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Lee CY, Lin YP, Lin CY, Lu PL, Liang FW. Enhancing indicator condition-guided HIV testing in Taiwan: a nationwide case-control study from 2009 to 2015. BMC Public Health 2024; 24:967. [PMID: 38580963 PMCID: PMC10998297 DOI: 10.1186/s12889-024-18499-6] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 04/02/2024] [Indexed: 04/07/2024] Open
Abstract
BACKGROUND Although indicator condition (IC)-guided HIV testing (IC-HIVT) is effective at facilitating timely HIV diagnosis, research on IC categories and the related HIV risk in Taiwan is limited. To improve the adoption and spread of IC-HIVT in Taiwan, this study compared the IC categories of people living with HIV (PLWH) and non-HIV controls and investigated delays in the diagnosis of HIV infection. METHODS This nationwide, retrospective, 1:10-matched case-control study analyzed data from the Notifiable Diseases Surveillance System and National Health Insurance Research Database to evaluate 42 ICs for the 5-year period preceding a matched HIV diagnostic date from 2009 to 2015. The ICs were divided into category 1 ICs (AIDS-defining opportunistic illnesses [AOIs]), category 2 ICs (diseases associated with impaired immunity or malignancy but not AOIs), category 3 ICs (ICs associated with sexual behaviors), and category 4 ICs (mononucleosis or mononucleosis-like syndrome). Logistic regression was used to evaluate the HIV risk associated with each IC category (at the overall and annual levels) before the index date. Wilcoxon rank-sum test was performed to assess changes in diagnostic delays following an incident IC category by HIV transmission routes. RESULTS Fourteen thousand three hundred forty-seven PLWH were matched with 143,470 non-HIV controls. The prevalence results for all ICs and category 1-4 ICs were, respectively, 42.59%, 11.16%, 15.68%, 26.48%, and 0.97% among PLWH and 8.73%, 1.05%, 4.53%, 3.69%, and 0.02% among non-HIV controls (all P < 0.001). Each IC category posed a significantly higher risk of HIV infection overall and annually. The median (interquartile range) potential delay in HIV diagnosis was 15 (7-44), 324.5 (36-947), 234 (13-976), and 74 (33-476) days for category 1-4 ICs, respectively. Except for category 1 for men who have sex with men, these values remained stable across 2009-2015, regardless of the HIV transmission route. CONCLUSIONS Given the ongoing HIV diagnostic delay, IC-HIVT should be upgraded and adapted to each IC category to enhance early HIV diagnosis.
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Affiliation(s)
- Chun-Yuan Lee
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, R.O.C
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, R.O.C
- M.Sc. Program in Tropical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, R.O.C
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, R.O.C
| | - Yi-Pei Lin
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, R.O.C
- M.Sc. Program in Tropical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, R.O.C
| | - Chun-Yu Lin
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, R.O.C
| | - Po-Liang Lu
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, R.O.C
- Center for Liquid Biopsy and Cohort Research, Kaohsiung Medical University, Kaohsiung, Taiwan, R.O.C
- School of Post-Baccalaureate Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, R.O.C
| | - Fu-Wen Liang
- Department of Public Health, College of Health Science, Kaohsiung Medical University, Kaohsiung, Taiwan, R.O.C..
- Center for Big Data Research, Kaohsiung Medical University, Kaohsiung, Taiwan, R.O.C..
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, R.O.C..
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Hsueh TY, Chen KH, Liu WD, Hung CC. Disseminated talaromycosis with presentations of painful oral ulcers and generalized papules in a 44-year-old man with advanced HIV infection. J Microbiol Immunol Infect 2023; 56:889-891. [PMID: 36925378 DOI: 10.1016/j.jmii.2023.02.008] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 01/26/2023] [Accepted: 02/25/2023] [Indexed: 03/08/2023]
Affiliation(s)
- Te-Yao Hsueh
- Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
| | - Kai-Hsiang Chen
- Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
| | - Wang-Da Liu
- Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan; Department of Medicine, National Taiwan University Cancer Center, Taipei, Taiwan.
| | - Chien-Ching Hung
- Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan; Department of Tropical Medicine and Parasitology, National Taiwan University College of Medicine, Taipei, Taiwan.
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Deepa P, Thirumeignanam D. Understanding the impact of halogen functional group (Br, Cl, F, OH) in amprenavir ligand of the HIV protease. J Biomol Struct Dyn 2023; 41:12157-12170. [PMID: 36645135 DOI: 10.1080/07391102.2023.2166121] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 01/01/2023] [Indexed: 01/17/2023]
Abstract
We focused our attention towards the most dreadful disease that threatens the mankind of 20th century - Acquired immunodeficiency syndrome (AIDS), caused through the human immunodeficiency virus (HIV) and a sexually transmitted infection (STI). In this study, our foremost interest was to identify the potency and stability of HIV ligand- Amprenavir (APV) and its modelled functional group (Br, Cl, F, CF3, CH3, NH2) ligands through halogen and hydrogen bond contact, which will have a clear portrait on the structure activity of protein ligand interactions. This will assist chemist in synthesizing novel APV ligands, which are expected to inhibit the activity of HIV-1 protease enzyme. The binding strength of Amprenavir ligand with interacting hinge region amino acid side chains: Isoleucine (ILE 147, 150, 184), Valine (VAL 82), Alanine (ALA 28), Aspartic acid (25, 30, 125, 130) and Glycine (GLY 127, 149) were understood through interaction energy calculations at HF, B3LYP, M052X, MP2 level of theories for different basis set (6-311 G**, LANL2DZ). The present work will reveal an understandable picture about the halogen and hydrogen bond interaction that grip the contact of ligand and amino acids in the hinge region. Overall the Halogen atom (Br, Cl, F) functional groups improved the binding strength of APV in HIV protease; which provide a new novel path for the functional group preference on the ligand that enclose perfectly with the amino acid in the hinge region.Communicated by Ramaswamy H. Sarma.
