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Sample records for immunodeficiency virus hiv-infected

  1. Frailty in people aging with human immunodeficiency virus (HIV) infection.

    PubMed

    Brothers, Thomas D; Kirkland, Susan; Guaraldi, Giovanni; Falutz, Julian; Theou, Olga; Johnston, B Lynn; Rockwood, Kenneth

    2014-10-15

    The increasing life spans of people infected with human immunodeficiency virus (HIV) reflect enormous treatment successes and present new challenges related to aging. Even with suppression of viral loads and immune reconstitution, HIV-positive individuals exhibit excess vulnerability to multiple health problems that are not AIDS-defining. With the accumulation of multiple health problems, it is likely that many people aging with treated HIV infection may be identified as frail. Studies of frailty in people with HIV are currently limited but suggest that frailty might be feasible and useful as an integrative marker of multisystem vulnerability, for organizing care and for comprehensively measuring the impact of illness and treatment on overall health status. This review explains how frailty has been conceptualized and measured in the general population, critically reviews emerging data on frailty in people with HIV infection, and explores how the concept of frailty might inform HIV research and care. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  2. Risk factors for human immunodeficiency virus (HIV) infections in homosexual men.

    PubMed Central

    Darrow, W W; Echenberg, D F; Jaffe, H W; O'Malley, P M; Byers, R H; Getchell, J P; Curran, J W

    1987-01-01

    To clarify risk factors for infection with the human immunodeficiency virus (HIV) we selected at random 785 homosexual men who had participated in studies of hepatitis B in San Francisco in 1978-80 for a follow-up study of the acquired immunodeficiency syndrome. Although most had not been contacted in over five years, 492 (63 per cent) were located and enrolled. The 240 (67 per cent) who had developed antibodies to HIV, as measured by an enzyme-linked immunosorbent assay (ELISA), were compared with 119 who had remained seronegative. In multivariate analyses, receptive anal intercourse with ejaculation by nonsteady sexual partners, many sexual partners per month, and other indicators of high levels of sexual activity were highly associated with seroconversions. None of the sexual practices that we studied appeared to offer protection against HIV infection. PMID:3030146

  3. Social interventions in the care of human immunodeficiency virus (HIV)-infected pregnant women.

    PubMed

    Levine, C; Allen, M H

    1995-08-01

    The incidence of infection with the human immunodeficiency virus (HIV) is increasing among women of childbearing age. Women now account for 18% of the total number of cases of the acquired immunodeficiency syndrome (AIDS), compared with 9% a decade ago. The medical care of pregnant HIV-infected women must take into account the high prevalence of substance abuse, preceded and often accompanied by significant levels of physical, emotional, and sexual trauma, and the concomitant stigmatization of these women in their families and communities. Pregnancy is often a time when women are motivated to make major positive behavioral and life-style changes. To do this, they need ongoing, multidisciplinary counseling and support, with recognition that progress may be intermittent and slow. The Special Prenatal Care Program at Bellevue Hospital is described to show the level of resource commitment that is needed as well as the nearly universal acceptance of voluntary HIV counseling and testing in these conditions. Trends in permanency planning for the children of HIV-infected women are described. Future research needs are outlined, including female-specific drug treatment and more effective contraceptive technology for both men and women.

  4. Physician breach of patient confidentiality among individuals with human immunodeficiency virus (HIV) infection: patterns of decision.

    PubMed Central

    Schwartzbaum, J A; Wheat, J R; Norton, R W

    1990-01-01

    To determine whether the sex, race, or sexual preference of a patient infected with immunodeficiency virus (HIV) influences a physician's decision to breach patient confidentiality, Tennessee primary care physicians were mailed a questionnaire containing a case study in which an HIV-infected patient presented a risk to a third party. Eight different descriptions of the sex, race, and sexual preference of the hypothetical patient were distributed randomly among the physicians, one description to each physician. The physicians were asked to decide whether to maintain confidentiality, notify the health department, or inform the patient's partner. Responses of 199 White male physicians were analyzed using an unconditional saturated logistic regression model. The odds ratios for these physicians saying they would send the patient's antibody status to the health department extend from 18.4 (95 percent confidence interval: 1.3, 260.1) for Black homosexual males to .5 (95 percent CI: 0, 11.5) for White homosexual females. The odds ratios for White male physicians saying they would inform the patient's partner range from 7.5 (95 percent CI: .8, 69.2) for Black heterosexual males to 1.0 (reference category) for Black homosexual females. The results suggest that when physicians decide to protect a third party by breaching an HIV-infected patient's confidentiality, their decision may be influenced in some cases by the race, sex, and sexual preference of the patient. PMID:2356907

  5. Occupational exposure to human immunodeficiency virus (HIV)-infected blood in Denver, Colorado, police officers.

    PubMed

    Hoffman, R E; Henderson, N; O'Keefe, K; Wood, R C

    1994-05-01

    The authors undertook a study of Denver, Colorado, police department officers to measure their risk of exposure to blood and human immunodeficiency virus (HIV) by type of work assignment and to document how exposures occurred. From December 1989 through March 1991, 137 officers reported an exposure to either blood or saliva, and 42 exposures to blood were independently documented. The overall rate of exposure to HIV-infected blood for medium and high risk assignments was 0.10 per 10,000 person-days. Thirty-two source persons underwent voluntary testing for HIV antibodies, and five (15.6%) were seropositive. Two thirds of the 42 blood exposures occurred in circumstances in which 1) there was little or no time for the officer to put on protective gloves and clothing because the officer was restraining or being assaulted by a suspect or 2) gloves would have not been protective because of penetration by needles. The authors conclude that Denver police officers rarely have percutaneous or mucosal exposures to blood, but when they do, the risk of exposure to HIV-infected blood is quite high. A health department can provide to police officers a number of services: evaluation of an incident involving contact with blood or body fluids to determine whether there was potential for disease transmission; information about modes of transmission and prevention of bloodborne diseases; serologic testing of source persons; HIV counseling for exposed officers and source persons; documentation for worker's compensation claims; and consultation regarding the use of zidovudine for postexposure prophylaxis.

  6. [HIV infection and acquired immunodeficiency syndrome].

    PubMed

    Takamatsu, J

    1997-05-01

    On June 4, 1981, MMWR published a report about Pneumocystis carinii pneumonia in homosexual men in Los Angeles. This was the first published report. A years later, this disease was named acquired immunodeficiency syndrome (AIDS). In the following year, Montangier et al in France discovered the causative agent, which they called lymphadenopathy virus (LAV), now known as human immunodeficiency virus (HIV). In 1985, solid-phase enzymeimmunoassay for the detection of the antibody to HIV was developed. Since then, other new techniques for the identification of HIV infection have been become available. These include more sensitive methods (for example; polymerase chain reaction techniques). Although these techniques facilitate early and definite diagnosis of infection, these tests may fail to detect the antibody in sera during window period of infection or overdiagnose infection in sera contaminated with genes not related to HIV. Although preventing blood exposure is the primary means of preventing occupationally acquired human immunodeficiency virus (HIV) infection, appropriate post-exposure management is an important element of workplace safety. Information suggesting that zidovudine (ZDV) postexposure prophylaxis (PEP) may reduce the risk for HIV transmission after occupational exposure to HIV infected blood prompted a Public Health Service (PHS) interagency working group, with expert consultation, and recommendations on PEP and management of occupational exposure to HIV in relation to these findings were discussed.

  7. Intestinal Damage and Inflammatory Biomarkers in Human Immunodeficiency Virus (HIV)-Exposed and HIV-Infected Zimbabwean Infants.

    PubMed

    Prendergast, Andrew J; Chasekwa, Bernard; Rukobo, Sandra; Govha, Margaret; Mutasa, Kuda; Ntozini, Robert; Humphrey, Jean H

    2017-09-15

    Disease progression is rapid in human immunodeficiency virus (HIV)-infected infants. Whether intestinal damage and inflammation underlie mortality is unknown. We measured plasma intestinal fatty acid binding protein (I-FABP), soluble CD14 (sCD14), interleukin 6 (IL-6), and C-reactive protein (CRP) at 6 weeks and 6 months of age in 272 HIV-infected infants who either died (cases) or survived (controls), and in 194 HIV-exposed uninfected (HEU) and 197 HIV-unexposed infants. We estimated multivariable odds ratios for mortality and postnatal HIV transmission for each biomarker using logistic regression. At 6 weeks, HIV-infected infants had higher sCD14 and IL-6 but lower I-FABP than HIV-exposed and HIV-unexposed infants (P < .001). CRP was higher in HIV-exposed than HIV-unexposed infants (P = .02). At 6 months, HIV-infected infants had highest sCD14, IL-6, and CRP concentrations (P < .001) and marginally higher I-FABP than other groups (P = .07). CRP remained higher in HIV-exposed vs HIV-unexposed infants (P = .04). No biomarker was associated with mortality in HIV-infected infants, or with odds of breast-milk HIV transmission in HIV-exposed infants. HIV-infected infants have elevated inflammatory markers by 6 weeks of age, which increase over time. In contrast to adults and older children, inflammatory biomarkers were not associated with mortality. HEU infants have higher inflammation than HIV-unexposed infants until at least 6 months, which may contribute to poor health outcomes.

  8. Upregulation of human immunodeficiency virus (HIV) replication by CD4 cross-linking in peripheral blood mononuclear cells of HIV-infected adults.

    PubMed Central

    Than, S; Oyaizu, N; Tetali, S; Romano, J; Kaplan, M; Pahwa, S

    1997-01-01

    This study was conducted with peripheral blood mononuclear cells from 67 human immunodeficiency virus (HIV)-infected adults. It supports the hypothesis that cross-linking of CD4 molecules by HIV gp120 can result in HIV upregulation and spread of infection. Underlying mechanisms include activation of latent infection by factors in addition to, or other than, tumor necrosis factor alpha. PMID:9223523

  9. Upregulation of human immunodeficiency virus (HIV) replication by CD4 cross-linking in peripheral blood mononuclear cells of HIV-infected adults.

    PubMed

    Than, S; Oyaizu, N; Tetali, S; Romano, J; Kaplan, M; Pahwa, S

    1997-08-01

    This study was conducted with peripheral blood mononuclear cells from 67 human immunodeficiency virus (HIV)-infected adults. It supports the hypothesis that cross-linking of CD4 molecules by HIV gp120 can result in HIV upregulation and spread of infection. Underlying mechanisms include activation of latent infection by factors in addition to, or other than, tumor necrosis factor alpha.

  10. A Case of Long-Term Seronegative Human Immunodeficiency Virus (HIV) Infection: The Importance of the Humoral Response to HIV

    PubMed Central

    Siemieniuk, Reed A. C.; van der Meer, Frank; van Marle, Guido; Gill, M. John

    2016-01-01

    Background. Seronegative human immunodeficiency virus (HIV) infections are exceedingly rare but might inform HIV-host physiology. Methods. We investigate the cause and consequences of a patient infected with HIV who did not mount a humoral response to HIV for 4 years. Results. The patient was confirmed HIV-uninfected by nucleic acid testing 4 months before rapidly progressing to acquired immune deficiency syndrome. The patient's humoral deficit was specific to HIV: he mounted robust humoral responses to all challenge vaccines including influenza A(H1N1)pdm09 and all T cell-dependent and -independent serotypes in the 23-valent pneumococcal polysaccharide vaccine. The virus had similar gp120 antigenicity to HIV-positive control serum as NL4-3 and YU2 prototype strains. Two human leukocyte antigen alleles associated with rapid progression were identified (B*08 and B*35), and a cytotoxic T-lymphocyte epitope site variant was noted: E277K. Viral decay (t1/2 ≈ 39 weeks) suggested that relatively long-lived cells were the source of ongoing viremia. Human immunodeficiency virus viremia was not suppressed until after the patient developed a humoral immune response, despite therapeutic antiretroviral levels. No resistance was detected by virtual phenotyping of virus obtained from serum or from gastrointestinal biopsies despite considerable antiretroviral selection pressure. Conclusions. Ineffective antibody production may be associated with a subgroup of extremely rapid HIV progressors. Although antiretroviral therapy may be sufficient to slow propagation of infection, it appears to be ineffective for HIV viral clearance in the absence of a humoral response. PMID:26858962

  11. Human Immunodeficiency Virus (HIV) Infections; Strain and Type Variations; Diagnosis and Prevention.

    DTIC Science & Technology

    1992-10-26

    Thorstensson, R, Chiodi , F, and Norrby, E: Hyperimmune antisera against synthetic peptides representing the glycoprotein of human immunodeficiency virus...Syndr, 5:177-187, 1992. 19. Barbas III, C F, Bj6rling E, Chiodi , F, Dunlop, N, Cababa, D, Jones T M, Zebedee, S L, Persson, M A A, Nara, P L, Norrby E...20. Chiodi , F, Keys, B, Albert, J, Hagberg, L, Lundeberg, J, Uhldn M, Feny6, E M, and Norkrans, G. HIV-1 is present in the cerebrospinal fluid of the

  12. Human Immunodeficiency Virus (HIV) Infections: Strain and Type Variations; Diagnosis and Prevention

    DTIC Science & Technology

    1991-04-30

    severity of HIV infection. The Lancet ii:660-662. 2. Feny6, E.M., Morfeldt-Minson, L., Chiodi , F., Lind, B., von Gegerfelt, A., Albert, J., Olausson...site-directed serology for HIV infections. AIDS Res. and Human Retroviruses 5:487-493. 20. Albert, J., Bredberg, U., Chiodi , F., Bbttiger, B., Feny6, E.M...Nystr6m, G., Pehrson, P.O., Chiodi , F., von Sydow, M., Moberg, L., Lidman, K., Christensson, B., Asj6, B. and Fenyd, E.M. (1987). Isolation of human

  13. Human immunodeficiency virus (HIV) infection, sexually transmitted diseases and HIV-antibody testing practices in Belgian prostitutes.

    PubMed Central

    Mak, R; Plum, J; Van Renterghem, L

    1990-01-01

    From December 1988 to April 1989, 154 female prostitutes in and around Ghent, Belgium, were interviewed about their knowledge, attitudes and practices in relation to the risks for sexually transmitted diseases (STD) and human immunodeficiency virus (HIV) infection in their profession. Thirty four women worked as window prostitutes, 120 picked up their clients in bars, clubs, and saunas. Blood samples were taken from 123 women. One (0.8%) was seropositive for HIV1, 19 (15.4%) had Hepatitis B core antibodies (anti-HBc), eight (6.4%) showed markers of syphilis. None of them were Hepatitis B surface antigen (HBsAg) carriers. Hepatitis C antibodies (anti-HCV) were present in the serum of three women (2.4%). Overall STD seroprevalence was higher in the group of window prostitutes than in the group of club prostitutes. One woman admitted intravenous drug use. Former testing for anti-HIV antibodies had been performed in 102 (66.5%) respondents, of whom 84 (82.3%) were tested in the year preceding the interview. In 74.5% of the cases, these tests were requested by the women themselves. These results suggest that HIV infection is not yet prevalent in non-intravenous drug using prostitutes in Ghent, but that this situation may change considering their higher rates of past STD. Window prostitutes are at higher risk than club prostitutes. Testing for HIV seems to be common practice, mostly at the request of the women themselves. Health education should discourage the notion of testing as an alternative to using condoms. PMID:2245981

  14. Noncirrhotic portal hypertension in a human immunodeficiency virus (HIV) infected adolescent

    PubMed Central

    Gouvêa, Aída de Fátima Thomé Barbosa; Machado, Daisy Maria; Beltrão, Suênia Cordeiro de Vasconcelos; do Carmo, Fabiana Bononi; Mattar, Regina Helena Guedes Motta; Succi, Regina Célia de Menezes

    2015-01-01

    OBJECTIVE: To alert the pediatrician who is following up HIV-infected patients about the possibility of non-cirrhotic portal hypertension (NCPH) in this period of life, in order to avoid the catastrophic consequences of this disease as bleeding esophageal varices. CASE DESCRIPTION: A 13 years old HIV-infected patient by vertical route was receiving didanosine (ddI) for 12 years. Although the HIV viral load had been undetectable for 12 years, this patient showed gradual decrease of CD4+ T cells, prolonged thrombocytopenia and high alkaline phosphatase. Physical examination detected splenomegaly, which triggered the investigation that led to the diagnosis of severe liver fibrosis by transient elastography, probably due to hepatic toxicity by prolonged use of ddI. COMMENTS: This is the first case of NCPH in HIV-infected adolescent described in Brazil. Although, the NCPH is a rare disease entity in seropositive patients in the pediatric age group, it should be investigated in patients on long-term ddI or presenting clinical and laboratories indicators of portal hypertension, as splenomegaly, thrombocytopenia and increased alkaline phosphatase. PMID:25913495

  15. Plant-derived leading compounds for chemotherapy of human immunodeficiency virus (HIV) infection.

    PubMed

    Vlietinck, A J; De Bruyne, T; Apers, S; Pieters, L A

    1998-03-01

    Many compounds of plant origin have been identified that inhibit different stages in the replication cycle of human immunodeficiency virus (HIV): 1) virus adsorption: chromone alkaloids (schumannificine), isoquinoline alkaloids (michellamines), sulphated polysaccharides and polyphenolics, flavonoids, coumarins (glycocoumarin, licopyranocoumarin) phenolics (caffeic acid derivatives, galloyl acid derivatives, catechinic acid derivatives), tannins and triterpenes (glycyrrhizin and analogues, soyasaponin and analogues); 2) virus-cell fusion: lectins (mannose- and N-acetylglucosamine-specific) and triterpenes (betulinic acid and analogues); 3) reverse transcription; alkaloids (benzophenanthridines, protoberberines, isoquinolines, quinolines), coumarins (calanolides and analogues), flavonoids, phloroglucinols, lactones (protolichesterinic acid), tannins, iridoids (fulvoplumierin) and triterpenes; 4) integration: coumarins (3-substituted-4-hydroxycoumarins), depsidones, O-caffeoyl derivatives, lignans (arctigenin and analogues) and phenolics (curcumin); 5) translation: single chain ribosome inactivating proteins (SCRIP's); 6) proteolytic cleavage (protease inhibition): saponins (ursolic and maslinic acids), xanthones (mangostin and analogues) and coumarins; 7) glycosylation: alkaloids including indolizidines (castanospermine and analogues), piperidines (1-deoxynojirimicin and analogues) and pyrrolizidines (australine and analogues); 8) assembly/release: naphthodianthrones (hypericin and pseudohypericin), photosensitisers (terthiophenes and furoisocoumarins) and phospholipids. The target of action of several anti-HIV substances including alkaloids (O-demethyl-buchenavianine, papaverine), polysaccharides (acemannan), lignans (intheriotherins, schisantherin), phenolics (gossypol, lignins, catechol dimers such as peltatols, naphthoquinones such as conocurvone) and saponins (celasdin B, Gleditsia and Gymnocladus saponins), has not been elucidated or does not fit in the

  16. Psychosocial aspects of human immunodeficiency virus (HIV) infection in a pre-HAART sample.

    PubMed

    Skydsbjerg, M; Lunn, S; Hutchings, B

    2001-09-01

    The psychosocial consequences of HLV-infection were studied using a semi-structured interview and the psychiatric questionnaire SCL-90-R, in 3 matched groups of homosexual men: 20 patients with Aids, 20 asymptomatic HIV-infected and 20 non-infected controls. The data was collected before the HAART (Highly Active Anti-retroviral Therapy) era. The results showed that the infected subjects more often concealed their homosexuality, engaged in more risky sexual behavior and were less inclined to regard AIDS as a serious problem. The infected subjects also revealed more psychopathology on 5 of the 9 indexes on the SCL-90. Across all 3 groups, contact ability was correlated to being open about homosexuality and to psychological well-being. These results indicate that HIV has considerable impact on psychological well-being among the infected and point to the need for health-care workers to be especially attentive to those HIV-infected who have difficulty in talking to others about their situation.

  17. Alcohol Use and Human Immunodeficiency Virus (HIV) Infection: Current Knowledge, Implications, and Future Directions

    PubMed Central

    Williams, Emily C.; Hahn, Judith A.; Saitz, Richard; Bryant, Kendall; Lira, Marlene C.; Samet, Jeffrey H.

    2016-01-01

    Alcohol use is common among people living with human immunodeficiency virus (HIV). In this narrative review, we describe literature regarding alcohol’s impact on transmission, care, co-infections and comorbidities that are common among people living with HIV (PLWH), as well as literature regarding interventions to address alcohol use and its influences among PLWH. This narrative review identifies alcohol use as a risk factor for HIV transmission, as well as a factor impacting the clinical manifestations and management of HIV. Alcohol use appears to have additive and potentially synergistic effects on common HIV-related comorbidities. We find that interventions to modify drinking and improve HIV-related risks and outcomes have had limited success to date, and we recommend research in several areas. Consistent with Office of AIDS Research/National Institutes of Health priorities, we suggest research to better understand how and at what levels alcohol influences comorbid conditions among PLWH, to elucidate the mechanisms by which alcohol use is impacting comorbidities, and to understand whether decreases in alcohol use improve HIV-relevant outcomes. This should include studies regarding whether state-of-the-art medications used to treat common co-infections are safe for PLWH who drink alcohol. We recommend that future research among PLWH include validated self-report measures of alcohol use and/or biological measurements, ideally both. Additionally, subgroup variation in associations should be identified to ensure that the risks of particularly vulnerable populations are understood. This body of research should serve as a foundation for a next generation of intervention studies to address alcohol use from transmission to treatment of HIV. Intervention studies should inform implementation efforts to improve provision of alcohol-related interventions and treatments for PLWH in healthcare settings. By making further progress on understanding how alcohol use affects

  18. Epstein-Barr virus and human immunodeficiency virus serological responses and viral burdens in HIV-infected patients treated with HAART

    NASA Technical Reports Server (NTRS)

    O'Sullivan, Cathal E.; Peng, RongSheng; Cole, Kelly Stefano; Montelaro, Ronald C.; Sturgeon, Timothy; Jenson, Hal B.; Ling, Paul D.; Butel, J. S. (Principal Investigator)

    2002-01-01

    Epstein-Barr virus (EBV) associated non-Hodgkin lymphoma is recognized as a complication of human immunodeficiency virus (HIV) infection. Little is known regarding the influence of highly active antiretroviral therapy (HAART) on the biology of EBV in this population. To characterize the EBV- and HIV-specific serological responses together with EBV DNA levels in a cohort of HIV-infected adults treated with HAART, a study was conducted to compare EBV and HIV serologies and EBV DNA copy number (DNAemia) over a 12-month period after the commencement of HAART. All patients were seropositive for EBV at baseline. Approximately 50% of patients had detectable EBV DNA at baseline, and 27/30 had detectable EBV DNA at some point over the follow-up period of 1 year. Changes in EBV DNA copy number over time for any individual were unpredictable. Significant increases in the levels of Epstein-Barr nuclear antigen (EBNA) and Epstein-Barr early antigen (EA) antibodies were demonstrated in the 17 patients who had a good response to HAART. Of 29 patients with paired samples tested, four-fold or greater increases in titers were detected for EA in 12/29 (41%), for EBNA in 7/29 (24%), for VCA-IgG in 4/29 (14%); four-fold decreases in titers were detected in 2/29 (7%) for EA and 12/29 (41%) for EBNA. A significant decline in the titer of anti-HIV antibodies was also demonstrated. It was concluded that patients with advanced HIV infection who respond to HAART have an increase in their EBV specific antibodies and a decrease in their HIV-specific antibodies. For the cohort overall, there was a transient increase in EBV DNA levels that had declined by 12 months. Copyright 2002 Wiley-Liss, Inc.

  19. Epstein-Barr virus and human immunodeficiency virus serological responses and viral burdens in HIV-infected patients treated with HAART

    NASA Technical Reports Server (NTRS)

    O'Sullivan, Cathal E.; Peng, RongSheng; Cole, Kelly Stefano; Montelaro, Ronald C.; Sturgeon, Timothy; Jenson, Hal B.; Ling, Paul D.; Butel, J. S. (Principal Investigator)

    2002-01-01

    Epstein-Barr virus (EBV) associated non-Hodgkin lymphoma is recognized as a complication of human immunodeficiency virus (HIV) infection. Little is known regarding the influence of highly active antiretroviral therapy (HAART) on the biology of EBV in this population. To characterize the EBV- and HIV-specific serological responses together with EBV DNA levels in a cohort of HIV-infected adults treated with HAART, a study was conducted to compare EBV and HIV serologies and EBV DNA copy number (DNAemia) over a 12-month period after the commencement of HAART. All patients were seropositive for EBV at baseline. Approximately 50% of patients had detectable EBV DNA at baseline, and 27/30 had detectable EBV DNA at some point over the follow-up period of 1 year. Changes in EBV DNA copy number over time for any individual were unpredictable. Significant increases in the levels of Epstein-Barr nuclear antigen (EBNA) and Epstein-Barr early antigen (EA) antibodies were demonstrated in the 17 patients who had a good response to HAART. Of 29 patients with paired samples tested, four-fold or greater increases in titers were detected for EA in 12/29 (41%), for EBNA in 7/29 (24%), for VCA-IgG in 4/29 (14%); four-fold decreases in titers were detected in 2/29 (7%) for EA and 12/29 (41%) for EBNA. A significant decline in the titer of anti-HIV antibodies was also demonstrated. It was concluded that patients with advanced HIV infection who respond to HAART have an increase in their EBV specific antibodies and a decrease in their HIV-specific antibodies. For the cohort overall, there was a transient increase in EBV DNA levels that had declined by 12 months. Copyright 2002 Wiley-Liss, Inc.

  20. Factors associated with incarceration and incident human immunodeficiency virus (HIV) infection among injection drug users participating in an HIV vaccine trial in Bangkok, Thailand, 1999-2003.

    PubMed

    Suntharasamai, Pravan; Martin, Michael; Vanichseni, Suphak; van Griensven, Frits; Mock, Philip A; Pitisuttithum, Punnee; Tappero, Jordan W; Sangkum, Udomsak; Kitayaporn, Dwip; Gurwith, Marc; Choopanya, Kachit

    2009-02-01

    To determine if incarceration was associated with human immunodeficiency virus (HIV) infection and identify risk factors for incarceration among injection drug users (IDUs) participating in an HIV vaccine trial in Bangkok. The AIDSVAX B/E HIV vaccine trial was a randomized, double-blind, placebo-controlled study. A proportional hazards model was used to evaluate demographic characteristics, risk behavior and incarceration as predictors of HIV infection and generalized estimation equation logistic regression analysis to investigate demographic characteristics and risk behaviors for predictors of incarceration. The trial was conducted in Bangkok Metropolitan Administration drug-treatment clinics, 1999-2003. A total of 2546 HIV-uninfected IDUs enrolled in the trial. HIV testing was performed and an interviewer-administered questionnaire was used to assess risk behavior and incarceration at baseline and every 6 months for a total of 36 months. HIV incidence was 3.4 per 100 person-years [95% confidence interval (CI), 3.0-3.9] and did not differ among vaccine and placebo recipients. In multivariable analysis, being in jail (P < 0.04), injecting (P < 0.0001), injecting daily (P < 0.0001) and sharing needles (P = 0.02) were associated with HIV infection and methadone maintenance was protective (P = 0.0006). Predictors of incarceration in multivariable analysis included: male sex (P = 0.04), younger age (P < 0.0001), less education (P = 0.001) and being in jail (P < 0.0001) or prison (P < 0.0001) before enrollment. Among IDUs in the AIDSVAX B/E trial, incarceration in jail was associated with incident HIV infection. IDUs in Thailand remain at high risk of HIV infection and additional prevention tools are needed urgently. HIV prevention services, including methadone, should be made available to IDUs.

  1. Revised Medical Criteria for Evaluating Human Immunodeficiency Virus (HIV) Infection and for Evaluating Functional Limitations in Immune System Disorders. Final rule.

    PubMed

    2016-12-02

    We are revising the criteria in the Listing of Impairments (listings) that we use to evaluate claims involving human immunodeficiency virus (HIV) infection in adults and children under titles II and XVI of the Social Security Act (Act). We also are revising the introductory text of the listings that we use to evaluate functional limitations resulting from immune system disorders. The revisions reflect our program experience, advances in medical knowledge, our adjudicative experience, recommendations from a commissioned report, and comments from medical experts and the public.

  2. [Analysis of p22-phox and p47-phox subcellular localization and distribution in neutrophils from human immunodeficiency virus (HIV) infected patients].

    PubMed

    Salmen, Siham; Montilla, Daniela; London, Maryuri; Velázquez, Dánely; Berrueta, Lisbeth

    2012-01-01

    During human immunodeficiency virus (HIV) infection a dysfunction of polymorphonuclear (PMN) cells has been described including a progressively altered superoxide production as disease progression. The NADPH oxidase has been described as a major source of superoxide. The neutrophil NADPH oxidase comprises a plasma membrane-bound cytochrome b558 (which is a heterodimer of one p22-phox and one gp91-phox subunit) and cytosolic subunits, namely p47-phox, p67-phox and p40-phox. During neutrophil activation in response to various agonists, the cytosolic subunits translocate to and associate with the cytochrome b558, a process that results in oxidase activation. Therefore, an altered superoxide production could be a consequence of abnormal distribution or translocation of NADPH oxidase components in response to HIV infection. We used several strategies including: confocal microscopy, subcellular fractionation and sucrose gradients, to analyze the cellular distribution of two of the NADPH oxidase components (p22-phox and p47-phox). We observed that in resting cells, a substantial proportion of p22-phox from HIV positive patients is distributed in regions close to the cytoplasmic membrane, sediment in high density sucrose fractions and is located in the cytoplasmic insoluble fraction. Additionally, a diffuse cytosolic distribution of p47-phox was observed in neutrophils from HIV infected patients. The results demonstrate an inappropriate cell distribution of NADPH-complex in PMN from HIV positive patients.

  3. Medical examination of aliens--removal of human immunodeficiency virus (HIV) infection from definition of communicable disease of public health significance. Final rule.

    PubMed

    2009-11-02

    Through this final rule, the Centers for Disease Control and Prevention (CDC), within the U.S. Department of Health and Human Services (HHS), is amending its regulations to remove "Human Immunodeficiency Virus (HIV) infection" from the definition of communicable disease of public health significance and remove references to "HIV" from the scope of examinations for aliens. Prior to this final rule, aliens with HIV infection were considered to have a communicable disease of public health significance and were thus inadmissible to the United States per the Immigration and Nationality Act (INA). While HIV infection is a serious health condition, it is not a communicable disease that is a significant public health risk for introduction, transmission, and spread to the U.S. population through casual contact. As a result of this final rule, aliens will no longer be inadmissible into the United States based solely on the ground they are infected with HIV, and they will not be required to undergo HIV testing as part of the required medical examination for U.S. immigration.

  4. Escalating morphine exposures followed by withdrawal in feline immunodeficiency virus-infected cats: a model for HIV infection in chronic opiate abusers.

    PubMed

    Barr, Margaret C; Huitron-Resendiz, Salvador; Sanchez-Alavez, Manuel; Henriksen, Steven J; Phillips, Tom R

    2003-11-24

    Opiate abuse is a risk factor for human immunodeficiency virus (HIV) infection. Because the direct effects of opiates on HIV infection are difficult to determine epidemiologically, animal models of lentivirus infection are relied upon to study the effects of opiates in the absence of confounding factors. Morphine, the predominant metabolite of heroin, is used in most experimental systems examining heroin abuse. In this study, morphine treatment of feline immunodeficiency virus (FIV)-infected cats modeled a typical pattern of escalating drug use interspersed with withdrawals. Plasma cortisol levels were measured for evidence of stress associated with morphine withdrawal. In the morphine-treated cats, cortisol levels peaked at time points corresponding to morphine withdrawal and returned to baseline levels during treatment and several weeks after the final withdrawal. Morphine-treated cats displayed clear behavioral and physical signs of opiate exposure and evidence of withdrawal when the drug was stopped. Morphine-exposed cats did not experience enhanced severity of FIV-related disease; in fact, morphine demonstrated a protective effect on FIV-associated changes in brainstem auditory evoked potentials. Our research suggests that opiate exposure is unlikely to adversely affect the progression of acute lentivirus infection and might be beneficial in controlling associated neurological disease.

  5. Antibody testing and counseling of dental patients at risk for human immunodeficiency virus (HIV) infection and associated clinical findings.

    PubMed

    Murrah, V A; Scholtes, G A

    1988-10-01

    Two hundred six dental patients were tested between 1985 and 1987 for antibodies to human immunodeficiency virus (HIV) when a review of their medical histories revealed a high risk for infection. Serologic results are correlated with soft tissue and osseous findings recorded during routine head and neck and radiographic examination. Counseling recommendations for use in association with testing are outlined. A more active role for the dentist as a preventive agent is advocated to combat the spread of acquired immunodeficiency syndrome (AIDS).

  6. Human immunodeficiency virus (HIV) nef-specific cytotoxic T lymphocytes in noninfected heterosexual contact of HIV-infected patients.

    PubMed Central

    Langlade-Demoyen, P; Ngo-Giang-Huong, N; Ferchal, F; Oksenhendler, E

    1994-01-01

    We report on the detection of HIV-specific cytotoxic T lymphocytes (CTL) among 23 regular partners of HIV-infected individuals. 15 of the 46 individuals enrolled in the study were positive for HLA-A2.1 typing. Among the 23 contacts studied, 7 were seropositive and 16 were seronegative on repeated tests. None of the 16 seronegative contacts were positive for p24 antigenemia nor were they positive by the lymphocytes coculture assay, although, in two instances HIV-1 DNA could be detected by PCR (in one case using a gag SK 38/39 primer, and in the other using a primer for the pol P3/P4 primer). These two individuals remained seronegative for 18 and 36 mo, respectively. HIV-specific cytotoxicity was performed in the 15 HLA-A2.1 subjects (7 indexes, 2 seropositive contacts, and 6 seronegative contacts) and in 4 HLA-matched HIV negative donors. CTL specific for env, gag, or nef proteins could not be detected in unstimulated bulk cultures of peripheral blood lymphocytes in any of the six seronegative contacts. However, using a limiting dilution assay we found an usually high frequency of HIV nef-specific CTL precursors (CTLp) for HIV env and gag was very similar to that observed in seronegative HLA-matched healthy donors. Because no presence of HIV could be demonstrated in these individuals, these findings argue against the possibility of a silent HIV infection and suggest that a CTL response against nef may be involved in a rapid and effective clearance of the virus after sexual exposure. PMID:8132769

  7. Response to region of difference 1 (RD1) epitopes in human immunodeficiency virus (HIV)-infected individuals enrolled with suspected active tuberculosis: a pilot study

    PubMed Central

    Vincenti, D; Carrara, S; Butera, O; Bizzoni, F; Casetti, R; Girardi, E; Goletti, D

    2007-01-01

    Tuberculosis is the most frequent co-infection in human immunodeficiency virus (HIV)-infected individuals, and which still presents diagnostic difficulties. Recently we set up an assay based on interferon (IFN)-γ response to region of difference 1 (RD1) peptides selected by computational analysis which is associated with active Mycobacterium tuberculosis replication. The objective of this study was to investigate the response to RD1 selected peptides in HIV-1-infected individuals in a clinical setting. The mechanisms of this immune response and comparison with other immune assays were also investigated. A total of 111 HIV-infected individuals with symptoms and signs consistent with active tuberculosis were enrolled prospectively. Interferon (IFN)-γ responses to RD1 selected peptides and recall antigens were evaluated by enzyme-linked immunospot assay. Results were correlated with CD4− T cell counts, individuals' characteristics, tuberculin skin test, QuantiFERON-TB Gold and T-SPOT.TB. Results from 21 (19%) individuals were indeterminate due to in vitro cell anergy. Among ‘non-anergic’ individuals, sensitivity for active tuberculosis of the assay based on RD1 selected peptides was 67% (24 of 36), specificity was 94% (three of 54). The assay also resulted positive in cases of extra-pulmonary and smear-negative pulmonary active tuberculosis. The response was mediated by CD4− effector/memory T cells and correlated with CD4− T cell counts, but not with plasma HIV-RNA load. Moreover, the RD1 selected peptides assay had the highest diagnostic odds ratio for active tuberculosis compared to tuberculin skin test (TST), QuantiFERON-TB Gold and T-SPOT.TB. RD1 selected peptides assay is associated with M. tuberculosis replication in HIV-infected individuals, although T cell anergy remains an important obstacle to be overcome before the test can be proposed as a diagnostic tool. PMID:17680823

  8. Thyroid function in multidrug-resistant tuberculosis patients with or without human immunodeficiency virus (HIV) infection before commencement of MDR-TB drug regimen.

    PubMed

    Ige, Olusoji Mayowa; Akinlade, Kehinde Sola; Rahamon, Sheu Kadiri; Edem, Victory Fabian; Arinola, Olatunbosun Ganiyu

    2016-06-01

    Mycobacterium tuberculosis and human immunodeficiency virus (HIV) are known to cause abnormal thyroid function. There is little information on whether HIV infection aggravates alteration of thyroid function in patients with MDR-TB. This study was carried out to determine if HIV co-infection alters serum levels of thyroid hormones (T3, T4) and thyroid stimulating hormone (TSH) in patients with MDR-TB patients and to find out the frequency of subclinical thyroid dysfunction before the commencement of MDR-TB therapy. This observational and cross-sectional study involved all the newly admitted patients in MDR-TB Referral Centre, University College Hospital, Ibadan, Nigeria between July 2010 and December 2014. Serum levels of thyroid stimulating hormone (TSH), free thyroxine (fT4) and free triiodothyronine (fT3) were determined using ELISA. Enrolled were 115 patients with MDR-TB, out of which 22 (19.13%) had MDR-TB/HIV co-infection. Sick euthyroid syndrome (SES), subclinical hypothyroidism and subclinical hyperthyroidism were observed in 5 (4.35%), 9 (7.83%) and 2 (1.74%) patients respectively. The median level of TSH was insignificantly higher while the median levels of T3 and T4 were insignificantly lower in patients with MDR-TB/HIV co-infection compared with patients with MDRT-TB only. It could be concluded from this study that patients with MDR-TB/HIV co-infection have a similar thyroid function as patients having MDR-TB without HIV infection before commencement of MDR-TB drug regimen. Also, there is a possibility of subclinical thyroid dysfunction in patients with MDR-TB/HIV co-infection even, before the commencement of MDR-TB therapy.

  9. Type I Interferon Upregulates Bak and Contributes to T Cell Loss during Human Immunodeficiency Virus (HIV) Infection

    PubMed Central

    Fraietta, Joseph A.; Mueller, Yvonne M.; Yang, Guibin; Boesteanu, Alina C.; Gracias, Donald T.; Do, Duc H.; Hope, Jennifer L.; Kathuria, Noshin; McGettigan, Shannon E.; Lewis, Mark G.; Giavedoni, Luis D.; Jacobson, Jeffrey M.; Katsikis, Peter D.

    2013-01-01

    The role of Type I interferon (IFN) during pathogenic HIV and SIV infections remains unclear, with conflicting observations suggesting protective versus immunopathological effects. We therefore examined the effect of IFNα/β on T cell death and viremia in HIV infection. Ex vivo analysis of eight pro- and anti-apoptotic molecules in chronic HIV-1 infection revealed that pro-apoptotic Bak was increased in CD4+ T cells and correlated directly with sensitivity to CD95/Fas-mediated apoptosis and inversely with CD4+ T cell counts. Apoptosis sensitivity and Bak expression were primarily increased in effector memory T cells. Knockdown of Bak by RNA interference inhibited CD95/Fas-induced death of T cells from HIV-1-infected individuals. In HIV-1-infected patients, IFNα-stimulated gene expression correlated positively with ex vivo T cell Bak levels, CD95/Fas-mediated apoptosis and viremia and negatively with CD4+ T cell counts. In vitro IFNα/β stimulation enhanced Bak expression, CD95/Fas expression and CD95/Fas-mediated apoptosis in healthy donor T cells and induced death of HIV-specific CD8+ T cells from HIV-1-infected patients. HIV-1 in vitro sensitized T cells to CD95/Fas-induced apoptosis and this was Toll-like receptor (TLR)7/9- and Type I IFN-dependent. This sensitization by HIV-1 was due to an indirect effect on T cells, as it occurred in peripheral blood mononuclear cell cultures but not purified CD4+ T cells. Finally, peak IFNα levels and viral loads correlated negatively during acute SIV infection suggesting a potential antiviral effect, but positively during chronic SIV infection indicating that either the virus drives IFNα production or IFNα may facilitate loss of viral control. The above findings indicate stage-specific opposing effects of Type I IFNs during HIV-1 infection and suggest a novel mechanism by which these cytokines contribute to T cell depletion, dysregulation of cellular immunity and disease progression. PMID:24130482

  10. Type I interferon upregulates Bak and contributes to T cell loss during human immunodeficiency virus (HIV) infection.

    PubMed

    Fraietta, Joseph A; Mueller, Yvonne M; Yang, Guibin; Boesteanu, Alina C; Gracias, Donald T; Do, Duc H; Hope, Jennifer L; Kathuria, Noshin; McGettigan, Shannon E; Lewis, Mark G; Giavedoni, Luis D; Jacobson, Jeffrey M; Katsikis, Peter D

    2013-01-01

    The role of Type I interferon (IFN) during pathogenic HIV and SIV infections remains unclear, with conflicting observations suggesting protective versus immunopathological effects. We therefore examined the effect of IFNα/β on T cell death and viremia in HIV infection. Ex vivo analysis of eight pro- and anti-apoptotic molecules in chronic HIV-1 infection revealed that pro-apoptotic Bak was increased in CD4+ T cells and correlated directly with sensitivity to CD95/Fas-mediated apoptosis and inversely with CD4+ T cell counts. Apoptosis sensitivity and Bak expression were primarily increased in effector memory T cells. Knockdown of Bak by RNA interference inhibited CD95/Fas-induced death of T cells from HIV-1-infected individuals. In HIV-1-infected patients, IFNα-stimulated gene expression correlated positively with ex vivo T cell Bak levels, CD95/Fas-mediated apoptosis and viremia and negatively with CD4+ T cell counts. In vitro IFNα/β stimulation enhanced Bak expression, CD95/Fas expression and CD95/Fas-mediated apoptosis in healthy donor T cells and induced death of HIV-specific CD8+ T cells from HIV-1-infected patients. HIV-1 in vitro sensitized T cells to CD95/Fas-induced apoptosis and this was Toll-like receptor (TLR)7/9- and Type I IFN-dependent. This sensitization by HIV-1 was due to an indirect effect on T cells, as it occurred in peripheral blood mononuclear cell cultures but not purified CD4+ T cells. Finally, peak IFNα levels and viral loads correlated negatively during acute SIV infection suggesting a potential antiviral effect, but positively during chronic SIV infection indicating that either the virus drives IFNα production or IFNα may facilitate loss of viral control. The above findings indicate stage-specific opposing effects of Type I IFNs during HIV-1 infection and suggest a novel mechanism by which these cytokines contribute to T cell depletion, dysregulation of cellular immunity and disease progression.

  11. Human immunodeficiency virus (HIV) phenotype and interleukin-2/ interleukin-10 ratio are associated markers of protection and progression in HIV infection.

    PubMed

    Clerici, M; Balotta, C; Salvaggio, A; Riva, C; Trabattoni, D; Papagno, L; Berlusconi, A; Rusconi, S; Villa, M L; Moroni, M; Galli, M

    1996-07-15

    Human immunodeficiency virus (HIV) isolability, rate of viral replication, HIV phenotype, type 1 and type 2 cytokine production, and CD4 counts were cross sectionally analyzed in 63 HIV seropositive (HIV+) individuals to establish possible correlations between virologic and immunologic markers of protection and progression. We observed that these markers are tightly correlated. Thus, lack or low prevalence of HIV isolability and the presence of nonsyncitium inducing strains are associated with the strongest type 1 cytokine production, the weakest type 2 cytokine production, and highest CD4 counts. Conversely, the isolation of highly replicating, syncitium-inducing HIV strains is associated with the weakest type 1 cytokine production, the strongest type 2 cytokine production, and lowest CD4 counts. Additionally, it was determined that the interleukin (IL)-10/IL-2 ratio best discriminates among different virologic scenarios. These data suggest that the virologic and immunologic correlates of disease protection and progression might be associated variables that define two different subsets of HIV+ individuals and lend support to a viro-immunologic hypothesis of HIV infection.

  12. Hepatitis B virus and HIV infection.

    PubMed

    Martín-Carbonero, Luz; Poveda, Eva

    2012-05-01

    Approximately 5 to 10% of human immunodeficiency virus- (HIV-) infected persons worldwide have chronic hepatitis B virus (HBV). The management of these patients merits special attention. They experience a faster progression to cirrhosis and more frequent liver-related death than HBV-monoinfected individuals. For this reason, therapy for both HIV and HBV is a priority in most cases. Some antivirals (i.e., tenofovir, lamivudine, emtricitabine) are active against both viruses and should be part of the antiretroviral treatment choice. However, drugs such as entecavir, telbivudine, or adefovir are active against HBV and may display some residual activity against HIV, occasionally leading to the selection of resistance mutations in the HIV polymerase, as is clearly shown with entecavir. Thus, they should be used only in the context of potent antiretroviral treatment. In this review, the authors will provide updated information on the natural history of HIV/HBV coinfected patients, when and which drugs should be used in treatment, and the concern about selection of drug resistance and vaccine escape mutants. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  13. Human immunodeficiency virus infection and pneumothorax

    PubMed Central

    Terzi, Eirini; Zarogoulidis, Konstantinos; Kougioumtzi, Ioanna; Dryllis, Georgios; Kioumis, Ioannis; Pitsiou, Georgia; Machairiotis, Nikolaos; Katsikogiannis, Nikolaos; Tsiouda, Theodora; Madesis, Athanasios; Karaiskos, Theodoros

    2014-01-01

    Pneumothorax is a serious and relatively frequent complication of human immunodeficiency virus (HIV) infection that may associate with increased morbidity and mortality and may prove difficult to manage, especially in patients with acquired immunodeficiency syndrome (AIDS). PMID:25337392

  14. Hearing Loss and Quality of Life (QOL) among Human Immunodeficiency Virus (HIV)-Infected and Uninfected Adults

    PubMed Central

    Duong, N; Torre, P; Springer, G; Cox, C; Plankey, MW

    2017-01-01

    Objective Research has established that human immunodeficiency virus (HIV) causes hearing loss. Studies have yet to evaluate the impact on quality of life (QOL). This project evaluates the effect of hearing loss on QOL by HIV status. Methods The study participants were from the Multicenter AIDS Cohort Study (MACS) and the Women's Interagency HIV study (WIHS). A total of 248 men and 127 women participated. Pure-tone air conduction thresholds were collected for each ear at frequencies from 250 through 8000 Hz. Pure-tone averages (PTAs) for each ear were calculated as the mean of air conduction thresholds in low frequencies (i.e., 250, 500, 1000 and 2000 Hz) and high frequencies (i.e., 3000, 4000, 6000 and 8000 Hz). QOL data were gathered with the Short Form 36 Health Survey and Medical Outcome Study (MOS)-HIV instrument in the MACS and WIHS, respectively. A median regression analysis was performed to test the association of PTAs with QOL by HIV status. Results There was no significant association between hearing loss and QOL scores at low and high pure tone averages in HIV positive and negative individuals. HIV status, HIV biomarkers and treatment did not change the lack of association of low and high pure tone averages with poorer QOL. Conclusion Although we did not find a statistically significant association of hearing loss with QOL by HIV status, testing for hearing loss with aging and recommending treatment may offset any presumed later life decline in QOL. PMID:28217403

  15. Human immunodeficiency virus (HIV)-specific effector CD8 T cell activity in patients with primary HIV infection.

    PubMed

    Alter, Galit; Merchant, Alefia; Tsoukas, Christos M; Rouleau, Danielle; LeBlanc, Roger P; Côté, Pierre; Baril, Jean-Guy; Thomas, Réjean; Nguyen, Vinh-Kim; Sékaly, Rafik-Pierre; Routy, Jean-Pierre; Bernard, Nicole F

    2002-03-15

    The interferon-gamma ELISPOT assay was used to assess and compare the magnitude and breadth of human immunodeficiency virus (HIV)-specific CD8 T cell responses in treatment-naive subjects during the first year of HIV primary infection and during the chronic phase of infection. Twenty-five subjects tested within a year of exposure to HIV resulting in seroconversion and 20 subjects with chronic infection were screened for HIV peptide-specific activity by stimulating peripheral blood mononuclear cells with a panel of 5-21 HLA class I-restricted HIV peptides (mean, 11.2 +/- 3.5 HIV peptides). There was a significant correlation between the magnitude and breadth of HIV-specific effector responses and time elapsed from exposure (r=0.63 for magnitude vs. time and r=0.64 for breadth vs. time; P<.02, paired t test). Maximal breadth of the HIV gene product reactivity was achieved within 2 months of exposure for Nef-specific responses and by 4 months of exposure for responses directed to Env, Gag, and reverse transcriptase.

  16. Drug fever induced by piperacillin/tazobactam in an elderly patient with underlying human immunodeficiency virus (HIV) infection.

    PubMed

    Swe, Thein; Ali, Mir; Naing, Akari Thein

    2016-07-20

    Our search of the literature revealed no detailed case reports about drug fever induced by piperacillin/tazobactam in a patient with HIV infection although there were a few case reports about drug fever due to piperacillin/tazobactam with other comorbidities. A 63-year-old male patient with HIV positive was admitted for acute cholecystitis. He was started on piperacillin/tazobactam. For the next 8 days, he had intermittent fever up to 103°F (39.4°C) with relative bradycardia although he showed clinical improvement. There was no laboratory or imaging findings suggestive of another infectious source and drug fever was suspected. The antibiotics were stopped and after 48 hours no fever was observed until the day of discharge. Piperacillin/tazobactam can induce fever in patients with cystic fibrosis and in patients with other conditions. Drug fever may be more prevalent in patients with HIV infection. It has no characteristic pattern and may not be associated with eosinophilia.

  17. Human immunodeficiency virus (HIV) infection patterns and risk behaviours in different population groups and provinces in Viet Nam

    PubMed Central

    Tuan, Nguyen Anh; Fylkesnes, Knut; Thang, Bui Duc; Hien, Nguyen Tran; Long, Nguyen Thanh; Van Kinh, Nguyen; Thang, Pham Hong; Manh, Pham Duc

    2007-01-01

    Abstract Objective To study patterns and determinants of HIV prevalence and risk-behaviour characteristics in different population groups in four border provinces of Viet Nam. Methods We surveyed four population groups during April–June 2002. We used stratified random-cluster sampling and collected data concomitantly on HIV status and risk behaviours. The groups included were female sex workers (n = 2023), injecting drug users (n = 1391), unmarried males aged 15–24 years (n = 1885) and different categories of mobile groups (n = 1923). Findings We found marked geographical contrasts in HIV prevalence, particularly among female sex workers (range 0–24%). The HIV prevalence among injecting drug users varied at high levels in all provinces (range 4–36%), whereas lower prevalences were found among both unmarried young men (range 0–1.3%) and mobile groups (range 0–2.5%). All groups reported sex with female sex workers. Less than 40% of the female sex workers had used condoms consistently. The strongest determinants of HIV infection among female sex workers were inconsistent condom use (adjusted odds ratio [OR], 5.3; 95% confidence interval [CI], 2.4–11.8), history of injecting drug use and mobility, and, among injecting drug users, sharing of injection equipment (adjusted OR, 7.3; 95% CI, 2.3–24.0) and sex with non-regular partners (adjusted OR 3.4; 95% CI 1.4–8.5). Conclusion The finding of marked geographical variation in HIV prevalence underscores the value of understanding local contexts in the prevention of HIV infection. Although lacking support from data from all provinces, there would appear to be a potential for sex work to drive a self-sustaining heterosexual epidemic. That the close links to serious injecting drug use epidemics can have an accelerating effect in increasing the spread of HIV merits further study. PMID:17242756

  18. Human immunodeficiency virus (HIV) infection patterns and risk behaviours in different population groups and provinces in Viet Nam.

    PubMed

    Tuan, Nguyen Anh; Fylkesnes, Knut; Thang, Bui Duc; Hien, Nguyen Tran; Long, Nguyen Thanh; Kinh, Nguyen Van; Thang, Pham Hong; Manh, Pham Duc; O'Farrell, Nigel

    2007-01-01

    To study patterns and determinants of HIV prevalence and risk-behaviour characteristics in different population groups in four border provinces of Viet Nam. We surveyed four population groups during April-June 2002. We used stratified random-cluster sampling and collected data concomitantly on HIV status and risk behaviours. The groups included were female sex workers (n = 2023), injecting drug users (n = 1391), unmarried males aged 15-24 years (n = 1885) and different categories of mobile groups (n = 1923). We found marked geographical contrasts in HIV prevalence, particularly among female sex workers (range 0-24%). The HIV prevalence among injecting drug users varied at high levels in all provinces (range 4-36%), whereas lower prevalences were found among both unmarried young men (range 0-1.3%) and mobile groups (range 0-2.5%). All groups reported sex with female sex workers. Less than 40% of the female sex workers had used condoms consistently. The strongest determinants of HIV infection among female sex workers were inconsistent condom use (adjusted odds ratio [OR], 5.3; 95% confidence interval [CI], 2.4-11.8), history of injecting drug use and mobility, and, among injecting drug users, sharing of injection equipment (adjusted OR, 7.3; 95% CI, 2.3-24.0) and sex with non-regular partners (adjusted OR 3.4; 95% CI 1.4-8.5). The finding of marked geographical variation in HIV prevalence underscores the value of understanding local contexts in the prevention of HIV infection. Although lacking support from data from all provinces, there would appear to be a potential for sex work to drive a self-sustaining heterosexual epidemic. That the close links to serious injecting drug use epidemics can have an accelerating effect in increasing the spread of HIV merits further study.

  19. Neutralizing antibody responses against autologous and heterologous viruses in acute versus chronic human immunodeficiency virus (HIV) infection: evidence for a constraint on the ability of HIV to completely evade neutralizing antibody responses.

    PubMed

    Deeks, Steven G; Schweighardt, Becky; Wrin, Terri; Galovich, Justin; Hoh, Rebecca; Sinclair, Elizabeth; Hunt, Peter; McCune, Joseph M; Martin, Jeffrey N; Petropoulos, Christos J; Hecht, Frederick M

    2006-06-01

    Acute human immunodeficiency virus (HIV) infection is associated with the rapid development of neutralization escape mutations. The degree to which viral evolution persists in chronic infection has not been well characterized, nor is it clear if all patients develop high-level neutralization antibody escape. We therefore measured neutralizing antibody responses against autologous and heterologous viruses in a cohort of acutely and chronically infected subjects (n = 65). Neutralizing antibody responses against both autologous virus and heterologous viruses were lower among individuals with acute infection than among those with chronic infection. Among chronically infected individuals, there was a negative correlation between the level of neutralizing antibodies against autologous virus and the level of viremia. In contrast, there was a positive correlation between the level of neutralizing antibodies against a panel of heterologous viruses and the level of viremia. Viral evolution, as defined by the presence of higher neutralizing titers directed against earlier viruses than against contemporaneous viruses, was evident for subjects with recent infection but absent for those with chronic infection. In summary, neutralizing antibody responses against contemporaneous autologous viruses are absent in early HIV infection but can be detected at low levels in chronic infection, particularly among those controlling HIV in the absence of therapy. HIV replication either directly or indirectly drives the production of increasing levels of antibodies that cross-neutralize heterologous primary isolates. Collectively, these observations indicate that although HIV continuously drives the production of neutralizing antibodies, there may be limits to the capacity of the virus to evolve continuously in response to these antibodies. These observations also suggest that the neutralizing antibody response may contribute to the long-term control of HIV in some patients while protecting

  20. Occupational Post-Exposure Prophylaxis (PEP) against Human Immunodeficiency Virus (HIV) Infection in a Health District in Cameroon: Assessment of the Knowledge and Practices of Nurses

    PubMed Central

    Aminde, Leopold Ndemnge; Takah, Noah Fongwen; Dzudie, Anastase; Bonko, Neville Mengnjo; Awungafac, George; Teno, Divine; Mbuagbaw, Lawrence; Sliwa, Karen

    2015-01-01

    Background Health care providers are at risk of acquiring human immunodeficiency virus (HIV) infection from occupational exposure, with nurses being the most vulnerable. There is no data on the awareness of post-exposure prophylaxis (PEP) among nurses in Cameroon. This study aimed to assess the knowledge, practices of nurses regarding PEP for HIV and their determinants in Cameroon. Methods A cross-sectional study was conducted between April and July 2013, and involved 80 nurses in a rural health district in the North West Region of Cameroon. Data was collected using a structured questionnaire and analysed using the SPSS software version 20. Results In all, 73.7% of the participants had poor knowledge about PEP for HIV. Though many (83.8%) had heard about PEP, just 10 (12.5%) had received formal training on PEP for HIV. Only 24 (30%) and 20 (25%) knew the correct drug regimen and duration of treatment respectively. The majority (85%) considered themselves to be at risk of acquiring HIV at work, with 54 (67.5%) having experienced an exposure in the past, mainly while setting up intravenous lines (57.4%), recapping needles (37.0%) and during delivery (24.1%). Of those exposed, ten (18.9%) received PEP, which was started after 24 hours in 50%. In multivariable regression analyses, awareness of hospital policy [OR: 0.043 (0.005–0.404), p-value = 0.006] was associated with Good knowledge on PEP for HIV. Conclusions The knowledge and practice of nurses on PEP for HIV in Cameroon is low. There is urgent need for training programmes and workshops to increase awareness, improve practice, and reduce the risk of HIV acquisition from work related activities among health care providers. PMID:25879442

  1. Tuberculosis Incidence and Risk Factors Among Human Immunodeficiency Virus (HIV)-Infected Adults Receiving Antiretroviral Therapy in a Large HIV Program in Nigeria.

    PubMed

    Chang, Charlotte A; Meloni, Seema Thakore; Eisen, Geoffrey; Chaplin, Beth; Akande, Patrick; Okonkwo, Prosper; Rawizza, Holly E; Tchetgen Tchetgen, Eric; Kanki, Phyllis J

    2015-12-01

    Background.  Despite the benefits of antiretroviral therapy (ART), tuberculosis (TB) is the leading cause of mortality among human immunodeficiency virus (HIV)-infected persons in Africa. Nigeria bears the highest TB burden in Africa and second highest HIV burden globally. This long-term multicenter study aimed to determine the incidence rate and predictors of TB in adults in the Harvard/AIDS Prevention Initiative in Nigeria (APIN) and President's Emergency Plan for AIDS Relief (PEPFAR) Nigeria ART program. Methods.  This retrospective evaluation used data collected from 2004 to 2012 through the Harvard/APIN PEPFAR program. Risk factors for incident TB were determined using multivariate Cox proportional hazards regression with time-dependent covariates. Results.  Of 50 320 adults enrolled from 2005 to 2010, 11 092 (22%) had laboratory-confirmed active TB disease at ART initiation, and 2021 (4%) developed active TB after commencing ART. During 78 228 total person-years (PY) of follow-up, the TB incidence rate was 25.8 cases per 1000 PY (95% confidence interval [CI], 24.7-27.0) overall, and it decreased significantly both with duration on ART and calendar year. Risk factors at ART initiation for incident TB included the following: earlier ART enrollment year, tenofovir-containing initial ART regimen, and World Health Organization clinical stage above 1. Time-updated risk factors included the following: low body mass index, low CD4(+) cell count, unsuppressed viral load, anemia, and ART adherence below 80%. Conclusions.  The rate of incident TB decreased with longer duration on ART and over the program years. The strongest TB risk factors were time-updated clinical markers, reinforcing the importance of consistent clinical and laboratory monitoring of ART patients in prompt diagnosis and treatment of TB and other coinfections.

  2. Human Immunodeficiency Virus (HIV)-Infected Patients Accept Finger Stick Blood Collection for Point-Of-Care CD4 Testing

    PubMed Central

    Scott, Lesley; Potgieter, Joachim; Kestens, Luc; Stevens, Wendy

    2016-01-01

    Introduction HIV-infected patients require antiretroviral treatment for life. To improve access to care, CD4 enumeration and viral load tests have been redesigned to be used as point-of-care techniques using finger-stick blood. Accurate CD4 counting in capillary blood requires a free flowing blood drop that is achieved by blade incision. The aim of this study was to assess the attitude of the patients toward blade-based finger-stick blood donation. Methods Four hundred and ninety-nine patients were included (299 patients from South Africa and 200 from Belgium). They completed a questionnaire to express their preference for finger stick or venipuncture, after undergoing both. The South African patient cohort was divided in two groups, receiving either single or multiple finger stick for CD4 and other HIV-related tests. The Belgian patients received a single finger stick for CD4 testing, and were asked to respond directly and again after two days. Results The majority of the patients preferred the finger stick to the venipuncture. The perceived pain using the blade was superior to a small needle, but similar to a large needle. They preferred up to three finger sticks over one venipuncture. Up to 30% of the patients changed their mind over two days. The main reason for choosing a finger stick was continued bleeding after venipuncture. The most cited objection to finger stick was pain/soreness. Conclusion Patient perceptions support the implementation of donating capillary blood with blade-based finger stick during CD4 point-of-care testing. PMID:27556894

  3. Parasite Clearance and Artemether Pharmacokinetics Parameters Over the Course of Artemether-Lumefantrine Treatment for Malaria in Human Immunodeficiency Virus (HIV)-Infected and HIV-Uninfected Ugandan Children

    PubMed Central

    Kajubi, Richard; Huang, Liusheng; Were, Moses; Kiconco, Sylvia; Li, Fangyong; Marzan, Florence; Gingrich, David; Nyunt, Myaing M.; Ssebuliba, Joshua; Mwebaza, Norah; Aweeka, Francesca T.

    2016-01-01

    Background. Artemisinins are primarily responsible for initial parasite clearance. Antimalarial pharmacokinetics (PK), human immunodeficiency virus (HIV) infection, and antiretroviral therapy have been shown to impact treatment outcomes, although their impact on early parasite clearance in children has not been well characterized. Methods. Parasite clearance parameters were generated from twice-daily blood smears in HIV-infected and HIV-uninfected Ugandan children treated with artemether-lumefantrine (AL). Artemether and dihydroartemisinin (DHA) area-under-the-curve from 0–8 hours (AUC0-8hr) after the 1st AL dose was compared with AUC0-8hr after the last (6th) dose in a concurrently enrolled cohort. The association between post-1st dose artemisinin AUC0-8hr and parasite clearance was assessed. Results. Parasite clearance was longer in HIV-infected versus HIV-uninfected children (median, 3.5 vs 2.8 hours; P = .003). Artemether AUC0-8hr was 3- to 4-fold lower after the 6th dose versus the 1st dose of AL in HIV-infected children on nevirapine- or lopinavir/ritionavir-based regimens and in HIV-uninfected children (P ≤ .002, 1st vs 6th-dose comparisons). Children on efavirenz exhibited combined post-1st dose artemether/DHA exposure that was significantly lower than those on lopinavir/ritonavir and HIV-uninfected children. Multiple regression analysis supported that the effect of artemether/DHA exposure on parasite clearance was significantly moderated by HIV status. Conclusions. Parasite clearance rates remain rapid in Uganda and were not found to associate with PK exposure. However, significant decreases in artemisinin PK with repeated dosing in nearly all children, coupled with small, but significant increase in parasite clearance half-life in those with HIV, may have important implications for AL efficacy, particularly because reports of artemisinin resistance are increasing. PMID:28018925

  4. Subtype B Human Immunodeficiency Virus (HIV) Type 1 Mutant That Escapes Detection in a Fourth-Generation Immunoassay for HIV Infection

    PubMed Central

    Gaudy, Catherine; Moreau, Alain; Brunet, Sylvie; Descamps, Jean-Michel; Deleplanque, Pascale; Brand, Denys; Barin, Francis

    2004-01-01

    We report a case of human immunodeficiency virus (HIV) type 1 infection not detected by a highly sensitive combined antigen-antibody assay. The virus was a subtype B strain harboring a unique sequence within the immunodominant epitope of the transmembrane glycoprotein. Immunochemical analysis indicated that this sequence was probably responsible for the failure to detect HIV antibodies. PMID:15184489

  5. Parainfluenza Virus Infection Among Human Immunodeficiency Virus (HIV)-Infected and HIV-Uninfected Children and Adults Hospitalized for Severe Acute Respiratory Illness in South Africa, 2009-2014.

    PubMed

    Cohen, Adam L; Sahr, Philip K; Treurnicht, Florette; Walaza, Sibongile; Groome, Michelle J; Kahn, Kathleen; Dawood, Halima; Variava, Ebrahim; Tempia, Stefano; Pretorius, Marthi; Moyes, Jocelyn; Olorunju, Steven A S; Malope-Kgokong, Babatyi; Kuonza, Lazarus; Wolter, Nicole; von Gottberg, Anne; Madhi, Shabir A; Venter, Marietjie; Cohen, Cheryl

    2015-12-01

    Background.  Parainfluenza virus (PIV) is a common cause of acute respiratory tract infections, but little is known about PIV infection in children and adults in Africa, especially in settings where human immunodeficiency virus (HIV) prevalence is high. Methods.  We conducted active, prospective sentinel surveillance for children and adults hospitalized with severe acute respiratory illness (SARI) from 2009 to 2014 in South Africa. We enrolled controls (outpatients without febrile or respiratory illness) to calculate the attributable fraction for PIV infection. Respiratory specimens were tested by multiplex real-time reverse-transcription polymerase chain reaction assay for parainfluenza types 1, 2, and 3. Results.  Of 18 282 SARI cases enrolled, 1188 (6.5%) tested positive for any PIV type: 230 (19.4%) were type 1; 168 (14.1%) were type 2; 762 (64.1%) were type 3; and 28 (2.4%) had coinfection with 2 PIV types. After adjusting for age, HIV serostatus, and respiratory viral coinfection, the attributable fraction for PIV was 65.6% (95% CI [confidence interval], 47.1-77.7); PIV contributed to SARI among HIV-infected and -uninfected children <5 years of age and among individuals infected with PIV types 1 and 3. The observed overall incidence of PIV-associated SARI was 38 (95% CI, 36-39) cases per 100 000 population and was highest in children <1 year of age (925 [95% CI, 864-989] cases per 100 000 population). Compared with persons without HIV, persons with HIV had an increased relative risk of PIV hospitalization (9.4; 95% CI, 8.5-10.3). Conclusions.  Parainfluenza virus causes substantial severe respiratory disease in South Africa among children <5 years of age, especially those that are infected with HIV.

  6. Modulation of Human Immunodeficiency Virus (HIV)-Specific Immune Response by Using Efavirenz, Nelfinavir, and Stavudine in a Rescue Therapy Regimen for HIV-Infected, Drug-Experienced Patients

    PubMed Central

    Trabattoni, Daria; Lo Caputo, Sergio; Biasin, Mara; Seminari, Elena; Di Pietro, Massimo; Ravasi, Giovanni; Mazzotta, Francesco; Maserati, Renato; Clerici, Mario

    2002-01-01

    Analysis of the virologic and immunomodulatory effects of an association of efavirenz (EFV), nelfinavir (NFV), and stavudine (d4T) was performed in 18 human immunodeficiency virus (HIV)-infected and highly active antiretroviral therapy (HAART)-experienced patients who failed multiple therapeutic protocols. Patients (<500 CD4+ cells/μl; >10,000 HIV copies/ml) were nonnucleoside reverse transcriptase inhibitor (NNRTI)-naive and were treated for 10 months with EFV (600 mg/day) in association with NFV (750 mg three times daily) and d4T (30 or 40 mg twice daily). Measurement of HIV peptide- and mitogen-stimulated production of interleukin-2 (IL-2), gamma interferon (IFN-γ), IL-4, and IL-10 as well as quantitation of mRNA for the same cytokines in unstimulated peripheral blood mononuclear cells were performed at baseline and 2 weeks (t1), 2 months (t2), and 10 months (t3) into therapy. The results showed that HIV-specific (but not mitogen-stimulated) IL-2 and IFN-γ production was augmented and IL-10 production was reduced in patients who received EFV, NFV, and d4T. Therapy was also associated with a reduction in HIV RNA in plasma and an increase in CD4+ cell count. These changes occurred in the first year of therapy (t2 and t3) and were confirmed by quantitation of cytokine-specific mRNA. Therapy with EFV, NFV, and d4T increases HIV-specific type 1 cytokine production as well as CD4 counts and reduces plasma viremia. This therapeutic regimen may be considered for use in cases of advanced HIV infection. PMID:12204968

  7. Modulation of human immunodeficiency virus (HIV)-specific immune response by using efavirenz, nelfinavir, and stavudine in a rescue therapy regimen for HIV-infected, drug-experienced patients.

    PubMed

    Trabattoni, Daria; Lo Caputo, Sergio; Biasin, Mara; Seminari, Elena; Di Pietro, Massimo; Ravasi, Giovanni; Mazzotta, Francesco; Maserati, Renato; Clerici, Mario

    2002-09-01

    Analysis of the virologic and immunomodulatory effects of an association of efavirenz (EFV), nelfinavir (NFV), and stavudine (d4T) was performed in 18 human immunodeficiency virus (HIV)-infected and highly active antiretroviral therapy (HAART)-experienced patients who failed multiple therapeutic protocols. Patients (<500 CD4(+) cells/ micro l; >10,000 HIV copies/ml) were nonnucleoside reverse transcriptase inhibitor (NNRTI)-naive and were treated for 10 months with EFV (600 mg/day) in association with NFV (750 mg three times daily) and d4T (30 or 40 mg twice daily). Measurement of HIV peptide- and mitogen-stimulated production of interleukin-2 (IL-2), gamma interferon (IFN-gamma), IL-4, and IL-10 as well as quantitation of mRNA for the same cytokines in unstimulated peripheral blood mononuclear cells were performed at baseline and 2 weeks (t1), 2 months (t2), and 10 months (t3) into therapy. The results showed that HIV-specific (but not mitogen-stimulated) IL-2 and IFN-gamma production was augmented and IL-10 production was reduced in patients who received EFV, NFV, and d4T. Therapy was also associated with a reduction in HIV RNA in plasma and an increase in CD4(+) cell count. These changes occurred in the first year of therapy (t2 and t3) and were confirmed by quantitation of cytokine-specific mRNA. Therapy with EFV, NFV, and d4T increases HIV-specific type 1 cytokine production as well as CD4 counts and reduces plasma viremia. This therapeutic regimen may be considered for use in cases of advanced HIV infection.

  8. Human immunodeficiency virus and menopause.

    PubMed

    Kanapathipillai, Rupa; Hickey, Martha; Giles, Michelle

    2013-09-01

    This article aims to review currently available evidence for women infected with human immunodeficiency virus (HIV) and menopause and to propose clinical management algorithms. Key studies addressing HIV and menopause have been reviewed, specifically age of menopause onset in HIV-infected women, frequency of menopausal symptoms, comorbidities associated with HIV and aging (including cardiovascular disease and bone disease), treatment of menopausal symptoms, and prevention of comorbidities in HIV-infected women. Studies suggest an earlier onset of menopause in HIV-infected women, with increased frequency of symptoms. Cardiovascular disease risk may be increased in this population, with combination antiretroviral therapy (cART) and chronic inflammation associated with HIV, contributing to increased risk. Chronic inflammation and cART have been independently implicated in bone disease. No published data have assessed the safety and efficacy of hormone therapy in relation to symptoms of menopause, cardiovascular risk, and bone disease among HIV-infected women. Few studies on menopause have been conducted in HIV-infected women compared with HIV-uninfected women. Many questions regarding age of menopause onset, frequency of menopausal symptoms and associated complications such as bone disease and cardiovascular disease, and efficacy of treatment among HIV-infected women remain. The incidence and severity of some of these factors may be increased in the setting of HIV and cART.

  9. Immunological abnormalities in human immunodeficiency virus (HIV)-infected asymptomatic homosexual men. HIV affects the immune system before CD4+ T helper cell depletion occurs.

    PubMed Central

    Miedema, F; Petit, A J; Terpstra, F G; Schattenkerk, J K; de Wolf, F; Al, B J; Roos, M; Lange, J M; Danner, S A; Goudsmit, J

    1988-01-01

    To investigate the effect of persistent HIV infection on the immune system, we studied leukocyte functions in 14 asymptomatic homosexual men (CDC group II/III) who were at least two years seropositive, but who still had normal numbers of circulating CD4+ T cells. Compared with age-matched heterosexual men and HIV-negative homosexual men, the CD4+ and CD8+ T cells from seropositive men showed decreased proliferation to anti-CD3 monoclonal antibody and decreased CD4+ T-helper activity on PWM-driven differentiation of normal donor B cells. Monocytes of HIV-infected homosexual men showed decreased accessory function on normal T cell proliferation induced by CD3 monoclonal antibody. The most striking defect in leukocyte functional activities was observed in the B cells of HIV-infected men. B cells of 13 out of 14 seropositive men failed to produce Ig in response to PWM in the presence of adequate allogeneic T-helper activity. These findings suggest that HIV induces severe immunological abnormalities in T cells, B cells, and antigen-presenting cells early in infection before CD4+ T cell numbers start to decline. Impaired immunological function in subclinically HIV-infected patients may have clinical implications for vaccination strategies, in particular the use of live vaccines in groups with a high prevalence of HIV seropositivity. PMID:2974045

  10. Antenatal testing for human immunodeficiency virus. Results from the Royal College of Obstetricians and Gynaecologists' National Study of HIV Infection in Pregnancy.

    PubMed

    Davison, C F; Ades, A E; Hudson, C N; Peckham, C S

    1989-12-16

    Current policies on antenatal testing for human immunodeficiency virus (HIV) in the main obstetric units of the United Kingdom and the Republic of Ireland were surveyed by postal questionnaire; 294 of 299 units responded. HIV testing was available at 192 (65%) of the 294 units that responded. 414 HIV-positive pregnancies in 386 women were reported from 74 (25%) units. Most were from Scotland, the four Thames Regions, and Ireland. In 46% of the HIV-positive women the infection was identified by antenatal testing; the remainder had been tested previously and knew that they were infected. The findings support the view that selective antenatal testing should be established in areas where no testing is offered at present and possibly that testing should be offered to all pregnant women in high-prevalence areas.

