Displaying publications 1 - 20 of 178 in total

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  1. Noratikah AH, Ajura AJ, Lau SH
    Trop Biomed, 2018 Dec 01;35(4):1041-1048.
    PMID: 33601851
    Histoplasmosis is a systemic fungal infection caused by inhalation of Histoplasma capsulatum, which is mainly found in bird and bat droppings. Oral manifestation of histoplasmosis may be the only initial manifestation of the disease or associated with chronic disseminated histoplasmosis. The first review of oral histoplasmosis among Malaysian population from 1967 to 1994 (27 years) revealed the occurrence of 37 cases, reported by Ng and Siar in 1996. This current study is the updated overview of oral histoplasmosis cases in Malaysia. The objective of the study was to review and describe clinical and demographic profile of oral histoplasmosis in Malaysia and to correlate histopathological features of oral histoplasmosis with patient's immunity status. We reviewed oral histoplasmosis cases diagnosed in Stomatology Unit, Institute for Medical Research (IMR), Kuala Lumpur from 1995 until 2016. The data was retrieved from the Oral Pathology Information system (OPIS) Stomatology Unit, IMR, which is the largest oral pathology database in Malaysia. Information regarding patients' sociodemographic data, medical illness, clinical presentation, histopathological features, and referring healthcare institutions was extracted from the clinical information which accompanied the biopsy request form. A total of 39 cases of oral histoplasmosis were identified from 1995-2016. Majority of them were male (89.7%). The age ranges from 29 to 85 years with mean age of 57.8 years. Almost half of them were Malays (51.3%), followed by Chinese (33.3%), Indians (7.7%), and other races (7.7%). The most common sites of oral histoplasmosis were tongue, gingiva, palate, and alveolar ridge. The main clinical presentation was ulcer (61.5%) whereas 38.5% presented clinically as swelling. 17.9% of patients were seropositive for human immunodeficiency virus (HIV), 12.8% had tuberculosis, 10.3% had diabetes mellitus, and 2.6% with hepatitis C. The incidence of oral histoplasmosis should raise suspicion of hidden immunodepression and may be the first manifestation of acquired immunodeficiency syndrome (AIDS). Early recognition and diagnosis is crucial to reduce risk of morbidity and mortality.
    Matched MeSH terms: Acquired Immunodeficiency Syndrome
  2. Salih, F.A.M., Haque, Q.M.
    MyJurnal
    The number of people worldwide living with human immunodeficiency virus/ acquired immunodeficiency virus (HIV/AIDS) is more than 40 million, among them 17.7 millions are women (UNAIDS/WHO, 2006) The latest report from the Eastern Mediterranean Region shows that at least one million people are infected with HIV; among them 30% are women. The great majority of reported cases in the Region are men. However, the ratio of men to women cases varies in different countries. It ranges between “9:1 (as for example in Egypt), to 2:1” (as in Morocco and some parts of Yemen). Due to religious, social and cultural values regarding female purity, women and girls living with HIV and AIDS are subjected to greater discrimination than men. WHO reports show that a large percentage of the infected women in Arab countries have contacted the infection from their husbands especially migrants and drug abusers. In Arab countries, studies conducted show that 86% of women choose not to disclose their status of infection for the fear of abandonment, rejection, discrimination, violence, upsetting family members, and accusations of infidelity from their partners, families, and communities. As a result, many women only seek help at the last minute when they are already been terminally ill. Violence against women and girls in its different forms increases women's vulnerability to HIV infection and undermines AIDS control efforts. The fear of violence prevents many women from accessing HIV information, from getting testing and seeking treatment. Stigma and discrimination may also prevent them from carrying out their normal life activities. When women are blamed, this can lead to heightened levels of sexual and