Academic literature on the topic 'HIV infections – Diagnosis – Asia'
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Journal articles on the topic "HIV infections – Diagnosis – Asia"
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Bath, Rachel E., Lynsey Emmett, Neville Q. Verlander, and Mark Reacher. "Risk factors for late HIV diagnosis in the East of England: evidence from national surveillance data and policy implications." International Journal of STD & AIDS 30, no. 1 (August 31, 2018): 37–44. http://dx.doi.org/10.1177/0956462418793327.
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In 2014, 42% of all HIV diagnoses in the East of England were diagnosed late. Individuals unaware of their HIV status will not benefit from lifesaving and infectious-limiting antiretroviral therapy, and they remain at risk of decreased life expectancy and onward transmission of HIV. We sought to identify risk factors associated with late HIV diagnosis in the East of England to inform future HIV testing and prevention strategies relevant to the local population. Data on all HIV infected individuals aged ≥16 years and diagnosed between 2008 and 2014 in the East of England were obtained from the national HIV and AIDS Reporting System. Late diagnosis was defined as CD4 cell count below 350 cells/mm3 within 91 days of diagnosis. Logistic regression investigated risk factors for late HIV diagnosis. A total of 2469 people were included; 1342 (54%) were late HIV diagnoses. In multivariable analysis risk factors for late diagnosis were: age ≥30 years, originating from WHO regions of South-East Asia or Europe (excluding UK), heterosexual orientation and being diagnosed as an inpatient or by a general practitioner. The odds of late diagnosis significantly reduced every year (OR 0.95, 95% CI 0.90–0.99, p = 0.042). Despite this year-on-year reduction continued high rates suggest future HIV testing and prevention strategies should be informed by local regional epidemiology to allow those at greatest risk to be targeted appropriately.
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Papalini, Chiara, Barbara Belfiori, Giovanni Martino, Rita Papili, Lucia Pitzurra, Stefano Ascani, and Maria Bruna Pasticci. "An Italian Case of Disseminated Histoplasmosis Associated with HIV." Case Reports in Infectious Diseases 2019 (November 16, 2019): 1–5. http://dx.doi.org/10.1155/2019/7403878.
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Histoplasma capsulatum is a dimorphic fungus, endemic in the Americas, Africa (var. duboisii), India, and Southeast Asia. H. capsulatum infection is rarely diagnosed in Italy, while in Latin America, progressive disseminated histoplasmosis (PDH) is one of the most frequent AIDS-defining illnesses and causes of AIDS-related deaths. We report a case of PDH and new HIV infection diagnosis in a Cuban patient, who has been living in Italy for the past 10 years. Bone marrow aspirate and peripheral blood smear microscopy suggested H. capsulatum infection. The diagnosis was confirmed with the culture method identifying its thermal dimorphism. Liposomal amphotericin B was administered alone for 10 days and then for another 2 days, accompanied with voriconazole; the former was stopped for probable side effects (persistent fever and worsening thrombocytopenia), and voriconazole was continued to complete 4 weeks. PDH maintenance treatment consisted of itraconazole for one year. Antiretroviral therapy (ART) was started on the third week of antifungal treatment. At the 3-year follow-up, the patient is adherent on ART, the virus was suppressed, and she has an optimal immune recovery. This case highlights the need to suspect histoplasmosis in the differential diagnosis of opportunistic infections in immunocompromised persons, native to or who have traveled to endemic countries.
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Osakwe, Nonso, Diane Johnson, Natalie Klein, and Dalia Abdel Azim. "A Rare Case of HHV-8 Associated Hemophagocytic Lymphohistiocytosis in a Stable HIV Patient." Case Reports in Infectious Diseases 2019 (April 28, 2019): 1–3. http://dx.doi.org/10.1155/2019/3297463.
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Background. Hemophagocytic lymphohistiocytosis (HLH) is a rare condition associated with viral infections including HIV. Cases have been reported mainly in advanced HIV/AIDS. This is a rare case that reports HLH associated with human herpes virus-8 (HHV-8) associated multicentric Castleman disease in a stable HIV patient. Case Presentation. A 70-year-old Asian male patient with history of stable HIV on medications with CD 4 cell count above 200 presented with cough and fever and was initially treated for pneumonia as an outpatient. Persisting symptoms prompted presentation to the hospital. The patient was found to have anemia which persisted despite repeated transfusion of packed red cells. A bone marrow biopsy to investigate anemia revealed hemophagocytosis. A CT scan revealed multiple enlarged lymph nodes and hepatosplenomegaly. An excisional lymph node biopsy revealed HHV-8 associated multicentric Castleman disease. The patient deteriorated despite initiation of treatment. Conclusion. HLH can occur at any stage of HIV, rapid diagnosis to identify possible underlying reactive infectious etiology and prompt initiation of treatment is crucial to survival.
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Astiti, Cok Istri Sri Dharma, Anak Agung Sagung Sawitri, and Ketut Tuti Parwati Merati. "Factors associated to first line antiretroviral therapy (ART) failure among HIV/AIDS patients at Sanglah Hospital, Bali." Public Health and Preventive Medicine Archive 5, no. 1 (July 1, 2017): 3. http://dx.doi.org/10.15562/phpma.v5i1.33.
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Background and purpose: The incidence of first line ART failure is increasing in the South East Asia region. The main referral hospital in Bali has recorded an increased use of second line ART due to the first line ART failure. This study aims to explore risk factors associated to first line ART failure.Methods: A case control study was conducted among people living with HIV and AIDS at Sanglah Hospital Denpasar who started first line ART between 2004 and 2013. Cases were those who diagnosed as having clinical treatment failure and still on treatment in 2015. Controls were those with no treatment failure. Sex and year of ART initiation were matched between case and control. Data were obtained from medical records that include initial regiments, HIV mode of transmission, the WHO HIV clinical stage, CD4 count, opportunistic infections, body mass index, hemoglobin level, and drug substitution at the beginning and during treatment. Risk factors were analysed using logistic regression.Results: Out of 68 HIV/AIDS patients with clinical ART failure, 72.1% were confirmed with immunological and 36.8% were confirmed with virological failure. Median time before treatment failure was 3.5 years. Factors associated to ART failure were HIV clinical stage IV (AOR=3.43; 95%CI=1.65-7.13) and being widow/widower (AOR=4.85; 95%CI=1.52-15.53). Patients with TB co-infection have a lower risk for treatment failure due to early diagnosis and treatment through TB-HIV program (AOR=0.32; 95%CI=0.14-0.70).Conclusions: Higher HIV clinical stage at ART initiation increases the risk of treatment failure. HIV-TB co-infection indirectly reduces the risk of treatment failure.
