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Kang Q, Pan W, Ma Y, Wang D, Jia H, Guo H, Sang F, Xu L, Xu Q, Jin Y. Mortality Risk Factors Among People Living with HIV Receiving Second--line Antiretroviral Therapy in Rural China. Curr HIV Res 2024; 22:CHR-EPUB-137479. [PMID: 38310467 DOI: 10.2174/011570162x280721240108065502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 11/24/2023] [Accepted: 12/28/2023] [Indexed: 02/05/2024]
Abstract
BACKGROUND Second-line antiretroviral therapy (ART) was introduced in Henan Province in 2009. The number of people living with human immunodeficiency virus (HIV) starting this therapy is increasing. OBJECTIVE This study aimed to investigate the survival and factors affecting mortality among this group. METHODS We conducted a retrospective cohort study of people living with HIV (PLHIV) who switched to second-line ART between May 1, 2010, and May 1, 2016., using the Kaplan-Meier method and Cox proportional hazards models. RESULTS We followed 3,331 PLHIV for 26,988 person-years, of whom 508 (15.3%) died. The mortality rate was 1.88/100 person-years. After adjusting for confounding factors, we found being a woman (hazard ratio [HR], 0.66; 95% confidence interval [CI] 0.55-0.79), > 50 years old (HR, 2.69; 95%CI, 2.03-3.56), single/windowed (HR, 1.26; 95%CI, 1.04-1.52), having > 6 years of education (HR, 0.78; 95%CI, 0.65-0.94), Chinese medicine (HR, 0.75; 95%CI, 0.52-0.96), liver injury (HR, 1.58; 95%CI, 1.19-2.10), and CD4+ T cell count <200 cells/µl (HR, 1.94; 95%CI, 1.47-2.55), or 200-350 cells/µl (HR, 1.37; 95%CI, 1.03-1.82) were associated with mortality risk. CONCLUSIONS We found lower mortality among PLHIV who switched to second-line ART than most previous studies. The limitations of a retrospective cohort may, therefore, have biased the data, and prospective studies are needed to confirm the results. Moreover, Chinese medicine combined with second-line ART shows potential as a treatment for HIV.
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Affiliation(s)
- Qiujia Kang
- The First Clinical Medical School, Henan University of Chinese Medicine, Zhengzhou, 45000, China
| | - Wanqi Pan
- The First Clinical Medical School, Henan University of Chinese Medicine, Zhengzhou, 45000, China
| | - Yanmin Ma
- Center for AIDS/STD Control and Prevention, Center for Disease Control and Prevention of Henan Province, Zhengzhou, 45000, China
| | - Dongli Wang
- The First Clinical Medical School, Henan University of Chinese Medicine, Zhengzhou, 45000, China
| | - Huangchao Jia
- The First Clinical Medical School, Henan University of Chinese Medicine, Zhengzhou, 45000, China
| | - Huijun Guo
- Department of Acquired Immune Deficiency Syndrome Treatment and Research Center, First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, 45000, China
| | - Feng Sang
- Henan Key Laboratory of Viral Diseases Prevention and Treatment of Chinese Medicine, Henan University of Chinese Medicine, Zhengzhou, 45000, China
| | - Liran Xu
- Department of Acquired Immune Deficiency Syndrome Treatment and Research Center, First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, 45000, China
| | - Qianlei Xu
- The First Clinical Medical School, Henan University of Chinese Medicine, Zhengzhou, 45000, China
- Department of Acquired Immune Deficiency Syndrome Treatment and Research Center, First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, 45000, China
| | - Yantao Jin
- Department of Acquired Immune Deficiency Syndrome Treatment and Research Center, First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, 45000, China
- Henan Key Laboratory of Viral Diseases Prevention and Treatment of Chinese Medicine, Henan University of Chinese Medicine, Zhengzhou, 45000, China
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Zhang F, Xu J, Zhu Y, Chen S, Shi Y, Zhan Z, Zhou J, Jiang Y, Wang H. Acute Pancreatitis Obstructed by a "Stone" as the First Manifestation of Eosinophilic Gastroenteritis in AIDS: A Case Report. Curr Med Imaging 2024; 20:CMIR-EPUB-136889. [PMID: 38254320 DOI: 10.2174/0115734056255617231114075914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 09/08/2023] [Accepted: 10/10/2023] [Indexed: 01/24/2024]
Abstract
BACKGROUND Acquired immune deficiency syndrome (AIDS) associated with eosinophilic gastroenteritis is rare. We report a case of duodenal "stone" inducing acute pancreatitis with eosinophilic gastroduodenitis in an AIDS patient. CASE SUMMARY A 73-year-old female AIDS patient came to the hospital with recurrent abdominal pain for 20 days. Computed tomography (CT) showed pancreatitis with exudation and a high-density shadow under the gastric antrum. Gastroscopy showed that the descending part of the duodenum was blocked by a "stone". The mucosa of the duodenum was rough, and a red polyp was found on the gastric body. The pathology result was chronic inflammation with eosinophilic granulocytes in the duodenal mucosa and gastric body polyp. CONCLUSION When AIDS patients suffer acute pancreatitis, the possibility of eosinophilic gastroenteritis needs to be considered to enable the patient to accept timely treatment.
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Affiliation(s)
- Fulong Zhang
- Department of Gastroenterology, Hang Zhou Xixi Hospital, 2 Hengbu Street, Xihu District, Hang Zhou 310032, Zhejiang, Province, China
| | - Jing Xu
- Department of Gastroenterology, Hang Zhou Xixi Hospital, 2 Hengbu Street, Xihu District, Hang Zhou 310032, Zhejiang, Province, China
| | - Yuandong Zhu
- Department of Gastroenterology, Hang Zhou Xixi Hospital, 2 Hengbu Street, Xihu District, Hang Zhou 310032, Zhejiang, Province, China
| | - Shurong Chen
- Department of Gastroenterology, Hang Zhou Xixi Hospital, 2 Hengbu Street, Xihu District, Hang Zhou 310032, Zhejiang, Province, China
| | - Yan Shi
- Department of Gastroenterology, Hang Zhou Xixi Hospital, 2 Hengbu Street, Xihu District, Hang Zhou 310032, Zhejiang, Province, China
| | - Zongyuan Zhan
- Department of Gastroenterology, Hang Zhou Xixi Hospital, 2 Hengbu Street, Xihu District, Hang Zhou 310032, Zhejiang, Province, China
| | - Jingwei Zhou
- Department of Gastroenterology, Hang Zhou Xixi Hospital, 2 Hengbu Street, Xihu District, Hang Zhou 310032, Zhejiang, Province, China
| | - Yuhong Jiang
- Department of Gastroenterology, Hang Zhou Xixi Hospital, 2 Hengbu Street, Xihu District, Hang Zhou 310032, Zhejiang, Province, China
| | - Hai Wang
- Department of Gastroenterology, Hang Zhou Xixi Hospital, 2 Hengbu Street, Xihu District, Hang Zhou 310032, Zhejiang, Province, China
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Valbert F, Koppe U, Schmidt D, Krings A, Gunsenheimer-Bartmeyer B, Dröge P, Ruhnke T, Behrens G, Bickel M, Boesecke C, Esser S, Wasem J, Neumann A. Optimization of HIV testing services in Germany using HIV indicator diseases: study protocol of the HeLP study. Arch Public Health 2023; 81:159. [PMID: 37626414 PMCID: PMC10464271 DOI: 10.1186/s13690-023-01161-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 07/27/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND Despite the potentially accompanying negative clinical, epidemiologic, and health economic effects, a large proportion of persons living with the human immunodeficiency virus (HIV) are diagnosed late. Internationally, numerous diseases are known to be HIV indicator diseases. Adequate HIV testing in the presence of HIV indicator diseases could help to diagnose unknown HIV infections earlier. The objective of the HeLP study is to validate published HIV indicator diseases for the German setting and to identify guidelines in terms of these indicator diseases in order to reduce knowledge gaps and increase HIV testing when HIV indicator diseases are diagnosed. METHODS A mixed methods approach is used. In a first step, published HIV indicator diseases will be identified in a systematic literature review and subsequently discussed with clinical experts regarding their relevance for the German setting. For the validation of selected indicator diseases different data sets (two cohort studies, namely HIV-1 seroconverter study & ClinSurv-HIV, and statutory health insurance routine data) will be analyzed. Sensitivity analyses using different time periods will be performed. Guidelines of HIV indicator diseases validated in the HeLP study will be reviewed for mentioning HIV and for HIV testing recommendations. In addition, semi-standardized interviews (followed by a free discussion) with guideline creators will identify reasons why HIV testing recommendations were (not) included. Subsequently, a random sample of physicians in medical practices will be surveyed to identify how familiar physicians are with HIV testing recommendations in guidelines and, if so, which barriers are seen to perform the recommended tests in everyday care. DISCUSSION The HeLP-study adopts the challenge to validate published HIV indicator diseases for the German setting and has the potential to close a knowledge gap regarding this objective. This has the potential to improve targeted HIV testing for patients with HIV indicator diseases and consequently lead to earlier HIV diagnosis. TRIAL REGISTRATION DRKS00028743.
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Affiliation(s)
- Frederik Valbert
- Institute for Healthcare Management and Research, University of Duisburg-Essen, Essen, Germany.
| | - Uwe Koppe
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Daniel Schmidt
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Amrei Krings
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | | | | | | | - Georg Behrens
- Department for Rheumatology and Immunology, Hannover Medical School, Hanover, Germany
- German Centre for Infection Research (DZIF), Bonn, Germany
| | | | - Christoph Boesecke
- German Centre for Infection Research (DZIF), Bonn, Germany
- Department of Medicine I, Bonn University Hospital, Bonn, Germany
| | - Stefan Esser
- Department of Dermatology and Venerology, University Hospital Essen, University Duisburg- Essen, Essen, Germany
| | - Jürgen Wasem
- Institute for Healthcare Management and Research, University of Duisburg-Essen, Essen, Germany
| | - Anja Neumann
- Institute for Healthcare Management and Research, University of Duisburg-Essen, Essen, Germany
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Lua I, Silva AF, Guimarães NS, Magno L, Pescarini J, Anderle RV, Ichihara MY, Barreto ML, Teles Santos CA, Chenciner L, Souza LE, Macinko J, Dourado I, Rasella D. The effects of social determinants of health on acquired immune deficiency syndrome in a low-income population of Brazil: a retrospective cohort study of 28.3 million individuals. Lancet Reg Health Am 2023; 24:100554. [PMID: 37521440 PMCID: PMC10372893 DOI: 10.1016/j.lana.2023.100554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 06/29/2023] [Accepted: 07/03/2023] [Indexed: 08/01/2023]
Abstract
Background Social determinants of health (SDH) include factors such as income, education, and race, that could significantly affect the human immunodeficiency virus and acquired immunodeficiency syndrome (HIV/AIDS). Studies on the effects of SDH on HIV/AIDS are limited, and do not yet provide a systematic understanding of how the various SDH act on important indicators of HIV/AIDS progression. We aimed to evaluate the effects of SDH on AIDS morbidity and mortality. Methods A retrospective cohort of 28.3 million individuals was evaluated over a 9-year period (from 2007 to 2015). Multivariable Poisson regression, with a hierarchical approach, was used to estimate the effects of SDH-at the individual and familial level-on AIDS incidence, mortality, and case-fatality rates. Findings A total of 28,318,532 individuals, representing the low-income Brazilian population, were assessed, who had a mean age of 36.18 (SD: 16.96) years, 52.69% (14,920,049) were female, 57.52% (15,360,569) were pardos, 34.13% (9,113,222) were white/Asian, 7.77% (2,075,977) were black, and 0.58% (154,146) were indigenous. Specific socioeconomic, household, and geographic factors were significantly associated with AIDS-related outcomes. Less wealth was strongly associated with a higher AIDS incidence (rate ratios-RR: 1.55; 95% confidence interval-CI: 1.43-1.68) and mortality (RR: 1.99; 95% CI: 1.70-2.34). Lower educational attainment was also greatly associated with higher AIDS incidence (RR: 1.46; 95% CI: 1.26-1.68), mortality (RR: 2.76; 95% CI: 1.99-3.82) and case-fatality rates (RR: 2.30; 95% CI: 1.31-4.01). Being black was associated with a higher AIDS incidence (RR: 1.53; 95% CI: 1.45-1.61), mortality (RR: 1.69; 95% CI: 1.57-1.83) and case-fatality rates (RR: 1.16; 95% CI: 1.03-1.32). Overall, also considering the other SDH, individuals experiencing greater levels of socioeconomic deprivation were, by far, more likely to acquire AIDS, and to die from it. Interpretation In the population studied, SDH related to poverty and social vulnerability are strongly associated with a higher burden of HIV/AIDS, most notably less wealth, illiteracy, and being black. In the absence of relevant social protection policies, the current worldwide increase in poverty and inequalities-due to the consequences of the COVID-19 pandemic, and the effects of war in the Ukraine-could reverse progress made in the fight against HIV/AIDS in low- and middle-income countries (LMIC). Funding National Institute of Allergy and Infectious Diseases (NAIDS), National Institutes of Health (NIH), US Grant Number: 1R01AI152938.
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Affiliation(s)
- Iracema Lua
- Institute of Collective Health, Federal University of Bahia (UFBA), Salvador, Bahia, Brazil
- Department of Health, State University of Feira de Santana (UEFS), Feira de Santana, Bahia, Brazil
| | - Andrea F. Silva
- Institute of Collective Health, Federal University of Bahia (UFBA), Salvador, Bahia, Brazil
- Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Salvador, Bahia, Brazil
| | - Nathalia S. Guimarães
- Institute of Collective Health, Federal University of Bahia (UFBA), Salvador, Bahia, Brazil
| | - Laio Magno
- Department of Life Sciences, State University of Bahia (UNEB), Salvador, Bahia, Brazil
| | - Julia Pescarini
- Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Salvador, Bahia, Brazil
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Rodrigo V.R. Anderle
- Institute of Collective Health, Federal University of Bahia (UFBA), Salvador, Bahia, Brazil
| | - Maria Yury Ichihara
- Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Salvador, Bahia, Brazil
| | - Mauricio L. Barreto
- Institute of Collective Health, Federal University of Bahia (UFBA), Salvador, Bahia, Brazil
- Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Salvador, Bahia, Brazil
| | - Carlos A.S. Teles Santos
- Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Salvador, Bahia, Brazil
| | - Louisa Chenciner
- Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Oxford, UK
- Oxford University Hospitals, Oxford, UK
- Department of Infection and Immunity, St George's University London, London, UK
| | - Luis Eugênio Souza
- Institute of Collective Health, Federal University of Bahia (UFBA), Salvador, Bahia, Brazil
| | - James Macinko
- Departments of Health Policy and Management and Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, California, USA
| | - Ines Dourado
- Institute of Collective Health, Federal University of Bahia (UFBA), Salvador, Bahia, Brazil
| | - Davide Rasella
- Institute of Collective Health, Federal University of Bahia (UFBA), Salvador, Bahia, Brazil
- ISGlobal, Hospital Clinic - Universitat de Barcelona, Barcelona, Spain
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Yang X, Li L, Zhang N, Hao L, Zhu X, Yu H, Wang G, Kang D. Analysis on epidemiological characters and HIV care continuum of HIV-infected students: a retrospective cohort study in Shandong province, China. BMC Infect Dis 2023; 23:496. [PMID: 37501181 PMCID: PMC10373422 DOI: 10.1186/s12879-023-08476-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 07/20/2023] [Indexed: 07/29/2023] Open
Abstract
BACKGROUD The proportion of HIV-infected students in China showed an increasing trend. This study aimed to identify the epidemiological characteristics and the HIV care continuum for HIV-infected students in Shandong Province, China. METHODS Case report and follow-up data of HIV-infected students were obtained from the National HIV/AIDS comprehensive response information management system. Logistic regression analyses were used to analyze the associating factors of HIV-infected students accepting CD4 + T cells (CD4) test and antiviral therapy (ART) in 30 days, and ArcGIS software was used for the spatial anlysis. RESULTS From 2017 to 2019, 403 HIV-infected students were reported in Shandong Province. The majority of them were male (99.5%) and transmitted through homosexual sexual activity(92.1%). Most of them lived in Jinan city and Qingdao city. 68.5% (276 cases) accepted CD4 test in 30 days, and 48.6% (196 cases) started ART in 30 days. The heterosexual transmitted cases (AOR = 0.458, 95%CI: 0.210-0.998), patients accepting HIV care in western area (AOR = 0.266,95%CI: 0.147-0.481) were less likely to test CD4 within 30 days; patients aged 23-25 (AOR = 2.316, 95%CI: 1.009-5.316) and patients who had tested CD4 within 30 days (AOR = 4.377; 95%CI: 2.572-7.447) prefered to receive ART within 30 days; patients accepted HIV care in central area (AOR = 0.407; 95%CI: 0.251-0.657) and western area (AOR = 0.508; 95%CI: 0.261-0.989) and patients diagnosed by voluntary blood donation (AOR = 0.352; 95%CI: 0.144-0.864) were less willing to receive ART in 30 days. CONCLUSIONS The HIV care continuum of HIV-infected students in Shandong Province still needed strenghthing. More health education and case management should be done for cases transmitted through heterosexual behavior, accepted HIV care in central and western area, and diagnosed by voluntary blood donation.
