4^th International Conference on HIV/AIDS, STDs and STIs October 03-05, 2016 Orlando, Florida, USA

Biography:

Dr. Robert W. Buckingham joins PHHS after having previously been appointed as the Jack W. Thompson, M.D. Distinguished Visiting Professor at the University of Michigan-Flint in 2013-14. A Yale graduate, Dr. Buckingham was appointed inaugural Executive Director/Dean of the School of Public Health with the University of Saskatchewan, in 2009. He has authored more than 12 books and many scientific referred papers, with the most recent being a textbook entitled, “A Primer on International Health” published by Allyn & Bacon, and five books on hospice care, including, “Care of the Dying Child” published by the Continuum Publishing Company, which was translated in seven languages. Research areas are Hospice care, Global public health and HIV/AIDS in South East Asia and Central America; He has wide range of publication and attended National or International Oral Presentations

Abstract:

This presentation will focus on the philosophy of care for the person with AIDS in the last 6 months of life. I will present palliative care for the special needs of the AIDS patient and their family. This presentation will focus on pain control, patient/family as the unit of care, palliative sedation, symptom control, continuity of care, respect of lifestyle, physician and nurse accessibility, control of loneliness, and fears of abandonment as well as grief management after the death of the loved one.

Biography:

Hiroshi Ohrui has received Ph.D. degree (1971) from The University of Tokyo. He joined RIKEN (1966), moved to Tohoku University (1881) and then to Yokohama University of Pharmacy (2006). His interest covers Organic Synthesis, Chemical Biology, and Chiral Discrimination.

Abstract:

ABSTRACT Since 4’-C-ethynyl-2-fluoro-2’-deoxyadenosine (EFdA) has attracted much attention due to its supremely excellent anti-HIV activity1-4), I would like to talk about the design1,2), synthesis3), and biological evaluation of EFdA1,2,4) including the clinical trials (phase1 and 1b) reported by Merck Sharp & Dohme4). INTRODUCTION Highly Active Anti-Retroviral Therapy (HAART) has made HIV-infection from fatal to clinically tractable lifelong infectious disease. However, the emergence of resistant HIV-mutants and the adverse effects of drugs are still critical problems to solve. EFdA which could solve these problems was developed by us1). I would like to discuss about (1) a general idea based on the mutation of viruses that it is possible to develop nucleosides which are active to viruses and not toxic to human beings2), (2) the working hypotheses for designing nucleoside which could solve the above problems1), (3) the efforts for the better syntheses of EFdA3), and (4) the biological evaluation of EFdA by Dr. H. Mitsuya and other groups1,2), and the clinical trials (phase 1 and 1b) reported by Merck Sharp & Dohme at CROI, 20164). RESULTS AND DISCUSSION On the basis of the general idea and the working hypotheses, 4’-C-substituted-2’-deoxynucleoside (4’SdN) was designed as the nucleoside which could prevent the emergence of resistant HIV-mutant and could be stable in plasma. The method to decrease the toxicity of nucleoside that the additional modification of a toxic nucleoside could decrease the toxicity of the nucleoside will be also discussed. Finally, EFdA was designed and synthesized by our constant efforts on the syntheses and biological evaluation of 4’SdN. The details of the general idea, the working hypotheses, the syntheses of EFdA, and the biological evaluation of EFdA will be discussed. CONCLUSION (Arial 12pt bold) The extensive Studies on 4’SdN have successfully developed EFdA. EFdA has prevented the emergence of resistant HIV mutants more than ten years, and is over 400 times more active than AZT and several orders of magnitude more active than the other clinical drugs and stable in plasma and lowly toxic. The clinical trials by Merck Sharp & Dohme have shown that EFdA is efficiently absorbed by both oral and parenteral administration and converted to 5’-O-triphosphate (EFdA-TP) promptly, EFdA-TP is very stable in human PMMCs and the half-life of EFdA-TP is over 100 hours, and further, once a week dosing of 10mg of EFdA is efficacious. Thus, EFdA is a very promising anti-HIV drug which could open a new paradigm in the anti-retroviral therapy.

Biography:

Lynne Stauff, MPA, ASQ, CQIA Public Health Consultant and Coordinator of the Tobacco Reduction in PLWH Project. She has worked in public health for more than 17 years as a project manager, local public health accreditation reviewer, educator and trainer, department change agent and public health consultant. Farid J Shamo MB ChB, M.Sc, MPH received his Medical degree from University of Baghdad in 1979 and his first Master in Community Medicine in 1986. His second Master in Public Health with a focus on Epidemiology from the University of Michigan in 2004. Over the past 35 years, Dr. Shamo has participated in numerous research teams and public health projects in partnership with national, state and local organizations such as (WHO), Ministry of Health in Iraq, the US Environmental Protection Agency and MDHHS. He is a recognized member of various advisory groups and coalitions. His research focused on chronic diseases, such as cardiovascular disease and diabetes mellitus, along with the associated risk factors as tobacco use and obesity. He has also published on Michigan’s Smoke-free air law and the decrease in Asthma hospitalizations since it’s implementation.

Abstract:

People Living with HIV (PLWH) in Michigan smoke cigarettes at 50% or more than 2 times the general population (21.4%). Although HIV disease has become a chronic disease when treated appropriately with HIV medications, PLWH are dying 12 years sooner from tobacco related illness before AIDS complications. They are dying from heart disease, diabetes and cancer all diseases caused by smoking. Learning of these alarming health disparities, the Tobacco Control Program (TCP) approached Michigan’s HIV Care and Prevention Section with a project concept and a funding request. The request was granted and the TCP now contracts with 14 AIDS Service Organizations (ASO) statewide to improve health outcomes in the HIV care population. Learn about the new Tobacco Reduction in PLWH Pilot Project which include results from an ASO employee assessment, a HIV client survey and client focus groups. ASO direct service providers are trained to deliver tobacco dependence treatment and to document the client encounters. The Project’s goal is to increase the number of HIV client tobacco quit attempts using evidence-based tobacco clinical practice guidelines and to incorporate those guidelines into routine provider practice. The project has highlighted the high tobacco use rates and poor health outcomes for PLWH. ASO providers are now aware of this health disparity and consistently ask HIV clients if they use tobacco and offer treatment. ASO service provider challenges and improvement opportunities will be discussed. Education, reliable data and consistent use of tobacco treatment guidelines will decrease the high smoking rate in PLWH ultimately improving health outcomes.

Biography:

Elizabeth Secord is a Professor of Pediatrics at Wayne State University, Children's Hospital of Michigan, USA. She is the Medical Director of the horizons adolescent and youth prevention and treatment program and the project challenge pediatric HIV prevention and treatment program in Detroit. She is also the Medical Director for the youth based STI prevention and treatment program for the city of Detroit. Her clinic continues to conduct multiple studies for HIV prevention and treatment through ATN, other networks and local research efforts.

Abstract:

Perinatal HIV infection was first identified in the mid 1980's, but adequate treatments were not identified and implemented until the 1990's. The incidence of perinatal HIV did not decline until after the perinatal HIV transmission study demonstrating effectiveness of Zidovudine in preventing maternal to fetal transmission. Children with HIV who survived have to cope with many situations that are unique to them as teens and adolescents with perinatally acquired HIV. They have often been raised by family that stepped in when their own parents died from HIV. They sometimes have cognitive impairment from their HIV, which was not treated adequately in early childhood. They often have acquired resistance from poor adherence throughout preadolescence and adolescence. They often have increased risk during their pregnancies compared to their peers. And all of the usual adolescence issues associated with chronic illness also occur in this population. The workshop will be a case based discussion addressing adherence, medication resistance and life skills in this very unique population of youth. It will also discuss disclosure issues and unique support systems.

Biography:

Charbell Miguel Haddad Kury, a Medical Doctor and Professor of Medicine, graduated from the Medical School of the Municipality of Campos dos Goytacazes, State of Rio de Janeiro, Brazil in 2003. He is expert in Public Health, from the Medicine School of Campos dos Goytacazes, in 2004. He is Pediatrician infectious disease specialist from the Jesus Hospital, Rio de Janeiro in 2007. He is also a Professor of Pediatrics of the Medicine Schools of Campos dos Goytacazes and the Federal University of Rio de Janeiro, Brazil. He has a Master’s degree in Applied Microbiology and Parasitology from the Fluminense Federal University, in 2013. He is a Pediatrician and Neonatologist of the St. John the Baptist Hospital, Municipality of Macaé, State of Rio de Janeiro, Brazil, since 2005 and Coordinator of Immunization and Health Surveillance of the Municipality of Campos dos Goytacazes, State of Rio de Janeiro, Brazil, since 2009. He did research on immunization programs, once the municipality of Campos dos Goytacazes implemented the largest immunization program.

Abstract:

The treatment of patients living with HIV/AIDS is not just the simple act of providing drugs and medical supervision, but fundamentally the act of rescuing the feeling of self-love and the fight against prejudice. Thus, the city of Campos dos Goytacazes, located within the state of Rio de Janeiro, Brazil, has a municipal program of patient care with a multidisciplinary strategy that involves not only the work of health professionals, but also to alternative strategies such as: The Health Strategy at school; The home support to HIV/AIDS patient and non-governmental organizations (NGOs). These provide support and recovery of citizenship of the users. However, much remains to be done to fight prejudice, and this action is not only the responsibility of government, but also the alignment of all social actors.

Biography:

William Hanna has completed his PhD from the University of Illinois postdoctoral studies from Northwestern University. He is currently the Director of Assay Development, at CY Molecular Diagnostics in San Diego, CA. He has published papers in reputed journals, is listed on several patents, and has been in the diagnostics industry for nearly 20 years.