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Oelrichs, Robert. "The subtypes of human immunodeficiency virus in Australia and Asia." Sexual Health 1, no. 1 (2004): 1. http://dx.doi.org/10.1071/sh03002.
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Worldwide, the human immunodeficiency virus exhibits a great genetic variability, with multiple circulating subtypes of the virus. This variability allows study of the movement of HIV strains within and between human populations but also has implications for diagnosis, treatment and monitoring. The type of HIV causing the epidemic in Australia is changing from being homogeneous subtype B, reflecting a greater regional diversity. In this paper the classification of HIV-1 subtypes and their distribution within the Australasian region are reviewed and the implications of these distribution patterns discussed.
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Lemoh, Chris, Rebecca Guy, Keflemariam Yohannes, Jenny Lewis, Alan Street, Bev Biggs, and Margaret Hellard. "Delayed diagnosis of HIV infection in Victoria 1994 to 2006." Sexual Health 6, no. 2 (2009): 117. http://dx.doi.org/10.1071/sh08028.
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Background: The identification of factors associated with delayed diagnosis of HIV infection in Victoria, Australia was the aim of the present study. Methods: Demographic and epidemiological characteristics of cases notified to the Victorian HIV surveillance database between 1 January 1994 and 31 December 2006 were analysed. Delayed diagnosis was defined as: CD4 count below 200 cells mm−3 at HIV diagnosis or diagnosis of AIDS earlier than 3 months after HIV diagnosis. Results: Diagnosis of HIV was delayed in 627 (22.6%) of 2779 cases. Of these, 528 (84.2%) had either a high-risk exposure or were born in a high-prevalence country. The most common exposure was male homosexual contact in 64.3% of cases. Independent risk factors for delayed diagnosis were: older age at diagnosis (30–39 years odds ratio [OR] 2.15, ≥ 50 years OR 7.50, P < 0.001), exposure via routes other than male homosexual sex or injecting drug use (heterosexual sex OR 2.51, P < 0.001, unknown/other route OR 4.24, P < 0.001); birth in Southern/Eastern Europe (OR 2.54), South-east Asia (OR 2.70) or the Horn of Africa/North Africa (OR 3.71, P < 0.001), and male gender (OR 0.47 for females, P < 0.001). Conclusion: Delay in the diagnosis of HIV infection is common in Victoria, but potentially avoidable in the majority of cases. Most people with delayed diagnosis had a history of male homosexual contact, injecting drug use, birth in a high-prevalence country or sexual contact with such individuals. An accurate sexual history, together with knowledge of their country of birth, should identify most individuals who should be offered an HIV test.
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Zijlstra, Eduard E. "Visceral leishmaniasis: a forgotten epidemic." Archives of Disease in Childhood 101, no. 6 (February 19, 2016): 561–67. http://dx.doi.org/10.1136/archdischild-2015-309302.
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Visceral leishmaniasis (VL or kala-azar) is most endemic in Asia and Africa and commonly affects young children. It is usually caused byLeishmania donovaniorLeishmania infantumthat are transmitted by Phlebotomine sand flies. Transmission may be anthroponotic or zoonotic or both, depending on the endemic area. Clinical features include fever, hepatosplenomegaly, weight loss and pancytopenia. Younger age, malnutrition and immunosuppression (HIV infection, use of immunosuppressive drugs) are risk factors. Many infections remain asymptomatic. Diagnosis is made by demonstration of theLeishmaniaparasite in aspirates of lymph node, bone marrow or spleen. Serological tests such as rK39 strip test are widely used but the sensitivity varies. qPCR is useful to detect low numbers of parasites and to monitor treatment. Treatment is with AmBisome monotherapy in most areas but with drug combinations elsewhere. HIV co-infected patients are most difficult to treat and often relapse. Control efforts focus on case finding, availability of diagnostic tools, reservoir control and protection from sand flies (insecticides, bed nets). There is no human vaccine.
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Combs, Barry C., and Carolien M. Giele. "An increase in overseas acquired HIV infections among heterosexual people in Western Australia." Sexual Health 6, no. 1 (2009): 35. http://dx.doi.org/10.1071/sh08010.
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Background: There has been a recent increase in the number of heterosexually acquired HIV infections among non-Aboriginal people in Western Australia (WA), which has not been reported in other Australian jurisdictions. This report describes the epidemiological features of this increase. Methods: A descriptive analysis was conducted of newly diagnosed HIV infections among non-Aboriginal WA residents notified to the Department of Health from 2002 to 2006. Analysis outcomes included demographics, exposure categories, and place of HIV acquisition. Results: From 2002 to 2006, 258 new HIV diagnoses were notified among non-Aboriginal WA residents. Over this period, the number of notifications increased from 41 cases in 2002 (2.2 cases/100 000 population) to 66 cases in 2006 (3.4 cases/100 000 population). Overall, 107 (42%) of the cases were heterosexually acquired, and the annual number increased threefold from 2002 to 2006 (12 to 36 cases, respectively). Of these cases, 64 (60%) were male and 43 (40%) were female. The majority (89%) of male cases acquired HIV overseas, mostly in countries other than their region of birth; South-east Asia was the most common place of acquisition reported. Over half (56%) of the female cases acquired HIV overseas, mainly in their region of birth (83%), and sub-Saharan Africa was the most common place of acquisition. Conclusion: There has been a recent increase in heterosexually acquired HIV infections among male and female WA residents, many of whom reported acquiring HIV overseas. Safe sex campaigns in WA should continue to reinforce safe sex messages among people travelling overseas.
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Shimizu, Kazuki, Hiroshi Nishiura, and Akifumi Imamura. "Investigation of the Proportion of Diagnosed People Living with HIV/AIDS among Foreign Residents in Japan." Journal of Clinical Medicine 8, no. 6 (June 5, 2019): 804. http://dx.doi.org/10.3390/jcm8060804.
