Abstract #1101: Severe Immunodeficiency at Disease Onset; Autoimmunity and Tuberculosis are the Best Predictors of Subclinical Hypothyroidism Among Indians with HIV Infection

2017 ◽  
Vol 23 ◽  
pp. 289
Author(s):  
Vineet Surana ◽  
Deep Dutta ◽  
Deepak Khandelwal ◽  
Rajiv Singla
Keyword(s):  
Hiv Infection ◽  
Subclinical Hypothyroidism ◽  
Disease Onset ◽  
Severe Immunodeficiency

scholarly journals Differential Diagnosis of Chorea—HIV Infection Delays Diagnosis of Huntington’s Disease by Years

2021 ◽  
Vol 11 (6) ◽  
pp. 710
Author(s):  
Jannis Achenbach ◽  
Simon Faissner ◽  
Carsten Saft
Keyword(s):  
Hiv Infection ◽  
Huntington's Disease ◽  
Huntington’S Disease ◽  
Disease Onset ◽  
Diagnostic Delay ◽  
Depression Scale ◽  
Cag Repeat ◽  
Psychiatric Disease ◽  
Disease Manifestation ◽  
Cross Sectional

Background: There is a broad range of potential differential diagnoses for chorea. Besides rare, inherited neurodegenerative diseases such as Huntington’s disease (HD) chorea can accompany basal ganglia disorders due to vasculitis or infections, e.g., with the human immunodeficiency virus (HIV). The clinical picture is complicated by the rare occurrence of HIV infection and HD. Methods: First, we present a case suffering simultaneously from HIV and HD (HIV/HD) focusing on clinical manifestation and disease onset. We investigated cross-sectional data regarding molecular genetic, motoric, cognitive, functional, and psychiatric disease manifestation of HIV/HD in comparison to motor-manifest HD patients without HIV infection (nonHIV/HD) in the largest cohort of HD patients worldwide using the registry study ENROLL-HD. Data were analyzed using ANCOVA analyses controlling for covariates of age and CAG repeat length between groups in IBM SPSS Statistics V.25. Results: The HD diagnosis in our case report was delayed by approximately nine years due to the false assumption that the HIV infection might have been the cause of chorea. Out of n = 21,116 participants in ENROLL-HD, we identified n = 10,125 motor-manifest HD patients. n = 23 male participants were classified as suffering from HIV infection as a comorbidity, compared to n = 4898 male non-HIV/HD patients. Except for age, with HIV/HD being significantly younger (p < 0.050), we observed no group differences regarding sociodemographic, genetic, educational, motoric, functional, and cognitive parameters. Male HIV/HD patients reported about a 5.3-year-earlier onset of HD symptoms noticed by themselves compared to non-HIV/HD (p < 0.050). Moreover, patients in the HIV/HD group had a longer diagnostic delay of 1.8 years between onset of symptoms and HD diagnosis and a longer time regarding assessment of first symptoms by the rater and judgement of the patient (all p < 0.050). Unexpectedly, HIV/HD patients showed less irritability in the Hospital Anxiety and Depression Scale (all p < 0.05). Conclusions: The HD diagnosis in HIV-infected male patients is secured with a diagnostic delay between first symptoms noticed by the patient and final diagnosis. Treating physicians therefore should be sensitized to think of potential alternative diagnoses in HIV-infected patients also afflicted by movement disorders, especially if there is evidence of subcortical atrophy and a history of hyperkinesia, even without a clear HD-family history. Those patients should be transferred for early genetic testing to avoid further unnecessary diagnostics and improve sociomedical care.

Early “Events” in Hiv Infection and Hiv-Associated Neoplasia

1999 ◽  
Vol 5 (S2) ◽  
pp. 1088-1089
Author(s):  
Herndier Brian
Keyword(s):  
Hiv Infection ◽  
Tissue Level ◽  
Hiv Disease ◽  
Research Focus ◽  
Retroviral Infection ◽  
Bodily Fluids ◽  
Hiv Epidemiology ◽  
Severe Immunodeficiency ◽  
Early Phases ◽  
Insight Into

The course of HIV infection necessarily involves the initial establishment of the virus in a receptive host environment. HIV disease involves active intracellular replication of the virus and spread of the virus from the initial compartment of the infection. Finally, from the virus’ perspective _ virions must enter a compartment suitable for eventual host-host transmission. In the vernacular of HIV epidemiology this implies some sort of “exchange of bodily fluids”.Recently, our research focus has been on tracking HIV during the early phases of infection. The goal is to piece together a full chronology of the disease at the tissue level. The emphasis will be on changes in lymphoid architecture that might ultimately be important in the pathogenesis of AIDS malignancies and offer insight into the dysfunctional aspects of immunity in the setting of retroviral infection. Because HIV disease often ultimately features a severe immunodeficiency, other pathogens by necessity play a role in shaping the “visible” immune response.

