scholarly journals 354. The Epidemiology and Clinical Features of Acanthamoeba Disease in the United States, 1956–2018

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S246-S246
Author(s):  
Kevin O’Laughlin ◽  
Jennifer R Cope ◽  
Zachary A Marsh
Keyword(s):  
United States ◽  
Case Reports ◽  
The United States ◽  
Severe Illness ◽  
People Living With Hiv ◽  
Cutaneous Lesions ◽  
Free Living ◽  
Organ Systems ◽  
Free Living Ameba ◽  
Soil And Water

Abstract Background Acanthamoeba is a free-living ameba found worldwide in soil and water that can cause severe illness. Transmission is thought to be through the skin, eyes, or lungs; Acanthamoeba can cause disseminated infection (Acanthamoeba disease) in addition to the more widely recognized Acanthamoeba keratitis. Infections however are rare, and only case reports or small case series have been published. We review Acanthamoeba disease cases from the Centers for Disease Control and Prevention (CDC) free-living ameba registry to characterize the disease in the United States. Methods CDC maintains a free-living ameba (FLA) registry of laboratory-confirmed Acanthamoeba cases (excluding keratitis) sourced from published case reports, CDC case report forms, and CDC laboratory results. SAS© version 9.4 software was used to calculate descriptive statistics and frequencies. Results We identified 163 cases of Acanthamoeba disease between 1956 and 2018. Of cases with documented outcome, 85% were fatal (105/124). Most (88%) cases were in patients who were immunocompromised (136/155): 66 people living with HIV (of whom 49 were classified as having AIDS); 33 recipients of organ transplantation; 30 people diagnosed with malignancy. The most common manifestation of disease was encephalitis (49%). Other clinical presentations included cutaneous lesions (20%) and rhinosinusitis (6%); 40 cases involved multiple organ systems. Median patient age was 42 years (range 0–83 years). Males accounted for 71% (114/160) of cases. California (29) and Texas (14) had the most case reports; 30 other states reported cases. The source of exposure was unknown in most cases (75%); soil and water were documented in 14 and 17 cases, respectively. Conclusion Acanthamoeba disease in the United States is primarily characterized by encephalitis and cutaneous lesions that affect predominately immunocompromised individuals. Acanthamoeba as a cause of encephalitis in immunocompromised patients should be considered by clinicians, which may lead to earlier diagnosis and treatment. Disclosures All Authors: No reported disclosures

Aflatoxin B1: Its Role in the Etiology of Reye's Syndrome

PEDIATRICS ◽  
1979 ◽  
Vol 64 (1) ◽  
pp. 71-75 ◽  
Author(s):  
Nell J. Ryan ◽  
Gwendolyn R. Hogan ◽  
A. Wallace Hayes ◽  
Peter D. Unger ◽  
Mohamed V. Siraj
Keyword(s):  
United States ◽  
Acute Phase ◽  
Aflatoxin B1 ◽  
Case Reports ◽  
The United States ◽  
Reye's Syndrome ◽  
Autopsy Specimens

Seven cases of Reye's syndrome in which aflatoxin B1 was isolated from the blood or liver or both are presented. In two cases aflatoxin B1 was found in the blood during the acute phase of the disease; a finding not previously reported. In six cases aflatoxin B1 was recovered from autopsy specimens of liver. A number of case reports linking aflatoxin B1 to Reye's syndrome have appeared in the literature but until now only one case has been reported from the United States. Aflatoxin B1 and its possible role in the etiology of Reye's syndrome is discussed. It is concluded that Reye's syndrome is the result of multiple interrelated factors.

scholarly journals Case Reports of Fatalities Involving Tianeptine in the United States

2018 ◽  
Vol 42 (7) ◽  
pp. 503-509 ◽  
Author(s):  
Erica L Bakota ◽  
Warren C Samms ◽  
Teresa R Gray ◽  
Deanna A Oleske ◽  
Merrill O Hines
Keyword(s):  
United States ◽  
Case Reports ◽  
The United States

scholarly journals 2497. Women’s Perspectives on and Experiences with Long-acting Injectable Anti-retroviral Therapy in the United States and Spain: the Potential Role of Gender in Patient Preferences

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S866-S866
Author(s):  
Andrea R Mantsios ◽  
Miranda Murray ◽  
Tahilin Sanchez Karver ◽  
Wendy Davis ◽  
David Margolis ◽  
...  
Keyword(s):  
United States ◽  
The United States ◽  
Phase Iii ◽  
Future Research ◽  
People Living With Hiv ◽  
Full Time ◽  
Daily Lives ◽  
Provider Perspectives ◽  
Long Acting ◽  
Trial Participants