  11. Pediatric human immunodeficiency virus infection.

    PubMed Central

    Domachowske, J B

    1996-01-01

    In the past decade, an increase in pediatric human immunodeficiency virus (HIV) infection has had a substantial impact on childhood morbidity and mortality worldwide. The vertical transmission of HIV from mother to infant accounts for the vast majority of these cases. Identification of HIV-infected pregnant women needs to be impoved so that appropriate therapy can be initiated for both mothers and infants. While recent data demonstrate a dramatic decrease in HIV transmission from a subset of women treated with zidovudine during pregnancy, further efforts at reducing transmission are desperately needed. This review focuses on vertically transmitted HIV infection in children, its epidemiology, diagnostic criteria, natural history, and clinical manifestations including infectious and noninfectious complications. An overview of the complex medical management of these children ensues, including the use of antiretroviral therapy. Opportunistic infection prophylaxis is reviewed, along with the important role of other supportive therapies. PMID:8894346

  12. Strongyloides Stercoralis Infection Among Human Immunodeficiency Virus (HIV)-Infected Patients in the United States of America: A Case Report and Review of Literature

    PubMed Central

    Guillamet, Laia Jimena Vazquez; Saul, Zane; Miljkovic, Goran; Vilchez, Gabriel Alejandro; Mendonca, Nikolai; Gourineni, Venkata; Lillo, Nicholas; Pinto, Marguerite; Baig, Aurangzaib; Gangcuangco, Louie Mar

    2017-01-01

    Patient: Male, 61 Final Diagnosis: Strongyloides stercolaris-associated diarrhea Symptoms: Diarrhea • epigastric pain • nausea • weight loss Medication: Ivermectin Clinical Procedure: Colonic biopsies Specialty: Infectious Diseases Objective: Rare disease Background: Strongyloides stercoralis infection is endemic in subtropical and tropical regions but is reported rather sporadically in temperate countries. In the USA, the highest rates of infection are from the southeastern states, predominantly among immigrants. There is paucity of case reports on S. stercoralis infection among HIV-infected patients who were born and raised in the USA. Case Report: A 61-year-old male with known HIV infection (CD4 count: 235 cells/uL, undetectable HIV RNA, on antiretroviral therapy) presented with a 3-month history of diarrhea. He was initially diagnosed to have diarrhea secondary to norovirus and later with Escherichia coli. He was treated with levofloxacin but the diarrhea persisted. Stool PCR, Clostridium difficile enzyme-linked immunoassay, cryptosporidium and giardia antigen, cyclospora and isospora smear, and fecal microscopy were all negative. Peripheral blood eosinophil count was 1,000 eosinophils/mcL. Colonic biopsies revealed fragments of S. stercoralis larvae within the crypts. The patient was treated with ivermectin with improvement of symptoms. Social history revealed that he was born and raised in the northeastern USA. He was a daily methamphetamine user and engaged in anal sex with men. He denied travel to endemic areas, except for a visit to Japan more than 30 years ago. Conclusions: Our case highlights that S. stercoralis may be an underdiagnosed/under-reported cause of chronic diarrhea among HIV-infected patients. What makes this case peculiar is that the patient was born and raised in the continental USA, absence of recent travel to endemic areas, and relatively high CD4 counts. Parasitic infections, such as S. stercoralis, should be considered among HIV-infected

  13. Safety and pharmacokinetics of hyperimmune anti-human immunodeficiency virus (HIV) immunoglobulin administered to HIV-infected pregnant women and their newborns. Pediatric AIDS Clinical Trials Group Protocol 185 Pharmacokinetic Study Group.

    PubMed

    Lambert, J S; Mofenson, L M; Fletcher, C V; Moye, J; Stiehm, E R; Meyer, W A; Nemo, G J; Mathieson, B J; Hirsch, G; Sapan, C V; Cummins, L M; Jimenez, E; O'Neill, E; Kovacs, A; Stek, A

    1997-02-01

    The pharmacokinetics and safety of hyperimmune anti-human immunodeficiency virus (HIV) intravenous immunoglobulin (HIVIG) were evaluated in the first 28 maternal-infant pairs enrolled in a randomized, intravenous immunoglobulin (IVIG)-controlled trial of HIVIG maternal-infant HIV transmission prophylaxis. Using 200 mg/kg, mean half-life and volume of distribution (Vd) in women were 15 days and 72 mL/kg, respectively, after one and 32 days and 154 mL/kg after three monthly infusions, with stable 4 mL/kg/day clearance. Transplacental passage occurred. Newborn single-dose half-life, Vd, and clearance were 30 days, 143 mL/kg, and 4 mL/kg/day, respectively. HIVIG rapidly cleared maternal serum immune complex-dissociated p24 antigen, and plasma HIV-1 RNA levels were stable. Mild to moderate adverse clinical effects occurred in 2 of 103 maternal and 2 of 25 infant infusions. No adverse hematologic, blood chemistry, or immunologic effects were seen. HIVIG is well-tolerated in HIV-infected pregnant women and their newborns, clears antigenemia, crosses the placenta, and exhibits pharmacokinetics similar to those of other immunoglobulin preparations.

  14. Routine analysis of induced sputum is not an effective strategy for screening persons infected with human immunodeficiency virus for Mycobacterium tuberculosis or Pneumocystis carinii. Pulmonary Complications of HIV Infection Study Group.

    PubMed

    Kvale, P A; Hansen, N I; Markowitz, N; Rosen, M J; Jordan, M C; Meiselman, L; Glassroth, J; Reichman, L B; Wallace, J M; Stansell, J D

    1994-09-01

    A prospective multicenter cohort study comprising 1,171 individuals who were seropositive for human immunodeficiency virus (HIV) but did not have AIDS at the time of enrollment and 182 HIV-seronegative controls, was studied by means of routine induced-sputum analysis in an attempt to detect occult tuberculosis or Pneumocystis carinii pneumonia. One occult case of tuberculosis was discovered upon the patient's enrollment (at baseline); none were discovered during follow-up. Two additional Mycobacterium tuberculosis isolates were recovered (one at baseline, one during follow-up) from subjects with symptoms or abnormalities evident on chest roentgenograms. Three specimens were false-positive (one for M. tuberculosis, two for P. carinii). Five pathogenic nontuberculous mycobacteria isolates were recovered during follow-up. Nonpathogenic, nontuberculous mycobacteria were recovered from 51 (4.6%) of 1,113 baseline specimens and 56 (3.7%) of 1,518 follow-up specimens, primarily at a center where the water supply was contaminated. We conclude that routine induced-sputum analysis is not an effective strategy for screening HIV-infected asymptomatic subjects for tuberculosis or P. carinii pneumonia before the onset of clinically recognizable disease activity.

  15. Antibody to hepatitis E virus in HIV-infected individuals and AIDS patients.

    PubMed

    Balayan, M S; Fedorova, O E; Mikhailov, M I; Rytick, P G; Eremin, V F; Danilova, T I; Shevelev, B I; Gorbacheva, E C; Pankova, G Y

    1997-07-01

    Antibody to hepatitis E virus of IgG class (anti-HEV IgG) is regularly detected in industrialized countries, where HEV is non-endemic, at levels not exceeding 2-3%; seropositive individuals are often found in certain groups of patients and professionals exposed to an increased risk of blood-borne infections. The present study was aimed at the identification of anti-HEV IgG in patients with human immunodeficiency virus (HIV) infection, including acquired immune deficiency syndrome (AIDS), living in Russia and Belarus, an area of low anti-HEV prevalence with a moderate spread of HIV infection and AIDS. In Russia, 13 out of 117 HIV-infected patients (11.1%) were found to be anti-HEV seropositive. This differed significantly from the frequency observed in the normal population (1.7%) but not from the frequency in a matching control, high-risk group consisting of male prisoners (8.0%). No difference in the frequency of anti-HEV IgG seropositivity was found between groups of HIV-infected men subdivided by sexual orientation. The rate of anti-HEV seropositivity increased with the progression of HIV infection, reaching 43.3% in AIDS patients and 38.1% in those who died from AIDS. In Belarus, anti-HEV IgG seropositivity was not found among 20 HIV-infected subjects nor among individuals from the control risk group, which consisted of 25 intravenous drug users. In conclusion, HEV infection may have common transmission mechanisms (risk factors) with HIV infection rather than represent an additional opportunistic infection in AIDS.

  16. Effectiveness of Increasing Emergency Department Patients’ Self-perceived Risk for Being Human Immunodeficiency Virus (HIV) Infected Through Audio Computer Self-interview–based Feedback About Reported HIV Risk Behaviors

    PubMed Central

    Merchant, Roland C.; Clark, Melissa A.; Langan, Thomas J.; Seage, George R.; Mayer, Kenneth H.; DeGruttola, Victor G.

    2011-01-01

    Objectives Prior research has demonstrated that emergency department (ED) patient acceptance of human immunodeficiency virus (HIV) screening is partially dependent on patients’ self-perceived risk of infection. The primary objective of this study was to determine the effectiveness of audio computer-assisted self-interview (ACASI)-based feedback. The intervention aimed to increase patient’s self-perceived risk of being HIV infected by providing immediate feedback on their risk behaviors. Methods This 1-year, randomized, controlled trial at a U.S. ED enrolled a random sample of 18- to 64-year-old subcritically ill or injured adult patients who were not known to be HIV infected. All participants completed an anonymous, ACASI-based questionnaire about their HIV risk behaviors related to injection drug use and sex, as well as their self-perceived risk for being HIV infected. Participants were randomly assigned to one of two study groups: an intervention group in which participants received immediate ACASI-based feedback in response to each of their reported risk behaviors or a no-intervention group without feedback. Participants were asked to indicate their level of HIV risk on a five-point scale before and after they answered the questions. Change in level of self-perceived HIV risk was calculated and compared by study group using Pearson’s chi-square test. An HIV risk behavior score that summarized reported HIV risk behavior was devised. Because HIV risk behaviors differ by sex, scores were calculated separately for each sex. Linear regression models that adjusted for study group and same subject covariance were employed to determine if higher HIV risk behavior scores were associated with an increase in self-perceived HIV risk. Results Of the 566 trial participants, the median age was 29 years (interquartile range [IQR] = 22–43 years), 62.2% were females, and 66.9% had been tested previously for HIV. After answering the reported HIV risk behavior questions, 12

  17. Effectiveness of increasing emergency department patients' self-perceived risk for being human immunodeficiency virus (HIV) infected through audio computer self-interview-based feedback about reported HIV risk behaviors.

    PubMed

    Merchant, Roland C; Clark, Melissa A; Langan, Thomas J; Seage, George R; Mayer, Kenneth H; DeGruttola, Victor G

    2009-11-01

    Prior research has demonstrated that emergency department (ED) patient acceptance of human immunodeficiency virus (HIV) screening is partially dependent on patients' self-perceived risk of infection. The primary objective of this study was to determine the effectiveness of audio computer-assisted self-interview (ACASI)-based feedback. The intervention aimed to increase patient's self-perceived risk of being HIV infected by providing immediate feedback on their risk behaviors. This 1-year, randomized, controlled trial at a U.S. ED enrolled a random sample of 18- to 64-year-old subcritically ill or injured adult patients who were not known to be HIV infected. All participants completed an anonymous, ACASI-based questionnaire about their HIV risk behaviors related to injection drug use and sex, as well as their self-perceived risk for being HIV infected. Participants were randomly assigned to one of two study groups: an intervention group in which participants received immediate ACASI-based feedback in response to each of their reported risk behaviors or a no-intervention group without feedback. Participants were asked to indicate their level of HIV risk on a five-point scale before and after they answered the questions. Change in level of self-perceived HIV risk was calculated and compared by study group using Pearson's chi-square test. An HIV risk behavior score that summarized reported HIV risk behavior was devised. Because HIV risk behaviors differ by sex, scores were calculated separately for each sex. Linear regression models that adjusted for study group and same subject covariance were employed to determine if higher HIV risk behavior scores were associated with an increase in self-perceived HIV risk. Of the 566 trial participants, the median age was 29 years (interquartile range [IQR] = 22-43 years), 62.2% were females, and 66.9% had been tested previously for HIV. After answering the reported HIV risk behavior questions, 12.6% of participants had an increase

  18. A Single Quantifiable Viral Load Is Predictive of Virological Failure in Human Immunodeficiency Virus (HIV)-Infected Patients on Combination Antiretroviral Therapy: The Austrian HIV Cohort Study.

    PubMed

    Leierer, Gisela; Grabmeier-Pfistershammer, Katharina; Steuer, Andrea; Sarcletti, Mario; Geit, Maria; Haas, Bernhard; Taylor, Ninon; Kanatschnig, Manfred; Rappold, Michaela; Ledergerber, Bruno; Zangerle, Robert

    2016-04-01

    Background.  Viral loads (VLs) detectable at low levels are not uncommon in patients on combination antiretroviral therapy (cART). We investigated whether a single quantifiable VL predicted virological failure (VF). Methods.  We analyzed patients receiving standard regimens with at least 1 VL measurement below the limit of quantification (BLQ) in their treatment history. The first VL measurement after 6 months of unmodified cART served as baseline VL for the subsequent analyses of the time to reach single VL levels of ≥200, ≥400, and ≥1000 copies/mL. Roche TaqMan 2.0 was used to quantify human immunodeficiency virus-1 ribonucleic acid. Factors associated with VF were determined by Cox proportional hazards models. Results.  Of 1614 patients included in the study, 68, 44, and 34 experienced VF ≥200, ≥400, and ≥1000 copies/mL, respectively. In multivariable analyses, compared with patients who were BLQ, a detectable VL ≤ 50 and VL 51-199 copies/mL predicted VF ≥ 200 copies/mL (hazards ratio [HR] = 2.19, 95% confidence interval [CI] = 1.06-4.55 and HR = 4.21, 95% CI = 2.15-8.22, respectively). In those with VL 51-199 copies/mL, a trend for an increased risk of VF ≥400 and VF ≥1000 copies/mL could be found (HR = 2.13, 95% CI = 0.84-5.39 and HR = 2.52, 95% CI = 0.96-6.60, respectively). Conclusions.  These findings support closer monitoring and adherence counseling for patients with a single measurement of quantifiable VL <200 copies/mL.

  19. Oral Manifestations of Human Immunodeficiency Virus Infection

    PubMed Central

    Epstein, Joel B.; Mathias, Richard G.

    1988-01-01

    The AIDS epidemic continues. All health-care workers, including physicians and dental personnel, may be instrumental in recognizing risk factors associated with Acquired Immunodeficiency Syndrome (AIDS) and Human Immunodeficiency Virus (HIV) infection. Oral signs and symptoms of HIV infection may be the first presentation of the disease or may develop during the course of the disease and require management. Knowledge of the signs, symptoms and associated infections and tumours is needed to assist in recognition, diagnosis, and treatment. ImagesFigure 1Figure 2Figure 3Figure 4Figure 5Figure 6Figure 7Figure 8Figure 9Figure 10Figure 11Figure 12Figure 13 PMID:21253078

  20. [Clinical assessment of the risk of Human Immunodeficiency virus (HIV) infection in the population consulting an anonymous and free screening center].

    PubMed

    Derancourt, C; Merle, C; Godeau, H; Vignon, F; Lemoussu, C; Verraes Derancourt, S; Bernard, P

    2004-01-01

    The anonymous and free AIDS screening centers were developed in France in 1987 to incite the general population to undergo screening for HIV infection. The aim of this paper was to conduct a prospective study describing the principle characteristics and level of risk of those consulting a center in the Year 1999. A face to face physician-consultant questionnaire was proposed to all the consultants that Year. It included 20 questions regrouped in general characteristics of the subject, number of previous screenings, reason for screening, type of risk taken, date of last risk taken, and number of sexual partners during the past 12 Months and throughout their life without the use of a condom. Two thousand six hundred seventy-eight persons consulted (sex ratio=1) aged a mean of 25.8 Years. The men were older than the women (respectively 27 versus 24.6; p<0.05). The reason for screening was a decision made by the couple in 44.6 p. 100, an unprotected sexual relationship in 47.6 p. 100 another reason in 7.6 p. 100 and drug abuse in 0.2 p. 100 of cases. The sex mode declared was heterosexual in 94.5 p. 100 and homo or bisexual in 5.4 p. 100. The majority of those consulting (66.2 p. 100) had had between 0 and 2 partners during the past 12 Months; 66 p. 100 had had more than 10 during their life without using a condom. The assessment of the global risk by the physician was: very high in 1 p. 100, high in 2.5 p. 100, moderate in 13.3 p. 100, low in 70.7 p. 100 and nil in 12.5 p. cent. Five HIV infections were diagnosed, all in persons at high or very high risk. These results should stimulate the radical differentiation of the management of persons consulting according to the level of risk identified by the medical questionnaire.

  1. [Human immunodeficiency virus (HIV) infection in mothers and infants in French Guyana. Epidemiologic study apropos of 44 women having conceived 55 children].

    PubMed

    Pradinaud, R; Sainte-Marie, D; Plat, J M; Cassiede, P; Vienne, P; Vigneron-Meleder, H; Wojcick, L; Wojcick, J M; Sankale-Suzanon, J; Patient, G

    1989-01-01

    The French Guyana is an Overseas French Department in South America, with 100,000 inhabitants among them are 20% of Haitian immigrants. At 31 December 1987, 103 AIDS cases have been recorded, 86% by heterosexual transmission. The first case dated May 1979 was retroactively diagnosed in an Haitian parturient, thank to her serum kept in the Pasteur institute of Cayenne. 44 women got their pregnancy during their HIV infection: 5 with clinical and biological evidence of AIDS, 7 developed AIDS after getting pregnant, and 10 out of these 12 women died. All of them were from a rather low social group and, generally, were not married. 43 are black (40 Haitians and 3 Guyanese Creoles), one is Indian and presented some psychic disorders. The mean age was 32 1/2 (from 15 to 51 years old). 55 babies were born: 12 developed AIDS (6 died during the first 15 months of their life); 14 are HIV +, 3 stillborns, 4 never tested and 22 developed negative reaction (with ELISA and Western-Blot) between 7.5 and 10 months of their life. Two Hutchinson's triads were observed. Prurigo is the most commonly skin manifestation observed.

  2. Testing an optimized community-based human immunodeficiency virus (HIV) risk reduction and antiretroviral adherence intervention for HIV-infected injection drug users.

    PubMed

    Copenhaver, Michael M; Lee, I-Ching; Margolin, Arthur; Bruce, Robert D; Altice, Frederick L

    2011-01-01

    The authors conducted a preliminary study of the 4-session Holistic Health for HIV (3H+), which was adapted from a 12-session evidence-based risk reduction and antiretroviral adherence intervention. Improvements were found in the behavioral skills required to properly adhere to HIV medication regimens. Enhancements were found in all measured aspects of sex-risk reduction outcomes, including HIV knowledge, motivation to reduce sex-risk behavior, behavioral skills related to engaging in reduced sexual risk, and reduced risk behavior. Improvements in drug use outcomes included enhancements in risk reduction skills as well as reduced heroin and cocaine use. Intervention effects also showed durability from post-intervention to the follow-up assessment point. Females responded particularly well in terms of improvements in risk reduction skills and risk behavior. This study suggests that an evidence-based behavioral intervention may be successfully adapted for use in community-based clinical settings where HIV-infected drug users can be more efficiently reached.

  3. Feline immunodeficiency virus latency

    PubMed Central

    2013-01-01

    Despite highly effective anti-retroviral therapy, HIV is thought to persist in patients within long-lived cellular reservoirs in the form of a transcriptionally inactive (latent) integrated provirus. Lentiviral latency has therefore come to the forefront of the discussion on the possibility of a cure for HIV infection in humans. Animal models of lentiviral latency provide an essential tool to study mechanisms of latency and therapeutic manipulation. Of the three animal models that have been described, the feline immunodeficiency virus (FIV)-infected cat is the most recent and least characterized. However, several aspects of this model make it attractive for latency research, and it may be complementary to other model systems. This article reviews what is known about FIV latency and chronic FIV infection and how it compares with that of other lentiviruses. It thereby offers a framework for the usefulness of this model in future research aimed at lentiviral eradication. PMID:23829177

  4. The Epidemiology of Human Immunodeficiency Virus Infection.

    ERIC Educational Resources Information Center

    Glasner, Peter D.; Kaslow, Richard A.

    1990-01-01

    Reviews epidemiology and natural history of human immunodeficiency virus-Type 1 (HIV-1) infection. Discusses early and late clinical manifestations, diagnosis of infection, incubation and latency periods, and survival time. Reviews data from published literature on distribution of HIV infection in adult United States population and factors that…

  5. The Epidemiology of Human Immunodeficiency Virus Infection.

    ERIC Educational Resources Information Center

    Glasner, Peter D.; Kaslow, Richard A.

    1990-01-01

    Reviews epidemiology and natural history of human immunodeficiency virus-Type 1 (HIV-1) infection. Discusses early and late clinical manifestations, diagnosis of infection, incubation and latency periods, and survival time. Reviews data from published literature on distribution of HIV infection in adult United States population and factors that…

  6. Systematic Literature Review and Meta-Analysis of Renal Function in Human Immunodeficiency Virus (HIV)-Infected Patients Treated with Atazanavir (ATV)-Based Regimens.

    PubMed

    Cure, Sandrine; Bianic, Florence; Espinas, Caroline; Hardy, Helene; Rosenblatt, Lisa; Juday, Timothy

    2015-01-01

    Some HIV antiretroviral therapies (ART) have been associated with renal toxicities, which become of increasing concern as HIV-infected patients age and develop comorbidities. The objective of this study was to evaluate the relative impact of atazanavir (ATV)-based regimens on the renal function of adult patients with HIV. We conducted a systematic literature review by searching PubMed, EMBASE, Cochrane library, and the CRD from 2000 until March 2013. Major HIV-related conferences occurring in the past two years were also searched. All randomized clinical trials and large cohort studies assessing renal function in treatment-naïve and/or treatment-experienced HIV patients on ATV-based regimens were included. Fixed-effect mixed-treatment network analyses were carried out on the most frequently reported renal outcomes. 23 studies met the inclusion criteria, and change in estimated glomerular filtration rate (eGFR) from baseline to 48 weeks was identified as the main outcome. Two networks including, respectively, six studies (using the Cockcroft-Gault method) and four studies (using MDRD and CKD-EPI) were analysed. With CG network, ATV/r + TDF/FTC was associated with lower impact on the decline of eGFR than ATV/cobicistat + TDF/FTC but with higher decrease in eGFR than ATV/r + ABC/3TC (difference in mean change from baseline in eGFR respectively +3.67 and -3.89). The use of ATV/cobicistat + TDF/FTC led to a similar decline in eGFR as EVG/cobicistat/TDF/FTC. With respect to third agents combined with TDF/FTC, ATV/r had a lower increase in eGFR in comparison to EFV, and no difference was shown when compared to SQV/r and DRV/r. The effect of ATV-based regimens on renal function at 48 weeks appears similar to other ART regimens and appears to be modest regardless of boosting agent or backbone, although TDF containing backbones consistently leads to greater decline in eGFR.

  7. Immunodeficiency, AIDS-related pneumonia, and risk of lung cancer among HIV-infected individuals.

    PubMed

    Marcus, Julia L; Leyden, Wendy A; Chao, Chun R; Horberg, Michael A; Klein, Daniel B; Quesenberry, Charles P; Towner, William J; Silverberg, Michael J

    2017-04-24

    The objective is to clarify the role of immunodeficiency and pneumonia in elevated lung cancer risk among HIV-infected individuals. Cohort study of HIV-infected and HIV-uninfected adults in a large integrated healthcare system in California during 1996-2011. We used Poisson models to obtain rate ratios for lung cancer associated with HIV infection, overall and stratified by recent CD4 cells/μl (HIV-uninfected as reference group), with χ tests for trends across CD4 strata. Fully adjusted models included demographics, cancer risk factors (smoking, drug/alcohol abuse, overweight/obesity), and prior pneumonia. Among 24 768 HIV-infected and 257 600 HIV-uninfected individuals, the lung cancer rate per 100 000 person-years was 66 (n = 80 events) for HIV-infected and 33 (n = 506 events) for HIV-uninfected individuals [rate ratio 2.0, 95% confidence interval (CI): 1.7-2.2]. Overall, HIV-infected individuals were at increased risk of lung cancer after adjustment for demographics and cancer risk factors (rate ratio 1.4, 95% CI: 1.1-1.7), but not after additional adjustment for pneumonia (rate ratio 1.2, 95% CI: 0.9-1.6). Lower CD4 cell counts were associated with higher risk of lung cancer in unadjusted and demographics-adjusted models (P < 0.001 for all), but this trend did not remain after adjustment for cancer risk factors and pneumonia. Compared with HIV-uninfected individuals, HIV-infected individuals with CD4 less than 200 cells/μl were not at increased risk of lung cancer in fully adjusted models. The increased lung cancer risk among HIV patients is attributable to differences in demographics, risk factors such as smoking, and history of pneumonia. Immunodeficiency does not appear to have an independent effect on lung cancer risk.

  8. Serological and molecular markers of hepatitis E virus infection in HIV-infected patients in Brazil.

    PubMed

    Ferreira, A C; Gomes-Gouvêa, Michele Soares; Lisboa-Neto, G; Mendes-Correa, M C J; Picone, C M; Salles, N A; Mendrone-Junior, A; Carrilho, F J; Pinho, J R R

    2017-09-30

    In Brazil, the circulation of hepatitis E virus (HEV) has been demonstrated in distinct groups of individuals and some animals, but its prevalence among individuals with human immunodeficiency virus (HIV) infection is unknown. This study aimed to assess the frequency of serological and molecular HEV markers in individuals infected with HIV from São Paulo, Brazil. Serum and plasma samples of 354 HIV-infected patients collected between 2007 and 2013 were included. All samples were tested for anti-HEV IgG and IgM antibodies and HEV RNA. Anti-HEV IgG and IgM antibodies were detected in 10.7% (38/354) and 1.4% (5/354) of the samples, respectively. Both antibodies were detected simultaneously in only two samples. HEV RNA was not detected in any sample. There was no significant correlation of anti-HEV serological status (positivity to anti-HEV IgG and/or IgM) with sex, age, CD4(+) T cell count, HIV viral load, antiretroviral therapy, liver enzyme levels, or coinfection with hepatitis B virus and/or hepatitis C virus. Our study provides serological evidence of past and recent HEV infections in HIV-infected patients from São Paulo, Brazil. However, the occurrence of ongoing HEV infection appears be a rare event in this population.

  9. Clinical and Virologic Manifestations of Primary Epstein-Barr Virus (EBV) Infection in Kenyan Infants Born to HIV-Infected Women

    PubMed Central

    Slyker, Jennifer A.; Casper, Corey; Tapia, Kenneth; Richardson, Barbra; Bunts, Lisa; Huang, Meei-Li; Maleche-Obimbo, Elizabeth; Nduati, Ruth; John-Stewart, Grace

    2013-01-01

    Background. Human immunodeficiency virus (HIV) infection is a risk factor for Epstein-Barr virus (EBV)–associated lymphomas. Characterizing primary infection may elucidate risk factors for malignancy. Methods. To describe clinical and virologic manifestations of primary EBV infection among infants born to HIV-infected women, specimens were utilized from a cohort study conducted in Nairobi, Kenya. HIV and EBV viral loads were measured serially in plasma. EBV serology was performed on EBV DNA–negative infants. Monthly clinical examinations were performed by pediatricians. Results. The probability of EBV infection by 1 year of age was .78 (95% CI, .67–.88) in HIV-infected and .49 (95% CI, .35–.65) in HIV-uninfected infants (P < .0001). At 2 years, probability of EBV infection was .96 (95% CI, .89–.99) in HIV-infected infants. Peak EBV loads were higher in HIV-infected versus HIV-uninfected infants (median 2.6 vs 2.1 log10 copies/mL; P < .0001). The majority of HIV-infected infants had detectable EBV DNA for >3 months (79%). Primary EBV infection was associated with cough, fever, otitis media, pneumonia, hepatomegaly, splenomegaly, and hospitalization in HIV-infected infants; conjunctivitis and rhinorrhea in HIV-uninfected infants. Conclusions. EBV infection occurs early in infants born to HIV-infected women. HIV infection was associated with more frequent and higher quantity EBV DNA detection. PMID:23493724

  10. Clinical and virologic manifestations of primary Epstein-Barr virus (EBV) infection in Kenyan infants born to HIV-infected women.

    PubMed

    Slyker, Jennifer A; Casper, Corey; Tapia, Kenneth; Richardson, Barbra; Bunts, Lisa; Huang, Meei-Li; Maleche-Obimbo, Elizabeth; Nduati, Ruth; John-Stewart, Grace

    2013-06-15

    Human immunodeficiency virus (HIV) infection is a risk factor for Epstein-Barr virus (EBV)-associated lymphomas. Characterizing primary infection may elucidate risk factors for malignancy. To describe clinical and virologic manifestations of primary EBV infection among infants born to HIV-infected women, specimens were utilized from a cohort study conducted in Nairobi, Kenya. HIV and EBV viral loads were measured serially in plasma. EBV serology was performed on EBV DNA-negative infants. Monthly clinical examinations were performed by pediatricians. The probability of EBV infection by 1 year of age was .78 (95% CI, .67-.88) in HIV-infected and .49 (95% CI, .35-.65) in HIV-uninfected infants (P < .0001). At 2 years, probability of EBV infection was .96 (95% CI, .89-.99) in HIV-infected infants. Peak EBV loads were higher in HIV-infected versus HIV-uninfected infants (median 2.6 vs 2.1 log10 copies/mL; P < .0001). The majority of HIV-infected infants had detectable EBV DNA for >3 months (79%). Primary EBV infection was associated with cough, fever, otitis media, pneumonia, hepatomegaly, splenomegaly, and hospitalization in HIV-infected infants; conjunctivitis and rhinorrhea in HIV-uninfected infants. EBV infection occurs early in infants born to HIV-infected women. HIV infection was associated with more frequent and higher quantity EBV DNA detection.

  11. Decrease in serial prevalence of coinfection with hepatitis C virus among HIV-infected patients in Spain, 1997-2006.

    PubMed

    Pérez Cachafeiro, Santiago; Del Amo, Julia; Iribarren, Jose A; Salavert Lleti, Miguel; Gutiérrez, Félix; Moreno, Ana; Labarga, Pablo; Pineda, Juan A; Vidal, Francesc; Berenguer, Juan; Moreno, Santiago

    2009-05-15

    The prevalence of injection drug use decreased from 67.3% in 1997 to 14.5% in 2006 among Spanish patients infected with human immunodeficiency virus (HIV). A parallel decrease in the prevalence of coinfection with hepatitis C virus was observed, from 73.8% in 1997 to 19.8% in 2006. This steady decrease in the prevalence of coinfection among Spanish patients was caused by a change in transmission routes of HIV infection.

  12. Effectiveness of the First Dose of BCG against Tuberculosis among HIV-Infected, Predominantly Immunodeficient Children.

    PubMed

    Van-Dunem, Joaquim C V D; Rodrigues, Laura C; Alencar, Luiz Claudio Arraes; Militão-Albuquerque, Maria de Fátima Pessoa; Ximenes, Ricardo Arraes de Alencar

    2015-01-01

    The objective of this study was to estimate the protective effect of Bacille Calmette-Guérin (BCG) vaccine against tuberculosis among (predominantly immunodeficient) HIV-infected children in Angola. A hospital-based case-control study was conducted with 230 cases, children coinfected with tuberculosis, and 672 controls, HIV-infected children from the same hospital, aged 18 months to 13 years. The presence of a vaccination scar was taken as a proxy marker for BCG vaccination. The crude effectiveness was 8% (95% CI: -26 to 32) and the adjusted effectiveness was 30% (95% CI: -75 to 72). The present study suggests that BCG does not have a protective effect against tuberculosis among immunodeficient HIV-infected children. Since BCG is no longer given to HIV-infected children, the study may not be replicated. Accepting that these findings should be considered with caution, they are nonetheless likely to be the last estimate of BCG efficacy in a sufficiently powered study.

  13. Molecular Epidemiology of Human Immunodeficiency Virus

    PubMed Central

    2017-01-01

    During the evolution of human immunodeficiency virus (HIV), transmissions between humans and primates resulted in multiple HIV lineages in humans. This evolution has been rapid, giving rise to a complex classification and allowing for worldwide spread and intermixing of subtypes, which has consequently led to dozens of circulating recombinant forms. In the Republic of Korea, 12,522 cases of HIV infection have been reported between 1985, when AIDS was first identified, and 2015. This review focuses on the evolution of HIV infection worldwide and the molecular epidemiologic characteristics of HIV in Korea. PMID:28332348

  14. Adherence to hepatitis A virus vaccination in HIV-infected men who have sex with men.

    PubMed

    Kourkounti, Sofia; Paparizos, Vassilios; Leuow, Kirsten; Paparizou, Eleni; Antoniou, Christina

    2015-10-01

    Although vaccination against hepatitis A virus (HAV) is essential for human immunodeficiency virus (HIV)-infected patients, the uptake of HAV vaccine is reported to be very low. From 2007 to 2012, 912 HIV-infected men in Athens, Greece were screened for exposure to HAV. Two doses of an HAV vaccine were recommended to 569 eligible patients. Reminder cards with scheduled vaccination visits were given to each patient. Among eligible patients, 62.2% (354/569) received both doses. Patients who were fully vaccinated compared with non-adherent patients were natives, older, had undetectable HIV viral load, higher CD4 T cell counts and lower nadir CD4 T cell counts. Multivariate logistic regression revealed that the patient's country of origin (p = 0.024; OR = 2.712; 95% CI, 1.139-6.457), CD4 T cell count (p < 0.001) and nadir CD4 T cell count (p < 0.001) were factors directly associated with adherence. In conclusion, adherence to HAV vaccination was better than in previously published data. Because many of the factors related to vaccination completion are parameters of HIV infection, it appears that physician interest in HIV care and vaccination planning is crucial to enhancing vaccine uptake. © The Author(s) 2015.

  15. Pediatric Pulmonary and Cardiovascular Complications of Vertically Transmitted HIV Infection (P2C2)

    ClinicalTrials.gov

    2016-04-13

    Acquired Immunodeficiency Syndrome; Lung Diseases; Cardiovascular Diseases; Heart Diseases; Heart Failure; HIV Infections; Cytomegalovirus Infections; Pneumocystis Carinii Infections; Ebstein-Barr Virus Infections

  16. Purinergic signaling and human immunodeficiency virus/acquired immune deficiency syndrome: From viral entry to therapy.

    PubMed

    Passos, Daniela F; Schetinger, Maria Rosa C; Leal, Daniela Br

    2015-08-12

    Human immunodeficiency virus (HIV) infection is a serious condition associated to severe immune dysfunction and immunodeficiency. Mechanisms involved in HIV-associated immune activation, inflammation and loss of CD4+ T cells have been extensively studied, including those concerning purinergic signaling pathways. Purinergic signaling components are involved in viral entry and replication and disease progression. Research involving the participation of purinergic signaling in HIV infection has been not only important to elucidate disease mechanisms but also to introduce new approaches to therapy. The involvement of purinergic signaling in the pathogenesis of HIV infection and its implications in the control of the HIV infection are reviewed in this paper.

  17. Pharmacological Inhibition of Feline Immunodeficiency Virus (FIV)

    PubMed Central

    Mohammadi, Hakimeh; Bienzle, Dorothee

    2012-01-01

    Feline immunodeficiency virus (FIV) is a member of the retroviridae family of viruses and causes an acquired immunodeficiency syndrome (AIDS) in domestic and non-domestic cats worldwide. Genome organization of FIV and clinical characteristics of the disease caused by the virus are similar to those of human immunodeficiency virus (HIV). Both viruses infect T lymphocytes, monocytes and macrophages, and their replication cycle in infected cells is analogous. Due to marked similarity in genomic organization, virus structure, virus replication and disease pathogenesis of FIV and HIV, infection of cats with FIV is a useful tool to study and develop novel drugs and vaccines for HIV. Anti-retroviral drugs studied extensively in HIV infection have targeted different steps of the virus replication cycle: (1) inhibition of virus entry into susceptible cells at the level of attachment to host cell surface receptors and co-receptors; (2) inhibition of fusion of the virus membrane with the cell membrane; (3) blockade of reverse transcription of viral genomic RNA; (4) interruption of nuclear translocation and viral DNA integration into host genomes; (5) prevention of viral transcript processing and nuclear export; and (6) inhibition of virion assembly and maturation. Despite much success of anti-retroviral therapy slowing disease progression in people, similar therapy has not been thoroughly investigated in cats. In this article we review current pharmacological approaches and novel targets for anti-lentiviral therapy, and critically assess potentially suitable applications against FIV infection in cats. PMID:22754645

  18. Cirrhosis, Liver Transplantation and HIV Infection Are Risk Factors Associated with Hepatitis E Virus Infection

    PubMed Central

    Riveiro-Barciela, Mar; Buti, María; Homs, María; Campos-Varela, Isabel; Cantarell, Carmen; Crespo, Manuel; Castells, Lluís; Tabernero, David; Quer, Josep; Esteban, Rafael; Rodriguez-Frías, Francisco

    2014-01-01

    Background Acute and chronic hepatitis E have been associated with high mortality and development of cirrhosis, particularly in solid-organ recipients and patients infected by human immunodeficiency virus. However, data regarding the epidemiology of hepatitis E in special populations is still limited. Aims Investigate seroprevalence and possible factors associated with HEV infection in a large cohort of immunosuppressed patients. Methods Cross-sectional study testing IgG anti-HEV in serum samples from 1373 consecutive individuals: 332 liver-transplant, 296 kidney-transplant, 6 dual organ recipients, 301 non-transplanted patients with chronic liver disease, 238 HIV-infected patients and 200 healthy controls. Results IgG anti-HEV was detected in 3.5% controls, 3.7% kidney recipients, 7.4% liver transplant without cirrhosis and 32.1% patients who developed post-transplant cirrhosis (p<0.01). In patients with chronic liver disease, IgG anti-HEV was also statistically higher in those with liver cirrhosis (2% vs 17.5%, p<0.01). HIV-infected patients showed an IgG anti-HEV rate of 9.2%, higher than those patients without HIV infection (p<0.03). Multivariate analysis showed that the factors independently associated with anti-HEV detection were liver cirrhosis, liver transplantation and HIV infection (OR: 7.6, 3.1 and 2.4). HCV infection was a protective factor for HEV infection (OR: 0.4). Conclusions HEV seroprevalence was high in liver transplant recipients, particularly those with liver cirrhosis. The difference in anti-HEV prevalence between Liver and Kidney transplanted cases suggests an association with advanced liver disease. Further research is needed to ascertain whether cirrhosis is a predisposing factor for HEV infection or whether HEV infection may play a role in the pathogeneses of cirrhosis. PMID:25068388

  19. Case Study: Delirium in an Adolescent Girl with Human Immunodeficiency Virus-Associated Dementia

    ERIC Educational Resources Information Center

    Scharko, Alexander M.; Baker, Eva H.; Kothari, Priti; Khattak, Hina; Lancaster, Duniya

    2006-01-01

    Delirium and human immunodeficiency virus (HIV)-associated dementia are well recognized neuropsychiatric consequences of HIV infection in adults. Almost nothing is known regarding the management of delirium in HIV-infected children and adolescents. HIV-related progressive encephalopathy is thought to represent the pediatric form of HIV-associated…

  20. Case Study: Delirium in an Adolescent Girl with Human Immunodeficiency Virus-Associated Dementia

    ERIC Educational Resources Information Center

    Scharko, Alexander M.; Baker, Eva H.; Kothari, Priti; Khattak, Hina; Lancaster, Duniya

    2006-01-01

    Delirium and human immunodeficiency virus (HIV)-associated dementia are well recognized neuropsychiatric consequences of HIV infection in adults. Almost nothing is known regarding the management of delirium in HIV-infected children and adolescents. HIV-related progressive encephalopathy is thought to represent the pediatric form of HIV-associated…

  1. Human immunodeficiency virus infection and the liver.

    PubMed

    Crane, Megan; Iser, David; Lewin, Sharon R

    2012-03-27

    Liver disease in human immunodeficiency virus (HIV)-infected individuals encompasses the spectrum from abnormal liver function tests, liver decompensation, with and without evidence of cirrhosis on biopsy, to non-alcoholic liver disease and its more severe form, non-alcoholic steatohepatitis and hepatocellular cancer. HIV can infect multiple cells in the liver, leading to enhanced intrahepatic apoptosis, activation and fibrosis. HIV can also alter gastro-intestinal tract permeability, leading to increased levels of circulating lipopolysaccharide that may have an impact on liver function. This review focuses on recent changes in the epidemiology, pathogenesis and clinical presentation of liver disease in HIV-infected patients, in the absence of co-infection with hepatitis B virus or hepatitis C virus, with a specific focus on issues relevant to low and middle income countries.

  2. Altered Virome and Bacterial Microbiome in Human Immunodeficiency Virus-Associated Acquired Immunodeficiency Syndrome.

    PubMed

    Monaco, Cynthia L; Gootenberg, David B; Zhao, Guoyan; Handley, Scott A; Ghebremichael, Musie S; Lim, Efrem S; Lankowski, Alex; Baldridge, Megan T; Wilen, Craig B; Flagg, Meaghan; Norman, Jason M; Keller, Brian C; Luévano, Jesús Mario; Wang, David; Boum, Yap; Martin, Jeffrey N; Hunt, Peter W; Bangsberg, David R; Siedner, Mark J; Kwon, Douglas S; Virgin, Herbert W

    2016-03-09

    Human immunodeficiency virus (HIV) infection is associated with increased intestinal translocation of microbial products and enteropathy as well as alterations in gut bacterial communities. However, whether the enteric virome contributes to this infection and resulting immunodeficiency remains unknown. We characterized the enteric virome and bacterial microbiome in a cohort of Ugandan patients, including HIV-uninfected or HIV-infected subjects and those either treated with anti-retroviral therapy (ART) or untreated. Low peripheral CD4 T cell counts were associated with an expansion of enteric adenovirus sequences and this increase was independent of ART treatment. Additionally, the enteric bacterial microbiome of patients with lower CD4 T counts exhibited reduced phylogenetic diversity and richness with specific bacteria showing differential abundance, including increases in Enterobacteriaceae, which have been associated with inflammation. Thus, immunodeficiency in progressive HIV infection is associated with alterations in the enteric virome and bacterial microbiome, which may contribute to AIDS-associated enteropathy and disease progression.

  3. Human Immunodeficiency Virus (HIV) in Military Service Members

    DTIC Science & Technology

    2013-06-07

    quantitative nucleic acid result for HIV infection according to a Food and Drug Administration-approved test. ...07 JUN 2013 2. REPORT TYPE 3. DATES COVERED 00-00-2013 to 00-00-2013 4. TITLE AND SUBTITLE Human Immunodeficiency Virus (HIV) in Military...and Readiness (USD(P&R)),” June 23, 2008 (b) DoD Instruction 6485.01, “Human Immunodeficiency Virus ,” October 17, 2006 (hereby cancelled) (c) DoD

  4. Testing for Human Immunodeficiency Virus

    MedlinePlus

    ... education Fact Sheet PFS005: Testing for Human Immunodeficiency Virus AUGUST 2015 • Reasons for Getting Tested • Who Should ... For More Information • Glossary Testing for Human Immunodeficiency Virus Human immunodeficiency virus (HIV) is the virus that ...

  5. The effect of tenidap on cytokines, acute-phase proteins, and virus load in human immunodeficiency virus (HIV)-infected patients: correlation between plasma HIV-1 RNA and proinflammatory cytokine levels.

    PubMed

    Dezube, B J; Lederman, M M; Chapman, B; Georges, D L; Dogon, A L; Mudido, P; Reis-Lishing, J; Cheng, S L; Silberman, S L; Crumpacker, C S

    1997-09-01

    Proinflammatory cytokines may be important in the pathogenesis of human immunodeficiency virus type 1 (HIV-1) disease. Tenidap decreases interleukin (IL)-6, IL-1, and tumor necrosis factor (TNF) production by peripheral blood mononuclear cells and decreases IL-6 plasma levels in rheumatoid arthritis patients. In this randomized double-blind study, 43 HIV-1-infected patients received tenidap (120 mg) or placebo daily for 6 weeks and then crossed over to the alternative therapy for an additional 6 weeks. Mean entry CD4 cell count was 140/microL. Analyses were performed on cytokines, acute-phase proteins, virus load, and CD4 cell counts. With the exception of small differences in plasma TNF levels, tenidap had no significant effect on these indices. Significant correlations of plasma IL-6 and TNF levels with HIV-1 RNA were noted. Six patients discontinued tenidap due to rash. The effects of tenidap in HIV-1 infection contrast to results in arthritis patients, in whom tenidap decreased plasma levels of IL-6 and acute-phase proteins.

  6. An Unusual Case of Primary Human Immunodeficiency Virus Infection Presenting as Mononucleosis-like Syndrome and Acute Aseptic Meningoencephalitis. Report of a Case and Review of the Literature.

    PubMed

    Corti, Marcelo; Gilardi, Leonardo

    2014-07-01

    Clinical presentation of primary human immunodeficiency virus (HIV) infection includes a wide spectrum of manifestations from asymptomatic infection to a symptomatic and severe illness. Central nervous system involvement should be always considered as a severe clinical form of primary HIV infection. Physicians should be aware to the broad clinical spectrum of primary HIV infection. We report a case of a female with diagnosis of mononucleosis-like syndrome and acute aseptic meningoencephalitis during primary HIV infection.

  7. An Unusual Case of Primary Human Immunodeficiency Virus Infection Presenting as Mononucleosis-like Syndrome and Acute Aseptic Meningoencephalitis. Report of a Case and Review of the Literature

    PubMed Central

    Corti, Marcelo; Gilardi, Leonardo

    2014-01-01

    Clinical presentation of primary human immunodeficiency virus (HIV) infection includes a wide spectrum of manifestations from asymptomatic infection to a symptomatic and severe illness. Central nervous system involvement should be always considered as a severe clinical form of primary HIV infection. Physicians should be aware to the broad clinical spectrum of primary HIV infection. We report a case of a female with diagnosis of mononucleosis-like syndrome and acute aseptic meningoencephalitis during primary HIV infection. PMID:25374871

  8. Symptoms of Autonomic Dysfunction in Human Immunodeficiency Virus

    PubMed Central

    Chow, Dominic; Nakamoto, Beau K.; Sullivan, Katherine; Sletten, David M.; Fujii, Satomi; Umekawa, Sari; Kocher, Morgan; Kallianpur, Kalpana J.; Shikuma, Cecilia M.; Low, Phillip

    2015-01-01

    This retrospective study evaluated the frequencies of symptoms associated with autonomic dysfunction in human immunodeficiency virus (HIV)-infected patients on stable combined antiretroviral therapy. Patients infected with HIV reported higher frequencies of dysautonomia symptoms compared with HIV-negative patients, particularly in the autonomic domains related to urinary, sleep, gastroparesis, secretomotor, pupillomotor, and male sexual dysfunction. PMID:26269797

  9. Risk Assessment for Human Immunodeficiency Virus among Pregnant Hispanic Adolescents.

    ERIC Educational Resources Information Center

    Berger, David K.; And Others

    1993-01-01

    Assessed human immunodeficiency virus (HIV) risk status of pregnant Hispanic adolescents in New York City. One-third of 87 adolescents were identified as being at increased risk for HIV infection. Sexual risk-taking behavior was most common factor that increased HIV risk. Birthplace and nationality were significantly associated with HIV risk…

  10. Dental management of HIV-infected individuals.

    PubMed

    Aldous, J A

    1990-11-01

    In 1981, a group of male homosexuals was found to have an immunological defect resulting in opportunistic infections. The pattern of symptoms became known as acquired immune deficiency syndrome (AIDS). Much time and expense have been invested to study the human immunodeficiency virus (HIV), prevent its spread, and find a cure for HIV infection. Fear of HIV infection has resulted in implementation of stricter infection control practices. Intervention by the Occupational Safety and Health Administration (OSHA) and Environmental Protection Agency (EPA) has mandated procedures for infection control and waste disposal. Ethical questions and social problems have surfaced concerning the treatment of HIV-infected patients. Despite reports on infection control, literature concerning management of HIV-infected dental patients is limited. Misinformation has prevented the application of reliable information about the care of HIV-infected individuals. An accurate general knowledge of HIV infection is essential for optimal care of these patients.

  11. ACOG Committee Opinion No. 536: Human immunodeficiency virus and acquired immunodeficiency syndrome and women of color.

    PubMed

    2012-09-01

    In the United States, most new cases of human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS) occur among women of color (primarily African American and Hispanic women). Most women of color acquire the disease from heterosexual contact, often from a partner who has undisclosed risk factors for HIV infection. Safe sex practices, especially consistent condom use, must be emphasized for all women, including women of color. A combination of testing, education, and brief behavioral interventions can help reduce the rate of HIV infection and its complications among women of color. In addition,biomedical interventions such as early treatment of patients infected with HIV and pre-exposure antiretroviral prophylaxis of high-risk individuals offer promise for future reductions in infections.

  12. Tuberculous meningitis in patients infected with human immunodeficiency virus.

    PubMed

    Garg, Ravindra Kumar; Sinha, Manish Kumar

    2011-01-01

    Tuberculosis is the most common opportunistic infection in human immunodeficiency virus (HIV) infected persons. HIV-infected patients have a high incidence of tuberculous meningitis as well. The exact incidence and prevalence of tuberculous meningitis in HIV-infected patients are not known. HIV infection does not significantly alter the clinical manifestations, laboratory, radiographic findings, or the response to therapy. Still, some differences have been noted. For example, the histopathological examination of exudates in HIV-infected patients shows fewer lymphocytes, epithelioid cells, and Langhan's type of giant cells. Larger numbers of acid-fast bacilli may be seen in the cerebral parenchyma and meninges. The chest radiograph is abnormal in up to 46% of patients with tuberculous meningitis. Tuberculous meningitis is likely to present with cerebral infarcts and mass lesions. Cryptococcal meningitis is important in differential diagnosis. The recommended duration of treatment in HIV-infected patients is 9-12 months. The benefit of adjunctive corticosteroids is uncertain. Antiretroviral therapy and antituberculosis treatment should be initiated at the same time, regardless of CD4 cell counts. Tuberculous meningitis may be a manifestation of paradoxical tuberculosis-associated immune reconstitution inflammatory syndrome. Some studies have demonstrated a significant impact of HIV co-infection on mortality from tuberculous meningitis. HIV-infected patients with multidrug-resistant tuberculous meningitis have significantly higher mortality. The best way to prevent HIV-associated tuberculous meningitis is to diagnose and isolate infectious cases of tuberculosis promptly and administer appropriate treatment.

  13. Immunopathogenesis of Oropharyngeal Candidiasis in Human Immunodeficiency Virus Infection

    PubMed Central

    de Repentigny, Louis; Lewandowski, Daniel; Jolicoeur, Paul

    2004-01-01

    Oropharyngeal and esophageal candidiases remain significant causes of morbidity in human immunodeficiency virus (HIV)-infected patients, despite the dramatic ability of antiretroviral therapy to reconstitute immunity. Notable advances have been achieved in understanding, at the molecular level, the relationships between the progression of HIV infection, the acquisition, maintenance, and clonality of oral candidal populations, and the emergence of antifungal resistance. However, the critical immunological defects which are responsible for the onset and maintenance of mucosal candidiasis in patients with HIV infection have not been elucidated. The devastating impact of HIV infection on mucosal Langerhans' cell and CD4+ cell populations is most probably central to the pathogenesis of mucosal candidiasis in HIV-infected patients. However, these defects may be partly compensated by preserved host defense mechanisms (calprotectin, keratinocytes, CD8+ T cells, and phagocytes) which, individually or together, may limit Candida albicans proliferation to the superficial mucosa. The availability of CD4C/HIV transgenic mice expressing HIV-1 in immune cells has provided the opportunity to devise a novel model of mucosal candidiasis that closely mimics the clinical and pathological features of candidal infection in human HIV infection. These transgenic mice allow, for the first time, a precise cause-and-effect analysis of the immunopathogenesis of mucosal candidiasis in HIV infection under controlled conditions in a small laboratory animal. PMID:15489345

  14. Human immunodeficiency virus induced oral candidiasis

    PubMed Central

    Warrier, S. Aravind; Sathasivasubramanian, S.

    2015-01-01

    Human immunodeficiency virus (HIV) infection is a worldwide health problem, which affects in both developing and developed countries. The oral lesions caused due to this disease can drastically change the life of the patient, in terms of quality. We can also know the progression of the disease and also the important immune status of the patient. Lots of information on HIV is known in the developed countries and very less reports are available in the developing countries. The morbidity of HIV disease is due to its association with opportunistic fungal infection and the most common among them is oral candidiasis. Here, we present a case report on an apparently healthy male patient of 39 years, who had oral candidiasis and was one of the indicators for HIV infection. PMID:26538978

  15. Bacterial Respiratory Infections Complicating Human Immunodeficiency Virus.

    PubMed

    Feldman, Charles; Anderson, Ronald

    2016-04-01

    Opportunistic bacterial and fungal infections of the lower respiratory tract, most commonly those caused by Streptococcus pneumoniae (the pneumococcus), Mycobacterium tuberculosis, and Pneumocystis jirovecii, remain the major causes of mortality in those infected with human immunodeficiency virus (HIV). Bacterial respiratory pathogens most prevalent in those infected with HIV, other than M. tuberculosis, represent the primary focus of the current review with particular emphasis on the pneumococcus, the leading cause of mortality due to HIV infection in the developed world. Additional themes include (1) risk factors; (2) the predisposing effects of HIV-mediated suppression on pulmonary host defenses, possibly intensified by smoking; (3) clinical and laboratory diagnosis, encompassing assessment of disease severity and outcome; and (4) antibiotic therapy. The final section addresses current recommendations with respect to pneumococcal immunization in the context of HIV infection, including an overview of the rationale underpinning the current "prime-boost" immunization strategy based on sequential administration of pneumococcal conjugate vaccine 13 and pneumococcal polysaccharide vaccine 23.

  16. Human immunodeficiency virus infection in childhood.

    PubMed

    Blokzijl, M L

    1988-03-01

    Acquired immunodeficiency syndrome is associated with considerable morbidity in infants and children. It is caused by human immunodeficiency virus (HIV) which can be transmitted vertically from mother to infant early in pregnancy. Transmission might also occur via breast milk. Although the exact transmission rate of HIV from mother to infant is not known, HIV can become a major threat to child survival. This threat is already present in Africa where high seroprevalences have been reported among infants and young children. Transmission via blood products is decreasing due to reliable methods of screening donors for HIV antibody. Where these tests are not available, parenteral transmission will increase the incidence of HIV infection. The clinical picture of HIV infection in children presents with failure to thrive, pulmonary interstitial pneumonitis, hepatosplenomegaly and recurrent bacterial infections. These are common manifestations of diseases prevalent in children in Africa where malnutrition and recurrent parasitic infections already cause immunosuppression. Recognition of the syndrome is therefore difficult. There is no available cure for HIV infection. Supportive treatment and relief of pain and suffering are the only means of management at present. Prevention of spread of the illness to infants and young children is therefore of paramount importance.

  17. Autoimmune diseases and HIV infection

    PubMed Central

    Virot, Emilie; Duclos, Antoine; Adelaide, Leopold; Miailhes, Patrick; Hot, Arnaud; Ferry, Tristan; Seve, Pascal

    2017-01-01

    Abstract To describe the clinical manifestations, treatments, prognosis, and prevalence of autoimmune diseases (ADs) in human immunodeficiency virus (HIV)-infected patients. All HIV-infected patients managed in the Infectious Diseases Department of the Lyon University Hospitals, France, between January 2003 and December 2013 and presenting an AD were retrospectively included. Thirty-six ADs were found among 5186 HIV-infected patients which represents a prevalence of 0.69% including immune thrombocytopenic purpura (n = 15), inflammatory myositis (IM) (n = 4), sarcoidosis (n = 4), Guillain–Barré syndrome (GBS) (n = 4), myasthenia gravis (n = 2), Graves’ disease (n = 2), and 1 case of each following conditions: systemic lupus erythematosus, rheumatoid arthritis, autoimmune hepatitis, Hashimoto thyroiditis and autoimmune hemolytic anemia. One patient presented 2 ADs. Thirty patients were known to be HIV-infected when they developed an AD. The AD preceded HIV infection in 2 patients. GBS and HIV infection were diagnosed simultaneously in 3 cases. At AD diagnosis, CD4 T lymphocytes count were higher than 350/mm3 in 63% of patients, between 200 and 350/mm3 in 19% and less than 200/mm3 in 19%. Twenty patients benefited from immunosuppressant treatments, with a good tolerance. ADs during HIV infection are uncommon in this large French cohort. Immune thrombocytopenic purpura, sarcoidosis, IM, and GBS appear to be more frequent than in the general population. Immunosuppressant treatments seem to be effective and well tolerated. PMID:28121924

  18. The HIV-Infected Patient and Family Social Support.

    ERIC Educational Resources Information Center

    Wolf, Thomas M.; And Others

    The goal of this study was to examine the complex interplay among family, neuropsychological, psychosocial, psychiatric, and immunological variables with human immunodeficiency virus (HIV)-infected homosexual/bisexual men and their families. The subjects were a broad spectrum of 29 outpatient HIV-infected homosexual/bisexual men between the ages…

  19. The HIV-Infected Patient and Family Social Support.

    ERIC Educational Resources Information Center

    Wolf, Thomas M.; And Others

    The goal of this study was to examine the complex interplay among family, neuropsychological, psychosocial, psychiatric, and immunological variables with human immunodeficiency virus (HIV)-infected homosexual/bisexual men and their families. The subjects were a broad spectrum of 29 outpatient HIV-infected homosexual/bisexual men between the ages…

  20. Immunogenicity and immunologic memory after hepatitis B virus booster vaccination in HIV-infected children receiving highly active antiretroviral therapy.

    PubMed

    Abzug, Mark J; Warshaw, Meredith; Rosenblatt, Howard M; Levin, Myron J; Nachman, Sharon A; Pelton, Stephen I; Borkowsky, William; Fenton, Terence

    2009-09-15

    Hepatitis B virus (HBV) is an important cause of comorbidity in human immunodeficiency virus (HIV)-infected individuals. The immunogenicity of HBV vaccination in children receiving highly active antiretroviral therapy (HAART) was investigated. HIV-infected children receiving HAART who had low to moderate HIV loads and who had previously received 3 doses of HBV vaccine were given an HBV vaccine booster. Concentrations of antibody to hepatitis B surface antigen (anti-HBs) were determined before vaccination and at weeks 8, 48, and 96. A subset of subjects was administered a subsequent dose, and anti-HBs was measured before and 1 and 4 weeks later. At entry, 24% of 204 subjects were seropositive. Vaccine response occurred in 46% on the basis of seropositivity 8 weeks after vaccination and in 37% on the basis of a 4-fold rise in antibody concentration. Of 69 subjects given another vaccination 4-5 years later, immunologic memory was exhibited by 45% on the basis of seropositivity 1 week after vaccination and by 29% on the basis of a 4-fold rise in antibody concentration at 1 week. Predictors of response and memory included higher nadir and current CD4 cell percentage, higher CD19 cell percentage, and undetectable HIV load. HIV-infected children frequently lack protective levels of anti-HBs after previous HBV vaccination, and a significant proportion of them do not respond to booster vaccination or demonstrate memory despite receiving HAART, leaving this population insufficiently protected from infection with HBV.

  1. HIV Infection Legal Issues: An Introduction for Developmental Services. Technical Report on Developmental Disabilities and HIV Infection, Number 2.

    ERIC Educational Resources Information Center

    Harvey, David C.; Decker, Curtis L.

    As agencies and programs serving individuals with developmental disabilities are called upon to serve a new population of individuals with human immunodeficiency virus (HIV) infection, they will be forced to confront complex legal questions. This paper discusses the legal frameworks in which individuals with HIV infection are considered eligible…

  2. Depoliticize Human Immunodeficiency Virus Infection: A Commentary

    PubMed Central

    1994-01-01

    Public-health policy is inconsistent in its approach to the sexually transmitted disease human immunodeficiency virus (HIV). Nearly every health agency has politicized the reporting, finding, and contacting of HIV cases. There is also no consistency among the various state health departments and the various federal health agencies. Until we have a uniform health policy that treats HIV infection as every other reportable sexually transmitted disease, we will make little progress toward controlling its inevitable increase in both cases and costs. PMID:18475369

  3. Neuromyelitis optica in patients with coexisting human immunodeficiency virus infections.

    PubMed

    Feyissa, Anteneh M; Singh, Parbhdeep; Smith, Robert G

    2013-09-01

    Two patients with known human immunodeficiency virus (HIV) infections and receiving antiretroviral treatment developed neuromyelitis optica (Devic's disease). One patient tested positive for serum aquaporin-4 immunoglobulin G antibodies. Both patients were treated with high dose pulsed intravenous methylprednisolone followed by standard sessions of plasma exchange both at the onset attack and during disease relapses. For maintenance therapy, one patient received rituximab infusions and the second patient received mycophenolate mofetil orally. Despite treatment, both patients are currently wheelchair-bound due to severe paraparesis. Neuromyelitis optica can occur in the course of HIV infection and poses an ongoing therapeutic challenge.

  4. Human immunodeficiency virus associated plasmablastic lymphoma: A case report

    PubMed Central

    Desai, Dinkar; Pandit, Siddharth; Jasphin, Shiny; Shetty, Akhil S.

    2016-01-01

    Non-Hodgkin's lymphoma (NHL) is the third common malignant lesion of the oral region. Plasmablastic lymphomas are rare, aggressive neoplasms occurring mostly in human immunodeficiency virus (HIV) infected individual which accounts for approximately 2.6% of all NHL. It usually presents as a diffuse growth and with diffuse pattern of histological presentation. It is very difficult to differentiate this lymphoma from other NHL. Immunohistochemical evaluation of various markers is an important criteria of the diagnostic protocol. Here, we describe a case of plasmablastic lymphoma in a 50-year-old female HIV-infected patient. The diagnosis was based on histopathological examination and immunophenotyping. PMID:27795651

  5. [Stroke in HIV-infected patients].

    PubMed

    Lino, Ireneia; Sousa, António; Correia, José

    2007-01-01

    The spectrum of human immunodeficiency virus infection (HIV) is changing. New drug treatments have reduced morbidity and mortality of this disease, therefore it is necessary to start treating the HIV infection as a chronical disease. The association of the stroke with the HIV infection was inicially thought to be a result of other opportunistic infeccions and tumors. However, the vascular disease associated with HIV infection has been a subject of research and debate. New evidence shows that the vascular diseases could be a threat for the pacients doing highly active antirretroviral therapy (HAART). In this paper, we review the association between the HIV infection and stroke. Furthermore, we have done an analysis of the risk for the stroke on pacients with HIV infection considering the changes of the infection spectrum by the introduction of HAART.

  6. Pharmacotherapy of pediatric and adolescent HIV infection

    PubMed Central

    Schuval, Susan J

    2009-01-01

    Significant advances have been made in the treatment of human immunodeficiency virus (HIV) infection over the past two decades. Improved therapy has prolonged survival and improved clinical outcome for HIV-infected children and adults. Sixteen antiretroviral (ART) medications have been approved for use in pediatric HIV infection. The Department of Health and Human Services (DHHS) has issued “Guidelines for the Use of Antiretroviral Agents in Pediatric HIV Infection”, which provide detailed information on currently recommended antiretroviral therapies (ART). However, consultation with an HIV specialist is recommended as the current therapy of pediatric HIV therapy is complex and rapidly evolving. PMID:19707256

  7. Oral lesions in infection with human immunodeficiency virus.

    PubMed Central

    Coogan, Maeve M.; Greenspan, John; Challacombe, Stephen J.

    2005-01-01

    This paper discusses the importance of oral lesions as indicators of infection with human immunodeficiency virus (HIV) and as predictors of progression of HIV disease to acquired immunodeficiency syndrome (AIDS). Oral manifestations are among the earliest and most important indicators of infection with HIV. Seven cardinal lesions, oral candidiasis, hairy leukoplakia, Kaposi sarcoma, linear gingival erythema, necrotizing ulcerative gingivitis, necrotizing ulcerative periodontitis and non-Hodgkin lymphoma, which are strongly associated with HIV infection, have been identified and internationally calibrated, and are seen in both developed and developing countries. They may provide a strong indication of HIV infection and be present in the majority of HIV-infected people. Antiretroviral therapy may affect the prevalence of HIV-related lesions. The presence of oral lesions can have a significant impact on health-related quality of life. Oral health is strongly associated with physical and mental health and there are significant increases in oral health needs in people with HIV infection, especially in children, and in adults particularly in relation to periodontal diseases. International collaboration is needed to ensure that oral aspects of HIV disease are taken into account in medical programmes and to integrate oral health care with the general care of the patient. It is important that all health care workers receive education and training on the relevance of oral health needs and the use of oral lesions as surrogate markers in HIV infection. PMID:16211162

  8. Bone health and human immunodeficiency virus infection.

    PubMed

    Schafer, Jason J; Manlangit, Kristine; Squires, Kathleen E

    2013-06-01

    Low bone mineral density is common among persons with human immunodeficiency virus (HIV) infection, and studies reporting increased fracture rates in this patient population are emerging. The causes of low bone mineral density, osteoporosis, and fractures in persons with HIV are likely multifactorial, involving traditional risk factors, HIV infection, and exposure to antiretroviral treatment. Specific antiretrovirals such as tenofovir may cause a greater loss of bone mineral density compared with other agents and have recently been linked to an increased risk for fracture. As a result, recent treatment guidelines suggest that clinicians consider avoiding tenofovir as initial therapy in postmenopausal women. Evaluating bone mineral density and vitamin D status in persons with HIV may be important steps in identifying those requiring pharmacotherapy; however, the appropriate timing for bone mineral density and vitamin D screening is uncertain, as is the appropriate method of replacing vitamin D in HIV-positive patients who are deficient. Further study is necessary to definitively determine the approach to evaluating bone health and managing low bone mineral density and vitamin D deficiency in patients with HIV infection.

  9. Immunology of pediatric HIV infection.

    PubMed

    Tobin, Nicole H; Aldrovandi, Grace M

    2013-07-01

    Most infants born to human immunodeficiency virus (HIV)-infected women escape HIV infection. Infants evade infection despite an immature immune system and, in the case of breastfeeding, prolonged repetitive exposure. If infants become infected, the course of their infection and response to treatment differs dramatically depending upon the timing (in utero, intrapartum, or during breastfeeding) and potentially the route of their infection. Perinatally acquired HIV infection occurs during a critical window of immune development. HIV's perturbation of this dynamic process may account for the striking age-dependent differences in HIV disease progression. HIV infection also profoundly disrupts the maternal immune system upon which infants rely for protection and immune instruction. Therefore, it is not surprising that infants who escape HIV infection still suffer adverse effects. In this review, we highlight the unique aspects of pediatric HIV transmission and pathogenesis with a focus on mechanisms by which HIV infection during immune ontogeny may allow discovery of key elements for protection and control from HIV. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  10. Immunology of Pediatric HIV Infection

    PubMed Central

    Tobin, Nicole H.; Aldrovandi, Grace M.

    2013-01-01

    Summary Most infants born to human immunodeficiency virus (HIV)-infected women escape HIV infection. Infants evade infection despite an immature immune system and, in the case of breastfeeding, prolonged repetitive, exposure. If infants become infected, the course of their infection and response to treatment differs dramatically depending upon the timing (in utero, intrapartum, or during breastfeeding) and potentially the route of their infection. Perinatally acquired HIV infection occurs during a critical window of immune development. HIV’s perturbation of this dynamic process may account for the striking age-dependent differences in HIV disease progression. HIV infection also profoundly disrupts the maternal immune system upon which infants rely for protection and immune instruction. Therefore, it is not surprising that infants who escape HIV infection still suffer adverse effects. In this review, we highlight the unique aspects of pediatric HIV transmission and pathogenesis with a focus on mechanisms by which HIV infection during immune ontogeny may allow discovery of key elements for protection and control from HIV. PMID:23772619

  11. Cryptococcal meningitis associated with tuberculosis in HIV infected patients.

    PubMed

    Singh, Urvinderpal; Aditi; Aneja, Pooja; Kapoor, B K; Singh, S P; Purewal, Sukhpreet Singh

    2013-07-01

    Opportunistic infections are common complications of advanced immuno-deficiency in individuals with Human Immunodeficiency Virus (HIV) infection. Following involvement of the lung, the central nervous system (CNS) is the second most commonly affected organ. We report two cases of concurrent cryptococcal meningitis and tuberculosis (TB) in HIV infected persons. A high suspicion of multiple opportunistic infections should be kept in mind in HIV seropositive individuals.

  12. Efficacy of zidovudine and human immunodeficiency virus (HIV) hyperimmune immunoglobulin for reducing perinatal HIV transmission from HIV-infected women with advanced disease: results of Pediatric AIDS Clinical Trials Group protocol 185.

    PubMed

    Stiehm, E R; Lambert, J S; Mofenson, L M; Bethel, J; Whitehouse, J; Nugent, R; Moye, J; Glenn Fowler, M; Mathieson, B J; Reichelderfer, P; Nemo, G J; Korelitz, J; Meyer, W A; Sapan, C V; Jimenez, E; Gandia, J; Scott, G; O'Sullivan, M J; Kovacs, A; Stek, A; Shearer, W T; Hammill, H

    1999-03-01

    Pediatric AIDS Clinical Trials Group protocol 185 evaluated whether zidovudine combined with human immunodeficiency virus (HIV) hyperimmune immunoglobulin (HIVIG) infusions administered monthly during pregnancy and to the neonate at birth would significantly lower perinatal HIV transmission compared with treatment with zidovudine and intravenous immunoglobulin (IVIG) without HIV antibody. Subjects had baseline CD4 cell counts /=200/microL) but not with time of zidovudine initiation (5.6% vs. 4.8% if started before vs. during pregnancy; P=. 75). The Kaplan-Meier transmission rate for HIVIG recipients was 4. 1% (95% confidence interval, 1.5%-6.7%) and for IVIG recipients was 6.0% (2.8%-9.1%) (P=.36). The unexpectedly low transmission confirmed that zidovudine prophylaxis is highly effective, even for women with advanced HIV disease and prior zidovudine therapy, although it limited the study's ability to address whether passive immunization diminishes perinatal transmission.

  13. Hepatitis C and human immunodeficiency virus coinfections.

    PubMed

    Dodig, M; Tavill, A S

    2001-01-01

    Hepatitis C virus (HCV) has become a major contributor to morbidity and mortality in patients with human immunodeficiency virus (HIV). It is estimated that 30% to 50% of patients with HIV are coinfected with HCV. Advances in antiretroviral therapy and improved life expectancy of HIV patients have resulted in an emergence of HCV-induced liver disease as a leading cause of significant morbidity and death in this population. Clinically, hepatitis C is a more severe disease in HIV-infected individuals, characterized by rapid progression toward end-stage liver disease. Highly active antiretroviral therapy is the mainstay of current acquired immunodeficiency syndrome management. One of the limiting side effects of combination therapy for HIV is hepatotoxicity, which is more common and often more serious in patients with underlying liver disease. Management of coinfected patients has no strict guidelines, but it is generally accepted that HIV infection needs to be treated before HCV. Hepatitis C in coinfected individuals is probably best treated using combination therapy (interferon alpha and ribavirin). It appears that combination therapy can safely be administered to this population and that previous concerns about ribavirin/zidovudine antagonism are unsubstantiated in clinical practice. Although initial results using only interferon alpha showed poor results in HIV coinfected patients, combination therapy seems to be as effective as in the general population. All HIV-HCV coinfected patients should be vaccinated against hepatitis B and hepatitis A; vaccines are safe and effective.

  14. Response of Human Immunodeficiency Virus-Associated Cerebral Angiitis to the Combined Antiretroviral Therapy

    PubMed Central

    Cheron, Julian; Wyndham-Thomas, Chloé; Sadeghi, Niloufar; Naeije, Gilles

    2017-01-01

    When secondary causes are excluded, mechanisms underlying central nervous system angiitis (ACNS) in human immunodeficiency virus (HIV)-infected patients are still not understood and optimal treatment remains undefined. We report here a patient with an untreated HIV infection who presented multiple ischemic strokes probably due to HIV-ACNS. ACNS signs on vessel-wall imaging magnetic resonance monitoring retracted with combined antiretroviral therapy without adjunct immunosuppressive drugs. PMID:28348548

  15. An audit of ranulae occurring with the human immunodeficiency virus infecton

    PubMed Central

    Butt, FM; Chindia, ML; Kenyanya, T; Gathece, LW; Rana, F

    2010-01-01

    Currently, published literature has increasingly projected the ranula as a lesion that may be closely associated with exposure to the human immunodeficiency virus (HIV). In this report, we document 28 patients who presented with ranulae, among whom 19 were HIV infected. In some, this was the only lesion that was the sentinel sign of HIV infection. Most probably, this lesion could be considered as one of the clinical markers of this infection. PMID:21180457

  16. Pathobiology of human papillomaviruses in human immunodeficiency virus - Infected persons.

    PubMed

    Krishnamurti, Uma; Unger, Elizabeth R

    2017-07-01

    There is a complex interrelationship between human papillomaviruses (HPV) and human immunodeficiency viruses (HIV) that has been recognized from the start of the HIV epidemic. Cervical cancer was used as a surveillance indicator for acquired immunodeficiency syndrome (AIDS) before definitive identification of the viral etiology of either condition were known. Careful epidemiologic studies combined with clinical and laboratory measures of HPV, HPV-associated disease, and HIV have helped us understand many aspects of the relationship between these two virus groups; however, questions remain. The histopathology associated with HPV is identical in HIV-positive and negative patients though the lesions are more frequent, with higher frequency of multiple HPV types, and persistent in HIV infected individuals. In this review we will briefly explain the pathobiology of HPV in HIV-infected persons and the potential impact of secondary (screening) and primary (vaccination) prevention to reduce HPV-associated disease in those infected with HIV. Published by Elsevier Inc.

  17. Human immunodeficiency virus type 1 infection of H9 cells induces increased glucose transporter expression.

    PubMed Central

    Sorbara, L R; Maldarelli, F; Chamoun, G; Schilling, B; Chokekijcahi, S; Staudt, L; Mitsuya, H; Simpson, I A; Zeichner, S L

    1996-01-01

    A clone obtained from a differential display screen for cellular genes with altered expression during human immunodeficiency virus (HIV) infection matched the sequence for the human GLUT3 facilitative glucose transporter, a high-velocity-high-affinity facilitative transporter commonly expressed in neurons of the central nervous system. Northern (RNA) analysis showed that GLUT3 expression increased during infection. Flow cytometry showed that GLUT3 protein expression increased specifically in the HIV-infected cells; this increase correlated with increased 2-deoxyglucose transport in the HIV-infected culture. HIV infection therefore leads to increased expression of a glucose transporter normally expressed at high levels in other cell types and a corresponding increase in glucose transport activity. If HIV infection places increased metabolic demands on the host cell, changes in the expression of a cellular gene that plays an important role in cellular metabolism might provide a more favorable environment for viral replication. PMID:8794382

  18. Pediatric human immunodeficiency virus infection and circulating IgD+ memory B cells.

    PubMed

    Jacobsen, Marianne C; Thiébaut, Rodolphe; Fisher, Christopher; Sefe, Delali; Clapson, Margaret; Klein, Nigel; Baxendale, Helen E

    2008-08-15

    Levels of circulating naive and memory B cells were measured in human immunodeficiency virus (HIV)-infected children and control subjects to determine whether the irreversible depletion of memory B cells described in HIV-infected adults occurs in children with HIV infection. Depletion of circulating IgD+ memory B cells was seen in HIV-infected children despite control of the HIV load with highly active antiretroviral therapy (HAART) (P =. 04). IgD+ memory B cell percentages did not correlate with CD4+ cell percentages (P =. 027) or disease duration (P =. 026). Naive/transitional and IgD- memory B cell numbers were not affected. Pediatric HIV infection is associated with selective depletion of circulating IgD+ memory B cells despite control of the HIV load with HAART.

