Park, Jung-Weon;Yang, Tae-Whan;Kim, Yun-Kyung;Choi, Byung-Min;Kim, Hai-Joong;Park, Dae-Won
Clinical and Experimental Pediatrics
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제57권3호
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pp.117-124
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2014
Purpose: Administration of antiretroviral drugs to mothers and infants significantly decreases mother-to-child human immunodeficiency virus (HIV) transmission; cesarean sections and discouraging breastfeeding further decreases this risk. The present study confirmed the HIV status of babies born to mothers infected with HIV and describes the characteristics of babies and mothers who received preventive treatment. Methods: This study retrospectively analyzed medical records of nine infants and their mothers positive for HIV who gave birth at Korea University Ansan Hospital, between June 1, 2003, and May 31, 2013. Maternal parameters, including HIV diagnosis date, CD4+ count, and HIV ribonucleic acid (RNA) copy number, were analyzed. Infant growth and development, HIV RNA copy number, and HIV antigen/antibody test results were analyzed. Results: Eight HIV-positive mothers delivered nine babies; all the infants received antiretroviral therapy. Three (37.5%) and five mothers (62.5%) were administered single- and multidrug therapy, respectively. Intravenous zidovudine was administered to four infants (50%) at birth. Breastfeeding was discouraged for all the infants. All the infants were negative for HIV, although two were lost to follow-up. Third trimester maternal viral copy numbers were less than 1,000 copies/mL with a median CD4+ count of $325{\mu}L$ ($92-729{\mu}L$). Among the nine infants, two were preterm (22.2%) and three had low birth weights (33.3%). Conclusion: This study concludes that prophylactic antiretroviral therapy, scheduled cesarean section, and prohibition of breastfeeding considerably decrease mother-to-child HIV transmission. Because the number of infants infected via mother-to-child transmission may be increasing, studies in additional regions using more variables are necessary.
AIDS and the spectrum of Human Immunodeficiency Virus(HIV) infections present a monumental challenge to the health of the Korean public. In response to this special challenge, I think public education and voluntary behavior changes are the most effective measures to fight the spread of the disease. Adolescents represent a critical risk group for prevention and intervention programming. Research indicates sexually active adolescents, homosexual contact, illicit drug use are an gradually increasing. These characteristically adolescent risk-taking behaviors suggest the need for schools and communities to mobilize intervention strategies. Schools are highly efficient ways to reach a majority of young people in Korea with HIV prevention programs. These programs include substantial attention to sexual and drug use behaviors with the long term objective of a multidimensional school health program. Information resulting from risk behavior surveillance activities and guidance on school health curricula is particularly useful. What is needed for adolescents is a revamping of education to give students the critical thinking and analytic skills that allow them to apply knowledge, make decisions, and think independently. The best HIV preventive education provides young people with opportunities to learn and practice just those skills. In the early stages of HIV education were focused solely on information. Providing information is easy but unfortunately, behavior change is not that simple to activate. Information must be combined with values exploration and skilly building, including responsible decision making, negotiation, refusal, and critical thinking skills. The same knowledge, attitudes and skills needed for effective HIV prevention also prevent or reduce other risks, including other sexually transmitted diseases, unwanted pregnancies, and alcohol or other drug use. The role of other youth serving organizations in HIV prevention is also important: parental and youth involvement is needed; it's important to presidential and governament leadership is essential to prevention education; promote integrated adolescent programs, to enhance health and education sector collaboration; and of course, we need to expand research on adolescent health and engage the media in health promotion. Among these changes, a school-based systematic health education of AIDS is certainly one of the essentials.
It is now more than two decades since the AIDS epidemic began with a cluster of Pneumocystis carinii pneumonia (PCP) in a community of homosexual men. Since then, many other infections have been characterized as opportunistic infections secondary to HIV infection. These include, but are not limited to, infections with Toxoplasma gondii, Cytomegalovirus (CMV), Mycobacterium avium complex (MAC), and Cryptococcus neoformans. Over the last two decades, there have been dramatic improvements in diagnosis, prevention and treatment of all these infections. As a result, in North America and Western Furope the rates of opportunistic infections secondary to AIDS have decreased substantially. We will review these common opportunistic infections below.
As the main aim of infectious disease epidemiology is to prevent a pathogen transmission, traditional epidemiological studies have focused on the evaluation of individual-level risk factors. But group-level factors as well as individual-level are important in understanding and controlling transmission of infectious diseases, especially sex-transmitted infectious diseases. Multi-level analysis (MLA) is known as a powerful analytical tool for investigating both levels simultaneously. While new cases of HIV/AIDS in Korea are increasing annually, it is urgently needed to establish research system for MLA led by Korea Centers for Disease Control & Prevention.
