Role of Cerebrospinal Fluid Shunting for Human Immunodeficiency Virus-positive Patients with Tuberculous Meningitis and Hydrocephalus

Neurosurgery ◽  
2000 ◽  
Vol 47 (3) ◽  
pp. 644-650
Author(s):  
Syed Sameer Nadvi ◽  
Narendra Nathoo ◽  
Ken Annamalai ◽  
James R. van Dellen ◽  
Ahmed I. Bhigjee
Keyword(s):  
Human Immunodeficiency Virus ◽  
Cerebrospinal Fluid ◽  
Tuberculous Meningitis ◽  
Hiv Positive ◽  
Negative Group ◽  
Cd4 Counts ◽  
Positive Group ◽  
Immunodeficiency Virus ◽  
Cerebrospinal Fluid Shunting ◽  
Hiv Negative

ABSTRACT OBJECTIVE Tuberculous meningitis (TBM) and its complications continue to have devastating neurological consequences for patients. Budgetary constraints, especially in developing countries, have made it necessary to select patients for shunting who are likely to experience good recoveries. To date, the value of cerebrospinal fluid shunting for human immunodeficiency virus (HIV)-positive patients with TBM has not been clearly established. METHODS Thirty patients with TBM and hydrocephalus were prospectively evaluated. Coincidentally, one-half of the patients were HIV-positive. All patients underwent uniform treatment, including ventriculoperitoneal shunt placement and antituberculosis treatment. CD4 counts were measured for all patients. Outcomes were assessed at 1 month. RESULTS No complications related to shunt insertion were noted. The HIV-positive group fared poorly (death, 66.7%; poor outcome, 64.7%), compared with the HIV-negative group (death, 26.7%; poor outcome, 30.8%). Despite cerebrospinal fluid shunting, no patient in the HIV-positive group experienced a good recovery (Glasgow Outcome Scale score of 5). This is in contrast to the six patients (40%) in the HIV-negative group who, with the same treatment, experienced good recoveries (Glasgow Outcome Scale scores of 5) at discharge (P < 0.14). No patient (either HIV-positive or HIV-negative) who presented in TBM Grade 4 survived, whereas no HIV-positive patient who presented in TBM Grade 3 survived. A significant relationship was noted between CD4 counts and patient outcomes (P < 0.031). CONCLUSION In the absence of obvious clinical benefit, HIV-positive patients with TBM should undergo a trial of ventricular or lumbar cerebrospinal fluid drainage, and only those who exhibit significant neurological improvement should proceed to shunt surgery.

scholarly journals Increasing genetic diversity of hepatitis C virus in haemophiliacs with human immunodeficiency virus coinfection

2007 ◽  
Vol 88 (9) ◽  
pp. 2513-2519 ◽  
Author(s):  
Yasuhito Tanaka ◽  
Kousuke Hanada ◽  
Hideji Hanabusa ◽  
Fuat Kurbanov ◽  
Takashi Gojobori ◽  
...  
Keyword(s):  
Genetic Diversity ◽  
Human Immunodeficiency Virus ◽  
Hepatitis C ◽  
Selective Pressure ◽  
Hiv Positive ◽  
Negative Group ◽  
Positive Group ◽  
Time Points ◽  
Immunodeficiency Virus ◽  
Hiv Negative

Patients with inherited bleeding disorders who received clotting factor concentrates before 1987 have high rates of hepatitis C virus (HCV) or HCV/human immunodeficiency virus (HIV) infection. To determine whether the persistent nature of HIV affects the genetic diversity of HCV by less selective pressure through the immunosuppression of HIV/HCV-coinfected patients, both the change of genetic diversity and selective pressure were examined in the HCV envelope genes (E1 and E2) of 325 genotype 1a subclones from eight HIV-positive and five HIV-negative patients with two time points (more than 6 years apart). To infer the genetic diversity of HCV in each patient, we used two approaches. One method was to estimate the difference of total evolutionary distances in the phylogenetic tree between the two time points, and another was to estimate the changes of genetic diversity along the time based on the coalescence theory. The two results indicate that the HIV-positive group has significantly more diverse population structure than the HIV-negative group. A comparative analysis of the synonymous and non-synonymous substitutions found that the HIV-positive group was subject to less selective pressure than the HIV-negative group. In conclusion, HIV-positive patients would have a more diversified HCV population than HIV-negative patients due to less selective pressure from the immune system.

