Optimizing the Dosage Regimen of Micafungin against <i>Candida spp</i>in HIV Positive Patients with EC Based on Mote Carlo Simulation

The objective of our study was to explore the possibility of the antifungal efficacy of various micafungin dosage regimens against Candida spp in HIV positive patients with EC. According to pharmacokinetic/pharmacodynamics parameters of micafungin in HIV positive patients and MICs distribution of micafungin against Candida spp. in published studies, the dosage regimens of micafungin were 50, 100 and 150 mg QD iv. Monte Carlo Simulation analysed the probability of target attainment and cumulative fraction of response. The results showed that micafungin has good antifungal effect in treating HIV positive patients with EC when pathomycetes are Candida albicans, Candida glabrata or Candida tropicalis, in dosage at 100 mg QD and 150 mg QD.

Family Status and Dilemma of HIV Positive Subjects

Objective To understand the family status and dilemma of HIV positive subjects and provide some related suggestions. Methods Constructured questionnaire and in-depth interview were used to survey their psychological needs of the 111 HIV positive subjects and AIDS patients from 4 provinces in China. Results HIV positive subjects and AIDS patients had strong mental stress. All of them hope to get support from their families; the most difficulty the subjects faced was economic poor. Conclusion It is a highlight to promote AIDS education to establish a good social environment in which HIV positive subjects and AIDS patients can live quietly and happily. And psychological support from their families and the society is very important to HIV positive subjects and AIDS patients.

HIV Positive Men Five Times that of Women

According to the latest statis-tics, China’s HIV positive men and women are in the ratio of 5.2:1. This sharp increase in the number of HIV positive men can be attributed to intravenous drug use and unprotected sex. The survey reveals that youth between the ages of 20 and 29, some of whom are college and technical school students, account for

False Positive HIV “Combo” Screening Test in a Hemodialysis Patient in Saudi Arabia: A Case Report and Review of the Literature

Introduction: HIV screening tests are routinely conducted on dialysis patients as the constant exposure of their blood during the dialysis process makes them a reasonable risk for blood-borne infections. However, in low prevalence settings, where HIV rates are <0.1% of the population, false positive results are more likely. This results in apprehension in the dialysis unit as breaches in infectious disease protocols could be presumed. This is illustrated in the case report below. Case Summary: A 62-year-old male Saudi end-stage kidney disease patient secondary to DM nephropathy began dialysis a year before presentation in a hemodialysis center in Saudi Arabia. Routine screening tests done at the start of dialysis revealed negative Hepatitis C, HIV 1 and 2 screening but a positive Hepatitis B surface antigen screen. The patient went for holiday dialysis at another facility and had a routine fourth-generation HIV test done which was positive. A confirmatory HIV PCR test was negative. Conclusion: This case highlights the need for caution in interpreting highly sensitive and specific HIV screening tests in a low-prevalence setting. Routine screening beyond the national recommendation may not be necessary in low-prevalence areas.

Factors influencing adherence to the food by prescription program among adult HIV positive patients in Addis Ababa, Ethiopia: a facility-based, cross-sectional study

