Background: HIV infection is considered to be an international health problem. In the last five years, WHO and ECDC described in HIV/AIDS surveillance reports the pandemic evolution of the infection, with the increasing number of infected persons and the relative stable number of death in spite of the new antiretroviral therapy and new adherence protocols.
Material and method: We made a review of the reported data concerning the HIV infection in Romania, presenting the specific aspects in Cluj-Napoca Regional Centre, which is the surveillance unit for the North-Western part of Romania
The presented data were collected between 1997 and 2017, including diagnosis, treatment, opportunistic infection, immunological evaluation, stadialization and outcome.
Results: In Romania, the first cases of AIDS in adults were diagnosed in 1985 and in children in 1989. At the end of 2001, WHO and UNAIDS reported 6,500 cases of HIV/AIDS infection, of which 4,000 (61.5%) in children and 2,500 (38.5%) in adults. The route of transmission was nosocomial in 50.5% of cases (in most of the babies born in 1987-1990), transfusions (22.6%), unknown (15.1%), sexual (8.2%) and perinatal (3.7%). Among the transmitting ways of HIV, in 2016 & 2017, in children predominated the nosocomial, followed by maternal-fetal and blood infections, and in adults, the heterosexual transmission predominated, followed by the drug users, and by the blood and derivatives transmission.
Conclusions: The fact that HIV is predominantly sexually transmitted and disproportionately affects populations that are already socially or economically marginalized or both have many ethical, social, economic and political challenges.
Maria Lagadinou is a doctor at University Hospital of patras, Greece. Research interest in infection diseases, HIV, AIDS. She has more than 20 papers published in full in international journals and is an editorial board member of national reviews.
INTODUCTION: HIV infection is a global problem, having affected about 33.4 million people worldwide, with sub-Saharan Africa accounting for more than half of it, still posing a public health hazard. Since 1981, when the first cases of HIV infection have been recorded, it has become a global epidemic with significant health, social and economic repercussions, especially in specific geographical areas such as Africa and South-East Asia. Over the past decade, Greece has despite the implementation of intensive prevention and treatment measures and the apparent stabilization of new recorded cases. However, the annual report of the Center for the Control and Prevention of Special Infections announces the significant increase in new cases.
PATIENTS AND METHODS: We studied the health-related quality of life of patients with HIV. It was given questionnaires (SF-36, MOS-HIV) and patients answered questions related to factors such as: physical health, physical role, social role, emotion, energy - vitality, mental health and general health. Completion of the questionnaires took place during regular patient visits in department of Infectious Diseases of the University Hospital of Patras. In that study took part a total of 58 patients who were receiving antiretroviral treatment. Exclusion criteria were newly diagnosed with HIV infection and the hospitalization for any reason.
RESULTS: With regard to physical health and as studied on the basis of the SF-36 questionnaire: 80.8% of the patients responded that they did not account for the time spent on their health. The percentage of patients who do not feel inferior (56.6%) is also high and 71.2% said they had no difficulty in completing their work. . In contrast to physical pain, most reported that their physical and mental problems affected their social behavior. Emotions that prevail for quite some time are gloom (35.4%) than respondents answered. According to MOS-ΗΙV Questionairre, 46.3% responded that they did not feel physical pain and therefore the latter did not affect or hinder work, answering 79.2%. In this questionnaire, patients were also asked about the quality of their lives: 44% responded that they were good enough. The activities (either intense or light) appear to be unaffected by both the disease and the treatment. Τhe majority of patients replied that they had never had difficulty thinking, remembering, never disturbing attention. As far as social activities are concerned, 35.2% said they were affected by health problems a few times. Both from the SF-36 questionnaire and the MOS-HIV, was found that physical as well as mental health of patients with acquired immunodeficiency is not affected as much as one would expect due to the simplified but still multiple medicines taken by patients with HIV, as well as the average values for the physical and mental health is quite high.