domestic violence, abandonment by families and communities, forced abortion or sterilization, dismissal from employment and loss of livelihood opportunities. A study of AIDS-related discrimination in Arab region found that over ten percent of women had lost financial support from family members since being diagnosed as HIV positive. There is a great deal of evidence to establish the significant link between gender-based violence and rising rates of HIV infection among women and girls throughout the world. HIV-positive women must be supported to make their own reproductive choices about whether and/or when to have children. Promote male involvement in sexual and reproductive health programmes. Finally the stigma, discrimination and violations must be stopped.
    Matched MeSH terms: Acquired Immunodeficiency Syndrome
  3. Kho SS, Tie ST, Chan SK, Yong MC, Chai SL, Voon PJ
    Respirol Case Rep, 2017 May;5(3):e00221.
    PMID: 28250931 DOI: 10.1002/rcr2.221
    Chylothorax is defined as the presence of chyle in the pleural cavity. Central vein thrombosis is an under-recognized cause of chylothorax in the adult population and is commonly related to central venous catheterization. Case 1 illustrates a patient with AIDS and disseminated tuberculosis with left chylothorax and central vein thrombosis after a month of antituberculosis therapy. Case 2 was a patient with advanced seminoma who presented with left chylothorax and central vein thrombosis while on chemotherapy. Chylothorax resolved with anticoagulation for both cases. Case 3 was a lymphoma patient with central vein thrombosis who developed chylothorax during chemotherapy. Chylothorax resolved with the continuation of anticoagulation and did not recur despite his progressive underlying lymphoma. There was no central venous catheterization in any of these three cases. These cases illustrate the unique association of central vein thrombosis and chylothorax and the importance of anticoagulation in its management.
    Matched MeSH terms: Acquired Immunodeficiency Syndrome
  4. Apenteng OO, Osei PP, Oduro B, Kwabla MP, Ismail NA
    Infect Dis Model, 2020;5:755-765.
    PMID: 33073067 DOI: 10.1016/j.idm.2020.09.009
    Malaysia is faced with a high HIV/AIDS burden that poses a public health threat. We constructed and applied a compartmental model to understand the spread and control of HIV/AIDS in Malaysia. A simple model for HIV and AIDS disease that incorporates condom and uncontaminated needle-syringes interventions and addresses the relative impact of given treatment therapy for infected HIV newborns on reducing HIV and AIDS incidence is presented. We demonstrated how treatment therapy for new-born babies and the use of condoms or uncontaminated needle-syringes impact the dynamics of HIV in Malaysia. The model was calibrated to HIV and AIDS incidence data from Malaysia from 1986 to 2011. The epidemiological parameters are estimated using Bayesian inference via Markov chain Monte Carlo simulation method. The reproduction number optimal for control of the HIV/AIDS disease obtained suggests that the disease-free equilibrium was unstable during the 25 years. However, the results indicated that the use of condoms and uncontaminated needle-syringes are pivotal intervention control strategies; a comprehensive adoption of the intervention may help stop the spread of HIV disease. Treatment therapy for newborn babies is also of high value; it reduces the epidemic peak. The combined effect of condom use or uncontaminated needle-syringe is more pronounced in controlling the spread of HIV/AIDS.
    Matched MeSH terms: Acquired Immunodeficiency Syndrome
  5. Sukeri S, Zahiruddin WM, Shafei MN, Hamat RA, Osman M, Jamaluddin TZMT, et al.
    PMID: 32882876 DOI: 10.3390/ijerph17176362
    BACKGROUND: Perceived severity and susceptibility refers to one's belief of the seriousness and the risk of contracting a specific disease. It is an essential study in public health as it assists in the understanding of the motivating factors towards disease prevention. This qualitative study aimed to explore perceived severity and susceptibility towards leptospirosis infection among respondents in two states of Malaysia.