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Affiliation(s)
- Xingguang Yang
- Shandong Center for Disease Control and Prevention, Jinan, 250014, China
| | - Ling Li
- Shandong Center for Disease Control and Prevention, Jinan, 250014, China
| | - Na Zhang
- Shandong Center for Disease Control and Prevention, Jinan, 250014, China
| | - Lianzheng Hao
- Shandong Center for Disease Control and Prevention, Jinan, 250014, China
| | - Xiaoyan Zhu
- Shandong Center for Disease Control and Prevention, Jinan, 250014, China
| | - Haiying Yu
- Shandong Center for Disease Control and Prevention, Jinan, 250014, China
| | - Guoyong Wang
- Shandong Center for Disease Control and Prevention, Jinan, 250014, China.
| | - Dianmin Kang
- Shandong Center for Disease Control and Prevention, Jinan, 250014, China
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Openshaw MR, Gervasi E, Fulgenzi CAM, Pinato DJ, Dalla Pria A, Bower M. Taxonomic reclassification of Kaposi Sarcoma identifies disease entities with distinct immunopathogenesis. J Transl Med 2023; 21:283. [PMID: 37106396 PMCID: PMC10142155 DOI: 10.1186/s12967-023-04130-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 04/12/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND The taxonomy of Kaposi Sarcoma (KS) is based on a classification system focused on the description of clinicopathological features of KS in geographically and clinically diverse populations. The classification includes classic, endemic, epidemic/HIV associated and iatrogenic KS, and KS in men who have sex with men (MSM). We assessed the medical relevance of the current classification of KS and sought clinically useful improvements in KS taxonomy. METHODS We reviewed the demographic and clinicopathological features of 676 patients with KS, who were referred to the national centre for HIV oncology at Chelsea Westminster hospital between 2000 and 2021. RESULTS Demographic differences between the different subtypes of KS exist as tautological findings of the current classification system. However, no definitive differences in clinicopathological, virological or immunological parameters at presentation could be demonstrated between the classic, endemic or MSM KS patients. Reclassifying patients as either immunosuppressed or non-immunosuppressed, showed that the immunosuppressed group had a significantly higher proportion of adverse disease features at presentation including visceral disease and extensive oral involvement, classified together as advanced disease (chi2 P = 0.0012*) and disseminated skin involvement (chi2 P < 0.0001*). Immunosuppressed patients had lower CD4 counts, higher CD8 counts and a trend towards higher HHV8 levels compared to non-immunosuppressed patients, however overall survival and disease specific (KS) survival was similar across groups. CONCLUSION The current system of KS classification does not reflect meaningful differences in clinicopathological presentation or disease pathogenesis. Reclassification of patients based on the presence or absence of immunosuppression is a more clinically meaningful system that may influence therapeutic approaches to KS.
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Affiliation(s)
- M R Openshaw
- Institute of Cancer and Genomics Sciences, University of Birmingham, Birmingham, UK.
- UK National Centre for HIV Oncology, Chelsea Westminster Hospital, London, UK.
| | - E Gervasi
- Infectious Diseases Unit, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - C A M Fulgenzi
- Department of Surgery and Cancer, Faculty of Medicine, Hammersmith Hospital, Imperial College London, London, UK
- Department of Medical Oncology, University Campus Bio-Medico of Rome, Rome, Italy
| | - D J Pinato
- Department of Surgery and Cancer, Faculty of Medicine, Hammersmith Hospital, Imperial College London, London, UK
- Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
| | - A Dalla Pria
- UK National Centre for HIV Oncology, Chelsea Westminster Hospital, London, UK
| | - M Bower
- UK National Centre for HIV Oncology, Chelsea Westminster Hospital, London, UK
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Liu S, Chen W, Cheng F, Ye X, Pan N, Lu H. Clinical characteristics and prognostic factors of 60 patients with acquired immune deficiency syndrome combined with Cryptococcus neoformans. BMC Infect Dis 2023; 23:204. [PMID: 37024795 PMCID: PMC10080839 DOI: 10.1186/s12879-023-08137-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 03/06/2023] [Indexed: 04/08/2023] Open
Abstract
OBJECTIVE Cryptococcal meningitis (CM) threatens people's health and is the main cause of opportunistic fungus-related death in acquired immune deficiency syndrome (AIDS) patients. Herein, we investigate the clinical characteristics and prognostic factors of AIDS patients with Cryptococcus neoformans in Wenzhou, Zhejiang Province, China. METHODS Our study enrolled AIDS patients diagnosed with Cryptococcus neoformans infection who were hospitalised in our hospital. They were divided into Group A (32 patients with CM) and Group B (28 patients without CM) according to their diagnosis. The differences between the two groups of patients' clinical symptoms, imaging examinations and laboratory examinations were observed. Statistical methods were used to analyse the difference in prognosis between the two groups. RESULTS Headache and fever were the most common clinical characteristics for patients with CM, while respiratory symptoms and fever were the most common clinical characteristics for patients without CM. The positive rate of cryptococcal capsular antigen, India ink staining and culture in the cerebrospinal fluid examination was higher in the CM patients than in the non-CM patients. The overall morbidity and mortality rate after systemic antifungal therapy was higher in the CM patients than in the non-CM patients. A higher incidence of headache, impaired consciousness, nuchal rigidity, first intracranial pressure > 200 mmH2O and mortality was observed in the CM patients than in the non-CM patients. Multifactorial logistic regression analysis showed that headache risk factors affecting the patient's prognosis at 12 weeks. CONCLUSION Patients with AIDS diagnosed with Cryptococcus neoformans infection have insidious clinical symptoms in the early stage, and their manifestation is often non-specific, resulting in poor prognosis and high mortality among CM patients compared to patients without CM. Therefore, early identification and timely antifungal therapy before the disease progresses to meningitis are of great value in improving the survival rate of patients.
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Affiliation(s)
- Saiduo Liu
- Departments of Infectious Disease, The Dingli Clinical College of Wenzhou Medical University, Wenzhou, Zhejiang, 325000, China
| | - Wei Chen
- Department of Radiology, The 2ed Affiliated Hospital of Wenzhou Medical University, Fuxue Lane, No. 2, Wenzhou, Zhejiang, 325000, China
| | - Fang Cheng
- Departments of Infectious Disease, The Dingli Clinical College of Wenzhou Medical University, Wenzhou, Zhejiang, 325000, China
| | - Xinchun Ye
- Departments of Infectious Disease, The Dingli Clinical College of Wenzhou Medical University, Wenzhou, Zhejiang, 325000, China
| | - Ning Pan
- Departments of Infectious Disease, The Dingli Clinical College of Wenzhou Medical University, Wenzhou, Zhejiang, 325000, China
| | - Hongzhou Lu
- Department of Infectious Disease, The 1st School of Medicine,School of Information and Engineering,The1st Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325000, China.
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Tan Y, Zhang Z, Wu M, Zou S, Guo W, Liang K. Unusual disseminated Talaromyces marneffei infection presenting with fever and diarrhea in an AIDS patient: a case report and literature review. Acta Clin Belg 2023; 78:67-70. [PMID: 35467497 DOI: 10.1080/17843286.2022.2067957] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND Gastrointestinal symptoms are not uncommon in patients infected with Talaromyces marneffei (T. marneffei). However, the reports on intestinal T. marneffei infection were rare. We report a case of disseminated T. marneffei infection with intestine involvement. CASE PRESENTATION A 41-year-old female with acquired immune deficiency syndrome (AIDS) was admitted to our hospital for long-term fever, followed by abdominal pain and diarrhea. The colonoscopy performed in our hospital revealed ulcerative lesions in the colon and terminal ileum. Periodic acid-Schiff (PAS) staining of intestinal ulcer revealed that the small dots distributed inside and outside of the macrophages were yeast microorganisms. Further culture of bone marrow sample was confirmed T. marneffei positive. A diagnosis of disseminated T. marneffei infection was made, with intestine involvement. We also summarized the clinical characteristics, endoscopic findings and histopathological features of intestinal T. marneffei by literature review. CONCLUSION In HIV-infected and other immunocompromised patients with gastrointestinal symptoms and/or associated abdominal imaging abnormalities, intestinal T. marneffei infection should be taken into consideration. Serious manifestations such as intestinal obstruction and intestinal perforation may occur. Early diagnosis is of great significance to prevent the deterioration of the illness and improve the prognosis. Histopathological examination and culture of intestinal lesions are helpful to improve the diagnosis of intestinal T. marneffei infection. ABBREVIATIONS AIDS: acquired immune deficiency syndrome; ART: antiretroviral therapy; ESR: erythrocyte sedimentation rate; PPD:purified protein derivative; HE: Hematoxylin and eosin; PAS: Periodic acid-Schiff; CMV: cytomegalovirus; GMS:Gomori's methenamine silver nitrate.
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Affiliation(s)
- Yuting Tan
- Department of Infectious Diseases, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | - Zhihan Zhang
- Department of Infectious Diseases, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | - Mengmeng Wu
- Department of Infectious Diseases, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | - Shi Zou
- Department of Infectious Diseases, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | - Wei Guo
- Pathology Department, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | - Ke Liang
- Department of Infectious Diseases, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China.,Department of Nosocomial Infection Management, Zhongnan Hospital of Wuhan University, Hubei, China.,Wuhan Research Center for Infectious Diseases and Cancer, Chinese Academy of Medical Sciences, Wuhan, Hubei, China.,Center of Preventing Mother-to-child Transmission for Infectious Diseases, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
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Reddy HK, Raju BP, Methre V, Samagani A. Kaposi's sarcoma: An interesting case report in a human immunodeficiency virus-positive heterosexual male. Indian J Sex Transm Dis AIDS 2022; 43:179-181. [PMID: 36743084 PMCID: PMC9890996 DOI: 10.4103/ijstd.ijstd_11_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 07/05/2021] [Accepted: 07/05/2021] [Indexed: 11/17/2022] Open
Abstract
Kaposi's sarcoma (KS) is an angioproliferative neoplasm that affects skin and other organs. It is one of the acquired immune deficiency syndrome (AIDS)-defining conditions, which tends to occur at low CD4 count. It is the most common neoplasm among patients with AIDS in the Western population. It is rarely reported from India. We report the case of a 38-year-old human immunodeficiency virus-positive heterosexual male, with an unusual presentation of KS.
