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Fulltext The indonesian variants of CRF33_01B: Near-full length sequence analysis

SahBandar IN, Takahashi K, Motomura K, Djoerban Z, Firmansyah I, Kitamura K, et al.

AIDS Res Hum Retroviruses, 2011 Jan;27(1):97-102.
PMID: 20958201 DOI: 10.1089/aid.2010.0163

Cocirculation of subtype B and CRF01_AE in Southeast Asia has led to the establishment of new recombinant forms. In our previous study, we found five samples suspected of being recombinants between subtype B and CRF01_AE, and here, we analyzed near full-length sequences of two samples and compared them to known CRFs_01B, subtype B, and CRF01_AE. Five overlapped segments were amplified with nested PCR from PBMC DNA, sequenced, and analyzed for genome mosaicism. The two Indonesian samples, 07IDJKT189 and 07IDJKT194, showed genome-mosaic patterns similar to CRF33_01B references from Malaysia, with one short segment in the 3' end of the p31 integrase-coding region, which was rather more similar to subtype B than CRF01_AE, consisting of unclassified sequences. These results suggest gene-specific continuous diversification and spread of the CRF33_01B genomes in Southeast Asia.

Matched MeSH terms: HIV Infections/virology*
Short communication: low prevalence of genotypic drug resistance mutations among antiretroviral-naive HIV type 1 patients in Malaysia

Tee KK, Kamarulzaman A, Ng KP

AIDS Res Hum Retroviruses, 2006 Feb;22(2):121-4.
PMID: 16478392

To assess the prevalence of mutations associated with drug resistance in antiretroviral-naive patients in Kuala Lumpur, Malaysia, genotypic resistance testing was conducted among drug-naive HIV-1 patients attending the University Malaya Medical Center (UMMC) between July 2003 and June 2004. Reverse transcriptase (RT) and protease genes of plasma virions were sequenced from 100 individuals. The majority of the patients were recently diagnosed. Codons 20-255 of the RT and 1-96 of the protease gene were examined for major and minor mutations associated with antiretroviral resistance reported by the International AIDS Society- USA (IAS-USA) Drug Resistance Mutations Group. The prevalence of patients with at least one major mutation conferring drug resistance was 1%, with only one patient having a Y181C amino acid substitution in the RT gene that confers high-level resistance to nevirapine and delavirdine. Minor mutations were detected in high prevalence in the protease gene. Amino acid substitutions I13V, E35D, and M36I were associated with CRF01_AE while L63P, V77I, and I93L were associated with subtype B. Baseline prevalence of major mutations associated with resistance to antiretroviral drugs was low among antiretroviral-naive HIV-1 patients, suggesting that routine drug resistance testing may be unnecessary for all individuals newly diagnosed with HIV or all patients beginning antiretroviral therapy.

Matched MeSH terms: HIV Infections/drug therapy; HIV Infections/virology*
The evolving molecular epidemiology of HIV type 1 among injecting drug users (IDUs) in Malaysia

Tee KK, Saw TL, Pon CK, Kamarulzaman A, Ng KP

AIDS Res Hum Retroviruses, 2005 Dec;21(12):1046-50.
PMID: 16379608

Earlier studies in the 1990s indicate that human immunodeficiency virus type 1 (HIV-1) subtype B has been the predominant subtype among injecting drug users (IDUs) in Malaysia. More recent studies performed between 2003 and 2004, however, show a high prevalence of unique CRF01_AE/B intersubtype recombinants among IDUs. To determine the subtype distribution among IDUs in Kuala Lumpur prior to the emergence of CRF01_AE/B intersubtype recombinants, the gag-pol or the reverse transcriptase gene was sequenced from IDUs who were diagnosed as HIV positive between 1993 and 2002. Subtype B was present at 50.0% followed by CRF01_AE/B recombinant at 41.7%, with more CRF01_AE/B recombinants detected between 2000 and 2002. All CRF01_AE/B recombinants shared similar recombination patterns. Interestingly, we found that this potential new candidate of circulating recombinant form (CRF) could have emerged as early as the mid-1990s. The results showed evidence of changing HIV-1 molecular epidemiology toward the predominance of CRF01_AE/B intersubtype recombinants among IDUs in Kuala Lumpur.

