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  1 / 294646 MEDLINE  
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[PMID]:26934548
[Au] Autor:Wallach I; Ducandas X; Martel M; Thomas R
[Ad] Dirección:Département de sexologie,Faculté des sciences humaines,Université du Québec à Montréal,Case postale 8888,succursale Centre-ville,Montréal (QC) H3C 3P8....
[Ti] Título:[Not Available].
[Ti] Título:Vivre à l'intersection du VIH et du vieillissement : quelles répercussions sur les liens sociaux significatifs?.
[So] Fuente:Can J Aging;35(1):42-54, 2016 Mar.
[Is] ISSN:1710-1107
[Cp] País de publicación:Canada
[La] Idioma:fre
[Ab] Resumen:This research examines obstacles faced by older people living with HIV in maintaining their significant social ties (family, friends) in the light of a double theoretical framework, inter-sectionality and the course of life. Favoring a qualitative methodology, this research is based on in-depth, semi-directed interviews with a diverse sample of 38 people living with HIV, aged 50-73 years. Analysis reveals that a significant proportion of participants have experienced ruptures or deterioration of close ties with intimates at the level of family or friends. The principal factors behind these difficulties are the past and present stigma associated with HIV and /or other social positions, long-term effects of HIV, issues related to aging and crosscutting effects of HIV and aging.
[Pt] Tipo de publicación:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Mes de ingreso:1603
[Sb] Subgrupo de revista:IM
[St] Status:In-Process
[do] DOI:10.1017/S0714980815000525


  2 / 294646 MEDLINE  
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[PMID]:26896884
[Au] Autor:Almeida-Silva F; Damasceno LS; Serna MJ; Valero C; Quintella LP; Almeida-Paes R; Muniz Mde M; Zancope-Oliveira RM
[Ad] Dirección:Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas (INI), Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro, Brazil....
[Ti] Título:Multiple opportunistic fungal infections in an individual with severe HIV disease: A case report.
[So] Fuente:Rev Iberoam Micol;33(2):118-21, 2016 Apr-Jun.
[Is] ISSN:2173-9188
[Cp] País de publicación:Spain
[La] Idioma:eng
[Ab] Resumen:BACKGROUND: Fungal infections have been commonly diagnosed in individuals with advanced HIV disease. Cryptococcosis, pneumocystosis, and histoplasmosis are the most frequent systemic mycoses in people suffering from HIV/AIDS. CASE REPORT: We report a case of multiple fungal infections in an advanced AIDS-patient. A 33-year-old HIV-positive man from Brazil was hospitalized due to diarrhea, dyspnea, emaciation, hypoxemia, extensive oral thrush, and a CD4+ T lymphocyte count of 20cells/mm(3). Honeycombed-structures consistent with Pneumocystis jirovecii were observed by direct immunofluorescence in induced sputum. Cryptococcus neoformans was recovered from respiratory secretion and cerebrospinal fluid cultures. Histopathology of the bone marrow also revealed the presence of Histoplasma capsulatum. Molecular assays were performed in a sputum sample. Nested-PCR confirmed the presence of P. jirovecii and H. capsulatum; qPCR multiplex was positive for C. neoformans and H. capsulatum. With the treatment of antifungal drugs the patient progressed satisfactorily. CONCLUSIONS: The diagnosis of several systemic mycoses demonstrates the vulnerability of advanced AIDS-patients. Thus, the detection of AIDS cases in the early stages of infection is necessary for a prompt and adequate introduction of HAART therapy, and the use of prophylaxis to control opportunistic infections.
[Pt] Tipo de publicación:JOURNAL ARTICLE
[Em] Mes de ingreso:1607
[Sb] Subgrupo de revista:IM
[St] Status:In-Data-Review


  3 / 294646 MEDLINE  
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[PMID]:27174988
[Au] Autor:Kong R; Xu K; Zhou T; Acharya P; Lemmin T; Liu K; Ozorowski G; Soto C; Taft JD; Bailer RT; Cale EM; Chen L; Choi CW; Chuang GY; Doria-Rose NA; Druz A; Georgiev IS; Gorman J; Huang J; Joyce MG; Louder MK; Ma X; McKee K; O'Dell S; Pancera M; Yang Y; Blanchard SC; Mothes W; Burton DR; Koff WC; Connors M; Ward AB; Kwong PD; Mascola JR
[Ad] Dirección:Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA....
