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Zhang Y, Zhao CS, Chen JM, Zhang Q. Efficacy of single-stage posterior surgery for HIV-positive patients with thoracolumbar tuberculosis. AIDS Res Ther 2022; 19:53. [PMID: 36419079 PMCID: PMC9682655 DOI: 10.1186/s12981-022-00478-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 11/04/2022] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE We aimed to observe the clinical effect of single-stage posterior surgery on HIV-positive patients with thoracolumbar tuberculosis. METHODS From October 2015 to October 2019, 13 HIV-positive patients with thoracolumbar tuberculosis who underwent single-stage posterior surgery were retrospectively analyzed (observation group), and 13 HIV-negative patients with thoracolumbar tuberculosis who were matched with the gender, age, operative site, and surgical approach during the same period were selected as the control group. Postoperative complications, hemoglobin, albumin, CD4+T lymphocyte count, operative site, operative time, and blood loss were recorded between the two groups. The clinical efficacy was evaluated by the visual analog scale (VAS), American Spinal Injury Association (ASIA) scale, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), kyphotic angle, correction rate of kyphosis, angle loss, and bone graft fusion time. RESULTS In the observation group, 7 patients had postoperative complications, including 1 patient with cerebrospinal fluid leakage, 1 patient with nerve root irritation, 1 patient with an opportunistic infection, and 4 with delayed wound healing. In the control group, 2 patients developed postoperative complications, including 1 with nerve root irritation and 1 with delayed wound healing. There was no statistically significant difference in the incidence of postoperative complications between the two groups (P > 0.05). CD4+T lymphocyte count, hemoglobin, and albumin in HIV-positive patients with postoperative complications were statistically different from those without postoperative complications (P all < 0.05). No tuberculosis recurrence was found at the last follow-up, ESR and CRP returned to normal, and there were no statistically significant differences in bone graft fusion time, VAS score, ASIA scale, correction rate of kyphosis, and angle loss between two groups (P all > 0.05). CONCLUSION Single-stage posterior surgery for HIV-positive patients with thoracolumbar tuberculosis could achieve satisfactory clinical efficacy through comprehensive preoperative evaluation, standardized perioperative antiviral and anti-tuberculosis treatments, and prevention of postoperative complications.
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Affiliation(s)
- Yao Zhang
- grid.24696.3f0000 0004 0369 153XDepartment of Orthopedics, Beijing Ditan Hospital, Capital Medical University, No. 8, Jingshun East Street, Chaoyang District, Beijing, 100015 China
| | - Chang-song Zhao
- grid.24696.3f0000 0004 0369 153XDepartment of Orthopedics, Beijing Ditan Hospital, Capital Medical University, No. 8, Jingshun East Street, Chaoyang District, Beijing, 100015 China
| | - Jia-min Chen
- grid.24696.3f0000 0004 0369 153XDepartment of Pathology, Beijing Ditan Hospital, Capital Medical University, No. 8, Jingshun East Street, Chaoyang District, Beijing, 100015 China
| | - Qiang Zhang
- grid.24696.3f0000 0004 0369 153XDepartment of Orthopedics, Beijing Ditan Hospital, Capital Medical University, No. 8, Jingshun East Street, Chaoyang District, Beijing, 100015 China
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Palm AA, Esbjörnsson J, Kvist A, Månsson F, Biague A, Norrgren H, Jansson M, Medstrand P. Intra-Patient Evolution of HIV-2 Molecular Properties. Viruses 2022; 14:v14112447. [PMID: 36366545 PMCID: PMC9698092 DOI: 10.3390/v14112447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 10/24/2022] [Accepted: 11/02/2022] [Indexed: 11/06/2022] Open
Abstract
Limited data are available on the pathogenesis of HIV-2, and the evolution of Env molecular properties during disease progression is not fully elucidated. We investigated the intra-patient evolution of molecular properties of HIV-2 Env regions (V1-C3) during the asymptomatic, treatment-naïve phase of the infection in 16 study participants, stratified into faster or slower progressors. Most notably, the rate of change in the number of potential N-linked glycosylation sites (PNGS) within the Env (V1-C3) regions differed between progressor groups. With declining CD4+ T-cell levels, slower progressors showed, on average, a decrease in the number of PNGSs, while faster progressors showed no significant change. Furthermore, diversity increased significantly with time in faster progressors, whereas no such change was observed in slower progressors. No differences were identified between the progressor groups in the evolution of length or charge of the analyzed Env regions. Predicted virus CXCR4 use was rare and did not emerge as a dominating viral population during the studied disease course (median 7.9 years, interquartile range [IQR]: 5.2-14.0) in either progressor groups. Further work building on our observations may explain molecular hallmarks of HIV-2 disease progression and differences in pathogenesis between HIV-1 and HIV-2.
