sodium-hypochlorite and AIDS-Related-Opportunistic-Infections

Diarrhea is frequent among persons infected with human immunodeficiency virus (HIV) but few interventions are available for people in Africa. We conducted a randomized controlled trial of a home-based, safe water intervention on the incidence and severity of diarrhea among persons with HIV living in rural Uganda. Between April 2001 and November 2002, households of 509 persons with HIV and 1,521 HIV-negative household members received a closed-mouth plastic container, a dilute chlorine solution, and hygiene education (safe water system [SWS]) or simply hygiene education alone. After five months, HIV-positive participants received daily cotrimoxazole prophylaxis (160 mg of trimethoprim and 800 mg of sulfamethoxazole) and were followed for an additional 1.5 years. Persons with HIV using SWS had 25% fewer diarrhea episodes (adjusted incidence rate ratio [IRR] = 0.75, 95% confidence interval [CI] = 0.59-0.94, P = 0.015), 33% fewer days with diarrhea (IRR = 0.67, 95% CI = 0.48-0.94, P = 0.021), and less visible blood or mucus in stools (28% versus 39%; P < 0.0001). The SWS was equally effective with or without cotrimoxazole prophylaxis (P = 0.73 for interaction), and together they reduced diarrhea episodes by 67% (IRR = 0.33, 95% CI = 0.24-0.46, P < 0.0001), days with diarrhea by 54% (IRR = 0.46, 95% CI = 0.32-0.66, P < 0.0001), and days of work or school lost due to diarrhea by 47% (IRR = 0.53, 95% CI = 0.34-0.83, P < 0.0056). A home-based safe water system reduced diarrhea frequency and severity among persons with HIV living in Africa and large scale implementation should be considered.

Topics: Adolescent; Adult; AIDS-Related Opportunistic Infections; Anti-Infective Agents; Child; Child, Preschool; Diarrhea; Disinfectants; Female; HIV; HIV Infections; Housing; Humans; Incidence; Infant; Infant, Newborn; Male; Middle Aged; Rural Population; Severity of Illness Index; Sodium Hypochlorite; Trimethoprim, Sulfamethoxazole Drug Combination; Uganda; Water Purification; Water Supply

A U.S. study of WF10, a mixture of Hydrogen Peroxide and bleach, suggested that WF10 improves the function of macrophages, damages HIV once WF10 is released by an infected cell, enhances resistance to infections, and does not interfere with AZT or ddI activity. WF10 does not show any toxicity in the liver, bone marrow, or kidneys; side effects were mild and temporary. WF10 is available from Canada through Health Canada's Special Access Programme and costs approximately $1,200 to $1,600 per cycle.

Topics: AIDS-Related Opportunistic Infections; Female; HIV; HIV Infections; Humans; Hydrogen Peroxide; Macrophage Activation; Macrophages; Male; Placebos; Sodium Hypochlorite; Virus Replication

Laos has a high prevalence of tuberculosis (TB) and a slowly increasing prevalence of human immunodeficiency virus/acquired immunedeficiency syndrome (HIV/AIDS). Sputum smear microscopy is the only method currently available for routine screening of pulmonary TB, although it only detects one in three cases among persons living with HIV (PLWH). Bleach treatment of sputum samples (bleach method) has been shown to significantly improve the sensitivity of the test; however, its effectiveness in PLWH remains to be determined in Laos.. To determine the performance of the bleach method as a diagnostic tool for pulmonary TB in PLWH and to assess its cost-effectiveness in Laos.. Of 174 sputum samples collected from 92 patients, 29 were culture-positive for Mycobacterium tuberculosis in 17 patients. The sensitivity of the direct method and the bleach method was respectively 59% and 93%, and specificity was 100% for both methods. The incremental cost-effectiveness ratio for screening an additional case was US$17.40.. The bleach method is simple, cheap, easy to perform and cost-effective in PLWH. Its implementation in laboratories involved in routine screening of pulmonary TB among PLWH would allow practitioners to start the treatment of this life-threatening co-infection earlier.

Topics: Adolescent; Adult; Aged; AIDS-Related Opportunistic Infections; Bacteriological Techniques; Bleaching Agents; Child; Coinfection; Cost-Benefit Analysis; Female; Health Care Costs; HIV Infections; Humans; Laos; Male; Microscopy; Middle Aged; Mycobacterium tuberculosis; Predictive Value of Tests; Prevalence; Prospective Studies; Sensitivity and Specificity; Sodium Hypochlorite; Specimen Handling; Sputum; Tuberculosis, Pulmonary; Young Adult

We describe the performance of bleach-digested Zeihl-Neelsen (ZN) smears in TB suspects with/without HIV. In total, 51 (26%) and 62 (31%) out of the first 198 spot and digested smears were positive. Seven of the 30 HIV-positive patients had TB and their ZN smears were negative, scanty or 1 +. Six of seven digested smears were scanty. Forty-two of 115 HIV-negative patients had TB. Eleven (26%) of their digested smears were negative, 12 (29%) scanty and 19 (45%) positive. Despite the lower bacilli numbers of HIV-positive patients, the technique had sensitivity and specificity similar to that in HIV-negative patients.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; AIDS-Related Opportunistic Infections; Cytological Techniques; Female; HIV Infections; Humans; Male; Microscopy; Middle Aged; Mycobacterium tuberculosis; Predictive Value of Tests; Sensitivity and Specificity; Sodium Hypochlorite; Specimen Handling; Sputum; Tuberculosis, Pulmonary