There are various diagnostic methods for detection of HIV infection. Among them, ELISA has been using most widely as a screening test. On the other hand, the Western blot method has been used as a confirmative test. The final confirmative tests are conducted on the seropositive sample and other supplementary methods such as HIV antigen test or molecular tests involving polymerase chain reaction should be performed in addition to Western blot for the confirmation. The clinical consequences of HIV infection encompass a spectrum ranging from an acute syndrome associated with primary infection to a prolonged asymptomatic state and advanced disease. It is best to regard HIV disease as beginning at the time of primary infection and progressing through various stages. Throughout the course of HIV infection, active viral replication and progressive immunologic impairment occur in most patients. With the exception of rare true long-term nonprogressors, HIV disease, when untreated, inexorably progresses even during the clinically latent stage. However, anti-retroviral therapy has had a major impact on blocking or slowing the progression of disease over extended periods of time in a substantial proportion of adequately treated patients. Overall, the clinical spectrum of HIV disease is constantly changing as patients live longer and new and better approaches to treatment and prophylaxis are developed.
Asymptomatic Diseases ; Blotting, Western ; Diagnosis* ; Enzyme-Linked Immunosorbent Assay ; Hand ; HIV ; HIV Infections ; HIV Long-Term Survivors ; Humans ; Mass Screening ; Polymerase Chain Reaction

OBJECTIVETo investigate the progression and drug resistance of long-term non-progressors during three follow-up in Henan province.

METHODSIn May 2009, 26 cases of long-term non-progressors were recruited who infected HIV more than 10 years with blood collection and supply routes, did not receive anti-retroviral therapy, CD4(+)T lymphocyte count ≥350/μl and did not show typical symptoms of AIDS from Weishi, Shangcai, and Linying of Henan Province. Continuous follow-up were conducted three times since 2009 every two years with cohort analysis, the epidemiological information of infection routes, infection time and blood were collected, and 78 parts of 10 ml EDTA anticoagulated whole blood were collected. The changes of CD4 (+) T lymphocytes, viral load, and virus gene variety were characterized from 2009 to 2014. In-house methods were used to explore primary drug resistance of long-term non-progressors. Nonparametric Kruskal-Wallis test were used to compare CD4(+) T lymphocyte count and viral load changes during different follow-up times.

RESULTSThe average age and infection time of 26 cases were (48.51 ± 6.75) years, (13.42 ± 4.26) years, respectively. Three follow-up times, CD4(+) T lymphocyte count P50 (P25-P75) was 573.5 (487.4-789.8), 499.8 (403.5-635.7), and 418.8 (297.6-537.8)/μl (H=63.99,P<0.001), respectively. And natural logarithm of viral load P50 (P25-P75) were 3.93 (3.43-4.55), 4.29 (3.78-4.75), 4.50 (4.01-4.81) (H=3.19,P=0.355), respectively. Subtype and phylogenetic analysis of HIV showed that prevalent cases were B subtype, accounting for 88.5% (23/26), and three cases showed restructuring changes. Two cases appeared highly resistant of 18 infected patients whose viral load >1 000 copies/ml.

CONCLUSIONThe CD4(+)T lymphocyte had a declining trend, virus subtype recombinant changes in a few cases, and primary drug resistance was found of long-term non-progressors in Henan province.

Adult ; CD4 Lymphocyte Count ; China ; Cohort Studies ; Disease Progression ; HIV ; classification ; drug effects ; HIV Infections ; epidemiology ; HIV Long-Term Survivors ; Humans ; Middle Aged ; Phylogeny ; Viral Load