CONCLUSION: This study reports on the quality of life related to the health of HIV-infected patients monitored at the Infectious Diseases Unit of the University General Hospital of Patras. The results may be optimistic for seropositive women, but their comparison with the quality of life of the healthy population, also done by other researchers, clearly shows lower scores for HIVpositive patients compared to healthy. The results of this study show that HIV-positive people, at the period of HAART, have a low level of quality of life related to health compared to the general population. This study could be extended to more HIV centers in Greece and carried thereby general conclusions which will likely contribute to a better routine clinical practice and to improve, and by extension reduce the side effects of antiretroviral drugs.
Professor University of Medicine and Pharmacy Iuliu Hatieganu, Romania
Key-words: HIV-epidemic; Control and Prevention; National Task Force; political-support; workable-policies; undivided-participation; perseverance; milestones; People who inject drugs (PWID); female sex-workers (FSW); transgender-people (TG); men who have sex with men (MSM); people living with HIV (PLHIV); HIV/AIDS-related deaths; antiretroviral; National Strategic Plan (NSP 2010 – 2015); at-risk populations; co-infections; financing; psycho-social factors; HIV-care; MDG6-target; enhanced focus-areas
Malaysia has been grappling with Control of the HIV-epidemic in its Prevention since the first-case in 1985 and since the National Task Force was established just before that – and, has seen some success. Strong political-support, workable-policies, undivided-participation and perseverance has been the mainstay.
The Aim of this Paper/Presentation is to describe the Epidemiology of HIV/AIDS in Malaysia in a literature-review along with the process of planning, policy-making, implementation, and evaluation of Control and Prevention programs in Malaysia since then, besides the constraints.
By 2015, Malaysia has successfully halved new-infections from 2000.
Major milestones in the country’s responses to HIV/AIDS, and the corresponding infection-rates are noted.
People who inject drugs (PWID), female sex-workers (FSW), transgender-people (TG) and men who have sex with men (MSM) represent the country’s most affected by the epidemic. There are an estimated 92,895 people living with HIV (PLHIV) at the end of 2015.
New HIV-infection has declined by 50%, while the number of HIV/AIDS-related deaths has stabilized. Availability and accessibility of antiretroviral has been enhanced since it became a component of care, treatment and prevention in 1990.
The pattern has shifted from PWID to increasingly more sexual-transmission.
The National Strategic Plan (NSP 2010 – 2015) addresses the vulnerable and at-risk populations, co-infections, financing, and psycho-social factors.
Malaysia has achieved the MDG6-target on HIV. But there is still a huge-gap in HIV-treatment, care and prevention coverage. This gap continues as enhanced focus-areas in the new strategic plan to end AIDS by 2030.
Chandra Hamal is an active member of YUFD NEPAL since 2010. Established in 2009, Youth Voice for Development aims to help the Nepalese citizen with all sorts of Developmental activities such as Poverty Elevation, protection of Human rights and raising the standard of human consciousness in many Issues/ Topics. Since its Commencement he, along with the organization has been carrying out many activities and operations for the well-being of the people of my Nation. Being an enthusiastic Social Motivator, he has pledged to devote himself and do his duties and responsibilities with full integrity and faithfulness.
This paper explores some of the key issues and challenges of government HIV/AIDS prevention and treatment program in Nepal. Providing HIV/AIDS prevention and treatment services in Nepal is associated with a number ofissues and challenges which are shaped mostly on cultural and managerial issues from grass root to policy level.Numerous efforts have been done and going on by Nepal government and non-government organization but still HIVprevention and treatment service is not able to reach all the most at risk populations because cultural issues andmanagerial issues are obstructing the services. The existing socio-cultural frameworks of Nepal do not provide anenvironment for any safe disclosure for person who is HIV infected. Thus, there is an urgent need to address thoseissues and challenges and strengthen the whole spectrums of health systems through collaborative approach to achievethe millennium development goals. It will be the purpose of this paper to contribute to the policy makers by exploringthe pertinent issues and challenges in the HIV/AIDS program.
