HIV Infection with Immunodeficiency Presenting with Subacute Cognitive Decline: Recent Illustrative Cases

CNS Spectrums ◽  
2007 ◽  
Vol 12 (11) ◽  
pp. 842-850 ◽  
Author(s):  
Daniel Costello ◽  
John Davis ◽  
Nagagopal Venna
Keyword(s):  
Hiv Infection ◽  
Opportunistic Infections ◽  
Brain Magnetic Resonance Imaging ◽  
Mental States ◽  
Neurological Deficits ◽  
Progressive Encephalopathy ◽  
Antiretroviral Drug ◽  
Immunodeficiency Virus ◽  
Systemic Symptoms ◽  
Work Up

ABSTRACTWe describe three recent patients in whom evaluation of subacute, progressive encephalopathy led to the initial diagnosis of human immunodeficiency virus infection. The clinical neurological picture of a predominance of abnormalities of mental function with few elementary neurological deficits, in conjunction with a paucity of systemic symptoms and lack of evidence for prior opportunistic infections preceding the encephalopathy are notable. The cognitive, behavioral, and neuropsychiatric disturbances are described in detail to illustrate the range of manifestations of disordered mental states associated with encephalopathy in individuals with HIV infection. The importance of a comprehensive and broad-minded work-up by brain magnetic resonance imaging, cerebrospinal fluid examination, and specific microbiological tests in delineating the potential multifactorial pathogenesis of the cerebral syndromes in relation to the HIV infection is emphasized. The gratifying long-term clinical improvements in parallel with resolution of neuroimaging and other laboratory abnormalities in response, to antiretroviral drug treatment are reported.

Unrecognised Human Immunodeficiency Virus Patients in an Emergency Department in Hong Kong: A Report of Four Cases

2005 ◽  
Vol 12 (3) ◽  
pp. 168-177
Author(s):  
KL Mok ◽  
PG Kan
Keyword(s):  
Emergency Department ◽  
Human Immunodeficiency Virus ◽  
Hong Kong ◽  
Hiv Infection ◽  
Opportunistic Infections ◽  
Hiv Patients ◽  
Accident And Emergency ◽  
Immunodeficiency Virus ◽  
High Index Of Suspicion ◽  
Immunodeficiency Syndrome

Human immunodeficiency virus (HIV) causes breakdown of the immune system and predisposes patients to various opportunistic infections and neoplasms. However, many patients may not be aware of the HIV infection before the development of their first HIV related complications. We reported four unrecognised HIV patients presenting to our accident and emergency department with common complications of HIV infection and the acquired immunodeficiency syndrome (AIDS). Although not as common as in America, emergency physicians in Hong Kong still have to take care of patients with unknown HIV status. The common presentations of HIV patients will be discussed. A high index of suspicion and knowledge of common HIV/AIDS complications are required for managing these patients.

Human immunodeficiency virus (HIV) infection

2011 ◽  
pp. 663-669
Keyword(s):  
Human Immunodeficiency Virus ◽  
Hiv Infection ◽  
Opportunistic Infections ◽  
Tissue Loss ◽  
Atherosclerotic Cardiovascular Disease ◽  
Hiv Disease ◽  
Hiv Replication ◽  
Pharmacological Management ◽  
Nutritional Conditions ◽  
Immunodeficiency Virus

Introduction, nutritional goals, and assessment 664 Unintentional weight and lean tissue loss 666 Cardiovascular risk and complications associated with HIV disease and treatment 667 Additional dietary issues 668 Untreated human immunodeficiency virus (HIV) infection leads to progressive suppression of immune function, eventually rendering the body susceptible to opportunistic infections and tumours. While there is no cure, antiretroviral therapy (ART) is highly effective in suppressing HIV replication. HIV disease is now a chronic condition and causes of death in this population have shifted from traditional AIDS-related illnesses to non-AIDS (Acquired Immune Deficiency Syndrome) events, the most common being atherosclerotic cardiovascular disease, liver disease, end-stage renal disease and non-AIDS–defining malignancies. There are a diverse range of nutritional conditions associated with HIV, reflecting the complexity of the disease and pharmacological management....

