Background: Lai Chau is one of northwestern provinces of Vietnam, where there was a drug vice and high prevalence of drug users. It is necessary to evaluate the situation of HIV infection in this group. Objectives: A study on HIV prevalence and factors relating to the behaviors of HIV Infection among Injecting Drug Users (IDUs) in various districts of Lai Chau province. Subjects and method: A quantitative, cross-sectional study was carried out on 330 IDUs in Lai Chau town and 3 districts of Lai Chau province from January to December 2007. Results: 40.30% of the IDUs tested positive for HIV, nearly 2 times higher than the prevalence in 2006 (23.2%). 87.27% of the IDUs never re-used their syringes and needles. However, 12.4% still sometimes re-used their syringes and needles. Of 43 IDUs (12.73%) who re-used their syringes and needles, only 27.91% always cleaned their syringes and needles, 23.26% cleaned their syringes and needles most of the time after using them and up to 27.91% only sometimes cleaned their syringes and needles. Most IDUs use heroin (97.88%). Percentage of IDUs sharing syringes and needles accounts for 12.42%. 10% of the IDUs had sexual intercourses with commercial sex workers within the last month. There is a relationship between the time of using drugs and the HIV prevalence rate. There is a double risk of HIV infection for the IDUs injecting drugs for 5 years and upwards compared to those injecting drugs less than 5 years. (p <0.05, OR = 2). Conclusion: It is required to develop communications in order to change the behaviors of HIV infection among IDUs in Lai Chau province.
HIV prevalence ; behaviors ; HIV infection ; injecting drug users ; Lai Chau

BACKGROUND: Statistical data of undiagnosed people living with human immunodeficiency virus (PLHIV) are of great importance to human immunodeficiency virus (HIV) infection control. This study estimated the total number of PLHIV using nationwide claims data.METHODS: This study used data of the incident HIV cases identified by the National Health Insurance System between 2009 and 2015. The number of patients with acquired immune deficiency syndrome (AIDS) was identified by diagnoses or prescription records. The estimated number of PLHIV and the time to diagnosis were calculated from the incident numbers of HIV and AIDS cases using the HIV Modeling Tool of the European Center for Disease Prevention and Control.RESULTS: Between 2009 and 2015, a total of 7,033 PLHIV and 2,899 AIDS patients were diagnosed. In 2009, the number of incident HIV cases was 873 (460 AIDS patients), increasing to 995 (337 AIDS patients) in 2015. Besides, the estimated number of prevalent cases was 10,753 in 2009, compared to 14,880 in 2015. Patients visiting health facilities accounted for 42.9% (4,616/10,753) in 2009 and 64.1% (9,544/14,880) in 2015. In 2009, there were 8,363 (77.8%) undiagnosed HIV cases, experiencing a decline to 6,215 (41.8%) in 2015. It took a mean of 6.96 years to diagnose after HIV infection.CONCLUSION: This study estimates the total burden of HIV infection in Korea for the first time using an internationally recognized HIV modeling tool. Claims data can be used to estimate the number of undiagnosed cases by identifying the total number of PLHIV and AIDS patients visiting health facilities.
Acquired Immunodeficiency Syndrome ; Diagnosis ; Health Facilities ; HIV Infections ; HIV ; Humans ; Infection Control ; Korea ; National Health Programs ; Prescriptions