PURPOSE: Infection with human immunodeficiency virus (HIV) remains a major global threat, and although the prevalence is comparatively still very low, the number of HIV-positive Koreans is increasing. However, there are no official guidelines as to how to treat people living with HIV/acquired immunodeficiency syndrome (AIDS) (PLWHA) or how to screen for potentially infectious people. This study assessed the level of knowledge and attitudes of dentists in Korea toward PLWHA, and their attitudes to screening patients for HIV infections. METHODS: A cross-sectional prospective survey targeting dentists working in Korea was conducted using a self-administered questionnaire. RESULTS: A satisfactory level of knowledge about HIV/AIDS and a relatively positive attitude toward PLWHA was found. Most of the respondents preferred rapid HIV testing using oral fluid as a specimen. The general attitude of dentists toward HIV/AIDS is sufficiently positive to enable provision of the best treatment to the patients in need. CONCLUSIONS: Most of the dentists require HIV testing in dental clinics. In spite of their needs, there are several obstacles. It is hoped that financial considerations and official legal requirements related to HIV testing strategies will be considered.
Acquired Immunodeficiency Syndrome ; AIDS-Related Opportunistic Infections ; Surveys and Questionnaires ; Dental Clinics ; Dentists ; HIV ; HIV Long-Term Survivors ; Humans ; Korea ; Mass Screening ; Prevalence ; Prospective Studies

PURPOSE: Infection with human immunodeficiency virus (HIV) remains a major global threat, and although the prevalence is comparatively still very low, the number of HIV-positive Koreans is increasing. However, there are no official guidelines as to how to treat people living with HIV/acquired immunodeficiency syndrome (AIDS) (PLWHA) or how to screen for potentially infectious people. This study assessed the level of knowledge and attitudes of dentists in Korea toward PLWHA, and their attitudes to screening patients for HIV infections. METHODS: A cross-sectional prospective survey targeting dentists working in Korea was conducted using a self-administered questionnaire. RESULTS: A satisfactory level of knowledge about HIV/AIDS and a relatively positive attitude toward PLWHA was found. Most of the respondents preferred rapid HIV testing using oral fluid as a specimen. The general attitude of dentists toward HIV/AIDS is sufficiently positive to enable provision of the best treatment to the patients in need. CONCLUSIONS: Most of the dentists require HIV testing in dental clinics. In spite of their needs, there are several obstacles. It is hoped that financial considerations and official legal requirements related to HIV testing strategies will be considered.
Acquired Immunodeficiency Syndrome ; AIDS-Related Opportunistic Infections ; Surveys and Questionnaires ; Dental Clinics ; Dentists ; HIV ; HIV Long-Term Survivors ; Humans ; Korea ; Mass Screening ; Prevalence ; Prospective Studies

OBJECTIVETo study the quantity of anti-R7V in individuals infected with HIV and AIDS patients and its relation with the progression of disease.

METHODSELISA and precipitation and other methods were used to investigate the quantity of anti-R7V in asymptomatic long-term survivors and AIDS patients.

RESULTSPositive rate and quantity of anti-R7V were higher in the HIV active ones and AIDS. It showed that the quantity and positive rate of anti-R7V were rather high in dissolving test.

CONCLUSIONSIt is strong suggestion for anti-R7V to obstruct the replication of virus by interfering the connection between HIV with CCR5 or CXCR4 and so it impossible HIV entering to CD4+ T cells.

Acquired Immunodeficiency Syndrome ; immunology ; Adolescent ; Adult ; Aged ; Child ; Female ; Follow-Up Studies ; HIV Antibodies ; blood ; HIV Infections ; immunology ; HIV Long-Term Survivors ; HIV-1 ; immunology ; Humans ; Male ; Middle Aged ; Receptors, CCR5 ; physiology ; Receptors, CXCR4 ; physiology

BACKGROUNDTo investigate variant genotyping of CCR2-64I, SDF1-3'A and CCR5Delta32 in HIV-1 infected Chinese Long-term nonprogressors and to study their association with disease progression.

METHODSThe genotypes of CCR2-64I, SDF1-3'A and CCR5Delta32 were detected by polymerase chain reaction/restriction fragment length polymorphism (PCR/RFLP) assay in seventeen HIV-1 infected Chinese Long-term nonprogressors (LTNPs) and thirty-nine Chinese typical progressors (TPs).

RESULTSThe frequency of CCR2-64I and SDF1-3'A in LTNPs are 50% and 62.5%, higher than those (23.08% and 33.33%) in TPs. Only one heterozygous CCR5 mutant was detected in LTNPs, and no CCR5 mutant in TPs.

CONCLUSIONVariant genotyping of CCR2-64ISDF1-3'A and CCR5Delta32 may be protective factors for delaying disease progression in HIV-1 infected Chinese LTNPs.