Abstract:

According to The Guardian “ZIKA VIRUS’s spread in Brazil continues, but where else is in danger?” (2016), 1.5 million people have been infected with the virus in Brazil, and more than 4,000 suspected cases of microcephaly. Zika is confirmed to cause a negative impact on fetal development, which leads to microcephaly, and damage to the neurological system in adults. Detecting Zika with serological assays that detect specific IgM or IgG against Zika are only useful later in the disease, while RT-PCR can detect the viral RNA sooner and more specifically since there is significant cross-reactivity between Flavivirus serology. Direct detection of Zika is possible from samples by utilizing RT-PCR to amplify Zika RNA. Real Time-PCR for detection and quantitation of specific amplicons has been achieved using quencher and dye labeled oligo probes (QDOPs). The QDOP has a fluorescent reporter dye at 5’-end and a quencher at the 3’-end. When the closed QDOP is excited by irradiation the reporter fluorescence is greatly reduced by quenching through the process of fluorescence resonance energy transfer. When the QDOP hybridizes to the target, the stem loop opens the reporter dye, with the quencher dye, thus increasing the reporter dye fluorescence intensity.

Biography:

Edward M Kian is the Welch-Bridgewater Endowed Chair of Sports Media in the School of Media and Strategic Communications. His research focuses on sport media, specifically examining the framing of gender, sex and LGBTQ in content, social media and Web 2.0, attitudes and experiences of sport media members and sport marketing. He has authored more than 85 journal articles, books, book chapters and conference papers.

Abstract:

In 1991, U.S. sports media were shocked when Ervin “Magic” Johnson, a five-time champion for the Los Angeles Lakers and arguably then the world’s most famous basketball player, announced he had contracted the HIV-AIDS virus before immediately retiring as a player from the National Basketball Association. During that period AIDS was largely viewed as a death sentence that most Americans wrongly believed affected only gay men. Johnson’s historic announcement began to change that attitude. In a landmark study on media framing of homosexuality in sport, a textual analysis of national newspaper coverage of HIV-infected athletes Johnson, diver Greg Louganis and boxer Tommy Morrison found that most of the articles on Johnson and Morrison expressed shock that both athletes had contracted the HIV virus, while also noting multiple times that each athlete had proclaimed they were heterosexual. However, no article in any of the examined newspapers on the openly gay and more effeminate Louganis noted how he had contracted a virus that at that time was associated predominately with gay men. Johnson, however, has not only survived with HIV but returned to play and later coach in the NBA, co-captained the U.S. Olympic “Dream Team” in 1992, has constantly remained in great shape and is a highly successful businessmen and television commentator. He is one of the prime reasons public attitudes have changed toward far greater acceptance of those infected with HIV. This research used a textual analysis to examine media framing of Johnson and HIV this decade. A Lexus-Nexus academic search was used to locate all articles published in major U.S. newspapers from January 1, 2010 through August 15, 2016 that mentioned Johnson and HIV and/or AIDS in the same article. All articles were read and coded by two researchers to search for dominate themes, using the overarching frameworks of Connell’s (1995) Hegemonic Masculinity and Anderson’s (2009) Inclusive Masculinity to interpret results.

Biography:

Arnold Mervyn Levin has received his Diploma in Occupational Health from the University of the Witwatersrand in Johannesburg. He has joined Private medical practice including treatment of patients who were HIV positive and suffering from AIDS. Currently involved in Occupational health and a Medical Advisor to Private Medical Health services. He has experience in MEDICAL and NON-MEDICAL and has much Authorship and published many papers. He has interest in MODERN ART.

Abstract:

In order to appreciate the rationale behind the "Toxin Concept" in the aetiology, clinical manifestations and therapy of AIDS, it is necessary to appreciate the following information. Being HIV positive only implies the presence of the appropriate antibody's to the invasion of the human body by the H I Virus. This is not in itself a disease, but rather the body's immune response to the presence of this virus. An analogy would be the deliberate, well planned and coordinated inoculation of children to produce the appropriate protective antibody without manifestation of the disease in question, for example, Measles. These antibodies cannot and should not be destroyed in an endeavour to "get rid of the virus". Patients who are HIV positive but without any evidence of a compromised immune system, should not undergo any form of therapy which may be harmful to this process as designed by "nature". In contrast to the above, AIDS is the disease protocol in which the immune system has been destroyed, which would result in a progressive disease which may be fatal. Therefore, it is only AIDS patients who require the appropriate therapy to overcome this life threatening disease. Our treatment of AIDS is centred on restoring the body's depleted immune system, so as to overcome the invading H I Virus. This is achieved by removal of the toxin which is responsible for the body's immune system being compromised. A normal blood count after the required period of antitoxin treatment is evidence of the success of this modality or treatment. Usually within a period of 6-9 months, patients have shown significant improvement in their health and their ability to lead normal lives. Once the latter has been achieved, the treatment is discontinued. At no stage was ARV medication used in the treatment of the patients with AIDS. The above concept has been proposed and carried out by me as an independent medical syndrome investigator.

Biography:

Negi Bharat Singh is currently a PhD scholar of International Health specialization in Kobe University, Japan. He has 10 years of working or research experience in public health sector in developing countries. He has completed his Master’s degree from Graduate School of Medicine, the University of Tokyo Japan.

Abstract:

A 7.8 magnitude earthquake April 2015 in Nepal claimed >8600 lives, 21900 were injured and 88000 people were displaced. >1000 of health facilities got damaged; 402 were completely destroyed. In such situation, HIV/AIDS can invite risk of public health threat as >95% medical adherence is required to prevent drug resistance and to control HIV complications. Our study aimed to assess the impact of earthquake on people living with HIV (PLHIV) especially adherence to antiretroviral therapy, risk of drug resistance or treatment failure and to assess post-traumatic stress disorder, HIV stigma and risky sexual behavior among PLHIVs. 305 PLHIVs were interviewed to find the information regarding ART drug adherence (last 4-day pill count), post traumatic stress disorder (PTSD), earthquake damage and loss, access to medical services, social support, discrimination and stigma and risky sexual behavior. Finding revealed that around 13% of the PLHIV reported treatment failure while only 8% of participants were not >95%-adherent to ART. Around 44% of the participant had PTSD symptoms, 49.8% reported being stigmatized and 45% did not use condom during last 3 months. 5% of participants lost their family member during the earthquake. Interestingly, ART adherence is not found statistically associated with PTSD, stigma and social support; however it is associated with disclosure sero-positive status. In resource-limit countries improving access to ART drugs and eliminating social stigma can prevent ART drug resistance during natural crisis.

Biography:

Tahani Al-Rahbeni has completed her PhD from the University of Aberdeen, United Kingdom in Molecular Toxicology and Genetics. Currently she is Postdoctoral Member at the Immunocompromised host department at KFSH&RC. Additionally she is the Vice Dean at Riyadh Colleges of Dentistry and Pharmacy and the Clinical and Administrative Coordinator of the Pharmacy Postgraduate Department.

Abstract:

A major complication of antiretroviral therapy is the development of resistance mutations that limit drug effectiveness. Very limited data are currently available on emerging HIV-1 drug resistance mutations in Saudi Arabia. Here, we present HIV-1 resistance data from clinical isolates of patients referred to and treated at KFSH&RC, Riyadh, Saudi Arabia. A retrospective analysis was done on the drug resistance mutation (DRM) profiles of 450 patients at KFSH&RC, who are undergoing HAART protocols and experienced virological failure with DRM detected by sequencing. These tests were done at our reference laboratory in Mayo clinic. The evaluation for DRM was at the earliest available testing done and diagnosed within 1 year of their estimated date of infection at KFSH&RC. All necessary comparisons of mutations and statistics were made. The highest frequency for DRM was observed in RTI’s (68%) followed by (47%) for both NNRTI’s and PRI’s. Our study showed that the DRM reported was similar to the annual international report, interestingly; the profile of mutations with each drug within the antiviral group was different from the international report. Additionally, a new set of novel mutations was also seen, that were neither reported nor seen in any international ARV drug resistance report. Resistance to ARV represents an increasing problem to patients at KFSH&RC. While some are infected with viruses harboring pre-existing mutations, most resistance mutations seem to develop during treatment and may be related to wrong treatment or patient non-compliance. Dissemination of drug resistant HIV-1 adds burden to the HIV-1 epidemic in the Middle East. Annual reporting of these DRM will aid in the development of ARV protocols.

Biography:

Vaishali Gautam has completed her MBBS from Lady Hardinge Medical College, India and currently pursuing Post-graduation in the field of Community Medicine from University College of Medical Sciences, India.

Abstract:

This study was conducted to better understand HIV/AIDS vulnerability and risk of a novel study population; migrant female college students using mixed method approach i.e quantitative and qualitative explanatory method. For quantitative aspect, a randomly selected group of 100 students were recruited and administered semi-closed questionnaire assessing their HIV/AIDS related knowledge and behaviour. Further, respondents with self-reported high risk sexual behavior were screened for in-depth interviews (qualitative aspect) with the purpose to identify the factors that increased their vulnerability and risk. 21% of the respondents had inadequate HIV/AIDS related knowledge, mean age of sexual initiation was 18.7 years and 10% of the respondents showed high risk sexual behavior as none used condom consistently. Statistically significant association was observed between respondent’s high risk behavior and having friends who were sexually exposed (fischer’s exact test, p value 0.005) and also with respondent’s partner’s current place of residence [LR, p value<.001].  On conducting in depth interviews; broadly four categories emerged; Gap in knowledge and behaviour, Push, Pull and behavioural factors. Push factors like greater opportunities, peer pressure and pull factor like coerced sexual intercourse led to adoption of high risk sexual behaviour. In addition, behavioural factors like inability to negotiate condom use, embarrassment in purchasing condom and poor self-perceived risk further increased the respondent’s vulnerability to acquire HIV infection. Keeping in mind that in India, migrant female students comprises a sizeable number hence we conclude that migrant female college students are vulnerable therefore requires focus to further measure their HIV vulnerability and risk.

Biography:

Sylvia Heloisa Arantes Cruz has completed her PhD from Santa Casa de São Paulo, Brazil. She is an Assistant Professor at Santa Casa de São Paulo, Brazil and at CRT/AIDS São Paulo, Brazil. Her research is on screening anal cancer in HIV-positive patients.