Matched MeSH terms: HIV Infections/epidemiology*; HIV Infections/virology
Current HIV type 1 molecular epidemiology profile and identification of unique recombinant forms in Jakarta, Indonesia

Sahbandar IN, Takahashi K, Djoerban Z, Firmansyah I, Naganawa S, Motomura K, et al.

AIDS Res Hum Retroviruses, 2009 Jul;25(7):637-46.
PMID: 19621986 DOI: 10.1089/aid.2008.0266

HIV infection is a major problem in Indonesia. The number of people living with HIV has been increasing from year to year, especially among injecting drug users (IDUs). Since there were only limited data about molecular epidemiology profiles of HIV/AIDS in Indonesia, a cross-sectional study involving 208 HIV-1-seropositive individuals was conducted in 2007 in Jakarta. The majority of participants were 16-30 years of age (64.9%) and 74.5% were male. The most frequent risk factor was injecting drug use (IDU) (45.7%) followed by heterosexual transmission (34.1%). Phylogenetic analysis of gag (p17 and p6) and env C2V3 regions showed 200 (96.2%) of 208 DNA samples were CRF01_AE and only 3 (1.4%) were subtype B. Five samples (2.4%) indicated discordant subtypes between the three aforementioned regions: three of them showed unique CRF01_AE/B recombination patterns in 2.3-kbp nucleotide sequences (from p17 to part of RT), including one sample showing similarity to CRF33_01B, reported previously in Malaysia. This study shows the current predominant subtype is CRF01_AE in every risk group, with a decreasing number of pure subtype B, and the first identification of CRF01_AE/B recombinant forms among HIV-1-seropositive Indonesians.

Matched MeSH terms: HIV Infections/genetics; HIV Infections/epidemiology*; HIV Infections/virology
Near full-length sequence analysis of a Unique CRF01_AE/B recombinant from Kuala Lumpur, Malaysia

Lau KA, Wang B, Kamarulzaman A, Ng KP, Saksena NK

AIDS Res Hum Retroviruses, 2007 Sep;23(9):1139-45.
PMID: 17919110

A new HIV-1 circulating recombinant form (CRF), CRF33_01B, has been identified in Malaysia. Concurrently we found a unique recombinant form (URF), that is, the HIV-1 isolate 06MYKLD46, in Kuala Lumpur, Malaysia. It is composed of B or a Thai variant of the B subtype (B') and CRF01_AE. Here, we determined the near full-length genome of the isolate 06MYKLD46 and performed detailed phylogenetic and bootscanning analyses to characterize its mosaic composition and to further confirm the subtype assignments. Although the majority of the 06MYKLD46 genome is CRF01_AE, we found three short fragments of B or B' subtype inserted along the genome. These B or B' subtype regions were 716 and 335 bp, respectively, in the protease-reverse transcriptase (PR-RT) region, similar to those found in CRF33_01B, as well as an extra 590 bp in the env gene region. Thus we suggest that 06MYKLD46 is a possible second-generation HIV-1 recombinant derived from CRF33_01B.

Matched MeSH terms: HIV Infections/epidemiology; HIV Infections/virology*
HIV type 1 gag subtype A is predominant in Malaysian intravenous drug users

Kasper P, Chalwatzis N, Duraisamy G, Ofenloch-Hähnle B, Faatz E

AIDS Res Hum Retroviruses, 1997 Sep 20;13(14):1251-3.
PMID: 9310293
Matched MeSH terms: HIV Infections/genetics*; HIV Infections/epidemiology*
HIV type 1 subtypes in Malaysia, determined with serologic assays: 1992-1996

Beyrer C, Vancott TC, Peng NK, Artenstein A, Duriasamy G, Nagaratnam M, et al.