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Affiliation(s)
- Harshitha K. Reddy
- Department of Dermatology, Venereology and Leprosy, Raja Rajeswari Medical College and Hospital, Bengaluru, Karnataka, India
| | - Belliappa P. Raju
- Department of Dermatology, Venereology and Leprosy, Raja Rajeswari Medical College and Hospital, Bengaluru, Karnataka, India
| | - Vishal Methre
- Department of Dermatology, Venereology and Leprosy, Raja Rajeswari Medical College and Hospital, Bengaluru, Karnataka, India
| | - Akshay Samagani
- Department of Dermatology, Venereology and Leprosy, Raja Rajeswari Medical College and Hospital, Bengaluru, Karnataka, India
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10
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Zhu K, Xu Q, Ma Y, Li P, Jia H, Jiang Q, Wang Y, Wu Z, Wang D, Guo H, Jin Y. Suboptimal Immune Recovery and Associated Factors Among People Living with HIV/AIDS on Second-line Antiretroviral Therapy in Central China: A Retrospective Cohort Study. J Med Virol 2022; 94:4975-4982. [PMID: 35710693 DOI: 10.1002/jmv.27944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 05/07/2022] [Accepted: 06/12/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND The introduction and scale-up of antiretroviral therapy (ART) have contributed to significantly improved patients with acquired immune deficiency syndrome (AIDS) quality of life and prolongs their survival. This has occurred by suppressing viral replication and recovering the CD4 cell count. However, some patients do not normalize their CD4 cell count, despite suppression of the viral load (VL). Patients with suboptimal immune recovery (SIR), as defined by a viral load(VL) < 400 copies/ml with a CD4 cell count of<200cells/μl, after ART initiation, exhibit severe immune dysfunction and have a higher risk of AIDS and non-AIDS events. In recent years, People living with HIV/AIDS (PLWHA) with first-line ART failure began to gradually switch to second-line ART. This study aimed to examine the prevalence and factors affecting SIR among people living with HIV/AIDS (PLWHA) who switch to second-line ART in rural China. METHODS A 1-year retrospective cohort study was conducted among PLWHA who switched to second-line ART between January 2009 and December 2018. All patients with a viral load(VL) < 400 copies/ml after 1 year of second-line ART were included. SIR was defined as a CD4 cell count <200 cells/μl and a viral load(VL) <400 copies/ml after 1 year of second-line ART. The data collected from medical records were analyzed by univariate and multivariate analyses. RESULTS A total of 5294 PLWHA met the inclusion criteria, 24 died, and 1152 were lost to follow-up after 1 year of second-line ART. Among 4118 PLWHA who were followed up, 3039 with a viral load(VL) <400 copies/ml had their data analyzed, and the prevalence of SIR was 13.1%. The patients' mean age at recruitment was 47.6±8.1 years and 45.3% were men. A total of 30.7% of patients were HIV-positive for >8 years and 88.2% were receiving ART before starting second-line ART for >3 years. The mean CD4 cell count was 354.8±238.2 cells/μl. A multivariable analysis showed that male sex, single status (unmarried or divorced), and a low CD4 cell count were risk factors for SIR among PLWHA with second-line ART. CONCLUSIONS The prevalence of SIR among PLWHA who switched to second-line ART in this retrospective cohort study is lower than that in most other studies. Several factors associated with SIR include male sex, marital status, and CD4 cell count levels in PLWHA. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Keying Zhu
- The First Clinical Medical School, Henan University of Chinese Medicine, Zhengzhou, 45000, China
| | - Qianlei Xu
- The First Clinical Medical School, Henan University of Chinese Medicine, Zhengzhou, 45000, China.,Department of Acquired Immune Deficiency Syndrome Treatment and Research Center, First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, 45000, China
| | - Yanmin Ma
- Center for AIDS/STD Control and Prevention, Center for Disease Control and Prevention of Henan Province, Zhengzhou, 45000, China
| | - Pengyu Li
- Department of Acquired Immune Deficiency Syndrome Treatment and Research Center, First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, 45000, China
| | - Huangchao Jia
- The First Clinical Medical School, Henan University of Chinese Medicine, Zhengzhou, 45000, China
| | - Qi Jiang
- The First Clinical Medical School, Henan University of Chinese Medicine, Zhengzhou, 45000, China
| | - Yueyuan Wang
- The First Clinical Medical School, Henan University of Chinese Medicine, Zhengzhou, 45000, China
| | - Zhihui Wu
- The First Clinical Medical School, Henan University of Chinese Medicine, Zhengzhou, 45000, China
| | - Dongli Wang
- The First Clinical Medical School, Henan University of Chinese Medicine, Zhengzhou, 45000, China
| | - Huijun Guo
- Department of Acquired Immune Deficiency Syndrome Treatment and Research Center, First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, 45000, China
| | - Yantao Jin
- Department of Acquired Immune Deficiency Syndrome Treatment and Research Center, First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, 45000, China.,Henan Key Laboratory of Viral Diseases Prevention and Treatment of Chinese Medicine, Henan University of Chinese Medicine, Zhengzhou, 45000, China
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11
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Xia P, Xing XD, Yang CX, Liao XJ, Liu FH, Huang HH, Zhang C, Song JW, Jiao YM, Shi M, Jiang TJ, Zhou CB, Wang XC, He Q, Zeng QL, Wang FS, Zhang JY. Activation-induced pyroptosis contributes to the loss of MAIT cells in chronic HIV-1 infected patients. Mil Med Res 2022; 9:24. [PMID: 35619176 PMCID: PMC9137088 DOI: 10.1186/s40779-022-00384-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 05/13/2022] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Mucosal-associated invariant T (MAIT) cells are systemically depleted in human immunodeficiency virus type 1 (HIV-1) infected patients and are not replenished even after successful combined antiretroviral therapy (cART). This study aimed to identify the mechanism underlying MAIT cell depletion. METHODS In the present study, we applied flow cytometry, single-cell RNA sequencing and immunohistochemical staining to evaluate the characteristics of pyroptotic MAIT cells in a total of 127 HIV-1 infected individuals, including 69 treatment-naive patients, 28 complete responders, 15 immunological non-responders, and 15 elite controllers, at the Fifth Medical Center of Chinese PLA General Hospital, Beijing, China. RESULTS Single-cell transcriptomic profiles revealed that circulating MAIT cells from HIV-1 infected subjects were highly activated, with upregulation of pyroptosis-related genes. Further analysis revealed that increased frequencies of pyroptotic MAIT cells correlated with markers of systemic T-cell activation, microbial translocation, and intestinal damage in cART-naive patients and poor CD4+ T-cell recovery in long-term cART patients. Immunohistochemical staining revealed that MAIT cells in the gut mucosa of HIV-1 infected patients exhibited a strong active gasdermin-D (GSDMD, marker of pyroptosis) signal near the cavity side, suggesting that these MAIT cells underwent active pyroptosis in the colorectal mucosa. Increased levels of the proinflammatory cytokines interleukin-12 (IL-12) and IL-18 were observed in HIV-1 infected patients. In addition, activated MAIT cells exhibited an increased pyroptotic phenotype after being triggered by HIV-1 virions, T-cell receptor signals, IL-12 plus IL-18, and combinations of these factors, in vitro. CONCLUSIONS Activation-induced MAIT cell pyroptosis contributes to the loss of MAIT cells in HIV-1 infected patients, which could potentiate disease progression and poor immune reconstitution.
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Affiliation(s)
- Peng Xia
- Senior Department of Infectious Diseases, the Fifth Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Infectious Diseases, Savaid Medical School, University of Chinese Academy of Sciences, Beijing, 100039, China.,Department of Infectious Diseases and Hepatology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Xu-Dong Xing
- Biomedical Pioneering Innovation Center (BIOPIC), School of Life Sciences, Peking University, Beijing, 100871, China
| | - Cui-Xian Yang
- Yunnan Infectious Disease Hospital, Kunming, 650301, China
| | - Xue-Jiao Liao
- the Third People's Hospital of Shenzhen, School of Medicine, Southern University of Science and Technology, Shenzhen, 518112, Guangzhou, China
| | - Fu-Hua Liu
- Senior Department of Infectious Diseases, the Fifth Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Infectious Diseases, Savaid Medical School, University of Chinese Academy of Sciences, Beijing, 100039, China.,Department of Infectious Diseases and Hepatology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Hui-Huang Huang
- Senior Department of Infectious Diseases, the Fifth Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Infectious Diseases, Savaid Medical School, University of Chinese Academy of Sciences, Beijing, 100039, China
| | - Chao Zhang
- Senior Department of Infectious Diseases, the Fifth Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Infectious Diseases, Savaid Medical School, University of Chinese Academy of Sciences, Beijing, 100039, China
| | - Jin-Wen Song
- Senior Department of Infectious Diseases, the Fifth Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Infectious Diseases, Savaid Medical School, University of Chinese Academy of Sciences, Beijing, 100039, China
| | - Yan-Mei Jiao
- Senior Department of Infectious Diseases, the Fifth Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Infectious Diseases, Savaid Medical School, University of Chinese Academy of Sciences, Beijing, 100039, China
| | - Ming Shi
- Senior Department of Infectious Diseases, the Fifth Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Infectious Diseases, Savaid Medical School, University of Chinese Academy of Sciences, Beijing, 100039, China
| | - Tian-Jun Jiang
- Senior Department of Infectious Diseases, the Fifth Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Infectious Diseases, Savaid Medical School, University of Chinese Academy of Sciences, Beijing, 100039, China
| | - Chun-Bao Zhou
- Senior Department of Infectious Diseases, the Fifth Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Infectious Diseases, Savaid Medical School, University of Chinese Academy of Sciences, Beijing, 100039, China
| | - Xi-Cheng Wang
- Yunnan Infectious Disease Hospital, Kunming, 650301, China
| | - Qing He
- the Third People's Hospital of Shenzhen, School of Medicine, Southern University of Science and Technology, Shenzhen, 518112, Guangzhou, China
| | - Qing-Lei Zeng
- Department of Infectious Diseases and Hepatology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China.
| | - Fu-Sheng Wang
- Senior Department of Infectious Diseases, the Fifth Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Infectious Diseases, Savaid Medical School, University of Chinese Academy of Sciences, Beijing, 100039, China.
| | - Ji-Yuan Zhang
- Senior Department of Infectious Diseases, the Fifth Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Infectious Diseases, Savaid Medical School, University of Chinese Academy of Sciences, Beijing, 100039, China.
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12
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Kim B, Ogwal M, Sande E, Kiyingi H, Serwadda D, Hladik W. Using geographical data and rolling statistics for diagnostics of respondent-driven sampling. Soc Networks 2022; 69:74-83. [PMID: 38616951 PMCID: PMC11009932 DOI: 10.1016/j.socnet.2020.05.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/16/2024]
Abstract
Respondent-driven sampling (RDS) is commonly used to sample from key populations without a sampling frame since traditional methods are unable to efficiently survey them. Surveying these populations is often desirable to inform service delivery, assess effectiveness of programs, and determine prevalence of diseases. However, there are concerns about how RDS works in practice due to its many assumptions. To assess some of these assumptions, we develop diagnostics using geographical data and demonstrate their utility by identifying lack of convergence and characterizing RDS reach in surveys conducted among female sex workers and men who have sex with men in Kampala, Uganda.
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Affiliation(s)
- Brian Kim
- Joint Program in Survey Methodology, University of Maryland, 1218 LeFrak Hall, 7251 Preinkert Dr., College Park, MD 20742, USA
| | - Moses Ogwal
- Makerere University School of Public Health, Old Mulago Hill Road, New Mulago Hospital Complex, P.O. Box 7072, Kampala, Uganda
| | - Enos Sande
- Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA 30333, USA
| | - Herbert Kiyingi
- Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA 30333, USA
| | - David Serwadda
- Makerere University School of Public Health, Old Mulago Hill Road, New Mulago Hospital Complex, P.O. Box 7072, Kampala, Uganda
| | - Wolfgang Hladik
- Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA 30333, USA
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13
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Wang CY, Liu J, Liang XP, Guo BL, Hu RZ, Liu Y. [Clinical characteristics and prognostic features of 63 HIV-associated diffuse large B-cell lymphoma: a single-center real-world study in China]. Zhonghua Xue Ye Xue Za Zhi 2022; 43:203-208. [PMID: 35405777 PMCID: PMC9072062 DOI: 10.3760/cma.j.issn.0253-2727.2022.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Indexed: 11/09/2022]
Abstract
Objective: This study aimed to look into the clinical characteristics and prognosis of patients with human immunodeficiency virus (HIV) -associated diffuse large B-cell lymphoma (DLBCL) . Methods: Retrospective review of the clinical data of 63 HIV-infected patients with DLBCL diagnosed at Chongqing University Cancer Hospital between July 2008 and August 2021. The Kaplan-Meier method was used to calculate survival curves, and the log-rank test method was used to compare survival between groups. The Cox proportional hazards model was used for multivariate analysis. Results: In 63 patients with HIV-associated DLBCL, 57 (90.5% ) were men, and the median age was 49 (23-87) years. The most common pathological subtype was the germinal center B-cell-like lymphoma (74.6% ) ; 46.0% (29/63) were combined with extranodal lesions. Seventeen of 63 (27.0% ) patients had large masses (≥7.5 cm) . Twenty of 63 (31.7% ) patients had B symptoms. The median CD4(+) T cell count was 203 (4-1022) ×10(6)/L. A total of 49% (25/51) patients had CD4(+) cell count <200×10(6)/L, 56.9% (33/58) had high (3-5) International Prognostic Index (IPI) scores, and 43.1% (25/58) had low (0-2) IPI scores. Further, 78% (46/59) were diagnosed with Ann Arbor Stage Ⅲ/Ⅳ, and 25.4% (16/63) didn't receive chemotherapy. A total of 22.2% (14/63) of patients received less than four cycles of chemotherapy, and 52.4% (33/63) received four or more cycles of chemotherapy. Among patients undergoing chemotherapy, 61.7% (29/47) received R-CHOP-like regimens, and 38.3% (18/47) used CHOP-like regimens. The 1-, 2-, 3-, and 5-year overall survival (OS) rates were 65.0% , 53.8% , 47.1% , and 43.5% , respectively. Univariate analysis revealed that age ≥ 60 years (P=0.012) , Eastern Cooperative Oncology Gruop Performance Status (ECOG-PS) score 2-4 points (P=0.043) , IPI score 3-5 points (P=0.001) , β(2)-MG elevation (≥5.5 mg/L) (P=0.007) , and systemic chemotherapy cycles less than four times (P<0.001) were the negative prognostic factors affecting the OS of patients. The Cox multivariate analysis depicted that age ≥60 years (HR=2.272, 95% CI 1.110-4.651, P=0.025) , IPI score 3-5 points (HR=3.562, 95% CI 1.794-7.074, P<0.001) , ECOG-PS score 2-4 points (HR=2.675, 95% CI 1.162-6.153, P=0.021) , and number of cycles of chemotherapy<4 (HR=0.290, 95% CI 0.176-0.479, P<0.001) were independent risk factors for adverse prognosis of OS. Conclusion: HIV-associated DLBCL is the most common HIV-related tumor, is most commonly seen in men, and has a high 1-year mortality rate. Chemotherapy combined with antiretroviral therapy can improve patient prognosis.
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Affiliation(s)
- C Y Wang
- Department of Hematology-Oncology, Chongqing University Cancer Hospital, Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing 400030, China
| | - J Liu
- Department of Hematology-Oncology, Chongqing University Cancer Hospital, Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing 400030, China
| | - X P Liang
- Department of Hematology-Oncology, Chongqing University Cancer Hospital, Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing 400030, China
| | - B L Guo
- Department of Hematology-Oncology, Chongqing University Cancer Hospital, Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing 400030, China
| | - R Z Hu
- Department of Hematology-Oncology, Chongqing University Cancer Hospital, Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing 400030, China
| | - Y Liu
- Department of Hematology-Oncology, Chongqing University Cancer Hospital, Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing 400030, China
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Chadyiwanembwa N, Habedi DS. High school teenage girls' perceptions of human immunodeficiency virus and acquired immune deficiency syndrome in Gauteng Province, South Africa: Age-mixing sexual partnerships. Afr J Reprod Health 2022; 26:80-87. [PMID: 37584999 DOI: 10.29063/ajrh2022/v26i2.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/17/2023]
Abstract
Age-disparity relationships between High School teenage girls and adults' male partners above 21 years were transactional in nature and believed to be spreading human immunodeficiency virus (HIV). Teenage girls lacked the capacity to negotiate condom use due to lack of autonomy, coupled with sexual violence. This resulted in HIV transmission and an increase in teenage pregnancies. The study explored and described the risky behaviours of High School teenage girls with regard to HIV and acquired immune deficiency syndrome (AIDS) transmission in Gauteng Province, South Africa. A non-experimental descriptive design was used in this study. The 109 respondents between 15 and 19-years were studied using modified, self-administered, structured questionnaire. Data analysis was done using Statistical Package for Social Sciences version 23. The 90% of the 19-year-old respondents had multiple concurrent sexual relationships and condom use was low. High School teenage girls had a low perception of HIV risk because they were involved in concurrent multiple sexual relationships with low condom use.
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Affiliation(s)
| | - Debbie Sk Habedi
- Department of Health Studies, University of South Africa, UNISA, South Africa
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15
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Wang Y, Yang J, Wen Y. Lessons from Epstein-Barr virus DNA detection in cerebrospinal fluid as a diagnostic tool for EBV-induced central nervous system dysfunction among HIV-positive patients. Biomed Pharmacother 2021; 145:112392. [PMID: 34781140 DOI: 10.1016/j.biopha.2021.112392] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 10/21/2021] [Accepted: 11/02/2021] [Indexed: 12/24/2022] Open
Abstract
Polymerase chain reaction (PCR) analysis of Epstein-Barr virus (EBV) DNA in cerebrospinal fluid (CSF) remains vital for evaluating active EBV infection involving the central nervous system (CNS). CSF EBV DNA was often found in conjunction with other microbial infection affecting the CNS among patients infected with human immunodeficiency virus (HIV). Sometimes CSF EBV DNA is detectable in patients without neurological symptoms. This review focused on the clinical and laboratory features of CNS EBV infection among patients with HIV, and discussed various types of EBV-associated CNS infections, and predominant neoplasms involving CNS such as primary central nervous system lymphoma (PCNSL), CNS-non-Hodgkin's lymphoma, smooth muscle tumors and leiomyosarcomas, EBV encephalitis or myelitis, EBV meningitis and EBV coinfection with other causative agents were also included. Furthermore, the metagenomic next-generation sequencing technique with high sensitivity for the detection of pathogenic coinfection in the CSF were also reviewed. We concluded that CSF EBV-DNA detection with high sensitivity and specificity could be a useful diagnostic tool for CNS lymphoma among HIV patients; however, it is still unknown for other CNS diseases. We further summarized and conclude that positive CSF EBV-DNA detection combined with specific brain focal lesions could be a minimally invasive method to diagnose PCNSL. The occurrence of positive CSF EBV-DNA was influenced by PCR detection limit, PCR methods, immunocompromised status, the possible influence of anti-herpetic therapy and anti-HIV therapy, and the size and location of a tumor mass. Uniform PCR methods as vital diagnostic tools and optimal EBV-DNA load threshold need to be established.
