Stigma in Malay Patients with HIV/AIDS in Malaysia

Background: Previous study noted severe impairment of social well-being, compared to other area of QoL in HIV patients, suggesting the role of moral and religious values concerning HIV infection. Objectives: The objective of this study was to evaluate the level and correlates of HIV-related stigma experienced by the patients. Methods: A total of 100 consenting Malay Muslim HIV patients attending the infectious disease out-patient clinic, Hospital Raja Perempuan Zainab II from July 2012 to February 2013 were recruited for study. Results: (1) Stigma among HIV patients attending out-patient clinic was high, particularly disclosure concerns; (2) Female HIV patients had significantly higher disclosure concerns compared to male HIV patients; (3) Among the studied variables, only disclosure was independently associated with total stigma. Conclusion: HIV-related stigma was high and significantly correlated with disclosure of HIV status among Malay Muslim HIV patients. Further studies are warranted to determine additional factors, such as culture and religiosity, which may influence the stigma

A comparison of the thermo-physical behavior of Engkabang (Shorea macrophylla) seed fat-canola oil blends and lard

A study was carried out to compare the thermo-physical behaviors of canola–Engkabang fat blends with those of lard (LD). Four blends were prepared by mixing canola oil with Engkabang fat (CaO/EF) in different ratios: EF-1, 75:25; EF-2, 70:30; EF-3, 65:35; EF-4, 60:40. The fat blends and LD were compared in terms of their basic physicochemical parameters, fatty acid and triacylglycerol (TAG) compositions, melting, solidification, hardness, and polymorphic properties. The slip melting points (SMP) of the fat blends were found to range from 24.8 to 31.2 °C; EF-2 was found to display an SMP value closer to that of LD. With respect to the melting curve of CaO, the melting curves of all fat blends were found to display an additional high-melting thermal transition in the temperature region above 10 °C. The peak maximum of the high-melting thermal transition of EF-3 was the closest to that of LD. The solid fat content (SFC) value of EF-3 was equal to that of LD at 25 °C, whereas the SFC values of EF-2 and LD were similar at 30 to 40 °C. According to textural analysis, EF-2 was found to display a hardness value somewhat closer to that of LD. X-ray diffraction analysis showed that LD and fat blends EF-1, EF-2, and EF-3 display β polymorphic forms

A Comparison of Assays for Accurate Copy Number Measurement of the Low-Affinity Fc Gamma Receptor Genes FCGR3A and FCGR3B

The FCGR3 locus encoding the low affinity activating receptor FcγRIII, plays a vital role in immunity triggered by cellular effector and regulatory functions. Copy number of the genes FCGR3A and FCGR3B has previously been reported to affect susceptibility to several autoimmune diseases and chronic inflammatory conditions. However, such genetic association studies often yield inconsistent results; hence require assays that are robust with low error rate. We investigated the accuracy and efficiency in estimating FCGR3 CNV by comparing Sequenom MassARRAY and paralogue ratio test-restriction enzyme digest variant ratio (RT-REDVR). In addition, since many genetic association studies of FCGR3B CNV were carried out using real-time quantitative PCR, we have also included the evaluation of that method’s performance in estimating the multi-allelic CNV of FCGR3B. The qPCR assay exhibited a considerably broader distribution of signal intensity, potentially introducing error in estimation of copy number and higher false positive rates. Both Sequenom and PRT-REDVR showed lesser systematic bias, but Sequenom skewed towards copy number normal (CN = 2). The discrepancy between Sequenom and PRT-REDVR might be attributed either to batch effects noise in individual measurements. Our study suggests that PRT-REDVR is more robust and accurate in genotyping the CNV of FCGR3, but highlights the needs of multiple independent assays for extensive validation when performing a genetic association study with multi-allelic CNVs

A 3D Microfluidic ELISA for the Detection of Severe Dengue: Sensitivity Improvement and Vroman Effect Amelioration by EDC–NHS Surface Modification