Pulmonary complications of HIV infection

2010 ◽  
pp. 3246-3253
Author(s):  
Mark J. Rosen
Keyword(s):  
General Population ◽  
Hiv Infection ◽  
Opportunistic Infection ◽  
Lymphocyte Count ◽  
Opportunistic Infections ◽  
Pulmonary Complications ◽  
Primary Determinant ◽  
Frequent Site ◽  
Severe Immunodeficiency ◽  
Cd4 Lymphocyte

The lung is a frequent site of opportunistic infection in patients with HIV infection, and noninfectious pulmonary disorders associated with HIV infection and antiretroviral treatments are increasingly common. The severity of immunocompromise, with CD4+ lymphocyte count the most reliable surrogate, is the primary determinant of the risk of developing specific pulmonary disorders: early in the course of HIV these are similar to those seen in the general population; opportunistic infections occur with severe immunodeficiency, but with frequency reduced by prophylaxis....

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

2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Neera Sharma ◽  
Lokesh Kumar Sharma ◽  
Deep Dutta ◽  
Adesh Kisanji Gadpayle ◽  
Atul Anand ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Immune Function ◽  
Highly Active Antiretroviral Therapy ◽  
Thyroid Dysfunction ◽  
Viral Infections ◽  
Disease Onset ◽  
Inverse Correlation ◽  
Cd4 Count ◽  
Highly Active

Background. Predictors of thyroid dysfunction in HIV are not well determined. This study aimed to determine the prevalence and predictors of thyroid dysfunction in HIV infected Indians.Methods. Consecutive HIV patients, 18–70 years of age, without any severe comorbid state, having at least 1-year follow-up at the antiretroviral therapy clinic, underwent clinical assessment and hormone assays.Results. From initially screened 527 patients, 359 patients (61.44±39.42months’ disease duration), having good immune function [CD4 count >200 cell/mm3: 90.25%; highly active antiretroviral therapy (HAART): 88.58%], were analyzed. Subclinical hypothyroidism (ScH) was the commonest thyroid dysfunction (14.76%) followed by sick euthyroid syndrome (SES) (5.29%) and isolated low TSH (3.1%). Anti-TPO antibody (TPOAb) was positive in 3.90%. Baseline CD4 count had inverse correlation with TPOAb after adjusting for age and body mass index. Stepwise linear regression revealed baseline CD4 count, TPOAb, and tuberculosis to be best predictors of ScH after adjusting for age, weight, duration of HIV, and history of opportunistic fungal and viral infections.Conclusion. Burden of thyroid dysfunction in chronic HIV infection with stable immune function is lower compared to pre-HAART era. Thyroid dysfunction is primarily of nonautoimmune origin, predominantly ScH. Severe immunodeficiency at disease onset, TPOAb positivity, and tuberculosis were best predictors of ScH.

scholarly journals Endotoxin in the pathogenesis of HIV infection

2020 ◽  
pp. 4-16
Author(s):  
Г.Р. Хасанова ◽  
В.А. Анохин ◽  
О.И. Биккинина ◽  
М.Ю. Яковлев
Keyword(s):  
Immune System ◽  
Hiv Infection ◽  
Disease Onset ◽  
Intestinal Wall ◽  
Infected People ◽  
Immune System Activation ◽  
Pathogenetic Therapy ◽  
Antibody Titers ◽  
Therapeutic Measures ◽  
Binding Antibody