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Affiliation(s)
- Yanli Wang
- Department of Infectious Diseases, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Jun Yang
- Neurology Department, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Ying Wen
- Department of Infectious Diseases, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, China.
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16
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Wulf HC, Heerfordt IM. Treatment of AIDS-related Kaposi's Sarcoma With Low-dose Radiotherapy - Follow-up on 2,305 Tumours. Anticancer Res 2021; 41:3871-3874. [PMID: 34281848 DOI: 10.21873/anticanres.15181] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 07/01/2021] [Accepted: 07/02/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM We aimed to report our experience obtained by treating AIDS-related Kaposi's sarcoma (KS) with radiotherapy before the era of antiretroviral therapy. PATIENTS AND METHODS This investigation was performed as a quality control of KS patients treated with low-dose radiotherapy at our department. KS patients referred to our section from 1983 up until 1990, were treated three times with radiotherapy (29-50 kV, 2-4 Gy), once every second week. RESULTS Initially, 74 skin KSs were treated three times with 2 Gy, of which 70% were treated successfully. Hereafter, other 2,066 KSs on the skin were treated three times with 4 Gy with a very high success rate of 93%. Additional 165 mucous KSs were treated three times with 4 Gy, of which 91% were treated successfully. CONCLUSION Low-dose radiotherapy is effective for the treatment of many AIDS-related KS patients.
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Affiliation(s)
- Hans Christian Wulf
- Department of Dermatology, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Ida M Heerfordt
- Department of Dermatology, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
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Breillat P, Pourcher V, Deshayes S, Buob D, Cez A, Michel PA, Boffa JJ, Langlois V, Grateau G, Georgin-Lavialle S. AA Amyloidosis in the Course of HIV Infection: A Report of 19 Cases Including 4 New French Cases and a Comprehensive Review of Literature. Nephron Clin Pract 2021; 145:675-683. [PMID: 34265778 DOI: 10.1159/000516982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 05/02/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION HIV infection has been recently retained as an unclear cause of AA amyloidosis. Our aim was to investigate cases of AA amyloidosis associated with HIV infection to understand if it could be considered as a cause of AA amyloidosis. METHODS A comprehensive literature review was conducted as well as retrospective study from French cases collected from our national reference center for AA amyloidosis. RESULTS Altogether, 19 patients with AA amyloidosis and HIV infection were found with 68% of men and median age at amyloidosis diagnosis of 38 years (range 28-75 years). Clinical presentation was nephrotic syndrome in 94% (n = 17/18). Among patients with renal involvement and assessable outcome (n = 17), 11 (64.7%) progressed to chronic kidney disease, with 6 (35%) end-stage renal disease. Seventy-five percent of patients had uncontrolled HIV infection and 71.4% CD4 counts <400/mm3 at amyloidosis diagnosis. Repeated or chronic bacterial or fungal infection was found in 47% of cases and a history of parenteral drug use in 55% of patients. Three patients had no classical or at least no suspected AA amyloidosis cause found or reported. CONCLUSIONS AA Amyloidosis is a rare condition in HIV patients with common renal involvement and significant risk of progression to chronic renal insufficiency. Because of the frequency related to other inflammatory conditions in this population, HIV is probably not an independent risk factor for AA amyloidosis.
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Affiliation(s)
- Paul Breillat
- Department of Internal Medicine, Sorbonne University, AP-HP, Tenon Hospital, Centre De Référence Des Maladies Auto-Inflammatoires Et Des Amyloses D'origine Inflammatoire (CEREMAIA), Paris, France
| | - Valérie Pourcher
- Department of Infectious Diseases, Sorbonne University, APHP, Pitié Salpétrière Hospital, INSERM 1136, Paris, France
| | - Samuel Deshayes
- Department of Internal Medicine, Normandie University, UNICAEN, CHU De Caen Normandie, Caen, France
| | - David Buob
- Department of Biopathology, Sorbonne University, AP-HP, Tenon Hospital, Paris, France
| | - Alexandre Cez
- Department of Nephrology, Sorbonne University, AP-HP, Tenon Hospital, Paris, France
| | | | - Jean-Jacques Boffa
- Department of Nephrology, Sorbonne University, AP-HP, Tenon Hospital, Paris, France
| | - Vincent Langlois
- Department of Internal Medicine, Jacques Monod Hospital, Le Havre, France
| | - Gilles Grateau
- Department of Internal Medicine, Sorbonne University, AP-HP, Tenon Hospital, Centre De Référence Des Maladies Auto-Inflammatoires Et Des Amyloses D'origine Inflammatoire (CEREMAIA), Paris, France
| | - Sophie Georgin-Lavialle
- Department of Internal Medicine, Sorbonne University, AP-HP, Tenon Hospital, Centre De Référence Des Maladies Auto-Inflammatoires Et Des Amyloses D'origine Inflammatoire (CEREMAIA), Paris, France
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18
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李 远, 崔 闻, 郭 雪, 朱 璠, 刘 思, 贾 碧, 汪 培, 马 迎. [Comparison of acquired immure deficiency syndrome-related knowledge and behavior between persons with and without human immunodeficiency virus- infection among young male students who have sex with men]. Beijing Da Xue Xue Bao Yi Xue Ban 2021; 53:511-517. [PMID: 34145853 PMCID: PMC8220046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Indexed: 11/08/2023]
Abstract
OBJECTIVE To understand the differences between young male students who have sex with men (MSM) with and without human immunodeficiency virus (HIV)-infection in acquired immure deficiency syndrome (AIDS)-related knowledge and behavior, and to provide a scientific reference to make targeted and effective measures in AIDS prevention. METHODS Using snow balling sampling combined with participants' referral, we conducted a questionnaire survey among 548 young MSM students (in whom there were both HIV-positive and HIV-negative) in Harbin, Tianjin, Xi'an, and Chongqing cities from April 2017 to March 2018. The chi-square test and binary Logistic regression were used to compare the differences in AIDS-related knowledge and behavior between males with and without HIV-infection. RESULTS A total of 583 questionnaires were obtained, of which 548 were valid, with an effective rate of 94.0%. Having a junior college education or below (P=0.002), a monthly consumption level of less than 2 000 RMB (P=0.021), and living off campus (P=0.004) were associated with being tested positive for HIV. In any period of schooling, receiving AIDS prevention education was a protective factor for HIV infection [Primary school OR=0.203 (0.073-0.561), junior high school OR=0.287 (0.142-0.581), senior high school OR=0.271 (0.142-0.518), and university OR=0.322 (0.168-0.616)]. There was no statistical difference between HIV positive and negative young MSM students in the cognition of "AIDS-related Knowledge for Public"(P=0.907) and "AIDS-related Knowledge for Youth"(P=0.782), with the awareness rate all about 90%. There was a statistical difference in the need for some specific knowledge (For "AIDS prevention and treatment policy", P=0.012, for "Ways to identify and prevent high-risk sexual behavior", P < 0.001). HIV-positive males had a younger age of first sexual activity (P=0.006), had more sexual partners in the early (P < 0.001) and had lower frequency of condom use (P < 0.001). However, there was no statistical difference in the later number of sexual partners (P=0.247) and the frequency of condom use (For regular sex partners, P=0.735, and for casual sex partners, P=0.765), which might be related to the change of sexual behavior characteristics caused by HIV infection (For regular sex partners, P < 0.001, and for casual sex partners, P=0.006). CONCLUSION There was no statistical difference between HIV positive and negative young MSM students in the cognition of "AIDS-related Knowledge for Public" and "AIDS-related Knowledge for Youth", which were both lower than 95% required by the state. However, the specificity in the knowledge needs was certainly shown. There was no significant difference in the recent sexual behavior between the two groups, but HIV positive students were more likely to have high-risk sexual behaviors in the early stage, so we should strengthen and move forward the sex education and AIDS prevention education with adjusted contents, and prevent high-risk sexual behaviors within young MSM students in the early stage.
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Affiliation(s)
- 远骋 李
- />北京大学公共卫生学院,北京大学儿童青少年卫生研究所,北京 100191Institute of Child and Adolescent Health, Peking University School of Public Health, Beijing 100191, China
| | - 闻心 崔
- />北京大学公共卫生学院,北京大学儿童青少年卫生研究所,北京 100191Institute of Child and Adolescent Health, Peking University School of Public Health, Beijing 100191, China
| | - 雪儿 郭
- />北京大学公共卫生学院,北京大学儿童青少年卫生研究所,北京 100191Institute of Child and Adolescent Health, Peking University School of Public Health, Beijing 100191, China
| | - 璠 朱
- />北京大学公共卫生学院,北京大学儿童青少年卫生研究所,北京 100191Institute of Child and Adolescent Health, Peking University School of Public Health, Beijing 100191, China
| | - 思辰 刘
- />北京大学公共卫生学院,北京大学儿童青少年卫生研究所,北京 100191Institute of Child and Adolescent Health, Peking University School of Public Health, Beijing 100191, China
| | - 碧波 贾
- />北京大学公共卫生学院,北京大学儿童青少年卫生研究所,北京 100191Institute of Child and Adolescent Health, Peking University School of Public Health, Beijing 100191, China
| | - 培 汪
- />北京大学公共卫生学院,北京大学儿童青少年卫生研究所,北京 100191Institute of Child and Adolescent Health, Peking University School of Public Health, Beijing 100191, China
| | - 迎华 马
- />北京大学公共卫生学院,北京大学儿童青少年卫生研究所,北京 100191Institute of Child and Adolescent Health, Peking University School of Public Health, Beijing 100191, China
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李 远, 崔 闻, 郭 雪, 朱 璠, 刘 思, 贾 碧, 汪 培, 马 迎. [Comparison of acquired immure deficiency syndrome-related knowledge and behavior between persons with and without human immunodeficiency virus- infection among young male students who have sex with men]. Beijing Da Xue Xue Bao Yi Xue Ban 2021; 53:511-517. [PMID: 34145853 PMCID: PMC8220046 DOI: 10.19723/j.issn.1671-167x.2021.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To understand the differences between young male students who have sex with men (MSM) with and without human immunodeficiency virus (HIV)-infection in acquired immure deficiency syndrome (AIDS)-related knowledge and behavior, and to provide a scientific reference to make targeted and effective measures in AIDS prevention. METHODS Using snow balling sampling combined with participants' referral, we conducted a questionnaire survey among 548 young MSM students (in whom there were both HIV-positive and HIV-negative) in Harbin, Tianjin, Xi'an, and Chongqing cities from April 2017 to March 2018. The chi-square test and binary Logistic regression were used to compare the differences in AIDS-related knowledge and behavior between males with and without HIV-infection. RESULTS A total of 583 questionnaires were obtained, of which 548 were valid, with an effective rate of 94.0%. Having a junior college education or below (P=0.002), a monthly consumption level of less than 2 000 RMB (P=0.021), and living off campus (P=0.004) were associated with being tested positive for HIV. In any period of schooling, receiving AIDS prevention education was a protective factor for HIV infection [Primary school OR=0.203 (0.073-0.561), junior high school OR=0.287 (0.142-0.581), senior high school OR=0.271 (0.142-0.518), and university OR=0.322 (0.168-0.616)]. There was no statistical difference between HIV positive and negative young MSM students in the cognition of "AIDS-related Knowledge for Public"(P=0.907) and "AIDS-related Knowledge for Youth"(P=0.782), with the awareness rate all about 90%. There was a statistical difference in the need for some specific knowledge (For "AIDS prevention and treatment policy", P=0.012, for "Ways to identify and prevent high-risk sexual behavior", P < 0.001). HIV-positive males had a younger age of first sexual activity (P=0.006), had more sexual partners in the early (P < 0.001) and had lower frequency of condom use (P < 0.001). However, there was no statistical difference in the later number of sexual partners (P=0.247) and the frequency of condom use (For regular sex partners, P=0.735, and for casual sex partners, P=0.765), which might be related to the change of sexual behavior characteristics caused by HIV infection (For regular sex partners, P < 0.001, and for casual sex partners, P=0.006). CONCLUSION There was no statistical difference between HIV positive and negative young MSM students in the cognition of "AIDS-related Knowledge for Public" and "AIDS-related Knowledge for Youth", which were both lower than 95% required by the state. However, the specificity in the knowledge needs was certainly shown. There was no significant difference in the recent sexual behavior between the two groups, but HIV positive students were more likely to have high-risk sexual behaviors in the early stage, so we should strengthen and move forward the sex education and AIDS prevention education with adjusted contents, and prevent high-risk sexual behaviors within young MSM students in the early stage.
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Affiliation(s)
- 远骋 李
- />北京大学公共卫生学院,北京大学儿童青少年卫生研究所,北京 100191Institute of Child and Adolescent Health, Peking University School of Public Health, Beijing 100191, China
| | - 闻心 崔
- />北京大学公共卫生学院,北京大学儿童青少年卫生研究所,北京 100191Institute of Child and Adolescent Health, Peking University School of Public Health, Beijing 100191, China
| | - 雪儿 郭
- />北京大学公共卫生学院,北京大学儿童青少年卫生研究所,北京 100191Institute of Child and Adolescent Health, Peking University School of Public Health, Beijing 100191, China
| | - 璠 朱
- />北京大学公共卫生学院,北京大学儿童青少年卫生研究所,北京 100191Institute of Child and Adolescent Health, Peking University School of Public Health, Beijing 100191, China
| | - 思辰 刘
- />北京大学公共卫生学院,北京大学儿童青少年卫生研究所,北京 100191Institute of Child and Adolescent Health, Peking University School of Public Health, Beijing 100191, China
| | - 碧波 贾
- />北京大学公共卫生学院,北京大学儿童青少年卫生研究所,北京 100191Institute of Child and Adolescent Health, Peking University School of Public Health, Beijing 100191, China
| | - 培 汪
- />北京大学公共卫生学院,北京大学儿童青少年卫生研究所,北京 100191Institute of Child and Adolescent Health, Peking University School of Public Health, Beijing 100191, China
| | - 迎华 马
- />北京大学公共卫生学院,北京大学儿童青少年卫生研究所,北京 100191Institute of Child and Adolescent Health, Peking University School of Public Health, Beijing 100191, China
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Liu C, He Y, Xiao G, Ouyang H, Zhang C. Analysis of the clinical effect of noninvasive mechanical ventilation in AIDS patients complicated with pneumonia. Am J Transl Res 2021; 13:3794-3799. [PMID: 34017567 PMCID: PMC8129412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 11/27/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To explore the clinical application effect of noninvasive mechanical ventilation for patients with acquired immune deficiency syndrome (AIDS) complicated with pneumonia. METHODS A prospective study was conducted on 86 patients with AIDS complicated with pneumocystis pneumonia. The patients were randomly divided into a control group and an experimental group, both of which were treated with conventional drugs. The control group was supplemented with oxygen via a mask, and the experimental group was additionally treated with noninvasive ventilator ventilation. The changes of arterial oxygen partial pressure, oxygenation index, respiratory frequency, pulse rate, serum albumin and other indicators between the two groups before and after treatment were observed. The patient's hospitalization time, overall improvement and mortality rate were compared. RESULTS Compared with those before treatment, the arterial oxygen partial pressure, oxygenation index, respiratory frequency, and pulse rate of the two groups of patients were significantly improved after treatment (P<0.05). The improvement of the experimental group after treatment was more significant than that of the control group, and the difference was statistically significant (P<0.001). After treatment, the proportion of recovery rate of serum albumin in the experimental group was 81.40%, which was significantly higher than that in the control group (53.49%), and the difference was statistically significant (P<0.05). Compared with the control group, hospitalization time, treatment improvement and mortality rate in the experimental group had significant advantages and statistical significance (P<0.05). CONCLUSION For AIDS patients complicated with pneumonia, noninvasive mechanical ventilation had obvious treatment effects, which could significantly improve respiratory function, reduce mortality rate, and increase recovery rate. It can be considered as a therapeutic method to be included in routine treatment protocols.
