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Cost and safety of assisted reproductive technologies for human immunodeficiency virus-1 discordant couples

World Journal of Virology 2015年第2期4卷 142-146页

作者： Ming-Yih Wu Hong-Nerng Ho Department of Obstetrics and Gynecology College of MedicineNational Taiwan University

Due to significant advances in the treatment of human immunodeficiency virus type-1(HIV-1), HIV-1 infection gradually has become a treatable chronic disease. Successfully treated HIV-positive individuals can have a normal life expectancy. Hence, more and more HIV-1 discordant couples in Taiwan and the rest of the world are seeking fertility assistance. Pre-treatment of highly active antiretroviral therapy(HAART) combined with sperm washing and RT-polymerase chain reaction examination for HIV-1 viral load has become the standard procedure to assist them to conceive. However,in order to reduce the transmission risk to the lowest level for the couple and to diminish the cost of health care for the insurance institutes or government, in vitro fertilization(IVF)-intracytoplasmic sperm injection(ICSI) therapy provides the ideal solution for HIV-1 discordant couples with infected men. Intrauterine insemination(IUI) theoretically introduces more than 107 times of sperm counts or semen volume to uninfected women vs IVF-ICSI. However, since some regimens of HAART may significantly decrease the sperm motility, compared to IVF-ICSI, IUI only produces 1/5 to 1/2 pregnancy rates per cycle. Given the risk of seroconversion of HIV infection which actually happens after successful treatment, IVF-ICSI for these HIV-1 seropositive men is more cost-effective and should be the first line treatment for these cases.

关键词： Highly active antiretroviral therapy human immunodeficiency virus-1 discordant Seroconversion Intrauterine insemination Intracytoplasmic sperm injection

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A Possible Alternative to the Accelerating Universe IV

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Journal of Modern Physics 2017年第4期8卷 622-635页

作者： Frank R. Tangherlini P.O. Box 928211 San Diego CA 92192 USA

This work briefly reviews and extends the author’s three previous works (2015), Journal of Modern Physics, 6, 78-87, and 1360-1370;(2016), 7, 1829-1844 that propose as an alternative to the accelerating ΛCDM universe, the decelerating Einstein de Sitter (EdS) universe, in which dark energy is a different phase of dark matter located only in intergalactic space (IGS), and that instead of a negative pressure, it has an index of refraction n≈1.50, and hence a reduced speed of light c / n through it. This allows the EdS universe to expand the extra distance necessary to obtain the diminished brightness of the Type Ia supernovae. In view of the recent suggestion that the universe is not accelerating, but possibly expanding uniformly, a table is given comparing both the accelerating and uniformly expanding universes with the EdS universe supplemented by the reduced speed of light. It is shown that fitting the uniformly expanding universe leads to a smaller value of n, and hence too short an age for the EdS universe, unlike the case with fitting the accelerating universe. The main result is that the proposed reduced speed of light in the IGS predicts discordant redshifts. It is shown that the current explanation of “accidental superposition,” is most likely insufficient to explain the number of observations, and that the present proposal could make up the difference. It can be tested astronomically, as illustrated in a figure.

关键词： Dark Energy Speed of Light Expansion Comparisons discordant Redshifts

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Baseline Clinical Profile of a “Normal Popu-lation” of HIV Exposed Sero-Negative (HESN) Partners May Impact HIV Biomedical Prevention Studies Negatively

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World Journal of AIDS 2015年第4期5卷 299-307页

作者： Pam Datong Evaezi Okpokoro Sophia Osawe Ruth Datiri Grace Choji Felicia Okolo Rebecca Abimiku Ille Mamman Alash’le Abimiku Plateau State Specialist Hospital Jos Nigeria Plateau State Human Virology Research Centre Jos Nigeria Institute of Human Virology Abuja Nigeria Institute of Human Virology University of Maryland School of Medicine Baltimore USA

The burden and viral diversity of HIV in Nigeria makes it suitable to evaluate biomedical prevention strategies including HIV vaccines. We document baseline clinical characteristics of a cohort of HIV Exposed Sero-Negative (HESN) partners to highlight background morbidities that might impact the interpretation of research findings especially in low income countries where “normal control” is based on physical appearance and self-reporting. We established a 2-year prospective cohort of HESN, and obtained, at baseline medical history, general physical examination findings and safety laboratory tests results. Among 534 participants with a mean age of 37 ± 9 years, the commonest symptoms were headache (25.5%) and fever (20%), which occurred more among females. Also, 13% reported a history of urethral/vaginal discharge and genital ulcer. High blood pressure (HBP) (i.e. blood pressure ≥ 140/90 mmhg) was a major abnormal examination finding, which occurred more among males (53.2% vs 26.2%, p < 0.01). More female participants had abnormal laboratory results with 31% having low hemoglobin concentration (<12 g/dl, p = 0.021);30% with elevated alanine transaminase level (p = 0.019) and 28% with abnormal blood urea nitrogen level (p = 0.093). HBP and abnormal safety laboratory are significant findings among so called “normal population” that could affect interpretation of research findings of HIV biomedical prevention studies in Nigeria.

关键词： Clinical Characteristics discordant Couple Developing Country HIV Vaccine Trial Nigeria

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