Knowledge, attitude and practices towards COVID-19 among people living with HIV in Pune, India: a cross-sectional study

Background: Studies on knowledge, attitude, and practices (KAP) are important for implementation of interventions. This cross-sectional study was conducted among HIV infected individuals attending antiretroviral therapy (ART) centre at Pune, India, to assess KAP towards COVID-19.Methods: The study conducted between June and December 2020 consisted of twelve, five and seven questions pertaining to knowledge, attitude, and practices respectively towards COVID-19. Frequencies and percentages of correct knowledge, attitude and practices were calculated. Overall knowledge scores were categorized into poor, moderate and good using class width equation.Results: Of the total 1175 participants enrolled, 649 (55.2%) were females. Mean age and CD4count of participants at study entry were 44 years (SD: 9.1) and 637 cells/mm3 (SD: 297) respectively. Overall, 400 (34.0%, 95% CI: 31.33-36.83), 612 (52.1%, 95% CI: 49.18-54.98) and 163 (13.9%, 95% CI: 11.95-15.98) participants had good, moderate and poor knowledge respectively regarding COVID-19. Illiterate participants had six times higher probability of having poor knowledge as compared to their counterparts (OR 5.70, 95% CI: 3.94-8.23; p<0.001). Majority of people living with (PLHIV) had correct attitude towards adherence to government prevention and control measures. Healthy preventive practices of social distancing (99.5%), wearing masks at public places (99.7%) and frequent washing hands with soap and water (98.7%) were followed by PLHIV.Conclusions: PLHIV have average knowledge, correct attitude towards adherence to government prevention and control measures, and appropriate practices towards prevention of COVID-19. Counselling sessions at ART centres should include information for improving knowledge related to COVID-19 especially targeting illiterate individuals.

Functional Invariant Natural Killer T Cells Secreting Cytokines Are Associated With Non-Progressive Human Immunodeficiency Virus-1 Infection but Not With Suppressive Anti-Retroviral Treatment

BackgroundCD1d restricted invariant natural killer T (iNKT) cells are important in the activation and regulation of immune responses. Limited information is available regarding the functional role of iNKT cells in the human immunodeficiency virus (HIV) disease progression.Methodologyα-GalCer stimulated iNKT cells were characterized for their functionality in terms of cytokine production (IFN-γ, TNF-α, IL-2, IL-4, and IL-21) and CD107a expression in HIV-1 infected [23 long-term non progressors (LTNPs), 28 progressors, 18 patients before and after suppressive anti-retroviral treatment (ART)] along with 25 HIV-1 negative subjects using multicolor flow cytometry.ResultsThe functional profile of α-GalCer stimulated iNKT cells was similar in LTNPs and healthy controls. The number of LTNPs showing functional response in terms of secretion of cytokines (IFN-γ/IL2/TNF-α) and CD107a expression was significantly higher than seen in the progressors. The cytokine secretion by the stimulated iNKT cells was predominantly Th1 type. The frequencies of iNKT cells showing secretion of IFN-γ or IL2 or TNF-α or expression of CD107a were higher in LTNPs (p &lt; 0.05 for all) and also significantly associated with lower plasma viral load (p value ranged from 0.04 to 0.003) and higher CD4 count (p value ranged from 0.02 to &lt;0.0001). The functional profile of the iNKT cells before and after ART did not differ significantly indicating absence of restoration of iNKT cells functionality after suppressive ART. The IL-4 and IL-21 secreting iNKT cells were rare in all study populations.ConclusionThe presence of functional iNKT cells secreting number of cytokines in non-progressive HIV infection could be one of the multiple factors required to achieve HIV control and hence have relevance in understanding the immunity in HIV infection. The failure of restoration of the iNKT functionality after ART should be potential area of future research

IL-1RN and IL-1β Polymorphism and ARV-Associated Hepatotoxicity

The severity of hepatic injury depends upon cytokines. Previous studies associated IL-1RN allele 2 with IL-1β production. Hence, we examined the association of IL-1 RN and IL-1β polymorphisms with ARV-associated hepatotoxicity. Genotyping of IL-1RN (VNTR), IL-1β (-511C/T) polymorphisms was done in 162 HIV-infected patients, 34 with ARV hepatotoxicity, 128 without hepatotoxicity, and 152 healthy controls using PCR and PCR-RFLP method. The haplotypes 1T and 2C enhanced the risk for severe hepatotoxicity (OR=1.41, P=0.25; OR=1.67, P=0.31). IL-1β-511TT genotype significantly represented among tobacco using HIV-infected individuals compared to nonusers (OR=3.74, P=0.05). IL-1β-511TT genotype among alcohol users increased the risk for hepatotoxicity (OR=1.80, P=0.90). IL-1β-511CT and -511TT genotypes overrepresented in alcohol using HIV-infected individuals (OR=2.29, P=0.27; OR=2.64, P=0.19). IL-RN 2/2 and 1/3 genotypes represented higher in nevirapine using hepatotoxicity patients (OR=1.42, P=0.64, OR=8.79, P=0.09). IL-1β-511CT and -511 TT genotypes among nevirapine users enhanced the risk for severe hepatotoxicity (OR=4.29, P=0.20; OR=1.95, P=0.56). IL-1β-511CT and -511TT genotypes were overrepresented in combined nevirapine and alcohol using HIV-infected individuals as compared to nevirapine users and alcohol nonusers (OR=2.56, P=0.26; OR=2.84, P=0.24). IL-1β-511TT genotype with tobacco, alcohol, and nevirapine usage revealed a trend of risk for the development of ARV-associated hepatotoxicity and its severity

Genetic attributes of blood-derived subtype-C HIV-1 tat and env in India and neurocognitive function.

Genetic elements in HIV-1 subtype B tat and env are associated with neurotoxicity yet less is known about other subtypes. HIV-1 subtype C tat and env sequences were analyzed to determine viral genetic elements associated with neurocognitive impairment in a large Indian cohort. Population-based sequences of HIV-1 tat (exon 1) and env (C2-V3 coding region) were generated from blood plasma of HIV-infected patients in Pune, India. Participants were classified as cognitively normal or impaired based on neuropsychological assessment. Tests for signature residues, positive and negative selection, entropy, and ambiguous bases were performed using tools available through Los Alamos National Laboratory (http://www.hiv.lanl.gov) and Datamonkey (http://www.datamonkey.org). HIV-1 subtype C tat and env sequences were analyzed for 155 and 160 participants, of which 34-36% were impaired. Two signature residues were unique to impaired participants in exon 1 of tat at codons 29 (arginine) and 68 (proline). Positive selection was noted at codon 29 among normal participants and at codon 68 in both groups. The signature at codon 29 was also a signature for low CD4+ (&lt;200 cells/mm(3)) counts but remained associated with impairment after exclusion of those with low CD4+ counts. No unique genetic signatures were noted in env. In conclusion, two signature residues were identified in exon 1 of HIV-1 subtype C tat that were associated with neurocognitive impairment in India and not completely accounted for by HIV disease progression. These signatures support a linkage between diversifying selection in HIV-1 subtype C tat and neurocognitive impairment