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Affiliation(s)
- Changming Liu
- The Third Department of Infection, The First Hospital of ChangshaChangsha, Hu’nan Province, China
| | - Yan He
- Department of Infection, The Second Xiangya Hospital of Central South UniversityChangsha, Hu’nan Province, China
| | - Gang Xiao
- Department of AIDS, The First Hospital of ChangshaChangsha, Hu’nan Province, China
| | - Hui Ouyang
- Department of Respiratory Medicine, The Fourth Hospital of ChangshaChangsha, Hu’nan Province, China
| | - Chan Zhang
- Department of Respiratory Medicine, The Fourth Hospital of ChangshaChangsha, Hu’nan Province, China
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21
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Kumar V, Singh J, Singh H. A randomized prospective study to assess health-related quality-of-life outcomes of antiretroviral therapy in human immunodeficiency virus-positive adults. Indian J Sex Transm Dis AIDS 2021; 42:50-56. [PMID: 34765938 PMCID: PMC8579595 DOI: 10.4103/ijstd.ijstd_102_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Accepted: 03/08/2020] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Health-related quality of life (HRQOL) in human immunodeficiency virus (HIV)-positive individuals is substantially challenged due to disease, opportunistic infections, lifelong commitment, and tolerability to antiretroviral therapy (ART) and various social, physical, and psychological domains. AIM This study was conducted to assess the magnitude of the impact on HRQOL in HIV-positive people from early access to ART. SETTINGS AND DESIGN This was a randomized, prospective, open-label study, conducted at the ART center attached to the Government Medical College, Amritsar. SUBJECTS AND METHODS This study comprised 240 HIV-infected adults in the age group >18 years who presented to the ART center. Approval from the Institutional Ethics Committee was obtained. Informed consent was taken from all the enrolled participants after explaining the study therapy and its benefits and side effects. Patients who presented early in their course of disease and had baseline CD4 count ≥350/mm3 were recruited in early arm and those with <350/mm3 or the development of symptomatic HIV-related disease in the late arm. Following stratification, both groups were 1:1 randomized by permuted block randomization. The primary objective was to assess HRQOL using the World Health Organization Quality of Life-HIV brief instrument (WHOQOL-HIV). STATISTICAL ANALYSIS USED The summary domain and total HRQOL scores were calculated using method developed by the WHOQOL-HIV group. Unpaired t-test was applied for statistical analysis, with level of significance expressed as P < 0.05. RESULTS Out of the total 240 HIV-positive patients, 120 who met eligibility criteria were recruited for the final analysis. There was a significant difference between HRQOL score of Physical domains and Psychological domains, between early and late arms at baseline and at the end of 9 months. CONCLUSIONS Quality of life is an important holistic measure for assessing the health of people living with HIV/AIDS.
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Affiliation(s)
- Vikas Kumar
- Department of Pharmacology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Jatinder Singh
- Department of Pharmacology, Government Medical College, Amritsar, Punjab, India
| | - Harpreet Singh
- Department of Medicine, Government Medical College, Amritsar, Punjab, India
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Nduaguba SO, Ford KH, Wilson JP, Lawson KA, Cook RL. Identifying subgroups within at-risk populations that drive late HIV diagnosis in a Southern U.S. state. Int J STD AIDS 2020; 32:162-169. [PMID: 33327899 PMCID: PMC7879228 DOI: 10.1177/0956462420947567] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
We aimed to identify subgroups within age, racial/ethnic, and transmission categories that drive increased risk for late HIV diagnosis (LHD). A 1996–2013 retrospective study of HIV-diagnosed individuals (N = 77,844) was conducted. The proportion of individuals with LHD (AIDS diagnosis within 365 days of HIV diagnosis) was determined, stratified by age, race/ethnicity, and transmission category. Logistic regression with interaction terms was used to identify groups/subgroups at risk for LHD during 1996–2001, 2002–2007, and 2008–2013. Respectively, 78%, 27%, 38%, and 31% were male, White, Black, and Hispanic. Overall, 39% had LHD with a 6.7% reduction for each year increase (OR = 0.93, 95% CI = 0.93–0.94, p < 0.01). Older age was significantly associated with increased odds of LHD (OR range = 1.90–4.55). Compared to their White counterparts, all Hispanic transmission categories (OR range = 1.31–2.58) and only Black female heterosexuals and men who have sex with men (MSM) (OR range = 1.14–1.33) had significantly higher odds of LHD during 1996–2001 and/or 2002–2007. Significance was limited to Hispanic MSM (all age categories), MSM/IDUs (30–59 years), and heterosexuals (18–29 years) and Black MSM (30–39 years) during 2008–2013. Older individuals and Hispanics (driven by MSM) are at increased risk for LHD. HIV testing interventions directed at seniors and Hispanic MSM can further reduce rates of LHD.
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Affiliation(s)
- Sabina O Nduaguba
- Department of Pharmaceutical Outcomes and Policy, University of Florida College of Pharmacy, Gainesville, FL, USA
| | - Kentya H Ford
- Health Outcomes Division, The University of Texas at Austin College of Pharmacy, Austin, TX, USA
| | - James P Wilson
- Health Outcomes Division, The University of Texas at Austin College of Pharmacy, Austin, TX, USA
| | - Kenneth A Lawson
- Health Outcomes Division, The University of Texas at Austin College of Pharmacy, Austin, TX, USA
| | - Robert L Cook
- Department of Epidemiology, University of Florida College of Medicine, Gainesville, FL, USA
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Lee WS, Parsons S, Cugley D, Rogers S, Lim LL, Hall A. Increased incidence of glaucoma medication usage in middle-aged Australian males taking antiretroviral medication - a population-based study. J Ophthalmic Inflamm Infect 2020; 10:30. [PMID: 33141357 PMCID: PMC7609505 DOI: 10.1186/s12348-020-00218-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Accepted: 10/12/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND To investigate a possible association between glaucoma and the use of anti-retroviral therapy (ART) for HIV in the Australian population. METHODS A retrospective review of Australian Pharmaceutical Benefits Scheme data was undertaken from July 2012 to December 2016, inclusive. Three patient groups were compared: those on both topical intraocular pressure (IOP) -lowering medication and ART, those on ART only, and those on IOP-lowering medication only, using the 2016 Australian resident population to estimate prevalence. Odds ratios (95% confidence intervals, [CI]) with Fishers exact test for p values were calculated stratified by age and gender. RESULTS The number of prescriptions for topical glaucoma medications in the general Australian population increased progressively by age with a peak prevalence in those aged 80 years and above. Prevalence of ART was highest in males aged 40-49 and 50-59 years (0.41% [CI 0.40, 0.42] and 0.44% [CI 0.43, 0.45], respectively). Our analysis identified an increase in the prescription of IOP-lowering medication in males on ART aged 30-39 (OR 2.23 [CI 1.32, 3.75], p = 0.007) and 40-49 (OR 1.86 [CI 1.42, 2.43], p < 0.001), compared to those not on ART. There were no statistically significant increased odds for females or males aged 50 years or more. CONCLUSION Compared with the known increase in glaucoma prevalence with age in the general Australian population, a statistically significant increased prevalence in use of IOP-lowering medications was found in males on ART aged 30-49 years. The mechanism for this is yet to be determined, but possible causes include sequelae of HIV infection, a drug-induced side effect, or increased medical surveillance.
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Affiliation(s)
- Wen-Shen Lee
- Ophthalmology, The Alfred Hospital, Alfred Health, Melbourne, Australia
| | - Shaun Parsons
- Ophthalmology, The Alfred Hospital, Alfred Health, Melbourne, Australia.,Ophthalmology, Royal Victorian Eye and Ear Hospital, Melbourne, Australia
| | - Dean Cugley
- Ophthalmology, Royal Victorian Eye and Ear Hospital, Melbourne, Australia
| | - Sophie Rogers
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Australia
| | - Lyndell L Lim
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Australia.,Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Australia
| | - Anthony Hall
- Ophthalmology, The Alfred Hospital, Alfred Health, Melbourne, Australia.
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Britto JJ, Yuvaraj J. Is there any perceptiveness about the mode of transmission of human immunodeficiency virus/ acquired immune deficiency syndrome? An analysis among the adolescent tribal students in Tamil Nadu. Indian J Sex Transm Dis AIDS 2020; 41:88-92. [PMID: 33062989 PMCID: PMC7529181 DOI: 10.4103/ijstd.ijstd_113_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 07/01/2018] [Indexed: 11/17/2022] Open
Abstract
Background: Cognizance about human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) among the community is still lacking. Seldom studies done in tribal area and to indentify the awareness about HIV/AIDS among the adolescent tribal students in Jawadhu hills of Tamil Nadu, with the objectives includes on social, demographical, and knowledge about HIV/AIDS were taken. For primary data, survey method and secondary data from various literatures gathered. Materials and Methods: Schedule tribe adolescent students, between the age groups of 13–21 years, from 8th to 12th standard, exclusively from Vellore and Tiruvannamalai educational districts, were taken, by applying STRATA method. Results: A total of 938 students from various tribal schools participated. Amongst them, 507 (54%) were males and 431 (46%) were females. Half of the respondents (50%) agreed that blood transfusion, intravenous drug use, and sharing infected needles are the major modes of transmission. Nearly 35% agreed that HIV/AIDS is transmitted by hugging, tattooing, dirty hands, breastfeeding, kissing on cheeks, shaving at the barber shop, shaking hands with AIDS patients, homosexuality and are food and waterborne. Conclusions: Formal HIV/AIDS education should be mandatory in their curriculum, where teachers get an opportunity to deliver the scientific information about HIV/AIDS. To acquire better knowledge about HIV/AIDS, sex education should be included in the mainstream of curriculum with the assistance of educational consultants, professional social workers, and also local non-governmental organizations to conduct further mindfulness camps about the HIV/AIDS.
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Affiliation(s)
- J John Britto
- Division of Health Services Research, Tribal Health research Unit, National Institute of Epidemiology, Chennai, Tamil Nadu, India
| | - J Yuvaraj
- Division of Health Services Research, Tribal Health research Unit, National Institute of Epidemiology, Chennai, Tamil Nadu, India
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González-Alcaide G, Menchi-Elanzi M, Nacarapa E, Ramos-Rincón JM. HIV/AIDS research in Africa and the Middle East: participation and equity in North-South collaborations and relationships. Global Health 2020; 16:83. [PMID: 32943058 PMCID: PMC7499968 DOI: 10.1186/s12992-020-00609-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Accepted: 08/11/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND HIV/AIDS has attracted considerable research attention since the 1980s. In the current context of globalization and the predominance of cooperative work, it is crucial to analyze the participation of the countries and regions where the infection is most prevalent. This study assesses the participation of African countries in publications on the topic, as well as the degree of equity or influence existing in North-South relations. METHODS We identified all articles and reviews of HIV/AIDS indexed in the Web of Science Core Collection. We analyzed the scientific production, collaboration, and contributions from African and Middle Eastern countries to scientific activity in the region. The concept of leadership, measured through the participation as the first author of documents in collaboration was used to determine the equity in research produced through international collaboration. RESULTS A total of 68,808 documents published from 2010 to 2017 were analyzed. Researchers from North America and Europe participated in 82.14% of the global scientific production on HIV/AIDS, compared to just 21.61% from Africa and the Middle East. Furthermore, the publications that did come out of these regions was concentrated in a small number of countries, led by South Africa (41% of the documents). Other features associated with HIV/AIDS publications from Africa include the importance of international collaboration from the USA, the UK, and other European countries (75-93% of the documents) and the limited participation as first authors that is evident (30 to 36% of the documents). Finally, the publications to which African countries contributed had a notably different disciplinary orientation, with a predominance of research on public health, epidemiology, and drug therapy. CONCLUSIONS It is essential to foster more balance in research output, avoid the concentration of resources that reproduces the global North-South model on the African continent, and focus the research agenda on local priorities. To accomplish this, the global North should strengthen the transfer of research skills and seek equity in cooperative ties, favoring the empowerment of African countries. These efforts should be concentrated in countries with low scientific activity and high incidence and prevalence of the disease. It is also essential to foster intraregional collaborations between African countries.
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Affiliation(s)
| | - Marouane Menchi-Elanzi
- Department of Internal Medicine, General University Hospital of Alicante, Alicante, Spain
| | - Edy Nacarapa
- Infectious Disease Division, Carmelo Hospital of Chókwè - Daughters of Charity, Saint Vincent of Paul, Chókwè, Gaza Province, Mozambique
- Tinpswalo Association, Research Unit, Vincentian Association to Fight AIDS and TB, Chókwè, Gaza Province, Mozambique
| | - José-Manuel Ramos-Rincón
- Department of Internal Medicine, General University Hospital of Alicante, Alicante, Spain.
- Department of Clinical Medicine, Miguel Hernandez University of Elche, Alicante, Spain.
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Donovan C, Patel H, Shetty S, Bierman L, Lustbader JM, Oboh-Weilke AM. Aggressive conjunctival Kaposi sarcoma as the initial manifestation of acquired immunodeficiency syndrome. Am J Ophthalmol Case Rep 2020; 19:100832. [PMID: 32715160 DOI: 10.1016/j.ajoc.2020.100832] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2018] [Revised: 06/04/2020] [Accepted: 07/10/2020] [Indexed: 12/04/2022] Open
Abstract
Purpose To report a case of Kaposi sarcoma in a patient with previously undiagnosed Human Immunodeficiency Virus (HIV) infection. Observations A 23-year-old male patient presented to the eye clinic with complaints of redness of his left eye for the past month. The patient had been seen one day prior to presentation in the emergency department for a neck mass and pneumonia. Exam was notable for a left hemorrhagic, nodular, bulbar conjunctival mass, a right hemorrhagic conjunctival lesion, and violaceous facial skin lesions. Due to suspicion for conjunctival Kaposi sarcoma, HIV and Acquired Immune Deficiency Syndrome (AIDS) serologies were obtained which returned positive. Biopsies of the ocular mass and axillary lymph nodes confirmed Kaposi sarcoma. The patient was started on anti-retroviral therapy and Doxorubicin. The left conjunctival mass initially progressed to cover most of his cornea but eventually regressed by 6 months. Conclusions and Importance Ocular involvement of Kaposi sarcoma as the initial manifestation of HIV/AIDS is rare with only a few reported cases. Since the advent of highly active antiretroviral therapy, conjunctival or adnexal Kaposi sarcoma is not commonly encountered by healthcare providers. Concern for Kaposi sarcoma of the conjunctiva in this patient led to the evaluation for HIV/AIDS. It is vital for all healthcare providers to have Kaposi sarcoma in the differential diagnosis of a hemorrhagic conjunctival or adnexal mass and be familiar with its association with HIV/AIDS. If suspected, appropriate counseling and testing should be performed.