  19. Tumor necrosis factor alpha selectively sensitizes human immunodeficiency virus-infected cells to heat and radiation

    SciTech Connect

    Wong, G.H.; McHugh, T.; Weber, R.; Goeddel, D.V. )

    1991-05-15

    We report here that infection of the human T-cell line HUT-78 with human immunodeficiency virus (HIV) increases its sensitivity to heat and radiation toxicity. A possible explanation for this result may be the reduced expression of manganous superoxide dismutase (MnSOD) in HIV-infected cells compared to uninfected cells. Tumor necrosis factor alpha (TNF-alpha) further sensitizes HIV-infected cells but not uninfected cells to heat and radiation. This is consistent with the ability of TNF-alpha to induce the expression of MnSOD in uninfected but not in HIV-infected cells. HIV-infected HUT-78 cell lines engineered to overexpress MnSOD are more resistant to heat and radiation than HIV-infected cells that do not overexpress MnSOD. However, treatment with TNF-alpha still sensitizes these cells to heat and radiation.

  20. Gonococcal arthritis in human immunodeficiency virus-infected patients. Review of the literature.

    PubMed

    Sena Corrales, Gabriel; Mora Navas, Laura; Palacios Muñoz, Rosario; García López, Victoria; Márquez Solero, Manuel; Santos González, Jesús

    We report a case of gonococcal arthritis in a patient with human immunodeficiency virus (HIV) infection and review 17 previously published cases; only one patient presented urethritis, and blood cultures were positive in one case. Gonococcal arthritis is rare in HIV-infected patients and is not usually associated with other symptoms. It should be considered in the differential diagnosis of acute arthritis in patients with HIV infection. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

  1. Influence of immune activation and inflammatory response on cardiovascular risk associated with the human immunodeficiency virus.

    PubMed

    Beltrán, Luis M; Rubio-Navarro, Alfonso; Amaro-Villalobos, Juan Manuel; Egido, Jesús; García-Puig, Juan; Moreno, Juan Antonio

    2015-01-01

    Patients infected with the human immunodeficiency virus (HIV) have an increased cardiovascular risk. Although initially this increased risk was attributed to metabolic alterations associated with antiretroviral treatment, in recent years, the attention has been focused on the HIV disease itself. Inflammation, immune system activation, and endothelial dysfunction facilitated by HIV infection have been identified as key factors in the development and progression of atherosclerosis. In this review, we describe the epidemiology and pathogenesis of cardiovascular disease in patients with HIV infection and summarize the latest knowledge on the relationship between traditional and novel inflammatory, immune activation, and endothelial dysfunction biomarkers on the cardiovascular risk associated with HIV infection.

  2. Performance of FACSPresto Point-of-Care Instrument for CD4-T Cell Enumeration in Human Immunodeficiency Virus (HIV)-Infected Patients Attending Care and Treatment Clinics in Belgium and Tanzania.

    PubMed

    Daneau, Géraldine; Aboud, Said; Prat, Irena; Urassa, Willy; Kestens, Luc

    2017-01-01

    CD4 T-cell counts are widely used to assess treatment eligibility and to follow-up HIV-infected patients. The World Health Organization prequalification of in vitro diagnostics program conducted a performance evaluation of the FACSPresto (BD Biosciences), a new point-of-care instrument to measure absolute CD4-T cell (CD4) counts and percentages in venous and capillary blood samples from HIV-infected patients. Patients were recruited in Belgium (200 patients) and in Tanzania (247 patients). Venous blood samples were analyzed in two nearby reference laboratories. In addition, nurses/technicians collected a capillary blood sample by finger prick directly into a FACSPresto CD4 cartridge. Assay precision was assessed on fresh blood and on external quality control samples. Trueness (bias) was assessed by comparing results from FACSPresto with the reference (single-platform FACSCalibur). Clinical misclassification was measured at 200, 350 and 500 cells/μL thresholds. Intra-assay precision was < 6%, and inter-assay < 8%. CD4 results from FACSPresto and reference method resulted in regression slopes of 0.99-1.11 using either venous or capillary blood. Correlation was better for venous than for capillary blood (minimum 0.97 vs 0.93 respectively). Capillary blood resulted in a larger bias than venous blood, with 24 and 83 cells/μL for absolute CD4 counts on capillary blood in Antwerp and Dar es Salaam respectively, vs 12 and 41 cells/μL on venous blood. Bias on CD4% was < 1% on both venous and capillary blood, and was proportionally better than for absolute CD4 counts. Clinical misclassification was in line with the average overestimation, showing a very good specificity, but sensitivity around 70-90%. The rejection rate was 11% on first reading, leading to 6% of all samples without final result after a second reading. The FACSPresto performed very well on venous blood samples, and well on capillary blood samples.

  3. Testing for Human Immunodeficiency Virus

    MedlinePlus

    ... incisions made in the mother’s abdomen and uterus. Human Immunodeficiency Virus (HIV): A virus that attacks certain cells of the body’s immune system and causes acquired immunodeficiency syndrome (AIDS). Immune System: ...

  4. Nonvertical, nonsexual transmission of human immunodeficiency virus in children.

    PubMed

    Vaz, Paula; Pedro, Alinia; Le Bozec, Soazig; Macassa, Eugenia; Salvador, Sergio; Biberfeld, Gunnel; Blanche, Stéphane; Andersson, Sören

    2010-03-01

    In a cohort of 450 human immunodeficiency virus (HIV)-infected children followed up in Maputo, Mozambique, 22 were born to HIV-uninfected mothers and had no history of sexual abuse. A case record review of these nonvertically, nonsexually infected children as well as a case-control study strongly suggests health care as possible source of infection for many of these children. This facet of the pediatric HIV epidemic should not be overlooked.

  5. Disseminated Histoplasmosis in Early Human Immunodeficiency Virus Infection.

    PubMed

    Bagla, Prabhava; Sarria, Juan C

    2017-03-01

    Early human immunodeficiency virus (HIV) infection leads to transient immunosuppression followed by a quasi-homeostatic state with slow progression towards AIDS. Histoplasmosis has never been reported in early HIV. We present a case of disseminated histoplasmosis with documented recent seroconversion and review the literature regarding other opportunistic infections in early HIV. Copyright © 2017 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

  6. Bone disease and HIV infection.

    PubMed

    Amorosa, Valerianna; Tebas, Pablo

    2006-01-01

    The high prevalence of bone demineralization among human immunodeficiency virus (HIV)-infected patients in the current therapeutic era has been described in multiple studies, sounding the alarm that we may expect an epidemic of fragility fractures in the future. However, despite noting high overall prevalences of osteopenia and osteoporosis, recent longitudinal studies that we review here have generally not observed accelerated bone loss during antiretroviral therapy beyond the initial period after treatment initiation. We discuss the continued progress toward understanding the mechanisms of HIV-associated bone loss, particularly the effects of HIV infection, antiretroviral therapy, and host immune factors on bone turnover. We summarize results of clinical trials published in the past year that studied the safety and efficacy of treatment of bone loss in HIV-infected patients and provide provisional opinions about who should be considered for bone disease screening and treatment.

  7. Clinical management of acute HIV infection: best practice remains unknown.

    PubMed

    Bell, Sigall K; Little, Susan J; Rosenberg, Eric S

    2010-10-15

    Best practice for the clinical management of acute human immunodeficiency virus (HIV) infection remains unknown. Although some data suggest possible immunologic, virologic, or clinical benefit of early treatment, other studies show no difference in these outcomes over time, after early treatment is discontinued. The literature on acute HIV infection is predominantly small nonrandomized studies, which further limits interpretation. As a result, the physician is left to grapple with these uncertainties while making clinical decisions for patients with acute HIV infection. Here we review the literature, focusing on the potential advantages and disadvantages of treating acute HIV infection outlined in treatment guidelines, and summarize the presentations on clinical management of acute HIV infection from the 2009 Acute HIV Infection Meeting in Boston, Massachusetts.

  8. HIV infections in otolaryngology

    PubMed Central

    Rzewnicki, Ireneusz; Olszewska, Ewa; Rogowska-Szadkowska, Dorota

    2012-01-01

    Summary HIV (human immunodeficiency virus) infection may produce no clinical symptoms for 10 years on average. However, after many years of infection most people develop symptoms that indicate progression of the disease. There are no regular characteristic symptoms or early stage, and no logical sequence of AIDS indicator disorders has been observed. People who are not aware of the infection are referred to physicians of various specializations, including otolaryngologists. It is on their knowledge about HIV infections, among other factors, that early diagnosis of the disease depends. Appropriate and quick introduction of anti-retroviral drugs may let a person with HIV live decades longer. PMID:22367140

  9. Knowledge and Awareness of Acute Human Immunodeficiency Virus Infection Among Mobile App-Using Men Who Have Sex With Men: A Missed Public Health Opportunity

    PubMed Central

    Siegler, Aaron J.; Sanchez, Travis; Sineath, R. Craig; Grey, Jeremy; Kahle, Erin; Sullivan, Patrick S.

    2015-01-01

    In a national online survey, we assessed awareness and knowledge of acute human immunodeficiency virus (HIV) infection manifestation among 1748 men who have sex with men (MSM). Only 39% of respondents were aware that acute HIV infection may be accompanied by symptoms. Education and increased access to acute HIV testing may facilitate MSM to appropriately seek acute HIV testing. PMID:26034766

  10. Knowledge and awareness of acute human immunodeficiency virus infection among mobile app-using men who have sex with men: a missed public health opportunity.

    PubMed

    Siegler, Aaron J; Sanchez, Travis; Sineath, R Craig; Grey, Jeremy; Kahle, Erin; Sullivan, Patrick S

    2015-01-01

    In a national online survey, we assessed awareness and knowledge of acute human immunodeficiency virus (HIV) infection manifestation among 1748 men who have sex with men (MSM). Only 39% of respondents were aware that acute HIV infection may be accompanied by symptoms. Education and increased access to acute HIV testing may facilitate MSM to appropriately seek acute HIV testing.

  11. Performance of FACSPresto Point-of-Care Instrument for CD4-T Cell Enumeration in Human Immunodeficiency Virus (HIV)-Infected Patients Attending Care and Treatment Clinics in Belgium and Tanzania

    PubMed Central

    Daneau, Géraldine; Aboud, Said; Prat, Irena; Urassa, Willy; Kestens, Luc

    2017-01-01

    Background CD4 T-cell counts are widely used to assess treatment eligibility and to follow-up HIV-infected patients. The World Health Organization prequalification of in vitro diagnostics program conducted a performance evaluation of the FACSPresto (BD Biosciences), a new point-of-care instrument to measure absolute CD4-T cell (CD4) counts and percentages in venous and capillary blood samples from HIV-infected patients. Methods Patients were recruited in Belgium (200 patients) and in Tanzania (247 patients). Venous blood samples were analyzed in two nearby reference laboratories. In addition, nurses/technicians collected a capillary blood sample by finger prick directly into a FACSPresto CD4 cartridge. Assay precision was assessed on fresh blood and on external quality control samples. Trueness (bias) was assessed by comparing results from FACSPresto with the reference (single-platform FACSCalibur). Clinical misclassification was measured at 200, 350 and 500 cells/μL thresholds. Results Intra-assay precision was < 6%, and inter-assay < 8%. CD4 results from FACSPresto and reference method resulted in regression slopes of 0.99–1.11 using either venous or capillary blood. Correlation was better for venous than for capillary blood (minimum 0.97 vs 0.93 respectively). Capillary blood resulted in a larger bias than venous blood, with 24 and 83 cells/μL for absolute CD4 counts on capillary blood in Antwerp and Dar es Salaam respectively, vs 12 and 41 cells/μL on venous blood. Bias on CD4% was < 1% on both venous and capillary blood, and was proportionally better than for absolute CD4 counts. Clinical misclassification was in line with the average overestimation, showing a very good specificity, but sensitivity around 70–90%. The rejection rate was 11% on first reading, leading to 6% of all samples without final result after a second reading. Conclusions The FACSPresto performed very well on venous blood samples, and well on capillary blood samples. PMID:28129324

  12. Cardiovascular disease associated with human immunodeficiency virus: a review.

    PubMed

    Costa, Luísa Amado; Almeida, Ana G

    2015-01-01

    The cardiovascular manifestations of human immunodeficiency virus (HIV) infection have changed significantly following the introduction of highly active antiretroviral therapy (HAART) regimens. On one hand, HAART has altered the course of HIV disease, with longer survival of HIV-infected patients, and cardiovascular complications of HIV infection such as myocarditis have been reduced. On the other hand, HAART is associated with an increase in the prevalence of both peripheral and coronary arterial disease. As longevity increases in HIV-infected individuals, long-term effects, such as cardiovascular disease, are emerging as leading health issues in this population. In the present review article, we discuss HIV-associated cardiovascular disease, focusing on epidemiology, etiopathogenesis, diagnosis, prognosis, management and therapy. Cardiovascular involvement in treatment-naive patients is still important in situations such as non-adherence to treatment, late initiation of treatment, and/or limited access to HAART in developing countries. We therefore describe the cardiovascular consequences in treatment-naive patients and the potential effect of antiretroviral treatment on their regression, as well as the metabolic and cardiovascular implications of HAART regimens in HIV-infected individuals.

  13. Schistosomiasis and Human Immunodeficiency Virus in Men in Tanzania.

    PubMed

    Downs, Jennifer A; de Dood, Claudia J; Dee, Hannah E; McGeehan, Megan; Khan, Hijab; Marenga, Abena; Adel, Patrick E; Faustine, Edward; Issarow, Benson; Kisanga, Emmanuel F; Kisigo, Godfrey Alfred; Ngahyolerwa, Salvius; Zahoro, Frank; Miyaye, Donald; Magawa, Ruth Gideon; Mngara, Julius; Lee, Myung Hee; Corstjens, Paul L A M; van Dam, Govert J; Fitzgerald, Daniel W

    2017-02-06

    Schistosomiasis is a parasitic worm infection that affects over 260 million individuals worldwide. Women with schistosome infections have been demonstrated to have a 4-fold increase in the odds of human immunodeficiency virus (HIV) infection compared with women without schistosome infections. A relationship between schistosome and HIV infections has not been clearly defined in men. Among 674 men aged 18-50 years living in rural Tanzania, we identified 429 (63.6%) who had a schistosome infection as defined by serum positivity for schistosome circulating anodic antigen, visualization of parasite eggs in urine or stool, or both. HIV infection was identified in 38 (5.6%). The odds of HIV infection was 1.3 [95% confidence interval = 0.6-2.5] (P = 0.53) among men with any schistosome infection (Schistosoma haematobium or Schistosoma mansoni), and it was 1.4 [0.6-3.3] (P = 0.43) among men with S. haematobium infection. Men with S. haematobium infection were significantly more likely to report the symptom of hemospermia than men without S. haematobium infection. We conclude that schistosome infections appear to have little to no association with HIV infection in men.

  14. Human immunodeficiency virus.

    PubMed

    Skinner, Anita

    2016-11-23

    What was the nature of the CPD activity, practice-related feedback and/or event and/or experience in your practice? The CPD article discussed the importance of human immunodeficiency virus (HIV) testing and diagnosing the condition as early as possible, so that antiretroviral treatment can be initiated and patient outcomes improved.

  15. Human immunodeficiency virus infection does not worsen prognosis of liver transplantation for hepatocellular carcinoma.

    PubMed

    Agüero, Fernando; Forner, Alejandro; Manzardo, Christian; Valdivieso, Andres; Blanes, Marino; Barcena, Rafael; Rafecas, Antoni; Castells, Lluis; Abradelo, Manuel; Torre-Cisneros, Julian; Gonzalez-Dieguez, Luisa; Salcedo, Magdalena; Serrano, Trinidad; Jimenez-Perez, Miguel; Herrero, Jose Ignacio; Gastaca, Mikel; Aguilera, Victoria; Fabregat, Juan; Del Campo, Santos; Bilbao, Itxarone; Romero, Carlos Jimenez; Moreno, Asuncion; Rimola, Antoni; Miro, Jose M

    2016-02-01

    The impact of human immunodeficiency virus (HIV) infection on patients undergoing liver transplantation (LT) for hepatocellular carcinoma (HCC) is uncertain. This study aimed to assess the outcome of a prospective Spanish nationwide cohort of HIV-infected patients undergoing LT for HCC (2002-2014). These patients were matched (age, gender, year of LT, center, and hepatitis C virus (HCV) or hepatitis B virus infection) with non-HIV-infected controls (1:3 ratio). Patients with incidental HCC were excluded. Seventy-four HIV-infected patients and 222 non-HIV-infected patients were included. All patients had cirrhosis, mostly due to HCV infection (92%). HIV-infected patients were younger (47 versus 51 years) and had undetectable HCV RNA at LT (19% versus 9%) more frequently than non-HIV-infected patients. No significant differences were detected between HIV-infected and non-HIV-infected recipients in the radiological characteristics of HCC at enlisting or in the histopathological findings for HCC in the explanted liver. Survival at 1, 3, and 5 years for HIV-infected versus non-HIV-infected patients was 88% versus 90%, 78% versus 78%, and 67% versus 73% (P = 0.779), respectively. HCV infection (hazard ratio = 7.90, 95% confidence interval 1.07-56.82) and maximum nodule diameter >3 cm in the explanted liver (hazard ratio = 1.72, 95% confidence interval 1.02-2.89) were independently associated with mortality in the whole series. HCC recurred in 12 HIV-infected patients (16%) and 32 non-HIV-infected patients (14%), with a probability of 4% versus 5% at 1 year, 18% versus 12% at 3 years, and 20% versus 19% at 5 years (P = 0.904). Microscopic vascular invasion (hazard ratio = 3.40, 95% confidence interval 1.34-8.64) was the only factor independently associated with HCC recurrence. HIV infection had no impact on recurrence of HCC or survival after LT. Our results support the indication of LT in HIV-infected patients with HCC. © 2015 by the American Association for the Study

  16. The Dilemmas of Childhood HIV Infection.

    ERIC Educational Resources Information Center

    Rudigier, Anne F.; And Others

    1990-01-01

    Increase in number of children infected with human immunodeficiency virus (HIV), and consequential developmental disabilities of these children are discussed. Families caring for HIV-infected children express four recurrent themes: psychological stress, grief and mourning, guilt and self-blame, and isolation and fear of discrimination. Flexible…

  17. Pediatric HIV Infection and Developmental Disabilities.

    ERIC Educational Resources Information Center

    Seidel, John F.

    This paper presents an overview of the developmental disabilities associated with pediatric Human Immunodeficiency Virus (HIV) infection, and examines efficacious practices for assessment and intervention programming. The focus population is early childhood into school age. The paper describes the complex array of challenges presented by these…

  18. Public Opinion, Public Policy, and HIV Infection.

    ERIC Educational Resources Information Center

    West, Jane

    1989-01-01

    A four-stage framework for considering the development of public policy in regard to the issue of HIV (Human Immunodeficiency Virus) infection is offered. The phases are denial, irrationality, acceptance, and the development of a rational response. Federal antidiscrimination policies which include persons with HIV infections as disabled are…

  19. Alcohol use disorder and its impact on chronic hepatitis C virus and human immunodeficiency virus infections

    PubMed Central

    Fuster, Daniel; Sanvisens, Arantza; Bolao, Ferran; Rivas, Inmaculada; Tor, Jordi; Muga, Robert

    2016-01-01

    Alcohol use disorder (AUD) and hepatitis C virus (HCV) infection frequently co-occur. AUD is associated with greater exposure to HCV infection, increased HCV infection persistence, and more extensive liver damage due to interactions between AUD and HCV on immune responses, cytotoxicity, and oxidative stress. Although AUD and HCV infection are associated with increased morbidity and mortality, HCV antiviral therapy is less commonly prescribed in individuals with both conditions. AUD is also common in human immunodeficiency virus (HIV) infection, which negatively impacts proper HIV care and adherence to antiretroviral therapy, and liver disease. In addition, AUD and HCV infection are also frequent within a proportion of patients with HIV infection, which negatively impacts liver disease. This review summarizes the current knowledge regarding pathological interactions of AUD with hepatitis C infection, HIV infection, and HCV/HIV co-infection, as well as relating to AUD treatment interventions in these individuals. PMID:27872681

  20. [Pulmonary complications in children with human immunodeficiency virus infection].

    PubMed

    Brockmann V, Pablo; Viviani S, Támara; Peña D, Anamaría

    2007-08-01

    Pulmonary complications in children infected by human immunodeficiency virus (HIV) are common and may be the first manifestation of acquired immunodeficiency syndrome (AIDS). The aim of our study was to review pulmonary diseases and complications in pediatric patients with HIV infection in a large tertiary hospital in Santiago, Chile. We performed a retrospective, descriptive analysis of 17 patients with HIV infection controlled at the Hospital Dr. Sótero del Rio. Respiratory complications/diseases were: overall pneumonia (n: 14), recurrent pneumonia (n: 10), citomegalovirus associated pneumonia (n: 4), Pneumocystis jiroveci associated pneumonia (n: 1) pulmonary tuberculosis (n: 1), lymphoid interstitial pneumonia (n: 3) and chronic pulmonary disease (n: 7). Microorganisms isolated were mostly atypical and frequently associated with severe and chronic pulmonary damage. A high degree of suspicion is required to detect atypical microorganisms promptly, in order to rapidly implement pathogen targeted therapy that could potentially decrease the possibility of sequelae.

  1. Rehabilitation in adults with human immunodeficiency virus-related diseases.

    PubMed

    O'Dell, M W; Dillon, M E

    1992-06-01

    The acquired immunodeficiency syndrome is a fatal disorder of cell-mediated immunity caused by the human immunodeficiency virus (HIV). As many as one million Americans infected with HIV can expect improved survival with more advanced treatment approaches. Complications of HIV infection occur in the brain, spinal cord, muscle, nerve, joints and other organ systems, which lead to extensive impairments. As survival increases, rehabilitation professionals can anticipate a greater number of referrals for the assessment and management of physical disability in persons with HIV infection. This article reviews HIV-related disease, impairment, disability and handicap pertinent to rehabilitation medicine. An agenda for future research is also proposed. Current knowledge and models or rehabilitation care can be applied to HIV-related physical disability in an effort to improve overall quality of life.

  2. Economic consequences for Medicaid of human immunodeficiency virus infection

    PubMed Central

    Baily, Mary Ann; Bilheimer, Linda; Wooldridge, Judith; well, Kathryn Lang; Greenberg, Warren

    1990-01-01

    Medicaid is currently a major source of financing for health care for those with acquired immunodeficiency syndrome (AIDS) and to a lesser extent, for those with other manifestations of human immunodeficiency virus (HIV) infection. It is likely to become even more important in the future. This article focuses on the structure of Medicaid in the context of the HIV epidemic, covering epidemiological issues, eligibility, service coverage and use, and reimbursement. A simple methodology for estimating HI\\'-related Medicaid costs under alternative assumptions about the future is also explained. PMID:10113503

  3. HIV infection connected to rising anal cancer rates in men in the U.S.

    Cancer.gov

    Human immunodeficiency virus (HIV) infection contributes substantially to the epidemic of anal cancer in men, but not women in the United States, according to new research from NCI. Chart shows overall incidence rates of anal cancers in general population

  4. Human immunodeficiency virus can productively infect cultured human glial cells.

    PubMed

    Cheng-Mayer, C; Rutka, J T; Rosenblum, M L; McHugh, T; Stites, D P; Levy, J A

    1987-05-01

    Six isolates of the human immunodeficiency virus (HIV) showed differences in their ability to productively infect glioma-derived cell lines and early-passage human brain cell cultures. Susceptibility to HIV infection correlated well with the expression of the astrocyte marker glial fibrillary acidic protein. The CD4 molecule was expressed on some, but not all, of the brain-derived cells; however, no correlation was observed between CD4 protein expression and susceptibility to virus infection. The results show that HIV can productively infect human brain cells, particularly those of glial origin, and suggest that these cell types in the brain can harbor the virus.

  5. Human Immunodeficiency Virus and Liver Disease Forum 2010: Conference Proceedings

    PubMed Central

    Sherman, Kenneth E.; Thomas, David L.; Chung, Raymond T.

    2013-01-01

    Liver disease continues to represent a critical mediator of morbidity and mortality in those with human immunodeficiency virus (HIV) infection. The frequent presence and overlap of concomitant injurious processes, including hepatitis C virus and hepatitis B virus infections, hepatoxicity associated with antiretroviral therapeutic agents, alcohol, and other toxins, in the setting of immunosuppression lead to rapid fibrotic progression and early development of end-stage liver disease. This conference summary describes the proceedings of a state-of-the-art gathering of international experts designed to highlight the status of current research in epidemiology, natural history, pathogenesis, and treatment of HIV and liver disease. PMID:21898501

  6. [Costs and cost-efficacy analysis of the preferred treatments by GESIDA/National Plan for AIDS for the initial antiretroviral therapy in adult human immunodeficiency virus (HIV) infected patients in 2012].

    PubMed

    Blasco, Antonio Javier; Arribas, José Ramón; Boix, Vicente; Clotet, Bonaventura; Domingo, Pere; González-García, Juan; Knobel, Hernando; López, Juan Carlos; Llibre, Josep M; Lozano, Fernando; Miró, José M; Podzamczer, Daniel; Santamaría, Juan Miguel; Tuset, Montserrat; Zamora, Laura; Lázaro, Pablo; Gatell, Josep M

    2012-06-01

    The GESIDA and National AIDS Plan panel of experts propose «preferred regimens» of antiretroviral treatment (ART) as initial therapy in HIV infected patients for 2012. The objective of this study is to evaluate the costs and the efficiency of initiating treatment with these «preferred regimens». Economic assessment of costs and efficiency (cost/efficacy) using decision tree analysis model. Efficacy was defined as the probability of having a viral load <50 copies/ml at week 48, in an intention-to-treat analysis. Cost of initiating treatment with an ART regime was defined as the costs of ART and all its consequences (adverse effects, changes of ART regime, and drug resistance analyses) during the first 48 weeks. The perspective of the analysis is that of the National Health System, considering only differential direct costs: ART (official prices), management of adverse effects, studies of resistance and determination of HLA B 5701. The setting is Spain and the costs are those of 2012. A sensitivity deterministic analysis was conducted, building three scenarios for each regime: baseline, most favourable, and most unfavourable cases. In the baseline case scenario, the cost of initiating treatment ranges from 6,895 euros for TDF/FTC+NVP to 12,067 euros for TDF/FTC+RAL. The efficacy ranges between 0.66 for ABC/3TC+LPV/r and 0.87 for TDF/FTC+RAL. Efficiency, in terms of cost/efficacy, varies between 9,387 and 13,823 euros per responder at 48 weeks, for TDF/FTC/EFV and TDF/FTC+RAL, respectively. In the most unfavourable scenario, the most efficient regime is TDF/FTC+NVP (9,742 per responder). Considering the official prices of ART, the most efficient regimens are TDF/FTC/EFV (baseline case and most favourable scenarios), and TDF/FTC+NVP (most unfavourable scenario). Copyright © 2012 Elsevier España, S.L. All rights reserved.

  7. Construction and use of a replication-competent human immunodeficiency virus (HIV-1) that expresses the chloramphenicol acetyltransferase enzyme.

    PubMed Central

    Terwilliger, E F; Godin, B; Sodroski, J G; Haseltine, W A

    1989-01-01

    The construction and properties of an infectious human immunodeficiency virus (HIV) that expresses the bacterial gene chloramphenicol acetyltransferase are described. This virus can be used in vitro to screen for drugs that inhibit HIV infection. The marked virus may also be used to trace the routes of infection from the site of inoculation in animal experiments. Images PMID:2726755

  8. No New HIV Infections With Increasing Use of HIV Preexposure Prophylaxis in a Clinical Practice Setting

    PubMed Central

    Volk, Jonathan E.; Marcus, Julia L.; Phengrasamy, Tony; Blechinger, Derek; Nguyen, Dong Phuong; Follansbee, Stephen; Hare, C. Bradley

    2015-01-01

    Referrals for and initiation of preexposure prophylaxis (PrEP) for human immunodeficiency virus (HIV) infection increased dramatically in a large clinical practice setting since 2012. Despite high rates of sexually transmitted infections among PrEP users and reported decreases in condom use in a subset, there were no new HIV infections in this population. PMID:26334052

  9. Immune reconstitution syndrome in a human immunodeficiency virus infected child due to giardiasis leading to shock

    PubMed Central

    Nandy, Sneha; Shah, Ira

    2015-01-01

    Human immunodeficiency virus (HIV)-associated immune reconstitution inflammatory syndrome has been reported in association with tuberculosis, herpes zoster (shingles), Cryptococcus neoformans, Kaposi's sarcoma, Pneumocystis pneumonia, hepatitis B virus, hepatitis C virus, herpes simplex virus, Histoplasma capsulatum, human papillomavirus, and Cytomegalovirus. However, it has never been documented with giardiasis. We present a 7-year-old HIV infected girl who developed diarrhea and shock following the initiation of antiretroviral therapy, and her stool showed the presence of giardiasis. PMID:26985424

  10. Women and Human Immunodeficiency Virus: A Historical and Personal Psychosocial Perspective.

    ERIC Educational Resources Information Center

    Wiener, Lori S.

    1991-01-01

    Presents brief historical look at women, human immunodeficiency virus (HIV), and Acquired Immune Deficiency Syndrome (AIDS). Describes women as invisible participants in AIDS epidemic and notes how societal sexism, racism, and classism have affected public perception of HIV infection and AIDS in women. Also considers the role of women as…

  11. Early Identification of Seronegative Human Immunodeficiency Virus Type 1 Infection with Severe Presentation▿

    PubMed Central

    Chin, Bum Sik; Lee, Sun Hee; Kim, Gab Jung; Kee, Mee Kyung; Suh, Soon Deok; Kim, Sung Soon

    2007-01-01

    Specific antibodies against human immunodeficiency virus (HIV), usually used for diagnosis, almost invariably become detectable within 3 months of exposure. We report on a patient whose HIV infection was identified early by a combined antigen/antibody test, but seroconversion did not occur for 7 months, until the implementation of antiretroviral therapy. PMID:17344360

  12. A Nursing Department's Response to Risks Associated with Human Immunodeficiency Virus.

    ERIC Educational Resources Information Center

    Kazanowski, Mary K.

    1992-01-01

    The Department of Nursing at Saint Anselm College in Manchester, New Hampshire, has integrated into the nursing curriculum theoretical and practical content that addresses the needs of the client infected with human immunodeficiency virus (HIV), the client at risk for HIV infection, and the nurse at risk for infection. (JOW)

  13. Dissecting the role of dendritic cells in simian immunodeficiency virus infection and AIDS

    PubMed Central

    Wonderlich, Elizabeth R.; Kader, Muhamuda; Wijewardana, Viskam

    2011-01-01

    Human immunodeficiency virus (HIV) infection is associated with the loss of the two principal types of dendritic cell (DC), myeloid DC (mDC) and plasmacytoid DC (pDC), but the mechanism of this loss and its relationship to AIDS pathogenesis remain ill-defined. The nonhuman primate is a powerful model to dissect this response for several reasons. Both DC subsets have been well characterized in nonhuman primates and shown to have strikingly similar phenotypic and functional characteristics to their counterparts in the human. Moreover, decline of mDC and pDC occurs in rhesus macaques with end-stage simian immunodeficiency virus (SIV) infection, the model of HIV infection in humans. In this brief review, we discuss what is known about DC subsets in pathogenic and nonpathogenic nonhuman primate models of HIV infection and highlight the advances and controversies that currently exist in the field. PMID:21717075

  14. Hepatitis B virus coinfection in human immunodeficiency virus-infected patients: A review

    PubMed Central

    Sun, Hsin-Yun; Sheng, Wang-Huei; Tsai, Mao-Song; Lee, Kuan-Yeh; Chang, Sui-Yuan; Hung, Chien-Ching

    2014-01-01

    Hepatitis B virus (HBV) infection is a leading cause of chronic hepatitis, liver cirrhosis, and hepatocellular carcinoma worldwide. Due to the shared modes of transmission, coinfection with HBV and human immunodeficiency virus (HIV) is not uncommon. It is estimated that 10% of HIV-infected patients worldwide are coinfected with HBV. In areas where an HBV vaccination program is implemented, the HBV seroprevalence has declined significantly. In HIV/HBV-coinfected patients, HBV coinfection accelerates immunologic and clinical progression of HIV infection and increases the risk of hepatotoxicity when combination antiretroviral therapy (cART) is initiated, while HIV infection increases the risk of hepatitis events, cirrhosis, and end-stage liver disease related to chronic HBV infection. With the advances in antiviral therapy, concurrent, successful long-term suppression of HIV and HBV replication can be achieved in the cART era. To reduce the disease burden of HBV infection among HIV-infected patients, adoption of safe sex practices, avoidance of sharing needles and diluent, HBV vaccination and use of cART containing tenofovir disoproxil fumarate plus emtricitabine or lamivudine are the most effective approaches. However, due to HIV-related immunosuppression, using increased doses of HBV vaccine and novel approaches to HBV vaccination are needed to improve the immunogenicity of HBV vaccine among HIV-infected patients. PMID:25356024

  15. Lymphoid organs function as major reservoirs for human immunodeficiency virus.

    PubMed Central

    Pantaleo, G; Graziosi, C; Butini, L; Pizzo, P A; Schnittman, S M; Kotler, D P; Fauci, A S

    1991-01-01

    The total number of human immunodeficiency virus type 1 (HIV-1)-infected circulating CD4+ T lymphocytes is considered to be a reflection of the HIV burden at any given time during the course of HIV infection. However, the low frequency of HIV-infected circulating CD4+ T lymphocytes and the low level or absence of plasma viremia in the early stages of infection do not correlate with the progressive immune dysfunction characteristic of HIV infection. In this study, we have determined whether HIV-infected circulating CD4+ T lymphocytes are a correct reflection of the total pool of HIV-infected CD4+ T cells (i.e., HIV burden). To this end, HIV burden has been comparatively analyzed in peripheral blood and lymphoid tissues (lymph nodes, adenoids, and tonsils) from the same patients. The presence of HIV-1 DNA in mononuclear cells isolated simultaneously from peripheral blood and lymphoid tissues of the same patients was determined by polymerase chain reaction amplification. We found that the frequency of HIV-1-infected cells in unfractionated or sorted CD4+ cell populations isolated from lymphoid tissues was significantly higher (0.5-1 log10 unit) than the frequency in peripheral blood. Comparable results were obtained in five HIV seropositive patients in the early stages of disease and in one patient with AIDS. These results demonstrate that a heavy viral load does reside in the lymphoid organs, indicating that they may function as major reservoirs for HIV. In addition, the finding of a heavy viral load in the lymphoid organs of patients in the early stages of disease may explain the progressive depletion of CD4+ T lymphocytes and the immune dysfunction associated with the early stages of HIV infection. Images PMID:1682922

  16. Repeatedly positive human immunodeficiency virus type 1 DNA polymerase chain reaction in human immunodeficiency virus-exposed seroreverting infants.

    PubMed

    Bakshi, S S; Tetali, S; Abrams, E J; Paul, M O; Pahwa, S G

    1995-08-01

    Three human immunodeficiency virus type 1 (HIV-1)-exposed children who had repeatedly positive DNA polymerase chain reaction (PCR) tests for HIV in > or = 5 samples before seroreversion to HIV-negative status are reported. The children belong to a cohort of 210 infants who were born to HIV-infected mothers and were tested at intervals of 1 to 3 months by HIV viral culture, PCR, and p24 antigen; only the PCR was positive in > or = 5 samples in the children reported here. Their clinical features were indistinguishable from other seroreverters. All three children had a transient drop in CD4:CD8 ratio to < 1.0. The transiently positive DNA PCR in HIV-exposed infants may indicate either that HIV infection was eliminated by a strong host immune response or that infection was caused by an attenuated/defective strain of virus.

  17. Increased Hepatitis E Virus Seroprevalence Correlates with Lower CD4+ Cell Counts in HIV-Infected Persons in Argentina

    PubMed Central

    Debes, José D.; Martínez Wassaf, Maribel; Pisano, María Belén; Isa, María Beatriz; Lotto, Martin; Marianelli, Leonardo G.; Frassone, Natalia; Ballari, Estefania; Bohjanen, Paul R.; Hansen, Bettina E.; Ré, Viviana

    2016-01-01

    Hepatitis E virus (HEV) is a single-stranded RNA virus that can cause hepatitis in an epidemic fashion. HEV usually causes asymptomatic or limited acute infections in immunocompetent individuals, whereas in immunosuppressed individuals such as transplant recipients, HEV can cause chronic infections. The risks and outcomes of HEV co-infection in patients infected with human immunodeficiency virus (HIV) are poorly characterized. We used a third generation immunoassay to measure serum IgG antibodies specific for HEV in 204 HIV-infected individuals from Argentina and a control group of 433 HIV-negative individuals. We found 15 of 204 (7.3%, 95%CI 3.74–10.96%) individuals in the HIV-positive group to have positive HEV IgG levels suggestive of previous infection, compared to 19 of 433 (4.4%, 95% CI 2.5–6.3%) individuals in the HIV-negative control group (p = 0.12). Among HIV-positive individuals, those with HEV seropositivity had lower CD4 counts compared to those that were HEV seronegative (average CD4 count of 234 vs 422 mm3, p = 0.01), indicating that patients with lower CD4 counts were more likely to be HEV IgG positive. Moreover, HEV seropositivity in patients with CD4 counts <200 mm3 was 16%, compared to 4.5% in those with CD4 counts >200 mm3 (p = 0.012). We found a positive PCR result for HEV in one individual. Our study found that increased seroprevalence of HEV IgG correlated with lower CD4 counts in HIV-infected patients in Argentina. PMID:27467394

  18. Increased Hepatitis E Virus Seroprevalence Correlates with Lower CD4+ Cell Counts in HIV-Infected Persons in Argentina.

    PubMed

    Debes, José D; Martínez Wassaf, Maribel; Pisano, María Belén; Isa, María Beatriz; Lotto, Martin; Marianelli, Leonardo G; Frassone, Natalia; Ballari, Estefania; Bohjanen, Paul R; Hansen, Bettina E; Ré, Viviana

    2016-01-01

    Hepatitis E virus (HEV) is a single-stranded RNA virus that can cause hepatitis in an epidemic fashion. HEV usually causes asymptomatic or limited acute infections in immunocompetent individuals, whereas in immunosuppressed individuals such as transplant recipients, HEV can cause chronic infections. The risks and outcomes of HEV co-infection in patients infected with human immunodeficiency virus (HIV) are poorly characterized. We used a third generation immunoassay to measure serum IgG antibodies specific for HEV in 204 HIV-infected individuals from Argentina and a control group of 433 HIV-negative individuals. We found 15 of 204 (7.3%, 95%CI 3.74-10.96%) individuals in the HIV-positive group to have positive HEV IgG levels suggestive of previous infection, compared to 19 of 433 (4.4%, 95% CI 2.5-6.3%) individuals in the HIV-negative control group (p = 0.12). Among HIV-positive individuals, those with HEV seropositivity had lower CD4 counts compared to those that were HEV seronegative (average CD4 count of 234 vs 422 mm3, p = 0.01), indicating that patients with lower CD4 counts were more likely to be HEV IgG positive. Moreover, HEV seropositivity in patients with CD4 counts <200 mm3 was 16%, compared to 4.5% in those with CD4 counts >200 mm3 (p = 0.012). We found a positive PCR result for HEV in one individual. Our study found that increased seroprevalence of HEV IgG correlated with lower CD4 counts in HIV-infected patients in Argentina.

  19. Oral lesions associated with human immunodeficiency virus disease.

    PubMed

    Patton, Lauren L

    2013-10-01

    Human immunodeficiency virus (HIV)-associated oral disease among people living with HIV infection includes oral candidiasis, oral hairy leukoplakia, Kaposi sarcoma, oral warts, herpes simplex virus ulcers, major aphthous ulcers or ulcers not otherwise specified, HIV salivary gland disease, and atypical gingival and periodontal diseases. Diagnosis of some oral lesions is based on clinical appearance and behavior, whereas others require biopsy, culture, or imaging for definitive diagnosis. Management strategies including pharmacologic and nonpharmacologic approaches are discussed in this article. Dentists also need to be cognizant of the potential oral side effects of HIV antiretroviral medications.

  20. Increased hot flash severity and related interference in perimenopausal human immunodeficiency virus-infected women.

    PubMed

    Looby, Sara E; Shifren, Jan; Corless, Inge; Rope, Alison; Pedersen, Maria C; Joffe, Hadine; Grinspoon, Steven

    2014-04-01

    As women with human immunodeficiency virus (HIV) are living longer, more are entering perimenopause. Prior studies suggest that HIV-infected women are more likely to have hot flashes than non-HIV-infected women. However, little is known regarding hot flash severity and hot flash-related interference with daily function, mood, and quality of life in this population. Perimenopausal HIV-infected and non-HIV-infected women matched by age, race, and menstrual patterns completed the Menopause Rating Scale (to assess hot flash severity) and the Hot Flash Related Daily Interference Scale (HFRDIS). Menopause Rating Scale and HFRDIS scores and subscores were compared between the groups. Thirty-three HIV-infected women and 33 non-HIV-infected women who were similar in age (median [interquartile range], 47 [45-48] vs 47 [46-49] y), race (64% vs 52% nonwhite, P = 0.32), and menstrual patterns (number of periods in the past year; 5 [4-9] vs 6 [4-10], P = 0.53) were studied. Perimenopausal HIV-infected women reported greater hot flash severity (HIV vs non-HIV: 2 [1-3] vs 1 [0-3], P = 0.03) and hot flash-related interference (HFRDIS total score, 37 [10-60] vs 6 [0-20], P = 0.001). Perimenopausal HIV-infected women experience greater hot flash severity and related interference compared with non-HIV-infected perimenopausal women. Increased distress secondary to hot flashes may reduce quality of life and negatively impact important health-promoting behaviors, including adherence to antiretroviral therapy, in HIV-infected women.

  1. Pro- and anti-inflammatory cytokines in human immunodeficiency virus infection and acquired immunodeficiency syndrome.

    PubMed

    Breen, Elizabeth Crabb

    2002-09-01

    In persons with human immunodeficiency virus (HIV) infection and/or acquired immunodeficiency syndrome (AIDS), the immune system becomes dysfunctional in many ways. There is both immunodeficiency due to the loss of CD4-positive T helper cells and hyperactivity as a result of B-cell activation. Likewise, both decreases and increases are seen in the production and/or activity of cytokines. Cytokine changes in HIV infection have been assessed by a variety of techniques, ranging from determination of cytokine gene expression at the mRNA level to secretion of cytokine proteins in vivo and in vitro. Changes in cytokine levels in HIV-infected persons can affect the function of the immune system, and have the potential to directly impact the course of HIV disease by enhancing or suppressing HIV replication. In particular, the balance between the pro-inflammatory cytokines interleukin (IL)-1, IL-6, and tumor necrosis factor-alpha, which up-regulate HIV expression, and IL-10, which can act both as an anti-inflammatory cytokine and a B-cell stimulatory factor, may play an important role in the progression to AIDS. In light of its ability to suppress the production of pro-inflammatory cytokines and, under some conditions, suppress HIV replication, increased IL-10 may be viewed as beneficial in slowing HIV disease progression. However, an association between increased IL-10 and the development of AIDS-associated B-cell lymphoma highlights the bifunctional nature of IL-10 as both an anti-inflammatory and B-cell-stimulatory cytokine that could have beneficial and detrimental effects on the course of HIV infection and AIDS.

  2. Nutritional and metabolic abnormalities in pre-AIDS HIV infection.

    PubMed

    Faintuch, Joel; Soeters, Peter B; Osmo, Helio G

    2006-06-01

    Since the earliest reports of human immunodeficiency virus (HIV) disease, undernutrition has been associated with HIV infection, typically with the late stages of the disease (namely acquired immunodeficiency syndrome), and may advance to severe wasting and cachexia. Specific micronutrient deficiencies are also recognized to occur with HIV infection, but their actual effect on the clinical course of the disease is hard to assess. The studies reviewed provide more insight into the complex interface between undernutrition and, in some cases, obesity and HIV/acquired immunodeficiency syndrome and highlight the possibility of alleviating or curing undernutrition by means of simple and comparatively inexpensive dietary adjustments.

  3. A review of renal disease in children with HIV infection.

    PubMed

    Jindal, Ankur Kumar; Tiewsoh, Karalanglin; Pilania, Rakesh Kumar

    2017-09-08

    Human immunodeficiency virus (HIV) infection continues to be a leading cause of morbidity and mortality. HIV-infected individuals are now surviving for a relatively longer period and this is because of easy accessibility to antiretroviral therapy these days. As a result, chronic disease-related complications are now being recognized more often. Kidney disease in HIV-infected children can vary from glomerular to tubular-interstitial involvement. We searched the database to identify various kidney diseases seen in HIV-infected children. We describe the epidemiology, pathogenesis, pathology, clinical and laboratory manifestations, management and outcome of commonly seen kidney disease in HIV-infected children. We also provide a brief overview of toxicity of antiretroviral drugs seen in HIV-infected children. Kidney involvement in HIV-infected children may arise because of HIV infection per se, opportunistic infections, immune mediated injury and drug toxicity. HIV-associated nephropathy is perhaps the most common and most severe form of kidney disease. Proteinuria may be a cost-effective screening test in the long-term management of HIV-infected children, however, there are no definite recommendations for the same. Other important renal diseases are HIV immune complex kidney disease, thrombotic microangiopathy, interstitial nephritis and vasculitis.

  4. Gene-based immunotherapy for human immunodeficiency virus infection and acquired immunodeficiency syndrome.

    PubMed

    Dropulic, Boro; June, Carl H

    2006-06-01

    More than 40 million people are infected with human immunodeficiency virus (HIV), and a successful vaccine is at least a decade away. Although highly active antiretroviral therapy prolongs life, the maintenance of viral latency requires life-long treatment and results in cumulative toxicities and viral escape mutants. Gene therapy offers the promise to cure or prevent progressive HIV infection by interfering with HIV replication and CD4+ cell decline long term in the absence of chronic chemotherapy, and approximately 2 million HIV-infected individuals live in settings where there is sufficient infrastructure to support its application with current technology. Although the development of HIV/AIDS gene therapy has been slow, progress in a number of areas is evident, so that studies to date have significantly advanced the field of gene-based immunotherapy. Advances have helped to define a series of ongoing and planned trials that may shed light on potential mechanisms for the successful clinical gene therapy of HIV.

  5. Proteinuria in paediatric patients with human immunodeficiency virus infection

    PubMed Central

    Giacomet, Vania; Erba, Paola; Di Nello, Francesca; Coletto, Sonia; Viganò, Alessandra; Zuccotti, GianVincenzo

    2013-01-01

    In human immunodeficiency virus (HIV)-infected people kidney disease is as an important cause of morbidity and mortality. Clinical features of kidney damage in HIV-infected patients range from asymptomatic microalbuminuria to nephrotic syndrome. The lack of specific clinical features despite the presence of heavy proteinuria may mask the renal involvement. Indeed, it is important in HIV patients to monitor renal function to early discover a possible kidney injury. After the introduction of antiretroviral therapy, mortality and morbidity associated to HIV-infection have shown a substantial reduction, although a variety of side effects for long-term use of highly active antiretroviral therapy, including renal toxicity, has emerged. Among more than 20 currently available antiretroviral agents, many of them can occasionally cause reversible or irreversible nephrotoxicity. At now, three antiretroviral agents, i.e., indinavir, atazanavir and tenofovir disoproxil fumarate have a well established association with direct nephrotoxicity. This review focuses on major causes of proteinuria and other pathological findings related to kidney disease in HIV-infected children and adolescents. PMID:24303454

  6. Proteinuria in paediatric patients with human immunodeficiency virus infection.

    PubMed

    Giacomet, Vania; Erba, Paola; Di Nello, Francesca; Coletto, Sonia; Viganò, Alessandra; Zuccotti, Gianvincenzo

    2013-04-16

    In human immunodeficiency virus (HIV)-infected people kidney disease is as an important cause of morbidity and mortality. Clinical features of kidney damage in HIV-infected patients range from asymptomatic microalbuminuria to nephrotic syndrome. The lack of specific clinical features despite the presence of heavy proteinuria may mask the renal involvement. Indeed, it is important in HIV patients to monitor renal function to early discover a possible kidney injury. After the introduction of antiretroviral therapy, mortality and morbidity associated to HIV-infection have shown a substantial reduction, although a variety of side effects for long-term use of highly active antiretroviral therapy, including renal toxicity, has emerged. Among more than 20 currently available antiretroviral agents, many of them can occasionally cause reversible or irreversible nephrotoxicity. At now, three antiretroviral agents, i.e., indinavir, atazanavir and tenofovir disoproxil fumarate have a well established association with direct nephrotoxicity. This review focuses on major causes of proteinuria and other pathological findings related to kidney disease in HIV-infected children and adolescents.

  7. Acute pancreatitis: Manifestation of acute HIV infection in an adolescent

    PubMed Central

    Bitar, Anas; Altaf, Muhammad; Sferra, Thomas J.

    2012-01-01

    Summary Background: Pancreatitis in the pediatric age group is not as common as in adults. Etiologies are various and differ from those in adults. Although infectious etiology accounts for a significant number of cases of pancreatitis, acute infection with Human Immunodeficiency Virus (HIV) was rarely reported as a possible etiology for acute pancreatitis in adults. Acute pancreatitis has never been reported as a presenting manifestation of acute HIV infection in children. Case Report: We describe a pediatric patient who presented with acute pancreatitis that revealed acute HIV infection. Conclusions: Acute pancreatitis as a primary manifestation of HIV infection is very rare. It may represent an uncommon aspect of primary HIV infection. We suggest that acute HIV infection should be considered in the differential diagnosis of acute pancreatitis at all ages. PMID:23569476

  8. HIV infection-related tuberculosis: clinical manifestations and treatment.

    PubMed

    Sterling, Timothy R; Pham, Paul A; Chaisson, Richard E

    2010-05-15

    Several aspects of human immunodeficiency virus (HIV) infection-related tuberculosis (TB) and its treatment differ from those of TB in HIV-uninfected persons. The risk of TB and the clinical and radiographic manifestations of disease are primary examples. Antiretroviral therapy has a profound effect on lowering the risk of TB in HIV-infected persons, but it can also be associated with immune reconstitution inflammatory disease and unmasking of previously subclinical disease. There are also differences in treatment of HIV infection-related TB because of overlapping drug toxicities and drug-drug interactions between antiretroviral therapy and anti-TB therapy.

  9. Prevalence and Predictors of Thyroid Dysfunction in Patients with HIV Infection and Acquired Immunodeficiency Syndrome: An Indian Perspective.

    PubMed

    Sharma, Neera; Sharma, Lokesh Kumar; Dutta, Deep; Gadpayle, Adesh Kisanji; Anand, Atul; Gaurav, Kumar; Mukherjee, Sabyasachi; Bansal, Rahul

    2015-01-01

    Background. Predictors of thyroid dysfunction in HIV are not well determined. This study aimed to determine the prevalence and predictors of thyroid dysfunction in HIV infected Indians. Methods. Consecutive HIV patients, 18-70 years of age, without any severe comorbid state, having at least 1-year follow-up at the antiretroviral therapy clinic, underwent clinical assessment and hormone assays. Results. From initially screened 527 patients, 359 patients (61.44 ± 39.42 months' disease duration), having good immune function [CD4 count >200 cell/mm(3): 90.25%; highly active antiretroviral therapy (HAART): 88.58%], were analyzed. Subclinical hypothyroidism (ScH) was the commonest thyroid dysfunction (14.76%) followed by sick euthyroid syndrome (SES) (5.29%) and isolated low TSH (3.1%). Anti-TPO antibody (TPOAb) was positive in 3.90%. Baseline CD4 count had inverse correlation with TPOAb after adjusting for age and body mass index. Stepwise linear regression revealed baseline CD4 count, TPOAb, and tuberculosis to be best predictors of ScH after adjusting for age, weight, duration of HIV, and history of opportunistic fungal and viral infections. Conclusion. Burden of thyroid dysfunction in chronic HIV infection with stable immune function is lower compared to pre-HAART era. Thyroid dysfunction is primarily of nonautoimmune origin, predominantly ScH. Severe immunodeficiency at disease onset, TPOAb positivity, and tuberculosis were best predictors of ScH.

  10. First detection of autochthonous Zika virus transmission in a HIV-infected patient in Rio de Janeiro, Brazil.

    PubMed

    Calvet, Guilherme A; Filippis, Ana Maria B; Mendonça, Marcos Cesar L; Sequeira, Patricia C; Siqueira, Andre M; Veloso, Valdilea G; Nogueira, Rita M; Brasil, Patrícia

    2016-01-01

    Since May 2015, Brazil's Ministry of Health has reported autochthonous transmission of Zika virus (ZIKV) in some states of the country. Simultaneous circulation of Dengue, Chikungunya and ZIKV in the country hinder both the diagnosis and the therapeutic approach of patients seeking care with acute febrile illnesses especially in patients with comorbidities. The association between HIV infection and endemic diseases has been described especially in tropical regions with varying levels of complications, although there has been no report of ZIKV in HIV-infected patients. We report the first autochthonous case of laboratory confirmed ZIKV infection in a HIV-infected patient in Rio de Janeiro, Brazil. He evolved with only mild symptoms and recovered well without major laboratory abnormalities. Phylogenetic analysis of the ZIKV detected in the patient sera clustered within the Asian clade. To the best of our knowledge, this is the first time that Zika virus co-infection is reported in a HIV-infected patient.

  11. Virus load as a marker of disease progression in HIV-infected children.

    PubMed

    Tetali, S; Abrams, E; Bakshi, S; Paul, M; Oyaizu, N; Pahwa, S

    1996-05-20

    The relationship of virus load to clinical disease progression in HIV-infected children remains to be elucidated. In this study, HIV-1 proviral DNA load was determined in peripheral blood mononuclear cells (PBMCs) by the quantitative competitive DNA polymerase chain reaction assay (QC-PCR) in 47 HIV-infected children subdivided by age (group I, < or = 2 years; group II, > or = 5 years), who were further categorized to include 12 rapid progressors (RP, age < or = 2 years, Centers for Disease Control [CDC] defined clinical category C and/or immune category 3, or death before age 2 years) and slow progressors (SP, age > or = 5 years, excluding CDC categories C and/or immune category 3). Significantly higher mean proviral copies/10(3) PBMCs were detected in group I versus group II (75.4 +/- 104.3 and 13.0 +/- 17.8 respectively, p < 0.0001) and in RP (158.0 +/- 118.2) as compared to either SP (11.8 +/- 18.8, p < 0.0001) or other age-matched infected children (20.3 +/- 38.8, p < 0.0001). Thus HIV-infected children appear to have a higher cell-associated virus load early in life, especially in association with rapid disease progression.

  12. Immunogenicity and Immunologic Memory after Hepatitis B Virus Booster Vaccination in HIV-Infected Children Receiving Highly Active Antiretroviral Therapy

    PubMed Central

    Abzug, Mark J.; Warshaw, Meredith; Rosenblatt, Howard M.; Levin, Myron J.; Nachman, Sharon A.; Pelton, Stephen I.; Borkowsky, William; Fenton, Terence

    2010-01-01

    Background Hepatitis B virus (HBV) is an important cause of comorbidity in human immunodeficiency virus (HIV)–infected individuals. The immunogenicity of HBV vaccination in children receiving highly active antiretroviral therapy (HAART) was investigated. Methods HIV-infected children receiving HAART who had low to moderate HIV loads and who had previously received ≥3 doses of HBV vaccine were given an HBV vaccine booster. Concentrations of antibody to hepatitis B surface antigen (anti-HBs) were determined before vaccination and at weeks 8, 48, and 96. A subset of subjects was administered a subsequent dose, and anti-HBs was measured before and 1 and 4 weeks later. Results At entry, 24% of 204 subjects were seropositive. Vaccine response occurred in 46% on the basis of seropositivity 8 weeks after vaccination and in 37% on the basis of a ≥4-fold rise in antibody concentration. Of 69 subjects given another vaccination 4–5 years later, immunologic memory was exhibited by 45% on the basis of seropositivity 1 week after vaccination and by 29% on the basis of a ≥4-fold rise in antibody concentration at 1 week. Predictors of response and memory included higher nadir and current CD4 cell percentage, higher CD19 cell percentage, and undetectable HIV load. Conclusions HIV-infected children frequently lack protective levels of anti-HBs after previous HBV vaccination, and a significant proportion of them do not respond to booster vaccination or demonstrate memory despite receiving HAART, leaving this population insufficiently protected from infection with HBV. PMID:19663708

  13. Overt and occult hepatitis B virus infection among treatment-naïve HIV-infected patients in Brazil.

    PubMed

    Oliveira, Marina Pedroso; Lemes, Pollyanne Sousa; Matos, Márcia Alves Dias; Del-Rios, Nativa Helena Alves; Carneiro, Megmar Aparecida Santos; Silva, Ágabo Macedo Costa; Lopes, Carmen Luci Rodrigues; Teles, Sheila Araújo; Aires, Rodrigo Sebba; Lago, Bárbara Vieira; Araujo, Natalia Motta; Martins, Regina Maria Bringel

    2016-07-01

    Although hepatitis B virus (HBV) and human immunodeficiency virus (HIV) co-infection is common, only few data are available on HBV among HIV patients including occult hepatitis B infection (OBI), regardless of serological markers. This study aims to determine the prevalence of OBI and overall HBV infection, associated factors, HBV genotypes, and surface (S) gene mutations in a population of treatment-naïve HIV-infected patients in Brazil. A cross-sectional study was conducted in treatment-naïve HIV-infected patients in Central Brazil. All samples were tested for HBV serological markers and HBV DNA. Sequence analysis of the S gene and overlapping polymerase gene was preformed. Overall, 25.1% (127/505) of the patients had markers of current or previous HBV infection, which was associated with age over 40 years, history of injection drug use, and homosexual sex. The hepatitis B surface antigen (HBsAg) seroprevalence was 4.9% (25/505). HBV DNA was detected in 39 out of 505 patients: 20 of them were HBsAg-positive and 19 were HBsAg-negative, resulting in an OBI prevalence of 3.8%. Patients with OBI had significantly higher HCV seropositivity rate compared to HBsAg-positive patients. Sequencing of the S gene revealed Y100C, T131N, and D144A mutations. One patient had the M204I and L180M drug-resistance mutations (polymerase). HBV genotypes A (A1, A2), D (D2, D3), and F (F2) were identified. In conclusion, OBI represented almost half of all HBV infections with detectable HBV DNA, suggesting that hepatitis B diagnosis in HIV patients should include in addition to serological markers the detection of HBV DNA. © 2016 Wiley Periodicals, Inc.

  14. Cancer Prevention in HIV-Infected Populations

    PubMed Central

    Goncalves, Priscila H.; Montezuma-Rusca, Jairo M.; Yarchoan, Robert; Uldrick, Thomas S.

    2016-01-01

    People living with human immunodeficiency virus (HIV) are living longer since the advent of effective combined antiretroviral therapy (cART). While cART substantially decreases the risk of developing some cancers, HIV-infected individuals remain at high risk for Kaposi sarcoma, lymphoma and several solid tumors. Currently HIV-infected patients represent an aging group, and malignancies have become a leading cause of morbidity and mortality. Tailored cancer-prevention strategies are needed for this population. In this review we describe the etiologic agents and pathogenesis of common malignancies in the setting of HIV, as well as current evidence for cancer prevention strategies and screening programs. PMID:26970136

  15. Innate immunity in resistance to HIV infection.

    PubMed

    Biasin, Mara; Clerici, Mario; Piacentini, Luca

    2010-11-01

    Resistance to human immunodeficiency virus (HIV) infection in subjects who do not seroconvert despite multiple exposures to the virus and to the progression to AIDS in HIV‐infected individuals depends on multiple factors involving both the innate and the adaptive immune system. The contribution of natural immunity in preventing HIV infection has so far received little attention, but many recently published articles suggest a key role for Toll‐like receptors, natural killer cells, interleukin‐22, acute‐phase amyloid A protein, and APOBEC3G in conferring resistance to HIV infection. The study of these factors will shed light on HIV pathogenesis and contribute to the development of new therapeutic approaches to this elusive disease.

  16. Human immunodeficiency virus antibody test and seroprevalence in psychiatric patients.

    PubMed

    Naber, D; Pajonk, F G; Perro, C; Löhmer, B

    1994-05-01

    Psychiatric inpatients are at risk for human immunodeficiency virus (HIV) infection. Investigations in the United States revealed seroprevalence rates of 5.5-8.9%. Therefore, inclusion of HIV antibody testing in routine laboratory screening is sometimes suggested. To investigate this issue for inpatients in the Department of Psychiatry, University of Munich, the incidence, reason for HIV testing and results were analyzed. Of 12,603 patients, hospitalized from 1985 to 1993, 4.9% (623 patients, 265 in risk groups) underwent the HIV test after informed consent. Thirty patients (4.8% of those tested) were found to be positive, but only in 5 cases (all of risk groups) was infection newly detected. Data indicate that, in psychiatry, HIV testing is reasonable only in patients in risk groups or if clinical variables suggest HIV infection.

  17. Emerging bone problems in patients infected with human immunodeficiency virus.

    PubMed

    Mondy, Kristin; Tebas, Pablo

    2003-04-01

    Recently, a high incidence of osteopenia and osteoporosis has been observed in individuals infected with human immunodeficiency virus (HIV). This problem appears to be more frequent in patients receiving potent antiretroviral therapy. Other bone-related complications in HIV-infected individuals, including avascular necrosis of the hip and compression fracture of the lumbar spine, have also been reported. People living with HIV have significant alterations in bone metabolism, regardless of whether they are receiving potent antiretroviral therapy. The underlying mechanisms to account for these observations remain unknown, although studies are underway to examine the relationship between the bone abnormalities and other complications associated with HIV and antiretroviral therapy. HIV-infected patients with osteopenia or osteoporosis should be treated similarly to HIV-seronegative patients with appropriate use of nutritional supplements (calcium and vitamin D) and exercise. Hormone replacement and antiresorptive therapies might be also indicated.

  18. Human immunodeficiency virus and migrant labor in South Africa.

    PubMed

    Jochelson, K; Mothibeli, M; Leger, J P

    1991-01-01

    The authors investigate the impact of the migrant labor system on heterosexual relationships on South African mines and assess the implications for the future transmission of human immunodeficiency virus (HIV) infection. The migrant labor system has created a market for prostitution in mining towns and geographic networks of relationships within and between urban and rural communities. A section of the migrant workforce and a group of women dependent on prostitution for economic support appear especially vulnerable to contracting HIV infection since they are involved in multiple sexual encounters with different, changing partners, usually without condom protection. Furthermore, sexually transmitted disease morbidity is extensive in the general and mineworker populations. Historically, migration facilitated the transmission of sexually transmitted diseases and may act similarly for HIV. Problems of combating the HIV epidemic in South Africa are discussed.

  19. Natural history of compensated hepatitis C virus-related cirrhosis in HIV-infected patients.

    PubMed

    Pineda, Juan A; Aguilar-Guisado, Manuela; Rivero, Antonio; Girón-González, José A; Ruiz-Morales, Josefa; Merino, Dolores; Ríos-Villegas, María J; Macías, Juan; López-Cortés, Luis F; Camacho, Angela; Merchante, Nicolás; Del Valle, José

    2009-10-15

    To provide information about the incidence and predictors of liver decompensation and death due to liver failure in human immunodeficiency virus (HIV)-infected patients with compensated hepatitis C virus (HCV)-related cirrhosis. Prospective cohort study of 154 HIV-HCV-coinfected patients with a new diagnosis of Child-Pugh-Turcotte (CPT) class A compensated cirrhosis. We evaluated time from diagnosis to the first liver decompensation and death from liver disease, as well as predictors of these outcomes. Thirty-six patients (23.4%) developed liver decompensation. The incidence of liver decompensation was 6.40 cases per 100 person-years (95% confidence interval [CI], 4.18-9.38 cases per 100 person-years). Factors independently associated with liver decompensation were lack of HCV therapy (hazard ratio [HR], 3.38; 95% CI, 1.09-10.53; P = .035), baseline CD4 cell counts

  20. HIV infection/acquired immunodeficiency syndrome at Siriraj Hospital, 2002: time for secondary prevention.

    PubMed

    Anekthananon, Thanomsak; Ratanasuwan, Winai; Techasathit, Wichai; Rongrungruang, Yong; Suwanagool, Surapol

    2004-02-01

    The authors retrospectively reviewed the medical records of HIV/AIDS patients who were admitted to the medical service, Siriraj Hospital from January 1, 2002 through December 31, 2002. Demographics, CD4 lymphocyte counts, discharge diagnoses, the incidence of Pneumocystis carinii pneumonia (PCP), cerebral toxoplasmosis and cryptococcosis in patients who received and did not receive appropriate chemoprophylaxis against those opportunistic infections when indicated, and outcome of the patients were collected. Three hundred medical records of 286 HIV/AIDS patients were available for review. One hundred and seventy two patients (60.1%) were male. Mean age of the patients was 36.8 +/- 9.91 years (range 14-74). The mean CD4 lymphocyte count that was determined in 165 patients was 74.7 +/- 134.21 cells/mm3 (range 0-894). Of the 300 admissions, 36 per cent were newly diagnosed HIV infection. Only 23 (7.7%) patients had received antiretroviral drugs at the time of hospitalization. The leading HIV-related diseases were tuberculosis (29.3%), Pneumocystis carinii pneumonia (18.7%), and cryptococcosis (15.7%). The rest of them included cytomegalovirus diseases (6.3%), lymphoma (6.3%), Salmonella bacteremia (6%), cerebral toxoplasmosis (5.7%), cryptosporidiosis (5.3%), disseminated Mycobacterium avium complex infection (1.0%), extrapulmonary histoplasmosis (1.0%), Candida esophagitis (1.0%), progressive multifocal leukoencephalopathy (1.0%), and rhodococcosis (0.7%). Among those for whom HIV infection was established and chemoprophylaxis for PCP, cerebral toxoplasmosis and cryptococcosis were indicated, 9.8 per cent vs 28.2 per cent, 3.6 per cent vs 5.1 per cent, and 10 per cent vs 15.2 per cent of whom received and did not receive the appropriate chemoprophylaxis developed PCP, cerebral toxoplasmosis and cryptococcosis respectively. One hundred and ninety (63.3%) patients were alive at discharge, 84 (28.0%) had died, 21 (7%) were referred to other hospitals, and 5 (1.7%) left

  1. Infectious Zika virus in vaginal secretions from an HIV-infected woman, France, August 2016.

    PubMed

    Penot, Pauline; Brichler, Ségolène; Guilleminot, Jean; Lascoux-Combe, Caroline; Taulera, Olivier; Gordien, Emmanuel; Leparc-Goffart, Isabelle; Molina, Jean-Michel

    2017-01-19

    A woman with controlled HIV infection developed in late August 2016 a pruritic rash with fever and conjunctival hyperaemia after a trip to the French Caribbean islands. On day 3 after symptom onset, Zika virus RNA was detected in plasma, urine and vaginal samples with respective viral loads of 3.8, 6.1 and 5.3 log copies/mL. Notably, we demonstrated the presence of infectious Zika virus particles in the vaginal samples by isolation in cell culture. This article is copyright of The Authors, 2017.

  2. Infectious Zika virus in vaginal secretions from an HIV-infected woman, France, August 2016

    PubMed Central

    Penot, Pauline; Brichler, Ségolène; Guilleminot, Jean; Lascoux-Combe, Caroline; Taulera, Olivier; Gordien, Emmanuel; Leparc-Goffart, Isabelle; Molina, Jean-Michel

    2017-01-01

    A woman with controlled HIV infection developed in late August 2016 a pruritic rash with fever and conjunctival hyperaemia after a trip to the French Caribbean islands. On day 3 after symptom onset, Zika virus RNA was detected in plasma, urine and vaginal samples with respective viral loads of 3.8, 6.1 and 5.3 log copies/mL. Notably, we demonstrated the presence of infectious Zika virus particles in the vaginal samples by isolation in cell culture. PMID:28128730

  3. Spatiotemporal dynamics of HIV infection

    NASA Astrophysics Data System (ADS)

    Strain, Matthew Carl

    Mathematical models of the dynamics of infection with the human immunodeficiency virus (HIV) have contributed to tremendous advances over the past 20 years. This thesis extends this previous work by exploring the importance of spatial heterogeneity in HIV infection both in vitro and in vivo in patients treated with highly-active antiretroviral therapy. Viral infections propagate locally in space, yet HIV infection has been widely regarded as equilibrated over the entire body of an infected patient. This dissertation constructs and explores a cellular automata model of viral spread at the cellular level. Coupling the automata to a blood compartment represented by a differential equation leads to a whole-body model of HIV infection that explicitly includes spatial effects at both the cellular and tissue levels. These models are tested by comparison with experimental data. A central prediction of the spatial model is that, due to competition between Brownian motion and viral lability, HIV infectivity increases with target cell density. This production is verified in a series of in vitro experiments in cell culture. The predicted independence of inhibitory concentrations of antiretoviral agents is verified for nevirapine, but azidothymidine inhibits HIV replication less efficiently in more dense cultures. These in vitro results suggest that systems allowing cell concentrations closer to tissue densities would better reflect virus replication kinetics, although standard measures of relative drug susceptibility may accurately reflect in vivo conditions. The coupled spatial model of in vivo dynamics is compared with novel mathematical analysis of experiments in HIV-infected patients. These analyses indicate that HIV DNA provides a useful marker of the size of long-lived cellular reservoirs of HIV. Levels of HIV DNA in peripheral blood are predictive of the average rate of residual virus production after years of treatment, regardless of whether patients initiate therapy

  4. Potential utility of empirical tuberculosis treatment for HIV-infected patients with advanced immunodeficiency in high TB-HIV burden settings.

    PubMed

    Lawn, S D; Ayles, H; Egwaga, S; Williams, B; Mukadi, Y D; Santos Filho, E D; Godfrey-Faussett, P; Granich, R M; Harries, A D

    2011-03-01

    The human immunodeficiency virus (HIV) and HIV-associated tuberculosis (TB-HIV) epidemics remain uncontrolled in many resource-limited regions, especially in sub-Saharan Africa. The scale of these epidemics requires the consideration of innovative bold interventions and 'out-of-the-box' thinking. To this end, a symposium entitled 'Controversies in HIV' was held at the 40th Union World Conference on Lung Health in Cancun, Mexico, in December 2009. The first topic debated, entitled 'Annual HIV testing and immediate start of antiretroviral therapy for all HIV-infected persons', received much attention at international conferences and in the literature in 2009. The second topic forms the subject of this article. The rationale for the use of empirical TB treatment is premised on the hypothesis that in settings worst affected by the TB-HIV epidemic, a subset of HIV-infected patients have such a high risk of undiagnosed TB and of associated mortality that their prognosis may be improved by immediate initiation of empirical TB treatment used in conjunction with antiretroviral therapy. In addition to morbidity and mortality reduction, additional benefits may include prevention of nosocomial TB transmission and TB preventive effect. Potential adverse consequences, however, may include failure to consider other non-TB diagnoses, drug co-toxicity, compromised treatment adherence, and logistical and resource challenges. There may also be general reluctance among national TB programmes to endorse such a strategy. Following fruitful debate, the conclusion that this strategy should be carefully evaluated in randomised controlled trials was strongly supported. This paper provides an in-depth consideration of this proposed intervention.

  5. Extrahepatic comorbidities associated with hepatitis C virus in HIV-infected patients.

    PubMed

    Soriano, Vicente; Berenguer, Juan

    2015-09-01

    HIV infection facilitates progression of hepatitis C virus (HCV)-related liver fibrosis, thus increasing the risk of cirrhosis and decompensated liver disease. Although the primary target of HCV infection is the liver, extrahepatic manifestations related to HCV contribute significantly to morbidity and mortality in patients with chronic hepatitis C. We review current data on extrahepatic comorbidities associated with HCV in HIV-infected patients. A large proportion of individuals coinfected with HIV/HCV has extrahepatic manifestations that may be indirectly or directly related to HCV infection. Extrahepatic manifestations include autoimmune and/or lymphoproliferative disorders, and cardiovascular, renal, metabolic, and central nervous system manifestations. Chronic immune activation and systemic inflammation, hallmarks of both HIV and HCV infection, may contribute greatly to extrahepatic comorbidities of HCV in this population group. There is substantial evidence that successful antiviral therapy might reduce both hepatic and extrahepatic manifestations of HCV infection in patients coinfected with HIV/HCV. A substantial burden of the morbidity and the mortality related to HCV in patients with or without HIV infection depends on its extrahepatic manifestations. HCV eradication following successful antiviral therapy might reduce both.

  6. Transmission and evolution of hepatitis C virus in HCV seroconverters in HIV infected subjects.

    PubMed

    Shen, Chengli; Gupta, Phalguni; Xu, Xiaochuan; Sanyal, Anwesha; Rinaldo, Charles; Seaberg, Eric; Margolick, Joseph B; Martinez-Maza, Otoniel; Chen, Yue

    2014-01-20

    HIV/HCV co-infection provides a model to determine the role of immunity on HCV transmission and evolution. In this study HCV transmission and evolution were evaluated in 6 HCV seroconverters in HIV-infected subjects with a wide range of CD4 cell count. The HCV envelope E1/E2 sequences were analyzed for transmission bottleneck, viral diversity/divergence, immune pressure, and mutations of HLA class I/II restricted epitopes. HCV infection started with transmission bottleneck in all HIV-infected individuals. During the 1.0-2.0 years of infection there was a shift of viral quasispecies in majority of the subjects from one to next visit. However, HCV diversity, divergence, mutations in HLA class I/II restricted and virus neutralizing epitopes were similar in all subjects regardless of CD4 cell count at the time of HCV infection. Our results suggest that HCV transmission and evolution in HIV-infected subjects may not be influenced by host CD4 cell count at the time of infection.

