Antarctica. The East African and Kuungan Orogenies were followed by phases of post-orogenic extension. Early ∼600-550 Ma extension is recorded in the Arabian-Nubian Shield and the Eastern Granulite-Cabo Delgado Nappe Complex. Later ∼550-480 Ma extension affected Mozambique and southern Madagascar. Both extension phases, although diachronous,are interpreted as the result of lithospheric delamination. Along the strike of the East African Orogen, different geodynamic settings resulted in the evolution of

  20. Orogen styles in the East African Orogen: A review of the Neoproterozoic to Cambrian tectonic evolution☆

    PubMed Central

    Fritz, H.; Abdelsalam, M.; Ali, K.A.; Bingen, B.; Collins, A.S.; Fowler, A.R.; Ghebreab, W.; Hauzenberger, C.A.; Johnson, P.R.; Kusky, T.M.; Macey, P.; Muhongo, S.; Stern, R.J.; Viola, G.

    2013-01-01

    The East African Orogen, extending from southern Israel, Sinai and Jordan in the north to Mozambique and Madagascar in the south, is the world́s largest Neoproterozoic to Cambrian orogenic complex. It comprises a collage of individual oceanic domains and continental fragments between the Archean Sahara–Congo–Kalahari Cratons in the west and Neoproterozoic India in the east. Orogen consolidation was achieved during distinct phases of orogeny between ∼850 and 550 Ma. The northern part of the orogen, the Arabian–Nubian Shield, is predominantly juvenile Neoproterozoic crust that formed in and adjacent to the Mozambique Ocean. The ocean closed during a protracted period of island-arc and microcontinent accretion between ∼850 and 620 Ma. To the south of the Arabian Nubian Shield, the Eastern Granulite–Cabo Delgado Nappe Complex of southern Kenya, Tanzania and Mozambique was an extended crust that formed adjacent to theMozambique Ocean and experienced a ∼650–620 Ma granulite-facies metamorphism. Completion of the nappe assembly around 620 Ma is defined as the East African Orogeny and was related to closure of the Mozambique Ocean. Oceans persisted after 620 Ma between East Antarctica, India, southern parts of the Congo–Tanzania–Bangweulu Cratons and the Zimbabwe–Kalahari Craton. They closed during the ∼600–500 Ma Kuungan or Malagasy Orogeny, a tectonothermal event that affected large portions of southern Tanzania, Zambia, Malawi, Mozambique, Madagascar and Antarctica. The East African and Kuungan Orogenies were followed by phases of post-orogenic extension. Early ∼600–550 Ma extension is recorded in the Arabian–Nubian Shield and the Eastern Granulite–Cabo Delgado Nappe Complex. Later ∼550–480 Ma extension affected Mozambique and southern Madagascar. Both extension phases, although diachronous,are interpreted as the result of lithospheric delamination. Along the strike of the East African Orogen, different geodynamic settings

  1. Carbon dioxide measurements in tropical east African biomes

    SciTech Connect

    Schnell, R.C.; Odh, S.A.; Njau, L.N.

    1981-06-20

    From January 1977 through May 1978 atmospheric CO/sub 2/ concentrations were measured hourly and/or continuously at bimonthly intervals over periods varying from 5 to 8 days at 10 different locations in Kenya, East Africa. During each of these periods, at least two, and in some cases five, vertical profile measurements of CO/sub 2/ concentrations were conducted above different biomes. A large diurnal CO/sub 2/ periodicity was observed over land, with daytime drawdowns to 322 ppm and nighttime buildups to more than 400 ppm observed in savannah regions. In and around tropical rain forests, drawdowns to 310 ppm and buildups to more than 400 ppm were regularly observed. On the higher reaches of Mount Kenya, the diurnal CO/sub 2/ cycle was considerably reduced in amplitude, with variations in the range of 2-6 ppm throughout the 16-month study period. On sunny days, the drawdown of CO/sub 2/ was measurable to heights of at least 4000 m above ground level. Other CO/sub 2/ measurements in air over the Indian Ocean (to distances of up to 450 km upwind of the coast) produced fairly consistent concentrations of about 328.5 ppm which did not fluctuate diurnally. The weekly mean CO/sub 2/ concentrations over Kenya appear to have a bimodal structure, with minima occurring in July and January. On the basis of the data collected during the study it appears likely that regular observations at a high-altitude station on Mount Kenya, either with flask sampling or continuous analyzer measurements, are likely to yield data useful for estimates of CO/sub 2/ concentration backgrounds and trends. Also, there is strong evidence that Mount Kenya would be a good location to measure large-scale interhemispheric CO/sub 2/ exchanges and provide a unique base from which to study the effects of the tropical biome on biogeochemical phenomena. 20 references, 12 figures, 2 tables.

  2. DEWORMING DELUSIONS? MASS DRUG ADMINISTRATION IN EAST AFRICAN SCHOOLS.

    PubMed

    Allen, Tim; Parker, Melissa

    2016-09-01

    Recent debates about deworming school-aged children in East Africa have been described as the 'Worm Wars'. The stakes are high. Deworming has become one of the top priorities in the fight against infectious diseases. Staff at the World Health Organization, the Gates Foundation and the World Bank (among other institutions) have endorsed the approach, and school-based treatments are a key component of large-scale mass drug administration programmes. Drawing on field research in Uganda and Tanzania, and engaging with both biological and social evidence, this article shows that assertions about the effects of school-based deworming are over-optimistic. The results of a much-cited study on deworming Kenyan school children, which has been used to promote the intervention, are flawed, and a systematic review of randomized controlled trials demonstrates that deworming is unlikely to improve overall public health. Also, confusions arise by applying the term deworming to a variety of very different helminth infections and to different treatment regimes, while local-level research in schools reveals that drug coverage usually falls below target levels. In most places where data exist, infection levels remain disappointingly high. Without indefinite free deworming, any declines in endemicity are likely to be reversed. Moreover, there are social problems arising from mass drug administration that have generally been ignored. Notably, there are serious ethical and practical issues arising from the widespread practice of giving tablets to children without actively consulting parents. There is no doubt that curative therapy for children infected with debilitating parasitic infections is appropriate, but overly positive evaluations of indiscriminate deworming are counter-productive. PMID:27428063

  3. HIV Infection and Microbial Diversity in Saliva

    PubMed Central

    Saxena, Deepak; Chen, Zhou; Liu, Gaoxia; Abrams, Willam R.; Phelan, Joan A.; Norman, Robert G.; Fisch, Gene S.; Corby, Patricia M.; Dewhirst, Floyd; Paster, Bruce J.; Kokaras, Alexis S.; Malamud, Daniel

    2014-01-01

    Limited information is available about the effects of HIV and subsequent antiretroviral treatment on host-microbe interactions. This study aimed to determine the salivary microbial composition for 10 HIV-seropositive subjects, before and 6 months after highly active antiretroviral therapy (HAART), compared with that for 10 HIV-seronegative subjects. A conventional culture and two culture-independent analyses were used and consistently demonstrated differences in microbial composition among the three sets of samples. HIV-positive subjects had higher levels of total cultivable microbes, including oral streptococci, lactobacilli, Streptococcus mutans, and Candida, in saliva than did HIV-negative subjects. The total cultivable microbial levels were significantly correlated with CD4+ T cell counts. Denaturing gradient gel electrophoresis (DGGE), which compared the overall microbial profiles, showed distinct fingerprinting profiles for each group. The human oral microbe identification microarray (HOMIM) assay, which compared the 16S rRNA genes, showed clear separation among the three sample groups. Veillonella, Synergistetes, and Streptococcus were present in all 30 saliva samples. Only minor changes or no changes in the prevalence of Neisseria, Haemophilus, Gemella, Leptotrichia, Solobacterium, Parvimonas, and Rothia were observed. Seven genera, Capnocytophaga, Slackia, Porphyromonas, Kingella, Peptostreptococcaceae, Lactobacillus, and Atopobium, were detected only in HIV-negative samples. The prevalences of Fusobacterium, Campylobacter, Prevotella, Capnocytophaga, Selenomonas, Actinomyces, Granulicatella, and Atopobium were increased after HAART. In contrast, the prevalence of Aggregatibacter was significantly decreased after HAART. The findings of this study suggest that HIV infection and HAART can have significant effects on salivary microbial colonization and composition. PMID:24523469

  4. Surface-wave Tomography of East African Rift System using Ambient Seismic Noise

    NASA Astrophysics Data System (ADS)

    Kim, S.; Kang, T.; Baag, C.; Nyblade, A. A.

    2008-12-01

    The surface-wave tomography technique for the ambient seismic noise is applied to the east African rift system to investigate shallow crustal structures of the region. Even if the technique has been widely used in many regions to investigate crustal structure in the world, there have been difficulties in application of the technique to the east African region because of unstable data conditions of PASSCAL experiments. A meticulous check of record by record enables us of applying the technique to understand the tectonic environment of the region. The long-period data of one month showing good quality in cross-correlation results are used in this study. They are from the 1994-95 Tanzania Passive-Source Seismic Experiment for the Tanzania craton and its surrounding rift zone, and from the 2000-02 Ethiopia/Kenya Broadband Seismic Experiment and the adjacent permanent stations of the African Array for the Ethiopia rift. The Rayleigh- and Love-wave group-speed maps were inverted using LSQR algorithm for several period bands (5 - 50 s). The preliminary group-speed distribution maps yield results roughly consistent with regional geology. The tomographic images of the Tanzania region show a strong high velocity anomaly at the location corresponding to the Tanzania craton and low velocity anomalies at the surrounding rift regions. For the Ethiopia regions, the features of low velocity anomalies roughly agree with the Tertiary volcanic regions. Combining the Tanzania and Ethiopia broadband arrays, the outline of the east African rift system can be identified as the low velocity anomalies in the surface-wave tomographic results. The structural variation with depth and the feature of the regional shear-wave anisotropy of crust will be explored by converting group- speed dispersion curves into shear-wave velocity structure.

  5. [Organ transplants in HIV infected patients. Update and recommendations].

    PubMed

    Barcan, Laura; Gadano, Adrian; Casetti, Isabel; Villamil, Federico

    2011-01-01

    Until few years ago, HIV infection was an absolute contraindication to consider organ transplants. Since HAART introduction, patient survival increased dramatically, but high mortality due to liver and kidney diseases became evident. For these reasons, this group of patients is now reconsidered for organ transplantation. In 2008, the Argentine Society of Transplants (SAT) and the Argentine Infectious Diseases Society (SADI), encouraged by the increasing published experience on kidney and liver transplants in this population, decided to form a Working Group, to prepare an update on this issue and elaborate practical recommendations for the better management of these patients. The first meeting was held on December 4th 2008. The most important conclusion was that HIV infection did not contraindicate a solid organ transplant. Later on, taking into account the accumulated experience and the available literature, the current document was prepared. HIV infected patients must fulfill certain clinical, immunological, virological and psychosocial criteria to be considered for solid organ transplants. HIV infected recipients of kidney and liver transplants currently show similar short and middle term survival to non HIV infected patients. There is not yet enough data on intrathoracic transplants in these patients in order to include them on a waiting list for these organs-transplants. Interactions between immunosupressors and antiretroviral drugs (specially protease inhibitors) are very important, and require a strict monitoring of immunosupressor levels.

  6. Suitability of HIV-Infected Subjects for Insurance.

    PubMed

    Singh, Gurmukh; Salkind, Alan R; Kneepkens, Robert F

    2015-01-01

    Objectives .- To ascertain the suitability of HIV-positive individuals for insurance coverage based on international data and practices. Background .- During the first decade of HIV epidemic, diagnosis of HIV-infection carried a poor prognosis. Since the introduction of Highly Active Anti-Retroviral Therapy (HAART or ART), HIV infection is more like other chronic diseases with infected individuals often living 20 or more years after the diagnosis of HIV infection Methods .- Review of peer-reviewed publications was undertaken to assess the risk of death in the HIV-infected population as a whole as well as subsets with favorable outcomes and those with additional comorbidities, such as co-infection with hepatitis viruses and drug use. Results .- Review of literature revealed that in well-educated, non-drug using individuals, negative for hepatitis B and C infection, who had CD 4 counts above 500/cmm, viral loads below 500 particles/mL, and were compliant with treatment, the mortality rate was similar to that of general population. Conclusions .- The risk of death, in at least a subset of HIV-positive subjects, is low enough that insurance providers should consider stratifying HIV-infected individuals according to mortality risk and offering insurance rates comparable to people with other diseases with similar mortality risks. PMID:27584807

  7. Care of Patients With HIV Infection: Antiretroviral Drug Regimens.

    PubMed

    Bolduc, Philip; Roder, Navid; Colgate, Emily; Cheeseman, Sarah H

    2016-04-01

    The advent of combination antiretroviral drug regimens has transformed HIV infection from a fatal illness into a manageable chronic condition. All patients with HIV infection should be considered for antiretroviral therapy, regardless of CD4 count or HIV viral load, for individual benefit and to prevent HIV transmission. Antiretroviral drugs affect HIV in several ways: entry inhibitors block HIV entry into CD4 T cells; nucleotide and nucleoside reverse transcriptase inhibitors prevent reverse transcription from RNA to DNA via chain-terminating proteins; nonnucleoside reverse transcriptase inhibitors prevent reverse transcription through enzymatic inhibition; integrase strand transfer inhibitors block integration of viral DNA into cellular DNA; protease inhibitors block maturation and production of the virus. Current guidelines recommend six combination regimens for initial therapy. Five are based on tenofovir and emtricitabine; the other uses abacavir and lamivudine. Five include integrase strand transfer inhibitors. HIV specialists should assist with treating patients with complicated HIV infection, including patients with treatment-resistant HIV infection, coinfection with hepatitis B or C virus, pregnancy, childhood infections, severe opportunistic infections, complex drug interactions, significant drug toxicity, or comorbidities. Family physicians can treat most patients with HIV infection effectively by choosing appropriate treatment regimens, monitoring patients closely, and retaining patients in care. PMID:27092564

  8. Identifying Recent HIV Infections: From Serological Assays to Genomics

    PubMed Central

    Moyo, Sikhulile; Wilkinson, Eduan; Novitsky, Vladimir; Vandormael, Alain; Gaseitsiwe, Simani; Essex, Max; Engelbrecht, Susan; de Oliveira, Tulio

    2015-01-01

    In this paper, we review serological and molecular based methods to identify HIV infection recency. The accurate identification of recent HIV infection continues to be an important research area and has implications for HIV prevention and treatment interventions. Longitudinal cohorts that follow HIV negative individuals over time are the current gold standard approach, but they are logistically challenging, time consuming and an expensive enterprise. Methods that utilize cross-sectional testing and biomarker information have become an affordable alternative to the longitudinal approach. These methods use well-characterized biological makers to differentiate between recent and established HIV infections. However, recent results have identified a number of limitations in serological based assays that are sensitive to the variability in immune responses modulated by HIV subtypes, viral load and antiretroviral therapy. Molecular methods that explore the dynamics between the timing of infection and viral evolution are now emerging as a promising approach. The combination of serological and molecular methods may provide a good solution to identify recent HIV infection in cross-sectional data. As part of this review, we present the advantages and limitations of serological and molecular based methods and their potential complementary role for the identification of HIV infection recency. PMID:26512688

  9. Cardiovascular risk and dyslipidemia management in HIV-infected patients.

    PubMed

    Stein, James H

    2012-01-01

    HIV infection and antiretroviral therapy each appear to increase cardiovascular disease risk. Increased risk may be attributable to the inflammatory effects of HIV infection and dyslipidemia associated with some antiretroviral agents. The prevalence of cardiovascular disease is increasing as patients live longer, age, and acquire traditional coronary heart disease (CHD) risk factors. In general, any additional cardiovascular risk posed by HIV infection or antiretroviral therapy is of potential concern for patients who are already at moderate or high risk for CHD. Long-term and well-designed studies are needed to more accurately ascertain to what degree HIV infection and antiretroviral therapy affect long-term cardiovascular disease risk. Management of dyslipidemia to reduce CHD risk in HIV-infected patients is much the same as in the general population, with the cornerstone consisting of statin therapy and lifestyle interventions. Smoking cessation is a major step in reducing CHD risk in those who smoke. This article summarizes a presentation by James H. Stein, MD, at the IAS-USA live continuing medical education activity held in New York City in March 2012.

  10. Dyslipidemia in HIV-infected individuals: from pharmacogenetics to pharmacogenomics.

    PubMed

    Tarr, Philip E; Rotger, Margalida; Telenti, Amalio

    2010-04-01

    HIV-infected individuals may have accelerated atherogenesis and an increased risk for premature coronary artery disease. Dyslipidemia represents a key pro-atherogenic mechanism. In HIV-infected patients, dyslipidemia is typically attributed to the adverse effects of antiretroviral therapy. Nine recent genome-wide association studies have afforded a comprehensive, unbiased inventory of common SNPs at 36 genetic loci that are reproducibly associated with dyslipidemia in the general population. Genome-wide association study-validated SNPs have now been demonstrated to contribute to dyslipidemia in the setting of HIV infection and antiretroviral therapy. In a Swiss HIV-infected study population, a similar proportion of serum lipid variability was explained by antiretroviral therapy and by genetic background. In the individual patient, both antiretroviral therapy and the cumulative effect of SNPs contribute to the risk of high low-density lipoprotein cholesterol, low high-density lipoprotein cholesterol and hypertriglyceridemia. Genetic variants presumably contribute to additional major metabolic complications in HIV-infected individuals, including diabetes mellitus and coronary artery disease. In an effort to explain an increasing proportion of the heritability of complex metabolic traits, ongoing large-scale gene resequencing studies are focusing on the effects of rare SNPs and structural genetic variants.

  11. Tobacco use and cessation in HIV-infected individuals

    PubMed Central

    Wewers, Mary Ellen; Ferketich, Amy; Diaz, Philip

    2013-01-01

    Synopsis The smoking prevalence estimates among HIV-infected individuals range from 40%-84%; much higher than the overall adult prevalence in the United States. Characteristics that are associated with smokers who are HIV-positive include drug and alcohol abuse, psychiatric comorbidities, and lower education and socioeconomic status. There are important health implications for HIV-infected smokers, including bacterial and Pneumocystis pneumonia, tuberculosis, COPD, lung cancer and coronary artery disease. To date, there have been few tobacco dependence treatment trials conducted among HIV-infected smokers. Most have used nicotine replacement therapy but abstinence rates were low. A recent preliminary study found the use of varenicline to be well tolerated and it may increase abstinence rates with HIV-infected individuals. Recommendations for future research include examining underlying factors that contribute to persistent smoking and barriers to abstinence, identifying ways to increase motivation for quit attempts, increasing the number of multi-centered, two-arm tobacco dependence treatment trials, and using highly efficacious first-line pharmacotherapy in tobacco dependence treatment intervention studies. Addressing the above-mentioned research gaps will help to reduce the tobacco-related disease burden of HIV-infected individuals in the future. PMID:23702169

  12. Talaromyces (Penicillium) marneffei infection in non-HIV-infected patients

    PubMed Central

    Chan, Jasper FW; Lau, Susanna KP; Yuen, Kwok-Yung; Woo, Patrick CY

    2016-01-01

    Talaromyces (Penicillium) marneffei is an important pathogenic thermally dimorphic fungus causing systemic mycosis in Southeast Asia. The clinical significance of T. marneffei became evident when the human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome epidemic arrived in Southeast Asia in 1988. Subsequently, a decline in the incidence of T. marneffei infection among HIV-infected patients was seen in regions with access to highly active antiretroviral therapy and other control measures for HIV. Since the 1990s, an increasing number of T. marneffei infections have been reported among non-HIV-infected patients with impaired cell-mediated immunity. Their comorbidities included primary adult-onset immunodeficiency due to anti-interferon-gamma autoantibodies and secondary immunosuppressive conditions including other autoimmune diseases, solid organ and hematopoietic stem cell transplantations, T-lymphocyte-depleting immunsuppressive drugs and novel anti-cancer targeted therapies such as anti-CD20 monoclonal antibodies and kinase inhibitors. Moreover, improved immunological diagnostics identified more primary immunodeficiency syndromes associated with T. marneffei infection in children. The higher case-fatality rate of T. marneffei infection in non-HIV-infected than HIV-infected patients might be related to delayed diagnosis due to the lack of clinical suspicion. Correction of the underlying immune defects and early use of antifungals are important treatment strategies. Clinicians should be familiar with the changing epidemiology and clinical management of T. marneffei infection among non-HIV-infected patients. PMID:26956447

  13. Fine needle aspiration of salivary gland masses in HIV-infected patients.

    PubMed

    Michelow, Pam; Dezube, Bruce J; Pantanowitz, Liron

    2012-08-01

    Salivary gland disease is an important manifestation of HIV-infection. The aim of this study was to evaluate the cytologic findings of salivary gland fine needle aspiration (FNA) in South African human immunodeficiency virus (HIV)-infected patients. A retrospective review was performed on confirmed HIV-positive patients who underwent FNA of various body sites, including salivary glands, over a 5-year period. There were 495 (14.1%) salivary gland FNAs out of a total of 3,501 HIV-positive patients. This included 260 (52.5%) parotid, 226 (45.7%) submandibular, 2 (0.4%) sublingual, and 7 (1.4%) specimens labeled as a salivary gland aspirate, exact site not provided. Patients were of average age 34 years (range 9 months to 63 years) with a female: male ratio of 1:0.6. There were 37 (7.5%) inadequate FNAs and 22 (4.4%) that contained normal gland constituents only. Most diagnoses were benign and comprised 168 (33.9%) reactive lymphadenopathy, 115 (23.2%) benign lymphoepithelial cysts, 62 (12.5%) mycobacterial infections, and 52 (10.5%) abscesses, of which 10 had associated mycobacterial infections. Neoplasms accounted for 31 (6.7%) diagnoses including 11 pleomorphic adenomas, 13 lymphoma, 3 Kaposi sarcoma, 1 squamous cell carcinoma, 1 metastatic carcinoma, and 1 rhabdomyosarcoma. There were four epidermoid inclusion cysts, three non-specific sialadenitis, one mucocele, and one spindle cell lesion not able to be further characterized. FNA is a useful procedure to evaluate salivary gland lesions in an HIV-infected population, allowing prompt management to be undertaken and obviating the need for surgery in many instances, an important consideration in an underfunded public health care system.

  14. Extension and Basin Evolution of the East Kivu Graben, Rwanda, East African Rift: Results of New Multichannel Seismic Reflection Imaging

    NASA Astrophysics Data System (ADS)

    Scholz, C. A.; Zhang, X.; Wood, D.; Mburu, D.

    2012-12-01

    The East Kivu Graben resides within the eastern part of Lake Kivu, the highest Great Lake in the western branch of the East African Rift. The lake is more than 440 m deep in the East Kivu Basin, with a catchment comprised of Precambrian metasedimentary rocks and late-Cenozoic volcanics. Lake Kivu is renowned for its uniquely stratified water column, which is charged with considerable quantities of dissolved CO2 and methane, the former due to magmatic degassing. In February and March 2012 514 km of single- and multi-channel seismic reflection data were acquired in the Rwandan waters of Lake Kivu. The 24-fold multichannel seismic data were acquired aboard a modular research vessel, using a 600 m-long hydrophone streamer and single 40 cubic inch airgun. Extension in the East Kivu basin is largely accommodated along a major N-S striking, east-dipping boundary fault observed along the eastern edge of Iwawa Island, and extending for ~40 km along the length of the basin. Numerous intrabasinal normal faults occur to the east of the boundary fault, commonly displacing the lake floor and controlling the location of modern sublacustrine channels. The deepest sedimentary reflections observed on the new MCS data are 1.2-1.5 km below lake floor, near the center of the basin and boundary fault. Crystalline basement is not observed in these deepest areas however, suggesting the presence of a substantial sedimentary section below the imaged strata. Stratal surfaces dip steeply to the west over large areas of the half-graben basin. An acoustically transparent seismic sequence up to ~25 m thick is observed at the lake floor, which overlies a pronounced erosional unconformity over much of the basin. Some intrabasinal normal faults are draped by and do not penetrate the upper sequences, indicating several generations of fault activity in the basin. The late-Pleistocene exposure surface likely correlates to the previous lake level low stage that persisted prior to volcanic damming by

  15. Early Life Circumstances as Contributors to HIV Infection

    PubMed Central

    Siegel, Karolynn; Lekas, Helen-Maria; Ramjohn, Destiny; Schrimshaw, Eric W.; VanDevanter, Nancy

    2015-01-01

    Adolescents may come from family settings that heighten their vulnerability to early sexual initiation, promiscuity and sexual exploitation. To illuminate how this may occur, we present a set of five representative cases of HIV-infected females from a sample of 26 adolescent and young adult HIV-infected females (ages 16–24) enrolled in a study about the adaptive challenges people their age faced living with the disease. Study participants were recruited from five New York City adolescent HIV clinics that provided comprehensive specialty medical and supportive ancillary social services to adolescents and young adults with HIV. Study participants completed a battery of standardizes measures, using ACASI, and participated in a semi-structured in-depth interview. Using the qualitative interview data, we illustrate how early life and family circumstances including neglectful or dysfunctional parenting (e.g., low parental supervision), sexual abuse, and unstable housing placed these young women on a risk trajectory for HIV infection. PMID:25397349

  16. The clinical implications of HIV infection and aging.

    PubMed

    John, M

    2016-04-01

    The objectives of this study, presented as part of a plenary session at WW7 in Hyderabad, India were to review (i) the epidemiology and current clinical issues of HIV infection with regard to HIV and older populations and (ii) models for increased morbidity and mortality in older HIV-positive individuals with implications for clinical care. HIV infection for those in treatment has become a complex chronic disease in which end-organ injury and resulting morbidity, functional decline, and mortality do not have a single etiology but reflect cumulative loss of organ system reserve from multiple interacting sources leading to functional decline, organ system failure, and death. Emerging guidelines and recommendations suggest a need for increased awareness and treatment of the multifaceted needs of the aging HIV-infected patient. PMID:27109276

  17. Urinary Markers of Tubular Injury in HIV-Infected Patients

    PubMed Central

    Gebreweld, Angesom

    2016-01-01

    Renal disease is a common complication of HIV-infected patients, associated with increased risk of cardiovascular events, progression to AIDS, AIDS-defining illness, and mortality. Early and accurate identification of renal disease is therefore crucial to improve patient outcomes. The use of serum creatinine, along with proteinuria, to detect renal involvement is essentially to screen for markers of glomerular disease and may not be effective in detecting earlier stages of renal injury. Therefore, more sensitive and specific markers are needed in order to early identify HIV-infected patients at risk of renal disease. This review article summarizes some new and important urinary markers of tubular injury in HIV-infected patients and their clinical usefulness in the renal safety follow-up of TDF-treated patients. PMID:27493802

  18. Modulation of East African Precipitation by the Indian Ocean Dipole (IOD) and ENSO

    NASA Astrophysics Data System (ADS)

    Shaaban, Ahmed A.

    Tropical East Africa is influenced by two main rainy seasons, during autumn and spring. During autumn, tropical East African precipitation is clearly influenced by Indian Ocean Dipole (IOD) and/or ENSO. During spring, there is no clear SST pattern in the Indian Ocean. The association between El Nino and positive IOD phases is much stronger than the association between La Nina and negative IOD during October and November. During October, the association between El Nino and wet condition over tropical eastern Africa is stronger than association between La Nina and dry conditions. During November, the association between positive IOD and eastern African precipitation is stronger than the association between La Nina and dry conditions. During short wet phases (such as autumn) over eastern Africa, two anticyclones form in the lower troposphere with upper baroclinic structure. These anticyclones decay rapidly by December. These anticyclones are responsible for supplying East Africa with increased moisture. Most strong positive IOD events are associated with wet outcomes over eastern Africa. Not all strong El Nino events lead to wet outcomes. It is well known that during northern spring, precipitation over eastern Africa is not connected to any inter-annual SST modes of variability. During northern spring, SST in Indian Ocean is nearly always sufficiently high to sustain convection, however, convection is not always active. We found that precipitation over eastern Africa during spring is associated with a dipole pattern of outgoing longwave radiation anomaly (OLRA) not associated with SST variability.

  19. The Oral Bacterial Communities of Children with Well-Controlled HIV Infection and without HIV Infection.

    PubMed

    Goldberg, Brittany E; Mongodin, Emmanuel F; Jones, Cheron E; Chung, Michelle; Fraser, Claire M; Tate, Anupama; Zeichner, Steven L

    2015-01-01

    The oral microbial community (microbiota) plays a critical role in human health and disease. Alterations in the oral microbiota may be associated with disorders such as gingivitis, periodontitis, childhood caries, alveolar osteitis, oral candidiasis and endodontic infections. In the immunosuppressed population, the spectrum of potential oral disease is even broader, encompassing candidiasis, necrotizing gingivitis, parotid gland enlargement, Kaposi's sarcoma, oral warts and other diseases. Here, we used 454 pyrosequencing of bacterial 16S rRNA genes to examine the oral microbiome of saliva, mucosal and tooth samples from HIV-positive and negative children. Patient demographics and clinical characteristics were collected from a cross-section of patients undergoing routine dental care. Multiple specimens from different sampling sites in the mouth were collected for each patient. The goal of the study was to observe the potential diversity of the oral microbiota among individual patients, sample locations, HIV status and various dental characteristics. We found that there were significant differences in the microbiome among the enrolled patients, and between sampling locations. The analysis was complicated by uneven enrollment in the patient cohorts, with only five HIV-negative patients enrolled in the study and by the rapid improvement in the health of HIV-infected children between the time the study was conceived and completed. The generally good oral health of the HIV-negative patients limited the number of dental plaque samples that could be collected. We did not identify significant differences between well-controlled HIV-positive patients and HIV-negative controls, suggesting that well-controlled HIV-positive patients essentially harbor similar oral flora compared to patients without HIV. Nor were significant differences in the oral microbiota identified between different teeth or with different dental characteristics. Additional studies are needed to better

  20. The Oral Bacterial Communities of Children with Well-Controlled HIV Infection and without HIV Infection.

    PubMed

    Goldberg, Brittany E; Mongodin, Emmanuel F; Jones, Cheron E; Chung, Michelle; Fraser, Claire M; Tate, Anupama; Zeichner, Steven L

    2015-01-01

    The oral microbial community (microbiota) plays a critical role in human health and disease. Alterations in the oral microbiota may be associated with disorders such as gingivitis, periodontitis, childhood caries, alveolar osteitis, oral candidiasis and endodontic infections. In the immunosuppressed population, the spectrum of potential oral disease is even broader, encompassing candidiasis, necrotizing gingivitis, parotid gland enlargement, Kaposi's sarcoma, oral warts and other diseases. Here, we used 454 pyrosequencing of bacterial 16S rRNA genes to examine the oral microbiome of saliva, mucosal and tooth samples from HIV-positive and negative children. Patient demographics and clinical characteristics were collected from a cross-section of patients undergoing routine dental care. Multiple specimens from different sampling sites in the mouth were collected for each patient. The goal of the study was to observe the potential diversity of the oral microbiota among individual patients, sample locations, HIV status and various dental characteristics. We found that there were significant differences in the microbiome among the enrolled patients, and between sampling locations. The analysis was complicated by uneven enrollment in the patient cohorts, with only five HIV-negative patients enrolled in the study and by the rapid improvement in the health of HIV-infected children between the time the study was conceived and completed. The generally good oral health of the HIV-negative patients limited the number of dental plaque samples that could be collected. We did not identify significant differences between well-controlled HIV-positive patients and HIV-negative controls, suggesting that well-controlled HIV-positive patients essentially harbor similar oral flora compared to patients without HIV. Nor were significant differences in the oral microbiota identified between different teeth or with different dental characteristics. Additional studies are needed to better

  1. Intestinal Parasitoses in HIV Infected Children in a Nigerian Tertiary Hospital

    PubMed Central

    Oyedeji, Olusola Adetunji; Adejuyigbe, Ebun; Oninla, Samuel Olorunyomi; Akindele, Abiodum Akeem; Adedokun, Samuel Adeyinka

    2015-01-01

    Background Intestinal parasitoses are common amongst people living in developing countries. They may impact negatively on the growth and health of immune competent children. There is paucity of information on the association between HIV and intestinal parasitoses in African children. Objective To identify the intestinal infections responsible for infections in HIV infected children and document characteristics of HIV infected children at a Nigerian teaching hospital. Materials and Methods Consecutive children attending a Paediatric anti-retroviral clinic were studied. Information such as socio-demographics and clinical characteristics elicited from clinical examination were recorded in the proforma. Stool samples of the children were obtained and examined for intestinal parasites. Data was analysed with the SPSS 18 software. Results A total 52 children were studied and their age ranged between 6 months and 14 years, with a mean of 6.5 years ± 3.93. The 52 were made up of 27 boys and 25 girls, giving a male: female ratio of 1.1:1. 10 (19.2%) of the 52 children were infected with cryptosporidium spp, while 1(1.9%) had Ascaris lumbricoides infestation. Anti-helminthics had previously been administered to 86.5% of children studied. Those who previously received anti-helminthics had lower prevalence estimates of cryptosporidium infections. (p<0.01, RR = 0.42, 95%CI = 0.20 – 0.90). Children on co-trimoxazole prophylaxis had lower prevalence estimates of cryptosporidium infections. (P<0.01, RR = 0.35, 95%CI = 0.14 – 0.91). Use of highly active antiretroviral drugs was also associated with lower prevalence estimates of intestinal cryptosporidium. (p=0.04, RR = 0.58, 95%CI = 0.31 – 1.10). Eight of the 10 children infected with cryptosporidium had recurrent abdominal pain in comparison with the six with recurrent abdominal pain amongst the 42 without cryptosporidial infections. (p<0.01, RR=5.6, 95%CI= 2.51 – 12.1). Conclusion Cryptosporidial infection is the most

  2. Transactional sex among young women in rural South Africa: prevalence, mediators and association with HIV infection

    PubMed Central

    Ranganathan, Meghna; Heise, Lori; Pettifor, Audrey; Silverwood, Richard J; Selin, Amanda; MacPhail, Catherine; Delany-Moretlwe, Sinead; Kahn, Kathleen; Gómez-Olivé, F Xavier; Hughes, James P; Piwowar-Manning, Estelle; Laeyendecker, Oliver; Watts, Charlotte

    2016-01-01

    Introduction Young adolescent women in sub-Saharan Africa are three to four times more likely to be HIV-positive than boys or men. One of the relationship dynamics that is likely to be associated with young women's increased vulnerability to HIV is transactional sex. There are a range of HIV-related risk behaviours that may drive this vulnerability. However, to date, limited epidemiological data exist on the role of transactional sex in increasing HIV acquisition, especially among young women in sub-Saharan Africa. Our paper presents data on the prevalence of self-reported engagement in transactional sex and explores whether transactional sex is associated with increased risk of HIV infection among a cohort of young, rural, sexually active South African women. We also explore whether this relationship is mediated through certain HIV-related risk behaviours. Methods We analyzed baseline data from a phase III trial of conditional cash transfers for HIV prevention of 693 sexually active, school-going young women aged 13–20 years in rural South Africa. We examined the association between young women's engagement in transactional sex and HIV infection. Transactional sex is defined as a non-commercial, non-marital sexual relationship whereby sex is exchanged for money and/or gifts. We explored whether this relationship is mediated by certain HIV-related risk behaviours. We used logistic and multinomial regression and report unadjusted and adjusted odds ratios with 95% CI. Results Overall, 14% (n=97) of sexually active young women reported engaging in transactional sex. Engagement in transactional sex was associated with an increased risk of being HIV-positive (aOR: 2.5, CI: 95% 1.19–5.25, p=0.01). The effect size of this association remained nearly unchanged when adjusted for certain other dimensions of HIV risk that might help explain the underlying pathways for this relationship. Conclusions This study provides quantitative support demonstrating that transactional

  3. The 3-dimensional cellular automata for HIV infection

    NASA Astrophysics Data System (ADS)

    Mo, Youbin; Ren, Bin; Yang, Wencao; Shuai, Jianwei

    2014-04-01

    The HIV infection dynamics is discussed in detail with a 3-dimensional cellular automata model in this paper. The model can reproduce the three-phase development, i.e., the acute period, the asymptotic period and the AIDS period, observed in the HIV-infected patients in a clinic. We show that the 3D HIV model performs a better robustness on the model parameters than the 2D cellular automata. Furthermore, we reveal that the occurrence of a perpetual source to successively generate infectious waves to spread to the whole system drives the model from the asymptotic state to the AIDS state.