Механизм прогрессирования иммуносупрессии при ВИЧ-инфекции не может быть сведен лишь к гибели CD4+ лимфоцитов вследствие репликации в них вируса. Полученные в результате многочисленных исследований данные свидетельствуют о важной роли избыточной активации иммунной системы в патогенезе заболевания. В качестве одного из факторов, поддерживающих активацию иммунной системы и развитие у ВИЧ-инфицированных разной степени проявлений системного воспалительного ответа, рассматривается эндотоксин (ЭТ) грамотрицательных бактерий. Роль эндотоксина в этом процессе подтверждается высокими показателями эндотоксина и растворимого рецептора CD14 в крови, а также изменениями уровня эндотоксин-связывающих антител у большей части больных с ВИЧ-инфекцией, находящихся на разных стадиях заболевания. Поступлению избыточных количеств эндотоксина в кровоток способствует повреждение кишечной стенки, характерное для течения ВИЧ-инфекции с самого начала заболевания, наблюдающееся в течение всей жизни пациента, и не купирующееся полностью на фоне антиретровирусной терапии (АРВТ). Определенный вклад в микробную транслокацию могут вносить и нарушения микробиоценоза кишечника, так же весьма характерные для течения ВИЧ-инфекции. Продолжение исследований в данном направлении позволит разработать методы патогенетической терапии, которые в сочетании с АРВТ смогут повысить эффективность лечебных мероприятий и увеличить продолжительность жизни пациентов. The mechanism of immunosuppression progression in HIV infection cannot be reduced only to destruction of CD4+ lymphocytes due to the virus replication. Multiple studies have stressed an important role of immune system overactivation in the pathogenesis of the disease. Endotoxin of gram-negative bacteria is considered as one of the factors supporting the immune system activation and manifestations of the systemic inflammatory response of different severity in HIV-infected people. This fact is confirmed by high levels of endotoxin and soluble CD14 receptor as well as by changes in endotoxin-binding antibody titers in a vast majority of patients with HIV infection at different stages of the disease. Excessive amounts of endotoxin release into the blood due to damage of the intestinal wall, which is typical for the course of HIV infection from the disease onset throughout the patient’s life and cannot be completely reversed by antiretroviral therapy (ART). Disorders of the intestinal microbiocenosis, which are also very typical for the HIV infection, can also contribute to the microbial translocation. Further studies in this direction will allow developing methods for pathogenetic therapy, which in combination with ART would increase the effectiveness of therapeutic measures and prolong the life expectancy of patients.

Particular clinical presentations of psoriasis in HIV patients

2011 ◽  
Vol 22 (11) ◽  
pp. 653-654 ◽  
Author(s):  
S Fernandes ◽  
G M Pinto ◽  
J Cardoso
Keyword(s):  
Hiv Infection ◽  
Metabolic Disorders ◽  
Psoriasis Vulgaris ◽  
Clinical Spectrum ◽  
Palmoplantar Keratoderma ◽  
Hiv Patients ◽  
Clinical Presentations ◽  
Severe Immunodeficiency ◽  
Scalp Lesions ◽  
Frequent Reason

Patients with HIV infection have a higher propensity for infectious, inflammatory, neoplastic and metabolic disorders. The link with psoriasis vulgaris is explained by well-known pathophysiological phenomena and can be observed at any stage of infection. The aim of our study was to characterize the clinical spectrum of psoriasis in a group of 50 patients with HIV. Our findings showed particular clinical presentations of psoriasis in those patients, suggesting a predilection for scalp lesions, palmoplantar keratoderma and flexural involvement, as well as a trend towards severe immunodeficiency. Psoriasis, a frequent reason for consultation, allows earlier suspicion and diagnosis of HIV in the presence of these particular patterns.

THE COURSE OF A COMBINATION OF HIV INFECTION, TUBERCULOSIS, KAPOSI'S SARCOMA IN A PATIENT WHO ARRIVED FROM THE PENITENTIARY SYSTEM (CLINICAL CASE)

2020 ◽  
pp. 72-77
Author(s):  
Pshenichnikova I.M. ◽  
Cgoeva E.A. ◽  
Hikmatullina I.M.
Keyword(s):  
Hiv Infection ◽  
Social Factors ◽  
Kaposi's Sarcoma ◽  
Clinical Case ◽  
Fatal Outcome ◽  
Kaposi’S Sarcoma ◽  
Hiv And Aids ◽  
Aids Epidemic ◽  
Severe Immunodeficiency ◽  
The Moment

The article discusses the problems of polymorbidity in HIV infection, the causes of the unfavorable course of combined diseases, and the influence of social factors on the outcome of diseases. An epidemic variant of Kaposi's sarcoma develops against the background of immunosuppression and is a clinical marker of AIDS. In the first years of the pandemic, it occurred in every third patient and was one of the most common AIDS indicator diseases. In recent years of the HIV and AIDS epidemic, the incidence of Kaposi's sarcoma has decreased by more than 10 times. The course of HIV-associated Kaposi's sarcoma can vary, from long-term stable, lasting for years, to progressive, leading to the patient's death in a few months. The introduction of ARV therapy into practice has also changed the clinical course of Kaposi's sarcoma, its forms with aggressive malignant course are now rare. However, they do occur. A clinical case of a combination of HIV infection, tuberculosis, Kaposi's sarcoma in a patient who arrived from the penitentiary system is presented. It is emphasized that social status and social maladaptation, including stay in prison, has a significant impact on the outcome of combined pathology, along with other aggravating factors. In a patient who has previously had tuberculosis, from the moment of HIV detection to the manifestation of Kaposi's sarcoma, 4 years passed, from the appearance of the first signs of Kaposi's sarcoma to the fatal outcome – 4 months. The clinical case demonstrates the difficulties of differential diagnosis of disseminated pulmonary tuberculosis with Kaposi's sarcoma in a patient with severe immunodeficiency due to HIV; and reflects the influence of social factors on the rapidly progressive course of the combined pathology.