  7. Micronutrient status and human immunodeficiency virus (HIV) infection.

    PubMed

    Bogden, J D; Baker, H; Frank, O; Perez, G; Kemp, F; Bruening, K; Louria, D

    1990-01-01

    This study surveyed serum concentrations of vitamins, electrolytes, and trace elements in subjects seropositive for HIV-1 by ELISA and confirmatory Western blot. Thirty subjects (26 males, 4 females) were recruited at a hospital clinic. Seventeen were classified as having mild or severe ARC (AIDS-related complex), 7 had AIDS, and 6 were asymptomatic. Eight had experienced weight loss of 10 pounds or more in the past 6 months. Most (93%) were anergic to skin test antigens. Percentages of subjects with below normal plasma concentrations include: zinc-30%, calcium-27%, magnesium-30%, carotenes-31%, total choline-50%, and ascorbate-27%. Eighty-seven percent of the subjects had at least one abnormally low value. Percentages with above normal values include: folate-37% and carnitine-37%. Some subjects with above normal values for plasma vitamins reported self-supplementation, usually with large doses. The results suggest that one or more abnormally low concentrations of the plasma micronutrients studied here are likely to be present in the majority of HIV seropositive patients.

  8. Increasing Rates of Obesity Among HIV-Infected Persons During the HIV Epidemic

    DTIC Science & Technology

    2010-04-01

    America Abstract Background: The prevalence and factors associated with overweight/obesity among human immunodeficiency virus (HIV)- infected persons are...SUPPLEMENTARY NOTES 14. ABSTRACT Background: The prevalence and factors associated with overweight/obesity among human immunodeficiency virus (HIV...baseline and last visit) of hypertension , hyperlipidemia, diabetes, or heart disease utilized Fisher’s exact tests. Patients diagnosed with the

  9. Adult-onset Still's disease presenting as fever of unknown origin in a patient with HIV infection.

    PubMed

    DelVecchio, Sally; Skidmore, Peter

    2008-02-15

    A 43-year-old African American man with known human immunodeficiency virus (HIV) infection was found to have adult-onset Still's disease manifesting as fever of unknown origin. In the era of highly active antiretroviral therapy, HIV-infected patients are preserving their immune status and, thus, must be evaluated in a manner similar to that for the general population.

  10. Public Policy Affirmations Affecting the Planning and Implementation of Developmental Services for Children and Adults with HIV Infection.

    ERIC Educational Resources Information Center

    Crocker, Allen C., Comp.; And Others

    The increasing number of individuals infected with symptomatic human immunodeficiency virus (HIV) infection has created a need to examine public policy issues and to further efforts in planning, implementing, and evaluating services for individuals with HIV infection and their families. A working conference was convened, which identified several…

  11. Spinal cord toxoplasmosis in human immunodeficiency virus infection/acquired immunodeficiency syndrome.

    PubMed

    García-García, Concepción; Castillo-Álvarez, Federico; Azcona-Gutiérrez, José M; Herraiz, María J; Ibarra, Valvanera; Oteo, José A

    2015-05-01

    Neurological complications in patients with human immunodeficiency virus infection/acquired immunodeficiency syndrome (HIV/AIDS) are still common, even in the era of highly active antiretroviral therapy. Opportunistic infections, immune reconstitution, the virus itself, antiretroviral drugs and neurocognitive disorders have to be considered when establishing the differential diagnosis. Toxoplasmic encephalitis remains the major cause of space-occupying lesions in the brain of patients with HIV/AIDS; however, spinal cord involvement has been reported infrequently. Here, we review spinal cord toxoplasmosis in HIV infection and illustrate the condition with a recent case from our hospital. We suggest that most patients with HIV/AIDS and myelitis with enhanced spine lesions, multiple brain lesions and positive serology for Toxoplasma gondii should receive immediate empirical treatment for toxoplasmosis, and a biopsy should be performed in those cases without clinical improvement or with deterioration.

  12. Multifactorial Nature of Human Immunodeficiency Virus Disease: Implications for Therapy

    NASA Astrophysics Data System (ADS)

    Fauci, Anthony S.

    1993-11-01

    The immunopathogenic mechanisms underlying human immunodeficiency virus (HIV) disease are extremely complex; the disease process is multifactorial with multiple overlapping phases. Viral burden is substantial and viral replication occurs throughout the entire course of HIV infection. Inappropriate immune activation and elevated secretion of certain cytokines compound the pathogenic process. Profound immunosuppression ultimately occurs together with a disruption of the microenvironment of the immune system, which is probably unable to regenerate spontaneously. Thus, therapeutic strategies in HIV disease must not be unidimensional, but rather must be linked to the complex pathogenic components of the disease and must address where feasible each of the recognized pathoclenic processes for the possibility of therapeutic intervention.

  13. Association of alpha interferon production with natural killer cell lysis of U937 cells infected with human immunodeficiency virus.

    PubMed Central

    Rappocciolo, G; Toso, J F; Torpey, D J; Gupta, P; Rinaldo, C R

    1989-01-01

    Mononuclear leukocytes from human immunodeficiency virus (HIV)-seronegative and -seropositive homosexual men lysed HIV-infected U937 cells to a significantly greater degree than uninfected U937 cells. Depletion of cell subsets with monoclonal antibodies and complement indicated that the effector cells were primarily of the CD16+ phenotype. Acid-stable alpha interferon (IFN-alpha) production induced by the HIV-infected cells correlated with, although was not an absolute requisite for, preferential lysis of the infected targets. The activity of these CD16+, natural killer (NK) cells decreased in relation to the duration of HIV infection and the presence of acquired immunodeficiency syndrome. Pretreatment of peripheral blood mononuclear cells from HIV-seronegative subjects, but not HIV-seropositive men, with IFN-alpha or recombinant interleukin-2 enhanced lysis of both uninfected and HIV-infected U937 cells. These results suggest that IFN-alpha-associated, NK-like mechanisms are active in the cytotoxic response against HIV-infected cells and that HIV infection results in an early and progressive depression of such responses. Prospective investigations may be useful in determining the role of this NK cell response in the natural history and pathogenesis of HIV infection and the efficacy of therapeutic modalities. PMID:2913035

  14. Respiratory Virus-Associated Severe Acute Respiratory Illness and Viral Clustering in Malawian Children in a Setting With a High Prevalence of HIV Infection, Malaria, and Malnutrition.

    PubMed

    Peterson, Ingrid; Bar-Zeev, Naor; Kennedy, Neil; Ho, Antonia; Newberry, Laura; SanJoaquin, Miguel A; Menyere, Mavis; Alaerts, Maaike; Mapurisa, Gugulethu; Chilombe, Moses; Mambule, Ivan; Lalloo, David G; Anderson, Suzanne T; Katangwe, Thembi; Cunliffe, Nigel; Nagelkerke, Nico; McMorrow, Meredith; Widdowson, Marc-Allain; French, Neil; Everett, Dean; Heyderman, Robert S

    2016-12-01

     We used data from 4 years of pediatric severe acute respiratory illness (SARI) sentinel surveillance in Blantyre, Malawi, to identify factors associated with clinical severity and coviral clustering.  From January 2011 to December 2014, 2363 children aged 3 months to 14 years presenting to the hospital with SARI were enrolled. Nasopharyngeal aspirates were tested for influenza virus and other respiratory viruses. We assessed risk factors for clinical severity and conducted clustering analysis to identify viral clusters in children with viral codetection.  Hospital-attended influenza virus-positive SARI incidence was 2.0 cases per 10 000 children annually; it was highest among children aged <1 year (6.3 cases per 10 000), and human immunodeficiency virus (HIV)-infected children aged 5-9 years (6.0 cases per 10 000). A total of 605 SARI cases (26.8%) had warning signs, which were positively associated with HIV infection (adjusted risk ratio [aRR], 2.4; 95% confidence interval [CI], 1.4-3.9), respiratory syncytial virus infection (aRR, 1.9; 95% CI, 1.3-3.0) and rainy season (aRR, 2.4; 95% CI, 1.6-3.8). We identified 6 coviral clusters; 1 cluster was associated with SARI with warning signs.  Influenza vaccination may benefit young children and HIV-infected children in this setting. Viral clustering may be associated with SARI severity; its assessment should be included in routine SARI surveillance. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

  15. Liver Disease in the HIV-Infected Individual

    PubMed Central

    Price, Jennifer C.; Thio, Chloe L.

    2010-01-01

    Since the advent of effective antiretroviral therapy (ART) for human immunodeficiency virus-1 (HIV), there has been a substantial decrease in deaths related to acquired immunodeficiency syndrome (AIDS). However, in the ART-era liver disease is now the most common non-AIDS related cause of death among HIV-infected patients, accounting for 14-18% of all deaths in this population and almost half of deaths among hospitalized HIV-infected patients. Just as the burden of non-AIDS morbidity and mortality has changed in the ART-era, the types of liver disease the clinician is likely to encounter among these patients have changed as well. This review will discuss the causes of liver disease in the HIV-infected population in the ART-era, including chronic hepatitis C virus, chronic hepatitis B virus, medication-related hepatotoxicity, alcohol abuse, nonalcoholic fatty liver disease, and AIDS-related liver diseases. PMID:20851211

  16. Cutaneous manifestations of opportunistic infections in patients infected with human immunodeficiency virus.

    PubMed Central

    Tappero, J W; Perkins, B A; Wenger, J D; Berger, T G

    1995-01-01

    Bacillary angiomatosis (BA) presents most commonly as a cutaneous disease and is caused by two organisms. Bartonella (Rochalimaea) henselae and Bartonella (Rochalimaea) quintana. Biopsy confirmation of cutaneous BA is essential because lesions can mimic nodular Kaposi's sarcoma in appearance. Although the vast majority of human immunodeficiency virus (HIV)-infected patients with BA have CD4 lymphocyte counts of less than 100 cells per mm3, the disease responds well to antimicrobial therapy. Staphylococcus aureus is the most common bacterial skin pathogen affecting HIV-infected patients. The prevalence of skin disease due to S. aureus may be explained by high nasal carriage rates for the organism ( > or = 50%) and altered immune function in conjunction with an impaired cutaneous barrier. Herpes simplex virus causes mucocutaneous disease early in the course HIV infection and ulcerative lesions at any site in advanced HIV infection. Herpes zoster is common early in the course of HIV infection; recurrent and disseminated herpes zoster infections are characteristic of patients with advanced HIV disease. Acyclovir resistance is usually seen in patients with large, untreated, ulcerative lesions of herpes simplex virus and in patients with chronic, verrucous lesions of varicella-zoster virus. Cutaneous cryptococcosis, histoplasmosis, and coccidiomycosis are markers of disseminated disease and require biopsy confirmation. Scabies is easily diagnosed but may be atypical in presentation and difficult to eradicate in advanced HIV disease. PMID:7553576

  17. Early Clinical Signs and Symptoms of HIV Infection

    PubMed Central

    Miedzinski, Lil J.

    1992-01-01

    Early clinical signs and symptoms of human immunodeficiency virus infection are protean and can reflect the effects of the virus or represent early manifestations of an illness associated with the acquired immunodeficiency syndrome. Knowledge of a patient's potential risk for HIV infection and of the natural history of the illness allow early signs and symptoms to be recognized. Early intervention can delay progression to AIDS. ImagesFigure 1Figure 2Figure 3Figure 4Figure 5Figure 6 PMID:21221397

  18. Human immunodeficiency virus has an aspartic-type protease that can be inhibited by pepstatin A.

    PubMed Central

    Seelmeier, S; Schmidt, H; Turk, V; von der Helm, K

    1988-01-01

    The protease encoded by the human immunodeficiency virus (HIV) processes the viral gag and gag-pol protein precursor by posttranslational cleavage. In this study we have demonstrated by site-specific mutagenesis (Asp----Thr) and by pepstatin A inhibition that the recombinant HIV protease is an aspartic-type protease. Furthermore, incubation of HIV-infected H9 cells with pepstatin A inhibited part of the intracellular processing of the HIV gag protein yet had no apparent toxicity on HIV-infected cells during 48 hr of incubation. Images PMID:3045820

  19. Recent Recommendations for Management of Human Immunodeficiency Virus-Positive Patients.

    PubMed

    Robbins, Miriam R

    2017-04-01

    Human immunodeficiency virus (HIV) infection has become a chronic condition. HIV is not a valid reason to deny, delay, or withhold dental treatment. There are no absolute contraindications and few complications associated with comprehensive oral health care treatment delivered in an outpatient setting for asymptomatic HIV-infected patients and clinically stable patients with AIDS. Consultation with the patient's medical provider and modifications in the delivery of dental treatment may be necessary when treating patients with advanced HIV disease or other comorbid conditions. Oral health care is an integral and important part of comprehensive health care for all patients with HIV/AIDS.

  20. Bubble continuous positive airway pressure in a human immunodeficiency virus-infected infant

    PubMed Central

    McCollum, E. D.; Smith, A.; Golitko, C. L.

    2014-01-01

    SUMMARY World Health Organization-classified very severe pneumonia due to Pneumocystis jirovecii infection is recognized as a life-threatening condition in human immunodeficiency virus (HIV) infected infants. We recount the use of nasal bubble continuous positive airway pressure (BCPAP) in an HIV-infected African infant with very severe pneumonia and treatment failure due to suspected infection with P. jirovecii. We also examine the potential implications of BCPAP use in resource-poor settings with a high case index of acute respiratory failure due to HIV-related pneumonia, but limited access to mechanical ventilation. PMID:21396221

  1. Role of dendritic cells in immunopathogenesis of human immunodeficiency virus infection.

    PubMed Central

    Weissman, D; Fauci, A S

    1997-01-01

    The role of dendritic cells (DC) in the pathogenesis of human immunodeficiency virus (HIV) disease has been a subject of considerable interest for several years. Initial studies focused on the infection, dysfunction, and depletion of DC in HIV-infected individuals. More recent studies have begun to identify the functional role of DC in the initiation and propagation of viral replication in T cells in HIV-infected individuals. This review discusses recent data regarding the role of DC in HIV disease with the aim of delineating basic immunopathogenic principles of infection and the development of therapeutic strategies. PMID:9105759

  2. Human immunodeficiency virus infection with human granulocytic ehrlichiosis complicated by symptomatic lactic acidosis.

    PubMed

    Springer, Sandra A; Altice, Frederick L

    2003-06-15

    Lactic acidosis has been reported as a complication associated with antiretroviral therapy; in particular, usually with use of nucleoside reverse-transcriptase inhibitors. We describe a human immunodeficiency virus (HIV)-infected patient with a history of lipodystrophy who presented with hepatic insult associated with documented human granulocytic ehrlichiosis (HGE). Despite a normal serum lactate level before the onset of acute coinfection, the patient developed symptomatic hyperlactatemia while receiving appropriate treatment for HGE. To date, this is the first presentation of symptomatic hyperlactatemia in a patient with HIV infection and HGE.

  3. Human immunodeficiency virus infection and diffuse polyneuropathy. Implications for rehabilitation medicine.

    PubMed Central

    Mukand, J. A.

    1991-01-01

    Patients at various stages of human immunodeficiency virus (HIV) infection require rehabilitation services. These patients present problems for each of the disciplines in a rehabilitation team, and all team members must confront the psychosocial and ethical issues involved with the disease. Patients with HIV infection may have polyneuropathy with multisystem involvement, including dysphagia, autonomic dysfunction, respiratory failure, bowel and bladder dysfunction, generalized weakness, a painful sensory neuropathy, and depression. Guidelines are presented for determining if inpatient rehabilitation or other settings are appropriate. Case management is a valuable strategy for the rehabilitation of patients with this complicated disorder. PMID:1866948

  4. Origin of the transmitted virus in HIV infection: infected cells versus cell-free virus.

    PubMed

    Sagar, Manish

    2014-12-15

    All human immunodeficiency virus type 1 (HIV-1)-infected inocula, such as genital secretions, breast milk, and blood, contain both cell-free virus and infected cells. The relative contributions of cell-free and/or cell-associated virus in establishing an infection in a naive host during the different modes of HIV-1 acquisition remains unclear. Studies aim to elucidate the source of the acquired virus because strategies to prevent acquisition may have differential efficacy against the different modes of transmission. In this review, I will detail some of the challenges in identifying the source of the transmitted virus, genotypic and phenotypic differences among cell-free compared with cell-associated HIV-1, and implications on the efficacy for prevention strategies.

  5. Thirty years of the human immunodeficiency virus epidemic and beyond

    PubMed Central

    Younai, Fariba S

    2013-01-01

    After more than 30 years of battling a global epidemic, the prospect of eliminating human immunodeficiency virus (HIV) as the most challenging infectious disease of the modern era is within our reach. Major scientific discoveries about the virus responsible for this immunodeficiency disease state, including its pathogenesis, transmission patterns and clinical course, have led to the development of potent antiretroviral drugs that offer great hopes in HIV treatment and prevention. Although these agents and many others still in development and testing are capable of effectively suppressing viral replication and survival, the medical management of HIV infection at the individual and the population levels remains challenging. Timely initiation of antiretroviral drugs, adherence to the appropriate therapeutic regimens, effective use of these agents in the pre and post-exposure prophylaxis contexts, treatment of comorbid conditions and addressing social and psychological factors involved in the care of individuals continue to be important considerations. PMID:24136672

  6. Medical and non-medical expenses for treating babies born to HIV-infected and non-HIV-infected mothers.

    PubMed

    Pansatiankul, Boonchian; Bunnag, Thanyanat; Leowsrisook, Pimsiri

    2003-08-01

    Most human immunodeficiency virus (HIV) infections among children under 5 years are transmitted perinatally. These children require more medical attention and hospitalization than non HIV-infected children. The expenses of HIV-infected children are mostly related to opportunistic infections. To compare the medical and non-medical expenses of treating babies born to HIV-infected and non-HIV-infected mothers at the Queen Sirikit National Institute of Child Health (QSNICH). Consecutive children of HIV-infected and non HIV-infected mothers born at Rajavithi Hospital, Bangkok, were recruited from 1993 to 1995. All of them were followed at QSNICH for free medical services. The demographic and pregnancy data of mothers and the characteristics of the babies of the two groups were compared as well as the number of the hospital visits and reported medical and non-medical expenses. 58 children of HIV-infected mothers and 119 children of non-HIV-infected mother were recruited during this period. Only 30 (51.7%) children of HIV-infected mothers could complete the 18-month requirement, while 90 (75.6%) of the babies born to non-HIV-infected mothers finished the 18 months follow-up period. The two groups did not differ much in terms of demographic characteristics, except that the infant fathers were younger and serology for syphilis was higher in the HIV-infected mothers. This indicated that the HIV-infected mothers had earlier sexual activity. Babies born to the HIV-infected mothers tended to have a lower birth weight and were small for gestational age (SGA). Nine out of 30 babies (30%) born to the HIV-infected mothers were found to be HIV positive at the 18th month of follow-up. The mean medical, non-medical, and total expenses of the babies of the infected group were 2,525.90 +/- 4,328.75, 1,323.07 +/- 1,452.41, 3,848.97 +/- 5,308.90 baht respectively, or were 2.4, 2.0, and 2.2 times those of the non-infected group. These expenses did not include antiretroviral therapy. The

  7. HIV infection in children.

    PubMed

    Canosa, C A

    1991-01-01

    Various studies have reported rates of human immunodeficiency virus (HIV) transmission from mother to child of 13-40%. Vertical transmission occurs in utero, during delivery, or, in a small number of cases, through breast milk. Whether mothers at various stages of HIV infection experience different rates of transmission remains unknown. Maternal antibodies cross the placenta and are present from birth up to 18 months of age. The offspring of HIV-positive mothers tend to be low birthweight, under 37 weeks' gestation, and at high risk of perinatal mortality. It is likely, however, that this profile is indicative of the low socioeconomic status of most women with HIV rather than a result of infection. Also emerging is a psychosocial profile of the HIV child. These children are isolated, neglected, battered, frequently abandoned, and exhibit various degrees of mental retardation. Also common are delayed psychomotor development, loss of developmental milestones, limited attention span, poor language development, and abnormal reflexes. These features result from the interaction of low socioeconomic status, a lack of psychosocial stimulation, nutritional deficiencies, and central nervous system infections. Since HIV-infected children tend to be the offspring of drug addicts, bisexuals, and prostitutes, they are not awarded the same compassion as children afflicted with other terminal illnesses. Moreover, these children are generally neglected by groups formed to provide support to AIDS patients. Thus, it is up to the general public, the mass media, and the health care system to advocate for the needs of these neglected children.

  8. Pattern of mucocutaneous manifestations in human immunodeficiency virus-positive patients in North India

    PubMed Central

    Kore, Sachin D.; Kanwar, Amrinder J.; Vinay, Keshavamurthy; Wanchu, Ajay

    2013-01-01

    Background: Mucocutaneous diseases are among the first-recognized clinical manifestations of acquired immune deficiency syndrome. They function as visual markers in assessing the progression of human immunodeficiency virus (HIV) infection. Given the relative ease of examination of skin, its evaluation remains an important tool in the diagnosis of HIV infection. Objective: To determine the pattern of mucocutaneous manifestations in HIV-positive patients and to correlate their presence with CD4 counts. Materials and Methods: This cross-sectional study included 352 HIV-infected patients seen at PGIMER, Chandigarh, India, over a period of 1 year. The patients were screened for mucocutaneous disorders by an experienced dermatologist. The patients were classified into different stages according to the World Health Organization clinical and immunological staging system. Results: The most prevalent infection was candidiasis, seen in 57 patients (16.2%). Prevalence of candidiasis, dermatophytosis, herpes simplex, herpes zoster, molluscum contagiosum (MC), seborrheic dermatitis, adverse drug reaction, nail pigmentation, xerosis and diffuse hair loss differed statistically according to the clinical stages of HIV infection. There was a statistically significant association between immunological stages of HIV infection and dermatophytosis. Conclusion: Results of our study suggest that mucocutaneous findings occur throughout the course of HIV infection. Dermatoses like MC and dermatophytosis show an inverse relation with CD4 cell count, and these dermatoses can be used as a proxy indicator of advanced immunosuppression to start highly active anti-retroviral therapy in the absence of facilities to carry out CD4 cell count. PMID:23919050

  9. Syphilis superinfection activates expression of human immunodeficiency virus I in latently infected rabbits.

    PubMed Central

    Tseng, C. K.; Hughes, M. A.; Hsu, P. L.; Mahoney, S.; Duvic, M.; Sell, S.

    1991-01-01

    Superinfection of latently human immunodeficiency virus (HIV)-infected rabbits with either Treponema pallidum or Shope fibroma virus (SFV) activates HIV expression. In addition, HIV-infected rabbits demonstrate prolonged cutaneous lesions (chancres) after intracutaneous challenge with T. pallidum, the causative agent of syphilis. Rabbits were infected by intravenous inoculation of 3 x 10(7) human T-cell lymphotrophic virus type III (HTLV-III)/B10 (HIV-1)-infected H9 (human) cells. Five weeks after initial infection, integrated HIV-1-specific DNA sequences were detected in the DNA of the peripheral blood lymphocytes of only one of eight rabbits using polymerase chain reactions (PCR); human DNA could not be detected at this time. Furthermore HIV infection could not be demonstrated by either seroconversion or PCR during the next 6 months. All HIV-infected rabbits remained clinically healthy and had normal white blood cell counts. Six months after HIV infection, four HIV-infected and two noninfected controls were superinfected with 10(6) T. pallidum in eight skin sites in the shaved skin of the back, and four infected and two control animals were challenged with an intradermal injection with SFV. After infection with either syphilis or SFV, the DNA from the white blood cells of all eight HIV-infected rabbits contained HIV sequences, and HIV sequences were demonstrated in dermal mononuclear cells of the syphilitic lesions by in situ hybridization. The SFV-induced tumors were rejected normally in the HIV-infected rabbits, but four of the four rabbits challenged with T. pallidum had delayed development of cutaneous lesions and three of four demonstrated larger and more prolonged lesions. White blood counts, mitogen responses, and interleukin-2 production remained within normal limits, and seroconversion for HIV was not detected. Three of four rabbits in a second group, challenged with T. pallidum 4 months after HIV-inoculation, also had delayed healing of syphilitic

  10. Dynamics of HIV infection in lymphoid tissue network.

    PubMed

    Nakaoka, Shinji; Iwami, Shingo; Sato, Kei

    2016-03-01

    Human immunodeficiency virus (HIV) is a fast replicating ribonucleic acid virus, which can easily mutate in order to escape the effects of drug administration. Hence, understanding the basic mechanisms underlying HIV persistence in the body is essential in the development of new therapies that could eradicate HIV infection. Lymphoid tissues are the primary sites of HIV infection. Despite the recent progress in real-time monitoring technology, HIV infection dynamics in a whole body is unknown. Mathematical modeling and simulations provide speculations on global behavior of HIV infection in the lymphatic system. We propose a new mathematical model that describes the spread of HIV infection throughout the lymphoid tissue network. In order to represent the volume difference between lymphoid tissues, we propose the proportionality of several kinetic parameters to the lymphoid tissues' volume distribution. Under this assumption, we perform extensive numerical computations in order to simulate the spread of HIV infection in the lymphoid tissue network. Numerical computations simulate single drug treatments of an HIV infection. One of the important biological speculations derived from this study is a drug saturation effect generated by lymphoid network connection. This implies that a portion of reservoir lymphoid tissues to which drug is not sufficiently delivered would inhibit HIV eradication despite of extensive drug injection.

  11. The Sexuality of Gay Men with HIV Infection.

    ERIC Educational Resources Information Center

    Gochros, Harvey L.

    1992-01-01

    Explores sexual needs and expression of gay men with human immunodeficiency virus (HIV) infection. Explores several potential positive functions of sustained sex life for these men and factors that inhibit sexual expression. Discusses issues influencing social work practice related to sexual needs of this growing population. Presents suggestions…

  12. The Experience of Children with Hemophilia and HIV Infection.

    ERIC Educational Resources Information Center

    Hall, Christopher S.

    1994-01-01

    Children with hemophilia and Human Immunodeficiency Virus (HIV) infection are not a transmission risk to other children, and they can help enact best practices for school attendance by other such children. The article examines the National Hemophilia Foundation's work to promote appropriate inclusion of students with hemophilia and HIV in all…

  13. The Sexuality of Gay Men with HIV Infection.

    ERIC Educational Resources Information Center

    Gochros, Harvey L.

    1992-01-01

    Explores sexual needs and expression of gay men with human immunodeficiency virus (HIV) infection. Explores several potential positive functions of sustained sex life for these men and factors that inhibit sexual expression. Discusses issues influencing social work practice related to sexual needs of this growing population. Presents suggestions…

  14. The Experience of Children with Hemophilia and HIV Infection.

    ERIC Educational Resources Information Center

    Hall, Christopher S.

    1994-01-01

    Children with hemophilia and Human Immunodeficiency Virus (HIV) infection are not a transmission risk to other children, and they can help enact best practices for school attendance by other such children. The article examines the National Hemophilia Foundation's work to promote appropriate inclusion of students with hemophilia and HIV in all…

  15. Substance Use among Women at Risk for HIV Infection.

    ERIC Educational Resources Information Center

    Wambach, K. G.; And Others

    1992-01-01

    Surveyed 620 nonpregnant, culturally diverse women at risk for human immunodeficiency virus (HIV) infection concerning alcohol, marijuana, powder cocaine, crack cocaine, and intravenous drug use. Found consumption levels which exceeded expectations based on general estimates of female substance use. Substance use was associated with specific…

  16. Prevalence of enteric viruses in human immunodeficiency virus seropositive patients in Venezuela.

    PubMed

    González, G G; Pujol, F H; Liprandi, F; Deibis, L; Ludert, J E

    1998-08-01

    The prevalence of enteric viruses associated with gastroenteritis was determined in 125 stool samples from patients infected with the human immunodeficiency virus (HIV), with or without diarrhea. Diagnostic assays included enzyme immunoassays for the identification of rotavirus, adenovirus, and Norwalk virus; polyacrylamide gel electrophoresis for atypical rotaviruses and picobirnaviruses and polymerase chain reaction for astrovirus. Enteric viruses were detected in 6.4% (8 of 125) of the stools collected: five (4.0%) samples positive for adenoviruses, and three (2.3%) samples positive for picobirnaviruses were detected. No rotavirus, astrovirus, or Norwalk virus were observed. Only one of the viruses identified (adenovirus) was found in a sample from a patient with diarrhea. Viruses were detected in 10% of the patients with AIDS, 14% of the symptomatic patients, and none of the asymptomatic persons. These results do not support a major role for enteric viruses in the diarrhea suffered by HIV-infected patients.

  17. Update on kidney transplantation in human immunodeficiency virus infected recipients

    PubMed Central

    Nashar, Khaled; Sureshkumar, Kalathil K

    2016-01-01

    Improved survival of human immunodeficiency virus (HIV) infected patients with chronic kidney disease following the introduction of antiretroviral therapy resulted in the need to revisit the topic of kidney transplantation in these patients. Large cohort studies have demonstrated favorable outcomes and proved that transplantation is a viable therapeutic option. However, HIV-infected recipients had higher rates of rejection. Immunosuppressive therapy did not negatively impact the course of HIV infection. Some of the immunosuppressive drugs used following transplantation exhibit antiretroviral effects. A close collaboration between infectious disease specialists and transplant professionals is mandatory in order to optimize transplantation outcomes in these patients. Transplantation from HIV+ donors to HIV+ recipients has been a subject of intense debate. The HIV Organ Policy Equity act provided a platform to research this area further and to develop guidelines. The first HIV+ to HIV+ kidney transplant in the United States and the first HIV+ to HIV+ liver transplant in the world were recently performed at the Johns Hopkins University Medical Center. PMID:27458559

  18. Sexual Transmission of Hepatitis C Virus Between HIV Infected Subjects and Their Main Heterosexual Partners

    PubMed Central

    Alipour, Abbas; Rezaianzadeh, Abbas; Hasanzadeh, Jafar; Rajaeefard, Abdorreza; Davarpanah, Mohammad Ali

    2013-01-01

    Background Overall, 60-70% of the hepatitis c virus (HCV) transmission routes is parenteral, and in 30-40% of the cases is unknown (e.g. sexual route). Knowing these routes in HIV infected dyads is very important due to clinical and methodological reasons. Objectives The present study aimed to identify and quantitatively investigate HIV-infected individuals and their main heterosexual partners regarding the risk factors of HCV transmission. Patients and Methods One hundred sixty eight of 984 couples were chosen through random generated numbers using a computer program from behavioral consultation center in Shiraz, Iran. We used actor partner independent model (APIM) and multilevel analysis to assess multiple risk factors for HCV, while partitioning the source of risk at the individual and couple levels. Results Age of the index samples was 38.71 ± 7 years, and 33.2 ± 6.3 for their main heterosexual partners; the mean duration of sexual relationship for couples was 11.9 (median = 8.5) years. Multivariate analysis showed that actor risk factor of intravenous drug using (IDU) (AOR= 13.03; 95% CI: 3.9- 43.82) and actor cofactors of HIV positivity (AOR = 7.1; 95% CI: 1.37- 36.97), razor sharing (AOR = 4.81; 95% CI: 1.84- 12.55), sex (AOR = 8.83; 95% CI: 3.16- 24.87), and condom use in sexual activity with main partner (AOR = 0.15; 95% CI: 0.02- 0.44) were associated with actor HCV positivity. Conclusions Health care providers need to pay special attention to sexual transmission of HCV among HIV-infected individuals, and should recommend control/preventive measures for HCV sexual transmission. PMID:24348647

  19. Talaromyces (Penicillium) marneffei infection in non-HIV-infected patients

    PubMed Central

    Chan, Jasper FW; Lau, Susanna KP; Yuen, Kwok-Yung; Woo, Patrick CY

    2016-01-01

    Talaromyces (Penicillium) marneffei is an important pathogenic thermally dimorphic fungus causing systemic mycosis in Southeast Asia. The clinical significance of T. marneffei became evident when the human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome epidemic arrived in Southeast Asia in 1988. Subsequently, a decline in the incidence of T. marneffei infection among HIV-infected patients was seen in regions with access to highly active antiretroviral therapy and other control measures for HIV. Since the 1990s, an increasing number of T. marneffei infections have been reported among non-HIV-infected patients with impaired cell-mediated immunity. Their comorbidities included primary adult-onset immunodeficiency due to anti-interferon-gamma autoantibodies and secondary immunosuppressive conditions including other autoimmune diseases, solid organ and hematopoietic stem cell transplantations, T-lymphocyte-depleting immunsuppressive drugs and novel anti-cancer targeted therapies such as anti-CD20 monoclonal antibodies and kinase inhibitors. Moreover, improved immunological diagnostics identified more primary immunodeficiency syndromes associated with T. marneffei infection in children. The higher case-fatality rate of T. marneffei infection in non-HIV-infected than HIV-infected patients might be related to delayed diagnosis due to the lack of clinical suspicion. Correction of the underlying immune defects and early use of antifungals are important treatment strategies. Clinicians should be familiar with the changing epidemiology and clinical management of T. marneffei infection among non-HIV-infected patients. PMID:26956447

  20. Transmission of human immunodeficiency virus in a dental practice.

    PubMed

    Ciesielski, C; Marianos, D; Ou, C Y; Dumbaugh, R; Witte, J; Berkelman, R; Gooch, B; Myers, G; Luo, C C; Schochetman, G

    1992-05-15

    To determine if patients of a dentist with the acquired immunodeficiency syndrome (AIDS) became infected with human immunodeficiency virus (HIV) during their dental care and, if so, to identify possible mechanisms of transmission. Retrospective epidemiologic follow-up of the dentist, his office practice, and his former patients. The practice of a dentist with AIDS in Florida. A dentist with AIDS, his health care providers and employees, and former patients of the dentist, including eight HIV-infected patients. Identification of risks for HIV transmission (if present), degree of genetic relatedness of the viruses, and identification of infection control and other office practices. Five of the eight HIV-infected patients had no confirmed exposures to HIV other than the dental practice and were infected with HIV strains that were closely related to those of the dentist. Each of the five had invasive dental procedures, done by the dentist after he was diagnosed with AIDS. Four of these five patients shared visit days (P greater than 0.2). Breaches in infection control and other dental office practices to explain these transmissions could not be identified. Although the specific incident that resulted in HIV transmission to these patients remains uncertain, the epidemiologic evidence supports direct dentist-to-patient transmission rather than a patient-to-patient route.

  1. Neutropenia during HIV Infection: Adverse Consequences and Remedies

    PubMed Central

    Shi, Xin; Sims, Matthew D; Hanna, Michel M; Xie, Ming; Gulick, Peter G; Zheng, Yong-Hui; Basson, Marc D; Zhang, Ping

    2016-01-01

    Neutropenia frequently occurs in patients with Human immunodeficiency virus (HIV) infection. Causes for neutropenia during HIV infection are multifactoral, including the viral toxicity to hematopoietic tissue, the use of myelotoxic agents for treatment, complication with secondary infections and malignancies, as well as the patient’s association with confounding factors which impair myelopoiesis. An increased prevalence and severity of neutropenia is commonly seen in advanced stages of HIV disease. Decline of neutrophil phagocytic defense in combination with the failure of adaptive immunity renders the host highly susceptible to developing fatal secondary infections. Neutropenia and myelosuppression also restrict the use of many antimicrobial agents for treatment of infections caused by HIV and opportunistic pathogens. In recent years, HIV infection has increasingly become a chronic disease because of progress in antiretroviral therapy (ART). Prevention and treatment of severe neutropenia becomes critical for improving the survival of HIV-infected patients. PMID:24654626

  2. Neutropenia during HIV infection: adverse consequences and remedies.

    PubMed

    Shi, Xin; Sims, Matthew D; Hanna, Michel M; Xie, Ming; Gulick, Peter G; Zheng, Yong-Hui; Basson, Marc D; Zhang, Ping

    2014-01-01

    Neutropenia frequently occurs in patients with Human immunodeficiency virus (HIV) infection. Causes for neutropenia during HIV infection are multifactoral, including the viral toxicity to hematopoietic tissue, the use of myelotoxic agents for treatment, complication with secondary infections and malignancies, as well as the patient's association with confounding factors which impair myelopoiesis. An increased prevalence and severity of neutropenia is commonly seen in advanced stages of HIV disease. Decline of neutrophil phagocytic defense in combination with the failure of adaptive immunity renders the host highly susceptible to developing fatal secondary infections. Neutropenia and myelosuppression also restrict the use of many antimicrobial agents for treatment of infections caused by HIV and opportunistic pathogens. In recent years, HIV infection has increasingly become a chronic disease because of progress in antiretroviral therapy (ART). Prevention and treatment of severe neutropenia becomes critical for improving the survival of HIV-infected patients.

  3. Epidemiological and clinical characteristics of hepatitis B virus in HIV-infected patients in Guangdong, China.

    PubMed

    Huang, S M; Cai, W P; Hu, F Y; Lan, Y; Liao, B L; Chen, Y P; Tang, X P

    2016-09-01

    This study investigated the epidemiological and clinical characteristics of hepatitis B virus (HBV) in HIV-infected adults at the time of antiretroviral therapy (ART) initiation in Guangdong province, China. A total of 2793 HIV-infected adults were enrolled between January 2004 and September 2011. Demographic data and laboratory parameters were collected, HBV-DNA levels were measured, and HBV genotypes were identified before ART initiation. The prevalence of hepatitis B surface antigen (HBsAg) in HIV-infected patients was 13.2%. A total of 266 HIV/HBV co-infected patients and 1469 HIV mono-infected patients were recruited. The median alanine aminotransferase and aspartate aminotransferase levels of HIV/HBV co-infected patients were higher than HIV mono-infected patients (32 U/L vs. 22 U/L, p < 0.001 and 35 U/L vs. 24 U/L, p < 0.001, respectively), whereas the median CD4 cell count of HIV/HBV co-infected patients was lower than HIV mono-infected patients (59 cells/mm(3) vs. 141 cells/mm(3), p < 0.001). The level of CD4 cell count was lower in hepatitis B e-antigen (HBeAg)-positive co-infected patients than HBeAg-negative patients (36 cells/mm(3) vs. 69 cells/mm(3), p = 0.014). A similar result was found in high level of HBV-DNA and low level of HBV-DNA groups (33 cells/mm(3) vs. 89 cells/mm(3), p < 0.001). HBV genotypes were classified as genotypes B and C. Patients infected with genotypes B and C differed significantly in terms of proportion of those who were HBeAg-positive (40.5% vs. 62.2%, p = 0.014). This study indicates a high prevalence of HBsAg in HIV-infected adults in Guangdong. The level of CD4 cell count in HIV/HBV co-infected patients was much lower than HIV mono-infected patients, especially in patients who were HBeAg-positive and had a high level of HBV-DNA. The predominant HBV genotype in HIV/HBV co-infected patients is genotype B.

  4. Invasive Aspergillus Sinusitis in Human Immunodeficiency Virus Infection: Case Report and Review of the Literature

    PubMed Central

    Humphrey, John M.; Walsh, Thomas J.; Gulick, Roy M.

    2016-01-01

    Invasive Aspergillus (IA) sinusitis is a life-threatening opportunistic infection in immunocompromised individuals, but it is uncommon in human immunodeficiency virus (HIV) infection. To gain a better understanding of the characteristics of IA sinusitis in this population, we present a unique case of chronic IA sinusitis in an HIV-infected patient taking antiretroviral therapy and review the literature summarizing published cases of invasive aspergillosis of the paranasal (n = 41) and mastoid (n = 17) sinuses in HIV-infected individuals. Among these cases, only 4 were reported after 1999, and 98% of patients had acquired immune deficiency syndrome. Orbital invasion occurred in 54% of paranasal sinus cases, whereas intracranial invasion was reported in 53% of mastoid sinus cases. The overall mortality was 79%. We also discuss various clinical and immunologic factors that may play a role in the development of IA and consider the changing epidemiology of aspergillosis in the era of effective antiretroviral therapy. PMID:27800523

  5. Prevalence of Human Immunodeficiency Virus Infection among Injection Drug Users Released from Jail

    PubMed Central

    Moradi, Ali Reza; Emdadi, Abbas; Soori, Bahram; Mostafavi, Ehsan

    2012-01-01

    Background Injecting drug users (IDUs) and prisoners are considered to be highly vulnerable to human immunodeficiency virus (HIV) infection in Iran. This study was carried out to determine the prevalence of HIV infection among IDUs released from jail in Bahar (Hamadan, Iran). Methods In a cross-sectional study, 118 IDUs who were prisoners during 2001-07 were evaluated. Their demographic and personal characteristics were assessed by a questionnaire. In order to determine HIV-positive individuals, blood samples were obtained from the participants and tested by enzyme-linked immunosorbent assay and Western blot technique. Findings Overall, 20.3% of the subjects had used non-sterile injecting equipment during their imprisonment. The prevalence of HIV infection among the studied population was 4.2%. Conclusion As the prevalence of HIV among IDUs released from jail is high, it is necessary for prison authorities to take measures against the increase in the prevalence of HIV among this group. PMID:24494150

  6. Isolated and bilateral simultaneous facial palsy disclosing early human immunodeficiency virus infection

    PubMed Central

    Sathirapanya, Pornchai

    2015-01-01

    Bilateral lower motor neuron type facial palsy is an unusual neurological disorder. There are few reports that associate it with the human immunodeficiency virus (HIV) infection on initial presentation. A 51-year-old married woman, who was previously healthy and had no risk of HIV infection, presented solely with bilateral simultaneous facial palsy. A positive HIV serology test was confirmed by an enzyme-linked immunosorbent assay test. Following a short course of oral prednisolone, the patient recovered completely from facial palsy in three months, even though an antiretroviral treatment was suspended. Exclusion of HIV infection in patients with bilateral facial palsy is essential for early diagnosis and management of HIV. PMID:26106247

  7. Macrophages in Progressive Human Immunodeficiency Virus/Simian Immunodeficiency Virus Infections

    PubMed Central

    DiNapoli, Sarah R.; Hirsch, Vanessa M.

    2016-01-01

    The cells that are targeted by primate lentiviruses (HIV and simian immunodeficiency virus [SIV]) are of intense interest given the renewed effort to identify potential cures for HIV. These viruses have been reported to infect multiple cell lineages of hematopoietic origin, including all phenotypic and functional CD4 T cell subsets. The two most commonly reported cell types that become infected in vivo are memory CD4 T cells and tissue-resident macrophages. Though viral infection of CD4 T cells is routinely detected in both HIV-infected humans and SIV-infected Asian macaques, significant viral infection of macrophages is only routinely observed in animal models wherein CD4 T cells are almost entirely depleted. Here we review the roles of macrophages in lentiviral disease progression, the evidence that macrophages support viral replication in vivo, the animal models where macrophage-mediated replication of SIV is thought to occur, how the virus can interact with macrophages in vivo, pathologies thought to be attributed to viral replication within macrophages, how viral replication in macrophages might contribute to the asymptomatic phase of HIV/SIV infection, and whether macrophages represent a long-lived reservoir for the virus. PMID:27307568

  8. Nutritional status of persons with HIV infection, persons with HIV infection and tuberculosis, and HIV-negative individuals from southern India.

    PubMed

    Swaminathan, Soumya; Padmapriyadarsini, C; Sukumar, B; Iliayas, Sheikh; Kumar, S Ramesh; Triveni, C; Gomathy, P; Thomas, Beena; Mathew, Minnie; Narayanan, P R

    2008-03-15

    We compared the nutritional status of individuals with human immunodeficiency virus (HIV) infection alone, individuals with HIV infection and tuberculosis (after completion of antituberculosis treatment), and HIV-negative individuals and found that malnutrition, anemia, and hypoalbuminemia were most pronounced among HIV-positive patients with tuberculosis. Weight loss was associated with loss of fat in female patients and with loss of body cell mass in male patients.

  9. Shedding of Live Vaccine Virus, Comparative Safety, and Influenza-Specific Antibody Responses after Administration of Live Attenuated and Inactivated Trivalent Influenza Vaccines to HIV-Infected Children

    PubMed Central

    Levin, Myron J.; Song, Lin-Ye; Fenton, Terrence; Nachman, Sharon; Patterson, Julie; Walker, Robert; Kemble, George; Allende, Maria; Hultquist, Micki; Yi, Tingting; Nowak, Barbara; Weinberg, Adriana

    2008-01-01

    HIV-infected children (n = 243), ≥5 to <18 years old, receiving stable antiretroviral therapy, were stratified by immunologic status and randomly assigned to receive intranasal live attenuated influenza vaccine (LAIV) or intramuscular trivalent inactivated influenza vaccine (TIV). The safety profile after LAIV or TIV closely resembled the previously reported tolerability to these vaccines in children without HIV infection. Post-vaccination hemagglutination inhibition (HAI) antibody responses and shedding of LAIV virus were also similar, regardless of immunological stratum, to antibody responses and shedding previously reported for children without HIV infection. LAIV should be further evaluated for a role in immunizing HIV-infected children. PMID:18597900

  10. Maternal Neutralization-Resistant Virus Variants Do Not Predict Infant HIV Infection Risk.

    PubMed

    Milligan, Caitlin; Omenda, Maxwel M; Chohan, Vrasha; Odem-Davis, Katherine; Richardson, Barbra A; Nduati, Ruth; Overbaugh, Julie

    2016-02-02

    Mother-to-child transmission (MTCT) of HIV provides a setting for studying immune correlates of protection. Neutralizing antibodies (NAbs) are suggested to contribute to a viral bottleneck during MTCT, but their role in blocking transmission is unclear, as studies comparing the NAb sensitivities of maternal viruses have yielded disparate results. We sought to determine whether transmitting mothers differ from nontransmitting mothers in the ability to neutralize individual autologous virus variants present at transmission. Ten transmitting and 10 nontransmitting HIV-infected mothers at high risk of MTCT were included in this study. Full-length HIV envelope genes (n = 100) were cloned from peripheral blood mononuclear cells obtained near transmission from transmitting mothers and at similar time points from nontransmitting mothers. Envelope clones were tested as pseudoviruses against contemporaneous, autologous maternal plasma in neutralization assays. The association between transmission and the log2 50% inhibitory concentration (IC50) for multiple virus variants per mother was estimated by using logistic regression with clustered standard errors. t tests were used to compare proportions of neutralization-resistant viruses. Overall, transmitting mothers had a median IC50 of 317 (interquartile range [IQR], 202 to 521), and nontransmitting mothers had a median IC50 of 243 (IQR, 95 to 594). Transmission risk was not significantly associated with autologous NAb activity (odds ratio, 1.25; P = 0.3). Compared to nontransmitting mothers, transmitting mothers had similar numbers of or fewer neutralization-resistant virus variants, depending on the IC50 neutralization resistance cutoff. In conclusion, HIV-infected mothers harbor mostly neutralization-sensitive viruses, although resistant variants were detected in both transmitting and nontransmitting mothers. These results suggest that MTCT during the breastfeeding period is not driven solely by the presence of maternal

  11. Hepatitis B virus infection among HIV-infected pregnant women in Malawi and transmission to infants.

    PubMed

    Chasela, Charles S; Kourtis, Athena P; Wall, Patrick; Drobeniuc, Jan; King, Caroline C; Thai, Hong; Teshale, Eyasu H; Hosseinipour, Mina; Ellington, Sascha; Codd, Mary B; Jamieson, Denise J; Knight, Rod; Fitzpatrick, Patricia; Kamili, Saleem; Hoffman, Irving; Kayira, Dumbani; Mumba, Noel; Kamwendo, Deborah D; Martinson, Francis; Powderly, William; Teo, Chong-Gee; van der Horst, Charles

    2014-03-01

    The extent of HBV infection to infants of HBV/HIV-coinfected pregnant women in sub-Saharan Africa is unknown. The aim of this study was to assess prevalence of HBV infection among antiretroviral-naïve, HIV-infected pregnant women in Malawi and examine HBV transmission to their infants. Plasma from 2048 HIV-infected, Malawian women and their infants were tested for markers of HBV infection. Study participants were provided standard-of-care health services, which included administration of pentavalent vaccine to infants at 6, 10, and 14 weeks of age. One-hundred and three women (5%) were HBsAg-positive; 70 of these HBsAg-positive women were also HBV-DNA-positive. Sixteen women (0.8%) were HBV-DNA-positive but HBsAg-negative. Five of 51 infants (9.8%) born to HBsAg-positive and/or HBV-DNA-positive women were HBV-DNA-positive by 48 weeks of age.HBV DNA concentrations of two infants of mothers who received extended lamivudine-containing anti-HIV prophylaxis were <4 log10 IU/ml compared to ⩾ 8 log10 IU/ml in three infants of mothers who did not. HBV DNA was detected in nearly 10% of infants born to HBV/HIV-coinfected women. Antenatal testing for HIV and HBV, if instituted, can facilitate implementation of prophylactic measures against infant infection by both viruses. Published by Elsevier B.V.

  12. Cardiac Disease Associated with Human Immunodeficiency Virus Infection.

    PubMed

    Bloomfield, Gerald S; Leung, Claudia

    2017-02-01

    Over the last 2 decades human immunodeficiency virus (HIV) infection has become a chronic disease requiring long-term management. Aging, antiretroviral therapy, chronic inflammation, and several other factors contribute to the increased risk of cardiovascular disease in patients infected with HIV. In low-income and middle-income countries where antiretroviral therapy access is limited, cardiac disease is most commonly related to opportunistic infections and end-stage manifestations of HIV/acquired immunodeficiency syndrome, including HIV-associated cardiomyopathy, pericarditis, and pulmonary arterial hypertension. Cardiovascular screening, prevention, and risk factor management are important factors in the management of patients infected with HIV worldwide. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Kaleidoscope of autoimmune diseases in HIV infection.

    PubMed

    Roszkiewicz, Justyna; Smolewska, Elzbieta

    2016-11-01

    Within the last 30 years, the human immunodeficiency virus (HIV) infection has changed its status from inevitably fatal to chronic disorder with limited impact on life span. However, this breakthrough was mainly the effect of introduction of the aggressive antiviral treatment, which has led to the clinically significant increase in CD4+ cell count, resulting in fewer cases of the acquired immunodeficiency syndrome (AIDS) and improved management of opportunistic infections occurring in the course of the disease. The occurrence of a particular autoimmune disease depends on degree of immunosuppression of the HIV-positive patient. In 2002, four stages of autoimmunity were proposed in patients infected by HIV, based on the absolute CD4+ cell count, feature of AIDS as well as on the presence of autoimmune diseases. Spectrum of autoimmune diseases associated with HIV infection seems to be unexpectedly wide, involving several organs, such as lungs (sarcoidosis), thyroid gland (Graves' disease), liver (autoimmune hepatitis), connective tissue (systemic lupus erythematosus, rheumatoid arthritis, polyarteritis nodosa and other types of vasculitis, antiphospholipid syndrome) or hematopoietic system (autoimmune cytopenias). This paper contains the state of art on possible coincidences between HIV infection and a differential types of autoimmune diseases, including the potential mechanisms of this phenomenon. As the clinical manifestations of autoimmunization often mimic those inscribed in the course of HIV infection, health care providers should be aware of this rare but potentially deadly association and actively seek for its symptoms in their patients.

  14. Liver transplantation in HIV-infected recipients.

    PubMed

    Roland, Michelle E; Stock, Peter G

    2006-08-01

    Although human immunodeficiency virus (HIV)-infected patients are living longer and dying less often from complications related to acquired immunodeficiency syndrome (AIDS), they are experiencing significant morbidity and mortality related to end-stage liver disease. Advances in the management of HIV disease have made it difficult to continue denying transplantation to this population based upon futility arguments alone. Patient and graft survival rates in HIV-infected study subjects appear similar to those in large transplant databases. There are no reports suggesting significant HIV disease progression. There are substantial interactions between immunosuppressants and antiretroviral drugs that require careful monitoring and dose adjustment. The evaluation and management of HIV-infected transplant candidates and recipients require excellent communication among a multidisciplinary team and the primary HIV care provider. It is critical that HIV clinicians and hepatologists are aware that liver transplantation is an option for HIV-infected patients at many transplant centers as delays in referral result in unnecessary mortality during the pretransplantation evaluation process.

  15. Partners in Crime: The Role of CMV in Immune Dysregulation and Clinical Outcome During HIV Infection.

    PubMed

    Freeman, Michael L; Lederman, Michael M; Gianella, Sara

    2016-02-01

    In the current era of combination antiretroviral therapy (ART), human immunodeficiency virus (HIV)-infected individuals are living longer and healthier lives. Nevertheless, HIV-infected persons are at greater risk for age-related disorders, which have been linked to residual immune dysfunction and inflammation. HIV-infected individuals are almost universally co-infected with cytomegalovirus (CMV) and both viruses are associated with inflammation-related morbidities. Therefore, a detailed investigation of the relationship between CMV and aging-related morbidities emerging during chronic HIV infection is warranted. Here, we review the literature on how CMV co-infection affects HIV infection and host immunity and we discuss the gaps in our knowledge that need elucidation.

  16. Prevention and treatment of human immunodeficiency virus/acquired immunodeficiency syndrome in resource-limited settings.

    PubMed Central

    Hogan, Daniel R.; Salomon, Joshua A.

    2005-01-01

    Strategies for confronting the epidemic of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) have included a range of different approaches that focus on prevention and treatment. However, debate persists over what levels of emphasis are appropriate for the different components of the global response. This paper presents an overview of this debate and briefly summarizes the evidence on a range of interventions designed to prevent the spread of HIV infection, paying particular attention to voluntary counselling and testing, treatment for sexually transmitted infections and prevention of mother-to-child transmission. We also review the experience with antiretroviral therapy to date in terms of response rates and survival rates, adherence, drug resistance, behavioural change and epidemiological impact. Although various studies have identified strategies with proven effectiveness in reducing the risks of HIV infection and AIDS mortality, considerable uncertainties remain. Successful integration of treatment and prevention of HIV/AIDS will require a balanced approach and rigorous monitoring of the impact of programmes in terms of both individual and population outcomes. PMID:15744406

  17. Disseminated varicella zoster virus in an immunized child as the acquired immunodeficiency syndrome-defining illness.

    PubMed

    Chilek, Katherine; Routhouska, Shannon; Tamburro, Joan

    2010-01-01

    Varicella zoster virus (VZV) immunization aids in the prevention of future VZV infections in immunocompetent patients; however, severely immunocompromised patients remain at increased risk of VZV infection. We report a case of a 10-year-old boy previously immunized to Varicella who presented with herpes zoster with hematogenous dissemination as the Acquired Immunodeficiency Syndrome-defining illness. Disseminated VZV is more commonly seen in human immunodeficiency virus (HIV)-infected individuals with more advanced disease, as was the case with our patient. Disseminated VZV infection in a previously immunized child should raise suspicion for underlying immunosuppression.

  18. Autoimmune diseases and HIV infection: A cross-sectional study.

    PubMed

    Virot, Emilie; Duclos, Antoine; Adelaide, Leopold; Miailhes, Patrick; Hot, Arnaud; Ferry, Tristan; Seve, Pascal

    2017-01-01

    To describe the clinical manifestations, treatments, prognosis, and prevalence of autoimmune diseases (ADs) in human immunodeficiency virus (HIV)-infected patients.All HIV-infected patients managed in the Infectious Diseases Department of the Lyon University Hospitals, France, between January 2003 and December 2013 and presenting an AD were retrospectively included.Thirty-six ADs were found among 5186 HIV-infected patients which represents a prevalence of 0.69% including immune thrombocytopenic purpura (n = 15), inflammatory myositis (IM) (n = 4), sarcoidosis (n = 4), Guillain-Barré syndrome (GBS) (n = 4), myasthenia gravis (n = 2), Graves' disease (n = 2), and 1 case of each following conditions: systemic lupus erythematosus, rheumatoid arthritis, autoimmune hepatitis, Hashimoto thyroiditis and autoimmune hemolytic anemia. One patient presented 2 ADs. Thirty patients were known to be HIV-infected when they developed an AD. The AD preceded HIV infection in 2 patients. GBS and HIV infection were diagnosed simultaneously in 3 cases. At AD diagnosis, CD4 T lymphocytes count were higher than 350/mm in 63% of patients, between 200 and 350/mm in 19% and less than 200/mm in 19%. Twenty patients benefited from immunosuppressant treatments, with a good tolerance.ADs during HIV infection are uncommon in this large French cohort. Immune thrombocytopenic purpura, sarcoidosis, IM, and GBS appear to be more frequent than in the general population. Immunosuppressant treatments seem to be effective and well tolerated.

  19. Human immunodeficiency virus infection in tuberculosis patients.

    PubMed

    Theuer, C P; Hopewell, P C; Elias, D; Schecter, G F; Rutherford, G W; Chaisson, R E

    1990-07-01

    Human immunodeficiency virus (HIV) serology was performed in non-Asian-born patients 18-65 years old with newly diagnosed tuberculosis at a county tuberculosis clinic, and demographic and clinical features of HIV-seropositive and HIV-seronegative patients were compared. Sixty of 128 eligible patients agreed to participate, of whom 17 (28%) were seropositive. Risk of HIV was associated with homosexual contact, intravenous drug use, or both; however, 4 (24%) of the 17 seropositives denied risk behaviors. Significantly more blacks (48%) than whites (10%) or Latinos (20%) were HIV-seropositive (P less than .01). Site of disease, tuberculin reactivity, response to therapy, drug toxicity, and relapse did not differ significantly between groups. HIV-seropositive patients had significantly lower median CD4+ cell counts (326/mm3, range 23-742/mm3, vs. 929/mm3, range 145-2962/mm3, P less than .0005) and median CD4+:CD8+ ratios (0.50, range 0.14-1.07 vs. 1.54, range 0.35-4.36, P less than .0001). HIV infection is associated with clinically typical tuberculosis and HIV screening of tuberculosis patients is recommended in areas where HIV is endemic.

  20. Prevalence of human immunodeficiency virus infection and associated risk factors among prison inmates in the City of Florianópolis.

    PubMed

    Felisberto, Mariano; Saretto, Antonio Adalberto; Wopereis, Sandro; Treitinger, Arício; Machado, Marcos José; Spada, Celso

    2016-01-01

    This study aimed to estimate the prevalence of human immunodeficiency virus (HIV) infection among prison inmates and to define the behavioral profile of infected individuals. In total, 147 individuals were interviewed and provided biological material. The study population consisted of male individuals who presented at the health unit of the Florianopolis State Penitentiary. The prevalence of HIV infection was 2.1% (95% confidence interval, 0.4-5.8). With respect to the behavioral profile of individuals, no variable showed statistical significance. The prevalence of HIV infection among prison inmates was higher than that reported for the general population.

  1. Rural habitat as risk factor for hepatitis E virus seroconversion in HIV-infected patients: A prospective longitudinal study.

    PubMed

    Rivero-Juarez, A; Cuenca-Lopez, F; Martinez-Peinado, A; Camacho, A; Real, L M; Frias, M; Gordon, A; Cantisán, S; Torre-Cisneros, J; Pineda, J A; Rivero, A

    2017-02-25

    Our objective was to determine the incidence and clinical manifestations of acute hepatitis E virus (HEV) in HIV-infected patients. A prospective longitudinal study including HIV-infected HEV-seronegative patients was conducted; HEV seroconversion (to IgG and/or IgM) was the main outcome variable. All patients were tested for HEV antibodies every 3-6 months. For patients who developed HEV seroconversion, a data collection protocol was followed to identify associated clinical manifestations and analytical alterations. A total of 627 patients (89.9%) were followed during a median of 11.96 months (IQR: 8.52-14.52 months) and formed the study population. Forty-one patients developed detectable anti-HEV antibodies (7.2 cases per 100 patients/year). Our study found a high incidence of HEV in HIV-infected patients in southern Spain strongly associated with a rural habitat.

  2. [Prevalence of hepatitis virus infection markers in HIV-infected patients in Southern Spain].

    PubMed

    Cifuentes, Celia; Mira, José A; Vargas, Julio; Neukam, Karin; Escassi, Carmen; García-Rey, Silvia; Gilabert, Isabel; González-Monclova, Marian; Bernal, Samuel; Pineda, Juan A

    2012-10-01

    To determine: (a) The prevalence of active infection by the hepatitis C virus (HCV) and hepatitis B virus (HBV) in HIV-infected patients, as well as previous exposure to hepatitis A virus (HAV), HBV and HCV. (b) The proportion of patients who have been vaccinated against HAV and/or HBV. (c) The HCV genotype distribution and the percentage of patients who have started treatment against HCV infection. All HIV-infected patients who attended the Infectious Diseases Unit of a tertiary care hospital in Southern Spain between September 2008 and February 2009 were included in a prospective cross-sectional study. A total of 520 patients were included. Three hundred and fifty-eight (69%) patients had positive HCV antibody, while 71% of them showed detectable HCV-RNA. The HCV genotype distribution was: 153 (62%) genotype 1, 49 (20%) genotype 3, and 45 (18%) genotype 4. One hundred and thirteen (36.5%) subjects had received treatment against HCV. The prevalence of active HBV infection was 4.4%, while the exposure to HBV was 54.8%. Four hundred and thirty-seven (84%) patients had positive markers of infection of HAV. Of the patients eligible to be vaccinated, 25.6% and 22.3% patients were vaccinated against HAV and HBV, respectively. The current prevalence of active HCV infection remains high in our area. There were no changes in the HCV genotype distribution. The number of patients with indication for HBV and HAV vaccination and receive these vaccines is low. Copyright © 2011 Elsevier España, S.L. All rights reserved.

  3. Aspartame Intake Relates to Coronary Plaque Burden and Inflammatory Indices in Human Immunodeficiency Virus.

    PubMed

    Hall, Leangelo N; Sanchez, Laura R; Hubbard, Jane; Lee, Hang; Looby, Sara E; Srinivasa, Suman; Zanni, Markella V; Stanley, Takara L; Lo, Janet; Grinspoon, Steven K; Fitch, Kathleen V

    2017-01-01

    Dietary sweeteners may contribute to metabolic dysregulation and cardiovascular disease (CVD), but this has not been assessed in human immunodeficiency virus (HIV). One hundred twenty-four HIV-infected and 56 non-HIV-infected participants, without history of known coronary artery disease were included. Dietary intake was assessed using a 4-day food record. Coronary plaque was determined using cardiac computed tomography angiography. Human immunodeficiency virus-infected participants had significantly greater intake of dietary sweeteners, including total sugar (P = .03) and added sugar (P = .009); intake of aspartame (artificial sweetener) was greater among aspartame consumers with HIV versus non-HIV consumers (P = .03). Among HIV-infected participants, aspartame intake was significantly associated with coronary plaque (P = .002) and noncalcified plaque (P = .007) segments, as well as markers of inflammation/immune activation (monocyte chemoattractant protein 1 and lipoprotein-associated phospholipase A2), which may contribute to increased atherogenesis. In multivariable regression modeling, aspartame remained an independent predictor of plaque in HIV. In contrast, among non-HIV-infected participants, no sweetener type was shown to relate to plaque characteristics. We demonstrate increased intake of dietary sweeteners and a potential novel association between aspartame intake, plaque burden, and inflammation in HIV. Our data suggest that aspartame may contribute to CVD risk in HIV. Further studies should address potential mechanisms by which aspartame may contribute to increased plaque burden and cardiovascular benefits of dietary strategies targeting aspartame intake in HIV.

  4. Aspartame Intake Relates to Coronary Plaque Burden and Inflammatory Indices in Human Immunodeficiency Virus

    PubMed Central

    Hall, Leangelo N.; Sanchez, Laura R.; Hubbard, Jane; Lee, Hang; Looby, Sara E.; Srinivasa, Suman; Zanni, Markella V.; Stanley, Takara L.; Lo, Janet; Grinspoon, Steven K.

    2017-01-01

    Abstract Background. Dietary sweeteners may contribute to metabolic dysregulation and cardiovascular disease (CVD), but this has not been assessed in human immunodeficiency virus (HIV). Methods. One hundred twenty-four HIV-infected and 56 non-HIV-infected participants, without history of known coronary artery disease were included. Dietary intake was assessed using a 4-day food record. Coronary plaque was determined using cardiac computed tomography angiography. Results. Human immunodeficiency virus-infected participants had significantly greater intake of dietary sweeteners, including total sugar (P = .03) and added sugar (P = .009); intake of aspartame (artificial sweetener) was greater among aspartame consumers with HIV versus non-HIV consumers (P = .03). Among HIV-infected participants, aspartame intake was significantly associated with coronary plaque (P = .002) and noncalcified plaque (P = .007) segments, as well as markers of inflammation/immune activation (monocyte chemoattractant protein 1 and lipoprotein-associated phospholipase A2), which may contribute to increased atherogenesis. In multivariable regression modeling, aspartame remained an independent predictor of plaque in HIV. In contrast, among non-HIV-infected participants, no sweetener type was shown to relate to plaque characteristics. Conclusions. We demonstrate increased intake of dietary sweeteners and a potential novel association between aspartame intake, plaque burden, and inflammation in HIV. Our data suggest that aspartame may contribute to CVD risk in HIV. Further studies should address potential mechanisms by which aspartame may contribute to increased plaque burden and cardiovascular benefits of dietary strategies targeting aspartame intake in HIV. PMID:28695142

  5. Screening for Human Immunodeficiency Virus (HIV)

    MedlinePlus

    Understanding Task Force Recommendations Screening for Human Immunodeficiency Virus (HIV) The U.S. Preventive Services Task Force (Task ... final recommendation statement on Screening for Human Immunodeficiency Virus (HIV) . This final recommendation statement applies to all ...

  6. Sildenafil as treatment for Human Immunodeficiency Virus-related pulmonary hypertension in a child.

    PubMed

    Wong, Abdul Rahim; Rasool, Aida Hanum G; Abidin, Nik Zainal; Noor, Abdul Rahmand; Quah, Ban Seng

    2006-03-01

    Human Immunodeficiency Virus (HIV)-related pulmonary hypertension is a relatively rare disease that can affect HIV sufferers. This is almost always associated with a poor outcome and death. An 18 month-old girl, probably the youngest on record, was diagnosed to have pulmonary hypertension (PHT) and retrospectively found to have HIV infection. Sildenafil was used to control her PHT and she remains alive even after 2 years.

  7. Cross-sectional epidemiology of hepatitis C virus detection and treatment in HIV-infected patients.

    PubMed

    Ena, Javier; Ruiz-de-Apodaca, Rosa F; Pasquau, Francisco; Amador, Concepción; Benito, Concepción

    2011-02-01

    Sustained virologic response to peginterferon plus ribavirin reduces liver-related complications and mortality in patients co-infected with HIV and hepatitis C virus. Therefore, the presence of any barriers to start hepatitis C virus therapy should be identified and eliminated in order to recruit all eligible patients. Cross-sectional study. In a HIV referral clinic we assessed the proportion of patients eligible for hepatitis C virus evaluation and treatment according to consensus guidelines. We identified 134 patients with hepatitis C virus and HIV co-infection. Twenty-one patients were excluded from the analysis due to never attending the HIV clinic (n=12) or having hepatitis C virus RNA not detectable (n=9). In the remaining 113 patients, only 61% had identification of hepatitis C virus genotype and quantification of hepatitis C viral load. Thirty-six patients started peginterferon plus ribavirin, and 16 (44%) achieved sustained virologic response. Seventy-seven patients did not receive treatment for hepatitis C virus due to the presence of medical contraindications (n=22), provider barriers (n=15), or patient barriers (n=40). Multivariate analysis identified lower education degree (odds ratio: 4.53; 95% confidence intervals: 1.36-15.16, p=0.014) and patient civil status single, separated or widower (odds ratio: 4.81; 95% confidence intervals: 1.54-14.99, p=0.007) as the independent determinants associated to not initiating therapy for hepatitis C virus infection in patients with barriers. A minor proportion of HIV-infected patients received appropriate assessment and treatment for hepatitis C virus infection. Social disadvantages require multidisciplinary models of health care to improve hepatitis C virus treatment initiation and success. Copyright © 2010 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  8. Oral Manifestations of Human Immunodeficiency Virus-Infected Patients

    PubMed Central

    Pakfetrat, Atessa; Falaki, Farnaz; Delavarian, Zahra; Dalirsani, Zohreh; Sanatkhani, Majid; Zabihi Marani, Mahsa

    2015-01-01

    Introduction: Oral lesions are among the earliest clinical manifestations of human immunodeficiency (HIV) infection and are important in early diagnosis and for monitoring the progression to acquired immunodeficiency syndrome (AIDS). The purpose of this study was to determine the prevalence of oral lesions and their relationship with a number of factors in HIV/AIDS patients attending an HIV center. Materials and Methods: A total of 110 HIV-positive patients were examined to investigate the prevalence of oral lesions according to the criteria established by the European Community Clearing House on Oral Problems Related to HIV Infection. An independent T-test was used for correlation of oral lesions with CD4+ count and a χ2 test was used for analysis of the relationship of co-infection with hepatitis B virus (HBV), sexual contact, route of transmission, history of drug abuse, and history of incarceration. Results: Most of the cases were male patients (82.7%). The mean age across all participants was 36.2±8.1 years. Rampant carries, severe periodontitis and oral candidiasis were the most notable oral lesions. Oral lesions were more prevalent in patients between 26–35 years of age. There was a significant difference between patients with and without pseudomembranous candidiasis and angular cheilitis according to mean level of CD4+. Conclusion: The most common oral presentations were severe periodontitis, pseudomembranous candidiasis and xerostomia. PMID:25745611

  9. Chronic Hepatitis C Virus Infection is Associated with All-Cause and Liver-Related Mortality in a Cohort of HIV-Infected Patients with Alcohol Problems

    PubMed Central

    Fuster, Daniel; Cheng, Debbie M.; Quinn, Emily K.; Nunes, David; Saitz, Richard; Samet, Jeffrey H.; Tsui, Judith I.

    2013-01-01

    Aims To assess the association between hepatitis C virus (HCV) infection and overall and liver-related death in human immunodeficiency virus (HIV)-infected patients with alcohol problems. Design We analyzed data from a cohort of HIV-infected adults with current or past alcohol problems enrolled between 2001 and 2003, searching for causes of death until 2010 using the National Death Index. Setting and participants Participants were HIV-infected adults with current or past alcohol problems, recruited in Boston, MA from HIV clinics at two hospitals, homeless shelters, drug treatment programs, subject referrals, flyers, and another cohort study with comparable recruitment sites. Measurements The primary and secondary outcomes were all-cause and liver-related mortality, respectively. The main independent variable was HCV RNA status (positive vs. negative). Mortality rates and Kaplan-Meier survival curves were calculated by HCV status for both overall and liver-related mortality. Cox proportional hazards models were used to assess the association between HCV infection and overall and liver-related death, adjusting for alcohol and drug use over time. Findings 397 adults (50% HCV-infected) were included. As of December 31, 2009, 83 cohort participants had died (60 HCV-infected, 23 HCV-uninfected; log rank test p<0.001), and 26 of those deaths were liver-related (21 HCV-infected, 5 HCV-uninfected; log rank test p<0.001). All-cause and liver-related mortality rates were 4.68 and 1.64 deaths per 100 person-years for HCV-infected patients and 1.65 and 0.36 per 100 person-years for those without HCV, respectively. In the fully adjusted Cox model, HCV infection was associated with both overall [HR 2.55 (95%CI:1.50–4.33), p<0.01], and liver-related mortality [HR 3.24 (95%CI:1.18–8.94), p=0.02]. Conclusion Hepatitis C virus infection is independently associated with all-cause and liver-related mortality in human immunodeficiency virus-infected patients with alcohol problems

  10. Missed Opportunities for Preventing Perinatal Transmission of Human Immunodeficiency Virus, Florida, 2007-2014.

    PubMed

    Trepka, Mary Jo; Mukherjee, Soumyadeep; Beck-Sagué, Consuelo; Maddox, Lorene M; Fennie, Kristopher P; Sheehan, Diana M; Prabhakar, Maithri; Thompson, Dan; Lieb, Spencer

    2017-02-01

    Despite declining numbers of perinatally exposed infants, an increase in perinatal human immunodeficiency virus (HIV) infections from 2011 to 2013 prompted this study to identify missed perinatal HIV prevention opportunities. Deidentified records of children born from 2007 through 2014, exposed to HIV perinatally, and reported to the Florida Department of Health were obtained. Crude relative risks (RRs) and 95% confidence intervals (CIs) for factors associated with perinatal transmission, nondiagnosis of maternal HIV infection, and nonreceipt of antiretroviral medication were calculated. Of the 4337 known singleton births exposed to maternal HIV infection, 70 (1.6%) were perinatally infected. Among perinatal transmission cases, more than one-third of mothers used illegal drugs or acquired a sexually transmitted infection during pregnancy. Perinatal transmission was most strongly associated with maternal HIV diagnosis during labor and delivery (RR 5.66, 95% CI 2.31-13.91) or after birth (RR 26.50, 95% CI 15.44-45.49) compared with antenatally or prenatally. Among the 29 women whose infection was not known before pregnancy and whose child was perinatally infected, 18 were not diagnosed during pregnancy; 12 had evidence of an acute HIV infection, and 6 had no prenatal care. Late diagnosis of maternal HIV infection appeared to be primarily the result of acute maternal infections and inadequate prenatal care. In Florida, effective programs to improve utilization of prenatal care and detection and primary prevention of prenatal acute infection are needed.

  11. Clinical features of seizures in patients with human immunodeficiency virus infection.

    PubMed

    Kim, Hyun Kyung; Chin, Bum Sik; Shin, Hyoung-Shik

    2015-06-01

    Patients with human immunodeficiency virus (HIV) infection have a higher burden of seizures, but few studies have examined seizures in HIV-infected individuals in Korea. A retrospective study was conducted to determine the epidemiology and clinical characteristics of seizures in patients with HIV infection. Among a total of 1,141 patients, 34 (3%) had seizures or epilepsy; 4 of these individuals had epilepsy before HIV infection, and the others showed new-onset seizures. Most patients exhibited moderate (200 to 500, n = 13) or low (below 200, n = 16) CD4 counts. The most common seizure etiology was progressive multifocal leukoencephalopathy (n = 14), followed by other HIV-associated central nervous system (CNS) complications (n = 6). Imaging studies revealed brain lesions in 21 patients. A total of 9 patients experienced only one seizure during the follow-up period, and 25 patients experienced multiple seizures or status epilepticus (n = 2). Multiple seizures were more common in patients with brain etiologies (P = 0.019) or epileptiform discharges on EEG (P = 0.032). Most seizures were controlled without anticonvulsants (n = 12) or with a single anticonvulsant (n = 12). Among patients with HIV infection, seizures are significantly more prevalent than in the general population. Most seizures, with the exception of status epilepticus, have a benign clinical course and few complications.

  12. Longitudinal evolution of bone mineral density and bone markers in human immunodeficiency virus-infected individuals.