Abstract:

HPV infection is responsible for warts and carcinoma in genital area. Almost 80% of the sexual active population is infected with at least one serotype. The cervix Pap smear is collected for the prevention of the cervix cancer performing a similar technique we are able to prevent anal cancer collecting anal Pap-smear. The rates of anal cancer are increasing since the start of HIV epidemic. The anal intercourse seems to be extremely related to HPV infection. Anal dysplasia is described as a precursor of anal squamous carcinoma, so anal cancer has been screened with anal Pap-smear protocol, high-resolution anoscopy and high-risk HPV DNA test. The aim of this study is to compare the findings of the screening with anal Pap-smear in 38 HIV-positive and negative patients from January 2014 to December 2015 at CRT/AIDS, São Paulo who previously had anal intercourse. The first anal Pap-smear sample was collected in 2014 and the second in 2015. The anal lesions were treated with 90% trichloroacetic acid (TCA) and 5% imiquimod for 12 weeks. The statistical analysis was performed using chi-square test and the significance level was set at less than 5%. 38 patients were evaluated, 28 were infected with high risk HPV; 10 of them presented improvement in anal Pap-smear after one year. We concluded that anal dysplasia was more common in HIV-positive patients and that high-risk HPV infection was related to anal dysplasia.

Biography:

Ezeama Martina is currently working at the Imo State University, Nigeria. Her research interest is HIV/AIDS, Public health etc.

Abstract:

Introduction: Strategies to prevent Human Immuno-deficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS among adolescents remain the greatest challenge in human development especially in developing countries like Nigeria. It is necessary to provide in school adolescents with appropriate HIV and AIDS preventive educational interventions. However, effective interventions for HIV prevention for adolescents are limited in Nigeria. This study investigated the effects of using Class-room Instruction (CI) and Drama (DR) for HIV and AIDS prevention among in school adolescents in Orlu Senatorial Zone.

Materials & Method: A quasi-experimental design using 165 students from three randomly selected co-educational secondary schools was adopted. There were two experimental groups (CI and DR) and control. Baseline data using a semi-structured questionnaire with 29-point knowledge and 9-point attitudinal scales were collected. To analyze knowledge, scores of <15 and ≥15 were classified as poor and good respectively; while for attitude, scores of <5 and ≥5 were categorized as negative and positive. The results for baseline studies were used to design interventions that were implemented for 8 weeks. Also mid-term and follow-up evaluations were conducted during the study. Data were analyzed using descriptive statistics, t-test and ANOVA at p=0.05.

Results: The mean ages of the respondents in CI, DR and control groups were 13.4±1.2, 13.9±1.5 and 13.8±1.2 years respectively. Knowledge scores on HIV/AIDS at baseline were 20.5±2.7, 20.4±2.6 and 21.1±2.7 for CI, DR and Control groups respectively. These scores increased to 22.7±2.7, 22.6±1.8 and 21.2±0.3 at mid-term for CI, DR and control, respectively. At follow-up, scores for CI and DR increased to 23.9±1.8 and 24.5±1.4 respectively while the score for the control dropped to 20.0±2.8. Scores for attitude among CI, DR and control groups during baseline study were 5.3±1.4, 4.9±1.5 and 5.3±1.0 respectively. For mid-term, attitude scores were 5.1±1.2, 5.0±0.9 and 4.7±1.5 for CI, DR and control respectively while scores for follow-up were 5.3±1.2, 5.6±0.7 and 4.5±1.2, indicating greater increase among the intervention groups than that of control.

Conclusion: Intervention using drama yielded more positive outcomes in both knowledge gained and in attitudinal change than others. Drama is therefore recommended as the most appropriate HIV intervention strategy to use for HIV and AIDS prevention among in school adolescents in Orlu Senatorial Zone, Imo State, Nigeria.

Biography:

Enwereji Ezinna Ezinne is a Professor and Lecturer in Dept. of Community Medicine, College of Medicine, Abia State University, Nigeria

Abstract:

Introduction: Partner notification is encouraged for safer sex practices and minimized HIV infection, but PLWHA report violence after disclosure. Most surveys focusing on violence HIV and AIDS have been used to assist women who experience violence but such surveys have some disadvantages. They concentrate on identifying women with violence but do not encourage the participation of such women in planning feasible interventions to reduce violence. The aim of study is to use participatory reservation approach (PRA) to involve PLWHA to identify interventions necessary to reduce domestic violence against them. Using PRA will show cost effective and efficient methods of reducing violence as well as ensuring sustainability of program.

Method: PRA was used to identify PLWHA who have experienced domestic violence. Data were collected through 12 focus group discussions and interview guides. A total sample of 96 PLWHA in network participated in the study. The perceptions of PLWHA on likely strategies for reducing violence were sought based on their local experiences. Data were analyzed quantitatively and qualitatively using simple percentages.

Results: Domestic violence was experienced by both sexes and perceived from different experiences including mutual exclusion or restriction from participating in family or community functions after disclosure. Out of 45 (46.9%) PLWHA that disclosed their status, 36 (40%) experienced violence. Interventions suggested were theater programs in public places, training male peer groups, encouraging gender equity and allowing women express their problems openly and stakeholders organizing workshops on gender inequity.

Conclusions: Result suggests that PRA is an efficient and cost effective method for sustaining interventions for reducing violence according to PLWHA perceptions. Training programs on risks of violence on HIV infection for PLWHA is need since both sexes experienced violence.

Biography:

Narendra Kumar Chopra has completed his Doctor of Medicine from MS University, India in year 1986. Subsequently he has completed his Fellowship in Tropical Medicine from London and WHO Fellowship in Leprosy Control in countries of South East Asia and Africa. He was awarded Melville Christian Memorial Award and Gold Medal in year 1995 for outstanding research in field of Leprosy. He was also awarded Rashtriya Gaurav Award in field of infectious diseases at national level. He has published more than 18 papers in reputed journals. Presently he is working as a Clinical Professor at the Faculty of Medicine, SEGI University, Clinical Campus Hospital Sibu (Sarawk) Malaysia.

Abstract:

The prospective study carried out for detecting HIV prevalence in 400 cases of STD attending Shanti ID clinic at Vadodara, Gujarat, India. All cases were screened for HIV status by ELISA and Western blot test. Out of 400 cases, 317 (79.23%) were males and 83 cases (20.75%) were females. 300 cases (75.00%) were in age group of 20-50 years, 34 cases (8.55%) were 0-20 years, 66 cases (16.25%) were above 50 years. Out of 400 cases 87 (21.75%) were syphilis, 45 cases (11.25%) were chancroid, 73 cases (18.25%) gonorrhoea, 110 cases (27.50%) herpes genitalis, 11 cases (2.75%) mollscum contagiosam, 44 cases (11%) genital scabies, 9 cases (22%) cytomegalovirus infection and 21 cases (5.24%) were having lymphogranuloma venerium. Out of 400 STD cases 67 cases (16.75) were HIV positive, amongst which 61 cases (91.04%) were HIV1 and remaining 6 cases (8.96%) were HIV2. Maximum number of STD cases was confirmed in age group of 20-50 years more in male than females, indicating high prevalence of STD in young adult population. The present study indicates screening of HIV test must be done in every STD case. The study concludes incidence of HIV is high in STD cases. Our study confirmed incidence of 67 cases of HIV positive (16.75%) and HIV1 (91.04%) is more common than HIV2.

Biography:

Nahom Tesfaluul Negassi is currently an Assistant Lecturer as well as Member of Research and Postgraduate Program in Asmara College of Health Sciences, Asmara Eritrea since 4 years. He is currently pursuing Masters in Clinical Laboratory Diagnostics, Department of Laboratory Medicine in The First Affiliated Hospital of Zhengzhou University, China.

Abstract:

Background: In resource poor countries like Ethiopia the survival of patients treated with ART depends on a variety of factors, which might vary greatly with economic, demographic, behavioral and health risk factors. However, factors affecting survival in Ethiopia are poorly understood. The aim of this study is to determine causes of mortality in adult HIV-positive patients receiving highly active anti retroviral treatment (HAART) in Dilla Referral Hospital.

Methods: The medical records of 1391 ART patients who enrolled at Dilla Hospital between 2010 and 2014 were reviewed and socio-demographic, clinical, behavioral and immunological data were collected. Multivariable Cox proportional hazards regression model was used to measure risk of death and identify the independent predictors of mortality.

Result: Out of 1391 cohorts of adults ART patients 1081 (77.7%) were alive and continued their treatment in the hospital, 128 (9.2%) were reported dead, 111 (8%) were transfer out and 71 (5.1%) were lost follow up. The probability of remaining alive and on treatment after 60 months of follow up was 89.3% for TB/HIV patients and 91.1% for HIV only infected patients. HIV patients who developed TB had shorter survival time than not developed TB. Death occurred 26% and 52% in the first 3 and 12 months of ART initiation respectively. The overall incidence rate of mortality during ART treatment was 3.5 per 100 person year observations (PYO). In multivariate analysis low body weight BMI <18.5 kg/m² (HR 3.12, 95% CI 1.39-7.76, P<0.0001), CD4 count less than 50 cells/mm³ (HR 4.55, 95% CI 1.19-8.44, p<0.002), anemia, WHO clinical stage III and IV, drug addiction and presence of active TB infection were predictor of survival and statistically significant association with mortality in HIV patients under ART follow up.

Conclusion: The presence of lower baseline CD4-cell, TB infection, WHO clinical stage III and IV, lower body weight, anemia and drug addiction were factors associated with mortality among ART clients. Improving nutritional status, prevention and control of TB and other opportunistic infections were the recalled recommendations to decrease AIDS-related morality. These determinants should be taken into account by health care providers to enhance better clinical outcomes of ART attendees.

Biography:

Adele Munsami is Research Psychologist who has completed a Masters in Research Psychology. She is a PhD candidate at the Nelson Mandela School of Medicine, University of KwaZulu-Natal, South Africa, where she will be exploring HIV Associated Neurocognitive Disorders. She is currently based at the Centre for the Aids Programme of Research in South Africa (CAPRISA), as a behavioral researcher and a study coordinator, under the guidance of Dr. Kogieleum Naidoo, who is a leading researcher in the field of TB-HIV research.

