scholarly journals Overt Lower Gastrointestinal Bleeding and Pseudotumor: A Rare Presentation of Cytomegalovirus Infection

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Akanksha Agrawal ◽  
Deepanshu Jain ◽  
Sameer Siddique
Keyword(s):  
Highly Active Antiretroviral Therapy ◽  
The Body ◽  
Cmv Infection ◽  
Rare Presentation ◽  
Multiple Organs ◽  
Highly Active ◽  
History Of ◽  
Acquired Immunodeficiency ◽  
Immunodeficiency Syndrome

Cytomegalovirus (CMV) is a ubiquitous organism which can infect multiple organs of the body. In an immunocompromised patient, it can have a myriad of gastrointestinal manifestations. We report a case of recurrent hematochezia and concomitant pseudotumor in an AIDS (acquired immunodeficiency syndrome) patient attributable to CMV infection. A 62-year-old man with a history of AIDS, noncompliant with highly active antiretroviral therapy (HAART), presented with bright red blood per rectum. Index colonoscopy showed presence of multiple ulcers, colonic stenosis, and mass-like appearing lesion. Biopsy confirmed CMV infection and ruled out malignancy. Cessation of dual antiplatelet therapy and compliance with HAART lead to clinical cessation of bleeding and endoscopic healing of ulcers with complete resolution of colon mass on follow-up colonoscopy.

Changes in acquired immunodeficiency syndrome–related lymphoma since the introduction of highly active antiretroviral therapy

Blood ◽  
2000 ◽  
Vol 96 (8) ◽  
pp. 2730-2734 ◽  
Author(s):  
Gail V. Matthews ◽  
Mark Bower ◽  
Sundhiya Mandalia ◽  
Tom Powles ◽  
Mark R. Nelson ◽  
...  
Keyword(s):  
Statistical Models ◽  
Highly Active Antiretroviral Therapy ◽  
Performance Status ◽  
Cd4 Count ◽  
Survival Duration ◽  
Hiv Positive ◽  
Highly Active ◽  
Acquired Immunodeficiency ◽  
Immunodeficiency Syndrome

Clinical data on 7840 HIV-positive patients, representing 43 745 patient-years of follow-up, has been collected. All patients with ARL since 1986 (n = 150) were assessed at presentation for prognostic factors and outcomes recorded. Comparisons are made between cases in the pre-HAART era (1988-1995), and the HAART era (1996-1999). Statistical models are used to calculate the incidence of ARL and factors predicting its development. The incidence of ARL has not changed over time (3 to 7 of 1000 patients per year,P = .933), but contributes to a greater percentage of first AIDS-defining illnesses (ADI) in the HAART era (P ≤ .0001). Older age, nadir CD4 count, and no prior HAART use, predict the development of ARL. There has been no change in stage at presentation, presence of B symptoms, performance status, or marrow involvement between the 2 time cohorts or between patients with or without prior HAART exposure. Similarly, there is no difference in survival duration between the pre-HAART and HAART era (log rankP = .15) or specifically in patients treated with HAART before ARL diagnosis (log rank P = .12). The use of HAART has not yet been shown to influence the incidence or survival of ARL. However, because nadir CD4 count and use of HAART are independent predictors of ARL development, this may translate into a future fall in new cases.

Changes in acquired immunodeficiency syndrome–related lymphoma since the introduction of highly active antiretroviral therapy

Blood ◽  
2000 ◽  
Vol 96 (8) ◽  
pp. 2730-2734 ◽  
Author(s):  
Gail V. Matthews ◽  
Mark Bower ◽  
Sundhiya Mandalia ◽  
Tom Powles ◽  
Mark R. Nelson ◽  
...  
Keyword(s):  
Statistical Models ◽  
Highly Active Antiretroviral Therapy ◽  
Performance Status ◽  
Cd4 Count ◽  
Survival Duration ◽  
Hiv Positive ◽  
Highly Active ◽  
Acquired Immunodeficiency ◽  
Immunodeficiency Syndrome