BACKGROUND: For the diagnosis of HIV infection, enzyme immunoassay (EIA) or chemiluminescence immunoassay (CLIA) is commonly used as a screening test. Although these methods have a high sensitivity and low cost, their high false positive rate can cause confusion in the patients and clinicians until a more specific test is done. OraQuick Advance Rapid HIV-1/2 Antibody Test (OraQuick) (OraSure Technologies, USA) is a rapid test that can detect HIV-1/2 antibodies in 20 minutes. It uses oral fluid, whole blood or serum sample. In this study, we evaluated the usefulness of the OraQuick as a screening and point-of-care test for HIV infection. METHODS: From Jan 2007 to Dec 2008, 45,276 samples referred to our laboratory were tested by CLIA method using the ADVIA Centaur (Bayer Healthcare LTD., USA) for HIV-1/2 antibody detection. Among them, 74 positive and 50 negative samples were tested by the Western immunoblot assay (WIB) and OraQuick test as a case-control study. Also, oral fluids from 30 HIV patients and 48 healthy persons were tested by OraQuick test. RESULTS: The sensitivity and specificity of OraQuick test (using serum samples) were 100% and 98.8% (95% confidence interval 96.9~100%), respectively. OraQuick tests (using oral fluid samples) were all positive for HIV patients but all negative for healthy persons. CONCLUSIONS: This study suggests that OraQuick can be used successfully as a rapid test for the early detection of HIV-1/2 antibody in patients visiting emergency departments and for the prevention of HIV infection in the health care providers.
Antibodies ; Blotting, Western ; Case-Control Studies ; Delivery of Health Care ; Emergencies ; HIV ; HIV Infections ; Humans ; Immunoassay ; Immunoenzyme Techniques ; Infection Control ; Luminescence ; Mass Screening ; Sensitivity and Specificity

According to the advance of antiretroviral regimen and the early treatment strategy, people living with human immunodeficiency virus (PLWH) are achieving the goal of virologic suppression and immune restoration. Most of them no more die of acquired immunodeficiency syndrome (AIDS) defining illnesses, and become older with chronic comorbidities such as cardiovascular, metabolic, hepatic, renal and neurological diseases. However some PLWH still visit hospitals as late presenters with very low CD4+ T cell counts, so that they suffer AIDS defining illnesses to die or experience severe neurological complications resulting in disabilities. Early palliative interventions are needed on the various symptoms of PLWH. Thus far chronic pains such as distal symmetric sensory polyneuropathies have been underevaluated. Active pain-relieving interventions are important to them. Recently we define end of life condition of human immunodeficiency virus (HIV) or eligibility to hospice care after adjusting current status of HIV treatment. Hospice teams should pay attention to the specific medical conditions, psychological needs, and social circumstances of PLWH. With just standard precautions as common infection control measures, general hospice cares can be provided to them like to other hospices subjects. For giving PLWH opportunities to have the end of life with value and dignity, hospice multidisciplinary team should intervene them early and aggressively. Now we need more clinical experiences and institutional improvements.
Acquired Immunodeficiency Syndrome ; Cell Count ; Chronic Pain ; Comorbidity ; HIV* ; Hospice Care ; Hospices* ; Infection Control ; Palliative Care* ; Polyneuropathies

Brown-Sequard Syndrome ; diagnosis ; Diagnosis, Differential ; HIV Infections ; complications ; Humans ; Male ; Middle Aged ; Mycobacterium avium-intracellulare Infection ; diagnosis

BACKGROUND: Insufficient training in infection control and occupational health among healthcare workers (HCWs) in countries with high human immunodeficiency virus (HIV) and tuberculosis (TB) burdens requires attention. We examined the effectiveness of a 1-year Certificate Program in Occupational Health and Infection Control conducted in Free State Province, South Africa in an international partnership to empower HCWs to become change agents to promote workplace-based HIV and TB prevention. METHODS: Questionnaires assessing reactions to the program and Knowledge, Attitudes, Skills, and Practices were collected pre-, mid-, and postprogram. Individual interviews, group project evaluations, and participant observation were also conducted. Quantitative data were analyzed using Wilcoxon signed-rank test. Qualitative data were thematically coded and analyzed using the Kirkpatrick framework. RESULTS: Participants recruited (n = 32) were mostly female (81%) and nurses (56%). Pre-to-post-program mean scores improved in knowledge (+12%, p = 0.002) and skills/practices (+14%, p = 0.002). Pre-program attitude scores were high but did not change. Participants felt empowered and demonstrated attitudinal improvements regarding HIV, TB, infection control, and occupational health. Successful projects were indeed implemented. However, participants encountered considerable difficulties in trying to sustain improvement, due largely to lack of pre-existing knowledge and experience, combined with inadequate staffing and insufficient management support. CONCLUSION: Training is essential to strengthen HCWs' occupational health and infection control knowledge, attitudes, skills, and practices, and workplace-based training programs such as this can yield impressive results. However, the considerable mentorship resources required for such programs and the substantial infrastructural supports needed for implementation and sustainability of improvements in settings without pre-existing experience in such endeavors should not be underestimated.
Capacity Building ; Delivery of Health Care* ; Education ; Female ; HIV* ; Humans* ; Infection Control ; Interviews as Topic ; Mentors ; Methods* ; Occupational Health* ; South Africa ; Tuberculosis*

