Idiopathic CD4 T-Cell Lymphocytopenia

Importance: Idiopathic CD4 T-cell lymphocytopenia (ICL) is an immunodeficiency disorder that presents with a decrease in CD4+ T cells without evidence of a human immunodeficiency virus infection. It is most commonly diagnosed after a patient presents with an opportunistic infection and can also be associated with malignancies and autoimmune diseases. This case presentation and literature review highlights the common skin findings in patients with ICL, mainly recalcitrant warts, and discusses the treatment options available. Observations: The patient described is the youngest reported with ICL presenting with isolated cutaneous findings of recalcitrant warts and psoriasis. Many treatment options were tried for the warts, with the most significant response to acitretin. Conclusions and Relevance: This case highlights the importance of considering underlying immunodeficiency in patients with recalcitrant warts as well as developing treatment plans. Such patients require close follow-up by both dermatology and immunology to monitor for the development of other diseases related to ICL.

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Gradually increased dyslipidemia in human immunodeficiency virus infected male patients with tenofovir plus lamivudine plus efavirenz primary treatment: a 3-year follow-up study

10.21203/rs.3.rs-55587/v1 ◽

2020 ◽

Author(s):

dafeng liu ◽

Bennan Zhao ◽

Xinyi Zhang ◽

Fengjiao Gao ◽

Jun Kang ◽

...

Keyword(s):

Human Immunodeficiency Virus ◽

T Cell ◽

Cd4 T Cell ◽

Infected Male ◽

Significant Difference ◽

Immunodeficiency Virus ◽

Male Patients ◽

Cd4 T Cell Count

Abstract IntroductionSince the start of highly active antiretroviral therapy (HAART) with TDF plus 3TC plus EFV, the long-term dynamic characteristics of lipid and purine metabolism in patients infected with human immunodeficiency virus (HIV) was unclear and worth studying.MethodsA prospective follow-up cohort study was the way. Sixty-one treatment-naive HIV infected male patients were divided into three groups based on the baseline CD4 + T cell count (26, 12, 23cases in < 200, from 200 to 350, > 350 three groups, respectively). Lipid and purine metabolism parameters of those patients within 144 weeks were analyzed.ResultTG, TC, LDL-c and HDL-c level all gradually increased within 144 weeks, but statistical significances of TC level and HDL-c level were only found (F = 4.214, 5.518, P = 0.001, 0.000 ,respectively). Moreover the percentage of hypercholesterolemia, hyper LDL cholesterolemia and hypertriglyceridemia all gradually increased, low HDL cholesterolemia gradually decreased, but there was only obvious difference of the latter (χ2 = 16.105, P = 0.0007).Furthermore the lower the baseline CD4 + T lymphocyte counts, the higher TG level, the lower TC level, LDL-c level and HDL-c level, but only significant difference of LDL-c level between three groups at baseline was found (F = 3.256,P = 0.0457).Although UA level and the percentages of hyperuricemia gradually increased within 144 weeks, but there was no significant difference between different follow-up time points groups and between three CD4 + T cell count groups (all P༞0.05).ConclusionsThese findings provide a reference for clinicians to monitor lipid metabolism parameters closely during long-term HAART with TDF plus 3TC plus EFV regimen.

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Even Individuals Considered as Long-Term Nonprogressors Show Biological Signs of Progression After 10 Years of Human Immunodeficiency Virus Infection

Blood ◽

10.1182/blood.v90.3.1133 ◽

1997 ◽

Vol 90 (3) ◽

pp. 1133-1140 ◽

Cited By ~ 58

Author(s):

Jean-Jacques Lefrère ◽

Laurence Morand-Joubert ◽

Martine Mariotti ◽

Hubertus Bludau ◽

Béatrice Burghoffer ◽

...