Objectives: Measurement of the incidence of the human immunodeficiency virus (HIV) is very important for epidemiological studies. Here, we determined the recency period with the AxSYM avidity assay and the BED-capture enzyme immunoassay (BED-CEIA) in Korean seroconverters. Methods: Two hundred longitudinal specimens from 81 seroconverters with incident HIV infections that had been collected at the Korea National Institute of Health were subjected to the AxSYM avidity assay (cutoff = 0.8) and BED-CEIA (cutoff = 0.8). The statistical method used to estimate the recency period in recent HIV infections was nonparametric survival analyses. Sensitivity and specificity were calculated for 10-day increments from 120 days to 230 days to determine the recency period. Results: The mean recency period of the avidity assay and BED-CEIA using a survival method was 158 days [95% confidence interval (CI), 135-181 days] and 189 days (95% CI, 170-208 days), respectively. Based on the use of sensitivity and specificity, the mean recency period for the avidity assay and BED-CEIA was 150 days and 200 days, respectively. Conclusion: We determined the recency period to estimate HIV incidence in Korea. These data showed that the nonparametric survival analysis often led to shorter recency periods than analysis of sensitivity and specificity as a new method. These findings suggest that more data from seroconverters and other methodologies are needed to determine the recency period for estimating HIV incidence.
Background: Human papillomavirus (HPV) is a very common sexually transmitted disease affecting both men and women and is responsible for different ano-genital cancers in either sex. Co-existing sexually transmitted infections (STI) including HIV have been considered as important co-factors for carcinogenesis induced by HPV. The purpose of this study was to determine the prevalence of any HPV, HPV 16 and HPV 18 and also concomitant STIs among female sex workers (FSW), men having sex with men (MSM) and injectable drug users (IDU). Material and Method: This cross-sectional study was conducted among 45 FSWs, 26 MSMs and 58 IDUs who attended the STI or de-addiction clinics. Genital scrape samples collected from glans penis and coronal sulcus in males and cervical squamo-columnar junction in females were tested for HPV DNA by PCR using HPV L1 consensus primer. Type specific PCR to detect HPV 16 and 18 was done on the samples positive on consensus PCR. All participants were tested for associated STIs including HIV and hepatitis B and cervical cytology was done on all females. Results: Among the FSWs, HPV was detected in 73.3% and HPV 16 and 18 was detected in 25.7%. Though the HPV prevalence was similarly high among MSMs (69.2%) and IDUs (72.4%), the prevalence of HPV 16 and 18 was much lower in these groups compared to the FSWs. Prevalence of cervico-vaginal infection with Trichomonas vaginalis and syphilis was significantly higher in the HPV positive women compared to the HPV negative women. There was no statistically significant difference in the prevalence of other STIs among HPV positive and negative women and men. Conclusion: HPV infection is highly prevalent among FSW, MSM and IDUs. Trichomonas vaginalis infection is more frequent in HPV positive women.
Objectives: It is necessary to examine groups carrying out sexually risky behavior because the prevalence of sexually transmitted diseases (STDs) is high among them. In this study, the prevalence of STDs among homosexuals and sexbuying men in South Korea was investigated, along with their sexual risk factors. Methods: Men who have sex with men (MSMs, n=108) were recruited in Seoul and Busan by applying the time location sampling method, while sex-buying men (n=118) were recruited from a john school in Gyeonggi province, the suburbs of Seoul. Dependent variables included past or present infection with syphilis, Chlamydia, gonorrhea, and human immunodeficiency virus. Independent variables included health behavior, social support, sexual behavior, and safe sex. Results: It was found that when the MSMs were non-drunk while having sexual intercourse (odds ratio [OR], 0.132), they showed a higher STD infection rate when they had a higher number of anal sex partners (OR, 5.872), rarely used condoms (OR, 1.980), had lower self-efficacy (OR, 0.229), and were more anxious about becoming infected with an STD (OR, 3.723). However, the men who paid for sex showed high STD infections when they had more sex partners (OR, 2.286) and lower education levels (OR, 3.028). Conclusions: STD infections among the two groups were high when they were engaged with many sex partners and not having protected sex. In other words, there was a gap in risky sex behavior within such groups, which was significantly related to the possibility of developing an STD. Therefore, the preventive intervention against STDs for these groups needs to be expanded to include management of sex behaviors.