Abstract:

Consistent condom use is protective against HIV transmission. Despite this, consistent condom use among HIV infected patients remains suboptimal. In a secondary analysis of SAPiT trial data, we assessed the impact of ART initiation and knowledge of HIV status on condom use over time (condom use behaviour reported during interviews conducted 6 monthly over 24 months) and consistent condom use (condom use reported at last sex act at all 6 monthly interviews conducted at 6-24 months). Among N=642 patients enrolled, 45.8% (294/642 were previously known HIV positive, 50.5% (324/642) tested HIV positive recently, and 3.7% (24/642) had missing data. At baseline, 59.2% (174/294) of patients with previous pre-trial knowledge of their HIV status (previously known HIV positive) and 46.3% (150/324) of patients that tested positive at study entry (recently known positive) reported condom use at last sex act, respectively (p = 0.002). At 6, 12, 18 and 24 months follow-up 78.3% (173/221), 83.5% (172/206), 81.4% (162/199), 83.5% (167/200) in the previously known positive, (p < 0.001), and 81.3% (174/214), 85% (170/200), 84.6% (165/195), 86% (160/186) in recently known positive (p < 0.001) patients reported condom use at last sex act, respectively. Reports of consistent condom use in previously known positive vs. recently known positive patients was 41.8% (123/294) and 36.7% (119/324) (p = 0.216), respectively. Despite an increase in condom use following study initiation, levels of use achieved, remains suboptimal for effective HIV prevention from known HIV infected individuals. These findings have implications for targeted HIV prevention messaging within ART-treatment-programmes.

Biography:

Simon Kang ethe is currently working as a professor at University of Fort Hare, South Africa.

Abstract:

The fight against the HIV and AIDS pandemic in South Africa has proved difficult because of the state of stigmatization that the pandemic has ushered in. The objective of this paper is to discuss the undesirable effects of stigmatization and possible measures to address the phenomenon in South Africa. The paper has used extensive review of literature to generate debates and discourses on stigmatization. Findings indicate that stigmatization is still pervasive and prevalent due to communities being subjected to different and conflicting truths on HIV and AIDS from both traditional and the bio-medical practitioners; poor policy and campaign conceptualization at nascent stages of the campaign making the disease looks mysterious and fearful and inadequate community education on stigma and stigmatization. The paper recommends increased political goodwill, massive community mobilization and sensitization campaigns especially on stigma and stigmatization, benchmarking the campaign strategies with other model countries that have tackled stigma and taking advantage of South Africa’s idol personalities in the campaign who have overcome stigmatization.

Biography:

Margaret Nassim Jahangir is a Clinician working with the Kenyan Ministry of Health. She serves as an In-Charge of the HIV Clinic. She has over five years’ experience in HIV/AIDS management and runs a mentorship program in the hospital. She has obtained her Diploma in Clinical Medicine and Surgery from KMTC, Mombasa. She is the Founder of Connect to Retain C.B.O, a community based organization that promote the wellbeing of youths infected with HIV in Kilifi County, Kenya. She is an alumnus of the Mandela Washington fellowship from Tulane University, Louisiana state, a flagship program by the president of United State of America.

Abstract:

Background: Despite scale up of antiretroviral therapy (ART) in sub-Saharan Africa, patients continue to initiate ART at an advanced stage of HIV infection, leading to poor outcomes.

Method: A retrospective analysis of routinely collected data from the HIV clinic at Kilifi County Hospital was done. Adults (≥15 years) initiated ART during 2008-2013 were included. The primary outcome was late ART initiation, defined as a baseline CD4 T-cell count of ≤100 cells/µL at ART initiation. Logistic regression was used to describe risk factors of late ART initiation.

Results: Overall, 1112 (female, n=790 [71.0%]; mean age, 37.5 [SD, 10.3] years) individuals were initiated ART during 2008-2013. The mean CD4 count at initiation was 211 [SD, 212]. Nearly a third (n=346 [31.1%]) initiated ART late. In multivariate analyses, male gender (Adjusted Odds Ratio, [95% C.I.], p-value: 1.5 [1.1-2.1] p=0.014), WHO Staging (stage IV vs. stage I; 4.6 [2.3-8.9], p<0.001), severe malnutrition (BMI<16 vs. BMI>18.5; 4.9 [3.0-7.8], p<0.001) and pre-ART duration (<6 months vs. >12 months: 2.7 [1.8-4.1] p<0.001) were associated with late ART initiation.

Conclusion: Findings show that about 1/3 of patients are initiating ART late. Patients who initiated ART<6 months after enrolment were more likely to have advanced HIV infection, suggesting that the clinic is succeeding in initiating ART rapidly but failing to catch patients early for enrolment into care. Men are particularly at risk and more needs to be done. Findings also emphasize use of malnutrition and advanced clinical staging as indicators to target sick patients for ART initiation, rather than waiting for CD4 testing.

Biography:

Fasika Esatu has completed her Master’s degree from University of Gondar, School of Medicine & Public Health. Currently she is the Regional Coordinator for the President's Emergency Plan for AIDS Relief (PEPFAR) USAID/E HIV Prevention & Care Support Program implemented by World Vision Ethiopia.

Abstract:

Sexual violence is a violation of human rights and a serious public health problem. It has a profound impact on physical and mental health, both immediately and many years after the assault. To date, sexual violence has received insufficient attention from researchers, policy-makers and program designers and it has been a long struggle to have it recognize as a legitimate public health issue. This study aims to assess the magnitude of sexual violence and its adverse RH outcome on house maids and to compare the adverse RH outcomes on sexually violated and non-violated maids. A cross-sectional analytical study was conducted among 523 house maids in Hawassa. After the quantitative data was collected using self-administered questionnaire data was entered, cleaned and analyzed using SPSS software. The life time prevalence of sexual violence were 15.3% with 95% CI (12.2, 18.4) and the 12 month prevalence of sexual violence were 5.9%. In this study the likely hood of experiencing sexual violence is higher among house maids who use any substance. The prevalence of any adverse RH outcome was 14.5% with 95% CI (11.5, 17.6) and the likely hood of experiencing adverse RH outcome is higher among those house maids who ever use any substance and house maids who experience sexual violence.

Biography:

Sukhvinder Kaur had her professional education and training in the area of Statistics, Monitoring and Evaluation, Management Information System and Research and has rich and diverse experience of 12 years of working with larger developmental causes like Reproductive and Child Health Care, HIV/AIDS and Tobacco with Ministry of Health and Family Welfare, India. She has also worked closely with stakeholders across varying levels, like government departments, development partners (CDC Atlanta, USAID, UNICEF, UN etc.) academia and research organizations in the area of Health interventions.

Abstract:

Introduction: Migrants are at risk of HIV-infection and transmission to their spouses. Therefore, migrant interventions should also address spouses of migrants in the place of origin. USAID PHFI-PIPPSE project is supporting National AIDS Control Organization in developing a comprehensive strategy for migrants at source and destination states.

Methodology & Theoretical Orientation: A cross-sectional survey was conducted in 2014 among 880 Currently Married Women (CMW) aged 15-49 years from high out migrant districts, i.e., Gorakhpur in Uttar Pradesh (State) and Cuttack in Odisha (State). In this paper, bi-variate and multivariate logistic regression methods have been used to investigate the association between exposure to intervention services and the safe sexual behaviour among CMW at source states.

Findings: In bivariate analysis, there is statistically significant and positive association between exposure to interventions and safe sex measures-HIV/AIDS testing and condom use. However after controlling the socio-economic and demographic variables, we found that majority of the intervention variables are not significantly associated with condom use and with HIV/AIDS testing. But, “attending the health and nutrition day meeting” [OR=1.036, p<0.05, CI (1.005-1.067)] is positively associated with HIV/AIDS testing among women and there is negative significant association between receiving HIV counselling service [OR=0.969, p<0.05, CI (0.938-1.001) and condom use.

Conclusion: The results corroborate that exposure to intervention not always leads to the safe sexual behaviour among CMW. The findings raise question on quality of exposure that women receivedon HIV/AIDS prevention at source states. An urgent intervention with ensured quality services is needed to promote safe sexual behaviour among CMW having migrant or returned migrant husbands at source states.

Biography:

Moges Amare Ambaw has completed his degree in Midwifery from Addis Ababa University and he is currently pursuing Clinical Internship. He was the Head of MNCH Department in St. Peter Hospital. He is also a Lecturer in Menilik II Health Science College and Trainer on PMTCT, Basic Emergency Obstetric and Newborn Care (BEmONC) and Family Planning.

Abstract:

The HIV/AIDS pandemic has succumbed millions of people throughout the world since it was first described in the early 1980s. In the past three decades the world has learned that HIV/AIDS is not only a health problem that can be addressed solely by the health sector but it is a social, economic, development and security issue that needs the united endeavors of all sectors including the public, private, religious, social and cultural structures of nations. This problem is worse in non-developed countries like Ethiopia. The prevalence of HIV at PMTCT site has shown a four-fold decrease during the five years period. The studies shows only 53% of known HIV positive mothers and 48% of known HIV exposed infants have received ARV prophylaxis. The estimated ARV coverage was found to be 11.6% for HIV positive mothers and 8.4% for their babies. Transmission of HIV from mother to child is mainly during pregnancy (Labor & delivery and during breast feeding). To prevent the transmission the four prongs must be implemented: Primary prevention of HIV infection; Prevention of unintended pregnancies among HIV-infected women; Prevention of HIV transmission from HIV-infected women to their offspring; and Provision of care and support to women infected with HIV, their infants, and their families. So integrating PMTCT service in all health system or sectors should be enhanced and need all stakeholders’ involvement.

Biography:

Ashenafi Kebede Debela has completed his BSc in Nursing from Addis Ababa University College of Health Science. He has been working in the Pediatric HIV and HAART Clinic in the same tertiary hospital where he has harvested lots of experience in pediatric HIV and Care. He is currently a Master’s student in Child Health at Addis Ababa University, Ethiopia.

