AGS-004 immunotherapy consists of autologous dendritic cells electroporated with four HIV RNAs encoding autologous Gag, Vpr, Rev and Nef antigens¹.  AGS-004 is undergoing testing using a kick and kill strategy in combination with the latency reversing drug, Vorinostat. To specifically target virus variants likely to emerge from a patient’s latent reservoir, RT-PCR amplification protocol is applied to HIV generated in supernatants of ex vivo mitogen-stimulated, latently infected CD4⁺ cells.  Up to 24 replicate cultures of activated CD4⁺ cells were established and monitored for viral outgrowth by p24^Gag ELISA. We previously observed that the cultures became positive at different rates with variable levels of p24 measured in each culture, suggesting diversity of emerging species².  To evaluate diversity of the emerging virus, individual clones of RT-PCR-amplified target regions were sequenced using the Sanger method and analyzed by phylogenetic tree analysis.  This analysis revealed that clone sequences generally grouped together by their origin culture, demonstrating similarity to one another. In contrast, the clone sequences from different individual cultures clustered separately from one another, indicating the presence of divergent viral species in independent cultures (as demonstrated in Gag example below). Therefore, diverse HIV species are being captured with RT-PCR amplification, both within as well as across the different replicate cultures of CD4⁺ cells. Using pooled CD4+ cell cultures as a substrate for amplification of RNA antigens, AGS-004 can direct the immune system to specifically target the unique autologous virus species in a patient’s latent reservoir. A clinical trial testing this hypotheses is on-going.

TBA

TBA

This study compared the oral bacterial community between HIV+ and HIV- Brazilian children. 27 HIV+ and 30 HIV- were enrolled in this study. Total saliva, biofilm from the dorsal tongue, and biofilm pooled from supragingival and subgingival sites were collected from all children. Genomic DNA was purified from all the oral samples and sequenced using Ion Torrent technology. The most represented phyla were Firmicutes (~58%) and Fusobacteria (~14%), In the supragingival biofilm, the phylum Firmicutes and genus Streptococcus were more frequent in HIV+ (~95% and 78%, respectively) than in HIV- individuals (~40% and 24%, respectively). In contrast, Neisseria spp. and Leptotrichia spp. showed relative abundance of approximately 13% and 15%, respectively, in HIV- samples; however these genera were undetected in HIV+ individuals. In the subgingival biofilm and on the tongue of HIV-, the relative abundance of the Veillonella spp. and Prevotella spp. genera were higher compared to HIV+. On the tongue, the genera with greater relative abundance in HIV+ were Neisseria spp. and Leptotrichia spp. In saliva, there was a slight difference in relative abundance of the genus Prevotella observed between HIV+ and non-HIV- (15% and 7%, respectively). While the Chao diversity index revealed an increase in the richness of sub- and supragingival biofilms in the HIV+ samples compared with HIV-, the Shannon diversity index was higher in HIV+ only for the biofilm supragingival samples. In conclusion, HIV+ children present an oral bacterial community with lower complexity than in HIV-; however, they have a higher frequency of the phyla Firmicutes and streptococci.

Introduction

HIV/AIDS continues to be a disease of public health importance especially in developing countries with high rate of unemployment, poverty and hunger. The aim of this study was to determine the pattern of presentation and factors associated with HIV/AIDS progression in a referral clinic in south eastern Nigeria

Methodology

A cross-sectional descriptive study was carried out among 349 HIV positive patients attending HIV clinic in Ebonyi state. Data was collected using anonymous pre-tested interviewer administered questionnaire and review of medical records. Odd ratios and 95% confidence intervals were computed and P values of < 0.05 were considered statistically significant.

Result

Three hundred and forty nine adult respondents attending ARV clinic took part in the study. Of the 349 subjects, 128(36.7%) were males and 221(63.3%) were females. The age range was 17 to 67 years with a mean and standard deviation of 40.40 ± 9.96 years. The mean BMI was 24.067( SD 5.105) and Waist Hip Ratio was 0.96, while the mean BP was 108.07/68.23 (SD 17.59/11.81. The majority of the respondents, 323(92.6%) had HIV 1 while 26(7.4%) had both HIV 1&2. Majority of the HIV positive patients 338(96.8%) were in clinical stage 2 followed by 10(2.9%) in stage 3 while  342 (98%) were on ART. The mean CD4 count of the respondents was 442.45 with SD of 252.664 while the mean ESR was 42.48 with SD 88.878 and mean viral count was 43.48 with SD of 88.87. The highest CD 4 count was among the age group 11-20 with 645.5±253.85 while the lowest CD4 count was among the age group 61-70 with CD4 count of 384.56±163.5. For marital status, the highest CD4 count was among the single with CD4 count of 460.35±258.13 while the lowest was among the married with CD4 count of 311.0±240.76. The CD4 count of urban dwellers 463.47±259.67 was also higher than that of rural dwellers 407.97±237.75.

 Being married (p<0.005) and place of residence (p< 0.053) were significantly associated with worse disease progression.

Conclusion

Efforts targeted at raising standard of management of HIV/AIDS and care for people living with the disease is needed in rural communities with worse disease progression. Programs should be directed at older married males