Postimplementation program evaluation data for 2 Lighthouse Trust pilot sites in Lilongwe, Malawi, February 2015 to June 2016.

<p>Postimplementation program evaluation data for 2 Lighthouse Trust pilot sites in Lilongwe, Malawi, February 2015 to June 2016.</p

Example core process and outcome indicators for an integrated hypertension/human immunodeficiency virus (HIV) clinical management program examined at 6-month intervals.

<p>Example core process and outcome indicators for an integrated hypertension/human immunodeficiency virus (HIV) clinical management program examined at 6-month intervals.</p

Recommended elements for successful hypertension and human immunodeficiency virus (HIV) management integration.

<p>Recommended elements for successful hypertension and human immunodeficiency virus (HIV) management integration.</p

Vitamin D deficiency is associated with IL-6 levels and monocyte activation in HIV-infected persons

<div><p>Background</p><p>Immune activation plays a key role in HIV pathogenesis. Markers of inflammation have been associated with vitamin D deficiency in the general population. Studies have also demonstrated associations of vitamin D deficiency with increased risk of HIV progression and death. The relationship between persistent inflammation and immune activation during chronic HIV infection and vitamin D deficiency remains unclear.</p><p>Methods</p><p>Cryopreserved specimens were analyzed from 663 participants at the time of enrollment from the Study to Understand the Natural History of HIV/AIDS in the Era of Effective Therapy (SUN Study) from 2004 to 2006. Biomarkers of inflammation, atherosclerosis, and coagulation were measured using enzyme-linked immunosorbent assays (ELISAs) and electrochemiluminescence. 25(OH)D, the stable precursor form of vitamin D, was measured using a radioimmunoassay with levels defined as: normal (≥30ng/mL), insufficient (20–29 ng/mL) and deficient (<20 ng/mL). Monocyte phenotypes were assessed by flow cytometry. Linear and logistic regression models were used to determine statistical associations between biomarkers and vitamin D deficiency.</p><p>Results</p><p>25(OH)D levels were deficient in 251 (38%) participants, insufficient in 222 (34%), and normal in 190 (29%). Patients with vitamin D deficiency, when compared to those with insufficient or normal vitamin D levels, had increased levels of IL-6 (23%; p<0.01), TNF-α (21%, p = 0.03), D-dimer (24%, p = 0.01), higher proportions of CD14^dimCD16+ (22%, p<0.01) and CX3CR1+ monocytes (48%; p<0.001) and decreased frequency of CCR2+ monocytes (-3.4%, p<0.001). In fully adjusted models, vitamin D associations with abnormal biomarker levels persisted for IL-6 levels and CX3CR1+ and CCR2+ phenotypes.</p><p>Conclusions</p><p>Vitamin D deficiency is associated with greater inflammation and activated monocyte phenotypes. The role of vitamin D deficiency in persistent immune activation and associated complications during chronic HIV disease should be further evaluated as a possible target for intervention.</p></div

Association of biomarkers and immune phenotypes with vitamin D deficiency, the Study to Understand the Natural History of HIV/AIDS in the Era of Effective Therapy, United States, 2004–2006

<p>Association of biomarkers and immune phenotypes with vitamin D deficiency, the Study to Understand the Natural History of HIV/AIDS in the Era of Effective Therapy, United States, 2004–2006</p

Baseline spearman correlations with vitamin D levels.

<p>A) Association of biomarkers with vitamin D (Vitamin D levels are based upon the measured levels per patient, *p<0.01)) B) Association of monocyte phenotypes with vitamin D (Vitamin D levels are based upon the measured levels per patient, * p<0.01).</p

Participant characteristics, the Study to Understand the Natural History of HIV/AIDS in the Era of Effective Therapy, United States, 2004–2006 (n = 663).

<p>Participant characteristics, the Study to Understand the Natural History of HIV/AIDS in the Era of Effective Therapy, United States, 2004–2006 (n = 663).</p

Demographic characteristics and HIV risk behaviors of 2268 clients whose finger-stick whole blood and oral fluid specimens were tested with the OraQuick Advance rapid HIV test, by state—incidence study, February 2005 through May 2005.

<p>A/PI/AI/AN/Other, Asian/Pacific Islander/American Indian/Alaska Native/Other; IDU, injection drug user; MSM, men who have sex with men; STD, sexually transmitted diseases.</p>a<p>Risk behaviors are not mutually exclusive.</p

OraQuick Advance rapid HIV antibody test results for 2268 clients tested with oral fluid, Incidence Study, February 2005 to June 2005.

a<p>Test line intensity of test device compared to test line intensity of low-positive external control.</p

Figure 1

<p>Epidemic curve of false-positive OraQuick rapid HIV antibody test results, oral fluid, by Month and Lot, University of Minnesota study, July 2002 through August 2004.</p