HIV/AIDS in Palestine: A growing concern

Quality of Life of People Living with HIV on Antiretroviral Therapy: A Cross-Sectional Study in Monastir, Tunisia

Introduction

Despite the benefits of an efficient antiretroviral therapy (ART), HIV/AIDS epidemic still represents the most seriousaffection worldwide that negatively impacts people's quality of life (QoL). As no studies exist on QoL in Tunisia, the aim of the present work was i: to assess, based on WHOQOL-HIV BREF tool, the perception of QoL of people living with HIV (PLHIV) receiving ART and ii: to investigate the relationship between socio-demographic features, disease-related variables and QoL domains' mean scores.

Methods

This cross-sectional study was conducted at the department of infectious diseases of F. Bourguiba Teaching Hospital in Monastir, Tunisia. One hundred and five participants receiving ART were involved. QoL assessment was based on the WHOQOL-HIV Bref including six domains with 29 items with scores ranged from the lowest (4) to the highest (20). Results were reported as frequencies and means (±SD). The Student's t-test for independent samples and the one-way ANOVA were performed to assess differences in QoL mean scores. Linear regression analysis was used to investigate predictors of QoL. The confidence interval was set at 95%.

Results

Clients' mean age was 39.20±10.18 years old with a male to female sex ratio of 3.12. Low mean scores were seen with the environment (12.34±2.90), social relations (12.58±3.94) and psychological domains (12.76±3.31), and moderate mean scores were noted for the physical (14.11±3.52), the spiritual (14.05±3.78) and the level of independence (13.98±3.57) domains. Regression analysis showed that health status and feeling healthy were related to all QoL domains and that profession, marital status and the presence of a confident person were related to environment and spiritual domains.

Conclusion

QoL of PLHIV on ART is affected. Concrete measures and strategies should be undertaken by healthcare stakeholders to improve QoL determinants.

Status of the HIV epidemic in key populations in the Middle East and north Africa: knowns and unknowns

The Middle East and north Africa is one of only two world regions where HIV incidence is on the rise, with most infections occurring among key populations: people who inject drugs, men who have sex with men, and female sex workers. In this Review, we show a trend of increasing HIV prevalence among the three key populations in the Middle East and north Africa. Although the epidemic continues at a low level in some countries or localities within a country, there is evidence for concentrated epidemics, with sustained transmission at considerable HIV prevalence among people who inject drugs and men who have sex with men in over half of countries in the region with data, and among female sex workers in several countries. Most epidemics emerged around 2003 or thereafter. The status of the epidemic among key populations remains unknown in several countries due to persistent data gaps. The HIV response in Middle East and north Africa remains far below global targets for prevention, testing, and treatment. It is hindered by underfunding, poor surveillance, and stigma, all of which are compounded by widespread conflict and humanitarian crises, and most recently, the advent of COVID-19. Investment is needed to put the region on track towards the target of eliminating HIV/AIDS as a global health threat by 2030. Reaching this target will not be possible without tailoring the response to the needs of key populations, while addressing, to the extent possible, the complex structural and operational barriers to success.

HIV Epidemic in Libya: Identifying Gaps

BACKGROUND

HIV (human immunodeficiency virus) and AIDS (acquired immunodeficiency syndrome) became a public issue in Libya after the infection of 400 children in El-Fatih Hospital in 1988. Due to the civil war, social and religious barriers, HIV prevalence is hard to establish, but it is generally believed to be increasing.

OBJECTIVE

This review (a) assesses the size and scope of the available literature on the HIV epidemic in Libya; and, (b) identifies the nature and extent of research conducted to date.

METHODS

A comprehensive search was performed using PubMed, Medline, Web of Science, ScienceDirect, Scopus, Academic Search Ultimate, Cochrane Library and Google Scholar. Primary research studies and official reports that are exclusively on Libya published during 1988-2021 were considered.

RESULTS

In total 25 studies were included: Ten primary research studies, four online news articles, six Government reports, one letter to the editor, one manuscript, three online databases.

CONCLUSION

Despite the low-quality data, the literature suggests there is an increase in HIV infection rates in Libya. Culturally sensitive research on sexual activities, women, HIV preventative methods and attitudes of the Libyan public will assist in developing an effective National AIDS Programme, reducing HIV stigma, supporting People Living with HIV (PLHIV) and decreasing infection rates.

Improved 3D-QSAR Prediction by Multiple Conformational Alignments and Molecular Docking Studies to Design and Discover HIV-I Protease Inhibitors

BACKGROUND

Inhibition of HIV-I protease enzyme is a strategic step for providing better treatment in retrovirus infections, which avoids resistance and possesses less toxicity.

OBJECTIVES

In the course of our research to discover new and potent protease inhibitors, 3D-QSAR (CoMFA and CoMSIA) models were generated using 3 different alignment techniques, including multifit alignment, docking based and Distill based alignment for 63 compounds. Novel molecules were designed from the output of this study.

METHODS

A total of 3 alignment methods were used to generate CoMFA and CoMSIA models. A Distill based alignment method was considered a better method according to different validation parameters. A 3D-QSAR model was generated and contour maps were discussed. The biological activity of designed molecules was predicted using the generated QSAR model to validate QSAR. The newly designed molecules were docked to predict binding affinity.

RESULTS

In CoMFA, leave one out cross-validated coefficient (q²), conventional coefficient (r²) and predicted correlation coefficient (r²_Predicted) values were found to be 0.721, 0.991 and 0.780, respectively. The best obtained CoMSIA model also showed significant cross-validated coefficient (q²), conventional coefficient (r²) and predicted correlation coefficient (r²_Predicted) values of 0.714, 0.987 and 0.721, respectively. Steric and electrostatic contour maps generated from CoMFA and hydrophobic and hydrogen bond donor and hydrogen bond acceptor contour maps from CoMSIA models were used to design new and bioactive protease inhibitors by incorporating bioisosterism and knowledge-based structure-activity relationship.

CONCLUSION

The results from both these approaches, ligand-based drug design and structure-based drug design, are adequate and promising to discover protease inhibitors.