Chemokine CXCL12 ; genetics ; China ; Gene Frequency ; Genotype ; HIV Infections ; genetics ; pathology ; virology ; HIV Long-Term Survivors ; HIV-1 ; physiology ; Host-Pathogen Interactions ; Humans ; Mutation ; Polymerase Chain Reaction ; Polymorphism, Restriction Fragment Length ; Receptors, CCR2 ; genetics ; Receptors, CCR5 ; genetics ; Receptors, HIV ; genetics

OBJECTIVETo explore the related testing indicators variation of HIV long-term non-progress populations.

METHODSThe long-term non-progress populations in some areas of Henan were recruited, and the study was carried out according to different CD4(+)T lymphocytes counts for two groups. The dynamic characteristics of immune status and viral load between LTNP-1group (CD4(+)T lymphocytes ≥ 500/µl, 42 cases) and LTNP-2 group(350/µl ≤ CD4(+)T lymphocytes < 500/µl, 49 cases) from July 2010 to August 2013 were observed. The characteristics of HIV elite controllers during the follow-up were also described.

RESULTSLTNP were recruited, 56% (51 cases) were men, and 44% (40 cases) were women. The study population were aged from 38 to 65 years old. A total of 320 individuals were followed-up, 14 cases were lost, 2 deaths, and 16 cases had received antiretroviral therapy during four years. To analyze the annual changes of CD4(+)T lymphocytes and VL of the group from 2010 to 2013, LTNP-1 group CD4(+)T lymphocytes from 654.0(545.2-809.5) decreased to 494.0(341.0-574.7), and LTNP-2 group decreased from 493.0 (429.5-770.0) to 343.5(253.0-500.8), CD4(+)T lymphocytes decline of over times of two groups in longitudinal analysis (χ(2) = 50.32, P < 0.01; χ(2) = 31.03, P < 0.01). lg (VL) of LTNP-1 group were 3.52 (3.15-4.27), 3.71 (2.70-4.55), 3.86 (3.59-4.55), 3.96 (3.25-4.36), and lg (VL) of TNP-2 group were 4.35 (3.72-4.83), 4.35 (3.97-4.94), 4.71 (3.96-4.95), 5.04(4.78-5.26), respectively (P > 0.05). The same year inter-group comparison found CD4(+)T lymphocytes of LTNP-1 group were higher than LTNP-2 group (Z = 5.23, P < 0.01; Z = 3.06, P < 0.01; Z = 2.51, P < 0.05; Z = 2.47, P < 0.05). VL of LTNP-2 group increased from 4.35(3.97-4.94) to 5.04 (4.78-5.26) during 2011 to 2013, were higher than LTNP-1 group in the same year (Z = 2.28, P < 0.05; Z = 2.58, P < 0.05; Z = 2.76, P < 0.05). 65 cases HCV antibody were positive in 91 individuals, and the HCV antibody positive rate was 76% (32/42), 67% (33/49) between LTNP-1 group and LTNP-2 group. Six elite controllers maintained CD4(+)T lymphocytes ≥ 500/µl, VL<1 000 copies/ml during four years follow-up.

CONCLUSIONThe long-term non-progress populations in Henan were overall healthy, and VL were relatively stable, there was a decreased trend of CD4 year by year, and HCV co-infection rate was high.

Adult ; China ; epidemiology ; Female ; Follow-Up Studies ; HIV Infections ; HIV Long-Term Survivors ; statistics & numerical data ; HIV Seropositivity ; Humans ; Male ; Middle Aged ; T-Lymphocytes ; Viral Load ; statistics & numerical data

OBJECTIVETo study the specific amino acid variation in Nef that may be related to disease progression after infection with HIV-1 subtype B, a predominant strain circulating in China, and to determine whether changes in Nef secondary structure may influence different stages of AIDS development based on the concept that the Nef gene of HIV infection dramatically alter the severity of viral infection and virus replication and disease progression, and that long-term non-progressors (LTNP) of HIV infection are commonly associated with either a deletion of the Nef gene or the defective Nef alleles.

