scholarly journals The Potential of Vaccines for the Control of AIDS

1994 ◽  
Vol 5 (suppl a) ◽  
pp. 36A-41A
Author(s):  
Margaret I Johnston ◽  
Patricia E Fast ◽  
Mary Clare Walker ◽  
Daniel Hoth
Keyword(s):  
Vaccine Development ◽  
Cytotoxic T Lymphocyte ◽  
Phase 1 ◽  
Cd4 Cell Count ◽  
Naked Dna ◽  
The Status ◽  
Subsequent Exposure ◽  
The Individual ◽  
Cd4 Cell ◽  
The Impact

The goal of a prophylactic human immunodeficiency (HIV) vaccine is to elicit immune response(s) that will, upon subsequent exposure to HIV. prevent lnfection and/or disease. On the other hand. therapeutic administration of a vaccine to an individual in whom infection is already established might benefit the individual by augmenting existing functional immune responses or inducing new ones. Development of vaccines for the prevention of AIDS offers unique challenges. Concerns regarding the safely of attenuated and whole-killed products have led to the pursuit of alternativc designs. including recombinant proteins, vectors and particles, synthetic peptides and naked DNA. Seven recombinant envelope. two recombinant vector and four other candidate vaccines that have entered into phase 1 trials in noninfected individuals have proven safe to date, and have differed In their ability lo induce functional antibody and Cytotoxic T lymphocytes. Two recombinant envelope products have recently progressed to phase 2 testing, Five envelope-based and six other products have entered trial in HIV-infected and individuals and have appeared to be safe, Evidence of new antibody, increased T cell proliferation and lncreased cytotoxic T lymphocyte activity have been reported. Additional placebo controlled trials will be required to evaluate the impact of therapeutic vaccination on CD4 cell count. viral burdrn and clinical end-points. The status of HIV/AIDS vaccine development is reviewed. with emphasis on the challenging task of finding an effieacious, safe, prophylactic vaccine.

scholarly journals Using record linkage to assess the impact of late presentation for care and treatment on short-term mortality among HIV-infected adults in rural South Africa.

2017 ◽  
Vol 1 (1) ◽  
Author(s):  
Chodziwadziwa Whiteson Kabudula ◽  
Georges Reniers ◽  
Francesc Xavier Gómez-Olivé ◽  
Kathleen Kahn ◽  
Stephen Tollman
Keyword(s):  
South Africa ◽  
Cell Count ◽  
Late Presentation ◽  
Short Term ◽  
Cd4 Cell Count ◽  
Short Term Mortality ◽  
Care And Treatment ◽  
Cd4 Cell ◽  
The Impact ◽  
Rural South Africa

ABSTRACT ObjectivesTo assess the impact of late presentation (CD4 cell count <200 cells/μl at presentation) for care and treatment on short-term mortality (death within a year of presentation) among HIV-infected adults in rural South Africa. ApproachWe applied deterministic and probabilistic record linkage approaches to link adult patients seeking care and treatment for HIV from a health facility between 2007 and 2013 to population under continuous surveillance by the Agincourt Health and Demographic Surveillance System (HDSS) in rural northeast South Africa. The resulting record-linked dataset was thereafter analysed to estimate short-term mortality (death within a year of presentation) differences in late presenters (initial presentation at health facility with CD4 cell count less than 200 cells/μl) and early presenters (presentation with CD4 cell count of 200 or more cells/μl). In the linked dataset, CD4 cell count was extracted from the health facility database where as date of death came from the HDSS database. ResultsA total of 3,553 patients who sought care and treatment for HIV at Bhubhezi clinic between 2007 and 2013 were linked to the Agincourt HDSS surveillance population. Proportion of patients classified as late presenters was 60.9%. Short-term mortality was 8.9% (317/3,553): 11.1% among those who presented late and 5.5 % among those who presented early (P<0.001). ConclusionRecord linkage facilitated the assessment of the impact of late presentation for care and treatment on short-term mortality among HIV-infected adults in rural South Africa. In the population studied, late presentation is high and is contributing to high mortality among people living with HIV. Strategies that would facilitate early presentation are needed in order to reduce mortality among people living with HIV.