    METHODS: Focus group discussions using the phenomenology approach was conducted involving 72 respondents in Selangor and Kelantan. Data were examined using content analysis.

    RESULTS: Respondents perceived leptospirosis infection as severe due to its poor disease prognosis and complications. However, some rated it less severe when compared with other chronic diseases such as cancer and AIDS. Their perceptions were influenced by their knowledge about the disease, media portrayal and frequency of health campaigns by the government. All respondents believed they were not susceptible to the disease.

    CONCLUSION: The low perceived susceptibility of leptospirosis infection is a matter of concern as it may contribute to respondents' lack of motivation towards preventing the disease. The study findings may provide the basis for health promotional activities designed to heighten public perceived threat towards leptospirosis infection and thereby improving preventive health behaviors for avoiding leptospirosis.

    Matched MeSH terms: Acquired Immunodeficiency Syndrome
  6. Khan K, Khan AH, Sulaiman SA, Soo CT, Akhtar A
    Jpn J Infect Dis, 2016;69(1):56-9.
    PMID: 26073728 DOI: 10.7883/yoken.JJID.2014.246
    In the current study we explored the occurrence of adverse drug reactions (ADRs) to antiretroviral therapy among human immune-deficiency virus (HIV)/AIDS patients. We concluded an observational retrospective study in all patients who were diagnosed with HIV infection and were receiving highly active antiviral therapy from Jan. 2007 to Dec. 2012 at Hospital Pulau Pinang, Malaysia. Patient socio-demographic details along with clinical features and susceptible ADRs were observed during the study period. Out of 743 patients, 571 (76.9%) were men, and 172 (23.1%) were women. Overall 314 (42.2%) patients experienced ADRs. A total of 425 ADRs were reported, with 311 (73.1%) occurring in men and 114 (26.8%) in women, with a significant statistical relationship (P value (P) = 0.02, OR = 1.21). Overall 239 (56.2%) ADRs were recorded among Chinese, 94 (22.1%) in Malay, and 71 (16.7%) in Indian patients, which had a statistically significant association with ADRs (P = 0.05, OR = 1.50). Out of a total 425 among ADRs, lipodystrophy was recorded in 151 (35.5%) followed by skin rashes in 80 (18.8%), anemia in 74 (17.4%), and peripheral neuropathy in 27 (6.3%) patients. These findings suggest a need of intensive monitoring of ADRs in HIV treatment centres across Malaysia.
    Matched MeSH terms: Acquired Immunodeficiency Syndrome
  7. Movahed E, Cheok YY, Tan GMY, Lee CYQ, Cheong HC, Velayuthan RD, et al.
    BMC Immunol, 2018 Nov 08;19(1):32.
    PMID: 30409128 DOI: 10.1186/s12865-018-0269-5
    BACKGROUND: IL-17A has emerged as a key player in the pathologies of inflammation, autoimmune disease, and immunity to microbes since its discovery two decades ago. In this study, we aim to elucidate the activity of IL-17A in the protection against Cryptococcus neoformans, an opportunistic fungus that causes fatal meningoencephalitis among AIDS patients. For this purpose, we examined if C. neoformans infection triggers IL-17A secretion in vivo using wildtype C57BL/6 mice. In addition, an enhanced green fluorescence protein (EGFP) reporter and a knockout (KO) mouse models were used to track the source of IL-17A secretion and explore the protective function of IL-17A, respectively.

    RESULTS: Our findings showed that in vivo model of C. neoformans infection demonstrated induction of abundant IL-17A secretion. By examining the lung bronchoalveolar lavage fluid (BALF), mediastinal lymph node (mLN) and spleen of the IL-17A-EGFP reporter mice, we showed that intranasal inoculation with C. neoformans promoted leukocytes lung infiltration. A large proportion (~ 50%) of the infiltrated CD4+ helper T cell population secreted EGFP, indicating vigorous TH17 activity in the C. neoformans-infected lung. The infection study in IL-17A-KO mice, on the other hand, revealed that absence of IL-17A marginally boosted fungal burden in the lung and accelerated the mouse death.

    CONCLUSION: Therefore, our data suggest that IL-17A is released predominantly from TH17 cells in vivo, which plays a supporting role in the protective immunity against C. neoformans infection.

    Matched MeSH terms: Acquired Immunodeficiency Syndrome
  8. Azlina Ibrahim, Alvin Oliver Payus
    MyJurnal
    Hepatic involvement in extra-pulmonary tuberculosis (TB) is rare, even in the endemic area. It has a high mortality rate as it can easily be misdiagnosed due to its rarity and non-specific presentations, and the treatment can be challenging for its hepatotoxic side-effect. A 55-year old man who was newly diagnosed with AIDS and pulmonary TB which complicated with anti-TB-induced transaminitis, presented with a few weeks history of fever and persistent diarrhoea. It was initially treated as microsporidia infection but the symptoms persisted despite given antiparasitic agent for more than a week. He was subjected to computed tomography (CT) scan of the abdomen and noted multiple hypoechoic lesion at multiple segments of the liver, which later confirmed to be liver TB by liver biopsy. As he could not tolerate Akurit-4 (Rifampicin 150 mg, Isoniazid 75 mg, Pyrazinamide 400 mg and Ethambutol 275 mg), the second-line treatment was given instead. He is currently well on regular clinic appointment. The objective of this case report is to share the rare occurrence of hepatic TB and the difficulty to treat it as the hepatotoxic effect of anti-TB medications complicate the liver damage due to the infection.
    Matched MeSH terms: Acquired Immunodeficiency Syndrome
  9. Oktafiani D, Megasari NL, Fitriana E, Nasronudin, Lusida MI, Soetjipto
    Infect Dis Rep, 2020 07 07;12(Suppl 1):8746.
    PMID: 32874472 DOI: 10.4081/idr.2020.8746
    Background: Human herpesvirus 8 (HHV-8) infection is etiologically related to Kaposi's sarcoma. Antibodies directed against HHV-8 can be detected in 80-95% of HIV-seropositive patients with KS. HHV-8 serological tests have been done in several countries in Southeast Asia such as Malaysia, and Thailand however no serological data is available in Indonesia. This study was to examine the presence of HHV- 8 antibodies in HIV-positive patients in Surabaya, Indonesia.

