Mitochondrial DNA depletion and respiratory chain enzyme deficiencies are present in peripheral blood mononuclear cells of HIV-infected patients with HAART-related lipodystrophy

The main objective of the present study was to ascertain if mitochondrial DNA (mtDNA) depletion as reported in HIV-infected patients with highly active antiretroviral therapy (HAART)-related lipodystrophy (LD) implies any degree of mitochondrial respiratory chain (MRC) dysfunction. For this purpose, we evaluated HIV patients on different HAART schedules with LD (group A; n=12) and on HAART but without LD (group B; n=12), and untreated HIV-infected patients as controls (group C; n=24). mtDNA content was determined on peripheral blood mononuclear cells (PBMCs) with a real-time PCR method. Complex II, III and IV activities of the MRC were simultaneously measured spectrophotometrically, as were spontaneous and stimulated oxygen consumption by PBMCs. Compared to controls (group C, 100%), patients with LD (group A) showed a decreased mtDNA content (54%, P<0.001), which was associated with a decline in complex III (62%, P<0.05) and IV activity (69%, P<0.05) (both complexes partially encoded by mtDNA), but not in complex II activity (exclusively encoded by nuclear DNA). Patients in group B showed a similar pattern of mitochondrial dysfunction but to a lesser extent and without statistical significance. Respiratory activities in both treated groups (A and B) did not differ in comparison with controls. We conclude that mtDNA depletion occurring during HAART is associated with deficiencies in MRC complexes partially encoded by mtDNA, which are detectable by PBMCs. Presented in 'Late Breakers and Hot Topics' session at 6th International Congress on Drug Therapy in HIV Infection, Glasgow, UK, 17-21 November 2002.     

Mitochondrial DNA depletion in HIV-infected patients is more pronounced with chronic hepatitis C and enhanced following treatment with pegylated interferon plus ribavirin

BACKGROUND: Mitochondrial DNA (mtDNA) damage seems to be responsible for many of the toxicities associated with the long-term use of nucleoside analogues in HIV-infected patients. These adverse effects, mainly lipoatrophy, seem to be even more pronounced in subjects with hepatitis C virus (HCV) co-infection. However, there is no information about a possible additive effect of HCV on mtDNA depletion nor about the impact of ribavirin use in HIV/HCV-coinfected individuals. PATIENTS AND METHODS: mtDNA was measured in peripheral blood mononuclear cells (PBMC) collected from 192 individuals classified into 4 groups: HIV-neg/HCV-neg (control group, n = 11), HIV-pos/HCV-neg (56), HIV-neg/HCV-pos (18) and HIV-pos/HCV-pos (107). A duplex real-time NASBA assay was used to quantify mtDNA on maximal platelet-depleted specimens and all experiments were run in duplicate. The mtDNA copy number per cell was estimated taking as reference the nuclear DNA copy number. RESULTS: The mean mtDNA values in the control group was 757 copies/cell, while it was 428, 349 and 296 for HIV-pos, HCV-pos and HIV/HCV-coinfected individuals, respectively (P < 0.001 for all groups relative to the control group). No significant differences were observed when comparing patients with HIV or HCV infections alone, but coinfected individuals showed a lower mtDNA copy number than patients infected with HIV (P < 0.001) or with HCV (P = 0.089). In a subset of 18 patients with HIV/HCV-coinfection, treatment with pegylated interferon plus ribavirin produced a further reduction in mtDNA (mean value, 189 copies/cell; P = 0.009). CONCLUSIONS: HIV and HCV may independently cause mtDNA depletion in PBMC. Coinfection may result in more pronounced mtDNA depletion. The administration of interferon plus ribavirin may further enhance mtDNA depletion. These findings may explain the greater risk of lipoatrophy of antiretroviral therapy in HIV-infected patients with HCV coinfection and why anti-HCV therapy may aggravate this effect.     