The Impact of Episodic CD4 Cell Count-Guided Antiretroviral Therapy on Quality of Life

2008 ◽  
Vol 47 (2) ◽  
pp. 185-193 ◽  
Author(s):  
William J Burman ◽  
Birgit Grund ◽  
Mollie P Roediger ◽  
Gerald Friedland ◽  
Janet Darbyshire ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Antiretroviral Therapy ◽  
Cell Count ◽  
Cd4 Cell Count ◽  
Cd4 Cell ◽  
The Impact

scholarly journals Avoiding Inpatient Delays in Antiretroviral Therapy via Low Cost Formulary Management

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S436-S436 ◽  
Author(s):  
Hannah Sundquist ◽  
Zahra Kassamali
Keyword(s):  
Antiretroviral Therapy ◽  
Reverse Transcriptase ◽  
Low Cost ◽  
Reverse Transcriptase Inhibitors ◽  
Nucleoside Reverse Transcriptase Inhibitors ◽  
Cd4 Cell Count ◽  
Viral Loads ◽  
Appropriate Therapy ◽  
Cd4 Cell ◽  
The Impact

Abstract Background Of 8 formulary HIV medications at our institution, 3 are no longer first line treatments. Agents unavailable on formulary are administered from a patient’s own supply. We examined the impact of availability of antiretroviral therapy (ART) on time to appropriate therapy among HIV positive inpatients. Methods Adult inpatients who received ART from 11/2015 – 10/2016 were included in this single-center review. Data were evaluated by encounter; individuals with multiple admissions were counted per admit. Descriptive statistics were used to evaluate the time from admission to ART order and administration. We noted discrepancies between ordered and home ART regimen, and any administration of partial therapy. Patients not taking ART prior to admission or without documentation of a home ART regimen were excluded from the outcomes analysis. A cost analysis was conducted to describe the financial impact of any recommended formulary changes. Results 36 patients with 55 inpatient encounters were evaluated; 46 (84%) had a documented home ART regimen. Mean age was 47.8 years, 67% were male, 36% met criteria for AIDS by CD4 cell count. Creatinine clearance was &lt; 60 ml/minute in 33% of subjects, 25% were admitted for an infectious issue. Median length of stay was 5 days. Half (49%) were taking nucleoside reverse transcriptase inhibitors, 22% integrase inhibitors, 19% protease inhibitors, 3% non-nucleoside reverse transcriptase inhibitors. In the 7 encounters (15%) with all ART on formulary, 100% received their full ART regimens as inpatients vs. 69% of those with partial or no ART on formulary. Median time to therapy doubled in patients who had partial or no home ART on formulary: 25 hours (median of 1 missed dose) vs.. 12 hours (median of 0 missed doses). Anticipated annual cost of formulary revisions, including addition of 4 agents, was $6016.37. Conclusion Having a complete ART regimen on formulary substantially increased likelihood of complete ART administration without delay. Adding an NRTI alternative to tenofovir was needed due to high rates of renal dysfunction; adding agents with higher barriers to resistance, dolutegravir and darunavir, were important as genotypes and viral loads are not always known at admit. Expanding the ART formulary provides a significant improvement in quality of care at a reasonable cost. Disclosures All authors: No reported disclosures.

scholarly journals The Impact of HIV Infection and CD4 Cell Count on the Performance of an Interferon Gamma Release Assay in Patients with Pulmonary Tuberculosis

PLoS ONE ◽  
2009 ◽  
Vol 4 (1) ◽  
pp. e4220 ◽  
Author(s):  
Martine G. Aabye ◽  
Pernille Ravn ◽  
George PrayGod ◽  
Kidola Jeremiah ◽  
Apolinary Mugomela ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Hiv Infection ◽  
Cell Count ◽  
Interferon Gamma ◽  
Interferon Gamma Release Assay ◽  
Cd4 Cell Count ◽  
Release Assay ◽  
Cd4 Cell ◽  
The Impact

The impact of diabetes on CD4 recovery in persons with HIV in an urban clinic in the United States

2017 ◽  
Vol 29 (1) ◽  
pp. 63-71 ◽  
Author(s):  
Julie A Zuniga ◽  
Kirk A Easley ◽  
Neeta Shenvi ◽  
Minh L Nguyen ◽  
Marcia Holstad
Keyword(s):  
African American ◽  
T Cell ◽  
Cell Count ◽  
African American Women ◽  
Cd4 T Cell ◽  
Cd4 Cell Count ◽  
Cell Counts ◽  
Cd4 Cell ◽  
The Impact ◽  
Cd4 T Cell Count