    Material and methods: Ninety-one serum samples were collected from HIVpositive patients in Surabaya, Indonesia. Human immunodeficiency virus-positive serum samples were collected from 10 homosexual men, 25 intravenous drug users (IVDUs) and 56 heterosexuals. Serums were then tested for the presence of HHV-8 antibody by using sandwich ELISA (Abbexa Ltd, Cambridge, UK).

    Results: The total of 91 HIV-infected were testing with antibodies to HHV-8 using enzyme-linked immunosorbent assay. Antibodies of HHV-8 were detected in 7/91 (7.7%) of the samples. According to a gender, six men (85.7%) and a women (14.3%) were positive of HHV-8 antibodies. No correlation regarding the gender and age from this study. The antibodies of HHV-8 was detected among intravenous drug users (IVDUs) men 5/7 (42.8%) and 2/7 (28.6%) from homosexual and heterosexual, respectively.

    Conclusion: This study found the presence of HHV-8 antibodies in 7.7% of patients in Surabaya, Indonesia. This finding was higher more than Southeast Asian countries. The patients with a positive result could suggest measures to prevent HHV-8 infection.

    Matched MeSH terms: Acquired Immunodeficiency Syndrome
  10. Lu TS, Holmes A, Noone C, Flaherty GT
    Trop Dis Travel Med Vaccines, 2020 Nov 27;6(1):24.
    PMID: 33292661 DOI: 10.1186/s40794-020-00124-0
    BACKGROUND: Sex tourism is defined as travel planned specifically for the purpose of sex, generally to a country where prostitution is legal. While much of the literature on sex tourism relates to the commercial sex worker industry, sex tourism also finds expression in non-transactional sexual encounters. This narrative review explores current concepts related to travel and sex, with a focus on trans-national sex tourism.

    METHODS: The PubMed database was accessed to source relevant literature, using combinations of pertinent search terms. Only articles published in the English language were selected. Reference lists of published articles were also examined for relevant articles.

    RESULTS: With regard to preferred destinations, South/Central America and the Caribbean were more likely to receive tourists looking for casual sex. Longer duration of travel, travelling alone or with friends, alcohol or drug use, being younger and being single were factors associated with higher levels of casual sex overseas. The majority of literature retrieved on sex workers focused on risk behaviours, sexually transmitted infections (STI), mobility of sex workers and how these factors affected their lives. Sex tourists require better access to effective methods of preventing HIV, such as pre-exposure prophylaxis, and better education on HIV prevention. Drugs and alcohol play a major role as risk factors for and cofactors in casual sexual behaviour while abroad.

    CONCLUSIONS: Travellers need to be informed of the increased risks of STI before travel. They should be aware of the local prevalence of STIs and the risks associated with their sexual practices when they travel, including engaging with commercial sex workers, having unprotected sexual intercourse and becoming victims of sexual violence.