  4. Correlates of Antiretroviral Therapy Adherence among HIV-Infected Older Adults

    PubMed Central

    McCoy, Katryna; Waldrop-Valverde, Drenna; Balderson, Benjamin H.; Mahoney, Christine; Catz, Sheryl

    2016-01-01

    Background Despite the success of antiretroviral therapy (ART), HIV-infected older African Americans experience higher mortality rates compared to their white counterparts. This disparity may be partly attributable to the differences in ART adherence by different racial and gender groups. The purpose of this study was to describe demographic, psychosocial, and HIV disease-related factors that influence ART adherence and to determine whether race and gender impact ART adherence among HIV-infected adults aged 50 years and older. Methods This descriptive study involved a secondary analysis of baseline data from 426 participants in “PRIME,” a telephone-based ART adherence and quality-of-life intervention trial. Logistic regression was used to examine the association between independent variables and ART adherence. Results Higher annual income and increased self-efficacy were associated with being ≥95% ART adherent. Race and gender were not associated with ART adherence. Conclusion These findings indicated that improvements in self-efficacy for taking ART may be an effective strategy to improve adherence regardless of race or gender. PMID:27071744

  5. Qualitative Investigation of a Brief Chronic Pain Screening Tool in HIV-Infected Patients

    PubMed Central

    Walcott, Melonie M.; Herbey, Ivan; Chamot, Eric; Ritchie, Christine; Saag, Michael S.; Kertesz, Stefan

    2014-01-01

    Abstract Chronic pain in HIV-infected patients is prevalent but understudied. A limitation of HIV/chronic pain research to date is the lack of a widely used chronic pain screening tool. A Brief Chronic Pain Screening tool (BCPS) has been described, but has not yet been tested in a clinical population. This study sought to evaluate how the BCPS is experienced by HIV-infected individuals, and adapt its questions if necessary. We conducted cognitive interviews using cognitive inquiry in participants from the UAB 1917 HIV Clinic Cohort. Data were analyzed using a process of inductive, iterative coding by three investigators. Results: Of 30 participants, most were male, African American, and less than 50 years old. Participants reported that the questions were understandable; however, feedback suggested concerns regarding lack of specificity in regard to the intensity and consistency of pain. An introductory statement aimed at improving clarity resulted in more divergent responses. This research team concluded that the version of the BCPS used in the first 30 interviews was optimum. Its inclusive language allows the respondent to decide what pain merits reporting. This study is the first investigation of the BCPS in a clinical population, and should lead to further quantitative validation studies of this tool. PMID:24621145

  6. Sexual partner notification of HIV infection among a National United States-based sample of HIV-infected men.

    PubMed

    Edelman, E J; Gordon, K S; Hogben, M; Crystal, S; Bryant, K; Justice, A C; Fiellin, D A

    2014-10-01

    Limited data exist on whether sexual partner notification practices among HIV-infected men, particularly those who have sex with men (MSM), vary by HIV viral load. We examined factors associated with complete (all partners) versus incomplete partner notification in 760 HIV-infected individuals across the United States, 49 % of whom were MSM. Thirty-four percent reported incomplete partner notification. Incomplete partner notification was more likely among black men, MSM, and those reporting casual partners and non-condom use. Partner notification practices did not vary by HIV viral load except among those with casual partners in whom a detectable viral load was associated with incomplete partner notification. Increased sexual partner notification among HIV-infected men, especially MSM, is needed.

  7. ILC You Later: Early and Irreparable Loss of Innate Lymphocytes in HIV Infection.

    PubMed

    Mudd, Joseph C; Brenchley, Jason M

    2016-02-16

    Loss of IL-17-producing cells in the gut during HIV infection is linked to GI barrier damage. Kløverpris et al. (2016) find that circulating ILCs are lost early and irreversibly during HIV infection. Early ART administration protects against the ILC loss, and this might be clinically beneficial to HIV-infected individuals. PMID:26885853

  8. TEC variations along an East Euro-African chain during 5th April 2010 geomagnetic storm

    NASA Astrophysics Data System (ADS)

    Shimeis, A.; Borries, C.; Amory-Mazaudier, C.; Fleury, R.; Mahrous, A. M.; Hassan, A. F.; Nawar, S.

    2015-05-01

    In this paper, we analyzed the variations of TEC along a latitudinal East Euro-African chain, during the storm of April 5, 2010. We observed a large asymmetry between the two hemispheres. We detected the presence of a TID in the Northern hemisphere on April 5. The propagation time of the TID from high to low latitudes and the speed of the TID was determined. On April 5, 6 and 7, we observed a decrease of the TEC and changes of the NO+ in the Northern hemisphere. This depletion is caused by the large-scale thermospheric wind disturbances due to Joule heating dissipation in the auroral zone.

  9. Interannual modulation of East African early short rains by the winter Arctic Oscillation

    NASA Astrophysics Data System (ADS)

    Gong, Dao-Yi; Guo, Dong; Mao, Rui; Yang, Jing; Gao, Yongqi; Kim, Seong-Joong

    2016-08-01

    In the present study, we analyzed the interannual linkage between the boreal winter Arctic Oscillation (AO) and East African early short rains. When the Indian Ocean Dipole and El Niño-Southern Oscillation variance are excluded by linear regression, the boreal winter AO index is significantly correlated with the October East African precipitation over the domain of 5°N-5°S and 35°-45°E for the period 1979-2014, r =+ 0.46. The upper ocean heat content likely acts as a medium that links the AO and East African precipitation. Significant subsurface warming and positive upper ocean heat content anomalies occur over the western Indian Ocean during the autumn following positive AO winters, which enriches the atmospheric moisture, intensifies convection, and enhances precipitation. Oceanic dynamics play a key role in causing this subsurface warming. Winter AO-related atmospheric circulation creates anomalous wind stress, which forces a downwelling oceanic Rossby wave between 60°-75°E and 5°-10°S, where the thermocline significantly deepens. This Rossby wave propagates westward and accompanies significant subsurface warming along the thermocline. The Rossby wave arrives at the western Indian Ocean in the late summer, significantly warming the region to the west of 55°E at a depth of 60-100 m. This warming remains significant through October. Correspondingly, the upper ocean heat content significantly increases by approximately 2-3 × 108 J m-2 in the region west of 60°E between 5° and 10°S. The role of these oceanic dynamics in linking the winter AO, and anomalous subsurface warming was tested by numerical experiments with an oceanic general circulation model. The experiments were performed with the forcing of AO-related wind stress anomalies over the Indian Ocean in the winter. The oceanic Rossby wave generated in the central Indian Ocean during boreal winter, the consequent subsurface warming, and the anomalous upper ocean heat content in October over the

  10. East African pigs have a complex Indian, Far Eastern and Western ancestry.

    PubMed

    Noce, A; Amills, M; Manunza, A; Muwanika, V; Muhangi, D; Aliro, T; Mayega, J; Ademun, R; Sànchez, A; Egbhalsaied, S; Mercadé, A; Masembe, C

    2015-08-01

    In this study, we have characterized the mitochondrial diversity of 81 swine from Uganda. Median-joining network analysis of D-loop sequences from these individuals and others characterized in previous studies allowed us to determine that Ugandan pigs cluster with populations from the West (Europe/North Africa), Far East and India. In addition, partial sequencing of the Y-chromosome UTY locus in 18 Ugandan domestic pigs revealed the segregation of a single HY1 lineage that has a cosmopolitan distribution. A Western and Far Eastern ancestry for East African pigs had been already reported, but this is the first study demonstrating an additional contribution from the Indian porcine gene pool. This result is consistent with the high frequency of zebuine alleles in cattle from East Africa. The geographic coordinates of East Africa, at the crossroads of many trading routes that, through the ages, linked Europe, Africa and Asia, might explain the rich and complex genetic heritage of livestock native to this area. PMID:26011180

  11. Drinking Trajectories among HIV-Infected Men Who Have Sex With Men: A Cohort Study of United States Veterans*

    PubMed Central

    Marshall, Brandon D.L.; Operario, Don; Bryant, Kendall J.; Cook, Robert L.; Edelman, E. Jennifer; Gaither, Julie R.; Gordon, Adam J.; Kahler, Christopher W.; Maisto, Stephen A.; McGinnis, Kathleen A.; van den Berg, Jacob J.; Zaller, Nickolas D.; Justice, Amy C.; Fiellin, David A.

    2015-01-01

    Background Although high rates of alcohol consumption and related problems have been observed among HIV-infected men who have sex with men (MSM), little is known about the long-term patterns of and factors associated with hazardous alcohol use in this population. We sought to identify alcohol use trajectories and correlates of hazardous alcohol use among HIV-infected MSM. Methods Sexually active, HIV-infected MSM participating in the Veterans Aging Cohort Study were eligible for inclusion. Participants were recruited from VA infectious disease clinics in Atlanta, Baltimore, New York, Houston, Los Angeles, Pittsburgh, and Washington, DC. Data from annual self-reported assessments and group-based trajectory models were used to identify distinct alcohol use trajectories over an eight-year study period (2002–2010). We then used generalized estimate equations (GEE) to examine longitudinal correlates of hazardous alcohol use (defined as an AUDIT-C score ≥4). Results Among 1,065 participants, the mean age was 45.5 (SD=9.2) and 606 (58.2%) were African American. Baseline hazardous alcohol use was reported by 309 (29.3%). Group-based trajectory modeling revealed a distinct group (12.5% of the sample) with consistently hazardous alcohol use, characterized by a mean AUDIT-C score of >5 at every time point. In a GEE-based multivariable model, hazardous alcohol use was associated with earning <$6,000 annually, having an alcohol-related diagnosis, using cannabis, and using cocaine. Conclusions More than 1 in 10 HIV-infected MSM US veterans reported consistent, long-term hazardous alcohol use. Financial insecurity and concurrent substance use were predictors of consistently hazardous alcohol use, and may be modifiable targets for intervention. PMID:25596785

  12. Drug resistance among newly-diagnosed HIV-infected children in the era of more efficacious antiretroviral prophylaxis

    PubMed Central

    Kuhn, Louise; Hunt, Gillian; Technau, Karl-Günter; Coovadia, Ashraf; Ledwaba, Johanna; Pickerill, Sam; Penazzato, Martina; Bertagnolio, Silvia; Mellins, Claude A.; Black, Vivian; Morris, Lynn; Abrams, Elaine J.

    2015-01-01

    Background In the era of more efficacious prevention of mother-to-child transmission (PMTCT) regimens, documenting the profile of drug resistance in HIV-infected infants and young children is critical to our efforts to improve care and treatment for children. Methods HIV drug resistance mutations in plasma virus were ascertained using population sequencing among 230 newly-diagnosed HIV-infected children under 2 years of age recruited in Johannesburg, South Africa, during 2011. By this time, more effective PMTCT regimens, including combination antiretroviral therapy (cART) for pregnant women, were being implemented. Results Two-thirds (67.4%) of HIV-infected children had been exposed to some form of maternal (89%) and/or infant (97%) PMTCT. Among PMTCT-exposed, 56.8% had non-nucleoside reverse transcriptase inhibitor (NNRTI), 14.8% nucleoside reverse transcriptase inhibitor (NRTI), and 1.3% protease inhibitor (PI) mutations. NNRTI mutations were strongly related to younger age. The remaining third (32.6%) had no reported or recorded PMTCT exposures but resistance to NNRTI was detected in 24.0%, NRTI in 10.7% and PI in 1.3%. Conclusion The new PMTCT strategies dramatically reduce the number of children who acquire infection but among those who do become infected, NNRTI resistance prevalence is high. In this South African setting with high PMTCT coverage, almost a quarter of children with no reported or recorded PMTCT also have drug resistance mutations. PMTCT history is an inadequate means of ruling out pre-treatment drug resistance. Our results support the use of PI-based first-line regimens in HIV-infected infants and young children regardless of PMTCT history. PMID:24785949

  13. Sulforaphane Inhibits HIV Infection of Macrophages through Nrf2

    PubMed Central

    Furuya, Andrea Kinga Marias; Sharifi, Hamayun J.; Jellinger, Robert M.; Cristofano, Paul; Shi, Binshan; de Noronha, Carlos M. C.

    2016-01-01

    Marburg virus, the Kaposi's sarcoma-associated herpesvirus (KSHV) and Dengue virus all activate, and benefit from, expression of the transcription regulator nuclear erythroid 2-related factor 2 (Nrf2). The impact of Nrf2 activation on human immunodeficiency virus (HIV) infection has not been tested. Sulforaphane (SFN), produced in cruciferous vegetables after mechanical damage, mobilizes Nrf2 to potently reprogram cellular gene expression. Here we show for the first time that SFN blocks HIV infection in primary macrophages but not in primary T cells. Similarly SFN blocks infection in PMA-differentiated promonocytic cell lines, but not in other cell lines tested. siRNA-mediated depletion of Nrf2 boosted HIV infectivity in primary macrophages and reduced the anti-viral effects of SFN treatment. This supports a model in which anti-viral activity is mediated through Nrf2 after it is mobilized by SFN. We further found that, like the type I interferon-induced cellular anti-viral proteins SAMHD1 and MX2, SFN treatment blocks infection after entry, but before formation of 2-LTR circles. Interestingly however, neither SAMHD1 nor MX2 were upregulated. This shows for the first time that Nrf2 action can potently block HIV infection and highlights a novel way to trigger this inhibition. PMID:27093399

  14. The Experience of Children with Hemophilia and HIV Infection.

    ERIC Educational Resources Information Center

    Hall, Christopher S.

    1994-01-01

    Children with hemophilia and Human Immunodeficiency Virus (HIV) infection are not a transmission risk to other children, and they can help enact best practices for school attendance by other such children. The article examines the National Hemophilia Foundation's work to promote appropriate inclusion of students with hemophilia and HIV in all…

  15. Sulforaphane Inhibits HIV Infection of Macrophages through Nrf2.

    PubMed

    Furuya, Andrea Kinga Marias; Sharifi, Hamayun J; Jellinger, Robert M; Cristofano, Paul; Shi, Binshan; de Noronha, Carlos M C

    2016-04-01

    Marburg virus, the Kaposi's sarcoma-associated herpesvirus (KSHV) and Dengue virus all activate, and benefit from, expression of the transcription regulator nuclear erythroid 2-related factor 2 (Nrf2). The impact of Nrf2 activation on human immunodeficiency virus (HIV) infection has not been tested. Sulforaphane (SFN), produced in cruciferous vegetables after mechanical damage, mobilizes Nrf2 to potently reprogram cellular gene expression. Here we show for the first time that SFN blocks HIV infection in primary macrophages but not in primary T cells. Similarly SFN blocks infection in PMA-differentiated promonocytic cell lines, but not in other cell lines tested. siRNA-mediated depletion of Nrf2 boosted HIV infectivity in primary macrophages and reduced the anti-viral effects of SFN treatment. This supports a model in which anti-viral activity is mediated through Nrf2 after it is mobilized by SFN. We further found that, like the type I interferon-induced cellular anti-viral proteins SAMHD1 and MX2, SFN treatment blocks infection after entry, but before formation of 2-LTR circles. Interestingly however, neither SAMHD1 nor MX2 were upregulated. This shows for the first time that Nrf2 action can potently block HIV infection and highlights a novel way to trigger this inhibition. PMID:27093399

  16. Geriatric Syndromes in Older HIV-Infected Adults

    PubMed Central

    Greene, Meredith; Covinsky, Kenneth E.; Valcour, Victor; Miao, Yinghui; Madamba, Joy; Lampiris, Harry; Cenzer, Irena Stijacic; Martin, Jeffrey; Deeks, Steven G.

    2015-01-01

    Background Geriatric syndromes such as falls, frailty, and functional impairment are multifactorial conditions used to identify vulnerable older adults. Limited data exists on these conditions in older HIV-infected adults and no studies have comprehensively examined these conditions. Methods Geriatric syndromes including falls, urinary incontinence, functional impairment, frailty, sensory impairment, depression and cognitive impairment were measured in a cross-sectional study of HIV-infected adults age 50 and older who had an undetectable viral load on antiretroviral therapy (ART). We examined both HIV and non-HIV related predictors of geriatric syndromes including sociodemographics, number of co-morbidities and non-antiretroviral medications, and HIV specific variables in multivariate analyses. Results We studied 155 participants with a median age of 57 (IQR 54-62); (94%) were men. Pre-frailty (56%), difficulty with instrumental activities of daily living (46%), and cognitive impairment (47%) were the most frequent geriatric syndromes. Lower CD4 nadir (IRR 1.16, 95% CI 1.06-1.26), non-white race (IRR 1.38, 95% CI 1.10-1.74), and increasing number of comorbidities (IRR 1.09, 95%CI 1.03-1.15) were associated with increased risk of having more geriatric syndromes. Conclusions Geriatric syndromes are common in older HIV infected adults. Treatment of comorbidities and early initiation of ART may help to prevent development of these age related complications. Clinical care of older HIV-infected adults should consider incorporation of geriatric principles. PMID:26009828

  17. Arterial hypertension and cardiovascular risk in HIV-infected patients.

    PubMed

    Calò, Lorenzo A; Caielli, Paola; Maiolino, Giuseppe; Rossi, Gianpaolo

    2013-08-01

    The dramatic change of the natural history of HIV-infected patients by highly active antiretroviral therapy (HAART) has exposed these patients to cardiovascular risk, including cardiovascular disease and hypertension. In HIV-infected patients, the development of arterial hypertension, at least in the medium-long term is an established feature, although recognized predictors of its development have not been clearly identified. In addition, conflicting data regarding the influence of antiretroviral therapy (ART) are reported. The presence of a proinflammatory state and oxidative stress-mediated endothelial dysfunction seem, however, to play a pathophysiologic role. In this review, we examine and provide a comprehensive, literature based, consideration of the pathophysiologic aspects of hypertension in these patients. HIV-infected patients, independently of the presence of hypertension, remain at very high cardiovascular risk due to the presence of the same cardiovascular risk factors recognized for the general population with, in addition, the indirect influence of the ART, essentially via its effect on lipid metabolism. This review based on the evidence from the literature, concludes that the management of HIV-infected patients in terms of cardiovascular prevention emerges as a priority. The consideration of cardiovascular risk in these patients should receive the same emphasis given for the general population at high cardiovascular risk, including adequate blood pressure control according to international guidelines.

  18. The challenges of modelling antibody repertoire dynamics in HIV infection

    SciTech Connect

    Luo, Shishi; Perelson, Alan S.

    2015-07-20

    Antibody affinity maturation by somatic hypermutation of B-cell immunoglobulin variable region genes has been studied for decades in various model systems using well-defined antigens. While much is known about the molecular details of the process, our understanding of the selective forces that generate affinity maturation are less well developed, particularly in the case of a co-evolving pathogen such as HIV. Despite this gap in understanding, high-throughput antibody sequence data are increasingly being collected to investigate the evolutionary trajectories of antibody lineages in HIV-infected individuals. Here, we review what is known in controlled experimental systems about the mechanisms underlying antibody selection and compare this to the observed temporal patterns of antibody evolution in HIV infection. In addition, we describe how our current understanding of antibody selection mechanisms leaves questions about antibody dynamics in HIV infection unanswered. Without a mechanistic understanding of antibody selection in the context of a co-evolving viral population, modelling and analysis of antibody sequences in HIV-infected individuals will be limited in their interpretation and predictive ability.

  19. The challenges of modelling antibody repertoire dynamics in HIV infection

    DOE PAGES

    Luo, Shishi; Perelson, Alan S.

    2015-07-20

    Antibody affinity maturation by somatic hypermutation of B-cell immunoglobulin variable region genes has been studied for decades in various model systems using well-defined antigens. While much is known about the molecular details of the process, our understanding of the selective forces that generate affinity maturation are less well developed, particularly in the case of a co-evolving pathogen such as HIV. Despite this gap in understanding, high-throughput antibody sequence data are increasingly being collected to investigate the evolutionary trajectories of antibody lineages in HIV-infected individuals. Here, we review what is known in controlled experimental systems about the mechanisms underlying antibody selectionmore » and compare this to the observed temporal patterns of antibody evolution in HIV infection. In addition, we describe how our current understanding of antibody selection mechanisms leaves questions about antibody dynamics in HIV infection unanswered. Without a mechanistic understanding of antibody selection in the context of a co-evolving viral population, modelling and analysis of antibody sequences in HIV-infected individuals will be limited in their interpretation and predictive ability.« less

  20. Medical School Policies Regarding Medical Students and HIV Infection.

    ERIC Educational Resources Information Center

    Tesch, Bonnie; And Others

    1993-01-01

    A telephone survey of 42 medical schools in areas of high, medium, and low incidence of human immunodeficiency virus (HIV) investigated school policies concerning prevention and reporting of HIV infection, confidentiality, screening, limiting clinical activities, counseling, vaccination, prophylactic drug administration, and disability and health…

  1. Bone health in children and adolescents with perinatal HIV infection

    PubMed Central

    Puthanakit, Thanyawee; Siberry, George K

    2013-01-01

    The long-term impact on bone health of lifelong HIV infection and prolonged ART in growing and developing children is not yet known. Measures of bone health in youth must be interpreted in the context of expected developmental and physiologic changes in bone mass, size, density and strength that occur from fetal through adult life. Low bone mineral density (BMD) appears to be common in perinatally HIV-infected youth, especially outside of high-income settings, but data are limited and interpretation complicated by the need for better pediatric norms. The potential negative effects of tenofovir on BMD and bone mass accrual are of particular concern as this drug may be used more widely in younger children. Emphasizing good nutrition, calcium and vitamin D sufficiency, weight-bearing exercise and avoidance of alcohol and smoking are effective and available approaches to maintain and improve bone health in all settings. More data are needed to inform therapies and monitoring for HIV-infected youth with proven bone fragility. While very limited data suggest lack of marked increase in fracture risk for youth with perinatal HIV infection, the looming concern for these children is that they may fail to attain their expected peak bone mass in early adulthood which could increase their risk for fractures and osteoporosis later in adulthood. PMID:23782476

  2. New cryptosporidium genotypes in HIV-infected persons.

    PubMed Central

    Pieniazek, N. J.; Bornay-Llinares, F. J.; Slemenda, S. B.; da Silva, A. J.; Moura, I. N.; Arrowood, M. J.; Ditrich, O.; Addiss, D. G.

    1999-01-01

    Using DNA sequencing and phylogenetic analysis, we identified four distinct Cryptosporidium genotypes in HIV-infected patients: genotype 1 (human), genotype 2 (bovine) Cryptosporidium parvum, a genotype identical to C. felis, and one identical to a Cryptosporidium sp. isolate from a dog. This is the first identification of human infection with the latter two genotypes. PMID:10341184

  3. Reassessing Medical Students' Willingness to Treat HIV-Infected Patients.

    ERIC Educational Resources Information Center

    Carter, Darren; And Others

    1996-01-01

    Surveyed 297 matriculating medical students at 3 Chicago medical schools concerning their willingness to treat HIV-infected patients. Found that 92% of the students agreed that patients with HIV would be welcome in their medical practices. Fear of infection and homophobia were associated with decreased willingness to treat. (MDM)

  4. Alcohol abuse and HIV infection: role of DRD2.

    PubMed

    Agudelo, Marisela; Khatavkar, Pradnya; Yndart, Adriana; Yoo, Changwon; Rosenberg, Rhonda; Devieux, Jessy G; Malow, Robert M; Nair, Madhavan

    2014-01-01

    According to a survey from the HIV Cost and Services Utilization Study (HCSUS), approximately 53% of HIV-infected patients reported drinking alcohol and 8% were classified as heavy drinkers. The role of alcohol as a risk factor for HIV infection has been widely studied and recent research has found a significant association between heavy alcohol consumption and lower levels of CD4 T cells among HIV-infected alcoholics. Although there is evidence on the role of alcohol as a risk factor for HIV transmission and disease progression, there is a need for population studies to determine the genetic mechanisms that affect alcohol's role in HIV disease progression. One of the mechanisms of interest is the dopaminergic system. To date, the effects of dopamine on HIV neuroimmune pathogenesis are not well understood; however, dopaminergic neural degeneration due to HIV is known to occur by viral invasion into the brain via immune cells, and modulation of dopamine in the CNS may be a common mechanism by which different types of substances of abuse impact HIV disease progression. Although previous studies have shown an association of D(2) dopamine receptor (DRD2) polymorphisms with severity of alcohol dependence, the expression of this allele risk on HIV patients with alcohol dependence has not been systematically explored. In the current study, DRD2 Taq1A and C957T SNP genotyping analyses were performed in 165 HIV-infected alcohol abusers and the results were examined with immune status and CD4 counts.

  5. Endothelial and platelet function alterations in HIV-infected patients.

    PubMed

    Gresele, P; Falcinelli, E; Sebastiano, M; Baldelli, F

    2012-03-01

    The HIV epidemic has huge dimensions: in 2009, 33.3million people worldwide, including 2.5million children, were affected by human immunodeficiency virus (HIV) infection. The introduction of Highly Active Anti-Retroviral Therapy (HAART) has significantly modified the course of HIV disease, with longer survival and improved quality of life, but it has simultaneously lead to the appearance of previously unrecognized complications, such as ischemic cardiovascular events. Many studies have shown a higher rate of premature atherosclerosis in patients with HIV infection, leading to coronary, cerebrovascular, or peripheral arterial disease. However, it is still debated whether cardiovascular complications are a consequence of HIV infection itself or of the long-term use of HAART. In particular, myocardial infarction has been suggested to be associated with the use of abacavir. Endothelial dysfunction and platelet activation are markers of atherosclerosis and of increased cardiovascular risk. Here we review the evidence that endothelial dysfunction and platelet alterations are associated with chronic HIV infection, the possible role of different HAARTs, and the possible pathophysiologic mechanisms. Potential therapeutic implications are also discussed.

  6. Reaching rural African American women difficult. Researcher discusses chief issues.

    PubMed

    2005-06-01

    Poverty and inequality are among the major challenges faced by the rural African American women at risk for HIV infection, and they increase this population's potential for becoming infected, an expert says.

  7. Post-collisional magmatism in the central East African Orogen: The Maevarano Suite of north Madagascar

    USGS Publications Warehouse

    Goodenough, K.M.; Thomas, Ronald J.; De Waele, B.; Key, R.M.; Schofield, D.I.; Bauer, W.; Tucker, R.D.; Rafahatelo, J.-M.; Rabarimanana, M.; Ralison, A.V.; Randriamananjara, T.

    2010-01-01

    Late tectonic, post-collisional granite suites are a feature of many parts of the Late Neoproterozoic to Cambrian East African Orogen (EAO), where they are generally attributed to late extensional collapse of the orogen, accompanied by high heat flow and asthenospheric uprise. The Maevarano Suite comprises voluminous plutons which were emplaced in some of the tectonostratigraphic terranes of northern Madagascar, in the central part of the EAO, following collision and assembly during a major orogeny at ca. 550 Ma. The suite comprises three main magmatic phases: a minor early phase of foliated gabbros, quartz diorites, and granodiorites; a main phase of large batholiths of porphyritic granitoids and charnockites; and a late phase of small-scale plutons and sheets of monzonite, syenite, leucogranite and microgranite. The main phase intrusions tend to be massive, but with variably foliated margins. New U-Pb SHRIMP zircon data show that the whole suite was emplaced between ca. 537 and 522 Ma. Geochemically, all the rocks of the suite are enriched in the LILE, especially K, and the LREE, but are relatively depleted in Nb, Ta and the HREE. These characteristics are typical of post-collisional granitoids in the EAO and many other orogenic belts. It is proposed that the Maevarano Suite magmas were derived by melting of sub-continental lithospheric mantle that had been enriched in the LILE during earlier subduction events. The melting occurred during lithospheric delamination, which was associated with extensional collapse of the East African Orogen. ?? 2009 Natural Environment Research Council.

  8. Evarcha culicivora chooses blood-fed Anopheles mosquitoes but other East African jumping spiders do not.

    PubMed

    Jackson, R R; Nelson, X J

    2012-06-01

    Previous research using computer animation and lures made from dead prey has demonstrated that the East African salticid Evarcha culicivora Wesolowska & Jackson (Araneae: Salticidae) feeds indirectly on vertebrate blood by actively choosing blood-carrying female mosquitoes as prey, and also that it singles out mosquitoes of the genus Anopheles (Diptera: Culicidae) by preference. Here, we demonstrate that E. culicivora's preference is expressed when the species is tested with living prey and that it is unique to E. culicivora. As an alternative hypothesis, we considered the possibility that the preference for blood-fed female anopheline mosquitoes might be widespread in East African salticids. When live-prey choice tests were carried out in 19 additional species, there were no instances in which blood-carrying mosquitoes were chosen significantly more often than other prey. Combined with the findings of previous work, these results suggest that it is possible that specialized predators play a role in the biological control of disease vectors. PMID:22032682

  9. Determinants of survival among HIV-infected chronic dialysis patients.

    PubMed

    Rodriguez, Rudolph A; Mendelson, Michael; O'Hare, Ann M; Hsu, Ling Chin; Schoenfeld, Patricia

    2003-05-01

    Over 100 HIV-infected patients have initiated chronic dialysis at San Francisco General Hospital (SFGH) since 1985. This study employed retrospective analysis to identify determinants of and trends in survival among HIV-infected patients who have initiated chronic dialysis at SFGH from January 1, 1985 to November 1, 2002 (n = 115). Cohort patient survival was compared with survival after an AIDS-opportunistic illness in all HIV-infected patients in San Francisco during the study period. Higher CD4 count (hazard ratio [HR], 0.86 per 50 cells/mm(3) increase; 95% confidence interval [CI], 0.80 to 0.93) and serum albumin (HR, 0.53 per 1 g/dl increase; CI, 0.36 to 0.78) at initiation of dialysis were strongly associated with lower mortality. Survival for those initiating dialysis during the era of highly active antiretroviral therapy (HAART) was 16.1 mo versus 9.4 mo for those initiating dialysis before this time, but this difference was not statistically significant. In adjusted analysis, only a non-statistically significant trend toward improved survival during the HAART era was noted (HR, 0.59; CI, 0.34 to 1.04). By comparison, survival for all HIV-infected patients after an AIDS-opportunistic illness in San Francisco increased from 16 mo in 1994 to 81 mo in 1996. The dramatic improvement in survival that has occurred since the mid-1990s for patients with HIV appears to be greatly attenuated in the sub-group undergoing dialysis. Although this may partly reflect confounding by race, injection drug use and HCV co-infection, future attempts to improve survival among HIV-infected dialysis patients should focus on barriers to the effective use of HAART in this group.

  10. The food of Near East, North West and Western African regions.

    PubMed

    Burlingame, Barbara

    2003-01-01

    Among the countries that can be classified as Near East Africa, North West Africa, and Western Africa, there is a great diversity of foods and dietary patterns. Prevalence of undernourishment as defined by FAO using dietary energy supply data, varies dramatically among these countries, with Tunisia in the lowest prevalence category (<2.5%), and Sierra Leone in the highest prevalence category (>35%). Throughout the 1960's, the dietary energy supply of North West African and Western African countries was similar. However, since the 1970s a great and consistent improvement has been seen in North and North West African countries. Both the proportion and number of undernourished in North Africa is now very similar to that of North America. Oil use, energy from fat, and protein from plant versus animal sources account for a large part of the food pattern differences between countries in these regions. Using Tunisia and Sierra Leone as examples again, dietary diversity as measured by the percentage of energy from foods other than starchy staples, is about 50% in the former, while in the latter, it is only 36%. Fatty fruits such as olives, cocoa and palm fruit have a special role in both the diet and the economies of the region. PMID:14505995

  11. The food of Near East, North West and Western African regions.

    PubMed

    Burlingame, Barbara

    2003-01-01

    Among the countries that can be classified as Near East Africa, North West Africa, and Western Africa, there is a great diversity of foods and dietary patterns. Prevalence of undernourishment as defined by FAO using dietary energy supply data, varies dramatically among these countries, with Tunisia in the lowest prevalence category (<2.5%), and Sierra Leone in the highest prevalence category (>35%). Throughout the 1960's, the dietary energy supply of North West African and Western African countries was similar. However, since the 1970s a great and consistent improvement has been seen in North and North West African countries. Both the proportion and number of undernourished in North Africa is now very similar to that of North America. Oil use, energy from fat, and protein from plant versus animal sources account for a large part of the food pattern differences between countries in these regions. Using Tunisia and Sierra Leone as examples again, dietary diversity as measured by the percentage of energy from foods other than starchy staples, is about 50% in the former, while in the latter, it is only 36%. Fatty fruits such as olives, cocoa and palm fruit have a special role in both the diet and the economies of the region.

  12. Comparisons of coat protein gene sequences show that East African isolates of Sweet potato feathery mottle virus form a genetically distinct group.

    PubMed

    Kreuze, J F; Karyeija, R F; Gibson, R W; Valkonen, J P

    2000-01-01

    Sweet potato feathery mottle virus (SPFMV, genus Potyvirus) infects sweet potatoes (Ipomoea batatas) worldwide, but no sequence data on isolates from Africa are available. Coat protein (CP) gene sequences from eight East African isolates from Madagascar and different districts of Uganda (the second biggest sweet potato producer in the world) and two West African isolates from Nigeria and Niger were determined. They were compared by phylogenetic analysis with the previously reported sequences of ten SPFMV isolates from other continents. The East African SPFMV isolates formed a distinct cluster, whereas the other isolates were not clustered according to geographic origin. These data indicate that East African isolates of SPFMV form a genetically unique group.

  13. Molecular characterization of two endothelin pathways in East African cichlid fishes.

    PubMed

    Diepeveen, Eveline T; Salzburger, Walter

    2011-12-01

    The adaptive radiations of cichlid fishes in East Africa have been associated with the acquisition of evolutionary novelties as well as the ecological opportunities existing in the East African Great lakes. Two remarkable evolutionary innovations are the pharyngeal jaw apparatus, found in all cichlid species, and the anal fin egg-spots of mouthbrooding cichlids. Based on their conserved functions during the development of both the jaw apparatus and pigmentation, the endothelin ligands and receptors form a putative link between these naturally and sexually selected traits. Here we study the evolutionary history of four members of two endothelin pathways (Edn1/EdnrAa and Edn3b/EdnrB1a) to elucidate their possible roles during the evolution and development of key innovations in East African cichlids species. The analyses performed on partial sequences (ca. 6,000 bp per taxon) show that all four endothelin family members evolved under purifying selection, although both ligands are characterized by an accelerated rate of protein evolution in comparison to the receptors. In accordance with earlier findings, we show that the mature protein sequence of Edn1 and Edn3 are highly conserved, also in cichlids, whereas the preproendothelin parts are variable indicating relaxed selective constraints. In the receptors, nonsynonymous substitutions were mainly found in the ligand-binding domains suggesting functional divergence. Gene expression assays with Real-Time PCR indeed reveal that the two studied endothelin pathways are expressed in the cichlid pharyngeal jaw and in the haplochromine egg-spot (among other pigment-cell containing tissues), suggesting their involvement during morphogenesis of naturally and sexually selected traits in cichlids. PMID:22271349

  14. Association between climate variability and malaria epidemics in the East African highlands

    PubMed Central

    Zhou, Guofa; Minakawa, Noboru; Githeko, Andrew K.; Yan, Guiyun

    2004-01-01

    The causes of the recent reemergence of Plasmodium falciparum epidemic malaria in the East African highlands are controversial. Regional climate changes have been invoked as a major factor; however, assessing the impact of climate in malaria resurgence is difficult due to high spatial and temporal climate variability and the lack of long-term data series on malaria cases from different sites. Climate variability, defined as short-term fluctuations around the mean climate state, may be epidemiologically more relevant than mean temperature change, but its effects on malaria epidemics have not been rigorously examined. Here we used nonlinear mixed-regression model to investigate the association between autoregression (number of malaria outpatients during the previous time period), seasonality and climate variability, and the number of monthly malaria outpatients of the past 10–20 years in seven highland sites in East Africa. The model explained 65–81% of the variance in the number of monthly malaria outpatients. Nonlinear and synergistic effects of temperature and rainfall on the number of malaria outpatients were found in all seven sites. The net variance in the number of monthly malaria outpatients caused by autoregression and seasonality varied among sites and ranged from 18 to 63% (mean = 38.6%), whereas 12–63% (mean = 36.1%) of variance is attributed to climate variability. Our results suggest that there was a high spatial variation in the sensitivity of malaria outpatient number to climate fluctuations in the highlands, and that climate variability played an important role in initiating malaria epidemics in the East African highlands. PMID:14983017

  15. Current kinematics and dynamics of Africa and the East African Rift System

    NASA Astrophysics Data System (ADS)

    Stamps, D. S.; Flesch, L. M.; Calais, E.; Ghosh, A.

    2014-06-01

    Although the East African Rift System (EARS) is an archetype continental rift, the forces driving its evolution remain debated. Some contend buoyancy forces arising from gravitational potential energy (GPE) gradients within the lithosphere drive rifting. Others argue for a major role of the diverging mantle flow associated with the African Superplume. Here we quantify the forces driving present-day continental rifting in East Africa by (1) solving the depth averaged 3-D force balance equations for 3-D deviatoric stress associated with GPE, (2) inverting for a stress field boundary condition that we interpret as originating from large-scale mantle tractions, (3) calculating dynamic velocities due to lithospheric buoyancy forces, lateral viscosity variations, and velocity boundary conditions, and (4) calculating dynamic velocities that result from the stress response of horizontal mantle tractions acting on a viscous lithosphere in Africa and surroundings. We find deviatoric stress associated with lithospheric GPE gradients are ˜8-20 MPa in EARS, and the minimum deviatoric stress resulting from basal shear is ˜1.6 MPa along the EARS. Our dynamic velocity calculations confirm that a force contribution from GPE gradients alone is sufficient to drive Nubia-Somalia divergence and that additional forcing from horizontal mantle tractions overestimates surface kinematics. Stresses from GPE gradients appear sufficient to sustain present-day rifting in East Africa; however, they are lower than the vertically integrated strength of the lithosphere along most of the EARS. This indicates additional processes are required to initiate rupture of continental lithosphere, but once it is initiated, lithospheric buoyancy forces are enough to maintain rifting.