Abstract:

Most studies conducted on HIV disclosure to infected children report on the challenges experienced by care givers to disclose HIV status to their HIV infected children. Objective of this study was to assess magnitude and factors affecting care givers’ disclosure of HIV diagnosis to their HIV infected children in Tikur Anbessa Hospital, Addis Ababa, Ethiopia. A facility based cross-sectional study was conducted from February 2015 - June 2015 among 239 primary care givers of HIV infected children aged 6- 18 years in Tikur Anbessa Hospital, Addis Ababa, Ethiopia. In this study, 25.9% of HIV-positive children were disclosed their HIV-positive status. The lower prevalence of disclosure in this study might be due to fear of stigma and discrimination by the family members, neighbors and friends. There is a need for the development of new appropriate disclosure guidelines and modules for health care providers and parents/caregivers as there was a low rate of disclosure; moreover, parent/caregivers expressed the need for assistance from the health care providers for future disclosures. Such guidelines should particularly focus on how to disclose the diagnosis of HIV to the infected children.

Biography:

Tukov is a Public Health researcher in Cameroon. He is participating in PhD program of School of Medicine, Griffith University, Queensland, Australia. His research concentrates on transmission, knowledge, attitude and sex behaviors among female sex workers in Cameroon. Before the PhD program, Tukov taught and studied in Public Health and Health Promotion for 8 years with a number of researches and projects in health prevention field.

Abstract:

Female sex workers (FSWs) are at heightened risk of sexually transmitted infections (STIs) and HIV. The purpose of this systematic literature review of STI/HIV prevalence for FSWs in Central Africa is to appraise and understand the burden of STIs and HIV.

Electronic databases searched included PubMed (MEDLINE), Embase, Global Health, MeSH, Cochrane Library, Health Reference Center, Pro Quest, Psyc INFO, Science Direct, Social Services Abstracts, SCOPUS, CINAHL, Web of Science, and POP Line. Relevant articles published from 2007 to 2012 were identified. The findings of this multi-country regional review provided reliable evidence that despite prevention efforts, FSWs remain one of the main populations most affected by HIV/STIs. The review reveals that the prevalence of HIV/STIs among FSWs in a number of African countries is high, especially in Cameroon and Nigeria, two countries with the highest HIV and STI prevalence. Furthermore, FSWs who work on the street, or freelance, or use multiple venues are significantly more likely to be infected with HIV/STIs than those who work from a single venue.

Biography:

Emmanuel has completed his Masters in Public Health from Makerere University School of Public Health. He is a Teaching Assistant in the department of Biostatistics and Epidemiology at the School of Public Health. His Research filed of interest include; Infectious Diseases (HIV and Tuberculosis); Maternal and Child Health. 

Abstract:

In 2010, the Uganda AIDs Information Center (AIC) designed an integration service model of the sexual reproductive health, HIV and maternal health, and piloted this in Katakwi and Mubende districts. However, there isn’t any information about the implementation process to guide model scale-up. This study evaluated the implementation process of the integrated model in the two districts to come up with suggestions for improved delivery of integrated services. A descriptive qualitative study was conducted during May to July 2014. Key informant interview were conducted with 21 health district managers and health workers, and 10 Focus Group Discussions (FGDs) with service users each comprising 6-10 members. A records review of monthly reports and health registers at districts for period 2010-2013 and in the health facilities for 12 months was done. Data were manually analyzed following a thematic framework approach. Several challenges were faced in the attempt to provide integrated services. Such included staff related challenges: staff shortage and absenteeism, knowledge gaps among health workers and high expectations of mothers. Other challenges were system related: limited space, stock outs of supplies and informal service charges; and service user’s challenges: failure to uphold confidentiality by health workers and unfriendly services for young mothers. The pilot implementation process of the integrated service model experienced several setbacks. Program managers at AIC need to pay much attention to these challenges prior to further scale-up to any other districts of Uganda. 

Biography:

Murugi Ndirangu is an Associate Professor in the Department of Nutrition and Healthcare Management in the College of Health Sciences at Appalachian State University, USA. Her research focuses on understanding the health of vulnerable populations and the efficacy of nutrition interventions for these groups in domestic and international settings. She has experience in global nutrition, HIV, food security and immigrant health.

Abstract:

Background: Malnourished HIV-positive individuals initiating antiretroviral treatment (ART) have increased risk of morbidity and mortality. Individuals who are food insecure may have increased risk of co-morbidities, making it difficult to gain or maintain weight. Co-morbidities with malnourishment can increase risk for opportunistic infection and cause mortality. Food supplements provided as part of a comprehensive ART care program may reduce food insecurity in resource limited settings. This study was based in Central Kenya and compared the household food security of HIV-positive participants receiving food supplements and nutrition counseling to participants receiving counseling only.

Methods: The FANTA III Household Food Insecurity Access Scale (HFIAS) was used to measure household food security of participants in the two groups. The Treatment Group received food supplements and nutrition counseling and the Control Group received nutrition counseling only for 24 weeks each. Household food security data were collected at baseline 24 and 48 weeks to detect how food supplements might impact food security. Data were analyzed with descriptive statistics and repeated measures ANOVA in SPSS Version 22 to observe differences among HFIAS scores across time.

Results: Compared to the Control Group’s improvement in food security across 48 weeks, the Treatment Group’s food security peaked at 24 weeks (p=0.026), then declined by 48 weeks (p=0.002) but did not decline to baseline.

Conclusion: Food supplementation can be effective in decreasing levels of food insecurity in HIV-infected populations.

Biography:

Isaac Iniabasi Effiong is a Research Scholar at Mayo Clinic in Florida. He graduated with distinction from the Master of Public Health program of the University of West Florida and is certified as a public health practitioner. He completed his medical education and did graduate residency training in obstetrics and gynecology at the University of Calabar. His research areas of interests are in public health and reproductive health/sexual health including HIV/AIDS and STD. He has published a research article on male infertility and presented 2 posters on reproductive health research.

Abstract:

The reported increase of cases of sexually-transmitted disease (STD) in the United States is fast becoming a health challenge in the country (CDC, 2016). Family physicians can play an important role in preventing new cases of STD in their patients by initiating discussion and advising patients on safe sexual practices during sexual health and non-sexual health consultations. A number of barriers may prevent a family physician from initiating discussion and advising patients on safe sexual practices. The purpose of this study was to identify the possible barriers to the initiation of discussion and advising of patients on safe sexual practices by Mayo Clinic Florida family physician. Data for the study was collected by written surveys. The survey assessed respondent gender, age group, level of medical education and possible barriers to their initiation of discussion and giving of advice to patients on safe sexual practices. With the study, it is hoped that improved knowledge of the perceptions and practices of family physicians in Mayo Clinic-Florida regarding the initiation of discussion and giving of advice to patients on safe sexual practices will arise. The knowledge may, in turn, contribute to better patient care, as the Continuing Medical Education or Clinical Training Program of family physicians may be adjusted to better prepare them to initiate discussion and give advice to patients on safe sexual practices.

Biography:

Rebeca Antunes Beraldo is currently a PhD student of HIV and Cardiovascular Disease at Ribeirao Preto Medical School, University of Sao Paulo, Brazil. She has completed her Master’s degree in 2013. She has been working with HIV patients since 2010, during her specialization period just after graduation in Nutrition at University of Sao Paulo. She has experience in HIV and clinical nutrition area with emphasis on the assessment of nutritional status. She has published 8 papers in reputed journals and has revised many articles of high impact factors’ journals.

Abstract:

Introduction: Several studies have found an association between HIV infection and the development of cardiovascular diseases. The probable etiologic mechanisms include inflammatory and chronic infectious process of the disease, in addition to the adverse effects of highly active antiretroviral therapy (HAART), which would promote metabolic changes towards an atherogenic profile.

Objective: To evaluate the metabolic profile of HIV patients on HAART.

Methodology: Biochemical tests of lipid profile and fasting glucose were performed. Systemic blood pressure was measured and ankle brachial index (ABI) exam was performed to evaluate peripheral atherosclerotic disease (PAD). Waist circumference (WC) was measured. The criteria suggested by The National Cholesterol Education Program III (NCEP-ATP III) to identify metabolic changes were used. It was also calculated Framinghan risk score (FRS). Duke treadmill score (DTS) was calculated based on results from the exercise test, including ST-segment depression, chest pain and exercise duration.

Results: We evaluated 448 patients (53.6% male) with a mean age of 44.13±9.93 years. Among the metabolic disorders, the most frequent changes were reduced HDL cholesterol (66.29%) and hypertriglyceridemia (45.98%). PAD (according to ABI) was present in 27.68%, while hypertension was present in 24.77%. The majority (62.50%) of patients had abdominal obesity. According to FRS, 34.37% of patients had absolute risk of heart attack in 10 years >10%. Also, according to DTS, 10.0% were at moderate risk.

Conclusions: The atherogenic metabolic profile of most of the patients highlights the importance of early intervention to prevent cardiovascular complications.

Biography:

Lilian Andreia Fleck Reinato has completed his Master degree in 2012 from University of São Paulo at Ribeirão Preto College of Nursing. She is currently a Doctoral student, Member from research group STI, HIV and AIDS since 2010.

Abstract:

People living with HIV/AIDS (PLWH) are highly vulnerable to colonization by sensitive and/or resistant microorganisms, some risk factors are previous hospitalization and use of antimicrobials. We conducted a cross-sectional study in two hospital units’ specialized care in HIV/AIDS. The nasal secretion samples were collected from PLWH hospitalized in the period from August 2011 to February 2015. All hospitalized patients were invited to participate in the study; the samples were composed by those who had more than one hospitalization during the collection period. Each patient was tested by the presence or absence of a nasal microorganism in the first and subsequent hospitalization. The descriptive statistics were used, obtaining the frequency of each variable and the analytics to compare the groups by the chi-square test or Fisher's exact test; it was considered the significance level as 5%. The data were analyzed using IBM SPSS version 20.0. The ethical aspects were contemplated. From the 527 participants 84 had more than one admission, that’s the study sample. The average age was 40 years (SD±9.1), 64.3% were male and 66.7% reported being white ethnicity, were using antimicrobial 72.6%. The successive hospitalizations were more observed among males (85.2%). Current antiretroviral therapy or use antimicrobial did not impact the association of microorganisms colonization (p=0.650; p=0.255), respectively. The presence of microorganism was identified in 53.6% of patients in some hospital. Staphylococcus aureus was isolated in 65.5% of samples when grouped all hospitalizations. The knowledge about the status of colonization of PLWH contributes to institute preventive measures to future infection.