[Ti] Título:Fusion peptide of HIV-1 as a site of vulnerability to neutralizing antibody.
[So] Fuente:Science;352(6287):828-33, 2016 May 13.
[Is] ISSN:1095-9203
[Cp] País de publicación:United States
[La] Idioma:eng
[Ab] Resumen:The HIV-1 fusion peptide, comprising 15 to 20 hydrophobic residues at the N terminus of the Env-gp41 subunit, is a critical component of the virus-cell entry machinery. Here, we report the identification of a neutralizing antibody, N123-VRC34.01, which targets the fusion peptide and blocks viral entry by inhibiting conformational changes in gp120 and gp41 subunits of Env required for entry. Crystal structures of N123-VRC34.01 liganded to the fusion peptide, and to the full Env trimer, revealed an epitope consisting of the N-terminal eight residues of the gp41 fusion peptide and glycan N88 of gp120, and molecular dynamics showed that the N-terminal portion of the fusion peptide can be solvent-exposed. These results reveal the fusion peptide to be a neutralizing antibody epitope and thus a target for vaccine design.
[Mh] Términos MeSH primario: Vacunas contra el SIDA/inmunología
Anticuerpos Neutralizantes/química
Anticuerpos Antivirales/química
Proteína gp120 de Envoltorio del VIH/inmunología
Proteína gp41 de Envoltorio del VIH/inmunología
VIH-1/inmunología
Proteínas Virales de Fusión/inmunología
[Mh] Términos MeSH secundario: Secuencia de Aminoácidos
Anticuerpos Neutralizantes/aislamiento & purificación
Anticuerpos Neutralizantes/ultraestructura
Anticuerpos Antivirales/ultraestructura
Linfocitos B/inmunología
Linfocitos B/virología
Cristalografía por Rayos X
Humanos
Interacciones Hidrofóbicas e Hidrofílicas
Epítopos Inmunodominantes/inmunología
Datos de Secuencia Molecular
Péptidos/inmunología
Conformación Proteica
Internalización del Virus
[Pt] Tipo de publicación:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL; RESEARCH SUPPORT, N.I.H., INTRAMURAL; RESEARCH SUPPORT, NON-U.S. GOV'T; RESEARCH SUPPORT, U.S. GOV'T, NON-P.H.S.
[Nm] Nombre de substancia:
0 (AIDS Vaccines); 0 (Antibodies, Neutralizing); 0 (Antibodies, Viral); 0 (HIV Envelope Protein gp120); 0 (HIV Envelope Protein gp41); 0 (Immunodominant Epitopes); 0 (Peptides); 0 (Viral Fusion Proteins)
[Em] Mes de ingreso:1606
[Cu] Fecha actualización por clase:160701
[Lr] Fecha última revisión:160701
[Sb] Subgrupo de revista:IM
[Da] Fecha de ingreso para procesamiento:160513
[St] Status:MEDLINE
[do] DOI:10.1126/science.aae0474


  4 / 294646 MEDLINE  
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[PMID]:26950901
[Au] Autor:Jiamsakul A; Kerr SJ; Ng OT; Lee MP; Chaiwarith R; Yunihastuti E; Van Nguyen K; Pham TT; Kiertiburanakul S; Ditangco R; Saphonn V; Sim BL; Merati TP; Wong W; Kantipong P; Zhang F; Choi JY; Pujari S; Kamarulzaman A; Oka S; Mustafa M; Ratanasuwan W; Petersen B; Law M; Kumarasamy N; TREAT Asia HIV Observational Database (TAHOD)
[Ad] Dirección:The Kirby Institute, UNSW Australia, Sydney, Australia....
[Ti] Título:Effects of unplanned treatment interruptions on HIV treatment failure - results from TAHOD.
[So] Fuente:Trop Med Int Health;21(5):662-74, 2016 May.