Abstract Background Adherence to antiretroviral therapy (ART) to treat HIV remains a critical global health challenge given its relationship with individual health outcomes and population-level transmission. Given barriers associated with oral ART adherence, and considerations of patients’ preferences, long-acting injectable (LA) ART (cabotegravir + rilpivirine) is under development and has been shown to be non-inferior to daily oral ART in Phase III trials. While most of the trial participants have been men, as LA ART gets closer to becoming available for routine clinical use, it is critical to understand how this option is perceived by women. Methods We conducted in-depth interviews with 67 individuals, 53 people living with HIV (PLHIV) and 14 healthcare providers, in 11 sites in the United States and Spain participating in Phase III LA ART trials (ATLAS, ATLAS 2-M and FLAIR). Twenty percent (10/53) of trial participants interviewed were women. Interviews explored patient and provider perspectives and experiences with LA ART, and appropriate candidates and recommendations to support use. Interviews were audio-recorded, transcribed and coded using thematic content analysis. Results Overall, several salient themes emerged regarding participant’s generally positive experiences transitioning from daily oral ART to injectable ART including: the importance of the clinical efficacy of LA ART, the ability to learn to manage injection side-effects over time, and the “freedom” reportedly afforded by LA ART logistically and psychosocially. Women interviewed shared many of the aforementioned positive perceptions of LA ART but also had some unique perspectives. Female participants discussed how LA ART was easier to integrate into their daily lives including managing their multiple roles and responsibilities, which often involved working full-time and taking care of themselves as well as their family and children. Conclusion Similar to all participants, female participants had generally positive views of LA ART. However, the gendered nature of their daily lives also led to some unique perspectives on why and how they were satisfied with LA ART that merits further exploration in future research. Disclosures All authors: No reported disclosures.

scholarly journals Association Between Bilirubin, Atazanavir, and Cardiovascular Disease Events Among People Living With HIV Across the United States

2019 ◽  
Vol 81 (5) ◽  
pp. e141-e147 ◽  
Author(s):  
Heidi M. Crane ◽  
Robin M. Nance ◽  
Susan R. Heckbert ◽  
Corey Ritchings ◽  
Lisa Rosenblatt ◽  
...  
Keyword(s):  
United States ◽  
Cardiovascular Disease ◽  
The United States ◽  
People Living With Hiv ◽  
Living With Hiv

scholarly journals Heterogeneity in the costs of medical care among people living with HIV/AIDS in the United States

AIDS ◽  
2019 ◽  
Vol 33 (9) ◽  
pp. 1491-1500 ◽  
Author(s):  
Benjamin Enns ◽  
Emanuel Krebs ◽  
William C. Mathews ◽  
Richard D. Moore ◽  
Kelly A. Gebo ◽  
...  
Keyword(s):  
United States ◽  
Medical Care ◽  
The United States ◽  
People Living With Hiv ◽  
Living With Hiv ◽  
Hiv Aids

scholarly journals Herpes Zoster Risk in Immunocompromised Adults in the United States: A Systematic Review

2019 ◽  
Vol 71 (7) ◽  
pp. e125-e134 ◽  
Author(s):  
Susannah L McKay ◽  
Angela Guo ◽  
Steven A Pergam ◽  
Kathleen Dooling
Keyword(s):  
United States ◽  
Herpes Zoster ◽  
Organ Transplant ◽  
Original Data ◽  
Hematologic Malignancies ◽  
The United States ◽  
People Living With Hiv ◽  
Solid Organ ◽  
Assessment Development ◽  
Cell Transplants

Abstract Background The primary reported risk factors for herpes zoster (HZ) include increasing age and immunodeficiency, yet estimates of HZ risk by immunocompromising condition have not been well characterized. We undertook a systematic literature review to estimate the HZ risk in immunocompromised patients. Methods We systematically reviewed studies that examined the risk of HZ and associated complications in adult patients with hematopoietic cell transplants (HCT), cancer, human immunodeficiency virus (HIV), and solid organ transplant (SOT). We identified studies in PubMed, Embase, Medline, Cochrane, Scopus, and clinicaltrials.gov that presented original data from the United States and were published after 1992. We assessed the risk of bias with Cochrane or Grading of Recommendations Assessment, Development, and Evaluation methods. Results We identified and screened 3765 records and synthesized 34 studies with low or moderate risks of bias. Most studies that were included (32/34) reported at least 1 estimate of the HZ cumulative incidence (range, 0–41%). There were 12 studies that reported HZ incidences that varied widely within and between immunocompromised populations. Incidence estimates ranged from 9 to 92 HZ cases/1000 patient-years and were highest in HCT, followed by hematologic malignancies, SOT, and solid tumor malignancies, and were lowest in people living with HIV. Among 17 HCT studies, the absence of or use of antiviral prophylaxis at <1 year post-transplant was associated with a higher HZ incidence. Conclusions HZ was common among all immunocompromised populations studied, exceeding the expected HZ incidence among immunocompetent adults aged ≥60 years. Better evidence of the incidence of HZ complications and their severity in immunocompromised populations is needed to inform economic and HZ vaccine policies.

Leveraging a Legacy of Activism: Black Lives Matter and the Future of HIV Prevention for Black MSM

2018 ◽  
Vol 30 (3) ◽  
pp. 208-212
Author(s):  
Derrick D. Matthews
Keyword(s):  
United States ◽  
The United States ◽  
Aids Education ◽  
Black Msm ◽  
People Living With Hiv ◽  
Black Lives Matter ◽  
Aids Epidemic ◽  
Hiv Epidemic ◽  
Sex With Men ◽  
Living With Hiv

This year marks the 30th anniversary of AIDS Education and Prevention. As we approach the United Nations goal of ending the AIDS epidemic by 2030, it is a useful time to reflect on and learn from history. In the United States, no such endeavor can be successful without addressing the specific context of Black men who have sex with men. In this commentary I highlight factors that led us to a state in which Black MSM represent approximately a quarter of all people living with HIV in the United States. I also look back at the power of activism during the beginning of the HIV epidemic. Using Black Lives Matter as a contemporary framework, I highlight natural linkages between activism 30 years ago, its incarnation and relationship to public health today, and its promise as the way forward in achieving the elimination of AIDS for Black MSM by 2030.

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