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Affiliation(s)
- Palanisamy Deepa
- Department of Physics, Manonmaniam Sundaranar University, Tirunelveli, India
| | - Duraisamy Thirumeignanam
- Department of Animal Nutrition, Veterinary College and Research Institute, Tamil Nadu Veterinary and Animal Sciences University, Tirunelveli, India
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Huang JL, Zhou XX, Luo P, Lu XY, Liang LH, Lan GB, Chen L, Lin FQ. Neutrophil-to-lymphocyte ratio and lactate dehydrogenase for early diagnosis of AIDS patients with Talaromyces marneffei infection. Ann Palliat Med 2022; 11:588-597. [PMID: 35249337 DOI: 10.21037/apm-22-36] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 02/21/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND This study aimed to explore the value of neutrophil-to-lymphocyte ratio (NLR) in combination with routine blood tests, lactate dehydrogenase (LDH), and T-lymphocyte subsets for the early diagnosis of acquired immunodeficiency syndrome (AIDS) combined with Talaromyces marneffei (TM) infection. METHODS A total of 166 confirmed AIDS patients were enrolled in this study. The observation group included 80 AIDS patients with TM infection, and the control group consisted of 86 AIDS patients with other complications. Regression analysis was performed to evaluate the predictive value of each index and the combination of these indexes for AIDS combined with TM infection using receiver operating characteristic (ROC) curve analysis. RESULTS NLR and LDH were significantly higher in patients in the observation group compared with those in the control group, and the differences were statistically significant (P<0.05). There was no statistical difference in platelets, infantile granulocytes (IGM), and nucleated red blood cells (NRBC) between the 2 groups (P>0.05). The area under the operating characteristic curve (AUC) of the observed indicators were: NLR, 0.628; hemoglobin (HGB), 0.704; LDH, 0.607; lymphocyte (LYM) count, 0.744; CD4+ T lymphocyte count, 0.789; and CD8+ T lymphocyte count, 0.701. The combined AUC of multiple indicators was 0.815, with a sensitivity and specificity of 76.2% and 76.1%, respectively. CONCLUSIONS NLR, HGB, LYM, LDH, and T lymphocyte subsets were diagnostic for early AIDS combined with TM infection , and CD4+ T lymphocytes had the best diagnostic efficacy alone.
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Affiliation(s)
- Ju-Lue Huang
- Key Laboratory of Clinical Laboratory Medicine of Guangxi Department of Education, the First Affiliated Hospital of Guangxi Medical University, Nanning, China; Department of Clinical Laboratory, the People's Hospital of Baise, Baise, China
| | - Xiao-Xuan Zhou
- Department of Clinical Laboratory, the People's Hospital of Baise, Baise, China
| | - Ping Luo
- The Center Blood Station of Baise, Baise, China
| | - Xiao-Yan Lu
- Department of Infectious Disease, the People's Hospital of Baise, Baise, China
| | - Lin-Hui Liang
- Department of Clinical Laboratory, the People's Hospital of Baise, Baise, China
| | - Gui-Bin Lan
- Department of Clinical Laboratory, the People's Hospital of Baise, Baise, China
| | - Li Chen
- Department of Clinical Laboratory, the People's Hospital of Baise, Baise, China
| | - Fa-Quan Lin
- Key Laboratory of Clinical Laboratory Medicine of Guangxi Department of Education, the First Affiliated Hospital of Guangxi Medical University, Nanning, China
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Kann G, Wetzstein N, Bielke H, Schuettfort G, Haberl AE, Wolf T, Kuepper-Tetzel CP, Wieters I, Kessel J, de Leuw P, Bickel M, Khaykin P, Stephan C. Risk factors for IRIS in HIV-associated Pneumocystis-pneumonia following ART initiation. J Infect 2021; 83:347-353. [PMID: 34242683 DOI: 10.1016/j.jinf.2021.06.027] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 05/27/2021] [Accepted: 06/30/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND HIV-infected patients with Pneumocystis-pneumonia (PCP) may develop paradoxical immune reconstitution inflammatory syndrome (IRIS), when combination antiretroviral therapy (cART) is started early during the course of PCP-treatment (PCPT). The aim of this study was to identify risk factors and predictors for PCP-IRIS and to improve individualized patient care. METHODS An ICD-10 code hospital database query identified all Frankfurt HIV Cohort patients being diagnosed with PCP from January 2010 - June 2016. Patient charts were evaluated retrospectively for demographic, clinical and therapeutic (cART/PCPT) characteristics and incidence of paradoxical IRIS according to French's case definitions. RESULTS IRIS occurred in 12/97 patients that started cART while on PCPT (12.4%). They had a higher rate of re-hospitalization (41.7vs. 4.7%; odds ratio (OR) 14.46; p = 0.009), intensive care treatment (66.7vs. 30.6%; OR = 4.54; p = 0.018), and longer median hospitalization (48 days vs. 23; p < 0.001). A high HIV-RNA level (> 6Log10/ml) before cART initiation was associated with IRIS development (41.6vs. 15.0%; OR 4.05; p = 0.042). Serum immunoglobulin G-levels (IgG) [mg/dl] were lower (894.0 vs. 1446.5; p = 0.023). CONCLUSION Higher hospitalization rate and morbidity parameters underscore the clinical importance of PCP-related paradoxical IRIS. A baseline viral load of > 6Log10/ml and serum IgG may help to assess individual risks for PCP-IRIS.
