Monocytes are a heterogeneous cell population having specialised functions and differing phenotype. They are a link between innate immune system and adaptive immune system therefore, to identify if immune activation exists in HIV-1 individuals with controlled virema and recovered CD4 T cell counts, we assessed cell surface monocyte activation markers (MAM) within the monocyte subsets.
An eight colour flow cytometry protocol was optimized by evaluating CD45, CD56, NKG2C, CD14, CD16, CD163, CD64 and CD143 in a cocktail and their appropriately matched isotype controls. Utilising this method we assessed MAM in 81 HIV infected individuals from the Western Australian HIV cohort (viremic and non viremic) and 24 normal healthy controls.
The results from this pilot study show little effect of HIV status, CD4 T cell count or age on monocyte subsets however females had lower proportion of classical monocytes than males. The results from MAM analysis did reveal an influence of HIV status on CD64 and CD143 expression on all monocyte subsets (p<0.01). There was no influence of HIV status on CD163 expression on classical or intermediate monocytes however, of interest, the non classical monocyte analysis did revealed an effect of HIV status, but not viral load, on CD163 expression. There was no effect of age or gender with any activation marker on any monocyte subsets. CD4T cell count was associated with viral load and CD64 expression on classical monocytes only.
Monitoring markers of monocyte activation provides a valuable insight into immune activation in HIV individuals. The expression of pro-inflammatory CD16+ monocytes suggests important effects of HIV on innate immunity and this technique appears to be viable and potentially useful for monitoring HIV disease.
The case is of a 30 year-old HIV positive Zimbabwean woman (UK resident) who arrived in Australia in January 2011 on a one-year working visa. She was diagnosed with HIV in 2003 in the UK and commenced on Atripla® in 2005. She was first seen in Adelaide in May 2011, requesting a script for Atripla.®.
Background: Liquid based anal Papanicolaou smears, followed by High Resolution Anoscopy (HRA) guided biopsies are increasingly being advocated to identify areas of High Grade Anal Intraepithelial Neoplasia (HGAIN). We hypothesized that the ability to identify HGAIN would increase with experience of the anoscopist, and that comparison with contemporary Papanicolaou smears might yield insights into technical abilities.
Indigenous Australians experience a greater burden of sexually transmitted infections, however are less likely than the general population to access sexual health services. We examined the effectiveness of an Indigenous cultural appropriateness audit in assessing a sexual health clinic with low rates of Indigenous clients.
Despite the high proportion of young people annually accessing general practices, including Aboriginal Medical Services (AMS), testing for Chlamydia trachomatis remains relatively low in urban areas. A project officer was employed within the Institute of Urban Indigenous Health (IUIH) to serve a mentoring and facilitation role for the SE Queensland network of AMS and their sexual health workers, with a view to improving testing, management and follow-up of chlamydia and other STIs by community controlled medical services.
Involving consumers in healthcare decisions is important for high quality care. We previously tested a brief, consumer-led intervention consisting of three questions in a trial employing trained, standardized patients. The intervention enhanced discussion of evidence and increased patient involvement. We now report a research translation study which tested implementation with real patients at a reproductive and sexual health clinic.
Case presentation: A 27 year-old Vietnamese man was diagnosed with HIV in April 2012 when he presented with cerebrospinal fluid (CSF)-culture positive Cryptococcus neoformans meningitis. CD4 count was 4 cells/µL and HIV viral load 228827 copies/mL. He was treated with two weeks of amphotericin B (0.7mg/kg/day) and 5-fluorocytosine (25mg/kg/QID), followed by consolidation and secondary prophylaxis with fluconazole. CSF cultures were negative at two weeks. A ventriculo-peritoneal shunt was inserted to manage persistently raised intracranial pressure and had to be replaced two weeks later due to bacterial shunt infection. Antiretroviral therapy (ART) was commenced after four weeks of treatment, and by September 2012, CD4 count was 107 cells/L and viral load 150 copies/mL.
This presentation, "Responding to the needs of consumers with complex trauma histories a consumer perspective" focuses on the needs of adult survivors of child abuse, highlighting the frequent