scholarly journals Immunological factors, but not clinical features, predict visceral leishmaniasis relapse in patients co-infected with HIV

2021 ◽  
Author(s):  
Yegnasew Takele ◽  
Tadele Mulaw ◽  
Emebet Adem ◽  
Caroline Jayne Shaw ◽  
Susanne Ursula Franssen ◽  
...  
Keyword(s):  
Visceral Leishmaniasis ◽  
Immunological Study ◽  
Hiv Patients ◽  
Immunological Markers ◽  
Cell Counts ◽  
Primary Hospital ◽  
Low Bmi ◽  
Immunological Factors ◽  
High Parasite

Visceral leishmaniasis (VL) has emerged as a clinically important opportunistic infection in HIV patients, as VL/HIV co-infected patients suffer from frequent VL relapse. Here, we followed cohorts of VL patients with or without HIV co-infections in Ethiopia and collected detailed clinical and immunological data during 12 months of follow-up. By the end of the study 78.1% of VL/HIV patients, but none of the VL only patients, had relapsed. Despite clinically defined cure, VL/HIV patients maintained high parasite loads, low BMI, hepatosplenomegaly and pancytopenia throughout follow-up. During detailed immunological study throughout the follow-up period, we identified three markers associated with VL relapse: i) failure to restore antigen-specific production of IFNγ, ii) persistently low CD4+ T cell counts, and iii) high expression of PD1 on CD4+ T cells. We show that these three markers combine well in predicting VL relapse, and that all three measurements are needed for optimal predictive power. These three immunological markers can be measured in primary hospital settings in Ethiopia and can predict VL relapse after anti-leishmanial therapy. The use of our prediction model has the potential to improve disease management and patient care.

scholarly journals Protein Status and CD4+ Cell Count in HIV Patients on Highly Active Anti-Retroviral Therapy

2019 ◽  
pp. 10-14
Keyword(s):  
Cell Count ◽  
Total Protein ◽  
Opportunistic Infections ◽  
Hiv Patients ◽  
Cd4 Cell Count ◽  
Highly Active ◽  
Protein Status ◽  
Cell Counts ◽  
Cd4 Cell

Background of Study: Malnutrition is associated with repeated opportunistic infections, rapid disease progression, and an increase in the incidence of human immunodeficiency virus (HIV) related mortality. The ability of anti-retroviral therapy (ART) in boosting the immune system depends on the nutritional status of the HIV patient. Aim: The study aimed at investigating the protein status and CD4+ cell counts in HIV patients taking highly active ART. Materials and Methods: The case-control study comprising of a total of 80 participants, compared the protein status and CD4+ cell count among baseline (ART-naïve n=20), switch (ART-resistant n=20), ART follow-up (n=20) patients, and apparently healthy controls (n=20). Results: The total protein of baseline patients was significantly (P<0.01) higher than that of the switch, follow-up, and controls. The CD4+ cell count of baseline patients was significantly (P=0.000) low compared to follow-up patients and controls. Total protein level and CD4+ cell count of switch patients were significantly (P=0.000) lower than that of follow-up patients and controls. Total protein of follow-up patients was significantly (P<0.02) higher than that of controls, while the CD4+ cell count of follow-up patients was significantly (P=0.000) lower than that of controls. Conclusion: The present study observed low protein along with low CD4+ cell count in switch patients, while a good outcome was observed in follow up patients.

scholarly journals HIV-1 co-infection increases relapse rate and shortens survival in patients with visceral leishmaniasis

2021 ◽  
Author(s):  
Yegnasew Takele ◽  
Tadele Mulaw ◽  
Emebet Adem ◽  
Rebecca Womersley ◽  
Myrsini Kaforou ◽  
...  
Keyword(s):  
Visceral Leishmaniasis ◽  
Relapse Rate ◽  
Immune Therapy ◽  
Previous History ◽  
First Episode ◽  
Hiv Viral Load ◽  
Hiv Patients ◽  
Ifn Gamma ◽  
Cell Counts ◽  
Hiv 1

