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

Author(s):  
Yegnasew Takele ◽  
Tadele Mulaw ◽  
Emebet Adem ◽  
Rebecca Womersley ◽  
Myrsini Kaforou ◽  
...  

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.

Intervirology ◽  
2021 ◽  
pp. 1-5
Author(s):  
Mohammad Reza Jabbari ◽  
Hoorieh Soleimanjahi ◽  
Somayeh Shatizadeh Malekshahi ◽  
Mohammad Gholami ◽  
Leila Sadeghi ◽  
...  

<b><i>Objectives:</i></b> The aim of present work was to assess cytomegalovirus (CMV) viremia in Iranian human immunodeficiency virus (HIV)-1-infected patients with a CD4+ count &#x3c;100 cells/mm<sup>3</sup> and to explore whether CMV DNA loads correlate with CD4+ cell counts or associated retinitis. <b><i>Methods:</i></b> This study was conducted at the AIDS research center in Iran on HIV-1-infected patients with CD4+ count &#x3c;100 cells/mm<sup>3</sup>, antiretroviral therapy-naive, aged ≥18 years with no previous history of CMV end-organ disease (CMV-EOD). <b><i>Results:</i></b> Thirty-nine of 82 patients (47.56%) had detectable CMV viral load ranging from 66 to 485,500 IU/mL. CMV viral load in patients with retinitis ranges from 352 to 2,720 IU/mL, and it was undetectable in 2 patients. No significant associations between CMV viremia and CD4+ cell count was found (<i>p</i> value = 0.31), whereas significant association of CMV viremia in HIV-infected patients with retinitis was found (<i>p</i> &#x3c; 0.02). <b><i>Conclusions:</i></b> We estimated the frequency of CMV viral load infection in Iranian HIV-1-infected patients with a CD4+ cell count &#x3c;100 mm<sup>3</sup>/mL in the largest national referral center for HIV-1 infection in Iran. Further research is required on the relevance of CMV viral load in diagnostic and prognostic value of CMV-EOD.


2018 ◽  
Vol 10 (02) ◽  
pp. 162-167
Author(s):  
Sakshee Gupta ◽  
Bharti Malhotra ◽  
Jitendra Kumar Tiwari ◽  
Prabhu Dayal Khandelwal ◽  
Rakesh Kumar Maheshwari

ABSTRACT BACKGROUND: Coinfections of human immunodeficiency virus (HIV) with hepatitis viruses may affect the progress of disease and response to therapy. OBJECTIVES: To study the incidence of hepatitis B virus (HBV) and hepatitis C virus (HCV) coinfections in HIV–positive patients and their influence on HIV–1 viral load and cluster of differentiation 4+ (CD4+) T–cell counts. MATERIALS AND METHODS: This pilot study was done on 179 HIV–positive patients attending antiretroviral therapy (ART) centre. Their blood samples were tested for HIV-1 viral load, CD4+ T–cell counts, hepatitis B surface antigen, anti–HCV antibodies, HBV DNA and HCV RNA polymerase chain reaction. RESULTS: Among the 179 patients, 7.82% (14/179) were coinfected with HBV and 4.46% (8/179) with HCV. Median CD4+ T–cell count of HIV monoinfected patients was 200 cells/µl and viral load was 1.67 log10 copies/µl. Median CD4+ T–cell counts of 193 cells/µl for HBV (P = 0.230) and 197 cells/µl for HCV (P = 0.610) coinfected patients were similar to that of HIV monoinfected patients. Viral load was higher in both HBV and HCV infected patients but statistically significant only for HCV (P = 0.017). Increase in CD4+ T–cell counts and decrease in HIV–1 viral load in coinfected patients on 2 years of ART were lower than that in HIV monoinfected patients. CONCLUSION: HBV/HCV coinfected HIV patients had similar CD4+ T–cell counts as in HIV monoinfected patients, higher HIV viral load both in chemo–naive patients and in those on ART as compared to HIV monoinfected patients. However, this study needs to be done on a large scale to assess the impact of coinfection on CD4 count and HIV viral load with proper follow–up of patients every 6 months till at least 2 years.


