Preface

Chapter 7 **Neurological Manifestations of HIV 121**

**Comorbidity in Children 143**

Chapter 9 **Oral Neoplasms in HIV Positive Patient 159**

Chapter 10 **Latent Tuberculosis Infection: Patho-Biology and**

Chapter 11 **HIV-Associated Cardiovascular Disease 185** Hadil Saad and Ntobeko A.B. Ntusi

Chapter 12 **Artificial Epitope-Based Immunogens in HIV-Vaccine Design 205**

**Transmission of HIV 227**

Chapter 13 **Vaginal Formulations for Prevention of Sexual**

Yarovaya

**VI** Contents

**Treatment 169**

**Section 4 Drugs and Vaccines 203**

Girish Modi, Andre Mochan and Mala Modi

Chapter 8 **Clinical Presentation, Diagnosis and Management of TB-HIV**

Correia dos Santos and Rodolfo Georgevich Neto

Rajneesh Thakur and Vangal Krishnaswamy Sashindran

Elena Vasilyeva, Marina Lozovskaya, Lyudmila Klochkova and Yuliya

Kelly Cristine Tarquinio Marinho, Elcio Magdalena Giovani, Camila

Larisa I. Karpenko, Sergei I. Bazhan, Alexey M. Eroshkin, Denis V.

María-Dolores Veiga-Ochoa, Roberto Ruiz-Caro, Raúl Cazorla-Luna,

Antonets, Anton N. Chikaev and Alexander A. Ilyichev

Araceli Martín-Illana and Fernando Notario-Pérez

The HIV pandemic has had a profound impact on the health of individuals, families and communities at all levels. Over time considerable progress has been made in the fields of care and prevention to mitigate the medical and social consequences of the outbreak. ART has improved survival and the quality of life for patients. However the disease burden re‐ mains great especially in Sub-Saharan Africa. Medical advances have improved our under‐ standing of the infection leading to new strategies for elimination.

This book provides new perspectives and state of the art updates on various aspects of HIV infection and related disease. Several experts from many parts of the world and in different fields of science have contributed to the creation of this book.

The first section discusses the UNAIDS 90-90-90 strategy for the elimination of HIV by 2030. Challenges and barriers that must be addressed are identified. Gaps in quality of care, par‐ ticularly low adherence, are critically analyzed and useful recommendations for discordant couples are made. An interesting review is also made on brain aging in HIV-1 infection. The changes and mechanisms in neurophysiology, neurochemistry, brain structure and activa‐ tion networks are discussed in considerable detail.

The second section examines immune disorders in HIV and Hepatitis C co-infected patients and discusses understanding the nature of the immune system activation in HIV/HCV coinfection, which is important in predicting the development of non-AIDS-defining diseases.

The third section discusses updates on treatment and management. The implications of coinfection with tuberculosis, HBV, their impact on treatment and the associated increased vi‐ ral load replication are reviewed. Chapters on related oral neoplasms and neurological clinical manifestations of HIV are also discussed. Drug resistant bacteria in HIV patients are described and appropriate drugs updated. Discussion of the social construction of the HIV stigma in Sub-Saharan Africa and its impact is analyzed. Barriers are identified in relation to gender and demographic parameters and useful recommendations are proposed.

The fourth section examines artificial epitope based immunogens. The construction of syn‐ thetic polypeptide HIV-1 immunogens using wide range T- and B- cell epitopes of main vi‐ rus antigens is discussed. Promising designs for new HIV vaccines to overcome variability and reduce adverse outcomes are suggested. The chapter presents experience in the devel‐ opment of artificial polyepitope HIV-1 immunogens, which can induce both a humoral re‐ sponse, and responses of cytotoxic (CD8 + CTL) and helpers (CD4 + Th) T-cells. Some potential vaginal formulations vaccines for prevention of sexual HIV transmission are sug‐ gested. The approaches, efficacy and associated challenges are also discussed.

This book contains valuable knowledge and experiences from experts in various parts of the world. It contains useful reference material.

I thank the authors for their contributions. I also thank Kristina Jurdana, Author Service Manager for the invaluable support and assistance*.*

> **Dr Samuel Okware PhD** Director General Uganda National Health Research Organisation Entebbe, Uganda

**Epidemiology**

**Section 1**

**Section 1**