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Abstract
Purpose of Review The introduction of the National Free Antiretroviral Therapy Program (NFATP) in 2003 by the China National Center for AIDS/STD Control and Prevention has led to dramatic increases in antiretroviral therapy (ART) coverage among HIV-infected Chinese patients. Despite limitations in the number of available free antiretroviral drugs, the overall mortality associated with HIV/AIDS has dropped from 39.3 per 100 person-years in 2002 to 3.1 in 2014. In this review, we summarize the challenges, responses, and achievements of antiretroviral therapy (ART) in China over the past 20 years. Recent Findings Continuous optimization of the Chinese National Guidelines for HIV/AIDS Diagnosis and Treatment has been guided by data from serial domestic multi-center studies aimed at evaluating efficacy and toxicity of available ART regimens among Chinese patients with HIV, with the goal of maximizing adherence, access, and efficacy. In addition, increasing attention has been focused on the importance of continuity in the HIV care cascade to promote linkage to care, and address the multidisciplinary chronic care needs HIV/AIDS patients on lifelong ART. Summary Great progress has been achieved in the past 20 years in terms of access to and optimization of antiretroviral treatment in China. As the number of patients receiving long-term ART continues to grow, the focus of HIV/AIDS treatment has gradually transitioned from urgent care to the management of non-AIDS-related chronic complications and control of chronic inflammation.
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Affiliation(s)
- Wei Cao
- Department of Infectious Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Evelyn Hsieh
- Department of Infectious Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.,Section of Rheumatology, Department of Internal Medicine, Allergy and Immunology, Yale School of Medicine, New Haven, CT, USA
| | - Taisheng Li
- Department of Infectious Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
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Cheng LJ, Kumar PA, Wong SN, Lau Y. Technology-Delivered Psychotherapeutic Interventions in Improving Depressive Symptoms Among People with HIV/AIDS: A Systematic Review and Meta-analysis of Randomised Controlled Trials. AIDS Behav 2020; 24:1663-1675. [PMID: 31587115 DOI: 10.1007/s10461-019-02691-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
With the increasing popularity of advanced technology, technology-delivered psychotherapeutic interventions (TPIs) may play a promising role in improving depressive symptoms among PLWHA. However, its effectiveness remains unclear. We aimed to synthesise the evidence of the effectiveness of TPIs in improving depressive symptoms of PLWHA using a meta-analytic approach. Seven databases were systematically searched for randomised controlled trials (RCTs) from the inception until August 14, 2018. Random-effects meta-analysis was adopted to assess effect size. Cochran's Q test and I2 were used to investigate the problem of heterogeneity. Sensitivity, subgroup analyses and meta-regression were performed. Of the 43,048 records identified, 14 RCTs were included. The meta-analysis revealed a small effect on reducing depressive symptom scores (d = 0.23, 95% CI - 0.39 to - 0.06) after TPIs. Random-effects meta-regression showed that publication year was a significant moderator (p = 0.013), whereby the latest trials had larger effect size in reducing the depressive symptoms than earlier trials. Our review suggested a possible future approach of utilising TPIs by means of mobile applications and internet-based interventions for PLWHA to reduce their depressive symptoms. This review highlighted the essential key features in designing future TPIs. The overall low-quality evidence suggested the need to conduct further high-quality.
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Borandegi F, Rahmanian F, Yazdanpanahi Z, Nematollahi A. The effect of self-care education regarding high-risk behaviors of acquired immune deficiency syndrome and smoking on knowledge and attitude of adolescent girls: An experimental study to health promotion. J Educ Health Promot 2020; 9:7. [PMID: 32154302 PMCID: PMC7032024 DOI: 10.4103/jehp.jehp_271_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Accepted: 10/03/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND The vulnerability of the youth to acquired immune deficiency syndrome (AIDS) and smoking is one of the most important public health issues around the world. Adequate knowledge about AIDS and smoking is a powerful tool for promoting positive attitudes and safe behaviors. OBJECTIVE This study aimed to determine the effect of self-care education on AIDS and smoking on the level of adolescents' knowledge and health attitude. MATERIALS AND METHODS This experimental study was conducted in the academic year of 2017-2018, and the participants were selected using randomized cluster sampling. These participants included 220 female students of the third grade of middle school in Isfahan (105 in the intervention group and 115 in the control group). Data were collected using a demographic questionnaire; a researcher-made questionnaire on knowledge about AIDS, knowledge about smoking, and attitudes toward smoking; and a standard questionnaire on students' attitude toward AIDS. After completing the pretest, the intervention group performed two training sessions and completed the posttest 1 month later. One month after completing the pretest, the control group completed the posttest and did not receive an intervention. Finally, the data were analyzed using descriptive statistics, statistical tests, and statistical software SPSS version 22. RESULTS The results showed that despite the similarity between the two groups at the beginning of the study, after self-care education, the knowledge level of AIDS (P < 0.001) and attitude toward AIDS (P < 0.001) and the knowledge level of smoking (P < 0.001) and attitude toward smoking (P < 0.001) in the intervention group were significantly higher than the control group. In intragroup analysis, it was also observed that the difference between the scores before and after was only significant in the intervention group. CONCLUSION It seems that education can promote the level of knowledge and attitude of adolescents toward AIDS.
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Affiliation(s)
- Forogh Borandegi
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fatemeh Rahmanian
- Department of Midwifery, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Yazdanpanahi
- Department of Midwifery, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Azar Nematollahi
- Department of Midwifery, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
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30
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Abstract
The first human immunodeficiency virus (HIV) infection was reported in Korea in 1985. The number of HIV-infected persons domestically increased in the 1990s showing epidemic indigenousization. Since then, the number of new infections gradually increased every year, and recently more than 1,000 newly infected cases were reported per year. A total of 12,522 infected individuals have been reported up to 2015, of which 2,020 died. The male to female ratio was 15.4:1, and 34.2% of them were under 30 years old. The infection route was homosexual and bisexual contact in 60.1% of cases and heterosexual contact in 34.6% of cases. Candidiasis, Pneumocystis pneumonia, tuberculosis were common as a AIDS (acquired immune deficiency syndrome)-defining illness. But with the introduction of antiretroviral therapy in the late 1990s, non-AIDS defining illnesses such as metabolic complications, cardiovascular diseases, bone diseases, and neuropsychiatric disorders such as neurocognitive dysfunction, depression, and anxiety are emerging as new health problems. The management policy switched its focus from regulating and monitoring of HIV-infected persons to ensuring access to treatment and promotion of voluntary HIV testing in high-risk groups. Also as the age of the infected persons increases, a need for various supports such as social rehabilitation, life counseling, and welfare has emerged.
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Affiliation(s)
- June Myung Kim
- Division of Infectious Diseases, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,AIDS Research Institute, Yonsei University College of Medicine, Seoul, Korea.
| | - Nam Joong Kim
- Division of Infectious Diseases, Department of Internal Medicine, Seoul National University, College of Medicine, Seoul, Korea
| | - Jun Yong Choi
- Division of Infectious Diseases, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,AIDS Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Bum Sik Chin
- Division of Infectious Diseases, Department of Internal Medicine, National Medical Center, Seoul, Korea
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31
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Keser G, Göcüncü N, Pekiner FN. Assessment of knowledge level about acquired immune deficiency syndrome and patient approaches of dental students. Niger J Clin Pract 2019; 22:1259-1265. [PMID: 31489863 DOI: 10.4103/njcp.njcp_116_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background The aim of this study was to evaluate the level of knowledge about HIV, and intraoral signs that can be seen in HIV positive patients and the interpretation of attitudes toward HIV positive patients of fourth- and fifth-grade students at Marmara University Faculty of Dentistry, İstanbul, Turkey. Material and Methods In our study, a questionnaire consisting of 23 questions was applied to 100 fourth- and 100 fifth-grade students totalling 200 dental students who are educated in Marmara University Faculty of Dentistry. Besides the knowledge level of the students, their attitudes were evaluated using the survey conducted. Chi-square (or Fisher's exact test at appropriate locations) was used to examine the relationship between categorical variables. Statistical significance level was determined as P < 0.05. Results Of the 200 participants, 46 (23.0%) were males and 154 (77.0%) were females. One hundred people (50%) are fourth grade, 100 people (50%) are fifth grade. The rate of fifth grade agreements for the question "Treatment of HIV positive patient increases the risk of transmission of HIV infection to dentist" was statistically higher than that of fourth-grade students (Fisher's exact P < 0,05). Fifth-grade knowledge of oral symptoms of HIV/AIDS was statistically higher than fourth grades (Fisher's exact P < 0.05). Conclusion As the grade level increases, the knowledge about HIV/AIDS raises portraying a relevant approach to patients with AIDS. Comprehensive training and motivation for improving dentistry students' awareness against HIV-positive patients will also improve knowledge and attitudes of the students that enable them to take better care of HIV-positive patients.
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Affiliation(s)
- G Keser
- Department of Oral Diagnosis and Maxillofacial Radiology, Marmara University, Faculty of Dentistry, İstanbul, Turkey
| | - N Göcüncü
- Dentistry Student, Marmara University, Faculty of Dentistry, İstanbul, Turkey
| | - F N Pekiner
- Department of Oral Diagnosis and Maxillofacial Radiology, Marmara University, Faculty of Dentistry, İstanbul, Turkey
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32
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Hester MM, Lee CK, Abraham A, Khoshkenar P, Ostroff GR, Levitz SM, Specht CA. Protection of mice against experimental cryptococcosis using glucan particle-based vaccines containing novel recombinant antigens. Vaccine 2019; 38:620-626. [PMID: 31699504 DOI: 10.1016/j.vaccine.2019.10.051] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 10/16/2019] [Accepted: 10/17/2019] [Indexed: 11/27/2022]
Abstract
Meningitis due to Cryptococcus neoformans is responsible for upwards of 180,000 deaths worldwide annually, mostly in immunocompromised individuals. Currently there are no licensed fungal vaccines, and even with anti-fungal drug treatment, cryptococcal meningitis is often fatal. Our lab previously demonstrated vaccination with recombinant cryptococcal proteins delivered in glucan particles (GPs) protects mice against an otherwise lethal infection. The aim of the present study was to discover additional cryptococcal antigens affording vaccine-mediated protection. Sixteen proteins, each with evidence of extracellularity, were selected for in vivo testing based on their abundance in protective alkaline extracts of an acapsular C. neoformans strain, their known immunogenicity, and/or their high transcript level during human infection. Candidate antigens were recombinantly expressed in E. coli, purified and loaded into GPs. BALB/c and C57BL/6 mice received three subcutaneous injections of GP-based vaccine, and survival was assessed for 84 days following a lethal orotracheal challenge with strain KN99. As with our six published GP-vaccines, we saw differences in overall protection between mouse strains such that BALB/c mice typically demonstrated better survival than C57BL/6 mice. From these studies, we identified seven new proteins which, when administered as GP-vaccines, protect BALB/c and/or C57BL/6 mice against cryptococcal infection. With these results, we expand the pool of novel protective antigens to eleven proteins and demonstrate the potential for selection of highly transcribed extracellular proteins as vaccine targets. These screens highlight the efficacy of GP-subunit vaccines and identify promising antigens for further testing in anti-cryptococcal, multi-epitope vaccine formulations.
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Affiliation(s)
- Maureen M Hester
- Department of Medicine, University of Massachusetts Medical School, Worcester, MA 01605, USA
| | - Chrono K Lee
- Department of Medicine, University of Massachusetts Medical School, Worcester, MA 01605, USA
| | - Ambily Abraham
- Program in Molecular Medicine, University of Massachusetts Medical School, Worcester, MA 01605, USA
| | - Payam Khoshkenar
- Program in Molecular Medicine, University of Massachusetts Medical School, Worcester, MA 01605, USA
| | - Gary R Ostroff
- Program in Molecular Medicine, University of Massachusetts Medical School, Worcester, MA 01605, USA
| | - Stuart M Levitz
- Department of Medicine, University of Massachusetts Medical School, Worcester, MA 01605, USA.
| | - Charles A Specht
- Department of Medicine, University of Massachusetts Medical School, Worcester, MA 01605, USA.
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33
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Lin CY, Liu YS, Ou MC. Epigastralgia in a middle-aged woman with acquired immunodeficiency syndrome. J Hepatobiliary Pancreat Sci 2019; 26:E8-E9. [PMID: 31368186 DOI: 10.1002/jhbp.661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Lin and colleagues presented an unusual case of AIDS-related cholecystopathy with an enlarged gallbladder and thickened wall. Cholecystopathy is a rare condition characterized by biliary abnormalities in AIDS patients, and the mechanism remains unclear. The authors aimed to heighten awareness of this entity in patients with advanced AIDS disease status.
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Affiliation(s)
- Chiao-Yun Lin
- Department of Medical Imaging, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No. 138 Sheng Li Road, Tainan, 704, Taiwan
| | - Yi-Sheng Liu
- Department of Medical Imaging, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No. 138 Sheng Li Road, Tainan, 704, Taiwan
| | - Ming-Ching Ou
- Department of Medical Imaging, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No. 138 Sheng Li Road, Tainan, 704, Taiwan
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34
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Jia CH, Wang L, Jing FH, Xie J, Qiu ZF, Li TS, Lyu W. [Clinical characteristics and T-lymphocyte subsets in 48 acquired immune deficiency syndrome patients with cytomegalovirus infections]. Zhonghua Nei Ke Za Zhi 2019; 58:191-197. [PMID: 30803177 DOI: 10.3760/cma.j.issn.0578-1426.2019.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the clinical features and T lymphocytes subsets in patients with acquired immune deficiency syndrome (AIDS) and cytomegalovirus (CMV) infection. Methods: A total of 48 hospitalized patients with human immunodeficiency virus (HIV)-1/AIDS and CMV infections were recruited at Peking Union Medical College Hospital from Jan 2010 to Aug 2017. Their clinical features and immune function were retrospectively analyzed. Patients with only HIV/AIDS in previous study were recruited as controls. Results: All 48 patients were at C3 stage, including 36 men and 12 women. Five of them were younger than 30 years old, 33 cases within 31-50 years old, and 10 cases older than 50 years old. Thirty-five patients had CD(4)(+)T lymphocytes ≤ 50 cells/μl, 7 cases with CD(4)(+)T cells 51-100/μl, 3 cases with 101-200 cells/μl, and 3 cases over 200 cells/μl. As to CMV infections, there were 31 cases of CMV viremia, 1 case of CMV encephalitis, 1 case of CMV enteritis, 5 cases of CMV pneumonia, and 9 cases of CMV retinitis. Other opportunistic infections were also common including 16 cases of pneumocystis pneumonia, 9 cases of tuberculosis, 5 cases of syphilis, 18 cases of digestive tract fungal infections, 8 cases of pulmonary fungal infections, 2 cases of EB virus infections, 2 cases of HIV encephalopathy/progressive multifocal leukoencephalopathy (PML), 3 cases of cryptococcal meningitis, 1 case of toxoplasma infection. In group of both CMV and HIV/AIDS infections, 100% patients had inverted CD(4)(+)/CD(8)(+) ratio. The immune activation marker CD(8)(+)CD(38)(+)/CD(8)(+) was higher (61.6%-98.8%) with a median value of 91.2% in 40 patients. HLA-DR(+)CD(8)(+)/CD(8)(+), another marker for T cell activation, was 25.5%-98.0% in 44 patients with a median value of 60.3%. Thirty-six patients had both immune activation markers positive. There was no significant difference in counts of B cells, natural killer cells, CD(4)(+) T cells, CD(8)(+) T cells and immune activation subsets stratified by gender and age (P>0.05). Meanwhile, neither serum HIV viral load nor serum CMV viral load was correlated with HLA-DR(+)CD(8)(+)/CD(8)(+), CD(8)(+)CD(38)(+)/CD(8)(+), CD(4)(+)T cell counts, and CD(4)(+)/CD(8)(+) ratio in the CMV and HIV/AIDS co-infection group (all P>0.05), while HIV viral load in HIV/AIDS only group was significantly correlated with HLA-DR(+)CD(8)(+)T/CD(8)(+), CD(38)(+)CD(8)(+)/CD(8)(+), CD(4)(+) T cell counts, CD(4)(+)/CD(8)(+) ratio (r=0.473, 0.575, -0.767 and -0.678, respectively, all P<0.05). Conclusions: CMV infections develop in HIV patients with advanced stage. CMV infection can cause life-threatening multiple organ lesions, especially in those with CD(4)(+) T cells less than 100 cells/μl. It is of great importance to screen CMV-IgM, pp65 antigen, CMV DNA to make early diagnosis and treatment.