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Foreign residents represent an increasing proportion of newly diagnosed human immunodeficiency virus (HIV) infections and acquired immunodeficiency syndrome (AIDS) cases in Japan, though scant research has addressed this. This study aimed to estimate the diagnosed proportion of people living with HIV/AIDS (PLWHA) among foreign residents in Japan, covering 1990–2017 and stratifying by geographic region of the country of origin. A balance equation model was employed to statistically estimate the diagnosed proportion as a single parameter. This used published estimates of HIV incidence and prevalence, population size, visit duration, travel volume, as well as surveillance data on HIV/AIDS in Japan. The proportion varied widely by region: People from Western Europe, East Asia and the Pacific, Australia and New Zealand, and North America were underdiagnosed, while those from sub-Saharan Africa, South and South-East Asia, and Latin America were more frequently diagnosed. Overall, the diagnosed proportion of PLWHA among foreign residents in Japan has increased, but the latest estimate in 2017 was as low as 55.3%; lower than the estimate among Japanese on the order of 80% and far below the quoted goal of 90%. This finding indicates a critical need to investigate the underlying mechanisms, including disparate access to HIV testing.
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Wipasa, Jiraprapa, Romanee Chaiwarith, Kriangkrai Chawansuntati, Jutarat Praparattanapan, Kritsadee Rattanathammethee, and Khuanchai Supparatpinyo. "Characterization of anti-interferon-γ antibodies in HIV-negative immunodeficient patients infected with unusual intracellular microorganisms." Experimental Biology and Medicine 243, no. 7 (March 7, 2018): 621–26. http://dx.doi.org/10.1177/1535370218764086.
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A major characteristic of immunodeficiency associated with life-threatening intracellular infection in adults is the presence of anti-interferon-γ antibodies. Although little is known about the mechanism underlying this syndrome, it is believed that the antibodies inhibit the activity of downstream signaling pathway of interferon-γ. In this study, the characteristics of these antibodies in patients who presented, or have a history of, intracellular infection and were positive to anti-interferon-γ antibodies were investigated. The antibodies exhibited mainly the IgG1 and the IgG4 subtypes and recognized the C-terminal of the interferon-γ linear epitope containing the KRKR motif, which is required for the biological activity of interferon-γ. The antibodies bound to recombinant interferon-γ with significantly lower avidity than antibodies to a recall antigen, tetanus toxoid, suggesting that the antibodies might have not undergone affinity maturation. The data from this study may provide fundamental information to better understand the properties of anti-interferon-γ antibodies, which can be useful for future studies. Impact statement An increase in the number of immunodeficient patients related to autoantibodies to interferon (IFN)-γ has been observed particularly in East Asian adults. These patients are often presented with opportunistic infections caused by intracellular pathogens, including non-tuberculous mycobacteria (NTM), Cryptococcus neoformans, Penicillium marneffei (now called Talaromyces marneffei), and non-typhoidal Salmonella spp. The mortality rate for this syndrome is relatively high with 32% patients dying at the median time of 25 months after diagnosis. Characterization of these autoantibodies may promote better understanding of the syndrome, an emerging health problem affecting East Asia populations and impeding their welfare and economic development.
Dissertations / Theses on the topic "HIV infections – Diagnosis – Asia"
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Tang, Chui-ying, and 鄧翠瑩. "Migration and the risk of HIV infection: a review in Asia." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2012. http://hub.hku.hk/bib/B4842559X.
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Asia has populated with the second largest number of people living with HIV/AIDS. Under the advancement of transportation, the open up of borders between cities and countries, and the process of globalisation, people move from their place of origin to other places for better living conditions and employment opportunities.
Mobile people and migrants are identified as the high risk population of HIV infection. Poverty, discrimination, limited access to healthcare and social services, separation with supports and families, being alienated in resident communities, and gender inequalities are the unfavourable conditions which make the migrant population vulnerable to HIV infection.
Existing literatures have investigated and examined the potential risk factors among the mobile population. Inconsistencies were found among research but high risk sexual behaviours and poor knowledge and attitude were observed and reviewed within the migrants. However, literatures which compared the people who migrated with other local people in the same population were not yet reviewed systemically. Therefore, this paper aimed to review the articles which compare the migrant group and the non-migrant group in Asian population to identify the association between migration and the risks of HIV infection.
A literature search of five databases (PubMed, Medline, Cochrane, CNKI, Wanfang Med Online) was performed and nine articles were eventually selected for review. The migration status of literature was studied as explanatory variable and compared across studies. Outcome variables of interest were grouped into four categories as: demographic characteristics, sexual practices, awareness towards HIV/AIDS, and disease prevalence.
To conclude, compared to people who did not migrate, migrants in Asia were more tend to be less educated, have multiple sex partners, engage in high risk sexual intercourse and commercial sex, but their overall condom usage were lower. Also, they had higher risk of sexually transmitted infections and poorer knowledge in HIV/AIDS.published_or_final_version
Public Health
Master
Master of Public Health
2
Nolte, Jeanine Lucasta. "The formulation and refinement of a polymerase chain reaction (PCR) assay for early diagnosis of paediatric HIV infection and genetic analysis of variants involved in vertical transmission of HIV-1." Master's thesis, University of Cape Town, 1996. http://hdl.handle.net/11427/26361.