Serum is commonly used as a specimen in immunoassays but the presence of heterophilic antibodies can potentially interfere with the test results. Previously, we have developed a microfluidic device called: 3D Stack for enzyme-linked immunosorbent assay (ELISA). However, its evaluation was limited to detection from a single protein solution. Here, we investigated the sensitivity of the 3D Stack in detecting a severe dengue biomarker—soluble CD163 (sCD163)—within the serum matrix. To determine potential interactions with serum matrix, a spike-and-recovery assay was performed, using 3D Stacks with and without surface modification by an EDC–NHS (N-ethyl-N′-(3-(dimethylamino)propyl)carbodiimide/N-hydroxysuccinimide) coupling. Without surface modification, a reduced analyte recovery in proportion to serum concentration was observed because of the Vroman effect, which resulted in competitive displacement of coated capture antibodies by serum proteins with stronger binding affinities. However, EDC–NHS coupling prevented antibody desorption and improved the sensitivity. Subsequent comparison of sCD163 detection using a 3D Stack with EDC–NHS coupling and conventional ELISA in dengue patients’ sera revealed a high correlation (R = 0.9298, p < 0.0001) between the two detection platforms. Bland–Altman analysis further revealed insignificant systematic error between the mean differences of the two methods. These data suggest the potentials of the 3D Stack for further development as a detection platform

Trends of CD4 cell count levels at the initiation of antiretroviral therapy over time and factors associated with late initiation of antiretroviral therapy among Asian HIV-positive patients

Introduction: Although antiretroviral therapy (ART) has been rapidly scaled up in Asia, most HIV-positive patients in the region still present with late-stage HIV disease. We aimed to determine trends of pre-ART CD4 levels over time in Asian HIV-positive patients and to determine factors associated with late ART initiation. Methods: Data from two regional cohort observational databases were analyzed for trends in median CD4 cell counts at ART initiation and the proportion of late ART initiation (CD4 cell counts <200 cells/mm3 or prior AIDS diagnosis). Predictors for late ART initiation and mortality were determined. Results: A total of 2737 HIV-positive ART-naïve patients from 22 sites in 13 Asian countries and territories were eligible. The overall median (IQR) CD4 cell count at ART initiation was 150 (46–241) cells/mm3. Median CD4 cell counts at ART initiation increased over time, from a low point of 115 cells/mm3 in 2008 to a peak of 302 cells/mm3 after 2011 (p for trend 0.002). The proportion of patients with late ART initiation significantly decreased over time from 79.1% before 2007 to 36.3% after 2011 (p for trend <0.001). Factors associated with late ART initiation were year of ART initiation (e.g. 2010 vs. before 2007; OR 0.40, 95% CI 0.27–0.59; p<0.001), sex (male vs. female; OR 1.51, 95% CI 1.18–1.93; p=0.001) and HIV exposure risk (heterosexual vs. homosexual; OR 1.66, 95% CI 1.24–2.23; p=0.001 and intravenous drug use vs. homosexual; OR 3.03, 95% CI 1.77–5.21; p<0.001). Factors associated with mortality after ART initiation were late ART initiation (HR 2.13, 95% CI 1.19–3.79; p=0.010), sex (male vs. female; HR 2.12, 95% CI 1.31–3.43; p=0.002), age (≥51 vs. ≤30 years; HR 3.91, 95% CI 2.18–7.04; p<0.001) and hepatitis C serostatus (positive vs. negative; HR 2.48, 95% CI 1.−4.36; p=0.035). Conclusions: Median CD4 cell count at ART initiation among Asian patients significantly increases over time but the proportion of patients with late ART initiation is still significant. ART initiation at higher CD4 cell counts remains a challenge. Strategic interventions to increase earlier diagnosis of HIV infection and prompt more rapid linkage to ART must be implemented

Analysis of raw quantification data (logEC50) for Sequenom MassARRAY.

<p>Correlation between raw individual copy number calls from the probes designed at 5′-, 3’-, and centre regions of the genes <i>FCGR3A</i> (A, B, and C) and <i>FCGR3B</i> (D, E, and F). Note that there is a clear seperation of 2 cluster plots indicating batch effects, as circled, due to different experimental batches. <b>A</b>, <b>3’ vs 5′; B, 3’ vs centre;</b> and <b>C, 5′ vs centre</b>; <b>D</b>, <b>5′ vs 3’; E, 3’ vs centre;</b> and <b>F, 5′ vs centre.</b> A and D, correlation between the 5- and 3- prime probes were slightly affected, probably due to the probes distance.</p

Percentage of concordant results of <i>FCGR3B</i> CN calls between the three different assays.

<p>Percentage of concordant results of <i>FCGR3B</i> CN calls between the three different assays.</p