To explore patients’ perceptions about motivators and barriers of adherence to highly active antiretroviral therapy among people living with HIV: A qualitative study

Objective:For people living with HIV(PLHIV),strict adherence to highly active antiretroviral therapy(HAART)is the key to effective treatment and retention in human immunodeficiency virus(HIV)care.There are many factors which promote or halt the antiretroviral therapy(ART)adherence practices.Therefore,the present study aimed to examine the HAART adherence levels and to explore patients’views about barriers and facilitators to HIV treatment adherence.Methods:Semi-structured interviews were conducted among 15 PLHIV at the ART clinic of Dr.Ram Manohar Lohia Hospital,New Delhi.Interviews were audio-recorded in the local Hindi language,and bilingual experts(English and Hindi)transcribed verbatim.Qualitative data were coded for themes and subthemes and analyzed using a phenomenological approach as per thematic content analysis.Results:Feeling of hopelessness,delayed ART initiation,difficult initial phase of ART,forget to take ART on time,fear of disclosure of HIV diagnosis,lack of privacy and negative social support,and impact of lockdown due to COVID-19 were revealed as significant barriers to ART adherence.At the same time,commitment to raise and educate children,ART to increase life span,maintain oneself to be physically fit and healthy,only a single pill per day,very supportive counselors and health-care professionals,and hope to give birth to a healthy child were identified as facilitators of HIV retention.Conclusion:Understanding patient’s perception about ART adherence,its motivational and barrier factors which are directly affecting ART adherence and retention of PLHIV in HIV treatment and follow-ups are of utmost importance to improve ART adherence during HIV patient care services.

Hepatitis C virus eradication in people living with human immunodeficiency virus:Where are we now?

Hepatitis C virus(HCV)/human immunodeficiency virus(HIV)co-infection still involves 2.3 million patients worldwide of the estimated 37.7 million living with HIV,according to World Health Organization.People living with HIV(PLWH)are six times greater affected by HCV,compared to HIV negative ones;the greater prevalence is encountered among people who inject drugs and men who have sex with men:the risk of HCV transmission through sexual contact in this setting can be increased by HIV infection.These patients experience a high rate of chronic hepatitis,which if left untreated progresses to end-stage liver disease and hepato-cellular carcinoma(HCC)HIV infection increases the risk of mother to child vertical transmission of HCV.No vaccination against both infections is still available.There is an interplay between HIV and HCV infections.Treatment of HCV is nowadays based on direct acting antivirals(DAAs),HCV treatment plays a key role in limiting the progression of liver disease and reducing the risk of HCC development in mono-and coinfected individuals,especially when used at an early stage of fibrosis,reducing liver disease mortality and morbidity.Since the sustained virological response at week 12 rates were observed in PLWH after HCV eradication,the AASLD has revised its simplified HCV treatment algorithm to also include individuals living with HIV.HCV eradication can determine dyslipidemia,since HCV promotes changes in serum lipid profiles and may influence lipid metabolism.In addition to these apparent detrimental effects on the lipid profile,the efficacy of DAA in HCV/HIV patients needs to be considered in light of its effects on glucose metabolism mediated by improvements in liver function.The aim of the present editorial is to describe the advancement in HCV treatment among PLWH.

The Effect Evaluation of Highly Active Antiretroviral Therapy to Patients with AIDS in Hubei Province of China

The effects of highly active antiretroviral therapy （HAART） to patients with AIDS in Hubei province of China were investigated in order to provide scientific evidence to reinforce the management of HAART. Self-made questionnaires and descriptive method of epidemiology were used to collect and describe the changes of clinical symptoms, HIV RIgA concentration, and immune function of patients with AIDS. After HAART, the effective rate of fever, cough, diarrhea, lymphadenectasis, weight loss, tetter, debility and fimgous infection was 92.4%, 90.85%, 92.91%, 90.73%, 93.69%, 89.04%, 92.34%, and 83.1%, respectively. Of 117 patients with detected HIV RNA concentration, 41.03% had declined over 0.5 log, and 52.99% less than 0.5 log. CD4^＋T cell count was obviously increased： the average number after HAART for 3 or 6 months was 237μL （26-755μL） and 239μL （17-833μL）, respectively HAART can improve AIDS patients＇ clinical symptoms, reduce HIV RNA concentration, and maintain immune function. It is very important for the effectiveness of HAART to raise clinical adherence of pa- tients with AIDS and have a persistent surveillance.