    PubMed

    Mondy, Kristin; Yarasheski, Kevin; Powderly, William G; Whyte, Michael; Claxton, Sherry; DeMarco, Debra; Hoffmann, Mary; Tebas, Pablo

    2003-02-15

    The underlying mechanisms of several bone disorders in human immunodeficiency virus (HIV)-infected persons and any relation to antiretroviral therapy have yet to be defined. A longitudinal study was conducted to estimate the prevalence of osteopenia or osteoporosis in HIV-infected persons; to assess bone mineralization, metabolism, and histomorphometry over time; and to evaluate predisposing factors. A total of 128 patients enrolled the study, and 93 were observed for 72 weeks. "Classic" risk factors (low body mass index, history of weight loss, steroid use, and smoking) for low bone mineral density (BMD) and duration of HIV infection were strongly associated with osteopenia. There was a weak association between low BMD and receipt of treatment with protease inhibitors; this association disappeared after controlling for the above factors. Markers of bone turnover tended to be elevated in the whole cohort but were not associated with low BMD. BMD increased slightly during follow-up. Traditional risk factors and advanced HIV infection play a more significant pathogenic role in the development of osteopenia and osteoporosis associated with HIV infection than do treatment-associated factors.

  13. Association between amebic liver abscess and Human Immunodeficiency Virus infection in Taiwanese subjects

    PubMed Central

    Hsu, Meng-Shuian; Hsieh, Szu-Min; Chen, Mao-Yuan; Hung, Chien-Ching; Chang, Shan-Chwen

    2008-01-01

    Purpose Invasive amebiasis is an emerging parasitic disorder in Taiwan, especially in patients diagnosed with human immunodeficiency virus (HIV) infection. Thirty-three Taiwanese subjects with amebic liver abscess (ALA) were examined and a possible correlation between ALA and HIV infection was investigated. Results Among ALA patients, the proportion of HIV-positive individuals increased during the study period. ALA was the first major clinical presentation in 54% of HIV patients with ALA. Overall, 58% (14/24) of HIV-infected patients had a CD4+ count > 200 cells/μL and 82.1% (23/28) had no concurrent opportunistic infection or other evidence of HIV infection. There was no marked difference in clinical characteristics between HIV-positive and HIV-negative ALA patients except the level of leukocytosis. Conclusion While the clinical characteristics described herein cannot be used to determine whether ALA patients have HIV infection, routine HIV testing is recommended in patients with ALA, even in the absence of HIV symptoms. PMID:18416821

  14. The temperature arrested intermediate of virus-cell fusion is a functional step in HIV infection.

    PubMed

    Henderson, Hamani I; Hope, Thomas J

    2006-05-25

    HIV entry occurs via membrane-mediated fusion of virus and target cells. Interactions between gp120 and cellular co-receptors lead to both the formation of fusion pores and release of the HIV genome into target cells. Studies using cell-cell fusion assays have demonstrated that a temperature-arrested state (TAS) can generate a stable intermediate in fusion related events. Other studies with MLV pseudotyped with HIV envelope also found that a temperature sensitive intermediate could be generated as revealed by the loss of a fluorescently labeled membrane. However, such an intermediate has never been analyzed in the context of virus infection. Therefore, we used virus-cell infection with replication competent HIV to gain insights into virus-cell fusion. We find that the TAS is an intermediate in the process culminating in the HIV infection of a target cell. In the virion-cell TAS, CD4 has been engaged, the heptad repeats of gp41 are exposed and the complex is kinetically predisposed to interact with coreceptor to complete the fusion event leading to infection.

  15. Dimension of chronic hepatitis C virus in HIV-infected patients in the interferon-free era: an overview from south Spain.

    PubMed

    Rivero-Juarez, A; Gutierrez-Valencia, A; Castaño, M; Merino, D; Neukam, K; Ríos-Villegas, M J; Lopez-Ruz, M A; Jiménez-Aguilar, P; Marquez, M; Collado, A; Gomez-Vidal, A; Hernandez-Quero, J; Tellez, F; Fernandez-Fuertes, E; Rivero, A; López-Cortés, L F

    2015-11-01

    The implementation of hepatitis C (HCV) direct-acting antiviral drugs is prioritized in several populations in which its application provides the most immediate and impactful benefit. In this scenario, a precise knowledge of the situation of human immunodeficiency virus (HIV)/HCV chronic co-infection is required to adequately address this disease. This cross-sectional study was performed in 21 hospitals in Andalusia (Spain). The study population consisted of HIV-infected patients with an active HCV chronic infection who were not receiving HCV treatment at the time of inclusion. A total of 13,506 HIV-infected patients were included in the study. Of them, 2561 (18.9 %) presented chronic HCV infection. The majority of the patients included were on highly active antiretroviral therapy (HAART; 96.2 %), showed plasma levels with an undetectable HIV viral load (92.5 %), and had a good immunological status (median CD4+ cell count of 486 cells/mL). The HCV genotype distribution was as follows: 58.1 % were genotype 1, 1.1 % were genotype 2, 16.1 % were genotype 3, and 22.1 % were genotype 4 (2.6 % were missing data). In total, 24.8 % of the patients showed liver fibrosis stage F0-F1, 27.9 % showed stage F2, 16.7 % showed stage F3, and 21 % showed stage F4 (9.6 % were missing data). With regards to previous HCV treatment experiences, 68.05 % of the patients were naïve and 31.95 % had failed to respond to a previous treatment. The burden of HCV/HIV co-infected patients in our population was reported as one in five HIV-infected patients requiring HCV treatment. The implementation of extra resources to face this important health challenge is mandatory.

  16. A computer-based surveillance system for human immunodeficiency virus infection in Singapore.

    PubMed

    Chew, S K; Snodgrass, I

    1995-04-01

    The first case of the human immunodeficiency virus (HIV) infection was detected in Singapore in 1985 and the first case of the acquired immunodeficiency syndrome (AIDS) in 1986. Since then, the number of infections had increased. By the end of 1993, there were 222 residents with HIV infection, including 75 cases of AIDS. In view of the rapidly increasing magnitude of HIV infection, a microcomputer-based surveillance system was designed and developed in 1992 to better monitor epidemiological trends of HIV infection in Singapore. OBJECTIVE--The objective was to define a composite model of a successful HIV and AIDS registry that included: (a) patient data forms, (b) patient's contact data forms, (c) data analysis, and (d) report generation. METHODOLOGY--An IBM-compatible desk-top microcomputer was used for the project. The main software used for computer programming and data analysis were DBase IV (Version 1.5) and Epi Info (Version 5.0), respectively. Security features were incorporated into the programme to ensure confidentiality of information and that only authorized personnel could gain access to the programme. MAIN FINDINGS--The system functioned as the National HIV Notification Registry and was able to track notifications, analyse data and enabled prompt dissemination of information. The system was also linked to another database system for tuberculosis to enhance surveillance of both HIV infection and tuberculosis. CONCLUSION--The authors believe that this system would enhance surveillance and provide timely information for national AIDS control programmes. However, the effectiveness of this computer-based surveillance system is dependent on an established notification structure with notifications of sufficient completeness for both HIV infection and AIDS.

  17. New diagnoses of human immunodeficiency virus infection in the Spanish pediatric HIV Cohort (CoRISpe) from 2004 to 2013.

    PubMed

    Jiménez de Ory, Santiago; González-Tomé, María Isabel; Fortuny, Claudia; Mellado, Maria Jose; Soler-Palacin, Pere; Bustillo, Matilde; Ramos, José Tomas; Muñoz-Fernández, Maria Angeles; Navarro, Maria Luisa

    2017-09-01

    Vertical human immunodeficiency virus (HIV) infection has decreased in industrialized countries in recent decades, but there are no studies on the mechanisms of HIV transmission among infected children in Spain. Our aim was to study the characteristics and trends of diagnoses of vertically HIV-infected children in Spain from 2004 to 2013.Vertically HIV-infected children were selected if they were diagnosed from 2004 to 2013, were aged 0 to 18 years old, and were included in the Cohort of the Spanish Pediatric HIV Network (CoRISpe). Demographic, clinical, immunological, and virological data at diagnosis were obtained. The rate of diagnoses of vertically HIV-infected children was calculated as the number of cases per 100,000 inhabitants. Obstetric data of mothers of Spanish children and prophylaxis at childbirth and postpartum were obtained.A total of 218 HIV-infected children were included in the study. Of this sample, 182 children (83.5%) were perinatally HIV infected, and 125 out of those 182 children (68.7%) were born in Spain. The vertically HIV-infected Spanish children were diagnosed earlier and were in better clinical and immunological condition at diagnosis than were foreign children. The rate of vertically HIV-infected children declined from 0.09 in 2004 to 0.03 in 2013 due to the decrease in the rate of children born in Spain (0.08 in 2004 vs 0.01 in 2013). A total of 60 out of 107 mothers (56.1%) of Spanish children were diagnosed at or after childbirth. However, this number declined between 2004 and 2013.The rate of new HIV diagnoses of vertically HIV-infected children decreased significantly between 2004 and 2013 from 0.09 to 0.03 per 100,000 inhabitants.

  18. Elevated alanine aminotransferase levels in HIV-infected persons without hepatitis B or C virus coinfection.

    PubMed

    Alghamdi, Saad; Alrbiaan, Abdullah; Alaraj, Ali; Alhuraiji, Ahmad; Alghamdi, Mohammad; Alrajhi, Abdulrahman

    2016-01-01

    Mortality related to human immunodeficiency (HIV) has improved with the use of antiretroviral therapy; however, liver disease-related mortality remains a major concern for the HIV population. Elevation of alanine aminotransferase (ALT) has been noted in HIV-infected persons even without viral hepatitis infection. The objective of this study was to determine the incidence and prevalence of chronic alanine ALT elevation among patients infected with HIV who are negative for hepatitis B or C infection. Retrospective chart review. We reviewed the medical records of all patients infected with HIV who had been treated from November 2002 to December 2010. Patients with an unknown or positive HBV or HCV infection status were excluded. We identified patient demographics, route of transmission, peak viral load, and nadir CD4 count. We followed 440 patients for up to 2265 person-years. A total of 123 patients developed chronically elevated ALT levels, with an incidence of 5.8 cases per 100 person-years. Chronically elevated ALT levels were associated with high HIV viral load, mean body mass index, and diabetes mellitus. We found exposure to lamivudine in 58% of the patients, efavirenz in 41%, and zidovudine in 38%. Abdominal ultrasounds revealed fatty liver in 20 of 39 (51%) of the patients. Among patients without viral hepatitis coinfection, the prevalence and incidence of chronic elevated ALT levels were high and accompanied by high HIV RNA levels and increased BMI. The limitations of this report are its retrospective nature and lack of a control group.

  19. Mycoplasma penetrans and Other Mycoplasmas in Urine of Human Immunodeficiency Virus-Positive Children

    PubMed Central

    Hussain, Althaf I.; Robson, William Lane M.; Kelley, Robin; Reid, Tanya; Gangemi, J. David

    1999-01-01

    Urine samples from children with human immunodeficiency virus (HIV) infection and healthy controls were examined for mycoplasmas by culture. Standard biochemical assays, sodium dodecyl sulfate-polyacrylamide gel electrophoresis, and PCR (16S and 16S-23S spacer rRNA region) were used for identification of isolates. Mycoplasmas were identified from 13 (87%) of 15 HIV-positive patients and 3 (20%) of 15 HIV-negative control patients. The frequency and type of mycoplasma varied with the severity of HIV infection. Mycoplasma penetrans, Mycoplasma pirum, Mycoplasma fermentans, and Mycoplasma genitalium were isolated from patients with severe immunodeficiency. Mycoplasma hominis and Ureaplasma urealyticum were isolated more frequently from children in the early stages of HIV infection and from HIV-negative patients. Mycoplasma penetrans was isolated from one (50%) of two patients in Centers for Disease Control and Prevention (CDC) group B and from five (55.5%) of nine pediatric patients with AIDS (CDC group C). This is the first report that indicates that “AIDS-associated” mycoplasmas are more common in HIV-infected children than in HIV-negative controls. PMID:10203515

  20. HIV Infection Status as a Predictor of Hepatitis C Virus RNA Testing in Primary Care

    PubMed Central

    Yartel, Anthony K.; Morgan, Rebecca L.; Rein, David B.; Brown, Kimberly Ann; Kil, Natalie B.; Massoud, Omar I.; Fallon, Michael B.; Smith, Bryce D.

    2015-01-01

    Introduction Receipt of hepatitis C virus (HCV) RNA testing following a positive HCV antibody (anti-HCV+) test result to establish current infection is a quality indicator for HCV-related care. This study examines HIV infection status as a predictor of HCV RNA test receipt after an anti-HCV+ result in the primary care setting. Methods Electronic medical records of anti-HCV+ patients from a multisite retrospective study of patients aged ≥18 years who utilized one or more primary care outpatient services during 2005–2010 were analyzed in 2014. A multivariable logistic regression model examined the independent relationships between patient characteristics and receipt of HCV RNA testing. Results Among 1,115 anti-HCV+ patients, 133 (11.9%) were also HIV-positive. Of these, 77.4% (n=103) underwent HCV RNA testing to determine current infection status. By contrast, 66.7% (n=654/980) of anti-HCV+ patients who were HIV-negative received HCV RNA testing. Following multivariable adjustment, the odds of receiving HCV RNA testing were higher among anti-HCV+ patients who were also HIV-positive (AOR=1.9, 95% CI=1.2, 3.0), compared with their HIV-negative counterparts. Elevated alanine aminotransferase level was also associated with receipt of HCV RNA testing (AOR=1.9, 95% CI=1.4, 2.4). Black race was associated with decreased odds of receiving HCV RNA testing (AOR=0.7, 95% CI=0.5, 1.0). Conclusions HIV infection status is independently associated with the likelihood of receiving HCV RNA testing following an anti-HCV+ result. One quarter of anti-HCV+ patients who were also HIV-positive and one third of their HIV-negative counterparts, respectively, did not receive testing to establish active HCV infection, which is imperative for appropriate care and treatment. PMID:25896194

  1. Human immunodeficiency virus infection in Singapore--the first 50 cases.

    PubMed

    Chew, S K; Chan, R; Monteiro, E H; Sng, E H

    1990-12-01

    As at 31 May 1990, fifty Singaporeans with the Human Immunodeficiency Virus (HIV) infection had been detected. Of these, nineteen had the Acquired Immunodeficiency Syndrome (AIDS). The majority of infected persons had been infected through sexual contact (homosexual 52%; bisexual 24%; heterosexual 20%) with men and women from countries where HIV infection was prevalent. The majority of infected patients (88%) were in the age range 20-39 years. There was one case of blood transfusion-associated AIDS. There were no infected paediatric or haemophiliac cases or intravenous drug use in any of the patients. A spectrum of AIDS-related opportunistic infections and cancers was observed, and Pneumocystis carinii pneumonia was the most frequent presentation. Thirteen patients with AIDS had died and the median survival time was about seven months.

  2. Leptospirosis and Human Immunodeficiency Virus Co-Infection Among Febrile Inpatients in Northern Tanzania

    PubMed Central

    Biggs, Holly M.; Galloway, Renee L.; Bui, Duy M.; Morrissey, Annie B.; Maro, Venance P.

    2013-01-01

    Abstract Background Leptospirosis and human immunodeficiency virus (HIV) infection are prevalent in many areas, including northern Tanzania, yet little is known about their interaction. Methods We enrolled febrile inpatients at two hospitals in Moshi, Tanzania, over 1 year and performed HIV antibody testing and the microscopic agglutination test (MAT) for leptospirosis. Confirmed leptospirosis was defined as ≥four-fold rise in MAT titer between acute and convalescent serum samples, and probable leptospirosis was defined as any reciprocal MAT titer ≥800. Results Confirmed or probable leptospirosis was found in 70 (8.4%) of 831 participants with at least one serum sample tested. At total of 823 (99.0%) of 831 participants had HIV testing performed, and 203 (24.7%) were HIV infected. Among HIV-infected participants, 9 (4.4%) of 203 had confirmed or probable leptospirosis, whereas among HIV-uninfected participants 61 (9.8%) of 620 had leptospirosis. Leptospirosis was less prevalent among HIV-infected as compared to HIV-uninfected participants [odds ratio (OR) 0.43, p=0.019]. Among those with leptospirosis, HIV-infected patients more commonly presented with features of severe sepsis syndrome than HIV-uninfected patients, but differences were not statistically significant. Among HIV-infected patients, severe immunosuppression was not significantly different between those with and without leptospirosis (p=0.476). Among HIV-infected adolescents and adults, median CD4 percent and median CD4 count were higher among those with leptospirosis as compared to those with other etiologies of febrile illness, but differences in CD4 count did not reach statistical significance (p=0.015 and p=0.089, respectively). Conclusions Among febrile inpatients in northern Tanzania, leptospirosis was not more prevalent among HIV-infected patients. Although some indicators of leptospirosis severity were more common among HIV-infected patients, a statistically significant difference was not

  3. Immunogenicity of the Bivalent Oral Cholera Vaccine Shanchol in Haitian Adults With HIV Infection.

    PubMed

    Ivers, Louise C; Charles, Richelle C; Hilaire, Isabelle J; Mayo-Smith, Leslie M; Teng, Jessica E; Jerome, J Gregory; Rychert, Jenna; LaRocque, Regina C; Xu, Peng; Kovácˇ, Pavol; Ryan, Edward T; Qadri, Firdausi; Almazor, Charles P; Franke, Molly F; Harris, Jason B

    2015-09-01

    We evaluated immune responses following bivalent oral cholera vaccination (Shanchol [Shantha Biotechnics]; BivWC) in a cohort of 25 human immunodeficiency virus (HIV)-infected adults in Haiti. Compared with adults without HIV infection, vaccination in HIV-infected individuals resulted in lower vibriocidal responses against Vibrio cholerae O1, and there was a positive relationship between the CD4(+) T-cell count and vibriocidal responses following vaccination. Nevertheless, seroconversion occurred at a rate of 65% against the Ogawa serotype and 74% against the Inaba serotype in adults with HIV infection. These results suggest that the vaccine retains substantial immunogenicity in adults with HIV infection and may benefit this population by protecting against cholera.

  4. The First Case of Vestibulocochlear Neuritis in a Patient with Acquired Immunodeficiency Syndrome in Korea.

    PubMed

    Park, Hyun Joo; Cho, Chin Saeng; Kim, Nak Min; Yun, Su A; Yoon, Hee Jung

    2016-06-01

    The incidence of human immunodeficiency virus (HIV) infections continue to increase throughout the world. Although neurologic complications are frequent in individuals with HIV infection or acquired immunodeficiency syndrome (AIDS), vestibulocochlear neuritis is still a relatively rare manifestation. We report the first case of vestibulocochlear neuritis occurring in an AIDS patient in Korea.

  5. The First Case of Vestibulocochlear Neuritis in a Patient with Acquired Immunodeficiency Syndrome in Korea

    PubMed Central

    Park, Hyun Joo; Cho, Chin Saeng; Kim, Nak Min; Yun, Su A

    2016-01-01

    The incidence of human immunodeficiency virus (HIV) infections continue to increase throughout the world. Although neurologic complications are frequent in individuals with HIV infection or acquired immunodeficiency syndrome (AIDS), vestibulocochlear neuritis is still a relatively rare manifestation. We report the first case of vestibulocochlear neuritis occurring in an AIDS patient in Korea. PMID:27433384

  6. Audio-vestibular function in human immunodeficiency virus infected patients in India.

    PubMed

    Mathews, Suma Susan; Albert, Rita Ruby; Job, Anand

    2012-07-01

    As the acquired immunodeficiency syndrome (AIDS) epidemic shows no signs of abating, the impact of AIDS is felt more in the developing countries due to socioeconomic reasons. The possibility of drug-induced ototoxicity also adds to the risk of audio vestibular dysfunction. We sought to determine if there was a difference between the audio-vestibular function in the asymptomatic human immunodeficiency virus (HIV) infected patients and patients with AIDS. A prospective, cross-sectional study A tertiary care center in South India The audio-vestibular system of 30 asymptomatic HIV positive subjects (group 1) and 30 subjects with AIDS (group 2), and age-matched 30 healthy controls (group 3) were assessed using pure tone audiometry and cold caloric test. Sixteen patients each, in group 1 and group 2 and four subjects in the control group were detected to have a hearing loss indicating significantly more HIV infected individuals (group 1 and 2) were having hearing loss (P=0.001). Kobrak's (modified) test showed 27% of patients in group 1 and 33% of patients in group 2 and none in the group 3 had a hypofunctioning labyrinth (P=0.001). It seems that the human immunodeficiency virus does affect the audio-vestibular pathway. There was a significant incidence of audio-vestibular dysfunction among the HIV infected patients, as compared to the control population (P=0.001) and no significant difference between the asymptomatic HIV seropositive patients and AIDS patients. Majority of the patients had no otological symptoms.

  7. Role of liver transplantation in human immunodeficiency virus positive patients

    PubMed Central

    Joshi, Deepak; Agarwal, Kosh

    2015-01-01

    End-stage liver disease (ESLD) is a leading cause of morbidity and mortality amongst human immunodeficiency virus (HIV)-positive individuals. Chronic hepatitis B and hepatitis C virus (HCV) infection, drug-induced hepatotoxicity related to combined anti-retro-viral therapy, alcohol related liver disease and non-alcohol related fatty liver disease appear to be the leading causes. It is therefore, anticipated that more HIV-positive patients with ESLD will present as potential transplant candidates. HIV infection is no longer a contraindication to liver transplantation. Key transplantation outcomes such as rejection and infection rates as well as medium term graft and patient survival match those seen in the non-HIV infected patients in the absence of co-existing HCV infection. HIV disease does not seem to be negatively impacted by transplantation. However, HIV-HCV co-infection transplant outcomes remain suboptimal due to recurrence. In this article, we review the key challenges faced by this patient cohort in the pre- and post-transplant period. PMID:26604639

  8. [Genetic diversity of human immunodeficiency viruses and antiretroviral therapy].

    PubMed

    Bobkova, M R

    2016-01-01

    The lecture is devoted to the analysis of the state-of-the-art of the impact of genetic diversity of human immunodeficiency (HIV) viruses on the pattern of infection and the efficiency of antiretroviral therapy (ART). It provides brief information on the origin and evolution of HIV and on the current classification of their genetic variants. The molecular epidemiological situation of HIV infection in Russia and nearby states and the major molecular HIV variants that are dominant in these countries, as well as their origin and prevalence trends are characterized. How the diversity of HIV can affect the efficiency of diagnosis, the transmission of the virus, and the pattern of HIV pathogenesis are briefly reviewed. The comparative data available in the world's scientific literature on these topics are given. More detailed attention is given to the possible causes of varying therapeutic effects against different HIV subtypes, as well as to the specific features of the formation and phenotyping manifestation of ART drug resistance mutations. There is evidence for the necessity of forming a unified follow-up system for treated HIV-infected patients during ART scaling, including in an effort to evaluate the impact of the specific features of the HIV genome on the efficiency of treatment regimens used in Russia.

  9. HIV-Associated Neurocognitive Disorders: The Relationship of HIV Infection with Physical and Social Comorbidities

    PubMed Central

    Tedaldi, Ellen M.; Minniti, Nancy L.; Fischer, Tracy

    2015-01-01

    The prevalence of HIV (human immunodeficiency virus) associated neurocognitive disorders (HAND) will undoubtedly increase with the improved longevity of HIV-infected persons. HIV infection, itself, as well as multiple physiologic and psychosocial factors can contribute to cognitive impairment and neurologic complications. These comorbidities confound the diagnosis, assessment, and interventions for neurocognitive disorders. In this review, we discuss the role of several key comorbid factors that may contribute significantly to the development and progression of HIV-related neurocognitive impairment, as well as the current status of diagnostic strategies aimed at identifying HIV-infected individuals with impaired cognition and future research priorities and challenges. PMID:25815329

  10. Prevalence and risk factors for hepatitis C virus, hepatitis B virus, and human immunodeficiency virus in transfused children in Kinshasa.

    PubMed

    Katabuka, M; Mafuta, M E; Ngoma, A M; Beya, P Mutombo; Yuma, S; Aketi, L; Kayembe, K P; Gini, J R

    2013-08-01

    To determine seroprevalence of hepatitis C virus (HCV), human immunodeficiency virus (HIV), and hepatitis B virus (HBV) and associated factors among transfused children. A multicenter cross-sectional study of transfused children aged between 18 mo and 13 y old was conducted in 4 hospitals in Kinshasa. Blood samples were collected for the detection of Hepatitis B surface antigen (HBsAg) and antibodies to HCV, HIV 1 and 2. A total of 177 (47.7 %) boys and 194 (52.3 %) girls participated in the study. The median age was 59.5 mo (Interquartile range IQR = 60.6). The prevalence rates of HCV, HBV, and HIV infection were 13.5 %, 1.6 %, and 1.3 %, respectively. Frequency of transfusion events were significantly associated with HCV (p < 0.001) and HIV (p < 0.05) infections. HCV infection was by far more frequently identified than HBV and HIV infections among Congolese transfused children. Frequency of transfusion events was the only significant risk factor associated with HCV and HIV infections but not for HBV.

  11. Decreases in human immunodeficiency virus infection rates in Kombolcha, Ethiopia: a 10-year data review

    PubMed Central

    Shiferaw, Melashu Balew; Gebregergs, Gebremedhin Berhe; Sinishaw, Mulusew Alemneh; Yesuf, Yohannes Amede

    2016-01-01

    Introduction Acquired immunodeficiency syndrome is one of the most serious public health and development challenges in sub-Saharan Africa, including Ethiopia. A particular challenge for prevention strategies has been the emergence of hotspot areas. Therefore, human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome programs should not be based on national level statistics, but need to be more focused geographically. Kombolcha is one of the high spot areas with different projects and development corridors. Hence, the aim of this study is to assess the trend of HIV infection rates among patients who visited Africa Service Committee clinic from 2005 to 2014. Methods An institutional-based cross-sectional study was conducted from January 1 to January 30, 2016. All records of new patients enrolled from February 8, 2005 to December 31, 2014 were reviewed. Data on sociodemographic information, risky sexual behavior, and HIV test result were collected from each study participant using data collection format. Data were analyzed using SPSS version 20.0. A multivariate logistic regression model was used to identify risk factors of HIV infection. Results The overall HIV infection was 10.8% (2,233/20,674). The rate of infection varied from 13.3% in 2005 to 4.5% in 2014, and its trend had significantly declined from 2008 to 2014. Urban residence (adjusted odds ratio [AOR]: 2.53; 95% confidence interval [CI]: 1.22–5.25), patients who ever had intercourse with penetration (AOR: 5.62; 95% CI: 1.11–28.57), and those who had marriage experience (AOR: 11.65; 95% CI: 4.2–32.3) were more infected with HIV. Conclusion The trend of HIV infection significantly reduced in the last 10 years in Kombolcha area. However, the HIV infection still remains high (4.5%) that needs intervention of those who had marriage experience, risky sexual behavior, and urban dwellers. PMID:27462177

  12. Pathological Role of Anti-CD4 Antibodies in HIV-Infected Immunologic Nonresponders Receiving Virus-Suppressive Antiretroviral Therapy.

    PubMed

    Luo, Zhenwu; Li, Zhen; Martin, Lisa; Wan, Zhuang; Meissner, Eric G; Espinosa, Enrique; Wu, Hao; Yu, Xiaocong; Fu, Pingfu; Julia Westerink, Maria Anna; Kilby, J Michael; Wu, Jennifer; Huang, Lei; Heath, Sonya L; Li, Zihai; Jiang, Wei

    2017-07-01

    Increased mortality and morbidity occur among human immunodeficiency virus (HIV)-infected patients in whom CD4+ T-cell counts do not increase despite viral suppression with antiretroviral therapy (ART). Here we identified an underlying mechanism. Significantly elevated plasma levels of anti-CD4 immunoglobulin G (IgG) were found in HIV-positive immunologic nonresponders (ie, HIV-positive individuals with CD4+ T-cell counts of ≤350 cells/μL), compared with levels in HIV-positive immunologic responders (ie, HIV-positive individuals with CD4+ T-cell counts of ≥500 cells/μL) and healthy controls. Higher plasma level of anti-CD4 IgG correlated with blunted CD4+ T-cell recovery. Furthermore, purified anti-CD4 IgG from HIV-positive immunologic nonresponders induced natural killer (NK) cell-dependent CD4+ T-cell cytolysis and apoptosis through antibody-dependent cell-mediated cytotoxicity (ADCC) in vitro. We also found that anti-CD4 IgG-mediated ADCC exerts greater apoptosis of naive CD4+ T cells relative to memory CD4+ T cells. Consistently, increased frequencies of CD107a+ NK cells and profound decreases of naive CD4+ T cells were observed in immunologic nonresponders as compared to responders and healthy controls ex vivo. These data indicate that autoreactive anti-CD4 IgG may play an important role in blunted CD4+ T-cell reconstitution despite effective ART. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

  13. Serum creatinine elevation after switch to dolutegravir in a human immunodeficiency virus-positive kidney transplant recipient

    PubMed Central

    Lee, D.H.; Malat, G.E.; Bias, T.E.; Harhay, M.N.; Ranganna, K.; Doyle, A.M.

    2017-01-01

    Dolutegravir is a preferred antiretroviral drug for human immunodeficiency virus (HIV)-infected patients following solid organ transplantation. It has potent antiretroviral activity and does not interact with calcineurin inhibitors. We describe a case of an HIV-infected kidney transplant patient, who was noted to have a rising serum creatinine following initiation of dolutegravir. At first an acute rejection episode was suspected, but this finding was later attributed to inhibition of creatinine secretion by dolutegravir. We suggest that an awareness of this potential effect of dolutegravir is important for providers who take care of HIV-positive kidney transplant recipients, in order to prevent potentially unnecessary testing. PMID:27159656

  14. [Candida laryngitis and HIV infection: description of 4 cases].

    PubMed

    Roig, P; Carrasco, R; Salavert, M; Navarro, V; Guix, J; Nieto, A; Bernacer, B

    1992-10-01

    Candidiasic laryngitis is a very rare Candida spp infection of mucosa, appearing typically in immunosuppressed patients, mainly in patients with neoplasia, and, recently, in patients with Human Immunodeficiency Virus (VIH) infection. We present four cases of candidiasic laryngitis and HIV infection, as well as the clinical description and evolution of said cases after treatment with fluconazole. We review, as well, the cases published on the scientific literature. We maintain that in each HIV infected patient, with or without oral candidiasis, who shows dysphonia, candidiasic laryngitis should be ruled out.

  15. Fulminant amebic colitis in an HIV-infected homosexual man.

    PubMed

    Ishioka, Haruhiko; Umezawa, Masami; Hatakeyama, Shuji

    2011-01-01

    We present a case of fulminant amebic colitis in a human immunodeficiency virus (HIV)-infected homosexual man. The patient developed colonic perforation over a short time despite empirical therapy with metronidazole, and underwent right hemicolectomy. Amebic colitis was pathologically diagnosed by identifying invasive trophozoites of Entamoeba in a surgical specimen. Amebic colitis is one of the important differential diagnoses of acute abdomen in HIV-infected patients and/or homosexual men, especially in East Asia. Although fulminant amebic colitis is a rare manifestation of amebiasis, early diagnosis and treatment are thought to be important to improve the outcome of this highly fatal complication.

  16. Herpes simplex virus type 2 and HIV infection among US military personnel: implications for health prevention programmes.

    PubMed

    Bautista, C T; Singer, D E; O'Connell, R J; Crum-Cianflone, N; Agan, B K; Malia, J A; Sanchez, J L; Peel, S A; Michael, N L; Scott, P T

    2009-09-01

    US military personnel are routinely screened for HIV infection. Herpes simplex virus type 2 (HSV-2) is a risk factor for HIV acquisition. To determine the association between HSV-2 and HIV, a matched case-control study was conducted among US Army and Air Force service members with incident HIV infections (cases) randomly matched with two HIV-uninfected service members (controls) between 2000 and 2004. HSV-2 prevalence was significantly higher among cases (30.3%, 138/456) than among controls (9.7%, 88/912, P < 0.001). HSV-2 was strongly associated with HIV in univariate (odds ratio [OR] = 4.2, 95% confidence interval [CI] = 3.1-5.8) and multiple analyses (adjusted [OR] = 3.9, 95% CI = 2.8-5.6). The population attributable risk percentage of HIV infection due to HSV-2 was 23%. Identifying HSV-2 infections may afford the opportunity to provide targeted behavioural interventions that could decrease the incidence of HIV infections in the US military population; further studies are needed.

  17. Neurological Complications in Controlled HIV Infection.

    PubMed

    Crossley, Kate M; Brew, Bruce J

    2013-12-01

    In recent years, there have been great advances in therapies for human immunodeficiency virus (HIV) that have allowed suppression of the virus and its effects on the body. Despite this progress, neurological complications persist in HIV-infected individuals. In this review we consider the possible ways that HIV might cause neurotoxicity and neuroinflammation. We discuss the spectrum of neurological disorders caused by HIV and its treatment, with a particular focus on both HIV-associated neurocognitive disorders and peripheral neuropathies. Since there has been a shift to HIV being a chronic illness, we also review the increasing prevalence of cerebrovascular disease and neurodegenerative disorders.

  18. Renal transplantation in human immunodeficiency virus-infected recipients: a case-control study from the Brazilian experience.

    PubMed

    Vicari, A R; Spuldaro, F; Sandes-Freitas, T V; Cristelli, M P; Requião-Moura, L R; Reusing, J O; Pierrotti, L C; Oliveira, M L; Girão, C M; Gadonski, G; Kroth, L V; Deboni, L M; Ferreira, G F; Tedesco-Silva, H; Esmeraldo, R; David-Neto, E; Saitovitch, D; Keitel, E; Garcia, V D; Pacheco-Silva, A; Medina-Pestana, J O; Manfro, R C

    2016-10-01

    Highly active antiretroviral therapy has turned human immunodeficiency virus (HIV)-infected patients with end-stage renal disease into suitable candidates for renal transplantation. We present the Brazilian experience with kidney transplantation in HIV-infected recipients observed in a multicenter study. HIV-infected kidney transplant recipients and matched controls were evaluated for the incidence of delayed graft function (DGF), acute rejection (AR), infections, graft function, and survival of patients and renal grafts. Fifty-three HIV-infected recipients and 106 controls were enrolled. Baseline characteristics were similar, but a higher frequency of pre-transplant positivity for hepatitis C virus and cytomegalovirus infections was found in the HIV group. Immunosuppressive regimens did not differ, but a trend was observed toward lower use of anti-thymocyte globulin in the group of HIV-infected recipients (P = 0.079). The HIV-positive recipient group presented a higher incidence of treated AR (P = 0.036) and DGF (P = 0.044). Chronic Kidney Disease Epidemiology Collaboration estimated that glomerular filtration rate was similar at 6 months (P = 0.374) and at 12 months (P = 0.957). The median number of infections per patient was higher in the HIV-infected group (P = 0.018). The 1-year patient survival (P < 0.001) and graft survival (P = 0.004) were lower, but acceptable, in the group of HIV-infected patients. In the Brazilian experience, despite somewhat inferior outcomes, kidney transplantation is an adequate therapy for selected HIV-infected recipients. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  19. Non-M Variants of Human Immunodeficiency Virus Type 1

    PubMed Central

    Mourez, Thomas; Simon, François

    2013-01-01

    SUMMARY The AIDS pandemic that started in the early 1980s is due to human immunodeficiency virus type 1 (HIV-1) group M (HIV-M), but apart from this major group, many divergent variants have been described (HIV-1 groups N, O, and P and HIV-2). The four HIV-1 groups arose from independent cross-species transmission of the simian immunodeficiency viruses (SIVs) SIVcpz, infecting chimpanzees, and SIVgor, infecting gorillas. This, together with human adaptation, accounts for their genomic, phylogenetic, and virological specificities. Nevertheless, the natural course of non-M HIV infection seems similar to that of HIV-M. The virological monitoring of infected patients is now possible with commercial kits, but their therapeutic management remains complex. All non-M variants were principally described for patients linked to Cameroon, where HIV-O accounts for 1% of all HIV infections; only 15 cases of HIV-N infection and 2 HIV-P infections have been reported. Despite improvements in our knowledge, many fascinating questions remain concerning the origin, genetic evolution, and slow spread of these variants. Other variants may already exist or may arise in the future, calling for close surveillance. This review provides a comprehensive, up-to-date summary of the current knowledge on these pathogens, including the historical background of their discovery; the latest advances in the comprehension of their origin and spread; and clinical, therapeutic, and laboratory aspects that may be useful for the management and the treatment of patients infected with these divergent viruses. PMID:23824367

  20. Recursion-based depletion of human immunodeficiency virus-specific naive CD4(+) T cells may facilitate persistent viral replication and chronic viraemia leading to acquired immunodeficiency syndrome.

    PubMed

    Tsukamoto, Tetsuo; Yamamoto, Hiroyuki; Okada, Seiji; Matano, Tetsuro

    2016-09-01

    Although antiretroviral therapy has made human immunodeficiency virus (HIV) infection a controllable disease, it is still unclear how viral replication persists in untreated patients and causes CD4(+) T-cell depletion leading to acquired immunodeficiency syndrome (AIDS) in several years. Theorists tried to explain it with the diversity threshold theory in which accumulated mutations in the HIV genome make the virus so diverse that the immune system will no longer be able to recognize all the variants and fail to control the viraemia. Although the theory could apply to a number of cases, macaque AIDS models using simian immunodeficiency virus (SIV) have shown that failed viral control at the set point is not always associated with T-cell escape mutations. Moreover, even monkeys without a protective major histocompatibility complex (MHC) allele can contain replication of a super infected SIV following immunization with a live-attenuated SIV vaccine, while those animals are not capable of fighting primary SIV infection. Here we propose a recursion-based virus-specific naive CD4(+) T-cell depletion hypothesis through thinking on what may happen in individuals experiencing primary immunodeficiency virus infection. This could explain the mechanism for impairment of virus-specific immune response in the course of HIV infection. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. CD8+ Lymphocytes Can Control HIV Infection in vitro by Suppressing Virus Replication

    NASA Astrophysics Data System (ADS)

    Walker, Christopher M.; Moody, Dewey J.; Stites, Daniel P.; Levy, Jay A.

    1986-12-01

    Lymphocytes bearing the CD8 marker were shown to suppress replication of human immunodeficiency virus (HIV) in peripheral blood mononuclear cells. The effect was dose-dependent and most apparent with autologous lymphocytes; it did not appear to be mediated by a cytotoxic response. This suppression of HIV replication could be demonstrated by the addition of CD8+ cells at the initiation of virus production as well as after several weeks of virus replication by cultured cells. The observations suggest a potential approach to therapy in which autologous CD8 lymphocytes could be administered to individuals to inhibit HIV replication and perhaps progression of disease.

  2. Renal pathology and HIV infection in Thailand.

    PubMed

    Praditpornsilpa, K; Napathorn, S; Yenrudi, S; Wankrairot, P; Tungsaga, K; Sitprija, V

    1999-02-01

    The existence of a human immunodeficiency virus (HIV)-associated nephropathy (HIVAN) as a distinct disease entity characterized by glomerulosclerosis is well established in North America and Western Europe. Although the large number of HIV-infected cases overwhelm the Asian countries, no cases of HIVAN are documented in the literature. We studied 26 cases of HIV-infected Thai patients with proteinuria greater than 1.5 g/d of protein during 1995 and 1996. None of the patients were treated with antiretroviral drugs at the time of renal biopsy. Intravenous drug addiction and sexual transmission were risk factors in 11 and 15 patients, respectively. Pathological examinations were performed by light microscopic and immunoperoxidase study. Mesangial proliferative glomerulonephritis was found in 17 cases, immunoglobulin A (IgA) nephropathy in 2 cases, and diffuse proliferative glomerulonephritis and interstitial nephritis secondary to cryptococcal infection in 2 cases each. One case each had membranous glomerulopathy, membranoproliferative glomerulonephritis, and granulomatous interstitial nephritis secondary to tuberculosis. The renal pathological findings of HIVAN with the unique features described in previous literature were not evident in these patients. Although the data in this study are limited to 26 HIV-infected Thai patients, we believe that HIVAN is uncommon in the Asian HIV-infected population.

  3. Shedding of Hepatitis C Virus in Semen of Human Immunodeficiency Virus-Infected Men

    PubMed Central

    Turner, Samuel S.; Gianella, Sara; Yip, Marcus J-S.; van Seggelen, Wouter O.; Gillies, Robert D.; Foster, Andrew L.; Barbati, Zachary R.; Smith, Davey M.; Fierer, Daniel S.

    2016-01-01

    Background. The epidemic of sexually transmitted hepatitis C virus (HCV) infection among human immunodeficiency virus (HIV)-infected men who have sex with men (MSM) has been documented for over a decade. Despite this, there is no consensus as to the risk factors for sexual acquisition of HCV in these men. Methods. We obtained paired semen and blood samples at 2-week intervals from HIV-infected MSM with recent and chronic HCV infection and quantified HCV in semen. Results. Hepatitis C virus was quantified in 59 semen specimens from 33 men. Hepatitis C virus was shed in 16 (27%) of semen specimens from 11 (33%) of the men. Median HCV viral load (VL) in semen was 1.49 log10 IU/mL. Hepatitis C virus VL in blood was significantly higher at the time of HCV shedding in semen than when HCV shedding in semen was not detected (P = .002). Furthermore, there was a significant correlation between the HCV VL in blood and semen overall (rs = 0.41; P = .001), and in the subgroup with recent HCV infection (rs = 0.37; P = .02), but not in the subgroup with chronic HCV infection (rs = 0.34; P = .1). Conclusions. One third of HIV-infected MSM coinfected with HCV shed HCV into their semen. Based on the HCV VL in semen in this study, an average ejaculate would deliver up to 6630 IU of virus into the rectum of the receptive partner. Therefore, our data strongly support that condoms should be used during anal intercourse among MSM to prevent transmission of HCV. PMID:27186582

  4. Human immunodeficiency virus infection and nutritional status in female drug addicts undergoing detoxification: anthropometric and immunologic assessments.

    PubMed

    Varela, P; Marcos, A; Santacruz, I; Ripoll, S; Requejo, A M

    1997-08-01

    To clarify the interrelations among drug abuse, malnutrition, and immunosuppression, the effects of human immunodeficiency virus (HIV) infection on the nutritional status of 17 noninfected and 19 HIV-infected asymptomatic female drug addicts undergoing detoxification were evaluated by measuring anthropometric and immunologic indexes. Anthropometric measurements were normal in both groups as a result of weight gain (approximately 10 kg) in every patient after the detoxification period. Leukocyte and lymphocyte values and CD2 lymphocyte subset counts were also similar in both groups. CD4 counts (P = 0.04) and the ratio of CD4 to CD8 cells (P = 0.6 x 10(-4)) were lower whereas CD8 counts (P = 0.003) were higher in the HIV-infected than in the noninfected group. Responses to a delayed-hypersensitivity skin test were below normal in both groups but significantly more so in the HIV-positive group (P = 0.05). CD19 counts were lower (P = 0.02) and values for serum immunoglobulins G and M were higher (51% and 37%, respectively) in the HIV-infected females than in the noninfected women. These results may suggest that despite anthropometric recovery, the HIV-infected women had depleted immune function, resulting not only from HIV infection but also from the subclinical malnutrition triggered by previous drug addiction.

  5. Persistent Peripheral Nervous System Damage in Simian Immunodeficiency Virus-Infected Macaques Receiving Antiretroviral Therapy.

    PubMed

    Dorsey, Jamie L; Mangus, Lisa M; Hauer, Peter; Ebenezer, Gigi J; Queen, Suzanne E; Laast, Victoria A; Adams, Robert J; Mankowski, Joseph L

    2015-11-01

    Human immunodeficiency virus (HIV)-induced peripheral neuropathy is the most common neurologic complication associated with HIV infection. In addition to virus-mediated injury of the peripheral nervous system (PNS), treatment of HIV infection with combination antiretroviral therapy (cART) may induce toxic neuropathy as a side effect. Antiretroviral toxic neuropathy is clinically indistinguishable from the sensory neuropathy induced by HIV; in some patients, these 2 processes are likely superimposed. To study these intercurrent PNS disease processes, we first established a simian immunodeficiency virus (SIV)/pigtailed macaque model in which more than 90% of animals developed PNS changes closely resembling those seen in HIV-infected individuals with distal sensory neuropathy. To determine whether cART alters the progression of SIV-induced PNS damage, dorsal root ganglia and epidermal nerve fibers were evaluated in SIV-infected macaques after long-term suppressive cART. Although cART effectively suppressed SIV replication and reduced macrophage activation in the dorsal root ganglia, PGP 9.5 immunostaining and measurements of epidermal nerve fibers in the plantar surface of the feet of treated SIV-infected macaques clearly showed that cART did not normalize epidermal nerve fiber density. These findings illustrate that significant PNS damage persists in SIV-infected macaques on suppressive cART.

  6. Lessons from the history of the human immunodeficiency virus/acquired immunodeficiency syndrome epidemic among Spanish drug injectors.

    PubMed

    De La Fuente, L; Bravo, M J; Barrio, G; Parras, F; Suárez, M; Rodés, A; Noguer, I

    2003-12-15

    In Spain, approximately 10 years passed between the time when human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) harm-reduction programs should have been developed with sufficient coverage to have an optimum impact on public health (before the HIV/AIDS epidemic's explosion in 1984) and the date of their actual implementation. This delay yielded an enormous cost for the country. The introduction of the virus in drug injector networks during a period of widespread diffusion of heroin injection and the lack of political awareness of the growing problem were 2 important factors that contributed to the important diffusion of the HIV infection among Spanish injection drug users. Lessons can be learned that may be of great interest in countries or territories facing similar challenges now and in the future.

  7. HIV infection and AIDS in China, 1985 through 1994.

    PubMed Central

    Yu, E S; Xie, Q; Zhang, K; Lu, P; Chan, L L

    1996-01-01

    OBJECTIVES. This paper analyzes data on the distribution of and risk factors for the acquired immunodeficiency syndrome (AIDS) and human immunodeficiency virus (HIV) infection in China. METHODS. Ten years of data on persons tested for HIV infection and AIDS and the proportion who tested positive were analyzed against the background of China's population count. The Chinese- and English-language literature on HIV and AIDS from 1985 through 1995 was also reviewed. RESULTS. Overall, more males than females had HIV infection. Intravenous drug use was the primary source of transmission, followed by heterosexual contacts. Only a small number of the persons tested were homosexual, but their proportion of HIV seropositivity ranked third to that of drug users; that of general hospital patients ranked fourth. CONCLUSIONS. HIV infection and AIDS in China began as a highly regionalized and largely rural problem in Yunnan Province. However, HIV infection and AIDS have become an emerging urban problem. HIV seropositivity is low among several groups thought to have an elevated risk. PMID:8712271

  8. Elevated homocysteine levels in human immunodeficiency virus-infected patients under antiretroviral therapy: A meta-analysis

    PubMed Central

    Deminice, Rafael; Silva, Talita Capoani Vieira; de Oliveira, Vitor Hugo Fernando

    2015-01-01

    AIM: To evaluate the association between the levels of homocysteine (Hcy), folate, vitamin B12 in human immunodeficiency virus (HIV)-infected patients who were treated with antiretroviral therapy (ART) or not treated with ART. METHODS: The PubMed and Scielo databases were searched. Eligible studies regarding plasma Hcy level in HIV-infected patients were firstly identified. After careful analysis by two independent researches, the identified articles were included in the review according to two outcomes (1) Hcy, folate and vitamin B12 blood concentration in HIV-infected subjects vs health controls and; (2) Hcy blood concentration in HIV-infected subjects under ART vs not treated with ART. RevMan (version 5.2) was employed for data synthesis. RESULTS: A total of 12 studies were included in outcome 1 (1649 participants, 932 cases and 717 controls). Outcome 1 meta-analysis demonstrated higher plasma Hcy (2.05 µmol/L; 95%CI: 0.10 to 4.00, P < 0.01) and decreased plasma folate concentrations (-2.74 ng/mL; 95%CI: -5.18 to -0.29, P < 0.01) in HIV-infected patients compared to healthy controls. No changes in vitamin B12 plasma concentration were observed between groups. All studies included in the outcome 2 meta-analysis (1167 participants; 404 HIV-infected exposed to ART and 757 HIV-infected non-ART patients) demonstrated higher mean Hcy concentration in subjects HIV-infected under ART compared to non-ART HIV subjects (4.13 µmol/L; 95%CI: 1.34 to 6.92, P < 0.01). CONCLUSION: This meta-analysis demonstrated that the levels of Hcy and folate, but not vitamin B12, were associated with HIV infection. In addition, Hcy levels were higher in HIV-infected patients who were under ART compared to HIV-infected patients who were not exposed to ART. Our results suggest that hyperhomocysteinemia should be included among the several important metabolic disturbances that are associated with ART in patients with HIV infection. PMID:25964880

  9. Human Immunodeficiency Virus Research Program

    DTIC Science & Technology

    1993-11-30

    disease process itself, on a realistic appraisal of the course and nature of the global epidemic, and on an accurlate assessment of the strengths and... natural history of a Anef SIVPBj isolate in macaques including virus load measurements, immune function and disease outcome. c) Determine if a Anef...an excellent animal model for human immunodeficiency disease in that the nature and course of the clinical disease are comparable and the immune

  10. Human immunodeficiency virus integration in a cell-free system.

    PubMed Central

    Ellison, V; Abrams, H; Roe, T; Lifson, J; Brown, P

    1990-01-01

    Integration of the viral genome into the nuclear DNA of a host cell plays a pivotal role in the replication of retroviruses. We have developed an in vitro method for studying the biochemistry of human immunodeficiency virus (HIV) integration by using extracts from HIV-infected cells. Analysis of the reaction products showed that HIV integration in vitro accurately reproduces the in vivo process. Integration occurred without apparent specificity for the target sequence, and the integrated provirus was directly flanked by a 5-base-pair duplication of DNA from the target site. HIV integration did not require a high-energy cofactor, and the enzymatic activities required for integration were recovered with the viral DNA when cell extracts were fractionated by gel exclusion chromatography. Images PMID:2335814

  11. Self Antigen Prognostic for Human Immunodeficiency Virus Disease Progression

    PubMed Central

    Bristow, Cynthia L.; Patel, Hirenkumar; Arnold, Roland R.

    2001-01-01

    We have recently found that an extracellular protein, α1 proteinase inhibitor (α1PI; α1 antitrypsin), is required for in vitro human immunodeficiency virus (HIV) infectivity outcome. We show here in a study of HIV-seropositive patients that decreased viral load is significantly correlated with decreased circulating α1PI. In the asymptomatic category of HIV disease, 100% of patients manifest deficient levels of active α1PI, a condition known to lead to degenerative lung diseases and a dramatically reduced life span. Further, HIV-associated α1PI deficiency is correlated with circulating anti-α1PI immunoglobulin G. These results suggest that preventing HIV-associated α1PI deficiency may provide a strategic target for preventing HIV-associated pathophysiology. PMID:11527807

  12. Sexual Assault: A Report on Human Immunodeficiency Virus Postexposure Prophylaxis

    PubMed Central

    Griffith, William F.; Ackerman, Gary E.; Zoellner, Cindy L.; Sheffield, Jeanne S.

    2010-01-01

    The objective of this report is to describe an urban county hospital human immunodeficiency virus (HIV) infection prevention protocol offering prophylactic combination antiretroviral medications to female victims of sexual assault. A retrospective chart review was conducted from June, 2007 through June, 2008 of 151 women who were prescribed antiretroviral prophylaxis by protocol. All women receiving HIV prophylaxis initially screened HIV seronegative. Of the 58 women who reported taking any HIV prophylaxis, 36 (62%) were HIV screened at 12 and/or 24 weeks and none had HIV seroconverted. Although the initiation of an HIV post exposure prophylaxis protocol for sexual assault in a county hospital population is feasible, patient follow-up for counseling and HIV serostatus evaluation is an identified barrier PMID:20706678

  13. Human immunodeficiency virus antibodies and the vaccine problem.

    PubMed

    Chiodi, F; Weiss, R A

    2014-05-01

    Despite the great advances made in controlling human immunodeficiency virus type 1 (HIV-1) infection with antiretroviral drug treatment, a safe and efficacious HIV vaccine has yet to be developed. Here, we discuss why clinical trials and vaccine development for HIV have so far been disappointing, with an emphasis on the lack of protective antibodies. We review approaches for developing appropriate HIV immunogens and the stimulation of long-lasting B-cell responses with antibody maturation. We conclude that candidate reagents in the pipeline for HIV vaccine development are unlikely to be particularly effective. Although the major funders of HIV vaccine research and development are placing increasing emphasis on clinical product development, a genuine breakthrough in preventing HIV infection through vaccines is more likely to come from novel immunogen research.

  14. Prevalence of seizures in children infected with human immunodeficiency virus.

    PubMed

    Samia, Pauline; Petersen, Reneva; Walker, Kathleen G; Eley, Brian; Wilmshurst, Jo M

    2013-03-01

    A retrospective study of 354 human immunodeficiency virus (HIV)-infected patients identified a subgroup of 27 children with seizures (7.6%, 95% confidence interval: 5.1%-10.9%). Of the total group, 13% (n = 46) had identifiable neurologic deficits and 30% (n = 107) had developmental delay. Both observations were significantly more frequent in the subgroup of patients with seizures (P < .001). The median age of patients with seizures was 20 months (range, 8-87 months) and the median baseline CD4 percentage was 13.5% (interquartile range, 8%-23%). Seizures were treated with sodium valproate (n = 11), phenobarbital (n = 3), diazepam (n = 2), lamotrigine (n = 1), and carbamazepine (n = 1). Combination therapy was required for 5 children. Suboptimal valproic acid levels were recorded for 3 patients. When resources are available, antiepileptic drug level monitoring is advised for children who require both antiepileptic and antiretroviral medications to facilitate optimal seizure management.

  15. [Physician-patient relationship in human immunodeficiency virus infection].

    PubMed

    Bryn, A; Merckx, M A

    1995-03-15

    Since the middle of this century--with, among other, the discoveries of penicillin and of streptomycin--doctors have tended to consider themselves as powerfully armed against transmissible diseases that caused so many premature deaths. The surge of human immunodeficiency virus (HIV) has bluntly faced us with a situation we have not been prepared for, but that was the daily duty of our predecessors: to care for an epidemic disease, yet without the ability to cure it; to treat infection until it provokes death unavoidably. In the face of this renewed challenge we must reconstruct forgotten relationships that we have not learnt, and that we must adapt to the circumstances of our time and to the peculiar modes of HIV transmission. This daily facet of HIV infection is not the least. It is presented here through the testimonies of a general practitioner and a psychiatrist, with the hope that any doctor will find them thoughtful and helpful.

  16. Secondary abdominal pregnancy in human immunodeficiency virus-positive woman

    PubMed Central

    Manyanga, Hudson; Lwakatare, Flora

    2016-01-01

    We report on an abdominal pregnancy in human immunodeficiency virus-positive mother, currently on antiretroviral therapy, which was discovered incidentally while training the obstetric ultrasound capacity building program. Although abdominal pregnancy is a rare form of ectopic pregnancy, it may be more common in women with HIV infection because they tend to have a higher rate of sexually transmitted diseases than the general population. The positive diagnosis of abdominal pregnancy is difficult to establish and is usually missed during prenatal assessment particularly in settings that lack routine ultrasound examination as is the case in most developing countries. For the management of abdominal pregnancy, surgical intervention is recommended and removal of the placenta is a key controversy. Ultrasonography is considered the front-line and most effective imaging method and an awareness with a high index of suspicion of abdominal pregnancy is vital for reducing associated high maternal and even higher perinatal mortality. PMID:27896258

  17. Stroke in patients with human immunodeficiency virus infection

    PubMed Central

    Tipping, Brent; de Villiers, Linda; Wainwright, Helen; Candy, Sally; Bryer, Alan

    2007-01-01

    Objective To report the nature of stroke in patients infected with human immunodeficiency virus (HIV) in a region with high HIV seroprevalence and describe HIV associated vasculopathy. Methods Patients with first ever stroke, infected with HIV and prospectively included in the stroke register of the Groote Schuur Hospital/University of Cape Town stroke unit were identified and reviewed. Results Between 2000 and 2006, 67 of the 1087 (6,1%) stroke patients were HIV infected. Of these, 91% (n = 61) were younger than 46 years. Cerebral infarction occurred in 96% (n = 64) of the HIV positive patients and intracerebral haemorrhage in 4% (n = 3). HIV infected young stroke patients did not demonstrate hypertension, diabetes, hyperlipidaemia or smoking as significant risk factors for ischaemic stroke. Infection as a risk factor for stroke was significantly more common in HIV positive patients (p = 0.018, OR 6.4, CI 3.1 to 13.2). In 52 (81%) patients with ischaemic stroke, an aetiology was determined. Primary aetiologies comprised infectious meningitides/vasculitides in 18 (28%) patients, coagulopathy in 12 (19%) patients and cardioembolism in nine (14%) patients. Multiple aetiologies were present in seven (11%) patients with ischaemic stroke. HIV associated vasculopathy was identified in 13 (20%) patients. The HIV associated vasculopathy manifested either extracranially (seven patients) as total or significant carotid occlusion or intracranially (six patients) as medium vessel occlusion, with or without fusiform aneurysmal dilation, stenosis and vessel calibre variation. Conclusion Investigation of HIV infected patients presenting with stroke will determine an aetiology in the majority of patients. In our cohort, 20% of patients demonstrated evidence of an HIV associated vasculopathy. PMID:17470469

  18. Immigration and HIV infection: a pilot study.

    PubMed

    Loue, S; Oppenheim, S

    1994-02-01

    This pilot study was conducted to determine areas in which additional education regarding the human immunodeficiency virus (HIV) is needed by the undocumented and recently immigrated HIV-infected population, and to obtain preliminary information on the ability of this community to access medical treatment for HIV. Information regarding health status, immigration status, and the use of medical services was obtained from all HIV-infected undocumented and recently immigrated individuals who sought services from a Southern California nonprofit agency between July 1, 1990 and December 31, 1990. A total of 54 such individuals presented for services. Thirteen individuals reported participating in shared needle usage for the administration of medication or vitamins, in addition to other known risk factors for HIV. Only one of these 13 individuals had access to nonemergency medical care. Additional research is necessary to determine the reasons for these needle sharing behaviors. Educational outreach is needed to address these behaviors as a possible risk factor for HIV transmission.

  19. Hepatitis E virus co-infection in HIV-infected patients in Foggia and Naples in southern Italy.

    PubMed

    Scotto, Gaetano; Grisorio, Benvenuto; Filippini, Pietro; Ferrara, Sergio; Massa, Salvatore; Bulla, Fabio; Martini, Salvatore; Filippini, Alberico; Tartaglia, Alessandra; Lo Muzio, Lorenzo; Fazio, Vincenzina

    2015-01-01

    Hepatitis E virus (HEV) infection represents an emerging infection in developed countries and is thought to be a zoonotic infection. It has recently been described as a new causative agent of acute and chronic hepatitis in immunosuppressed subjects, including HIV-infected patients. The aim of this study was to assess the sero-virological prevalence of HEV in HIV patients and in the general population as control group. A prospective and observational cohort study was carried out in two hospitals in southern Italy. The seroprevalence of HEV was determined in a cohort of 959 subjects, 509 (53%) of whom were HIV-positive patients and 450 were from the general population. Serum samples were tested for anti-HEV antibodies; repeatedly positive results were confirmed by a Western blot assay. In positive patients HEV RNA and genotypes were also determined. A total of 46 (4.8%) of the 959 serum samples examined were reactive to anti-HEV Ig and confirmed by Western blotting. The prevalence of HEV antibodies (IgG and/or IgM) was 2.7% in the control group and 6.7% in HIV-infected patients. Anti-HEV IgM was found in 6/46 (13.0%) of the anti-HEV Ig-positive serum samples, in 5/34 HIV patients and in 1/12 of the general population. No HIV-infected patient presented chronic hepatitis with HEV infection alone. This study indicates a higher circulation of HEV in HIV-infected patients, whereas a low prevalence of HEV antibodies in the general Italian population was shown. Chronic hepatitis with HEV alone was absent, while it was present in subjects with HIV-HEV, co-infected with hepatitis B virus (HBV) and/or hepatitis C virus (HCV).

  20. Relative Efficacy of a Pregnancy, Sexually Transmitted Infection, or Human Immunodeficiency Virus Prevention--Focused Intervention on Changing Sexual Risk Behavior among Young Adults

    ERIC Educational Resources Information Center

    Norton, Wynne E.; Fisher, Jeffrey D.; Amico, K. Rivet; Dovidio, John F.; Johnson, Blair T.

    2012-01-01

    Objectives: Despite findings suggesting that young adults are more concerned about experiencing an unplanned pregnancy or contracting a sexually transmitted infection (STI) than becoming human immunodeficiency virus (HIV) infected, no empirical work has investigated whether the specific focus of an intervention may be more or less efficacious at…

  1. Relative Efficacy of a Pregnancy, Sexually Transmitted Infection, or Human Immunodeficiency Virus Prevention--Focused Intervention on Changing Sexual Risk Behavior among Young Adults

    ERIC Educational Resources Information Center

    Norton, Wynne E.; Fisher, Jeffrey D.; Amico, K. Rivet; Dovidio, John F.; Johnson, Blair T.

    2012-01-01

    Objectives: Despite findings suggesting that young adults are more concerned about experiencing an unplanned pregnancy or contracting a sexually transmitted infection (STI) than becoming human immunodeficiency virus (HIV) infected, no empirical work has investigated whether the specific focus of an intervention may be more or less efficacious at…

  2. Management of Human Immunodeficiency Virus Infection in Advanced Age

    PubMed Central

    Greene, Meredith; Justice, Amy C.; Lampiris, Harry W.; Valcour, Victor

    2013-01-01

    Importance Human immunodeficiency virus (HIV)-positive patients treated with antiretroviral therapy now have increased life expectancy and develop chronic illnesses that are often seen in older HIV-negative patients. Objective To address emerging issues related to aging with HIV. Screening older adults for HIV, diagnosis of concomitant diseases, management of multiple comorbid medical illnesses, social isolation, polypharmacy, and factors associated with end-of-life care are reviewed. Evidence Acquisition Published guidelines and consensus statements were reviewed. PubMed and PsycINFO were searched between January 2000 and February 2013. Articles not appearing in the search that were referenced by reviewed articles were also evaluated. Findings The population of older HIV-positive patients is rapidly expanding. It is estimated that by 2015 one-half of the individuals in the United States with HIV will be older than age 50. Older HIV-infected patients are prone to having similar chronic diseases as their HIV-negative counterparts, as well as illnesses associated with co-infections. Medical treatments associated with these conditions, when added to an antiretroviral regimen, increase risk for polypharmacy. Care of aging HIV-infected patients involves a need to balance a number of concurrent comorbid medical conditions. Conclusions and Relevance HIV is no longer a fatal disease. Management of multiple comorbid diseases is a common feature associated with longer life expectancy in HIV-positive patients. There is a need to better understand how to optimize the care of these patients. PMID:23549585

  3. Global Considerations in Human Immunodeficiency Virus-Associated Respiratory Disease.

    PubMed

    Rylance, Jamie; Meghji, Jamilah; Miller, Robert F; Ferrand, Rashida A

    2016-04-01

    Respiratory tract infection, particularly tuberculosis, is a major cause of mortality among human immunodeficiency virus (HIV)-infected individuals. Antiretroviral therapy (ART) has resulted in a dramatic increase in survival, although coverage of HIV treatment remains low in many parts of the world. There is a concurrent growing burden of chronic noninfectious respiratory disease as a result of increased survival. Many risk factors associated with the development of respiratory disease, such as cigarette smoking and intravenous drug use, are overrepresented among people living with HIV. In addition, there is emerging evidence that HIV infection may directly cause or accelerate the course of chronic lung disease. This review summarizes the clinical spectrum and epidemiology of respiratory tract infections and noninfectious pulmonary pathologies, and factors that explain the global variation in HIV-associated respiratory disease. The potential for enhancing diagnoses of noninfective chronic conditions through the use of clinical algorithms is discussed. We also consider issues in assessment and management of HIV-related respiratory disease in view of the increasing global scale up of ART. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  4. Herpes zoster ophthalmicus in patients with human immunodeficiency virus infection.

    PubMed

    Margolis, T P; Milner, M S; Shama, A; Hodge, W; Seiff, S

    1998-03-01

    To investigate the ocular complications of herpes zoster ophthalmicus in patients with human immunodeficiency virus (HIV) infection. This was a retrospective cohort study of 48 HIV-infected patients (48 eyes) treated at San Francisco General Hospital for herpes zoster ophthalmicus from December 1985 through March 1994. All patients were initially treated with either intravenous or oral acyclovir. The median CD4 lymphocyte count at diagnosis was 48 per mm3 (range, 2 to 490 per mm3). Fifteen patients (31%) had mild or no ocular involvement. Seventeen patients (35%) had stromal keratitis, mostly mild, and two (4)% developed chronic infectious pseudodendritic keratitis. Twenty-four study patients (50%) had iritis, but only three (6%) had elevations in intraocular pressure. Two patients (4%) developed postherpetic neuralgia, and two others (4%) had zoster-associated central nervous system disease. Only two patients (4%) developed necrotizing retinitis, both in the form of the progressive outer retinal necrosis syndrome. Excluding the patients with retinitis and central nervous system disease, the rate of sight-threatening complications in our series was lower than expected. Almost one third of study patients had no ocular complications or only mild surface epithelial disease. Although the relatively low incidence of sight-threatening disease in our study population may have been a consequence of aggressive management with acyclovir, chronic infectious pseudodendritic keratitis, retinitis, and central nervous system disease, complications of ophthalmic zoster whose pathogenesis is largely a consequence of active viral replication, were particularly devastating and difficult to manage.

  5. [Changes in vertically transmitted human immunodeficiency virus infection Chile].

    PubMed

    Chávez P, Ana; Alvarez P, Ana M; Wu H, Elba; Peña D, Anamaría; Vizueta R, Eloísa

    2007-10-01

    The identification of various risk factors of vertical human immunodeficiency virus (HIV) transmission resulted in the development of strategies whose aim was to decrease the mother's viral load, to reduce her child's exposure to it during delivery, and to avoid the subsequent viral exposure due to breastfeeding. The administration of antiretroviral treatment during pregnancy, delivery and to the neonate (PACTG 076) proved to be useful. At a first stage, zidovudine was used. A triple combination therapy was then administered. Initially, the viral transmission in mothers who were enrolled in protocols for vertically transmitted HIV prophylaxis was reduced to 9.5%, whereas the last measurement carried out between 1998 and 2005, the initial figure was brought down to 2%. Nevertheless, the delivery of infected children whose mother's HIV status was unknown is still considered likely to happen. The main step to be taken to reduce HIV infection among children is to perform universal HIV tests during pregnancy, so that HIV positive pregnant patients conveniently receive proper prophylaxis. We look forward to achieving this by following the new prevention guidelines of vertically-transmitted HIV infection, developed by the Comisión Nacional del SIDA of the Chilean Health Ministry.

  6. Age at menopause and menopause-related symptoms in human immunodeficiency virus-infected Thai women.

    PubMed

    Boonyanurak, Pongrak; Bunupuradah, Torsak; Wilawan, Kittisak; Lueanyod, Aksorn; Thongpaeng, Parawee; Chatvong, Duangjai; Sophonphan, Jiratchaya; Saeloo, Siriporn; Ananworanich, Jintanat; Chaithongwongwatthana, Surasith

    2012-07-01

    There are limited data for age at menopause (AM) and menopause-related symptoms in human immunodeficiency virus (HIV)-infected Asian women. We investigated AM and menopause-related symptoms in HIV-infected Thai women. HIV-infected Thai women 40 years or older who did not receive any hormone therapy in the 8-week period preceding the study were enrolled. Participants completed the Menopause-Specific Quality of Life survey for their symptoms in the past 30 days. Menopause was defined as having the last menstrual period more than 1 year ago. Multivariate Cox proportional hazard regression analysis was used to identify factors associated with menopause. Two hundred sixty-eight HIV-infected women were enrolled; their median age was 44.6 (41.8-48.7) years, and the ratio of their Centers for Disease Control and Prevention clinical classifications (A:B:C) was 53%:34%:13%; 95% were using highly active antiretroviral therapy. The median (interquartile range [IQR]) CD4 count was 575 (437-758) cells/μL, and 93% had HIV-RNA of less than 1.7log10 copies/mL. Among the 55 women who had reached menopause, the mean (SD) AM was 47.3 (5.1) years. The mean (SD) AM in our study was earlier than the previous report of 49.5 (3.6) years in non-HIV-infected Thai women (difference, -2.2 y; 95% CI, -3.2 to -1.2, P < 0.01). Postmenopausal women had more symptoms, including night sweats (P = 0.03), change in sexual desire (P = 0.01), and avoiding intimacy (P = 0.01), compared with nonpostmenopausal women. No differences in psychosocial or physical domains between groups were found. Factors associated with menopause were Centers for Disease Control and Prevention clinical classification B or C (hazard ratio, 1.7; 95% CI, 1.0-3.03, P = 0.04), and no sexual act in the past month (hazard ratio, 4.9; 95% CI, 1.5-16.0, P = 0.01). No associations of later age of menarche, parity, marital status, educational level, income, body mass index, CD4 count, and HIV-RNA with menopause were found. AM in HIV-infected

  7. Acute and Chronic Hepatitis E Virus Infection in HIV-Infected United States Women

    PubMed Central

    Kuniholm, Mark H.; Ong, Edgar; Hogema, Boris M.; Koppelman, Marco; Anastos, Kathryn; Peters, Marion G.; Seaberg, Eric C.; Chen, Yue; Nelson, Kenrad E.; Linnen, Jeffrey M.

    2015-01-01

    Exposure to hepatitis E virus (HEV) is common in the United States (US) but there are few data on prevalence of HEV/HIV co-infection in US populations. We tested 2,919 plasma samples collected from HIV-infected (HIV+) women and men enrolled in US cohort studies for HEV viremia using a high-throughput nucleic acid testing (NAT) platform. NAT+ samples were confirmed by real-time polymerase chain reaction (PCR). Samples were selected for testing primarily on the basis of biomarkers of liver disease and immune suppression. Prevalence of HEV viremia was 3/2,606 and 0/313 in tested plasma samples collected from HIV+ women and men, respectively. All HEV isolates were genotype 3a. Based on follow-up testing of stored samples, one woman had chronic HEV infection for >4 years while 2 women had acute HEV detectable at only a single study visit. Conclusion To our knowledge this is the first reported case of chronic HEV infection in an HIV+ US individual. We also confirm that chronic HEV infection can persist despite a CD4+ count >200 cells/mm3. These data suggest that HEV infection is rare in the HIV+ US population. PMID:26646162

  8. New Antiretroviral Therapies for Pediatric HIV Infection

    PubMed Central

    Morris, Jennifer L.; Kraus, Donna M.

    2005-01-01

    Human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome affect millions of children worldwide. The development of antiretroviral therapy has significantly improved the morbidity and mortality of pediatric patients infected with HIV. Currently, 4 classes of antiretroviral agents exist: nucleoside / nucleotide reverse transcriptase inhibitors, non-nucleoside reverse transcriptase inhibitors, protease inhibitors, and entry inhibitors. A total of 21 single-entity antiretroviral agents and 4 co-formulated antiretroviral products hold Food and Drug Administration (FDA) approval for treatment of HIV-1 infection. However, not all of these agents are indicated for use in patients less than 18 years of age. Since the year 2000, 7 new antiretroviral agents (atazanavir, emtricitabine, enfuvirtide, fosamprenavir, lopinavir/ritonavir, tenofovir, and tipranavir) have been approved by the FDA for use in adult patients as part of combination therapy for the treatment of HIV-1 infection. Although only 3 of these newer agents (emtricitabine, enfuvirtide, and lopinavir/ritonavir) are currently FDA approved for use in pediatric patients, pediatric clinical studies of the other 4 new agents are currently underway. The purpose of this article is to review these 7 new antiretroviral agents and describe their roles in the treatment of pediatric HIV infection. For each drug, the following information will be addressed: FDA-approved indication and age groups, clinical efficacy, pharmacokinetics, adverse drug reactions, clinically relevant drug interactions, pediatric and adult dosing, dosage forms, administration, and place in the treatment of pediatric HIV infection. PMID:23118639

  9. Science challenging HIV infection.

    PubMed

    Rao, R R; Lakshi, V

    1993-04-01

    The first accepted report of a novel human, slow virus disease belonging to "lentivirus" known as acquired immunodeficiency syndrome can be traced to reports of June 1981. HIV-1 and HIV-2 were later found over the period 1984-86 to be unequivocally associated with AIDS. They are two serologically distinct viruses belonging to the same family with the unique properties of integration and latency in the host cell genome and the presence of reverse transcriptase. Typical of all retroviruses, the HIV genome comprises three genes governing the synthesis of all core proteins, replication protein encoding, and envelope proteins. HIV uses the CD4 antigen on T-helper cells, and about 40% of blood monocytes and tissue macrophages as a cell surface receptor. HIV may, however, also infect cells which contain no CD4. Macrophages serve as the main reservoir of HIV and may carry the virus to different organs. Very recently a rare type of white blood cell called the dendritic cell has been found to allow for direct infection by HIV during sexual intercourse. These cells are prominently present in the anal and vaginal mucosa. The authors discuss facts and figures on the HIV epidemic, the Indian scenario, classification of the clinical spectrum, the enzyme immunoassay HIV testing format, Western blot, immunofluorescence antibody, HIV culture, flow cytometry, radio immuno precipitation assay, and the detection of HIV DNA. Significant advances have been made over the last ten years in understanding the pathogenesis of HIV infection and accurately diagnosing infected individuals, with recombinant technology, polymerase chain reaction, and the construction of synthetic hybrid virus rapidly becoming part of routine diagnostics. More sensitive, specific, and rapid techniques are, however, needed for the early diagnosis and management of AIDS cases. The need for more ideal antibody incorporating both regulatory and structural proteins of the virion, preferably manufactured using

  10. Immunization of children at risk of infection with human immunodeficiency virus.

    PubMed Central

    Moss, William J.; Clements, C. John; Halsey, Neal A.

    2003-01-01

    This paper reviews the English language literature on the safety, immunogenicity and effectiveness in children infected with the human immunodeficiency virus (HIV) of vaccines currently recommended by WHO for use in national immunization programmes. Immunization is generally safe and beneficial for children infected with HIV, although HIV-induced immune suppression reduces the benefit compared with that obtained in HIV-uninfected children. However, serious complications can occur following immunization of severely immunocompromised children with bacillus Calmette-Gu rin (BCG) vaccine. The risk of serious complications attributable to yellow fever vaccine in HIV-infected persons has not been determined. WHO guidelines for immunizing children with HIV infection and infants born to HIV-infected women differ only slightly from the general guidelines. BCG and yellow fever vaccines should be withheld from symptomatic HIV-infected children. Only one serious complication (fatal pneumonia) has been attributed to measles vaccine administered to a severely immunocompromised adult. Although two HIV-infected infants have developed vaccine-associated paralytic poliomyelitis, several million infected children have been vaccinated and the evidence does not suggest that there is an increased risk. The benefits of measles and poliovirus vaccines far outweigh the potential risks in HIV-infected children. The policy of administering routine vaccines to all children, regardless of possible HIV exposure, has been very effective in obtaining high immunization coverage and control of preventable diseases. Any changes in this policy would have to be carefully examined for a potential negative impact on disease control programmes in many countries. PMID:12640478

  11. Presence of Different Hepatitis C Virus Genotypes in Plasma and Peripheral Blood Mononuclear Cell Samples of Iranian Patients with HIV Infection.

