Background: The aim of this study is to evaluate the influence of a possible polymorphism 108I mutation detected in a treatment-naive HIV-1-infected patient on the evolution of EFV resistance.
Methods: HIV-1 clinical isolate (KK141), carrying V/I mixture at position 108 in the RT region, was obtained from a treatment-naive patient. PBMCs were infected with KK141 in the presence of 0.01, μM EFV and cultured with 1.5- to 2-fold increasing concentrations of EFV. Emergence of resistance-associated mutations in escaped viruses was monitored by sequence analysis of the RT gene, and drug-susceptibility was determined by MAGIC5 assay.
Results: 108I mutants became predominant by week 3 with modest resistance to EFV, although no additional resistant-mutation was observed, and the virus replication was suppressed in further cultivation with increased concentrations of EFV. Interestingly, when the EFV-selected V108I variant was cultured in the absence of EFV for 4 more weeks, an A62V mutation emerged instead of a re-growth of 108V wild-type virus, and an additional mutation (K103N or V100I) emerged in the A62V/V108I variants when they were cultured with EFV again. On the other hand, when PBMCs were infected with KK141 in the absence of EFV and then cultured in the presence of EFV, highly-resistant variants harboring K103R/V179D/Y181C/Y188H mutations were induced only from the virus with 108V.
Conclusions: The pre-existing V108I mutation detected in a treatment-naive patient is not likely to lead the emergence of highly-resistant variants to EFV. However, the co-existence of A62V, associated with multi-nucleoside resistance, might increase the fitness of V108I variants under the pressure of EFV and enhance the development of resistance.

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Objective: This research aimed to describe the characteristics of HIV optimism, and to investigate whether HIV optimism (reduced concern about HIV and beliefs that HIV positive people with undetectable viral loads cannot pass on the virus) is associated with HIV risk behavior and psychological factors including self-esteem, loneliness, sexual sensation-seeking and sexual compulsivity.
Method: An anonymous self-administered questionnaire was conducted with gay and bisexual men in the Tokyo and Kanto area recruited using E-mail and face-to-face contact through snowball sampling using gay web portal sites, gay social groups and personal social contacts. The data of 94 (50.3%) men was used for analysis.
Result: The percentage of respondents reporting consistent condom usage was 52.6%. The sample of 31.9%-3.2% agreed with HIV optimism statements. HIV risk behavior tended to be associated with higher HIV optimism. High optimism was associated with higher sexual sensation-seeking, and tended to be associated with higher sexualcompulsivity. Moreover, ANOVA indicated an interaction between HIV optimism and HIV risk behavior on self-esteem.
Conclusion: The results indicate an association between reduced HIV concern and HIV risk behavior among Japanese gay and bisexual men of this sample. Moreover, HIVoptimism is associated with psychological factors. However, these results should not be generalized because of sampling bias. This study suggests that HIV prevention interventions among gay and bisexual men should take into account HIV optimism and the need for psychological support. In order to clarify the psychological support for gay and bisexual men, further research on HIV optimism is needed.

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Objective: We report a surgical case of Cytomegalovirus (CMV)-induced ischemic colitis in a patient with acquired immunodeficiency syndrome (AIDS).
Case Report: A 57-year-old woman was referred to another hospital for poor eyesight in March 2007. She was diagnosed as having multiple sclerosis and was treated with systemic prednisolone. Two weeks later, she had sudden abdominal pain and hematochezia and was admitted to another emergency hospital. Because her laboratory data and results ofcolon endoscopy suggested widespread necrosis of colon, she underwent an abdominal operation. A pathological specimen showed acute vasculitic change and a thrombus in a submucosal vein and there were endothelial cells with intranuclear inclusions typical of CMV infection. We comfirmed the diagnosis of CMV-induced ischemic colitis. HIV antibody, which was analyzed after informed consent had been obtained, was positive.
Conclusion: CMV colitis is a frequent and severe complication in patients with AIDS. However, CMV-induced ischemic colitis is rare. Patients with CMV colitis complain of abdominal pain, diarrhea and hematochezia, which are usually caused by gastrointestinal inflammation or ulceration. CMV-induced ischemic colitis is often fatal.

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Objective: To measure the effects of attendance and treatment of HIV/AIDS patients at outpatient department on clinical, laboratory results, and sexual behavior.
Subjects and Methods: A study was conducted through a questionnaire and review of medical records for HIV/AIDS patients attending outpatient departments in three hospitals in Osaka City in 2005-2006.
Results: (1) Conditions at HIV Testing upon Diagnosis and Sexual Behavior
127HIV/AIDS patients in 3 hospitals replied to the questionnaire. 97.6% of them were male. Most (85.1%) of the residents in Osaka City attended health facility for HIV test within the city. 93.5% of 123 persons visited medical facilities within one month after HIV positive results were given. 81.5% of persons diagnosed at medical facilities “visited” medical facilities in a week for further examination and treatment, while 48.4% of persons diagnosed at city and ward public health offices did so in a week. 77% of them reduced risky sexual behavior in the past 6 months compared with the period prior to HIV positive results being known. In particular, 80.6% of persons diagnosed at city and ward public health offices reduced risky sexual behavior. It was more than that (65.6%) of persons diagnosed at medical facilities. The difference is statistically significant (x² test, p< 0.05).
(2) The effects of treatment on symptoms and laboratory tests 59 HIV/AIDS patients in 3 hospitals agreed to examination of their medical charts. 18.5% of them experienced default to attend the outpatient department on their scheduled dates in 2005-2006.35 received HAART and only one patient (2.9%) stopped treatment for more than 2 months. Symptoms improved or have not changed in 88.2% and viral load & CD4 count improved or have not changed in 81.3% of patients.
Conclusion: As most of the HIV/AIDS patients who regularly receive medical consultation and treatment improved symptoms and laboratory results, efforts on early case finding and early treatment would lead to reduction of HIV infection in future. Therefore it is important to increase opportunity further for HIV testing.

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Objective: Increased use of HIV screening is being promoted as a means of checking the increase in HIV infection, but screening is not yet sufficiently widespread. Although some prior research concerning HIV testing investigated motivations among individuals undergoing testing and test structures, investigation of conditions among ordinary groups is inadequate. The current research was conducted to determine awareness and usage of HIV testing among youth.
Method: The research was conducted in June and July 2007 with 271 male and female students enrolled at five universities in Tokyo suburbs as the subjects. The analysis was conducted on the 233 subjects who provided adequate responses. The survey subjects were requested to access and respond to a Web survey questionnaire. The survey itemsused a scale developed by Misovich, S.J.
Results: Approximately 70% of the subjects believe that an HIV test can be conducted when donating blood. Approximately 40% of the subjects do not fully understand that there is a period before infection can be detected by an HIV test. About 75 % of boththe male and female subjects were able to correctly identify locations where HIV testing is performed. Of the subjects, 3.5% have undergone HIV testing.
Conclusions: This research revealed that many individuals incorrectly believe that HIV testing can be performed when donating blood, suggesting that the provision of accurate information and additional measures that will lead to testing are needed.

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