[Is] ISSN:1365-3156
[Cp] País de publicación:England
[La] Idioma:eng
[Ab] Resumen:OBJECTIVES: Treatment interruptions (TIs) of combination antiretroviral therapy (cART) are known to lead to unfavourable treatment outcomes but do still occur in resource-limited settings. We investigated the effects of TI associated with adverse events (AEs) and non-AE-related reasons, including their durations, on treatment failure after cART resumption in HIV-infected individuals in Asia. METHODS: Patients initiating cART between 2006 and 2013 were included. TI was defined as stopping cART for >1 day. Treatment failure was defined as confirmed virological, immunological or clinical failure. Time to treatment failure during cART was analysed using Cox regression, not including periods off treatment. Covariables with P < 0.10 in univariable analyses were included in multivariable analyses, where P < 0.05 was considered statistically significant. RESULTS: Of 4549 patients from 13 countries in Asia, 3176 (69.8%) were male and the median age was 34 years. A total of 111 (2.4%) had TIs due to AEs and 135 (3.0%) had TIs for other reasons. Median interruption times were 22 days for AE and 148 days for non-AE TIs. In multivariable analyses, interruptions >30 days were associated with failure (31-180 days HR = 2.66, 95%CI (1.70-4.16); 181-365 days HR = 6.22, 95%CI (3.26-11.86); and >365 days HR = 9.10, 95% CI (4.27-19.38), all P < 0.001, compared to 0-14 days). Reasons for previous TI were not statistically significant (P = 0.158). CONCLUSIONS: Duration of interruptions of more than 30 days was the key factor associated with large increases in subsequent risk of treatment failure. If TI is unavoidable, its duration should be minimised to reduce the risk of failure after treatment resumption.
[Pt] Tipo de publicación:JOURNAL ARTICLE
[Em] Mes de ingreso:1604
[Cu] Fecha actualización por clase:160701
[Lr] Fecha última revisión:160701
[Sb] Subgrupo de revista:IM
[St] Status:In-Data-Review
[do] DOI:10.1111/tmi.12690


  5 / 294646 MEDLINE  
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[PMID]:27077672
[Au] Autor:Leung V; Chiu YL; Kotler DP; Albu J; Zhu YS; Ham K; Engelson ES; Hammad H; Christos P; Donovan DS; Ginsberg HN; Glesby MJ
[Ad] Dirección:a Department of Medicine , Weill Cornell Medical College , New York , NY , USA....
[Ti] Título:Effect of Recombinant Human Growth Hormone and Rosiglitazone for HIV-Associated Abdominal Fat Accumulation on Adiponectin and other Markers of Inflammation.
[So] Fuente:HIV Clin Trials;17(2):55-62, 2016 Mar.
[Is] ISSN:1528-4336
[Cp] País de publicación:England
[La] Idioma:eng
[Ab] Resumen:BACKGROUND/OBJECTIVE: In a previous report of HIV-infected patients with fat redistribution, we found that recombinant human growth hormone (rhGH) therapy reduced visceral adipose tissue (VAT) but increased insulin resistance, and that the addition of rosiglitazone reversed the negative effects of rhGH on insulin sensitivity. In this study, we sought to determine the effects of rhGH and rosiglitazone therapy on an array of inflammatory and fibrinolytic markers. METHODS: 72 patients with HIV-associated abdominal obesity and insulin resistance were randomized to treatment with rhGH, rosiglitazone, the combination of rhGH and rosiglitazone, or placebo for 12 weeks. Subjects with plasma and serum samples available at weeks 0 (n=63) and 12 (n=46-48) were assessed for adiponectin, C-reactive protein, homocysteine, interleukin-1, interleukin-6, tumor necrosis factor alpha, interferon gamma, fibrinogen, plasminogen activator inhibitor-1 antigen, and tissue plasminogen activator antigen. RESULTS: Treatment with both rosiglitazone alone and the combination of rosiglitazone and rhGH for 12 weeks resulted in significant increases in adiponectin levels from baseline. Adiponectin levels did not change significantly in the rhGH arm alone . There were no significant changes in the other biomarkers among the different treatment groups. DISCUSSION: In this study of HIV-infected patients with altered fat distribution, treatment with rosiglitazone had beneficial effects on adiponectin concentrations, an effect that was also seen with a combination of rosiglitazone and rhGH. RhGH administration alone, however, did not demonstrate any significant impact on adiponectin levels despite reductions in VAT.