Patients co-infected with visceral leishmaniasis (VL) and HIV-1 (VL/HIV patients) suffer from recurrent VL relapses and increased mortality. The aim of our study was to test the hypothesis that HIV patients who present with their first episode of VL (primary VL/HIV patients) experience less relapses and lower mortality as compared to VL/HIV patients who have a previous history of VL relapses (recurrent VL/HIV patients). Our results show that primary VL/HIV patients have a lower parasite load and that their relapse-free survival is significantly longer. Relapses in both groups of patients occur independently of HIV viral load. Our clinical and immunological analyses of these patients at the time of diagnosis and during follow-up show that the poorer prognosis of recurrent VL/HIV patients is accompanied by lower weight gain and lower recovery of all blood cell lineages, as well as lower production of antigen-specific IFN-gamma, lower CD4+ T cell counts and higher expression levels of the inhibitory receptor PD1 on CD4+ and CD8+ T cells. We propose that in addition to the current treatments, novel interventions should be considered at the time of VL diagnosis in VL/HIV patients and suggest that improved anti-leishmanial and antiretroviral treatments, as well as immune therapy, through PD1/PDL-1 blockade and/or through IFN-gamma administration, could result in more efficient parasite killing and thereby reduce the relapse rate and improve survival.

scholarly journals High Levels of TNF-α and TIM-3 as a Biomarker of Immune Reconstitution Inflammatory Syndrome in People with HIV Infection

Life ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 527
Author(s):  
Lucero A. Ramon-Luing ◽  
Ranferi Ocaña-Guzman ◽  
Norma A. Téllez-Navarrete ◽  
Mario Preciado-García ◽  
Dámaris P. Romero-Rodríguez ◽  
...  
Keyword(s):  
Immune Reconstitution Inflammatory Syndrome ◽  
Immune Reconstitution ◽  
Control Group ◽  
Hiv Patients ◽  
Art Initiation ◽  
Tnf Α ◽  
Ifn Γ ◽  
Α Level ◽  
Inflammatory Syndrome

Immune reconstitution inflammatory syndrome (IRIS) is an exacerbated immune response that can occur to HIV+ patients after initiating antiretroviral therapy (ART). IRIS pathogenesis is unclear, but dysfunctional and exhausted cells have been reported in IRIS patients, and the TIM-3/Gal-9 axis has been associated with chronic phases of viral infection. This study aimed to evaluate the soluble levels of TIM-3 and Gal-9 and their relationship with IRIS development. TIM-3, Gal-9, TNF-α, IFN-γ, IL-6, TNFR1, TNFR2, E-cadherin, ADAM10, and ADAM17 were measured to search for IRIS-associated biomarkers in plasma samples from 0-, 4-, 8-, 12-, and 24-weeks after ART initiation of 61 HIV+ patients (15 patients developed IRIS, and 46 did not). We found that patients who developed IRIS had higher levels of TIM-3 [median 4806, IQR: 3206–6182] at the time of the IRIS events, compared to any other follow-up time evaluated in these patients or compared with a control group of patients who did not develop IRIS. Similarly, IRIS patients had a higher TNF-α level [median 10.89, IQR: 8.36–12.34] at IRIS events than any other follow-up time evaluated. Other molecules related to the TIM-3 and TNF-α pathway (Gal-9, IL-6, IFN-γ, TNFR1, TNFR2, ADAM-10, and ADAM-17) did not change during the IRIS events. In conclusion, our data suggest that a high level of soluble TIM-3 and TNF-α could be used as an IRIS biomarker.

scholarly journals CD19 Cell Count at Baseline Predicts B Cell Repopulation at 6 and 12 Months in Multiple Sclerosis Patients Treated with Ocrelizumab

2021 ◽  
Vol 18 (15) ◽  
pp. 8163
Author(s):  
Gianmarco Abbadessa ◽  
Giuseppina Miele ◽  
Paola Cavalla ◽  
Paola Valentino ◽  
Girolama Alessandra Marfia ◽  
...  
Keyword(s):  
B Cell ◽  
Cell Count ◽  
Considerable Proportion ◽  
Cell Counts ◽  
Time Scheduling ◽  
Magnetic Resonance Imaging Mri ◽  
Multiple Sclerosis Patients ◽  
Kinetics Of ◽  
Cell Repopulation