    Matched MeSH terms: Acquired Immunodeficiency Syndrome
  11. Syaziah, I., Azura, S.S., Tzar, M.N.
    Medicine & Health, 2018;13(2):103-113.
    MyJurnal
    The AIDS epidemic in Southeast Asia has led to a marked rise in the incidence of talaromycosis (penicilliosis) marneffei. The aim of this cross-sectional study was to determine the clinico-epidemiological features and outcome predictors of talaromycosis in Malaysia. We identified Talaromycosis marneffei cases from cultures of sterile specimens from 191 human immunodeficiency virus (HIV)- infected patients. Talaromycosis increased from 20-25 (2010-2011) to 45-50 cases per year (2012-2014). Talaromycosis was the HIV-presenting illness in 117 (61.3%) patients. The incidence of talaromycosis as HIV-presenting illness showed an increasing trend from 10.7 (2010) to 26.4 (2014) cases per 1000 new HIV patients. The patients were between 19 and 74 of age (mean 37.2+9.4 years) and the male to female ratio was 7.7:1. Malay (73, 38.2%) and Chinese (70, 36.3%) were the most prevalent ethnic groups. Common clinical manifestations included loss of weight (85.9%), fever (84.8%) and cough (67%), while skin lesions were only present in 42.9% cases. Common concurrent infections were oral candidiasis (79.6%), tuberculosis (36.1%) and hepatitis C infection (20.9%). Most patients (93.7%) were anaemic with mean haemoglobin level of 9.9+2.3 g/dL, 39% had impaired liver function, and 18.8% were neutropaenic. Median CD4 cell count was 16 cells/L. Most patients (70.4%) received intravenous amphotericin B followed by itraconazole. At 8-month follow up, 148 (81.8%) patients were alive while 33 (18.2%) had died. Intravenous drug abuse, concurrent toxoplasma encephalitis and concurrent Pneumocystis jiroveci pneumonia independently predicted death outcome in both univariate and multivariate logistic regression analyses.
    Matched MeSH terms: Acquired Immunodeficiency Syndrome
  12. Sohn AH, Lumbiganon P, Kurniati N, Lapphra K, Law M, Do VC, et al.
    AIDS, 2020 08 01;34(10):1527-1537.
    PMID: 32443064 DOI: 10.1097/QAD.0000000000002583
    OBJECTIVE: To implement a standardized cause of death reporting and review process to systematically disaggregate causes of HIV-related deaths in a cohort of Asian children and adolescents.

    DESIGN: Death-related data were retrospectively and prospectively assessed in a longitudinal regional cohort study.

    METHODS: Children under routine HIV care at sites in Cambodia, India, Indonesia, Malaysia, Thailand, and Vietnam between 2008 and 2017 were followed. Causes of death were reported and then independently and centrally reviewed. Predictors were compared using competing risks survival regression analyses.

    RESULTS: Among 5918 children, 5523 (93%; 52% male) had ever been on combination antiretroviral therapy. Of 371 (6.3%) deaths, 312 (84%) occurred in those with a history of combination antiretroviral therapy (crude all-cause mortality 9.6 per 1000 person-years; total follow-up time 32 361 person-years). In this group, median age at death was 7.0 (2.9-13) years; median CD4 cell count was 73 (16-325) cells/μl. The most common underlying causes of death were pneumonia due to unspecified pathogens (17%), tuberculosis (16%), sepsis (8.0%), and AIDS (6.7%); 12% of causes were unknown. These clinical diagnoses were further grouped into AIDS-related infections (22%) and noninfections (5.8%), and non-AIDS-related infections (47%) and noninfections (11%); with 12% unknown, 2.2% not reviewed. Higher CD4 cell count and better weight-for-age z-score were protective against death.

    CONCLUSION: Our standardized cause of death assessment provides robust data to inform regional resource allocation for pediatric diagnostic evaluations and prioritization of clinical interventions, and highlight the continued importance of opportunistic and nonopportunistic infections as causes of death in our cohort.