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Affiliation(s)
- Gerrit Kann
- Department of Internal Medicine, Infectious Diseases, University Hospital Frankfurt, Goethe University, Theodor-Stern-Kai 7, Frankfurt am Main 60590, Germany
| | - Nils Wetzstein
- Department of Internal Medicine, Infectious Diseases, University Hospital Frankfurt, Goethe University, Theodor-Stern-Kai 7, Frankfurt am Main 60590, Germany
| | - Hannah Bielke
- Department of Internal Medicine, Infectious Diseases, University Hospital Frankfurt, Goethe University, Theodor-Stern-Kai 7, Frankfurt am Main 60590, Germany
| | - Gundolf Schuettfort
- Department of Internal Medicine, Infectious Diseases, University Hospital Frankfurt, Goethe University, Theodor-Stern-Kai 7, Frankfurt am Main 60590, Germany
| | - Annette E Haberl
- Department of Internal Medicine, Infectious Diseases, University Hospital Frankfurt, Goethe University, Theodor-Stern-Kai 7, Frankfurt am Main 60590, Germany
| | - Timo Wolf
- Department of Internal Medicine, Infectious Diseases, University Hospital Frankfurt, Goethe University, Theodor-Stern-Kai 7, Frankfurt am Main 60590, Germany
| | - Claus P Kuepper-Tetzel
- Department of Internal Medicine, Infectious Diseases, University Hospital Frankfurt, Goethe University, Theodor-Stern-Kai 7, Frankfurt am Main 60590, Germany
| | - Imke Wieters
- Department of Internal Medicine, Infectious Diseases, University Hospital Frankfurt, Goethe University, Theodor-Stern-Kai 7, Frankfurt am Main 60590, Germany
| | | | | | | | | | - Christoph Stephan
- Department of Internal Medicine, Infectious Diseases, University Hospital Frankfurt, Goethe University, Theodor-Stern-Kai 7, Frankfurt am Main 60590, Germany.
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Kumagai T, Doki N, Kobayashi T, Yamada R, Hishima T, Adachi H, Konuma R, Fujita M, Wada A, Kishida Y, Konishi T, Nagata A, Yamada Y, Kaito S, Yoshifuji K, Mukae J, Akiyama M, Inamoto K, Toya T, Igarashi A, Najima Y, Kakihana K, Sakamaki H, Ohashi K. [Vacuolar myelopathy after allogeneic bone marrow transplantation in a patient with acute lymphoblastic leukemia]. Rinsho Ketsueki 2021; 61:1625-1627. [PMID: 33298658 DOI: 10.11406/rinketsu.61.1625] [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: 11/09/2022]
Abstract
Vacuolar myelopathy (VM) is known to be a neurological complication in patients with acquired immunodeficiency syndrome (AIDS). In autopsy-based studies, VM was reported in approximately 20-50% of patients with AIDS. It manifests in various says, mainly presenting as a painless spastic paraparesis with a sensory ataxia. We present a rare case of VM after bone marrow transplantation (BMT) in a patient without AIDS. A 50-year-old man developed weakness in the lower legs, leg muscle atrophy, and difficulty in walking 86 days after BMT. The patient died from septic shock on day 309. The autopsy revealed intralamellar vacuolation in the spinal white matter, which was compatible with VM.
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Affiliation(s)
- Takuma Kumagai
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital
| | - Noriko Doki
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital
| | - Takeshi Kobayashi
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital
| | - Rin Yamada
- Department of Pathology, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital
| | - Tsunekazu Hishima
- Department of Pathology, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital
| | - Hiroto Adachi
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital
| | - Ryosuke Konuma
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital
| | - Masahiro Fujita
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital
| | - Atsushi Wada
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital
| | - Yuya Kishida
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital
| | - Tatsuya Konishi
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital
| | - Akihito Nagata
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital
| | - Yuta Yamada
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital
| | - Satoshi Kaito
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital
| | - Kota Yoshifuji
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital
| | - Junichi Mukae
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital
| | - Megumi Akiyama
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital
| | - Kyoko Inamoto
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital
| | - Takashi Toya
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital
| | - Aiko Igarashi
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital
| | - Yuho Najima
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital
| | - Kazuhiko Kakihana
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital
| | - Hisashi Sakamaki
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital
| | - Kazuteru Ohashi
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital
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Guan C, Shi Y, Liu J, Yang Y, Zhang Q, Lu Z, Zheng G, Ye W, Xue M, Zhou X, Zhang N, Li H, Xie R, Chen B, Lu P. Pulmonary involvement in acquired immunodeficiency syndrome-associated Kaposi's sarcoma: a descriptive analysis of thin-section manifestations in 29 patients. Quant Imaging Med Surg 2021; 11:714-724. [PMID: 33532271 DOI: 10.21037/qims-20-284] [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] [Indexed: 12/12/2022]
Abstract
Background Acquired immunodeficiency syndrome-associated Kaposi's sarcoma (AIDS-KS) was the first malignant neoplasm to be described as being related to AIDS. The lungs are the most common visceral site of AIDS-KS. This study aimed to analyze the computed tomography (CT) manifestations of pulmonary involvement in AIDS-KS. Methods Twenty-nine male patients were enrolled in this retrospective study. Imaging evaluation parameters included lesion distribution, the flame sign, interlobular septal thickening, peribronchovascular interstitium thickening, ground-glass opacity (GGO), dilated blood vessels in lesions, and pleural effusion. Results A peribronchovascular distribution was observed in all patients, predominantly in the lower lobes. Of the patients, 58.62% (17/29) exhibited the flame sign, 75.86% (22/29) had interlobular septal thickening, 72.41% (21/29) had peribronchovascular interstitium thickening, 82.76% (24/29) had GGO, and 34.48% (10/29) had pleural effusion. Enlarged lymph nodes with a short-axis diameter >1.0 cm were found in 41.38% (12/29) of the patients. Of the 12 patients who underwent contrast-enhanced CT (CECT), 90.91% (11/12) had dilated blood vessels, and nodules, consolidations, and lymph nodes were observed to be strongly enhanced. Intrapulmonary lesions decreased in size or number after appropriate treatment during follow-up. Conclusions Common CT manifestations of pulmonary AIDS-KS include the flame sign, peribronchovascular distribution, peribronchovascular interstitium thickening, interlobular septa thickening, GGO, dilated blood vessel, and strong enhancement of nodules, consolidations, and lymph nodes. It is helpful to follow up the therapeutic effect of pulmonary AIDS-KS by chest CT.