The HNRC 500-Neuropsychology of Hiv infection at different disease stages

1995 ◽  
Vol 1 (3) ◽  
pp. 231-251 ◽  
Author(s):  
Robert K. Heaton ◽  
Igor Grant ◽  
Nelson Butters ◽  
Desireé A. White ◽  
Donald Kirson ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Brain Magnetic Resonance Imaging ◽  
Speed Of Information Processing ◽  
Immunodeficiency Virus ◽  
The Central Nervous System ◽  
Asymptomatic Stage ◽  
Magnetic Resonance Imaging Mri ◽  
Cellular Immune ◽  
Disease Stages

AbstractThe present study examined neuropsychological (NP) functioning and associated medical, neurological, brain magnetic resonance imaging (MRI), and psychiatric findings in 389 nondemented males infected with Human Immunodeficiency Virus-Type 1 (HIV-1), and in 111 uninfected controls. Using a comprehensive NP test battery, we found increased rates of impairment at each successive stage of HIV infection. HIV-related NP impairment was generally mild, especially in the medically asymptomatic stage of infection, and most often affected attention, speed of information processing, and learning efficiency; this pattern is consistent with earliest involvement of subcortical or frontostriatal brain systems. NP impairment could not be explained on the bases of mood disturbance, recreational drug or alcohol use, or constitutional symptoms; by contrast, impairment in HIV-infected subjects was related to central brain atrophy on MRI, as well as to evidence of cellular immune activation and neurological abnormalities linked to the central nervous system. (JINS, 1995, 1, 231–251.)

scholarly journals Co-infection by Cryptococcus neoformans fungaemia and Non tuberculous Mycobacterium together with Pneumocystis jiroveci pneumonia in a patient with newly diagnosed HIV infection

2021 ◽  
Author(s):  
Eihab Subahi ◽  
safwan aljafar ◽  
haidar barjas ◽  
Mohamed Abdelrazek ◽  
Fatima Rasoul
Keyword(s):  
Human Immunodeficiency Virus ◽  
Hiv Infection ◽  
Cryptococcus Neoformans ◽  
Opportunistic Infections ◽  
Newly Diagnosed ◽  
Aids Patients ◽  
Pneumocystis Jiroveci ◽  
Pneumocystis Jiroveci Pneumonia ◽  
Immunodeficiency Virus

Opportunistic infections are common in human immunodeficiency virus (HIV)-infected patients. Co-infections with Cryptococcus neoformans together with Mycobacterium and Pneumocystis jiroveci pneumonia (PCP) are rare, and typically occur in immunocompromised individuals, particularly AIDS patients.

scholarly journals Trends in Mortality From Human Immunodeficiency Virus Infection, 1984–2016: An Autopsy-Based Study

2019 ◽  
Vol 144 (5) ◽  
pp. 572-579 ◽  
Author(s):  
Sobia Nizami ◽  
Cameron Morales ◽  
Kelly Hu ◽  
Robert Holzman ◽  
Amy Rapkiewicz
Keyword(s):  
New York ◽  
Human Immunodeficiency Virus ◽  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Highly Active Antiretroviral Therapy ◽  
Opportunistic Infections ◽  
City Hospital ◽  
Aids Epidemic ◽  
Highly Active ◽  
Immunodeficiency Virus

Context.— With increasing use and efficacy of antiretroviral therapy for human immunodeficiency virus (HIV) infection, deaths from acquired immunodeficiency syndrome (AIDS)–defining conditions have decreased. Objective.— To examine trends in the cause of death of HIV-infected patients who underwent autopsy at a major New York City hospital from 1984 to 2016, a period including the major epochs of the AIDS epidemic. Design.— Retrospective review of autopsy records and charts with modeling of trends by logistic regression using polynomial models. Results.— We identified 252 autopsies in adult patients with AIDS (by 1982 definition) or HIV infection. Prior to widespread use of highly active antiretroviral therapy, in 1984–1995, on average 13 autopsies per year were done. Post–highly active antiretroviral therapy, the average number of autopsies declined to 4.5 per year. The fitted mean age at death was 35 years in 1984 and increased curvilinearly to 46 years (95% CI, 43–49) in 2016 (P < .001). By regression analysis, mean CD4+ T-cell count increased from 6 in 1992 to 64 in 2016 (P = .01). The proportion of AIDS-defining opportunistic infections decreased, from 79% in 1984–1987 to 41% in 2008–2011 and 29% in 2012–2016 (P = .04). The frequency of nonopportunistic infections, however, increased from 37% in 1984–1987 to 73% in 2008–2011 and 57% in 2012–2016 (P = .001). The frequency of AIDS-defining and other malignancies did not change significantly during the study period. The prevalence of atherosclerosis at autopsy rose dramatically, from 21% in 1988–1991 to 54% in 2008–2011 (P < .001). Conclusions.— Despite limitations of autopsy studies, many trends in the evolution of the HIV/AIDS epidemic are readily discernable.

scholarly journals Markers predicting progression of human immunodeficiency virus-related disease.

