Background: Limited data are available on the incidence and factors associated with viral rebound following viral suppression among HIV-infected individuals taking antiretroviral therapy (ART) in Kenya. Furthermore, the durability of viral suppression among HIV individuals taking ART is unknown. Information on incidence rates and factors associated with HIV viral load rebound and the durability of viral suppression (undetectable HIV copies in plasma) among HIV-infected individuals taking ART, will help improve the long-term management of HIV-infected individuals and explore approaches to longterm HIV remission or complete cure. Objectives: The objectives of this study were to investigate the incidence rates of viral rebound following viral suppression, factors associated with viral rebound, and the durability of viral suppression among HIV-infected individuals on ART from Kilifi, Meru, and Nakuru counties in Kenya. Methods: This was a retrospective study involving 600 HIV-infected individuals taking combination ART (cART) and enrolled in comprehensive care centers (CCCs) at Malindi Sub-county Hospital, Nakuru Level 5 Hospital, and Meru Level 5 Hospital in Kenya. The medical files were inspected and medical history records abstracted for the selected participants. Participant laboratory data including HIV viral loads, types and history of ART, and treatment history of any opportunistic infections were abstracted using an abstraction checklist. Participants were grouped into those who achieved HIV viral suppression, with viral loads lower than the detection limit (LDL) (viral suppression), and those who experienced one or more detectable viral load measurements >40 copies/ml following the initial LDL (viral rebound). Durable viral suppression was defined as all viral load values at LDL over the 2-year period (2017)(2018)(2019). Univariate and multivariate Poisson regression analyses were performed to assess the rates of viral rebound, as well as to investigate factors associated with it. Results: Out of 549 HIV-positive patients, 324/549 (59%) achieved HIV viral suppression (Meru 159/ 194 (82%), Nakuru 21/178 (12%), and Malindi 144/177 (81%)). The overall viral rebound rate was 41%, with site-specific viral rebound of 88.2%, 18.6%, and 18.0% in Nakuru, Malindi, and Meru, respectively. There was an overall rate of first viral rebound of 3.9 (95% confidence interval (CI) 6.9-14.4), 0.7 (95% CI 0.5-1.0), and 0.89 (95% CI 0.64-1.24) per 100 person-months in Nakuru, Malindi, and Meru, respectively. Good ART adherence (p = 0.0002), widow status (p = 0.0062), and World Health Organization (WHO) stage I (p = 0.0002) were associated with viral suppression, while poor ART adherence (p < 0.0001), WHO stage II (p = 0.0024), and duration on ART of 36 months (p = 0.0350) were associated with viral rebound. Conclusions: The rate of viral suppression in patients on cART in the CCCs fell short of the WHO target. However, the study provides proof of evidence of undetectable viral load levels for more than 2 years, a sign that the Un...
The processing of jackfruit (Artocarpus heterophyllus Lam) yields a considerable amount of bio-waste. Accumulation of this waste is considered a health risk because it is a potential source of air and water pollution. Recycling of the unutilized fruit parts, therefore, reduces the quantity and the impact of the bio-waste released to the environment. The purpose of this study was to determine the phytochemical profile, antioxidant and antimicrobial activities of extracts from three fruit parts (peel, fiber and the core) of jackfruit sampled from the coastal region of Kenya. Different extraction techniques and solvents were tested. The highest phenolic and flavonoid content of the peels, fiber and the core were obtained from methanol extracts following a 48-hour incubation. The values were recorded at 17.07±5.16 mg/g, 23.28±4.73 mg/g, and 15.68±3.74 mg/g for the phenolics and 28.55±12.42 mg/g, 35.4±9.53 mg/g and 36.23±2.54 mg/g for the flavonoids, respectively. The highest tannin content was obtained from distilled water extracts following homogenization recorded at 10.82±2.63 mg/g, 10.39±4.10 mg/g and 10.52±1.05 mg/g for peels, fiber and core, respectively. The fiber extracts gave the highest 2,2-diphenyl-1-picrylhydrazyl (DPPH) scavenging activity followed by the core at 61.51±29.90% and 51.06±33.39%, respectively. The antioxidant activity was highest for methanol fiber extracts at 61.51±29.90% for DPPH radical scavenging activity and 7.94±4.56 mg/mL for reducing power assay. The best antibacterial activity against Xanthomonas axonopodis pv. manihotis (Xam) was obtained from Ethyl acetate extracts showed. The unutilized jackfruit parts, therefore, are a potential source of natural antioxidants as well as antibacterial, for agriculture and food industry