  16. Association between climate variability and malaria epidemics in the East African highlands.

    PubMed

    Zhou, Guofa; Minakawa, Noboru; Githeko, Andrew K; Yan, Guiyun

    2004-02-24

    The causes of the recent reemergence of Plasmodium falciparum epidemic malaria in the East African highlands are controversial. Regional climate changes have been invoked as a major factor; however, assessing the impact of climate in malaria resurgence is difficult due to high spatial and temporal climate variability and the lack of long-term data series on malaria cases from different sites. Climate variability, defined as short-term fluctuations around the mean climate state, may be epidemiologically more relevant than mean temperature change, but its effects on malaria epidemics have not been rigorously examined. Here we used nonlinear mixed-regression model to investigate the association between autoregression (number of malaria outpatients during the previous time period), seasonality and climate variability, and the number of monthly malaria outpatients of the past 10-20 years in seven highland sites in East Africa. The model explained 65-81% of the variance in the number of monthly malaria outpatients. Nonlinear and synergistic effects of temperature and rainfall on the number of malaria outpatients were found in all seven sites. The net variance in the number of monthly malaria outpatients caused by autoregression and seasonality varied among sites and ranged from 18 to 63% (mean=38.6%), whereas 12-63% (mean=36.1%) of variance is attributed to climate variability. Our results suggest that there was a high spatial variation in the sensitivity of malaria outpatient number to climate fluctuations in the highlands, and that climate variability played an important role in initiating malaria epidemics in the East African highlands.

  17. Calibration and application of the branched GDGT temperature proxy on East African lake sediments

    NASA Astrophysics Data System (ADS)

    Loomis, Shannon E.; Russell, James M.; Ladd, Bethany; Street-Perrott, F. Alayne; Sinninghe Damsté, Jaap S.

    2012-12-01

    Branched glycerol dialkyl glycerol tetraethers (brGDGTs) are a novel proxy for mean annual air temperature (MAAT) and have the potential to be broadly applicable to climate reconstruction using lacustrine sediments. Several calibrations have been put forth relating brGDGT distributions to MAAT using a variety of linear regressions, including the methylation (MBT) and cyclization (CBT) indices of brGDGTs, the relative abundances of the major, non-cyclized brGDGTs (MbrGDGTs), and best subsets regression (BSR) of the fractional abundances of the nine most common brGDGTs. However, these calibrations have rarely been applied to lake sediment cores to reconstruct temperatures and test the applicability of this proxy as a paleothermometer. We present an expanded East African lakes surface sediment brGDGT dataset based upon 111 lakes and examine three methods of calibrating brGDGTs to MAAT. These methods include recalculations of the East African lake MBT/CBT calibration and MbrGDGTs calibrations, as well as a new stepwise forward selection (SFS) calibration that uses the four combined brGDGTs that explain the most variance in temperature in our calibration set. We apply these new calibrations as well as five previously published lacustrine brGDGT calibrations to the brGDGT distributions of our surface sediment dataset and a 48 kyr sediment core from Sacred Lake, Mt. Kenya, producing the first brGDGT temperature reconstruction available from a small tropical lake. We compare the reconstructed temperatures to previously published paleotemperature records from East Africa to help us assess the performance of the brGDGT calibrations. We find that the SFS calibration has a consistently low root mean squared error of prediction (RMSEP) over the entire range of MAAT, while the MBT/CBT and MbrGDGT calibrations have relatively large RMSEPs, particularly between lakes with similar temperatures but variable pH. This suggests that these techniques do not properly deconvolve the

  18. Economic costs of HIV infection: an employer's perspective.

    PubMed

    Liu, G G; Yin, D D; Lyu, R; Chaikledkaew, U; Louie, S

    2002-01-01

    The introduction of highly active antiretroviral therapy has proven highly effective in treating patients with HIV/AIDS. However, the high cost of the advanced antiretroviral therapy has led to increased financial constraints on both patients and payers. From business firms'perspective, especially those with operations in developing countries, it is crucial to determine the long-term economic cost implications of alternative employment and benefit policies for HIV-infected workers or those at high risk for the disease. A simulation model is developed to predict the comprehensive lifetime economic costs of HIV-infected workers to an employer. This model employs age,CD4(+) cell counts,and plasma HIV-1 RNA level as major predictors of the disease progression and patient survival in the determination of various cost functions. Major cost components considered include direct expenses on health insurance premium,life insurance premium, short-term disability benefits, long-term disability benefits, hiring/training expenses, and indirect costs resulting from reduced or lost productivity at work. An individual model and a group model are derived to estimate the costs of an individual and a group of HIV-infected patients, respectively. Over a 10-year period, following the nonadvanced antiretroviral treatment regimen, the group model predicts that the total lifetime cost of an HIV-infected worker can be as high as U.S. 90,000 dollars to his/her employer, of which 60,000 dollars would be various explicit costs and 30,000 dollars lost work productivity. Sensitivity analysis further demonstrated that changes in the initial level of age,CD4(+) cell count, HIV-1 RNA viral load,CD4(+) cell decline rate, and the costs of medical care influence the dynamics of the cost functions. HIV infection can result in sizable economic costs to an employer over the lifetime course of an infected employee if not treated with the advanced antiretroviral therapy. These cost estimates provide a

  19. Accuracy of Clinical Suspicion and Pathologic Diagnosis of Kaposi Sarcoma in East Africa

    PubMed Central

    Woodruff, Carina Martin; Forrestel, Amy; Wenger, Megan; McCalmont, Timothy; LeBoit, Philip; Maurer, Toby; Laker-Oketta, Miriam; Muyindike, Winnie; Bwana, Mwebesa; Buziba, Nathan; Busakhala, Naftali; Wools-Kaloustian, Kara; Martin, Jeffrey

    2016-01-01

    Background: HIV-associated Kaposi sarcoma (KS) is one of the most common malignancies in sub-Saharan Africa. The diagnosis is often based on clinical suspicion, without histopathologic confirmation. When biopsies are performed, the accuracy of interpretation by local pathologists is poorly understood. We assessed the accuracy of clinical suspicion and pathologic diagnosis of KS in 2 East African countries. Methods: At 2 large HIV care sites in Uganda and Kenya, we evaluated consecutive biopsies performed from October 2008 to January 2013 on HIV-infected adults with clinically suspected KS. Biopsies were interpreted by both local African pathologists and a group of US-based dermatopathologists from a high volume medical center. For the purpose of this analysis, the US-based dermatopathologist interpretation was used as the gold standard. Positive predictive value was used to characterize accuracy of local African clinical suspicion of KS, and concordance, sensitivity, and specificity were used to characterize accuracy of local pathologic diagnosis. Results: Among 1106 biopsies, the positive predictive value of clinical suspicion of KS was 77% (95% confidence interval: 74% to 79%). When KS was not histopathologically diagnosed, clinically banal conditions were found in 35%, medically significant disorders which required different therapy in 59% and life-threatening diseases in 6%. Concordance between African pathologists and US-based dermatopathologists was 69% (95% confidence interval: 66% to 72%). Sensitivity and specificity of African pathologic diagnoses were 68% and 89%, respectively. Conclusions: Among East African HIV-infected patients, we found suboptimal positive predictive value of clinical suspicion of KS and specific, but not sensitive, histopathologic interpretation. The findings call for abandonment of isolated clinical diagnosis of KS in the region and augmentation of local dermatopathologic services. PMID:26452066

  20. Potential Health Impacts of Heavy Metals on HIV-Infected Population in USA

    PubMed Central

    Xu, Xiaohui; Hu, Hui; Dailey, Amy B.; Kearney, Greg; Talbott, Evelyn O.; Cook, Robert L.

    2013-01-01

    Purpose Noninfectious comorbidities such as cardiovascular diseases have become increasingly prevalent and occur earlier in life in persons with HIV infection. Despite the emerging body of literature linking environmental exposures to chronic disease outcomes in the general population, the impacts of environmental exposures have received little attention in HIV-infected population. The aim of this study is to investigate whether individuals living with HIV have elevated prevalence of heavy metals compared to non-HIV infected individuals in United States. Methods We used the National Health and Nutrition Examination Survey (NHANES) 2003-2010 to compare exposures to heavy metals including cadmium, lead, and total mercury in HIV infected and non-HIV infected subjects. Results In this cross-sectional study, we found that HIV-infected individuals had higher concentrations of all heavy metals than the non-HIV infected group. In a multivariate linear regression model, HIV status was significantly associated with increased blood cadmium (p=0.03) after adjusting for age, sex, race, education, poverty income ratio, and smoking. However, HIV status was not statistically associated with lead or mercury levels after adjusting for the same covariates. Conclusions Our findings suggest that HIV-infected patients might be significantly more exposed to cadmium compared to non-HIV infected individuals which could contribute to higher prevalence of chronic diseases among HIV-infected subjects. Further research is warranted to identify sources of exposure and to understand more about specific health outcomes. PMID:24023932

  1. Evaluation of the capability of RegCM4.0 in simulating East African climate

    NASA Astrophysics Data System (ADS)

    Ogwang, Bob Alex; Chen, Haishan; Li, Xing; Gao, Chujie

    2016-04-01

    The International Centre for Theoretical Physics (ICTP) regional climate model RegCM4.0 is used in this study to examine its ability to reproduce the climate of East Africa (EA) in regard to the annual cycle and June-to-August (JJA) seasonal climatology. Two domain sizes [large domain (LD) and small domain (SD)] and two cumulus convection schemes [Grell convection scheme with Fritsch-Chappell closure assumption (GRE scheme) and MIT scheme (EMA scheme)] are used. Simulations were done for the period 1989-2008 at a resolution of 50 km. The experiments were performed with the initial and lateral boundary conditions obtained from ERA-Interim-gridded reanalysis data at a 1.5° resolution. The variables investigated are precipitation, temperature, humidity, diurnal temperature range, and 850-hPa winds. Results show that the model realistically reproduces the East African climate, with a few discrepancies due to the different cumulus convection schemes and the domain sizes used. Grell with Fritsch-Chappell (Grell-FC) scheme captures well the observed climate in regard to the annual cycle and June-to-August seasonal climatology, with a tendency to underestimate rainfall over the JJA rainfall maximum region (RMR). This scheme performs better in LD than in SD. EMA scheme similarly captures well the observed climatology. It tends to overestimate rainfall over RMR. It however performs better in SD than in LD. The ensemble mean of simulations with GRE and EMA schemes (ENSM) tends to offer an improved representation of the observed climate, with a few discrepancies owing to the individual schemes used. In general, therefore, considering the performance of the model in both domains, the East African climate based on this study is better simulated by the Grell-FC scheme over LD. The observed biases in this study signify that the ability of the model in simulating climate over East Africa is still a significant challenge. Thus, future work must focus on improving the performance of

  2. Mortality and Risk Stratification of HIV Infected Individuals.

    PubMed

    Heltemes, Bradley R

    2015-01-01

    For the first decade and a half after the Human Immunodeficiency Virus (HIV) was first identified, the prognosis for most people infected with HIV was quite poor. Life insurance companies responded accordingly and insurance laboratories developed new means to test for the infection. However, it is now clear that people with HIV infection are living longer and that the majority of deaths occurring among those on treatment are now no longer due to AIDS-defining illnesses. This review examines the results of selected studies which analyzed mortality outcomes in those with HIV infection, the many factors which influence those outcomes, and the limitations in the data and in their applicability to an insurance population. PMID:27584921

  3. Clinical Care of the HIV-Infected Drug User

    PubMed Central

    Bruce, R. Douglas; Altice, Frederick L.

    2007-01-01

    HIV/AIDS and chemical dependency, both of which are complicated by and intertwined with mental illness, are complex, overlapping spheres that adversely influence each other and the overall clinical outcomes of the affected individual [1]. Each disorder individually impacts tens of millions of people, with explosive epidemics described worldwide. Drug users have increased age matched morbidity and mortality for a number of medical and psychiatric conditions. HIV/AIDS, with its immunosuppressed states and direct virologic effects, exacerbate morbidity and mortality further among HIV-infected drug users. This article addresses the adverse consequences of HIV/AIDS, drug injection, the secondary comorbidities of both, and the impact of immunosuppression on presentation of disease as well as approaches to managing the HIV-infected drug user. PMID:17502234

  4. What Can We Learn From Measles? No New HIV Infections.

    PubMed

    Smith, Davey M

    2015-01-01

    Reducing the incidence of HIV infection until there are no new infections depends on driving the number of secondary infections produced by a typical source infection in a completely susceptible population (basic reproduction number; R0) down to less than 1. Components of R0 that must be addressed are the number of sexual contacts the infectious person makes per unit of time (C), the probability of transmission per single sexual contact with the infectious person (P), and the duration that the infected person is infectious to others (D) (R0 = C × P × D). Numerous strategies may contribute to driving transmission of HIV infection down to zero, including early initiation of antiretroviral treatment and pre- or postexposure prophylaxis. This article summarizes a presentation by Davey M. Smith, MD, at the IAS-USA continuing education program held in San Francisco, California, in March 2015.

  5. [Psychosocial aspects on the treatment of HIV-infection].

    PubMed

    Battegay, Manuel; Haerry, David Hans-U; Fehr, Jan; Staehelin, Cornelia; Wandeler, Gilles; Elzi, Luigia

    2014-08-01

    Psychological and social factors have a deep impact on the treatment of HIV-infection, from the readiness to start antiretroviral therapy to treatment adherence over time. Among psychological factors, anxiety may affect HIV-infected persons in all stages of disease, from the disclosure of HIV diagnosis to the decision to start and maintain treatment. This is a lifelong challenge for both patients and doctors. Psychiatric comorbidities (depression, addiction) may enhance negative psychological effects of HIV. Among social factors, stigma and discrimination may occur in families and at work, leading to a loss of social support resulting in isolation and poverty. This may prevent HIV-positive individuals from seeking medical care. These aspects are particularly important in some groups of patients as injecting drug users and migrants. Acknowledgment and consideration of psychosocial factors are therefore essential for the long term success of antiretroviral therapy. PMID:25093317

  6. Continued risky behavior in HIV-infected youth.

    PubMed Central

    Diamond, C; Buskin, S

    2000-01-01

    OBJECTIVES: The purpose of this study was to describe and compare risky behaviors in HIV-infected youths and adults. METHODS: Records of HIV-infected outpatients were reviewed for the period January 1990 to February 1998. Youths (younger than 22 years at HIV diagnosis and younger than 25 years at study entry, n = 139) were compared with adults (22 years or older at HIV diagnosis or 25 years or older at study entry, n = 2880). Risky behaviors occurring after HIV diagnosis included unsafe sex and needle sharing. RESULTS: Female and male youths were more than twice as likely as adults to engage in risky behavior (adjusted odds ratios of 2.6 and 2.3, respectively). CONCLUSIONS: Both youths and adults continue to engage in risky behaviors after HIV diagnosis. Prospective studies are needed, along with targeted public health campaigns, for youths with HIV and for those at risk of infection. PMID:10630148

  7. Update on kidney transplantation in HIV-infected recipients.

    PubMed

    Norman, Silas P; Kommareddi, Mallika; Kaul, Daniel R

    2012-01-01

    HIV infection has historically been a contraindication to kidney transplantation. Prior to the era of potent antiretroviral therapy, the survival of HIV-infected patients was too poor to justify transplantation. In the last 15 years there has been substantial improvement in antiretroviral medications, such that HIV-positive patients are living longer and developing chronic diseases such as end-stage renal disease. The improvement in survival of HIV-positive patients has resulted in transplant centers increasingly considering infected patients appropriate for kidney transplantation. Recently, the results of the first prospective multicenter trial of kidney transplantation into HIV-positive candidates were released, showing the success and challenges of transplantation into this population. In light of the multicenter findings as well as national registry data, kidney transplantation should be considered the standard-of-care renal replacement therapy for HIV-positive end-stage renal disease patients and they should be referred and evaluated for kidney transplantation accordingly. PMID:22833063

  8. Cytokines and T-Cell Homeostasis in HIV Infection.

    PubMed

    Freeman, Michael L; Shive, Carey L; Nguyen, Thao P; Younes, Souheil-Antoine; Panigrahi, Soumya; Lederman, Michael M

    2016-10-01

    Untreated human immunodeficiency virus (HIV) infection is characterized by progressive CD4(+) T-cell depletion and CD8(+) T-cell expansion, and CD4(+) T-cell depletion is linked directly to the risk for opportunistic infections and infection-associated mortality. With suppression of HIV replication by antiretroviral therapy, circulating CD4(+) Tcell numbers typically improve while CD8(+) T-cell expansion persists, and both CD4(+) T-cell cytopenia and CD8(+) T-cell expansion are associated with morbidity and mortality. In this brief review, we report on the role that selected homeostatic and inflammatory cytokines may play both in the failure of CD4(+) T-cell restoration and the CD8(+) T-cell expansion that characterize HIV infection. PMID:27625431

  9. [Microsporidia and cryptosporidia coinfection in an HIV-infected newborn].

    PubMed

    Abdelmalek, R; Anane, S; Chabchoub, N; Essid, R; Aoun, K; Chaabéne, T Ben; Bouratbine, A

    2011-05-01

    Microsporidiosis and cryptosporidiosis are emerging opportunistic infections responsible for intestinal manifestations that are often severe in immunocompromised patients. A case of microsporidiosis-cryptosporidiosis coinfection is reported in an HIV-infected newborn. The patient was a 17-day-old female, exclusively breastfed and with no contact with animals. Microsporidiosis and cryptosporidiosis were diagnosed after systematic screening in stool samples using both specific staining and PCR. Two species of microsporidia, Encephalitozoon intestinalis and Enterocytozoon bieneusi, and Cryptosporidium hominis were identified. The contamination of the newborn probably resulted from direct human-to-human transmission during close contact with the mother (who had diarrhea and refused stool sampling). This report highlights the usefulness of the screening of intestinal microsporidiosis and cryptosporidiosis in HIV-infected subjects for better management.

  10. Rift Valley Fever Outbreak with East-Central African Virus Lineage in Mauritania, 2003

    PubMed Central

    Faye, Ousmane; Diallo, Mawlouth; Diop, Djibril; Bezeid, O. Elmamy; Bâ, Hampathé; Niang, Mbayame; Dia, Ibrahima; Mohamed, Sid Ahmed Ould; Ndiaye, Kader; Diallo, Diawo; Ly, Peinda Ogo; Diallo, Boubacar; Nabeth, Pierre; Simon, François; Lô, Baïdy

    2007-01-01

    In October 2003, 9 human cases of hemorrhagic fever were reported in 3 provinces of Mauritania, West Africa. Test results showed acute Rift Valley fever virus (RVFV) infection, and a field investigation found recent circulation of RVFV with a prevalence rate of 25.5% (25/98) and 4 deaths among the 25 laboratory-confirmed case-patients. Immunoglobulin M against RVFV was found in 46% (25/54) of domestic animals. RVFV was also isolated from the mosquito species Culex poicilipes. Genetic comparison of virion segments indicated little variation among the strains isolated. However, phylogenetic studies clearly demonstrated that these strains belonged to the East-Central African lineage for all segments. To our knowledge, this is the first time viruses of this lineage have been observed in an outbreak in West Africa. Whether these strains were introduced or are endemic in West Africa remains to be determined. PMID:18214173

  11. Testing the stages model in the adaptive radiation of cichlid fishes in East African Lake Tanganyika

    PubMed Central

    Muschick, Moritz; Nosil, Patrik; Roesti, Marius; Dittmann, Marie Theres; Harmon, Luke; Salzburger, Walter

    2014-01-01

    Adaptive radiation (AR) is a key process in the origin of organismal diversity. However, the evolution of trait disparity in connection with ecological specialization is still poorly understood. Available models for vertebrate ARs predict that diversification occurs in the form of temporal stages driven by different selective forces. Here, we investigate the AR of cichlid fishes in East African Lake Tanganyika and use macroevolutionary model fitting to evaluate whether diversification happened in temporal stages. Six trait complexes, for which we also provide evidence of their adaptiveness, are analysed with comparative methods: body shape, pharyngeal jaw shape, gill raker traits, gut length, brain weight and body coloration. Overall, we do not find strong evidence for the ‘stages model’ of AR. However, our results suggest that trophic traits diversify earlier than traits implicated in macrohabitat adaptation and that sexual communication traits (i.e. coloration) diversify late in the radiation. PMID:25274371

  12. Predicting East African spring droughts using Pacific and Indian Ocean sea surface temperature indices

    USGS Publications Warehouse

    Funk, Christopher C.; Hoell, Andrew; Shukla, Shraddhanand; Blade, Ileana; Liebmann, Brant; Roberts, Jason B.; Robertson, Franklin R.

    2014-01-01

    In southern Ethiopia, Eastern Kenya, and southern Somalia poor boreal spring rains in 1999, 2000, 2004, 2007, 2008, 2009 and 2011 contributed to severe food insecurity and high levels of malnutrition. Predicting rainfall deficits in this region on seasonal and decadal time frames can help decision makers support disaster risk reduction while guiding climate-smart adaptation and agricultural development. Building on recent research that links more frequent droughts to a stronger Walker Circulation, warming in the Indo-Pacific warm pool, and an increased western Pacific sea surface temperature (SST) gradient, we explore the dominant modes of East African rainfall variability, links between these modes and sea surface temperatures, and a simple index-based monitoring-prediction system suitable for drought early warning.

  13. Rift Valley fever outbreak with East-Central African virus lineage in Mauritania, 2003.

    PubMed

    Faye, Ousmane; Diallo, Mawlouth; Diop, Djibril; Bezeid, O Elmamy; Bâ, Hampathé; Niang, Mbayame; Dia, Ibrahima; Mohamed, Sid Ahmed Ould; Ndiaye, Kader; Diallo, Diawo; Ly, Peinda Ogo; Diallo, Boubacar; Nabeth, Pierre; Simon, François; Lô, Baïdy; Diop, Ousmane Madiagne

    2007-07-01

    In October 2003, 9 human cases of hemorrhagic fever were reported in 3 provinces of Mauritania, West Africa. Test results showed acute Rift Valley fever virus (RVFV) infection, and a field investigation found recent circulation of RVFV with a prevalence rate of 25.5% (25/98) and 4 deaths among the 25 laboratory-confirmed case-patients. Immunoglobulin M against RVFV was found in 46% (25/54) of domestic animals. RVFV was also isolated from the mosquito species Culex poicilipes. Genetic comparison of virion segments indicated little variation among the strains isolated. However, phylogenetic studies clearly demonstrated that these strains belonged to the East-Central African lineage for all segments. To our knowledge, this is the first time viruses of this lineage have been observed in an outbreak in West Africa. Whether these strains were introduced or are endemic in West Africa remains to be determined.

  14. Carbonate-Silicate Association in the Kamafugite of the Toro-Ankole Province (East African Rift)

    NASA Astrophysics Data System (ADS)

    Muravyeva, Natalya; Senin, Valery

    2010-05-01

    Carbonatite melts play an important role in the magmatism of the East African Rift Zone. A tight spatial association of high-Mg ultrapotassic and carbonatite rocks in the Western branch of the East African Rift suggests the genetic relationship of their parental melts. New evidence of such connection of kamafugitic and carbonatite magmas were obtained during study of the volcanic rocks of kamafugitic affinity in Toro-Ankole province. Primary carbonates (calcite and dolomite) were found as inclusions in olivine from ugandite and mafurite of the Bunyaruguru volcanic field. In the ugandite carbonates contain in the crystallized melt inclusions in olivine phenocrysts consist also of kalsilite, clinopyroxene, mica, and titanomagnetite. Some inclusions reach up to 40x75µm, the host olivine is 150x300µm in size. In the mafurite carbonates form rare microlites, microphenocrysts, and lenses with cavities in central parts, and occur as inclusions in olivine phenocrysts and aggregates in the adjacent zones. These aggregates are multiphase and in mineral set resemble carbonatites: they contain kalsilite, clinopyroxene, magnetite, phillipsite, and mica. Also the two-phase carbonate-sulfate inclusions in olivine were found. The most part of carbonates in composition correspond to calcites with low magnesium, iron, sodium, strontium, and barium contents. The carbonates from two-phase inclusions in olivine from the mafurite are significantly higher magnesian, approaching pure dolomite. The different types of carbonate in mafurite vary in Sr, Ba, Na and K. The highest content of these elements is observed in groundmass carbonates, reaching 2.44 wt % SrO, 1.25% BaO, 0.64% Na2O, and 1.23% K2O. Such assemblage in kamafugites have not been described yet. Some olivines contain microinclusions of sulfate (barite), occurs as fine (10-20 µm) rounded inclusions. The presence of barite inclusions in the olivine of the studied mafurite indicates the high sulfur content in the primary melt

  15. Allometric scaling predicts preferences for burned patches in a guild of East African grazers.

    PubMed

    Sensenig, Ryan L; Demment, Montague W; Laca, Emilio A

    2010-10-01

    The high herbivore diversity in savanna systems has been attributed to the inherent spatial and temporal heterogeneity related to the quantity and quality of food resources. Allometric scaling predicts that smaller-bodied grazers rely on higher quality forage than larger-bodied grazers. We replicated burns at varying scales in an East African savanna and measured visitation by an entire guild of larger grazers ranging in size from hare to elephant. We found a strong negative relationship between burn preference and body mass with foregut fermenters preferring burns to a greater degree than hindgut fermenters. Burns with higher quality forage were preferred more than burns with lower quality forage by small-bodied grazers, while the opposite was true for large-bodied grazers. Our results represent some of the first experimental evidence demonstrating the importance of body size in predicting how large herbivores respond to fire-induced changes in plant quality and quantity.

  16. Cutaneous protothecosis in a patient with previously undiagnosed HIV infection.

    PubMed

    Fong, Kenneth; Tee, Shang-Ian; Ho, Madeline S L; Pan, Jiun Yit

    2015-08-01

    Protothecosis is an uncommon condition resulting from infection by achlorophyllous algae of the Prototheca species. Immunocompromised individuals are generally most susceptible to protothecal infection and tend to develop severe and disseminated disease. However, the association between protothecosis and HIV-induced immunosuppression is not clear, with only a handful of cases having been described to date. Here we report a case of cutaneous protothecosis in a Chinese man with previously undiagnosed HIV infection that responded well to oral itraconazole. PMID:24592936

  17. HIV Infection--Guangdong Province, China, 1997-2007.

    PubMed

    2009-04-24

    In 2007, an estimated 700,000 persons in China were living with human immunodeficiency virus (HIV) infection. An estimated 50,000 new HIV infections and 20,000 deaths related to acquired immunodeficiency syndrome (AIDS) occurred in 2007, and an estimated 71% of persons with HIV infection were unaware of their HIV status. In 2007, 40.6% of those living with HIV had been infected through heterosexual transmission and 38.1% through injection-drug use. Guangdong Province in southeastern China is the country's most populous province, with an estimated 75.6 million permanent residents and 16.5 million migrants; the province has undergone rapid economic development. Since 1986, a case-based surveillance system (CBSS) in China has collected data on persons infected with HIV, including demographic characteristics and transmission categories. To assess recent trends in HIV infection in the province, the Guangdong Center for Disease Control, with technical assistance from CDC, analyzed CBSS data for the period 1997--2007. The results of that analysis indicated that the number of HIV cases increased from 102 in 1997 to 4,593 in 2007, although this increase resulted, in part, from expanded testing and surveillance. Among males classified by HIV transmission category, 82.1% of newly diagnosed infections were attributed to injection-drug use. Among females classified by HIV transmission category, 53.7% engaged in high-risk heterosexual conduct. Despite substantial methodologic limitations, these results can be useful to Guangdong public health agencies in targeting and evaluating HIV prevention, care, and treatment programs. PMID:19390507

  18. HIV infection is associated with attenuated frontostriatal intrinsic connectivity

    PubMed Central

    Ipser, Jonathan C.; Brown, Gregory G.; Bischoff-Grethe, Amanda; Connolly, Colm G.; Ellis, Ronald J.; Heaton, Robert K.; Grant, Igor

    2015-01-01

    Objective HIV-associated cognitive impairments are prevalent, and are consistent with injury to both frontal cortical and subcortical regions of the brain. The current study aimed to assess the impact of HIV infection on functional connections within the frontostriatal network, circuitry hypothesized to be highly vulnerable to HIV infection. Method Fifteen HIV-positive and 15 demographically matched control participants underwent 6 minutes of resting-state functional magnetic resonance imaging (RS-fMRI). Multivariate group comparisons of age-adjusted estimates of connectivity within the frontostriatal network were derived from BOLD data for dorsolateral prefrontal cortex (DLPFC), dorsal caudate and mediodorsal thalamic regions of interest. Whole-brain comparisons of group differences in frontostriatal connectivity were conducted, as were pairwise tests of connectivity associations with measures of global cognitive functioning and clinical and immunological characteristics (nadir and current CD4 count, duration of HIV infection, plasma HIV RNA). Results HIV – associated reductions in connectivity were observed between the DLPFC and the dorsal caudate, particularly in younger participants (< 50 years, N = 9). Seropositive participants also demonstrated reductions in dorsal caudate connectivity to frontal and parietal brain regions previously demonstrated to be functionally connected to the DLPFC. Cognitive impairment, but none of the assessed clinical/immunological variables, was associated with reduced frontostriatal connectivity. Conclusions In conclusion, our data indicate that a diagnosis of HIV is associated with attenuated intrinsic frontostriatal connectivity. Intrinsic connectivity of this network may therefore serve as a marker of the deleterious effects of HIV infection on the brain, possibly via HIV-associated dopaminergic abnormalities. These findings warrant independent replication in larger studies. PMID:25824201

  19. Cryptococcal Infections in Non-Hiv-Infected Patients

    PubMed Central

    Pappas, Peter G.

    2013-01-01

    Infections due to Cryptococcus species occur globally and in a wide variety of hosts, ranging from those who are severely immunosuppressed to those who have phenotypically “normal” immune systems. Approximately 1 million cases of cryptococcosis occur throughout the world, and is it estimated that there are 650,000 associated deaths annually. Most of these cases occur among patients with advanced HIV disease, but a growing number occur among solid organ transplant recipients and others receiving exogenous immunosuppression, patients with innate and acquired immunodeficiency, and otherwise immunologically normal hosts. Much of our recent knowledge is solely derived from clinical experience over the last 2 to 3 decades of cryptococcosis among HIV-infected patients. However, based on recent observations, it is clear that there are substantial differences in the epidemiology, clinical features, approaches to therapy, and outcome when comparing HIV-infected to non–HIV-infected individuals who have cryptococcosis. If one carefully examines cryptococcosis in the three largest subgroups of patients based on host immune status, specifically, those with HIV, solid organ transplant recipients, and those who are non-HIV, non-transplant (NHNT) infected persons, then one can observe very different risks for infection, varied clinical presentations, long-term complications, mortality, and approaches to therapy. This article focuses on cryptococcosis in the non–HIV-infected patient, including a brief review of ongoing events in the Pacific Northwest of the United States and Canada relative to the outbreak of Cryptococcus gattii infections among a largely immunologically normal population, and highlights some of the key insights and questions which have emerged as a result of these important new observations. PMID:23874010

  20. The Omo Mursi Formation: a window into the East African Pliocene.

    PubMed

    Drapeau, Michelle S M; Bobe, René; Wynn, Jonathan G; Campisano, Christopher J; Dumouchel, Laurence; Geraads, Denis

    2014-10-01

    Dating to more than four million years ago (Ma), the Mursi Formation is among the oldest of the Plio-Pleistocene Omo Group deposits in the lower Omo Valley of southwestern Ethiopia. The sedimentary sequence is exposed along a strip ∼35 km by 4 km, but it has received relatively little attention due to the difficult access to this area. Although expeditions to the lower Omo Valley between 1968 and 1973 focused primarily on the Usno and Shungura Formations, survey of the Mursi Formation produced a faunal collection of about 250 specimens deriving exclusively from the Yellow Sands area at the southern extent of the exposures. In 2009, we reinitiated an investigation of the formation by focusing on the most northern exposures, and a new fossil site, Cholo, was identified. Cholo is depositionally similar to the lowermost exposures at the Yellow Sands, although no stratigraphic correlation between the two localities has yet been made. The fossiliferous sediments at Cholo are capped by a prominent vitric tuff that is compositionally distinct from any other known tephra preserved in East African rift basins, including the only known vitric tuff at the Yellow Sands. The faunal assemblage of the Yellow Sands area presents interesting characteristics: the fossils generally show little weathering and include a large proportion of suids (44% of the mammalian fauna) and a small proportion of bovids (14%) compared with other Pliocene African sites. The sample is also unusual in the high frequency of deinotheres (7%). Taxon-specific stable carbon isotopic composition of the Mursi mammals tends to show generally higher proportions of C3 diets compared with other Pliocene sites in East Africa and Chad. This and the particular faunal proportions suggest that the environments represented by the Mursi Formation were more closed than those of other Pliocene sites.

  1. InSAR Observations of Magmatic Processes in the East African Rift

    NASA Astrophysics Data System (ADS)

    Biggs, Juliet; Anthony, Elizabeth; Ebinger, Cynthia; Amelung, Falk; Gourmelen, Noel

    2010-05-01

    The role of magma in accommodating extension and it's relationship to fault-based extension in continental rifting is poorly understood. Here we present observations of the temporal and spatial evolution of surface displacements resulting from magmatic processes in the East African Rift. A systematic InSAR surveys have detected geodetic activity at six of the volcanoes in the East African Rift. In Kenya, subsidence of 2-5 cm occurred at Suswa and Menengai during 1997-2000, ~9cm of uplift at Longonot in 2004-2006 and ~21 cm of uplift at Paka during 2006-2007. The deformation is episodic, and no deformation was observed at these volcanoes during other time-periods. The best-fitting source models for each episode is inflation or deflation of a horizontal lensoid at a depth of 2-5 km. The episodic nature of the activity, its lack of correlation with seasons, and the preferred source geometry are all consistent with activity in the volatile-rich cap to a crystal-rich magma chamber beneath each of the 4 volcanoes. A seismic swarm occurred in Northern Tanzania from July 14 to August 4 2007. Using InSAR images from Envisat (IS2 and IS6) and ALOS, we show that the seismic swarm was accompanied by 1) subsidence that can be attributed to ~40 cm of normal motion on a NE striking fault, 2) the intrusion of ~2.4 m wide dyke, 3) deflation of a point source magma chamber and 4) collapse of a shallow graben. The large number of available SAR images allows us to examine the sequence and time-dependent behaviour of these processes and relationship between diking and faulting.

  2. Impaired CD4 T Cell Memory Response to Streptococcus pneumoniae Precedes CD4 T Cell Depletion in HIV-Infected Malawian Adults

    PubMed Central

    Mzinza, David; Harawa, Visopo; Miles, David J. C.; Jambo, Kondwani C.; Gordon, Stephen B.; Williams, Neil A.; Heyderman, Robert S.

    2011-01-01

    Objective Invasive pneumococcal disease (IPD) is a leading cause of morbidity and mortality in HIV-infected African adults. CD4 T cell depletion may partially explain this high disease burden but those with relatively preserved T cell numbers are still at increased risk of IPD. This study evaluated the extent of pneumococcal-specific T cell memory dysfunction in asymptomatic HIV infection early on in the evolution of the disease. Methods Peripheral blood mononuclear cells were isolated from asymptomatic HIV-infected and HIV-uninfected Malawian adults and stained to characterize the underlying degree of CD4 T cell immune activation, senescence and regulation. Pneumococcal-specific T cell proliferation, IFN-γ, IL-17 production and CD154 expression was assessed using flow cytometry and ELISpot. Results We find that in asymptomatic HIV-infected Malawian adults, there is considerable immune disruption with an increase in activated and senescent CD4+CD38+PD-1+ and CD4+CD25highFoxp3+ Treg cells. In the context of high pneumococcal exposure and therefore immune stimulation, show a failure in pneumococcal-specific memory T cell proliferation, skewing of T cell cytokine production with preservation of interleukin-17 but decreased interferon-gamma responses, and failure of activated T cells to express the co-stimulatory molecule CD154. Conclusion Asymptomatic HIV-infected Malawian adults show early signs of pneumococcal- specific immune dysregulation with a shift in the balance of CD4 memory, T helper 17 cells and Treg. Together these data offer a mechanistic understanding of how antigen-specific T cell dysfunction occurs prior to T cell depletion and may explain the early susceptibility to IPD in those with relatively preserved CD4 T cell numbers. PMID:21980502

  3. Blood vitamins and trace elements in Northern-East African cheetahs (Acinonyx jubatus soemmeringii) in captivity in the Middle East.

    PubMed

    Beckmann, Katie M; O'Donovan, Declan; McKeown, Sean; Wernery, Ulli; Basu, Puja; Bailey, Tom A

    2013-09-01

    There are few published data regarding the endangered Northern-East African cheetah (Acinonyx jubatus soemmeringii), held in captivity in the Middle East and Europe. Studies have demonstrated a high incidence of disease in captive cheetahs, in which vitamin and trace element imbalances have often been implicated. Blood vitamin and trace element reference values in cheetahs merit further investigation. In this study, blood samples were opportunistically collected from apparently healthy A. j. soemmeringii from two collections (A and B) with successful breeding programs in the United Arab Emirates. The cheetahs were fed whole prey of mixed species (and, in Collection B, goat muscle and bone as well) dusted with vitamin and mineral supplements. Mean serum vitamin and trace element values (for cheetahs > 4 mo in age) were as follows: vitamin A (retinol), 2.20 microM/L (n = 27); vitamin B1, 0.0818 microM/L (n = 45); vitamin C, 28.6 microM/L (n=10); vitamin E (alpha-tocopherol), 35.6 microM/L (n = 27); copper (Cu), 12.53 microM/L (n = 27); selenium (Se), 3.10 microM/L (n = 27); and zinc (Zn), 10.87 microM/L (n = 27). Mean values of vitamin A, vitamin E, Cu, and Zn fell within ranges of published cheetah mean values, and mean Se was lower than range values for cheetahs presented in one previous study; blood vitamin B1 and vitamin C values of cheetahs have not previously been published. The values were taken to indicate that the cheetahs' nutritional status was adequate with regard to those nutrients analyzed. Serum vitamin E was particularly high in cheetahs fed fresh whole prey, and on this basis vitamin E supplementation of fresh whole prey appeared to have been unnecessary. There were differences (P < 0.05) between collections in serum vitamin B1, vitamin E, Cu, and 10 other hematologic and biochemical parameters. Nine hematologic and blood biochemical parameters differed among age categories.

