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Computational models can facilitate the understanding of complex biomedical systems such as in HIV/AIDS. Untangling the dynamics between HIV and CD4+ cellular populations and molecular interactions can be used to investigate the effective points of interventions in the HIV life cycle. With that in mind, we have developed a state transition systems dynamics and stochastic model that can be used to examine various alternatives for the control and treatment of HIV/AIDS. The specific objectives of our study were to use a cellular/molecular model to study optimal chemotherapies for reducing the HIV viral load and to use the model to study the pattern of mutant viral populations and resistance to drug therapies. The model considers major state variables (uninfected CD4+ lymphocytes, infected CD4+ cells, replicated virions) along with their respective state transition rates (viz. CD4+ replacement rate, infection rate, replication rate, depletion rate). The state transitions are represented by ordinary differential equations. The systems dynamics model was used for a variety of computational experimentations to evaluate HIV mutations, and to evaluate effective strategies in HIV drug therapy interventions.

During the ART era, persistent immune activation remains a significant challenge in people living with HIV (PLWH). Microbial translocation play an essential role in this setting. Probiotics have several immunological benefits which can reverse this process. The purpose of this paper is to investigate the safety and efficacy of probiotics on CD4 counts among Iranian PLWH.

In total, 50 PLWH with CD4 counts above 350 cells/mm³ did not receive ART participated in a randomized, double-blind trial and underwent 24 weeks of treatment with either LactoCare® or placebo twice daily. CD4 counts of the patients were measured at baseline, 12 weeks and 24 later in the two groups. Side effects were measured monthly using a specific checklist.

The mean CD4 count of the patients showed a significant difference between the two groups after six months. Through six months follow up, the mean CD4 count of the patients showed a significant reduction as compared to the baseline in the placebo group; however, it did not show a significant difference in the probiotic group. Repeated Measures Anova test showed a significant effect for time × treatment interaction on the CD4 count during the trial course. No significant difference between the two groups concerning adverse events was reported.

It seems the use of probiotics in PLWH with a CD4 count above 350 cells/mm³ who are not receiving antiretroviral drugs is safe and can reduce the devastating process of CD4+ T cells in these patients.

Purpose – This study investigates the sociodemographics, late entry to antiretroviral therapy (ART), and clinical markers associated with AIDS-related mortality.

Methodology/Approach – Applying retrospective cohort design, 960 medical records of people who died of AIDS, from October 2006 to December 2014, were accessed from the ART center at tertiary health care center of Ranchi (India).

Findings – With useable data from 889 medical records revealed that the majority of people who died of AIDS consisted of married males in the age group of 19–40 years who were truck drivers, migrant laborers, and of rural origins. The median survival period was below 3 months following the ART. Males and people on the pre-ART group had a shorter survival period than their counterparts. Early mortality was associated with lower CD4+ T cell counts, the third or fourth clinical stage, ambulatory or bed-ridden functional status, and poor medication adherence.

Research limitations/implications – This study was limited to the analysis of AIDS deceased people only; it did not compare the survival duration with living people on ART. The lower CD4+ T cell counts and medication adherence, being strong predictors of mortality, can be addressed to attain higher survival rates of people who have AIDS.

Originality/Value of Paper – This is the first study conducted in the tribal-populated region, covering a large sample of 889 cases. Unique findings of this study update the existing data on AIDS-related mortality.

The purpose of this study is to estimate the average cost of treatment and investigate the related parameters of HIV/AIDS among patients based on their annual treatment regime during the 2017 in Izmir.

The average annual direct cost of an HIV patient's treatment was estimated for 2017 at four university hospitals in a retrospective study in Izmir, Turkey. Inclusion criteria included confirmed HIV infection, age = 18 years, visited one of the hospitals at least three times a year and with at least one CD4+ T cell count. The average annual treatment cost per patient was calculated using accounting data for 527 patients from the hospitals' electronic databases.

