Opportunistic fungal infections account for a significant amount of morbidity associated with human immunodeficiency virus (HIV) disease. Oral candidiasis is one of the earliest premonitory signs of HIV infection and its diagnosis may have grave prognostic implications for the eventual development of full blown acquired immunodeficiency syndrome (AIDS). It is considered as an important marker of immune suppression and may be the initial manifestation of the disease in about 10% of HIV-infected adults. Careful history taking and detailed examination of the patient's oral cavity are important parts of the physical examination, and diagnosis requires appropriate investigative techniques. Early recognition, diagnosis, and treatment of HIV-associated oral lesions may reduce morbidity. This review is intended to provide information on clinical variants of oral candidiasis and management as dental care providers are likely to be among the first to recognize such manifestations.

Aims: To determine the prevalence, bacterial profile and antimicrobial susceptibility of asymptomatic bacteriuria in Human Immunodeficiency Virus (HIV) positive individuals. Materials and Methods: Urine from 300 HIV positive individuals were collected and cultured on cysteine lactose electrolyte deficient (CLED) agar and identified using standard techniques. Modified Kirby Bauer disc diffusion test was done according to Central Laboratory Standards Institute (CLSI) guidelines for antimicrobial sensitivity testing of the isolates. Results were compiled and statistically analyzed. Results: Of the 300 patients, 211 (70.3%) showed no growth, 77 (25.7%) had insignificant bacteriuria with a colony count of <10 ⁵ CFU/ml and 12 (4.0%) had significant bacteriuria with colony count >10 ⁵ CFU/ml without any signs or symptoms of urinary tract infections. The bacteriuria was significantly more in females (83.3%) than males (16.7%) with a P value of < 0.001. Eight (66.7%) cases of significant bacteriuria occurred in patients who were not on cotrimoxazole prophylaxis whereas 4 (33.3%) cases occurred in those who were on cotrimoxazole prophylaxis for at least one year. Conclusion: The incidence of asymptomatic bacteriuria was relatively less as compared to other studies and no correlation was found with CD4 counts, although evaluation with a larger study population needs to be undertaken.

Introduction: This study was carried out among people living with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) receiving antiretroviral therapy (ART) in a tertiary health facility in Nigeria and it is aimed at determining practice of adherence among these patients. Materials and Methods: A total of 282 HIV positive patients receiving ART in Nnamdi Azikiwe University Teaching Hospital, Nnewi were selected by systematic random sampling technique and using a semi-structured, interviewer administered questionnaire, responses were elicited from them on knowledge and perception of ART and adherence. Practice of adherence was determined by self-report. Findings were analyzed using Statistical Package for the Social Sciences version 17 (IBM Corp, Chicago Illinois, USA). Results: Most of the respondents were females (66.3%) and their mean age of the respondents was 36.63 ΁ 8.56 years. Most of the respondents have good knowledge of ART and adherence, even though most of them (64.2%) thought that ART cures HIV/AIDS. Most patients still considered HIV/AIDS as a serious illness (78.0%). Only about half of them (50.7%) were of the opinion that ART reduces the risk of HIV transmission. However, the general perception of adherence was good. The mean level of adherence was 97.8%, however, about 86% of them attained optimal adherence level. Conclusion: The study revealed fairly good knowledge and perception of ART and adherence among the patients. The level of ART adherence was also high; however there is a need to address some gaps in knowledge identified as part of measures aimed at improving adherence in the long run.

Introduction: Human Immune deficiency virus infection is a major public health issue in Sub-Saharan Africa with Nigeria having one of the highest burden of human immunodeficiency virus (HIV) disease among pregnant women and children. Since 2003, Aminu Kano Teaching Hospital (AKTH) has been providing prevention-of-mother-to-child transmission (PMTCT) services. This study examined the pattern of HIV counseling and testing (HCT) uptake among antenatal clients at the hospital during a 6-year period. This includes the period when decentralization of PMTCT services occurred in Nigeria. Materials and Methods: This is a hospital-based prospective study that included all pregnant women attending antenatal clinic (ANC) at AKTH, from January 2007 to December 2012. Since October 2003, data are prospectively recorded in registers and later entered into a database. The registers captured information on clients' age, parity, occupation and gestational age at time of registering; they also noted voluntary counseling and testing (VCT)/HCT uptake, HIV sero-status and partner's HIV status. The study obtained data from the hospital registers and subsequently analyzed it using the EPI-Info^; version 3.2.2 (released in 2004) statistical software package. Results: The mean maternal age was 27.2 ΁ 5.3 years and the median parity is 1 with a range of 1-14. Of the 23,378 new attendees at ANC, 23,078 (98.7%) accepted testing for HIV. Acceptance of HIV test stayed at 100% from 2007 to 2011 and only dipped slightly to 93.3% in 2012. Overall HIV prevalence was 5.5%. HIV prevalence stabilized at between 8.1% and 8.4% in 2007 and 2008 respectively, before rising to peak at 10.0% in 2009 and started declining to 5.8% in 2010 before reaching its lowest values of 1.7% and 1.1% in 2011 and 2012 respectively. This trend was statistically significant with a P < 0.000. Conclusions: There is a high uptake of VCT among ANC clients and HIV prevalence has decreased significantly in the last 3 years in AKTH, probably as a result of decentralization of PMTCT services.