scholarly journals Lepromatous Leprosy and Human Immunodeficiency Virus: A Rare Co-infection

2019 ◽  
Vol 53 (2) ◽  
Author(s):  
Marie Len A. Camaclang ◽  
Eileen Liesl A. Cubillan
Keyword(s):  
Human Immunodeficiency Virus ◽  
Hiv Infection ◽  
Immune Reconstitution ◽  
Clinical Presentation ◽  
Lepromatous Leprosy ◽  
Immunodeficiency Virus ◽  
Atypical Clinical Presentation ◽  
History Of ◽  
Severe Immunodeficiency ◽  
Immunological Recovery

We report a 23-year-old male with lepromatous leprosy atypically presenting with 5-year history of asymptomatic, verrucous papules, and nodules. Human Immunodeficiency Virus (HIV) testing was positive with depressed CD4 count. In HIV/leprosy co-infection, most of the documented patients were diagnosed with paucibacillary leprosy as immune reconstitution disease (IRD) from treatment-induced immunological recovery. Rarely, multibacillary lepromatous leprosy is encountered in the setting of untreated, severe immunodeficiency. Atypical clinical presentation warrants investigation for concurrent HIV infection.

scholarly journals A Case Report of HIV-Related Bilateral Inflammatory Myofibroblastic Tumors of Adrenal Gland

2021 ◽  
Author(s):  
Mengmeng Zhang ◽  
Hui Liu ◽  
Zhiqiang Zhu ◽  
Yu Zhang ◽  
Yanyan Zhang
Keyword(s):  
Adrenal Gland ◽  
Hiv Infection ◽  
Highly Active Antiretroviral Therapy ◽  
Inflammatory Infiltration ◽  
Ct Guided ◽  
Highly Active ◽  
First Case ◽  
Inflammatory Myofibroblastic Tumors ◽  
Adrenal Masses ◽  
Severe Immunodeficiency

Abstract Inflammatory myofibroblastic tumor (IMT) is a rare disease which mostly occurs at younger age and locates in lung in general population. We report a rare case of 44-year-old man diagnosed adrenal IMT with HIV infection, who refused regular highly active antiretroviral therapy (HAART) 13 years ago until in hospital because of findings of adrenal masses. The patient underwent CT-guided needle biopsy successfully, and the pathological analysis documented the diagnosis of IMT by the feature of proliferation of fibroblastic-myofibroblastic with inflammatory infiltration. We failed to perform tumor complete resection due to diffuse invasion of tumor under laparoscope. The patient was complicated with severely multiple pulmonary infection post to surgery because of immunodeficiency, that eventually caused the death of patient 2 months later. This case reminds us that IMTs may be too aggressive and progressed in HIV-positive patients with irregular HAART to perform surgical resections, and severe immunodeficiency can be more fatal. To our knowledge, this case is the second IMT patient with HIV infection worldwide, but the first case occurs at adrenal gland rather than lung in adult.

scholarly journals Modern possibilities of diagnostics of tuberculosis in patients with HIV infection

2021 ◽  
Vol 69 (1) ◽  
Author(s):  
Alyona Kuznetsova ◽  
◽  
Elena Borodulina ◽  
Keyword(s):  
Hiv Infection ◽  
Positive Result ◽  
Screening Method ◽  
Latent Tuberculosis ◽  
Hiv Infections ◽  
Tuberculosis Infection ◽  
Steady Growth ◽  
Severe Immunodeficiency ◽  
Diagnostic Complex

The problem of the steady growth of HIV-associated tuberculosis has become increasingly urgent in recent years in Russia. Diagnosis of tuberculosis is particularly difficult at the stage of severe immunodeficiency. Objective. to evaluate the effectiveness of the T-SPOT ® method.TB in the diagnosis of tuberculosis infection in patients with HIV infection. Materials and methods. in the period for 2019-2020, the T-SPOT®.TB results were analyzed in 396 patients. The criteria for inclusion in this study were the age of 18 years and older, the diagnosis of HIV infection, follow-up at the AIDS center. Results. in the group with a positive T-SPOT®.TB and changes on the computed tomogram, the verified diagnosis of tuberculosis was 90.7% of the group with both signs and 75.5% of those with a positive result T-SPOT®.TB. The group with a positive result T-SPOT®.TB and no changes on the CT scan is 16.8% of those with a positive result T-SPOT®.TB,such patients were diagnosed with „latent tuberculosis infection”. Conclusion. T-SPOT®.TB can be used in the diagnostic complex of monitoring patients with HIV infections — as a screening method that allows not only to verify the diagnosis, but also to detect latent tuberculosis.

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