  4. Smart nanoparticles as targeting platforms for HIV infections

    NASA Astrophysics Data System (ADS)

    Adhikary, Rishi Rajat; More, Prachi; Banerjee, Rinti

    2015-04-01

    While Human Immunodeficiency Virus (HIV) infections are reducing in incidence with the advent of Highly Active Anti-retroviral Therapy (HAART), there remain a number of challenges including the existence of reservoirs, drug resistance and anatomical barriers to antiretroviral therapy. To overcome these, smart nanoparticles with stimuli responsive release are proposed for delivery of anti-retroviral agents. The paper highlights the strategic similarities between the design of smart antiretroviral nanocarriers and those optimized for cancer chemotherapy. This includes the development of nanoparticles capable of passive and active targeting as well as those that are responsive to various internal and external triggers. For antiretroviral therapy, the relevant triggers for stimuli responsive release of drugs include semen, enzymes, endosomal escape, temperature and magnetic field. Deriving from the experience of cancer chemotherapy, additional potential triggers are light and ultrasound which remain hitherto unexplored in HIV therapy. In addition, the roles of nanomicrobicides (nanogels) and virus mimetic nanoparticles are discussed from the point of view of prevention of HIV transmission. The challenges associated with translation of smart nanoparticles for HIV infections to realize the Millennium Development Goal of combating HIV infections are discussed.

  5. Educational software for simulating risk of HIV infection

    NASA Astrophysics Data System (ADS)

    Rothberg, Madeleine A.; Sandberg, Sonja; Awerbuch, Tamara E.

    1994-03-01

    The AIDS epidemic is still growing rapidly and the disease is thought to be uniformly fatal. With no vaccine or cure in sight, education during high school years is a critical component in the prevention of AIDS. We propose the use of computer software with which high school students can explore via simulation their own risk of acquiring an HIV infection given certain sexual behaviors. This particular software is intended to help students understand the three factors that determine their risk of HIV infection (number of sexual acts, probability that their partners are infected, and riskiness of the specific sexual activities they choose). Users can explicitly calculate their own chances of becoming infected based on decisions they make. Use of the program is expected to personalize the risk of HIV infection and thus increase users' concern and awareness. Behavioral change may not result from increased knowledge alone. Therefore the effectiveness of this program in changing attitudes toward risky sexual behaviors would be enhanced when the simulation is embedded in an appropriate curriculum. A description of the program and an example of its use are presented.

  6. The Surprising Role of Amyloid Fibrils in HIV Infection.

    PubMed

    Castellano, Laura M; Shorter, James

    2012-01-01

    Despite its discovery over 30 years ago, human immunodeficiency virus (HIV) continues to threaten public health worldwide. Semen is the principal vehicle for the transmission of this retrovirus and several endogenous peptides in semen, including fragments of prostatic acid phosphatase (PAP248-286 and PAP85-120) and semenogelins (SEM1 and SEM2), assemble into amyloid fibrils that promote HIV infection. For example, PAP248-286 fibrils, termed SEVI (Semen derived Enhancer of Viral Infection), potentiate HIV infection by up to 105-fold. Fibrils enhance infectivity by facilitating virion attachment and fusion to target cells, whereas soluble peptides have no effect. Importantly, the stimulatory effect is greatest at low viral titers, which mimics mucosal transmission of HIV, where relatively few virions traverse the mucosal barrier. Devising a method to rapidly reverse fibril formation (rather than simply inhibit it) would provide an innovative and urgently needed preventative strategy for reducing HIV infection via the sexual route. Targeting a host-encoded protein conformer represents a departure from traditional microbicidal approaches that target the viral machinery, and could synergize with direct antiviral approaches. Here, we review the identification of these amyloidogenic peptides, their mechanism of action, and various strategies for inhibiting their HIV-enhancing effects.

  7. Migration, Marital Change, and HIV Infection in Malawi

    PubMed Central

    Anglewicz, Philip

    2013-01-01

    Research on the relationship between migration and HIV infection in sub-Saharan Africa often suggests that migrants are at higher risk of HIV infection because they are more likely to engage in risk behavior than non-migrants, and tend to move to areas with a relatively higher HIV prevalence. While migration may be a risk factor for HIV infection, I instead focus on the possibility that the HIV positive are more likely to migrate. Using a longitudinal dataset of permanent rural residents and migrants from Malawi, I find that migrants originating from rural areas are indeed more likely than non-migrants to be HIV positive and to have engaged in HIV risk behavior. The increased HIV risk among migrants may be due to the selection of HIV positive individuals into migration; I find that HIV positive individuals are more likely migrate than those who are HIV negative. The explanation for this phenomenon appears to be marital instability, which occurs more frequently among HIV positive individuals and leads to migration after marital change. PMID:22109083

  8. Correction options for lipoatrophy in HIV-infected patients.

    PubMed

    Engelhard, Peter

    2006-03-01

    Lipoatrophy (LA) is a form of lipodystrophy, characterized by volume depletion caused by fat loss in the limbs, buttocks, and face. Facial volume loss is the most obvious outward sign of LA because it alters the facial contours in the cheeks, temples, and orbits. Lipodystrophy and LA are most commonly seen in patients with HIV on highly active antiretroviral therapy (HAART), which was introduced in the mid-1990s for the management of HIV, and is currently considered the mainstay therapy for HIV-infected patients. However, the etiology of LA is likely multifactorial as underlying patient conditions, including duration and severity of HIV and increasing age, have also been found to contribute to its occurrence. The volume loss of LA can be very dramatic with some patients exhibiting no signs of facial fat. As a result, many HIV-infected patients with associated LA suffer from psychological and lifestyle effects, which can lead to noncompliance with HAART. Thus, increases in facial volume and improvement in morphology is anticipated to reduce anxiety caused by LA in HIV-infected patients, and improve quality of life. This review discusses the benefits and limitations of several treatment options available to correct the volume depletion associated with LA, including antiretroviral switching, permanent surgical implants and injectables, poly-L-lactic acid, collagen, and hyaluronic acid derivatives. PMID:16548712

  9. [Pneumocystosis in non-HIV-infected immunocompromised patients].

    PubMed

    Fillâtre, P; Revest, M; Belaz, S; Robert-Gangneux, F; Zahar, J-R; Roblot, F; Tattevin, P

    2016-05-01

    Pneumocystis jiroveci (formerly P. carinii) is an opportunistic fungus responsible for pneumonia in immunocompromised patients. Pneumocystosis in non-HIV-infected patients differs from AIDS-associated pneumocystosis in mostly two aspects: diagnosis is more difficult, and prognosis is worse. Hence, efforts should be made to target immunocompromised patients at higher risk of pneumocystosis, so that they are prescribed long-term, low-dose, trimethoprime-sulfamethoxazole, highly effective for pneumocystosis prophylaxis. Patients at highest risk include those with medium and small vessels vasculitis, lymphoproliferative B disorders (chronic or acute lymphocytic leukaemia, non-Hodgkin lymphoma), and solid cancer on long-term corticosteroids. Conversely, widespread use of prophylaxis in all patients carrier of inflammatory diseases on long-term corticosteroids is not warranted. The management of pneumocystosis in non-AIDS immunocompromised patients follows the rules established for AIDS patients. The diagnosis relies on the detection of P. jiroveci cyst on respiratory samples, while PCR does not reliably discriminate infection from colonization, in 2015. High-doses trimethoprim-sulfamethoxazole is, by far, the treatment of choice. The benefit of adjuvant corticosteroid therapy for hypoxic patients, well documented in AIDS patients, has a much lower level of evidence in non-HIV-infected patients, most of them being already on corticosteroid by the time of pneumocystosis diagnosis anyway. However, based on its striking impact on morbi-mortality in AIDS patients, adjuvant corticosteroid is recommended in hypoxic, non-HIV-infected patients with pneumocystosis by many experts and scientific societies.

  10. Coping With Stress Strategies in HIV-infected Iranian Patients.

    PubMed

    Mahmoudi, Maryam; Dehdari, Tahereh; Shojaeezadeh, Davoud; Abbasian, Ladan

    2015-01-01

    Stress has significant adverse impacts on health outcomes of HIV-infected patients. Our study explored coping with stress strategies by HIV-infected Iranian patients. A qualitative content analysis study was conducted at the Consultation Clinic of HIV at the Imam Khomeini Hospital in Tehran, Iran in 2012. Twenty-six semi-structured in-depth interviews were done. Participants were asked about coping strategies for stress. After the first interview, continuous analysis of data was started and continued up to data saturation. Results showed that participants used two categories of strategies (emotion-based coping and problem-based coping) to cope with stress. Emotion-based coping had two sub-themes: adaptive and maladaptive. The problem-based coping category had three sub-themes: participation in education sessions, adherence to medication, and efforts to maintain a healthy lifestyle. Explanations of different strategies available to HIV-infected patients to cope with stress may help develop tailored interventions to improve the psychological conditions of people living with HIV.

  11. Estimation of HIV infection and incubation via state space models.

    PubMed

    Tan, W Y; Ye, Z

    2000-09-01

    By using the state space model (Kalman filter model) of the HIV epidemic, in this paper we have developed a general Bayesian procedure to estimate simultaneously the HIV infection distribution, the HIV incubation distribution, the numbers of susceptible people, infective people and AIDS cases. The basic approach is to use the Gibbs sampling method combined with the weighted bootstrap method. We have applied this method to the San Francisco AIDS incidence data from January 1981 to December 1992. The results show clearly that both the probability density function of the HIV infection and the probability density function of the HIV incubation are curves with two peaks. The results of the HIV infection distribution are clearly consistent with the finding by Tan et al. [W.Y. Tan, S.C. Tang, S.R. Lee, Estimation of HIV seroconversion and effects of age in San Francisco homosexual populations, J. Appl. Stat. 25 (1998) 85]. The results of HIV incubation distribution seem to confirm the staged model used by Satten and Longini [G. Satten, I. Longini, Markov chain with measurement error: estimating the 'true' course of marker of the progression of human immunodeficiency virus disease, Appl. Stat. 45 (1996) 275]. PMID:10942785

  12. HIV-infected mothers' experiences during their infants' HIV testing.

    PubMed

    Shannon, Maureen T

    2015-04-01

    Both survival with HIV and rates of perinatal HIV infection have significantly declined during the past decade, due to antiretroviral therapies that interrupt HIV transmission to the fetus and newborn. Although HIV is no longer routinely fatal to mothers or transmitted to fetuses, and the testing of newborns for HIV has been improved, evidence about HIV-infected mothers' experiences during the months of their infants' HIV testing predates these improvements. This qualitative study on 16 mothers was an analysis of interviews conducted several weeks after testing was completed and all infants had been determined to be uninfected. Mothers reported that their experiences evolved during the months of testing. Initial reactions included maternal trauma and guilt associated with infant testing. They then reported learning to cope with the roller coaster ride of repeated testing with the help of information from clinicians. By the end of the testing period, ambiguity began to resolve as they engaged in tentative maternal-infant attachment and expressed desire for a sense of normalcy. Need for support and fear of stigma persisted throughout. These findings expand current knowledge about this experience and suggest clinical strategies to guide HIV-infected women during this stressful period. PMID:25739368

  13. [AIDS and HIV infection in Poland in 2006].

    PubMed

    Nitka, Anna; Rosińska, Magdalena; Janiec, Janusz

    2008-01-01

    The cumulative number of AIDS cases diagnosed in Poland in 1986 to 2006 reached 1929, and 855 AIDS deaths were registered during this time. In recent years a minor upward trend in AIDS incidence is observed with the highest numbers of incident cases in 2004- 175 (incidence 0.46 per 100,000) and 2006 -156 (0.41 per 100,000). The number of reported deaths decreased from 64 in 2005 to 44 in 2006. Taking into account the official life statistics data, AIDS deaths might be underreported. In 2006, with 750 newly detected HIV infections, the incidence (2.0 per 100,000) was higher than observed during recent years. Injecting drug users constituted the most numerous risk group both among the AIDS cases (51.9%) and the HIV infection cases (15.2% of all cases and 52.5% of cases with known transmission route). In 2006 the infection was diagnosed in 15 children of infected mothers. The proportion of reports of HIV infections with missing information on the risk group though remained very high (71.1% of all 2006 reports). In order to monitor the epidemiological situation better quality of data will need to be assured.

  14. The Diagnosis of HIV Infection in Infants and Children.

    PubMed

    Abdollahi, Alireza; Saffar, Hana

    2016-01-01

    It is estimated that the number of HIV infected children globally has increased from 1.6 million in 2001 to 3.3 million in 2012. The number of children below 15 years of age living with HIV has increased worldwide. Published data from recent studies confirmed dramatic survival benefit for infants started anti-retroviral therapy (ART) as early as possible after diagnosis of HI. Early confirmation of HIV diagnosis is required in order to identify infants who need immediate ART. WHO has designed recommendations to improve programs for both early diagnoses of HIV infection and considering ART whenever indicated? It is strongly recommended that HIV virologocal assays for diagnosis of HIV have sensitivity of at least 95% and ideally greater than 98% and specificity of 98% or more under standardized and validated conditions. Timing of virological testing is also important. Infants infected at or around delivery may take short time to have detectable virus. Therefore, sensitivity of virological tests is lower at birth. In utero HIV infection, HIV DNA or RNA can be detected within 48 h of birth and in infants with peripartum acquisition it needs one to two weeks. Finally it is emphasized that all laboratories performing HIV tests should follow available services provided by WHO or CDC for quality assurance programs. Both clinicians and staffs providing laboratory services need regular communications, well-defined SOPs and nationally validated algorithms for optimal use of laboratory tests. Every country should use assays that have been validated by national reference laboratory. PMID:27499768

  15. Modeling dynamics of HIV infected cells using stochastic cellular automaton

    NASA Astrophysics Data System (ADS)

    Precharattana, Monamorn; Triampo, Wannapong

    2014-08-01

    Ever since HIV was first diagnosed in human, a great number of scientific works have been undertaken to explore the biological mechanisms involved in the infection and progression of the disease. Several cellular automata (CA) models have been introduced to gain insights into the dynamics of the disease progression but none of them has taken into account effects of certain immune cells such as the dendritic cells (DCs) and the CD8+ T lymphocytes (CD8+ T cells). In this work, we present a CA model, which incorporates effects of the HIV specific immune response focusing on the cell-mediated immunities, and investigate the interaction between the host immune response and the HIV infected cells in the lymph nodes. The aim of our work is to propose a model more realistic than the one in Precharattana et al. (2010) [10], by incorporating roles of the DCs, the CD4+ T cells, and the CD8+ T cells into the model so that it would reproduce the HIV infection dynamics during the primary phase of HIV infection.

  16. Care of Patients With HIV Infection: Diagnosis and Monitoring.

    PubMed

    Bolduc, Philip; Roder, Navid; Colgate, Emily; Cheeseman, Sarah H

    2016-04-01

    Appropriate screening for HIV infection is the cornerstone of HIV-related care. There have been several recent changes in testing technology and screening recommendations. The US Preventive Services Task Force recommends universal HIV screening at least once for adolescents and adults ages 15 to 65 years, and additional screening for patients at higher risk, although evidence is insufficient to determine optimum rescreening intervals. All pregnant women should be screened for HIV infection in the first trimester, and pregnant women at high risk should be screened again in the third trimester. The Centers for Disease Control and Prevention recommends use of an algorithm using fourth-generation tests for screening; this decreases the window period between infection and detection to as few as 14 days, thereby reducing the number of false-negative results. Home HIV testing kits, which require follow-up confirmatory testing, also are available. Clinicians should be aware of HIV-specific laws in their states, including those criminalizing HIV exposure and transmission. Thorough medical and laboratory evaluations are essential at initiation of care for patients with HIV infection, along with appropriate follow-up monitoring, as recommended in various guidelines. PMID:27092562

  17. Clinical management considerations for dyslipidemia in HIV-infected individuals.

    PubMed

    Kirchner, Jeffrey T

    2012-01-01

    Dyslipidemia is common in patients with human immunodeficiency virus (HIV) and may result in significant morbidity, including coronary heart disease (CHD). Treatment of dyslipidemia in these patients is generally based on the National Cholesterol Education Program Adult Treatment Panel III goals for individuals without HIV. For individuals with ≥ 2 cardiovascular risk factors, the risk of CHD should be evaluated using the Framingham risk calculator and managed accordingly. Switching to an antiretroviral regimen with a favorable lipid profile should be considered before pharmacologic management if virologic suppression can be maintained. Statins are the first-choice therapy for elevated low-density lipoprotein cholesterol, but in HIV-infected individuals, special consideration must be given to drug-drug interactions, specifically those between protease inhibitors and statins. Management of dyslipidemia in HIV-infected individuals is a challenging but important aspect of chronic disease management. Additional research, specifically related to the role of chronic inflammation, is needed to better define the relationship between HIV infection and cardiovascular disease.

  18. Parasitic infections in HIV infected individuals: Diagnostic & therapeutic challenges

    PubMed Central

    Nissapatorn, Veeranoot; Sawangjaroen, Nongyao

    2011-01-01

    After 30 years of the human immunodeficiency virus (HIV) epidemic, parasites have been one of the most common opportunistic infections (OIs) and one of the most frequent causes of morbidity and mortality associated with HIV-infected patients. Due to severe immunosuppression, enteric parasitic pathogens in general are emerging and are OIs capable of causing diarrhoeal disease associated with HIV. Of these, Cryptosporidium parvum and Isospora belli are the two most common intestinal protozoan parasites and pose a public health problem in acquired immunodeficiency syndrome (AIDS) patients. These are the only two enteric protozoan parasites that remain in the case definition of AIDS till today. Leismaniasis, strongyloidiasis and toxoplasmosis are the three main opportunistic causes of systemic involvements reported in HIV-infected patients. Of these, toxoplasmosis is the most important parasitic infection associated with the central nervous system. Due to its complexity in nature, toxoplasmosis is the only parasitic disease capable of not only causing focal but also disseminated forms and it has been included in AIDS-defining illnesses (ADI) ever since. With the introduction of highly active anti-retroviral therapy (HAART), cryptosporidiosis, leishmaniasis, schistosomiasis, strongyloidiasis, and toxoplasmosis are among parasitic diseases reported in association with immune reconstitution inflammatory syndrome (IRIS). This review addresses various aspects of parasitic infections in term of clinical, diagnostic and therapeutic challenges associated with HIV-infection. PMID:22310820

  19. Micro RNA in Exosomes from HIV-Infected Macrophages.

    PubMed

    Roth, William W; Huang, Ming Bo; Addae Konadu, Kateena; Powell, Michael D; Bond, Vincent C

    2015-12-22

    Exosomes are small membrane-bound vesicles secreted by cells that function to shuttle RNA and proteins between cells. To examine the role of exosomal micro RNA (miRNA) during the early stage of HIV-1 infection we characterized miRNA in exosomes from HIV-infected macrophages, compared with exosomes from non-infected macrophages. Primary human monocytes from uninfected donors were differentiated to macrophages (MDM) which were either mock-infected or infected with the macrophage-tropic HIV-1 BaL strain. Exosomes were recovered from culture media and separated from virus particles by centrifugation on iodixanol density gradients. The low molecular weight RNA fraction was prepared from purified exosomes. After pre-amplification, RNA was hybridized to microarrays containing probes for 1200 miRNA species of known and unknown function. We observed 48 miRNA species in both infected and uninfected MDM exosomes. Additionally, 38 miRNAs were present in infected-cell exosomes but not uninfected-cell exosomes. Of these, 13 miRNAs were upregulated in exosomes from HIV-infected cells, including 4 miRNA species that were increased by more than 10-fold. Though numerous miRNA species have been identified in HIV-infected cells, relatively little is known about miRNA content in exosomes from these cells. In the future, we plan to investigate whether the upregulated miRNA species we identified are increased in exosomes from HIV-1-positive patients.

  20. [Spectrum of cardiovascular disease in HIV-infected patients].

    PubMed

    Lozano, Fernando

    2009-09-01

    A large body of evidence indicates that HIV-infected patients, both men and women, as well as adults and children, have a higher risk of developing arteriosclerotic cardiovascular disease. This evidence comes from studies whose main primary variables were the clinical manifestations of arteriosclerotic cardiovascular disease (acute myocardial infarction, silent myocardial ischemia, stroke and peripheral arterial disease) and the distinct markers of premature atherosclerosis and endothelial dysfunction determined in different sites (carotid, coronary or peripheral arteries) and with distinct diagnostic procedures (carotid intimamedia thickening, coronary artery calcification, flow-mediated vasodilation, arterial rigidity, ankle/arm index, etc.). This excess risk of arteriosclerotic cardiovascular disease in HIV-positive patients is clearly associated with the HIV infection per se and with classical cardiovascular risk factors, and, to a lesser extent and less uniformly, with the use of first-generation protease inhibitors. Hypertension, whose association with HIV infection is far less clear, is related to both traditional cardiovascular risk factors and to lipodystrophy.

  1. Hepatitis C virus infection in HIV-infected patients.

    PubMed

    Sulkowski, Mark S

    2004-09-01

    Because of shared routes of transmission, hepatitis C and HIV coinfection is common in the United States, affecting 15% to 30% of HIV-infected individuals. In the era of highly effective antiretroviral therapy, hepatitis C virus (HCV)-related liver disease has emerged as a significant cause of morbidity and mortality. Accordingly, the Infectious Diseases Society of America and the American Association for the Study of Liver Disease guidelines for the management of HCV recommend that patients with HIV/HCV undergo medical evaluation for HCV-related liver disease and consideration for HCV treatment and, if indicated, orthotopic liver transplantation. However, the treatment of patients with HIV/HCV is complicated by the relatively high prevalence of medical and psychiatric comorbidities and the challenges of anti-HCV therapy in the setting of HIV disease and antiretroviral therapy. Nonetheless, recently completed randomized controlled trials provide evidence of the safety, tolerability, and efficacy of HCV treatment with pegylated interferon-alpha plus ribavirin in HIV-infected individuals. This review focuses on the epidemiology, natural history, and management of HCV in the HIV-infected patient.

  2. Seasonal patterns of mixed species groups in large East African mammals.

    PubMed

    Kiffner, Christian; Kioko, John; Leweri, Cecilia; Krause, Stefan

    2014-01-01

    Mixed mammal species groups are common in East African savannah ecosystems. Yet, it is largely unknown if co-occurrences of large mammals result from random processes or social preferences and if interspecific associations are consistent across ecosystems and seasons. Because species may exchange important information and services, understanding patterns and drivers of heterospecific interactions is crucial for advancing animal and community ecology. We recorded 5403 single and multi-species clusters in the Serengeti-Ngorongoro and Tarangire-Manyara ecosystems during dry and wet seasons and used social network analyses to detect patterns of species associations. We found statistically significant associations between multiple species and association patterns differed spatially and seasonally. Consistently, wildebeest and zebras preferred being associated with other species, whereas carnivores, African elephants, Maasai giraffes and Kirk's dik-diks avoided being in mixed groups. During the dry season, we found that the betweenness (a measure of importance in the flow of information or disease) of species did not differ from a random expectation based on species abundance. In contrast, in the wet season, we found that these patterns were not simply explained by variations in abundances, suggesting that heterospecific associations were actively formed. These seasonal differences in observed patterns suggest that interspecific associations may be driven by resource overlap when resources are limited and by resource partitioning or anti-predator advantages when resources are abundant. We discuss potential mechanisms that could drive seasonal variation in the cost-benefit tradeoffs that underpin the formation of mixed-species groups.

  3. Helium isotopes at Rungwe Volcanic Province, Tanzania, and the origin of East African Plateaux

    NASA Astrophysics Data System (ADS)

    Hilton, D. R.; Halldórsson, S. A.; Barry, P. H.; Fischer, T. P.; de Moor, J. M.; Ramirez, C. J.; Mangasini, F.; Scarsi, P.

    2011-11-01

    We report helium isotope ratios (3He/4He) of lavas and tephra of the Rungwe Volcanic Province (RVP) in southern Tanzania. Values as high as 15RA (RA = air 3He/4He) far exceed typical upper mantle values, and are the first observation of plume-like ratios south of the Turkana Depression which separates the topographic highs of the Ethiopia and Kenya domes. The African Superplume - a tilted low-velocity seismic anomaly extending to the core-mantle boundary beneath southern Africa - is the likely source of these high 3He/4He ratios. High 3He/4He ratios at RVP together with similarly-high values along the Main Ethiopian Rift and in Afar provide compelling evidence that the African Superplume is a feature that extends through the 670-km seismic discontinuity and provides dynamic support - either as a single plume or via multiple upwellings - for the two main topographic features of the East Africa Rift System as well as heat and mass to drive continuing rift-related magmatism.

  4. Conceptualizations of heterosexual anal sex and HIV risk in five East African communities.

    PubMed

    Duby, Zoe; Colvin, Christopher

    2014-01-01

    Heterosexual anal sex is underresearched and little understood, particularly in the African context. Existing prevalence data indicate that heterosexual anal sex is a widespread practice, yet little is known about the way in which it is conceptualized and understood. Describing findings from qualitative research conducted in Kenya, Tanzania, and Uganda, we shed light on conceptualizations of heterosexual anal sex and its relation to human immunodeficiency virus (HIV). These findings suggest that penile-anal sex is practiced by men and women in Africa for a range of reasons, including virginity maintenance, contraception, fulfillment of male pleasure, relationship security, menstruation, in the presence of vaginal complications, financial gain, fidelity, and prestige. Despite anal sex being the most efficient way to transmit HIV sexually, there is widespread lack of knowledge about its risks. These findings describe the ways in which anal sex is conceptualized in five East African communities, highlighting how penile-anal intercourse is often not considered "sex" and how the omission of anal sex in safe-sex messaging is interpreted as meaning that anal sex is safe. In light of its frequency and risks, greater attention must be paid to heterosexual anal sex in Africa to ensure a comprehensive approach to HIV prevention.

  5. Oral lesions among HIV-infected children on antiretroviral treatment in West Africa

    PubMed Central

    Meless, David; Ba, Boubacar; Faye, Malick; Diby, Jean-Serge; N’zoré, Serge; Datté, Sébastien; Diecket, Lucrèce; N’Diaye, Clémentine; Aka, Edmond Addi; Kouakou, Kouadio; Ba, Abou; Ekouévi, Didier Koumavi; Dabis, François; Shiboski, Caroline; Arrivé, Elise

    2014-01-01

    Objectives To estimate the prevalence of oral mucosal diseases and dental caries among HIV-infected children receiving antiretroviral treatment (ART) in West Africa, and to identify factors associated with the prevalence of oral mucosal lesions. Methods Multi-center cross-sectional survey in 5 pediatric HIV clinics in Côte d’Ivoire, Mali and Sénégal. A standardized examination was performed by trained dentists on a random sample of HIV-infected children aged 5 to 15 years receiving ART. The prevalence of oral and dental lesions and mean number of decayed, missing/extracted and filled teeth (DMFdefT) in temporary and permanent dentition were estimated with their 95% confidence interval (95%CI). We used logistic regression to explore the association between children’s characteristics and the prevalence of oral mucosal lesions, expressed as prevalence odds ratio (POR). Results The median age of the 420 children (47% females) enrolled was 10.4 years (interquartile range [IQR]=8.3–12.6). The median duration on ART was 4.6 years (IQR=2.6–6.2); 84 (20.0%) had CD4 count<350 cells/mm3. 35 children (8.3%; 95%CI: [6.1–11.1]) exhibited 42 oral mucosal lesions (24 were candidiasis); 86.0% (95%CI=82.6–89.3) of children had DMFdefT≥1. The presence of oral mucosal lesions was independently associated with CD4 count<350 cells/mm3 (POR=2.96, 95% CI=1.06–4.36) and poor oral hygiene (POR=2.69, 95%CI=1.07–6.76). Conclusions Oral mucosal lesions still occur in HIV-infected African children despite ART, but rarely. However, dental caries were common and severe in this population, reflecting the need to include oral health in the comprehensive care of HIV. PMID:24386972

  6. A live weight-heart girth relationship for accurate dosing of east African shorthorn zebu cattle.

    PubMed

    Lesosky, Maia; Dumas, Sarah; Conradie, Ilana; Handel, Ian Graham; Jennings, Amy; Thumbi, Samuel; Toye, Phillip; Bronsvoort, Barend Mark de Clare

    2013-01-01

    The accurate estimation of livestock weights is important for many aspects of livestock management including nutrition, production and appropriate dosing of pharmaceuticals. Subtherapeutic dosing has been shown to accelerate pathogen resistance which can have subsequent widespread impacts. There are a number of published models for the prediction of live weight from morphometric measurements of cattle, but many of these models use measurements difficult to gather and include complicated age, size and gender stratification. In this paper, we use data from the Infectious Diseases of East Africa calf cohort study and additional data collected at local markets in western Kenya to develop a simple model based on heart girth circumference to predict live weight of east African shorthorn zebu (SHZ) cattle. SHZ cattle are widespread throughout eastern and southern Africa and are economically important multipurpose animals. We demonstrate model accuracy by splitting the data into training and validation subsets and comparing fitted and predicted values. The final model is weight(0.262) = 0.95 + 0.022 × girth which has an R (2) value of 0.98 and 95 % prediction intervals that fall within the ± 20 % body weight error band regarded as acceptable when dosing livestock. This model provides a highly reliable and accurate method for predicting weights of SHZ cattle using a single heart girth measurement which can be easily obtained with a tape measure in the field setting. PMID:22923040

  7. Multi Scale Imaging of Seismic Structure beneath the Western Branch of the East-African Rift

    NASA Astrophysics Data System (ADS)

    Jakovlev, A.; Rumpker, G.; Koulakov, I.

    2010-12-01

    In this study, we investigate the crustal and upper mantle velocity structure beneath the East African Rift System (EARS) as a whole and beneath the Rwenzori Mountains in western Uganda in particular. The most interesting features here is the mountain range of approximately 50 km-wide, with a length of about 150 km, which is situated within the western branch of the East African rift zone and reaches the altitudes of more than 5000 m. The joint tomographic inversion was used to investigate the velocity structure beneath the Rwenzoris on a local scale down to the depth of about 75 - 80 km. Arrival times from 2053 local and 284 teleseismic earthquakes recorded by a temporary network equipped 35 short period and broad-band stations were used as an input for the joint tomographic inversion. The network is covering an area of 140×90 km2. To estimate resolution ability and stability of the obtained results we performed many different tests. The tests show that the best horizontal resolution is achieved in the northern part of the study area, where the density of the ray coverage is highest. In shallow depths where local earthquake rays dominate, the vertical and horizontal resolution is relatvely high, while in deeper sections covered with teleseismic rays, the anomalies seem to be strongly smeared and can be interpreted only on a qualitative level. Velocity structure in the upper crust agrees with the distribution of the main geological units, such as sedimentary basins, igneous outcrops, thermal fields etc. For the uppermost mantle, our results reveal an inclined boundary between the high-velocity Tanzania craton and low-velocity patterns beneath the rift. The same position of the contact between craton and rift zone was obtained in the regional tomographic study of the EARS as a whole. This regional study was based on the ISC data, which contains information about arrival times of signals from earthquakes at more than 7000 stations of the global seismological network

  8. Frequency of human immunodeficiency virus type-2 in hiv infected patients in Maputo City, Mozambique

    PubMed Central

    2011-01-01

    The HIV/AIDS pandemic is primarily caused by HIV-1. Another virus type, HIV-2, is found mainly in West African countries. We hypothesized that population migration and mobility in Africa may have facilitated the introduction and spreading of HIV-2 in Mozambique. The presence of HIV-2 has important implications for diagnosis and choice of treatment of HIV infection. Hence, the aim of this study was to estimate the prevalence of HIV-2 infection and its genotype in Maputo, Mozambique. HIV-infected individuals (N = 1,200) were consecutively enrolled and screened for IgG antibodies against HIV-1 gp41 and HIV-2 gp36 using peptide-based enzyme immunoassays (pepEIA). Specimens showing reactivity on the HIV-2 pepEIA were further tested using the INNO-LIA immunoblot assay and HIV-2 PCR targeting RT and PR genes. Subtype analysis of HIV-2 was based on the protease gene. After screening with HIV-2 pepEIA 1,168 were non-reactive and 32 were reactive to HIV-2 gp36 peptide. Of this total, 30 specimens were simultaneously reactive to gp41 and gp36 pepEIA while two samples reacted solely to gp36 peptide. Only three specimens containing antibodies against gp36 and gp105 on the INNO-LIA immunoblot assay were found to be positive by PCR to HIV-2 subtype A. The proportion of HIV-2 in Maputo City was 0.25% (90%CI 0.01-0.49). The HIV epidemic in Southern Mozambique is driven by HIV-1, with HIV-2 also circulating at a marginal rate. Surveillance program need to improve HIV-2 diagnosis and consider periodical survey aiming to monitor HIV-2 prevalence in the country. PMID:21849066

  9. OBESITY AND DYSLIPIDEMIA IN BEHAVIORALLY HIV-INFECTED YOUNG WOMEN: ADOLESCENT TRIALS NETWORK (ATN) STUDY 021

    PubMed Central

    Mulligan, Kathleen; Harris, D. Robert; Monte, Dina; Stoszek, Sonia; Emmanuel, Patricia; Hardin, Dana S.; Kapogiannis, Bill G.; Worrell, Carol; Meyer, William A.; Sleasman, John; Wilson, Craig M.