Biography:

Lilian Andreia Fleck Reinato has completed his Master degree in 2012 from University of São Paulo at Ribeirão Preto College of Nursing. She is currently a Doctoral student, Member from research group STI, HIV and AIDS since 2010.

Abstract:

People with HIV/AIDS (PLWH) with a compromised immunity and high number of admissions with prolonged use of antimicrobials they are favorable to colonization by numerous microorganisms in the hospital environment, including Staphylococcus aureus. Health professionals, especially nursing professionals during direct contact with these patients, objects and surfaces, constitute a class susceptible to colonization by resistant pathogens. The aim to study was to evaluate the colonization by Staphylococcus aureus in saliva and nasal secretion of nursing professionals who care for PLWH. Cross-sectional study conducted in five inpatient units in state of São Paulo in Brazil. Saliva samples and nasal secretions were obtained from nursing professionals in three stages in the period from April 2014 to February 2015. The nasal secretion samples collected were processed in the institution's microbiology laboratory. All ethical aspects were included. 100 nursing professionals are participated in the study (19 registered nursing, 22 nursing technicians and 59 nursing assistants). The clinical experience was mean 12.9 (SD±7.6) years. We identified 43 (43.0%) nursing professionals with positive cultures to Staphylococcus aureus in the saliva and/or nasal secretions; of these 36 (36.0%) were oxacillin-sensitive Staphylococcus aureus and seven (7.0%) to oxacillin-resistant Staphylococcus aureus. Regarding to training about standard precautions 91 (91.0%) of the professionals nurses received training. The prevalence of the Staphylococcus aureus in the nasal secretion was 32.0% and saliva 1.0% and both were 10.0%. The training about standard precautions is a measure, essential in preventing the risk of the colonization of these microorganism and infection control.

Biography:

Ibtehaj S Al-Sharif has completed her Bachelor’s degree from the King Saud University, Kingdom of Saudi Arabia in Biochemistry. She is currently a Research Assistant at the Immunocompromised host department at KFSH&RC. She has 6 publications to her credit.

Abstract:

Human immunodeficiency virus, type 1/2 (HIV-1/HIV-2) are both lentivirus that cause acquired immunodeficiency syndrome (AIDS). Unlike HIV-1 virus, the HIV-2 is distantly related to HIV-1, the virus responsible for the global AIDS pandemic. Although HIV-1 and HIV-2 have similar transmission routes and can cause immunodeficiency, patients infected with HIV-2 have lower viral loads than those infected with HIV-1. Therefore, up to date, an HIV-2 viral load assay (or diagnostic test) does not exist. Accordingly, our aim was to develop a sensitive viral load assay utilizing digital PCR to quantify HIV-2 RNA in plasma and to validate it for clinical use. A real-time polymerase reaction (RT-PCR) assay is used that amplifies HIV-2 (LTR region) in parallel with a whole virus internal control; derived from a Mouse Hepatitis Virus (M gene), to monitor the assay performance. In addition a reference of viral stock of HIV-2 is used to report the absolute number of HIV-2 RNA in International Units (IU). The same method was repeated using the stock HIV-2 only, utilizing the digital PCR to validate the viral load assay. Our assay was able detect as low as 8 IU/mL from patient samples which is below the reported minimum level of HIV-2 detection using standard protocols. Our results also show high specificity to HIV-2 with validated reproducible results.

Biography:

Dr. NWAKO Okechukwu Francis had his B.Sc in Applied Microbiology(upper credit ) in 2001 and proceeded to Medical School where he graduated in 2009. In 2012, he obtained his M.Sc( Medical Microbiology) and has completed his Ph.D course work in Medical Microbiology with major in Mycology. He hope to complete his research work by 2016. He obtained his Primary in Internal Medicine in 2010 and became a specialist in Internal Medicine in 2015 from the West Africa College of Physicians. He has published several original articles in international journals and has attended several conferences both locally and internationally including the famous HIV/AIDS 2013 organized by OMICS conferences. He has reviewed many articles for British Journal of Medicine and Medical Research and Journal of AIDS.

Abstract:

Biography:

Lamin Ceesay a Gambian and a person living with HIV, I was diagnosed in October 1998. I joined Santa Yalla Support Society in January 1999. I declared my status during World AIDS Day December 2000. I started advocating for universal access to treatment Care and Support for people living with HIV from December 2000 to date.

Abstract:

Introduction:

•                      As a Person living with HIV (PLHIV) I speak frequently in public about the challenges faced by PLHIV. PLHIVs, especially Women and Girls face serious problems of stigma and discrimination. We need to address stigma and discrimination by developing a stigma reduction strategy, demystify ignorance and the fear of AIDS.

•                      I also believe that we PLHIV’s are best placed to stop the further spread of the Virus by disclosing our status and create more awareness among individuals and communities of the need for behavior change. We need to promote correct and consistent use of condoms to prevent the spread of the virus.

•                      Santa Yalla organizes training workshops on HIV for our members to create awareness about positive living for PLHIV. People want to know if I am still having sex and if yes, with whom. They want to know whether my children know my HIV status.

•                      We also conduct community HIV sensitizations meetings. We invite five villages in one forum. We meet with the village chiefs and elders and explain our mission and agreed with the chiefs that each Village should come with two elderly Men, two elderly Women, three boys and three girls, and they will all assemble in the bigger Village in that surrounding, and if the village chiefs agreed we select and agreed on a date for the meeting, and they should announce it to every-body in their communities. After all these we will do a follow up to see if the announcement have reached everyone to attend the meeting, and we will invite the Imam and the Pastor to do the opening prayers to bless the occasion.

•                      After the opening prayers, the introduction is done by the Program Manager, followed by presentation by a PLHIV during which we cover: HIV/AIDS and STIs, HIV counseling & testing, importance of PMTCT, HIV Stigma and Discrimination, Care and Support for PLHIV.

•                      We provide counseling & testing with partners. We do the counselling and our partner provide testing services. Taking this approach, we have made a lot of progress; a high number of people now know their HIV status.

•                      Follow up after testing is also conducted to those who tested positive to support them enroll into care and into the HIV Support Groups.

Conclusion:

For effective response to the HIV & AIDS epidemic, concerted efforts are required and PLHIVs actively participate in the planning, implementation and monitoring of the HIV program.

Biography:

Hernandez Requejo D work in Tropical Medicine Institute in attendance prescribes and research in progression markers and oxidative stress in patient HIV/AIDS with antiretroviral treatment. She has participated in many courses and national and international congress. She has publications in reputed journals.

Abstract:

Background: Infection with the Human Immunodeficiency Virus (HIV) is a major health problem. The functional capacity of the immune system gradually declines with aging.

Objective: To demonstrate that the elderly patients with HIV/AIDS who follow treatment with antiretroviral drugs present a fall in viral load and a rise in the CD4+ T-lymphocytes with this treatment.

Methods: A cross sectional prospective observational study was conducted in 44 HIV/AIDS patients attended in the Medical Services offered by IPK who received treatment with different antiretroviral schemes.

Results: It was observed that there was an average rise of 97 cel per µL in the CD4+ T-lymphocytes, as well as an average fall of 3583 cp/µL in viral load after the antiretroviral treatment.

Conclusions: With this study, we can conclude that there was a rise in CD4+ T-lymphocytes and a fall in the viral load in the elderly patients with HIV/AIDS who followed treatment with antiretroviral drugs, what evidences the immunological reconstitution and virologist control of these patients with the use of antiretroviral therapy.

Biography:

Bayelign Girma Gedamu has completed his Nursing degree at Haramaya University in 2009 and currently a MPH student at Addis Continental Institute of Public Health. He is also working at St. Peter TB Specialized Hospital as a Nursing Coordinator in Clinical Trial on Standardized Treatment Regimen on Anti-tuberculosis drugs for patients with MDR-TB (STREAM).

Abstract:

Background: Adolescents girls (10-19 years) in Ethiopia represent over 45% of total population. Many national and international non-governmental health agencies are running programmers to reduce the incidence of STDs. The larger the age gaps between sexual partners, the greater the likelihood of being STDs and HIV-infected. I can provide an insight to the reproductive and sexual health needs of adolescent’s girls in urban high schools by assessing their knowledge, awareness and practice about these diseases.

Objectives: To assess the knowledge, awareness and practice among adolescents girls regarding sexually transmitted diseases.

Study Design: A descriptive quantitative cross sectional study was conducted at ENTOTO high school adolescent girls. Total of 384 subjects was selected using to phase of selection from February 2014 to April 2014.

Results: All the selected sample students (384) filled the self-administered questionnaire properly. So that non-response rate is zero. Out of 384 (100%) sample students who fill the self-administered questionnaire 306 (79.69%) knows the signs and symptoms of the STDs and 78 (20.31%) did not know about STDs, 336 (87.50%) knows the route of transmission of STDs and rest 48 (12.50%) did not know the route of transmissions. From the total sample, 229 (59.63%) students had history of sexually transmitted infections.

Conclusions: Appropriate health care seeking behavior and information education and communication activities should be promoted to adolescent girls.

Biography:

Dr Dike Chidi Clement is the Medical Officer in-charge at the IMO state polytechnic orlu campus medical Centre, he is also the Medical Director Sancta Maria hospital orlu. He has interests in research and has an MSc in clinical pharmacology.

Abstract:

Human immunodeficiency virus is the causal agent of the dreaded disease AIDS with hundreds of thousands of new cases per year. Infected individuals are faced with a myriad of challenges in a world that is hostile and unsupportive. Amongst the many problem faced by PLWHA is depression. Depression a psychiatric disorder associated low self esteem and a feeling dejection. We found that depression is more common in females with HIV than males. When compared for prevalence, is higher in white females (56%) than black females (34%) have recently emerged as a significant factor in management and prognosis of HIV.

In the medical management of HIV more emphasis is placed on the highly active antiretroviral therapy while bypassing other treatment modalities which might have synergistic effects. This unfortunate scenario is so because there are few established guidelines for identifying and treatment of depression in PLWHA. However further studies would go a long way to improve understand other implicated variable.