2020 ◽  
Vol 21 (10) ◽  
pp. 3590
Author(s):  
Francisco Miguel Conesa-Buendía ◽  
Patricia Llamas-Granda ◽  
Patricia Atencio ◽  
Alfonso Cabello ◽  
Miguel Górgolas ◽  
...  

Plasma levels of adenosine deaminase (ADA), an enzyme that deaminates adenosine to inosine, are increased during inflammation. An increase in ADA activity occurs with lower human immunodeficiency virus (HIV) viral load and higher CD4+ T cell counts. We aimed to investigate the role of plasma ADA as a biomarker of inflammation in treatment-naïve HIV patients who received tenofovir or another nucleoside analog for comparison. Ninety-two treatment-naïve patients were included in the study and grouped by treatment, i.e., tenofovir disoproxil fumarate (TDF), tenofovir alafenamide (TAF) or Triumeq. ADA activity was measured in plasma and cytokines were analyzed by MILLIPLEX® MAP-Luminex® Technology. Plasma concentration of monocytes and neutrophils was measured at 0, 3, and 12 months post-treatment. Treatment-naïve HIV patients had increased ADA concentrations (over 15 U/L) that decreased after treatment with TAF and Triumeq, though this did not occur in TDF-treated patients. However, all groups exhibited a pro-inflammatory systemic profile at 12 months of treatment. Plasma GM-CSF levels decreased after 12 months of treatment in the TDF group, with a concomitant decrease in blood monocyte count, and a negative correlation with ADA values was found. In conclusion, ADA levels may be modulated by antiretroviral therapy in HIV patients, possibly affecting inflammatory status.


2019 ◽  
Vol 147 ◽  
Author(s):  
A-Mei Zhang ◽  
Ming Yang ◽  
Li Gao ◽  
Mi Zhang ◽  
Lingshuai Jiao ◽  
...  

Abstract Hepatitis C virus (HCV) infection was frequent in human immunodeficiency virus (HIV) patients in Yunnan province. We studied the epidemic characteristics of HCV in HIV/HCV co-infected patients. Serum from 894 HIV-1 patients was collected, together with basic information and biochemical features. All samples were infected with HIV through injecting drug users (IDUs) and sexual transmission (ST). The NS5B gene was amplified and sequenced to affirm HCV genotype. In total, 202 HIV patients were co-infected with HCV, and most (81.19%) of co-infected patients were IDUs. Genotype 3b was predominant (37.62%) in these samples, and its frequency was similar in patients with IDU and ST. The frequencies of genotypes 1a, 1b, 3a, 6a, 6n, 2a and 6u were 3.96%, 16.34%, 23.76%, 6.93%, 10.40%, 0.50% and 0.50%, respectively. However, genotype 3a showed significantly different frequency in HCV patients with IDU and ST (P = 0.019). When HCV patients were divided into subgroups, the haemoglobin (HGB) level was significantly higher in patients with genotype 3a than in patients with 3b (P = 0.033), 6a (P = 0.006) and 6n (P = 0.007), respectively. Although no difference existed among HCV subgroups, HIV-viral load was identified to be positively correlated with the HGB level and CD4+ cells when dividing HCV/HIV co-infected persons into male and female groups. In conclusion, genotype 3b was the predominant HCV genotype in Yunnan HIV/HCV co-infected persons. The HGB level was higher in patients with genotype 3a than others. HIV-viral load was positively correlated with the HGB level and CD4+ cells in the male or female HCV-infected group.


Author(s):  
Fatima Youssoufi ◽  
Hicham El Annaz ◽  
Abdelilah Laraqui ◽  
Reda Tagajdid ◽  
Rachid Abi ◽  
...  