    2009-01-01

    Background The goal of this study was to determine the nature and prevalence of abnormalities in lipids, glucose metabolism, and body composition in behaviorally HIV-infected young women and their relationship to different classes of antiretroviral therapy (ART) regimens. Methods We conducted a cross-sectional multicenter study in behaviorally infected women ages 12-24 years (HIVpos; N=173) and seronegative controls (HIVneg; N=61). HIVpos women were categorized as ART-naïve (N=85), on a non-nucleoside reverse transcriptase inhibitor-containing regimen (NNRTI; N=33), on a protease inhibitor-containing regimen (PI; N=36), or on a non-NNRTI/non-PI containing regimen (N=19). Measurements included fasting lipids; glucose and insulin before and 2 hours after an oral glucose challenge; high-sensitivity C-reactive protein (hsCRP); anthropometry; fat distribution (dual energy X-ray absorptiometry); and ART and medical histories. Race-adjusted results were compared across groups and within HIVpos groups. Results The median age was 20 (range 14-24) years. 77% of HIVpos were African American, 35% smoked cigarettes, and 32% reported exercising regularly. More than 40% had a BMI ≥25 kg/m2. Triglycerides; total, HDL, and non-HDL cholesterol; and hsCRP differed significantly among groups, with higher levels most common among those on ART. Indices of glucose metabolism did not differ among groups. In general, cholesterol, hsCRP, and indices of glucose metabolism worsened as BMI increased. Conclusions Obesity, dyslipidemia, and inflammation were prominent in HIV-infected adolescent women and, coupled with other risk factors, may accelerate the lifetime risk of cardiovascular disease and other adverse events. These results underscore the need for a multifaceted approach to addressing risk reduction in this population. PMID:19947855

  10. Apolipoprotein B Gene Polymorphisms and Dyslipidemia in HIV Infected Adult Zimbabweans

    PubMed Central

    Zhou, Danai Tavonga; Oektedalen, Olav; Duri, Kerina; Stray-Pedersen, Babill; Gomo, Exnevia

    2016-01-01

    Background: Dyslipidemia does not occur in all HIV-infected or antiretroviral therapy-experienced patients suggesting role of host genetic factors but there is paucity of data on association between dyslipidemia and gene polymorphisms in Zimbabwe. Objective: To determine association of lipoprotein levels and apolipoprotein B polymorphisms in HIV-infected adults. Method: Demographic data were collected from 103 consenting patients; lipoprotein levels were determined and blood samples were successfully genotyped for both apolipoprotein B 2488C>T Xba1 and apolipoprotein B 4154G>A p.Gln4154Lys EcoR1 polymorphisms by real time polymerase chain reaction. Results: Mean age of genotyped patients was 40.3 ± 10.1 years, 68% were female; prevalence of dyslipidemia was 67.4%. Of 103 samples genotyped for apolipoprotein B Xba1 polymorphism, 76 (74%) were homozygous C/C, 24 (23%) were heterozygous C/T and only three (3%) were homozygous T/T. Apolipoprotein B EcoR1 polymorphism showed little variability, one participant had rare genotype A/A, 68.3% had wild type genotype G/G. Conclusion: Observed frequencies of apolipoprotein B XbaI and EcoRI polymorphisms matched other African studies. In spite of low numbers of rare variants, there was positive association between both total cholestrol and high density lipoprotein with ECoR1 wild type G/G genotype, suggesting that ECoRI 4154 G allele could be more protective against coronary heart disease than EcoR1 4154 A allele. There is need for further research at population level to confirm whether apolipoprotein B ECoR1 genotyping is useful for predicting risk of dyslipidemia in HIV patients in our setting. PMID:27790293

  11. Hearing Loss in HIV-Infected Children in Lilongwe, Malawi

    PubMed Central

    Hrapcak, Susan; Kuper, Hannah; Bartlett, Peter; Devendra, Akash; Makawa, Atupele; Kim, Maria; Kazembe, Peter; Ahmed, Saeed

    2016-01-01

    Introduction With improved access to antiretroviral therapy (ART), HIV infection is becoming a chronic illness. Preliminary data suggest that HIV-infected children have a higher risk of disabilities, including hearing impairment, although data are sparse. This study aimed to estimate the prevalence and types of hearing loss in HIV-infected children in Lilongwe, Malawi. Methods This was a cross-sectional survey of 380 HIV-infected children aged 4–14 years attending ART clinic in Lilongwe between December 2013-March 2014. Data was collected through pediatric quality of life and sociodemographic questionnaires, electronic medical record review, and detailed audiologic testing. Hearing loss was defined as >20 decibels hearing level (dBHL) in either ear. Predictors of hearing loss were explored by regression analysis generating age- and sex-adjusted odds ratios. Children with significant hearing loss were fitted with hearing aids. Results Of 380 patients, 24% had hearing loss: 82% conductive, 14% sensorineural, and 4% mixed. Twenty-one patients (23% of those with hearing loss) were referred for hearing aid fitting. There was a higher prevalence of hearing loss in children with history of frequent ear infections (OR 7.4, 4.2–13.0) and ear drainage (OR 6.4, 3.6–11.6). Hearing loss was linked to history of WHO Stage 3 (OR 2.4, 1.2–4.5) or Stage 4 (OR 6.4, 2.7–15.2) and history of malnutrition (OR 2.1, 1.3–3.5), but not to duration of ART or CD4. Only 40% of caregivers accurately perceived their child’s hearing loss. Children with hearing impairment were less likely to attend school and had poorer emotional (p = 0.02) and school functioning (p = 0.04). Conclusions There is an urgent need for improved screening tools, identification and treatment of hearing problems in HIV-infected children, as hearing loss was common in this group and affected school functioning and quality of life. Clear strategies were identified for prevention and treatment, since most

  12. Sismotectonics in the western branch of the East African Rift System

    NASA Astrophysics Data System (ADS)

    Delvaux, Damien; Kervyn, François; Mulumba, Jean-Luc; Kipata, Louis; Sebagenzi, Stanislas; Mavonga, Georges; Macheyeki, Athanas; Temu, Elly Bryan

    2013-04-01

    The western branch of the East African rift system is known of its particular seismic activity with larger magnitude (up to Ms 7.3) and more frequent destructive earthquakes than in the eastern branch. As a contribution to the IGCP 601 project Seismotectonic Map of Africa, we compiled the known active faults, thermal springs and historical seismicity in Central Africa. Using the rich archives of the Royal Museum for Central Africa, publications and own field observations, we present a compilation of available data relative to the current seismotectonic activity along the western branch of the East African rift system, in DRC, Rwanda, Burundi and Tanzania. Neotectonic activity related to the western rift branch is in general well expressed and relatively well studied in the eastern flank of this rift branch, in Uganda, Rwanda, Burundi and Tanzania. In contrast, the western flank of this rift branch, largely exposed in the DRC, has attracted less attention. However, data collected during the colonial times show significant sismotectonic activity in East DRC, not only in the western flank of the western rift branch, but extending far westwards up to the margin of the Congo basin. In particular, our predecessors paid a special attention to the mapping and description of thermal springs, noticing that they are often controlled by active faults. In addition, the operators of the relatively dense network of meteorological stations installed in the DRC, Rwanda and Burundi also recorded were with variable level of completeness and detail the earthquakes that they could felt. This provides a rich database that is used to complete the existing knowledge on historical seismicity. An important effort has still to be paid to identify and map potentially active fault due to poor field accessibility, tropical climate weathering and vegetation coverage. The main problem in the compilation of active fault data is that very few of them have been investigated by paleoseismic trenching

  13. Comparison of simulated and reconstructed variations in East African hydroclimate over the last millennium

    NASA Astrophysics Data System (ADS)

    Klein, François; Goosse, Hugues; Graham, Nicholas E.; Verschuren, Dirk

    2016-07-01

    The multi-decadal to centennial hydroclimate changes in East Africa over the last millennium are studied by comparing the results of forced transient simulations by six general circulation models (GCMs) with published hydroclimate reconstructions from four lakes: Challa and Naivasha in equatorial East Africa, and Masoko and Malawi in southeastern inter-tropical Africa. All GCMs simulate fairly well the unimodal seasonal cycle of precipitation in the Masoko-Malawi region, while the bimodal seasonal cycle characterizing the Challa-Naivasha region is generally less well captured by most models. Model results and lake-based hydroclimate reconstructions display very different temporal patterns over the last millennium. Additionally, there is no common signal among the model time series, at least until 1850. This suggests that simulated hydroclimate fluctuations are mostly driven by internal variability rather than by common external forcing. After 1850, half of the models simulate a relatively clear response to forcing, but this response is different between the models. Overall, the link between precipitation and tropical sea surface temperatures (SSTs) over the pre-industrial portion of the last millennium is stronger and more robust for the Challa-Naivasha region than for the Masoko-Malawi region. At the inter-annual timescale, last-millennium Challa-Naivasha precipitation is positively (negatively) correlated with western (eastern) Indian Ocean SST, while the influence of the Pacific Ocean appears weak and unclear. Although most often not significant, the same pattern of correlations between East African rainfall and the Indian Ocean SST is still visible when using the last-millennium time series smoothed to highlight centennial variability, but only in fixed-forcing simulations. This means that, at the centennial timescale, the effect of (natural) climate forcing can mask the imprint of internal climate variability in large-scale teleconnections.

  14. Exploring Pacific Climate Variability and Its Impacts on East African Water Resources and Food Security

    NASA Astrophysics Data System (ADS)

    Funk, C. C.; Hoerling, M. P.; Hoell, A.; Liebmann, B.; Verdin, J. P.; Eilerts, G.

    2014-12-01

    In 8 out the past 15 boreal springs (1999, 2000, 2004, 2008, 2009, 2011, 2012, and 2013), substantial parts of eastern East Africa experienced very low boreal spring rains. These rainfall deficits have triggered widespread food insecurity, and even contributed to the outbreak of famine conditions in Somalia in 2011. At both seasonal and decadal time scales, new science supported by the USAID Famine Early Warning Systems Network seeks to understand the mechanisms producing these droughts. We present research suggesting that the ultimate and proximate causes of these increases in aridity are i) stronger equatorial Pacific SST gradients and ii) associated increases in the strength of the Indo-Pacific Walker circulation. Using observations and new modeling ensembles, we explore the relative contributions of Pacific Decadal Variability (PDV) and global warming under warm and cold east Pacific Ocean states. This question is addressed in two ways: by using atmospheric GCMs forced with full and ENSO-only SSTs, and ii) by decomposing coupled ocean-atmosphere climate simulations into PDV and non-PDV components. These analyses allow us to explore the Walker circulation's sensitivity to climate change under various PDV states, and inform a tentative bracketing of 2030 climate conditions. We conclude by discussing links to East African development. Regions of high rainfall sensitivity are delineated and intersected with recent changes in population and land cover/land use. The interaction of elevation and climate is shown to create climatically secure regions that are likely to remain viable even under drier and warmer conditions; such regions may be logical targets for agricultural intensification. Conversely, arid low elevation regions are likely to experience substantial temperature impacts. Continued expansion into these areas may effectively create more 'drought' even if rainfall increases.

  15. HIV-infected mental health patients: characteristics and comparison with HIV-infected patients from the general population and non-infected mental health patients

    PubMed Central

    2013-01-01

    Objectives HIV-infected patients are at increased risk of developing mental health symptoms, which negatively influence the treatment of the HIV-infection. Mental health problems in HIV-infected patients may affect public health. Psychopathology, including depression and substance abuse, can increase hazardous sexual behaviour and, with it, the chance of spreading HIV. Therefore, it is important to develop an optimal treatment plan for HIV-infected patients with mental health problems. The majority of HIV-infected patients in the Netherlands (almost 60%) are homosexual men. The main objectives of this study were to describe the clinical and demographic characteristics of patients with HIV who seek treatment for their mental health symptoms in the Netherlands. Secondly, we tested whether HIV infected and non-infected homosexual patients with a lifetime depressive disorder differed on several mental health symptoms. Methods We compared a cohort of 196 patients who visited the outpatient clinic for HIV and Mental Health with HIV-infected patients in the general population in Amsterdam (ATHENA-study) and with non-HIV infected mental health patients (NESDA-study). DSM-IV diagnoses were determined, and several self-report questionnaires were used to assess mental health symptoms. Results Depressive disorders were the most commonly occurring diagnoses in the cohort and frequent drug use was common. HIV-infected homosexual men with a depressive disorder showed no difference in depressive symptoms or sleep disturbance, compared with non-infected depressive men. However, HIV-positive patients did express more symptoms like fear, anger and guilt. Although they showed significantly more suicidal ideation, suicide attempts were not more prevalent among HIV-infected patients. Finally, the HIV-infected depressive patients displayed a considerably higher level of drug use than the HIV-negative group. Conclusion Habitual drug use is a risk factor for spreading HIV. It is also more

  16. Intestinal parasites and HIV infection in Tanzanian children with chronic diarrhea.

    PubMed

    Cegielski, J P; Msengi, A E; Dukes, C S; Mbise, R; Redding-Lallinger, R; Minjas, J N; Wilson, M L; Shao, J; Durack, D T

    1993-02-01

    The authors attempted to determine whether specific intestinal parasites are associated with HIV infection in Tanzanian children with chronic diarrhea. This prospective, cross-sectional study included all children aged 15 months to 5 years admitted with chronic diarrhea and a group of age-matched controls and took place at Muhimbili University College of Health Sciences, Dar es Salaam, Tanzania. Standardized history, physical examination, HIV serology, and stool parasitology were evaluated for all subjects. The authors compared 3 groups - HIV infected and non-HIV-infected children with chronic diarrhea and controls without diarrhea--and they measured fecal parasites and nutritional status. Chronic diarrhea accounted for one-fourth of all cases of diarrheal disease in the defined age range, and children with chronic diarrhea were severely malnourished. 40% of all subjects with chronic diarrhea were HIV-seropositive. Although intestinal parasites were detected in approximately 50% of all 3 groups, diarrheagenic parasites were detected in up to 40% of children with chronic diarrhea. Blastocystis hominis was detected only in HIV-infected patients. HIV infection was common in children with chronic diarrhea, and parasitic agents of diarrhea may be important in children with chronic diarrhea both with and without HIV infection in this setting. B. hominis was more frequent in HIV-infected children. The immunocompromising effects of severe malnutrition may have diminished the differences between HIV-infected and non-HIV-infected children. PMID:8466683

  17. Pediatric Pulmonary and Cardiovascular Complications of Vertically Transmitted HIV Infection (P2C2)

    ClinicalTrials.gov

    2016-04-13

    Acquired Immunodeficiency Syndrome; Lung Diseases; Cardiovascular Diseases; Heart Diseases; Heart Failure; HIV Infections; Cytomegalovirus Infections; Pneumocystis Carinii Infections; Ebstein-Barr Virus Infections

  18. Behçet's disease diagnosed after acute HIV infection: viral replication activating underlying autoimmunity?

    PubMed

    Roscoe, Clay; Kinney, Rebecca; Gilles, Ryan; Blue, Sky

    2015-05-01

    Behçet's disease is an autoimmune systemic vasculitis that can occur after exposure to infectious agents. Behçet's disease also has been associated with HIV infection, including de novo development of this condition during chronic HIV infection and resolution of Behçet's disease symptoms following initiation of antiretroviral therapy. We describe a patient who presented with systemic vasculitis with skin and mucous membrane ulcerations in the setting of acute HIV infection, who was eventually diagnosed with Behçet's disease, demonstrating a possible link between acute HIV infection, immune activation and development of autoimmunity.

  19. HIV infection in the etiology of lung cancer: confounding, causality, and consequences.

    PubMed

    Kirk, Gregory D; Merlo, Christian A

    2011-06-01

    Persons infected with HIV have an elevated risk of lung cancer, but whether the increase simply reflects a higher smoking prevalence continues to be debated. This review summarizes existing data on the association of HIV infection and lung cancer, with particular attention to study design and adjustment for cigarette smoking. Potential mechanisms by which HIV infection may lead to lung cancer are discussed. Finally, irrespective of causality and mechanisms, lung cancer represents an important and growing problem confronting HIV-infected patients and their providers. Substantial efforts are needed to promote smoking cessation and to control lung cancer among HIV-infected populations.

  20. Motivation, Management, and Mastery: A Theory of Resilience in the Context of HIV Infection

    PubMed Central

    De Santis, Joseph P.; Florom-Smith, Aubrey; Vermeesch, Amber; Barroso, Susana; DeLeon, Diego A.

    2013-01-01

    BACKGROUND Clients with HIV infection have been conceptualized as a resilient population. Although a few researchers have documented resilience among clients with HIV infection, a theory of resilience in the context of HIV infection has not been developed. The purpose of this study was to describe the process by which resilience occurs for clients in the context of HIV infection. METHOD Grounded theory methodology was used to sample and analyze data from 15 qualitative interviews with adults with HIV infection. Data were collected until saturation was reached. RESULTS A theory, motivation, management, and mastery, a description of the process by which resilience occurs in the context of HIV infection, emerged from the data. CONCLUSION Many clients living with HIV infection are resilient, despite the physical, psychological, and social challenges of this chronic illness. Nursing interventions to promote resilience among clients with HIV infection should be directed toward identification of client motivation factors and disease management strategies that may influence health outcomes of people living with HIV infection. PMID:23392433

  1. The role of social support and negative affect in medication adherence for HIV-infected men who have sex with men.

    PubMed

    Woodward, Eva N; Pantalone, David W

    2012-01-01

    Combinations of medications that control HIV viral replication are called antiretroviral therapy (ART). Regimens can be complex, so medication adherence is often suboptimal, although high rates of adherence are necessary for ART to be effective. Social support, which has been directly and indirectly associated with better treatment adherence in HIV-infected individuals, influences negative affect, including depression and anxiety. Our study assessed whether current anxious and depressive symptoms mediated the relationship between general social support and recent self-reported medication adherence in HIV-infected men who have sex with men (N= 136; 65% White, 15% Black/African American). Results revealed no direct effect, but an indirect effect of depressive (95% CI [-.011, -.0011]) and anxious symptoms (95% CI [-.0097, -.0009]), between social support and medication adherence. Greater levels of social support were associated with lower levels of depression and anxiety, which in turn were associated with lower ART adherence.

  2. The physical and psychological effects of HIV infection and its treatment on perinatally HIV-infected children

    PubMed Central

    Vreeman, Rachel C; Scanlon, Michael L; McHenry, Megan S; Nyandiko, Winstone M

    2015-01-01

    Introduction As highly active antiretroviral therapy (HAART) transforms human immunodeficiency virus (HIV) into a manageable chronic disease, new challenges are emerging in treating children born with HIV, including a number of risks to their physical and psychological health due to HIV infection and its lifelong treatment. Methods We conducted a literature review to evaluate the evidence on the physical and psychological effects of perinatal HIV (PHIV+) infection and its treatment in the era of HAART, including major chronic comorbidities. Results and discussion Perinatally infected children face concerning levels of treatment failure and drug resistance, which may hamper their long-term treatment and result in more significant comorbidities. Physical complications from PHIV+ infection and treatment potentially affect all major organ systems. Although treatment with antiretroviral (ARV) therapy has reduced incidence of severe neurocognitive diseases like HIV encephalopathy, perinatally infected children may experience less severe neurocognitive complications related to HIV disease and ARV neurotoxicity. Major metabolic complications include dyslipidaemia and insulin resistance, complications that are associated with both HIV infection and several ARV agents and may significantly affect cardiovascular disease risk with age. Bone abnormalities, particularly amongst children treated with tenofovir, are a concern for perinatally infected children who may be at higher risk for bone fractures and osteoporosis. In many studies, rates of anaemia are significantly higher for HIV-infected children. Renal failure is a significant complication and cause of death amongst perinatally infected children, while new data on sexual and reproductive health suggest that sexually transmitted infections and birth complications may be additional concerns for perinatally infected children in adolescence. Finally, perinatally infected children may face psychological challenges, including

  3. Sexual risk of HIV infection among expatriates posted in AIDS endemic areas.

    PubMed

    de Graaf, R; van Zessen, G; Houweling, H; Ligthelm, R J; van den Akker, R

    1997-07-15

    A survey conducted among 864 Dutch expatriates returning home from assignment in AIDS-endemic areas in sub-Saharan Africa, Latin America, and South and South East Asia revealed a low rate of HIV infection, despite widespread high-risk sexual practices. During an average stay out of the country of 26 months in 1991-96, 41% of the 634 male respondents reported sex with casual or steady local partners and 11% with casual or steady expatriate partners. Among the 230 female expatriates, these rates were 31% and 24%, respectively. 58% of men with casual local partners paid for sex at least once. Among men, consistent condom use was practiced in 69% of encounters with casual local partners and 63% of the time with casual expatriate partners. Among women, these rates were 64% and 48%, respectively. The prevalence of consistent condom use with casual local partners in this study was three times greater than that identified in a study conducted among Dutch expatriates in 1987-89. Condom use with regular local or expatriate partners was substantially lower (16.1-27.8%), however. Inconsistent condom use with casual partners was significantly associated, among men, with being abroad for a longer period of time, failure to bring condoms with them from the Netherlands, posting in an Asian country, and a relatively low estimated HIV prevalence in the local population. Among women, these risk factors were failure to take condoms to their destination and lack of intention at departure to have sex abroad. Only one case of HIV infection was detected in the 847 respondents who underwent serologic testing. Since expatriates function as a bridge between areas with high and low HIV prevalence, educational campaigns that prepare departing workers for differences between the sexual culture at home and abroad and encourage them to take a supply of condoms are recommended.

  4. Short communication: Tenofovir diphosphate in dried blood spots as an objective measure of adherence in HIV-infected women.

    PubMed

    Castillo-Mancilla, Jose R; Searls, Kristina; Caraway, Patricia; Zheng, Jia-Hua; Gardner, Edward M; Predhomme, Julie; Bushman, Lane R; Anderson, Peter L; Meditz, Amie L

    2015-04-01

    Simple and reproducible tools to assess antiretroviral adherence are needed. A level of tenofovir diphosphate (TFV-DP) in dried blood spots (DBS) <1,250 fmol/punch is predicted to identify imperfect adherence. Herein we evaluated TFV-DP in DBS as a measure of adherence among HIV-infected women. DBS and peripheral blood mononuclear cells (PBMCs) were collected twice (∼1 week apart) in 35 well-controlled HIV-infected women [median age 42 years, 14 African American/black (AA)] receiving daily coformulated tenofovir/emtricitabine and either atazanavir/ritonavir (n=20) or raltegravir (n=16). TFV-DP in DBS and PBMCs was quantified by LC-MS/MS. Six-month adherence was measured as average days between monthly pharmacy refills. Data were loge transformed for analysis and presented as median (range); the correlation between continuous variables was analyzed using the Pearson correlation coefficient. The average TFV-DP between the two visits (aTFV-DP) in DBS and PBMCs was 1,874 (706-3,776) fmol/punch and 125 (1-278) fmol/10(6) cells, respectively. AA women had lower levels of aTFV-DP in DBS compared to whites (1,660 vs. 1,970 fmol/punch; p=0.04), with a viremic patient having the lowest drug levels (706 fmol/punch). Days between pharmacy refills were 34 (30-54) vs. 30 (26-40) in women with TFV-DP in DBS <1,250 vs. ≥1,250 fmol/punch (p=0.006). TFV-DP in DBS was negatively correlated with an increasing number of days between refills (r=-0.56, p=0.002). TFV-DP DBS was a reliable and objective measure of adherence in HIV-infected women based on a strong inverse relationship with pharmacy refill adherence.

  5. Short communication: Tenofovir diphosphate in dried blood spots as an objective measure of adherence in HIV-infected women.

    PubMed

    Castillo-Mancilla, Jose R; Searls, Kristina; Caraway, Patricia; Zheng, Jia-Hua; Gardner, Edward M; Predhomme, Julie; Bushman, Lane R; Anderson, Peter L; Meditz, Amie L

    2015-04-01

    Simple and reproducible tools to assess antiretroviral adherence are needed. A level of tenofovir diphosphate (TFV-DP) in dried blood spots (DBS) <1,250 fmol/punch is predicted to identify imperfect adherence. Herein we evaluated TFV-DP in DBS as a measure of adherence among HIV-infected women. DBS and peripheral blood mononuclear cells (PBMCs) were collected twice (∼1 week apart) in 35 well-controlled HIV-infected women [median age 42 years, 14 African American/black (AA)] receiving daily coformulated tenofovir/emtricitabine and either atazanavir/ritonavir (n=20) or raltegravir (n=16). TFV-DP in DBS and PBMCs was quantified by LC-MS/MS. Six-month adherence was measured as average days between monthly pharmacy refills. Data were loge transformed for analysis and presented as median (range); the correlation between continuous variables was analyzed using the Pearson correlation coefficient. The average TFV-DP between the two visits (aTFV-DP) in DBS and PBMCs was 1,874 (706-3,776) fmol/punch and 125 (1-278) fmol/10(6) cells, respectively. AA women had lower levels of aTFV-DP in DBS compared to whites (1,660 vs. 1,970 fmol/punch; p=0.04), with a viremic patient having the lowest drug levels (706 fmol/punch). Days between pharmacy refills were 34 (30-54) vs. 30 (26-40) in women with TFV-DP in DBS <1,250 vs. ≥1,250 fmol/punch (p=0.006). TFV-DP in DBS was negatively correlated with an increasing number of days between refills (r=-0.56, p=0.002). TFV-DP DBS was a reliable and objective measure of adherence in HIV-infected women based on a strong inverse relationship with pharmacy refill adherence. PMID:25328112

  6. Oral Glucose Tolerance Testing identifies HIV+ infected women with Diabetes Mellitus (DM) not captured by standard DM definition

    PubMed Central

    Tian, Fang; Anastos, Kathryn; Cohen, Mardge H; Tien, Phyllis C

    2016-01-01

    Objective HIV-infected (HIV+) individuals may have differential risk of diabetes mellitus (DM) compared to the general population, and the optimal diagnostic algorithm for DM in HIV+ persons remains unclear. We aimed to assess the utility of oral glucose tolerance testing (OGTT) for DM diagnosis in a cohort of women with or at risk for HIV infection. Methods Using American Diabetic Association DM definitions, DM prevalence and incidence were assessed among women enrolled in the Women’s Interagency HIV Study. DM was defined by 2-hour OGTT ≥ 200 mg/dL (DM_OGTT) or a clinical definition (DM_C) that included any of the following: (i) anti-diabetic medication use or self-reported DM confirmed by either fasting glucose (FG) ≥126 mg/dL or HbA1c ≥ 6.5%, (ii) FG ≥ 126 mg/dL confirmed by a second FG ≥ 126 mg/dL or HbA1c 6.5%, or (iii) HbA1c 6.5% confirmed by FG ≥ 126 mg/dL cohort. Results Overall, 390 women (285 HIV+, median age 43 years; 105 HIV−, median age 37 years) were enrolled between 2003-2006. Over half of all women were African American. Using DM_C, DM prevalence rates were 5.6% and 2.8% among HIV+ and HIV− women, respectively. Among HIV+ women, adding DM_OGTT to DM_C increased DM prevalence from 5.6% to 7.4%, a 31% increase in the number of diabetes cases diagnosed (p=0.02). In HIV− women, no additional cases were diagnosed by DM-OGTT. Conclusion In HIV+ women, OGTT identified DM cases that were not identified by a standardized clinical definition. Further investigation is needed to determine whether OGTT should be considered as an adjunctive tool for DM diagnosis in the setting of HIV infection. PMID:27066296

  7. Mapping the East African Ionosphere Using Ground-based GPS TEC Measurements

    NASA Astrophysics Data System (ADS)

    Mengist, Chalachew Kindie; Kim, Yong Ha; Yeshita, Baylie Damtie; Workayehu, Abyiot Bires

    2016-03-01

    The East African ionosphere (3°S-18°N, 32°E-50°E) was mapped using Total Electron Content (TEC) measurements from ground-based GPS receivers situated at Asmara, Mekelle, Bahir Dar, Robe, Arbaminch, and Nairobi. Assuming a thin shell ionosphere at 350 km altitude, we project the Ionospheric Pierce Point (IPP) of a slant TEC measurement with an elevation angle of >10° to its corresponding location on the map. We then infer the estimated values at any point of interest from the vertical TEC values at the projected locations by means of interpolation. The total number of projected IPPs is in the range of 24-66 at any one time. Since the distribution of the projected IPPs is irregularly spaced, we have used an inverse distance weighted interpolation method to obtain a spatial grid resolution of 1°×1° latitude and longitude, respectively. The TEC maps were generated for the year 2008, with a 2 hr temporal resolution. We note that TEC varies diurnally, with a peak in the late afternoon (at 1700 LT), due to the equatorial ionospheric anomaly. We have observed higher TEC values at low latitudes in both hemispheres compared to the magnetic equatorial region, capturing the ionospheric distribution of the equatorial anomaly. We have also confirmed the equatorial seasonal variation in the ionosphere, characterized by minimum TEC values during the solstices and maximum values during the equinoxes. We evaluate the reliability of the map, demonstrating a mean error (difference between the measured and interpolated values) range of 0.04-0.2 TECU (Total Electron Content Unit). As more measured TEC values become available in this region, the TEC map will be more reliable, thereby allowing us to study in detail the equatorial ionosphere of the African sector, where ionospheric measurements are currently very few.

  8. Seasonal patterns of mixed species groups in large East African mammals.

    PubMed

    Kiffner, Christian; Kioko, John; Leweri, Cecilia; Krause, Stefan

    2014-01-01

    Mixed mammal species groups are common in East African savannah ecosystems. Yet, it is largely unknown if co-occurrences of large mammals result from random processes or social preferences and if interspecific associations are consistent across ecosystems and seasons. Because species may exchange important information and services, understanding patterns and drivers of heterospecific interactions is crucial for advancing animal and community ecology. We recorded 5403 single and multi-species clusters in the Serengeti-Ngorongoro and Tarangire-Manyara ecosystems during dry and wet seasons and used social network analyses to detect patterns of species associations. We found statistically significant associations between multiple species and association patterns differed spatially and seasonally. Consistently, wildebeest and zebras preferred being associated with other species, whereas carnivores, African elephants, Maasai giraffes and Kirk's dik-diks avoided being in mixed groups. During the dry season, we found that the betweenness (a measure of importance in the flow of information or disease) of species did not differ from a random expectation based on species abundance. In contrast, in the wet season, we found that these patterns were not simply explained by variations in abundances, suggesting that heterospecific associations were actively formed. These seasonal differences in observed patterns suggest that interspecific associations may be driven by resource overlap when resources are limited and by resource partitioning or anti-predator advantages when resources are abundant. We discuss potential mechanisms that could drive seasonal variation in the cost-benefit tradeoffs that underpin the formation of mixed-species groups. PMID:25470495

  9. Seasonal Patterns of Mixed Species Groups in Large East African Mammals

    PubMed Central

    Kiffner, Christian; Kioko, John; Leweri, Cecilia; Krause, Stefan

    2014-01-01

    Mixed mammal species groups are common in East African savannah ecosystems. Yet, it is largely unknown if co-occurrences of large mammals result from random processes or social preferences and if interspecific associations are consistent across ecosystems and seasons. Because species may exchange important information and services, understanding patterns and drivers of heterospecific interactions is crucial for advancing animal and community ecology. We recorded 5403 single and multi-species clusters in the Serengeti-Ngorongoro and Tarangire-Manyara ecosystems during dry and wet seasons and used social network analyses to detect patterns of species associations. We found statistically significant associations between multiple species and association patterns differed spatially and seasonally. Consistently, wildebeest and zebras preferred being associated with other species, whereas carnivores, African elephants, Maasai giraffes and Kirk's dik-diks avoided being in mixed groups. During the dry season, we found that the betweenness (a measure of importance in the flow of information or disease) of species did not differ from a random expectation based on species abundance. In contrast, in the wet season, we found that these patterns were not simply explained by variations in abundances, suggesting that heterospecific associations were actively formed. These seasonal differences in observed patterns suggest that interspecific associations may be driven by resource overlap when resources are limited and by resource partitioning or anti-predator advantages when resources are abundant. We discuss potential mechanisms that could drive seasonal variation in the cost-benefit tradeoffs that underpin the formation of mixed-species groups. PMID:25470495

  10. Molecular genetic analyses of historical lake sediments from the East African Rift Valley

    NASA Astrophysics Data System (ADS)

    Epp, L. S.; Stoof, K.; Trauth, M. H.; Tiedemann, R.

    2009-04-01

    Ancient DNA research, especially that of environmental samples, has to date focussed mainly on samples obtained from colder regions, owing to better DNA preservation. We explored the potential of using ancient DNA from sediments and sediment cores of shallow lakes in Kenya. These lakes, located in the eastern branch of the East African Rift Valley, are in close proximity, yet display strikingly different hydrological and geological features. Present day lakes range in alkalinity from pH 11 (Lake Elmenteita) to pH 8 (Lake Naivasha), and in depth from less than one meter to 15 meters. Historically they have undergone a number of drastic changes in lake level and environmental conditions, both on geological timescales and during the last centuries. Within this setting we employed molecular genetic methods to study DNA from recent and historic lake sediments, focussing on rotifers and diatoms. We analyzed population and species succession in the alkaline-saline crater lake Sonachi since the beginning of the 19th century, as well as distributions in recent and historic sediments of other lakes of the East African Rift System. To specifically detect diatoms, we developed a protocol using taxon-specific polymerase chain reactions and separation of products by denaturing high performance liquid chromatography (DHPLC). Employing this protocol we retrieved "ancient" DNA from a number of taxonomically diverse organisms, but found diatoms only in sediments younger than approximately 90 years. Using higly specific reactions for rotifers of the genus Brachionus, we tracked species and population succession in Lake Sonachi during the last 200 years. Populations were dominated by a single mitochondrial haplotype for a period of 150 years, and two putatively intraspecific turnovers in dominance occurred. They were both correlated to major environmental changes documented by profound visible changes in sediment composition of the core: the deposition of a volcanic ash and a

  11. Can the 2011 East African drought be attributed to human-induced climate change?

    NASA Astrophysics Data System (ADS)

    Lott, Fraser; Christidis, Nikolaos; Stott, Peter

    2013-04-01

    Can the 2011 East African drought be attributed to human-induced climate change? Fraser C Lott, Nikolaos Christidis, Peter A Stott Met Office Hadley Centre, Fitzroy Road, Exeter EX1 3BP, UK In early 2011, the Greater Horn of Africa was impacted by a particularly severe drought. It consisted of the failure of two successive rainy seasons, known in Kenya as the "short rains" (typically October to December) and the "long rains" (March to June). This study applies the technique of event attribution to the two rainy seasons preceding the drought of 2011, aiming to quantify how the probability of this event has changed due to anthropogenic climate change. Using observed sea surface temperatures (SSTs) with the state-of-the-art atmosphere model HadGEM3-A, the precipitation totals during late 2010 (the "short rains") and early 2011 (the "long rains") were simulated in a 100-member ensemble to produce possible distributions of precipitation consistent with observed SSTs, sea ice conditions and atmospheric concentrations of greenhouse gases. Several 100-member alternative "natural" distributions of precipitation (consistent with a world in which there was no human influence on climate) were also simulated by removing anthropogenic emissions in the atmosphere and by subtracting the difference in SSTs and sea ice that are due to anthropogenic forcings, as produced in a range of coupled atmosphere-ocean simulations (HadCM3, HadGEM1, HadGEM2-ES). Comparing these simulated precipitation distributions to the observed TAMSAT African rainfall dataset, no evidence was found for a human influence on the 2010 short rains, with their failure being more clearly affected by La Niña. However, human influence was found to significantly increase the probability of long rains as dry as, or drier than, those in 2011. The magnitude of this increase in probability depends on the pattern by which human influence is estimated to have changed observed SSTs, and in turn on the coupled model chosen

  12. Shaded Relief with Height as Color, Virunga and Nyiragongo Volcanoes and the East African Rift

    NASA Technical Reports Server (NTRS)

    2002-01-01

    Volcanic, tectonic, erosional and sedimentary landforms are all evident in this comparison of two elevation models of a region along the East African Rift at Lake Kivu. The area shown covers parts of Congo, Rwanda and Uganda.

    These two images show exactly the same area. The image on the left was created using the best global topographic data set previously available, the U.S. Geological Survey's GTOPO30. In contrast, the much more detailed image on the right was generated with data from the Shuttle Radar Topography Mission, which collected enough measurements to map 80 percent of Earth's landmass at this level of precision. Elevation is color coded, progressing from green at the lower elevations through yellow to brown at the higher elevations. A false sun in the northwest (upper left) creates topographic shading.

    Lake Kivu is shown as black in the Shuttle Radar Topography Mission version (southwest corner). It lies within the East African Rift, an elongated tectonic pull-apart depression in Earth's crust. The rift extends to the northeast as a smooth lava- and sediment-filled trough. Two volcanic complexes are seen in the rift. The one closer to the lake is the Nyiragongo volcano, which erupted in January 2002, sending lava toward the lake shore and through the city of Goma. East of the rift, even more volcanoes are seen. These are the Virunga volcano chain, which is the home of the endangered mountain gorillas. Note that the terrain surrounding the volcanoes is much smoother than the eroding mountains that cover most of this view, such that topography alone is a good indicator of the extent of the lava flows. But this clear only at the higher spatial resolution of the shuttle mission's data set.

    For some parts of the globe, Shuttle Radar Topography Mission measurements are 30 times more precise than previously available topographical information, according to NASA scientists. Mission data will be a welcome resource for national and local governments

  13. HIV infection among Quebec women giving birth to live infants.

    PubMed Central

    Hankins, C A; Laberge, C; Lapointe, N; Lai Tung, M T; Racine, L; O'Shaughnessy, M

    1990-01-01

    This is the first anonymous unlinked seroprevalence study in Canada to use serum samples from newborns to determine the seroprevalence rate of human immunodeficiency virus (HIV) infection among childbearing women. Of the 68,808 samples tested 42 were confirmed as positive, for an overall crude seroprevalence rate of 6.1 per 10,000 live births (95% confidence interval [CI] 4.4 to 8.3), or 1 woman in 1638. Women who lived on Montreal island had an overall rate of 17.9 per 10,000 live births (95% CI 12.2 to 25.4), or 1 woman in 559. We observed a significant association between revenue index and seroprevalence; the rates were as high as 46.4 per 10,000 live births (95% CI 18.7 to 95.3), or 1 woman in 216, for Montreal island postal code areas with revenue indexes 20% or more below the provincial median. Extrapolation of the data suggested that 56 women with HIV infection gave birth to a live infant during 1989 in Quebec. Even though attempts to generalize the data from childbearing women to women of childbearing age have an inherent conservative bias, the results of our study suggest that 988 women (95% CI 713 to 1336) aged 15 to 44 years in Quebec had HIV infection in 1989. The actual number is likely substantially higher. The need for well-designed, creative interventions to prevent further HIV transmission to women is evident. Planning for the provision of medical and psychosocial services sensitive to specific needs of women who are already infected should start immediately. PMID:2224716

  14. Analysis of Michigan Medicaid costs to treat HIV infection.

    PubMed

    Solomon, D J; Hogan, A J; Bouknight, R R; Solomon, C T

    1989-01-01

    To obtain better understanding of the nature and cost of health care related to human immunodeficiency virus (HIV) infection, medical payment records were analyzed for 204 men, women, and children older than 60 months who had indications of HIV infection. The records were those of Michigan Medicaid, the General Assistance Medical Program, and the Resident County Hospitalization Program, with service dates on or after January 1, 1984, and which were processed by November 30, 1987. Patient payment records were coded according to whether the patient's condition was considered to be pre-HIV, HIV unrelated, possibly HIV related, or HIV related. Average monthly payments were found to be $150 for pre-HIV patient payment records, $114 for those HIV unrelated, $57 for those possibly related, and $1,213 for those related to HIV infection. HIV-related monthly payments rose from about $1,500 per month in the period 3 months prior to the patient's death to more than $8,000 in the last month of life. Men were found to have twice as many claims as women, and men's claims cost about three times as much. A higher percentage of women than men (91 percent versus 37 percent) received pre-HIV paid services, indicating a higher percentage of women were at least initially receiving Medicaid for reasons other than an HIV-related disability. Diagnostic categories that accounted for the bulk of the HIV-related health care utilization included infectious and parasitic diseases, acquired immunodeficiency syndrome, diseases of the respiratory system, and non-HIV-specific immunity disorders. Inpatient hospitalization accounted for more than 75 percent of the payments, followed by physician costs (11 percent), pharmacy costs (5 percent), and outpatient costs (3 percent). A total of 45, or about 22 percent of the recipients, received zidovudine (AZT) prescriptions at an average monthly cost of $404. PMID:2508170

  15. Contributors to diffusion impairment in HIV-infected persons.

    PubMed

    Gingo, Matthew R; He, Jiayan; Wittman, Catherine; Fuhrman, Carl; Leader, Joseph K; Kessinger, Cathy; Lucht, Lorrie; Slivka, William A; Zhang, Yingze; McMahon, Deborah K; Sciurba, Frank C; Morris, Alison

    2014-01-01

    Abnormal diffusing capacity is common in HIV-infected individuals, including never smokers. Aetiologies for diffusing capacity impairment in HIV are not understood, particularly in those without a history of cigarette smoking. Our study was a cross-sectional analysis of 158 HIV-infected individuals without acute respiratory symptoms or infection with the aim to determine associations between a diffusing capacity of the lung for carbon monoxide (D(LCO)) % predicted and participant demographics, pulmonary spirometric measures (forced expiratory volume in 1 s (FEV1) and FEV1/forced vital capacity), radiographic emphysema (fraction of lung voxels < -950 Hounsfield units), pulmonary vascular/cardiovascular disease (echocardiographic tricuspid regurgitant jet velocity, N-terminal pro-brain natriuretic peptide) and airway inflammation (induced sputum cell counts), stratified by history of smoking. The mean D(LCO) was 65.9% predicted, and 55 (34.8%) participants had a significantly reduced D(LCO) (<60% predicted). Lower D(LCO) % predicted in ever-smokers was associated with lower post-bronchodilator FEV1 % predicted (p<0.001) and greater radiographic emphysema (p=0.001). In never-smokers, mean±SD D(LCO) was 72.7±13.4% predicted, and D(LCO) correlated with post-bronchodilator FEV1 (p=0.02), sputum neutrophils (p=0.03) and sputum lymphocytes (p=0.009), but not radiographic emphysema. Airway obstruction, emphysema and inflammation influence D(LCO) in HIV. Never-smokers may have a unique phenotype of diffusing capacity impairment. The interaction of multiple factors may account for the pervasive nature of diffusing capacity impairment in HIV infection.