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Affiliation(s)
- Angelica A. Palm
- Department of Laboratory Medicine, Lund University, 22184 Lund, Sweden
- Department of Translational Medicine, Lund University, 20502 Lund, Sweden
- Correspondence:
| | - Joakim Esbjörnsson
- Department of Translational Medicine, Lund University, 20502 Lund, Sweden
- Nuffield Department of Medicine, University of Oxford, Oxford OX3 7BN, UK
| | - Anders Kvist
- Department of Clinical Sciences, Lund University, 22184 Lund, Sweden
| | - Fredrik Månsson
- Department of Translational Medicine, Lund University, 20502 Lund, Sweden
| | - Antonio Biague
- National Public Health Laboratory, Bissau 1041, Guinea-Bissau
| | - Hans Norrgren
- Department of Clinical Sciences, Lund University, 22184 Lund, Sweden
| | - Marianne Jansson
- Department of Laboratory Medicine, Lund University, 22184 Lund, Sweden
| | - Patrik Medstrand
- Department of Translational Medicine, Lund University, 20502 Lund, Sweden
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Berzow D, Descamps D, Obermeier M, Charpentier C, Kaiser R, Guertler L, Eberle J, Wensing A, Sierra S, Ruelle J, Gomes P, Mansinho K, Taylor N, Jensen B, Döring M, Stürmer M, Rockstroh J, Camacho R. Human Immunodeficiency Virus-2 (HIV-2): A Summary of the Present Standard of Care and Treatment Options for Individuals Living with HIV-2 in Western Europe. Clin Infect Dis 2021; 72:503-509. [PMID: 32227124 DOI: 10.1093/cid/ciaa275] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 03/12/2020] [Indexed: 11/13/2022] Open
Abstract
Human immunodeficiency virus-2 (HIV-2) is endemic in some countries in West Africa. Due to the lower prevalence in industrialized countries, there is limited experience and knowledge on the management of individuals living with HIV-2 in Europe. Compared to HIV-1, there are differential characteristics of HIV-2 regarding diagnostic procedures, the clinical course, and, most importantly, antiretroviral therapy. We integrated the published literature on HIV-2 (studies and reports on epidemiology, diagnostics, the clinical course, and treatment), as well as expert experience in diagnosing and clinical care, to provide recommendations for a present standard of medical care of those living with HIV-2 in Western European countries, including an overview of strategies for diagnosis, monitoring, and treatment, with suggestions for effective drug combinations for first- and second-line treatments, post-exposure prophylaxis, and the prevention of mother-to-child transmission, as well as listings of mutations related to HIV-2 drug resistance and C-C motif chemokine receptor type 5 and C-X-C motif chemokine receptor type 4 coreceptor tropism.
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Affiliation(s)
- Dirk Berzow
- Praxis for Infectiology, Hamburg, Germany.,Deutsche Arbeitsgemeinschaft niedergelassener Ärzte in der Versorgung HIV-Infizierter (DAGNAE) Berlin, Germany
| | - Diane Descamps
- Laboratoire de Virologie, Hôpital Bichat-Claude Bernard, Paris, France.,Université de Paris, Institut national de la santé et de la recherche médicale (INSERM), Unité mixte de recherche (UMR),1137, Laboratory Infection, Antimicrobials, Modelling, Evolution (IAME), Paris, France
| | - Martin Obermeier
- Deutsche Arbeitsgemeinschaft niedergelassener Ärzte in der Versorgung HIV-Infizierter (DAGNAE) Berlin, Germany.,Medical Center for Infectious Diseases, Berlin, Germany.,Gesellschaft für Virologie e.V., Freiburg, Germany
| | - Charlotte Charpentier
- Laboratoire de Virologie, Hôpital Bichat-Claude Bernard, Paris, France.,Université de Paris, Institut national de la santé et de la recherche médicale (INSERM), Unité mixte de recherche (UMR),1137, Laboratory Infection, Antimicrobials, Modelling, Evolution (IAME), Paris, France
| | - Rolf Kaiser
- Gesellschaft für Virologie e.V., Freiburg, Germany.,Institute of Virology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany.,German AIDS Society (Deutsche AIDS-Gesellschaft, DAIG), Hamburg, Germany.,Paul-Ehrlich-Gesellschaft für Chemotherapie, Rheinbach, Germany
| | - Lutz Guertler
- Gesellschaft für Virologie e.V., Freiburg, Germany.,German AIDS Society (Deutsche AIDS-Gesellschaft, DAIG), Hamburg, Germany.,National Reference Center for Retroviruses, Max von Pettenkofer Institute for Hygiene and Medical Microbiology, University of Munich, Munich, Germany
| | - Josef Eberle
- Gesellschaft für Virologie e.V., Freiburg, Germany.,German AIDS Society (Deutsche AIDS-Gesellschaft, DAIG), Hamburg, Germany.,National Reference Center for Retroviruses, Max von Pettenkofer Institute for Hygiene and Medical Microbiology, University of Munich, Munich, Germany
