Virological outcome among HIV-1 infected patients on first-line antiretroviral treatment in semi-rural HIV clinics in Togo

The development of HIV related pulmonary arterial hypertension (PAH) reduces the probability of survival by half as compared with HIV-infected individuals without HIV related PAH. HIV infected patients have a greater incidence of PAH compared to general population and have a 2500-fold increased risk of developing PAH. It is therefore important to have a recent overview of the problem in Africa, the most HIV affected part of the world (70 % of all HIV infection in the world). First, we discussed the epidemiology of HIV-related PAH in Africa. Second, the current understanding of the HIV-related PAH pathogenesis has been covered. Third, role of highly active antiretroviral therapy on HIV-related PAH has been revisited. There are few data concerning epidemiology of HIV related pulmonary hypertension in Africa leading to necessity to conduct further prospective large studies. The prevalence of PAH among HIV infected people in Africa varies from 5 to 13 %. The prevalence of HIV-related PAH in Africa is notably high compared to those in developed countries and in general population. The pathogenesis of PAH is clearly complex, and probably results from the interaction of multiple modulating genes with environmental factors. The physiopathology includes cytokines secretion increase which induces dysregulation of endothelial and vascular smooth muscle cell growth and imbalance of endogenous vasodilators and constrictors; HIV viral proteins which induces vascular oxidative stress, smooth myocyte proliferation and migration, and endothelial injury and genetic predisposition due to some major histocompatibility complex alleles, particularly HDL-DR6 and HLA-DR5. Histologically, HIV related PAH has the same characteristics with other types PAH. Antiretroviral therapy have a beneficial effect on the outcome of HIV related pulmonary hypertension, but it lacks evidence from large prospective studies.     

HIV seroprevalence among inmates in Togo

Background

There is no data on HIV seroprevalence among prisoners in Togo.

Methods

A cross-sectional study was conducted among prisoners in Togo from November 2011 to January 2012. The study population was included by selecting the most densely populated prison in each of the six Togo regions, and by including prisoners (at least18 years of age and having been in prison for more than 30 days) on a voluntary basis. HIV prevalence was estimated with a 95% confidence interval (CI).

Results

One thousand three hundred and fourty-two prisoners were included in the study. Their median age was 28 years, (IQR 25–33 years) and 39 (2.9%) were women. The median time spent in the prison was 10 months, interquartile range [4–24 months]. HIV testing was accepted by 96.0%. HIV seroprevalence in prisons was 4.3%, 95 CI% [3.2–5.5%]. Few prisoners (2.9%) reported having had sex in prisons. The only factor associated with HIV infection was gender with an HIV seroprevalence of 14.3% for women compared to 4.0% for men (P = 0.003).

Conclusion

The prevention and the management of HIV infection should be a priority in Togolese prisons. This requires implementing healthcare facilities in prisons.     

Men With Breast Cancer Have Same Disease-Specific and Event-Free Survival as Women

Background  Breast carcinoma in men is an uncommon disease. The aim of this study is to compare overall survival (OS) and disease-specific survival (DSS) in a group of matched men and women with breast cancer. Methods  Each man with breast cancer recorded in the database was matched with two women. Matching was done based on age, year of diagnosis, and stage. To compare breast cancer characteristics between men and women, the chi-square test was used for qualitative data and the t-test for quantitative data. Overall survival and DSS were calculated using Kaplan-Meier methods. Cox proportional hazards models have been used to compare survival rates between men and women. Results  The 58 male breast cancer patients were matched with 116 female patients. The mean age at diagnosis was 63.9 ± 11.9 years for men and 65.7 ± 11.5 years for women (P = .72). The median follow-up was 9.7 years for men and 10.7 years for women. The 5- and 10-year OS for men were, respectively, 58.9% and 33.9%. The 5- and 10-year OS for women were 68.2% and 52.1%. Men with breast cancer had a significant risk of dying compared with women (hazard ratio [HR] = 1.59; 95% confidence interval (95% CI), 1.04–2.42, P = .03). The 5- and 10-year DSS were 73.0% and 55.1% for men, and 72.8 and 61.2% for women, respectively. There was no difference in DSS between the two matched groups (HR = 1.26; 95% CI, 0.76–2.10, P = .37). Conclusions  The prognosis for men with breast carcinoma is similar to that for women with similar-stage disease.     

