Jornal de AIDS e Pesquisa Clínica

Abstract Objective: Donovanosis, caused by Calymmatobacterium granulomatis, is a recognized cause of genital ulcer disease. Extragenital donovanosis in acquired immunodeficiency syndrome (AIDS) and lymph nodes is documented rarely. The aim of this report is to highlight implications of lymph node involvement as the initial manifestation of donovanosis, especially in AIDS. Materials and methods: This is a retrospective clinicopathological 6 year study that reviewed the features of lymph node biopsies and patients presenting with nodal donovanosis. Results: Of a total of 198 patients with donovanosis, 4 patients with nodal disease were identified. Patient 1, on anti-tuberculous therapy for pulmonary tuberculosis for 2 weeks, developed subcutaneous nodules on her legs and left-sided inguinal lymphadenopathy. Biopsies confirmed erythema induratum and nodal donovanosis in the former and latter sites, respectively. Patients 2 and 3 presented with right-sided inguinal lymphadenopathy that simulated lymphoma. Lymph node biopsy confirmed donovanosis. Further examination on follow-up, confirmed ulcers on the cervix and penis, in patients 2 and 3, respectively. Biopsies of these genital ulcers demonstrated donovanosis in both patients. Patient 4 presented with a left-sided neck mass, biopsy of which confirmed nodal donovanosis. Subsequent biopsy of a pre-auricular ulcer and of the cervix confirmed donovanosis. HIV seropositivity and AIDS were confirmed in all patients. Patient 1 died of pulmonary tuberculosis while disease resolution was achieved in the others following 4-6 weeks of trimethoprim-sulfamethoxazole treatment. Conclusion: Heightened clinicopathological recognition of nodal donovanosis, lymph node biopsy and careful histomorphological assessment thereof are pivotal, not only for diagnostic confirmation of nodal donovanosis and its distinction from other common nodal infections, especially in the AIDS context, but also as a sentinel clue to genital donovanosis, HIV infection and AIDS.  

Objective: Despite the effort to reduce the rate of HIV infection, AIDS still remains the major cause of death around the world, predominantly in Sub-Sahara Africa. Neither a cure, nor an HIV vaccine has been found to date and the disease can only be managed by using High Active Antiretroviral Therapy (HAART). The need for non-toxic regiments has brought about the necessity for additional HIV treatment to lower mortality rates. Antimicrobial Peptides (AMPs) had proven to be a promising therapeutic agent against HIV. The aim of this research was to identify AMPs, which binds gp120 at the area where gp120 interacts with CD4+, to prevent HIV invasion and HIV replication. Method: Putative AMPs were identified using an In Silico mathematical algorithm, Profile Hidden Markov Models (HMMER). The AMPS 3-D structures was carried out using I-TASSER and the modelled AMPs were docked against the HIV protein gp120 using PATCHDOCK. Subsequently, molecular method was used to show the anti-HIV ability of these putative to validate by inhibiting HIV-1 replication. Results: The In Silico results showed that 30 putative anti-HIV AMPs were identified. Furthermore, out of the 10 best ranked putative AMPs, based on their E-value, selected for In Silico docking, two AMPs proved to inhibit HIV-1 NL4- 3 with maximal effective concentration (EC50) values of 37.5 μg/ml and 93.75 μg/ml respectively. This result looks promising since 150 μg/ml AMPs could not achieved 80% toxicity of the human T cells, thus high Therapeutics Index (TI) might be obtained if 50% cytotoxic concentration (CC50) is established. Conclusion: The ability of these AMPs to inhibit HIV replication justifies the usage of HMMER in design and discovery. Additionally, these AMPs pave the way for the design of anti-HIV peptide-based drugs.

Despite the marked progress in coverage of prevention of mother to child HIV transmission (PMTCT) programs, mother to child HIV transmission (MTCT) rate is not well documented in Southwest Ethiopia. A retrospective follow up study was carried at Jimma University Specialized Hospital PMTCT clinic to quantify MTCT rate and its predictors among HIV-exposed infants. Data were extracted from medical records of HIV-infected women and exposed infants between September 2010 and December 2012. Univariate and multivariate logistic regression analyses were carried out to identify potential factors predicting MTCT. A total of 146 infants born to HIV-infected mothers were included in the analysis. Out of 146 infants, 25 (17%, 95% CI: 11%-23.2%) were HIV positive. In the adjusted multivariate logistic regression analysis, mothers being on late AIDS stage (AOR=5.8; 95% CI: 1.6-16.5), absence of maternal PMTCT interventions (AOR=4.9; 95% CI: 1.4-16.5), home delivery (AOR=8.1; 95% CI: 2.1-31.9) and mixed infant feeding (AOR=5.6; 95% CI: 1.4-41.2) were independently associated with MTCT. We documented a high rate of MTCT among exposed infants in Southwest Ethiopia. All pregnant HIV positive mothers should be enrolled in PMTCT programs at earlier stage and exclusive breast feeding should be encouraged so as to decrease MTCT.