Biography:

Ireen Kapaba Silweya has completed BA in Education from University of Zambia and a Diploma in Management for International Public Health from Emory University/SMDP. She is currently pursuing Masters in Leadership and Administration. She has previously managed several projects focusing on HIV and AIDS working with vulnerable groups and communities. She currently also facilitates as a part time Lecture at the University of Zambia, School of Medicine, under the community medicine department. She has previously presented papers on effects of HIV on vulnerable groups (school children etc) at the Global Health Council, Reproductive Health Conference among others. Currently she is the CEO of Barefeet Theatre, Zambia.

Abstract:

Barefeet is a Zambian local NGO working with vulnerable youths on the street and those with potential to get onto the street for various reasons and very exposed to contracting HIV. Barefeet uses and empowers these identified youths with theatre and art skills in a transformative manner in 40 centers working with over 15,000 target audience. The youths then step out into target communities to engage the community members (normally average of 500 per community audience) and through a process participatory performance (PPP) approach using theatre, key messages on HIV are shared with the communities among other themes. The trained youths act as change agents and role models to discuss the HIV issues using creative performance theatre. The youths remain as community creative theatre groups to conduct continuous awareness creation and knowledge providers on HIV/AIDS, STIs and STDs among other health issues. The use of by participatory and creative theatre by Barefeet has proved very effective and has achieved several outcomes including; increased access to testing, access to medical checkups, reduction of stigma, improved community support of the HIV affected and infected community members, especially youths who see the fellow youths performing as role models.

Biography:

Ali Nikfarjam is the Head of Diseases Control and Prevention group at Deputy of Health, Tehran University of Medical Science (TUMS) since 2010. He was the HIV/AIDS/STI Expert in TUMS for five years. He is a Member of research committee in Deputy of Health, Tehran University of Medical Sciences. His professional experience includes epidemiology of communicable disease infection control and outbreak investigation. He is also a Member of hospital infection control committee and research committee of Tehran University of Medical Sciences.

Abstract:

Infection of human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) is one of the grave health concerns confronting global public health. According to UNIDS recent statistics, more than 35 million people have died and about 30 million people are currently living with HIV/AIDS. There remains a need to better understand the prognostic factors affecting the long-term survival in patients with HIV/AIDS, particularly in developing countries. We extracted data from 487 patients’ medical records available at a clinic for behavioral diseases in Tehran University of Medical Sciences. The sample included 433 (88.9%) male patients while 54 (11.1%) of the subjects were female. The mean age and related standard deviation of the patients were 39.4 and 11.8 years, respectively. The outcomes of interest were the survival rates of progression to death in AIDS-positive subjects. The effect of several prognostic factors on survival time was investigated. One-year, five-year and ten-year survival rates from time of AIDS diagnosis to death were 91%, 73% and 31%, respectively. Hazard ratio of progression to death in AIDS-positive subjects who were co-infected with tuberculosis was 5.66 (p=0.001) whereas hazard ratio of death from AIDS-related causes was 3.20 in patients who did not receive highly active antiretroviral therapy compared to those who did (p=0.04). Co-infection with tuberculosis was one of the most important prognostic factors of progression of AIDS. Antiretroviral treatment was found to be an effective measure in suppressing HIV viral replication and improving the survival of patients living with AIDS.

Biography:

Abstract:

Background: Sexually transmitted infections (STIs) cause devastating sexual and reproductive health complications if poorly treated. Moreover, people with STIs are at higher risk of acquiring or transmitting HIV infection. Thus, programs for the prevention and treatment of STIs remain important elements of HIV prevention programs. World health organization (WHO) recommends 90% of primary point-of-care sites provide comprehensive care for people with STIs by 2015.

Objective: To assess quality of STIs case management and identify its determinant factors.

Methods: Health facility based survey was conducted from May 16 to 26, 2016 in Adama town which is the one of the largest towns in Ethiopia and popular host spot for commercial sex. First, a total of 66 STIs case management service providing units were randomly selected. Thereafter, health care providers working in the units were surveyed employing contextualized WHO tool.

Result: Generally, 62 (94%) providers responded to the interview. 45 (72.6%) of the respondents treated a total of 211 STI cases in a month preceding the survey. Out of 53 (85.5%) providers that responded they use syndromic approach for STI case management, only 29 (54.7%) providers correctly mentioned treatment for urethral discharge syndrome. Receiving no training on national guidelines was found significantly associated with stating incorrect regimen (c²_corrected=6.40; p=0.01). For vaginal discharge syndrome, also, only 20 (37.7%) providers correctly mentioned the treatment. Receiving no training (c²_corrected=14.00; p<0.001), less than 5 days training (Fisher’s exact test p=0.038) and being diploma level profession (c²_corrected=7.85; p=0.005) were found significantly associated with stating incorrect regimen. Concerning genital ulcer syndrome, only 2 (3.8%) providers correctly mentioned the regimen.

Conclusion: Quality of STI case management was poor at health care facilities in Adma town.

Recommendation: Training of health care providers on national guidelines for STI case management for at least five days is one of the mainstays to improve quality of STI case management.

Biography:

Mebratu Mitiku (MSc in CTID M) Coordinator of MSC program in Clinical Tropical I fectious disease Medicine (CTID Med) at University of Gondar, College of Medicine and Health Sciences Department of Internal Medicine.

Abstract:

Utilization of dual contraceptive methods can reduce both high fertility problem, Human immunodeficiency virus (HIV) and the transmission of resistant HIV strain between partners. This study aimed at assessing the prevalence and associated factors of dual contraceptive use among HIV positive women attending care at Gondar University Hospital, Northwest Ethiopia. An institutional based cross-sectional study was conducted among women attending at Gondar university hospital. Systematic random sampling technique was employed to recruit 630 participants from July to August, 2013. A pretested and structured questionnaire supplemented with chart review was used to collect data. Data were entered to EPI INFO version 3.5.3 and exported to SPSS version 20 for further analysis. Descriptive statistics was employed. Logistic regression was carried out and odds ratio with 95% confidence intervals were computed to identify associated factors. Dual contraceptive use was found to be 13.2%. Age of the respondents (AOR=0.17; 95% CI=0.04-0.63), counseling from health care providers (AOR=0.26; 95% CI=0.12-0.58) and spousal discussion about dual contraceptive (AOR=19.00; 95% CI=8.32-43.36) were associated with dual contraceptive use. In this hospital dual contraceptive was low. Integration of HIV care follow-up clinic with family planning should be emphasized.

Biography:

Babayemi Oluwaseun Olakunde is an Assistant Chief Program Officer in the programs coordination department of the National Agency for the Control AIDS, Nigeria. He is a Graduate of Medicine and Surgery from Obafemi Awolowo University, Nigeria and holds a Master’s degree in Public Health from the University of Sheffield. His research interests are in health policy, planning and financing.

Abstract:

The recent insurgence in the Nigeria has contributed to the upsurge in the number of internally displace persons (IDPs) particularly in the Northeast zone. It is estimated that about 2 million persons are internally displaced. Most of these IDPs are sheltered in formal and informal camps in the affected areas. Among other diseases, IDPs are vulnerable to HIV infection. Factors such as sexual and gender-based violence, exploitation, social instability and poverty predispose IDPs to HIV infection. Despite their vulnerability, access to HIV prevention, treatment and care services remains a major gap in many camps. The National Agency for the Control AIDS coordinated the implementation of HCT outreach in three states in the Northeast zone of Nigeria. The 4-day outreach was held simultaneously in 14 camps across the three States (5 in Adamawa, 4 in Borno and 5 in Yobe). The outreach was a single disease approach with focus only on HIV. Incentives such as clothes, food items and toiletries were provided in some camps to enhance uptake. The HCT was done by trained counsellors and testers and services were provided in line with the Nigerian national testing algorithm. All the positive clients were referred for HIV care and treatment. A total of 14,403 IDPs were tested out of which 5,041 (36%) were males and 9002 (64%) were females. Sixty-two (0.4%) IDPs tested positive (Male: 18; Female: 44). The positivity rate among females (0.5%) was higher than males (0.4%). The positivity rates in the camps were lower in comparison with the prevalence rate in the general population (Adamawa: 0.2% vs. 1.9%; Borno: 1% vs. 2.4%; Yobe: 0.3% vs. 5.3%). However these may not be representative of the entire IDP population as these were IDPs that had access to formal camps. There is a need to promote HIV prevention in IDP camps through the minimum prevention package intervention (combination prevention approach) and also ensure linkages to treatment and care for HIV positive IDPs. Enumeration and mapping of locations of IDP camps is imperative to facilitate the smooth provision of these services.

Biography:

Dominique Savio Habimana has completed his MBChB in 2013 from National University of Rwanda, since then he has been appointed in Internal Medicine Department as the Head of Department of HIV and other STIs.

Abstract:

Alpha-fetoprotein (AFP) is a serum glycoprotein secreted by the liver in fetal life and by liver tumors, even though not very specific but being the most available and affordable in our settings, it has been used as a predictor of cirrhosis and hepatocellular carcinoma in HIV and HBV co-infected versus solely HBV infected patients. This study was aiming at assessing the real impact of HIV on the prognosis of HBV infected patients. A random study with neither sex nor age selection was conducted for 50 HIV and HBV co-infected and 50 solely HBV infected patients attending our Internal Medicine Clinic. The findings were: For all co-infected patients, the level of AFP was considerably higher, 6 times than the solely HBV infected patients: 36 HBV and HIV co-infected patients were with remarkably increased AFP level with worse clinical manifestations whereas for the solely HBV infected, only 6 showed AFP level that was above the upper limit with relatively light clinical manifestations; among HIV and HBV co-infected patients, only 4 cleared the HBV infection while for the other part 20 of them cleared.The remaining ones were with dormant, non-active infection. In conclusion; HIV is an accelerator of HBV infection towards hepatocellurar carcinoma as well as liver cirrhosis and bad prognosis in general.

Biography:

Jean-Daniel Ndikumana. I am from Burundi. I left Burundi for Belgium where I got because of my sexual orientation and gender identity my refugee status.