  16. Differential Gene Expression in HIV-Infected Individuals Following ART

    PubMed Central

    Massanella, Marta; Singhania, Akul; Beliakova-Bethell, Nadejda; Pier, Rose; Lada, Steven; White, Cory H.; Pérez-Santiago, Josué; Blanco, Julià; Richman, Douglas D.; Little, Susan J.; Woelk, Christopher H.

    2013-01-01

    Previous studies of the effect of ART on gene expression in HIV-infected individuals have identified small numbers of modulated genes. Since these studies were underpowered or cross-sectional in design, a paired analysis of peripheral blood mononuclear cells (PBMCs), isolated before and after ART, from a robust number of HIV-infected patients (N=32) was performed. Gene expression was assayed by microarray and 4,157 differentially expressed genes (DEGs) were identified following ART using multivariate permutation tests. Pathways and Gene Ontology (GO) terms over-represented for DEGs reflected the transition from a period of active virus replication before ART to one of viral suppression (e.g., repression of JAK-STAT signaling) and possible prolonged drug exposure (e.g. oxidative phosphorylation pathway) following ART. CMYC was the DEG whose product made the greatest number of interactions at the protein level in protein interaction networks (PINs), which has implications for the increased incidence of Hodgkin’s lymphoma (HL) in HIV-infected patients. The differential expression of multiple genes was confirmed by RT-qPCR including well-known drug metabolism genes (e.g., ALOX12 and CYP2S1). Targets not confirmed by RT-qPCR (i.e., GSTM2 and RPL5) were significantly confirmed by droplet digital (ddPCR), which may represent a superior method when confirming DEGs with low fold changes. In conclusion, a paired design revealed that the number of genes modulated following ART was an order of magnitude higher than previously recognized. PMID:23933117

  17. Seroprevalence of hepatitis E in HIV infected patients in Greece.

    PubMed

    Politou, Marianna; Boti, Sofia; Androutsakos, Theodoros; Valsami, Serena; Pittaras, Theodoros; Kapsimali, Violetta

    2015-09-01

    HEV infection is an emerging public health problem worldwide Data concerning HEV infection in HIV+ patients in Greece is scare. The aim of the study was to determine HEV seroprevalence in patients with HIV infection in Greece. We studied 243 HIV(+) patients 214 men (88%) and 29 women (12%) with a median age of 45 years (range 19-83) who attended the HIV unit of Pathophysiology Department of Laikon General Hospital in Athens for the presence of anti-HEV IgG antibodies with (EIA) (EIA HEV IgG, Adaltis, Rome, Italy Eighteen/243 patients (7.3%) were positive for HEV IgG antibodies, a seroprevalence that was not different from that described for the blood donors group from Greece There was no difference of the presence of HbsAg, hepatitis C and hepatitis A between the HEV(+) and HEV(-) patients. There was no statistically significant difference between the HEV(+) and HEV(-) group in terms of HIV acquisition, sexual orientation, median duration of HIV infection, ART treatment, or duration of ART. Only the median age of HEV(+) was 52 years (35-78) while that of HEV(-) was 44 years (19-83)(P = 0.03). Only 2/18(11.1%) HEV(+) HIV(+) patients had abnormal ALT and AST values. The seroprevalence of hepatitis E in HIV(+) patients in Greece seems to be the same with that of the general population thus implying that HIV infection is not a risk factor for HEV infection and only age shows a positive correlation with seropositivity.

  18. [Pneumocystosis in non-HIV-infected immunocompromised patients].

    PubMed

    Fillâtre, P; Revest, M; Belaz, S; Robert-Gangneux, F; Zahar, J-R; Roblot, F; Tattevin, P

    2016-05-01

    Pneumocystis jiroveci (formerly P. carinii) is an opportunistic fungus responsible for pneumonia in immunocompromised patients. Pneumocystosis in non-HIV-infected patients differs from AIDS-associated pneumocystosis in mostly two aspects: diagnosis is more difficult, and prognosis is worse. Hence, efforts should be made to target immunocompromised patients at higher risk of pneumocystosis, so that they are prescribed long-term, low-dose, trimethoprime-sulfamethoxazole, highly effective for pneumocystosis prophylaxis. Patients at highest risk include those with medium and small vessels vasculitis, lymphoproliferative B disorders (chronic or acute lymphocytic leukaemia, non-Hodgkin lymphoma), and solid cancer on long-term corticosteroids. Conversely, widespread use of prophylaxis in all patients carrier of inflammatory diseases on long-term corticosteroids is not warranted. The management of pneumocystosis in non-AIDS immunocompromised patients follows the rules established for AIDS patients. The diagnosis relies on the detection of P. jiroveci cyst on respiratory samples, while PCR does not reliably discriminate infection from colonization, in 2015. High-doses trimethoprim-sulfamethoxazole is, by far, the treatment of choice. The benefit of adjuvant corticosteroid therapy for hypoxic patients, well documented in AIDS patients, has a much lower level of evidence in non-HIV-infected patients, most of them being already on corticosteroid by the time of pneumocystosis diagnosis anyway. However, based on its striking impact on morbi-mortality in AIDS patients, adjuvant corticosteroid is recommended in hypoxic, non-HIV-infected patients with pneumocystosis by many experts and scientific societies. PMID:26644039

  19. Urban legends series: oral manifestations of HIV infection.

    PubMed

    Patton, L L; Ramirez-Amador, V; Anaya-Saavedra, G; Nittayananta, W; Carrozzo, M; Ranganathan, K

    2013-09-01

    Human immunodeficiency virus-related oral lesions (HIV-OLs), such as oral candidiasis (OC) and oral hairy leukoplakia (OHL), have been recognized as indicators of immune suppression since the beginning of the global HIV epidemic. The diagnosis and management of HIV disease and spectrum of opportunistic infection has changed over the past 30 years as our understanding of the infection has evolved. We investigated the following controversial topics: (i) Are oral manifestations of HIV still relevant after the introduction of highly active antiretroviral therapy (HAART)? (ii) Can we nowadays still diagnose HIV infection through oral lesions? (iii) Is the actual classification of oral manifestations of HIV adequate or does it need to be reviewed and updated? (iv) Is there any novelty in the treatment of oral manifestations of HIV infection? Results from extensive literature review suggested the following: (i) While HAART has resulted in significant reductions in HIV-OLs, many are still seen in patients with HIV infection, with OC remaining the most common lesion. While the relationship between oral warts and the immune reconstitution inflammatory syndrome is less clear, the malignant potential of oral human papillomavirus infection is gaining increasing attention. (ii) Effective antiretroviral therapy has transformed HIV from a fatal illness to a chronic manageable condition and as a result expanded screening policies for HIV are being advocated both in developed and in developing countries. Affordable, reliable, and easy-to-use diagnostic techniques have been recently introduced likely restricting the importance of HIV-OLs in diagnosis. (iii) The 1993 EC-Clearinghouse classification of HIV-OLs is still globally used despite controversy on the relevance of periodontal diseases today. HIV-OL case definitions were updated in 2009 to facilitate the accuracy of HIV-OL diagnoses by non-dental healthcare workers in large-scale epidemiologic studies and clinical trials. (iv

  20. Leptin expression in HIV-infected patients during antiretroviral therapy

    PubMed Central

    Tiliscan, Cătălin; Aramă, Victoria; Mihăilescu, Raluca; Munteanu, Daniela Ioana; Streinu-Cercel, Adrian; Ion, Daniela Adriana; Rădulescu, Mihaela Andreea; Popescu, Cristina; Lobodan, Alina Elena; Negru, Anca Ruxandra; Aramă, Ştefan Sorin

    2015-01-01

    Background Leptin is an adipokine with complex metabolic, neuroendocrine and immune functions. Our objective was to evaluate leptin serum levels in a cohort of Romanian HIV-infected patients undergoing antiretroviral therapy in relation to their immune-virological status, lipid and glucose metabolic abnormalities and the presence of metabolic syndrome (MS). Methods We enrolled consecutive non-diabetic HIV-infected patients aged 18 and over on stable cART for at least 6 months. Blood samples were tested for: leptin, CD4 T cells count, HIV viral load and lipid panel. Results A total of 90 HIV-infected patients were included in the study: 50 males (55.6%) with a mean age of 33.3 years and 40 females with a mean age of 30.4 years. Most patients (74.4%) had HIV viral load below the limit of detection and the median CD4 count for the cohort was 476 (410) cells/cmm. More than one third of the patients (41.1%) had hypoleptinemia. The prevalence of MS was 13.3%. Hypoleptinemia was significantly more frequent in men. In a subset of patients with undetectable HIV viral load, the median leptin value was 0.6 (6.07) ng/mL in patients with poor immune recovery (CD4 count ≤ 200/cmm) compared to 2 (3.07) ng/mL for those with better immune response (CD4 count > 200/cmm), without statistical significance. The median values of leptin were similar for persons with and without MS criteria. HDL-cholesterol values were positively correlated to leptin values in a linear regression model. Conclusion A significant proportion of patients in our study presented low levels of leptin; this finding was not associated with immune and virological parameters or the presence of MS. Hypoleptinemia was significantly correlated with lower levels of HDL-cholesterol, a key cardiovascular risk factor. PMID:26405677

  1. The epidemiology of HIV infection and AIDS in Thailand.

    PubMed

    Weniger, B G; Limpakarnjanarat, K; Ungchusak, K; Thanprasertsuk, S; Choopanya, K; Vanichseni, S; Uneklabh, T; Thongcharoen, P; Wasi, C

    1991-01-01

    There were very few AIDS cases reported in Thailand as of 1988, where HIV was introduced relatively late in the course of the AIDS pandemic. Thailand was therefore classified as an epidemiologic pattern III country with regard to the HIV/AIDS pandemic. Also in 1988, however, Thailand experienced a major and rapid increase in HIV prevalence among IV drug users (IVDU). The Thai experience with HIV after the rapid spread first among IVDUs has been successive waves of HIV transmission to female prostitutes, then to their non-IVDU male clients, and then into the non-prostitute wives and girlfriends of these latter men in the general population. Three years after being declared a pattern III country, 300,000 people in Thailand were estimated to be infected out of a population of 55 million. Reasons for this unprecedented rapid spread of HIV infection may eventually come from research on sexual behavior and related diseases given the lack of evidence for human host genetic factors or particularly virulent etiologic agent factors to explain the phenomenon. The reason and dynamics behind the timing and rapidity of the 1988 epidemic among IVDUs for now remains unknown. The authors note that the scenario of HIV transmission observed in Thailand also seems to be unfolding in neighboring countries. HIV infection among female prostitutes and heterosexual men is consistently highest in the northern Thai provinces adjacent to Myanmar and Laos. This paper reviews the epidemiology and prevention of HIV infection and AIDS in Thailand, updating previous reports and commentary, and including previously unpublished or not widely available data.

  2. Altered Functional Response to Risky Choice in HIV Infection

    PubMed Central

    Connolly, Colm G.; Bischoff-Grethe, Amanda; Jordan, Stephan J.; Woods, Steven Paul; Ellis, Ronald J.; Paulus, Martin P.; Grant, Igor

    2014-01-01

    Background Risky decision-making is commonly observed in persons at risk for and infected with HIV and is associated with executive dysfunction. Yet it is currently unknown whether HIV alters brain processing of risk-taking decision-making. Methods This study examined the neural substrate of a risky decision-making task in 21 HIV seropositive (HIV+) and 19 seronegative (HIV-) comparison participants. Functional magnetic resonance imaging was conducted while participants performed the risky-gains task, which involves choosing among safe (20 cents) and risky (40/80 cent win or loss) choices. Linear mixed effects analyses examining group and decision type were conducted. Robust regressions were performed to examine the relationship between nadir CD4 count and Kalichman sexual compulsivity and brain activation in the HIV+ group. The overlap between the task effects and robust regressions was explored. Results Although there were no serostatus effects in behavioral performance on the risky-gains task, HIV+ individuals exhibited greater activation for risky choices in the basal ganglia, i.e. the caudate nucleus, but also in the anterior cingulate, dorsolateral prefrontal cortex, and insula relative to the HIV- group. The HIV+ group also demonstrated reduced functional responses to safe choices in the anterior cingulate and dorsolateral prefrontal cortex relative to the HIV- group. HIV+ individuals with higher nadir CD4 count and greater sexual compulsivity displayed lower differential responses to safe versus risky choices in many of these regions. Conclusions This study demonstrated fronto-striatal loop dysfunction associated with HIV infection during risky decision-making. Combined with similar between-group task behavior, this suggests an adaptive functional response in regions critical to reward and behavioral control in the HIV+ group. HIV-infected individuals with higher CD4 nadirs demonstrated activation patterns more similar to seronegative individuals. This

  3. HIV-infected microglia mediate cathepsin B-induced neurotoxicity.

    PubMed

    Zenón, Frances; Cantres-Rosario, Yisel; Adiga, Radhika; Gonzalez, Mariangeline; Rodriguez-Franco, Eillen; Langford, Dianne; Melendez, Loyda M

    2015-10-01

    HIV-1-infected mononuclear phagocytes release soluble factors that affect the homeostasis in tissue. HIV-1 can prompt metabolic encephalopathy with the addition of neuronal dysfunction and apoptosis. Recently, we reported that HIV-1 enhances the expression and secretion of bioactive cathepsin B in monocyte-derived macrophages, ultimately contributing to neuronal apoptosis. In this research, we asked if microglia respond to HIV infection similarly by modifying the expression, secretion, and neurotoxic potential of cathepsin B and determined the in vivo relevance of these findings. HIV-1ADA-infected human primary microglia and CHME-5 microglia cell line were assessed for expression and activity of cathepsin B, its inhibitors, cystatins B and C, and the neurotoxicity associated with these changes. Human primary neurons were exposed to supernatants from HIV-infected and uninfected microglia in the presence of cathepsin B inhibitors and apoptosis was assessed by TUNEL. Microglial expression of cathepsin B was validated in brain tissue from HIV encephalitis (HIVE) patients. HIV-infected microglia secreted significantly greater levels of cathepsin B, cystatin B, and cystatin C compared to uninfected cells. Increased apoptosis was observed in neurons exposed to supernatants from HIV-1 infected microglia at day 12 post-infection. The cathepsin B inhibitor CA-074 and cathepsin B antibody prevented neuronal apoptosis. Increased microglia-derived cathepsin B, cystatin B, and cystatin C and caspase-3+ neurons were detected in HIVE brains compared to controls. Our results suggest that HIV-1-induced cathepsin B production in microglia contributes to neuronal apoptosis and may be an important factor in neuronal death associated with HIVE.

  4. HIV-infected microglia mediate cathepsin B induced neurotoxicity

    PubMed Central

    Zenón, Frances; Cantres-Rosario, Yisel; Adiga, Radhika; Gonzalez, Mariangeline; Rodriguez-Franco, Eillen; Langford, Dianne; Melendez, Loyda M.

    2015-01-01

    BACKGROUND HIV-1-infected mononuclear phagocytes release soluble factors that affect the homeostasis in tissue. HIV-1 can prompt metabolic encephalopathy with the addition of neuronal dysfunction and apoptosis. Recently, we reported that HIV-1 enhances the expression and secretion of bioactive cathepsin B in monocyte-derived macrophages, ultimately contributing to neuronal apoptosis. In this research, we request if microglia respond to HIV infection similarly by modifying the expression, secretion, neurotoxic potential of cathepsin B and the in vivo relevance of these findings. METHODS HIV-ADA infected human primary microglia and CHME-5 were assessed for expression and activity of cathepsin B, its inhibitors, cystatins B and C, and neurotoxicity associated with these changes. Human primary neurons were exposed to supernatants from HIV-infected and uninfected microglia in the presence of cathepsin B inhibitors and apoptosis was assessed by TUNEL. Microglial expression of cathepsin B was validated in brain tissue from HIVE patients. RESULTS HIV-infected microglia secreted significantly greater levels of cathepsin B, cystatin B, and cystatin C compared to uninfected cells. Increased apoptosis was observed in neurons exposed to supernatants from HIV-1 infected microglia at days 12 post-infection. The cathepsin B inhibitor CA-074 and cathepsin B antibody prevented neuronal apoptosis. Increased microglia-derived cathepsin B, cystatin B, and cystatin C and caspase-3+ neurons were detected in HIVE brains compared to controls. CONCLUSIONS Our results suggest that HIV-1-induced cathepsin B production in microglia contributes to neuronal apoptosis and may be an important factor in neuronal death associated with HIVE. PMID:26092112

  5. Towards an understanding and application of environmental flow requirements for human welfare in East African Rivers

    NASA Astrophysics Data System (ADS)

    McClain, Michael

    2013-04-01

    In semi-arid regions of Africa, rivers are of vital importance to humans for the many direct ecosystem services they provide and, in some cases, for their potential to irrigate and power larger-scale development. More than in most regions of the world, Africans still rely individually on rivers for domestic water, nutrition, and other materials contributing to their daily welfare. This has led to a uniquely African adaptation of the environmental flow concept to incorporate the basic water needs of people as well as ecosystems. The combined flow is referred to as the 'Reserve'. East Africa has seen comparatively little development of its water resources to-date, but ambitious initiatives are underway to increase water use in new large-scale irrigation schemes and hydropower projects. Consequently, a number of comprehensive environmental flow assessments and ecohydrological research activities have recently been carried out in the region. This presentation briefly reviews the initiatives underway across the region but focuses mainly on combined research and flow-setting efforts in the transboundary Mara River Basin of Kenya and Tanzania, home to more than 800,000 people and the region's most popular conservation areas, Masai-Mara National Reserve and Serengeti National Park. Since 2006 a team of scientists, in cooperation with water authorities and the World Wide Fund for Nature (WWF), has investigated the hydrology, hydraulics, biology, and human uses of the Mara River in order to make initial environmental flow (reserve) recommendations. The flow regime of the still largely unregulated Mara River, based on analyses or 20+ years of data from three gauging stations, is highly variable and perennial flow in the middle reaches is dependent on inflows from two tributaries draining the heavily deforested Mau Escarpment, one of Kenya's five water towers. Downstream flows are also seasonally influenced by inflows from ephemeral tributaries that drain degraded grazing

  6. Discovery of sublacustrine hydrothermal activity and associated massive sulfides and hydrocarbons in the north Tanganyika trough, East African Rift

    SciTech Connect

    Tiercelin, J.J.; Mondeguer, A. ); Thouin, C. ); Kalala, T. )

    1989-11-01

    Massive sulfides and carbonate mineral deposits associated with sublacustrine thermal springs were recently discovered along the Zaire side of the north Tanganyika trough, western branch of the East African Rift. This hydrothermal activity, investigated by scuba diving at a maximum depth of 20 m, is located at the intersection of major north-south normal faults and northwest-southeast faults belonging to the Tanganyika-Rukwa-Malawi (TRM) strike-slip fault zone. The preliminary results presented here come from analyses of sulfide deposits, hydrothermal fluids, and associated hydrocarbons that result from geothermal activity in this part of the East African Rift filled by a thick pile of sediment, the north Tanganyika trough.

  7. Half-precessional dynamics of monsoon rainfall near the East African Equator.

    PubMed

    Verschuren, Dirk; Sinninghe Damsté, Jaap S; Moernaut, Jasper; Kristen, Iris; Blaauw, Maarten; Fagot, Maureen; Haug, Gerald H

    2009-12-01

    External climate forcings-such as long-term changes in solar insolation-generate different climate responses in tropical and high latitude regions. Documenting the spatial and temporal variability of past climates is therefore critical for understanding how such forcings are translated into regional climate variability. In contrast to the data-rich middle and high latitudes, high-quality climate-proxy records from equatorial regions are relatively few, especially from regions experiencing the bimodal seasonal rainfall distribution associated with twice-annual passage of the Intertropical Convergence Zone. Here we present a continuous and well-resolved climate-proxy record of hydrological variability during the past 25,000 years from equatorial East Africa. Our results, based on complementary evidence from seismic-reflection stratigraphy and organic biomarker molecules in the sediment record of Lake Challa near Mount Kilimanjaro, reveal that monsoon rainfall in this region varied at half-precessional ( approximately 11,500-year) intervals in phase with orbitally controlled insolation forcing. The southeasterly and northeasterly monsoons that advect moisture from the western Indian Ocean were strengthened in alternation when the inter-hemispheric insolation gradient was at a maximum; dry conditions prevailed when neither monsoon was intensified and modest local March or September insolation weakened the rain season that followed. On sub-millennial timescales, the temporal pattern of hydrological change on the East African Equator bears clear high-northern-latitude signatures, but on the orbital timescale it mainly responded to low-latitude insolation forcing. Predominance of low-latitude climate processes in this monsoon region can be attributed to the low-latitude position of its continental regions of surface air flow convergence, and its relative isolation from the Atlantic Ocean, where prominent meridional overturning circulation more tightly couples low

  8. Malaria in East African highlands during the past 30 years: impact of environmental changes.

    PubMed

    Himeidan, Yousif E; Kweka, Eliningaya J

    2012-01-01

    East African highlands are one of the most populated regions in Africa. The population densities in the highlands ranged between 158 persons/km(2) in Ethiopia and 410 persons/km(2) in Rwanda. According to the United Nations Population Fund, the region has the world's highest population growth rate. These factors are likely behind the high rates of poverty among the populations. As there were no employment opportunities other than agricultural, this demographic pressure of poor populations have included in an extensive unprecedented land use and land cover changes such as modification of bushland, woodland, and grassland on hillsides to farmland and transformation of papyrus swamps in valley bottoms to dairy pastures and cropland and changing of fallows on hillsides from short or seasonal to longer or perennial. Areas harvested for food crops were therefore increased by more than 100% in most of the highlands. The lost of forest areas, mainly due to subsistence agriculture, between 1990 and 2010 ranged between 8000 ha in Rwanda and 2,838,000 ha in Ethiopia. These unmitigated environmental changes in the highlands led to rise temperature and optimizing the spread and survival of malaria vectors and development of malaria parasites. Malaria in highlands was initially governed by low ambient temperature, trend of malaria transmission was therefore increased and several epidemics were observed in late 1980s and early 2000s. Although, malaria is decreasing through intensified interventions since mid 2000s onwards, these environmental changes might expose population in the highlands of east Africa to an increase risk of malaria and its epidemic particularly if the current interventions are not sustained. PMID:22934065

  9. Malaria in East African highlands during the past 30 years: impact of environmental changes

    PubMed Central

    Himeidan, Yousif E.; Kweka, Eliningaya J.

    2012-01-01

    East African highlands are one of the most populated regions in Africa. The population densities in the highlands ranged between 158 persons/km2 in Ethiopia and 410 persons/km2 in Rwanda. According to the United Nations Population Fund, the region has the world's highest population growth rate. These factors are likely behind the high rates of poverty among the populations. As there were no employment opportunities other than agricultural, this demographic pressure of poor populations have included in an extensive unprecedented land use and land cover changes such as modification of bushland, woodland, and grassland on hillsides to farmland and transformation of papyrus swamps in valley bottoms to dairy pastures and cropland and changing of fallows on hillsides from short or seasonal to longer or perennial. Areas harvested for food crops were therefore increased by more than 100% in most of the highlands. The lost of forest areas, mainly due to subsistence agriculture, between 1990 and 2010 ranged between 8000 ha in Rwanda and 2,838,000 ha in Ethiopia. These unmitigated environmental changes in the highlands led to rise temperature and optimizing the spread and survival of malaria vectors and development of malaria parasites. Malaria in highlands was initially governed by low ambient temperature, trend of malaria transmission was therefore increased and several epidemics were observed in late 1980s and early 2000s. Although, malaria is decreasing through intensified interventions since mid 2000s onwards, these environmental changes might expose population in the highlands of east Africa to an increase risk of malaria and its epidemic particularly if the current interventions are not sustained. PMID:22934065

  10. Misclassification of men with reported HIV infection in Ukraine.

    PubMed

    Čakalo, Jurja-Ivana; Božičević, Ivana; Vitek, Charles; Mandel, Jeffrey S; Salyuk, Tetyana; Rutherford, George W

    2015-10-01

    We analyzed data on reported mode of transmission in case reports of HIV-infections among men in Ukraine. The number of men who were reported to have acquired HIV through heterosexual transmission increased substantially in 2006-2011. However, we estimate that up to 40 % of reported cases of heterosexual transmission among men may actually represent misclassified men who have sex with men or persons who inject drugs. These findings indicate a need to improve the quality of data on reported mode of HIV transmission. Accurate information has important public health implications in planning prevention and treatment services.

  11. Mortality in HIV infected individuals in Pune, India

    PubMed Central

    Ghate, Manisha; Deshpande, Swapna; Tripathy, Srikanth; Godbole, Sheela; Nene, Madhura; Thakar, Madhuri; Risbud, Arun; Bollinger, Robert; Mehendale, Sanjay

    2011-01-01

    Background & objectives: With the presence of HIV epidemic for more than two decades in India, rise in the number of HIV related deaths is expected. Data on mortality in HIV infected individuals from prospective studies are scanty in India. We report here data on mortality in a systematically followed cohort of HIV infected individuals at Pune, Maharashtra, India Methods: A total of 457 HIV infected individuals were enrolled in a prospective study in Pune between September 2002 and November 2004. They were evaluated clinically and monitored for CD4 counts at every quarterly visit. Mortality data were collected from the records of hospital facilities provided by the study. If the death occurred outside such hospitals; relatives of the participants were requested to inform about the death. Results: Median CD4 count in study participants was 218 cells/µl (95% CI: 107-373) at baseline. The median duration of follow up was 15 months (IQR: 12, 22). Mortality was higher in antiretroviral therapy (ART) naive patients compared to those who received treatment (16.59 vs. 7.25 per 100 person years). Participants above 35 yr of age, CD4 count less than or equal to 100 cells/µl at baseline, tuberculosis at any study time point and ART status were independently associated with high mortality [(RR=1.97; 95% CI: (1.23, 3.14), P=0.005, (RR=33.20, 95%CI (7.59, 145.29), P<0.001, (RR=2.38, 95% CI (1.38, 4.09), P= 0.002 and RR=5.60, 95% CI (3.18, 9.86), P<0.001, respectively]. Interpretation & conclusions: High mortality at advanced immunosuppression highlights the importance of early detection of HIV infection. Emphasis needs to be given at timely diagnosis and management of tuberculosis and ART initiation. It is important to create awareness about availability of free antiretroviral drugs in the government ART roll out programme. PMID:21537095

  12. Use of Machine Learning Techniques for Iidentification of Robust Teleconnections to East African Rainfall Variability in Observations and Models

    NASA Technical Reports Server (NTRS)

    Roberts, J. Brent; Robertson, Franklin R.; Funk, Chris

    2014-01-01

    Providing advance warning of East African rainfall variations is a particular focus of several groups including those participating in the Famine Early Warming Systems Network. Both seasonal and long-term model projections of climate variability are being used to examine the societal impacts of hydrometeorological variability on seasonal to interannual and longer time scales. The NASA / USAID SERVIR project, which leverages satellite and modeling-based resources for environmental decision making in developing nations, is focusing on the evaluation of both seasonal and climate model projections to develop downscaled scenarios for using in impact modeling. The utility of these projections is reliant on the ability of current models to capture the embedded relationships between East African rainfall and evolving forcing within the coupled ocean-atmosphere-land climate system. Previous studies have posited relationships between variations in El Niño, the Walker circulation, Pacific decadal variability (PDV), and anthropogenic forcing. This study applies machine learning methods (e.g. clustering, probabilistic graphical model, nonlinear PCA) to observational datasets in an attempt to expose the importance of local and remote forcing mechanisms of East African rainfall variability. The ability of the NASA Goddard Earth Observing System (GEOS5) coupled model to capture the associated relationships will be evaluated using Coupled Model Intercomparison Project Phase 5 (CMIP5) simulations.

  13. Giant seismites and megablock uplift in the East African Rift: evidence for Late Pleistocene large magnitude earthquakes.

    PubMed

    Hilbert-Wolf, Hannah Louise; Roberts, Eric M

    2015-01-01

    In lieu of comprehensive instrumental seismic monitoring, short historical records, and limited fault trench investigations for many seismically active areas, the sedimentary record provides important archives of seismicity in the form of preserved horizons of soft-sediment deformation features, termed seismites. Here we report on extensive seismites in the Late Quaternary-Recent (≤ ~ 28,000 years BP) alluvial and lacustrine strata of the Rukwa Rift Basin, a segment of the Western Branch of the East African Rift System. We document examples of the most highly deformed sediments in shallow, subsurface strata close to the regional capital of Mbeya, Tanzania. This includes a remarkable, clastic 'megablock complex' that preserves remobilized sediment below vertically displaced blocks of intact strata (megablocks), some in excess of 20 m-wide. Documentation of these seismites expands the database of seismogenic sedimentary structures, and attests to large magnitude, Late Pleistocene-Recent earthquakes along the Western Branch of the East African Rift System. Understanding how seismicity deforms near-surface sediments is critical for predicting and preparing for modern seismic hazards, especially along the East African Rift and other tectonically active, developing regions.

  14. Phylogeography of the Afromontane Prunus africana reveals a former migration corridor between East and West African highlands.

    PubMed

    Kadu, C A C; Schueler, S; Konrad, H; Muluvi, G M M; Eyog-Matig, O; Muchugi, A; Williams, V L; Ramamonjisoa, L; Kapinga, C; Foahom, B; Katsvanga, C; Hafashimana, D; Obama, C; Geburek, T

    2011-01-01

    Scattered populations of the same tree species in montane forests through Africa have led to speculations on the origins of distributions. Here, we inferred the colonization history of the Afromontane tree Prunus africana using seven chloroplast DNA loci to study 582 individuals from 32 populations sampled in a range-wide survey from across Africa, revealing 22 haplotypes. The predominant haplotype, HT1a, occurred in 13 populations of eastern and southern Africa, while a second common haplotype, HT1m, occurred in populations of western Uganda and western Africa. The high differentiation observed between populations in East Africa was unexpected, with stands in western Uganda belonging with the western African lineage. High genetic differentiation among populations revealed using ordered alleles (N(ST) = 0.840) compared with unordered alleles (G(ST) = 0.735), indicated a clear phylogeographic pattern. Bayesian coalescence modelling suggested that 'east' and 'west' African types likely split early during southward migration of the species, while further more recent splitting events occurred among populations in the East of the continent. The high genetic similarity found between western Uganda and west African populations indicates that a former Afromontane migration corridor may have existed through Equatorial Africa.

  15. Investigating “mass hysteria” in early postcolonial Uganda: Benjamin H. Kagwa, East African psychiatry, and the Gisu

    PubMed Central

    Pringle, Yolana

    2016-01-01

    In the early 1960s, medical officers and administrators began to receive reports of what was being described as “mass madness” and “mass hysteria” in Tanganyika (now Tanzania) and Uganda. Each epidemic reportedly affected between 300 and 600 people and, coming in the wake of independence from colonial rule, caused considerable concern. One of the practitioners sent to investigate was Benjamin H. Kagwa, a Ugandan-born psychiatrist whose report represents the first investigation by an African psychiatrist in East Africa. This article uses Kagwa’s investigation to explore some of the difficulties facing East Africa’s first generation of psychiatrists as they took over responsibility for psychiatry. During this period, psychiatrists worked in an intellectual climate that was both attempting to deal with the legacy of colonial racism, and which placed faith in African psychiatrists to reveal more culturally sensitive insights into African psychopathology. The epidemics were the first major challenge for psychiatrists such as Kagwa precisely because they appeared to confirm what colonial psychiatrists had been warning for years—that westernization would eventually result in mass mental instability. As this article argues, however, Kagwa was never fully able to free himself from the practices and assumptions that had pervaded his discipline under colonial rule. His analysis of the epidemics as a “mental conflict” fit into a much longer tradition of psychiatry in East Africa, and stood starkly against the explanations of the local community. PMID:24191308

  16. Sedimentary budgets of the Tanzania coastal basin and implications for uplift history of the East African rift system

    NASA Astrophysics Data System (ADS)

    Said, Aymen; Moder, Christoph; Clark, Stuart; Abdelmalak, Mohamed Mansour

    2015-11-01

    Data from 23 wells were used to quantify the sedimentary budgets in the Tanzania coastal basin in order to unravel the uplift chronology of the sourcing area located in the East African Rift System. We quantified the siliciclastic sedimentary volumes preserved in the Tanzania coastal basin corrected for compaction and in situ (e.g., carbonates) production. We found that the drainage areas, which supplied sediments to this basin, were eroded in four episodes: (1) during the middle Jurassic, (2) during the Campanian-Palaeocene, (3) during the middle Eocene and (4) during the Miocene. Three of these high erosion and sedimentation periods are more likely related to uplift events in the East African Rift System and earlier rift shoulders and plume uplifts. Indeed, rapid cooling in the rift system and high denudation rates in the sediment source area are coeval with these recorded pulses. However, the middle Eocene pulse was synchronous with a fall in the sea level, a climatic change and slow cooling of the rift flanks and thus seems more likely due to climatic and eustatic variations. We show that the rift shoulders of the East African rift system have inherited their present relief from at least three epeirogenic uplift pulses of middle Jurassic, Campanian-Palaeocene, and Miocene ages.

  17. Giant Seismites and Megablock Uplift in the East African Rift: Evidence for Late Pleistocene Large Magnitude Earthquakes

    PubMed Central

    Hilbert-Wolf, Hannah Louise; Roberts, Eric M.

    2015-01-01

    In lieu of comprehensive instrumental seismic monitoring, short historical records, and limited fault trench investigations for many seismically active areas, the sedimentary record provides important archives of seismicity in the form of preserved horizons of soft-sediment deformation features, termed seismites. Here we report on extensive seismites in the Late Quaternary-Recent (≤ ~ 28,000 years BP) alluvial and lacustrine strata of the Rukwa Rift Basin, a segment of the Western Branch of the East African Rift System. We document examples of the most highly deformed sediments in shallow, subsurface strata close to the regional capital of Mbeya, Tanzania. This includes a remarkable, clastic ‘megablock complex’ that preserves remobilized sediment below vertically displaced blocks of intact strata (megablocks), some in excess of 20 m-wide. Documentation of these seismites expands the database of seismogenic sedimentary structures, and attests to large magnitude, Late Pleistocene-Recent earthquakes along the Western Branch of the East African Rift System. Understanding how seismicity deforms near-surface sediments is critical for predicting and preparing for modern seismic hazards, especially along the East African Rift and other tectonically active, developing regions. PMID:26042601

  18. Giant seismites and megablock uplift in the East African Rift: evidence for Late Pleistocene large magnitude earthquakes.