AIDS Res Hum Retroviruses, 1998 Dec 20;14(18):1687-91.
PMID: 9870323

We investigated the molecular epidemiology of HIV-1 subtypes in Malaysia among injecting drug users (IDUs) and sexual transmission risk groups, using serologic and genetic techniques. Frozen sera collected at a general hospital, a blood bank, several drug treatment centers, and an STD clinic in Kuala Lumpur, between 1992 and 1996, were investigated retrospectively. V3 peptide serotyping and monomeric gp120 capture serotyping were used to study 89 known HIV-1-infected subjects. The methods differentiate subtypes B, E, and C. V3 peptide and gp120 capture results were comparable. No subtype C-specific reactive sera were found; one specimen was dually reactive for subtypes C and B, using the V3 peptide ELISA; and four were durally reactive for subtypes E and C using this assay. Genotypic analysis of HIV-1 gag RNA in serum was done on a subset of subjects and confirmed serologic findings. HIV-1 subtypes differed significantly by risk category: of 53 IDUs, 29 (55%) were infected with subtype B and 19 (36%) were infected with subtype E, 3 (6%) were dually reactive, and 2 (4%) were not typable. Of 36 persons with heterosexual risks, 29 (81%) were infected with subtype E, 5 (14%) were infected with subtype B, and 2 (5%) were not typable. Persons with IDU risks were significantly more likely to be infected with subtype B than were those with sexual risks (OR 5.89; 95% CI, 1.94-18.54; p < 0.001). Subtypes B and E of HIV-1 appear to predominate in Malaysia; subtype B was more prevalent among IDUs; subtype E was more prevalent among all other groups. These results may have important HIV-1 vaccine implications.

Matched MeSH terms: HIV Infections/epidemiology; HIV Infections/virology
HIV type 1 subtypes in Malaysia include B, C, and E

Brown TM, Robbins KE, Sinniah M, Saraswathy TS, Lee V, Hooi LS, et al.

AIDS Res Hum Retroviruses, 1996 Nov 20;12(17):1655-7.
PMID: 8947304
Matched MeSH terms: HIV Infections/epidemiology; HIV Infections/virology*
Characterization of a New HIV-1 CRF01_AE/B Recombinant Virus Form Among Men Who Have Sex with Men in Shanghai, China

Ou W, Li K, Feng Y, Huang Q, Ge Z, Sun J, et al.

AIDS Res Hum Retroviruses, 2019 04;35(4):414-418.
PMID: 30229664 DOI: 10.1089/AID.2018.0197

To date, there are 16 types of CRF01_AE/B circulating recombinant forms identified, and most of them are distributed in Asian countries such as China, Malaysia, and Singapore. Previous HIV molecular epidemiological surveys showed that CRF01_AE (27.6%) and B (9.6%) subtypes are predominant strains in mainland of China. At the same time, the HIV-1 virus spreads faster in the men who have sex with men (MSM) population than in other risk groups. In Shanghai district, ∼66.0% of newly reported cases were infected through homosexual transmission. In this study, we report a novel recombinant strain of CRF01_AE/B. The near full-length genome phylogenetic tree showed that the strain clustered with the CRF01_AE reference sequence and placed in the peripheral position within the branch of the CRF01_AE strain. Subregional evolutionary results indicated that the CRF01_AE subtype was derived from cluster 4 of CRF01_AE, which is mainly distributed in northern China. The subtype B was correlated with the U.S./Europe B, which are widely prevalent in the Chinese MSM population. In recent years, a large number of recombinant forms between CRF01_AE and B strains are continuously emerging in China. Therefore, understanding the current epidemic recombinant forms will have significant implications for prevention and treatment of HIV/AIDS.

Matched MeSH terms: HIV Infections/epidemiology; HIV Infections/virology*
Fulltext Short Communication: Impact of Viral Load Use on Treatment Switch in Perinatally HIV-Infected Children in Asia

Jamal Mohamed T, Teeraananchai S, Kerr S, Phongsamart W, Nik Yusoff NK, Hansudewechakul R, et al.