[Mh] Términos MeSH primario: Grasa Abdominal/metabolismo
Adiponectina/sangre
Infecciones por VIH/complicaciones
Hormona de Crecimiento Humana/administración & dosificación
Hipoglucemiantes/administración & dosificación
Obesidad/quimioterapia
Tiazolidinedionas/administración & dosificación
[Mh] Términos MeSH secundario: Grasa Abdominal/efectos de drogas
Adulto
Anciano
Biomarcadores/sangre
Glucemia/metabolismo
Proteína C-Reactiva/metabolismo
Quimioterapia Combinada
Femenino
Infecciones por VIH/inmunología
Infecciones por VIH/metabolismo
Humanos
Interleucina-6/sangre
Masculino
Mediana Edad
Obesidad/etiología
Obesidad/inmunología
Obesidad/metabolismo
Adulto Joven
[Pt] Tipo de publicación:JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL; RESEARCH SUPPORT, N.I.H., EXTRAMURAL
[Nm] Nombre de substancia:
0 (Adiponectin); 0 (Biomarkers); 0 (Blood Glucose); 0 (Hypoglycemic Agents); 0 (IL6 protein, human); 0 (Interleukin-6); 0 (Thiazolidinediones); 05V02F2KDG (rosiglitazone); 12629-01-5 (Human Growth Hormone); 9007-41-4 (C-Reactive Protein)
[Em] Mes de ingreso:1606
[Cu] Fecha actualización por clase:160701
[Lr] Fecha última revisión:160701
[Sb] Subgrupo de revista:IM
[Da] Fecha de ingreso para procesamiento:160415
[St] Status:MEDLINE
[do] DOI:10.1080/15284336.2015.1126424


  6 / 294646 MEDLINE  
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[PMID]:27025337
[Au] Autor:Hosseinipour MC; Bisson GP; Miyahara S; Sun X; Moses A; Riviere C; Kirui FK; Badal-Faesen S; Lagat D; Nyirenda M; Naidoo K; Hakim J; Mugyenyi P; Henostroza G; Leger PD; Lama JR; Mohapi L; Alave J; Mave V; Veloso VG; Pillay S; Kumarasamy N; Bao J; Hogg E; Jones L; Zolopa A; Kumwenda J; Gupta A; Adult AIDS Clinical Trials Group A5274 (REMEMBER) Study Team
[Ad] Dirección:UNC Project, Lilongwe, Malawi; University of North Carolina School of Medicine, Chapel Hill, NC, USA. Electronic address: mina_hosseinipour@med.unc.edu....
[Ti] Título:Empirical tuberculosis therapy versus isoniazid in adult outpatients with advanced HIV initiating antiretroviral therapy (REMEMBER): a multicountry open-label randomised controlled trial.
[So] Fuente:Lancet;387(10024):1198-209, 2016 Mar 19.