    PubMed

    Hilbert-Wolf, Hannah Louise; Roberts, Eric M

    2015-01-01

    In lieu of comprehensive instrumental seismic monitoring, short historical records, and limited fault trench investigations for many seismically active areas, the sedimentary record provides important archives of seismicity in the form of preserved horizons of soft-sediment deformation features, termed seismites. Here we report on extensive seismites in the Late Quaternary-Recent (≤ ~ 28,000 years BP) alluvial and lacustrine strata of the Rukwa Rift Basin, a segment of the Western Branch of the East African Rift System. We document examples of the most highly deformed sediments in shallow, subsurface strata close to the regional capital of Mbeya, Tanzania. This includes a remarkable, clastic 'megablock complex' that preserves remobilized sediment below vertically displaced blocks of intact strata (megablocks), some in excess of 20 m-wide. Documentation of these seismites expands the database of seismogenic sedimentary structures, and attests to large magnitude, Late Pleistocene-Recent earthquakes along the Western Branch of the East African Rift System. Understanding how seismicity deforms near-surface sediments is critical for predicting and preparing for modern seismic hazards, especially along the East African Rift and other tectonically active, developing regions. PMID:26042601

  19. Molecular Definition of Vaginal Microbiota in East African Commercial Sex Workers ▿ †

    PubMed Central

    Schellenberg, John J.; Links, Matthew G.; Hill, Janet E.; Dumonceaux, Tim J.; Kimani, Joshua; Jaoko, Walter; Wachihi, Charles; Mungai, Jane Njeri; Peters, Geoffrey A.; Tyler, Shaun; Graham, Morag; Severini, Alberto; Fowke, Keith R.; Ball, T. Blake; Plummer, Francis A.

    2011-01-01

    Resistance to HIV infection in a cohort of commercial sex workers living in Nairobi, Kenya, is linked to mucosal and antiinflammatory factors that may be influenced by the vaginal microbiota. Since bacterial vaginosis (BV), a polymicrobial dysbiosis characterized by low levels of protective Lactobacillus organisms, is an established risk factor for HIV infection, we investigated whether vaginal microbiology was associated with HIV-exposed seronegative (HESN) or HIV-seropositive (HIV+) status in this cohort. A subset of 44 individuals was selected for deep-sequencing analysis based on the chaperonin 60 (cpn60) universal target (UT), including HESN individuals (n = 16), other HIV-seronegative controls (HIV-N, n = 16), and HIV+ individuals (n = 12). Our findings indicate exceptionally high phylogenetic resolution of the cpn60 UT using reads as short as 200 bp, with 54 species in 29 genera detected in this group. Contrary to our initial hypothesis, few differences between HESN and HIV-N women were observed. Several HIV+ women had distinct profiles dominated by Escherichia coli. The deep-sequencing phylogenetic profile of the vaginal microbiota corresponds closely to BV+ and BV− diagnoses by microscopy, elucidating BV at the molecular level. A cluster of samples with intermediate abundance of Lactobacillus and dominant Gardnerella was identified, defining a distinct BV phenotype that may represent a transitional stage between BV+ and BV−. Several alpha- and betaproteobacteria, including the recently described species Variovorax paradoxus, were found to correlate positively with increased Lactobacillus levels that define the BV− (“normal”) phenotype. We conclude that cpn60 UT is ideally suited to next-generation sequencing technologies for further investigation of microbial community dynamics and mucosal immunity underlying HIV resistance in this cohort. PMID:21531840

  20. Meaning of care for terminally Ill HIV-infected patients by HIV-infected peer caregivers in a simulation-based training program in South Korea.

    PubMed

    Kim, Sunghee; Shin, Gisoo

    2015-01-01

    The purpose of this study was to develop a simulation-based training program for people living with HIV (PLWH) as peer caregivers who would take care of terminally ill, HIV-infected patients. We used qualitative research methods and standardized patients to explore the meaning of caring for patients as peer caregivers. Study participants included 32 patients registered as PLWH at the South Korea Federation for HIV/AIDS. The meanings of peer caregiving were categorized into four dimensions: physical, psychological, relational, and economic. Our study had benefits in knowledge acquisition for caregivers as well as care recipients, empathy with HIV-infected care recipients, improvement in self-esteem and social participation, and financial self-sufficiency to enable independent living for caregivers. The simulation training program for PLWH peer caregivers for terminally ill HIV-infected patients demonstrated value, for both PLWH caregivers and terminally ill HIV-infected patients in South Korea, to improve the quality of care.

  1. The episode of genetic drift defining the migration of humans out of Africa is derived from a large east African population size.

    PubMed

    Elhassan, Nuha; Gebremeskel, Eyoab Iyasu; Elnour, Mohamed Ali; Isabirye, Dan; Okello, John; Hussien, Ayman; Kwiatksowski, Dominic; Hirbo, Jibril; Tishkoff, Sara; Ibrahim, Muntaser E

    2014-01-01

    Human genetic variation particularly in Africa is still poorly understood. This is despite a consensus on the large African effective population size compared to populations from other continents. Based on sequencing of the mitochondrial Cytochrome C Oxidase subunit II (MT-CO2), and genome wide microsatellite data we observe evidence suggesting the effective size (Ne) of humans to be larger than the current estimates, with a foci of increased genetic diversity in east Africa, and a population size of east Africans being at least 2-6 fold larger than other populations. Both phylogenetic and network analysis indicate that east Africans possess more ancestral lineages in comparison to various continental populations placing them at the root of the human evolutionary tree. Our results also affirm east Africa as the likely spot from which migration towards Asia has taken place. The study reflects the spectacular level of sequence variation within east Africans in comparison to the global sample, and appeals for further studies that may contribute towards filling the existing gaps in the database. The implication of these data to current genomic research, as well as the need to carry out defined studies of human genetic variation that includes more African populations; particularly east Africans is paramount. PMID:24845801

  2. The episode of genetic drift defining the migration of humans out of Africa is derived from a large east African population size.

    PubMed

    Elhassan, Nuha; Gebremeskel, Eyoab Iyasu; Elnour, Mohamed Ali; Isabirye, Dan; Okello, John; Hussien, Ayman; Kwiatksowski, Dominic; Hirbo, Jibril; Tishkoff, Sara; Ibrahim, Muntaser E

    2014-01-01

    Human genetic variation particularly in Africa is still poorly understood. This is despite a consensus on the large African effective population size compared to populations from other continents. Based on sequencing of the mitochondrial Cytochrome C Oxidase subunit II (MT-CO2), and genome wide microsatellite data we observe evidence suggesting the effective size (Ne) of humans to be larger than the current estimates, with a foci of increased genetic diversity in east Africa, and a population size of east Africans being at least 2-6 fold larger than other populations. Both phylogenetic and network analysis indicate that east Africans possess more ancestral lineages in comparison to various continental populations placing them at the root of the human evolutionary tree. Our results also affirm east Africa as the likely spot from which migration towards Asia has taken place. The study reflects the spectacular level of sequence variation within east Africans in comparison to the global sample, and appeals for further studies that may contribute towards filling the existing gaps in the database. The implication of these data to current genomic research, as well as the need to carry out defined studies of human genetic variation that includes more African populations; particularly east Africans is paramount.

  3. Drivers of Intensity and Prevalence of Flea Parasitism on Small Mammals in East African Savanna Ecosystems.

    PubMed

    Young, Hillary S; Dirzo, Rodolfo; McCauley, Douglas J; Agwanda, Bernard; Cattaneo, Lia; Dittmar, Katharina; Eckerlin, Ralph P; Fleischer, Robert C; Helgen, Lauren E; Hintz, Ashley; Montinieri, John; Zhao, Serena; Helgen, Kristofer M

    2015-06-01

    The relative importance of environmental factors and host factors in explaining variation in prevalence and intensity of flea parasitism in small mammal communities is poorly established. We examined these relationships in an East African savanna landscape, considering multiple host levels: across individuals within a local population, across populations within species, and across species within a landscape. We sampled fleas from 2,672 small mammals of 27 species. This included a total of 8,283 fleas, with 5 genera and 12 species identified. Across individual hosts within a site, both rodent body mass and season affected total intensity of flea infestation, although the explanatory power of these factors was generally modest (<10%). Across host populations in the landscape, we found consistently positive effects of host density and negative effects of vegetation cover on the intensity of flea infestation. Other factors explored (host diversity, annual rainfall, anthropogenic disturbance, and soil properties) tended to have lower and less consistent explanatory power. Across host species in the landscape, we found that host body mass was strongly positively correlated with both prevalence and intensity of flea parasitism, while average robustness of a host species to disturbance was not correlated with flea parasitism. Cumulatively, these results provide insight into the intricate roles of both host and environmental factors in explaining complex patterns of flea parasitism across landscape mosaics.

  4. Plasma progesterone and blood metabolite profiles in post-partum small east African zebu cows.

    PubMed

    Tegegne, A; Entwistle, K W; Mukasa-Mugerwa, E

    1993-05-01

    Plasma progesterone profiles were used to monitor post-partum reproductive activity in 12 Small East African zebu (Bos indicus) cows allocated to either supplementary or no supplementary feeding (control) with continuous or restricted (twice daily) suckling regimes. Intact bulls were used for breeding. Blood samples were collected 3 times a week for 33 weeks to determine plasma progesterone levels. Weekly blood samples were also used to determine blood metabolite concentrations. Plasma progesterone levels remained below 1 ng/ml in all cows until week 12 post-partum. Only 5 cows showed ovarian activity over the 33 week period. Cows that cycled expressed irregular and short-lived progesterone rises (> 1 ng/ml) lasting 8 to 12 days prior to establishment of normal patterns of progesterone secretion where progesterone levels ranged from 8 to 10 ng/ml in cows with normal cycles. Plasma total protein, albumin, globulin, blood urea nitrogen and glucose levels varied over time without consistent trends, and were not influenced by either supplementary feeding of suckling regimes, nor differed between cyclic and acyclic cows. It was concluded that extended post-partum anoestrus, conception failure and early embryonic mortality were responsible for lowered reproductive efficiency in zebu cows. Blood metabolite concentrations were not good indicators of nutritional status and were not related to post-partum ovarian activity. PMID:8236477

  5. Predicting East African spring droughts using Pacific and Indian Ocean sea surface temperature indices

    NASA Astrophysics Data System (ADS)

    Funk, C.; Hoell, A.; Shukla, S.; Bladé, I.; Liebmann, B.; Roberts, J. B.; Robertson, F. R.; Husak, G.

    2014-03-01

    In southern Ethiopia, Eastern Kenya, and southern Somalia, poor boreal spring rains in 1999, 2000, 2004, 2007, 2008, 2009, and 2011 contributed to severe food insecurity and high levels of malnutrition. Predicting rainfall deficits in this region on seasonal and decadal time frames can help decision makers implement disaster risk reduction measures while guiding climate-smart adaptation and agricultural development. Building on recent research that links more frequent droughts in that region to a stronger Walker Circulation, warming in the Indo-Pacific warm pool, and an increased western Pacific sea surface temperature (SST) gradient, we show that the two dominant modes of East African boreal spring rainfall variability are tied, respectively, to western-central Pacific and central Indian Ocean SST. Variations in these rainfall modes can be predicted using two previously defined SST indices - the West Pacific Gradient (WPG) and Central Indian Ocean index (CIO), with the WPG and CIO being used, respectively, to predict the first and second rainfall modes. These simple indices can be used in concert with more sophisticated coupled modeling systems and land surface data assimilations to help inform early warning and guide climate outlooks.

  6. Estimating the age of formation of lakes: An example from Lake Tanganyika, East African Rift system

    SciTech Connect

    Cohen, A.; Soreghan, M.J.; Scholz, C.A.

    1993-06-01

    Age estimates for ancient lakes are important for determining their histories and their rates of biotic and tectonic evolution. In the absence of dated core material from the lake`s sedimentary basement, several techniques have been used to generate such age estimates. The most common of these, herein called the reflection seismic-radiocarbon method (RSRM), combines estimates of short-term sediment-accumulation rates derived from radiocarbon-dated cores and depth-to-basement estimates derived from reflection-seismic data at or near the same locality to estimate an age to basement. Age estimates form the RSRM suggest that the structural basins of central Lake Tanganyika began to form between 9 and 12 Ma. Estimates for the northern and southern basins are younger (7 to 8 Ma and 2 to 4 Ma, respectively). The diachroneity of estimates for different segments of the lake is equivocal, and may be due to erosional loss of record in the northern and southern structural basins or to progressive opening of the rift. The RSRM age estimates for Lake Tanganyika are considerably younger than most prior estimates and clarify the extensional history of the western branch of the East African Rift system. 31 refs., 3 figs., 1 tab.

  7. Do estimated and actual species phylogenies match? Evaluation of East African cichlid radiations.

    PubMed

    Huang, Huateng; Tran, Lucy A P; Knowles, L Lacey

    2014-09-01

    A large number of published phylogenetic estimates are based on a single locus or the concatenation of multiple loci, even though genealogies of single or concatenated loci may not accurately reflect the true history of species diversification (i.e., the species tree). The increased availability of genomic data, coupled with new computational methods, improves resolution of species relationships beyond what was possible in the past. Such developments will no doubt benefit future phylogenetic studies. It remains unclear how robust phylogenies that predate these developments (i.e., the bulk of phylogenetic studies) are to departures from the assumption of strict gene tree-species tree concordance. Here, we present a parametric bootstrap (PBST) approach that assesses the reliability of past phylogenetic estimates in which gene tree-species tree discord was ignored. We focus on a universal cause of discord-the random loss of gene lineages from genetic drift-and apply the method in a meta-analysis of East African cichlids, a group encompassing historical scenarios that are particularly challenging for phylogenetic estimation. Although we identify some evolutionary relationships that are robust to gene tree discord, many past phylogenetic estimates of cichlids are not. We discuss the utility of the PBST method for evaluating the robustness of gene tree-based phylogenetic estimations in general as well as for testing the clade-specific performance of species tree estimation methods and designing sampling strategies that increase the accuracy of estimated species relationships.

  8. Precessional(?) Variability in East African Aridity During the Past Few Hundred Thousand Years

    NASA Astrophysics Data System (ADS)

    Shi, J.; Brown, E. T.; Johnson, T. C.; Scholz, C. A.; Cohen, A. S.; King, J.

    2007-12-01

    We used scanning X-ray fluorescence to investigate fluctuations in calcium abundance in the upper 200 m of cores MAL05-1B and 1C recovered by the Lake Malawi Drilling Project from a central lake site. Conspicuous variations in calcium concentrations reflect the abundance of endogenic calcite, which accumulates during periods of relatively dry conditions in the Malawi basin. Major calcium peaks occur at fairly regular intervals down core. The power spectrum of calcium on a depth scale reveals a large concentration of variance in the 20-meter- band. More detailed analyses were undertaken on MAL05-1C which has a well-constrained age-depth model built on radiocarbon, paleointensity, inclination, 10Be, and OSL dating [Scholz et al., in press]. We attribute the cycles of calcium fluctuation in MAL05-1C to monsoonal climate driven by variations in local insolation dominated by eccentricity-modulated precession. Scholz, C.A., T.C. Johnson, A.S. Cohen, J.W. King, J.A. Peck, J.T. Overpeck, M.K. Talbot, E.T. Brown, L. Kalindekafe, P.Y.O. Amoako, R.P. Lyons, T.M. Shanahan, I.S. Castaneda, C.W. Heil, S.L. Forman, L.R. McHargue, K. Beuning, J. Gomez, and J. Pierson, East African megadroughts between 135-75 kyr ago and implications for early human history, Proceedings of the National Academy of Sciences, in press.

  9. 42 CFR Appendix A to Part 130 - Definition of HIV Infection or HIV

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false Definition of HIV Infection or HIV A Appendix A to... PAYMENTS RICKY RAY HEMOPHILIA RELIEF FUND PROGRAM Pt. 130, App. A Appendix A to Part 130—Definition of HIV Infection or HIV ER31MY00.000 ER31MY00.001...

  10. 42 CFR Appendix A to Part 130 - Definition of HIV Infection or HIV

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false Definition of HIV Infection or HIV A Appendix A to... PAYMENTS RICKY RAY HEMOPHILIA RELIEF FUND PROGRAM Pt. 130, App. A Appendix A to Part 130—Definition of HIV Infection or HIV ER31MY00.000 ER31MY00.001...

  11. 42 CFR Appendix A to Part 130 - Definition of HIV Infection or HIV

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Definition of HIV Infection or HIV A Appendix A to... PAYMENTS RICKY RAY HEMOPHILIA RELIEF FUND PROGRAM Pt. 130, App. A Appendix A to Part 130—Definition of HIV Infection or HIV ER31MY00.000 ER31MY00.001...

  12. 42 CFR Appendix A to Part 130 - Definition of HIV Infection or HIV

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false Definition of HIV Infection or HIV A Appendix A to... PAYMENTS RICKY RAY HEMOPHILIA RELIEF FUND PROGRAM Pt. 130, App. A Appendix A to Part 130—Definition of HIV Infection or HIV ER31MY00.000 ER31MY00.001...

  13. HIV Infection among People Who Inject Drugs: The Challenge of Racial/Ethnic Disparities

    ERIC Educational Resources Information Center

    Des Jarlais, Don C.; McCarty, Dennis; Vega, William A.; Bramson, Heidi

    2013-01-01

    Racial/ethnic disparities in HIV infection, with minority groups typically having higher rates of infection, are a formidable public health challenge. In the United States, among both men and women who inject drugs, HIV infection rates are elevated among Hispanics and non-Hispanic Blacks. A meta-analysis of international research concluded that…

  14. 42 CFR Appendix A to Part 130 - Definition of HIV Infection or HIV

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Definition of HIV Infection or HIV A Appendix A to... PAYMENTS RICKY RAY HEMOPHILIA RELIEF FUND PROGRAM Pt. 130, App. A Appendix A to Part 130—Definition of HIV Infection or HIV ER31MY00.000 ER31MY00.001...

  15. AIDS Prevention Guide. The Facts about HIV Infection and AIDS. Putting the Facts to Use.

    ERIC Educational Resources Information Center

    Centers for Disease Control and Prevention (DHHS/PHS), Atlanta, GA.

    Many teenagers engage in behaviors that increase their risk of becoming infected with HIV. This document is a compilation of information about AIDS and HIV Infection, and provides suggestions for parents and other adults in discussing AIDS/HIV with young people. Basic facts are outlined, including what AIDS is and how HIV infection causes AIDS;…

  16. Barriers to Antiretroviral Medication Adherence in Young HIV-Infected Children

    ERIC Educational Resources Information Center

    Roberts, Kathleen Johnston

    2005-01-01

    The purpose of this exploratory study was to examine, from the perspectives of both HIV-infected children and such children's primary guardians, the barriers children face in adhering to combination antiretroviral therapies. Nine HIV-infected young children and 14 guardians of HIV-positive children were interviewed about what the children's lives…

  17. Balamuthia mandrillaris and Acanthamoeba Amebic Encephalitis with Neurotoxoplasmosis Coinfection in a Patient with Advanced HIV Infection

    PubMed Central

    Chan, Joseph C.; Castellano-Sanchez, Amilcar; Hirzel, Alicia; Laowansiri, Panthipa; Tuda, Claudio; Visvesvara, Govinda S.; Qvarnstrom, Yvonne; Ratzan, Kenneth R.

    2012-01-01

    We describe a patient with advanced HIV infection and Balamuthia mandrillaris and Acanthamoeba amebic encephalitis with Toxoplasma gondii coinfection. A multidisciplinary effort and state-of-the-art diagnostic techniques were required for diagnosis. Our patient is the first reported case of an HIV-infected person with dual Balamuthia mandrillaris and Acanthamoeba amebic encephalitis with neurotoxoplasmosis coinfection. PMID:22170911

  18. Risk for HIV Infection among Adolescents in the Border City of Tijuana, Mexico

    ERIC Educational Resources Information Center

    Martinez-Donate, Ana P.; Blumberg, Elaine J.; Hovell, Melbourne F.; Sipan, Carol L.; Zellner, Jennifer A.; Hughes, Suzanne

    2004-01-01

    Previous studies have suggested high rates of HIV infection and other sexually transmitted infections in theU.S.-Mexico border region. However, no information is available on the risk for HIV infection among Mexican adolescents living in this geographic area. This study examines the prevalence of HIV risk practices and psychosocial correlates…

  19. What the volcanism of the East African Rift tells us on its evolution and dynamics: a reappraisal

    NASA Astrophysics Data System (ADS)

    Michon, Laurent

    2015-04-01

    The East African Rift (EAR) is one of the most studied tectonic structures on Earth. Classically, it is described as extending from Afar in the North to the Malawi rift in the South, along the eastern and western branches, respectively. A widely accepted consensus also exists on two main points: 1- the rift initiated first with plume emplacement below the northern part of the eastern branch and 2- extension and volcanism subsequently migrated southward along the western branch (e.g., Ebinger, 1989). However, an increasing amount of new geochronological data on the volcanic activity in the southern part of the East African Rift tends to weaken these interpretations and imposes a reassessment of the rift dynamics. The volcanic activity being one of the main characteristics of this rift, I use it here to determine the lateral extension of the rift system and to assess the rift activity through times. First, the volcanism unambiguously indicates that the rift is not limited to the African continent but can be traced in the Mozambique Channel and in Madagascar where it is closely related to active tectonics (graben and transfer faults) initiated since at least the Miocene. Moreover, the synthesis of more than 800 published geochronological data of volcanic products distributed over the overal East African Rift allows the distinction of two parts. The first part, the Northern EAR, corresponds to the sole eastern branch, which is characterized by volcanic plateaus resulting from huge magma flux during three main periods (32-28, 18-12, 6-0 Ma). Provinces of the second part, the Southern EAR (the western branch, the Mozambique Channel and Madagascar), share rift-related scattered volcanic centres characterized by coeval periods of activity since the Oligocene (28-24, 20-16 and 12-0 Ma). This synthesis highlights the lack of southward migration of the volcanism during the evolution of the East African Rift and instead reveals the almost synchronous development of the

  20. Cancer Knowledge and Opportunities for Education Among HIV-Infected Patients in an Urban Academic Medical Center.

    PubMed

    Fisher, Lydia H; Stafford, Kristen A; Fantry, Lori E; Gilliam, Bruce L; Riedel, David J

    2015-06-01

    HIV-infected patients frequently present with advanced stage cancer. It is possible that late stage presentation may be related to lack of cancer knowledge and/or barriers to care. Questionnaires were administered to 285 adult HIV-infected patients to evaluate knowledge of cancer risk factors and symptoms and barriers to care between 2011 and 2012. Differences in mean and percent scores by group were assessed using a t test for independent samples and chi-square analysis, respectively. Respondents were predominantly male (64%), African-American (86%), and low income (60% < $10,000/year). Thirty-four (12%) had been diagnosed with cancer, and 169 (59%) had a family history of cancer. The mean knowledge score was 17.5 out of 24 questions (73%). Mean scores were not significantly different by sex, age, race, or income. Respondents with a college education scored significantly higher than those with less than a high school education (p < 0.01). In unadjusted analysis, a higher proportion of patients with a personal/family history of cancer (74%) scored in the highest quartile (>70% correct) compared to those without any personal history of cancer (62%) (p = 0.03). There was a higher level of cancer knowledge in this population compared to studies that have evaluated the HIV-uninfected population. Nevertheless, there were knowledge deficits, suggesting the need for further education about cancer to improve earlier detection rates and, ultimately, outcomes.

  1. Immunogenicity of the Bivalent Oral Cholera Vaccine Shanchol in Haitian Adults With HIV Infection.

    PubMed

    Ivers, Louise C; Charles, Richelle C; Hilaire, Isabelle J; Mayo-Smith, Leslie M; Teng, Jessica E; Jerome, J Gregory; Rychert, Jenna; LaRocque, Regina C; Xu, Peng; Kovácˇ, Pavol; Ryan, Edward T; Qadri, Firdausi; Almazor, Charles P; Franke, Molly F; Harris, Jason B

    2015-09-01

    We evaluated immune responses following bivalent oral cholera vaccination (Shanchol [Shantha Biotechnics]; BivWC) in a cohort of 25 human immunodeficiency virus (HIV)-infected adults in Haiti. Compared with adults without HIV infection, vaccination in HIV-infected individuals resulted in lower vibriocidal responses against Vibrio cholerae O1, and there was a positive relationship between the CD4(+) T-cell count and vibriocidal responses following vaccination. Nevertheless, seroconversion occurred at a rate of 65% against the Ogawa serotype and 74% against the Inaba serotype in adults with HIV infection. These results suggest that the vaccine retains substantial immunogenicity in adults with HIV infection and may benefit this population by protecting against cholera.

  2. The context and experience of becoming HIV infected for Zimbabwean women: unheard voices revealed.

    PubMed

    Gona, Clara M; DeMarco, Rosanna

    2015-01-01

    Zimbabwean women are at high risk for HIV infection but often are not the focus of inquiry unless they are participants in controlled trials. In this phenomenological study, we interviewed 17 women living with advanced HIV infection to better understand their experiences and the aftermath of being diagnosed with HIV. Open-ended interviews were audiotaped, transcribed, translated into English, and analyzed. Two themes (living with suspicion of HIV infection and sensing the engulfing anguish of being HIV infected) emerged and were found to reflect the essence of the phenomena. Even though the women had suspected being HIV infected from internal and external cues, a confirmed diagnosis threw them into a state of anguish prompted by the possibility of dying from a disease they "did not deserve." When designing prevention and treatment interventions, for the interventions to be effective, clinicians working with this population should consider the complexity of issues involved.

  3. Health care experiences of HIV-infected women with fertility desires in Mexico: a qualitative study.

    PubMed

    van Dijk, Marieke G; Wilson, Kate S; Silva, Martha; Contreras, Xipatl; Fukuda, H Dawn; García, Sandra G

    2014-01-01

    Increased access to antiretroviral therapy has enabled Mexican HIV-infected women to resume healthy sexual and reproductive lives and reduce the risk of mother-to-child transmission of HIV infection. However, little information is available on the experiences of HIV-infected women desiring children. In this qualitative study, we conducted in-depth interviews with 31 HIV-infected women in four Mexican cities. The findings indicated that most of the women were given limited information on their pregnancy options. With some exceptions, the women felt they were denied the option to have (or to have more) children and advised to undergo tubal ligations or abortions. The findings of this study indicate that ongoing efforts are needed to promote the reproductive rights of HIV-infected women in Mexico and to ensure that they receive options aligned with their fertility desires.

  4. Bystander CD4+ T lymphocytes survive in HIV-infected human lymphoid tissue

    NASA Technical Reports Server (NTRS)

    Grivel, Jean-Charles; Biancotto, Angelique; Ito, Yoshinori; Lima, Rosangela G.; Margolis, Leonid B.

    2003-01-01

    HIV infection is associated with depletion of CD4(+) T cells. The mechanisms of this phenomenon remain to be understood. In particular, it remains controversial whether and to what extent uninfected ("bystander") CD4(+) T cells die in HIV-infected individuals. We address this question using a system of human lymphoid tissue ex vivo. Tissue blocks were inoculated with HIV-1. After productive infection was established, they were treated with the reverse transcriptase inhibitor nevirapine to protect from infection those CD4(+) T cells that had not yet been infected. These CD4(+) T cells residing in HIV-infected tissue are by definition bystanders. Our results demonstrate that after nevirapine application the number of bystander CD4(+) T cells is conserved. Thus, in the context of HIV-infected human lymphoid tissue, productive HIV infection kills infected cells but is not sufficient to cause the death of a significant number of uninfected CD4(+) T cells.

  5. Partners in Crime: The Role of CMV in Immune Dysregulation and Clinical Outcome During HIV Infection

    PubMed Central

    Freeman, Michael L.; Lederman, Michael M.

    2016-01-01

    In the current era of combination antiretroviral therapy (ART), human immunodeficiency virus (HIV)-infected individuals are living longer and healthier lives. Nevertheless, HIV-infected persons are at greater risk for age-related disorders, which have been linked to residual immune dysfunction and inflammation. HIV-infected individuals are almost universally co-infected with cytomegalovirus (CMV) and both viruses are associated with inflammation-related morbidities. Therefore, a detailed investigation of the relationship between CMV and aging-related morbidities emerging during chronic HIV infection is warranted. Here, we review the literature on how CMV co-infection affects HIV infection and host immunity and we discuss the gaps in our knowledge that need elucidation. PMID:26810437

  6. Hodgkin lymphoma in the elderly, pregnant, and HIV-infected.

    PubMed

    Bachanova, Veronika; Connors, Joseph M

    2016-07-01

    Hodgkin lymphoma (HL) presenting in patients with co-incidental advanced age, pregnancy, or human immunodeficiency virus (HIV) infection is uniquely challenging to manage. In this article we integrate recent evidence and clinical expertise to present recommendations for diagnosis and therapeutic management. Older patients with HL need to be carefully evaluated for comorbidies after which judicious choice of chemotherapy should minimize functional compromise. A pregnant patient with concurrent HL should be staged with minimal use of imaging requiring ionizing radiation and treated in an individualized manner optimally combining the strategies of treatment deferral when appropriate, use of single-agent vinblastine for symptomatic disease and reservation of multi-agent chemotherapy for the small minority of patients with aggressive clinical presentation. Treatment of HL coincident with HIV infection requires a combination of highly active anti-retroviral agents (HAART), standard multi-agent chemotherapy with meticulous attention to drug-drug interactions, and vigorous supportive care to ensure the best chance of cure. PMID:27496312

  7. Dendritic cell based vaccines for HIV infection: the way ahead.

    PubMed

    García, Felipe; Plana, Montserrat; Climent, Nuria; León, Agathe; Gatell, Jose M; Gallart, Teresa

    2013-11-01

    Dendritic cells have a central role in HIV infection. On one hand, they are essential to induce strong HIV-specific CD4⁺ helper T-cell responses that are crucial to achieve a sustained and effective HIV-specific CD8⁺ cytotoxic T-lymphocyte able to control HIV replication. On the other hand, DCs contribute to virus dissemination and HIV itself could avoid a correct antigen presentation. As the efficacy of immune therapy and therapeutic vaccines against HIV infection has been modest in the best of cases, it has been hypothesized that ex vivo generated DC therapeutic vaccines aimed to induce effective specific HIV immune responses might overcome some of these problems. In fact, DC-based vaccine clinical trials have yielded the best results in this field. However, despite these encouraging results, functional cure has not been reached with this strategy in any patient. In this Commentary, we discuss new approaches to improve the efficacy and feasibility of this type of therapeutic vaccine.

  8. Urban to rural routes of HIV infection spread in Ethiopia.

    PubMed

    Shabbir, I; Larson, C P

    1995-10-01

    A descriptive survey to identify routes of spread of HIV infection from urban to rural populations was carried out in a rural south-central Ethiopian district. High risk practices for HIV infection and transmission were first documented among rural residing former soldiers, merchants and students. Extramarital intercourse during the previous 3 months was reported by 45-50% of these subgroups. In 25-37%, intercourse with an urban commercial sex worker (CSW) was reported and condom use varied from 10 to 30% among subgroups. The perceived risk for AIDS was low and changes in risk behaviours were minimal. Next, 502 rural males farmers were surveyed. An extramarital sexual contact in the past 3 months was reported by 13.5%, with 7% reporting their most recent contact with an urban CSW. Only 6% of farmers reported using condoms. Awareness of AIDS was reported by 59% and, of these, only 28% perceived they were vulnerable. In this study increased knowledge was associated with more frequent high risk sexual practices. It is concluded that the spread of AIDS into rural communities is occurring as a result of the high frequency of high risk sexual behaviours in specific rural residing subgroups which frequently travel into urban communities in combination with a low background prevalence of high risk practices among the general male farmer population. PMID:7563263

  9. Epidemiology of Meningitis in an HIV-Infected Ugandan Cohort

    PubMed Central

    Rajasingham, Radha; Rhein, Joshua; Klammer, Kate; Musubire, Abdu; Nabeta, Henry; Akampurira, Andrew; Mossel, Eric C.; Williams, Darlisha A.; Boxrud, Dave J.; Crabtree, Mary B.; Miller, Barry R.; Rolfes, Melissa A.; Tengsupakul, Supatida; Andama, Alfred O.; Meya, David B.; Boulware, David R.

    2015-01-01

    There is limited understanding of the epidemiology of meningitis among human immunodeficiency virus (HIV)-infected populations in sub-Saharan Africa. We conducted a prospective cohort study of HIV-infected adults with suspected meningitis in Uganda, to comprehensively evaluate the etiologies of meningitis. Intensive cerebrospiral fluid (CSF) testing was performed to evaluate for bacterial, viral, fungal, and mycobacterial etiologies, including neurosyphilis,16s ribosomal DNA (rDNA) polymerase chain reaction (PCR) for bacteria, Plex-ID broad viral assay, quantitative-PCR for HSV-1/2, cytomegalovirus (CMV), Epstein–Barr virus (EBV), and Toxoplasma gondii; reverse transcription-PCR (RT-PCR) for Enteroviruses and arboviruses, and Xpert MTB/RIF assay. Cryptococcal meningitis accounted for 60% (188 of 314) of all causes of meningitis. Of 117 samples sent for viral PCR, 36% were EBV positive. Among cryptococcal antigen negative patients, the yield of Xpert MTB/RIF assay was 22% (8 of 36). After exclusion of cryptococcosis and bacterial meningitis, 61% (43 of 71) with an abnormal CSF profile had no definitive diagnosis. Exploration of new TB diagnostics and diagnostic algorithms for evaluation of meningitis in resource-limited settings remains needed, and implementation of cryptococcal diagnostics is critical. PMID:25385864

  10. [Control of HCV, HBV and HIV Infections in Hemodialysis].

    PubMed

    Fabrizi, Fabrizio; Martin, Paul; Messa, Piergiorgio

    2013-01-01

    Infections with blood-borne pathogens are still common among patients on maintenance dialysis all over the world. The control of infection due to blood-borne viruses (particularly HBV) within dialysis units has been a major goal in the management of patients with chronic kidney disease in the industrialized world. Standard precautions and specific procedures have been recommended to prevent infections with HBV, HCV and HIV within dialysis units. Isolation of HBsAg positive patients by dialysis rooms, staff and machines continues to be an important step to control HBV infection within dialysis units, according to the CDC and other regulatory agencies. Some prospective observational studies have reported the complete prevention of HCV transmission to hemodialysis patients in the absence of any isolation policy, and the use of dedicated dialysis machines for HCV-infected patients is not recommended by clinical guidelines. Isolation of HCV-infected patients should be considered in special circumstances only. Vaccination is an important tool against transmission of HBV among patients on long-term dialysis even if the immune response towards the hepatitis B vaccine remains unsatisfactory. Hemodialysis is considered a low risk setting for the transmission of human immunodeficiency virus (HIV) infection, providing that standard and specific procedures are carefully observed. HIV-infected patients do not have to be isolated from other patients or dialyzed separately on dedicated machines.

  11. Robustness of a cellular automata model for the HIV infection

    NASA Astrophysics Data System (ADS)

    Figueirêdo, P. H.; Coutinho, S.; Zorzenon dos Santos, R. M.

    2008-11-01

    An investigation was conducted to study the robustness of the results obtained from the cellular automata model which describes the spread of the HIV infection within lymphoid tissues [R.M. Zorzenon dos Santos, S. Coutinho, Phys. Rev. Lett. 87 (2001) 168102]. The analysis focused on the dynamic behavior of the model when defined in lattices with different symmetries and dimensionalities. The results illustrated that the three-phase dynamics of the planar models suffered minor changes in relation to lattice symmetry variations and, while differences were observed regarding dimensionality changes, qualitative behavior was preserved. A further investigation was conducted into primary infection and sensitiveness of the latency period to variations of the model’s stochastic parameters over wide ranging values. The variables characterizing primary infection and the latency period exhibited power-law behavior when the stochastic parameters varied over a few orders of magnitude. The power-law exponents were approximately the same when lattice symmetry varied, but there was a significant variation when dimensionality changed from two to three. The dynamics of the three-dimensional model was also shown to be insensitive to variations of the deterministic parameters related to cell resistance to the infection, and the necessary time lag to mount the specific immune response to HIV variants. The robustness of the model demonstrated in this work reinforce that its basic hypothesis are consistent with the three-stage dynamic of the HIV infection observed in patients.

  12. Urinary Biomarkers of Kidney Diseases in HIV-infected children

    PubMed Central

    Perazzo, Sofia; Soler-García, Ángel A.; Hathout, Yetrib; Das, Jharna R.; Ray, Patricio E.

    2015-01-01

    A significant number of children infected with the HIV-1 virus all over the world are at risk of developing renal diseases that could have a significant impact on their treatment and quality of life. It is necessary to identify children undergoing the early stages of these renal diseases, as well as the potential renal toxicity that could be caused by antiretroviral drugs, in order to prevent the development of cardiovascular complications and chronic renal failure. This article describes the most common renal diseases seen in HIV-infected children, as well as the value and limitations of the clinical markers that are currently being used to monitor their renal function and histological damage in a non-invasive manner. In addition, we discuss the progress made during the last 10 years in the discovery and validation of new renal biomarkers for HIV-infected children and young adults. Although significant progress has been made during the early phases of the biomarkers discovery, more work remains to be done to validate the new biomarkers in a large number of patients. The future looks promising, however, the new knowledge needs to be integrated and validated in the context of the clinical environment where these children are living. PMID:25764519

  13. Partner Violence and Health among HIV-Infected Jail Detainees

    PubMed Central

    Meyer, Jaimie P.; Wickersham, Jeffrey A.; Fu, Jeannia J.; Brown, Shan-Estelle; Sullivan, Tami P.; Springer, Sandra A.; Altice, Frederick L.