Background: The kinetics of B cell repopulation in MS patients treated with Ocrelizumab is highly variable, suggesting that a fixed dosage and time scheduling might be not optimal. We aimed to investigate whether B cell repopulation kinetics influences clinical and radiological outcomes and whether circulating immune asset at baseline affects B cell repopulation kinetics. Methods: 218 MS patients treated with Ocrelizumab were included. Every six months we collected data on clinical and magnetic resonance imaging (MRI) activity and lymphocyte subsets at baseline. According to B cell counts at six and twelve months, we identified two groups of patients, those with fast repopulation rate (FR) and those with slow repopulation rate (SR). Results: A significant reduction in clinical and radiological activity was found. One hundred fifty-five patients had complete data and received at least three treatment cycles (twelve-month follow-up). After six months, the FR patients were 41/155 (26.45%) and 10/41 (29.27%) remained non-depleted after twelve months. FR patients showed a significantly higher percentage of active MRI scan at twelve months (17.39% vs. 2.53%; p = 0,008). Furthermore, FR patients had a higher baseline B cell count compared to patients with an SR (p = 0.02 and p = 0.002, at the six- and twelve-month follow-ups, respectively). Conclusion: A considerable proportion of MS patients did not achieve a complete CD19 cell depletion and these patients had a higher baseline CD19 cell count. These findings, together with the higher MRI activity found in FR patients, suggest that the Ocrelizumab dosage could be tailored depending on CD19 cell counts at baseline in order to achieve complete disease control in all patients.

scholarly journals Canine visceral leishmaniasis follow-up: a new anti-IgG serological test more sensitive than ITS-1 conventional PCR

2017 ◽  
Vol 248 ◽  
pp. 62-67 ◽  
Author(s):  
Angélica Rosa Faria ◽  
Simone da Fonseca Pires ◽  
Alexandre Barbosa Reis ◽  
Wendel Coura-Vital ◽  
Júlia Angélica Gonçalves da Silveira ◽  
...  
Keyword(s):  
Visceral Leishmaniasis ◽  
Serological Test ◽  
Canine Visceral Leishmaniasis ◽  
Conventional Pcr

scholarly journals Visceral leishmaniasis (Kala-azar) in Qom Province, Iran: Report of two cases

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 1371
Author(s):  
Leyli Zanjirani Farahani ◽  
Abedin Saghafipour ◽  
Mehdi Mohebali ◽  
Behnaz Akhoundi ◽  
Hedayatollah Raufi
Keyword(s):  
Visceral Leishmaniasis ◽  
Rural Areas ◽  
Control Strategies ◽  
Sand Fly ◽  
Recurrent Fever ◽  
Kala Azar ◽  
Periodic Monitoring ◽  
History Of ◽  
The Common

Visceral leishmaniasis (VL) is a fatal parasitic zoonotic worldwide disease, which transmits to humans by the infected Phlebotomine sand fly bite. The common form of VL in Iran is the Mediterranean type with the causative agent of Leishmania infantum, whose main reservoirs are stray and domesticated dogs. The disease has several endemic foci in Iran, mostly seen among children under the age of 10, living in rural areas and nomadic tribes. The first cases of Kala-Azar in Qom province, central Iran, were reported in the year 2001, from the villages of Ghahan district. After conducting VL control strategies in the area, no new cases of the disease had been reported until recently. The cases described here are two 2-year-old girls, living in the urban parts of Qom province, one of whom did not have a history of traveling to known endemic areas of the disease. The patients were admitted to hospital in 2016-2017, complaining from recurrent fever with unrecognized reason, associated with decreased appetite and weight loss. Disease follow-up demonstrated anemia and splenomegaly, which led to diagnosis of VL, and both patients are now fully recovered. VL was presumed to be controlled in Qom province but the present cases indicate that possible VL existence remains in the region. Therefore, urgent studies and periodic monitoring are needed to identify potential reservoirs of VL in the area.

scholarly journals A Comparison of Effectiveness of Compassion-Focused Therapy (CFT) and Mindfulness-Based Stress Reduction (MBSR) on Psychological Flexibility of HIV Patients in Imam Khomeini Hospital