Currently, I work in an association whose objective is the defense, promotion and structuring of secularism in Belgium: the Lay Action Center of the Province of Luxembourg (CAL/Luxembourg). I am committed as leader and I am also in charge of a project aimed at asylum seekers LGBTQI set up by the service Maison Arc-en-Ciel of Lay Action Center of the Province of Luxembourg.

LGBTQI activist in Burundi since 2009, I am a representative of MSM in East Africa AFYA MINORITY and defender of human rights in East Africa and the Horn of Africa.

Abstract:

Immigrants and LGBTI refugees account for a growing proportion of people living with HIV worldwide. This highlights the need to establish equitable services in prevention awareness, treatment and support to immigrants and refugees infected and affected by HIV. Immigrants and LGBTI refugees living with HIV face complex barriers that have a significant impact on their health and well-being as well as their ability to become full citizens. Immigrants and LGBTI refugees living with HIV face complex challenges like trauma inherent in the course of any immigrant; the complexity of the immigration system in the host country; the difficulties of adapting to a new culture; accessibility problems in housing and employment and prejudice and discrimination both within their own cultural community and in society in general. These people also face barriers in terms of access to HIV information, treatment and support; these obstacles are caused by language barriers and other cultural divisions and the lack of medical knowledge and systemic discrimination. All these constraints and obstacles have considerable impact on the health and welfare of these people, as well as their ability to become full citizens. People living with HIV are very afraid that their application be rejected, especially since the HIV test is mandatory for all new entrants who apply for immigration.

Biography:

Calleb Onyango is a master’s student at Maseno University and serves as senior medical laboratory technologist with ministry of health, department of national blood transfusion services of Kenya. He serves in the department of microbiology as analyst of blood pathogens. In addition, he is a team member in strengthening of laboratory management towards accreditation program in improving quality testing at regional blood transfusion center of Kisumu. His research group combines experimental and epidemiological surveillances of key TTI markers among blood donors in western Kenya.

Abstract:

Background: Transfusion Transmissible Infections (TTIs) especially, Human Immunodeficiency Virus (HIV), Hepatitis B Virus (HBV), Hepatitis C Virus (HCV) and syphilis are among the greatest threat to blood safety for recipients. Globally, up to 3% of HIV infections are transmitted through blood transfusion. In sub-Saharan Africa, about 10% of blood donors are permanently deferred from subsequent donation due to TTIs seropositivity with Kenya recording 5.26% overall prevalence. Although continuous monitoring and reporting on TTIs prevalence among donors is essential for detecting changes in TTIs epidemiology and evaluating donors’ selection criteria to improve blood safety, no comprehensive study has been conducted in western Kenya to determine the prevalence of TTIs and the associated determinants among voluntary donors.

Objective: To determine the seroprevalence of HIV, HBV, HCV and syphilis and to assess the socio-demographic distribution and risk factors among voluntary blood donors in Homabay, Kisumu and Siaya in western Kenya.

Design: A cross-sectional descriptive study.

Methods: A total of 1200 blood donors aged 16-65 years were recruited by systematic random sampling and their socio-demographic characteristics recorded in a questionnaire. Samples were collected from units of blood donated and tested at Kisumu Regional Blood Transfusion Center for antigens/antibodies to hepatitis B and C virus, HIV-1 and 2 using enzyme linked immunosorbent assay while syphilis antibodies were tested using Rapid Plasma Reagin test. Subsequently, all reactive samples were retested using chemiluminescent immunoassay to confirm reactive test results. Descriptive statistic was used to obtain data for TTIs seroprevalence in subgroups. Chi-square test for independence to test the distribution of socio-demographic variables among the four TTIs markers and multivariate logistic regressions to test the association and statistical significance between selected determinants and tests outcome. All tests were two-tailed and a P-value<0.05 was considered as statistically significant.

Results: Of the 1200 donors enrolled, 110 (9.2%) had serological evidence of infections with at least one pathogen while 3 (0.25%) had dual infections with HBV being the predominant marker. The overall seroprevalence of HIV, HBV, HCV and syphilis was 1.08%, 3.33%, 3.25% and 1.50% respectively. Correlates independently and significantly associated with HIV infections was gender (male vs. female: Odds Ratio [OR] 1.2; 95% Confidence Interval [CI] 0.39-3.71). For HBV infections, the predictors were marital status (single vs. married: OR 1.7; 95% CI 0.73-2.73), risky sexual behavior (>1 partner vs. 0-1 partner: OR 2.7; 95% CI 1.03-7.19). For HCV infections, the predictors were blood transfusion history (transfused vs. non-transfused: OR 3.3; CI 0.73-14.46). For syphilis infections, the predictors were region (Siaya vs. Homabay: OR 1.5; 95% CI 0.50-4.52), age (25-34 vs.15-24 years: OR 2.7; 95% CI 0.61-12.09) and drug use (user vs. non-user: OR 6.3; 95% CI 0.77-51.26).

Conclusion: HIV rate is lower while the rates of syphilis, hepatitis B and C virus remain higher among voluntary donors in western Kenya. Drug use, age, gender, risky sexual behavior and blood transfusion history remain the major predictors of TTIs.

Recommendation: Enhancing donors’ notifications, deferrals and referrals by KNBTS is fundamental in reducing the disease burden and improving safety in the blood donor pool. Similarly, quantification of transfusion-associated syphilis that can be prevented if chemiluminiscent immunoassays were regionally implemented is suggested.

Biography:

Mariangela Cavarelli has completed her PhD in 2007 from University of Milan and Postdoctoral studies from San Raffaele Scientific Institut. She is a Researcher at the Commissariat à l'énergie atomique et aux énergies alternatives (CEA), France, where she is conducting studies that aim to understand the cellular and molecular mechanisms of HIV transmission through the intestinal mucosa in human and non human primates model. She has published 17 papers in reputed journals and is serving as an Editorial Board Member for Frontiers in Immunology.

Abstract:

HIV infection frequently occurs through colorectal mucosa where mononuclear phagocytes (MP), comprising dendritic cells (DC) and macrophages (Mf) are among the first target cells. We showed that colonic lamina propria CD11c+DCSIGN+CD68- cells sample luminal R5 HIV through an env-CCR5 interaction, a mechanism exploited by HIV to bypass the intact epithelial barrier. These data raise the question on which MP subset is mediating infection and thus, which may be the definitive fate of the virus. We used multicolor flow cytometry, immunofluorescence and ex vivo explant culture of colorectal mucosa to define MP distribution and their susceptibility to HIV/SIV infection and tissue samples from healthy human donors and Cynomolgus macaques. CD64 allowed to differentiating colonic DC (CD11c+CD64-) and Mf (CD11c+CD64+). Three subset of DC were identified on the basis of CD103 and CX3CR1 expression. The totality of colonic Mf was CX3CR1+ while about 50% expressed the CD163. Interestingly, CCR5 was preferentially expressed by the CD11c+CX3CR1+ cells, which support their involvement in active sampling of HIV and in transmission of infection in situ. In support of this, CD11c+CX3CR1+ but not CD103+ cells penetrated the intestinal epithelium following ex vivo R5 HIV-1 stimulation. Furthermore, only SIVmac but not SIVagm strains attract LP CD11c+ cells at intra-epithelial level, suggesting a role in the pathogenesis of the infection. In conclusion we outlined new findings concerning the phenotype and function of intestinal MP and discuss the relative contribution of different subsets of DC and Mf in the early events of HIV transmission at mucosal sites.

Biography:

Vladimir Zajac has completed his PhD. in 1982 at the Cancer Research Institute of        Slovak Academy of Sciences in Bratislava (Slovakia), where he worked as the Head of Department of Cancer Genetics from 1996 to 2010. He joined the Medical Faculty of the Comenius University as Associate Professor of Genetics in 2007. He has published 70 papers mostly in reputed journals and he was editor of the book „Bacteria, viruses and parasites in AIDS process“ (InTech, 2011). 

Abstract:

There is an increasing evidence, pointing out that GIT and other mucosal tissue, and not the blood, are the main places of HIV infection and CD4+T cells loss. These findings go along with the new studies about the role of bacterial translocation in the gut as central driver of AIDS pathogenesis It is demonstrate clearly that bacteria can induce in the gut and the vagina transcription of silenced genes, including HIV-1 provirus. The HIV-1 has been also detected in the bowel crypt cells and lamina propria.  We have identified HIV-like sequences and HIV-like proteins in bacteria and yeast in a cohort of 80 HIV positive patients from: a)  intestinal tract of American and Slovak HIV-positive patients; b) respiratory tract of Cambodian and Kenyan HIV-positive children. Detected sequences were for 90% homologous with the corresponding sequences of HIV-1. Using monoclonal antibodies (MAB) against HIV-1 antigens p17, p24, gp41 and p55 we have identified HIV-like proteins in bacterial extracts of most tested patients. HIV-like  protein of size 95 kDa was detected by MAB against HIV-1 gp120 in Candida species of all Cambodian and Kenyan samples. Specific properties of patient´s microbiota was found by cocultivation with HL-60 cells and significant reducing the viral load in a cohort of AIDS patients after administration of probiotics E. coli Nissle 1917 as well. From these results it can be hypothesized that bacteria and yeasts may act as a natural host of the sequence of HIV from the beginning of mankind. Throughout a series of epidemics, most individuals harboring many pathogenic microbes with HIV sequences excite. This tremendous longtime „sanitary process“ - continued until the eighteenth century - took place mainly in Europe, Asia and North Africa. However, administration of antibiotics, drugs and anal intercourse induced intestinal dysbiosis and pathogenic bacteria were re-propagated. When pathogenic microbes bearing HIV sequences moved to the majority, penetrated from the intestinal tract into the blood, infected/lysed lymphocytes and started the process of immunodeficiency. Presented hypothesis answered many until now unanswered questions: origin of HIV, connection of AIDS with TBC in Africa, absence of „gold standard“ in Africa, the presence of HIV reservoirs after antiretroviral therapy, the rarity of complete viral particles detection in the material from AIDS patients. According to our results there is a strong objection again dogma that HIV was transmitted to humans from apes in Africa about 35-50 years ago on the route of accidental contacts. On the basis of evolutionary process we submit proposals for an explanation of one of the most serious problems concerning this disease, which is a large-scale HIV positive in Africa.