T-CELL RESPONSE OF ADVANCED AIDS PATIENTS AFTER HIGHLY ACTIVE ANTIRETROVIRAL THERAPY

Objective To investigate the response on late stage Chinese AIDS patients after highly active antiretroviral therapy （HAART）. Methods From October 2002 to March 2004, 20 cases of late stage Chinese AIDS patients were selected to participate in this opened and randomised study, we purposely chose those with CD4＋ T cell counts 〈 100/mm^3. All of them had one or two opportunistic infections and none had been treated with anti-HIV drugs. All patients were tested with CD4＋ （naive CD4＋ T cell defined by CD45RA＋ and CD62L＋, memory CD4＋ T cell defined by CD45RA-）, CD8＋ T cell, plasma HIV viral load, and clinical manifestations on before, during, and after HAART （5 different regimes） on 1, 3, 6, 9, and 12 months. Before HAART mean CD4＋ T cell counts were 32 ± 31 （range 2-91）/mm^3, and plasma HIV viral load were 5.07 ± 0.85（range 2.04-5.70） log copies/mL. In 1 month＇s time patients treated with HAAT had mean CD4＋ and CD8＋ T cell counts increasing rapidly. After 1 month the increasing speed turned to slow down, but HIV viral load decreased predominantly within the first 3 months. The major part of increasing CD4＋ T cells were memory CD4＋ T cells, as for naive CD4＋ T cells increasing low and slow. Clinical symptoms and signs improved, and opportunistic infections reduced. The quality of life will be far much better than before. Each patient was followed for 12 months, and had finished 12 months＇ HAAT. Conclusion This is the first report in China that late stage Chinese AIDS patients after HAART could have their immune reconstitution. The regular pattern is similar to what had been reported in Western countries and also in China. So it is worth to treat late stage Chinese AIDS patients with HAAT.

Highly Active and Stable Ni_2P/SiO_2 Catalyst for Hydrogenation of C_9 Petroleum Resin

Catalytic hydrogenation is an appropriate method for the improvement of C9 petroleum resin（C9PR） quality. In this study, the Ni2P/SiO2（containing 10% of Ni） catalyst prepared by the temperature-programmed reduction（TPR） method was used for hydrogenation of C9 petroleum resins. The effect of reaction conditions on catalytic performance was studied, and the results showed that the optimum reaction temperature, pressure and liquid hourly space velocity（LHSV） was 250 ℃, 6.0 MPa, and 1.0 h-1, respectively. The bromine numbers of hydrogenated products were maintained at low values（250 mg Br/100g） within 300h, showing the high activity and stability of Ni2P/SiO2 catalyst. The fresh and spent catalysts were characterized by X-ray diffraction（XRD）, BET surface area（BET） analysis, scanning electron microscopy（SEM）, transmission electron microscopy（TEM）, Fourier transform infrared（FTIR） pyridine adsorption, and X-ray photoelectron spectroscopy（XPS）. Compared with the traditional sulfurated-Ni W catalysts, Ni2P possessed globe-like structure instead of layered structure like the active phase of Ni WS, thereof exposing more active sites, which were responsible for the high activity of Ni2P/SiO2 catalyst. The stability of Ni2P/SiO2 catalyst was probably attributed to its high sulfur tolerance, antisintering, anti-coking and carbon-resistance ability. These properties might be further ascribed to the special Ni-P-S surface phase, high thermal stability of Ni2P nanoparticles and weak surface acidity for the Ni2P/SiO2 catalyst.