[Is] ISSN:1474-547X
[Cp] País de publicación:England
[La] Idioma:eng
[Ab] Resumen:BACKGROUND: Mortality within the first 6 months after initiating antiretroviral therapy is common in resource-limited settings and is often due to tuberculosis in patients with advanced HIV disease. Isoniazid preventive therapy is recommended in HIV-positive adults, but subclinical tuberculosis can be difficult to diagnose. We aimed to assess whether empirical tuberculosis treatment would reduce early mortality compared with isoniazid preventive therapy in high-burden settings. METHODS: We did a multicountry open-label randomised clinical trial comparing empirical tuberculosis therapy with isoniazid preventive therapy in HIV-positive outpatients initiating antiretroviral therapy with CD4 cell counts of less than 50 cells per µL. Participants were recruited from 18 outpatient research clinics in ten countries (Malawi, South Africa, Haiti, Kenya, Zambia, India, Brazil, Zimbabwe, Peru, and Uganda). Individuals were screened for tuberculosis using a symptom screen, locally available diagnostics, and the GeneXpert MTB/RIF assay when available before inclusion. Study candidates with confirmed or suspected tuberculosis were excluded. Inclusion criteria were liver function tests 2·5 times the upper limit of normal or less, a creatinine clearance of at least 30 mL/min, and a Karnofsky score of at least 30. Participants were randomly assigned (1:1) to either the empirical group (antiretroviral therapy and empirical tuberculosis therapy) or the isoniazid preventive therapy group (antiretroviral therapy and isoniazid preventive therapy). The primary endpoint was survival (death or unknown status) at 24 weeks after randomisation assessed in the intention-to-treat population. Kaplan-Meier estimates of the primary endpoint across groups were compared by the z-test. All participants were included in the safety analysis of antiretroviral therapy and tuberculosis treatment. This trial is registered with ClinicalTrials.gov, number NCT01380080. FINDINGS: Between Oct 31, 2011, and June 9, 2014, we enrolled 850 participants. Of these, we randomly assigned 424 to receive empirical tuberculosis therapy and 426 to the isoniazid preventive therapy group. The median CD4 cell count at baseline was 18 cells per µL (IQR 9-32). At week 24, 22 (5%) participants from each group died or were of unknown status (95% CI 3·5-7·8) for empirical group and for isoniazid preventive therapy (95% CI 3·4-7·8); absolute risk difference of -0·06% (95% CI -3·05 to 2·94). Grade 3 or 4 signs or symptoms occurred in 50 (12%) participants in the empirical group and 46 (11%) participants in the isoniazid preventive therapy group. Grade 3 or 4 laboratory abnormalities occurred in 99 (23%) participants in the empirical group and 97 (23%) participants in the isoniazid preventive therapy group. INTERPRETATION: Empirical tuberculosis therapy did not reduce mortality at 24 weeks compared with isoniazid preventive therapy in outpatient adults with advanced HIV disease initiating antiretroviral therapy. The low mortality rate of the trial supports implementation of systematic tuberculosis screening and isoniazid preventive therapy in outpatients with advanced HIV disease. FUNDING: National Institutes of Allergy and Infectious Diseases through the AIDS Clinical Trials Group.
[Mh] Términos MeSH primario: Infecciones Oportunistas Relacionadas con el SIDA/prevención & control
Fármacos Anti-VIH/uso terapéutico
Antituberculosos/uso terapéutico
Isoniazida/uso terapéutico
Tuberculosis/prevención & control
[Mh] Términos MeSH secundario: Infecciones Oportunistas Relacionadas con el SIDA/inmunología
Adulto
Instituciones de Atención Ambulatoria
Recuento de Linfocito CD4
Femenino
Infecciones por VIH/quimioterapia
Infecciones por VIH/inmunología
Humanos
Estimación de Kaplan-Meier
Masculino
Resultado del Tratamiento
Tuberculosis/inmunología
[Pt] Tipo de publicación:JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL; RESEARCH SUPPORT, N.I.H., EXTRAMURAL
[Nm] Nombre de substancia:
0 (Anti-HIV Agents); 0 (Antitubercular Agents); V83O1VOZ8L (Isoniazid)
[Em] Mes de ingreso:1604
[Cu] Fecha actualización por clase:160701
[Lr] Fecha última revisión:160701
[Sb] Subgrupo de revista:AIM; IM
[Da] Fecha de ingreso para procesamiento:160330
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE


  7 / 294646 MEDLINE  
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[PMID]:26534788
[Au] Autor:Kalichman S; Kalichman MO; Cherry C
[Ad] Dirección:a Department of Psychology , University of Connecticut , Storrs , CT , USA.
[Ti] Título:Medication beliefs and structural barriers to treatment adherence among people living with HIV infection.
[So] Fuente:Psychol Health;31(4):383-95, 2016.