BACKGROUND: Health care workers (HCWs) are exposed to patients' blood occupationally by needlesticks or sharps injuries and by direct contact to mucous membranes or skins. This study was performed to investigate actively the descriptive epidemiology of HCWs' blood exposures in a University Hospital in Korea. METHODS: Over a 5 year period (from Jan, 1996 to Dec. 31, 2000), in a acute, educational, tertiary and about 1,500 beds university hospital, blood exposure episodes were reported by HCWs. The reported cases of 532 were analysed epidemiologically and statistically using PC SAS 6.12. RESULTS: The proportions of male and female were 44.0% (234), 56.0% (298) respectively the mean age was 29.2 years and the mode of career was 12 months. Distributions by job titles were 44.9% (239/532) in doctors' 29.5% (157/532) in registered nurses' 9.0% (48/532) in aid nurses, 6.4%(34/532) in housekeepers and 4.3%(23/532) in technicians. The proportions per 100 HCWs by job category were 4.4%(239/5,489) in doctors, 3.7%(157/4,262) in registered nurses and 1.3%(23/ 1,786) in technicians. and that per 100 beds was 6.8% (529/7,730). Distribution of reported cases were 13.0% (69/532), 11.5% (61/532), 9.2%(49/532) in March, April and May respectively. The major type of exposure was percutaneous injuries (96.3%, 513/533), and the most of them was needlesticks (91.4%, 469/513). The largest number of blood exposures occurred in inpatient ward(48.4%, 257/532) and the most injured body part was fingers (782%, 412/527), especially 1st finger (25%, 84/332). Blood exposure accidents were occurred during invasive procedures(66.3%, 341/514) and most of them were blood sampling(22.9%, 78/341) and recapping(20.8%, 71/341). Hepatitis B virus was the major bloodborne pathogens of reported cases (55.8%. 293/525). Post exposure prophylaxis and follow up were done for susceptible person but the seroposive conversions in them were not found. The association between job categories and exposure types and that between job titles and occurrence places were significant statistically(CMH chi-square p=0.001). The reporting cases of HBV exposures were decreased but those of HIV exposures were increased annually during the study period. CONCLUSION: We could find the descriptive epidemiology of Hews' occupational exposures to blood in a university hospital in Korea. And we can support the data in order to establish the policy or act for HCWs' safety and health from the boodborne hazards. In addition, to confirm the preventive effects of infection control activities for Hews from the risk of bloodborne diseases.
Blood-Borne Pathogens ; Cross Infection ; Delivery of Health Care* ; Epidemiology ; Female ; Fingers ; Follow-Up Studies ; Hepatitis B virus ; HIV ; Humans ; Infection Control ; Inpatients ; Korea ; Male ; Mucous Membrane ; Needlestick Injuries ; Occupational Exposure ; Occupations ; Post-Exposure Prophylaxis ; Skin

Animal bites are a common problem managed by primary physicians and often involve wound infection, neurovascular injury, poor cosmetic outcome, and high medical costs. During clinical assessment, a thorough medical history is acquired, including details of the bite circumstances and the patient's immune status and vaccination history. A meticulous physical examination should be performed in order to identify any injuries to deep structures, in addition to exploring the wound by creating a narrow opening and using diagnostic tools such as radiograph and ultrasound where necessary. Infection is the most problematic complication after a bite injury. Cleaning, irrigation, and debridement are the most important steps in preventing infection. The use of prophylactic antibiotics is controversial, but probably indicated in immunocompromised individuals and in anatomical areas that are more likely to be infected, such as the hand and foot. The decision to close a bite wound must be based on consideration of the benefit of a good cosmetic outcome and the increased risk of infection. In Korea, human rabies has not occurred since 2005, but the transmission of rabies is still a concern with animal bites. The transmission of viral hepatitis, herpes virus and human immunodeficiency virus can occur following human bites. To prevent the transmission of various viruses, healthcare providers should know the guidelines for post-bite exposure prophylaxis.
Animals ; Anti-Bacterial Agents ; Bites and Stings ; Bites, Human ; Debridement ; Foot ; Hand ; Health Personnel ; Hepatitis ; HIV ; Humans ; Immunization ; Korea ; Physical Examination ; Rabies ; Ultrasonography ; Vaccination* ; Wound Infection ; Wounds and Injuries