AIDS Res Hum Retroviruses, 2017 03;33(3):230-233.
PMID: 27758114 DOI: 10.1089/AID.2016.0039

We sought to assess the impact of routine HIV viral load (VL) monitoring on the incidence of switching from a first- to a second-line antiretroviral therapy (ART) regimen, and to describe factors associated with switch. Data from a regional cohort of 16 clinical programs in six Asian countries were analyzed. Second-line switch was defined as a change from a non-nucleoside reverse transcriptase inhibitor (NNRTI) to a protease inhibitor (PI) or vice versa, and ≥1 of the following: (1) reported treatment failure by local criteria, (2) switch of ≥1 additional drug, or (3) a preceding HIV VL ≥1,000 copies/ml. Routine VL was having ≥1 test after ≥24 weeks of ART and ≥1 time/year thereafter. Factors associated with time to switch were evaluated with death and loss to follow-up as competing risks. A total of 2,398 children were included in this analysis. At ART initiation, the median (interquartile range) age was 6.0 (3.3-8.9) years, more than half had WHO stage 3 or 4, the median CD4 was 189 (47-456) cells/mm3, 93% were on NNRTI-based first-line ART, and 34% had routine VL monitoring. Treatment switch occurred in 17.6% of patients, at a median of 35 (22-49) months. After adjusting for country, sex, first ART regimen, and CD4% at ART initiation, children with routine VL monitoring were 1.46 (95% confidence interval 1.11-1.93) times more likely to be switched (p = .007). Scale-up of VL testing will lead to earlier identification of treatment failure, and it can help guide earlier switches to prevent resistance.

Matched MeSH terms: HIV Infections/drug therapy*; HIV Infections/virology*
Fulltext Cross-Neutralizing CRF01_AE-Infected Plasma from Malaysia Targets CD4-Binding Site of Human Immunodeficiency Virus Type-1 Envelope Glycoprotein

Ng QR, Tee KK, Binley JM, Tong T

AIDS Res Hum Retroviruses, 2022 Feb;38(2):162-172.
PMID: 34006141 DOI: 10.1089/AID.2020.0299

Human immunodeficiency virus type-1 (HIV-1) antigenic variation poses a great challenge for vaccine immunogen design to elicit broadly neutralizing antibodies (bNAbs). Over the last 10-15 years, great progress has been made to understand the conserved sites of sensitivity on HIV envelope glycoprotein spikes targeted by bNAbs. Plasma neutralization mapping and monoclonal antibody isolation efforts have revealed five major conserved epitope clusters. Most of this work has focused on subtype B and C-infected Caucasian or African donors. It is not clear if the same epitopes and epitope rank order preferences are also true in donors infected with different HIV-1 subtypes and with different racial backgrounds. To investigate this point, in this study we report the first attempt to profile the bNAb specificities of CRF01_AE-infected Malaysian plasmas. We first measured neutralization titers of 21 plasmas against a subtype A, B, and AE pseudovirus panel. This revealed that 14% (3 of 21) plasmas had cross-clade breadth. Focusing on the cross-neutralizing plasma P9, we used AE and JR-FL mutant pseudoviruses, gp120 monomer interference, and native polyacrylamide gel electrophoresis to better understand the neutralization specificity. P9 demonstrates CD4-binding-site specificity with trimer dependence and D368 independence.

Matched MeSH terms: HIV Infections*
Fulltext Factors associated with pre-treatment HIV RNA: application for the use of abacavir and rilpivirine as the first-line regimen for HIV-infected patients in resource-limited settings

Kiertiburanakul S, Boettiger D, Ng OT, Van Kinh N, Merati TP, Avihingsanon A, et al.