New Activated Carbon with High Thermal Conductivity and Its Microwave Regeneration Performance

Using a walnut shellas a carbon source and ZnCl_2 as an activating agent,we resolved the temperature gradient problems of activated carbon in the microwave desorption process.An appropriate amount of silicon carbide was added to prepare the composite activated carbon with high thermalconductivity while developing VOC adsorption-microwave regeneration technology.The experimentalresults show that the coefficient of thermalconductivity of SiC-AC is three times as much as those of AC and SY-6.When microwave power was 480 W in its microwave desorption,the temperature of the bed thermaldesorption was 10 ℃ to 30 ℃ below that of normalactivated carbon prepared in our laboratory.The toluene desorption activation energy was 16.05 k J·mol^（-1）,which was 15% less than the desorption activation energy of commercialactivated carbon.This study testified that the process could maintain its high adsorption and regeneration desorption performances.

An Assessment of the Level of Knowledge of HIV-Infected Patients about Highly Active Antireteroviral Therapy and Waiting Times and Their Influence on Antiretroviral Therapy Adherence at a Primary Healthcare Centre of South Africa

Objectives： The study assessed if the level of knowledge of HIV-infected about HAART and waiting-times in the PHC （primary healthcare） clinic have an influence on antiretroviral adherence. Methods： A descriptive-cross-sectional study was conducted in South Africa. Data collected uses a standardized-questionnaire and face-to-face-exit interviews. Pill-count technique was performed and a value of≥ 95% acceptable. Data were analysed using SPSS. Univariate-factors associated with poor-adherence to knowledge about HAART and waiting times were assessed using ANOVA and p ≤ 0.05 considered statistically significant. Key findings： Of 86 enrolled, 63（73.3%） were females and 23（26.7%） males, with mean-age （± SD） of 35.6（±9.6） years and on HAART for 35.5（± 31.8） months ranging from 1-137. Of these, 27（31.40%） and 25（29.07%） were on WHO stages 2 and 3 respectively. Adherence-rates computed from 32 patients, 23（71.9%） revealed poor adherence-rates. The level of knowledge about HAART in terms of names of tablets, correct-dose, frequency, adverse-effects had no influence on ARV-adherence （p _〉 0.05）. Of 23 non-compliant, 10 （40%） gave the reason of drugs-unavailability, 7（30%） adverse-effects, 5（20%） drugs＇ complexity, and 1（10%） too busy to take them. Waiting areas associated with poor ARV-adherence were reception （p = 0.028）, doctors （p = 0.027）, while nurse＇s station （p = 0.29） and pharmacy （p = 0.43） revealed acceptable ARV-adherence.

Cytomegalovirus retinitis in the highly active anti-retroviral therapy era

Cytomegalovirus(CMV)retinitis is an opportunistic infection that has traditionally affected those who have HIV/AIDS or immunosuppressed individuals.CMV retinitis previously infected one-third of AIDS patients in the pre-highly active antiretroviral therapy(HAART)era,but since HAART,Western countries have seen an 80%decrease in the incidence of the disease.More recently,CMV retinitis has been reported in patients who are immunosuppressed,often due to chemotherapy or immunomodulatory medications.The diagnosis of CMV retinitis is often suspected based on clinical findings,with polymerase chain reaction for confirmation of CMV,especially in atypical cases.Highly active antiretroviral therapy and anti-CMV medications(systemic or local)remain the mainstay of treatment.However,for those who are not responsive to HAART,CMV retinitis remains a challenge,and can still lead to significant vision loss.Moreover,a regimen of anti-CMV medications can sometimes lead to viral resistance or organ toxicity.Complications such as immune recovery retinitis and rhegmatogenous retinal detachments continue to threaten the vision of patients who develop CMV retinitis.These complications can arise following initiation of treatment or if patients show disease progression.Proper vision screening for CMV retinitis in immunosuppressed patients at-risk is necessary for early detection and treatment.

Ni/Mo_2 N as a Highly Active Hydrodenitrogenation Catalyst

The catalysts were prepared by the temperature programmed reaction (TPR) of MoO3 with NH3 at various temperatures in the range of 573K～973K, and their hydrodenitrogenation (HDN) activities were tested in situ.It is shown that molybdenum nitrid(Mo2N) was formed above 923K and its intermediate MoO2 formed at about 573～623K under the rapid (5K/min.) TPR conditions.Mo2N is the most active species for pyridine HDN among MoO3,MoO2,MoS2,and Mo2N. Moreover,it can be promoted by adding Ni component.It is shown that the Ni/Mo2N catalyst prepared by adding some NiO into the precursor MoO3 has a steady HDN activity Which is far higher than that of the commercial sulfided NiMo/Al2O3(HR346) catalyst.