1994 ◽  
Vol 7 (1) ◽  
pp. 14-28 ◽  
Author(s):  
C M Tsoukas ◽  
N F Bernard
Keyword(s):  
Human Immunodeficiency Virus ◽  
Immune System ◽  
Hiv Infection ◽  
Disease Progression ◽  
Opportunistic Infections ◽  
Surrogate Marker ◽  
Disease Process ◽  
Surrogate Markers ◽  
Hiv Disease ◽  
Immunodeficiency Virus

Human immunodeficiency virus (HIV) interacts with the immune system throughout the course of infection. For most of the disease process, HIV activates the immune system, and the degree of activation can be assessed by measuring serum levels of molecules such as beta 2-microglobulin and neopterin, as well as other serum and cell surface phenotype markers. The levels of some of these markers correlate with clinical progression of HIV disease, and these markers may be useful as surrogate markers for development of clinical AIDS. Because the likelihood and timing of development of clinical AIDS following seroconversion, for any particular individual, are not readily predictable, the use of nonclinical disease markers has become critically important to patient management. Surrogate markers of HIV infection are, by definition, measurable traits that correlate with disease progression. An ideal marker should identify patients at highest risk of disease progression, provide information on how long an individual has been infected, help in staging HIV disease, predict development of opportunistic infections associated with AIDS, monitor the therapeutic efficacy of immunomodulating or antiviral treatments, and the easily quantifiable, reliable, clinically available, and affordable. This review examines the current state of knowledge and the role of surrogate markers in the natural history and treatment of HIV infection. The clinical usefulness of each marker is assessed with respect to the criteria outlined for the ideal surrogate marker for HIV disease progression.

HIV-vacuolar myelopathy: an unusual early presentation in HIV

2020 ◽  
pp. 095646242093378
Author(s):  
Jacob Leffert ◽  
Rangarajan Purushothaman ◽  
George Koshy Vilanilam ◽  
Marc Stanley ◽  
Atul Kothari
Keyword(s):  
Human Immunodeficiency Virus ◽  
Hiv Infection ◽  
Rare Case ◽  
Late Presentation ◽  
Neurological Deficits ◽  
Newly Diagnosed ◽  
Early Presentation ◽  
Immunodeficiency Virus ◽  
Vacuolar Myelopathy ◽  
High Index Of Suspicion

Human immunodeficiency virus (HIV)-vacuolar myelopathy is a late presentation of HIV infection and rarely the presenting symptom. Treatment of HIV-vacuolar myelopathy involves anti-retroviral therapy, but neurological deficits are devastating if diagnosis is delayed. We present a rare case of a patient who presented with HIV-vacuolar myelopathy as the initial presentation in a case of newly diagnosed HIV. The case emphasizes the importance of a high index of suspicion and diagnosis for better outcomes in HIV-vacuolar myelopathy.

scholarly journals Progress in the Prevention and Treatment of AIDS Associated with Tuberculosis

2016 ◽  
Vol 5 (2) ◽  
pp. 44-49 ◽  
Author(s):  
Wenlong He ◽  
Rui Li ◽  
Yaogang Wang
Keyword(s):  
Hiv Infection ◽  
Opportunistic Infections ◽  
Epidemiological Studies ◽  
Public Health Care ◽  
Rapid Progression ◽  
The Public ◽  
Immunodeficiency Virus ◽  
Latent Tb ◽  
Latent Tb Infection ◽  
And Control