Role of Cerebrospinal Fluid Shunting for Human Immunodeficiency Virus-positive Patients with Tuberculous Meningitis and Hydrocephalus

Neurosurgery ◽  
2000 ◽  
Vol 47 (3) ◽  
pp. 644-650 ◽  
Author(s):  
Syed Sameer Nadvi ◽  
Narendra Nathoo ◽  
Ken Annamalai ◽  
James R. van Dellen ◽  
Ahmed I. Bhigjee
Keyword(s):  
Human Immunodeficiency Virus ◽  
Cerebrospinal Fluid ◽  
Tuberculous Meningitis ◽  
Immunodeficiency Virus ◽  
Cerebrospinal Fluid Shunting

scholarly journals Epidemiology and Hospital Course of Patients With Acute Salpingitis and Coincident HIV

1993 ◽  
Vol 1 (2) ◽  
pp. 91-93
Author(s):  
Iris Ayala-Rodriguez ◽  
Joseph Apuzzio
Keyword(s):  
Hospitalized Patients ◽  
University Hospital ◽  
Hiv Positive ◽  
Negative Group ◽  
Positive Group ◽  
Immunodeficiency Virus ◽  
The Mean ◽  
Wbc Count ◽  
Hiv Seropositive ◽  
Hiv Negative

Objective: To compare the epidemiology and hospital course of patients with acute salpingitis with and without coincident human immunodeficiency virus (HIV) seropositivity.Methods: Patients admitted to the UMDNJ-University Hospital in Newark, New Jersey from January 1, 1991, to December 31, 1991, with acute salpingitis were studied.Results: Eight percent of all hospitalized patients with acute salpingitis were HIV-positive. The mean age of the HIV-negative group was 25.4 compared with 29.6 years in the HIV-positive group. Gonorrhea and chlamydia were present in 49% and 22%, respectively, in HIV-negatives and in 40% and 20% of HIV-positives. Two of 5 (40%) HIV-positive patients had tuboovarian abscesses compared with 12 of 59 (20%) HIV-negative patients. Three of 5 (60%) HIV-positive patients had admission WBC counts fewer than 10,000/mm3 compared to 6 of 59 (12%) of HIV-negatives (P = 0.024). The hospital stay was 5.4 days for HIV-positives and 5.8 days for HIV-negatives.Conclusions: Eight percent of hospitalized patients with acute salpingitis were HIV-seropositive. Neisseria gonorrhoeae and chlamydia were commonly found organisms in both groups. The initial WBC count was lower for HIV-positive patients. The hospital course of both groups was similar.

scholarly journals Prevalence of Peripheral Vestibular Impairment in Adults with Human Immunodeficiency Virus

2021 ◽  
Vol 25 (1) ◽  
pp. 36-42
Author(s):  
Alison Millar ◽  
Karin Joubert ◽  
Alida Naude
Keyword(s):  
Human Immunodeficiency Virus ◽  
Vestibular Function ◽  
Head Impulse Test ◽  
Hiv Positive ◽  
Positive Group ◽  
Head Impulse ◽  
Immunodeficiency Virus ◽  
Central Compensation ◽  
The Impact ◽  
Hiv Negative