[Is] ISSN:1476-8321
[Cp] País de publicación:England
[La] Idioma:eng
[Ab] Resumen:BACKGROUND: People living in poverty face multiple structural challenges to medication adherence including lack of transportation, inadequate housing and food insecurity. The degree to which individuals' motivations to remain adherent may overcome structural barriers has received limited attention. PURPOSE: To examine whether medication necessity and concerns beliefs predict antiretroviral therapy (ART) adherence over and above structural adherence barriers associated with poverty. METHODS: People living with HIV in a southern US city (N = 942) completed computerised interviews, an objective measure of adherence and HIV viral suppression obtained from medical records. Hierarchical logistic regression models were constructed to examine demographic and illness characteristics, structural barriers, mental health, substance use and medication necessity and concerns beliefs as predictors of ART adherence. RESULTS: In multivariable models, current drug use and medication necessity and concerns beliefs predicted treatment adherence over and above demographic, health, mental health and structural factors. CONCLUSIONS: Medication beliefs are proximal and powerful motivating factors that predict adherence. Adherence interventions should directly address medication beliefs in developing strategies to manage barriers facing people with HIV living in poverty.
[Mh] Términos MeSH primario: Antirretrovirales/uso terapéutico
Infecciones por VIH/quimioterapia
Conocimientos, Actitudes y Práctica en Salud
Accesibilidad a los Servicios de Salud
Cumplimiento de la Medicación/psicología
[Mh] Términos MeSH secundario: Adulto
Femenino
Humanos
Modelos Logísticos
Masculino
Cumplimiento de la Medicación/estadística & datos numéricos
Mediana Edad
Motivación
Análisis Multivariante
Pobreza
Trastornos Relacionados con Sustancias/psicología
[Pt] Tipo de publicación:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL
[Nm] Nombre de substancia:
0 (Anti-Retroviral Agents)
[Em] Mes de ingreso:1607
[Cu] Fecha actualización por clase:160701
[Lr] Fecha última revisión:160701
[Sb] Subgrupo de revista:IM
[Da] Fecha de ingreso para procesamiento:160227
[St] Status:MEDLINE
[do] DOI:10.1080/08870446.2015.1111371


  8 / 294646 MEDLINE  
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[PMID]:26871882
[Au] Autor:Chen L; Mahapatra T; Fu G; Huang S; Zheng H; Tucker JD; Yang B; Zhao J; Detels R; Tang W
[Ad] Dirección:*Department of STI control, Guangdong Provincial Center for Skin Disease and STI Control, Guangzhou, China;†Department of Epidemiology, School of Public Health, University of California, Los Angeles, CA;‡Department of HIV and STI Prevention and Control, Jiangsu Provincial Central for Disease Prevention and Control, Nanjing, China;§University of North Carolina, Project-China, Guangzhou, China; and‖Monitoring and Evaluation Unit, The Global Fund to Fight AIDS, Tuberculosis and Malaria, Geneva, Switzerland.
[Ti] Título:Male Clients of Male Sex Workers in China: An Ignored High-Risk Population.
[So] Fuente:J Acquir Immune Defic Syndr;71(3):316-22, 2016 Mar 1.
[Is] ISSN:1944-7884
[Cp] País de publicación:United States
[La] Idioma:eng
[Ab] Resumen:BACKGROUND: There is a high prevalence of HIV/syphilis among male sex workers, but no formal study has ever been conducted focusing on male clients of male sex workers (MCM). A detailed investigation was thus called for, to determine the burden and sociobehavioral determinants of HIV and syphilis among these MCM in China. METHODS: As part of a multicenter cross-sectional study, using respondent-driven and snowball sampling, 2958 consenting adult men who have sex with men (MSM) were recruited, interviewed, and tested for HIV and syphilis between 2008 and 2009. The distributions of sociodemographic characteristics, risk behaviors, and HIV/syphilis prevalence were determined and compared between MCM and other MSM. RESULTS: Among recruited MSM, 5.0% (n = 148) were MCM. HIV prevalences for MCM and other MSM were 7.4% and 7.7%, whereas 18.9% and 14.0% were positive for syphilis, respectively. Condomless anal intercourse (CAI) was reported by 59.5% of MCM and 48.2% of MSM. Multiple logistic regression revealed that compared with other MSM, MCM were more likely to have less education [for ≤ elementary level, adjusted odds ratio (aOR) = 3.13, 95% confidence interval (95% CI): 1.42 to 6.90], higher income (for >500 US Dollars per month, aOR = 2.97, 95% CI: 1.53 to 5.77), more often found partners at parks/restrooms (aOR = 4.01, 95% CI: 2.34 to 6.85), reported CAI (aOR = 1.49, 95% CI: 1.05 to 2.10), reported a larger sexual network (for ≥ 10, aOR = 2.70, 95% CI: 1.44 to 5.07), and higher odds of syphilis (aOR = 1.54, 95% CI: 1.00 to 2.38). CONCLUSIONS: The greater frequency of risk behaviors and high prevalence of HIV and syphilis indicated that HIV/syphilis prevention programs in China need to pay special attention to MCM as a distinct subgroup, which was completely ignored until date.