Autoimmune hepatitis in a patient infected by HIV-1 and under highly active antiretroviral treatment:Case report and literature review

Liver disease has recently been described as an im-portant cause of morbidity and mortality in patientsinfected with human immunodeficiency virus （HIV）.Liver test changes are useful surrogates of the burdenof liver disease. Previous studies have shown that trans-aminase elevations are frequent among these patients.The cause of those changes is harder to establish inHIV-patients. We present a 61-year-old caucasian male,diagnosed with HIV type 1 infection since 1998, underhighly active antiretroviral treatment （HAART）, withvirological suppression and immunological recovery.He presented in a follow-up laboratory workup highvalues of transaminases, arthralgia at the hip joints and hepatomegaly. Liver function tests were normal. Theantibodies to hepatitis viruses were negative. However,autoimmune study and liver biopsy were compatible with autoimmune hepatitis （AIH）. The AIH is a rare di-agnosis in HIV-infected patients perhaps because the elevation of transaminases and changes in liver function tests are often associated to HAART or to other possible liver diseases, namely viral hepatitis and non-alcoholic steatohepatitis. The diagnosis may be underestimated. There are no specifc recommendations available for the treatment of HIV-associated AIH although the immuno-supression with slower tapering seems the most reason-able approach.

Highly Active Anhydrous Potassium Fluoride

Highly active anhydrous potassium fluoride has many uses. Its good performance is demonstrated in high activity, high recovery, low consumption and the low emission of accessory substances during the process of organic fluorination. Moreover. there is no need to use an expensive intertransferable catalyst in the process of fluorination. Under the same conditions and within the same time limit, the fluorination rate of the product is 97% while that of ordinary anhydrous potassium fluoride is 58%. The product, developed recently by the Shenyang Chemical Research Institute, can remain in a state of superfine powder for a long time in air

Factors Affecting Adherence to Highly Active Antiretroviral Therapy among Patients Attending Public Healthcare Facility

The research focused on factors associated with poor adherence to HAART （highly active antiretroviral therapy） among HIV/AIDS. A descriptive cross sectional study was conducted using a standardized questionnaire and face-to-face exit interviews to collect data. Pill-counts were performed and computed adherence rate of ≥ 95% was considered acceptable. Data were analyzed using SPSS 21.0. Univariate factors associated with poor dherence to HAART were assessed with ANOVA （analysis of variance） and logistic regression model excluded confounders determining independent predictors of poor adherence. A P ≤ 0.05 was statistical significant. Of 102 HIV-infected on HAART for 24.68 ± 20.5 months, 83.3% were females and 16.7% males. The mean age （± SD） was 35.09 ± 9.3 years. Univariate factors associated with poor adherence to HAART were： CD4 count 〉 350 cells/mm3 0（2 = 46; P = 0.05）, age 〉 35 years 0（2 = 28.75; P = 0.011）, primary educational background （χ2 = 9.18; P = 0.027）, HAART regimen 1A-TDF （χ2 = 14.37; P = 0.003）, and 〉 4 combined tablets （χ2 = 11.87; P = 0.001）. There was a linear correlation between age and primary educational background （r = 0.538; P 〈 0.001）. After adjusting for univariate confounders, primary educational background （P = 0.020） and 〉 4 combined tablets （P = 0.026） were identified as independent predictors of poor adherence to HAART. Although there is an increase number of HIV-infected receiving HAART, these findings have shown that many of these will not adhere to their treatment once they improve clinically. This could be due to lack of education and complexity of combined ARVs with other drugs.