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Affiliation(s)
- Chunshuang Guan
- Department of Radiology, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Yuxin Shi
- Department of Radiology, Shanghai Public Health Clinical Center, Shanghai, China
| | - Jinxin Liu
- Department of Radiology, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China
| | - Yuxin Yang
- Department of Radiology, The Sixth People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, China
| | - Qianqian Zhang
- Department of Radiology, Zhoukou Central Hospital, Zhoukou, China
| | - Zhiyan Lu
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Guangping Zheng
- Department of Radiology, The Shenzhen No. 3 People's Hospital, Guangdong Medical College, Shenzhen, China
| | - Wen Ye
- Department of Radiology, Shanghai Public Health Clinical Center, Shanghai, China
| | - Ming Xue
- Department of Radiology, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Xingang Zhou
- Department of Pathology, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Na Zhang
- Department of Radiology, Chengdu Public Health Clinical Center, Chengdu, China
| | - Hongjun Li
- Department of Radiology, Beijing You'an Hospital, Capital Medical University, Beijing, China
| | - Ruming Xie
- Department of Radiology, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Budong Chen
- Department of Radiology, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Puxuan Lu
- Department of Radiology, Shenzhen Center for Chronic Disease Control, Shenzhen, China
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Chakraborty R, Pandya D, Kar PP, Sethi JK. Kaposi's sarcoma associated with advanced HIV infection: A case report. J Family Med Prim Care 2020; 9:4463-4466. [PMID: 33110887 PMCID: PMC7586607 DOI: 10.4103/jfmpc.jfmpc_913_20] [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: 05/18/2020] [Revised: 06/19/2020] [Accepted: 07/11/2020] [Indexed: 11/24/2022] Open
Abstract
Acquired immunodeficiency syndrome was recognized in the early 1980s. It was more common in men who had sex with previously healthy men and young people and were affected by atypical pneumopathy caused by an opportunistic microorganism, identified as Pneumocystis carinii, and presently known as Pneumocystis jiroveci. Histopathology of the purplish or brown nodular lesions revealed Kaposi's sarcoma (KS). KS is the most frequent neoplasm in patients with human immunodeficiency virus infection. Its pathophysiology has been associated with the presence of a herpes virus, whose etiologic agent is a member of herpes virus type 8 family, which gets transmitted through sexual contact. Here, we present a case report to present the diagnosis and bring the light of knowledge to the Dentist the need of therapeutic measures in the treatment of the pathology.
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Affiliation(s)
- Rakashree Chakraborty
- Department of Oral Medicine and Radiology, Maharishi Markandeshwar College of Dental Sciences and Research, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, India
| | - Divya Pandya
- Department of Oral Medicine and Radiology, Kusum Devi Sundarlal Dugar Jain Dental College and Hospital, Kolkata, West Bengal, India
| | - Pinak Pani Kar
- Department of Oral and Maxillofacial Surgery, Buddha Institute of Dental Sciences and Hospital, Patna, Bihar, India
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Maleki MR, Derakhshani N, Azami-Aghdash S, Naderi M, Nikoomanesh M. Quality of Life of People with HIV/AIDS in Iran: A Systematic Review and Meta-Analysis. Iran J Public Health 2020; 49:1399-1410. [PMID: 33083316 PMCID: PMC7554383 DOI: 10.18502/ijph.v49i8.3861] [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] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Background: Assessing the quality of life in HIV/AIDS patients is of great importance not only for evaluating the effect of the disease, but also to measure the impact of the interventions in order to improve their quality of life in clinical researches. Therefore, this study aimed to systematically review the quality of life of HIV/AIDS patients in Iran. Methods: In this systematic review and meta-analysis, the literature search using the related chain of keywords was conducted from 1 Jan 1987 to 30 Apr 2019 in PubMed, Scopus, Web of Science, Embase, Iranian Scientific Information Database (SID), and Magiran. Moreover, hand search of the key journals and the gray literature was performed. The meta-analysis was performed by CMA2 software. Results: Out of the 1576 retrieved records, eight studies met the inclusion criteria. The average age of the patients was 37.15 ± 9.46 years. The average score of quality of life before and after sensitivity analysis was (39.13 [28.36–49.901 95% CI P>0.000] vs. 49.05 [46.31–51.79 95% CI P>0.000]). Moreover, the average score of quality of life was respectively 38.86±3.83 vs. 40±6.37 among married compared with single patients, 56.33±4.67 vs. 43.64±1.94 for employment vs. unemployment status. While quality of life was measured in terms of education level, the score was 29.59±9.34 vs. 41.65±4.45 in the individuals with primary school versus academic education. Conclusion: The QOL score of the HIV/AIDS patients in Iran was significantly low. Therefore, the study highlights the importance of strengthening efforts to undertake necessary investigations in order to provide adequate health insurance, extensive and affordable welfare services, and more appropriate social and mental supports in order to improve the quality of life of the individuals with HIV/AIDS in Iran.