The purpose of this study was to exam the impact of type 2 diabetes mellitus (T2DM) on CD4 cell count trends in adults with HIV. In a longitudinal retrospective study in an urban primary care HIV clinic in the southeastern United States from 2010 to 2012, patients with HIV medical charts were audited to obtain their CD4 cell count, diabetes status, weight, and demographic information. Rates of increase of CD4 T cell count (i.e. slopes) were obtained using a linear mixed-effects model. Most of the HIV–T2DM cohort (n = 262) and HIV-only cohort (n = 2399) were African American (76%) and male (77%). The CD4 T cell counts were consistently higher in the HIV–T2DM cohort ( p < .0001). The mean rate of CD4 T cell count increase (mean ± SE) was 63 ± 9 cells/µl/year in HIV–T2DM African American women and 28 ± 7 cells/µl/year in HIV–T2DM African American men ( p = 0.003). In the multivariable slope analysis, the CD4 T cell count increase was significantly faster for HIV–T2DM African American women than for all other patients (mean difference = 30/cells/µl/year, 95% CI: 13–47; p < 0.001). Gender, race/ethnicity, and the diagnosis of diabetes influenced the recovery of CD4 cell counts.

Classics and Dance

Classics ◽  
2017 ◽  
Author(s):  
Fiona Macintosh
Keyword(s):  
18Th Century ◽  
Modern World ◽  
Greco Roman ◽  
15Th Century ◽  
The Arts ◽  
Birth Of Tragedy ◽  
The Status ◽  
Tragic Drama ◽  
The Individual ◽  
The Impact

The impact of ancient Greek and Roman dance on modern dance has been perceptible since at least the 15th century. While classical reception in dance is now recognized as a sub-category within dance studies and a serious dimension to classical performance reception, previously this interrelationship, if acknowledged at all, was generally discussed in terms of modern dance’s regular dependence on Greco-Roman myth for its subject matter rather than with reference to any systematic formal links. However, with the recent interest in ancient pantomime scholarly attention has been given to the ancient origins of modern ballet, ballet d’action, which in the first decades of the 18th century took its cues from Roman pantomime. In the first decade of the 18th century, the synthesis of the arts began to unravel and dance was no longer allied to opera or spoken theatrical entertainment. It now had to find its own genealogy and Aristotle’s idea of dance as mimetic action, combined with treatises on Roman pantomime (itself a direct descendent of Greek tragedy), provided the theoretical underpinning for the 18th-century ballets d’action. Dance was to follow the ancients in having something important to say; and Greek tragic drama was realized in 18th-century danced drama without the aid of either speech or (unlike ancient pantomime) song. By the last quarter of the 18th century, ballet had acquired sufficient status to become a high cultural art form sui generis; and it had done so with the ancient example as both guide and legitimizing authority. Ballet, like other performance arts, depends very much on its genealogy: not least because its major stars very often belong to dancing dynasties. Ballet continued to look back to antiquity, but with the decline in the status of the dancer in the 19th century the links with antiquity were often deliberately suppressed. However, by the end of the century, and especially following Nietzsche’s The Birth of Tragedy out of the Spirit of Music (1872), where the singing/dancing chorus was restored to discussions on tragedy, Greek dance finally began to attract attention among scholars and artists alike. The aim of this bibliography is to trace this perceived, occasionally actual and tactical, but very often suppressed, debt to ancient dance in the modern world from the 15th century down to the present day, focusing on the individual dancer, dancing collectivities, and their relationship to scholarship.

scholarly journals Nocardia FarcinicaLung Abscess Presenting in the Context of Advanced HIV Infection: Spontaneous Resolution in Response to Highly Active Antiretroviral Therapy Alone

2009 ◽  
Vol 20 (3) ◽  
pp. e103-e106 ◽  
Author(s):  
Arienne S King ◽  
Jose G Castro ◽  
Gordon CK Dow
Keyword(s):  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Highly Active Antiretroviral Therapy ◽  
Opportunistic Pathogen ◽  
Cd4 Cell Count ◽  
Highly Active ◽  
Metastatic Infection ◽  
History Of ◽  
Cd4 Cell ◽  
The Impact

A 43-year-old man, known to be HIV-positive, presented with a six-week history of symptoms including cough, hemoptysis, anterior chest pain, fever and wasting. His CD4 cell count was 46 cells/μL, and his chest x-ray showed a cavitating lesion in the left upper lobe. Sputum culture was positive forNocardia farcinica. His infection resolved following initiation of antiretroviral therapy.Nocardiais an uncommon opportunistic pathogen in patients with HIV infection and is usually associated with advanced CD4 depletion, cavitary pneumonia, metastatic infection and high mortality. The impact of antiretroviral therapy onNocardiainfection in the setting of HIV has not been clearly elucidated. The current report is the first to present a case in which a complete clinical cure ofNocardiapneumonia has been documented, primarily in response to highly active antiretroviral therapy alone.