Background: During the past 35 years, highly effective ART has saved the lives of millions of people worldwide by suppressing viruses to undetectable levels. However, this does not translate to the absence of viruses in the body as HIV persists in latent reservoirs. Indeed, rebounded HIV has been recently observed in the Mississippi and California infants previously thought to have been cured. Hence, much remains to be learned about HIV latency, and the search for the best strategy to eliminate reservoir is the direction current research is taking. A systems-level approach that fully recapitulate the dynamics and complexity of HIV-1 latency in vivo and applicable in human therapy is prudent for HIV eradication to be more feasible. Objectives: The main barriers preventing the cure of HIV with antiretroviral therapy have been identified, progress has been made in the understanding of the therapeutic targets to which potentially eradicating drugs could be directed, integrative strategies have been proposed and clinical trials with various alternatives are underway. The aim of this review is to provide an update on the main advances in HIV eradication, with particular emphasis on the obstacles to HIV eradication and the different strategies proposed. We highlight the core challenges of each strategy and propose the most promising strategy and newresearch avenues in HIV eradication strategies. Methods: We conducted a systematic literature search of all English-language articles published between 2015 and 2019 using MEDLINE (PubMed) and Google scholar. Where available, medical subject headings (MeSH) were used as search terms and included: HIV, HIV latency, HIV reservoir, latency reactivation and HIV cure. Additional search terms consisted ofsuppression, persistence, establishment, generation, and formation. A total of 250 articles were found usingthe above search terms. Of these, 89 relevant articles related to HIV-1 latency establishment and eradication strategies were collected and reviewed, with no limitation of study design. Additional studies (commonly referenced and/or older and more recent articles of significance) were selected from bibliographies and references listed in the primary resources. Results : :In general, when exploring the literature, there are four main strategies heavily researched and provides promising strategies to the elimination of latent HIV: Haematopoietic Stem-Cell Transplantation, Shock and Kill Strategy, Gene-specific transcriptional activation using RNA-guided CRISPR-Cas9 system, and Block and Lock strategy. Most of these strategies studies are applicable in vitro, leaving many questions about the extent to which, or if any, these strategies are applicable to complex picture in vivo. However, the success of these strategies at least shows in part that HIV-1 can be cured, though some strategies are too invasive and expensive to become a standard of care for all HIV-infected patients. Conclusion: Recent advances hold promise for the ultimate cure of HIV infection. A systems-level approach that fully recapitulate the dynamics and complexity of HIV-1 latency in vivo and applicable in human therapy is prudent for HIV eradication to be more feasible. Future studies aimed at achieving a prolonged HIV remission state are more likely to be successful if they focus on a combination strategy including the block and kill, and stem cell approaches. These strategies propose a functional cure with minimal toxicity for patients. We believe that the cure of HIV infection will be attained in the short term if a strategy based on purging the reservoirs is complemented with an aggressive HAART strategy.
Background Tea, a widely consumed beverage worldwide increasingly elicits interest due to reported high levels of polyphenols. Polyphenols have been extensively investigated, as they are a potential source of natural antioxidants. Methods The aim of the study was to determine and compare the phytochemical composition and antioxidant activities of aqueous and methanol extracts of black, green, purple, and white teas found in selected regions of Kenya.A total of 56 samples were obtained from tea classified as black, green,purple, and white tea in various factories. The samples were then grounded and extracted using methanol and de-ionized water for 48 hours. The composition of phenolic and tannin contents was determined using Folin- Ciocalteu method. Flavonoids content was determined through the formation of the flavonoids– aluminum complex assay. Antioxidant activity was determined through the DPPH scavenging activity and the iron-reducing power of the extracts. Results The phenolic contents in all samples were significantly higher than flavonoid and tannin levels. In samples extracted with water, the phenolic contents were high (41.74 ± 5.25) mg/g, while flavonoid (0.58 ± 0.06 mg/g) and tannin levels (2.47 ± 0.79) mg/g were relatively low. There was a negative correlation between phytochemicals and the antioxidant activity of the various teas. Conclusions The findings suggest that the different teas have high levels of phytochemicals and are natural antioxidants, however there is no significant variation at p = 0.05 in the composition of phytochemical compounds among the different tea groups.
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