Objective: The objective of the study is to determine whether retesting for human immunodeficiency virus (HIV) in labor is important in Nigeria. Subjects and Methods: A prospective cohort study involving 400 antenatal women who tested HIV-negative at booking in an obstetric unit of a university college hospital in Nigeria were retested in labor at least 12 weeks from initial tests. Seropositive mothers and exposed infants had antiretroviral prophylaxis and were followed-up. Main outcome measures were rate of acceptance to rescreen, incidences of seroconversion, mother-to-child transmission and associated factors. Results: Majority 96.4% (400/415) accepted whereas 3.6% (15/400 N) declined retesting on the grounds of a previous negative result. The seroconversion rate was 0.25%. Maternal age ≥25 years (OR = 5.0), secondary and post-secondary education (OR = 622.4) and parity ≥1 (OR = 17.2) were significant factors for acceptance to rescreen whereas occupation (P = 0.25) and marital status (P = 0.23) were not. The only HIV-exposed infant from the seroconverted mother was not breastfed and tested negative at 6 and 12 weeks using deoxyribonucleic acid polymerase chain reaction. Conclusion: The rate of seroconversion was low, but perinatal HIV infection was averted. Supposedly low-risk women could seroconvert and cause vertical transmission (VT). Retesting may still be important in resource-constrained settings to identify women with recent infection, institute appropriate interventions to avert VT thereby achieving the international goal of "no new HIV infection by 2015". Although a large multicenter study to evaluate our findings is ongoing, studies to determine the cost-benefits of such interventions are justified.

Introduction: As more and more people with human immunodeficiency virus (HIV) live longer and enjoy healthier lives because of antiretroviral therapy, there are an increasing number of sexual transmissions of HIV. It is exceedingly important to assess the proportion of unsafe sexual practices among people living with HIV/AIDS (PLWHAs) and their disclosure status so that behavioral intervention can be designed optimally for them in order to curb secondary HIV transmission and potential reinfection with different or drug resistant strain of HIV. Aim: To assess sexual behavior and serostatus disclosure of PLWHAs attending antiretroviral therapy (ART) center in Vadodara. Settings and Design: The current cross-sectional study was carried out at ART center of a tertiary care hospital - Shree Sayaji General (SSG) Hospital, Vadodara after taking necessary permissions and approval from institutional review board (IRB). Materials and Methods: A semistructured questionnaire was used for interview with PLWHA who are on ART after taking written and informed consent. Data was entered and analyzed using Epi Info software. Results: A total of 175 PLWHAs were enrolled in this study. Forty-three percent of the PLWHAs practiced premarital sex, while 15% of them practiced extramarital sex (EMS). Nearly 90% of these sexual practices were unsafe. Fifty-eight percent of the PLWHAs continued these unsafe sexual practices even after HIV diagnosis. Nearly 20% of the PLWHAs did not receive any counseling regarding sexual behavior. Ninety-five percent of respondents had disclosed their serostatus to their spouse. Conclusions: Still a remarkable proportion of PLWHAs indulge in unsafe sexual practices and the most common reason encountered among them was desire for child. Although majority of the participants had disclosed their serostatus to their spouse, many respondents did not mention their serostatus to other sexual partners. There is a need to stress on the importance of safe sex among PLWHAs not only to prevent transmission to their partners, but also to help them avoid receiving potentially resistant HIV strains in case of seroconcordant couples. A need-based sexual behavior-related motivational counseling needs to be focused on.