Infectious and inflammatory diseases have repeatedly shown strong genetic associations within the major histocompatibility complex (MHC); however, the basis for these associations remains elusive. To define host genetic effects on the outcome of a chronic viral infection, we performed genome-wide association analysis in a multiethnic cohort of HIV-1 controllers and progressors, and we analyzed the effects of individual amino acids within the classical human leukocyte antigen (HLA) proteins. We identified >300 genome-wide significant single-nucleotide polymorphisms (SNPs) within the MHC and none elsewhere. Specific amino acids in the HLA-B peptide binding groove, as well as an independent HLA-C effect, explain the SNP associations and reconcile both protective and risk HLA alleles. These results implicate the nature of the HLA–viral peptide interaction as the major factor modulating durable control of HIV infection.
Primary infection with drug-resistant HIV-1 is well documented. We have followed up patients infected with such viruses to determine the stability of resistance-associated mutations. Fourteen patients who experienced primary infection with genotypic evidence of resistance were followed for up to 3 years. Drug resistance-associated mutations persisted over time in most patients studied. In particular, M41L, T69N, K103N, and T215 variants within reverse transcriptase (RT) and multidrug resistance demonstrated little reversion to wild-type virus. By contrast, Y181C and K219Q in RT, occurring alone, disappeared within 25 and 9 months, respectively. Multidrug resistance in 2 patients was found to be stable for up to 18 months, the maximum period studied. We conclude that certain resistance-associated mutations are highly stable and these data support the recommendation that all new HIV diagnoses in areas where primary resistance may occur should undergo genotyping irrespective of whether the date of seroconversion is known.
The outbreak was successfully controlled. However, it is difficult to determine which of the interventions implemented were most effective. Future outbreaks should be used as an opportunity to evaluate interventions using apps.
Six outbreaks of infectious syphilis in the United Kingdom, ongoing since 2012, have been investigated among men who have sex with men (MSM) and heterosexual men and women aged under 25 years. Interventions included case finding and raising awareness among healthcare professionals and the public. Targeting at-risk populations was complicated as many sexual encounters involved anonymous partners. Outbreaks among MSM were influenced by the use of geospatial real-time networking applications that allow users to locate other MSM within close proximity.
HIV (Human Immuno-deficiency Virus) infection has a multi system effect. some publications claimed deterioration of smell perception in HIV. In this study, we present our smell assessment in a group of HIV patients using market available tests. Methods: Cross sectional observational study of 19 patients recruited from a North Wales genito-urinary medicine (GUM) clinic. Inclusion and exclusion criteria were applied to HIV diagnosed patients. Patients who gave consent for the study were invited to an ENT clinic where smell and nasal assessment took place. Patients had anterior rhinoscoy. Smell Threshold test kit was used to assess smell sensation. Normal score smell threshold was considered if score was 5.5 or above. Results: 16 males and 3 females, age range 22-75 (mean 46 years old). 2 African and 17 Caucasian origin subjects. 14/19 (74%) had HIV diagnosis for less than five years. 11/19 (58%) had hyposmia (mean 4.40 while normal score is 5.50) when tested. 16/19 (84%) complained of no hyposmia prior to testing. 12/19 (63%) had highly active anti-retroviral therapy (HAART) treatment. 6/19 (32%) used recreational drugs (Cannabis). None of the patients had cognitive impairment. Conclusions: HIV patients had hyposmia although patients did not report it as a compalaint. Smell threshold is affected in HIV positive patients. This is important for patients health and safety. We recommend assessment of smell in HIV positive patients so they become aware of their reduced sense and its implication.
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