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  • ISSN: 2374-0094
    Early Online
    Volume 5, Issue 1
    Research Article
    Hung Viet Pham*, Lam Van Nguyen, Yen Thi Le, Hanh Hong Thi Mai, Chung Thu Thi Phan, and Liem Thanh Nguyen
    Introduction: Antiretroviral therapy (ART) was scaled up in HIV-infected Vietnamese children and adults as well. Few studies documented the association between drug-naïve resistant HIV-1 with treatment outcome, especially in children. This study aimed to determine the rate of drug-resistance mutations before initiating ART, and the treatment outcome after six months of ART.
    Methods: During 2010 - 2011, 140 HIV-1 infected children were admitted at National Children Hospital Viet Nam. Of them, 116 were initiated first-line ART, their clinical profile, CD4+ T-cell counts, and HIV load after six months of ART were retrospectively collected. Their plasma before initiating ART was stored for analysis by 2012. Of 116 samples, 52 had the HIV-1 pol gene successfully sequenced to detect drug- resistance mutations.
    Results: 18 children (29.0 ± 28.8 months) died, within an average of 1.6 ± 1.4 months of ART. Baseline WHO clinical stage 3-4 (p<0.001), and lower CD4+ T-cell counts (p=0.03) was associated with fatality. Stored plasma samples of 52 were sufficiently analyzed, six carried drug-resistance HIV-1. One of six was exposed to ART through prevention of mother-to-child transmission. Of RT-inhibition resistance, three had single mutant; one had K65R/Q151M / K101E/Y181C with six-month virological failure. Among PR-inhibition resistance, two had either M46L or M46L/L90M.
    Conclusion: Transmitted drug - resistance mutations were found in 9.6% of 52 children. Six-month treatment outcome was induced by baseline clinical and immunological stage. Pre-treatment drug-resistance mutations might not associate with six-month mortality but induce risk of virological failure.
    Luis Casado-Gonzalez, Candela Menendez, Maria Martinez-Sela, Noelia Moran, Alicia Garcia-Perez, Jose A. Boga, Jonathan Fernandez, Mercedes Rodriguez, and Azucena Rodriguez-Guardado*
    Objective: Human immunodeficiency virus (HIV) co-infection with parasitic diseases is an issue not only in parasite-endemic countries but also for persons who have migrated to more developed countries where the infections may go unrecognized due to lack of experience by the practitioners especially that the patients are often asymptomatic when parasite burdens are low. For this reason, we performed a systematic screening program for parasitic diseases in immigrant patients with HIV infection. The results of this program are described.
    Design: A cross-sectional study was conducted to evaluate the results of this screening program.
    Methods: Screening for all patients comprised blood count, biochemistry, basic urinalysis, CD4+ cell counts, HIV viral load and HIV-subtypes, Hepatitis B virus, hepatitis C virus, syphilis antibodies, and PPD test. Parasitological test included three concentrated stool samples, detection techniques for Plasmodium and serological detection of Schistosoma spp., Strongyloides and Chagas' disease.
    Results: 63 patients were analyzed. Thirty-four patients had a parasitic disease. The geographical distribution of the patients was as follows: Central Africa (52.4%), South America (31.7%), West Africa (9.5%); North-Africa and Centro America (3.2% each). Thirty-four (54%) patients had a parasitic disease. The most frequent disease was intestinal parasites followed by filariasis and Chagas's disease. Parasitic diseases were more frequent in patients from Central Africa (11 vs 22, p=0.033, OR 3.00 [0.95-9.62])
    Twenty-eight patients (44.4%) were infected with intestinal parasites and in this case viral load was significantly higher in infected patients 287,970 ± 982,009 RNA viral copies/mm3 vs 83,616 ± 196,220, (p=0.041). In the rest there are no statistical differences in age, sex, and time in Spain and the average CD4+ cell count between infected and not infected patients.
    Conclusions: This study supports the use of screening for parasitic diseases in immigrant patients with HIV infection.
    Editorial
    Marcio Cristiano de Melo*
    Nurses professional smake use of epidemiological tools from the research developed by the matriarch of the profession Florence Nightingale between the years 1853-1856. The kills acquired through teaching epidemiology leverage the professional performance withthe use of existing resources (according to the epidemiological approach), awareness and organization of ideas on the health problems of a particular area, community or person, sets targets for achieving of investigations to evaluations and enables the nurse to clearly identify identification, analysis and interpretation of possible social, economic and/or political determinants that aims at solving problems [1].
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