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Paediatric human immunodeficiency virus (HIV) infection has become a major socio-economic health problem in recent years as the number of HIV-1 infected children steadily increases. The majority of these infants are infected through mother-to-child transmission, with the frequency of vertical transmission varying between 12,9% and 65%. In order to implement appropriate management and possible treatment of these infected neonates, it is essential to have reliable laboratory tests for the early diagnosis of an HIV infection. At the time that this study was initiated, the diagnosis of HIV-1 infection in the Groote Schuur Hospital Virology Laboratory depended almost exclusively on serological assays. Such assays are of limited value for infants under 18 months of age, as maternal lgG antibody to HIV-1 is transferred via the placenta and may persist in the baby for up to 18 months. Available lgG antibody tests do not distinguish reliably between passively acquired maternal antibody and that produced by the infant itself. A valuable method of establishing the presence of true infection is provided by the polymerase chain reaction (PCR) technique which allows the identification, and subsequent exponential amplification of low levels of specific viral nucleic acid using specific oligonucleotide primers. A major aim of this study was to develop and instigate a (PCR) assay for the early diagnosis of HIV infection in infected infants. This was successfully achieved by the adaptation and optimization of an existing standard PCR protocol to suit the specific needs of a routine diagnostic service. Preliminary requirements involved the selection of primers and probes and establishing optimal parameters for: ionic strength, Taq DNA polymerase concentration, primer concentration, deoxynucleotide triphosphate concentration, and hybridization conditions for most efficient functioning of the test. The devised method entailed the extraction of proviral DNA from peripheral blood mononuclear cells, amplification of HIV-1 specific sequences by PCR, and identification by Southern blot hybridization with digoxigenin (DIG)-labelled probes. Thereafter the efficacy of the assay was tested on 45 infants (under 15 months of age) all born to seropositive mothers and therefore at risk for HIV infection. Forty-two of these infants had antibodies to HIV-1 and the remaining 3 were seronegative. The latter 3 also tested negative for HIV proviral DNA when PCR was performed, using at least 2 different HIV-1 primer pairs and their respective DIG-labelled probes. However, 27 (64%) of the 42 seropositive infants were also HIV-PCR positive and the remaining 15 (36%) seropositive infants were negative for HIV proviral DNA. Positive PCR tests correlated well with clinical data indicative of active HIV-1 infection for the majority of infants in the neonatal period, although it could not provide proof of infection in newborn babies (less than 1 week of age). The development of an in-house PCR protocol specific for HIV-1 has not only provided a valuable diagnostic assay for neonatal infection, but has also given insight into the parameters required for high sensitivity and the stringent precautionary measures that need to be applied to avoid contamination problems. The second part of this study was devoted to DNA sequence analysis of cloned HIV isolates from an infected mother and her 3-month-old infant. Nucleotide sequence variation between isolates of HIV-1 has been well documented. Examination of the third variable region (particularly the V3- loop) in the env gene of HIV-1 of our mother-infant pair confirmed this variation and provided the first genetic epidemiological data of this nature in the local community. Proviral DNA from both mother and baby was amplified using V3-specific degenerate primers and cloned. Clones containing the insert DNA were 2 identified by colony-blot hybridization. Their nucleotide and amino acid sequences were analyzed by using various computer programs. The degree of similarity between variants from the mother and infant in this study differed to a large extent from previous studies. The virus population harboured by the mother displayed highly homogeneous V3 sequences (1,04% variation) compared to the isolates from her 3-month-old infant, which showed a higher degree (1,8%) of heterogeneity. Phylogenetic analysis of the different isolates from mother and infant demonstrated that an HIV-1 subtype C virus was the infectious agent. This classification was confirmed by the characteristic amino-acid sequence of the tetrapeptide motif of the V3 loop present in the isolates from both mother and infant as well as the absence of a potential N-linked glycosylation site proximal to the first cysteine of the V3 loop, which is characteristic of subtype C viruses. Based on the amino acids present at positions 306 and 320 of the V3 loop, it could also be concluded that isolates from both the mother and her baby were consistent with the non-syncytium inducing (NSI) phenotype of HIV-1, thus indicating that, contrary to popular belief, NSI variants can be responsible for initiating infection. Data obtained from these genetic investigations of variants involved in vertical transmission of HIV-1 can form a useful basis for future comparative studies.
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Hon, Kit-sum Annie, and 韓潔心. "Can home-based HIV testing improve test uptake in Africa?" Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2010. http://hub.hku.hk/bib/B45172353.
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Liang, Jianguo, and 梁建国. "HIV-1 early diagnosis of men having sex with men in Hong Kong and discovery of novel agents for HIV-1 treatment from traditional Chinese herbal medicine." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2013. http://hdl.handle.net/10722/196459.
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Over the 30 years since it was first identified, the HIV/AIDS epidemic has had historically unprecedented severity and impact. There are approximately 33.4 million people living with HIV-1/AIDS which urges to seek novel approaches for HIV-1 diagnosis and HIV-1 therapy.
Men who have sex with men (MSM) are severely affected by HIV-1 and constitute a large proportion of HIV-infected individuals. In Hong Kong, the transmission route of homosexual and bisexual contacts accounted for nearly 50% of incidence in 2012. To investigate HIV-1 prevalence among MSM in Hong Kong, the combination of fast antibody test (FAT) and real-time dried-blood-spot-based quantitative polymerase chain reaction (DBS-qPCR) was employed for 474 participants chosen randomly from community testing sites of MSM within a one-year period which showed a 4.01% (19/474) rate of HIV-1 prevalence among MSM in Hong Kong with three cases at the acute phase among the newly infected participants. The new survey demonstrated that the risk factors of MSM are mostly correlated with the receptive role during anal sex and syphilis infection.
In this study, two traditional Chinese herbal medicines (TCHM), Sanguisorba officinalis (SO) and Spatholobus suberectus (SS), inhibited the infection of model cell lines expressing HIV-1 targets by HIV-1 pseudoviruses, while the anti-HIV-1 properties of SO were demonstrated for the first time. Both SO and SS were able to block not only infection by pseudoviral HIV-1 CCR5-tropic and CXCR4-tropic strains, but also RT and PI drug-resistant strains. Mechanistic studies revealed that SO and SS interact with the viral envelope to prevent the infection of target cells by HIV-1. Two compounds derived from SO and SS, named Gallic acid (GA) and Jiazhi (JZ), retained anti-HIV-1 properties and blocked HIV-1 infection by acting on the viral envelope.
Small molecules derived from TCHM were also investigated for their capacity to activate HIV-1 from latency. A small molecule derived from SS, Daidzein (DDZ), demonstrated the potentials to trigger HIV-1 reactivation in latently infected cell lines. DDZ enhanced gene expression from HIV-1 LTR in which the Sp1 binding site plays an important role. The Akt pathway is also involved in the initiation of DDZ-induced activation. Phosflow analysis revealed that DDZ activated the Akt pathway in various subpopulations of T cells, including memory CD4+ T cells which are considered to be a major reservoir for HIV-1. The structure-activity relationships (SARs) study demonstrated the 4'-hydroxyisoflavone as bio-functional core structure. Addition of a hydroxyl group on C-5 position significantly decreases its biological function of HIV-1 latency activation.
In summary, this study investigates HIV prevalence and incidence using an assay for early HIV-1 diagnosis and performs an analysis of risk factors of behavior which contributes to the effective control of HIV transmission in Hong Kong and its neighbors in Asia. It also demonstrates a drug research sourced from traditional Chinese herbal medicines that which sheds lights on drug discovery from traditional herbal medicines and facilitates mechanistic drug design for HIV-1 eradication.published_or_final_version
Microbiology
Doctoral
Doctor of Philosophy
5
Srasuebkul, Preeyaporn Public Health & Community Medicine Faculty of Medicine UNSW. "Evaluating monitoring strategies, short-term disease progression and rate of treatment change in HIV-infected patients commencing antiretroviral therapy in the Asia-Pacific region." Publisher:University of New South Wales. Public Health & Community Medicine, 2008. http://handle.unsw.edu.au/1959.4/41673.