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Affiliation(s)
- C H Jia
- Department of Infectious Diseases, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China (is working on the Department of Infectious Diseases, the Third Hospital of Qinhuangdao, Qinhuangdao 066000, China)
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35
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Kim B, Choi YW, Pai H, Kim J. A Case of Human Immunodeficiency Virus -triggered Hemophagocytic Lymphohistocytosis Presenting with Severe Bleeding Tendency. Infect Chemother 2018; 53:802-807. [PMID: 31668025 PMCID: PMC8731258 DOI: 10.3947/ic.2018.0203] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Accepted: 11/27/2017] [Indexed: 11/24/2022] Open
Abstract
Human immunodeficiency virus (HIV) is one of the less common triggers of secondary hemophagocytic lymphohistiocytosis (HLH) in which coagulation disorder is a frequent manifestation. Here, we present a case of HIV-triggered secondary HLH presenting with severe bleeding tendency and fever. Despite high-dose dexamethasone infusion (10 mg/body surface area/day), progressive disseminated intravascular coagulation and thrombocytopenia resulted in massive hemathochezia: the bleeding episode ceased after endoscopic hemoclipping. After then, he took a highly-active antiretroviral therapy (HAART). Eventually, body temperature and overall laboratory findings normalized in response to HAART. Clinicians should not overlook HIV infection as a possible trigger of secondary HLH. In such cases, HAART is the core treatment.
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Affiliation(s)
- Bongyoung Kim
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Yeon Woo Choi
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Hyunjoo Pai
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Jieun Kim
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
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36
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Deresz LF, Karsten M, Corrêa IF, Sonza A, Ikeda MLR, da Silva CS, Lago PD. Functional capacity and ventilatory efficiency are preserved in well-controlled people living with human immunodeficiency virus/acquired immunodeficiency syndrome. J Exerc Rehabil 2018; 14:680-687. [PMID: 30276193 PMCID: PMC6165965 DOI: 10.12965/jer.1836132.066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Accepted: 05/28/2018] [Indexed: 01/07/2023] Open
Abstract
To verify and compare the responses of the cardiopulmonary variables to the incremental test in physically inactive people living with human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) (PLWHA) with well-controlled disease and physically inactive healthy subjects (non-HIV/AIDS). Participants performed a cardiopulmonary exercise test (CPX) on a treadmill. Data were analyzed using the Mann–Whitney test and Spearman correlation. Nine PLWHA (5 women) and 9 non-HIV/AIDS gender and activity level-matched controls were included in the data analysis. Data are expressed in median (range). No difference was shown in the PLWHA group when compared to the control group in functional capacity (peak oxygen consumption [VO2peak]: 29.9 (20.9–36.4) mL/kg/min vs. 32.2 (24.5–39.4) mL/kg/min) and ventilatory efficiency (oxygen uptake efficiency slope [OUES]: 2,058 [1,474–3,204] vs. 2,612 [1,383–4,119]; minute ventilation carbon dioxide production slope: 27.4 [22.5–33.6] vs. 27.5 [20.4–38.1]). The results are also similar to maximal heart rate, oxygen pulse, gas exchange threshold, respiratory compensation point, heart rate recovery, and half-time of VO2peak recovery. OUES had a strong correlation with VO2peak in the PLWHA group (rs=0.70, P=0.04) and control group (rs=0.78, P=0.02). The results of this study indicate that functional capacity and ventilatory efficiency in PLWHA with well-controlled disease are preserved and are not different from sedentary subjects. In this sense, when CPX is unavailable, the aerobic assessment and prescription could be based on simpler procedures used in healthy subjects.
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Affiliation(s)
- Luís Fernando Deresz
- Post Graduation Program in Health Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil.,Physical Education Department, Health Sciences Institute, Universidade Federal de Juiz de Fora, Governador Valadares, Brazil
| | - Marlus Karsten
- Physical Therapy Department, Universidade do Estado de Santa Catarina (UDESC), Florianópolis, Brazil
| | | | - Anelise Sonza
- Physical Therapy Department, Universidade do Estado de Santa Catarina (UDESC), Florianópolis, Brazil
| | - Maria Letícia Rodrigues Ikeda
- Nursing Department, Universidade do Vale do Rio dos Sinos, São Leopoldo, Brazil.,Health Secretariat of State of Rio Grande do Sul, Porto Alegre, Brazil
| | - Candissa Silva da Silva
- Post Graduation Program in Health Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil
| | - Pedro Dal Lago
- Post Graduation Program in Health Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil.,Physical Therapy Department, UFCSPA, Porto Alegre, Brazil
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37
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Sun JP, Shan D. [Thoughts of international cooperation programs of HIV/AIDS in China]. Zhonghua Yu Fang Yi Xue Za Zhi 2018; 52:873-875. [PMID: 30196630 DOI: 10.3760/cma.j.issn.0253-9624.2018.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- J P Sun
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
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38
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Abstract
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.
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Affiliation(s)
- Miriam R Robbins
- Department of Dental Medicine, Winthrop University Hospital, 200 Old Country Road, Suite 460, Mineola, NY 11501, USA; Department of Oral and Maxillofacial Pathology, Radiology and Medicine, New York University College of Dentistry, 345 E. 24th Street, New York, NY 10010, USA.
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39
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Yunina DS, Elkayam N, Patel S, Okoli F, Chapnick E, Hecht M. Newly diagnosed AIDS with neurosyphilis, Kaposi sarcoma, pancytopenia, oropharyngeal candidiasis, and pseudomonal pneumonia: We shouldn't be seeing this anymore. IDCases 2018; 13:e00426. [PMID: 30101071 PMCID: PMC6076223 DOI: 10.1016/j.idcr.2018.e00426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 07/07/2018] [Accepted: 07/07/2018] [Indexed: 10/28/2022] Open
Abstract
The incidence of new human immunodeficiency virus (HIV) infections is declining and is half of what it was in the mid 1990s. We present a case of newly diagnosed HIV with acquired immune deficiency syndrome (AIDS), Neurosyphilis, Kaposi Sarcoma, and multiple opportunistic infections. Although this type of patient was not uncommon in the pre-antiretroviral era, we do not often see such a constellation of conditions in a single individual. The significance of this case lies not in the diagnosis, but rather in the number of the diagnoses and the thought process used to attain them.
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Affiliation(s)
- Daria S. Yunina
- Internal Medicine, Department of Medicine, Maimonides Medical Center, Brooklyn, NY, USA,Corresponding author at: Dept of Internal Medicine, Maimonides Medical Center, NY, 11219, USA.
| | - Natalie Elkayam
- Internal Medicine, Department of Medicine, Maimonides Medical Center, Brooklyn, NY, USA
| | - Shanti Patel
- Internal Medicine, Department of Medicine, Maimonides Medical Center, Brooklyn, NY, USA
| | - Fidelis Okoli
- Internal Medicine, Department of Medicine, Maimonides Medical Center, Brooklyn, NY, USA
| | - Edward Chapnick
- Infectious Disease, Department of Medicine, Maimonides Medical Center, Brooklyn, NY, USA
| | - Melvyn Hecht
- Geriatrics, Department of Medicine, Maimonides Medical Center, Brooklyn, NY, USA
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40
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Chen HH, Fu BT, Zhu QY, Lu HX, Luo LH, Chen L, Liu XH, Zhou XJ, Huang JH, Feng XX, Shan GS, Shen ZY. [Dynamic variations of BMI and influencing factors among HIV/AIDS patients receiving highly active antiretroviral therapy in Liuzhou, Guangxi Zhuang Autonomous Region, 2013-2014]. Zhonghua Liu Xing Bing Xue Za Zhi 2018; 39:487-490. [PMID: 29699043 DOI: 10.3760/cma.j.issn.0254-6450.2018.04.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To understand the dynamic variation of BMI and influencing factors among HIV/AIDS patients receiving highly active anti-retroviral therapy (HAART) in Liuzhou, Guangxi Zhuang Autonomous Region (Guangxi). Methods: HIV/AIDS patients receiving HAART for the first time since 1 January 2013 were selected. Data on BMI was analyzed among patients receiving HAART at baseline,6 months and 12 months after treatment. By using the general linear model repeated measures of analysis of variance, BMI dynamic variations and influencing factors were described and analyzed. Results: The average BMI of 2 871 patients at baseline, 6th months and 12th months appeared as (20.65±3.32), (20.87±3.22) and (21.18±3.20), respectively, with differences all statistically significant (F=18.86, P<0.001). BMI were increasing over time with treatments (F=37.25, P<0.001). Main influencing factors were noticed as: age, sex, marital status, baseline data of CD(4)(+)T cells and the WHO classification on clinical stages. Conclusions: Higher proportion of BMI malnutrition counts was seen among patients before receiving HAART in Liuzhou. BMI of the patients that were on HAART seemed being influenced by many factors. It is necessary to select appropriate treatment protocols on different patients so as to improve the nutritional status of the patients.
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Affiliation(s)
- H H Chen
- Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China
| | - B T Fu
- Luzhai Center for Disease Control and Prevention, Luzhai 545600, China
| | - Q Y Zhu
- Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China
| | - H X Lu
- Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China
| | - L H Luo
- Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China
| | - L Chen
- Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China
| | - X H Liu
- Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China
| | - X J Zhou
- Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China
| | - J H Huang
- Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China
| | - X X Feng
- Liuzhou Center for Disease Control and Prevention, Liuzhou 455001, China
| | - G S Shan
- Liuzhou Center for Disease Control and Prevention, Liuzhou 455001, China
| | - Z Y Shen
- Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China
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Executive summary of the GeSIDA consensus document on control and monitoring of HIV-infected patients. Enferm Infecc Microbiol Clin 2018; 37:467-475. [PMID: 29793873 DOI: 10.1016/j.eimc.2018.03.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Accepted: 03/30/2018] [Indexed: 11/29/2022]
Abstract
The continuous increase in our knowledge of HIV medicine and antiretroviral treatment has led us to draft specific consensus documents focused on topics other than antiretroviral therapy, such as treatment of opportunistic diseases, pre- and post-exposure prophylaxis, metabolic abnormalities, treatment of HBV or HCV coinfection, treatment of patients coinfected with tuberculosis, osteoporosis, kidney disorders, and cardiovascular risk. Accordingly, the AIDS Study Group (GeSIDA) of the Spanish Society of Infectious Diseases and Clinical Microbiology has promoted the drafting of this consensus document on the control and monitoring of adult patients infected with HIV. The document provides recommendations on the initial evaluation and subsequent monitoring of HIV-infected patients that will prove useful for all professionals involved in the management of this infection.
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Affiliation(s)
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- Complexo Hospitalario Universitario/IIS Galicia Sur, Clara Campoamor, Pontevedra, Vigo, Spain
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Sheehan DM, Trepka MJ, Fennie KP, Prado G, Madhivanan P, Dillon FR, Maddox LM. Individual and Neighborhood Determinants of Late HIV Diagnosis Among Latinos, Florida, 2007-2011. J Immigr Minor Health 2018; 19:825-834. [PMID: 27119364 DOI: 10.1007/s10903-016-0422-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The objective of this study was to examine individual and neighborhood determinants of late HIV diagnosis by gender and birthplace among Latinos. Florida HIV surveillance data for 2007-2011 were merged with American Community Survey data to estimate the odds of late HIV diagnosis (AIDS within 3 months of HIV diagnosis). Of 5522 HIV-positive Latinos, 26.5 % were diagnosed late. The odds ratio (OR) for late diagnosis was 1.39 times higher for males than females [95 % confidence interval (CI) 1.14-1.69]. Neighborhood-level factors associated with late diagnosis included residing in the 3 highest quartiles of neighborhood unemployment for males. The OR was 1.22 times higher for foreign- than US-born Latinos (95 % CI 1.07-1.40). Among foreign-born, residing in areas in the 2nd and 3rd quartiles of unemployment, in rural areas, and areas with <25 % Hispanic/Latino population were associated with late diagnosis. Population-based HIV testing campaigns may require tailoring to ensure that they effectively reach male Latinos in areas with high unemployment and foreign-born Latinos in rural and predominantly non-Latino areas.
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Affiliation(s)
- Diana M Sheehan
- Center for Substance Use and HIV/AIDS Research on Latinos in the United States (C-SALUD), Florida International University, 11200 SW 8th St, Miami, FL, 33199, USA.,Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th St, AHC 5, Room 478, Miami, FL, 33199, USA
| | - Mary Jo Trepka
- Center for Substance Use and HIV/AIDS Research on Latinos in the United States (C-SALUD), Florida International University, 11200 SW 8th St, Miami, FL, 33199, USA. .,Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th St, AHC 5, Room 478, Miami, FL, 33199, USA.
| | - Kristopher P Fennie
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th St, AHC 5, Room 478, Miami, FL, 33199, USA
| | - Guillermo Prado
- Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th St, Miami, FL, 33136, USA
| | - Purnima Madhivanan
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th St, AHC 5, Room 478, Miami, FL, 33199, USA
| | - Frank R Dillon
- Department of Educational and Counseling Psychology, School of Education, University at Albany - State University of New York, 1400 Washington Ave, Albany, NY, 12222, USA
| | - Lorene M Maddox
- HIV/AIDS Section, Florida Department of Health, 4052 Bald Cypress Way, Tallahassee, FL, 32399, USA
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43
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Yang J, Xu HF, Cheng WB, Gu YZ, Xu P, Yu QY, Lyu P. [Characteristics and influencing factors regarding social relations among men who have sex with men]. Zhonghua Liu Xing Bing Xue Za Zhi 2018; 39:478-482. [PMID: 29699041 DOI: 10.3760/cma.j.issn.0254-6450.2018.04.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To study the characteristics of social relations and relative factors among MSM in Guangzhou. Methods: Data was collected through a cross-sectional study in Guangzhou from November 2016 to May 2017. Sample size was estimated and participants were recruited from the voluntary counseling and testing services (VCT) which were set for MSM population, by nongovernmental organizations (NGOs) and the Centers for Disease Control and Prevention (CDC). Social ties and demographic characteristics of the respondents and their sexual partners were analyzed through both Chi square test and generalized estimating equations (GEE). Results: A total of 1 073 MSM, together with their nominated 4 301 partners were successfully recruited and involved in this study. Age (OR=1.2, P=0.01) and non-internet based intercourse (OR=1.65, P<0.01) were easy to form close relation with strong ties. Compared with MSM traditional venues (chess and cards room, tea room bathhouse, club), general public venue (bars, KTV, parks, shopping malls, schools, restaurants) (OR=1.46-3.12, P<0.01) showed close relation with strong ties. Our finding showed that MSM at the age of 18-25 preferred to build weak ties with the older MSM, while the 26-30-year-olds and 31-40-year-olds prefer to establish weak ties with younger partners but the 41-50-year-olds preferred to develop weak ties with one that were ten years younger. Conclusions: Clusters were noticed in the MSM populations when grouping and making friends with ones at different age. Characteristics regarding the relationship between sexual partners in choosing venues and ways of dating were different. Targeted intervention programs need to be explored innovatively.