| | - Annemarie Wensing
- European AIDS Clinical Society, Brussels, Belgium.,Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, Netherlands
| | - Saleta Sierra
- Institute of Virology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Jean Ruelle
- Laboratories Department, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Perpetua Gomes
- Instituto Universitário Egas Moniz, Lisboa, Portugal.,Molecular Biology Laboratory, Laboratório de Biologia Molecular, Centro Hospitalar de Lisboa Ocidental, Egas Moniz Hospital, Lisboa, Portugal
| | - Kamal Mansinho
- Centro Hospitalar de Lisboa Occidental, Hospital de Egas Moniz, Lisboa, Portugal
| | - Ninon Taylor
- Third Medical Department with Hematology, Medical Oncology, Hemostaseology, Infectious Diseases and Rheumatology, Oncologic Center, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Björn Jensen
- Paul-Ehrlich-Gesellschaft für Chemotherapie, Rheinbach, Germany.,Department of Gastroenterology, Hepatology and Infectious Diseases, Heinrich-Heine University Hospital, Düsseldorf, Germany
| | - Matthias Döring
- Department for Computational Biology and Applied Algorithmics, Max-Planck Institute for Informatics, Saarland Informatics Campus, Saarbrücken, Germany
| | - Martin Stürmer
- Medizinisches Versorgungszentrum, Frankfurt am Main, Germany
| | - Jürgen Rockstroh
- European AIDS Clinical Society, Brussels, Belgium.,Department of Medicine I, Bonn University Hospital, Bonn, Germany
| | - Ricardo Camacho
- Katholieke Universiteit, Department of Microbiology and Immunology, Rega Institute for Medical Research, Clinical and Epidemiological Virology, Leuven, Belgium
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Low-Bias RNA Sequencing of the HIV-2 Genome from Blood Plasma. J Virol 2018; 93:JVI.00677-18. [PMID: 30333167 PMCID: PMC6288329 DOI: 10.1128/jvi.00677-18] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 09/14/2018] [Indexed: 11/20/2022] Open
Abstract
Accurate determination of the genetic diversity present in the HIV quasispecies is critical for the development of a preventative vaccine: in particular, little is known about viral genetic diversity for the second type of HIV, HIV-2. A better understanding of HIV-2 biology is relevant to the HIV vaccine field because a substantial proportion of infected people experience long-term viral control, and prior HIV-2 infection has been associated with slower HIV-1 disease progression in coinfected subjects. The majority of traditional and next-generation sequencing methods have relied on target amplification prior to sequencing, introducing biases that may obscure the true signals of diversity in the viral population. Additionally, target enrichment through PCR requires a priori sequence knowledge, which is lacking for HIV-2. Therefore, a target enrichment free method of library preparation would be valuable for the field. We applied an RNA shotgun sequencing (RNA-Seq) method without PCR amplification to cultured viral stocks and patient plasma samples from HIV-2-infected individuals. Libraries generated from total plasma RNA were analyzed with a two-step pipeline: (i) de novo genome assembly, followed by (ii) read remapping. By this approach, whole-genome sequences were generated with a 28× to 67× mean depth of coverage. Assembled reads showed a low level of GC bias, and comparison of the genome diversities at the intrahost level showed low diversity in the accessory gene vpx in all patients. Our study demonstrates that RNA-Seq is a feasible full-genome de novo sequencing method for blood plasma samples collected from HIV-2-infected individuals.IMPORTANCE An accurate picture of viral genetic diversity is critical for the development of a globally effective HIV vaccine. However, sequencing strategies are often complicated by target enrichment prior to sequencing, introducing biases that can distort variant frequencies, which are not easily corrected for in downstream analyses. Additionally, detailed a priori sequence knowledge is needed to inform robust primer design when employing PCR amplification, a factor that is often lacking when working with tropical diseases localized in developing countries. Previous work has demonstrated that direct RNA shotgun sequencing (RNA-Seq) can be used to circumvent these issues for hepatitis C virus (HCV) and norovirus. We applied RNA-Seq to total RNA extracted from HIV-2 blood plasma samples, demonstrating the applicability of this technique to HIV-2 and allowing us to generate a dynamic picture of genetic diversity over the whole genome of HIV-2 in the context of low-bias sequencing.
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