    PubMed

    Dehghani-Dehej, Farzaneh; Sarvari, Jamal; Esghaei, Maryam; Hosseini, Seyed Younes; Garshasbi, Saba; Kalantari, Saeed; Monavari, Seyed Hamidreza; Fakhim, Atousa; Keyvani, Hossein; Bokharaei-Salim, Farah

    2017-08-28

    Due to the similar routes of transmission, individuals infected with the human immunodeficiency virus (HIV) may become infected with the hepatitis C virus (HCV) simultaneously. The aim of this study was to investigate the frequency of HCV co-infection in Iranian individuals with HIV infection, and to genotype HCV in plasma and PBMC specimens of these patients. From September 2015 to October 2016, a total of 140 Iranian individuals with HIV infection were enrolled in this cross-sectional study. The RNA from plasma and PBMC specimens was extracted, and genomic HCV-RNA was amplified using RT-nested PCR with primers that target 5'-UTR. The HCV genotyping used the RFLP technique. To confirm HCV genotype, 10 randomly selected HCV-positive samples were also submitted for sequencing. The mean age of patients was 35.7 ± 13.5 years (range: 1-66). Out of 140 patients, 62 (44.3%) were positive for anti-HCV antibodies; among these, viral genomic RNA was detected in 34 (24.3%) and 39 (27.9%) of the plasma and PBMC specimens, respectively. The HCV genotyping showed a similar pattern of subtypes 1a (44% vs 46.2%), 3a (32.4% vs 33.3%) and 1b (17.6% vs 17.9%) in all sera and PBMC samples. It is noteworthy that the HCV genotypes in plasma and PBMC specimens of 6 HCV co-infected patients were not the same. This study reveals that HIV/HCV co-infection is high in Iranian patients (44.3%), especially in people who have high-risk factors (83.9%). Also, HIV/HCV co-infected individuals may have dissimilar HCV genotypes in their plasma and PBMC specimens. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  12. Skills-Based, Interactive Computer Interventions to Prevent HIV Infection Among African-American and Hispanic Adolescents

    PubMed Central

    Schinke, Steven P.; Orlandi, Mario A.

    2010-01-01

    The spread of the acquired immunodeficiency virus (AIDS) virus, human immunodeficiency virus (HIV) infection, is increasingly evident. Despite the attention that HIV infection has received, few effective prevention strategies have been developed. The present paper reviews the epidemiology of AIDS among African-American and Hispanic adolescents. From epidemiological data, the authors argue for preventive approaches to reduce the risks of HIV transmission among African-American and Hispanic adolescents. Emphasizing culturally sensitive prevention strategies, the authors describe an intervention for these adolescents that combines skills-based and interactive computer approaches. PMID:20589223

  13. Skills-Based, Interactive Computer Interventions to Prevent HIV Infection Among African-American and Hispanic Adolescents.

    PubMed

    Schinke, Steven P; Orlandi, Mario A

    1990-01-01

    The spread of the acquired immunodeficiency virus (AIDS) virus, human immunodeficiency virus (HIV) infection, is increasingly evident. Despite the attention that HIV infection has received, few effective prevention strategies have been developed. The present paper reviews the epidemiology of AIDS among African-American and Hispanic adolescents. From epidemiological data, the authors argue for preventive approaches to reduce the risks of HIV transmission among African-American and Hispanic adolescents. Emphasizing culturally sensitive prevention strategies, the authors describe an intervention for these adolescents that combines skills-based and interactive computer approaches.

  14. Liver Fibrosis during an Outbreak of Acute Hepatitis C Virus Infection in HIV-Infected Men: A Prospective Cohort Study

    PubMed Central

    Fierer, Daniel S.; Uriel, Alison J.; Carriero, Damaris C.; Klepper, Arielle; Dieterich, Douglas T.; Mullen, Michael P.; Thung, Swan N.; Fiel, M. Isabel; Branch, Andrea D.

    2015-01-01

    Outbreaks of acute hepatitis C virus (HCV) infection are occurring in HIV-infected men who have sex with men. We evaluated risk factors and liver histopathology in 11 consecutively enrolled men with newly acquired HCV infection that was diagnosed on the basis of antibody seroconversion, new elevations in alanine aminotransferase level, and wide fluctuations in HCV RNA level. Ten patients reported unprotected anal intercourse, and 7 reported “club-drug” use, including methamphetamine. Liver biopsy showed moderately advanced fibrosis (Scheuer stage 2) in 9 patients (82%). No cause of liver damage other than acute HCV infection was identified. The specific pathways leading to periportal fibrosis in HIV-infected men with newly acquired HCV infection require investigation. PMID:18627270

  15. Low immunologic response to highly active antiretroviral therapy in naive vertically human immunodeficiency virus type 1-infected children with severe immunodeficiency.

    PubMed

    Resino, Salvador; Alvaro-Meca, Alejandro; de José, Maria Isabel; Martin-Fontelos, Pablo; Gutiérrez, Maria Dolores Gurbindo; Léon, Juan Antonio; Ramos, José Tomás; Ciria, Luis; Muñoz-Fernández, Maria Angeles

    2006-04-01

    We conducted a retrospective study to analyze the CD4 recovery of naive vertically human immunodeficiency virus-infected children with severe immunodeficiency who were followed up during at least 4 years of receiving highly active antiretroviral therapy (HAART). Children with baseline CD4 of <15% did not reach a mean CD4 of > or =25% after the 4th year on HAART. We conclude that starting HAART after severe immunosuppression of naive HIV-infected children may not be effective for recovery of normal %CD4.

  16. Examination of brains of AIDS cases for human immunodeficiency virus and human cytomegalovirus nucleic acids.

    PubMed Central

    Walker, D G; Itagaki, S; Berry, K; McGeer, P L

    1989-01-01

    The role of direct virus infection as a determining factor in acquired immunodeficiency syndrome (AIDS) dementia was investigated using in situ hybridisation for human immunodeficiency virus (HIV) and human cytomegalovirus (HCMV). Four of the five AIDS dementia patients in this series demonstrated HIV infected cells distributed in widely different parts of the brain, but only one case showed HCMV infected cells. The greater abundance of HIV was in subcortical white matter in nodular areas consisting of monocyte/macrophage infiltrates. The cells were occasionally arranged as a multinucleated syncitium. In two cases, a few large cells with the appearance of neurons were positive for HIV hybridisation. By appropriate treatment with ribonuclease, it was shown that hybridisation was primarily to HIV RNA. HCMV infected cells were observed in small numbers in only one of the positive cases, suggesting that HCMV is not a determining factor in AIDS dementia. HCMV positive cells were located in the grey matter, with an appearance suggestive of neurons. Cells expressing the MHC-class II antigen HLA-DR, a marker of reactive microglia and macrophages, were observed to be extensive in affected brain sections in the one case examined. These cells were present in greater number than HIV infected cells. In this case, extensive numbers of HIV infected cells were noticed along the peripheral margin of the substantia innominata. This could indicate infection in this case of a critical brain region from the cerebrospinal fluid. Images PMID:2543795

  17. From Wasting to Obesity: The Contribution of Nutritional Status to Immune Activation in HIV Infection.

    PubMed

    Koethe, John R; Heimburger, Douglas C; PrayGod, George; Filteau, Suzanne

    2016-10-01

    The impact of human immunodeficiency virus (HIV) infection on innate and adaptive immune activation occurs in the context of host factors, which serve to augment or dampen the physiologic response to the virus. Independent of HIV infection, nutritional status, particularly body composition, affects innate immune activation through a variety of conditions, including reduced mucosal barrier defenses and microbiome dysbiosis in malnutrition and the proinflammatory contribution of adipocytes and stromal vascular cells in obesity. Similarly, T-cell activation, proliferation, and cytokine expression are reduced in the setting of malnutrition and increased in obesity, potentially due to adipokine regulatory mechanisms restraining energy-avid adaptive immunity in times of starvation and exerting a paradoxical effect in overnutrition. The response to HIV infection is situated within these complex interactions between host nutritional health and immunologic function, which contribute to the varied phenotypes of immune activation among HIV-infected patients across a spectrum from malnutrition to obesity.

  18. Different clinical presentation of community-onset bacteremia among human immunodeficiency virus-infected and human immunodeficiency virus-uninfected adults in the ED.

    PubMed

    Lee, Ching-Chi; Chu, Feng-Yuan; Ko, Wen-Chien; Chi, Chih-Hsien

    2014-10-01

    The objective of this study is to analyze the differences in clinical presentation and outcome of community-onset bacteremia between human immunodeficiency virus (HIV)-infected adults and HIV-uninfected adults visiting the emergency department (ED). A multicenter, case-control study with a ratio of 1:4 was conducted retrospectively over an 8-year period. Demographic characteristics, severity of illness, and clinical outcomes determined from chart records were analyzed. In total, 74 HIV-infected adults (case patients) and 288 HIV-uninfected adults (control patients) were examined. Significant differences in clinical presentation, severity, and the source of bacteremia as well as bacteremia-causing microorganisms between the case patients and control patients were observed by univariate analyses. Using multivariate analyses, the following variables were positively associated with case patients: male sex (odds ratio [OR], 3.42; P = .01), bacteremia due to endocarditis (OR, 7.68; P = .007), bacteremia due to Salmonella enteritidis (OR, 4.29; P = .03), and comorbidity with chronic hepatitis (OR, 5.65; P < .001). Moreover, several independent risk factors of 28-day mortality were discovered, including inappropriate empirical antibiotic therapy after the ED visit (OR, 9.01; P < .001), an initial syndrome with septic shock (OR, 5.37; P < .001); a Pittsburgh bacteremia score greater than or equal to 4 points at the ED (OR, 4.28; P = .002), severe underlying disease based on McCabe classification (rapid and ultimately fatal; OR, 3.31; P = .002), and bacteremia due to pneumonia (OR, 2.66; P = .03). Of note, HIV infection was not a significant factor affecting 28-day mortality. This study demonstrated that the clinical characteristics, the severity, and the character of bacteremia in HIV-infected and uninfected patients varied among community-onset bacteremic patients visiting the ED, despite the limited impact of HIV infection on short-term outcomes. Copyright © 2014

  19. Phylogenetic evidence for underreporting of male-to-male sex among human immunodeficiency virus-infected donors in the Netherlands and Flanders.

    PubMed

    van de Laar, Thijs J; Bezemer, Daniela; van Laethem, Kristel; Vandewalle, Giovani; de Smet, Annie; van Wijngaerden, Eric; Claas, Eric C; van Sighem, Ard I; Vandamme, Anne-Mieke; Compernolle, Veerle; Zaaijer, Hans L

    2017-05-01

    Separate transmission networks for human immunodeficiency virus (HIV) coexist. Molecular typing of viral genomes can provide insight in HIV transmission routes in donors for whom risk behavior-based donor selection failed. This study includes all HIV-infected Dutch and Flemish donors in the period 2005 to 2014 (n = 55). Part of the HIV polymerase (pol) gene was amplified, sequenced, and compared with more than 10,000 HIV strains obtained from HIV-infected Dutch and Flemish patients. The most likely transmission route was determined based on HIV phylogeny and the donor's self-reported risk behavior during the exit interview. HIV-infected donors were predominantly male (69%), were repeat donors (73%), were born in the Netherlands or Belgium (95%), and harbored HIV Subtype B (68%). Seventy-five percent of HIV-infected male donors were part of robust phylogenetic clusters linked to male-to-male sex, while only 24% of HIV-infected male donors reported male-to-male sex during posttest counseling. Sex between men and women accounted for 13% of HIV infections in male donors and 93% of HIV infections in female donors based on phylogenetic analysis. Only 40% of HIV-infected female donors had HIV Subtype B; 65% of female donors reported a foreign partner and indeed HIV sequences interspersed with sequences from HIV-endemic areas abroad, in particular sub-Saharan Africa. HIV typing helps to understand HIV transmission routes in donor populations. We found substantial underreporting of male-to-male sex among HIV-infected male donors. Donor education on HIV risk factors and the danger of window-period donations and a donor environment that encourages frank disclosure of sexual behavior will contribute to a decrease of HIV-infected donors. © 2017 AABB.

  20. Isolated homonymous hemianopsia due to presumptive cerebral tubercular abscess as the initial manifestation of human immunodeficiency virus infection.

    PubMed

    Gharai, Sujit; Venkatesh, Pradeep; Sinha, Anindita; Garg, Satpal; Ghosh, Prapti

    2012-07-01

    We report a case of isolated homonymous hemianopsia due to presumptive cerebral tubercular abscess as the initial manifestation of human immunodeficiency virus (HIV) infection. A 30-year-old man presented to our outpatient department with sudden loss of visibility in his left visual field. He had no other systemic symptoms. Perimetry showed left-sided incongruous homonymous hemianopsia denser above the horizontal meridian. Magnetic resonance imaging revealed irregular well-marginated lobulated lesions right temporo-occipital cerebral hemisphere and left high fronto-parietal cerebral hemisphere suggestive of brain tubercular abscess. Serological tests for HIV were reactive, and the patient was started only on anti-tubercular drugs with the presumptive diagnosis of cerebral tubercular abscess. Therapeutic response confirmed the diagnosis. Atypical ophthalmic manifestations may be the initial presenting feature in patients with HIV infection. This highlights the need for increased index of suspicion for HIV infection in young patients with atypical ophthalmic manifestations.

  1. Cellulitis-like symptoms manifested by bone metastasis of lung cancer in a patient living with human immunodeficiency virus.

    PubMed

    Kashima, Jumpei; Okuma, Yusuke; Watanabe, Kageaki; Ajisawa, Atushi; Hishima, Tsunekazu

    2016-09-01

    Human immunodeficiency virus (HIV)-infected patients are at a high risk of cancer compared with the general population. As the use of antiretroviral therapy (ART) has increased, non-AIDS-defining cancers have also increased in the past decade. A 61-year-old man with HIV infection on ART developed a painful, erythematous and oedematous lower left leg and an associated fever. He was initially treated with antibiotics for cellulitis but there was no improvement, which warranted further investigation. A translucent lesion was found by X-ray imaging and bone scintigraphy showed bone metastasis from a primary adenocarcinoma of the lung, documented by chest computed tomography and an axillary lymph node biopsy. The patient died three months after the diagnosis despite undergoing chemotherapy. This case demonstrates that physicians should consider metastatic malignancies as a differential diagnoses for diverse skin changes in HIV-infected patients. © The Author(s) 2015.

  2. Pediatric human immunodeficiency virus and acquired immunodeficiency syndrome: an overview.

    PubMed

    Layton, T L; Davis-McFarland, E

    2000-01-01

    This article covers the epidemiological manifestations of human immunodeficiency virus and acquired immunodeficiency syndrome (HIV/AIDS) in children, demographic statistics, and information on the three modes of virus transmission. The various opportunistic diseases and neurological dysfunction that characterize pediatric HIV are described. The Center for Disease Control pediatric HIV classification system is presented, and the developmental disorders often found in children with HIV are discussed. The Universal Disease Precautions of the American Speech and Hearing Association (ASHA) for clinicians is also presented.

  3. Modulation of apoptosis and viral latency - an axis to be well understood for successful cure of human immunodeficiency virus.

    PubMed

    Timilsina, Uddhav; Gaur, Ritu

    2016-04-01

    Human immunodeficiency virus (HIV) is the causative agent of the deadly disease AIDS, which is characterized by the progressive decline of CD4(+)T-cells. HIV-1-encoded proteins such as envelope gp120 (glycoprotein gp120), Tat (trans-activator of transcription), Nef (negative regulatory factor), Vpr (viral protein R), Vpu (viral protein unique) and protease are known to be effective in modulating host cell signalling pathways that lead to an alteration in apoptosis of both HIV-infected and uninfected bystander cells. Depending on the stage of the virus life cycle and host cell type, these viral proteins act as mediators of pro- or anti-apoptotic signals. HIV latency in viral reservoirs is a persistent phenomenon that has remained beyond the control of the human immune system. To cure HIV infections completely, it is crucial to reactivate latent HIV from cellular pools and to drive these apoptosis-resistant cells towards death. Several previous studies have reported the role of HIV-encoded proteins in apoptosis modulation, but the molecular basis for apoptosis evasion of some chronically HIV-infected cells and reactivated latently HIV-infected cells still needs to be elucidated. The current review summarizes our present understanding of apoptosis modulation in HIV-infected cells, uninfected bystander cells and latently infected cells, with a focus on highlighting strategies to activate the apoptotic pathway to kill latently infected cells.

  4. Pityriasis rubra pilaris in the setting of HIV infection: clinical behaviour and association with explosive cystic acne.

    PubMed

    Martin, A G; Weaver, C C; Cockerell, C J; Berger, T G

    1992-06-01

    The development of pityriasis rubra pilaris (PRP) in three patients with human immunodeficiency virus (HIV) infection is described. Two of the patients had onset of severe generalized cystic acne concomitant with their development of PRP. PRP and acne conglobata should be added to the group of cutaneous disorders that can present in a more virulent manner in the setting of HIV infection. The association of cystic acne with PRP and their response to treatment are discussed.

  5. Increased frequency of alpha-synuclein in the substantia nigra in human immunodeficiency virus infection.

    PubMed

    Khanlou, Negar; Moore, David J; Chana, Gursharan; Cherner, Mariana; Lazzaretto, Deborah; Dawes, Sharron; Grant, Igor; Masliah, Eliezer; Everall, Ian P

    2009-04-01

    The frequency of neurodegenerative markers among long surviving human immunodeficiency virus (HIV)-infected individuals is unknown, therefore, the present study investigated the frequency of alpha-synuclein, beta-amyloid, and HIV-associated brain pathology in the brains of older HIV-infected individuals. We examined the substantia nigra of 73 clinically well-characterized HIV-infected individuals aged 50 to 76 years from the National NeuroAIDS Tissue Consortium. We also examined the frontal and temporal cortical regions of a subset of 36 individuals. Neuritic alpha-synuclein expression was found in 16% (12/73) of the substantia nigra of the HIV+cases and none of the older control cases (0/18). beta-Amyloid deposits were prevalent and found in nearly all of the HIV+cases (35/36). Despite these increases of degenerative pathology, HIV-associated brain pathology was present in only 10% of cases. Among older HIV+adults, HIV-associated brain pathology does not appear elevated; however, the frequency of both alpha-synuclein and beta-amyloid is higher than that found in older healthy persons. The increased prevalence of alpha-synuclein and beta-amyloid in the brains of older HIV-infected individuals may predict an increased risk of developing neurodegenerative disease.

  6. Abnormalities in Resting-State Functional Connectivity in Early Human Immunodeficiency Virus Infection

    PubMed Central

    Wang, Xue; Foryt, Paul; Ochs, Renee; Chung, Jae-Hoon; Wu, Ying; Parrish, Todd

    2011-01-01

    Abstract Limited information is available concerning changes that occur in the brain early in human immunodeficiency virus (HIV) infection. This investigation evaluated resting-state functional connectivity, which is based on correlations of spontaneous blood oxygen level-dependent functional magnetic resonance imaging (fMRI) oscillations between brain regions, in 15 subjects within the first year of HIV infection and in 15 age-matched controls. Resting-state fMRI data for each session were concatenated in time across subjects to create a single 4D dataset and decomposed into 36 independent component analysis (ICA) using Multivariate Exploratory Linear Optimized Decomposition into Independent Components. ICA components were back-reconstructed for each subject's 4D data to estimate subject-specific spatial maps using the dual-regression technique. Comparison of spatial maps between HIV and controls revealed significant differences in the lateral occipital cortex (LOC) network. Reduced coactivation in left inferior parietal cortex within the LOC network was identified in the HIV subjects. Connectivity strength within this region correlated with performance on tasks involving visual-motor coordination (Grooved Pegboard and Rey Figure Copy) in the HIV group. The findings indicate prominent changes in resting-state functional connectivity of visual networks early in HIV infection. This network may sustain injury in association with the intense viremia and brain viral invasion before immune defenses can contain viral replication. Resting-state functional connectivity may have utility as a noninvasive neuroimaging biomarker for central nervous system impairment in early HIV infection. PMID:22433049

  7. "Frontal systems" behaviors in comorbid human immunodeficiency virus infection and methamphetamine dependency.

    PubMed

    Marquine, María J; Iudicello, Jennifer E; Morgan, Erin E; Brown, Gregory G; Letendre, Scott L; Ellis, Ronald J; Deutsch, Reena; Woods, Steven Paul; Grant, Igor; Heaton, Robert K

    2014-01-30

    Human immunodeficiency virus (HIV) infection and methamphetamine (MA) dependence are associated with neural injury preferentially involving frontostriatal circuits. Little is known, however, about how these commonly comorbid conditions impact behavioral presentations typically associated with frontal systems dysfunction. Our sample comprised 47 HIV-uninfected/MA-nondependent; 25 HIV-uninfected/MA-dependent; 36 HIV-infected/MA-nondependent; and 28 HIV-infected/MA-dependent subjects. Participants completed self-report measures of "frontal systems" behaviors, including impulsivity/disinhibition, sensation-seeking, and apathy. They also underwent comprehensive neurocognitive and neuropsychiatric assessments that allowed for detailed characterization of neurocognitive deficits and comorbid/premorbid conditions, including lifetime Mood and Substance Use Disorders, Attention-Deficit/Hyperactivity Disorder, and Antisocial Personality Disorder. Multivariable regression models adjusting for potential confounds (i.e., demographics and comorbid/premorbid conditions) showed that MA dependence was independently associated with increased impulsivity/disinhibition, sensation-seeking and apathy, and HIV infection with greater apathy. However, we did not see synergistic/additive effects of HIV and MA on frontal systems behaviors. Global neurocognitive impairment was relatively independent of the frontal systems behaviors, which is consistent with the view that these constructs may have relatively separable biopsychosocial underpinnings. Future research should explore whether both neurocognitive impairment and frontal systems behaviors may independently contribute to everyday functioning outcomes relevant to HIV and MA.

  8. The metabolic syndrome and HIV infection.

    PubMed

    Li Vecchi, Valentina; Maggi, Paolo; Rizzo, Manfredi; Montalto, Giuseppe

    2014-01-01

    The metabolic syndrome (MetS), a cluster of risk factors for cardiovascular disease and type 2 diabetes, has become an important public health problem. Considerable differences in the prevalence of the MetS in human immunodeficiency virus (HIV)-infected subjects have been reported, as a consequence of several limitations regarding the diagnostic critera for MetS. New evidence suggests that the use of optimal waist cut-off points specific for the various ethnic populations could represent a step forward in overcoming these limitations. Also the use of specific cut-off points for measuring upper trunk fat as an adjunctive criterion of MetS in HIV patients with lipodystrophy could represent an interesting new research topic. Although metabolic disorders have been associated indirectly with highly active antiretroviral therapy (HAART), directly with HIV infection per se or with host conditions, current circumstances could change the framework of MetS in the HIV setting: For example, the aging HIV population and newer, less metabolically toxic antiretroviral drugs. Lipotoxicity and adipokines have been focused as key issues for explaining MetS in HIV patients. Several studies have investigated the pathophysiology of MetS and cardiovascular complications in HIV infection. Evidence shows that both HIV infection per se and HIV-related chronic immune activation despite antiretroviral therapy are critical factors linking MetS and cardiovascular complications. Current epidemiological and pathogenetic data on MetS in HIV infection, prevention strategies and therapeutic options for all MetS components are reviewed in the light of the recent Adult Treatment Panel IV recommendations and the new antiretroviral drugs.

  9. HIV infection presenting as bone marrow cryptococcosis

    PubMed Central

    Dharwadkar, Arpana; Vimal, Shruti; Buch, Archana C.; Panicker, N. K.

    2014-01-01

    Disseminated cryptococcal infection is an uncommon initial manifestation in immunocompromised patients. We report a rare case of a 40-year-old female presenting with fever and burning epigastrium. Peripheral blood film revealed a leukoerythroblastic picture with thrombocytopenia. Bone marrow aspiration showed granulomas along with cryptococcal yeast forms. The ELISA test for detection of human immunodeficiency virus (HIV) antigen was positive. Disseminated cryptococcosis can develop as the first manifestation of HIV infection in previously healthy individuals and granulomas in such bone marrow aspiration smears are a valuable clue to an underlying opportunistic infection. PMID:25161991

  10. [HIV infection and AIDS in urology].

    PubMed

    Fischer, C; Miller, J; Gahr, M; Ringert, R H

    1994-05-01

    Up to December 1993, a total of 10858 AIDS cases were reported to the central AIDS registry at the Federal Health Office. Human immunodeficiency virus is acquired through needle sharing (i.v. drug users), contaminated blood transfusions, intercourse with infected persons and transplacentally by fetuses. In Germany, about seven people a day are estimated to acquire the HIV infection. Half the patients will develop systemic manifestations of AIDS within 12-13 years. Only a small percentage of these patients suffer from urological manifestations, e.g. urinary tract infection, prostatism or HIV-associated nephropathy. Nevertheless, knowledge of genitourinary pathology caused by HIV makes early diagnosis of AIDS possible.

  11. High prevalence of antibodies against hepatitis E virus in HIV-infected patients with unexplained liver disease.

    PubMed

    Merchante, Nicolás; Parra-Sánchez, Manuel; Rivero-Juárez, Antonio; Cifuentes, Celia; Camacho, Ángela; Macías, Juan; Martínez-Dueñas, Loreto; Pérez-Navarro, Elisabet; Rivero, Antonio; Pineda, Juan A

    2015-10-01

    To look for evidence of hepatitis E virus (HEV) exposure in HIV-infected patients with unexplained elevations of liver stiffness (LS). Case-control study conducted in 31 HIV-infected patients with unexplained elevations of LS and in 31 HIV-controls with normal LS, matched by age, sex and CD4 cell-counts. Serum HEV antibodies were tested by two ELISA procedures and by Immunoblot. We defined exposure to HEV as the detection of serum HEV antibodies by at least one of the two ELISA assays, provided that it was confirmed by Immunoblot. A real-time PCR RNA assay was conducted in all plasma samples to identify subjects with active HEV infection. Exposure to HEV was demonstrated, according to the criteria used in this study, in 9 (29%) of the cases, whereas it was shown in 5 (16%) of the controls (p=.3). Serum HEV RNA was detected in none of the controls and in only in one case. This patient had a documented chronic hepatitis E with progression to cirrhosis. HEV antibodies are frequently found in HIV-infected patients with unexplained liver disease. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  12. Immune-mediated cytopenias in human immunodeficiency virus: the first reported case of idiopathic aplastic anaemia successfully treated with immunosuppression.

    PubMed

    Hapgood, G; Hoy, J F; Morrissey, C O; Jane, S M

    2013-04-01

    Although isolated cytopenias are relatively common in human immunodeficiency virus (HIV), the incidence of aplastic anaemia is extremely rare. We report here the first case of a HIV-infected patient who developed severe idiopathic aplastic anaemia, and who was safely and effectively treated with anti-thymocyte globulin and cyclosporin. We briefly review immune-mediated cytopenias in HIV, including their frequency, pathophysiology and management strategies.

  13. Methicillin-resistant Staphylococcus aureus in HIV-infected patients

    PubMed Central

    Hidron, Alicia I; Kempker, Russell; Moanna, Abeer; Rimland, David

    2010-01-01

    Concordant with the emergence of methicillin-resistant Staphylococcus aureus (MRSA) in the community setting, colonization and infections with this pathogen have become a prevalent problem among the human immunodeficiency virus (HIV)-positive population. A variety of different host- and, possibly, pathogen-related factors may play a role in explaining the increased prevalence and incidence observed. In this article, we review pathophysiology, epidemiology, clinical manifestations, and treatment of MRSA in the HIV-infected population. PMID:21694896

  14. [Prevalence of hepatitis C virus antibody among newly reported HIV infection cases in Henan, 2012-2014].

    PubMed

    Liu, Jia; Fan, Panying; Xue, Xiujuan; Sun, Guoqing; Liu, Chunhua; Tian, Suian; Li, Jie; Li, Ning; Sun, Dingyong; Zhu, Qian; Wang, Zhe

    2015-11-01

    To study the prevalence of antibody to hepatitis C virus (anti-HCV) among newly reported HIV infection cases in Henan province, 2012-2014. HIV-1 BED incidence test and anti-HCV test were conducted in newly diagnosed HIV infection cases in Henan, which were reported through national AIDS information system between 1 July 2012 and 30 June 2014. The data of 4 267 newly reported HIV-1 infection cases were analyzed, the positive rate of anti-HCV was 13.19% (563/4 267). The anti HCV was highest in those infected with HIV through injection drug use (77.27%), the anti-HCV positive rates in those infected with HIV through blood donation/transfusion, heterosexual contact, homosexual contact and mother-to-child transmission were 15.06%, 15.81%, 3.74% and 8.96%, respectively. Kaifeng (32.04%), Nanyang (14.67%), Shangqiu (25.00%), Zhumadian (25.00%) and Zhoukou (18.86%) were the first five prefectures with the high anti-HCV positive rates. The anti-HCV positive rate in BED positive patients (recent HIV-1 infections) was 7.50% (86/1 146). The multivariate logistic regressions analysis revealed that BED negative, aged >40 years, being farmer, HIV infection though injection drug use and living in in Kaifeng, Nanyang, Shangqiu, Zhumadian and Zhoukou were the risk factors for HCV infection. The positive rate of anti-HCV declined between 2012-2014 in newly reported HIV infection cases in Henan, but the positive rate of anti-HCV was high in risk population and in some areas.

  15. Hepatitis B virus prevalence, risk factors and genotype distribution in HIV infected patients from West Java, Indonesia.

    PubMed

    Fibriani, Azzania; Wisaksana, Rudi; Alisjahbana, Bachti; Indrati, Agnes; Schutten, Martin; van Crevel, Reinout; van der Ven, Andre; Boucher, Charles A B

    2014-04-01

    Indonesia currently faces both an increasing HIV incidence and a high hepatitis B virus (HBV) burden. The objective of our study is to examine the prevalence, risk factors, and genotypic distribution of HBV infection among HIV infected patients in West Java, Indonesia. A cross sectional study was conducted among a cohort of HIV infected patients in 2008. Demographic and disease related variables were compared between HBV negative and positive patients. Logistic regression was applied to determine risk factors for HBV co-infection. HBV and HIV genotyping was performed in co-infected patients. Of 636 HIV-infected patients, the rate of HBV co-infection was 7%. The proportion of males was higher in HBV/HIV co-infected patients than in HIV mono-infected patients (93% vs. 72%, P=0.001). A history of injecting drug use (IDU), but not tattooing, was associated with HBV co-infection [P=0.035 OR 2.41 (95% CI 1.06-5.47)]. In the HIV and HBV treatment naive patients, CD4 cells counts <50cells/mm(3), HIV-RNA plasma ≥10,000copies/ml and AST level above normal were more often found in patients with high HBV-DNA levels (≥20,000IU/ml) as compared to those with low HBV DNA (<20.000IU/ml) (P<0.05). As in the general population, B3 was the dominant subtype in HBV co-infected patients. The prevalence of active HBV infection and the genotype distribution among HIV infected individuals is similar to the overall population in Java. However, an increased prevalence was observed in men with a history of IDU, underlining the need for routine HBV screening and monitoring. Copyright © 2014 Elsevier B.V. All rights reserved.

  16. Missed Opportunities for Prevention of Mother-to-Child Transmission of Human Immunodeficiency Virus.

    PubMed

    Scott, Gwendolyn B; Brogly, Susan B; Muenz, Daniel; Stek, Alice M; Read, Jennifer S

    2017-04-01

    To identify missed opportunities for prevention of mother-to-child transmission of human immunodeficiency virus (HIV). Data regarding HIV-infected children born between 2002 and 2009 to HIV-infected women enrolled in the U.S. International Maternal Pediatric Adolescent AIDS Clinical Trials prospective cohort study (protocol P1025) were reviewed. The characteristics of the HIV-infected infants and their mothers and the mothers' clinical management are described. Twelve cases of mother-to-child transmission of HIV occurred among 1,857 liveborn neonates, for a prevalence of 0.65 per 100 live births to HIV-infected women (95% confidence interval 0.33-1.13). Four transmissions occurred in utero, three were peripartum transmissions, and the timing of transmission for five neonates was unable to be determined. None were breastfed. Seven women had plasma viral loads greater than 400 copies/mL near delivery. Six women had less than 11 weeks of antiretroviral therapy during pregnancy; three of these women had premature deliveries. One woman received no antiretroviral therapy during pregnancy because she was diagnosed with HIV postpartum. Six had poor to moderate adherence to antiretroviral therapy. Four of the five mothers with viral loads greater than 1,000 copies/mL delivered preterm neonates. There were five women who delivered by cesarean; four were nonelective cesarean deliveries and only one was an elective cesarean delivery for HIV prevention. Despite access to high-level care and follow-up, a small proportion of HIV-infected women transmitted the virus to their neonates. This case series provides insight into factors contributing to HIV perinatal transmission and can inform the development of new strategies for prevention of mother-to-child transmission of HIV. ClinicalTrials.gov, https://clinicaltrials.gov, NCT00028145.

  17. Plasma virus load evaluation in relation to disease progression in HIV-infected children.

    PubMed

    Tetali, S; Bakshi, S; Than, S; Pahwa, S; Abrams, E; Romano, J; Pahwa, S G

    1998-05-01

    The objective of this study was to investigate the relationship of plasma HIV RNA load with survival and disease progression in HIV-infected children and to determine its correlation with cellular HIV DNA. Virus load (VL, HIV RNA copies/ml) was determined retrospectively by nucleic acid sequence-based amplification (NASBA) assay in 144 stored plasma samples between birth and 48 months in 50 children of whom 40 are alive (age range, 2-13 years). On the basis of clinical and immunologic status children were classified as rapid progressors (RPs), or nonrapid progressors (NRPs). Proviral HIV DNA quantitated by QC-PCR (quantitative competitive polymerase chain reaction) in 24 children was compared with plasma HIV RNA. At age <3 months, plasma VL <750,000 copies/ml was associated with significantly higher survival to age >2 years (p < or =0.01) compared with a VL of > or =750,000 copies/ml. Increasing mortality was observed with increasing plasma HIV RNA levels at ages 3-24 months and baseline VL of infants who died before age 24 months was significantly higher (p = 0.004) than baseline VL of those who survived beyond 24 months. Although baseline VL in infants classified as RPs was higher than that of NRPs, the difference was not statistically significant. Among surviving children 2-13 years of age, the baseline VL obtained at <24 months of age was not predictive of disease severity. Although no significant correlation was noted between plasma HIV RNA and proviral DNA, the concurrence of positive and negative results was >80%. We conclude that high plasma HIV RNA in infancy is associated with increased mortality.

  18. Incidence of hepatitis C virus infection among injection drug users during an outbreak of HIV infection

    PubMed Central

    Patrick, David M.; Tyndall, Mark W.; Cornelisse, Peter G.A.; Li, Kathy; Sherlock, Chris H.; Rekart, Michael L.; Strathdee, Steffanie A.; Currie, Sue L.; Schechter, Martin T.; O'Shaughnessy, Michael V.

    2001-01-01

    Background Beginning in 1994, Vancouver experienced an explosive outbreak of HIV infection among injection drug users (IDUs). The objectives of this study were to measure the prevalence and incidence of hepatitis C virus (HCV) infection in this context and to examine factors associated with HCV seroconversion among IDUs. Methods IDUs recruited through a study site and street outreach completed interviewer-administered questionnaires covering subjects' characteristics, behaviour, health status and service utilization and underwent serologic testing for HIV and HCV at baseline and semiannually thereafter. A Cox proportional hazards model was used to identify independent correlates of HCV seroconversion. Results As of Nov. 30, 1999, 1345 subjects had been recruited into the study cohort. The prevalence of anti-HCV antibodies was 81.6% (95% confidence interval [CI] 79.6% to 83.6%) at enrolment. Sixty-two HCV seroconversions occurred among 155 IDUs who were initially HCV negative and who returned for follow-up, for an overall incidence density rate of 29.1 per 100 person-years (95% CI 22.3 to 37.3). The HCV incidence remained above 16 per 100 person-years over 3 years of observation (December 1996 to November 1999), whereas HIV incidence declined from more than 19 to less than 5 per 100 person-years. Independent correlates of HCV seroconversion included female sex, cocaine use, injecting at least daily and frequent attendance at a needle exchange program. Interpretation Because of high transmissibility of HCV among those injecting frequently and using cocaine, the harm reduction initiatives deployed in Vancouver during the study period proved insufficient to eliminate hepatitis C transmission in this population. PMID:11599327

  19. Human immunodeficiency virus-infected subjects have no altered myocardial perfusion.

    PubMed

    Catzin-Kuhlmann, Andres; Orea-Tejeda, Arturo; Castillo-Martínez, Lilia; Colín-Ramírez, Eloisa; Asz, Daniel; Aguirre, Víctor H; Herrera, Luis E; Valles, Victoria; Aguilar-Salinas, Carlos A; Sierra, Juan; Calva, Juan J

    2007-10-31

    We assessed myocardial perfusion (blinded interpretation of a single-photon emission computed tomography) and known risk factors for atherosclerosis in 105 randomly selected human immunodeficiency virus (HIV)-infected patients in a clinic in Mexico City and in a community sample of 105 age and gender-matched infection-free subjects. An abnormal scan was obtained in 4.8% of the infected and in 7.6% of the non-infected subjects. Severity of scintigraphic abnormalities was similar in both groups. In these Mexican HIV-infected patients, despite a long time of infection and of exposure to combined antiretroviral therapy and to other classical risk factors for atherosclerosis, there was no evidence of increased risk for abnormal myocardial perfusion. Dissimilar magnitude in the hazard of coronary heart disease may occur among infected populations with different frequencies of traditional predisposing factors for cardiovascular illness.

  20. Human immunodeficiency virus infection of cells arrested in the cell cycle.

    PubMed Central

    Lewis, P; Hensel, M; Emerman, M

    1992-01-01

    Cell proliferation is necessary for proviral integration and productive infection of most retroviruses. Nevertheless, the human immunodeficiency virus (HIV) can infect non-dividing macrophages. This ability to grow in non-dividing cells is not specific to macrophages because, as we show here, CD4+ HeLa cells arrested at stage G2 of the cell cycle can be infected by HIV-1. Proliferation is necessary for these same cells to be infected by a murine retrovirus, MuLV. HIV-1 integrates into the arrested cell DNA and produces viral RNA and protein in a pattern similar to that in normal cells. In addition, our data suggest that the ability to infect non-dividing cells is due to one of the HIV-1 core virion proteins. HIV infection of non-dividing cells distinguishes lentiviruses from other retroviruses and is likely to be important in the natural history of HIV infection. Images PMID:1322294

  1. Mycobacterium avium Complex Osteomyelitis in Persons With Human Immunodeficiency Virus: Case Series and Literature Review

    PubMed Central

    Wood, Brian R.; Buitrago, Martha O.; Patel, Sugat; Hachey, David H.; Haneuse, Sebastien; Harrington, Robert D.

    2015-01-01

    In persons with advanced immunosuppression, Mycobacterium avium complex (MAC) typically causes disseminated disease with systemic symptoms. We report 2 cases in which MAC caused localized osteomyelitis in human immunodeficiency virus (HIV)-infected individuals on antiretroviral therapy with rising CD4 counts. We summarize 17 additional cases of HIV-associated MAC osteomyelitis from the literature and compare CD4 count at presentation for vertebral cases versus nonvertebral cases, which reveals a significantly higher CD4 at presentation for vertebral cases (median 251 cells/µL vs 50 cells/µL; P = .043; Mann–Whitney U test). The literature review demonstrates that the majority of cases of MAC osteomyelitis, especially vertebral, occurs in individuals with CD4 counts that have increased to above 100 cells/µL on antiretroviral therapy. Among HIV-infected individuals with osteomyelitis, MAC should be considered a possible etiology, particularly in the setting of immune reconstitution. PMID:26180837

  2. Nasopharyngeal carriage of Streptococcus pneumoniae in adults infected with human immunodeficiency virus in Jakarta, Indonesia.

    PubMed

    Harimurti, Kuntjoro; Saldi, Siti R F; Dewiasty, Esthika; Khoeri, Miftahuddin M; Yunihastuti, Evi; Putri, Tiara; Tafroji, Wisnu; Safari, Dodi

    2016-01-01

    This study investigated the distribution of serotype and antimicrobial susceptibility of Streptococcus pneumoniae carried by adults infected with human immunodeficiency virus (HIV) in Jakarta, Indonesia. Specimens of nasopharyngeal swab were collected from 200 HIV infected adults aged 21 to 63 years. Identification of S. pneumoniae was done by optochin susceptibility test and PCR for the presence of psaA and lytA genes. Serotyping was performed with sequential multiplex PCR and antibiotic susceptibility with the disk diffusion method. S. pneumoniae strains were carried by 10% adults with serotype 6A/B 20% was common serotype among cultured strains in 20 adults. Most of isolates were susceptible to chloramphenicol (80%) followed by clindamycin (75%), erythromycin (75%), penicillin (55%), and tetracycline (50%). This study found resistance to sulphamethoxazole/trimethoprim was most common with only 15% of strains being susceptible. High non-susceptibility to sulphamethoxazole/trimethoprim was observed in S. pneumoniae strains carried by HIV infected adults in Jakarta, Indonesia.

  3. Dynamics of HIV infection on 2D cellular automata

    NASA Astrophysics Data System (ADS)

    Benyoussef, A.; HafidAllah, N. El; ElKenz, A.; Ez-Zahraouy, H.; Loulidi, M.

    2003-05-01

    We use a cellular automata approach to describe the interactions of the immune system with the human immunodeficiency virus (HIV). We study the evolution of HIV infection, particularly in the clinical latency period. The results we have obtained show the existence of four different behaviours in the plane of death rate of virus-death rate of infected T cell. These regions meet at a critical point, where the virus density and the infected T cell density remain invariant during the evolution of disease. We have introduced two kinds of treatments, the protease inhibitors and the RT inhibitors, in order to study their effects on the evolution of HIV infection. These treatments are powerful in decreasing the density of the virus in the blood and the delay of the AIDS onset.

  4. Nigerian Dental Technology Students and Human Immunodeficiency Virus Infection: Knowledge, Misconceptions and Willingness to Care

    PubMed Central

    Azodo, CC; Omili, MA; Akeredolu, PA

    2014-01-01

    Background: The rehabilitative dental care is important for maintaining adequate nutrition, guarding against wasting syndrome and malnutrition among human immunodeficiency virus (HIV)-infected individuals. Aim: The aim of this study is to determine the Nigerian dental technology students’ knowledge and misconceptions about HIV infection and their willingness to care for HIV-infected patients. Subjects and Methods: This descriptive cross-sectional study of dental technology students of Federal School of Dental Therapy and Technology Enugu, Nigeria was conducted in 2010. Data was subjected to descriptive, non-parametric and parametric statistics using the statistical package for the social sciences (SPSS) version 17.0 (Chicago Illinois, USA). P < 0.05 was considered significant. Results: The knowledge about the mode of HIV transmission and prevention among the respondents was high with some misconceptions. Specifically, the misconceptions about HIV transmission through a mosquito bite (P = 0.02) and shaking of hands (P = 0.03) were higher among respondents in the higher class than those in lower class. However, 10.6% (21/198), 6.1% (12/198) and 4.0% (8/198) of the respondents erroneous described HIV as harmless, self-limitation and antibiotics responsive infection respectively. Of the respondents, 78.8% (156/198) and 83.3% (165/198) of them expressed willingness to care for HIV-infected patients and expressed need for training in the clinical care of HIV-infected patients respectively. Overall, the respondents opined that the dental therapists are the most suitable dental professional to pass HIV-related information to patients in the dental setting ahead of dentists and dental surgery assistants. Conclusion: The expressed willingness to care for HIV-infected patients, knowledge about the mode of HIV transmission and prevention among the respondents were high with existent misconceptions. There were no significant differences in the knowledge about HIV infection

  5. A Developmental Neuropsychological Model for the Study of Children with HIV Infection.

    ERIC Educational Resources Information Center

    Gioia, Gerard A.; And Others

    A developmental neuropsychological model is presented to address critical factors critical to the functional outcome in children with human immunodeficiency virus (HIV) infection. In the model, which is derived from work at the Boston Children's Hospital Acquired Immune Deficiency Syndrome (AIDS) program, neuropsychological outcomes are determined…

  6. Sexual and Drug Use Behavior in Perinatal HIV-Infected Youth: Mental Health and Family Influences

    ERIC Educational Resources Information Center

    Mellins, Claude A.; Elkington, Katherine S.; Brackis-Cott, Elizabeth; Bauermeister, Jose A.; Dolezal, Curtis; McKay, Mary; Wiznia, Andrew; Bamji, Mahrukh; Abrams, Elaine J.

    2009-01-01

    A study found that youth and caregiver mental health problem have greater impact than key environmental factors and family functioning on sex and drug use risk behaviors in perinatally human immunodeficiency virus (HIV)-infected (PHIV+) and PHIV- youths. No differences in the rates of sexual risk behavior and substance use were observed between…

  7. Guidelines for Counselling about HIV Infection and Disease. WHO AIDS Series 8.

    ERIC Educational Resources Information Center

    World Health Organization, Geneva (Switzerland).

    The present guidelines have been prepared to provide counselors, health care workers, and others with a model for use in counseling people affected directly or indirectly by Human Immunodeficiency Virus (HIV) infection and Acquired Immune Deficiency Syndrome (AIDS). The guidelines describe the nature, role, and principles of counseling, the…

  8. The Confidentiality Rights of HIV-Infected Individuals within a School.

    ERIC Educational Resources Information Center

    Adams-Nepote, Sue

    The right of Human Immunodeficiency Virus (HIV) infected students and staff members to continue in the public school system without disruption has been legally established. However, the question now lies in the legal implications of confidentiality. School districts must implement policies and procedures to ensure medical record confidentiality of…

  9. Self-Deferral, HIV Infection, and the Blood Supply: Evaluating an AIDS Intervention.

    ERIC Educational Resources Information Center

    Kaplan, Edward H.; Novick, Alvin

    1990-01-01

    This paper evaluates the effectiveness of self-deferral, a social screen implemented to protect the U.S. blood supply from human immunodeficiency virus (HIV) infection prior to the advent of laboratory testing. Mathematical models are developed to estimate the number of infectious transfusions ultimately leading to AIDS prior to self-deferral.…

  10. The Confidentiality Rights of HIV-Infected Individuals within a School.

    ERIC Educational Resources Information Center

    Adams-Nepote, Sue

    The right of Human Immunodeficiency Virus (HIV) infected students and staff members to continue in the public school system without disruption has been legally established. However, the question now lies in the legal implications of confidentiality. School districts must implement policies and procedures to ensure medical record confidentiality of…

  11. Sexual and Drug Use Behavior in Perinatal HIV-Infected Youth: Mental Health and Family Influences

    ERIC Educational Resources Information Center

    Mellins, Claude A.; Elkington, Katherine S.; Brackis-Cott, Elizabeth; Bauermeister, Jose A.; Dolezal, Curtis; McKay, Mary; Wiznia, Andrew; Bamji, Mahrukh; Abrams, Elaine J.

    2009-01-01

    A study found that youth and caregiver mental health problem have greater impact than key environmental factors and family functioning on sex and drug use risk behaviors in perinatally human immunodeficiency virus (HIV)-infected (PHIV+) and PHIV- youths. No differences in the rates of sexual risk behavior and substance use were observed between…

  12. Counseling the HIV-Infected Client: A Psychosocial Model for Assessment and Intervention.

    ERIC Educational Resources Information Center

    Hoffman, Mary Ann

    1991-01-01

    Presents model providing conceptual framework to help counselors assess client's resources for addressing psychosocial issues resulting from human immunodeficiency virus (HIV) infection. Hypothesizes that four client resources (special characteristics, social supports, situation, and client characteristics) predict or moderate client's response to…

  13. Self-Deferral, HIV Infection, and the Blood Supply: Evaluating an AIDS Intervention.

    ERIC Educational Resources Information Center

    Kaplan, Edward H.; Novick, Alvin

    1990-01-01

    This paper evaluates the effectiveness of self-deferral, a social screen implemented to protect the U.S. blood supply from human immunodeficiency virus (HIV) infection prior to the advent of laboratory testing. Mathematical models are developed to estimate the number of infectious transfusions ultimately leading to AIDS prior to self-deferral.…

  14. Combined use of an immunotoxin and cyclosporine to prevent both activated and quiescent peripheral blood T cells from producing type 1 human immunodeficiency virus.

    PubMed Central

    Bell, K D; Ramilo, O; Vitetta, E S

    1993-01-01

    Two different populations of infected T cells are present in human immunodeficiency virus (HIV)-infected individuals: activated cells that produce virions and quiescent cells that harbor the viral genome but are unable to produce virus unless they are activated. Using an in vitro model of acute HIV infection, we have evaluated the effect of depleting activated T cells with an immunotoxin and subsequently inhibiting activation of quiescent T cells with an immunosuppressive agent. CD25 (Tac, p55), the alpha chain of the interleukin 2 receptor, is expressed on activated, but not quiescent, T cells. An anti-CD25-ricin A chain immunotoxin eliminated activated, CD25+ HIV-infected cells and, thereby, inhibited viral production by these cells. Subsequent addition of cyclosporine to the residual CD25- cells prevented their activation and thereby suppressed their ability to produce virus and to propagate the infection to uninfected T cells. Images PMID:8434001

  15. Clinical training in human immunodeficiency virus disease for community physicians. The Los Angeles experience.

    PubMed Central

    Katsufrakis, P. J.; Radecki, S. E.

    1992-01-01

    In the past decade, the increased number of persons being treated for infection with the human immunodeficiency virus (HIV) has placed an enormous burden on specialty clinics. This is especially true in Los Angeles, where care of patients with the acquired immunodeficiency syndrome (AIDS) has been termed a "crisis" situation. Especially in its early stages, HIV disease can be appropriately managed by primary care physicians who provide patients with medical and psychological counseling and refer them to specialists when major AIDS-related complications develop. Physicians completing their training as recently as 5 years ago, however, received little systematic preparation in the care of HIV-infected patients and thus may lack important skills such as the ability to recognize opportunistic infections early in their course. By means of a 1-week intensive preceptorship in a high-volume AIDS clinic, we are preparing community physicians to assume a more active role in providing care for this growing patient population. In the preceptorship, participants receive one-on-one training from specialists in infectious diseases, pulmonary diseases, and hematology and oncology, as well as from internists and family physicians. Evaluation of the clinical experience demonstrated a greater level of confidence on the part of program participants in treating HIV-infected patients and showed that participants screen and test high-risk patients in their practices and devote a substantial proportion of their practices to caring for HIV-infected patients. PMID:1615654

  16. Immunopathogenesis of feline immunodeficiency virus infection in the fetal and neonatal cat

    PubMed Central

    Kolenda-Roberts, Holly M.; Kuhnt, Leah A.; Jennings, Ryan N.; Mergia, Ayalew; Gengozian, Nazareth; Johnson, Calvin M.

    2008-01-01

    The global incidence of pediatric HIV infection is estimated at 2.3 million children, most acquiring the infection from their mothers in utero, peripartum, or postpartum. Pediatric HIV infection typically causes a rapidly progressive disease when compared with adult infection, due in part to the profound susceptibility of the neonatal thymus to productive infection or degenerative changes. Failed production of naïve T-lymphocytes further limits the success of antiviral therapy to restore immunologic function. In this review, we explore the use of feline immunodeficiency virus (FIV) infection of domestic cats as an animal model for pediatric HIV infection. Cats infected with FIV represent the smallest host of a naturally occurring lentivirus, and the immunodeficiency syndrome elicited by FIV infection is similar to that of HIV-AIDS. The feline-FIV model uniquely reproduces several key aspects of immunosuppressive lentivirus infection of the thymus, allowing investigators to define viral determinants of pathogenicity, influence of host age on disease outcome, and therapeutic strategies to restore thymus function. PMID:17485330

  17. Water, electrolytes, and acid-base alterations in human immunodeficiency virus infected patients

    PubMed Central

    Musso, Carlos G; Belloso, Waldo H; Glassock, Richard J

    2016-01-01

    The clinical spectrum of human immunodeficiency virus (HIV) infection associated disease has changed significantly over the past decade, mainly due to the wide availability and improvement of combination antiretroviral therapy regiments. Serious complications associated with profound immunodeficiency are nowadays fortunately rare in patients with adequate access to care and treatment. However, HIV infected patients, and particularly those with acquired immune deficiency syndrome, are predisposed to a host of different water, electrolyte, and acid-base disorders (sometimes with opposite characteristics), since they have a modified renal physiology (reduced free water clearance, and relatively increased fractional excretion of calcium and magnesium) and they are also exposed to infectious, inflammatory, endocrinological, oncological variables which promote clinical conditions (such as fever, tachypnea, vomiting, diarrhea, polyuria, and delirium), and may require a variety of medical interventions (antiviral medication, antibiotics, antineoplastic agents), whose combination predispose them to undermine their homeostatic capability. As many of these disturbances may remain clinically silent until reaching an advanced condition, high awareness is advisable, particularly in patients with late diagnosis, concomitant inflammatory conditions and opportunistic diseases. These disorders contribute to both morbidity and mortality in HIV infected patients. PMID:26788462

  18. Pediatric human immunodeficiency virus infection. Recent evidence on the utilization and costs of health services.

    PubMed

    Hsia, D C; Fleishman, J A; East, J A; Hellinger, F J

    1995-05-01

    To measure the utilization and costs of pediatric human immunodeficiency virus (HIV)-related health care services. Cohort survey. Eight outpatient departments serving large numbers of HIV-infected children in five standard metropolitan areas with high prevalence of HIV-infected children. One hundred forty-one HIV-seropositive children older than 15 months of age or children whose clinical conditions meet the definition of acquired immunodeficiency syndrome (AIDS) at any age who visited the selected providers during the second quarter of 1991. None. Quarterly interview survey (via adult proxies) of health care services utilization during each preceding 3-month period, repeated six times between March 1991 and August 1992. Charge data were abstracted from inpatient, outpatient, home health care, and pharmacy bills. Children with AIDS averaged 1.4 hospitalizations, 16 inpatient days, two emergency department visits, 18 ambulatory care visits, 15 professional home health care visits, and one dental visit per year, generating an estimated $37,928 in annual charges. The HIV-infected children used fewer services, with annual charges of $9382. We found lower utilization than reported in prior research on pediatric HIV and similar unit costs after inflation adjustment. Increasing experience in clinical management and expanded ambulatory care may have contributed to reductions in inpatient services utilization and total costs since the mid-1980s.

  19. [Infections with human immunodeficiency viruses. Part II: Antiretroviral drugs, therapeutic options, and diagnostics].

    PubMed

    Stock, Ingo

    2011-07-01

    Infections with the human immunodeficiency virus 1 (HIV- 1) lead to the acquired immunodeficiency syndrome (AIDS), resulting in the establishment of a wide range of severe opportunistic infections. Since the introduction of the highly active antiretroviral therapy (HAART) into the treatment of HIV infections, in many cases a delayed appearance of AIDS-defining diseases is achievable. Life expectancy of antiretrovirally treated HIV-infected people applying HAART could be considerably extended and now resembles that of several other chronic diseases. For the initial treatment of HIV-1 infection, an adjunction with three antiretroviral agents is generally used. In most cases, the application of two nucleoside or nucleotide reverse transcriptase inhibitors (NRTI) together with a non-nucleoside reverse transcriptase inhibitor (NNRTI), a protease inhibitor (PI) or an integrase inhibitor (II) is recommended. Before and during antiretroviral treatment, antiretroviral drug resistances, individual tolerance profiles and the needs of the individual patient, as well as several interactions with other drugs have to be considered. Diagnostics of HIV infection is based upon the proof of specific antibodies.

  20. BK Virus Encephalitis in HIV-Infected Patients: Case Report and Review

    PubMed Central

    Antoniolli, Luciana; Borges, Rafael

    2017-01-01

    Encephalitis and meningitis due to BKPyV are unusual and emerging condition. Only a few cases of BKPyV encephalitis have been reported in hematopoietic stem cell transplant recipients, with the majority of cases presenting with concurrent hemorrhagic cystitis and HIV-infected patients. The authors report two HIV-infected patients with the diagnosis of BKPyV encephalitis and discuss the main clinical, diagnostic, and therapeutic aspects of this infection in patients with AIDS. Physicians should be aware to recognize the main clinical features and diagnose BKPyV central nervous infection in the setting of AIDS. PMID:28326104

  1. Torque Teno Midi Virus/Small Anellovirus in Sera of Healthy, HIV/HCV and HIV Infected Individuals in Lorestan Province, Iran

    PubMed Central

    Fatholahi, Maryam; Bouzari, Majid

    2015-01-01

    Background: Torque Teno Midi Virus/Small Anellovirus (TTMDV/SAV) is a member of the Gammatorquevirus genus within the family Anelloviridae. It is detected in healthy, Hepatitis B Virus, Hepatitis C Virus and HIV infected individuals and also patients with acute respiratory disease in different countries, but its role in clinical diseases and its full geographical distribution is still unclear. Objectives: The current study aimed to detect the frequency of infection with TTMDV/SAV in the sera of healthy blood donors, hepatitis C infected and HIV positive individuals in Lorestan province, Iran; and also investigate the possible role of TTMDV/SAV virus in liver diseases. Materials and Methods: Fifty two, 36, 4, and 110 serum samples from HIV positive, patients with HIV/HCV and HIV/HCV/HBV co-infections, and healthy individuals were collected in Khorramabad city, respectively. Nested-polymerase chain reaction was performed using SMAs/SMAr primers to detect TTMDV/SAV DNA. Serum aminotransferases were measured. Results: In the HIV/HCV, HIV/HCV/HBV, HIV, and control cases, 29 (80.5%), 3 (75%), 43 (82.7%), and 16 (14.5%) were positive for DNA of TTMDV/SAV, respectively. In the HIV/HCV infected cases and HIV positive cases the level of Alanine aminotransferase (ALT) and Aspartate aminotransferase (AST) were not significantly different in TTMDV/SAV infected and non-infected individuals (P > 0.05). Conclusions: Although significant differences (P < 0.01) were observed in the frequency of TTMDV/SAV between healthy controls and each of the HIV positive and HIV/HCV co-infected individuals, no significant difference was observed between HIV positive and HIV/HCV co-infected cases, which may be due to HIV associated immunodeficiency. This is the first time that TTMDV/SAV is reported in HIV infected individuals worldwide. Interpretation of the high frequency of the virus (82.7%) in HIV cases needs more detailed studies. PMID:26862377

  2. Prevention of diarrhoea in children with HIV infection or exposure to maternal HIV infection.

    PubMed

    Humphreys, Eliza H; Smith, Nathan A; Azman, Hana; McLeod, Deanna; Rutherford, George W

    2010-06-16

    Diarrhoea is a major cause of morbidity and mortality among infants and children worldwide, especially in low- and middle-income countries. Human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) is a condition that similarly disproportionately affects low- and middle-income countries; of the nearly 2.1 million children under age 15 years living with HIV/AIDS, the large majority reside in sub-Saharan Africa. Infants and children with HIV infection have more frequent and more severe diarrhoea than children without HIV. Interventions including vitamin A, zinc and cotrimoxazole may contribute substantially to preventing diarrhoea in children with HIV infection or exposure to HIV. We perform a systematic review of randomised controlled trials and nonrandomised studies that examine the effectiveness of vitamin A, zinc and cotrimoxazole on mortality and morbidity from diarrhoea in HIV-infected and -exposed infants and children. Electronic databases including Pubmed, Central and EMBASE were searched without limits to language from 1980 to April 2010. Conference database searches were performed, experts were contacted and bibliographies were handsearched. Randomised controlled trials (RCTs) and nonrandomised studies (NRSs) that examined the effectiveness of the three interventions were included. Two reviewers independently assessed citations for eligibility and double-extracted included studies. Assessment of bias of individual studies was performed independently by both reviewers. Only two summary estimates were performed due to heterogeneity in study design and interventions. Four RCTs were identified for vitamin A. One RCT was identified for zinc. One RCT and two NRSs were identified for cotrimoxazole. Vitamin A reduced mortality overall in children with HIV infection (four studies). A pooled estimate of three studies for reduction in mortality from vitamin A compared to placebo had a relative risk (DerSimonian and Laird method, random effects) of 0

  3. Human Immunodeficiency Virus: Adolescent Emergencies.

    PubMed

    Salas-Humara, Caroline; Wood, Sarah M; D'Angelo, Lawrence J; Dowshen, Nadia

    2015-12-01

    Many adolescents are at high risk for HIV infection, and those who are infected or at-risk commonly present to the ED, often as their only or frequent source of care. It is important to consider routine screening and to have a high index of suspicion for AHI in this setting. If a diagnosis of HIV infection is made, immediate linkage to care with a specialist in adolescent and young adult HIV infection should be prioritized. For the known HIV-infected patient, management must consider unique possibilities of OIs, IRIS, and medication side effects. For any patient on ART, drug-drug interactions must be noted as part of any treatment plan. If a young person presents with a recent sexual or needlestick exposure of concern, every effort to prescribe and ensure follow-up for PEP should be made. It is essential for physicians to understand and comply with local regulations regarding HIV testing and adolescents' rights for associated confidential care. Finally, physicians who see adolescents in acute care settings have a tremendous opportunity to make a difference in ensuring improved health outcomes for youth living with HIV and to prevent new infections.

  4. BK virus infection in human immunodeficiency virus-infected patients.

    PubMed

    Ledesma, J; Muñoz, P; Garcia de Viedma, D; Cabrero, I; Loeches, B; Montilla, P; Gijon, P; Rodriguez-Sanchez, B; Bouza, E

    2012-07-01

    The aim of this study is to evaluate the prevalence of BK virus (BKV) infection in HIV-positive patients receiving highly active antiretroviral therapy (HAART) in our hospital. The presence of BKV was analysed in urine and plasma samples from 78 non-selected HIV-infected patients. Clinical data were recorded using a pre-established protocol. We used a nested PCR to amplify a specific region of the BKV T-large antigen. Positive samples were quantified using real-time PCR. Mean CD4 count in HIV-infected patients was 472 cells/mm3 and median HIV viral load was <50 copies/mL. BKV viraemia was detected in only 1 HIV-positive patient, but 57.7% (45 out of 78) had BKV viruria, which was more common in patients with CD4 counts>500 cells/mm3 (74.3% vs 25.7%; p=0.007). Viruria was present in 21.7% of healthy controls (5 out of 23 samples, p=0.02). All viral loads were low (<100 copies/mL), and we could not find any association between BKV infection and renal or neurological manifestations. We provide an update on the prevalence of BKV in HIV-infected patients treated with HAART. BKV viruria was more common in HIV-infected patients; however, no role for BKV has been demonstrated in this population.

  5. GH response to GHRH plus arginine is impaired in lipoatrophic women with human immunodeficiency virus compared with controls.

    PubMed

    Zirilli, Lucia; Orlando, Gabriella; Carli, Federica; Madeo, Bruno; Cocchi, Stefania; Diazzi, Chiara; Carani, Cesare; Guaraldi, Giovanni; Rochira, Vincenzo

    2012-03-01

    GH secretion is impaired in lipodystrophic human immunodeficiency virus (HIV) patients and inversely related to lipodystrophy-related fat redistribution in men. Less is known about the underlying mechanisms involved in reduced GH secretion in HIV-infected women. A case-control, cross-sectional study comparing GH/IGF1 status, body composition, and metabolic parameters in 92 nonobese women with HIV-related lipodystrophy and 63 healthy controls matched for age, ethnicity, sex, and body mass index (BMI). GH, IGF1, IGF binding protein 3 (IGFBP3), GH after GHRH plus arginine (GHRH+Arg), several metabolic variables, and body composition were evaluated. GH response to GHRH+Arg was lower in HIV-infected females than in controls. Using a cutoff of peak GH ≤ 7.5 μg/l, 20.6% of HIV-infected females demonstrated reduced peak GH response after GHRH+Arg. In contrast, none of the control subjects demonstrated a peak GH response ≤ 7.5 μg/l. Bone mineral density (BMD), quality of life, IGF1, and IGFBP3 were lowest in the HIV-infected females with a GH peak ≤ 7.5 μg/l. BMI was the main predictive factor of GH peak in stepwise multiregression analysis followed by age, with a less significant effect of visceral fat in the HIV-infected females. This study establishes that i) GH response to GHRH+Arg is lower in lipoatrophic HIV-infected women than in healthy matched controls, ii) BMI more than visceral adipose tissue or trunk fat influences GH peak in this population, and iii) HIV-infected women with a GH peak below or equal to 7.5 μg/l demonstrate reduced IGF1, IGFBP3, BMD, and quality of life.

  6. Effects of Smoking on Non-AIDS-Related Morbidity in HIV-Infected Patients

    PubMed Central

    Shirley, Daniel K.; Kaner, Robert J.; Glesby, Marshall J.

    2013-01-01

    Tobacco smoking has many adverse health consequences. Patients with human immunodeficiency virus (HIV) infection smoke at very high rates, and many of the comorbidities associated with smoking in the general population are more prevalent in this population. It is likely that a combination of higher smoking rates along with an altered response to cigarette smoke throughout the body in persons with HIV infection leads to increased rates of the known conditions related to smoking. Several AIDS-defining conditions associated with smoking have been reviewed elsewhere. This review aims to summarize the data on non-AIDS-related health consequences of smoking in the HIV-infected population and explore evidence for the potential compounding effects on chronic systemic inflammation due to HIV infection and smoking. PMID:23572487

  7. Human papillomavirus in the HIV-infected host: epidemiology and pathogenesis in the antiretroviral era.

    PubMed

    Brickman, Cristina; Palefsky, Joel M

    2015-03-01

    Human papillomavirus (HPV) infection is associated with essentially all cervical cancers, 80-90 % of anal cancers, and a high proportion of oropharyngeal, vaginal, penile, and vulvar cancers. Malignancy is preceded by the development of precancerous lesions termed high-grade squamous intraepithelial lesions (HSIL). Men and women with human immunodeficiency virus (HIV) infection are at high risk of HPV-related malignancies. The incidence of anal cancer in particular has markedly risen during the antiretroviral era due to the increased longevity of patients with HIV and the absence of anal malignancy screening programs. HIV infection may facilitate initial HPV infection by disrupting epithelial cell tight junctions. Once infection is established, HIV may promote HSIL development via the up-regulation of HPV oncogene expression and impairment of the immune response needed to clear the lesion. HIV-infected women should be screened for cervical HSIL and cancer, and HIV-infected men and women should be considered for anal screening programs.

  8. HIV infection and risk behaviors among male port workers in Santos, Brazil.

    PubMed Central

    Larcerda, R; Stall, R; Gravato, N; Tellini, R; Hudes, E S; Hearst, N

    1996-01-01

    OBJECTIVES. This paper measured the extent to which human immunodeficiency virus (HIV) infection has spread among the male working-class population of Santos, Brazil. METHODS. Questionnaires on risk behaviors and blood tests were administered to a random sample (n = 395) of male port workers employed by the Santos Port Authority. RESULTS. Although the rate of HIV infection among these men- the working-class male population of Santos-remains low (1.1%), self-reported behavioral risks for HIV infection are common. CONCLUSIONS. There is still time to prevent a widespread outbreak of HIV infection among the hetero-sexual population of Santos and of the transportation corridors emanating from that city. PMID:8712280

  9. Periodontitis as an early presentation of HIV infection.

    PubMed Central

    Tenenbaum, H C; Mock, D; Simor, A E

    1991-01-01

    OBJECTIVE: To determine whether the presence of rapidly progressive periodontitis (RPP) in people at high risk for acquired immunodeficiency syndrome (AIDS) may be the first symptom of previously unrecognized human immunodeficiency virus (HIV) infection. DESIGN: Case series. SETTING: Dental clinic. PATIENTS: Twenty patients who presented or were referred to the dental clinic over 6 months for the treatment of unexplained RPP and were at high risk for AIDS. OUTCOME MEASURES: Diagnosis of HIV infection: identification of candidal organisms in cytologic smears, determination of complete and differential blood counts and of ratio between T4 (helper) and T8 (suppressor) lymphocytes, and performance of HIV antibody assays. MAIN RESULTS: All of the patients were men, although sex was not an inclusion criterion. Sixteen (80%) of the 20 patients were found to have HIV infection. Four had been aware that they were HIV positive: two admitted it only when their T4:T8 ratio was known and the other two when the T4:T8 test was explained or requested. Fifteen of the patients were homosexual, three came from AIDS-endemic areas, and two had hemophilia. The RPP was responsible for alveolar bone loss in all of the patients. One patient lost bone in one site because of localized osteomyelitis. Only five patients had concurrent candidal overgrowth, and three had Kaposi's sarcoma. The mean T4:T8 ratio was 0.57 (standard deviation 0.52). CONCLUSIONS: These findings suggest that periodontal disease may be one of the first clinical presentations of previously undiagnosed HIV infection. Thus, patients at high risk for AIDS who present with aggressive periodontal disease should be investigated for possible HIV infection. However, further, prospective studies are required to confirm the contention that RPP is one of the first signs of HIV infection or AIDS. Images Fig. 1 Fig. 2 Fig. 3 PMID:2025822

  10. [Clinical features of oral lesions in patients with human immunodeficiency virus infection/acquired immunodeficiency syndrome in Guangxi autonomous region].

    PubMed

    Yong, Xiangzhi; Jiang, Lanlan; Lu, Xiangchan; Liu, Wei; Wu, Nianning; Tao, Renchuan

    2014-08-01

    To investigate the features of oral lesions in patients with human immunodeficiency virus infection/acquired immunodeficiency syndrome (HIV/AIDS). A total of 127 HIV-seropositive patients were interviewed for health information and examined for their HIV-related oral lesions according to the EC Clearing House Criteria on Oral Problems related to HIV-Infection (1992). The examinations were conducted by dental specialist and HIV specialist. The CD4 T cell count in peripheral blood of the patients was tested by flow cytometry. The patients were divided into HIV- infected group (42) and AIDS group (85) according to CDC Classification System for HIV- Infected Adults and Adolescents (revised in 1993). Chi-square test was used to test the relationship between systemic disease and oral lesions, and the difference of the prevalence of oral lesions between the two groups. Among the 127 patients, oral candidiasis (51/127), oral hairy leukoplakia (24/127) were common oral manifestation. There was no relationship between the oral manifestation and systemic disease (P = 0.397). The occurrence of oral lesions and oral candidiasis was significantly different between the two groups (χ² = 7.684, P = 0.006; χ² = 14.410, P < 0.001). The CD4 count was related to the prevalence of oral lesions (P = 0.006) and oral candidasis (P = 0.003). Most oral lesions appeared before the appearance of systemic disease. Oral candidiasis and oral hairy leukoplakia were the most common lesions.Oral lesions had no relationship with systemic disease but could be still an indicator for disease progress.

  11. Role of uncontrolled HIV RNA level and immunodeficiency in the occurrence of malignancy in HIV-infected patients during the combination antiretroviral therapy era: Agence Nationale de Recherche sur le Sida (ANRS) CO3 Aquitaine Cohort.

    PubMed

    Bruyand, Mathias; Thiébaut, Rodolphe; Lawson-Ayayi, Sylvie; Joly, Pierre; Sasco, Annie Jeanne; Mercié, Patrick; Pellegrin, Jean Luc; Neau, Didier; Dabis, François; Morlat, Philippe; Chêne, Geneviève; Bonnet, Fabrice

    2009-10-01

    Human immunodeficiency virus (HIV)-infected patients are at higher risk of malignancies. In addition to traditional determinants, a specific deleterious effect of HIV and immunodeficiency is speculated. We aimed at studying the association between immunological and virological characteristics of HIV-infected patients in care and the risk of acquired immunodeficiency syndrome (AIDS)-defining and non-AIDS-defining malignancies. Patients consecutively enrolled in the hospital-based Agence Nationale de Recherche sur le Sida (ANRS) CO3 Aquitaine Cohort were included if the duration of follow-up was >3 months during the period 1998-2006. Multivariate modeling used an extended Cox proportional hazards model for time-dependent covariates and delayed entry. The 4194 patients included in the study developed 251 first malignancies during 22,389 person-years. A higher incidence of AIDS-defining malignancies (107 cases) was independently associated with (1) both longer and current exposures to a plasma HIV RNA level >500 copies/mL (hazard ratio [HR], 1.27 per year [P<.001] and 3.30 [P<.001], respectively) and (2) both longer and current exposure to a CD4(+) cell count <200 cells/mm(3) (HR, 1.36 per year [P<.001] and 6.33 [P<.001], respectively). A higher incidence of non-AIDS-defining malignancies (144 cases) was independently associated with longer and current exposure to a CD4(+) cell count <500 cells/mm(3) (HR, 1.13 per year [P=.01] and 2.07 [P<.001], respectively) and male sex (HR, 1.69; P=.02) but not with plasma HIV RNA level (P=.49 and P=.10 for cumulative and current exposures, respectively). Uncontrolled plasma HIV RNA level was independently associated with a higher likelihood of developing AIDS-defining malignancies, whereas immunosuppression was associated with a higher risk of developing any type of malignancies. Antiretroviral treatment should aim at reaching and maintaining a CD4(+) count >500 cells/mm(3) to prevent the occurrence of malignancy, this should be

  12. Cancer stage at diagnosis in patients infected with the human immunodeficiency virus and transplant recipients.

    PubMed

    Shiels, Meredith S; Copeland, Glenn; Goodman, Marc T; Harrell, Janna; Lynch, Charles F; Pawlish, Karen; Pfeiffer, Ruth M; Engels, Eric A

    2015-06-15

    It is unknown whether immunosuppression results in more aggressive, advanced stage cancers. Because cancer stage is influenced both by tumor biology and medical surveillance, the authors assessed cancer stage in individuals infected with the human immunodeficiency virus (HIV) and solid organ transplant recipients, 2 immunosuppressed groups with differences in their health care use. The authors used data on all cases of 15 cancer types diagnosed during 1996 through 2010 in 2 studies that linked US cancer registries with HIV and transplant registries. Odds ratios (ORs) for advanced (vs local) disease were estimated comparing HIV and transplant populations with immunocompetent individuals in polytomous logistic regression models adjusted for age, sex, race, registry, and year. A total of 8411 of 4.5 million cancer cases occurred in HIV-infected individuals and 7322 of 6.4 million cancer cases occurred in transplant recipients. Compared with immunocompetent patients with cancer, those infected with HIV were more likely to be diagnosed with distant stage lung (OR, 1.13), female breast (OR, 1.99), and prostate (OR, 1.57) cancers, whereas transplant recipients had fewer distant stage lung (OR, 0.54), female breast (OR, 0.75), and prostate (OR, 0.72) cancers. Both immunosuppressed populations had a shift toward advanced stage melanoma (ORs of 1.97 for HIV-infected individuals and 1.82 for transplant recipients) and bladder cancer (ORs of 1.42 for HIV-infected individuals and 1.54 for transplant recipients). Bladder cancer and melanoma were more likely to be diagnosed at a nonlocal stage in both HIV-infected individuals and transplant recipients, suggesting a role for immunosuppression in their progression. In addition, we observed a shift for some common cancers toward later stages in HIV-infected individuals and toward earlier stages in transplant recipients, which is consistent with differential access to medical care or surveillance. © 2015 American Cancer Society.