AIDS Res Ther, 2017;14:27.
PMID: 28484509 DOI: 10.1186/s12981-017-0151-1

BACKGROUND: Abacavir and rilpivirine are alternative antiretroviral drugs for treatment-naïve HIV-infected patients. However, both drugs are only recommended for the patients who have pre-treatment HIV RNA <100,000 copies/mL. In resource-limited settings, pre-treatment HIV RNA is not routinely performed and not widely available. The aims of this study are to determine factors associated with pre-treatment HIV RNA <100,000 copies/mL and to construct a model to predict this outcome.
METHODS: HIV-infected adults enrolled in the TREAT Asia HIV Observational Database were eligible if they had an HIV RNA measurement documented at the time of ART initiation. The dataset was randomly split into a derivation data set (75% of patients) and a validation data set (25%). Factors associated with pre-treatment HIV RNA <100,000 copies/mL were evaluated by logistic regression adjusted for study site. A prediction model and prediction scores were created.
RESULTS: A total of 2592 patients were enrolled for the analysis. Median [interquartile range (IQR)] age was 35.8 (29.9-42.5) years; CD4 count was 147 (50-248) cells/mm3; and pre-treatment HIV RNA was 100,000 (34,045-301,075) copies/mL. Factors associated with pre-treatment HIV RNA <100,000 copies/mL were age <30 years [OR 1.40 vs. 41-50 years; 95% confidence interval (CI) 1.10-1.80, p = 0.01], body mass index >30 kg/m2(OR 2.4 vs. <18.5 kg/m2; 95% CI 1.1-5.1, p = 0.02), anemia (OR 1.70; 95% CI 1.40-2.10, p 350 cells/mm3(OR 3.9 vs. <100 cells/mm3; 95% CI 2.0-4.1, p 2000 cells/mm3(OR 1.7 vs. <1000 cells/mm3; 95% CI 1.3-2.3, p 25 yielded the sensitivity of 46.7%, specificity of 79.1%, positive predictive value of 67.7%, and negative predictive value of 61.2% for prediction of pre-treatment HIV RNA <100,000 copies/mL among derivation patients.
CONCLUSION: A model prediction for pre-treatment HIV RNA <100,000 copies/mL produced an area under the ROC curve of 0.70. A larger sample size for prediction model development as well as for model validation is warranted.

Matched MeSH terms: HIV Infections/drug therapy*; HIV Infections/virology*
Fulltext Adapting an Evidence-Based Intervention Targeting HIV-Infected Prisoners in Malaysia

Copenhaver MM, Tunku N, Ezeabogu I, Potrepka J, Zahari MM, Kamarulzaman A, et al.

AIDS Res Treat, 2011;2011:131045.
PMID: 21860786 DOI: 10.1155/2011/131045

HIV-infected prisoners in Malaysia represent a critical target population for secondary HIV risk reduction interventions and care. We report on the process and outcome of our formative research aimed at systematically selecting and adapting an EBI designed to reduce secondary HIV risk and improve adherence to antiretroviral therapy among soon-to-be-released HIV-infected prisoners. Our formative work involved a critical examination of established EBIs and associated published reports complemented by data elicited through structured interviews and focus groups with key stakeholders, members of the target population, and their family members. Based on all information, we adapted the Holistic Health Recovery Program targeting people living with HIV (HHRP+), an EBI, to consist of eight 2-hour sessions that cover a range of specified topics so that participants may individually apply intervention content as needed to accommodate their particular substance abuse, HIV risk, and antiretroviral adherence issues. This study provides a complete example of the process of selecting and adapting an EBI-taking into account both empirical evidence and input from target organization stakeholders and target population members and their families-for use in real world prison settings where high-risk populations are concentrated.

Matched MeSH terms: HIV Infections*
Fulltext A multi-step pace towards a cure for HIV: kick, kill, and contain

López M

AIDS Rev, 2013 Jul-Sep;15(3):190-1.
PMID: 24002204

The 7th IAS Conference held in July 2013 in Kuala Lumpur, Malaysia, heard about a number of cases of "functional cure" in people who had started antiretroviral therapy soon after HIV infection, including a German case that can now be added to the "Mississippi baby" report presented at CROI 2012 and 14 individuals of the French VISCONTI cohort. All these persons maintained an undetectable viral load after coming off antiretrovirals.

Matched MeSH terms: HIV Infections/drug therapy*; HIV Infections/immunology
Fulltext Bone mineral density loss, osteoporosis, and fractures in HIV

Labarga P

AIDS Rev, 2013 Jul-Sep;15(3):189-90.
PMID: 24002203

The link between HIV and reduced bone mineral density, including osteopenia and the more severe osteoporosis, is well established. HIV infection has also been associated with an increased risk of fractures. It is so far unclear whether this is due to HIV itself, resulting inflammatory and metabolic changes, antiretroviral toxicity, or some combination of factors. This topic was the focus of major debate at the 7th IAS Conference held in Kuala Lumpur, Malaysia, in early July 2013.