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This thesis assesses factors associated with a number of short and long-term outcomes in HIV-infected patients receiving antiretroviral treatment in Asia. Analyses in this thesis were based on two cohorts of HIV-infected patients; The Treat Asia HIV Observational Database (TAHOD), a multi-centre prospective observational cohort from countries in Asia-Pacific region, and the HIV Netherlands Australia Thailand (HIV-NAT) collaboration cohort, a cohort of patients treated with antiretroviral treatments at HIV-NAT in Bangkok, Thailand. We examined factors associated with time to immunological failure endpoints, such as CD4≤ 200 cells/??L, CD4≤ 100 cells/ ??L, and CD4 return to baseline, and with the virological failure endpoint, detectable viral load defined as a value greater than 500 copies/mL. Multivariate Cox proportional hazard models were used. Results showed that CD4 count at baseline and changes in CD4 strongly predicted immunological failure. For virological failure, detectable viral load at baseline was the strongest predictor. As a step to developing simplified monitoring strategies, in which patients with a low risk of failure could have their monitoring CD4 count and viral load tests deferred, we developed predictive models for each immunological and virological failure endpoint. Models were developed on the HIV-NAT cohort, and validated on the independent TAHOD cohort. For predictive models, the complementary log-log transformation for each endpoint was fitted appropriate to the interval censored nature of the data. To assess goodness-of-fit, cut-offs were defined for the predicted risks that separated patients from low risk to high risk. Overall, the observed versus expected failures from HIV-NAT data agreed quite well across all endpoints, probably reflecting that the HIV-NAT database was the data we built the models upon. Not only did these models fit the HIV-NAT database well, they also discriminated patients from low to high risk groups. When we validated models with TAHOD data, the observed and expected failures agreed well only in the model for CD4 count return to baseline. For most of the endpoints, the predictive models overestimated the number of failures, with predicted values larger than observed. However, the proportions of failures were lowest in the low risk group and highest in the high risk group, indicating that our models did discriminate between patients at high and low risk, and that the predictive models might still be of use for the purpose of simplified monitoring strategies. With CD4 count and viral load monitoring tests now comprising a large component of the cost of HIV treatment in resource limited settings, we developed and assessed a simplified monitoring strategy that aimed to reduce the numbers of monitoring tests performed. The predictive models developed earlier were used to calculate the probabilities of failure in TAHOD patients. We assumed that patients would have their CD4 and viral load assessments annually, at baseline and at one year, predicted risk of failure at ensuing clinical visits, week 12, 24 and 36. For patients at low predicted risk of failure at ensuing clinical visits, we assessed the effect of deferring monitoring tests, both in terms of blood tests avoided, and in terms of delaying detection of failure in some patients. A number of levels for the predicted risk of failure that lead to deferral of testing were evaluated. The results suggested that predicted probabilities of failure of 10% - 20% gave the best results across all failure endpoints. These cut-offs could save a median of 598 (51.6%) (range 37 (2.6%)_-1,218 (81.9%) ) blood tests over the first year of treatment, but would fail to detect 29 (18%) (range 10 (7.4%) - 128 (39.3%) ) failures. The median time from failure to detection in those patients who did fail and had deferred monitoring tests was 28 weeks. Rates of antiretroviral treatment change in TAHOD were examined. We identified patterns and factors associated with the rate of treatment change. Median time to the first treatment change was 3.2 years. Factors predicting rate of treatment change in TAHOD were treatment combination, being on second or third combination, number of drugs available in each site and being an injecting drug user. The overall rate of treatment change in TAHOD was 29 per 1OO-person-year. Around 30% of patients stopped their treatment due to adverse events. These rates of treatment change are lower than have been seen in patients in western countries. This may be due to patients in developing countries having access to fewer antiretroviral drugs than patients in developed countries.
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Berggren, Palme Ingela. "Tuberculosis and HIV interaction in Ethiopian children : aspects on epidemiology, diagnosis and clinical management /." Stockholm, 2002. http://diss.kib.ki.se/2002/91-7349-296-5/.
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Wong, Mei-wan Farah, and 黃美雲. "Financial burden for HIV/AIDS patients to access antiretroviral therapy in Asian developing countries." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2013. http://hdl.handle.net/10722/193826.
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Background: Since the beginning of 21st century, several Asian countries started implementing their national free antiretroviral therapy (ART) programs to tackle one of the most striking public health issues in Asia – HIV/AIDS. Despite the efforts being made, the treatment coverage remains as low as 44% in 2010. Previous studies have identified financial constraint is a major barrier in accessing ART and an important reason of poor ART adherence in Asia. The purpose of this literature review is to explore the extent of financial burden experienced by people living with HIV (PLHIV) where free ART policy is implemented, and to provide valuable information for policy-making in reducing financial barriers and improve uptake of ART.
Methods: Literature search was performed by entering keywords in PubMed and Medline. Articles were screened and selected for in-depth review according to the inclusion and exclusion criteria. A process on data synthesis was performed on the final eligible papers.
Results: Five studies from four Asian countries describing the out-of-pocket health expenditure incurred by PLHIV during the delivery of ART were included in this review.
Findings: Out of all direct medical costs, the cost of drug was most important in contributing to the total costs for patients without health insurance, while the cost of transportation was more important for patients covered by health insurance. Direct medical costs increased with advancing stage of disease. Rural patients would have spent up to 1,173% of their monthly income per capita, or more than 100% of their total household expenditure even when ART was provided free-of-charge. Patients have also highlighted free ARV drugs were sometimes not available in the health facility and they had to turn to the private market. Hence, the extent of financial burden in this review might be underestimated.
Conclusion: Based on the data available, we concluded that increased accessibility of free ART should be accompanied with sustained ARV drugs supply and increased financial support for PLHIV.published_or_final_version
Community Medicine
Master
Master of Public Health
8
Ng, Jenny, and 吳仲嫣. "Reducing HIV infections in Hong Kong: a systematic review of the cost-effectiveness of expanded screening." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2012. http://hub.hku.hk/bib/B48425138.
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Background
Routine voluntary HIV screening has been found to be cost-effective in regions with undiagnosed prevalence > 0.1%. However, a large proportion of infected patients are still unaware of their status and presenting to care late, leading to greater risk s for infection. As expanded ART has been shown to be highly effective in improving patient health and reducing HIV viral load, a strategy of expanded screening with earlier initiation of ART may be effective at reducing the numbers of new infections.