Case-Fatality Rates and Sequelae Resulting from Neisseria meningitidis Serogroup C Epidemic,Niger, 2015

We describe clinical symptoms, case-fatality rates, and prevalence of sequelae during an outbreak of Neisseria meningitidis serogroup C infection in a rural district of Niger. During home visits, we established that household contacts of reported case-patients were at higher risk for developing meningitis than the general population.Key words: Neisseria meningitidis, meningitis, meningococcal, Serogroup C meningococcal meningitis, bacteria, gram-negative bacteria, epidemics, complications, NigerA novel strain of Neisseria meningitidis serogroup C has been circulating in parts of the African meningitis belt since 2013 (1), causing a large-scale epidemic in Nigeria and Niger in 2015. This novel strain appeared after the introduction of a conjugate vaccine (PsA-TT, MenAfriVac) against N. meningitidis serogroup A, previously the major cause of epidemic meningitis in the region. N. meningitidis serogroup A has been virtually eliminated as a result of PsA-TT, although the first cases of N. meningitidis serogroup C in Nigeria in 2013 predated MenAfriVac introduction there. We describe case-fatality rates and sequelae resulting from infection with N. meningitidis serogroup C in a rural health district of Niger.     

Missense exonic mitochondrial mutation in cytochrome b gene of Saccharomyces cerevisiae,resulting in core protein deficiency in complex III of the respiratory chain

Summary The level of core protein I and subunit VI of mitochondrial complex III (which are coded by the nuclear genome) was found to be greatly diminished in a yeast strain carrying a mutation (W7) in the mitochondrial gene coding for cytochrome b. This suggests that intricate interactions occur in complex III biogenesis between proteins of cytoplasmic and mitochondrial origin. This mutant was characterized by a low cytochrome b level and a loss of activity in the b-c₁ segment of the respiratory chain. It was compared to another mutant showing similar biochemical characteristics, but which had integrated core protein I, as shown by antibody binding experiments. In mutant devoid of core protein I, cytochrome b was found to be reducible by NADH but not by succinate, suggesting two different electron transfer pathways inside comples III from each substrate to cytochrome b heme(s).Abbreviations rho° cytoplasmic petite, with all mitochondrial DNA deleted - EPR electron paramagnetic resonance - DNFB 2,4-dinitrofluorobenzene     

Sputum smear conversion during intensive TB treatment phase according to HIV status, in hospitalised patients in Togo

Method

We prospectively studied patients with pulmonary TB, with or without HIV-1 co-infection, from December 1, 2007 to December 1, 2008. Two groups of patients naive for TB and antiretroviral treatment (group A: 96 co-infected TB/HIV and group B: 171 TB infected but HIV negative) were selected randomly. The CD4 count was assessed according to HIV status, and all patients received RHEZ TB treatment for 2 months. Pulmonary smear was assessed at two weeks, four weeks, six weeks, and eight weeks.

Result

Two hundred and sixty seven patients were treated (26.6% of admissions). The mean age was 34.62 ± 11 years and the sex ratio was 1.3. A proportion of 35.75% patients were HIV co-infected with a median CD4 count at 157 cells per millimeter cube. The sputum smear conversion was obtained for more than 87.5% of patients in group A and 24.56% in group B at two weeks; 94% of patients in group A and 61.83% in group B at four weeks; 100% of patients in group A and 87.33% in group B at six weeks, and 100% of patients in group A and 96.77% in group B at eight weeks. P < 0.05 at six weeks.

Conclusion

HIV infected TB patients were more susceptible to treatment than TB/HIV infected patients in the first six weeks.