जर्नल ऑफ एड्स एंड क्लिनिकल रिसर्च

Objective: To find out how the World Health Organization Clinical Stages of HIV infection and use of antiretroviral therapy influence cognitive functioning of school-aged HIV-infected Nigerian children.

Method: Cognitive assessments of 69 HIV positive children aged 6–15 years were performed using Raven’s Standard Progressive Matrices. Thirty children were on Highly Active Antiretroviral Therapy. The children were subdivided for the purpose of analysis into two cognitive developmental stages using Piaget’s developmental stage: the concrete operation stage (6–11 years) and the formal operation stage (12–15 years). Children on antiretroviral therapies were also compared with those not on therapies. HIV infection was staged using the revised World Health Organization Clinical Staging for Paediatric HIV/AIDS.

Result: The overall mean cognitive score for HIV positive subjects on antiretroviral therapy was 20.9 which was significantly higher than the overall score for subjects not on therapies of 14.6 (p=0.007). In the age group 6–11 years, the mean cognitive scores became lower significantly with worsening clinical stage for subjects irrespective of use of anti-retroviral therapy. The mean scores for subjects on therapy were significantly higher than that of their counterparts not yet on therapy at the same clinical stage. There were no significant differences in the cognitive scores at different clinical stages among the children in the age group 12–15 years.

Conclusion: Cognitive scores were lower with worsening clinical staging in the younger school-aged HIV-infected Nigerian children. Subjects on Highly Active Anti-retroviral Therapy had better cognitive scores than subjects not on therapy at the same clinical stage. Routine neuropsychological evaluation for school-aged HIV-infected children are recommended with an emphasiss on the younger children.

Background: Hepatitis B and AIDS are major health problems worldwide. The number of infected people is liable to increase. Both diseases run chronic courses causing a financial drain of family sources. Awareness towards prevention and control of these diseases is necessary among both educated and illiterate people. This study aimed to assess the University of Kassala students’ knowledge and awareness of the infectious nature of the two diseases.

Method: A cross-sectional study was conducted among the students of the University of Kassala, Kassala State, Sudan. The study was held from April through July 2011. Data was collected through self administered questionnaire and analyzed by using SPSS version (16.0).

Findings: A total of 395 students has responded to the study, and completed a questionnaire on knowledge and awareness about hepatitis B and AIDS. Among these, 185 (46.8%) were males and 210 (53.2%) were females with ages ranging from 17 to 35 years (mean: 20.45 ± 2.89). The overall study revealed that, there was a weakness in general knowledge about viral diseases (AIDS and HBV) among students. Regarding AIDS, the students were knowledgeable about the communicability, infectious nature and transmission modes, but misconception was observed about symptoms and preventive measures. Concerning HBV viral infection, the students showed poor knowledge on causative agents, mode of transmission, symptoms and prevention. A significant difference was found between the students’ knowledge of AIDS and HBV concerning the routes of transmission (P= 0.009), symptoms (P=0.000) and prevention measures (P=0.000). These findings may be attributed to absence of formal school based health education in our country which may be the main reason for the poor knowledge of viral diseases including AIDS and hepatitis B.

Conclusion: This study showed that the students had poor knowledge and awareness, particularly about HBV compared to AIDS. As students play a pivotal role in dissemination of knowledge and raising awareness among their families and communities, more efforts should be exerted to develop the two parameters, particularly among the students of non- medical profession in order to limit the hazardous effects of such diseases.

HIV-infected individuals constitute a population highly susceptible to opportunistic infections, particularly oral candidiasis caused by the most pathogenic human fungal species Candida albicans. Host-produced salivary antimicrobial peptides are considered to be an important part of the host innate immune system involved in protection of the oral cavity against colonization and infection by microbial species. Histatin-5 (Hst-5) specifically has exhibited potent anti-candidal properties in vitro. However, its importance in protecting the oral mucosa against candidal colonization and importantly, its contribution to the observed enhanced susceptibility of HIV-infected individuals to candidiasis has not been previously investigated. To that end, a novel immunoassay was used to demonstrate significant decrease in salivary Hst-5 levels in HIV+ individuals concomitant with enhanced candidal prevalence. Further, saliva’s anti-candidal potency was found to be proportional to Hst-5 concentration and significantly compromised in HIV+ subjects compared to controls. The key role for Hst-5 was further confirmed upon exposure to the Hst-5-specific antibody where saliva’s initial killing activity was substantially compromised. Combined, these findings identify Hst-5 as a key anti-candidal salivary component and demonstrate its decreased levels in HIV infection providing new insights into oral Innate immune defense mechanisms and the enhanced susceptibility of HIV+ individuals to oral candidiasis

Raltegravir and Atazanavir/ritonavir are potent first line therapeutic options for HIV treatment naïve patients. We studied raltegravir (RAL) or atazanavir/ritonavir (ATV/r) both with tenofovir/emtricitabine in a predominantly African American indigent patient population in Houston, Texas. Results from 17 patients at 48 weeks (wk); 9 in the RAL group and 8 in the ATV/r group were available for analyses. We evaluated CD4+ count, CD4%, HIV RNA viral load (VL) levels, and lipid profile at wk 0, 6, 14, 30, and 48. IL-6 and homocysteine levels were available at wk 0 and 48. Among the lipid panel between the 2 groups, triglycerides became statistically significantly lower in the raltegravir group at 14 weeks and persisted at a lower level through 48 wk. There were no significant differences in CD4+ cell count, CD4%, log VL, total cholesterol, LDL, HDL, IL-6, and homocyseine levels. Both RAL and ATV/r in combination with tenofovir/emtricitabine provide similar immunologic and virologic efficacy. There was a slight difference observed in changes in triglyceride levels but other lipid changes were similar. IL-6 and homocystine levels changed to a similar degree with these potent antiretroviral regimens.