AbstractEpidemiological studies have shown that infection with the human immunodeficiency virus (HIV) is an influential risk factor for infection withMycobacterium tuberculosis(MTb), the rapid progression of the initial infection to active tuberculosis (TB), and the reactivation of latent TB infection. MTb infection is also one of the most common opportunistic infections in people with HIV, including AIDS patients receiving anti-retroviral therapy. Given the prevalence of HIV infection, the incidence of TB infection, which had begun to decline, is facing a severe situation. HIV associated with TB exerts an immense burden on the public health-care system, especially in countries with high incidences of HIV infection. Therefore, the global policies for the prevention and control of TB should be revised. Moreover, an increased investment in TB control has to be guaranteed. The purpose of this review is to summarize the recent progress in the prevention, treatment, and control of HIV and TB co-infection.

scholarly journals Modern Solutions in the Treatment of HIV: From Antiretroviral Drug Therapy to Human Genome Editing

2021 ◽  
pp. 159-169
Author(s):  
Milana Ruslanovna Sebaeva ◽  
Iman Vladimirovna Gelogaeva ◽  
Naida Ramizovna Suleymanova ◽  
Kamila Umarovna Balaeva ◽  
Aishat Arslanovna Dauletova ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Sharp Decrease ◽  
Viral Diseases ◽  
Adequate Treatment ◽  
Antiretroviral Drug ◽  
Short Period ◽  
Immunodeficiency Virus ◽  
Acquired Immunodeficiency ◽  
Pathogenic Microbes ◽  
Immunodeficiency Syndrome

The human immunodeficiency virus (HIV) belongs to a group of anthroponotic viral diseases that cause HIV infection in the human body, apotheosely transforming into acquired immunodeficiency syndrome (AIDS). HIV infection, in people without adequate treatment, can lead to serious damage to the immune system (hereinafter referred to as IS), which leads to a sharp decrease in resistance to conditionally pathogenic microbes, as well as to the prevalence of oncological pathologies that may lead to death. Due to its simplicity, convenience, efficiency and cost-effectiveness, CRISPR/Cas has found application in a short period of time in a wide variety of fields of fundamental and applied medicine and biotechnology.

scholarly journals Prevalence aetiology and clinical spectrum of abnormal adrenal functions in human immunodeficiency virus infection

2019 ◽  
Vol 6 (03) ◽  
pp. 4384-4389
Author(s):  
Ajay Nathan ◽  
KS Brar ◽  
Arun K Valsan ◽  
Nimitha K Mohan ◽  
Gautam Singh
Keyword(s):  
Human Immunodeficiency Virus ◽  
Virus Infection ◽  
Human Immunodeficiency Virus Infection ◽  
Hiv Infection ◽  
Opportunistic Infections ◽  
Early Stage ◽  
Statistical Tests ◽  
Clinical Spectrum ◽  
Response To Treatment ◽  
Immunodeficiency Virus

Aim: To find Prevalence, Aetiology and Clinical Spectrum of abnormal adrenal functions in Human Immunodeficiency Virus infection. To diagnose and treat adrenal dysfunction in various stages of HIV infection and see the response to treatment if required. Material & Methods: 100 patients with HIV infection being admitted to our hospital was evaluated for abnormal adreno cortical functions. Immune dysfunction was assessed with CD4 count. Statistical tests (chi squared test) were applied to the collected data to find out any significant correlations. Results: The overall prevalence of adrenocortical abnormalities in HIV positive patients was 14% which included hypocortisolemia in 3% and hypercortisolemia in 11% of patients. Frequency of hypocortisolemia was significantly associated with presence of HIV infection with opportunistic infections and low CD4 counts (less than 50cells). In patients having hypercortisolemia, ONDST (Over night dexamethasone suppression test) was done and it showed reduction of serum cortisol to expected level (suppressed to <1.8 mcg/dl). Adjustment disorders and drugs mainly efavirnz more than nevirapine was incriminated in the same. Conclusion: HPA axis dysfunction is frequently encountered in HIV infected patients. The commonest dysfunction was hypercortisolemia probably due to elevated cytokines. Hypercortisolemia is a feature of early stage HIV infection. The likelihood of adrenal insufficiency increases as the disease advances and patient enters a more immunocompromised state. Hypocortisolemia should be treated regardless of the existence of associated symptoms. Hypercortisolemia in the absence of features of Cushing’s syndrome is common and should not promote treatment or specific studies.

Sign in / Sign up

Export Citation Format

Share Document