scholarly journals How we treat patients with lung cancer during the SARS-CoV-2 pandemic: primum non nocere

ESMO Open ◽  
2020 ◽  
Vol 4 (Suppl 2) ◽  
pp. e000765 ◽  
Author(s):  
Giuseppe Banna ◽  
Alessandra Curioni-Fontecedro ◽  
Alex Friedlaender ◽  
Alfredo Addeo
Keyword(s):  
Lung Cancer ◽  
Negative Impact ◽  
Treatment Decision ◽  
Pulmonary Complications ◽  
Difficult Time ◽  
The Status ◽  
Patient’S Outcome ◽  
Novel Coronavirus ◽  
The Individual ◽  
The Impact

New cases of the novel coronavirus, also known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continue to rise worldwide. A few reports have showed that mortality due to SARS-CoV-2 is higher in elderly patients and other active comorbidities including cancer. To date, no effective treatment has been identified and management for critically ill patients relies on management in intensive care units. Patients with lung cancer are at risk of pulmonary complications from COVID-19. Furthermore, the use of chemotherapy might have a negative impact in patient’s outcome. Therefore, the risk/benefit ratio of systemic anticancer treatment (SACT) has to be considered. For each patient, several factors including age and comorbidities, as well as the number of hospital visits for treatment, can influence this risk. Each hospital around the world has issued some internal policy guidelines for oncologists, aiming to limit risks during this difficult time. We hereby propose a tool to support oncologists and physicians in treatment decision for patients with lung cancer. There are several variables to consider, including the extent of the epidemic, the local healthcare structure capacity, the risk of infection to the individual, the status of cancer, patients’ comorbidities, age and details of the treatment. Given this heterogeneity, we have based our suggestions bearing in mind some general factors There is not easy, universal solution to oncological care during this crisis and, to complicate matters, the duration of this pandemic is hard to predict. It is important to weigh the impact of each of our decisions in these trying times rather than rely on routine automatisms.

scholarly journals 1304. Pharmacist Impact on HIV Management in a Psychiatric Patient Population

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S470-S470
Author(s):  
Alice Margulis ◽  
Stepan Uhlyar ◽  
Nafeesa Chin-Beckford ◽  
Veronica Salazar ◽  
Kailynn DeRonde ◽  
...  
Keyword(s):  
Psychiatric Patient ◽  
Patient Population ◽  
Laboratory Testing ◽  
Mental Illnesses ◽  
Hiv Viral Load ◽  
Cd4 Cell Count ◽  
Institutional Review ◽  
Hiv Management ◽  
Cd4 Cell ◽  
The Impact

Abstract Background Patients with mental illnesses are more than four times more likely to have human immunodeficiency virus (HIV) compared with the general population. HIV management can be especially challenging in these patients due to potential substance abuse, drug interactions, and nonadherence. The purpose of this study was to determine the impact of pharmacist management of antiretroviral (ARV) therapy in a psychiatric patient population. Methods This is an institutional review board-approved, single-center, retrospective study of patients admitted to a psychiatric hospital with an order for one or more ARV medication(s) between October 2016 and March 2017 (no pharmacist involvement), October 2017 and March 2018 (partial pharmacist involvement), and November 2018 and January 2019 (consistent pharmacist involvement). Patients were excluded if less than 18 years of age, pregnant, incarcerated, or taking ARV medication(s) for a non-HIV indication. The primary outcome was difference in appropriateness of ARV therapy prior to and during pharmacist involvement. Secondary outcomes were appropriateness of opportunistic infection (OI) prophylaxis and laboratory testing. Results A total of 37 patients were included per group. A greater number of appropriate ARV regimens were initiated with partial pharmacist involvement compared with no pharmacist involvement (62% vs. 32%, P = 0.0096), as well as with consistent pharmacist involvement compared with partial pharmacist involvement (84% vs. 62%, P = 0.0327). There was a trend toward increased HIV viral load draws with partial vs. no pharmacist involvement (54% vs. 43%, P = 0.24) and additionally with consistent vs. partial pharmacist involvement (62% vs. 54%, P = 0.32). With consistent pharmacist involvement, more patients had a resulted CD4 cell count (65%) than with both partial and no pharmacist involvement (57%). Of the patients requiring OI prophylaxis, appropriate prophylaxis was initiated in more patients with consistent pharmacist involvement (57%) than with partial pharmacist involvement (50%) or no pharmacist involvement (11%). Conclusion Pharmacist involvement in HIV management in a psychiatric patient population increased appropriateness of ARV therapy, laboratory testing, and OI prophylaxis. Disclosures All authors: No reported disclosures.

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