  13. Derivation and Validation of the Denver Human Immunodeficiency Virus (HIV) Risk Score for Targeted HIV Screening

    PubMed Central

    Haukoos, Jason S.; Lyons, Michael S.; Lindsell, Christopher J.; Hopkins, Emily; Bender, Brooke; Rothman, Richard E.; Hsieh, Yu-Hsiang; MacLaren, Lynsay A.; Thrun, Mark W.; Sasson, Comilla; Byyny, Richard L.

    2012-01-01

    Targeted screening remains an important approach to human immunodeficiency virus (HIV) testing. The authors aimed to derive and validate an instrument to accurately identify patients at risk for HIV infection, using patient data from a metropolitan sexually transmitted disease clinic in Denver, Colorado (1996–2008). With multivariable logistic regression, they developed a risk score from 48 candidate variables using newly identified HIV infection as the outcome. Validation was performed using an independent population from an urban emergency department in Cincinnati, Ohio. The derivation sample included 92,635 patients; 504 (0.54%) were diagnosed with HIV infection. The validation sample included 22,983 patients; 168 (0.73%) were diagnosed with HIV infection. The final score included age, gender, race/ethnicity, sex with a male, vaginal intercourse, receptive anal intercourse, injection drug use, and past HIV testing, and values ranged from −14 to +81. For persons with scores of <20, 20–29, 30–39, 40–49, and ≥50, HIV prevalences were 0.31% (95% confidence interval (CI): 0.20, 0.45) (n = 27/8,782), 0.41% (95% CI: 0.29, 0.57) (n = 36/8,677), 0.99% (95% CI: 0.63, 1.47) (n = 24/2,431), 1.59% (95% CI: 1.02, 2.36) (n = 24/1,505), and 3.59% (95% CI: 2.73, 4.63) (n = 57/1,588), respectively. The risk score accurately categorizes patients into groups with increasing probabilities of HIV infection. PMID:22431561

  14. Hypercalciuria is the main renal abnormality finding in Human Immunodeficiency Virus-infected children in Venezuela.

    PubMed

    Gonzalez, Corina; Ariceta, G; Langman, C B; Zibaoui, P; Escalona, L; Dominguez, L F; Rosas, M A

    2008-05-01

    Kidney involvement in children with Human Immunodeficiency Virus (HIV) infection is increasing in prevalence in parallel with the longer survival of HIV-infected patients and the side-effects of new antiretroviral drugs. However, there are only a few reports describing renal tubular disorders in HIV+ children. This is a cross-sectional, case series study evaluating kidney disease in 26 Venezuelan HIV-infected children. The study cohort consisted of 15 girls and 11 boys, with a median age of 5.9 years (25-75th percentile: 3.6-7.8), who had been treated with antiretrovirals for 2.8 +/- 0.4 years, Overall, the patients were short for their age and gender (Z-height: -3.1; 25-75th percentile: -4.94 to -1.98), and 15 showed signs of mild to moderate malnutrition. All of the children had a normal estimated glomerular filtration rate (136 +/- 22.6 ml/min/1.73 m2), and glomerular involvement was only observed in one patient with isolated proteinuria. None had nephromegaly. In contrast, tubular disorders were commonly found. Hypercalciuria was detected in 16 of the patients (UCa/Cr = 0.28; 25-75th percentile: 0.17-0.54 mg/mg), with five of these showing crystalluria. Eight children showed hyperchloremia, and three had frank metabolic acidosis. Kidney stones were absent in all, but one boy had bilateral medullary nephrocalcinosis. Conclusion, in Venezuelan children, HIV infection per se, or its specific treatment, was commonly associated with renal tubular dysfunction, especially hypercalciuria and acidosis, potentially leading to nephrocalcinosis and growth impairment. We recommend renal tubular evaluation during the follow-up of children with HIV infection.

  15. Severe Thrombocytopenia and Acute Cytomegalovirus Colitis during Primary Human Immunodeficiency Virus Infection

    PubMed Central

    Furuhata, Masanori; Yanagisawa, Naoki; Nishiki, Shingo; Sasaki, Shugo; Suganuma, Akihiko; Imamura, Akifumi; Ajisawa, Atsushi

    2016-01-01

    We herein report the case of a 25-year-old man who was referred to our hospital due to acute cytomegalovirus (CMV) colitis. The initial blood tests showed that the patient had concurrent primary human immunodeficiency virus (HIV) infection and severe thrombocytopenia. Raltegravir-based antiretroviral therapy (ART) was initiated without the use of ganciclovir or corticosteroids and resulted in a rapid clinical improvement. Platelet transfusions were only necessary for a short period, and subsequent colonoscopy revealed a completely healed ulcer. This case implies that ART alone could be effective for treating severe thrombocytopenia during primary HIV and CMV coinfection. PMID:27980271

  16. Subdural hematoma occurred after spinal anesthesia in a human immunodeficiency virus-infected patient

    PubMed Central

    Kim, Kyung Tae; Kim, Ji Yeon; Kim, Eun Mi; Kim, Jun Hyun

    2017-01-01

    A 25-year-old male patient who was infected with human immunodeficiency virus (HIV) underwent a condyloma excision under spinal anesthesia. The patient complained of suspicious postdural puncture headache. The patient did not respond to conservative management. Subsequently, the subdural hematoma (SDH) was found through magnetic resonance imaging. In response, an epidural blood patch was used to improve the symptoms and inhibit the enlargement of the SDH. The patient was discharged after it was confirmed that a headache had subsided without increasing SDH. Anesthesiologist should be aware of other causes of headaches after spinal anesthesia in HIV-infected patients and should carefully and accurately identify the cause. PMID:28217066

  17. Provider-initiated testing and counselling for human immunodeficiency virus among tuberculosis patients in Guangxi.

    PubMed

    Wang, X-W; Liu, Y; Dong, B-Q; Liu, F-Y; Chen, Q

    2010-07-01

    To assess the prevalence of TB-HIV (tuberculosis-human immunodeficiency virus) co-infection and the effect of provider-initiated HIV testing and counselling (PITC) strategy among TB patients, we applied the PITC strategy to recruit and investigate 2795 newly registered TB patients from 15 TB institutes in Guangxi Province, Southern China. HIV test acceptance rate and HIV positivity were respectively 99.1% and 2.2%. This study indicates that it is feasible and effective to implement PITC HIV testing in TB patients. Guangxi Province had a high burden of HIV infection among TB patients.

  18. Extensive astrocyte infection is prominent in human immunodeficiency virus-associated dementia.

    PubMed

    Churchill, Melissa J; Wesselingh, Steven L; Cowley, Daniel; Pardo, Carlos A; McArthur, Justin C; Brew, Bruce J; Gorry, Paul R

    2009-08-01

    Astrocyte infection with human immunodeficiency virus (HIV) is considered rare, so astrocytes are thought to play a secondary role in HIV neuropathogenesis. By combining double immunohistochemistry, laser capture microdissection, and highly sensitive multiplexed polymerase chain reaction to detect HIV DNA in single astrocytes in vivo, we showed that astrocyte infection is extensive in subjects with HIV-associated dementia, occurring in up to 19% of GFAP+ cells. In addition, astrocyte infection frequency correlated with the severity of neuropathological changes and proximity to perivascular macrophages. Our data indicate that astrocytes can be extensively infected with HIV, and suggest an important role for HIV-infected astrocytes in HIV neuropathogenesis.

  19. Pulmonary toxoplasmosis in human immunodeficiency virus-infected patients in the era of antiretroviral therapy.

    PubMed

    Velásquez, Jorge N; Ledesma, Bibiana A; Nigro, Monica G; Vittar, Natalia; Rueda, Nestor; De Carolis, Luis; Figueiras, Olga; Carnevale, Silvana; Corti, Marcelo

    2016-01-01

    Toxoplasmosis is a severe opportunistic infection in patients infected with the human immunodeficiency virus (HIV). The lung is a major site of infection after the central nervous system. In this report we described two cases of pneumonia due to Toxoplasma gondii infection in HIV patients with antiretroviral therapy. Clinical and radiological abnormalities are not specific. Pulmonary toxoplasmosis should be considered in HIV-infected patients with late stage of HIV, CD4 count less than 100 cells/µl and a poor adherence to HAART.

  20. Gonadal function and reproductive health in women with human immunodeficiency virus infection.

    PubMed

    Yalamanchi, Swaytha; Dobs, Adrian; Greenblatt, Ruth M

    2014-09-01

    Most human immunodeficiency virus (HIV) infections among women occur early in reproductive life, which highlights the importance of understanding the impact of HIV on reproductive functions, and also the potential implications of reproductive function and aging on the course of HIV disease. Ovarian function is a crucial component of reproductive biology in women, but standard assessment methods are of limited applicability to women with chronic diseases such as HIV. Pregnancy can now be achieved without transmission of HIV to sexual partner or newborn, but complications of pregnancy may be more common in women infected with HIV than uninfected women.

  1. Statistical behavior of time dynamics evolution of HIV infection

    NASA Astrophysics Data System (ADS)

    González, Ramón E. R.; Santos, Iury A. X.; Nunes, Marcos G. P.; de Oliveira, Viviane M.; Barbosa, Anderson L. R.

    2017-09-01

    We use the tools of the random matrix theory (RMT) to investigate the statistical behavior of the evolution of human immunodeficiency virus (HIV) infection. By means of the nearest-neighbor spacing distribution we have identified four distinct regimes of the evolution of HIV infection. We verified that at the beginning of the so-called clinical latency phase the concentration of infected cells grows slowly and evolves in a correlated way. This regime is followed by another one in which the correlation is lost and that in turn leads the system to a regime in which the increase of infected cells is faster and correlated. In the final phase, the one in which acquired immunodeficiency syndrome (AIDS) is stablished, the system presents maximum correlation as demonstrated by GOE distribution.

  2. Treatment interruptions in HIV-infected subjects.

    PubMed

    Bongiovanni, Marco; Casana, Maddalena; Tincati, Camilla; d'Arminio Monforte, Antonella

    2006-09-01

    Despite a high antiviral efficacy, the use of highly active antiretroviral therapy (HAART) in clinical practice is often impaired by the long-term toxicity of antiretroviral treatment, the increased rate of human immunodeficiency virus-1 (HIV-1) drug resistance in treated patients and the cost of therapies, so that possible interruption of HAART has to be considered as part of the current clinical practice. However, this strategy is usually followed by a rapid viral rebound with a substantial loss of CD4 T lymphocytes because the HIV suppression with HAART does not result in reconstitution of the HIV-specific immune response. Structured treatment interruption (STI) has already been investigated in HIV-infected subjects with well-controlled viral replication (initiating treatment during primary or chronic HIV infection) and in those with multiple treatment failures. A clear benefit of STI in patients with chronic infection remains controversial and these benefits are more often observed in patients starting treatment during primary HIV infection.

  3. B-cell responses to HIV infection.

    PubMed

    Moir, Susan; Fauci, Anthony S

    2017-01-01

    The induction of neutralizing antibodies directed against the human immunodeficiency virus (HIV) has received considerable attention in recent years, in part driven by renewed interest and opportunities for antibody-based strategies for prevention such as passive transfer of antibodies and the development of preventive vaccines, as well as immune-based therapeutic interventions. Advances in the ability to screen, isolate, and characterize HIV-specific antibodies have led to the identification of a new generation of potent broadly neutralizing antibodies (bNAbs). The majority of these antibodies have been isolated from B cells of chronically HIV-infected individuals with detectable viremia. In this review, we provide insight into the phenotypic and functional attributes of human B cells, with a focus on HIV-specific memory B cells and plasmablasts/cells that are responsible for sustaining humoral immune responses against HIV. We discuss the abnormalities in B cells that occur in HIV infection both in the peripheral blood and lymphoid tissues, especially in the setting of persisting viremia. Finally, we consider the opportunities and drawbacks of intensively interrogating antibodies isolated from HIV-infected individuals to guide strategies aimed at developing effective antibody-based vaccine and therapeutic interventions for HIV. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.

  4. Sulforaphane Inhibits HIV Infection of Macrophages through Nrf2

    PubMed Central

    Furuya, Andrea Kinga Marias; Sharifi, Hamayun J.; Jellinger, Robert M.; Cristofano, Paul; Shi, Binshan; de Noronha, Carlos M. C.

    2016-01-01

    Marburg virus, the Kaposi's sarcoma-associated herpesvirus (KSHV) and Dengue virus all activate, and benefit from, expression of the transcription regulator nuclear erythroid 2-related factor 2 (Nrf2). The impact of Nrf2 activation on human immunodeficiency virus (HIV) infection has not been tested. Sulforaphane (SFN), produced in cruciferous vegetables after mechanical damage, mobilizes Nrf2 to potently reprogram cellular gene expression. Here we show for the first time that SFN blocks HIV infection in primary macrophages but not in primary T cells. Similarly SFN blocks infection in PMA-differentiated promonocytic cell lines, but not in other cell lines tested. siRNA-mediated depletion of Nrf2 boosted HIV infectivity in primary macrophages and reduced the anti-viral effects of SFN treatment. This supports a model in which anti-viral activity is mediated through Nrf2 after it is mobilized by SFN. We further found that, like the type I interferon-induced cellular anti-viral proteins SAMHD1 and MX2, SFN treatment blocks infection after entry, but before formation of 2-LTR circles. Interestingly however, neither SAMHD1 nor MX2 were upregulated. This shows for the first time that Nrf2 action can potently block HIV infection and highlights a novel way to trigger this inhibition. PMID:27093399

  5. Sulforaphane Inhibits HIV Infection of Macrophages through Nrf2.

    PubMed

    Furuya, Andrea Kinga Marias; Sharifi, Hamayun J; Jellinger, Robert M; Cristofano, Paul; Shi, Binshan; de Noronha, Carlos M C

    2016-04-01

    Marburg virus, the Kaposi's sarcoma-associated herpesvirus (KSHV) and Dengue virus all activate, and benefit from, expression of the transcription regulator nuclear erythroid 2-related factor 2 (Nrf2). The impact of Nrf2 activation on human immunodeficiency virus (HIV) infection has not been tested. Sulforaphane (SFN), produced in cruciferous vegetables after mechanical damage, mobilizes Nrf2 to potently reprogram cellular gene expression. Here we show for the first time that SFN blocks HIV infection in primary macrophages but not in primary T cells. Similarly SFN blocks infection in PMA-differentiated promonocytic cell lines, but not in other cell lines tested. siRNA-mediated depletion of Nrf2 boosted HIV infectivity in primary macrophages and reduced the anti-viral effects of SFN treatment. This supports a model in which anti-viral activity is mediated through Nrf2 after it is mobilized by SFN. We further found that, like the type I interferon-induced cellular anti-viral proteins SAMHD1 and MX2, SFN treatment blocks infection after entry, but before formation of 2-LTR circles. Interestingly however, neither SAMHD1 nor MX2 were upregulated. This shows for the first time that Nrf2 action can potently block HIV infection and highlights a novel way to trigger this inhibition.

  6. Effectiveness of the South African expanded program of immunization against hepatitis B in children infected with human immunodeficiency virus-1 living in a resource-limited setting of Kwazulu-Natal.

    PubMed

    Beghin, Jean-Christophe; Ruelle, Jean; Sokal, Etienne; Bachy, Antoine; Krishna, Malini; Hall, Leslie; Goubau, Patrick; Van der Linden, Dimitri

    2017-01-01

    Prevalence of Human-Immunodeficiency-Virus/Hepatitis-B-virus (HIV/HBV) coinfection and HBV vaccination response in children are unknown in Kwazulu-Natal. This study included 183 HIV-infected and 108 HIV-uninfected children aged between 5 and 15 years screened for HBV infection and vaccination. HBV infection occurred in 2.1% and 0% of HIV-infected and uninfected children respectively. Serological response to immunization was shown in 15.8% and 61.1% of HIV-infected and uninfected children, respectively (P < 0.001). Even if prevalence of HBV infection was low in these cohorts, HIV-infected children will stay at risk of infection if the vaccine schedule is not adapted. J. Med. Virol. 89:182-185, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  7. Differential Recovery of Candida Species from Subgingival Sites in Human Immunodeficiency Virus-Positive and Healthy Children from Rio de Janeiro, Brazil

    PubMed Central

    Portela, M. B.; Souza, I. P. R.; Costa, E. M. M. B.; Hagler, A. N.; Soares, R. M. A.; Santos, A. L. S.

    2004-01-01

    The prevalence of subgingival Candida species was studied in 52 human immunodeficiency virus (HIV)-positive and 42 HIV-negative children. Candida was cultured from 22 (42.3%) and 3 (7.1%) HIV-infected and control children, respectively. C. albicans was the most common Candida species isolated from HIV-infected children, followed by C. dubliniensis, C. glabrata, and C. tropicalis. In the HIV-positive group, the prevalence of Candida isolation was significantly higher in children who presented with low CD4+-T-lymphocyte counts, elevated viral loads, and gingivitis. PMID:15583343

  8. Efficacy of an unsupervised 8-month rifampicin-containing regimen for the treatment of pulmonary tuberculosis in HIV-infected adults

    PubMed Central

    Johnson, J. L.; Okwera, A.; Nsubuga, P.; Nakibali, J. G.; Whalen, C. C.; Hom, D.; Cave, M. D.; Yang, Z. H.; Mugerwa, R. D.; Ellner, J. J.

    2010-01-01

    SUMMARY SETTING National Tuberculosis Treatment Centre, Mulago Hospital, Kampala, Uganda. OBJECTIVE To assess the efficacy of a daily, self-administered 8-month rifampicin-containing regimen for the treatment of pulmonary tuberculosis (TB) in human immunodeficiency virus (HIV) infected adults. DESIGN Treatment outcomes in patients with pulmonary TB treated with a single 8-month regimen and followed in a prospective epidemiological study. RESULTS Two hundred and sixty-five HIV-infected and 26 non-HIV-infected adults with initial episodes of pulmonary tuberculosis were treated with 2 months of daily isoniazid (INH), rifampicin (RMP), ethambutol and pyrazinamide followed by 6 months of daily INH + RMP. Median follow-up was 17.8 months. Ninety-five per cent of the HIV-infected and all of the non-HIV-infected patients who had sputum examined were sputum culture negative after 2 months of treatment. Twenty-two HIV-infected and no non-HIV-infected patients died during treatment. Relapse rates were 8.4% (5.9 per 100 person-years of observation [PYO], 95%CI 3.2–8.6) among HIV-infected patients and 4.5% (2.1/100 PYO, 95%CI 0–7.8) for non-HIV-infected patients. Adverse drug reactions occurred in 37% of the HIV-infected patients; most were minor and self-limiting. CONCLUSION An 8-month RMP-containing regimen was well tolerated and effective in the treatment of HIV-infected adults with initial episodes of pulmonary TB. Relapse rates were similar to those reported with 6-month short-course regimens in HIV-infected individuals. Decisions about the duration of anti-tuberculosis treatment for HIV-infected adults must balance programme resources and the likelihood of poor compliance with longer regimens with the potential for a modest decrease in relapses with longer treatment. PMID:11092715

  9. Oral Candida carriage and immune status in Thai human immunodeficiency virus-infected individuals.

    PubMed

    Thanyasrisung, Panida; Kesakomol, Piyanate; Pipattanagovit, Patchara; Youngnak-Piboonratanakit, Pornpan; Pitiphat, Waranuch; Matangkasombut, Oranart

    2014-05-01

    Oral candidiasis is a common opportunistic infection among human immunodeficiency virus (HIV)-infected individuals, with growing concerns about the emergence of non-albicans species with resistance to antifungal agents. This cross-sectional study determined the prevalence of oral Candida species in Thai HIV-infected adults and factors affecting their colonization. Candida species were identified from oral rinse samples of 60 HIV-infected participants of the MTCT-Plus initiative and 49 healthy controls by culture-based and molecular assays. The prevalence of oral Candida carriage was similar in HIV-infected patients (56.6 %) and in controls (55.1 %, P = 0.87). Candida albicans was the most predominant species in both groups (94.1 % of Candida carriers in HIV, 88.9 % in control). Interestingly, Candida dubliniensis was the second most common species in controls (29.6 %) and the third in HIV-infected patients (11.8 %, P = 0.08). Multivariate analysis showed that, amongst HIV-infected individuals, CD4 count <200 cells mm(-3) was associated with increased prevalence of oral carriage of both C. albicans (P = 0.03) and non-albicans species (P = 0.03). Moreover, patients with tuberculosis infection had a higher prevalence of the non-albicans species than those without (P = 0.03). Intriguingly, contraceptive use was also associated positively with non-albicans and multi-species carriage (P = 0.04 for both). However, use of antiretroviral drugs protected the patients from Candida carriage (P = 0.03), especially from C. albicans (P = 0.02). In conclusion, while HIV-infected individuals had a similar prevalence of oral Candida carriage to that of the control group, host immune status, tuberculosis infection, and contraceptive use may influence oral colonization of Candida, especially of the non-albicans species.

  10. Immune Activation Response in Chronic HIV-Infected Patients: Influence of Hepatitis C Virus Coinfection

    PubMed Central

    Márquez, Mercedes; Romero-Cores, Paula; Montes-Oca, Monserrat; Martín-Aspas, Andrés; Soto-Cárdenas, María-José; Guerrero, Francisca; Fernández-Gutiérrez, Clotilde; Girón-González, José-Antonio

    2015-01-01

    Objectives We have analyzed the parameters (bacterial translocation, immune activation and regulation, presence of HCV coinfection) which could be implicated in an inappropriate immune response from individuals with chronic HIV infection. The influence of them on the evolution of CD4+ T cell count has been investigated. Patients and methods Seventy HIV-infected patients [monoinfected by HIV (n = 20), HCV-coinfected (with (n = 25) and without (n = 25) liver cirrhosis)] and 25 healthy controls were included. Median duration of HIV infection was 20 years. HIV- and HCV-related parameters, as well as markers relative to bacterial translocation, monocyte and lymphocyte activation and regulation were considered as independent variables. Dependent variables were the increase of CD4+ T cell count during the follow-up (12 months). Results Increased values of bacterial translocation, measured by lipopolysaccharide-binding protein, monocyte and lymphocyte activation markers and T regulatory lymphocytes were detected in HIV-monoinfected and HIV/HCV coinfected patients. Serum sCD14 and IL-6 were increased in HIV/HCV-coinfected patients with liver cirrhosis in comparison with those with chronic hepatitis or HIV-monoinfected individuals. Time with undetectable HIV load was not related with these parameters. The presence of cirrhosis was negatively associated with a CD4+ T cell count increase. Conclusion In patients with a chronic HIV infection, a persistent increase of lipopolysaccharide-binding protein and monocyte and lymphocyte modifications are present. HCV-related cirrhosis is associated with more elevated serum concentrations of monocyte-derived markers. Cirrhosis influences the continued immune reconstitution of these patients. PMID:25775475

  11. REVIEW OF CONTROL OF HUMAN IMMUNODEFICIENCY VIRUS INFECTION IN NIGERIA.

    PubMed

    Dami, N; Shehu, N Y; Dami, S; Iroezindu, M O

    2015-01-01

    The global scourge of human immunodeficiency virus (HIV) infection is inundating, especially in sub-Saharan Africa and in particular Nigeria which is home to 10% of the world's HIV-infected persons. The target of the millennium development goal 6 is to halt and reverse the spread of HIV/AIDS by 2015. HIV control in Nigeria was initially shrouded in denial and apathy. Subsequently, a more pragmatic approach was launched during the tenure of President Olusegun Obasanjo. Several policies were formulated. The national prevalence of HIV witnessed some progressive decline and is currently 4.1%. There is now improvement in both HIV awareness and counselling and testing. Greater access to antiretroviral therapy and other support services have also been witnessed with over 300,000 persons currently on drugs. Notable achievements have been recorded in prevention of mother to child transmission (PMTC). However, with increased access to antiretroviral therapy, antiretroviral drug resistance has become inevitable. Acquired drug resistance is high-82% and transmitted drug resistance ranges between 0.7 and 4.5%. The achievements were largely facilitated by international partnerships which have become more streamlined in recent years. A sustained shift to indigenously sourced financial and manpower resource has become imperative. It is also important to integrate HIV facilities with other existing health care facilities for sustainability and cost-effectiveness. In an attempt to strengthen the national response, President Goodluck Ebele Jonathan launched the President's Comprehensive Response Plan for HIV/AIDS in Nigeria. It is hoped that this well-articulated policy would be well implemented to significantly reverse the epidemic.

  12. Human immune deficiency virus (HIV) infection during pregnancy at Gadarif hospital, Eastern Sudan.

    PubMed

    Adam, Gamal K; Ahmed, Mohammed Ahmed A; Ali, AbdelAziem A

    2016-10-01

    This was a prospective study conducted on all pregnant and parturient women attending Gadarif Maternity Hospital, Sudan from January 2009 to December 2013 to investigate the maternal characteristics, pregnancy outcomes and estimate of maternal to child transmission of HIV among HIV infected women. During the study period, there were 26 HIV positive mothers among 6420 tested women yielding an incidence rate of 0.4%. The majority of these 26 infected women were of urban residence (69.2%), presented with normal CD4+ T cell count; ? 350\\cu. mm3 (96.2%), had less than secondary education (57.7%) and housewives (84.6%). The mean age (SD) was significantly varied between the sero-positive and sero-negative women, 25.9 (5.7) vs. 36.1 (5.7), p = <0.001. More proportion of infected women had maternal anaemia and gave preterm birth, and none of the newborn babies was HIV infected until the age of 96 weeks. It is thus HIV infected women in eastern Sudan were young and likely desire more children.

  13. Intestinal Epithelial Barrier Disruption through Altered Mucosal MicroRNA Expression in Human Immunodeficiency Virus and Simian Immunodeficiency Virus Infections

    PubMed Central

    Gaulke, Christopher A.; Porter, Matthew; Han, Yan-Hong; Sankaran-Walters, Sumathi; Grishina, Irina; George, Michael D.; Dang, Angeline T.; Ding, Shou-Wei; Jiang, Guochun; Korf, Ian

    2014-01-01

    ABSTRACT Epithelial barrier dysfunction during human immunodeficiency virus (HIV) infection has largely been attributed to the rapid and severe depletion of CD4+ T cells in the gastrointestinal (GI) tract. Although it is known that changes in mucosal gene expression contribute to intestinal enteropathy, the role of small noncoding RNAs, specifically microRNA (miRNA), has not been investigated. Using the simian immunodeficiency virus (SIV)-infected nonhuman primate model of HIV pathogenesis, we investigated the effect of viral infection on miRNA expression in intestinal mucosa. SIV infection led to a striking decrease in the expression of mucosal miRNA compared to that in uninfected controls. This decrease coincided with an increase in 5′-3′-exoribonuclease 2 protein and alterations in DICER1 and Argonaute 2 expression. Targets of depleted miRNA belonged to molecular pathways involved in epithelial proliferation, differentiation, and immune response. Decreased expression of several miRNA involved in maintaining epithelial homeostasis in the gut was localized to the proliferative crypt region of the intestinal epithelium. Our findings suggest that SIV-induced decreased expression of miRNA involved in epithelial homeostasis, disrupted expression of miRNA biogenesis machinery, and increased expression of XRN2 are involved in the development of epithelial barrier dysfunction and gastroenteropathy. IMPORTANCE MicroRNA (miRNA) regulate the development and function of intestinal epithelial cells, and many viruses disrupt normal host miRNA expression. In this study, we demonstrate that SIV and HIV disrupt expression of miRNA in the small intestine during infection. The depletion of several key miRNA is localized to the proliferative crypt region of the gut epithelium. These miRNA are known to control expression of genes involved in inflammation, cell death, and epithelial maturation. Our data indicate that this disruption might be caused by altered expression of mi

  14. Impact of HIV infection on cardiac deformation.

    PubMed

    Mendes, Lígia; Silva, Daniela; Miranda, Carla; Sá, Joana; Duque, Luís; Duarte, Nelson; Brito, Paula; Bernardino, Leonel; Poças, José

    2014-09-01

    The aim of this study was to detect abnormalities in left ventricular myocardial function due to HIV (human immunodeficiency virus) infection without established cardiovascular disease. An echocardiogram was performed in 50 asymptomatic HIV-infected patients (age 41 ± 6 years, 64% male) and in 20 healthy individuals. Conventional echocardiography and pulsed tissue Doppler imaging (TDI) were performed according to the guidelines. The strain rate of the basal segments was obtained with color tissue Doppler and used to evaluate systolic strain rate (SRS), early diastolic strain rate (SRE) and late diastolic strain rate (SRA). Longitudinal, radial and circumferential strain were assessed by 2D speckle tracking. The mean duration of HIV infection was 10 ± 5 years, CD4 count was 579 ± 286 cells/mm³, 32% had detectable viral load, and 86% were under treatment. Of the HIV-infected patients, one had grade 1 diastolic dysfunction. The groups were not different except for E wave (HIV 0.72 ± 0.17 m/s vs. control 0.84 ± 0.16 m/s, p=0.01), longitudinal strain (-19.5 ± 1.9% vs. -21 ± 2%, p=0.005), SRS (-1.1 ± 0.28 s⁻¹ vs. -1.3 ± 0.28 s⁻¹, p=0.02) and SRE (1.8 ± 0.4 s⁻¹ vs. 2.2 ± 0.4 s⁻¹, p<0.001), but only SRS (p=0.03, 95% CI 0.036; 0.67) and SRE (p=0.001, 95% CI -0.599; -0.168) had independent value. In an HIV-infected population without established cardiovascular disease, myocardial deformation abnormalities can be detected with strain and strain rate, revealing markers of myocardial injury. Copyright © 2013 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.

  15. Position of the American Dietetic Association and Dietitians of Canada: nutrition intervention in the care of persons with human immunodeficiency virus infection.

    PubMed

    Fields-Gardner, Cade; Fergusson, Pamela

    2004-09-01

    Infection with the human immunodeficiency virus (HIV) and the development of acquired immunodeficiency syndrome (AIDS) have had a significant impact on domestic and global health, social, political, and economic outcomes. Prevention and treatment efforts to control HIV infection are more demanding than in previous decades. Achieving food and nutrition security, and managing nutrition-related complications of HIV infection and the multiple aspects of disease initiated by or surrounding HIV infection, referred to as HIV disease, remain challenges for patients and for those involved with HIV/AIDS prevention, care, and treatment efforts. Confounding clinical issues include medication interactions, coinfection with other infections and diseases, wasting, lipodystrophy, and others. Dietetics professionals, other health care professionals, and people infected with HIV will need to understand and address multiple complex aspects of HIV infection and treatment to improve survival, body functions, and overall quality of life. Individualized nutrition care plans will be an essential feature of the medical management of persons with HIV infection and AIDS.

  16. Effects of Antiretroviral Therapy to Prevent HIV Transmission to Women in Couples Attempting Conception When the Man Has HIV Infection - United States, 2017.

    PubMed

    Brooks, John T; Kawwass, Jennifer F; Smith, Dawn K; Kissin, Dmitry M; Lampe, Margaret; Haddad, Lisa B; Boulet, Sheree L; Jamieson, Denise J

    2017-08-18

    Existing U.S. guidelines recommend that men with human immunodeficiency virus (HIV) infection should achieve virologic suppression* with effective antiretroviral therapy (ART) before attempting conception (1). Clinical studies have demonstrated that effective ART profoundly reduces the risk for HIV transmission (2-4). This information might be useful for counseling couples planning a pregnancy in which the man has HIV infection and the woman does not (i.e., a mixed HIV-status couple, often referred to as a serodiscordant couple).

  17. Optimization of Human Immunodeficiency Virus Treatment During Incarceration

    PubMed Central

    Meyer, Jaimie P.; Cepeda, Javier; Wu, Johnny; Trestman, Robert L.; Altice, Frederick L.; Springer, Sandra A.

    2014-01-01

    IMPORTANCE Human immunodeficiency virus (HIV) management in correctional settings is logistically feasible, but HIV-related outcomes before release have not been recently systematically examined. OBJECTIVE To evaluate HIV treatment outcomes throughout incarceration, including jail and prison. DESIGN, SETTING, AND PARTICIPANTS Retrospective cohort study of longitudinally linked demographic, pharmacy, and laboratory data on 882 prisoners within the Connecticut Department of Correction (2005–2012) with confirmed HIV infection, who were continually incarcerated 90 days or more, had at least 2 HIV-1 RNA and CD4 lymphocyte measurements, and were prescribed antiretroviral therapy. MAIN OUTCOMES AND MEASURES Three electronic databases (correctional, laboratory, and pharmacy) were integrated to assess HIV viral suppression (HIV-1 RNA levels, <400 copies/mL) on intake and release. Secondary outcomes were mean change in log-transformed HIV-1 RNA levels and mean change in CD4 lymphocyte count during incarceration. Demographic characteristics, prescribed pharmacotherapies, receipt of directly observed therapy, and duration of incarceration were analyzed as possible explanatory variables for HIV viral suppression in logistic regression models. RESULTS Among 882 HIV-infected prisoners with 1185 incarceration periods, mean HIV-1 RNA level decreased by 1.1 log10 and CD4 lymphocyte count increased by 98 cells/μL over time, with a higher proportion achieving viral suppression by release compared with entry (70.0% vs 29.8%; P < .001); 36.9% of antiretroviral therapy (ART) regimens were changed during incarceration. After adjusting for baseline HIV-1 RNA level, prerelease viral suppression correlated with female sex (adjusted odds ratio, 1.81; 95% CI, 1.26–2.59) and psychiatric disorder severity below the sample median (adjusted odds ratio, 1.50; 95% CI, 1.12–1.99), but not race/ethnicity, incarceration duration, ART regimen or dosing strategy, or directly observed therapy

  18. Association of herpes simplex virus type 2 infection and syphilis with human immunodeficiency virus infection among men who have sex with men in Peru.

    PubMed

    Lama, Javier R; Lucchetti, Aldo; Suarez, Luis; Laguna-Torres, Victor A; Guanira, Juan V; Pun, Monica; Montano, Silvia M; Celum, Connie L; Carr, Jean K; Sanchez, Jorge; Bautista, Christian T; Sanchez, Jose L

    2006-11-15

    We evaluated associations between human immunodeficiency virus (HIV) infection, herpes simplex virus type 2 (HSV-2) infection, and syphilis among men who have sex with men (MSM) in Peru. A surveillance survey of 3280 MSM was conducted; sexual behavior was assessed with a structured computer-assisted self-interview, and serum antibody testing was performed for HIV, HSV-2, and Treponema pallidum. HIV, HSV-2, and syphilis seroprevalences of 13.9%, 46.3%, and 13.4% were detected, respectively. HSV-2 seroprevalence was twice as high in HIV-infected subjects (80.5%) than it was in HIV-uninfected subjects (40.8%) (P < .01), and HSV-2 seropositivity (adjusted odds ratio [AOR], 5.66) was found to be strongly associated with HIV infection. In addition, homosexual self-definition (AOR, 3.12), exchange of sex for money (AOR, 1.61), unprotected sex (no condom) (AOR, 2.81), history of sex work (AOR, 1.89), oral receptive sex (AOR, 1.43), and cocaine use before/during sex (AOR, 2.53) within the preceding 6 months, as well as such sexually transmitted infections (STIs) and STI syndromes as proctitis (AOR, 2.80), genital ulcer disease (GUD) (AOR, 2.06), prior syphilis (AOR, 2.64), genital warts (AOR, 1.70), and self-reported STIs within the preceding 6 months (AOR, 1.61), were also found to be significant predictors of HIV infection. We found a strong association between HSV-2 seropositivity and HIV infection. Intervention measures against GUD due to HSV-2 infection and syphilis, such as routine testing, early detection, HSV-2 suppressive treatment, and condom distribution, need to be enhanced as part of STI prevention strategies at a national level to effectively reduce HIV infection among MSM in Peru.

  19. Microbial Translocation and Inflammation Occur in Hyperacute Immunodeficiency Virus Infection and Compromise Host Control of Virus Replication

    PubMed Central

    DiNapoli, Sarah R.; Greene, Justin M.; Lehrer-Brey, Gabrielle; Gieger, Samantha M.; Buechler, Connor R.; Crosno, Kristin A.; Peterson, Eric J.; Wiseman, Roger W.; Estes, Jacob D.; Sacha, Jonah B.; Brenchley, Jason M.; O’Connor, David H.

    2016-01-01

    Within the first three weeks of human immunodeficiency virus (HIV) infection, virus replication peaks in peripheral blood. Despite the critical, causal role of virus replication in determining transmissibility and kinetics of progression to acquired immune deficiency syndrome (AIDS), there is limited understanding of the conditions required to transform the small localized transmitted founder virus population into a large and heterogeneous systemic infection. Here we show that during the hyperacute “pre-peak” phase of simian immunodeficiency virus (SIV) infection in macaques, high levels of microbial DNA transiently translocate into peripheral blood. This, heretofore unappreciated, hyperacute-phase microbial translocation was accompanied by sustained reduction of lipopolysaccharide (LPS)-specific antibody titer, intestinal permeability, increased abundance of CD4+CCR5+ T cell targets of virus replication, and T cell activation. To test whether increasing gastrointestinal permeability to cause microbial translocation would amplify viremia, we treated two SIV-infected macaque ‘elite controllers’ with a short-course of dextran sulfate sodium (DSS)–stimulating a transient increase in microbial translocation and a prolonged recrudescent viremia. Altogether, our data implicates translocating microbes as amplifiers of immunodeficiency virus replication that effectively undermine the host’s capacity to contain infection. PMID:27926931

  20. Stages of HIV Infection

    MedlinePlus

    ... Infection Subscribe Translate Text Size Print Stages of HIV Infection How Does HIV Progress in Your Body? Without treatment, HIV advances ... are the three stages of HIV infection: Acute HIV Infection Stage Within 2-4 weeks after HIV ...

  1. Preventing opportunistic infections in human immunodeficiency virus-infected persons: implications for the developing world.

    PubMed

    Kaplan, J E; Hu, D J; Holmes, K K; Jaffe, H W; Masur, H; De Cock, K M

    1996-07-01

    More than 18 million persons in the world are estimated to have been infected with human immunodeficiency virus (HIV), the cause of the acquired immunodeficiency syndrome (AIDS). As immunodeficiency progresses, these persons become susceptible to a wide variety of opportunistic infections (OIs) The spectrum of OIs varies among regions of the world. Tuberculosis is the most common serious OI in sub-Saharan Africa and is also more common in Latin America and in Asia than in the United States. Bacterial and parasitic infections are prevalent in Africa; protozoal infections such as toxoplasmosis, cryptosporidiosis, and isosporiasis are also common in Latin America. Fungal infections, including cryptococcosis and Penicillium marneffei infection, appear to be prevalent in Southeast Asia. Despite limited health resources in these regions, some measures that are recommended to prevent OIs in the United States may be useful for prolonging and improving the quality of life of HIV-infected persons. These include trimethoprim-sulfamethoxazole to prevent Pneumocystis carinii pneumonia, toxoplasmosis, and bacterial infections; isoniazid to prevent tuberculosis; and 23-valent pneumococcal vaccine to prevent disease due to Streptococcus pneumoniae. Research is needed to determine the spectrum of OIs and the efficacy of various prevention measures in resource-poor nations, and health officials need to determine a minimum standard of care for HIV-infected persons. An increasing problem in the developing world, HIV/AIDS should receive attention comparable to other tropical diseases.

  2. Infection of nonlymphoid cells by human immunodeficiency virus type 1 or type 2.

    PubMed Central

    Ikeuchi, K; Kim, S; Byrn, R A; Goldring, S R; Groopman, J E

    1990-01-01

    Human epithelial cells (L132) derived from embryonic lung and human lung fibroblasts (MRC5) were infected by human immunodeficiency virus type 1 (HIV-1) or type 2 (HIV-2). Surface CD4 protein was detected on these cells, and recombinant soluble CD4 (sCD4) blocked infection, indicating that HIV infection was mediated by the cell surface CD4 protein. In contrast, infection of human primary chondrocyte cells (C23), synovial cells (HSA), and foreskin fibroblasts (F13) was apparently independent of cell CD4-mediated mechanisms. Surface CD4 protein could not be detected on these cells, and sCD4 did not block the infection. F13 cells could be infected only by HIV-2, not by HIV-1, under our experimental conditions. In cells of mesenchymal orgin, viral production could be detected only after cocultivation with the human T-lymphoid H9 cells but not by conventional viral assays, including reverse transcriptase and p24 antigen assays in cell culture supernatant and immunofluorescence of host cells. Our DNA transfection studies indicated that this lack of detectable viral production was not due to the inefficient use of the HIV long terminal repeat or the Tat protein in these cells. These mesenchymal and epithelial cells were susceptible to HIV infection but differed in mechanism of virus entry compared with hematopoietic cells such as T lymphocytes. These observations may provide insights into clinical syndromes such as lung dysfunction in HIV-infected newborns and connective tissue disorders in HIV-infected adults. Images PMID:2384919

  3. Enteric Virus Infections and Diarrhea in Healthy and Human Immunodeficiency Virus-Infected Children

    PubMed Central

    Liste, Mary B.; Natera, Ivelisse; Suarez, José A.; Pujol, Flor H.; Liprandi, Ferdinando; Ludert, Juan E.

    2000-01-01

    Forty-three stool samples from 27 human immunodeficiency virus (HIV)-seropositive children and 38 samples from 38 HIV-negative children, collected during a 15-month period, were examined for enteric viruses. Diagnostic assays included enzyme immunoassays for rotavirus, adenovirus, and Norwalk virus; polyacrylamide gel electrophoresis for picobirnavirus and atypical rotavirus; and PCR for astrovirus and enterovirus. Specimens from HIV-positive children were more likely than those of HIV-negative children to have enterovirus (56 versus 21%; P < 0.0002) and astrovirus (12 versus 0%; P < 0.02), but not rotavirus (5 versus 8%; P > 0.5). No adenoviruses, picobirnaviruses, or Norwalk viruses were found. The rates of virus-associated diarrhea were similar among HIV-positive and HIV-negative children. Enteroviruses were excreted for up to 6 months in HIV-positive children; however, no evidence for prolonged excretion of poliovirus vaccine was observed. These results suggest that although infection with enterovirus and astrovirus may be frequent in HIV-infected children, enteric viruses are not associated with the diarrhea frequently suffered by these children. PMID:10921942

  4. Duration of hospitalization and appetite of HIV-infected South African children.

    PubMed

    Mda, Siyazi; van Raaij, Joop M A; MacIntyre, Una E; de Villiers, François P R; Kok, Frans J

    2011-04-01

    Human immunodeficiency virus (HIV)-infected children generally show poor growth. Episodes of diarrhoea and pneumonia in HIV-infected children are thought to be more severe than in HIV-uninfected children. The objective of this study was to compare duration of hospitalization, appetite and nutritional status of HIV-infected children with that of uninfected children. A cross-sectional study was performed on children (2-24 months) admitted with diarrhoea or pneumonia to the university hospital. Children were tested for HIV, and the duration of hospitalization was noted for 189 children. Follow-up for blood analysis (n=154) and appetite measurement (n=48) was performed 4-8 weeks after discharge. Appetite was measured as ad libitum intake of a commercial infant cereal using highly standardized procedures. Hospitalization (in days) was significantly longer in HIV-infected children; among children admitted with diarrhoea (5.9 ± 1.9 vs. 3.8 ± 1.5) (mean ± standard deviation) and with pneumonia (9.0 ± 2.5 vs. 5.9 ± 1.9). Serum zinc, iron and transferrin concentrations, and haemoglobin levels were significantly lower in HIV-infected children compared with uninfected children. Appetites [amounts eaten (g) per kg body weight] of HIV-infected children were significantly poorer than those of HIV-uninfected children (18.6 ± 5.8 vs. 25.2 ± 7.4). The eating rates (g min(-1) ) of HIV-infected children were also slower (17.6 ± 6.2 vs. 10.1 ± 3.7) Mean Z-scores for length-for-age were significantly lower among HIV-infected children compared with HIV-uninfected children. Weight-for-length Z-scores were not significantly different. In summary, HIV-infected children had a 55% longer duration of hospitalization and a 21% lower appetite.

  5. Human Immunodeficiency Virus (HIV) Research (AIDS)

    DTIC Science & Technology

    1993-07-15

    human TO cells, but peak expression was only 1 /10- 1 /100th that of human cells. Semi-quantitative PCR analyses indicated that the low virus expression... human TO cells, but peak expression was only 1 /101/100th that of human cells. Semi-quantitative PCR analyses indicated that the low virus expression...vaccine development, t~e study of selected simian- human immunodeficiency virus (SHIV) chiaeric viruses ; the refinement of diagnostic strategies for

  6. Measuring media use in college students with and without human immunodeficiency virus infection.

    PubMed

    Dunn-Navarra, Ann-Margaret; Toussi, Sima S; Cohn, Elizabeth; Neu, Natalie; Larson, Elaine L

    2014-01-01

    Media applications have shown promise for health education. The aims of this study were to develop and evaluate a media survey measure and compare media use among college students with and without human immunodeficiency virus (HIV) infection. Using a cross-sectional, descriptive design, a convenience sample of college students (N = 53) were recruited. Psychometric testing of the media instrument was performed, and the tool was then used to compare media use among HIV-infected undergraduates (n = 15), other undergraduates (n = 23), and nursing students (n = 15). Psychometric testing of the media instrument demonstrated a high degree of reliability (intraclass correlation = .998; 95% confidence intervals = .997, .999). All respondents had computers with Internet access and cellular phones. Among HIV-infected undergraduate students, 86.7% reported spending 5 minutes or more viewing television during the previous 24 hours outside of school and or work, in comparison with 34.8% of the other undergraduate students with no known chronic illness and 46.7% of the nursing students (p = .002 and .05, respectively). Preferred modes to access health information and communicate with health care providers for all respondents were the Internet (86.8%) and telephone (62.3%), respectively. Assessment of media use among adolescents and young adults will aid in planning for their health education needs. Copyright © 2014 National Association of Pediatric Nurse Practitioners. Published by Mosby, Inc. All rights reserved.

  7. Diarrheagenic Escherichia coli in Human Immunodeficiency Virus (HIV) Pediatric Patients in Lima, Perú

    PubMed Central

    Medina, Anicia M.; Rivera, Fulton P.; Romero, Liliana M.; Kolevic, Lenka A.; Castillo, Maria E.; Verne, Eduardo; Hernandez, Roger; Mayor, Yovanna E.; Barletta, Francesca; Mercado, Erik; Ochoa, Theresa J.

    2010-01-01

    We conducted a prospective study in three hospitals in Lima in human immunodeficiency virus (HIV) children to determine the frequency of diarrheagenic Escherichia coli. Five E. coli colonies/patients were studied by a multiplex real-time polymerase chain reaction to identify the six currently recognized groups of diarrhea-associated E. coli. We have analyzed 70 HIV-associated diarrheal and 70 control samples from HIV-infected children without diarrhea. Among the diarrheal episodes 19% were persistent, 3% dysenteric, and 33% were associated with moderate or severe dehydration. The diarrheagenic E. coli were the most commonly isolated pathogens in diarrhea (19%) and control samples (26%) (P = 0.42), including enteroaggregative (6% versus 10%), enteropathogenic (6% versus 10%), and enterotoxigenic E. coli (4% versus 3%), respectively. The HIV-infected children with diarrhea had the worse age-related immunosuppression, higher viral loads, and were on highly active antiretroviral treatment (HAART) less often than HIV-infected children without diarrhea. Diarrheagenic E. coli were highly resistant to ampicillin (74%) and cotrimoxazole (70%). PMID:20595495

  8. Pyrimethamine pharmacokinetics in human immunodeficiency virus-positive patients seropositive for Toxoplasma gondii.

    PubMed Central

    Jacobson, J M; Davidian, M; Rainey, P M; Hafner, R; Raasch, R H; Luft, B J

    1996-01-01

    Pyrimethamine pharmacokinetics were studied in 11 human immunodeficiency virus (HIV)-positive patients who were seropositive for exposure to Toxoplasma gondii and were taking zidovudine (AIDS Clinical Trials Group Protocol 102). Pyrimethamine was administered at 50 mg daily for 3 weeks to achieve steady state, and pharmacokinetic profiles were determined after administration of the last dose. Noncompartmental and compartmental analyses were performed. Population pharmacokinetic analysis assuming a one-compartment model yielded the following estimates: area under the 24-h concentration-time curve, 42.7 +/- 12.3 micrograms.h/ml; halflife, 139 +/- 34 h; clearance, 1.28 +/- 0.41 liters/h; volume of distribution, 246 +/- 641; and absorption rate constant, 1.5 +/- 1.3 liters/h. These values are similar to those seen in subjects without HIV infection. Pyrimethamine pharmacokinetics did not differ significantly in those subjects who were intravenous drug users. Adverse effects were noted in 73% of those initially enrolled in this study, leading to discontinuation for 38%. No association was noted between pyrimethamine levels and the incidence of adverse events. No significant differences were seen in zidovudine pharmacokinetic parameters obtained from studies performed before and during treatment with pyrimethamine. In summary, pyrimethamine exhibited pharmacokinetics in HIV-infected patients that were similar to those in non-HIV-infected subjects and it did not alter the pharmacokinetics of zidovudine in these patients. PMID:8726001

  9. Human Immunodeficiency Virus-Specific CD8+ T Cells in Human Breast Milk

    PubMed Central

    Sabbaj, Steffanie; Edwards, Bradley H.; Ghosh, Mrinal K.; Semrau, Katherine; Cheelo, Sanford; Thea, Donald M.; Kuhn, Louise; Ritter, G. Douglas; Mulligan, Mark J.; Goepfert, Paul A.; Aldrovandi, Grace M.

    2002-01-01

    Breast-feeding infants of human immunodeficiency virus (HIV)-infected women ingest large amounts of HIV, but most escape infection. While the factors affecting transmission risk are poorly understood, HIV-specific cytotoxic T-lymphocyte (CTL) responses play a critical role in controlling HIV levels in blood. We therefore investigated the ability of breast milk cells (BMC) from HIV-infected women from the United States and Zambia to respond to HIV-1 peptides in a gamma interferon enzyme-linked immunospot assay. All (n = 11) HIV-infected women had responses to pools of Gag peptide (range, 105 to 1,400 spot-forming cells/million; mean = 718), 8 of 11 reacted to Pol, 7 reacted to Nef, and 2 of 5 reacted to Env. Conversely, of four HIV-negative women, none responded to any of the tested HIV peptide pools. Depletion and tetramer staining studies demonstrated that CD8+ T cells mediated these responses, and a chromium-release assay showed that these BMC were capable of lysing target cells in an HIV-specific manner. These data demonstrate the presence of HIV-specific major histocompatibility complex class I-restricted CD8+ CTLs in breast milk. Their presence suggests a role in limiting transmission and provides a rationale for vaccine strategies to enhance these responses. PMID:12097549

  10. Seroprevalence of Brucellosis in Human Immunodeficiency Virus Infected Patients in Hamadan, Iran.

    PubMed

    Keramat, Fariba; Majzobi, Mohammad Mehdi; Poorolajal, Jalal; Ghane, Zohreh Zarei; Adabi, Maryam

    2017-08-01

    Brucellosis is a systemic disease with a wide spectrum of clinical manifestations. This study aimed to determine the seroprevalence of brucellosis in human immunodeficiency virus (HIV) infected patients in Hamadan Province in the west of Iran. A total of 157 HIV-infected patients were screened through standard serological tests, including Wright's test, Coombs' Wright test, and 2-mercaptoethanol Brucella agglutination test (2ME test), blood cultures in Castaneda media, and CD4 counting. Data were analyzed using Stata version 11. Wright and Coombs' Wright tests were carried out, and only 5 (3.2%) patients had positive serological results. However, all patients had negative 2ME results, and blood cultures were negative for Brucella spp. Moreover, patients with positive serology and a mean CD4 count of 355.8 ± 203.11 cells/μL had no clinical manifestations of brucellosis, and, and the other patients had a mean CD4 count of 335.55 ± 261.71 cells/μL. Results of this study showed that HIV infection is not a predisposing factor of acquiring brucellosis.

  11. Meningococcal Disease in Patients With Human Immunodeficiency Virus Infection: A Review of Cases Reported Through Active Surveillance in the United States, 2000–2008

    PubMed Central

    Harris, Christine M.; Li, Jianmin; Hall, H. Irene; Lee, Adria; Zell, Elizabeth; Harrison, Lee H.; Petit, Susan; Farley, Monica M.; Lynfield, Ruth; Miller, Lisa; Nichols, Megin; Reingold, Arthur; Schaffner, William; Thomas, Ann; MacNeil, Jessica R.; Clark, Thomas A.; Cohn, Amanda C.

    2016-01-01

    Background. Although human immunodeficiency virus (HIV) infection is an established risk factor for several bacterial infections, the association between HIV infection and meningococcal disease remains unclear. Methods. Expanded chart reviews were completed on persons with meningococcal disease and HIV infection reported from 2000 through 2008 from 9 US sites participating in an active population-based surveillance system for meningococcal disease. The incidence of meningococcal disease among patients meeting Centers for Disease Control and Prevention acquired immune deficiency syndrome (AIDS) surveillance criteria was estimated using data from the National HIV Surveillance System for the participating sites. Results. Thirty-three cases of meningococcal disease in individuals with HIV infection were reported from participating sites, representing 2.0% of all reported meningococcal disease cases. Most (75.8%) persons with HIV infection were adult males aged 25 to 64 years old. Among all meningococcal disease cases aged 25 to 64 years old, case fatality ratios were similar among HIV-infected and HIV-uninfected persons (13.3% vs 10.6%; P = .6). The cumulative, mean incidence of meningococcal disease among patients aged 25 to 64 years old with HIV infection ever classified as AIDS was 3.5 cases per 100000 person years (95% confidence interval [CI], 2.1–5.6), compared with 0.3 cases per 100000 person years (95% CI, 0.3–0.3) for persons of the same age group not reported to have AIDS (relative risk = 12.9; 95% CI, 7.9–20.9). Conclusions. Individuals with HIV infection meeting the AIDS surveillance case definition have a higher incidence of meningococcal disease compared with the general adult population. PMID:28018927

  12. The increasing impact of human immunodeficiency virus infections, sexually transmitted diseases, and viral hepatitis in Durham County, North Carolina: a call for coordinated and integrated services.

    PubMed

    Kolman, Marc; DeCoster, Mary; Proeschold-Bell, Rae Jean; Hunter, Genevieve Ankeny; Bartlett, John; Seña, Arlene C

    2011-01-01

    Durham County, North Carolina, faces high rates of human immunodeficiency virus (HIV) infection (with or without progression to AIDS) and sexually transmitted diseases (STDs). We explored the use of health care services and the prevalence of coinfections, among HIV-infected residents, and we recorded community perspectives on HIV-related issues. We evaluated data on diagnostic codes, outpatient visits, and hospitalizations for individuals with HIV infection, STDs, and/or hepatitis B or C who visited Duke University Hospital System (DUHS). Viral loads for HIV-infected patients receiving care were estimated for 2009. We conducted geospatial mapping to determine disease trends and used focus groups and key informant interviews to identify barriers and solutions to improving testing and care. We identified substantial increases in HIV/STDs in the southern regions of the county. During the 5-year period, 1,291 adults with HIV infection, 4,245 with STDs, and 2,182 with hepatitis B or C were evaluated at DUHS. Among HIV-infected persons, 13.9% and 21.8% were coinfected with an STD or hepatitis B or C, respectively. In 2009, 65.7% of HIV-infected persons receiving care had undetectable viral loads. Barriers to testing included stigma, fear, and denial of risk, while treatment barriers included costs, transportation, and low medical literacy. Data for health care utilization and HIV load were available from different periods. Focus groups were conducted among a convenience sample, but they represented a diverse population. Durham County has experienced an increase in the number of HIV-infected persons in the county, and coinfections with STDs and hepatitis B or C are common. Multiple barriers to testing/treatment exist in the community. Coordinated care models are needed to improve access to HIV care and to reduce testing and treatment barriers.

  13. Effects of protein-energy malnutrition and human immunodeficiency virus-1 infection on essential fatty acid metabolism in children.

    PubMed

    Decsi, T; Koletzko, B

    2000-06-01

    This report summarizes data on the availability of essential fatty acids (EFAs) and their long-chain polyunsaturated fatty acid (LCPUFA) metabolites in protein-energy malnutrition (PEM), in human immunodeficiency virus-1 (HIV-1) infection for which less information is available, and the combination of both PEM and HIV-1. The contribution of different EFAs and LCPUFAs to the fatty-acid composition of plasma and erythrocyte membrane lipids was found to be reduced in children with PEM in comparison with well-nourished children. In addition to limited dietary EFA supply, reduced bioconversion of EFAs to their respective LCPUFA metabolites and/or peroxidative degradation of LCPUFAs may contribute to the reduction of LCPUFA status in malnourished children. Restoration of normal energy, protein, and EFA intakes does not appear to readily correct abnormalities of plasma and erythrocyte membrane LCPUFA values. Enhanced dietary supply of LCPUFAs and/or improved supply of antioxidant vitamins may represent novel therapeutic modalities in severe PEM. With and without PEM, HIV infection was related to altered availability of various EFAs and LCPUFAs in HIV-seropositive children. The plasma total lipid fatty-acid profiles seen in well-nourished children with HIV infection were compatible with an HIV infection-related enhancement of the metabolic activity of the conversion of EFAs to their respective LCPUFA metabolites. However, the plasma phospholipid EFA and LCPUFA profiles seen in severely malnourished children with HIV infection more closely resembled those seen in children with PEM but without HIV infection than in those in children with HIV infection but no PEM. Metabolic studies using stable isotope-labeled fatty acids may contribute to better understanding of the HIV-related changes in EFA metabolism and clearly are needed before therapeutic conclusions can be drawn.

  14. The interaction between malaria and human immunodeficiency virus infection in severely anaemic Malawian children: a prospective longitudinal study.

    PubMed

    Kyeyune, Francis X; Calis, Job C J; Phiri, Kamija S; Faragher, Brian; Kachala, David; Brabin, Bernard J; van Hensbroek, Michaël Boele

    2014-06-01

    Malaria and human immunodeficiency virus (HIV) infection are co-prevalent in sub-Saharan Africa and cause severe anaemia in children. Interactions between these infections occur in adults, although these are less clear in children. The aim of study was to determine their interaction in a cohort of severely anaemic children. Severely anaemic Malawian children were enrolled, tested for HIV and malaria, transfused and followed for 18 months for malaria incidence. Antiretrovirals were not widely available in Malawi during the study period. Of 381 children (haemoglobin <5 g/dl), 357 consented for HIV testing, 12.6% were HIV-infected, and 59.5% had malaria parasitaemia. At enrolment, HIV-infected children had similar malaria parasitaemia prevalence (59.1% vs. 58.7%; P = 0.96) and parasite density (geometric mean [parasites/μl] 6903 vs. 12417; P = 0.18) as HIV-negative children. There were no differences in mean CD4%, or prevalence of severe immunosuppression, between those with and without malaria parasitaemia. Plasma viral load correlated negatively with log parasitaemia (r = -0.78; P = 0.01). During follow-up, HIV-infected children did not experience more frequent parasitaemias or symptomatic malaria episodes. Adjusted risk estimates (95% CI) for malaria parasitaemia in HIV-infected children at 6 and 18 months follow-up were 0.39 (0.13-1.14) and 0.40 (0.11-1.51), respectively. Severely anaemic HIV-infected children showed no increased susceptibility to asymptomatic or symptomatic malaria during or following their anaemic episode, although all experienced lower parasite prevalence during follow-up. This contrasts with data in adults and may relate to the malaria immunity of young children which is insufficiently developed to be impaired by HIV. The negative correlation between viral load and malaria parasitaemia remains unexplained. © 2014 John Wiley & Sons Ltd.

  15. Heat shock protein-based therapeutic strategies against human immunodeficiency virus type 1 infection.

    PubMed Central

    Brenner, B G; Wainberg, M A

    1999-01-01

    Heat shock proteins (hsps) and cyclophilins (CypA) are intracellular chaperone molecules that facilitate protein folding and assembly. These proteins are selectively expressed in cells following exposure to a range of stress stimuli, including viral infection. Hsp species are highly immunogenic, eliciting humoral, cytotoxic T lymphocyte (CTL), and natural killer (NK) cell responses against viruses, tumours, and infectious diseases. This review discusses the roles of stress proteins in immunity and viral life cycles, vis-à-vis the development of Hsp-based therapeutic strategies against human immunodeficiency virus type-1 (HIV-1) infection. Cumulative findings are cited implicating the requirement of CypA in HIV-1 replication and formation of infectious virions. Studies by our group show the upregulated expression of hsp27 and hsp70 during single-cycle HIV infections. These species redistribute to the cell surface following HIV-infection and heat stress, serving as targets for NK and antibody-dependent cellular cytotoxicity. Co-immunoprecipitation and Western blot studies show that hsp27, hsp70, and hsp78 complex with HIV-1 viral proteins intracellularly. Hsp70, hsp56, and CypA are assembled into HIV-1 virions. The ability of hsps to interact with HIV-1 viral proteins, combined with their inherent adjuvant and immunogenic properties, indicates that hsps may serve as vehicles for antigen delivery and the design of vaccines against acquired immunodeficiency syndrome. PMID:10231014

  16. Tp-e interval and Tp-e/QT ratio in patients with Human Immunodeficiency Virus.

    PubMed

    Ünal, Sefa; Yayla, Çağrı; Açar, Burak; Ertem, Ahmet G; Akboğa, Mehmet K; Gökaslan, Serkan; Erdöl, Mehmet A; Sönmezer, Meliha Ç; Kaya Kiliç, Esra; Ataman Hatipoğlu, Çiğdem; Aydoğdu, Sinan; Temizhan, Ahmet

    2017-03-09

    Human Immunodeficiency Virus (HIV) infection and AIDS are known to cause cardiovascular diseases such as premature coronary artery disease, cardiomyopathy, and arrhythmias. Recently, Tp-e interval and Tp-e/QT ratio has been shown as a novel marker of ventricular repolarization. We aimed to evaluate the ventricular repolarization using Tp-e interval and Tp-e/QT ratio in patients with Human Immunodeficiency Virus (HIV) infection. Totally 48 patients with HIV and 60 control subjects were enrolled to the study. Tp-e interval, Tp-e/QT and Tp-e/QTc ratio were measured from the 12-lead electrocardiogram. Tp-e interval, Tp-e/QT ratio and Tp-e/QTc ratio were significantly higher in patients with HIV than control subjects (all p<0.01). In correlation analysis, there were positive correlation between Tp-e interval and disease duration (r=0.298, p=0.048). and inverse correlation between Tp-e interval and CD4 count(r=-0.303, p=0.036). Our study showed that Tp-e interval, Tp-e/QT and Tp-e/QTc ratios were increased in patients with HIV than control subjects.

  17. Out of the Shadows: Building an Agenda and Strategies for Preventing HIV Infection and AIDS among Street and Homeless Youth.

    ERIC Educational Resources Information Center

    Center for Population Options, Washington, DC.

    This report summarizes the findings of a conference that examined the problem of Human Immunodeficiency Virus (HIV) infection and Acquired Immune Deficiency Syndrome (AIDS) among street and homeless youth. Street and homeless youth, by virtue of their circumstances and the behaviors they engage in, are at great risk of becoming infected with HIV,…

  18. Microbiome in HIV infection

    PubMed Central

    Salas, January T.; Chang, Theresa L.

    2014-01-01

    HIV primary infection occurs at mucosa tissues, suggesting an intricate interplay between microbiome and HIV infection. Recent advanced technologies of high-throughput sequencing and bioinformatics allow researchers to explore nonculturable microbes including bacteria, virus and fungi and their association with diseases. HIV/SIV infection is associated with microbiome shifts and immune activation that may affect the outcome of disease progression. Similarly, altered microbiome and inflammation are associated with increased risks of HIV acquisition, suggesting the role of microbiome in HIV transmission. In this review, we will focus on microbiome in HIV infection at various mucosal compartments. Understanding the relationship between microbiome and HIV may offer insights into development of better strategies for HIV prevention and treatment. PMID:25439273

  19. Liver fibrosis progression is related to CD4 cell depletion in patients coinfected with hepatitis C virus and human immunodeficiency virus.

    PubMed

    Puoti, M; Bonacini, M; Spinetti, A; Putzolu, V; Govindarajan, S; Zaltron, S; Favret, M; Callea, F; Gargiulo, F; Donato, F; Carosi, G

    2001-01-01

    A total of 204 patients with liver biopsy-proven hepatitis C virus (HCV) infection, 84 with and 120 without human immunodeficiency virus (HIV) coinfection, were studied, to evaluate variables possibly associated with the stage of liver fibrosis. All patients were injection drugs users, with a mean age of 32 years and an estimated duration of HCV infection of 12 years. Twenty-four patients (11%) had many fibrous septa with (5%) or without (6%) cirrhosis, 56 (27%) had few fibrous septa, and 124 (60%) had no fibrous septa. In all patients, an association was found between CD4 cell counts <500 cells/mm(3)and the presence of many fibrous septa (odds ratio, 3.2; P=.037), independent of HIV infection and other factors. These results suggest that HIV infection-induced CD4 depletion is independently associated with the severity of liver fibrosis in chronic HCV infection.

  20. Central Nervous System Strongyloidiasis and Cryptococcosis in an HIV-Infected Patient Starting Antiretroviral Therapy

    PubMed Central

    Rodríguez, Mónica; Flores, Paúl; Ahumada, Víctor; Vázquez-Vázquez, Lorena; Alvarado-de la Barrera, Claudia; Reyes-Terán, Gustavo

    2012-01-01

    We report a case of Strongyloides stercoralis hyperinfection syndrome with central nervous system involvement, in a patient with late human immunodeficiency virus (HIV) infection starting antiretroviral therapy, in whom Strongyloides stercoralis larvae and Cryptococcus neoformans were isolated antemortem from cerebrospinal fluid. Our patient was not from an endemic region for the parasite, so strongyloidiasis was not originally suspected. For this reason, we conclude that Strongyloides stercoralis infection should be suspected in HIV-infected patients starting antiretroviral therapy in order to avoid potential fatal outcomes. PMID:22924046

  1. Lack of endemic HIV infection in Venezuela.

    PubMed

    Azocar, J; Martinez, C; McLane, M F; Allan, J; Essex, M

    1987-01-01

    A seroepidemiological survey of human immunodeficiency virus (HIV) infection was recently conducted in 556 serum samples from donors in rural and urban areas of Venezuela and from aboriginal Amazonian Indians. The samples were tested for the presence of antibodies to HIV by the ELISA technique using several commercially available kits. 19 samples were positive. These samples then were tested by immunofluorescence, Western blot, and radioimmunoprecipitation techniques as confirmatory assays. 4 seropositive control samples from patients from Caracas with Acquired Immune Deficiency Syndrome (AIDS) or AIDS-Related Complex (ARC) were analyzed. None of the samples from rural or aboriginal Indians could be confirmed by these assays. These sera also were evaluated for antibodies to STLV-3 by Western blot analysis. No positive samples were identified. The results fail to support earlier studies suggesting that HIV or a related virus is endemic in the Venezuelan population.

  2. Prevention and treatment of opportunistic infections and other coinfections in HIV-infected patients: May 2015.

    PubMed

    Iribarren, José Antonio; Rubio, Rafael; Aguirrebengoa, Koldo; Arribas, Jose Ramón; Baraia-Etxaburu, Josu; Gutiérrez, Félix; Lopez Bernaldo de Quirós, Juan Carlos; Losa, Juan Emilio; Miró, José Ma; Moreno, Santiago; Pérez Molina, José; Podzamczer, Daniel; Pulido, Federico; Riera, Melchor; Rivero, Antonio; Sanz Moreno, José; Amador, Concha; Antela, Antonio; Arazo, Piedad; Arrizabalaga, Julio; Bachiller, Pablo; Barros, Carlos; Berenguer, Juan; Caylá, Joan; Domingo, Pere; Estrada, Vicente; Knobel, Hernando; Locutura, Jaime; López Aldeguer, José; Llibre, Josep Ma; Lozano, Fernando; Mallolas, Josep; Malmierca, Eduardo; Miralles, Celia; Miralles, Pilar; Muñoz, Agustín; Ocampo, Agustín; Olalla, Julián; Pérez, Inés; Pérez Elías, Ma Jesús; Pérez Arellano, José Luis; Portilla, Joaquín; Ribera, Esteban; Rodríguez, Francisco; Santín, Miguel; Sanz Sanz, Jesús; Téllez, Ma Jesús; Torralba, Miguel; Valencia, Eulalia; Von Wichmann, Miguel Angel

    2016-10-01

    Despite the huge advance that antiretroviral therapy represents for the prognosis of infection by the human immunodeficiency virus (HIV), opportunistic infections (OIs) continue to be a cause of morbidity and mortality in HIV-infected patients. OIs often arise because of severe immunosuppression resulting from poor adherence to antiretroviral therapy, failure of antiretroviral therapy, or unawareness of HIV infection by patients whose first clinical manifestation of AIDS is an OI. The present article updates our previous guidelines on the prevention and treatment of various OIs in HIV-infected patients, namely, infections by parasites, fungi, viruses, mycobacteria, and bacteria, as well as imported infections. The article also addresses immune reconstitution inflammatory syndrome. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  3. Human Immunodeficiency Virus Disease Severity, Psychiatric Symptoms, and Functional Outcomes in Perinatally Infected Youth

    PubMed Central

    Nachman, Sharon; Chernoff, Miriam; Williams, Paige; Hodge, Janice; Heston, Jerry; Gadow, Kenneth D.

    2012-01-01

    Objective To evaluate associations between human immunodeficiency virus (HIV) disease severity and psychiatric and functional outcomes in youth with perinatal HIV infection. Design Cross-sectional analysis of entry data from an observational, prospective 2-year study. Logistic and linear regression models adjusted for potential confounders were used. Setting Twenty-nine sites of the International Maternal Pediatrics Adolescent AIDS Clinical Trials Group study in the United States and Puerto Rico. Participants Youth aged 6 to 17 years who had HIV infection (N=319). Main Exposures Antiretroviral treatment and perinatal HIV infection. Main Outcome Measures Youth and primary care-givers were administered an extensive battery of measures that assessed psychiatric symptoms; cognitive, social, and academic functioning; and quality of life. Results Characteristics of HIV were a current CD4 percentage of 25% or greater (74% of participants), HIV RNA levels of less than 400 copies/mL (59%), and current highly active antiretroviral therapy (81%). Analyses indicated associations of past and current Centers for Disease Control and Prevention class C designation with less severe attention-deficit/hyperactivity disorder inattention symptoms, older age at nadir CD4 percentage and lower CD4 percentage at study entry with more severe conduct disorder symptoms, higher RNA viral load at study entry with more severe depression symptoms, and lower CD4 percentage at study entry with less severe symptoms of depression. There was little evidence of an association between specific antiretroviral therapy and severity of psychiatric symptoms. A lower nadir CD4 percentage was associated with lower quality of life, worse Wechsler Intelligence Scale for Children Coding Recall scores, and worse social functioning. Conclusion Human immunodeficiency virus illness severity markers are associated with the severity of some psychiatric symptoms and, notably, with cognitive, academic, and social

  4. Selective killing of CD4+ cells harboring a human immunodeficiency virus-inducible suicide gene prevents viral spread in an infected cell population.

    PubMed Central

    Caruso, M; Klatzmann, D

    1992-01-01

    We have stably expressed in CD4+ lymphoid cells the herpes simplex virus type 1 thymidine kinase (HSV1-TK) gene under the control of the human immunodeficiency virus (HIV) promoter and transactivation response element sequences. Upon HIV infection these regulatory sequences were transactivated, switching on high-level expression of HSV1-TK. This in turn caused the death of HIV-infected cells when they were cultured in the presence of acyclovir, a nucleoside analog that becomes toxic after phosphorylation by HSV1-TK. The elimination of HIV-infected cells resulted in the arrest of HIV spreading in the culture. Complete protection of HSV1-TK-expressing cells was obtained using acyclovir concentrations that are commonly detected in the plasma of patients treated for HSV1 infection. Thus, expression of this DNA construct generates a pool of CD4+ booby-trapped cells that, as a population, are resistant to HIV infection. Our data provide a rationale for the use of suicide genes in the design of gene therapy of HIV infection. Images PMID:1346066

  5. A Comparison of Seminal Hepatitis C Virus (HCV) RNA Levels During Recent and Chronic HCV Infection in HIV-Infected and HIV-Uninfected Individuals

    PubMed Central

    Bradshaw, Daniel; Lamoury, Francois; Catlett, Beth; Applegate, Tanya L.; Mcallister, John; Dore, Gregory J.; Matthews, Gail V.; Danta, Mark

    2015-01-01

    Background. We aimed to characterize seminal hepatitis C virus (HCV) RNA dynamics in human immunodeficiency virus (HIV)–positive men with acute HCV infection given its potential role in sexual transmission of HCV. Methods. Men with acute HCV infection (duration, ≤12 months) or chronic HCV infection (duration, >12 months) were prospectively recruited. Paired semen and blood samples were assayed for HCV RNA levels. Results were analyzed using χ2, Fisher exact, Mann–Whitney U, and Kruskal–Wallis tests. Results. Eighteen men (27.3%) had acute HCV and HIV coinfection, 22 (33.3%) had chronic HCV infection and HIV coinfection, and 26 (39.4%) had chronic HCV monoinfection. HCV RNA was detected in semen specimens from 29 of 66 men (43.9%). The median HCV RNA level in blood was 4.0 log IU/mL higher than that in semen. HCV RNA levels were correlated in semen and blood (r2 = 0.142). Neither HIV positivity nor acute HCV infection was associated with an increased frequency of seminal HCV RNA detection. Among men with acute HCV and HIV coinfection, the median HCV RNA level in blood specimens from those with seminal HCV RNA was higher than that in blood specimens from those without seminal HCV RNA (P = .001). Seminal HCV RNA was detected in ≥1 sample for 26 of 35 men (74.3%) attending follow up. Conclusions. HCV RNA was detected in semen during both acute and chronic HCV infection. This was unaffected by HIV positivity or the phase of HCV infection. Elevated seminal HCV RNA levels could contribute to sexual transmission of HCV, but other factors, including high-risk behaviors, may be the main drivers for HCV transmission in HIV-infected individuals. PMID:25293369

  6. Characteristics and survival of HIV-infected patients not screened for hepatitis C virus infection in a hospital-based cohort.