Background and Objectives: Globally, the human immunodeficiency virus (HIV) is responsible for one of the most serious pandemics to date. The vulnerability of the vestibular system in individuals with HIV has been confirmed, and central vestibular impairments have been frequently reported. However, there are disagreements on the impact of HIV on peripheral vestibular function. Thus, the current study aimed to determine the prevalence of peripheral vestibular impairment, specifically related to the semi-circular canals (SCCs), in HIV-positive individuals receiving antiretroviral (ARV) treatment.Subjects and Methods: A total of 92 adults between the ages of 18 and 50 years (divided into two groups) participated in the study. The first group comprised HIV-positive individuals receiving ARV treatment (n1=60), and the second group comprised HIV-negative participants (n2=32). The video head impulse test was used to conduct the head impulse paradigm (HIMP).Results: Bilateral normal HIMP results were obtained in 95% of the HIV-positive participants and all HIV-negative participants. The gain of the left posterior SCCs was significantly lower in the HIV-positive group, while the gains of all other canals between the two groups were comparable.Conclusions: The prevalence of peripheral vestibular impairment in the HIV-positive group was not significantly different from that of the HIV-negative group. The reduced prevalence in the current study may be attributed to participant characteristics, the test battery employed, and the central compensation of the vestibular dysfunctions at the later stages of infection.

Incidental Learning and Memory Deficits on a Computerized Symbol-Digit Modalities Test in Adults with HIV/AIDS

2020 ◽  
pp. 1-7
Author(s):  
David J. Hardy ◽  
Steven A. Castellon ◽  
Charles H. Hinkin
Keyword(s):  
Learning And Memory ◽  
Incidental Learning ◽  
Hiv Positive ◽  
Control Group ◽  
Cognitively Impaired ◽  
Negative Group ◽  
Positive Group ◽  
Immunodeficiency Virus ◽  
Hiv Positive Adults ◽  
Hiv Negative

Abstract Objective: Incidental learning and memory, as well as processing speed, were examined in human immunodeficiency virus (HIV)-positive adults and a seronegative control group. Methods: Participants completed a computerized Symbol-Digit Modalities Test (cSDMT) with two blocked conditions: a set of trials with the standard symbol–digit pairings and the second set with a rearranged symbol–digit pairings. Results: HIV-positive adults showed slower overall reaction time compared to the HIV-negative group. More importantly, the most cognitively impaired HIV-positive group showed no interference in the rearranged set of symbol–digit pairings from the standard pairings on the cSDMT. Conclusion: The relative slowing, or interference, in the HIV-negative group and two HIV-positive groups (unimpaired and impaired) was quite large (between 122 and 131 ms). We argue that the lack of such relative slowing in the most cognitively impaired HIV-positive group indicates a deficit in incidental learning and memory.

scholarly journals Field Evaluation of the Determine Rapid Human Immunodeficiency Virus Diagnostic Test in Honduras and the Dominican Republic

1999 ◽  
Vol 37 (11) ◽  
pp. 3698-3700 ◽  
Author(s):  
Carol J. Palmer ◽  
Jose M. Dubon ◽  
Ellen Koenig ◽  
Eddy Perez ◽  
Arba Ager ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Dominican Republic ◽  
Rapid Test ◽  
Hiv Positive ◽  
Serum Samples ◽  
Cd4 Counts ◽  
Viral Loads ◽  
Immunodeficiency Virus ◽  
Hiv Negative ◽  
Red Line

Rapid detection of human immunodeficiency virus (HIV) infection can result in improved patient care and/or faster implementation of public health preventive measures. A new rapid test, Determine (Abbott, Abbott Park, Ill.), detects HIV type 1 (HIV-1) and HIV-2 antibodies within 15 min by using 50 μl of serum or plasma. No specialized equipment or ancillary supplies are required, and results are read visually. A positive result is noted by the appearance of a red line. An operational control (red line) indicates proper test performance. We evaluated the Determine rapid HIV detection test with a group of well-characterized serum samples (CD4 counts and viral loads were known) and serum samples from HIV-positive individuals at field sites in Honduras and the Dominican Republic. In the field evaluations, the results obtained by the Determine assay were compared to those obtained by local in-country HIV screening procedures. We evaluated serum from 100 HIV-positive patients and 66 HIV-negative patients. All samples gave the expected results. In a companion study, 42 HIV-positive samples from a Miami, Fla., serum bank were tested by the Determine assay. The samples had been characterized in terms of CD4 counts and viral loads. Fifteen patients had CD4 counts <200 cells/mm3, while 27 patients had CD4 counts >200 cells/mm3. Viral loads ranged from 630 to 873,746 log10 copies/ml. All samples from the Miami serum bank were positive by the Determine test. Combined results from the multicenter studies indicated that the correct results were obtained by the Determine assay for 100% (142 of 142) of the HIV-positive serum samples and 100% (66 of 66) of the HIV-negative serum samples. The Determine test was simple to perform and the results were easy to interpret. The Determine test provides a valuable new method for the rapid identification of HIV-positive individuals, especially in developing countries with limited laboratory infrastructures.

