GERMS

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Open AccessCommunication

Predicting HIV Treatment Response in Romania—Comment

by Maja Stanojeviæ, Djordje Jevtoviæ and Gordana Dragoviæ

GERMS 2012, 2(1), 23-24; https://doi.org/10.11599/germs.2012.1010 - 1 Mar 2012

Cited by 2 | Viewed by 19

1In recent years mathematical modeling has become a valuable tool in the analysis of infectious disease dynamics at both individual and population level [...] Full article

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Open AccessArticle

Entecavir as Specific Antiviral Therapy in Selected Cases of Severe Acute Hepatitis B

by Oana Streinu-Cercel, Anca Streinu-Cercel, Liliana Lucia PreoŢEscu and Adrian Streinu-Cercel

GERMS 2012, 2(1), 18-22; https://doi.org/10.11599/germs.2012.1009 - 1 Mar 2012

Cited by 6 | Viewed by 22

Abstract

The role of specific antiviral treatment in severe acute hepatitis B has been subject to debate during the past few years. We present clinical findings in a series of three cases of severe acute hepatitis B and one case of acute hepatitis B treated with entecavir during 2007-2009, with interesting evolution. Entecavir appeared to improve the clinical evolution in the reported cases. Two of the patients displayed HBsAg to HBsAb seroconversion while another patient went into an inactive HBsAg carrier state. In the case of mild acute hepatitis B, the liver enzymes had returned to normal, symptomatology had receded but HBsAg had remained positive. Without data on viral load, we were unable to determine whether the patient had entered an inactive HBsAg carrier state or had continued into the services of another medical unit, for treatment of chronic HBV infection. We also discuss into detail a case which displayed transient initial HBe seroconversion at 1 week, followed by seroreversion to positive HBeAg and negative HBeAb at week 3, and a new seroconversion at week 7. We assess the possible roles of precore mutations, antibody-dependent cellular cytotoxicity, coinfection with Epstein Barr virus and the function of Kupffer cells. Full article

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Open AccessArticle

Serum Adipokines and HIV Viral Replication in Patients Undergoing Antiretroviral Therapy

by Victoria Aramă, Cătălin Tilişcan, Daniela Adriana Ion, Raluca Mihăilescu, Daniela Munteanu, Anca Streinu-Cercel, Ana Maria Tudor, Adriana Hristea, Viorica Leoveanu, Ioana Olaru and Ştefan Sorin Aramă

GERMS 2012, 2(1), 12-17; https://doi.org/10.11599/germs.2012.1008 - 1 Mar 2012

Cited by 6 | Viewed by 15

Abstract

Introduction: Several studies have reported that cytokines secreted by adipose tissue (adipokines) may be linked to HIV replication. The aim of the study was to evaluate the relationship between HIV replication and serum levels of adipokines, in a Caucasian HIV-infected population of men and women undergoing complex antiretroviral therapy. Methods: A cross-sectional study was conducted in an unselected sample of 77 HIV-1-positive patients. Serum adipokines levels were measured including circulating adiponectin, leptin, resistin, tumor necrosis factor alpha (TNF-alpha) and interleukin-6 (IL-6). Patients were divided into two groups: Group 1—with undetectable viral load and Group 2—with persistent HIV viral replication. Differences between groups were tested using independent-sample t-test for Gaussian variables and Mann–Whitney–Wilcoxon test for non-parametric variables. Pearson's chi-squared test was used for correlation analysis. Results: A total of 77 patients (age range: 17–65, mean: 32.5 years) including 44 men (57.1% men, age range: 17–63 years, mean: 34.1 years) and 33 women (42.9% women age range: 19–65 years, mean: 30.3 years) were included in the study. TNF-alpha had significantly higher serum levels in patients with detectable viral load (16.89 vs. 9.35 pg/mL), (p = 0.043), but correlation analysis lacked statistical significance. Adiponectin had median serum levels of 9.22 μg/mL in Group 1 vs. 16.50 μg/mL in Group 2 but the results lacked statistical significance (p = 0.059). Higher leptin, IL-6 and resistin serum levels were noted in patients with undetectable HIV viral load, without statistical significance. Conclusions: The present study reported higher TNF-alpha serum levels in patients with persistent HIV viral load. We found no statistically significant correlations between adiponectin, leptin, resistin and IL-6 and HIV viral load in our Caucasian HIV-positive study population, undergoing antiretroviral therapy. Full article

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Open AccessArticle

The Use of Computational Models to Predict Response to HIV Therapy for Clinical Cases in Romania

by Andrew D Revell, LuminiŢA Ene, Dan Duiculescu, Dechao Wang, Mike Youle, Anton Pozniak, Julio Montaner and Brendan A Larder

GERMS 2012, 2(1), 6-11; https://doi.org/10.11599/germs.2012.1007 - 1 Mar 2012

Cited by 11 | Viewed by 22

Abstract

Introduction: A major challenge in Romania is the optimisation of antiretroviral therapy for the many HIV-infected adults with, on average, a decade of treatment experience. The RDI has developed computational models that predict virological response to therapy but these require a genotype, which is not routinely available in Romania. Moreover the models, which were trained without any Romanian data, have proved most accurate for patients from the healthcare settings that contributed the training data. Here we develop and test a novel model that does not require a genotype, with test data from Romania. Methods: A random forest (RF) model was developed to predict the probability of the HIV viral load (VL) being reduced to <50 copies/ml following therapy change. The input variables were baseline VL, CD4 count, treatment history and time to follow-up. The model was developed with 3188 treatment changes episodes (TCEs) from North America, Western Europe and Australia. The model’s predictions for 100 independent TCEs from the RDI database were compared to those of a model trained with the same data plus genotypes and then tested using 39 TCEs from Romania in terms of the area under the ROC curve (AUC). Results: When tested with the 100 independent RDI TCEs, the AUC values for the models with and without genotypes were 0.88 and 0.86 respectively. For the 39 Romanian TCEs the AUC was 0.60. However, when 14 cases with viral loads that may have been between 50 and 400 copies were removed, the AUC increased to 0.83. Discussion: Despite having been trained without data from Romania, the model predicted treatment responses in treatment-experienced Romanian patients with clade F virus accurately without the need for a genotype. The results suggest that this approach might be generalisable and useful in helping design optimal salvage regimens for treatment-experienced patients in countries with limited resources where genotyping is not always available. Full article

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Open AccessEditorial

AIDS and Sexually Transmitted Infections in Africa

by Oana Streinu-Cercel

GERMS 2012, 2(1), 5; https://doi.org/10.11599/germs.2012.1006 - 1 Mar 2012

Cited by 2 | Viewed by 13

Abstract

One of the major infectious diseases events of 2011 was the 16th International Conference on AIDS and Sexually Transmitted Infections in Africa (ICASA) that took place at Addis Ababa, Ethiopia, during 4-8 December 2011 [...] Full article

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GERMS, Volume 2, Issue 1 (03 2012) – 5 articles

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