scholarly journals Longitudinal Changes in Spirometry in South African Adolescents Perinatally Infected With Human Immunodeficiency Virus Who Are Receiving Antiretroviral Therapy

2019 ◽  
Vol 70 (3) ◽  
pp. 483-490 ◽  
Author(s):  
Leah N Githinji ◽  
Diane M Gray ◽  
Sipho Hlengwa ◽  
Landon Myer ◽  
Takwanisa Machemedze ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Antiretroviral Therapy ◽  
Lung Function ◽  
Highly Active Antiretroviral Therapy ◽  
Forced Expiratory Volume ◽  
Limited Information ◽  
Hiv Viral Load ◽  
Mixed Effect ◽  
Longitudinal Changes ◽  
Immunodeficiency Virus

Abstract Background Despite increased access to highly active antiretroviral therapy (HAART), lung disease remains common in human immunodeficiency virus (HIV)–infected (HIV+) adolescents. There is limited information on changes in lung function over time in perinatally HIV+ adolescents on HAART. The objective was to investigate the progression of spirometry findings over 2 years in HIV+ adolescents on HAART in a prospective cohort, the Cape Town Adolescent Antiretroviral Cohort (CTAAC). Methods HIV+ adolescents aged 9–14 years, with at least 6 months of HAART, and a comparator group of healthy HIV-uninfected (HIV–), age-matched controls were enrolled in CTAAC. Spirometry and bronchodilator testing were done at baseline, 12 months, and 24 months. Mixed-effect models were used to compute longitudinal changes in lung function. Results Five hundred fifteen HIV+ adolescents, mean age 12 (standard deviation [SD], 1.6) years, 50.4% male, and 110 HIV– adolescents, mean age 11.8 (SD, 1.8) years, 45.6% male, were tested at baseline; 477 (93%) HIV+ and 102 (93%) HIV– adolescents at 12 months; and 473 (92%) HIV+ and 97 (88%) HIV– adolescents at 24 months. Only 5.4% of the HIV+ adolescents had HIV viral load >10 000 copies/mL at baseline. Forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) were lower in the HIV+ compared to the HIV– adolescents and tracked with no deterioration or catch-up over 2 years. Previous pulmonary tuberculosis (PTB) or lower respiratory tract infection (LRTI) was significantly associated with reduced FEV1 and FVC (P < .05 for both). Conclusions HIV+ adolescents had lower lung function over 2 years than HIV– adolescents. This study highlights the need for lung function surveillance and prevention of LRTIs and PTB in HIV+ adolescents.

scholarly journals Remission of progressive multifocal leukoencephalopathy in HIV- positive patient after multidisciplinary rehabilitation: a case report

2020 ◽  
pp. 74-79
Author(s):  
Elena DUMEA ◽  
Raluca MIHAI ◽  
Mihaela MAVRODIN ◽  
Gabriela DOGARU ◽  
PASCU Corina
Keyword(s):  
Human Immunodeficiency Virus ◽  
Antiretroviral Therapy ◽  
Progressive Multifocal Leukoencephalopathy ◽  
Highly Active Antiretroviral Therapy ◽  
Jc Virus ◽  
Hiv Positive ◽  
Hiv Viral Load ◽  
Multidisciplinary Rehabilitation ◽  
Truncal Ataxia ◽  
Immunodeficiency Virus

Introduction: One of the most common neurologic disease in Acquired Immunodeficiency Syndrome (AIDS) caused by Human Immunodeficiency Virus (HIV) is represented by progressive multifocal leukoencephalopathy (PML), being caused by John Cunningham (JC) polyoma virus. Case presentation: We report a case of a 27 years old women, HIV-positive since childhood, under specific antiretroviral therapy with good adherence to it in that period but starting with adolescence adherence to highly active antiretroviral therapy (HAART) decreased. In this context her HIV viral load increased to a 690.000 copies/ml, and CD4 collapsed at 57 cells/mmc. She presented in our clinic with ataxic left hemiparesis, truncal ataxia and left hemi-hypoesthesia. Cerebrospinal fluid (CSF) showed a slightly pleocytosis and polymerase chain reaction performed from CSF diagnosed John Cunningham (JC) virus. Once diagnosis established, we reinitiated HAART, but some neurologic disorders persisted like difficulty of the left upper member, having the modified Rankin scale (mRS) of 5. The patient started a multidisciplinary rehabilitation (MDR) treatment, specifically adapted. It consisted of 4 sessions of neuromotor treatments, 20 sessions of massages, and 12 sessions of occupational therapy. According to MDR, the patient improved the ataxic walking, without support, presenting an improvement mRS of 3. Conclusions: AIDS patients with PML could require a prolonged MDR treatment for neurological disorders and rehabilitation treatment promptly should be applied when such diagnosis is suspected. Key words: progressive multifocal leukoencephalopathy, human immunodeficiency virus, neurological disorder, multidisciplinary rehabilitation,

scholarly journals Highly Active Antiretroviral Therapy Normalizes the Function of Progenitor Cells in Human Immunodeficiency Virus–Infected Patients

1998 ◽  
Vol 178 (5) ◽  
pp. 1299-1305 ◽  
Author(s):  
Susanne Dam Nielsen ◽  
Annette Kjær Ersbøll ◽  
Lars Mathiesen ◽  
Jens Ole Nielsen ◽  
John‐Erik Stig Hansen
Keyword(s):  
Human Immunodeficiency Virus ◽  
Antiretroviral Therapy ◽  
Progenitor Cells ◽  
Highly Active Antiretroviral Therapy ◽  
Highly Active ◽  
Immunodeficiency Virus

scholarly journals Highly Active Antiretroviral Therapy in Human Immunodeficiency Virus Type 1-Infected Children: Analysis of Cellular Immune Responses

2001 ◽  
Vol 8 (5) ◽  
pp. 943-948 ◽  
Author(s):  
Vesna Blazevic ◽  
Shirley Jankelevich ◽  
Seth M. Steinberg ◽  
Freda Jacobsen ◽  
Robert Yarchoan ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
T Cell ◽  
Antiretroviral Therapy ◽  
Highly Active Antiretroviral Therapy ◽  
Delayed Type Hypersensitivity ◽  
Strong Increase ◽  
Highly Active ◽  
Cell Counts ◽  
Immunodeficiency Virus

ABSTRACT The present study analyzes the effect of highly active antiretroviral therapy (HAART) on restoration of cellular immunity in human immunodeficiency virus (HIV)-infected children over a 24-week period following initiation of HAART with ritonavir, nevirapine, and stavudine. The immunological parameters evaluated at four time points (at enrollment and at 4, 12, and 24 weeks of therapy) included cytokine production by monocytes as well as T-cell proliferation in response to mitogen, alloantigen, and recall antigens including HIV type 1 envelope peptides. Circulating levels of interleukin-16 (IL-16) were measured, in addition to CD4+ T-cell counts, plasma HIV RNA levels, and the delayed-type hypersensitivity (DTH) response. At enrollment the children exhibited defects in several immune parameters measured. Therapy increased CD4+ T-cell counts and decreased viral loads significantly. By contrast, the only immunological parameter that was significantly increased was IL-12 p70 production by monocytes; the DTH response to Candida albicans also showed a strong increase in patients becoming positive. In conclusion, these results demonstrate that HAART in HIV-infected children affects the dynamics of HIV replication and the CD4+ T-cell count over 24 weeks, similar to the pattern seen in HIV-infected adults. Furthermore, these data indicate improvement in antigen-presenting cell immunological function in HIV-infected children induced by HAART.

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