Abstract WP426: Subarachnoid Hemorrhage in patients infected with Human Immunodeficiency Virus

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Haralabos Zacharatos ◽  
Malik M Adil ◽  
Ameer E Hassan ◽  
Sarwat I Gilani ◽  
Adnan I Qureshi
Keyword(s):  
Human Immunodeficiency Virus ◽  
Subarachnoid Hemorrhage ◽  
Blood Transfusion ◽  
Hospital Mortality ◽  
Hiv Infection ◽  
The United States ◽  
Hiv Positive ◽  
Published Data ◽  
Immunodeficiency Virus ◽  
Hiv Negative

Background: There is limited data regarding the unique attributes of ischemic stroke among patients infected with human immunodeficiency virus (HIV). There is no published data regarding the occurrence and outcomes of subarachnoid hemorrhage (SAH) among HIV infected persons. Methods: The largest all-payer Nationwide Inpatient Sample (NIS 2002-2010) data was used to identify and analyze all patients presenting with the primary diagnosis of SAH in the United States. Among this cohort, we identified the patients who were not HIV positive and those who were HIV positive. Patient demographics, medical co-morbidities, in-hospital complications, in-hospital procedures, and discharge disposition were compared between the two groups. The association between HIV infection and outcomes was evaluated in multivariate analysis after adjusting for potential confounders. Results: Of the 351,491 patients admitted with SAH, 1367 (0.39%) were infected with HIV. HIV infected patients were younger, mean age [±SD] of 45 ±14.2 years versus those who were not 58±19 years, (p<0.0001). The rate of blood transfusion [27,286 (7.8%) versus 245.6 (18%), p=0.0003], mechanical ventilation [51,199 (14.6%) versus 316.1(23.1%), p=0.008], and sepsis [14,644 (4.2%) versus 236.1 (17.3%), p<0.0001] was significantly higher among HIV infected patients. After adjusting for age, gender, hypertension, coagulopathy, atrial fibrillation, renal failure, and dyslipidemia, HIV negative patients had a significantly higher rate of discharge to home (odds ratio [OR] 1.9, 95% CI: 1.4-2.6, p<0.0001) and lower in-patient mortality (OR 0.4, 95% CI: 0.3-0.5, p<0.001). Further adjustment for blood transfusion and sepsis reduced the odds of discharge to home for the HIV negative patients, from 1.9 to 1.7 but did not affect in-hospital mortality. Conclusion: The in-hospital mortality in HIV infected patients with SAH is higher despite these patients being younger than non-HIV infected patients. We believe that this study provides a nationwide perspective which may have some important implications for early recognition and diagnosis of HIV-infection in SAH patients.