[Mh] Términos MeSH primario: Infecciones por VIH/epidemiología
Infecciones por VIH/transmisión
Homosexualidad Masculina
Trabajadores Sexuales
[Mh] Términos MeSH secundario: Adulto
China/epidemiología
Condones/utilización
Estudios Transversales
Infecciones por VIH/complicaciones
Humanos
Masculino
Maloclusión
Sexo Seguro
Sífilis/complicaciones
Sífilis/epidemiología
Adulto Joven
[Pt] Tipo de publicación:JOURNAL ARTICLE; MULTICENTER STUDY; RESEARCH SUPPORT, N.I.H., EXTRAMURAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mes de ingreso:1606
[Cu] Fecha actualización por clase:160701
[Lr] Fecha última revisión:160701
[Sb] Subgrupo de revista:IM; X
[Da] Fecha de ingreso para procesamiento:160213
[St] Status:MEDLINE
[do] DOI:10.1097/QAI.0000000000000833


  9 / 294646 MEDLINE  
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[PMID]:26452066
[Au] Autor:Amerson E; Woodruff CM; Forrestel A; Wenger M; McCalmont T; LeBoit P; Maurer T; Laker-Oketta M; Muyindike W; Bwana M; Buziba N; Busakhala N; Wools-Kaloustian K; Martin J
[Ad] Dirección:*Department of Dermatology, University of California-San Francisco, San Francisco, CA; †Yale School of Medicine, New Haven, CT; ‡Department of Dermatology, University of Pennsylvania, Philadelphia, PA; §Department of Epidemiology and Biostatistics, University of California-San Francisco, San Francisco, CA; ‖Department of Pathology and Laboratory Medicine, University of California-San Francisco, San Francisco, CA; ¶Infectious Disease Institute, Makerere University, Kampala, Uganda; #Department of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda; **Department of Pathology, Moi University School of Medicine, Eldoret, Kenya; ††Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya; ‡‡Department of Hematology and Oncology, Moi Teaching and Referral Hospital, Eldoret, Kenya; and §§Department of Medicine, Indiana University School of Medicine, Indianapolis, IN.
[Ti] Título:Accuracy of Clinical Suspicion and Pathologic Diagnosis of Kaposi Sarcoma in East Africa.
[So] Fuente:J Acquir Immune Defic Syndr;71(3):295-301, 2016 Mar 1.
[Is] ISSN:1944-7884
[Cp] País de publicación:United States
[La] Idioma:eng
[Ab] Resumen: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.
[Mh] Términos MeSH primario: Infecciones por VIH/complicaciones
Sarcoma de Kaposi/diagnóstico
[Mh] Términos MeSH secundario: Biopsia
Humanos
Kenia/epidemiología
Sarcoma de Kaposi/epidemiología
Sarcoma de Kaposi/patología
Sensibilidad y Especificidad
Uganda/epidemiología
[Pt] Tipo de publicación:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mes de ingreso:1606
[Cu] Fecha actualización por clase:160701
[Lr] Fecha última revisión:160701
[Sb] Subgrupo de revista:IM; X
[Da] Fecha de ingreso para procesamiento:160212
[St] Status:MEDLINE
[do] DOI:10.1097/QAI.0000000000000862


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[PMID]:26379068
[Au] Autor:Gandhi RT; Kwon DS; Macklin EA; Shopis JR; McLean AP; McBrine N; Flynn T; Peter L; Sbrolla A; Kaufmann DE; Porichis F; Walker BD; Bhardwaj N; Barouch DH; Kavanagh DG
[Ad] Dirección:*Massachusetts General Hospital, Division of Infectious Diseases, Boston, MA; †Ragon Institute of Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard, Cambridge, MA; ‡Biostatistics Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA; §Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM) and University of Montreal, Montréal, QC, Canada; ‖Howard Hughes Medical Institute, Chevy Chase, MD; ¶Division of Hematology and Medical Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY; and #Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
[Ti] Título:Immunization of HIV-1-Infected Persons With Autologous Dendritic Cells Transfected With mRNA Encoding HIV-1 Gag and Nef: Results of a Randomized, Placebo-Controlled Clinical Trial.