2021 ◽  
Author(s):  
Manzar Amirkhani ◽  
Shohreh Ghorbanshiroudi ◽  
Mohammadreza Zarbakhsh Bahri ◽  
Seyed Ahmad Seyed Alinaghei
Keyword(s):  
Stress Reduction ◽  
Psychological Flexibility ◽  
Analysis Of Covariance ◽  
Psychological State ◽  
Control Group ◽  
Psychological Interventions ◽  
Hiv Patients ◽  
Compassion Focused Therapy ◽  
Mindfulness Based Stress Reduction

Background: HIV patients are exposed to many psychological problems, including psychological inflexibility. It seems that psychological interventions can be effective to improve the psychological state of these patients. Therefore, in this study, we aimed to compare the effectiveness of interventions with 2 methods of Compassion-Focused Therapy (CFT) and Mindfulness-Based Stress Reduction (MBSR) program on psychological flexibility of HIV patients in Imam Khomeini Hospital. Methods: The present study was a descriptive-analytical study that was performed as an intervention in the period from May to January in 2020 on 54 HIV patients referred to Voluntary Counseling and Testing (VCT) center of Imam Khomeini Hospital Complex. The samples of the study mode were selected by available sampling and randomly divided in 3 groups of 18 people based on CFT, MBSR session and the control group. Each treatment was presented to 2 experimental groups for 10 sessions per week and the control group was placed on a waiting lists. Patients' psychological flexibility was assessed by the Acceptance and Action Questionnaire- II "AAQ-II" in 3 stages: pre-test, post-test and follow-up. SPSS 23 software and analysis of covariance, bonferoni test and one-way analysis of variance were used to analyze the data. Results: The results showed that CFT and MBSR were effective on increasing psychological flexibility of HIV patients (p < 0.01). Comparison of the effectiveness of the 2 therapies showed that CFT caused a further increase on increasing psychological flexibility (p < 0.01). Changes in follow-up 3 months after treatment also remained stable (p < 0.01). Conclusion: Findings of the study show that the use of therapies in this study can be effective in planning psychological interventions to promote and improve mental health in HIV patients.

scholarly journals Predictors of Tuberculosis in HIV Patients in the Clinic Voluntary Counseling and Testing in Medan City

2019 ◽  
Author(s):  
Rahayu Lubis ◽  
Jemadi Jemadi ◽  
Surya Utama ◽  
Rasmaliah Rasmaliah
Keyword(s):  
Tertiary Education ◽  
Hiv Patients ◽  
Chi Square ◽  
Voluntary Counseling ◽  
Voluntary Counseling And Testing ◽  
Counseling And Testing ◽  
Chi Square Test ◽  
History Of ◽  
Low Bmi ◽  
Spss Software

Abstract Background: The incidence of tuberculosis in HIV patients (TB-HIV) w as estimated at 126 per 100,000 in the world. The number of HIV infected patients in Indonesia around 190,000 to 400,00 0 and the prevalence of TB-HIV is 5%. Data TB-HIV still increase s and they are un aware of that until a late stage. Understanding the risk factors of people with TB-HIV co-infection is important to know. This study aims to know the predictors of TB-HIV patients in the clinic voluntary counseling and testing (VCT) in Medan city. Methods: This is a case-control study. The case is TB-HIV patients (aged > 20 years) seen at clinic VCT Medan in 2016. Control is HIV patients without TB (aged > 20 years) seen in the same clinic VCT. The number of cases was 120 and the number of control 120. Data were collected from the medical record. Data were analyzed using the chi-square test in SPSS software. Results: The t otal was 240 patients. The majority were in the age group 31-40 years old (52.9%), male (75.8%), married (71.7%), had tertiary education (85.4%), had employment (89.2%) . Significant factors were CD4 < 500 cells/ml (OR 3.92; 95% CI 2.13-7.22), BMI < 18.5 kg/m2 (OR 5.79; 95% CI 3.25-10.21), had history of TB family (OR 7.9; 95% CI 3.67-18.18), adherence ARV (OR 1.35; 95% CI 1.02-1.79). Conclusions: The predictors of incidence TB-HIV co-infection was low CD4, low BMI, and had a family history of TB. Pay the attention for the nutritional status of TB-HIV patients and provide appropriate nutritional intake needs and adherence ARV.

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