Pharmaceutical management of HIV infection is complex, and proper adherence to antiretroviral regimens is contingent on active patient involvement in treatment. We examined the relationship between patient understanding of HIV and its treatment and health literacy. Structured interviews were conducted with 157 HIV-infected individuals receiving care at a community-based clinic in Shreveport, Louisiana, USA. In all, 48% of patients were reading below a 9th grade level. One-third of patients could not name their HIV medications and this was significantly related to low literacy (P < 0.01). Two-thirds of those reading below the 9th grade level did not know how to take their medications correctly (P < 0.05), and 75% did not know the meaning of a CD4 count or viral load (P < 0.001). Patients with low literacy skills were more likely to state that their physician was their sole source of HIV information (P < 0.005). Physicians may require training to appropriately convey health information to patients of low literacy.

Systemic lupus erythematosus (SLE) is an autoimmune disease most prevalent in women between the ages of twenty and sixty. Successful treatment remains challenging due to a lack of understanding of the underlying mechanisms and multiple symptoms ranging from skin rashes to glomerulonephritis. The pathogenesis of SLE has been linked to a B-cell hyperproliferation unique to afflicted patients. These B-cells generate large quantities of IgG autoantibodies, ultimately capable of leading to lupus nephritis and renal failure. The significance of cytokines in SLE and in murine lupus, a related disease in mice, has been debated, particularly with respect to B-cell activity. Potential roles of auto-regulatory and inflammatory cytokines have been investigated. In particular, IL-6 and IL-10 have been shown to be key factors in regulating autoantibody-secreting B-cell activity in lupus. Here, we will provide a critical overview of our current knowledge of the regulatory roles of these two cytokines in SLE.

No abstract