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Affiliation(s)
- Mohammad Reza Maleki
- Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Naser Derakhshani
- Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Saber Azami-Aghdash
- Tabriz Health Services Management Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mehran Naderi
- Department of Food Science and Technology, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahdi Nikoomanesh
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
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Abstract
Persons living with HIV (PLWH) are significantly more likely to die by suicide compared to the general population. This is the first study to examine the impact of posttraumatic stress disorder (PTSD), major depressive disorder (MDD), insomnia, and substance use disorders on suicidal ideation/behavior among PLWH using electronic medical record (EMR) data. We also evaluated the mutual influence of interactions between PTSD and substance use disorders on suicide risk, consistent with the substance abuse, violence exposure, and HIV/AIDS "SAVA" syndemic model. Participants (n = 2336) were HIV+ individuals recruited through the Center for AIDS Research (CFAR). Participants provided informed consent for extraction of their EMR. As hypothesized, univariate analyses revealed that PTSD, MDD, insomnia, alcohol and other substance use disorders (cocaine abuse and cocaine dependence, opioid abuse and dependence, cannabis abuse, other psychoactive substance abuse and dependence, and polysubstance use disorder) were each positively associated with suicidal ideation/behavior. Also as hypothesized, a multivariable analysis found that alcohol and cocaine dependence, MDD, and PTSD were significant predictors of suicidal ideation/behavior. Contrary to hypotheses, none of the interactions between PTSD and substance use disorders were significantly associated with suicidal ideation/behavior.
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Affiliation(s)
- Lily A Brown
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - Ifrah Majeed
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - Wenting Mu
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - Jesse McCann
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - Stephen Durborow
- Clinical Research Computing Unit, University of Pennsylvania, Philadelphia, PA, USA
| | - Song Chen
- Department of Mathematics and Statistics, University of Wisconsin, La Crosse, WI, USA
| | - Michael B Blank
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
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Abstract
Hemodialysis patients are at increased risk for development of blood-borne viral infections. Human immunodeficiency virus (HIV), a once fatal infection, has become treatable, but continues to be associated with increased mortality. Hepatitis B and C viral infections can lead to acute and chronic hepatitis, cirrhosis, or hepatocellular carcinoma. Young children and immunocompromised patients are more likely to develop chronic disease leading to increased morbidity and mortality, as compared to the healthy population. The hemodialysis population is at increased risk of blood-borne viral infections as compared to the general population due to multiple factors. Here we review risk factors of blood-borne viral infections, strategies for prevention, and approach to therapy in the pediatric hemodialysis population.
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Affiliation(s)
- Shina Menon
- Division of Nephrology, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, WA, USA
| | - Raj Munshi
- Division of Nephrology, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, WA, USA.
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12
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Mohole J, Ho AL, Sussman ES, Pendharkar AV, Lee M. Focal Intramedullary Spinal Cord Lesion in Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome: Toxoplasmosis Versus Lymphoma. World Neurosurg 2019; 127:227-231. [PMID: 30981796 DOI: 10.1016/j.wneu.2019.04.057] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 02/11/2019] [Revised: 04/04/2019] [Accepted: 04/05/2019] [Indexed: 11/16/2022]
Abstract
BACKGROUND Neurologic complications are common in patients with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS). Although both the central nervous system (CNS) and the peripheral nervous system can be affected, 80% of patients with HIV/AIDS have CNS involvement during the course of their illness. The brain is the primary site of HIV/AIDS-associated CNS complications. Spinal cord involvement is rare, particularly focal intramedullary spinal cord lesions without any associated cerebral lesions. Among various opportunistic infections and malignancies, toxoplasmosis and CNS lymphoma are the most common causes of focal neurologic disease in patients with HIV/AIDS. Distinguishing between toxoplasmosis and CNS lymphoma is challenging, as the diseases have similar clinical presentations. CASE DESCRIPTION In a woman with newly diagnosed HIV infection, myelopathy manifested as an isolated, single intramedullary spinal cord lesion. CONCLUSIONS Common methods to distinguish the diagnoses of toxoplasmosis and CNS lymphoma are addressed. There should be a high index of suspicion for toxoplasmosis in patients with HIV/AIDS presenting with a focal intramedullary spinal cord lesion.
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Affiliation(s)
- Jyodi Mohole
- Department of Neurosurgery, Santa Clara Valley Medical Center, San Jose, California, USA
| | - Allen L Ho
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, California, USA
| | - Eric S Sussman
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, California, USA
| | - Arjun V Pendharkar
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, California, USA
| | - Marco Lee
- Department of Neurosurgery, Santa Clara Valley Medical Center, San Jose, California, USA; Department of Neurosurgery, Stanford University School of Medicine, Stanford, California, USA.
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13
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Ahmadi-Motamayel F, Vaziri-Amjad S, Goodarzi MT, Samie L, Poorolajal J. Evaluation of Salivary Melatonin Levels in HIV-positive Patients: A Historical Cohort Study. Rev Recent Clin Trials 2018; 12:168-173. [PMID: 28745217 DOI: 10.2174/1574887112666170725132528] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Revised: 07/17/2017] [Accepted: 07/21/2017] [Indexed: 11/22/2022]
Abstract
BACKGROUND Human immunodeficiency virus (HIV) affects lymphocytes, resulting in acquired immunodeficiency syndrome. Oxidative stress may play an important role in HIV pathogenesis. Melatonin has antioxidant, antiinflammatory and immunomodulatory effects. OBJECTIVE The aim of this study was to evaluate salivary melatonin levels in HIV-positive patients and a healthy control group. METHODS Forty-nine HIV-positive and 49 healthy subjects were included in this study. Patients' drug consumption and clinical examination results were registered in questionnaires. Unstimulated whole saliva was collected in the morning. The melatonin levels were measured by melatonin ELISA kits. Statistical analyses were performed with STATA 12, using t-test and chi-squared test. RESULTS Salivary melatonin levels were significantly lower in the case group in comparison with the healthy control group (P=0.001). Age was significantly higher in the case group. Chi-squared test showed no statistically significant difference between the case and control groups in smoking (P=0.591) and addiction (P=0.204) but gender differences were observed (P=0.001). CONCLUSION Salivary melatonin level as an antioxidant was lower in HIV-positive patients. Further studies are necessary to understand the exact role of melatonin in HIV-positive patients and its therapeutic effects.