    Matched MeSH terms: Acquired Immunodeficiency Syndrome
  13. Anderson D, Nathoo N, Lu JQ, Kowalewska-Grochowska KT, Power C
    J Neurovirol, 2018 06;24(3):376-378.
    PMID: 29508303 DOI: 10.1007/s13365-018-0620-x
    Sarcocystosis is a zoonotic infection that causes intestinal and muscular illnesses in humans. Sarcocystosis was until recently considered rare in humans. To complete their life cycle, Sarcocystis species require both a definitive and an intermediate host. Humans are the definitive host when infected by one of two species: Sarcocystis hominis (from eating undercooked beef) or Sarcocystis suihominis (from eating uncooked pork). Infection with either of these species results in intestinal sarcocystosis, causing a self-limited disease characterized by nausea, abdominal pain, and diarrhea. Humans act as the intermediate host when infected by Sarcocystis nesbitti, resulting in the markedly different clinical picture of muscular sarcocystosis. Most documented cases of muscular sarcocystosis were assumed to be acquired in Malaysia, in addition to other regions of Southeast Asia and India. Published cases of muscular sarcocystosis from the Middle East, Central and South America, and Africa are all rare. Although the clinical presentation of muscular sarcocystosis remains to be fully characterized, fever, myalgia, and headache are among the most common symptoms. Here, we report a patient from sub-Saharan Africa with chronic Sarcocystis myopathy and well-controlled HIV-AIDS.
    Matched MeSH terms: Acquired Immunodeficiency Syndrome
  14. Anita S, Khalijah MY, Mahanim MY, Abd Rashid K, Rahimah MA, Ahmad Razin AM, et al.
    MyJurnal
    HIV/AIDS is a global issue and the fourth biggest killer worldwide. Report from Ministry Of Health Malaysia showed factory workers are among the social group that are mostly infected (10.4%). A cross~sectional study was carried out to determine the socio-demographic factor and its relationship with knowledge, attitude and HIV-related risk behavior among factory workers in Selangor, Negeri Sembilan and MaIacca. This study involved 3300 factory workers selected randomly and were given self-guided questionnaire. With response rate about 95.4% (3148), the level of knowledge was high (97.3%) and the attitude was positive (81 %). However there was still an amount of fear towards HIV/AlDS patient. Logistic regression showed significant difference (p<0.05) between level of knowledge and ethnic group, income and level of education and between attitude and income and level of knowledge. About 27.7% of respondents smoked cigarette. 4.2% involved with drugs of which 0.7% administered intravenously, 2.3% were homosexuals, 2.5% were bisexuals and 3.1% were hererosexuals. HIV/AIDS prevention and control intervention should take into consideration the local socio-cultural factors and commitment from the top level management in the factory·
    Matched MeSH terms: Acquired Immunodeficiency Syndrome
  15. Fauziah, M.N., Anita, S., Shaari, N., Ahamad, J., Senan, Pratap, Muhammad Amir, K.
    MyJurnal
    The objectives of this study were to determine the prevalence of HI V iryfection, risk factors and to measure the knowledge on AIDS among fishermen in Terengganu. In this survey fishermen registered with the Malaysian Fishery Development Board in Terengganu were studied. There were 600 eligible fishermen based on a list provided by the Malaysian Fishery Development Board (MFDB). Study sites were at 6 loading centres where health personnel awaited returning fishermen between 4. 00pm —7. 00 pm during a period of one month, A total of 542 registeredfshermen were studied and this corresponded to a response rate of 90.3 %. The majority of the fishermen were Malays (98.6%}, Nine fishermen were tested positive to HIV antibody and this corresponds to a
    g prevalence of I. 7%. Prevalence of HIV is higher among those with a positive history of drug use, single marital status and also among the unskilled workers who represented the socio-economically poorer group of fishermen. Almost 89% of respondents have heard about HIV/AIDS and among these, 93% received information through TV and radio. The mean knowledge score was significantly higher among fishermen admitting to drug taking, sex with prostitutes, and those who have had at least a secondary school education. The Prevalence of HIV infection among fishermen is higher than in the general population. Risk characterisation of HI V injection was statistically signyicant onlv among fishermen who gave positive history of drug used. Findings also suggest that poorer fishermen based on multiple indicators to socioeconomic status had a higher risk of being HIV positive as well as being less knowledgeable about AIDS, Health promotion strategies should focus on the use of TV and radio as an interactive medium to reach out to risk groups among fishermen as its popularity has been determined by this study.
    Matched MeSH terms: Acquired Immunodeficiency Syndrome
  16. Abiola, Abdulrahman Surajudeen, Lekhraj Rampal, Norlijah Othman, Faisal Ibrahim, Hayati Kadir@Shahar, Anuradha P. Radhakrishnan
    MyJurnal