Oh, Eun-Ji;Zang, Yaran;Kim, Jung-Woo;Lee, Mi Nam;Song, Ju Han;Oh, Sin-Hye;Kwon, Seung Hee;Yang, Jin-Woo;Koh, Jeong-Tae
International Journal of Oral Biology
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제44권4호
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pp.173-181
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2019
The CC chemokine receptor 5 (CCR5) is a G protein-coupled receptor that regulates chemotaxis and effector functions of immune cells. It also serves as the major co-receptor for the entry of human immunodeficiency virus (HIV). Recently, CCR5 inhibitors have been developed and used for the treatment or prevention of HIV infections. Additionally, it has been identified that CCR5 controls bone homeostasis by regulating osteoclastogenesis and the communication between osteoblasts and osteoclasts. However, the effects of CCR5 inhibition on bone tissue in elderly patients are unknown. This study aimed to examine the bone phenotype of aged CCR5 knockout (KO) mice. Femoral and tibial bones were isolated from 12-month and 18-month old wild-type (WT) and CCR5 KO mice, and microcomputed tomography and histology analyses were performed. Twelve-month-old CCR5 KO mice exhibited a decreased trabecular bone mass and cortical bone thickness in both femoral and tibial bones compared with age-matched WT mice. Eighteen-month-old mice also showed a decreased trabecular bone mass in femurs compared with control WT mice, but not in tibial bones. Unlike in 12-month-old mice, the cortical margin of femurs and tibias in 18-month-old mice were rough, likely because they were aggravated by the deficiency of CCR5. Overall, our data suggest that the deficiency of CCR5 with aging can cause severe bone loss. When CCR5 inhibitors or CCR5 inactivating technologies are used in elderly patients, a preventive strategy for bone loss should be considered.
Since the first report of RNA interference (RNAi) less than a decade ago, this type of molecular intervention has been introduced to repress gene expression in vitro and also for in vivo studies in mammals. Understanding the mechanisms of action of synthetic small interfering RNAs (siRNAs) underlies use as therapeutic agents in the areas of cancer and viral infection. Recent studies have also promoted different theories about cell-specific targeting of siRNAs. Design and delivery strategies for successful treatment of human diseases are becomingmore established and relationships between miRNA and RNAi pathways have been revealed as virus-host cell interactions. Although both are well conserved in plants, invertebrates and mammals, there is also variabilityand a more complete understanding of differences will be needed for optimal application. RNA interference (RNAi) is rapid, cheap and selective in complex biological systems and has created new insight sin fields of cancer research, genetic disorders, virology and drug design. Our knowledge about the role of miRNAs and siRNAs pathways in virus-host cell interactions in virus infected cells is incomplete. There are different viral diseases but few antiviral drugs are available. For example, acyclovir for herpes viruses, alpha-interferon for hepatitis C and B viruses and anti-retroviral for HIV are accessible. Also cancer is obviously an important target for siRNA-based therapies, but the main problem in cancer therapy is targeting metastatic cells which spread from the original tumor. There are also other possible reservations and problems that might delay or even hinder siRNA-based therapies for the treatment of certain conditions; however, this remains the most promising approach for a wide range of diseases. Clearly, more studies must be done to allow efficient delivery and better understanding of unwanted side effects of siRNA-based therapies. In this review miRNA and RNAi biology, experimental design, anti-viral and anti-cancer effects are discussed.
Although the officially confirmed incidence of the acquired immune deficiency syndrome(AIDS) has remained low thus far in Korea, the progression of the pandemic has been rapid, concerned about an eventual increase in transmission. Until a vaccine or cure is found, public information and education remain an important weapon against AIDS. For the year 2000, the current WHO projection is that there will be a cumulative total of 40 million HIV infections in man, woman and children, of which more than 90% will be in the developing countries. The incerased mortality among adults and children has raised concerns that AIDS may become so devastaing as to reverse positive population growth rates and wipe out entire population. In order to plan for the rising incidence of patient with AIDS, an assessment of AIDS-related cognition and behavior, attitude of the recognized high-risk groups is necessary. Considering that undergraduates have sexuality active and more oriented toward sexual concerns than other ages. Adolescents today are more sexually involved than in the past: The media, including films, music, and television, reinforce sexual concerns by preseating images of highly sexual adolescents. Incidence of both petting and sexual intercourse in higher and occurs at earlier ages, they are important reservoir of AIDS infection. Hence, it has become important to emymerats and describe the knowledge, attitude and behavior of them, I want.. This information will eventually guide the direction of change in public policies and education programs to meet the challenges of AIDS. The objective of this study were to identity Knowledge, Attitude, Experience of Sex and AIDS in Korea. The data were collected by survey at Korean Federation for AIDS Affairs, INC. and J university, K junior college. After October in 1993, surveyed with 507 student during their's college days in Seoul. The questionnaire was designed to provide information on sex and AIDS-related knowledge and attitudes and experience. AIDS-related knowledge was measured by using 26 questions on mode of transmission and AIDS-related attitudes were measured by 7 questions, AIDS-related experience was measured by 5 questions. There were the main dependent variables in our study, In conclusion, students during their university day need to develop AIDS-preventive education programs. Clearly, the many AIDS-prevention educational effort need to be guided by well trained health agents. Financial supports from all sectors (i.e., public and private) of our society are required to achieve that end. Further researches on AIDS-related Knowledge and Attitude and behaviors of undergraduates are needed for the development of comprehensive AIDS prevention programs.
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