OPTICALLY ACTIVE AMINO ACIDS WITH HIGHLY BRANCHED SIDE CHAIN (I) SYNTHESIS OF D- AND L- 2-AMINO-5,5-DIMETHYLHEXANOIC ACID AND 2-AMINO-6,6-DIMETHYLHEPTANOIC ACID

The title compounds were prepared by the enzymatic resolution of the corresponding N-acetylated DL-amino acids methyl esters, which were obtained from t-butyl chloride via an 8-step synthesis.

High Efficiency and Stable Organic Light-Emitting Diodes Based on Thermally Activated Delayed Fluorescence Emitter

High efficiency, stable organic light-emitting diodes （OLEDs） based on 2-pheyl-4＇-carbazole-9-H-Thioxanthen-9- one-10, 10-dioxide （TXO-PhCz） with different doping concentration are constructed. The stability of the encap- sulated devices are investigated in detail. The devices with the 10 wt% doped TXO-PhCz emitter layer （EML） show the best performance with a current efficiency of 52.1 cd/A, a power efficiency of 32.71re^W, and an external quantum efficiency （EQE） of 17.7%. The devices based on the lOwt%-doped TXO-PhCz EML show the best operational stability with a half-life time （LTSO） of 8Oh, which is 8 h longer than that of the reference devices based on fac-tris（2-phenylpyridinato）iridium（ Ⅲ） （Ir（ppy）a）. These indicate excellent stability of TXO-PhCz for redox and oxidation processes under electrical excitation and TXO-PhCz can be potentially used as the emitters for OLEDs with high efficiency and excellent stability. The high-performance device based on TXO-PhCz with high stability can be further improved by the optimization of the encapsulation technology and the development of a new host for TXO-PhCz.

Ultrathin organic polymer with p-πconjugated structure for simultaneous photocatalytic disulfide bond generation and CO_(2)reduction

Combining photocatalytic organic reactions with CO_(2)reduction is an efficient solar energy utilization mode,but it is still limited by the organic species that can be matched and the low conversion.Herein,ultrathin organic polymer with p-πconjugated structure(TPP)was rationally designed and prepared,and showed a high yield of CO(15.2 mmol g^(-1))and conversion of SAS coupled products(100%),far exceeding the organic polymer with P=O structure.The enhanced photoredox activity of TPP is ascribed to the orbital interaction between the p-orbital on phosphorus and theπ-orbitals of aromatic,which can accelerate the photoinduced charge carrier separation and improve the CO_(2)adsorption capacity.TPP can also be used for the dehydrocoupling of various benzyl mercaptans to the corresponding SAS bond products.This work provides a new concept for the efficient synthesis of disulfide bonds combined with CO_(2)reduction in a photoreaction system.

Homoepitaxial growth of (100) Si-doped β-Ga_(2)O_(3) films via MOCVD

Homoepitaxial growth of Si-doped β-Ga_(2)O_(3) films on semi-insulating(100) β-Ga_(2)O_(3) substrates by metalorganic chemical vapor deposition(MOCVD) is studied in this work. By appropriately optimizing the growth conditions, an increasing diffusion length of Ga adatoms is realized, suppressing 3D island growth patterns prevalent in(100) β-Ga_(2)O_(3) films and optimizing the surface morphology with [010] oriented stripe features. The slightly Si-doped β-Ga_(2)O_(3) film shows smooth and flat surface morphology with a root-mean-square roughness of 1.3 nm. Rocking curves of the(400) diffraction peak also demonstrate the high crystal quality of the Si-doped films. According to the capacitance–voltage characteristics, the effective net doping concentrations of the films are 5.41 × 10~(15) – 1.74 × 10~(20) cm~(-3). Hall measurements demonstrate a high electron mobility value of 51cm~2/(V·s), corresponding to a carrier concentration of 7.19 × 10~(18) cm~(-3) and a high activation efficiency of up to 61.5%. Transmission line model(TLM) measurement shows excellent Ohmic contacts and a low specific contact resistance of 1.29 × 10~(-4) Ω·cm~2 for the Si-doped film, which is comparable to the Si-implanted film with a concentration of 5.0 × 10~(19) cm~(-3), confirming the effective Si doing in the MOCVD epitaxy.