Aim
A systematic review was carried out with the aim of understanding what drives the cost-effectiveness of expanded HIV screening at low prevalence rates. A thorough investigation of sensitivity analysis was done to determine if low prevalent regions can implement screening at good value for cost and how money should be spent to maximize benefits.
Methods
An extensive literature review of studies published in English between 1996 and 2010 were identified from various electronic databases, included gray literature search and hand search. A qualitative assessment of the literature was undertaken.
Results
Results of the analysis found that expanded screening can be cost-effective at undiagnosed prevalence rates below that of current recommendations. Factors of linkage to care, and benefits of reduced secondary transmissions through reduced risk behaviors had the most impact on models. Screening while maximizing benefits due to linkage to care and secondary transmissions can may be appropriate for low prevalence regions such as Hong Kong, however further analysis would be necessary.published_or_final_version
Public Health
Master
Master of Public Health
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Mohaleni, Mamabolo Promise. "Pre-and post-HIV diagnosis help-seeking behaviour by patients receiving antiretroviral treatment at Witbank Hospital in Mpumalanga Province." Thesis, University of Limpopo (Turfloop Campus), 2013. http://hdl.handle.net/10386/1049.
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Thesis (M.A. (Clinical Psychology)) --University of Limpopo, 2013Studies have indicated that help-seeking behaviour of people living with HIV is not predictable and linear and may entail the utilization of western medicine, traditional medicine and/or complementary medicine. The aim of this study was to explore pre- and post- HIV diagnosis help-seeking behaviour by patients receiving antiretroviral treatment at Witbank Hospital in Mpumalanga Province (South Africa).A qualitative, descriptive phenomenological approach was utilized in the study. Ten participants (male = 5; female = 5, and aged between 30 and 50 years)diagnosed with HIV and who came to the hospital to collect their treatment and for medical review were interviewed using semi-structured interviews. Interpretive analysis method was used to analyse the data. The results suggest the preference for western medicine pre-and post-HIV diagnosis. The results further suggest that help-seeking behaviour is a dynamic process embedded mainly in the conceptualization of the health problem, perception of its severity, the treatment given, and social support experienced.
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Orikiriza, Patrick. "Improving diagnosis of childhood tuberculosis in a high TB-HIV prevalent setting." Thesis, Montpellier, 2019. http://www.theses.fr/2019MONTT026.
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L’Organisation Mondiale de la Santé estime qu’en 2017 près d’un million d’enfants de moins de 15 ans ont développé la tuberculose mais seulement la moitié des cas ont été notifiés. Les difficultés pour recueillir des échantillons de crachat chez les enfants et la nature paucibacillifère de la tuberculose pédiatrique représentent de véritables challenges diagnostiques. Cela aboutit à la prescription fréquente de traitement empirique avec un risque de sur- ou sous-diagnostic. De plus, peu de laboratoires dans les pays à ressources limitées ont les capacités du diagnostic de la tuberculose. Les échantillons doivent être transportés vers des laboratoires de référence pouvant affecter les performances des tests, notamment en l’absence de chaine de froid.Trois études ont été menées à Mbarara (Ouganda) pour évaluer des échantillons non-respiratoires et des méthodes de conservation des échantillons pour améliorer le diagnostic de la tuberculose de l’enfant. Dans la première étude, nous avons évalué les performances de l’XpertMTB/RIF sur les expectorations et les selles d’enfants avec présomption de tuberculose et nous avons documenté le devenir des enfants selon la décision thérapeutique. Dans la deuxième étude, nous avons évalué les performances de l’XpertMTB/RIF dans les selles et du test lipoarabinomanann (LAM) dans les urines chez des enfants admis dans un état critique. Dans la troisième étude, nous avons déterminé le taux de détection avec XpertMTB/RIF et la culture MGIT d’échantillons de crachats frottis-positifs conservés à température ambiante sans traitement, ou traités avec Omnigène ou éthanol à différents périodes de temps.Sur 392 enfants (âge médian 3,9 ans, 45,5% de filles et 31% VIH positifs) inclus dans la 1e étude, 4,3% ont été confirmés microbiologiquement. L’XpertMTB/RIF dans le crachat avait une sensibilité de 90,9% et une spécificité de 99,1% contre un test de référence microbiologique. La sensibilité et la spécificité de l’Xpert dans les selles étaient de 55,6% et 98,2%. La mortalité était de 6,9% à trois mois, et était plus importante chez les enfants traités (10,7%) que chez les enfants non-traités (4,5%). Aucun des enfants traités pour une tuberculose microbiologiquement confirmée n’est décédé contre 12,3% de ceux traités de façon empirique.Parmi les 234 enfants (âge médian 16,5 mois, 48,3% de filles, 31,6% VIH positifs et 58,5% sévèrement malnutris) inclus dans la 2e étude, 5,1% avaient une tuberculose microbiologiquement confirmée. XpertMTB/RIF dans les selles avait une sensibilité de 50% et une spécificité de 99,1%. La sensibilité du test urinaire LAM était de 50% et la spécificité de 74,1%. Les faux positifs LAM étaient plus fréquents parmi les résultats positifs LAM de bas grade et dans les urines avec une contamination bactérienne.Dans la 3e étude, après 15jours, il n’y avait pas de différence de détection par XpertMTB/RIF entre les échantillons traités avec Omnigène ou éthanol et les échantillons non traités, ne montrant pas de bénéfice de l’ajout d’un conservateur. Nous avons décrit une baisse substantielle de viabilité de Mycobacterium tuberculosis dans les échantillons traités par Omnigène, ce qui n’est pas en faveur de l’utilisation de l’Omnigène pour le transport des échantillons avant culture MGIT.En conclusion, XpertMTB/RIF dans les selles a montré des résultats prometteurs chez les enfants ne pouvant pas cracher et pourrait être une alternative intéressante à des méthodes plus complexes comme l’induction du crachat et l’aspiration gastrique pour les centres de santé primaire des pays à ressources limitées. La faible spécificité du LAM dans les urines nécessite des investigations complémentaires avant son utilisation pour le diagnostic de la tuberculose de l’enfant. En dépit des résultats encourageants de l’XpertMTB/RIF sur les échantillons conservés avec Omnigène ou l’éthanol, des investigations complémentaires dans des conditions programmatiques sont nécessairesThe world health organization estimates that in 2017, close to 1 