Matched MeSH terms: HIV Infections/complications; HIV Infections/physiopathology*
Fulltext HIV incidence in Asia: a review of available data and assessment of the epidemic

Dokubo EK, Kim AA, Le LV, Nadol PJ, Prybylski D, Wolfe MI

AIDS Rev, 2013 Apr-Jun;15(2):67-76.
PMID: 23681434

Rates of new HIV infections in Asia are poorly characterized, likely resulting in knowledge gaps about infection trends and the most important areas to target for interventions. We conducted a systematic review of peer-reviewed English language publications and conference abstracts on HIV incidence in thirteen countries - Bangladesh, Cambodia, China, India, Indonesia, Laos, Malaysia, Myanmar, Philippines, Singapore, Taiwan, Thailand, and Vietnam. We obtained data on HIV incidence rate, incidence estimation method, population, and risk factors for incident infection. Our search yielded 338 unique incidence estimates from 70 published articles and 41 conference abstracts for eight countries. A total of 138 (41%) were obtained from prospective cohort studies and 106 (31%) were from antibody-based tests for recent infection. High HIV incidence rates were observed among commercial sex workers (0.4-27.8 per 100 person-years), people who inject drugs (0.0-43.6 per 100 person-years) and men who have sex with men (0.7-15.0 per 100 person-years). Risk factors for incident HIV infection include brothel-based sex work and cervicitis among commercial sex workers; young age, frequent injection use and sharing needles or syringes among people who inject drugs; multiple male sexual partners, receptive anal intercourse and syphilis infection among men who have sex with men. In the countries with available data, incidence rates were highest in key populations and varied widely by incidence estimation method. Established surveillance systems that routinely monitor trends in HIV incidence are needed to inform prevention planning, prioritize resources, measure impact, and improve the HIV response in Asia.

Matched MeSH terms: HIV Infections/epidemiology*
The Risk and Impact of COVID-19 Pandemic on Immunosuppressed Patients: Cancer, HIV, and Solid Organ Transplant Recipients

Mohammed AH, Blebil A, Dujaili J, Rasool-Hassan BA

AIDS Rev, 2020;22(3):151-157.
PMID: 33118527 DOI: 10.24875/AIDSRev.20000052

Toward the end of the year 2019, there was the eruption of an acute respiratory syndrome, which is widely referred as coronavirus disease (COVID-19) from Wuhan, Hubei Province. The disease causes a range of respiratory illnesses, which are fatal. The COVID-19 disease has spread globally and has significantly impacted the health delivery systems, travel regulations, and economic activities and has posed and upsurge of responsibilities for the frontline healthcare workers. Due to the nature of the COVID-19 disease, it has typically caused complications which include pneumonia, multiple organ dysfunction together with renal failure, and acute respiratory distress syndrome. As of date, there is no approved vaccine or treatment for COVID-19 though there are ongoing research studies to formulate a treatment. COVID-19 is highly contagious, and the risk of infection is higher for patients with immunesuppressed patients than regular patients. The immunesuppressed conditions include cancer, HIV, and patients with solid organ transplants (SOT). This paper aims to review the risk and impact of COVID-19 on immunesuppressed patients, with a focus on cancer, HIV, and patients with SOT and the essence of special parameters for their care and management. Despite the fatal effects of this global pandemic, the findings of this study indicate the high risk which immunosuppressed patients have to contract the disease; thus, the governments and health delivery systems have to offer them extra support and treatment.