Background:One way of addressing malnutrition among HIV/AIDS patients is through the Food by Prescription program(FBP)and many studies have explained the treatment outcomes after therapeutic food supplementation,though available evidences on adherence levels and factors associated with these sorts of programs are limited.The findings of this study would therefore contribute to the existing knowledge on adherence to Ready-to-Use Therapeutic/Supplementary Food(RUF)in Ethiopia.Methods:A facility-based,cross-sectional study supplemented with qualitative methods was conducted among 630 adult HIV+patients.Their level of adherence to RUF was measured using the Morisky 8-item Medication Adherence Scale(MMAS-8).The total score on the MMAS-8 ranges from 0 to 8,with scores of<6,6 to<8,and 8 reflecting low,medium,and high adherence,respectively.Patients who had a low or a moderate rate of adherence were considered non-adherent.Results:The level of adherence was found to be 36.3%with a 95.0%response rate.With the exception of the educational status,other socio-demographic variables had no significant effect on adherence.Those who knew the benefits of the FBP program were 1.78 times more likely to adhere to the therapy than the referent groups.On the other hand,patients who were not informed on the duration of the treatment,those prescribed with more than 2 sachets/day and had been taking RUF for more than 4 month were less likely to adhere.The main reasons for non-adherence were not liking the way the food tasted and missing follow-up appointments.Stigma and sharing and selling food were the other reasons,as deduced from the focus group discussion(FGD)findings.Conclusion:The observed level of adherence to the FBP program among respondents enrolled in the intervention program was low.The major factors identified with a low adherence were a low level of education,poor knowledge on the benefits of RUF,the longer duration of the program,consuming more than two prescribed sachets of RUF per day,and not being informed about the duration of the treatment.Therefore,counseling patients on the program’s benefits,including the treatment plans,would likely contribute to improved adherence.

Contraceptive Prevalence and Pattern among HIV Positive Women in Port Harcourt, South-South Nigeria

Objective To evaluate the prevalence rate and pattern of contraceptive use among HIV positive women in Port Harcourt, Nigeria. Methods Anonymous self administered questionnaires were applied to HIV positive women receiving care at HIV clinic of the University of Port Harcourt Teaching Hospital between September and November 2010. Results A total of 228 questionnaires were retrieved out of 250 distributed. The grouping age 29-34 years accounted for 47.8% of the respondents, 51.3% had secondary education, 55.5% were married while 43.4% were nulliparous. The mode of acquiring HIV was unknown in 60.1% and 34.2% of their partners were HIV positive. Majority （64.0%） of the patients did not use any form of contraception before diagnosis while 42.1% used male condoms after diagnosis. Contraceptive methods used were female condom （0.4%）, oral contraceptive pills （16.2%）, abstinence （14.5%） and rhythm method （1.8%）, Only 6.1% used the dual method, which is the simultaneous use of two methods and one of which must be a condom. Contraceptive prevalence rate （CPR） was 81.1%. Conclusion Though the overall use of contraception in HIV positive women in Port Harcourt is high, the dual method use which protects against pregnancy and transmission of HIV is low. Dual method is the recommended method for HIV positive women who do not intend to get pregnant. Therefore the use of dual method should be advocated.

Evaluating the Knowledge of HIV Transmission and Prevention of Mother to Child Transmission (PMTCT) of HIV among HIV-Positive Mothers Accessing Care in Military Hospital in Lagos, Nigeria

Introduction: The prevention of mother-to-child transmission (PMTCT) plays a major role in limiting the number of children being infected by HIV. There is dearth of studies that explored the knowledge of HIV transmission and PMTCT among women living with HIV. Methods: This was a cross-sectional, descriptive study of HIV-positive mothers receiving medical care at the adult antiretroviral therapy (ART) clinic, 68 Nigeria Army Reference Hospital Yaba. A pre-tested structured questionnaire was used to collect information from the subjects concerning their socio-demographic, knowledge of HIV transmission and mother-to-child transmission of HIV and preventive measures. SPSS v23 was used for data analysis. Results: Out of the 374 participants, 282 (75.4%) were aware that HIV can be transmitted to an unborn baby from the positive mother. Of these, 240 (85.1%) were well-informed that increase mother’s viral load can increase the chances of mother-to-child transmission. 268 (95%) understood that giving of antiretroviral drugs during and after pregnancy can lower transmission risk, while 254 (90.1%) saw the use of breast milk substitutes as another prevention strategy. There was statistically significant association between the respondents’ knowledge of PMTCT and their husbands’/partners’ awareness of their HIV status. Conclusion: In conclusion, our study demonstrated a good knowledge of HIV transmission, MTCT and PMTCT among women who were receiving ART in our centre. Disclosure is a significant factor found to be associated with PMTCT knowledge. More studies can also explore if the observations in our study with women living with HIV will be comparable in similar population in different settings.