million children below 15 years developed tuberculosis but only half of them were notified. Difficulty to obtain sputum in children and the paucibacillary nature of intrathoracic childhood tuberculosis challenge the diagnosis of tuberculosis in children. This leads to the common use of empirical treatment with a high risk of over or under diagnosis. Besides that, few facilities in low resource settings have adequate laboratory capacity to diagnose tuberculosis. Samples must be transported to a reference laboratory, which can effect performance of the tests, especially in the absence of cold chain.Three studies were conducted in Mbarara (Uganda) to evaluate non-respiratory samples and specimen preservation methods to improve diagnosis of pediatric tuberculosis. In the first study, we assessed the performance of XpertMTB/RIF on sputum and stool in children with presumptive tuberculosis and documented outcomes of children according to the tuberculosis treatment decision. In the second study, we assessed the performance of stool XpertMTB/RIF and urine lipoarabinomanann (LAM) among children admitted with severe illness. In the 3rd study, we determined XpertMTB/RIF and MGIT culture recovery rates of smear positive sputum specimen kept untreated at room temperature and treated with either Omnigene or ethanol over different time periods.Of 392 children (median age 3.9 years, 45.4% female and 31% HIV infected) enrolled in the 1st study, 4.3% (17/392) were microbiologically confirmed tuberculosis. Using a microbiological reference standard, sputum XpertMTB/RIF had a 90.9% sensitivity and specificity of 99.1%. The sensitivity and specificity of stool XpertMTB/RIF was 55.6% and 98.2%. The study reported mortality of 6.9% within three months with a higher proportion (10.7%) among children treated for tuberculosis compared to the non-treated children (4.5%). None of treated children with bacteriologically confirmed tuberculosis died compared to 12.3% of those treated empirically.Of 234 patients (median age 16.5 months, 48.3% female, 31.6% HIV infected, 58.5% severely malnourished) enrolled in the 2nd study, 5.1% were microbiologically confirmed tuberculosis. Stool XpertMTB/RIF had a sensitivity of 50% and specificity of 99.1%. For the urine LAM test, it was 50% and 74.1%, respectively. False positive LAM results were more common among low grade positive LAM results and occurred more frequently when urine samples had bacterial contamination.The 3rd study documented that by 15th day, there was no difference of XpertMTB/RIF recovery rate between samples treated with Omnigene or ethanol and untreated samples, meaning that in the study conditions there was no benefit of adding any preservative for samples stored at room temperature up to 15 days. We observed a substantial loss of viability of Mycobacterium tuberculosis on samples treated with Omnigene, which does not support the use of Omnigene for sample transportation before MGIT testing.In conclusion, XpertMTB/RIF on stool gave promising results for the use in children unable to provide sputum and could be an interesting alternative to more complex methods such as sputum induction and gastric aspirate for primary health care centers of limited resource countries. The low specificity of the urine LAM requires further investigation before its use for diagnosis of tuberculosis in children. Despite the encouraging XpertMTB/RIF results from specimen preserved either with Omnigene or ethanol further evaluation under routine field conditions is necessary
Books on the topic "HIV infections – Diagnosis – Asia"
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Medical Laboratory and Clinical Scientists Council (Zimbabwe). Rapid HIV testing: Trainer's guide. 3rd ed. [Harare]: Ministry of Health and Child Welfare, 2006.
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V, Deutsche AIDS-Hilfe e. HIV-Test 2000: Bestandsaufnahme und Perspektiven. Berlin: Deutsche AIDS-Hilfe e.V., 2000.
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Phair, John P. Contemporary diagnosis and management of HIV/AIDS infections. Newtown, PA: Handbooks In Health Care, 1997.
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P, Flaherty John, ed. Contemporary diagnosis and management of HIV/AIDS infections. 2nd ed. Newtown, Pa: Handbooks in Health Care, 2003.
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P, Flaherty John, and Taiwo Babafemi O, eds. Contemporary diagnosis and management of HIV/AIDS infections. 3rd ed. Newtown, Pa: Handbooks in Health Care Co., 2009.
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Drugs, death, and disease: Reporting on AIDS in Southeast Asia. Quezon City, Philippines: Philippine Center for Investigative Journalism, 2001.
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University, Johns Hopkins, ed. Johns Hopkins HIV guide: Treatment and management of HIV. 2nd ed. Sudbury, Mass: Jones & Bartlett Learning, 2012.
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Great Britain. Department of Health. Guidelines for pre-test discussion on HIV testing. (London): Department of Health, 1996.
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Human Rights Law Network (New Delhi, India), ed. Against mandatory pre-marital HIV testing in India. New Delhi: Human Rights Law Network, 2008.
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Points to consider: Responses to HIV/AIDS in Africa, Asia, and the Caribbean. London: Adonis & Abbey, 2008.
Find full textBook chapters on the topic "HIV infections – Diagnosis – Asia"
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Essex, M., and Yichen Lu. "HIV/AIDS: Lessons from a New Disease Pandemic." In Emerging Infections in Asia, 133–42. Boston, MA: Springer US, 2008. http://dx.doi.org/10.1007/978-0-387-75722-3_8.
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Gürtler, L. G., L. Zekeng, J. M. Tsague, A. Brunn, E. Afane Ze, J. Eberle, and L. Kaptue. "HIV-1 subtype O: epidemiology, pathogenesis, diagnosis, and perspectives of the evolution of HIV." In Imported Virus Infections, 195–202. Vienna: Springer Vienna, 1996. http://dx.doi.org/10.1007/978-3-7091-7482-1_17.
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Beyrer, Chris, and Henry Stephens. "Transmission of HIV and Other Infections in Southeast Asia." In AIDS in Asia, 317–33. Boston, MA: Springer US, 2004. http://dx.doi.org/10.1007/978-0-306-48536-7_23.
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Shao, Yiming, and Fan Lv. "Current HIV/AIDS Diagnosis, Reporting, and Surveillance in China." In AIDS in Asia, 351–64. Boston, MA: Springer US, 2004. http://dx.doi.org/10.1007/978-0-306-48536-7_25.
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Rudén, U., P. A. Broliden, J. Trojnar, and B. Wahren. "Synthetic peptides in the diagnosis of HIV-1 and HIV-2 infections." In Peptides 1990, 911–13. Dordrecht: Springer Netherlands, 1991. http://dx.doi.org/10.1007/978-94-011-3034-9_373.