METHODSThe study subjects were divided into LTNP1(n=14), LTNP2 (n=16) and slow progressor (SP, n=19) groups for mutational analysis of the Nef sequence. The data were obtained by using Bioedit, MEGA, Anthewin and SAS software.

RESULTSResidues in Nef TA(48/49) and K151 occurred more frequently in the LTNP group while AA(48/49) was more frequently observed in the SP group. Of the differences observed in the secondary structure comparison using Nef consensus sequences of these three groups, one was roughly corresponding to the Nef(48/49) mutation site.

CONCLUSIONTA(48/49), K(151), and AA(48/49) in the Nef gene might be associated with the different stages of HIV infection, and there may be a link between the Nef secondary structure and the progression of HIV-1 infection.

Amino Acid Sequence ; Base Sequence ; Blood Donors ; CD4 Lymphocyte Count ; China ; epidemiology ; Disease Progression ; Gene Products, nef ; genetics ; HIV Infections ; epidemiology ; virology ; HIV Long-Term Survivors ; HIV-1 ; classification ; genetics ; Humans ; Molecular Sequence Data ; Mutation ; genetics ; Time Factors

INTRODUCTIONThere is little detailed information on human immunodeficiency virus (HIV) amongst older adults in Singapore.

MATERIALS AND METHODSA retrospective study of 121 consecutive referrals of patients presenting for HIV care was conducted. Demographic, clinical and laboratory variables were collected. A prognostic model derived from the North American Veterans' Affairs Cohort Study (VACS) was used to estimate prognosis.

RESULTSThe median age at presentation was 43 (range, 18 to 76). Thirty-eight patients (31%) were aged 50 or older and 106 patients (88%) were male. Older patients were more likely to be of Chinese ethnicity (P = 0.035), married (P = 0.0001), unemployed or retired (P = 0.0001), and to have acquired their infection heterosexually (P = 0.0002). The majority of patients in both groups were symptomatic at presentation. Eighty-one (67%) had CD4 counts less than 200 at baseline with no observable differences in HIV ribonucleic acid (RNA) or clinical stage based on age. Non-Acquired Immunodeficiency Syndrome (AIDS) morbidity was observed more frequently amongst older patients. The estimated prognosis of patients differed significantly based on age. Using the VACS Index and comparing younger patients with those aged 50 and above, mean 5 year mortality estimates were 25% and 50% respectively (P <0.001). A trend towards earlier antiretroviral therapy was noted amongst older patients (P = 0.067) driven mainly by fewer financial difficulties reported as barriers to treatment.

CONCLUSIONOlder patients form a high proportion of newly diagnosed HIV/AIDS cases and present with more non-AIDS morbidity. This confers a poor prognosis despite comparable findings with younger patients in terms of clinical stage, AIDS-defining illness, CD4 count and HIV viral load.

Acquired Immunodeficiency Syndrome ; mortality ; Adolescent ; Adult ; Age Factors ; Aged ; Female ; HIV Infections ; mortality ; HIV Long-Term Survivors ; Humans ; Male ; Middle Aged ; Models, Theoretical ; Mortality ; trends ; Prognosis ; Retrospective Studies ; Singapore ; epidemiology ; Social Class ; Young Adult

A chronic psychological disorder is often encountered in adult survivors of severe and repeated child abuse. We report a case of successful Eye Movement Desensitization and Reprocessing (EMDR) treatment in a multiply traumatized survivor whose previous treatments with psychotropic medication and supportive psychotherapy were unsuccessful. A series of consecutive six weekly sessions of EMDR were given. The patient completed Symptom Checklist-90-Revised. Dissociative Experiences Scale. State and Trait Anxiety Inventory, Beck Depression Inventory and Impact of Event Scale-Revised at four points; at two months and a week before EMDR, a week and six months after EMDR. After EMDR, the patient improved on all the measures of scales. These gains were maintained at six months after the termination of treatment. This case suggests a possible application of EMDR with for chronic difficult-to-treat post traumatic conditions.
Adult ; Anxiety ; Child ; Child Abuse ; Depression ; Eye Movement Desensitization Reprocessing ; Eye Movements* ; Humans ; Psychotherapy ; Stress Disorders, Post-Traumatic ; Survivors ; Weights and Measures