    2013-01-01

    Purpose Little is known about the association of intimate partner violence (IPV) with specific HIV treatment outcomes, especially among criminal justice (CJ) populations who are disproportionately affected by IPV, HIV, mental and substance use disorders (SUDs) and are at high risk of poor post-release continuity of care. Design/Methodology/Approach Mixed methods were used to describe the prevalence, severity, and correlates of lifetime IPV exposure among HIV-infected jail detainees enrolled in a novel jail-release demonstration project in Connecticut. Additionally, the effect of IPV on HIV treatment outcomes and longitudinal healthcare utilization was examined. Findings Structured baseline surveys defined 49% of 84 participants as having significant IPV-exposure, which was associated with female gender, longer duration since HIV diagnosis, suicidal ideation, having higher alcohol use severity, having experienced other forms of childhood and adulthood abuse, and homo/bisexual orientation. IPV was not directly correlated with HIV healthcare utilization or treatment outcomes. In-depth qualitative interviews with 20 surveyed participants, however, confirmed that IPV was associated with disengagement from HIV care especially in the context of overlapping vulnerabilities, including transitioning from CJ to community settings, having untreated mental disorders, and actively using drugs or alcohol at the time of incarceration. Value Post-release interventions for HIV-infected CJ populations should minimally integrate HIV secondary prevention with violence reduction and treatment for SUDs. PMID:24376468

  14. Dental care access and use among HIV-infected women.

    PubMed Central

    Shiboski, C H; Palacio, H; Neuhaus, J M; Greenblatt, R M

    1999-01-01

    OBJECTIVES: This study sought to identify predictors of dental care use in HIV-infected women. METHODS: In a cross-sectional survey of HIV-infected women enrolled in the northern California site of the Women's Interagency HIV Study, dental care use and unmet need were assessed in relation to selected variables. RESULTS: Among 213 respondents, who were predominantly Black and younger than 45 years, 43% had not seen a dentist and 53% (among dentate women) reported no dental cleaning in more than a year (although 67% had dental insurance coverage, mainly state Medicaid). Nine percent were edentulous. Among nonusers of dental care, 78% reported that they wanted care but failed to get it. Barriers included fear of and discomfort with dentists, not getting around to making an appointment, and not knowing which dentist to visit. Multivariate analysis showed that lack of past-year dental care was associated mainly with unemployment, a perception of poor oral health, and edentulism. CONCLUSIONS: HIV-positive women appear to be underusing dental care services. Fear and lack of information regarding available resources, in addition to unemployment and perception of poor oral health, may be important barriers. PMID:10358671

  15. Clinical Evaluation of Shilajatu Rasayana in patients with HIV Infection

    PubMed Central

    Gupta, G. D.; Sujatha, N.; Dhanik, Ajay; Rai, N. P.

    2010-01-01

    AIDS is one of the serious global health concerns caused by Human Immuno Deficiency(HIV) virus and is predominantly a sexually transmitted disease. Currently there is no vaccine or cure for AIDS still Anti Retroviral Therapy (ART) is successful. It reduces both the mortality and the morbidity of HIV infection, but is expensive and inaccessible in many countries. However intense the therapy may be, HIV virus is rarely eliminated, and drug resistance is a major setback during long-term therapy. The development of new drugs and strategies and exploring alternative systems of medicine for antiviral herbs or drugs is the need of the age to improve treatment outcomes. Ayurveda describes many diseases which incorporate HIV like illness e.g. Rajayakshma, Ojo Kshaya, Sannipata jwara etc. HIV infection affects multisystems, chiefly the Immune System which can be correlated to Ojo Kshaya. Rasayana Chikitsa is the frontline therapy employed to treat Ojus disorders. Therefore Shilajatu (Mineral pitch), Centella asiatica (Mandukaparni), Tinospora cordifolia (Guduchi) and Emblica officinalis (Amalaki), well known for their Immuno-modulator and antioxidant properties were selected to evaluate their role on immune system. The study was carried on 20 patients from OPD and IPD of Kayachikitsa, S.S.Hospital, IMS, BHU and was randomly allocated into Treated group (Shilajatu+ART) and Control group (ART). Treated Group responded better to ART both clinically and biochemically. The results show that Shilajatu decreases the recurrent resistance of HIV virus to ART and improves the outcome of the therapy PMID:22131681

  16. Simulation of HIV infection in artificial immune systems

    NASA Astrophysics Data System (ADS)

    Sieburg, Hans B.; McCutchan, J. Allen; Clay, Oliver K.; Cabalerro, Lisa; Ostlund, James J.

    1990-09-01

    Infection by the human immunodeficiency virus (HIV) causes a multi-faceted disease process which ultimately leads to severe degenerative conditions in the immune and nervous systems. The complexity of the virus/host-system interaction has brought into sharp focus the need for alternative efforts by which to overcome the limitations of available animal models. This article reports on the dynamics of HIV infection in an artificial immune system (AIS), a novel in silico tool for bio-medical research. Using a method of graphical programming, the HIV/AIS interactions are described at the cellular level and then transferred into the setting of an asynchronous cellular automaton simulation. A specific problem in HIV pathogenesis is addressed: To determine the extent by which the physiological connectivity of a normal B-cell, T-cell, macrophage immune system supports persistence of infection and disease progression to AIDS. Several observations are discussed which will be presented in four categories: (a) the major known manifestations of HIV infection and AIDS; (b) the predictability of latency and sudden progression to disease; (c) the predictability of HIV-dependent alterations of cytokine secretion patterns, and (d) secondary infections, which are found to be a critical element in establishing and maintaining a progressive disease dynamics. The effects of exogenously applied cytokine Interleukin 2 are considered. All results are summarized in a phase-graph model of the global HIV/AIS dynamical system.

  17. New ways of preventing HIV infection: thinking simply, simply thinking

    PubMed Central

    Short, R.V

    2006-01-01

    HIV infection is the greatest health crisis in human history. It continues to spread unchecked among the poor in the developing world because we have failed to design simple preventative methods that are available and affordable to those living on under $2 a day. Five new methods are discussed. (i) A natural microbicide. Intravaginal lime or lemon juice has been used for centuries as a traditional contraceptive. The juice can also kill HIV in the laboratory, but clinical trials are needed to see if vaginal application is acceptable, safe and effective. (ii) Intravaginal oestrogen. Monkeys can be protected from Simian immunodeficiency virus (SIV) infection by keratinizing the vagina with topical oestrogen. If women take the oral contraceptive pill vaginally it retains its contraceptive efficacy, and the oestrogen it contains should thicken the vagina and protect against HIV infection. Clinical trials are needed. (iii) Male circumcision. Removal of the inner foreskin removes the main site of HIV entry into the penis, resulting in a sevenfold reduction in susceptibility to infection. The practice needs to be promoted. (iv) Post-coital penile hygiene. Wiping the penis immediately after intercourse with lime or lemon juice or vinegar should kill the virus before it has had a chance to infect. A clinical trial of efficacy is needed. (v) PhotoVoice. Asking schoolchildren in developing countries to photograph their impressions of HIV/AIDS is a powerful way of getting them to discuss the subject openly, and develop their own preventative strategies. PMID:16627296

  18. Hepatitis C Virus Infection in HIV-infected Patients.

    PubMed

    Sulkowski, Mark S.

    2001-10-01

    The hepatitis C virus (HCV) is a spherical enveloped RNA virus of the Flaviviridae family, classified within the Hepacivirus genus. Since its discovery in 1989, HCV has been recognized as a major cause of chronic hepatitis and hepatic fibrosis that progresses in some patients to cirrhosis and hepatocellular carcinoma. In the United States, approximately 4 million people have been infected with HCV, and 10,000 HCV-related deaths occur each year. Due to shared routes of transmission, HCV and HIV co-infection are common, affecting approximately one third of all HIV-infected persons in the United States. In addition, HIV co-infection is associated with higher HCV RNA viral load and a more rapid progression of HCV-related liver disease, leading to an increased risk of cirrhosis. HCV infection may also impact the course and management of HIV disease, particularly by increasing the risk of antiretroviral drug-induced hepatotoxicity. Thus, chronic HCV infection acts as an opportunistic disease in HIV-infected persons because the incidence of infection is increased and the natural history of HCV infection is accelerated in co-infected persons. Strategies to prevent primary HCV infection and to modify the progression of HCV-related liver disease are urgently needed among HIV/HCV co-infected individuals.

  19. Hepatitis C virus infection in HIV-infected patients.

    PubMed

    Sulkowski, Mark S

    2007-10-01

    The hepatitis C virus (HCV) is a spherical enveloped RNA virus of the Flaviviridae family, classified within the Hepacivirus genus. Since its discovery in 1989, HCV has been recognized as a major cause of chronic hepatitis and hepatic fibrosis that progresses in some patients to cirrhosis and hepatocellular carcinoma. In the United States, approximately 4 million people have been infected with HCV, and 10,000 HCVrelated deaths occur each year. Due to shared routes of transmission, HCV and HIV co-infection are common, affecting approximately one third of all HIV-infected persons in the United States. In addition, HIV co-infection is associated with higher HCV RNA viral load and a more rapid progression of HCV-related liver disease, leading to an increased risk of cirrhosis. HCV infection may also impact the course and management of HIV disease, particularly by increasing the risk of antiretroviral drug-induced hepatotoxicity. Thus, chronic HCV infection acts as an opportunistic disease in HIV-infected persons because the incidence of infection is increased and the natural history of HCV infection is accelerated in co-infected persons. Strategies to prevent primary HCV infection and to modify the progression of HCV-related liver disease are urgently needed among HIV/HCV co-infected individuals.

  20. Epidemiology of meningitis in an HIV-infected Ugandan cohort.

    PubMed

    Rajasingham, Radha; Rhein, Joshua; Klammer, Kate; Musubire, Abdu; Nabeta, Henry; Akampurira, Andrew; Mossel, Eric C; Williams, Darlisha A; Boxrud, Dave J; Crabtree, Mary B; Miller, Barry R; Rolfes, Melissa A; Tengsupakul, Supatida; Andama, Alfred O; Meya, David B; Boulware, David R

    2015-02-01

    There is limited understanding of the epidemiology of meningitis among human immunodeficiency virus (HIV)-infected populations in sub-Saharan Africa. We conducted a prospective cohort study of HIV-infected adults with suspected meningitis in Uganda, to comprehensively evaluate the etiologies of meningitis. Intensive cerebrospiral fluid (CSF) testing was performed to evaluate for bacterial, viral, fungal, and mycobacterial etiologies, including neurosyphilis,16s ribosomal DNA (rDNA) polymerase chain reaction (PCR) for bacteria, Plex-ID broad viral assay, quantitative-PCR for HSV-1/2, cytomegalovirus (CMV), Epstein-Barr virus (EBV), and Toxoplasma gondii; reverse transcription-PCR (RT-PCR) for Enteroviruses and arboviruses, and Xpert MTB/RIF assay. Cryptococcal meningitis accounted for 60% (188 of 314) of all causes of meningitis. Of 117 samples sent for viral PCR, 36% were EBV positive. Among cryptococcal antigen negative patients, the yield of Xpert MTB/RIF assay was 22% (8 of 36). After exclusion of cryptococcosis and bacterial meningitis, 61% (43 of 71) with an abnormal CSF profile had no definitive diagnosis. Exploration of new TB diagnostics and diagnostic algorithms for evaluation of meningitis in resource-limited settings remains needed, and implementation of cryptococcal diagnostics is critical.

  1. Mapping the Elephants of the 19th Century East African Ivory Trade with a Multi-Isotope Approach

    PubMed Central

    Lee-Thorp, Julia; Collins, Matthew J.; Lane, Paul J.

    2016-01-01

    East African elephants have been hunted for their ivory for millennia but the nineteenth century witnessed strongly escalating demand from Europe and North America. It has been suggested that one consequence was that by the 1880s elephant herds along the coast had become scarce, and to meet demand, trade caravans trekked farther into interior regions of East Africa, extending the extraction frontier. The steady decimation of elephant populations coupled with the extension of trade networks have also been claimed to have triggered significant ecological and socio-economic changes that left lasting legacies across the region. To explore the feasibility of using an isotopic approach to uncover a ‘moving frontier’ of elephant extraction, we constructed a baseline isotope data set (δ13C, δ15N, δ18O and 87Sr/86Sr) for historic East African elephants known to have come from three distinct regions (coastal, Rift Valley, and inland Lakes). Using the isotope results with other climate data and geographical mapping tools, it was possible to characterise elephants from different habitats across the region. This baseline data set was then used to provenance elephant ivory of unknown geographical provenance that was exported from East Africa during the late nineteenth and early twentieth centuries to determine its likely origin. This produced a better understanding of historic elephant geography in the region, and the data have the potential to be used to provenance older archaeological ivories, and to inform contemporary elephant conservation strategies. PMID:27760152

  2. [Investigation of occult hepatitis B in HIV infected patients].

    PubMed

    Altınbaş, Akif; Ergünay, Koray; Calık Başaran, Nursel; Alp, Alpaslan; Turgut, Didem; Hasçelik, Gülşen; Uzun, Ömrüm; Unal, Serhat

    2011-04-01

    Due to their shared transmission route, hepatitis B virus (HBV) or hepatitis C virus (HCV) co-infections can be observed in human immunodeficiency virus (HIV)-infected cases and are associated with more severe clinical courses. The detection of HBV DNA despite HBV surface antigen (HBsAg) seronegativity is defined as occult HBV infections. According to the current seroepidemiological data, Turkey is classified as an intermediate HBV, low HIV endemic region. Occult HBV infections have previously been reported from Turkey but has not been investigated previously in HIV infected cohorts. The aim of this study was to identify occult HBV infections in HIV-infected persons. Twenty-eight HIV-positive cases followed-up at Hacettepe University Hospital, Infectious Diseases Unit were included in the study after informed consent. For the detection of HBsAg, anti-HBs and anti-HCV, commercial ELISA tests (Architect System, Abbott Diagnostics, USA) were employed. Absolute CD4+ and CD8+ T-cell counts were determined via flow cytometry. HIV viral load was calculated via COBAS TaqMan HIV-1 Real-time PCR (Roche Diagnostics, USA) and the presence of HBV DNA was evaluated via COBAS TaqMan HBV Real-time PCR (Roche Diagnostics, USA), in addition to a nested PCR assay targeting HBV S gene. The mean age of the study group was 43.2 (range between 27-65) years, 64.3% (18/28) of them were males and the mean duration of HIV infection was 4.2 (2-11) years. Mean CD4+ ve CD8+ T-cell counts were 414 ± 267 cells/mm3 and 854 ± 293 cells/mm3, respectively. Twenty-six (92.8%) cases were under highly-active anti-retroviral therapy at the time of the study, 88.5% of which included HBV-active drugs (lamivudine or tenofovir). HIV RNA were found negative in 11 (39.3%) patients, of those nine (81.8%) were the cases who treated with HBV-active antiretroviral therapy. HBsAg were negative in all of the 28 patients, while the positivity rates of anti-HBs and anti-HCV were 39.3% (11/28) and 3.6% (1

  3. Barriers to accessing HIV services for Black African communities in Cambridgeshire, the United Kingdom.

    PubMed

    Shangase, Phindile; Egbe, Catherine O

    2015-02-01

    The majority of new HIV diagnoses in the United Kingdom (UK) occur in people with heterosexually acquired HIV infection, the majority of whom are African communities. Current research shows that despite health promotion efforts and advances in therapy these communities are accessing HIV care late. This study therefore explored barriers to equal access to HIV services by African migrants in the UK. Kleinman's (Patients and healers in the context of culture: an exploration of the borderland between anthropology, medicine, and psychiatry, vol 3. University of California Press, Berkeley, 1980) model of health care systems was applied in this research as a theoretical framework and lens through which the reported findings are viewed as it places health within the broader context of culture. In this research a qualitative approach with focus groups was used. A total of thirty participants were recruited from African migrant community organisations in Cambridgeshire in the East of England strategic health authority in order to study the experiences of African migrants when accessing sexual health services. It was found that barriers to equal access to HIV services exist for African communities in Cambridgeshire. These included language barriers and others bordering on the use of traditional medicine by African migrants, understanding of cultural diversity, awareness of how and where to access HIV services, and getting information about HIV. Findings highlighted the importance of taking the sectors of Kleinman's [1] model into consideration when planning HIV services for African communities. PMID:24878614

  4. 300 Years of East African Climate Variability from Oxygen Isotopes in a Kenya Coral

    NASA Astrophysics Data System (ADS)

    Dunbar, R.

    2003-04-01

    Instrumental records of climate variability from the western Indian Ocean are relatively scarce and short. Here I present a monthly resolution stable isotopic record acquired from a large living coral head (Porites) from the Malindi Marine Reserve, Kenya (3^oS, 40^oE). The annual chronology is precise and is based on exceptionally clear high and low density growth band couplets. The record extends from 1696 to 1996 A.D., making it the longest coral climate record from the Indian Ocean and one of the longest available worldwide. We have analyzed the uppermost portion of the coral colony in triplicate, using 3 separate cores. This upper section, used for calibration purposes, also provides estimates of signal fidelity and noise in the climate recording system internal to the colony. Coral δ18O at this site primarily records SST; linear regression of monthly coral δ18O vs. SST yields a slope of -0.26 ppm δ18O per ^oC, and δ18O explains ˜57% of the SST variance. Additional isotopic variability may result from changes in seawater δ18O due to local runoff or regional evaporation/precipitation balance, but these changes are likely to be small because local rainfall δ18O is not strongly depleted relative to seawater and salinity gradients are small. The coral record indicates a clear warming trend of about 1.5^oC that accelerates in the latest 20th century, superimposed on strong decadal variability that persists throughout the record. In fact, δ18O values in the 1990's exceed the 300 year envelope (they are lower) and correspond with apparently unprecedented coral bleaching in coastal East Africa. The decadal component of the Malindi coral record reflects a regional climate signal spanning much of the western equatorial Indian Ocean. In general, East African SST and rainfall are better correlated with Pacific ENSO indicators than with the Indian Monsoon at all periods (inter-annual through multi-decadal) but the correlation weakens after 1975. One dramatic new

  5. Is there an epidemic of HIV Infection in the US ESRD program?

    PubMed

    Eggers, Paul W; Kimmel, Paul L

    2004-09-01

    Surveys revealed increases in the prevalence of HIV-infected patients in the US end-stage renal disease (ESRD) program in the 1980s and early 1990s, with clustering in young black men 25 to 44 yr old. Since the availability of highly active antiretroviral therapy in 1996, the prognosis of HIV-infected patients has improved, and therapy has been shown to change the course of classic HIV-associated nephropathy. We used the United States Renal Data System database to determine if the incidence and prevalence of HIV-infected patients with renal disease has increased in the ESRD program, by means of principal diagnoses and comorbid AIDS-defining diagnoses. As the number of US patients living with AIDS increased 57% from 214,711 in 1995 to 337,017 in 2000, and the number of incident ESRD patients increased 29.9% from 72,827 to 94,602, the number of incident HIV-infected patients increased only by 3.5%, from 1133 to 1171. Over this time, the percentage of incident ESRD patients with HIV infection fell from 1.56% to 1.24%. Among black men 25 to 44 yr of age, HIV infection as a proportion of incident ESRD cases fell from 8.5% to 6.2% from 1995 to 2000. The incident rate per million of AIDS or HIV infection in black men aged 25 to 44 fell from 107 in 1995 to 78 per million in 2000. The incidence rate for HIV-infected women in the ESRD program rose 14% while it declined 7% in men. Almost 2000 HIV-infected women, or 28.8% of the population, have initiated therapy for ESRD with hemodialysis. The number of prevalent cases increased in absolute numbers 81.3% from 2687 to 4871 (0.90% to 1.16% of the ESRD program). One-year survival rates for HIV-infected incident ESRD patients increased from 53.1% to 67.1% from 1995 to 2000. Although these values may be underestimates because of underreporting due to confidentiality concerns and lack of biopsy confirmation, we conclude that although the prevalence of HIV infection is increasing in the US ESRD population, the increase as a

  6. The species flocks of East African cichlid fishes: recent advances in molecular phylogenetics and population genetics

    NASA Astrophysics Data System (ADS)

    Salzburger, Walter; Meyer, Axel

    With more than 3,000 species, the fish family Cichlidae is one of the most species-rich families of vertebrates. Cichlids occur in southern and central America, Africa, Madagascar, and India. The hotspot of their biodiversity is East Africa, where they form adaptive radiations composed of hundreds of endemic species in several lakes of various sizes and ages. The unparalleled species richness of East African cichlids has been something of a conundrum for evolutionary biologists and ecologists, since it has been in doubt whether these hundreds of species arose by allopatric speciation or whether it is necessary to invoke somewhat less traditional models of speciation, such as micro-allopatric, peripatric, or even sympatric speciation or evolution through sexual selection mediated by female choice. Ernst Mayr's analyses of these evolutionary uniquely diverse species assemblages have contributed to a more direct approach to this problem and have led to a deeper understanding of the patterns and processes that caused the formation of these huge groups of species. We review here recent molecular data on population differentiation and phylogenetics, which have helped to unravel, to some extent, the patterns and processes that led to the formation and ecological maintenance of cichlid species flocks. It is becoming apparent that sexually selected traits do play an important role in speciation in micro-allopatric or even sympatric settings. Species richness seems to be roughly correlated with the surface area, but not the age, of the lakes. We observe that the oldest lineages of a species flock of cichlids are often less species-rich and live in the open water or deepwater habitats. While the species flocks of the Lake Malawai and the Lake Victoria areas were shown to be monophyletic, the cichlid assemblage of Lake Tanganyika seems to consist of several independent species flocks. Cichlids emerge as an evolutionary model system in which many fundamental questions in

  7. Achaean Continental Crust Under the Pan-African Orogenic Belt, East Antarctica

    NASA Astrophysics Data System (ADS)

    Ishikawa, M.

    2001-12-01

    Lützow-Holm Complex, located in East Antarctica, is a Cambrian collision zone between Achaean craton (Napier Complex) and Dronning Moud Land, where occurs the upper amphibolite- to granulite-facies rocks, and it is regarded as a part of the Pan-African orogenic belt during Gondwana continent amalgamation. The exhumation of the granulite-facies rocks with clockwise P-T path has been attributed to extensive surface erosion (up to 30 km thick) of double-thickened crust, but the common belief that higher-pressure garnet bearing rocks e.g. high-pressure granulites and/or eclogites exist at deeper level of crust is not supported by geophysical data. In this paper we reconstruct crustal structure beneath Lützow-Holm Complex by combining ultrasonic velocity of rocks with seismic velocity structure. Consequently our results suggest that Achaean continental crust (lower pressure) exists under the Pan-African Orogenic Belt (higher pressure), and propose a new tectonic model for exhumation of the granulite-facies metamorphic belt instead of the double-thickened crust model. P-wave velocity (Vp) in ultra-high temperature granulites (UHT) was measured up to 1.0 GPa from 25°C to 400°C with a piston-cylinder-type high-pressure apparatus. Rocks measured are meta-igneous UHT rocks collected from Mount Riiser-Larsen, Enderby Land, East Antarctica where the Achaean Napier Complex occurs. Core rock samples with 14mm diameter and 12mm long were subjected to high-pressure experiments. All rocks show a rapid increase of Vp at low pressure up to 0.4 GPa and nearly constant Vp at higher pressures. The Vp values measured at 1.0 GPa and 400°C are 7.17 km/s for a meta-pyroxenite, 6.93 km/s, 6.88 km/s for mafic granulites and 6.17 km/s for an orthopyroxene felsic gneiss. The Vp values measured for the Napier mafic granulites are comparable to the lower crustal layer (6.95 km/s of Vp at depth from 33 to 40 km) under the Lützow-Holm Complex. The present results suggest that the lower crust

  8. Oral Health Inequalities between Rural and Urban Populations of the African and Middle East Region.

    PubMed

    Ogunbodede, E O; Kida, I A; Madjapa, H S; Amedari, M; Ehizele, A; Mutave, R; Sodipo, B; Temilola, S; Okoye, L

    2015-07-01

    Although there have been major improvements in oral health, with remarkable advances in the prevention and management of oral diseases, globally, inequalities persist between urban and rural communities. These inequalities exist in the distribution of oral health services, accessibility, utilization, treatment outcomes, oral health knowledge and practices, health insurance coverage, oral health-related quality of life, and prevalence of oral diseases, among others. People living in rural areas are likely to be poorer, be less health literate, have more caries, have fewer teeth, have no health insurance coverage, and have less money to spend on dental care than persons living in urban areas. Rural areas are often associated with lower education levels, which in turn have been found to be related to lower levels of health literacy and poor use of health care services. These factors have an impact on oral health care, service delivery, and research. Hence, unmet dental care remains one of the most urgent health care needs in these communities. We highlight some of the conceptual issues relating to urban-rural inequalities in oral health, especially in the African and Middle East Region (AMER). Actions to reduce oral health inequalities and ameliorate rural-urban disparity are necessary both within the health sector and the wider policy environment. Recommended actions include population-specific oral health promotion programs, measures aimed at increasing access to oral health services in rural areas, integration of oral health into existing primary health care services, and support for research aimed at informing policy on the social determinants of health. Concerted efforts must be made by all stakeholders (governments, health care workforce, organizations, and communities) to reduce disparities and improve oral health outcomes in underserved populations. PMID:26101336

  9. Capacity Building and Financing Oral Health in the African and Middle East Region.

    PubMed

    Mumghamba, E G; Joury, E; Fatusi, O; Ober-Oluoch, J; Onigbanjo, R J; Honkala, S

    2015-07-01

    Many low- and middle-income countries do not yet have policies to implement effective oral health programs. A reason is lack of human and financial resources. Gaps between resource needs and available health funding are widening. By building capacity, countries aim to improve oral health through actions by oral health care personnel and oral health care organizations and their communities. Capacity building involves achieving measurable and sustainable results in training, research, and provision of care. Actions include advancement of knowledge, attitudes and skills, expansion of support, and development of cohesiveness and partnerships. The aim of this critical review is to review existing knowledge and identify gaps and variations between and within different income levels in relation to the capacity building and financing oral health in the African and Middle East region (AMER). A second aim is to formulate research priorities and outline a research agenda for capacity building and financing to improve oral health and reduce oral health inequalities in the AMER. The article focuses on capacity building for oral health and oral health financing in the AMER of the IADR. In many communities in the AMER, there are clear and widening gaps between the dental needs and the existing capacity to meet these needs in terms of financial and human resources. Concerted efforts are required to improve access to oral health care through appropriate financing mechanisms, innovative health insurance schemes, and donor support and move toward universal oral health care coverage to reduce social inequality in the region. It is necessary to build capacity and incentivize the workforce to render evidence-based services as well as accessing funds to conduct research on equity and social determinants of oral health while promoting community engagement and a multidisciplinary approach.

  10. At the tip of a propagating rift - The offshore East African Rift

    NASA Astrophysics Data System (ADS)

    Franke, Dieter; Jokat, Wilfried; Ladage, Stefan; Stollhofen, Harald; Klimke, Jennifer; Lutz, Ruediger; Mahanjane, Stefane; Ehrhardt, Axel; Schreckenberger, Bernd

    2016-04-01

    Numerous studies have addressed various aspects of the East African Rift system (EARS) but surprisingly few the offshore continuation of the south-eastern branch of the rift into the Mozambique Channel. Here, we present new evidence for neotectonic deformation derived from modern seismic reflection data and supported by additional geophysical data. The Kerimbas Graben offshore northern Mozambique is the most prominent manifestation of sub-recent extensional deformation. The seismic reflection data reveals that recent normal faulting often utilizes preexisting, deeply buried half-graben structures which likely are related to the formation of the Somali Basin. The ~30 km wide and ~150 km long symmetric graben is in a stage where the linkage of scattered normal faults already did happen, resulting in increased displacement and accommodation of most of the extension across the basin. However, deep earthquakes below the rift indicate a strong and still preserved lithospheric mantle. Extension is becoming diffuse where an onshore suture, subdividing the northern from the southern metamorphic basement onshore Mozambique, is closest to the offshore rift. It appears likely that this suture is the origin for the variation in rifting style, indicating that mantle fabric resulting from a Cambrian collision has been preserved as mechanical anisotropy of the lithospheric mantle. Further south the rift focuses in an about 30 km wide half-graben. An important finding is that the entire offshore branch of the EARS lacks significant volcanism. Along the offshore EARS there are only negligible indications for recent volcanism in the reflection seismic data such as sills and dikes. Apparently the "Comoros mantle plume" (French and Romanowicz, 2015) has a very minor influence on the progressive extensional deformation along the northern Mozambique continental margin, leading eventually to breakup sometimes in the future. Combining structural with earthquake data reveals that the magma

  11. Ambient Noise Tomography of the East African Rift System in Mozambique

    NASA Astrophysics Data System (ADS)

    Domingues, A.; Chamussa, J.; Silveira, G. M.; Custodio, S.; Lebedev, S.; Chang, S.; Ferreira, A. M.; Fonseca, J. F.

    2013-12-01

    A wide range of studies has shown that the cross-correlation of ambient noise can provide an estimate of the Greens functions between pairs of stations. Project MOZART (funded by FCT, Lisbon, PI J. Fonseca) deployed 30 broadband (120s) seismic stations from the SEIS-UK Pool in Central Mozambique and NE South Africa, with the purpose of studying the East African Rift System (EARS) in Mozambique. We applied the Ambient Noise Tomography (ANT) method to broadband seismic data recorded from March 2011 until July 2012. Cross-correlations were computed between all pairs of stations, and from these we obtained Rayleigh wave group velocity dispersion curves for all interstation paths, in the period range from 3 to 50 seconds. We tested various approaches for pre-processing the ambient noise data regarding time-domain and spectral normalisation, as well as the use of phase cross-correlations. Moreover, we examined the robustness of our dispersion maps by splitting our dataset into various sub-sets of Green's functions with similar paths and by quantifying the differences between the dispersion maps obtained from the various sub-sets of data. We find that while the geographical distribution of the group velocity anomalies is well constrained, the amplitudes of the anomalies are slightly less robust. We performed a three-dimensional inversion to obtain the S-wave velocity of the crust and upper mantle. In addition, our preliminary results show a good correlation between the Rayleigh wave group velocity and the geology of Mozambique. In order to extend the investigation to longer periods and, thus, to be able to look into the lithosphere-asthenosphere depth range in the upper mantle, we apply a recent implementation of the surface-wave two-station method (teleseismic interferometry) and augment our dataset with Rayleigh wave phase velocities curves in broad period ranges.

  12. Ambient Noise Tomography of the East African Rift System in Mozambique

    NASA Astrophysics Data System (ADS)

    Domingues, Ana; Custódio, Susana; Chamussa, José; Silveira, Graça; Chang, Sung-Joon; Lebedev, Sergei; Ferreira, Ana; Fonseca, João

    2014-05-01

    Project MOZART - MOZAmbique Rift Tomography (funded by FCT, Lisbon) deployed a total of 30 temporary broadband seismic stations from the SEIS-UK Pool in central and south Mozambique and in NE South Africa. The purpose of this project is the study of the East African Rift System (EARS) in Mozambique. We estimated preliminary locations with the data recorded from April 2011 to July 2012. A total of 307 earthquakes were located, with ML magnitudes ranging from 0.9 to 3.9. We observe a linear northeast-southwest distribution of the seismicity that seems associated to the Inhaminga fault. The seismicity in the northeast sector correlates well with the topography, tracing the Urema rift valley. The seismicity extends to ~300km, reaching the M7 2006 Machaze earthquake area. In order to obtain an initial velocity model of the region, we applied the ambient noise method to the MOZART data and two additional stations from AfricaARRAY. Cross-correlations were computed between all pairs of stations, and we obtained Rayleigh wave group velocity dispersion curves for all interstation paths, in the period range from 3 to 50 seconds. The geographical distribution of the group velocity anomalies is in good agreement with the geology map of Mozambique, having lower group velocities in sedimentary basins areas and higher velocities in cratonic regions. We also observe two main regions with different velocities that may indicate a structure not proposed in previous studies. We perform a three-dimensional inversion to obtain the S-wave velocity of the crust and upper mantle, and in order to extend the investigation to longer periods we apply a recent implementation of the surface-wave two-station method (teleseismic interferometry), while augmenting our dataset with Rayleigh wave phase velocities curves in broad period ranges. In this way we expect to be able to look into the lithosphere-asthenosphere depth range.

  13. Mixed-host aggregations and helminth parasite sharing in an East African wildlife-livestock system.

    PubMed

    VanderWaal, Kimberly; Omondi, George Paul; Obanda, Vincent

    2014-09-15

    Parasitic infections transmitted between livestock and wildlife pose a significant risk to wildlife conservation efforts and constrain livestock productivity in tropical regions of the world. Gastrointestinal helminths are among the most ubiquitous parasites, and many parasites within this taxon can readily infect a wide range of host species. Factors shaping bidirectional transmission of parasites in wildlife-livestock systems are understudied. In this study, we investigate the prevalence and diversity of helminth infections in an East African community of wild and domestic ungulates. We also identify pairs of host species between which transmission may be possible based on shared parasite taxa, and explore the role of multi-host aggregations in shaping patterns of parasite sharing. Helminth taxa detected included Trichostrongylus, Trichuris, Paramphistomum, Skrjabinema, Strongyloides, Strongylus spp., and other strongyle-type nematodes. We found that nearly 50% of individuals harbored at least one species of helminth, but certain species, such as zebra and impala, exhibited higher prevalence than others. High canopy feeders, like giraffe, had lower prevalence than hosts feeding at medium and low foraging heights. For helminths, patterns of parasite sharing likely emerge from shared space use, which is mediated in part by mixed-species aggregations. The frequency with which host species associated together in mixed-species aggregations was positively correlated with the number of parasite taxa shared. We suggest that variation among species in their tendency to form mixed-species aggregations creates heterogeneity in transmission opportunities, and consequently, parasite sharing across ungulate species. These results enhance our understanding of the role of spatiotemporal relationships among host species in shaping parasite communities in mixed wildlife-livestock grazing systems. PMID:25086496

  14. Economic values for production and functional traits of Small East African goat using profit functions.

    PubMed

    Mbuku, Samuel; Kosgey, Isaac; Okeyo, Mwai; Kahi, Alexander

    2014-06-01

    Economic values for production traits (milk yield, MY, g; 12-month live weight, yLW, kg; consumable meat percentage, CM, %) and functional traits (mature doe live weight, DoLW, kg; mature buck live weight, LWb, kg; kidding frequency, KF; pre-weaning survival rate, PrSR, %; post-weaning survival rate, PoSR,%; doe survival rate, DoSR, %; and residual feed intake, RFI, kg) were estimated using profit functions for the Small East African goat. The scenario evaluated was a fixed flock size, and the resultant economic values (Kes per doe per year) were 34.46 (MY), 62.35 (yLW), 40.69 (CM), 0.15 (DoLW), 2.84 (LWb), 8.69 (KF), 17.38 (PrSR), 16.60 (PoSR), 16.69 (DoSR) and -3.00 (RFI). Similarly, the economic values decreased by -14.7 % (MY), -2.7 % (yLW), -23.9 % (CM), -6.6 % (DoLW), -98 % (LWb), -8.6 % (KF), -8.2 % (PrSR), -8.9 % (PoSR), -8.1 % (DoSR) and 0 % (RFI) when they were risk rated. The economic values for production and functional traits, except RFI, were positive, which implies that genetic improvement of these traits would have a positive effect on the profitability in the pastoral production systems. The application of an Arrow-Pratt coefficient of absolute risk aversion (λ) at the level of 0.02 resulted in a decrease on the estimated economic values, implying that livestock keepers who were risk averse were willing to accept lower expected returns. The results indicate that there would be improvement in traits of economic importance, and, therefore, easy-to-manage genetic improvement programmes should be established.

  15. Trading or coercion? Variation in male mating strategies between two communities of East African chimpanzees

    PubMed Central

    Kaburu, Stefano S. K.; Newton-Fisher, Nicholas E.

    2015-01-01

    Across taxa, males employ a variety of mating strategies, including sexual coercion and the provision, or trading, of resources. Biological market theory (BMT) predicts that trading of commodities for mating opportunities should exist only when males cannot monopolize access to females and/or obtain mating by force, in situations where power differentials between males are low; both coercion and trading have been reported for chimpanzees (Pan troglodytes). Here, we investigate whether the choice of strategy depends on the variation in male power differentials, using data from two wild communities of East African chimpanzees (Pan troglodytes schweinfurthii): the structurally despotic Sonso community (Budongo, Uganda) and the structurally egalitarian M-group (Mahale, Tanzania). We found evidence of sexual coercion by male Sonso chimpanzees, and of trading—of grooming for mating—by M-group males; females traded sex for neither meat nor protection from male aggression. Our results suggest that the despotism–egalitarian axis influences strategy choice: male chimpanzees appear to pursue sexual coercion when power differentials are large and trading when power differentials are small and coercion consequently ineffective. Our findings demonstrate that trading and coercive strategies are not restricted to particular chimpanzee subspecies; instead, their occurrence is consistent with BMT predictions. Our study raises interesting, and as yet unanswered, questions regarding female chimpanzees’ willingness to trade sex for grooming, if doing so represents a compromise to their fundamentally promiscuous mating strategy. It highlights the importance of within-species cross-group comparisons and the need for further study of the relationship between mating strategy and dominance steepness. PMID:26279605

  16. Adaptive divergence between lake and stream populations of an East African cichlid fish.

    PubMed

    Theis, Anya; Ronco, Fabrizia; Indermaur, Adrian; Salzburger, Walter; Egger, Bernd

    2014-11-01

    Divergent natural selection acting in different habitats may build up barriers to gene flow and initiate speciation. This speciation continuum can range from weak or no divergence to stro