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Affiliation(s)
- J Yang
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - H F Xu
- Department of HIV/AIDS Control and Prevention, Guangzhou Center for Disease Control and Prevention, Guangzhou 510000, China
| | - W B Cheng
- Department of HIV/AIDS Control and Prevention, Guangzhou Center for Disease Control and Prevention, Guangzhou 510000, China
| | - Y Z Gu
- Department of HIV/AIDS Control and Prevention, Guangzhou Center for Disease Control and Prevention, Guangzhou 510000, China
| | - P Xu
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Q Y Yu
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - P Lyu
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
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Doda A, Negi G, Gaur DS, Harsh M. Human immunodeficiency virus/ acquired immune deficiency syndrome: A survey on the knowledge, attitude, and practice among medical professionals at a tertiary health-care institution in Uttarakhand, India. Asian J Transfus Sci 2018; 12:21-26. [PMID: 29563671 PMCID: PMC5850693 DOI: 10.4103/ajts.ajts_147_16] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION: Health-care professionals are trained health-care providers who occupy a potential vanguard position in human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) prevention programs and the management of AIDS patients. This study was performed to assess HIV/AIDS-related knowledge, attitude, and practice (KAP) and perceptions among health-care professionals at a tertiary health-care institution in Uttarakhand, India, and to identify the target group where more education on HIV is needed. MATERIALS AND METHODS: A cross-sectional KAP survey was conducted among five groups comprising consultants, residents, medical students, laboratory technicians, and nurses. Probability proportional to size sampling was used for generating random samples. Data analysis was performed using charts and tables in Microsoft Excel 2016, and statistical analysis was performed using the Statistical Package for the Social Science software version 20.0. RESULTS: Most participants had incomplete knowledge regarding the various aspects of HIV/AIDS. Attitude in all the study groups was receptive toward people living with HIV/AIDS. Practical application of knowledge was best observed in the clinicians as well as medical students. Poor performance by technicians and nurses was observed in prevention and prophylaxis. All groups were well informed about the National AIDS Control Policy except technicians. CONCLUSION: Poor knowledge about HIV infection, particularly among the young medical students and paramedics, is evidence of the lacunae in the teaching system, which must be kept in mind while formulating teaching programs. As suggested by the respondents, Information Education Communication activities should be improvised making use of print, electronic, and social media along with interactive awareness sessions, regular continuing medical educations, and seminars to ensure good quality of safe modern medical care.
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Affiliation(s)
- Ananya Doda
- Resident, Department Pathology, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India
| | - Gita Negi
- Associate Professor, Department Pathology, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India
| | - Dushyant Singh Gaur
- Professor, Department Pathology, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India
| | - Meena Harsh
- Professor & Head, Department Pathology, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India
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Álvarez Barreneche MF, Restrepo Castro CA, Hidrón Botero A, Villa Franco JP, Trompa Romero IM, Restrepo Carvajal L, Eusse García A, Ocampo Mesa A, Echeverri Toro LM, Porras Fernández de Castro GP, Ramírez Rivera JM, Agudelo Restrepo CA. Hospitalization causes and outcomes in HIV patients in the late antiretroviral era in Colombia. AIDS Res Ther 2017; 14:60. [PMID: 29132400 PMCID: PMC5683524 DOI: 10.1186/s12981-017-0186-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Accepted: 11/09/2017] [Indexed: 12/18/2022] Open
Abstract
Background Antiretroviral therapy (ART) has modified the natural history of HIV-infection: the incidence of opportunistic infections (OIs) has decreased and mortality associated to HIV has improved dramatically. The reasons for hospitalization have changed; OIs are no longer the most common reason for admission. This study describes the patient population, admission diagnosis and hospital course of HIV patients in Colombia in the ART era. Methods Patients admitted with HIV/AIDS at six hospitals in Medellin, Colombia between August 1, 2014 and July 31, 2015 were included. Demographic, laboratory, and clinical data were prospectively collected. Results 551 HIV-infected patients were admitted: 76.0% were male, the median age was 37 (30–49). A new diagnosis of HIV was made in 22.0% of patients during the index admission. 56.0% of patients of the entire cohort had been diagnosed with HIV for more than 1 year and 68.9% were diagnosed in an advanced stage of the disease. More than 50.0% of patients had CD4 counts less than 200 CD4 cells/μL and viral loads greater than 100,000 copies. The main reasons for hospital admissions were OIs, tuberculosis, esophageal candidiasis and Toxoplasma encephalitis. The median hospital stay was 14 days (IQR 8–23). Admission to the intensive care unit (ICU) was required in 10.3% of patients and 14.3% were readmitted to the hospital; mortality was 5.4%. Conclusions Similar to other countries in the developing world, in Colombia, the leading cause of hospitalization among HIV-infected patients remain opportunistic infections. However, in-hospital mortality was low, similar to those described for high-income countries. Strategies to monitor and optimize the adherence and retention in HIV programs are fundamental to maximize the benefit of ART.
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Rockstroh JK, Wasmuth JC. [HIV infection : Test and treatment]. Internist (Berl) 2016; 57:773-83. [PMID: 27368530 DOI: 10.1007/s00108-016-0099-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
In Europe depending on the country 15-80 % of all individuals infected with human immunodeficiency virus (HIV) are either not aware of the diagnosis or are diagnosed later. An early HIV diagnosis could, however, considerably improve the prognosis of individuals infected with HIV and decrease the risk of new infections; therefore, in the presence of indicator diseases, such as sexually transmitted diseases, oral thrush, herpes zoster and lymphoma, the performance of a HIV test is of utmost importance. A newly diagnosed HIV infection represents an indication for starting antiretroviral combination therapy independent of the clinical stage or CD4 cell count. A decline of the viral burden to below the limit of detection and subsequent continuous suppression of viral replication can prevent transition from HIV to acquired immune deficiency syndrome (AIDS) and if started early enough a normal life expectancy can be achieved. Challenges which remain in HIV therapy are the lifelong daily intake of medication and the complex long-term adverse effects.
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Cheng CH, Hsu YH. Immune reconstitution inflammatory syndrome-associated disseminated Kaposi's sarcoma in a patient infected with human immunodeficiency virus: Report of an autopsy case. Tzu Chi Med J 2017; 29:41-45. [PMID: 28757763 PMCID: PMC5509186 DOI: 10.4103/tcmj.tcmj_9_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Immune reconstitution inflammatory syndrome is a collection of inflammatory disorders associated with paradoxical worsening of preexisting infectious processes following the initiation of highly active antiretroviral therapy (HAART) in individuals infected with human immunodeficiency virus (HIV). It involves a wide range of pathogens, neoplasms such as Kaposi's sarcoma (KS) and some autoimmune diseases. We describe an autopsy report of a 40-year-old man infected with HIV. He experienced a rapid dissemination of KS resulting in death within 6 months after starting HAART. His serum viral load had significantly decreased 4 log10 within 32 days and his CD4+ T-cell count increased 4-fold. He presented with multiple skin lesions over the chin and anterior neck, which rapidly spread over the trunk, 4 extremities, perianal region, and penis. Finally, he developed acute dyspnea and a plain chest radiograph showed bilateral pulmonary infiltrations. Despite treatment, he died of acute respiratory failure. At autopsy, multiple KS lesions were noted in the bilateral lungs, liver, kidneys, and gastrointestinal tract. Increased inflammatory cytokines during immune reconstruction from HAART-reactive human herpes virus type-8 infection, linked to the tumorigenesis of KS, finally led to rapid dissemination and death.
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Affiliation(s)
- Chiu-Hsuan Cheng
- Department of Pathology, Buddhist Tzu Chi General Hospital and University, Taiwan
| | - Yung-Hsiang Hsu
- Department of Pathology, Buddhist Tzu Chi General Hospital and University, Taiwan.,School of Medicine, Tzu Chi University, Hualien, Taiwan
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Bundhun PK, Pursun M, Huang WQ. Does infection with human immunodeficiency virus have any impact on the cardiovascular outcomes following percutaneous coronary intervention?: a systematic review and meta-analysis. BMC Cardiovasc Disord 2017; 17:190. [PMID: 28716008 PMCID: PMC5514470 DOI: 10.1186/s12872-017-0624-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Accepted: 07/12/2017] [Indexed: 11/27/2022] Open
Abstract
Background A direct link between human immunodeficiency virus (HIV)-infected patients and the risk of cardiovascular diseases (CVD) has been shown in recent scientific research. However, this issue is controversial since other previous reports showed no apparent impact of HIV or its anti-retroviral drugs on the cardiovascular system. We aimed to systematically compare the postinterventional adverse cardiovascular outcomes which were observed in patients with and without HIV infection during a mean follow up period ranging from 1 year to 3 years. Methods Common electronic databases were searched for studies which compared postinterventional adverse cardiovascular outcomes [mortality, myocardial infarction (MI), cardiac death, target vessel revascularization (TVR), target lesion revascularization (TLR), stroke and major adverse cardiac events (MACEs)] in patients with and without HIV infection. Statistical analysis was carried out by the RevMan 5.3 software whereby Odds Ratios (OR) and 95% Confidence Intervals (CIs) were generated. Results Two thousand two hundred and sixty-eight (2268) patients (821 patients were HIV positive and 1147 patients were HIV negative) were analyzed. The current results showed that mortality was not significantly increased among patients who were HIV positive with OR: 1.13, 95% CI: 0.65–1.96; P = 0.66. Cardiac death was also similarly reported with OR: 1.16, 95% CI: 0.50–2.68; P = 0.74. However, even if recurrent MI, TVR, TLR, MACEs and stroke were higher in patients who were HIV positive, with OR: 1.32, 95% CI: 0.88–2.12; P = 0.18, OR: 1.36, 95% CI: 0.88–2.12; P = 0.17, OR: 1.22, 95% CI: 0.72–2.06; P = 0.46, OR: 1.29, 95% CI: 0.89–1.85; P = 0.17 and OR: 1.47, 95% CI: 0.44–4.89; P = 0.53 respectively, these results were not statistically significant. Conclusion Patients who were infected with HIV had similar mortality post coronary intervention compared to patients who were not infected by the virus, during a mean follow-up period of 1–3 years. In addition, no significant increase in MI, TVR, TLR, MACEs and stroke were observed during this follow up period. Therefore, it might be concluded that no apparent impact of HIV on the cardiovascular outcomes was observed post coronary intervention.
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Affiliation(s)
- Pravesh Kumar Bundhun
- Institute of Cardiovascular Diseases, the First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, 530027, People's Republic of China
| | - Manish Pursun
- Guangxi Medical University, Nanning, Guangxi, 530027, People's Republic of China
| | - Wei-Qiang Huang
- Institute of Cardiovascular Diseases, the First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, 530027, People's Republic of China. .,Institute of Cardiovascular Diseases, the First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, 530021, People's Republic of China.
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Hiremath SB, Desai M. A study on prevalence and correlates of depression among women living with human immunodeficiency virus/ acquired immune deficiency syndrome in North Karnataka. Ind Psychiatry J 2017; 26:188-193. [PMID: 30089968 PMCID: PMC6058429 DOI: 10.4103/ipj.ipj_3_16] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
CONTEXT Depression is the most prevalent psychiatric condition seen in human immunodeficiency virus (HIV)-positive individuals. Various biological, sociocultural, and economic factors make women more vulnerable to HIV and acquired immune deficiency syndrome (AIDS). Depression affects medication adherence and immunity against HIV thus contribute significantly to disease progression. AIMS The aim is to assess the prevalence, sociodemographic, and clinical correlates of depression among women living with HIV/AIDS. SETTINGS AND DESIGN Antiretroviral therapy (ART) centre attached to government medical college hospital in North Karnataka and cross-sectional design. MATERIALS AND METHODS This study was conducted among of 145 women living with HIV/AIDS, depression was assessed using Beck Depression Inventory, and social support was assessed using Lubben Social Network Scale and quality of life (QoL) using the World Health Organization QoL BREF scale. STATISTICAL ANALYSIS USED Data were analyzed using Statistical Package for the Social Sciences version 20.0. Chi-square test with P value less than 0.05 was taken as statistically significant. RESULTS Among 145 HIV-positive women, 50 (34.5%) were depressed. Depression was statistically significant in women from rural background. Significant association between depression and risk of social isolation was observed. Scores of all domains of QoL, that is, physical, psychological, social, and environmental were reducing with increase in the severity of depression indicating that QoL was decreasing with increase in severity of depression. Among the four domains, social domain was the most affected. CONCLUSIONS Depression among women living with HIV/AIDS which is underdiagnosed and undertreated. Depression negatively impacts adherence and immunity leading rapid progression of the infection. Therefore, early diagnosis and treatment of depression are essential.
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Affiliation(s)
- Shivanand B Hiremath
- Department of Psychiatry, Karnataka Institute of Medical Sciences, Hubballi, Karnataka, India
| | - Mahesh Desai
- Department of Psychiatry, Karnataka Institute of Medical Sciences, Hubballi, Karnataka, India
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Oliveira Serra MAA, Araújo E Silva R, Beserra EP, Melo TN, Sousa LV, Araújo MFM. Use of alcohol and drugs in the view of people living with HIV/AIDS: a qualitative study. Public Health 2017; 149:99-105. [PMID: 28582690 DOI: 10.1016/j.puhe.2017.04.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Revised: 03/25/2017] [Accepted: 04/17/2017] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To investigate the meaning of the experiences of patients infected by HIV using antiretroviral therapy, regarding the use of alcohol and drugs. STUDY DESIGN A qualitative phenomenological study. METHOD A total of 25 patients receiving antiretroviral treatment participated in the investigation, of which 14 were male and 11 were females, who expressed their feelings and perceptions through participation in focus groups and the interpretation of costumes. The empirical material was transcribed in full and later organized and analyzed using the phenomenological method. RESULTS Based on this amusing experience we realized that participants were unaware of the effects of the use of alcohol and drugs in the AIDS progression. Since they have kept with their smoking and alcoholism habits to be accepted in a social group and consequently prevent prejudice. We believe that our health education strategy was adequate to improve antiretroviral therapy, since it helped in subject comprehension and patients self-care body expression. CONCLUSION This phenomenological study made it possible to understand the experience of patients living with HIV regarding the use of alcohol and drugs, and contributes to the planning and implementation of intervention programs based on a participative model of care, with a view to prioritizing the holistic aspects involved in the treatment of people living with HIV/AIDS.
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Affiliation(s)
| | | | - E P Beserra
- Federal University of Ceará, Fortaleza, Brazil
| | - T N Melo
- Federal University of Maranhão, Imperatriz, Brazil
| | - L V Sousa
- Federal University of Maranhão, Imperatriz, Brazil
| | - M F M Araújo
- University for International Integration Lusophony Afro Brazilian, Brazil
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