Background: HIV/AIDS is an exceptional epidemic that requires an exceptional response. Material and method: There are in active evidence 371 patients, 288 of them being with antiretroviral therapy. We present the situation of newly diagnosed cases in the last five years in Cluj, in association with the CD4 count and the opportunistic infections. The opportunistic infections were in most of the cases correlated with the CD4 count. Most of the patients were asymptomatic at the moment of the diagnosis. In patients with CD4 count over 500/cmm, the percentage of opportunistic infections was bigger for respiratory lower tract infections (22%), followed by CMV retinitis (11%) and diarrhea (5%). The patients diagnosed in AIDS stage, with CD4 count under 200/cmm presented especially esophageal candidiasis (15%), followed by pulmonary and lymph node tuberculosis (8%), syphilis (7%). Opportunistic infections of the nervous system were represented, in 2-4% of the cases, by cerebral toxoplasmosis and cryptococosis. Pneumocystis jirovecii pneumonia was detected in 3-7% of cases. The severe infections characteristic to AIDS stages were represented by candidiasis (28%), cryptococal meningitis, cerebral toxoplasmosis (in 4% of cases) and reactivation of Varicella virus (in 10% of cases). In conclusion, the number of newly detected HIV/AIDS patients is gradually increasing; most of them are being with severe opportunistic infections at the time of the diagnosis. Except the opportunistic infections, the most common clinical condition was wasting syndrome. All the infections were correlated with the immune status, with no particular aspects.
Hepatitis B virus (HBV) is responsible of chronic infection in 350 million people worldwide and represents a major factor for liver cirrhosis and hepatocellular carcinoma. There are eight main HBV genotypes with particular geographic distribution. Mutations appear as a response to external pressure and host’s conditions. Assays are available to determine HBV genotypes and to detect the presence of viral mutants, including those that confer drug resistance. Vaccine escape mutants are also studied. The genetic diversity of HBV plays an important role in the evolution of HBV infections and has been associated with clinical outcome and response to antiviral therapy.
This infection is one of the main causes of fertility between women. The aims were the estimation of prevalence rate, clinical symptoms of women and their husbands in comparison with other societies. In a cross-sectional study in 2015 to 2017, we collected vaginal discharge of 249 women with infectious discharge, burning, itching and 64 urethral discharge of their husbands. We examined for parasite (direct and staining method), symptom kind and age in women and in positive cases husbands. The urinary infection or other STI were excluded from the study. Data were analyzed by SPSS software.64 women had trichomonas (25.7%). The most common symptoms were infectious discharge 100%, burning 90.6%, and itching 85.9%. The most of patients were at >35 years old group. 64 men participated in study. 20 of them had trichomonas infection (31.25%). But 80% of positive men did not have any kind of symptom. The results showed, there was no significant difference between parasite existence and symptom or residency area (p>0.05). But there was significant difference with age group and educational rate (p<0.05). The examination of patients husbands is necessary. Also, vaginal discharge test must be achieved as soon as possible. Educational programs for family health are essential too.
HIV, HBV and HCV are the major STIs. Due to common methods of transmission, HBV positive individuals are at risk of co- infection with HIV and HCV infections. The seroepidemiologic rates of co- infection with HBV, HCV and HIV have been variable worldwide pertaining to the geographic regions, and the type of exposure, however, there is no sufficient information about pregnancy period. The aim of this research is surveying the seroepidemiology of HIV, HCV, and HBV in pregnant women and correlation with socio- economic factors. A total of 186 blood samples of pregnant women in the first trimester were collected and studied for HBsAg, HCVAb, and HIVAb by ECL method from April 2017 to March 2018. Data about Age, socioeconomic factors were analyzed by SPSS and Chi-square.
Seroepidemiologic rate of anti- HIV was 0%, HCV Ab 0.54 %( 1 case), and HBsAg, 1.61% (3 cases) . Co -infection for HBsAg and HCVAb was seen in 1person (0.54%). There was no significant relation between socioeconomic factors ( p>0.005), but there was significant relation between HBV and HCV positive rate and age group( p<0005). The all positive cases were at 35 to 40 years age group. The overwhelming majority of STI like HBV ,HCV ,and HIV in developing countries are transmitted via sexual contact now . But in the past, intravenous drug addiction was the common way in Iran. HBV vaccination and free lab tests for pregnant women in Iran are the main cause for reducing STI rates in all various socioeconomic groups of people .We recommend that all people should be tested regarding STI factors before marriage and pregnancy time for deduction of infections in the future. Likewise, educational programs are necessary.