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Affiliation(s)
- Fatemeh Ahmadi-Motamayel
- Dental Research Center and Research Center for Molecular Medicine, Hamadan University of Medical Sciences, Hamadan. Iran
| | - Samaneh Vaziri-Amjad
- Department of Oral Medicine, Hamadan University of Medical Sciences, Hamadan. Iran
| | - Mohammad Taghi Goodarzi
- Research Center for Molecular Medicine, Hamadan University of Medical Sciences, Hamadan. Iran
| | - Lida Samie
- Research Center for Health Sciences and Department of Epidemiology & Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan. Iran
| | - Jalal Poorolajal
- Research Center for Health Sciences and Department of Epidemiology & Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan. Iran
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14
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Ozdemir B, Yetkin MA, Bastug A, But A, Aslaner H, Akinci E, Bodur H. Evaluation of epidemiological, clinical, and laboratory features and mortality of 144 HIV/AIDS cases in Turkey. HIV Clin Trials 2018; 19:69-74. [PMID: 29566585 DOI: 10.1080/15284336.2018.1453990] [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] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Background The number of HIV/AIDS cases in Turkey is increasing rapidly, as is the number of cases worldwide. The aim of this study is to evaluate the characteristics of the clinical and laboratory findings and epidemiological features of HIV/AIDS patients to obtain useful data on the epidemic type and transmission routes associated with Turkey and to identify risk factors for mortality. Methods The patient records of 144 HIV-infected patients who were admitted to our clinic between 2000 and 2015 were analyzed retrospectively. Results Most of the cases (55%) were diagnosed due to the detection of anti-HIV-positive individuals without clinical symptoms. The mean CD4 + lymphocyte count on first admission was 108 cells/μL for those admitted before 2009 and 265 cells/μL for those admitted after 2009 (p = 0.003). When the pre- and post-2009 groups were compared for the status of the disease, 55.6 and 44.4% of patients were in the AIDS stage, respectively (p = 0.04). The most noted opportunistic infection was mycobacterial, and throughout the follow-up, 31.2% of the cases were fatal. Conclusions Early diagnosis of HIV infection can have a direct impact on prognosis and survival. Therefore, screening laboratory investigations should be extended, particularly in high-risk groups.
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Affiliation(s)
- Burcu Ozdemir
- a Department Of Infectious Diseases and Clinical Microbiology , Ankara Numune Training and Research Hospital , Ankara , Turkey
| | - Meltem A Yetkin
- b Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology , Giresun University , Giresun , Turkey
| | - Aliye Bastug
- a Department Of Infectious Diseases and Clinical Microbiology , Ankara Numune Training and Research Hospital , Ankara , Turkey
| | - Ayşe But
- a Department Of Infectious Diseases and Clinical Microbiology , Ankara Numune Training and Research Hospital , Ankara , Turkey
| | - Halide Aslaner
- a Department Of Infectious Diseases and Clinical Microbiology , Ankara Numune Training and Research Hospital , Ankara , Turkey
| | - Esragul Akinci
- a Department Of Infectious Diseases and Clinical Microbiology , Ankara Numune Training and Research Hospital , Ankara , Turkey
| | - Hurrem Bodur
- a Department Of Infectious Diseases and Clinical Microbiology , Ankara Numune Training and Research Hospital , Ankara , Turkey
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15
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Suzuki J, Sasahara T, Toshima M, Morisawa Y. Peripherally inserted central catheter-related bloodstream infection due to Tsukamurella pulmonis: a case report and literature review. BMC Infect Dis 2017; 17:677. [PMID: 29020942 PMCID: PMC5637316 DOI: 10.1186/s12879-017-2796-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2017] [Accepted: 10/04/2017] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Tsukamurella pulmonis is an aerobic gram-positive and rod-shaped organism that causes central catheter-related bloodstream infections in immunocompromised hosts. However, peripherally inserted central catheter (PICC)-related bloodstream infections due to this organism have not been reported. CASE PRESENTATION We describe a case of a 48-year-old man with acquired immunodeficiency syndrome and diffuse large B cell lymphoma who received five courses of chemotherapy including rituximab , cyclophosphamide , doxorubicin hydrochloride , vincristine , and prednisone via a PICC. Five days after the last chemotherapy course, he presented with a high fever and shaking chills. His absolute neutrophil count was 4200/μL. Cultures obtained from blood and PICC culture revealed T. pulmonis. The colony count of T. pulmonis grown from PICC culture was 103 colony-forming units. Therefore, he was diagnosed with T. pulmonis bacteremia resulting from PICC-related bloodstream infection. The patient's condition improved and he became afebrile within 48 h after intravenous administration of cefozopran hydrochloride, which is a fourth generation cephalosporin. CONCLUSIONS PICCs can be associated with T. pulmonis bacteremia, and fourth generation cephalosporins may be effective treatment.