Abstract Clinical data on 7840 HIV-positive patients, representing 43 745 patient-years of follow-up, has been collected. All patients with ARL since 1986 (n = 150) were assessed at presentation for prognostic factors and outcomes recorded. Comparisons are made between cases in the pre-HAART era (1988-1995), and the HAART era (1996-1999). Statistical models are used to calculate the incidence of ARL and factors predicting its development. The incidence of ARL has not changed over time (3 to 7 of 1000 patients per year,P = .933), but contributes to a greater percentage of first AIDS-defining illnesses (ADI) in the HAART era (P ≤ .0001). Older age, nadir CD4 count, and no prior HAART use, predict the development of ARL. There has been no change in stage at presentation, presence of B symptoms, performance status, or marrow involvement between the 2 time cohorts or between patients with or without prior HAART exposure. Similarly, there is no difference in survival duration between the pre-HAART and HAART era (log rankP = .15) or specifically in patients treated with HAART before ARL diagnosis (log rank P = .12). The use of HAART has not yet been shown to influence the incidence or survival of ARL. However, because nadir CD4 count and use of HAART are independent predictors of ARL development, this may translate into a future fall in new cases.

scholarly journals Chronic Cystoisospora belli infection in a Colombian patient living with HIV and poor adherence to highly active antiretroviral therapy

Biomédica ◽  
2021 ◽  
Vol 41 (Supl. 1) ◽  
pp. 17-22
Author(s):  
Ana Luz Galván-Díaz ◽  
Juan Carlos Alzate ◽  
Esteban Villegas ◽  
Sofía Giraldo ◽  
Jorge Botero ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Highly Active Antiretroviral Therapy ◽  
Diarrheal Disease ◽  
Opportunistic Infections ◽  
Poor Adherence ◽  
Highly Active ◽  
Immunodeficiency Virus ◽  
Acquired Immunodeficiency ◽  
Immunodeficiency Syndrome ◽  
Living With Hiv

Cystoisospora belli is an intestinal Apicomplexan parasite associated with diarrheal illness and disseminated infections in humans, mainly immunocompromised individuals such as those living with the human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS). An irregular administration of highly active antiretroviral therapy (HAART) in HIV patients may increase the risk of opportunistic infections like cystoisosporiasis.We describe here a case of C. belli infection in a Colombian HIV patient with chronic gastrointestinal syndrome and poor adherence to HAART. His clinical and parasitological cure was achieved with trimethoprim-sulfamethoxazole treatment. Although a reduction in the number of C. belli cases has been observed since the use of HAART, this parasite still has to be considered as a differential diagnosis of diarrheal disease in HIV/AIDS patients.Effective interventions enhancing adherence to HAART should be included in HIV patient care programs.

scholarly journals Keratoconjunctivitis associated with nevirapine toxicity in HIV pregnant woman

2012 ◽  
Vol 2 (1) ◽  
pp. 6
Author(s):  
Bety Yañez
Keyword(s):  
Highly Active Antiretroviral Therapy ◽  
Stevens Johnson Syndrome ◽  
Amniotic Membrane Transplantation ◽  
Eye Drops ◽  
Highly Active ◽  
Johnson Syndrome ◽  
Immunodeficiency Virus ◽  
Acquired Immunodeficiency ◽  
The Right ◽  
Immunodeficiency Syndrome

Highly active antiretroviral therapy (HAART) is the treatment of choice for human immunodeficiency virus-acquired immunodeficiency syndrome (HIV-AIDS) patients. Severe side effects of these drugs have been described that produce generalized autoimmune blistering diseases, such as Stevens-Johnson syndrome and toxic epidermal necrosis (TEN). These complications may seriously compromise the patient’s life or cause disabling consequences such as blindness. We describe a case of 21-year old female HIV patient with a CD4 count of 126 cells/microliter. Ten days post elective caesarean delivery she restarted HAART with nevirapine and developed TEN after approximately two weeks. Nevirapine was discontinued, but despite this, ocular surface disorder persisted. She presented severe bilateral keratoconjunctivitis that was treated with free tear substitutes, moxifloxacyn, and prednisolone acethate eye drops. At 2-month follow up her visual acuity without correction was 20/160 in the right eye and 20/40 in the left. She had bilateral moderate cicatricial keratoconjunctivitis and a central corneal leukoma in the right eye. Early treatment is important and should consist of preservative-free lubricants, and amniotic membrane transplantation to decrease the frequency of severe sequelae such as keratitis and corneal leukomas that will reduce the quality of life for these patients.