Antimalarial drug resistance markers in human immunodeficiency virus (HIV)-positive and HIV-negative adults with asymptomatic malaria infections in Port Harcourt, Nigeria

2021 ◽  
Author(s):  
Ifeyinwa Chijioke-Nwauche ◽  
Mary C Oguike ◽  
Chijioke A Nwauche ◽  
Khalid B Beshir ◽  
Colin J Sutherland
Keyword(s):  
Human Immunodeficiency Virus ◽  
Drug Resistance ◽  
Drug Susceptibility ◽  
Blood Film ◽  
University Hospital ◽  
Hiv Positive ◽  
Asymptomatic Malaria ◽  
Immunodeficiency Virus ◽  
Before And After ◽  
Hiv Negative

Abstract Background In Nigeria, indiscriminate use of antimalarial drugs may contribute to the threat of drug resistance, but this has not been evaluated among people living with human immunodeficiency virus (HIV). Methods HIV-positive adults attending a university hospital HIV clinic and HIV-negative adult volunteers from the university hospital community with a positive blood film were treated with artemether–lumefantrine. Parasite DNA from before and after treatment was polymerase chain reaction amplified to identify molecular markers of drug susceptibility. Results The pfcrt76T genotype was prevalent among both HIV-positive and HIV-negative participants (78.6% and 68.2%, respectively). Three new mutations in the pfmdr1 gene—F73S, S97L and G165R—and the uncommon pfdhps S436F variant were detected, whereas pfdhps K540E and pfdhfr I164L were absent. The A437G allele of pfdhps predominated (62/66 [94%]). The I431 V mutation was found in 19 of 66 pretreatment pfdhps sequences (28.8%). The pfmdr1 86N allele was significantly more common at day 3 post-treatment than at baseline (odds ratio 8.77 [95% confidence interval 1.21 to 380]). Conclusions We found evidence of continued chloroquine use among HIV-positive individuals. Selection for the pfmdr1 86N after artemether–lumefantrine treatment was observed, indicating a possible threat to antimalarial efficacy in the study area. The complexity of pfdhps haplotypes emphasises the need for careful monitoring of anti-folate susceptibility in Nigeria.

Trypanosoma cruziParasitemia in Chronic Chagas Disease: Comparison between Human Immunodeficiency Virus (HIV)–Positive and HIV‐Negative Patients

2002 ◽  
Vol 186 (6) ◽  
pp. 872-875 ◽  
Author(s):  
Ana Marli C. Sartori ◽  
José Eluf Neto ◽  
Elizabete Visone Nunes ◽  
Lucia Maria Almeida Braz ◽  
Hélio H. Caiaffa‐Filho ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Chagas Disease ◽  
Hiv Positive ◽  
Immunodeficiency Virus ◽  
Chronic Chagas Disease ◽  
Hiv Negative

scholarly journals Human immunodeficiency virus (HIV) Tat-reactive antibodies present in normal HIV-negative sera and depleted in HIV-positive sera. Identification of the epitope.

1992 ◽  
Vol 175 (5) ◽  
pp. 1247-1253 ◽  
Author(s):  
T C Rodman ◽  
F H Pruslin ◽  
S E To ◽  
R Winston
Keyword(s):  
Human Immunodeficiency Virus ◽  
Natural Antibodies ◽  
Hiv Positive ◽  
Tat Protein ◽  
Very High Frequency ◽  
Hiv Pathogenesis ◽  
Humoral Immune ◽  
Igm Antibodies ◽  
Immunodeficiency Virus ◽  
Hiv Negative

We have detected, in sera of normal human immunodeficiency virus (HIV)-free subjects, IgM antibodies reactive with the Tat protein of HIV in significant titers and at very high frequency, and, in HIV-positive sera, progressively lower titers as HIV pathogenesis ensues. Epitope analysis indicates that the Tat-reactive antibodies of both HIV-negative and HIV-positive sera are homologous, suggesting, therefore, that their decline in HIV-positive sera may represent attrition of a host defense factor. The identified epitope displays minimal homology with that previously defined for another set of IgM antibodies shown to be present in normal sera, deficient in HIV-positive sera, and postulated to be natural antibodies. We propose that the Tat-reactive antibodies, as well, are a set of natural antibodies and that the normal humoral immune system includes a repertoire of antibodies, nonimmunogenic in origin, that contribute to immune homeostasis and, consequently, to host resistance to HIV pathogenesis.

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