Background: The human leukocyte antigen-B*44 (HLA-B*44) allele has been reported to have promising results in the control of human immunodeficiency virus-1 (HIV-1) infection and associated with protection against HIV-1 disease progression. In the Moroccan HIV-1 infected patients, the contribution of this allele has not been established. This study aimed to evaluate the distribution of HLA-B*44 allele among HIV-1-infected in Morocco. Additionally, investigate HLA-B*44 allele association with demographical and HIV clinical parameters.Methods: One hundred and sixty-seven HIV-1 infected, antiretroviral naive individuals were enrolled in this study. The HLA-B*44 allele screening was performed using the PCR amplification.Results: Of the 167 individuals genotyped, 26 (16%) of them expressing the HLA-B*44 allele. Clinical stages at diagnosis, median pre-treatment HIV viral load (pVL) and CD4 T cell counts differ significantly (p = 0.0001, p=0.001 and p=0.0001 respectively) between the patients who had been expressing the HLA-B*44 allele and patients who had not been expressing this allele. The presence of HLA-B*44 allele was significantly associated with pVL and CD4 T cell counts (p=0.004 and p=0.0001 respectively). The bivariate analysis has showed that the expression of the HLA-B*44 allele was strongly associated with advanced HIV infection (Odd ratio (OR) 0.12 (95% confidence interval (CI) 0.04-0.37), p=0.0001).Conclusions: Author have described for the first time in Morocco the association of the HLA-B*44 allele with the clinical parameters of HIV infection. These results expand the knowledge of the distribution and effect of this allele in the Moroccan population.


2021 ◽  
Author(s):  
Yegnasew Takele ◽  
Tadele Mulaw ◽  
Emebet Adem ◽  
Caroline Jayne Shaw ◽  
Susanne Ursula Franssen ◽  
...  

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.


2006 ◽  
Vol 78 (1) ◽  
pp. 113-121 ◽  
Author(s):  
Ana M.B. Martínez ◽  
Vanusa P. da Hora ◽  
Adriana L. dos Santos ◽  
Raul Mendoza-Sassi ◽  
Andréa Von Groll ◽  
...  

Different human immunodeficiency virus type 1 (HIV-1) subtypes may have distinct biological, immunological and pathogenic properties. Efficiency of mother-to-child transmission (MTCT) may be among those properties, but few and controversial results have been described so far. In this study, 102 children born from HIV-1-infected mothers between 1998 and 2004 in the city of Rio Grande, Brazil were analyzed for potential risk factors associated with MTCT. That geographic region is characterized by a high proportion of subtype C-infected subjects, and it allowed comparison between subtypes B and C and their influence on MTCT. The analysis also included clinical, obstetric and immunological parameters. Multivariate regression analyses were conducted to evaluate the influence of the parameters on MTCT, and prevalence ratios (PR) and 95% confidence intervals (CI95) were also calculated. A surprisingly high prevalence of subtype C of over 70% was found. Only the HIV viral load and the use of ACTG 076 protocol were predictive of MTCT. HIV subtype and CD4 T-cell counts were not associated with increased risk of transmission. Although a clear expansion of subtype C is evident in southern Brazil, it does not seem to correlate with increased risk of vertical transmission.


2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Zhiqiang Cao ◽  
Jianjun Li ◽  
Huanhuan Chen ◽  
Chang Song ◽  
Zhiyong Shen ◽  
...  

Abstract To assess whether human immunodeficiency virus type 1 (HIV-1) genotype influences baseline CD4+ T lymphocyte (CD4+) cell count and mortality of patients. The study was conducted from 2014 to 2019 in Guangxi, China, and included 2845 newly diagnosed HIV patients. We used a median regression model to compare CD4+ cell counts in patients newly diagnosed with different HIV-1 genotypes, and a Cox regression model to analyze the associations between HIV-1 genotypes and mortality before and after antiretroviral treatment (ART). In newly diagnosed HIV patients, the baseline CD4+ cell counts of patients with CRF01_AE were significantly lower than those of patients with CRF07_BC, CRF08_BC, and other genotypes. Compared with CRF01_AE, patients infected with CRF07_BC (hazard ratio, 0.55; 95% CI 0.36–0.85), CRF08_BC (hazard ratio, 0.67; 95% CI 0.52–0.85), or other genotypes (hazard ratio, 0.52; 95% CI 0.29–0.94) had significantly lower mortality rates before ART. There were no significant associations between different HIV-1 genotypes and mortality after ART. HIV-1 genotype significantly influences baseline CD4+ cell count and mortality before ART in newly diagnosed HIV patients. We find no significant difference in the outcome of death after ART in patients with different HIV-1 genotypes.


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