人类免疫缺陷病毒感染儿童抗病毒治疗后外周血单个核细胞线粒体DNA含量检测

目的 研究我国人类免疫缺陷病毒(human immunodeficiency virus,HIV)感染儿童抗逆转录病毒治疗(active anti-retrovirus therapy,ART)后外周血单个核细胞(peripheral blood mononuclear cells,PBMC)线粒体DNA含量及其相关影响因素.方法 选择96例ART的HIV感染患儿、30例未治疗的HIV感染患儿及55例正常对照儿童,检测PBMC线粒体DNA含量,结合儿童的临床信息及实验室检测结果进行综合分析.结果 ART组患儿PBMC内线粒体DNA含量为(17.39±9.31),明显低于未治疗组患儿(26.35±11.74)及对照组儿童(28.37±12.14)PBMC内线粒体DNA含量,差异有统计学意义(P＜0.01);患儿ART后PBMC内线粒体DNA含量与基线CD4+T淋巴细胞计数、基线病毒载量、性别、年龄及HIV感染途径均无相关性.结论 PBMC线粒体DNA含量可反映儿童抗病毒治疗后的线粒体损伤毒性,可能成为线粒体毒性检测指标.     

Imprisonment and tuberculosis in HIV-infected women

The incidence of concomitant infections of tuberculosis (TB) and HIV in the same subject is on the increase, especially among inmates of jails and correctional institutions. The investigator examined the medical records of a sample of HIV-positive women prisoners for the presence of TB, and compared them to a sample of HIV-positive women who were not prisoners. Tuberculosis was found to be related to HIV-positive women prisoners (X2 (1, N = 56) = 4.62, p less than .04). The nosocomial spread of TB among HIV-positive women prisoners has an exponential potential for increase, not only to other prisoners, but to caretakers and to the overwhelmed communities to which they are released. Their infants and children are at risk for both infections. Nurses who work with HIV-positive patients, especially those with a recent prison history, drug addiction, or homelessness are at increased risk for contracting tuberculosis from their patients, often of the drug-resistant type.     

不孕女性甲状腺功能的检测分析

目的：探讨甲状腺功能检测在不孕女性诊治过程中的临床实用价值。方法采用电化学发光免疫技术,分别检测160例不孕女性（不孕组）和160例健康体检女性（健康对照组）的血清促甲状腺激素（TSH）、游离三碘甲状腺原氨酸（FT3）、游离甲状腺素（FT4）、三碘甲状腺原氨酸（T3）、甲状腺素（T4）、抗甲状腺过氧化物酶抗体（TPOAb）和抗甲状腺球蛋白抗体（TGAb）水平,并进行比较分析。结果不孕组女性TSH、TPOAb、TGAb水平明显高于对照组,而T3水平明显低于对照组,差异有统计学意义（P＜0．05）;不孕组TSH、T3、TPOAb和TGAb的阳性率分别为20．63％、16．25％、17．50％和15．63％,对照组阳性率分别为5．63％、2．50％、5．00％和3．75％,不孕组阳性率明显高于对照组,差异有统计学意义（P＜0．05）。结论甲状腺功能异常与不孕症有密切的关系。     

Traditional practices used by infertile women in Turkey

AYAZ S. & YAMAN EFE S. (2010) Traditional practices used by infertile women in Turkey. International Nursing Review 57 , 383–387 Background: Numerous traditional methods are used in the treatment of infertility around the world. Aim: To identify the traditional practices of infertile women using one clinic in Ankara, Turkey. Design and Methods: The population comprised all women (5700) who attended one infertility outpatient clinic in 2007. The sample was calculated using sample calculation formula and 410 women were included in the study. The survey method was used for data collection. Findings: Of the responding women, 27.3% had tried a traditional practice, and 67.8% who tried traditional practices used an herbal mixture. The reason for the women's use of a traditional practice was ‘hope’ (66.9%), and 15.2% of them had experienced an adverse effect related with traditional practice. Maternal education level, perceived economic status, duration of marriage all significantly affected the use of traditional practices (P < 0.05). The women who had received unsuccessful medical treatment for infertility and who had experienced side effects after medical treatment had a higher rate of use of traditional practice (P < 0.05). Conclusions: Almost one in three of the women who responded to the questionnaire had tried traditional methods, and some experienced adverse effects related to the practice. For couples with infertility problems, educational programmes and consultation services should be organized with respect to their traditional culture. Women should be informed about the hazards of traditional practices and avoidance of harmful practices, and continuous emotional support must be provided for infertile couples. In the future, nursing staff should play a much larger role in these supportive services.     