The mean treatment cost per patient was US$4,381.93. Costs for treatment and care were statistically significantly higher (US$5,970.55) for patients with CD4+ T cell counts of fewer than 200 cells/mm³ than for other patients with CD4+ T cell counts above 200 cells/mm³. The mean treatment cost for patients who were 50 years old or older (US$4,904.24) was statistically significantly higher than for those younger than 50 years (US$4,216.10). The mean treatment cost for female patients (US$4,624.92) was higher than that of male patients ($US4,339.72), although the difference was not statistically significant. The main cost driver was antiretroviral treatment (US$3,852.38 per patient), accounting for almost 88% of all costs. However, the high burden of antiretroviral treatment cost is counterbalanced by relatively low care and hospitalization costs in Turkey.

The paper contributes to the literature by providing average annual treatment cost of an HIV-infected patient in Turkey by using a comprehensive bottom up approach. Moreover, cost drivers of HIV treatment are investigated.

Human diet consists of an enormous variety of both plants and animal proteins, many of which are potentially immunogenic. Industrial processing of foods and digestion in the gastrointestinal tract causes changes and breakdown of proteins into peptides, which are also potential immunogens. Foods commonly known to cause allergic reactions are fish, milk, eggs, fruits, vegetables, nuts, legumes and meat. Once sensitised to a particular antigen, subsequent exposure may result in a marked and immediate reaction characterised by vomiting, diarrhoea, abdominal cramps, itching and swelling of the mouth and skin, dizziness and occasionally systemic anaphylaxis. Allergic reactions involve complex processes and interactions between the allergen and immunological components in the digestive tract such as antigen absorption, processing and presentation, T cell and B cell activation, development of oral tolerance or allergic sensitivity, antigen‐specific IgE antibody synthesis. Allergen binding to allergen‐specific mast cell membrane‐bound IgE antibodies triggers mast cell degranulation. This results in the release of histamine and other chemotactic mediators responsible for clinical symptoms.

The purpose of this paper is to show that a combination of Adomian and Alienor methods can be used to solve the problem of parameters identification of HIV/AIDS model. This model involves a system of three ordinary differential equations.

Parameters identification leads to the minimization of an error functional given by the sum of variations between measured variables and calculated variables obtained by solving the system of differential equations. We assume that the quantity of healthy cells CD4 + T and the viral load contents in the blood are measured.

The identification was realized by applying the combined Adomian/Alienor method allowing to reduce the problem to a minimization problem in dimention one.

Simulation results are given for illustration.

Application to parameter identification in an HIV model‐compatible, results to other methods.

This study aims to evaluate the immunomodulatory effect of traditional drink of black cincau-based wedang uwuh (WUB) on alloxan-induced diabetic rats.

WUB consists of dried herbs such as black cincau leaves (Mesona palustris BL), red ginger (Zingiber officinale Rosc), cloves (Syzgium aromaticum), sappan wood (Caesalpinia sappan Lin) and soursop leaves (Annona muricata). In this study, the rats were divided into five groups: normal control, diabetic control and three groups of WUB (WUB 13.5 mL/kg and WUB 27 mL/kg) or wedang uwuh commercial (WUC) treated diabetic groups. WUB or WUC was administered by gavage for three days after rats were confirmed diabetic induced by alloxan; these injections were continued for 28 days. At the end of the experiment, the spleen of rats was analyzed using flow cytometry. Data were analyzed by ANOVA followed by Tukey test using Minitab version 16.0.

This study showed that WUB significantly inhibited the expression of pro-inflammatory cytokines (interferon-Y [IFN-ɣ] and tumor necrosis factor-α [TNF-a]) and anti-inflammatory cytokines (interleukin 10 [IL-10] and transforming growth factor-β [TGF-ß]), and achieved a balance between pro-inflammatory and anti-inflammatory cytokines that were not significantly different from normal controls. WUB 27 was able to regulate the production of relative average cytokines IFN-ɣ (7.6 ± 3.5; p = 0.010), TNF-a (8.7 ± 2.4; p = 0.018), IL-10 (6.3 ± 2.4; p = 0.001) and TGF-ß (7.4 ± 2.1; p = 0.004) that was significantly different from diabetic control. This study’s results validate that the use of WUB can result in immunomodulatory activity in diabetic rats.