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Affiliation(s)
- Jun Suzuki
- Division of Infectious Diseases, Jichi Medical University Hospital, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498 Japan
| | - Teppei Sasahara
- Division of Infectious Diseases, Jichi Medical University Hospital, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498 Japan
- Department of Infection and Immunity, School of Medicine, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498 Japan
| | - Masaki Toshima
- Division of Infectious Diseases, Jichi Medical University Hospital, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498 Japan
| | - Yuji Morisawa
- Division of Infectious Diseases, Jichi Medical University Hospital, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498 Japan
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16
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Yanagisawa K, Ogawa Y, Uchiumi H, Gohda F, Mawatari M, Ishizaki T, Mitsui T, Yokohama A, Handa H, Tsukamoto N, Nojima Y. Gene polymorphisms of mannose-binding lectin confer susceptibility to Pneumocystis pneumonia in HIV-infected patients. J Infect Chemother 2015; 21:769-75. [PMID: 26271591 DOI: 10.1016/j.jiac.2015.07.006] [Citation(s) in RCA: 9] [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: 03/20/2015] [Revised: 06/12/2015] [Accepted: 07/13/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND Mannose-binding lectin (MBL) plays an important role in innate immunity. The aim of this study was to determine whether genetic variants of MBL confer susceptibility to Pneumocystis pneumonia (PCP) in patients with advanced human immunodeficiency virus (HIV) infections. OBJECTIVE HIV patients (n = 53) having CD4 counts <200/μL who were admitted to our hospital were analyzed. Of these 53 patients, 30 had PCP at admission, and 23 did not. Genotypes at six single nucleotide polymorphisms (SNP) in MBL2 gene and serum MBL levels were determined for each patient, and compared between patients with or without PCP. We also examined whether MBL enhances phagocytosis of macrophages against rat-type Pneumocystis organism in vitro. RESULTS Genotypes associated with low production of MBL were significantly more common in the PCP group than in the non-PCP group (P = 0.049, odds ratio 2.17, 95% CI 1.02-4.63). Serum MBL levels were significantly higher in the non-PCP group (P = 0.039). Findings from in vitro experiments indicated that MBL act as a direct opsonin enhancing macrophage-mediated phagocytosis of Pneumocystis organisms. CONCLUSION Genetic variation of MBL production influences susceptibility to PCP in patients with advanced HIV infection, and can be regarded as a risk factor for PCP.
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Affiliation(s)
- Kunio Yanagisawa
- Gunma University Graduate School of Medicine, Department and Medicine and Clinical Science, Japan
| | - Yoshiyuki Ogawa
- Gunma University Graduate School of Medicine, Department and Medicine and Clinical Science, Japan.
| | - Hideki Uchiumi
- Gunma University Graduate School of Medicine, Department and Medicine and Clinical Science, Japan
| | - Fumito Gohda
- Gunma University Graduate School of Medicine, Department and Medicine and Clinical Science, Japan
| | - Momoko Mawatari
- Gunma University Graduate School of Medicine, Department and Medicine and Clinical Science, Japan
| | - Takuma Ishizaki
- Gunma University Graduate School of Medicine, Department and Medicine and Clinical Science, Japan
| | - Takeki Mitsui
- Gunma University Graduate School of Medicine, Department and Medicine and Clinical Science, Japan
| | - Akihiko Yokohama
- Gunma University Hospital, Division of Blood Transfusion Service, Japan
| | - Hiroshi Handa
- Gunma University Graduate School of Medicine, Department and Medicine and Clinical Science, Japan
| | | | - Yoshihisa Nojima
- Gunma University Graduate School of Medicine, Department and Medicine and Clinical Science, Japan
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Corti M, Villafañe M, Minue G, Campitelli A, Narbaitz M, Gilardi L. Clinical features of AIDS patients with Hodgkin's lymphoma with isolated bone marrow involvement: report of 12 cases at a single institution. Cancer Biol Med 2015; 12:41-5. [PMID: 25859410 PMCID: PMC4383845 DOI: 10.7497/j.issn.2095-3941.2014.0024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2014] [Accepted: 02/02/2015] [Indexed: 11/24/2022] Open
Abstract
Objective To study the main clinical and histopathological features of 12 patients with Hodgkin’s lymphoma (HL) diagnosed primarily from bone marrow (BM) involvement. Methods We included 12 acquired immunodeficiency syndrome (AIDS) patients with HL assisted in the F. J. Muñiz Infectious Diseases Hospital since January 2002 to December 2013. The diagnosis of HL with primary BM involvement in patients was confirmed by clinical, histopathological, and immunohistochemical findings. Results All patients presented “B” symptoms and pancytopenia. All of them had stage IV neoplasm disease because of BM infiltration. The median of CD4+ T-cell counts was 114 cells/μL, and mixed cellularity (MC) was the most frequent histopathological subtype of 92% cases. Conclusion When other causes are excluded, BM biopsy should be performed in AIDS patients with “B” symptoms and pancytopenia to evaluate BM infiltration by atypical lymphocytes.
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Affiliation(s)
- Marcelo Corti
- 1 HIV/AIDS Department, F. J. Muñiz Hospital, Buenos Aires 1406, Argentina ; 2 Hematology Unit, 3 Histopathology Laboratory, F. J. Muñiz Hospital, Buenos Aires 1429, Argentina ; 4 National Academy of Medicine, Histopathology Laboratory, Buenos Aires 1425, Argentina ; 5 Sociedad Iberoamericana de Informacion Cientifica, Scientific Coordination, Buenos Aires 1061, Argentina
| | - Maria Villafañe
- 1 HIV/AIDS Department, F. J. Muñiz Hospital, Buenos Aires 1406, Argentina ; 2 Hematology Unit, 3 Histopathology Laboratory, F. J. Muñiz Hospital, Buenos Aires 1429, Argentina ; 4 National Academy of Medicine, Histopathology Laboratory, Buenos Aires 1425, Argentina ; 5 Sociedad Iberoamericana de Informacion Cientifica, Scientific Coordination, Buenos Aires 1061, Argentina
| | - Gonzalo Minue
- 1 HIV/AIDS Department, F. J. Muñiz Hospital, Buenos Aires 1406, Argentina ; 2 Hematology Unit, 3 Histopathology Laboratory, F. J. Muñiz Hospital, Buenos Aires 1429, Argentina ; 4 National Academy of Medicine, Histopathology Laboratory, Buenos Aires 1425, Argentina ; 5 Sociedad Iberoamericana de Informacion Cientifica, Scientific Coordination, Buenos Aires 1061, Argentina