    PubMed

    Bénet, T; D'Oliveira, A; Voirin, N; Livrozet, J-M; Cotte, L; Peyramond, D; Chidiac, C; Touraine, J-L; Fabry, J; Trepo, C; Allard, R; Vanhems, P

    2007-10-01

    The rate of human immunodeficiency virus (HIV) disease progression or death of individuals coinfected with hepatitis C virus (HCV) is conflicting. The complete-case analysis systematically used, excludes patients unscreened for HCV. Our objective was to assess if rate of survival differed between HIV-infected patients screened and unscreened for HCV in a hospital-based prospective cohort study. Patients were enrolled in the Lyon section of the French Hospital Database on HIV between 1 July 1992 and 31 May 2005. A multivariate Cox regression model was used to analyse the association of HCV screening with survival. Of 3244 patients, 299 (9.2%) were not screened for HCV. The populations screened and unscreened differed by the proportion of acquired immune deficiency syndrome at baseline, presumed route of infection, CD4 cell count category at baseline, mean duration of follow-up, mean number of visits per year, type of antiretroviral therapy and survival. The rate of progression to death was higher for non-HCV-screened vs HCV-screened patients: the incidence rate among HCV-screened patients was 22.9/1000 patient-years; the incidence rate among HCV-unscreened patients was 52.4/1000 patient-years. The adjusted hazards ratio of death was 2.48 [95% confidence interval (1.83-3.35); P < 0.001] for patients with unknown HCV status compared with others. In conclusion, unscreened or unknown HCV status was associated with an increased risk of death in our hospital cohort. Important prognostic factors are related to, or confounded by the practice of HCV screening.

  7. Knowledge and risks of human immunodeficiency virus transmission among veterans with severe mental illness.

    PubMed

    Strauss, Jennifer L; Bosworth, Hayden B; Stechuchak, Karen M; Meador, Keith M; Butterfield, Marian I

    2006-04-01

    This study is among the first to examine knowledge about human immunodeficiency virus (HIV) and behavioral risks for HIV transmission among veterans with severe mental illness (SMI), a group at high risk for HIV infection. This study examined associations between accuracy of HIV knowledge, risk behaviors, and clinical and demographic characteristics in a sample of male veteran psychiatric inpatients diagnosed with SMI (N = 353). Results showed high rates of inaccurate HIV knowledge, with > 40% of patients demonstrating some inaccuracies, particularly those related to the progression and symptoms of acquired immunodeficiency syndrome. Inaccurate HIV knowledge was associated with older age, minority status, education level, marital status, no homelessness within the previous 6 months, and no reported history of illicit intranasal drug use. There is a need for more effective HIV prevention interventions for persons with SMI.

  8. Human Immunodeficiency Virus as a Chronic Disease: Evaluation and Management of Nonacquired Immune Deficiency Syndrome-Defining Conditions

    PubMed Central

    Serrano-Villar, Sergio; Gutiérrez, Félix; Miralles, Celia; Berenguer, Juan; Rivero, Antonio; Martínez, Esteban; Moreno, Santiago

    2016-01-01

    In the modern antiretroviral therapy (ART) era, motivated people living with human immunodeficiency virus (HIV) who have access to therapy are expected to maintain viral suppression indefinitely and to receive treatment for decades. Hence, the current clinical scenario has dramatically shifted since the early 1980s, from treatment and prevention of opportunistic infections and palliative care to a new scenario in which most HIV specialists focus on HIV primary care, ie, the follow up of stable patients, surveillance of long-term toxicities, and screening and prevention of age-related conditions. The median age of HIV-infected adults on ART is progressively increasing. By 2030, 3 of every 4 patients are expected to be aged 50 years or older in many countries, more than 80% will have at least 1 age-related disease, and approximately one third will have at least 3 age-related diseases. Contemporary care of HIV-infected patients is evolving, and questions about how we might monitor and perhaps even treat HIV-infected adults have emerged. Through key published works, this review briefly describes the most prevalent comorbidities and age-associated conditions and highlights the differential features in the HIV-infected population. We also discuss the most critical aspects to be considered in the care of patients with HIV for the management and prevention of age-associated disease. PMID:27419169

  9. Suicidal ideation and suicide attempts among human immunodeficiency virus-infected adults: differences in risk factors and their implications.

    PubMed

    Kang, Cho Ryok; Bang, Ji Hwan; Cho, Sung-Il; Kim, Kui Nam; Lee, Hee-Jin; Ryu, Bo Yeong; Cho, Soo Kyung; Lee, Young Hwa; Oh, Myoung-Don; Lee, Jong-Koo

    2016-01-01

    Many studies have investigated risk factors for suicidal ideation and suicide attempt; however, most have failed to show differences in risk factors between suicidal ideation and suicide attempt among the human immunodeficiency virus (HIV)-infected population. This study was designed to identify differences in risk factors between suicidal ideation and suicide attempts among HIV-infected adults in Seoul. A face-to-face survey of 457 HIV-infected adults was conducted by the Seoul Metropolitan Government in 2013. Multivariate logistic regression analysis was used to identify factors associated with suicidal ideation and suicide attempt. Among 422 participants, 44% had suicidal ideation, and 11% had suicide attempts. The independent risk factors for suicidal ideation were young and middle age, living with someone, history of AIDS-defining opportunistic disease, history of treatment for depression, lower social support, and psychological status. Beneficiaries of National Medical Aid, economic barriers to treatment, history of treatment for depression, and lower psychological status were independently associated with suicide attempts. Patients with HIV in Korea were treated without cost in some centers. Thus, experiencing an economic barrier to treatment might be due in part to ignorance of HIV care policies. Our findings indicate that suicide attempts are associated with socioeconomic factors and information inequality regarding medical care. In conclusion, suicidal ideation closely associated with the psychosocial factors, whereas suicide attempt demonstrates a stronger association with socioeconomic factors. Suicide prevention measures should be implemented to provide information to help HIV-infected patients.

  10. Oral innate immunity in HIV infection in HAART era.

    PubMed

    Nittayananta, Wipawee; Tao, Renchuan; Jiang, Lanlan; Peng, Yuanyuan; Huang, Yuxiao

    2016-01-01

    Oral innate immunity, an important component in host defense and immune surveillance in the oral cavity, plays a crucial role in the regulation of oral health. As part of the innate immune system, epithelial cells lining oral mucosal surfaces not only provide a physical barrier but also produce different antimicrobial peptides, including human β-defensins (hBDs), secretory leukocyte protease inhibitor (SLPI), and various cytokines. These innate immune mediators help in maintaining oral homeostasis. When they are impaired either by local or systemic causes, various oral infections and malignancies may be developed. Human immunodeficiency virus (HIV) infection and other co-infections appear to have both direct and indirect effects on systemic and local innate immunity leading to the development of oral opportunistic infections and malignancies. Highly active antiretroviral therapy (HAART), the standard treatment of HIV infection, contributed to a global reduction of HIV-associated oral lesions. However, prolonged use of HAART may lead to adverse effects on the oral innate immunity resulting in the relapse of oral lesions. This review article focused on the roles of oral innate immunity in HIV infection in HAART era. The following five key questions were addressed: (i) What are the roles of oral innate immunity in health and disease?, (ii) What are the effects of HIV infection on oral innate immunity?, (iii) What are the roles of oral innate immunity against other co-infections?, (iv) What are the effects of HAART on oral innate immunity?, and (v) Is oral innate immunity enhanced by HAART?

  11. Inhibition of apoptosis in human immunodeficiency virus-infected cells enhances virus production and facilitates persistent infection.

    PubMed Central

    Antoni, B A; Sabbatini, P; Rabson, A B; White, E

    1995-01-01

    Apoptosis is one of several mechanisms by which human immunodeficiency virus type 1 (HIV-1) exerts its cytopathic effects. CD4+ Jurkat T-cell lines overexpressing the adenovirus E1B 19K protein, a potent inhibitor of apoptosis, were used to examine the consequences of inhibition of apoptosis during acute and chronic HIV-1 infections. E1B 19K protein expression inhibited HIV-induced apoptosis, enhanced virus production, and established high levels of persistent viral infection. One E1B 19K-expressing line appeared to undergo HIV-induced death via a nonapoptotic mechanism, illustrating that HIV infection results in lymphocyte depletion through multiple pathways. Increased virus production associated with sustained cell viability suggests that therapeutic approaches involving inhibition of HIV-induced programmed cell death may be problematic. PMID:7884884

  12. Knowledge and attitude regarding human immunodeficiency virus/acquired immunodeficiency syndrome in dermatological outpatients.

    PubMed

    Kouznetsov, L; Kuznetsov, A V; Ruzicka, T; Matterne, U; Wienecke, R; Zippel, S A

    2009-08-01

    Dermatologists are often the first-line specialists who recognize and diagnose human immunodeficiency virus (HIV) infection because of pathognomic skin signs. It is therefore important to investigate attitudes and knowledge regarding HIV/acquired immunodeficiency syndrome (AIDS) amongst dermatological patients in order to provide information for dermatologists and to draw their attention to the issues. Awareness of HIV/AIDS, its prevention, and hypothetical behaviour were surveyed in dermatological outpatients. The anonymous cross-sectional survey was conducted with consecutive German-speaking outpatients aged 18-65 years, who registered at the dermatological outpatient's clinic (excluding venereology, genitourinary or HIV medicine) of the University of Munich (Germany). Three hundred forty-seven (77.5%) questionnaires were accepted for analysis. Most of the patients knew about HIV incurability (89.4%), HIV transmissibility during needle sharing (95.3%), or vaginal (87.4%) and anal intercourse (79.5%), as well as about HIV prevention by condom use (97.8%), and use of single needles (76.2%). However, knowledge gaps and misconceptions were detected regarding the risk of HIV transmission during oral sex, and the efficacy of sexual fidelity and avoidance of blood transfusions in HIV prevention. The lowest knowledge level (< 50% correct answers) was detected in patients aged 50-59 years, in unemployed, divorced/widowed, and in those without or with incomplete school education. Patient education about HIV/AIDS in dermatological ambulant settings should be performed differentially with regard to socio-demographic factors, and focused on the topic of oral sexual HIV transmission and on some other specific misconceptions.

  13. Impact of HIV Infection and Zidovudine Therapy on RBC Parameters and Urine Methylmalonic Acid Levels.

    PubMed

    Adediran, Adewumi; Osunkalu, Vincent; Wakama, Tamunomieibi; John-Olabode, Sarah; Akinbami, Akinsegun; Uche, Ebele; Akanmu, Sulaimon

    2016-01-01

    Background. Anaemia is a common complication of human immunodeficiency virus (HIV) infection. The aim of this study was to investigate the impact of HIV infection and zidovudine on red blood cells (RBC) parameters and urine methylmalonic acid (UMMA) levels in patients with HIV infection. Material and Methods. A cross-sectional study involving 114 subjects, 94 of which are HIV-infected nonanaemic and 20 HIV negative subjects (Cg) as control. Full blood count parameters and urine methylmalonic acid (UMMA) level of each subject were determined. Associations were determined by Chi-square test and logistic regression statistics where appropriate. Results. Subjects on zidovudine-based ART had mean MCV (93 fL) higher than that of control group (82.9 fL) and ART-naïve (85.9 fL) subjects and the highest mean RDW. Mean UMMA level, which reflects vitamin B12 level status, was high in all HIV-infected groups but was significantly higher in ART-naïve subjects than in ART-experienced subjects. Conclusion. Although non-zidovudine therapy may be associated with macrocytosis (MCV > 95 fL), zidovudine therapy and ART naivety may not. Suboptimal level of vitamin B12 as measured by high UMMA though highest in ART-naïve subjects was common in all HIV-infected subjects.

  14. Prevalence, correlates, and risk perception of HIV infection among heroin users in Central Taiwan.

    PubMed

    Lin, Tsang-Yaw; Chen, Vincent C H; Lee, Chao-Hui; Chen, Chung-Ying; Shao, Wen-Chuan; Chang, Sheng-Huang; Chou, Jen-Yu; Lai, Te-Jen; Ferri, Cleusa P; Gossop, Michael; Lee, Charles T C

    2013-12-01

    We investigated the prevalence and correlated factors of human immunodeficiency virus (HIV) among heroin users attending methadone maintenance treatment (MMT) programs in Central Taiwan, and explored the degree of risk perception of HIV infection among the participants. Our study participants were 781 heroin users seeking treatment at the MMT program at Tsaotun Psychiatric Center in Taiwan. The presence of HIV antibodies was identified by microparticle enzyme immunoassay and confirmed by western blot. Multivariate logistic regression was used to identify the independent correlates of HIV infection. The mean age of the sample was 36.1 years [standard deviation (SD) = 7.6]; of the patients, 710 (90.9%) were men. The prevalence of HIV infection among our study population was 20.7%. Multivariate logistic regression analysis revealed that HIV infection was independently associated with the age of the patients of initial heroin use, heroin injection use, nondrug-related criminal convictions, needle-sharing behaviors, and sharing injection paraphernalia. A strong agreement existed between self-reported HIV serostatus and the results of laboratory analyses, with 88.8% of patients reporting their condition correctly. We found a high rate of HIV infection among patients in the MMT program. Factors associated with HIV infection were mostly related to drug-use behaviors. These findings stress the importance of education regarding drug-risk behaviors. Copyright © 2013. Published by Elsevier B.V.

  15. Epidemiology of contemporary seroincident HIV infection in the Navy and Marine corps.

    PubMed

    Brett-Major, David M; Hakre, Shilpa; Naito, Neal A; Armstrong, Adam; Bower, Eric A; Michael, Nelson L; Scott, Paul T

    2012-11-01

    Human Immunodeficiency Virus (HIV) infection continues at a steady rate among U.S. Sailors and Marines. This study provides the first service-specific description of HIV infection demographics. All Sailors and Marines identified as HIV infected between January 2005 and August 2010 were included. The project compared personnel and epidemiologic data, and tested reposed sera in the Department of Defense Serum Repository. This group comprised 410 Sailors and 86 Marines, predominantly men. HIV infected Marines were more likely to be foreign born than their Navy counterparts, 42% versus 10%, p < 0.001. Approximately half of the patients had deployed including to the wars in Iraq or Afghanistan. Nearly half of each group was infected by the age of 25. Similar to the U.S. epidemic, Black race was over-represented. Unlike national rates, Hispanic Sailors and Marines were not over-represented. Demographics were distinct for those of specific occupational specialties. Certain ship classes carried lower incidences. Clustering of HIV infection risk occurred around deployment. The Navy and Marine Corps have different patterns of HIV infection, which may merit distinct approaches to prevention. The Navy may have unique targets for prevention efforts to include pipeline training and first assignment as well as particular occupational environments.

  16. Screening HIV-infected persons for tuberculosis--Cambodia, January 2004-February 2005.

    PubMed

    2005-11-25

    Worldwide, tuberculosis (TB) is one of the most common causes of death among persons infected with human immunodeficiency virus (HIV). The World Health Organization recommends screening HIV-infected persons for TB disease after HIV diagnosis, before initiation of highly active antiretroviral therapy (HAART), and during routine follow-up care. In 2003, health officials in Banteay Meanchey Province, Cambodia, in conjunction with CDC and the U.S. Agency for International Development (USAID), began a pilot project to increase TB screening among persons with HIV infection. Subsequently, CDC analyzed and evaluated data from the first 14 months of the project. This report summarizes the results of that analysis, which determined that, during January 2004--February 2005, among persons with HIV infection at voluntary counseling and confidential testing (VCCT) clinics, 37% were screened for TB disease, and 24% of those screened had TB disease diagnosed. On the basis of these findings, the Provincial Health Department (PHD) took action to increase awareness of the risk for TB among HIV-infected persons. During the 3 months after these measures were implemented, the TB screening rate among persons with HIV infection increased to 61%. Evaluation of projects like the one conducted in Banteay Meanchey Province can help develop an evidence-based approach for removing barriers to screening HIV-infected persons for TB.

  17. Psychosocial and cultural correlates of depression among Hispanic men with HIV infection: a pilot study.

    PubMed

    De Santis, J P; Gonzalez-Guarda, R M; Vasquez, E P

    2012-12-01

    Depression is a common mental health condition among persons with human immunodeficiency virus (HIV) infection. Depression influences quality of life, social relationships and adherence to medication therapy. Little is known about depression among Hispanic men with HIV infection. The purpose of this pilot study was to describe the relationships of depression to other psychosocial factors (self-esteem, Hispanic stress, substance abuse and violence) and cultural factors (familism and Hispanic stress) among a sample of Hispanic men with HIV infection. Using a cross-sectional, descriptive research design a convenience sample of 46 Hispanic men with HIV infection was recruited and surveyed from the South Florida area of the USA. The majority of the participants (65%; n = 30) were depressed. In addition, the majority of participants reported high familism and self-esteem and low Hispanic stress. A history of substance abuse and childhood and adult violence were common. Significant relationships were noted between depression, and self-esteem, Hispanic stress, substance abuse, and adult physical violence. Healthcare providers need to be aware of the high rates of depression, substance abuse and violence that may occur among Hispanic men with HIV infection. More research is needed to further explore the relationship of these factors, as well as to determine the impact that these variables have on adherence to medication therapy among Hispanic men with HIV infection.

  18. Herpes zoster could be an early manifestation of undiagnosed human immunodeficiency virus infection.

    PubMed

    Lai, Shih-Wei; Lin, Cheng-Li; Liao, Kuan-Fu; Chen, Wen-Chi

    2016-05-01

    No formal epidemiological research based on systematic analysis has focused on the relationship between herpes zoster and immunodeficiency virus (HIV) infection in Taiwan. Our aim was to explore whether herpes zoster is an early manifestation of undiagnosed human HIV infection in Taiwan. This was a retrospective cohort study using the database of the Taiwan National Health Insurance Program. A total of 35,892 individuals aged ≤ 84 years with newly diagnosed herpes zoster from 1998 to 2010 were assigned to the herpes zoster group, whereas 143,568 sex-matched and age-matched, randomly selected individuals without herpes zoster served as the non-herpes zoster group. The incidence of HIV diagnosis at the end of 2011 was estimated in both groups. The multivariable Cox proportional hazards regression model was used to estimate the hazard ratio and 95% confidence interval (CI) for risk of HIV diagnosis associated with herpes zoster and other comorbidities including drug dependence and venereal diseases. The overall incidence of HIV diagnosis was 4.19-fold greater in the herpes zoster group than that in the non-herpes zoster group (3.33 per 10,000 person-years vs. 0.80 per 10,000 person-years, 95% CI 4.04-4.35). The multivariable Cox proportional hazards regression analysis revealed that the adjusted hazard ratio of HIV diagnosis was 4.37 (95% CI 3.10-6.15) for individuals with herpes zoster and without comorbidities, as compared with individuals without herpes zoster and without comorbidities. Herpes zoster is associated with HIV diagnosis. Patients who have risk behaviors of HIV infection should receive regular surveillance for undiagnosed HIV infection when they present with herpes zoster. Copyright © 2015. Published by Elsevier B.V.

  19. Impact of IL-22 gene polymorphism on human immunodeficiency virus infection in Han Chinese patients.

    PubMed

    Hu, Jun; Li, Yi; Chen, Lin; Yang, Zhengrong; Zhao, Guanglu; Wang, Yushu; Cheng, Jinquan; Zhao, Jin; Peng, Ying

    2016-12-01

    To analyze the polymorphism of the IL-22 gene in Han Chinese patients and to evaluate the influence of IL-22 polymorphism on human immunodeficiency virus (HIV) infection. IL-22 gene polymorphism was analyzed in 73 blood samples from healthy participants. The influence of the genotype and allele distribution of three single nucleotide polymorphisms (rs2227484, rs2227485, and rs2227513) of IL-22 on HIV infection was evaluated in 619 HIV seropositive patients and 619 healthy controls. To determine the association between the rs2227513 genotype and IL-22 levels in plasma, we randomly selected 29 HIV seropositive blood samples and 15 healthy blood samples and measured the levels of IL-22. Nine single nucleotide polymorphism loci of the IL-22 gene were found (rs2227484, rs2227485, rs2227491, rs2227508, rs2227513, rs1179249, rs1179250, rs1179251, and rs1182844). Stratified analysis (by sex) showed a higher association of HIV infection and the A/G genotype and G allele at rs2227513 in women, but not in men (A/G genotype odds ratio = 5.24, 95% confidence interval = 1.13-24.27; allele G odds ratio = 5.27, 95% confidence interval 1.15-24.23). The rs2227513 A/G genotype was also associated with significantly higher levels of plasma IL-22, regardless of whether the patient was HIV seropositive or seronegative. Our results suggest that IL-22 production in blood might act as a pathogenic factor in HIV infection. Copyright © 2014. Published by Elsevier B.V.

  20. Effects of Fecal Microbial Transplantation on Microbiome and Immunity in Simian Immunodeficiency Virus-Infected Macaques

    PubMed Central

    Hensley-McBain, Tiffany; Zevin, Alexander S.; Manuzak, Jennifer; Smith, Elise; Gile, Jillian; Miller, Charlene; Agricola, Brian; Katze, Michael; Reeves, R. Keith; Kraft, Colleen S.; Langevin, Stanley

    2016-01-01

    ABSTRACT An altered intestinal microbiome during chronic human immunodeficiency virus (HIV) infection is associated with mucosal dysfunction, inflammation, and disease progression. We performed a preclinical evaluation of the safety and efficacy of fecal microbiota transplantation (FMT) as a potential therapeutic in HIV-infected individuals. Antiretroviral-treated, chronically simian immunodeficiency virus (SIV)-infected rhesus macaques received antibiotics followed by FMT. The greatest microbiota shift was observed after antibiotic treatment. The bacterial community composition at 2 weeks post-FMT resembled the pre-FMT community structure, although differences in the abundances of minor bacterial populations remained. Immunologically, we observed significant increases in the number of peripheral Th17 and Th22 cells and reduced CD4+ T cell activation in gastrointestinal tissues post-FMT. Importantly, the transplant was well tolerated with no negative clinical side effects. Although this pilot study did not control for the differential contributions of antibiotic treatment and FMT to the observed results, the data suggest that FMT may have beneficial effects that should be further evaluated in larger studies. IMPORTANCE Due to the immunodeficiency and chronic inflammation that occurs during HIV infection, determination of the safety of FMT is crucial to prevent deleterious consequences if it is to be used as a treatment in the future. Here we used the macaque model of HIV infection and performed FMT on six chronically SIV-infected rhesus macaques on antiretroviral treatment. In addition to providing a preclinical demonstration of the safety of FMT in primates infected with a lentivirus, this study provided a unique opportunity to examine the relationships between alterations to the microbiome and immunological parameters. In this study, we found increased numbers of Th17 and Th22 cells as well as decreased activation of CD4+ T cells post-FMT, and these changes

  1. Molecular Epidemiology of Kaposi’s Sarcoma-Associated Herpes Virus, and Risk Factors in HIV-infected Patients in Tehran, 2014

    PubMed Central

    Hesamizadeh, Khashayar; Keyvani, Hossein; Bokharaei-Salim, Farah; Monavari, Seyed Hamidreza; Esghaei, Maryam; Jahanbakhsh Sefidi, Fatemeh

    2016-01-01

    Background Kaposi’s sarcoma (KS) remains the most common malignancy among HIV-infected patients. Human herpesvirus type-8 (HHV-8) is regarded as the infectious etiological agent of Kaposi’s sarcoma (KSHV). Diagnostic procedures associated with KSHV are not routinely performed in HIV-infected subjects. Objectives The main objective of this study is to obtain information on KSHV epidemiology in Iranian HIV-infected individuals. Patients and Methods In the present cross-sectional study, 109 patients with established HIV infection, who visited a governmental and referral center for HIV screening in Tehran (Tehran west health center (TWHC)) between May 2014 and July 2015 were enrolled according to the convenience sample strategy. After peripheral blood collection, isolation of plasma and peripheral blood mononuclear cell (PBMC) compartments, DNA extraction was performed. KSHV DNA was analyzed by nested polymerase chain reaction (nested PCR) using primers from ORF-26 (virus minor capsid). Results Among all 109 HIV-infected patients, 67 (61.5%) were male, with an age range of 2 - 64 years (mean ± standard deviation 35.8 ± 13.3). KSHV DNA was found in PBMC and plasma samples of six (5.5%) and four (3.6%) patients, respectively. Conclusions This study revealed a considerable prevalence of KSHV DNA, during latent and lytic phases, among HIV-infected patients. Risk factors for KSHV infection acquisition and concurrent. 0+infection with HIV were also evaluated. Diagnosis of KSHV in the group could be helpful for prognosis of Kaposi’s sarcoma and clinical management. PMID:28191343

  2. Selective Destruction Of Cells Infected With The Human Immunodeficiency Virus

    DOEpatents

    Keener, William K.; Ward, Thomas E.

    2006-03-28

    Compositions and methods for selectively killing a cell containing a viral protease are disclosed. The composition is a varient of a protein synthesis inactivating toxin wherein a viral protease cleavage site is interposed between the A and B chains. The variant of the type II ribosome-inactivating protein is activated by digestion of the viral protease cleavage site by the specific viral protease. The activated ribosome-inactivating protein then kills the cell by inactivating cellular ribosomes. A preferred embodiment of the invention is specific for human immunodeficiency virus (HIV) and uses ricin as the ribosome-inactivating protein. In another preferred embodiment of the invention, the variant of the ribosome-inactivating protein is modified by attachment of one or more hydrophobic agents. The hydrophobic agent facilitates entry of the variant of the ribosome-inactivating protein into cells and can lead to incorporation of the ribosome-inactivating protein into viral particles. Still another preferred embodiment of the invention includes a targeting moiety attached to the variants of the ribosome-inactivating protein to target the agent to HIV infectable cells.

  3. Selective destruction of cells infected with human immunodeficiency virus

    DOEpatents

    Keener, William K.; Ward, Thomas E.

    2003-09-30

    Compositions and methods for selectively killing a cell containing a viral protease are disclosed. The composition is a variant of a protein synthesis inactivating toxin wherein a viral protease cleavage site is interposed between the A and B chains. The variant of the type II ribosome-inactivating protein is activated by digestion of the viral protease cleavage site by the specific viral protease. The activated ribosome-inactivating protein then kills the cell by inactivating cellular ribosomes. A preferred embodiment of the invention is specific for human immunodeficiency virus (HIV) and uses ricin as the ribosome-inactivating protein. In another preferred embodiment of the invention, the variant of the ribosome-inactivating protein is modified by attachment of one or more hydrophobic agents. The hydrophobic agent facilitates entry of the variant of the ribosome-inactivating protein into cells and can lead to incorporation of the ribosome-inactivating protein into viral particles. Still another preferred embodiment of the invention includes a targeting moiety attached to the variants of the ribosome-inactivating protein to target the agent to HIV infectable cells.

  4. Human immunodeficiency virus serostatus and the risk of postextraction complications.

    PubMed

    Dodson, T B; Perrott, D H; Gongloff, R K; Kaban, L B

    1994-04-01

    Despite the increasing prevalence of human immunodeficiency virus (HIV) disease in the population and the increasing likelihood that HIV-positive (HIV+) patients may have an extraction, little is known about the risk of postoperative complications in this group. The goal of this investigation was to assess the risk of postoperative complications in HIV+ patients after tooth extraction. The study was designed as a retrospective cohort study with a sample consisting of 145 males who underwent tooth extraction. The patients' medical and dental records were reviewed to identify HIV serostatus, to document the frequency and type of postoperative complications, and to collect data on potential confounding variables. Forty-four patients were identified as HIV+. The postoperative complication rate in HIV+ patients was 20.9% and for HIV-negative (HIV-) patients 2.9% (relative risk = 7.0, 95% confidence interval = 2.0-25.0, P = 0.001). Furthermore, as the manifestations of the symptoms of HIV infection became more severe, the postextraction complication rate also increased (P = 0.008). The results of this study suggest that HIV+ patients have an increased risk of postextraction complications and as the level of HIV disease increases, the risk of complications also increases. While the findings of this study are consistent with studies based on case series, prospective cohort studies are required to confirm the findings.

  5. Federal spending for illness caused by the human immunodeficiency virus.

    PubMed

    Winkenwerder, W; Kessler, A R; Stolec, R M

    1989-06-15

    Is the federal government devoting sufficient resources to fighting the epidemic of human immunodeficiency virus (HIV) infection, and are these resources being spent appropriately? Some observers contend that the amounts have been inadequate, but until now there has been no overall accounting of federal activities and spending to combat the epidemic. We report expenditure data collected from federal agencies for the years 1982 to 1989. In all, $5.5 billion will have been spent on HIV-related illness during this period by the federal government, nearly 60 percent of it by the U.S. Public Health Service. Federal spending on HIV-related illness in 1989 will reach $2.2 billion, representing over one third of all estimated national (public and private) HIV expenditures, and tripling state expenditures. In 1992, federal spending on the epidemic will reach an estimated $4.3 billion. Although sizable, this will be just 1.8 percent of all 1992 federal health dollars. Similarly, in 1992, national (public and private) spending on HIV-related illness will consume roughly 1.6 percent of all health-related costs in the United States. Federal spending for HIV research and prevention is similar to funding for other major diseases, including some conditions, such as cancer and heart disease, that now have a greater impact on mortality.

  6. Disparities in cancer treatment among patients infected with the human immunodeficiency virus.

    PubMed

    Suneja, Gita; Lin, Chun Chieh; Simard, Edgar P; Han, Xuesong; Engels, Eric A; Jemal, Ahmedin

    2016-08-01

    Patients with cancer who are infected with the human immunodeficiency virus (HIV) are less likely to receive cancer treatment compared with HIV-uninfected individuals. However, to the authors' knowledge, the impact of insurance status and comorbidities is unknown. Data from the National Cancer Data Base were used to study nonelderly adults diagnosed with several common cancers from 2003 to 2011. Cancer treatment was defined as chemotherapy, surgery, radiotherapy, or any combination during the first course of treatment. Multivariate logistic regression was used to examine associations between HIV status and lack of cancer treatment, and identify predictors for lack of treatment among HIV-infected patients. A total of 10,265 HIV-infected and 2,219,232 HIV-uninfected cases were included. In multivariate analysis, HIV-infected patients with cancer were found to be more likely to lack cancer treatment for cancers of the head and neck (adjusted odds ratio [aOR], 1.48; 95% confidence interval [95% CI], 1.09-2.01), upper gastrointestinal tract (aOR, 2.62; 95% CI, 2.04-3.37), colorectum (aOR, 1.70; 95% CI, 1.17-2.48), lung (aOR, 2.46; 95% CI, 2.19-2.76), breast (aOR, 2.14; 95% CI, 1.16-3.98), cervix (aOR, 2.81; 95% CI, 1.77-4.45), prostate (aOR, 2.16; 95% CI, 1.69-2.76), Hodgkin lymphoma (aOR, 1.92; 95% CI, 1.66-2.22), and diffuse large B-cell lymphoma (aOR, 1.82; 95% CI, 1.65-2.00). Predictors of a lack of cancer treatment among HIV-infected individuals varied by tumor type (solid tumor vs lymphoma), but black race and a lack of private insurance were found to be predictors for both groups. In the United States, HIV-infected patients with cancer appear to be less likely to receive cancer treatment regardless of insurance and comorbidities. To the authors' knowledge, the current study is the largest study of cancer treatment in HIV-infected patients with cancer in the United States and provides evidence of cancer treatment disparities even after controlling for differences

  7. Sexually Transmitted Infections in Youth With Controlled and Uncontrolled Human Immunodeficiency Virus Infection.

    PubMed

    Camacho-Gonzalez, Andres F; Chernoff, Miriam C; Williams, Paige L; Chahroudi, Ann; Oleske, James M; Traite, Shirley; Chakraborty, Rana; Purswani, Murli U; Abzug, Mark J

    2016-07-20

    Sexually transmitted infections (STIs), including human immunodeficiency virus (HIV), disproportionately affect adolescents and young adults (AYAs) ages 13-24 years. Sexually transmitted infections likewise are a risk factor for HIV acquisition and transmission; however, there is a lack of data on STI acquisition in HIV-infected AYAs. We determined the incidence of STIs in HIV-infected AYAs 12.5 <25 years of age in the International Maternal Pediatric Adolescent AIDS Clinical Trials (IMPAACT) P1074 observational cohort study. Univariate and multivariable logistic regression models were used to evaluate the association of HIV control (mean viral load <500 copies/mL and CD4(+) T cells >500 cells/mm(3) in the year preceding STI diagnosis) and other risk factors with STI occurrence. Of 1201 enrolled subjects, 1042 participants met age criteria and were included (49% male, 61% black, 88% perinatally infected; mean age 18.3 years). One hundred twenty participants had at least 1 STI on study, of whom 93 had their first lifetime STI (incidence rate = 2.8/100 person-years). For individual STI categories, 155 incident category-specific events were reported; human papillomavirus (HPV) and chlamydial infections were the most common. In the multivariable model, having an STI was associated with older age (adjusted odds ratio [aOR] = 1.13; 95% confidence interval [CI], 1.05-1.22), female sex (aOR = 2.65; 95% CI, 1.67-4.21), nonperinatal HIV acquisition (aOR = 2.33; 95% CI, 1.29-4.22), and uncontrolled HIV infection (aOR = 2.05; 95% CI, 1.29-3.25). Sexually transmitted infection acquisition in HIV-infected AYAs is associated with older age, female sex, nonperinatal HIV acquisition, and poorly controlled HIV infection. Substantial rates of STIs among HIV-infected AYAs support enhanced preventive interventions, including safe-sex practices and HPV vaccination, and antiretroviral adherence strategies. © The Author 2016. Published by Oxford University Press on behalf of the

  8. [The HIV-infection outbreak in the town Lys'va (Perm region): homozygote genotype CCR5 delta32/CCR5 delta32 provides the high level of the persistence in the parenteral transmission of the virus].

    PubMed

    Riabov, G S; Kazennova, E V; Korepanova, L B; Mal'tseva, E A; Zhalnin, V V; Krasnikova, L A; Zverev, S Ia; Pokrovskiĭ, V V; Bobkov, A F; Weber, J N

    2002-01-01

    Specific features of human immunodeficiency virus type 1 (HIV-1) transmission among injecting drug users were studied on HIV infection outbreak in Lysva, the Perm region. During the period from November 1998 to March 2000, 32 injecting drug users infected with the subtype A HIV-1 variant originating from the same source, were found in this town. To understand the role of the CCR5 delta 32 mutation in parenteral transmission of HIV-1 the distribution of the mutant CCR5 delta 32 allele in HIV-infected and in non-infected but HIV-exposed drug users (n = 74) was analysed. The percentage of the homozygous CCR5 delta 32 genotype among HIV-exposed individuals (4/74, 5.4%) was significantly (p < 0.05) higher than the analogous rate for healthy blood donors in Russia (1/163, 0.6%). Thus, the homozygosity for this mutant allele confers a high resistance level to HIV even in parenteral transmission.

  9. Revised surveillance case definitions for HIV infection among adults, adolescents, and children aged <18 months and for HIV infection and AIDS among children aged 18 months to <13 years--United States, 2008.

    PubMed

    Schneider, Eileen; Whitmore, Suzanne; Glynn, Kathleen M; Dominguez, Kenneth; Mitsch, Andrew; McKenna, Matthew T

    2008-12-05

    For adults and adolescents (i.e., persons aged >/=13 years), the human immunodeficiency virus (HIV) infection classification system and the surveillance case definitions for HIV infection and acquired immunodeficiency syndrome (AIDS) have been revised and combined into a single case definition for HIV infection. In addition, the HIV infection case definition for children aged <13 years and the AIDS case definition for children aged 18 months to <13 years have been revised. No changes have been made to the HIV infection classification system, the 24 AIDS-defining conditions for children aged <13 years, or the AIDS case definition for children aged <18 months. These case definitions are intended for public health surveillance only and not as a guide for clinical diagnosis. Public health surveillance data are used primarily for monitoring the HIV epidemic and for planning on a population level, not for making clinical decisions for individual patients. CDC and the Council of State and Territorial Epidemiologists recommend that all states and territories conduct case surveillance of HIV infection and AIDS using the 2008 surveillance case definitions, effective immediately.

  10. Effective use of frozen donor peripheral blood mononuclear cells for human immunodeficiency virus type 1 isolation from vertically infected pediatric patients.

    PubMed Central

    Paul, M O; Tetali, S; Pahwa, S

    1994-01-01

    In this study, we examined variables related to human immunodeficiency virus (HIV) isolation utilizing samples from 51 HIV-infected (153 plasma and 122 peripheral blood mononuclear cell [PBMC] samples) and 57 uninfected (182 plasma and 163 PBMC samples) infants. Our chief observation was that cryopreservation of donor PBMCs does not significantly alter their sensitivity or specificity for isolation of HIV from patient PBMCs or plasma. PMID:8051275

  11. Effective use of frozen donor peripheral blood mononuclear cells for human immunodeficiency virus type 1 isolation from vertically infected pediatric patients.

    PubMed

    Paul, M O; Tetali, S; Pahwa, S

    1994-05-01

    In this study, we examined variables related to human immunodeficiency virus (HIV) isolation utilizing samples from 51 HIV-infected (153 plasma and 122 peripheral blood mononuclear cell [PBMC] samples) and 57 uninfected (182 plasma and 163 PBMC samples) infants. Our chief observation was that cryopreservation of donor PBMCs does not significantly alter their sensitivity or specificity for isolation of HIV from patient PBMCs or plasma.

  12. Roles for biological membranes in regulating human immunodeficiency virus replication and progress in the development of HIV therapeutics that target lipid metabolism.

    PubMed

    Haughey, Norman J; Tovar-y-Romo, Luis B; Bandaru, Veera Venkata Ratnam

    2011-06-01

    Infection by the human immunodeficiency virus (HIV) involves a number of important interactions with lipid components in host membranes that regulate binding, fusion, internalization, and viral assembly. Available data suggests that HIV actively modifies the sphingolipid content of cellular membranes to create focal environments that are favorable for infection. In this review, we summarize the roles that membrane lipids play in HIV infection and discuss the current status of therapeutics that attempt to modify biological membranes to inhibit HIV.

  13. Effect of Intercurrent Infections and Vaccinations on Immune and Inflammatory Biomarkers Among Human Immunodeficiency Virus-Infected Adults on Suppressive Antiretroviral Therapy

    PubMed Central

    Tan, Darrell H. S.; Szadkowski, Leah; Raboud, Janet; Yi, Tae Joon; Shannon, Brett; Kaul, Rupert; Liles, W. Conrad; Walmsley, Sharon

    2015-01-01

    We used generalized estimating equations to quantify the impact of recent vaccination or intercurrent infections on immune and inflammatory biomarkers among 144 human immunodeficiency virus (HIV)-infected adults with HIV RNA < 50 copies/mL on antiretroviral therapy. These events were associated with a 2.244 µg/mL increase in high sensitivity C-reactive protein and should be routinely assessed in future studies. PMID:26380337

  14. HIV Infection of Hepatocytes Results in a Modest Increase in Hepatitis C Virus Expression In Vitro

    PubMed Central

    Kong, Ling; Welge, Jeffrey A.; Powell, Eleanor A.; Blackard, Jason T.

    2014-01-01

    Previous studies demonstrate that soluble HIV proteins impact both hepatocyte function and HCV replication in vitro. It has also been reported that HIV can productively infect hepatocytes. We therefore investigated the impact of HIV infection of hepatocytes on HCV expression. The Huh7.5JFH1 cell line that constitutively expresses infectious HCV was infected with the lab-adapted strains HIVNL4-3 or HIVYK-JRCSF. HCV expression was quantified via HCV core antigen ELISA, Western blot, and strand-specific real-time PCR for positive-sense and negative-sense HCV RNA. After HIVNL4-3 infection of Huh7.5JFH1 cells, positive-sense and negative-sense HCV RNA levels were elevated compared to HIV uninfected cells. Increased HCV RNA synthesis was also observed after infection of Huh7.5JFH1 cells with HIVYK-JRCSF. HIV-induced HCV core production was decreased in the presence of the anti-HIV drugs AZT, T20, and raltegravir, although these medications had a minimal effect on HCV expression in the absence of HIV. HCV core, NS3, and NS5A protein expression were increased after HIV infection of Huh7.5JFH1 cells. Chemically inactivated HIV had a minimal effect on HCV expression in Huh7.5JFH1 cells suggesting that ongoing viral replication was critical. These data demonstrate that HIV induces HCV RNA synthesis and protein production in vitro and complement previous in vivo reports that HCV RNA levels are elevated in individuals with HIV/HCV co-infection compared to those with HCV mono-infection. These findings suggest that HIV suppression may be a critical factor in controlling liver disease, particularly if the underlying liver disease is not treated. PMID:24586227

  15. Primate immunodeficiency virus classification and nomenclature: Review.

    PubMed

    Foley, Brian T; Leitner, Thomas; Paraskevis, Dimitrios; Peeters, Martine

    2016-12-01

    The International Committee for the Taxonomy and Nomenclature of Viruses does not rule on virus classifications below the species level. The definition of species for viruses cannot be clearly defined for all types of viruses. The complex and interesting epidemiology of Human Immunodeficiency Viruses demands a detailed and informative nomenclature system, while at the same time it presents challenges such that many of the rules need to be flexibly applied or modified over time. This review outlines the nomenclature system for primate lentiviruses and provides an update on new findings since the last review was written in 2000.

  16. Primate immunodeficiency virus classification and nomenclature: Review

    DOE PAGES

    Foley, Brian T.; Leitner, Thomas; Paraskevis, Dimitrios; ...

    2016-10-24

    The International Committee for the Taxonomy and Nomenclature of Viruses does not rule on virus classifications below the species level. The definition of species for viruses cannot be clearly defined for all types of viruses. The complex and interesting epidemiology of Human Immunodeficiency Viruses demands a detailed and informative nomenclature system, while at the same time it presents challenges such that many of the rules need to be flexibly applied or modified over time. As a result, this review outlines the nomenclature system for primate lentiviruses and provides an update on new findings since the last review was written inmore » 2000.« less

  17. Primate immunodeficiency virus classification and nomenclature: Review

    SciTech Connect

    Foley, Brian T.; Leitner, Thomas; Paraskevis, Dimitrios; Peeters, Martine

    2016-10-24

    The International Committee for the Taxonomy and Nomenclature of Viruses does not rule on virus classifications below the species level. The definition of species for viruses cannot be clearly defined for all types of viruses. The complex and interesting epidemiology of Human Immunodeficiency Viruses demands a detailed and informative nomenclature system, while at the same time it presents challenges such that many of the rules need to be flexibly applied or modified over time. As a result, this review outlines the nomenclature system for primate lentiviruses and provides an update on new findings since the last review was written in 2000.

  18. Real-Time PCR Assay for Clinical Management of Human Immunodeficiency Virus-Infected Patients with Visceral Leishmaniasis

    PubMed Central

    Bossolasco, Simona; Gaiera, Giovanni; Olchini, Davide; Gulletta, Maurizio; Martello, Leonardo; Bestetti, Arabella; Bossi, Laura; Germagnoli, Luca; Lazzarin, Adriano; Uberti-Foppa, Caterina; Cinque, Paola

    2003-01-01

    To evaluate the usefulness of a real-time PCR for Leishmania DNA in the diagnosis and follow-up of patients with human immunodeficiency virus type 1 (HIV-1) and Leishmania coinfection, Leishmania DNA levels were measured in whole peripheral blood from 25 HIV-infected patients with clinical features suggestive of visceral leishmaniasis. Leishmania DNA was detected in 10 of 25 patients with microscopically confirmed visceral leishmaniasis and in none of those without this disease. Following treatment with liposomal amphotericin B, a clinical response was observed in 9 of 10 patients, in association with significantly decreased parasite loads. Seven patients relapsed clinically a median of 110 days after the end of treatment, in association with substantial increases in Leishmania DNA levels. Leishmania DNA levels correlated with the clinical course of visceral leishmaniasis, and their measurement at diagnosis and during and after treatment seems to be useful in the clinical management of HIV-infected patients with this disease. PMID:14605142

  19. Serum creatinine elevation after switch to dolutegravir in a human immunodeficiency virus-positive kidney transplant recipient.

    PubMed

    Lee, D H; Malat, G E; Bias, T E; Harhay, M N; Ranganna, K; Doyle, A M

    2016-08-01

    Dolutegravir is a preferred antiretroviral drug for human immunodeficiency virus (HIV)-infected patients following solid organ transplantation. It has potent antiretroviral activity and does not interact with calcineurin inhibitors. We describe a case of an HIV-infected kidney transplant patient, who was noted to have a rising serum creatinine following initiation of dolutegravir. At first, an acute rejection episode was suspected, but this finding was later attributed to inhibition of creatinine secretion by dolutegravir. We suggest that an awareness of this potential effect of dolutegravir is important for providers who take care of HIV-positive kidney transplant recipients, in order to prevent potentially unnecessary testing. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  20. Aggressive restenosis after percutaneous intervention in two coronary loci in a patient with human immunodeficiency virus infection

    PubMed Central

    Alkhalil, Mohammad; Conlon, Christopher P; Ashrafian, Houman; Choudhury, Robin P

    2017-01-01

    A 54-year-old black African woman, 22 years human immunodeficiency virus (HIV)-positive, presented with an acute coronary syndrome. She was taking two nucleoside reverse transcriptase inhibitors and two protease inhibitors. Viral load and CD4 count were stable. Angiography revealed a right coronary artery lesion, which was treated with everolimus eluting stent. She also underwent balloon angioplasty to the first diagonal. She re-presented on three different occasions and technically successful coronary intervention was performed. The patient has reported satisfactory compliance with dual anti platelet therapy throughout. She was successfully treated with surgical revascularisation. The patient did not experience any clinical recurrence on follow up. This case demonstrates exceptionally aggressive multifocal and recurrent instent restenosis in a patient treated for HIV infection, raising the possibility of an association with HIV infection or potentially components of retro viral therapy. PMID:28255546

  1. Comparison of depression, anxiety, stress, and related factors among women and men with human immunodeficiency virus infection

    PubMed Central

    Saadat, Mina; Behboodi, Zahra M.; Saadat, Ebrahim

    2015-01-01

    AIMS: To compare depression, anxiety, stress, and related factors among women and men with human immunodeficiency virus (HIV) infection. SETTINGS AND DESIGN: In this cross-sectional survey conducted between November and September 2013, 200 participants with HIV/acquired immune deficiency syndrome (AIDS) attending Consultation Centers. MATERIALS AND METHODS: Participants with HIV/AIDS were interviewed using the Depression, Anxiety and Stress Scales questionnaire (DASS21 ). RESULTS: There were significant associations between marital status of women and the level of depression (P < 0.05). However, the mean depression and anxiety in women are greater than men (P < 0.05), and the mean stress in men is greater than women (P < 0.05). CONCLUSIONS: HIV infection is related with psychiatric disorders. According to the results, women are more vulnerable to depression and anxiety and they need more care. Management of these psychiatric disorders is very important and requires innovative comprehensive approaches. PMID:25838749

  2. Aggressive restenosis after percutaneous intervention in two coronary loci in a patient with human immunodeficiency virus infection.

    PubMed

    Alkhalil, Mohammad; Conlon, Christopher P; Ashrafian, Houman; Choudhury, Robin P

    2017-02-16

    A 54-year-old black African woman, 22 years human immunodeficiency virus (HIV)-positive, presented with an acute coronary syndrome. She was taking two nucleoside reverse transcriptase inhibitors and two protease inhibitors. Viral load and CD4 count were stable. Angiography revealed a right coronary artery lesion, which was treated with everolimus eluting stent. She also underwent balloon angioplasty to the first diagonal. She re-presented on three different occasions and technically successful coronary intervention was performed. The patient has reported satisfactory compliance with dual anti platelet therapy throughout. She was successfully treated with surgical revascularisation. The patient did not experience any clinical recurrence on follow up. This case demonstrates exceptionally aggressive multifocal and recurrent instent restenosis in a patient treated for HIV infection, raising the possibility of an association with HIV infection or potentially components of retro viral therapy.

  3. Fast track, dynein-dependent nuclear targeting of human immunodeficiency virus Vpr protein; impaired trafficking in a clinical isolate.

    PubMed

    Caly, Leon; Kassouf, Vicki T; Moseley, Gregory W; Diefenbach, Russell J; Cunningham, Anthony L; Jans, David A

    2016-02-12

    Nuclear import of the accessory protein Vpr is central to infection by human immunodeficiency virus (HIV). We previously identified the Vpr F72L mutation in a HIV-infected, long-term non-progressor, showing that it resulted in reduced Vpr nuclear accumulation and altered cytoplasmic localisation. Here we demonstrate for the first time that the effects of nuclear accumulation of the F72L mutation are due to impairment of microtubule-dependent-enhancement of Vpr nuclear import. We use high resolution imaging approaches including fluorescence recovery after photobleaching and other approaches to document interaction between Vpr and the dynein light chain protein, DYNLT1, and impaired interaction of the F72L mutant with DYNLT1. The results implicate MTs/DYNLT1 as drivers of Vpr nuclear import and HIV infection, with important therapeutic implications.

  4. The state of science: violence and HIV infection in women.

    PubMed

    Manfrin-Ledet, Linda; Porche, Demetrius J

    2003-01-01

    Violence and human immunodeficiency virus (HIV) are two critical public health problems affecting the lives of millions of women today. The purpose of this article is to review the state of science that exists in linking the phenomena of violence and HIV infection in women. The history and scope of violence and HIV infection is presented. Theoretical models for the phenomena of violence and abuse against women and HIV risk behavior reduction are explored. The literature review consists of 44 research articles that examine risk factors for violence and HIV, violence associated with HIV/AIDS disclosure, history of violence and HIV/AIDS, forced or coercive sex and HIV/AIDS, and violence associated with HIV self-protection conduct. Implications for nursing practice and nursing research are presented.

  5. Potent inhibition of human immunodeficiency virus by MDL 101028, a novel sulphonic acid polymer.

    PubMed

    Taylor, D L; Brennan, T M; Bridges, C G; Mullins, M J; Tyms, A S; Jackson, R; Cardin, A D

    1995-10-01

    MDL 101028, a novel biphenyl disulphonic acid urea co-polymer was designed and synthesised as a heparin mimetic. This low molecular weight polymer showed potent inhibition of human immunodeficiency virus type 1 (HIV-1) replication in a number of host-cell/virus systems, including primary clinical isolates of the virus cultured in human peripheral blood mononuclear cells (PBMCs). When compared with the heterogeneous polysulphated molecules, heparin and dextran sulphate, this chemically defined compound showed equivalent antiviral activity with 50% inhibitory concentrations (IC50s) in the range 0.27-3.0 micrograms/ml in the host-cell/virus systems tested. MDL 101028 also inhibited the replication of HIV type 2 and the simian immunodeficiency virus (SIV), as well as HIV-1 variants resistant to reverse transcriptase inhibitors. Virus growth was blocked when exposure of T-lymphocytes to MDL 101028 was restricted to the virus absorption stage, or even in whole blood conditions. MDL 101028 did not irreversibly inactivate virions, and in contrast to heparin, did not inhibit the attachment of radiolabelled HIV-1 to CD4+ T-cells. MDL 101028 blocked HIV-induced cell-to-cell fusion and this activity appears to explain the mechanism of its antiviral action. The antiviral evaluation of discrete oligomer molecules of MDL 101028 showed that a polymer chain length of six repeating units had optimal potency. The lack of anticoagulant properties and significant antiviral activity in whole blood may allow the development of MDL 101028 as a treatment of HIV infections.

  6. Prevalence of occult hepatitis C virus infection in the Iranian patients with human immunodeficiency virus infection.

    PubMed

    Bokharaei-Salim, Farah; Keyvani, Hossein; Esghaei, Maryam; Zare-Karizi, Shohreh; Dermenaki-Farahani, Sahar-Sadat; Hesami-Zadeh, Khashayar; Fakhim, Shahin

    2016-11-01

    Occult hepatitis C virus (HCV) infection is a new form of chronic HCV infection described by the presence of the genomic HCV-RNA in liver biopsy and/or peripheral blood mononuclear cell (PBMC) samples, and undetectable levels or absence of HCV-RNA and in the absence or presence of anti HCV antibodies in the plasma specimens. The aim of the present study was to evaluate the occurrence of occult HCV infection (OCI) among Iranian subjects infected with human immunodeficiency virus (HIV) using RT-nested PCR. From March 2014 until April 2015, 109 Iranian patients with established HIV infection were enrolled in this cross-sectional study. After extraction of viral RNA from the plasma and PBMC samples, HCV-RNA status was examined by RT-nested PCR using primers from the 5'-NTR. HCV genotyping was conducted using RFLP analysis. For the confirmation of HCV genotyping by RFLP method, the PCR products were sequenced. Of the 109 patients, 50 were positive for antibodies against HCV. The HCV-RNA was detected in PBMC specimens in 6 (10.2%) out of the total 59 patients negative for anti-HCV Abs and undetectable plasma HCV-RNA and also from 4 (8.0%) out of the total 50 patients positive for anti-HCV Abs and undetectable plasma HCV-RNA. HCV genotyping analysis showed that 6 (60.0%) patients were infected with HCV subtype 3a, 3 (30.0%) were infected with HCV subtype 1a and 1 (10.0%) patient was infected with HCV subtype 1b. This study revealed the incidence of OCI (9.2%) in HIV-infected Iranian patients. Hence, designing prospective studies focusing on the detection of OCI in these patients would provide more information. J. Med. Virol. 88:1960-1966, 2016. © 2016 Wiley Periodicals, Inc.

  7. Human immunodeficiency virus postexposure prophylaxis for adolescents and children.

    PubMed

    Merchant, R C; Keshavarz, R

    2001-08-01

    Children and adolescents are at risk for human immunodeficiency virus (HIV) infection. Transmission occurs through perinatal exposures, injecting drug use, consensual and nonconsensual sex, needle-stick and sharp injuries, and possibly some unusual contacts. Youth engaging in high-risk sexual activities are especially endangered. Half of the estimated worldwide 5.3 million new HIV infections occur in adolescents and young adults aged 15 to 24. Of 20 000 known new adult and adolescent cases in the United States, 25% involve 13- to 21-year-olds. More than 1.4 million children worldwide (aged 15 and younger) are believed to be infected, and >1640 new cases are diagnosed daily. Of the 432 000 people reported to be living with HIV or acquired immunodeficiency syndrome (AIDS) in the United States, 5575 are children under 13. HIV postexposure prophylaxis (PEP) is a form of secondary HIV prevention that may reduce the incidence of HIV infections. HIV PEP is commonly conceived of as 2 types: occupational and nonoccupational. Occupational HIV PEP is an accepted form of therapy for health care workers exposed to HIV through their jobs. A landmark study of healthcare workers concluded that occupational HIV PEP may be efficacious. Well-established US national guidelines for occupational HIV PEP exist for this at-risk population. Nonoccupational HIV PEP includes all other forms of HIV PEP, such as that given after sexual assault and consensual sex, injecting drug use, and needle-stick and sharp injuries in non-health care persons. Pediatric HIV PEP is typically the nonoccupational type. The efficacy of nonoccupational HIV PEP is unknown. The presumed efficacy is based on a collection of animal and human data concerning occupational, perinatal, and nonoccupational exposures to HIV. In contrast to occupational HIV PEP, there are no national US guidelines for nonoccupational HIV PEP, and few recommendations are available for its use for adolescents and children. Regardless of this

  8. Sleep patterns are disturbed in cats infected with feline immunodeficiency virus.

    PubMed Central

    Prospéro-García, O; Herold, N; Phillips, T R; Elder, J H; Bloom, F E; Henriksen, S J

    1994-01-01

    Human immunodeficiency virus (HIV)-related sleep disturbances have been reported early in AIDS. Likewise, the feline immunodeficiency virus (FIV), a natural lentivirus pathogen of cats, produces a similar immunodeficiency syndrome with neurological sequelae. To identify the neurophysiological substrate of FIV infection in brain, pathogen-free cats were infected with the Maryland strain of FIV. Eight weeks after inoculation, all FIV-infected cats seroconverted and virus was detected in the cerebrospinal fluid and in the mononuclear cells of peripheral blood. Ten to 12 months after the FIV inoculation, inoculated and control cats were surgically implanted with electrodes to record the sleep/wake cycle. These sleep recordings were obtained under conditions controlling for environmental variables and instrumental adaptation. FIV-infected cats spent 50% more time awake than the sham-inoculated controls and exhibited many more sleep/waking stage shifts--i.e., 40% more than controls. In addition, FIV-infected cats showed approximately 30% of rapid eye movement (REM) sleep reduction compared to controls. The latency to sleep and REM sleep onset was also significantly delayed in FIV-infected cats. In addition, a remarkable increase in cortically recorded spindle activity (8-13 Hz) was observed during slow-wave sleep in some infected subjects, similar to changes described in HIV-infected humans. Moreover, infected cats exhibited no overt signs of systemic morbidity, such as hyperpyrexia or body weight loss. These results indicate that FIV-infected cats exhibit sleep abnormalities similar to the sleep disturbances previously described in AIDS patients and further support the feline preparation as a valuable animal model of HIV infection of the central nervous system. PMID:7809152

  9. Duration of Influenza Virus Shedding Among HIV-Infected Adults in the cART Era, 2010–2011

    PubMed Central

    Bush, Timothy; Kojic, E. Milu; Overton, Edgar T.; Henry, Keith; Önen, Nur; Rhame, Frank; Conley, Lois; Brooks, John T.; Fry, Alicia

    2016-01-01

    Abstract The duration of influenza virus shedding in HIV-infected adults is unknown and could affect quarantine and treatment recommendations. Participants were monitored for influenza-like illness (ILI), defined as fever and cough or sore throat, using weekly telephone audio computer-assisted self-interviews. Those with ILI were further evaluated at three HIV specialty clinics. For those with influenza, we collected nasopharyngeal washes every 3 days after the date of confirmed influenza infection for 21–28 days; specimens underwent reverse transcriptase - polymerase chain reaction (RT-PCR) and viral culture. Duration of influenza virus shedding was the interval from the date of onset (day 0) of ILI to the date of last culture-positive specimen. Characteristics were compared between patients with and without influenza using Fisher's exact test. We used the Wilcoxon rank-sum test to examine factors that may have affected influenza virus shedding. From October 2010 to April 2011, we enrolled 961 participants in syndromic surveillance and diagnosed 20 patients with influenza whose characteristics were as follows: median age 48 years (interquartile range [IQR]: 43–53), 60% male, 50% non-Hispanic black, 95% had been prescribed combination highly active antiretroviral therapy (cART), 85% were virologically suppressed (HIV RNA <400 copies/ml), median CD4 cell count 317 cells/mm3 (IQR: 190-544), and median follow-up time 21 days (IQR: 19–22). Compared with persons without influenza, persons with influenza were more likely to be older, use injection drugs, and have a lower median CD4 cell count and were less likely to have had an influenza vaccination in the past 12 months. Median durations of shedding, PCR detection, and ILI symptoms were 3 (IQR: 0–5), 10 (IQR: 6–15), and 14 days (IQR: 12–26), respectively. Median days of shedding were similar among patients with and without any prior influenza vaccination (0 vs. 4, p = .448), HIV viral suppression (2 vs

  10. A human immunodeficiency virus peer education program for adolescent females.

    PubMed

    Slap, G B; Plotkin, S L; Khalid, N; Michelman, D F; Forke, C M

    1991-09-01

    Black adolescent females living in urban environments are at high risk for human immunodeficiency virus (HIV) infection. Our objectives were to develop an HIV peer education program and to pilot-test its effect on knowledge and sexual behavior. Between September 1989 and March 1990, all females aged 12-19 years attending an inner-city, hospital-based adolescent clinic were invited to meet individually with trained peer educators (10 females aged 16-19 years) to discuss acquired immunodeficiency syndrome (AIDS) and its prevention. Each participant completed a modified version of the AIDS Knowledge and Attitudes Survey immediately before and 2-6 weeks after the counseling session. Of the 283 counseled patients, 241 (85%) completed the follow-up questionnaire and comprised the study sample. Mean age was 15.6 years, mean Hollingshead (parental occupational) score was 3.4, and 216 (90%) patients were black. Baseline knowledge about routes of transmission was high and did not improve on follow-up. Comparison of individual baseline and follow-up responses revealed improvements (p less than 0.05) in routes by which HIV is not transmitted, methods of prevention, individuals at risk, and general information about AIDS. The improvement in total score between baseline and follow-up was 38% for patients with low baseline scores, 13% for middle scores, and 3% for high scores (p less than 0.05). At baseline, 50 (21%) patients reported sexual intercourse within the preceding 2 weeks, compared to 33 (14%) at follow-up (p less than 0.05). Of the sexually active patients, 22 (44%) reported no condom use at baseline, compared to 11 (33%) at follow-up (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

  11. Low occupational risk of human immunodeficiency virus infection among dental professionals.

    PubMed

    Klein, R S; Phelan, J A; Freeman, K; Schable, C; Friedland, G H; Trieger, N; Steigbigel, N H

    1988-01-14

    We studied 1309 dental professionals (1132 dentists, 131 hygienists, and 46 assistants) without behavioral risk factors for the acquired immunodeficiency syndrome (AIDS) to determine their occupational risk for infection with human immunodeficiency virus (HIV). Subjects completed questionnaires on behavior; type, duration, and location of their dental practice; infection-control practices; and estimated numbers of potential occupational exposures to HIV. Serum samples were tested for antibodies to HIV and to hepatitis B surface antigen (unvaccinated subjects). Fifty-one percent of the subjects practiced in locations where many cases of AIDS have been reported. Seventy-two percent treated patients who had AIDS or were at increased risk for it. Ninety-four percent reported accidental puncturing of the skin with instruments used in treating patients. Adherence to recommended infection-control practices was infrequent. Twenty-one percent of unvaccinated subjects had antibodies to hepatitis B surface antigen. Only one dentist without a history of behavioral risk factors for AIDS had serum antibodies to HIV. We conclude that despite infrequent compliance with recommended infection-control precautions, frequent occupational exposure to persons at increased risk for HIV infection, and frequent accidental puncturing of the skin with sharp instruments, dental professionals are at low occupational risk for HIV infection.

  12. Campus courtship behavior and fear of human immunodeficiency virus infection by university students.

    PubMed

    Ebomoyi, E W; Bissonette, N E; Ukaga, O M

    1998-07-01

    Data were collected by telephone from a random sample of 762 students at the University of Northern Colorado to examine students' fear of human immunodeficiency virus (HIV) infection and their suggested approaches to prevent the spread of the disease. Of the 762 students interviewed, 177 (24.1%) believed that HIV/acquired immunodeficiency syndrome (AIDS) was a threat to socialization on campus. Fourteen percent of the female students considered HIV/AIDS to be a threat compared with 10.1% of their male counterparts. Among all interviewees, 573 (76.7%) believed HIV/AIDS was a threat to romance at the university. Statistically significant association was found between the perceived fear of HIV/AIDS and gender. With regard to actual sexual intercourse, 86.4% of the students believed that HIV/AIDS was a major threat compared with 13.6% who did not. The association between the perception about HIV/AIDS as a threat to on-campus sexual intercourse and gender was statistically significant. Of the entire sample, 69.3% suggested abstinence as an approach to avoid HIV infection. Slightly more than 24% suggested condom use. Eighteen (10.8%) students advised that sexual contact should be only with a trusted partner. More information about HIV/AIDS should be provided to all students, especially women, in institutions of higher learning. More information can reduce the fear associated with this deadly disease.

  13. The human immunodeficiency virus epidemic in India. Current magnitude and future projections.

    PubMed

    Bollinger, R C; Tripathy, S P; Quinn, T C

    1995-03-01

    Since the first case of the human immunodeficiency virus (HIV) infection was documented in India in 1986, there has been an explosive increase in HIV transmission. In this review we describe the chronology of the HIV epidemic in India, preliminary information about the clinical presentation of the acquired immunodeficiency syndrome (AIDS), the biological and behavioral aspects of HIV transmission in the Indian setting, and projections regarding the future of the HIV epidemic in India. Using recent data obtained by searching the computerized literature and published abstracts, conference proceedings, and publications from the government of India, we show that India is experiencing a major epidemic of HIV transmission in high-risk populations of commercial sex workers, sexually transmitted disease clinic patients, intravenous drug users, and commercial blood donors. There is also evidence of recent spread of the epidemic from these high-risk groups to other risk groups in India, and from urban centers to rural populations. It is estimated that 1.6 million people are currently infected with HIV in India. At the present rate of transmission, India will have the largest number of HIV-infected individuals of any country in the world by the end of this decade, with more than 5 million infected individuals. Because limited data are available, comprehensive and well-designed epidemiologic surveys are urgently needed to adequately characterize the HIV epidemic in India and to help implement targeted and effective educational and prevention-oriented programs.

  14. Characterization of monoclonal antibodies against the human immunodeficiency virus matrix protein, p17gag: identification of epitopes exposed at the surfaces of infected cells.

    PubMed

    Shang, F; Huang, H; Revesz, K; Chen, H C; Herz, R; Pinter, A

    1991-09-01

    Eight monoclonal antibodies reactive with the matrix protein of human immunodeficiency virus type 1 (HIV-1), p17gag, were isolated from rats which had been immunized with solubilized HIV-1 lysate. The epitope specificities of these antibodies were determined with a series of synthetic peptides representing overlapping regions of p17. Six of the antibodies were mapped to three distinct regions of p17, while two antibodies (G11g1 and G11h3) reacted only with intact recombinant p17, suggesting that they were directed against conformational or discontinuous epitopes. All the antibodies bound to HIV-infected cells which had been permeabilized with acetone, but only G11g1 and G11h3 reacted with live HIV-infected cells. Specificity studies with diverse virus strains demonstrated that these two antibodies recognized distinct epitopes, one which was group specific for HIV-1, and one which was shared with HIV type 2 and simian immunodeficiency virus. Binding competition studies indicated that these epitopes were proximal in native p17. Despite their reactivity with intact cells, these two antibodies did not possess appreciable virus-neutralizing activity. These results indicate that a form of p17 is expressed on the surfaces of live HIV-infected cells which is accessible to some, but not all, antibodies against p17. These cell surface molecules may play a role in the generation of antibodies against p17gag that are characteristic of early stages of HIV infection, and they may act as natural targets for the immune system and as potential targets for immunotherapy of HIV-infected cells.

  15. Co-infections with hepatitis B and C viruses in human immunodeficiency virus-infected patients in Morocco.

    PubMed

    Rebbani, K; Ouladlahsen, A; Bensghir, A; Akil, A; Lamdini, H; Issouf, H; Brahim, I; Kitab, B; Fakhir, F Z; Wakrim, L; Marhoum El Filali, K; Himmich, H; Ezzikouri, S; Benjelloun, S

    2013-10-01

    Human immunodeficiency virus (HIV), hepatitis B virus (HBV) and hepatitis C virus (HCV) are major public health concerns. We aimed to determine the prevalence of HBV and HCV infections among HIV-infected patients, and to identify the main circulating hepatitis strains in Morocco. The study was carried out in 503 HIV-infected patients. Our survey indicated that the prevalence of HIV/hepatitis co-infection was 10.6%; 5.2% of patients were HBV surface antigen positive, and 5.4% of patients were anti-HCV positive. Among the HBV surface antigen-positive group, HBV DNA sequencing identified exclusively genotype D (D1: 26.7%; D7: 73.3%) in accordance with what is found in the general population. In contrast, sequencing of HCV isolates produced an unusual subtype distribution with a decreasing order of prevalence: 1a, 3a (both 23.5%), 1b, 4a (both 17.6%), 1c (11.8%) and 6h (6%).

  16. Parasitic infections in HIV infected individuals: Diagnostic & therapeutic challenges

    PubMed Central

    Nissapatorn, Veeranoot; Sawangjaroen, Nongyao

    2011-01-01

    After 30 years of the human immunodeficiency virus (HIV) epidemic, parasites have been one of the most common opportunistic infections (OIs) and one of the most frequent causes of morbidity and mortality associated with HIV-infected patients. Due to severe immunosuppression, enteric parasitic pathogens in general are emerging and are OIs capable of causing diarrhoeal disease associated with HIV. Of these, Cryptosporidium parvum and Isospora belli are the two most common intestinal protozoan parasites and pose a public health problem in acquired immunodeficiency syndrome (AIDS) patients. These are the only two enteric protozoan parasites that remain in the case definition of AIDS till today. Leismaniasis, strongyloidiasis and toxoplasmosis are the three main opportunistic causes of systemic involvements reported in HIV-infected patients. Of these, toxoplasmosis is the most important parasitic infection associated with the central nervous system. Due to its complexity in nature, toxoplasmosis is the only parasitic disease capable of not only causing focal but also disseminated forms and it has been included in AIDS-defining illnesses (ADI) ever since. With the introduction of highly active anti-retroviral therapy (HAART), cryptosporidiosis, leishmaniasis, schistosomiasis, strongyloidiasis, and toxoplasmosis are among parasitic diseases reported in association with immune reconstitution inflammatory syndrome (IRIS). This review addresses various aspects of parasitic infections in term of clinical, diagnostic and therapeutic challenges associated with HIV-infection. PMID:22310820

  17. Screening for Cervical Cancer and Sexually Transmitted Diseases Among HIV-Infected Women

    PubMed Central

    Frazier, Emma L.; Sutton, Madeline Y.; Tie, Yunfeng; McNaghten, A.D.; Blair, Janet M.; Skarbinski, Jacek

    2017-01-01

    Background Women living with HIV infection are at higher risk for cervical cancer, an AIDS-defining diagnosis. We examined the prevalence of cervical cancer and sexually transmitted disease (STD) screening among human immunodeficiency virus (HIV)-infected women and factors associated with the receipt of Papanicolaou (Pap) tests. Methods We did a cross-sectional analysis of weighted data from a sample of HIV-infected adults receiving outpatient medical care. We used matched interview (report of Pap test) and medical record data (STD screenings) from HIV-infected women. We performed logistic regression to compute adjusted prevalence ratios and 95% confidence intervals for the association between demographic, behavioral, and clinical factors and receipt of Pap tests among HIV-infected women. Results Data were available for 2,270 women, who represent 112,894 HIV-infected women; 62% were African American, 17% were Hispanic/Latina, and 18% were white. Most (78%) reported having a Pap test in the past year. Among sexually active women (n= 1234), 20% reported sex without condoms, 27% were screened for gonorrhea, and 29% were screened for chlamydia. Being screened for STDs was less likely among women who did not have a Pap test in the past year (adjusted prevalence ratios 0.82, 95% confidence interval 0.77–0.87). Women who were ≥50 years of age and reported income above federal poverty level, no sexual activity, depression, no HIV care from an obstetrician/gynecologist, and no documented STD tests, were less likely to report a Pap test (p < 0.05). Conclusions Screening for cervical cancer and STDs among HIV-infected women is suboptimal. Clinical visits for Pap tests are an important opportunity for HIV-infected sexually active women to also receive STD screenings and counseling regarding condoms. PMID:26447835

  18. Diagnoses and Prevalence of HIV Infection Among Hispanics or Latinos - United States, 2008-2013.

    PubMed

    Gray, Kristen Mahle; Valverde, Eduardo E; Tang, Tian; Siddiqi, Azfar-e-Alam; Hall, H Irene

    2015-10-09

    Hispanics or Latinos represent about 17% of the total U.S. population and are disproportionately affected by human immunodeficiency virus (HIV) infection in the United States. In 2013, the rate of HIV diagnosis among Hispanics or Latinos (18.7) was nearly three times that of non-Hispanic whites (6.6). To better characterize HIV infection among Hispanics or Latinos aged ≥13 years in the United States, CDC analyzed data from the National HIV Surveillance System (NHSS). During 2008-2013, the rate of diagnoses of HIV infection among adult and adolescent Hispanics or Latinos decreased from 28.3 per 100,000 population in 2008 to 24.3 in 2013 (estimated annual percentage change [EAPC] = -3.6); however, the number of diagnoses among males with infection attributed to male-to-male sexual contact increased 16%, from 6,141 in 2008 to 7,098 in 2013 (EAPC = 3.0). In 2013, the rate of diagnosis of HIV infection among males (41.3) was six times the rate among females (6.8). During 2008-2013, behavioral risk factors for HIV infection among Hispanics or Latino differed among males and females and by place of birth. Among Hispanic or Latino males born in Puerto Rico, the proportion of HIV infections attributed to injection drug use (24.9%) was greater than among those born elsewhere. Among HIV-infected Hispanic or Latino females, those born in the United States (21.2%) and Puerto Rico (20.5%) had a greater proportion of HIV infections attributed to injection drug use than those born elsewhere. Additional interventions and public health strategies to further decrease the rates of HIV among the Hispanic or Latino population are needed.

  19. Screening for Cervical Cancer and Sexually Transmitted Diseases Among HIV-Infected Women.

    PubMed

    Frazier, Emma L; Sutton, Madeline Y; Tie, Yunfeng; McNaghten, A D; Blair, Janet M; Skarbinski, Jacek

    2016-02-01

    Women living with HIV infection are at higher risk for cervical cancer, an AIDS-defining diagnosis. We examined the prevalence of cervical cancer and sexually transmitted disease (STD) screening among human immunodeficiency virus (HIV)-infected women and factors associated with the receipt of Papanicolaou (Pap) tests. We did a cross-sectional analysis of weighted data from a sample of HIV-infected adults receiving outpatient medical care. We used matched interview (report of Pap test) and medical record data (STD screenings) from HIV-infected women. We performed logistic regression to compute adjusted prevalence ratios and 95% confidence intervals for the association between demographic, behavioral, and clinical factors and receipt of Pap tests among HIV-infected women. Data were available for 2,270 women, who represent 112,894 HIV-infected women; 62% were African American, 17% were Hispanic/Latina, and 18% were white. Most (78%) reported having a Pap test in the past year. Among sexually active women (n = 1234), 20% reported sex without condoms, 27% were screened for gonorrhea, and 29% were screened for chlamydia. Being screened for STDs was less likely among women who did not have a Pap test in the past year (adjusted prevalence ratios 0.82, 95% confidence interval 0.77-0.87). Women who were ≥50 years of age and reported income above federal poverty level, no sexual activity, depression, no HIV care from an obstetrician/gynecologist, and no documented STD tests, were less likely to report a Pap test (p < 0.05). Screening for cervical cancer and STDs among HIV-infected women is suboptimal. Clinical visits for Pap tests are an important opportunity for HIV-infected sexually active women to also receive STD screenings and counseling regarding condoms.