PURPOSE: The aim of this study was to evaluate the clinical features of emergency department (ED) visits by patients infected with human immunodeficiency virus (HIV) and the need for infection control strategies. METHODS: We retrospectively reviewed electronic ED logs and medical records to find all ED visits by HIV-infected patients from November 1999 to May 2004. The demographic data, the ED disposition, and the length of ED or hospital stay were collected from the ED logs. Clinical and laboratory data were obtained from the medical records. RESULTS: A total of 91 ED visits by HIV-infected 57 patients were considered. The mean age of the patients was 40.7+/-10.9 years, and 91.2% of the patients were male. Among these visits, 53 (58.2%) involved AIDS-related conditions (the AIDS-related group); the other 38 visits by HIV-infected patients were for non-AIDS-related reasons (the non-AIDSrelated group). There was no statistical difference between AIDS-related and non-AIDS-related groups in the length of ED stay (33.2 vs. 39.8 hours, p=.458). Fever was the most common complaint (n=23, 16.0%). As categorized diagnoses, constitutional symptoms were the most common (n=38, 26.4%). A total of 51 patient-visits (56.0%) were admitted to the hospital, and the most common final diagnosis was pulmonary disease (n=22, 43.1%). The number of ED visits by patients with active pulmonary tuberculosis was 15 (16.5%), which represented 22.4% of ED visits by patients with constitutional or respiratory symptoms. CONCLUSION: Fever was the most common cause of ED visits by HIV-infected patients, and pulmonary disease was the most common diagnosis. Patients with the active pulmonary tuberculosis who need respiratory isolation are common among HIV-infected patients.
Diagnosis ; Electronics ; Emergencies* ; Emergency Service, Hospital* ; Fever ; HIV* ; Humans ; Humans* ; Infection Control* ; Length of Stay ; Lung Diseases ; Male ; Medical Records ; Retrospective Studies ; Tuberculosis ; Tuberculosis, Pulmonary

OBJECTIVETo study the CD8+ cell noncytotoxic antiviral response (CNAR) to HIV in nosocomial HIV infected individuals, and reveal the relationship between the CNAR and CD4+ cell count.

METHODCD8+ cells from HIV-1 sero-positive individuals were separated by immunomagnetic beads and mixed with CD4+ cells at different CD8 CD4 cell input ratios (2:1, 1:1, 0.5:1 and 0.25:1). Reverse transcriptase (RT) activity of cocultured supernatant was tested and compared with negative control and the suppression rate of HIV-1 replication was measured.

RESULTThe average CD8:CD4 cell input ratios to reach 80% suppression of HIV replication in the group with CD4 < 300/microl and CD4 > 300/microl were 2.4:1 and 1.3:1, respectively (P < 0.05).

CONCLUSIONCNAR activity in HIV infected individuals is associated with CD4+ cell count. The ability to suppress HIV replication in subjects with CD4 > 300 is stronger than those with CD4 < 300.

Adult ; Aged, 80 and over ; Anti-HIV Agents ; therapeutic use ; CD4-Positive T-Lymphocytes ; drug effects ; immunology ; CD8-Positive T-Lymphocytes ; drug effects ; immunology ; Cells, Cultured ; Cross Infection ; drug therapy ; immunology ; Female ; HIV ; drug effects ; immunology ; HIV Infections ; drug therapy ; immunology ; Humans ; Male ; Middle Aged