Matched MeSH terms: HIV Infections/complications*
HIV Treatment Adherence - A Shared Burden for Patients, Health-Care Providers, and Other Stakeholders

Abdulrahman SA, Ganasegeran K, Rampal L, Martins OF

AIDS Rev, 2019;21(1):28-39.
PMID: 30899114 DOI: 10.24875/AIDSRev.19000037

Successful HIV treatment is contingent on sustained high levels of treatment adherence. Several barriers to optimal adherence have been documented. In this article, we first review the global burden of non-adherence among HIV/AIDS positive individuals on a public health scale. Second, we synthesized available evidence from different study designs and stratified across the European, African, and Asian literature to determine the factors influencing adherence to scheduled clinic appointments and medication non-adherence. Third, we discuss common measurement techniques that quantify the magnitude of non-adherence, their relative advantages and limitations in current practice. From January to May 2018, we reviewed guidelines, standard operating procedures, journal articles, and book chapters on treatment adherence among HIV patients receiving adherence to antiretroviral therapy (ART) globally. We searched PubMed, Medline, Google Scholar, and Cochrane Database of Systematic Reviews with the search terms "adherence," "adherence behavior," "medication adherence," and "HIV patients," or "HIV/AIDS," and "Antiretroviral Therapy" or "ART" or "ARVs" or "highly active ART " from 2000 to 2017. We also identified articles through searches of authors' files and previous research on HIV. We included only papers published in English in this review. We then generated a final list of reference on the basis of originality and the broad scope of this review. We found rich literature evidence of research findings and best practice recommendations on the importance of adherence in HIV/AIDS management, a general understanding of factors associated with non-adherence and approaches to investigating non-adherence behavior among different populations. We observed significant contextual differences exist with regard to barriers and burden of non-adherence among these populations.

Matched MeSH terms: HIV Infections
Do Highly Active Antiretroviral Therapy Drugs in the Management of HIV Patients Influence Success of Dental Implants?

Sivakumar I, Arunachalam S, Choudhary S, Mahmoud-Buzayan M, Tawfiq O, Sharan J

AIDS Rev, 2020;22(1):3-8.
PMID: 32167505 DOI: 10.24875/AIDSRev.20000107

HIV infection is a global pandemic that affects CD4 cells in the immune system and leads to lethal opportunistic infections. The advent of highly active antiretroviral therapy (HAART) has induced a marked reduction in the viral load and an increase in the CD4 cell count, thereby changing the course of the disease from an acute life-threatening condition to chronic disease. Accordingly, need and demand for oral rehabilitation in HIV positive population have increased in recent years. However, few drugs used in the HAART regimen have also known to be associated with osteopenia and osteoporosis. Although HAART reduces the morbidity in HIV patients, it remains unknown to what extent the therapy influences the implant healing. Few scientific literatures have identified osteoporosis and HIV infection as an unconducive milieu for dental implant placement and survival but demonstrated favorable outcomes in short-term assessments. The long-term impact of bone metabolic effects of HAART on implant success remains a conundrum.

Matched MeSH terms: HIV Infections/complications*; HIV Infections/drug therapy*
Malaysia urges ASEAN to tackle AIDS crisis

AIDS Wkly, 2000 Aug 7.
PMID: 12349742

Urgent action is needed to fight the alarming spread of HIV/AIDS that infected 1.3 million people in Southeast Asia last year alone, Malaysia's foreign minister said July 24, 2000. Syed Hamid said the Association of Southeast Asian Nations (ASEAN) should tackle at regional and national level an epidemic that was taking its most drastic toll among the region's youth. "HIV/AIDS not only represents a major public health and social problem but is a serious challenge to development as well," Syed Hamid told the opening ceremony of ASEAN's 33rd annual foreign ministers' meeting. The crisis requires commitment at the "highest political level," he said, warning that HIV/AIDS could become a transnational problem within the 10-member group. Foreign ministers have recommended their leaders discuss the crisis later this year at an informal summit in Singapore and hold a summit on HIV/AIDS in conjunction with the 7th ASEAN Summit in Brunei next year. "I think people recognized the importance and the adverse impacts on our social development," Syed Hamid told reporters later. "I think it is a real issue that we cannot run away from." Among ASEAN members, Thailand, Cambodia, and Myanmar have some of the highest infection rates in Asia of HIV, the virus that causes AIDS.

Matched MeSH terms: HIV Infections*

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