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Nguyen, Nang L., Rodney Arcenas, and Yi-Wei Tang. "Laboratory Diagnosis of HIV-1 Infections: State of the Art." In Advanced Techniques in Diagnostic Microbiology, 445–73. Cham: Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-95111-9_18.
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Tang, Yi-Wei. "Molecular Diagnosis of HIV-1 Infections: Current State of the Art." In Advanced Techniques in Diagnostic Microbiology, 785–812. Boston, MA: Springer US, 2012. http://dx.doi.org/10.1007/978-1-4614-3970-7_41.
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Chakrabarti, Arunaloke. "Difficulties Faced in Asian Countries for the Diagnosis of Fungal Infections and Possible Solutions." In Clinical Practice of Medical Mycology in Asia, 199–205. Singapore: Springer Singapore, 2019. http://dx.doi.org/10.1007/978-981-13-9459-1_13.
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Kwoh, Deborah Y., and Thomas R. Gingeras. "The Use of Transcription-based Amplification Systems in the Diagnosis of HIV-1 Infections." In Applied Virology Research, 33–58. Boston, MA: Springer US, 1994. http://dx.doi.org/10.1007/978-1-4757-9265-2_3.
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Chaiwarith, Romanee, Khuanchai Supparatpinyo, and Thira Sirisanthana. "Talaromyces (Penicillium) marneffei infection." In Oxford Textbook of Medicine, edited by Christopher P. Conlon, 1375–78. Oxford University Press, 2020. http://dx.doi.org/10.1093/med/9780198746690.003.0157.
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Talaromyces (formerly Penicillium) marneffei was first isolated from bamboo rats Rhizomys sinensis in Vietnam in 1956. The fungus is endemic in Southeast Asia, north-east India, south China, Hong Kong, and Taiwan. Fewer than 40 cases of infection with T. marneffei were reported before the HIV epidemic. Since then, the incidence of disseminated T. marneffei infection has increased markedly. Talaromyces marneffei infection is very rare in the immunocompetent but one of the most common opportunistic infections in HIV-infected people in Southeast Asia, north-eastern India, southern China, Hong Kong, and Taiwan. Presentation is usually with fever, chills, lymphadenopathy, hepatomegaly, and splenomegaly, with skin lesions—most commonly papules with central necrotic umbilication—in two-thirds of cases. Diagnosis is made by microscopy of bone marrow aspirate or biopsy specimens. Standard treatment, which is usually effective, is with amphotericin B followed by itraconazole.
Conference papers on the topic "HIV infections – Diagnosis – Asia"
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McCartney, D., T. Pinheiro, J. Gomez, P. Galdino, M. de Sousa Mascena Veras, and P. Mayaud. "P386 Acceptability of self-collected samples for diagnosis of sexually transmitted infections among transgender women in São Paulo cohort study." In Abstracts for the STI & HIV World Congress, July 14–17 2021. BMJ Publishing Group Ltd, 2021. http://dx.doi.org/10.1136/sextrans-2021-sti.421.
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Medland, N., C. Fairley, J. Wu, X. Wu, E. Chow, X. Xu, Z. Ge, X. Zhuang, and L. Zhang. "P341 Predicting the diagnosis of HIV and sexually transmitted infections among men who have sex with men using machine learning approaches." In Abstracts for the STI & HIV World Congress, July 14–17 2021. BMJ Publishing Group Ltd, 2021. http://dx.doi.org/10.1136/sextrans-2021-sti.391.
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Consolacion, Theodora, Janyn Mercado, Olga Mazo, Venessa Ryan, Linda Hoang, Muhammad Morshed, Mark Gilbert, Mark Hull, Troy Grennan, and Jason Wong. "P747 Characteristics of chlamydia/gonorrhea infections associated with a subsequent syphilis diagnosis in british columbia, canada." In Abstracts for the STI & HIV World Congress (Joint Meeting of the 23rd ISSTDR and 20th IUSTI), July 14–17, 2019, Vancouver, Canada. BMJ Publishing Group Ltd, 2019. http://dx.doi.org/10.1136/sextrans-2019-sti.806.
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Abe, T., T. Terao, Y. Nakayama, Y. Kato, M. Kazama, and I. Takahashi. "HEMOPHILIAC MENINGITIS WITH PARTICULAR MANIFESTATION AND HIV ANTIBODIY IN SPINAL FLUID." In XIth International Congress on Thrombosis and Haemostasis. Schattauer GmbH, 1987. http://dx.doi.org/10.1055/s-0038-1644139.
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A 25-year-old patient with hemophilia A, who had had thrombocytopenia since 1985, was admitted to a hospital in August 1986 because of headache and slight disturbance of consciousness. Diagnosis of cerebral bleeding was made based on brain CT scan. Lymphadanopathy was noted then, and after relief of the symptoms S. aureus sepsis developed. Examination of serum for HIV antibody performed at this time gave a positive result. He was transferred to our hospital for evaluation of AIDS-relatedimmunologic disorder. The ratio of T4/T8 was 0.16, but no definitive opportunistic infections were found. Soon later, he developed headache and fever. There were no other neurological signs. Spinal fluid examination revealedlymphocytic pleocytosis without bacilli, fungi or antibodiesto viruses commonly causing encephalomeningitis. However, antibodyto HIV was detected in the spinalfluid. By a supportive care with useof antibacterial agents thesymptoms were alleviated with diminishing of the pleocytosis in spinal fluid. Lentinan, an antitumor polysaccharide, was administered with some effect on his immunologic functions. Three months later, meningitis recurred which wasalsorelieved by a supportive care.HIV is known to cause meningeal and CNS diseases. In this case the presence of HIV antibody in the spinal fluid was interpreted to be due to HIV invasion of nervous system. Furthermore, this casehas some particular feature in consideration of the common pictureof neurological involvements of AIDS, indicating that HIV induced a variety of meningeal and CNS manifestations.
Reports on the topic "HIV infections – Diagnosis – Asia"
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Erling, Norrby, and Eva M. Fenyo. Human Immunodeficiency Virus (HIV) Infections: Strain and Type Variations; Diagnosis and Prevention. Fort Belvoir, VA: Defense Technical Information Center, April 1991. http://dx.doi.org/10.21236/ada237815.
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Orme, I. M. Early Diagnosis and Treatment of Opportunistic Mycobacterial Infections in HIV-Seropositive AIDS Patients. Fort Belvoir, VA: Defense Technical Information Center, August 1990. http://dx.doi.org/10.21236/ada227796.
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