    Adherence to antiretroviral therapy (ART) prevents disease progression, and the emergence of resistant mutations. It also reduces morbidity, and the necessity for more frequent, complicated regimens which are also relatively more expensive. Minimum adherence levels of 95% are required for treatment success. Poor adherence to treatment remains a stumbling block to the success of treatment programs. This generates major concerns about possible resistance of the human immunodeficiency virus (HIV) to the currently available ARVs. This paper aims to describe baseline results from a cohort of 242 Malaysian patients receiving ART within the context of an intervention aimed to improve adherence and treatment outcomes among patients initiating ART. A single-blinded Randomized Controlled Clinical Trial was conducted between January and December, 2014 in Hospital Sungai Buloh. Data on socio-demographic factors, clinical symptoms and adherence behavior of respondents was collected using modified, pre-validated Adult AIDS Clinical Trials Group (AACTG) adherence questionnaires. Baseline CD4 count, viral load, weight, full blood count, blood pressure, Liver function and renal profile tests were also conducted and recorded. Data was analyzed using SPSS version 22 and R software. Patients consisted of 215 (89%) males and 27 (11%) females. 117 (48%) were Malays, 98 (40%) were Chinese, 22 (9%) were Indians while 5 (2%) were of other ethnic minorities. The mean age for the intervention group was 32.1 ± 8.7 years while the mean age for the control group was 34.7 ± 9.5 years. Mean baseline adherence was 80.1 ± 19.6 and 85.1 ± 15.8 for the intervention and control groups respectively. Overall mean baseline CD4 count of patients was 222.97 ± 143.7 cells/mm³ while overall mean viral load was 255237.85 ± 470618.9. Patients had a mean weight of 61.55 ± 11.0 kg and 61.47 ± 12.3 kg in the intervention and control groups, respectively. Males account for about 90% of those initiating ART in the HIV clinic, at a relatively low CD4 count, high viral load and sub-optimal medication adherence levels at baseline.
    Matched MeSH terms: Acquired Immunodeficiency Syndrome
  17. Yadav, M.
    MyJurnal
    Human Herpesvirus-6 (HHV-6) infections are ubiquitous in human populations with an antibody prevalence of 30-85 percent in normal adults. The virus in vivo infects T-lympho-cytes, at various stages of differentiation and is cytopathic to host cell during productive infection. In culture the virus is pleiotropic for several established cell lines including T and B lymphocytes, macrophages and neural cells. Primary viral infection occurs mostly in early childhood. The saliva is the primary source of infection. The infection remains clinically silent in majority but it establishes a lifelong latent presence. However, in about 30 percent of infants, probably a varient HHV-6, causes exanthem subitum (roseola infantum). If the primary infection of HHV-6 is delayed until adolescence it is accompanied by clinical manifestation of an Epstein-Barr virus like infectious mononucleosis in some individuals. Depressed host immune functions may reactivate the latent HHV-6 infection and further aggravation of the primary disease. Since the virus is cytopathic to the host cell the presence of HHV-6 in AIDS patients and other lympholiferative disorders may increase the severity and pathogenicity of the primary disease. Antibodies to the HHV-6 are enhanced in autoimmune disorders, chronic fatigue syndrome, progressive lymphoroliferative disorders and organ transplant patients on immunosuppressive drugs therapy. While considerable basic immunovirological information has been obtained in the last 4 years, large gaps in knowledge still exist on the biologic interaction of HHV-6 with the host.
    Matched MeSH terms: Acquired Immunodeficiency Syndrome
  18. Ramli, M., Mohd Aznan, M.A., Maliya. S., Muhamad Shaiful Lizam, M.A., Muhammad Salman, M.H., Mohamad Faqihuddin, H., et al.
    MyJurnal
    Introduction: Lack of knowledge and negative attitude towards HIV/AIDS may be the risk factors for HIV infection among transsexuals. Research on knowledge and attitude towards HIV infection in transsexual communities is very limited at both local and international levels. This study aimed to assess the knowledge and attitude towards HIV infection among the male-to-female transsexual community in Kuantan, Pahang.
    Methods: A cross-sectional study was carried out from July to August 2014 among 33 male-to-female transsexuals in Kuantan, Pahang. Convenience sampling was used. Participants who gave consent answered a self-administered questionnaire. Data obtained was analyzed with descriptive statistics, χ2-test, and independent sample t test.
    Results: The majority of the subjects in this study were 29 years and below (48.5%), Muslims (93.9%), and had completed up to secondary education (60.6%). Most of them were sex workers (60.6%), and had relatively low income (no income to RM 3000, mean of RM1528). A total of 87.9% of the subjects demonstrated good knowledge and also positive attitude towards HIV/AIDS. Level of education was significantly associated with scores in knowledge (p=0.01).
    Conclusions: Despite the positive outcome from this study, misconceptions towards HIV/AIDS still exist among transsexuals. Education and interventions from multiple directions on HIV/AIDS are essential to deliver the correct information to this population, so as to emphasize prevention, early detection, and holistic medical care. Transsexuals also require attention from religious bodies and non-governmental organizations to help them in employment, financial, spiritual, and psycho-social issues.