Preparation of High Activity Admixture from Steel Slag,Phosphate Slag and Limestone Powder

The problem of low disposal and utilization rate of bulk industrial solid waste needs to be solved.In this paper,a high-activity admixture composed of steel slag-phosphate slag-limestone powder was proposed for most of the solid waste with low activity and a negative impact on concrete workability,combining the characteristics of each solid waste.The paper demonstrates the feasibility and explains the principle of the composite system in terms of water requirement of standard consistency,setting time,workability,and mechanical properties,combined with the composition of the phases,hydration temperature,and microscopic morphology.The results showed that the steel slag:phosphate slag:limestone=5:2:3 gave the highest activity of the composite system,over 92%.Besides,the composite system had no significant effect on water demand and setting time compared to cement,and it could significantly increase the 7 and 28 d activity of the system.The composite system delayed the exothermic hydration of the cement and reduced the exothermic heat but had no effect on the hydration products.Therefore,the research in this paper dramatically improved the solid waste dissipation in concrete,reduced the amount of cement in concrete and positively responded to the national slogan of carbon neutral and peaking.

Highly exposed Cu active sites as efficient peroxidase mimics for colorimetric analysis

Nanozymes are nanomaterials with intrinsic enzyme-mimic activity,but their large-scale application is generally limited by their low catalytic activity.Herein,we demonstrated that highly exposed Cu active sites on two-dimensional(2D)nitrogen-doped carbon(Cu_(x)/NC)can serve as efficient peroxidase-like(POD)catalysts with high atomic utilization.Specially,the uniformly distributed Cu active sites could react with H_(2)O_(2)to produce singlet oxygen(^(1)O_(2))under acidic conditions,which can efficiently oxidizes colorless 3,3',5,5'-tetramethylbenzidine(TMB)to blue oxidized TMB(oxTMB).Among various Cu_(x)/NC nanozymes studied,the Cuo.14/NC exhibited smaller maximum catalytic velocities(V_(max))and Menten constant(K_(m))for TMB and H_(2)O_(2).Benefiting from the highly active peroxidase-like activity,the Cu_(0.14)/NC nanozyme could be successfully applied for the hydroquinone(HQ)and ascorbic acid(AA)detection applications through the inhibitory effect of HQ and AA.More interestingly,α-glucosidase(α-Glu)detection sensing platform could be constructed based on HQ as a signal transmitter,with the detection range ranging from O to 12 U/L and the minimum detection limit being 0.68 U/L.This work provides not only an idea for the rational design of highly exposed Cu active sites but also fabricate an effective detection sensing platform forHQ,AA,andα-Glu detection.

Preparation and characterization of amorphous boron powder with high activity

The amorphous boron powders with high activity were prepared by the high-energy ball milling-combustion synthesis method. The effects of the milling rate and milling time on the crystallinity, microscopic morphology and reactivity of amorphous boron powder were studied. The results show that the crystallinity of amorphous nano-boron powder is only 22.5%, and its purity reaches 92.86%. The high-energy ball milling can significantly refine boron powder particle sizes, whose average particle sizes are smaller than 50 nm, and specific surface areas are of up to 70.03 m2/g. When the transmission electron beam irradiates the samples, they rapidly melt. It can be seen that the monomer amorphous boron size is less than 30 nm from the specimen melting traces, which indicates that the samples have high reactivity.

Hepatitis C and HIV co-infection:a review

Co-infection with hepatitis C virus and humanimmunodeficiency virus is common in certainpopulations. Among HCV(+) persons, 10 % are alsoHIV (+), and among HIV (+) persons, 25 % are alsoHCV(+). Many studies have shown that in intravenousdrug users, co-infection prevalence can be as high as90-95 %. There is increasing evidence supporting theconcept that people infected with HIV have a muchmore rapid course of their hepatitis C infection.Treatment of co-infection is often challenging becausehighly active anti-retroviral therapy (HAART) therapyis frequently hepatotoxic, especially in the presence ofHCV. The purpose of this review is to describe theeffects that HIV has on hepatitis C, the effects thathepatitis C has on HIV, and the treatment options inthis challenging population.