Utility of Brain Biopsy in Patients with Acquired Immunodeficiency Syndrome before and after Introduction of Highly Active Antiretroviral Therapy

Neurosurgery ◽  
2007 ◽  
Vol 61 (1) ◽  
pp. 130-141 ◽  
Author(s):  
Joshua M. Rosenow ◽  
Alan Hirschfeld
Keyword(s):  
Antiretroviral Therapy ◽  
Progressive Multifocal Leukoencephalopathy ◽  
Acquired Immunodeficiency Syndrome ◽  
Highly Active Antiretroviral Therapy ◽  
Brain Biopsy ◽  
Karnofsky Performance Score ◽  
Highly Active ◽  
Number Of Patients ◽  
Acquired Immunodeficiency ◽  
Immunodeficiency Syndrome

Abstract OBJECTIVE This study investigates the changing indications, results, and practice patterns of brain biopsy in patients with acquired immunodeficiency syndrome (AIDS) as treatment evolved with the development of highly active antiretroviral therapy (HAART). METHODS We collected data on 246 patients with AIDS who were undergoing brain biopsy of intracranial lesions. Patients were managed in accordance with a uniform protocol. Patients were divided into two groups of those biopsied in the era before (1992–1996) or after (1997–2001) the use of HAART. RESULTS The introduction of HAART led to a steep decrease in the number of biopsies performed annually. The protocol functioned well. Diagnoses were obtained for 92.3% of patients. Lymphoma was the most frequent diagnosis (52.9% of patients), followed by progressive multifocal leukoencephalopathy (18.9% of patients) and toxoplasmosis (8.1% of patients). No patient who underwent lesion biopsy for reasons of negative toxoplasmosis titers or atypical radiology evaluation was diagnosed with toxoplasmosis. Nineteen patients who experienced failed toxoplasmosis treatment were diagnosed with toxoplasmosis. Toxoplasmosis titers had a high specificity and a negative predictive value. Patients with progressive multifocal leukoencephalopathy or nondiagnostic biopsies were more likely to have solitary lesions. The average Karnofsky performance score at the time of biopsy was 72.4, which is still within the range of independent functioning. Significant intracerebral hemorrhages were only observed in patients with lymphoma who also had low platelet counts. CONCLUSION Although the number of patients with AIDS who require brain biopsy has decreased, the procedure still has merits. The paradigm we developed was useful for selecting patients for early biopsy. Patients with AIDS who also have intracerebral lesions should have toxoplasmosis titers performed, and those whose titers are negative for toxoplasmosis should undergo early brain biopsy.

A Review on Quinoline Derived Scaffolds as Anti-HIV Agents

2019 ◽  
Vol 19 (6) ◽  
pp. 510-526 ◽  
Author(s):  
Nisha Chokkar ◽  
Sourav Kalra ◽  
Monika Chauhan ◽  
Raj Kumar
Keyword(s):  
Human Immunodeficiency Virus ◽  
Highly Active Antiretroviral Therapy ◽  
Fast Rate ◽  
Highly Active ◽  
Immunodeficiency Virus ◽  
Acquired Immunodeficiency ◽  
Quinolone Derivative ◽  
Immunodeficiency Syndrome ◽  
Anti Hiv Agents ◽  
Anti Hiv

After restricting the proliferation of CD4+T cells, Human Immunodeficiency Virus (HIV), infection persists at a very fast rate causing Acquired Immunodeficiency Syndrome (AIDS). This demands the vigorous need of suitable anti-HIV agents, as existing medicines do not provide a complete cure and exhibit drawbacks like toxicities, drug resistance, side-effects, etc. Even the introduction of Highly Active Antiretroviral Therapy (HAART) failed to combat HIV/AIDS completely. The major breakthrough in anti-HIV discovery was marked with the discovery of raltegravir in 2007, the first integrase (IN) inhibitor. Thereafter, the discovery of elvitegravir, a quinolone derivative emerged as the potent HIV-IN inhibitor. Though many more classes of different drugs that act as anti-HIV have been identified, some of which are under clinical trials, but the recent serious focus is still laid on quinoline and its analogues. In this review, we have covered all the quinoline-based derivatives that inhibit various targets and are potential anti-HIV agents in various phases of the drug discovery.

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