To the best of the authors’ knowledge, this is the first study on the immunomodulatory effect of WUB which is developed based on WUC; WUB has been used by Indonesian people as a functional beverage which acts as an immune booster and body warmer.

The purpose of this study is to explore the association of serum retinol and number of circulating inflammatory cells and disease activity in patients with ulcerative colitis.

A total of 60 patients with ulcerative colitis were enrolled in a cross-sectional pilot study. Patients were recruited from specialized clinic of Tabriz University of Medical Sciences, Iran between April and August 2015. Mayo clinic index was used to assess clinical disease activity score. Blood samples were collected. Serum retinol was assessed using HPLC to determine vitamin A status. Complete blood count and lymphocyte phenotyping were performed by automated hematology analyzer and flow-cytometric analysis, respectively.

According to Mayo scoring, 68.33 per cent of patients had mild and 31.66 per cent had moderate or severe disease activity. About 43.33 per cent of patients were vitamin A deficient, with 23.33 per cent having moderate to severe deficiency (serum retinol < 20 µg/dl). Lower levels of serum retinol and higher count and percentages of CD3+, CD8+ T cells and neutrophil to lymphocyte ratio were statistically associated with disease activity according to univariate analysis (p = 0.002, 0.037, <0.001, 0.031, 0.002 and 0.039); however, in binary logistic regression, only lower levels of serum retinol were independently associated with disease activity with a OR of 0.564 (p = 0.021; 95 per cent CI 0.35-0.92).

Vitamin A deficiency was detected in this study population. Patients with moderate to severe disease activity demonstrated lower serum retinol, higher CD8+ T cells and neutrophil to lymphocyte ratio compared to patients with mild disease activity.

Criminalization of drug use in Malaysia has concentrated people who inject drugs (PWID) and people living with HIV into prisons where health services are minimal and HIV-related mortality is high. Few studies have comprehensively assessed the complex health needs of this population. The paper aims to discuss these issues.

From October 2012 through March 2013, 221 sequentially selected HIV-infected male prisoners underwent a comprehensive health assessment that included a structured history, physical examination, and clinically indicated diagnostic studies.

Participants were mostly PWID (83.7 percent) and diagnosed with HIV while incarcerated (66.9 percent). Prevalence of hepatitis C virus (90.4 percent), untreated syphilis (8.1 percent), active (13.1 percent), and latent (81.2 percent) tuberculosis infection was several fold higher than non-prisoner Malaysian adults, as was tobacco use (71.9 percent) and heavy drinking (30.8 percent). Most (89.5 percent) were aware of their HIV status before the current incarceration, yet few had been engaged previously in HIV care, including pre-incarceration CD4 monitoring (24.7 percent) or prescribed antiretroviral therapy (ART) (16.7 percent). Despite most (73.7 percent) meeting Malaysia’s criteria for ART (CD4 <350 cells/μL), less than half (48.4 percent) ultimately received it. Nearly one-quarter (22.8 percent) of those with AIDS (<200 cells/μL) did not receive ART.

Drug addiction and communicable disease comorbidity, which interact negatively and synergistically with HIV and pose serious public health threats, are highly prevalent in HIV-infected prisoners. Interventions to address the critical shortage of healthcare providers and large gaps in treatment for HIV and other co-morbid conditions are urgently needed to meet the health needs of HIV-infected Malaysian prisoners, most of whom will soon transition to the community.

The Adomian’s technique is used for solving differential systems for modeling the HIV immune dynamics (or immune response). We also compare both models for determining the most computable one. A solution of the Marchuk‐Petrov‐Belykh model and one using a simplified model are presented together with some conclusions.