Primary care of HPV management in HIV-infected women

The natural history of human papillomavirus (HPV) differs in women infected with (human immunodeficiency virus) HIV when compared with the general population. This report provides insight into the complexities of treating HPV infection and the differences found in HIV-infected women. By understanding the challenges associated with this opportunistic infection in HIV-infected women, nurse practitioners will be better prepared to provide primary care to this specific population.     

Antiretroviral therapy and preterm birth in HIV-infected women

The use of combination antiretroviral therapy for the prevention of mother to child transmission of HIV infection has achieved vertical HIV transmission rates of <1%. The use of these drugs is not without risk to the mother and infant. Pregnant women with HIV-infection are at high risk of preterm birth (PTB <37 weeks), with 2–4-fold the risk of uninfected women. There is accumulating evidence that certain combinations are associated with higher rates of PTB that others or no antiretroviral treatment. Understanding the pathogenesis of PTB in this group of women will be essential to target preventative strategies in the face of increasing HIV prevalence and rapidly expanding mother-to-child-transmission prevention programmes.     

Conception practices of HIV-infected women in the Midwest.

The aim of this interpretive study was to understand pregnancy intentions and conception practices of HIV-infected women. A purposive sample of 3 White and 12 African American women who were interested in becoming mothers was recruited from a hospital clinic and a private practice in the Midwest. Participants were interviewed three times at monthly intervals. Data were analyzed using interpretive methods. Three conception practices were identified: (a) a technical method using self-insemination, (b) a minimize-risk approach based on use of highly active antiretroviral therapy, and (c) a default approach in which no plan for conception was evident. Although all of the women reported that they had talked with their health care providers about conception, most did not have adequate information to make an informed choice. Nurses play a critical role in shaping conception decisions by providing accurate, understandable information about conception practices specific to a woman's social realities and cultural values.     

多囊卵巢综合征致不孕患者的相关因素分析

目的 探讨多囊卵巢综合征（PCOS）致不孕患者的相关因素.方法 选择2008年1月至2012年12月因不孕症来我院就诊确诊为PCOS患者98例（PCOS组）,在同期因不孕症就诊、无PCOS表现且腹腔镜检查卵巢组织结构正常的患者中随机选取280例作为对照组,回顾性分析两组患者的一般资料、生育相关因素、腹腔镜探查情况.结果 PCOS组初潮年龄在13岁以下者51例（52.0％）,对照组113例（40.4％）,组间比较差异有统计学意义（x2=4.03,P＜0.05）;PCOS组月经不规律11例（11.2％）,对照组12例（4.3％）,组间比较差异有统计学意义（x2 =6.12,P＜0.05）;PCOS组盆腔粘连60例（21.1％）,对照组224例（40.4％）,组间比较差异有统计学意义（x2 =13.70,P＜0.05）.月经不规律是不孕女性PCOS发生的危险因素（OR=1.770,95％ CI为1.09～2.88,P=0.002）.结论 临床应加强对青春期月经初潮提前及月经不规律且有PCOS相关症状人群的关注,早期筛查、早期发现,早期预防、早期治疗,从而降低PCOS致不孕的发生率,降低远期并发症.     

Gender-specific considerations in the antiretroviral management of HIV-infected women

The vast majority of HIV-infected women are of childbearing potential, so issues surrounding reproduction and mother-to-child transmission of the virus are critical in the management of this population. Optimal antiretroviral management of pregnant women is a major global issue since antiretroviral regimens offered to pregnant women to decrease mother-to-child transmission in many countries are often not highly active against HIV. The subsequent emergence of resistant virus can have long-term sequelae for the mother, child, and ultimately, other exposed individuals. The efficacy of antiretroviral therapy appears similar in men and women, although women may experience higher toxicity profiles, which may, in turn, be related to the higher antiretroviral concentrations shown in pharmacokinetic studies. Further investigation into gender-related issues, including sex-associated antiretroviral toxicities, unique pharmacokinetic profiles and optimal antiretroviral management during pregnancy is needed.