Keyword(s):

T Cell ◽

Cell Count ◽

Copy Number ◽

Cd4 T Cell ◽

Viral Copy Number ◽

Immunodeficiency Virus ◽

Viral Copy ◽

Cd4 T Cell Count

Abstract Despite a decade of human immunodeficiency virus (HIV) seropositivity, a few individuals termed as long-term nonprogressors (LTNPs) maintain a stable CD4+ T-cell count for a period of time. The aim of this study was to establish, through the sequential determination of all known predictors of HIV disease, the proportion of such patients having stringent criteria of true long-term nonprogression. Among 249 individuals who were HIV-infected and prospectively followed up over a 10-year period (1985 to 1995), 12 having a CD4+ T-cell count greater than 500/μL (LTNP I group) and 9 having a CD4+ T-cell count less than 500 but stable over time (LTNP II group) after at least 10 years of infection without intervention of antiviral therapy, were studied over the entire follow-up period. The plasma HIV RNA copy number and the serum concentrations of p24 antigen, each anti-HIV antibody, neopterin, β-2-microglobulin, Immunoglobulin (Ig) G and IgA were determined every 18 months over the study period. Cellular and plasma viremias were cross-sectionaly assayed in all 21 patients. Only two patients had strictly no marker of progression over the follow-up period. They were the only ones who had, over the 10-year period, a viral copy number too low to be detected. The other patients had a viral copy number higher than 400/mL at at least one visit and increasing over the follow-up period, and they evidenced one or more markers of virological or immunological deterioration. Cellular viremia was positive in all patients but two, while plasma viremia was negative in all but one. The population of individuals termed as LTNPs is not virologically and immunologically homogeneous. The majority present biological signs of HIV disease progression. A new pattern of true LTNP can be drawn through stringent criteria based on the whole known predictors. This pattern appears to be rare in HIV-positive population.

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Even Individuals Considered as Long-Term Nonprogressors Show Biological Signs of Progression After 10 Years of Human Immunodeficiency Virus Infection

Blood ◽

10.1182/blood.v90.3.1133.1133_1133_1140 ◽

1997 ◽

Vol 90 (3) ◽

pp. 1133-1140 ◽

Cited By ~ 1

Author(s):

Jean-Jacques Lefrère ◽

Laurence Morand-Joubert ◽

Martine Mariotti ◽

Hubertus Bludau ◽

Béatrice Burghoffer ◽

...

Keyword(s):

T Cell ◽

Cell Count ◽

Copy Number ◽

Cd4 T Cell ◽

Viral Copy Number ◽

Immunodeficiency Virus ◽

Viral Copy ◽

Cd4 T Cell Count

Despite a decade of human immunodeficiency virus (HIV) seropositivity, a few individuals termed as long-term nonprogressors (LTNPs) maintain a stable CD4+ T-cell count for a period of time. The aim of this study was to establish, through the sequential determination of all known predictors of HIV disease, the proportion of such patients having stringent criteria of true long-term nonprogression. Among 249 individuals who were HIV-infected and prospectively followed up over a 10-year period (1985 to 1995), 12 having a CD4+ T-cell count greater than 500/μL (LTNP I group) and 9 having a CD4+ T-cell count less than 500 but stable over time (LTNP II group) after at least 10 years of infection without intervention of antiviral therapy, were studied over the entire follow-up period. The plasma HIV RNA copy number and the serum concentrations of p24 antigen, each anti-HIV antibody, neopterin, β-2-microglobulin, Immunoglobulin (Ig) G and IgA were determined every 18 months over the study period. Cellular and plasma viremias were cross-sectionaly assayed in all 21 patients. Only two patients had strictly no marker of progression over the follow-up period. They were the only ones who had, over the 10-year period, a viral copy number too low to be detected. The other patients had a viral copy number higher than 400/mL at at least one visit and increasing over the follow-up period, and they evidenced one or more markers of virological or immunological deterioration. Cellular viremia was positive in all patients but two, while plasma viremia was negative in all but one. The population of individuals termed as LTNPs is not virologically and immunologically homogeneous. The majority present biological signs of HIV disease progression. A new pattern of true LTNP can be drawn through stringent criteria based on the whole known predictors. This pattern appears to be rare in HIV-positive population.

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