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Prognostic Impact of Sarcopenia along with Radiotherapy throughout Patients Using Advanced Gastric Cancers Addressed with Anti-PD-1 Antibody.
OBJECTIVE Astrocytes are proposed to be a critical reservoir of HIV in the brain. find more However, HIV infection of astrocytes is inefficient in vitro except for cell-to-cell transmission from HIV-infected cells. Here, we explore mechanisms by which cell-free HIV bypasses entry and post-entry barriers leading to a productive infection. METHODS HIV infection of astrocytes was investigated by a variety of techniques including transfection of CD4-expressing plasmid, treatment with lysosomotropic agents or using a transwell culture system loaded with HIV-infected lymphocytes. Infection was monitored by HIV-1 p24 in culture supernatants and integrated proviral DNA was quantified by Alu-PCR. RESULTS Persistent HIV infection could be established in astrocytes by transfection of proviral DNA, transduction with VSV-G-pseudotyped viruses, transient expression of CD4 followed by HIV infection, or the infection treated with lysosomotropic chloroquine or Tat-HA2 peptide. In absence of these treatments, HIV entered via endocytosis as seen by electronmicroscopy and underwent lysosomal degradation without proviral integration, indicating endocytosis is a dead end for HIV in astrocytes. Nevertheless, productive infection was observed when astrocytes were in close proximity but physically separated from HIV-infected lymphocytes in the transwell cultures. This occurred with X4 or dual tropic R5X4 viruses and was blocked by an antibody or antagonist to CXCR4. CONCLUSIONS A CD4-independent, CXCR4-dependent mechanism of viral entry is proposed, by which immature HIV particles from infected lymphocytes might directly bind to CXCR4 on astrocytes and trigger virus-cell fusion during or after the process of viral maturation. This mechanism may contribute to the formation of brain HIV reservoirs.OBJECTIVES To assess the validity of self-reported HIV status, and investigate factors that influence accurate reporting of HIV-positive status, in a population tested and informed of their HIV test result. DESIGN Prospective cohort study. METHODS We compared self-reported HIV status to biomarker-confirmed HIV test status among participants of Karonga Health and Demographic Surveillance Site (HDSS) in rural northern Malawi. We linked information on HIV test results to subsequent self-reported HIV status, and calculated sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for self-reported HIV status (considered as a diagnostic test). We used Poisson regression with robust variance estimators to examine predictors of accurate self-reporting of HIV-positive status. RESULTS Among 17,445adults who tested for HIV, were recorded as having received their HIV test results, and had a subsequent self-reported HIV status between 2007 and 2018 PPV of self-reported HIV status was 98.0% (95% confidence interval (CI) 97.3-98.7); NPV was 98.3 (98.1-98.5); sensitivity was 86.1% (84.5-87.7); and specificity was 99.8% (99.7-99.9). Among true HIV-positive people, those who were younger, interviewed in community settings, and had tested for HIV longer ago were more likely to misreport their HIV-positive status. CONCLUSIONS In this setting, self-report provides good estimates of test-detected HIV prevalence, suggesting that it can be used when HIV test results are not available. Despite frequent HIV testing, younger people and those interviewed in community settings were less likely to accurately report their HIV-positive status. More research on barriers to self-reporting of HIV status is needed in these sub-groups. This study examines registration timelines of antiretroviral medicines (ARVs) in Ghana and Kenya, to assess whether prior reviews by the US Food and Drug Administration Tentative Approval or World Health Organization prequalification (WHO/PQP) affect in-country approval timelines.Data were collected from online and national databases. Median in-country review period in Ghana was nine months compared to 25 in Kenya. ARVs with Tentative Approval and WHO/PQP status did not benefit from shorter in-country review periods.OBJECTIVE To examine the relationship between poverty, operationalized using a novel material security measure, and adherence to antiretroviral therapy (ART) among people who use illicit drugs (PWUD) in a context of universal access to HIV care. DESIGN We analyzed data from a community-recruited prospective cohort in Vancouver, Canada (n = 623), from 2014 - 2017. METHODS We used multivariable generalized mixed-effects analyses to estimate longitudinal factors associated with mean material security score. We then estimated the association between achieving ≥ 95% adherence to ART and overall mean material score, as well as mean score for three factors derived from a factor analysis. The three factors structure, employed in the current analyses, were Factor 1 (basic needs); Factor 2 (housing-related variables) and Factor 3 (economic resources). RESULTS Recent incarceration [β-coefficient (β) = -0.176, 95% Confidence Interval [95%CI] -0.288, -0.063), unmet health needs (β = -0.110, 95% CI -0.178, -0.042), unmet social service needs (β = -0.264, 95% CI -0.336, -0.193) and having access to social services (β= -0.102, 95% CI -0.1586, -0.0465) were among the factors associated with lower material security scores. Contrary to expectations that low levels of material security in this population would lead to poor ART adherence, we did not observe a significant relationship between adherence and overall material security score, as well as for each factor individually. CONCLUSION Our findings highlight the potentially important role of no-cost, universal access to HIV prevention and treatment, in mitigating the impact of socioeconomic disadvantage on ART adherence.BACKGROUND Current guidelines recommend surveillance for hepatocellular carcinoma (HCC) in high-risk patients. This high risk is defined by the presence of cirrhosis. However, HCC due to underlying nonalcoholic steatohepatitis (NASH), even without progressing to cirrhosis, is a rising concern. Hence, we aimed to determine the association of HCC with NASH using a large national database. METHODS A cross-sectional study was performed using the 2012 National Inpatient Sample. The study group was all adult patients' age 18-90 years who have a diagnosis of NASH which was identified using the International Classification of Diseases 9th version (ICD-9) codes. The control group included the rest of adult individuals without discharge records of NASH. We identified the diagnosis of HCC in both study and control groups using the ICD-9 codes. We calculated the association between NASH and HCC using univariable and multivariate logistic regression. RESULTS Totally, 30 712 524 hospitalizations were included in our study.
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