[So] Fuente:J Acquir Immune Defic Syndr;71(3):246-53, 2016 Mar 1.
[Is] ISSN:1944-7884
[Cp] País de publicación:United States
[La] Idioma:eng
[Ab] Resumen:BACKGROUND: HIV-1 eradication may require reactivation of latent virus along with stimulation of HIV-1-specific immune responses to clear infected cells. Immunization with autologous dendritic cells (DCs) transfected with viral mRNA is a promising strategy for eliciting HIV-1-specific immune responses. We performed a randomized controlled clinical trial to evaluate the immunogenicity of this approach in HIV-1-infected persons on antiretroviral therapy. METHODS: Fifteen participants were randomized 2:1 to receive intradermal immunization with HIV-1 Gag- and Nef-transfected DCs (vaccine) or mock-transfected DCs (placebo) at weeks 0, 2, 6, and 10. All participants also received DCs pulsed with keyhole limpet hemocyanin (KLH) to assess whether responses to a neo-antigen could be induced. RESULTS: After immunization, there were no differences in interferon-gamma enzyme-linked immunospot responses to HIV-1 Gag or Nef in the vaccine or placebo group. CD4 proliferative responses to KLH increased 2.4-fold (P = 0.026) and CD8 proliferative responses to KLH increased 2.5-fold (P = 0.053) after vaccination. There were increases in CD4 proliferative responses to HIV-1 Gag (2.5-fold vs. baseline, 3.4-fold vs. placebo, P = 0.054) and HIV-1 Nef (2.3-fold vs. baseline, 6.3-fold vs. placebo, P = 0.009) among vaccine recipients, but these responses were short-lived. CONCLUSION: Immunization with DCs transfected with mRNA encoding HIV-1 Gag and Nef did not induce significant interferon-gamma enzyme-linked immunospot responses. There were increases in proliferative responses to HIV-1 antigens and to a neo-antigen, KLH, but the effects were transient. Dendritic cell vaccination should be optimized to elicit stronger and long-lasting immune responses for this strategy to be effective as an HIV-1 therapeutic vaccine.
[Mh] Términos MeSH primario: Vacunas contra el SIDA/inmunología
Células Dendríticas/inmunología
Infecciones por VIH/terapia
ARN Mensajero/genética
Productos del Gen gag del Virus de la Inmunodeficiencia Humana/inmunología
Productos del Gen nef del Virus de la Inmunodeficiencia Humana/inmunología
[Mh] Términos MeSH secundario: Vacunas contra el SIDA/administración & dosificación
Vacunas contra el SIDA/uso terapéutico
Adulto
Ensayo de Immunospot Ligado a Enzimas
Femenino
Infecciones por VIH/quimioterapia
Infecciones por VIH/prevención & control
Humanos
Inmunización
Inyecciones Intradérmicas
Masculino
Mediana Edad
ARN Mensajero/inmunología
Transfección
Productos del Gen gag del Virus de la Inmunodeficiencia Humana/genética
Productos del Gen nef del Virus de la Inmunodeficiencia Humana/genética
[Pt] Tipo de publicación:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL; RESEARCH SUPPORT, N.I.H., EXTRAMURAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nombre de substancia:
0 (AIDS Vaccines); 0 (RNA, Messenger); 0 (gag Gene Products, Human Immunodeficiency Virus); 0 (nef Gene Products, Human Immunodeficiency Virus); 0 (nef protein, Human immunodeficiency virus 1)
[Em] Mes de ingreso:1606
[Cu] Fecha actualización por clase:160701
[Lr] Fecha última revisión:160701
[Sb] Subgrupo de revista:IM; X
[Da] Fecha de ingreso para procesamiento:160212
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE
[do] DOI:10.1097/QAI.0000000000000852



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