| | - Ana Campitelli
- 1 HIV/AIDS Department, F. J. Muñiz Hospital, Buenos Aires 1406, Argentina ; 2 Hematology Unit, 3 Histopathology Laboratory, F. J. Muñiz Hospital, Buenos Aires 1429, Argentina ; 4 National Academy of Medicine, Histopathology Laboratory, Buenos Aires 1425, Argentina ; 5 Sociedad Iberoamericana de Informacion Cientifica, Scientific Coordination, Buenos Aires 1061, Argentina
| | - Marina Narbaitz
- 1 HIV/AIDS Department, F. J. Muñiz Hospital, Buenos Aires 1406, Argentina ; 2 Hematology Unit, 3 Histopathology Laboratory, F. J. Muñiz Hospital, Buenos Aires 1429, Argentina ; 4 National Academy of Medicine, Histopathology Laboratory, Buenos Aires 1425, Argentina ; 5 Sociedad Iberoamericana de Informacion Cientifica, Scientific Coordination, Buenos Aires 1061, Argentina
| | - Leonardo Gilardi
- 1 HIV/AIDS Department, F. J. Muñiz Hospital, Buenos Aires 1406, Argentina ; 2 Hematology Unit, 3 Histopathology Laboratory, F. J. Muñiz Hospital, Buenos Aires 1429, Argentina ; 4 National Academy of Medicine, Histopathology Laboratory, Buenos Aires 1425, Argentina ; 5 Sociedad Iberoamericana de Informacion Cientifica, Scientific Coordination, Buenos Aires 1061, Argentina
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18
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Harris E, Butler JS, Cassidy N. Aggressive plasmablastic lymphoma of the thoracic spine presenting as acute spinal cord compression in a case of asymptomatic undiagnosed human immunodeficiency virus infection. Spine J 2014; 14:e1-5. [PMID: 24362000 DOI: 10.1016/j.spinee.2013.12.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2012] [Revised: 10/28/2013] [Accepted: 12/14/2013] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Plasmablastic lymphoma (PBL) is a rare aggressive variant of diffuse large B-cell lymphoma. PURPOSE We describe a rare case of an aggressive PBL presenting as acute spinal cord compression requiring thoracic decompression and fusion, in a case of previously undiagnosed human immunodeficiency virus (HIV) infection. STUDY DESIGN A case report. PATIENT SAMPLE A patient with PBL of the thoracic spine. OUTCOME MEASURES Preoperative magnetic resonance imaging, pathologic findings from the operative specimen, and serum HIV testing confirmed the diagnosis. METHODS We present the case of a 33-year-old Caucasian woman with a 10-day history of thoracic back pain and a 1-day history of sudden-onset bilateral lower limb weakness and paresthesia from below the level of the umbilicus (American Spinal Injury Association [ASIA] Grade C). Magnetic resonance imaging demonstrated an extradural mass extending from T3 to T6 within the left posterior canal, resulting in significant cord compression. A complete debulking of the tumor mass and an instrumented posterior thoracic fusion was performed. RESULTS Histopathologic examination of the specimen revealed tumor cells of PBL, and subsequent HIV testing was positive. She was treated with intravenous and intrathecal chemotherapy to prevent recurrence. Her lower limb neurologic status improved to ASIA Grade D over the subsequent 2 weeks. CONCLUSIONS We report the case of an aggressive PBL presenting as acute spinal cord compression requiring urgent surgical intervention, on a background of undiagnosed HIV infection.
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Affiliation(s)
- Ella Harris
- National Spinal Injuries Unit, Department of Trauma & Orthopaedic Surgery, Mater Misericordiae University Hospital, Eccles St, Dublin 7, Ireland.
| | - Joseph S Butler
- National Spinal Injuries Unit, Department of Trauma & Orthopaedic Surgery, Mater Misericordiae University Hospital, Eccles St, Dublin 7, Ireland
| | - Noelle Cassidy
- National Spinal Injuries Unit, Department of Trauma & Orthopaedic Surgery, Mater Misericordiae University Hospital, Eccles St, Dublin 7, Ireland
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Wayengera M, Kajumbula H, Byarugaba W. Harnessing pharmacogenomics to tackle resistance to the "nucleoside reverse trancripatse inhibitor" backbone of highly active antiretroviral therapy in resource limited settings. Open AIDS J 2008; 2:78-81. [PMID: 19274067 PMCID: PMC2627514 DOI: 10.2174/1874613600802010078] [Citation(s) in RCA: 4] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2008] [Revised: 08/28/2008] [Accepted: 08/29/2008] [Indexed: 11/22/2022] Open
Abstract
Background The sustainable use of HAART within the sub-Saharan and other developing world settings faces the emerging challenge of drug resistance. Nucleoside reverse transcriptase inhibitors (NRTI) form the backbone of HAART and preserving their “antiviral efficacy” is thus critical to sustainable HAART use. Methods A systematic review of the “mechanisms of evolution” of resistance to NRTI at the HIV genome level, and the phenotypic manifestations on drug pharmacokinetics was done. Conclusion This paper provides an evidence based account of how the knowledge of pharmacogenomics may be exploited to tackle NRTI resistance within limited resource.
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Affiliation(s)
- Misaki Wayengera
- Division of Human and Molecular Genetics-Dept of Pathology College of Health Sciences, Makerere University P.O. Box 7072, Kampala, Uganda.
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20
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Mohan Harjai M, Sharma R, Menon PK, Nagpal BM, Singh Y. SURGEON AND HIV INFECTION: Post Exposure Prophylaxis: Need of the hour. Med J Armed Forces India 2000; 56:328-31. [PMID: 28790754 DOI: 10.1016/S0377-1237(17)30221-6] [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: 11/23/2022] Open
Abstract
HIV infection in HCW is an occupational hazard requiring policy decisions by the health care administrators. In this article we have outlined a post exposure prophylaxis protocol following HIV exposure in HCWs. By determining the HIV status code of the source and the HIV exposure code of the HCWs, recommendations for PEP are forwarded. Occupational exposures should be considered urgent medical and surgical concerns to ensure timely administration of PEP. At the end, an algorithm is provided to guide exposed health-care workers in deciding when to consider PEP.
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