    Matched MeSH terms: Acquired Immunodeficiency Syndrome
  19. Yassin Ibrahim, Rosnah Sutan, Khalib Bin Abdul Latif, Al - Abed A. Al - Abed, Amara, Ahmed, Adam, Ishag
    MyJurnal
    Adherence to antiretroviral therapy (ART) plays an important role in the treatment outcomes of human immunodeficiency virus (HIV) infection. Poor adherence would result in failure to prevent viral replication as well as an increased risk of developing drug resistance. Adherence to a life long treatment such as antiretroviral therapy is usually a complicated issue that requires careful and continuous collaboration of patient, family and healthcare provider. The objective of this study was to assess adherence to antiretroviral therapy and its associated factors among people living with HIV. This is a health facility-based cross sectional study conducted among adults’ people living with HIV in Omdurman HIV/AIDS centre, Sudan. Data was collected through direct interview using semi-structured questionnaire. There were only 144/846 (17.02%) who adhered to antiretroviral therapy as prescribed by their doctors. The remaining 51.18% were taking the therapy but not regularly, 31.21% were taking it but currently not and 0.59% stated that they have never taken any antiretroviral therapy. Factors associated with poor adherence that have been identified include female gender (Adj. OR = 3.46 (95%CI: 1.46-8.21), P = 0.005), younger age (Adj. OR = 1.14 (95%CI: 1.02-1.28), P = 0.022), being unemployed (Adj. OR = 5.94 (95%CI: 1.51-23.40), P = 0.011), those who were divorced, separated or widowed (Adj. OR = 11.35 (95%CI: 1.74-73.96), P = 0.011) and respondents who perceived that their health status is poor (Adj. OR = 5.21 (95%CI: 1.44-18.81), P = 0.012) or very poor (Adj. OR = 4.04 (95%CI: 1.27-12.81), P = 0.018). Educational level and social support against HIV-related stigma and discrimination were not significantly associated with adherence. Adherence to antiretroviral therapy among the respondents is very poor. Urgent interventions based on modifiable factors and mainly targeting females and younger age group are needed to improve adherence to antiretroviral therapy among people living with HIV.
    Matched MeSH terms: Acquired Immunodeficiency Syndrome
  20. Maha, A., Azhar, M. Z., Sherina, M. S., Sharmili, V., Rampal, L., Abdah, A., et al.
    MyJurnal
    Introduction: HIV/AIDS is one of the leading health problems worldwide. There is an increasing rate among the ages between 13 to 49 years old. School based intervention is an important component of community-based interventions for HIV/AIDS and is the best stage to promote abstinence which is best maintained among those not sexually experienced. Objectives: This study was carried out to determine attitude towards sex among secondary school children in Selangor state. Methods: A cross-sectional study design was used. Four out of nine districts in Selangor state were selected at random. Students were divided according to gender, academic performance (good or poor) with no behavioural problems
    and students with evidence of behaviour problems (at risk). Results: Out of 149 students, the majority (56.4%) were females. The majority of students did not think sex should be discussed in depth and do not speak to parents, teachers, religious teachers, counselors, relatives, doctors or nurses but speak to friends regarding sex. More than half watch pornography. A significantly higher percentage of male students in the weak and at-risk group admit to thinking of intimacy (hugging and kissing) with the opposite gender. A higher number of these students would try sex out of curiosity, for fun, because it was difficult to say ‘no’ to and that they would like it. A significantly higher percentage will try sex because they did not want to hurt their girlfriends’ feeling by saying ‘no’. While the majority of students think intimacy will end in sex, a significantly higher percentage of male at-risk students think just talking with the opposite gender will end in sex. The majority of male students responded feeling attracted to the picture of a girl in sexy clothing but a significantly higher percentage of at-risk students also felt attracted to the picture of a girl properly attired. A significantly higher percentage of male at-risk students say parents do not say sex before marriage is wrong and a significantly higher percentage of
    male students of weak and at-risk groups say girlfriends say sex before marriage is okay. A significantly higher percentage of weak and at-risk students speak to doctors regarding sex and think sex should be discussed in depth. Conclusion: Weak and at-risk male students appeared to have a more vulnerable attitude towards sex. This may predispose them to risky sexual behaviours leading to HIV/AIDS. Poor academic performance and behaviour problems may not be different as potential sexual risk predictors. The information obtained will be useful in designing intervention programmes in the prevention of HIV/AIDS.
    Matched MeSH terms: Acquired Immunodeficiency Syndrome
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