Gliosarcoma: An Unusual Cause of Cerebral Mass Lesion in a Patient with AIDS

2008 ◽  
Vol 21 (6) ◽  
pp. 835-838
Author(s):  
M. Corti ◽  
N. Trione ◽  
E. Muzzio ◽  
C. Yampolsky ◽  
D. Lewi ◽  
...  
Keyword(s):  
Highly Active Antiretroviral Therapy ◽  
Stereotactic Biopsy ◽  
Opportunistic Infections ◽  
Brain Biopsy ◽  
Histopathological Diagnosis ◽  
Cerebral Lesion ◽  
Stereotactic Brain Biopsy ◽  
Highly Active ◽  
Immunodeficiency Virus ◽  
The Central Nervous System

Malignant glioma is the most common primary brain neoplasm. Generally, gliomas are not included in the differential diagnosis of enhancing lesions of the central nervous system in patients infected by the human immunodeficiency virus. We report a case of gliosarcoma in a patient with AIDS presenting as a single cerebral lesion. Stereotactic brain biopsy was obtained and definitive histopathological diagnosis of gliosarcoma was made. A decline in the incidence of opportunistic infections associated with highly active antiretroviral therapy suggest the importance of early stereotactic biopsy to confirm the diagnosis of these neoplasms.

Stereotactic Brain Biopsy in Eloquent Areas Assisted by Navigated Transcranial Magnetic Stimulation: a Technical Case Report

2018 ◽  
Vol 17 (3) ◽  
pp. E124-E129 ◽  
Author(s):  
Jiri Bartek ◽  
Gerald Cooray ◽  
Mominul Islam ◽  
Margret Jensdottir
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Magnetic Stimulation ◽  
Stereotactic Biopsy ◽  
Brain Biopsy ◽  
Awake Surgery ◽  
Histopathological Diagnosis ◽  
Navigated Transcranial Magnetic Stimulation ◽  
Stereotactic Brain Biopsy ◽  
Eloquent Areas ◽  
The Brain

Abstract BACKGROUND AND IMPORTANCE Stereotactic brain biopsy (SB) is an important part of the neurosurgical armamentarium, with the possibility of achieving histopathological diagnosis in otherwise inaccessible lesions of the brain. Nevertheless, the procedure is not without the risk of morbidity, which is especially true for lesions in eloquent parts of the brain, where even a minor adverse event can result in significant deficits. Navigated transcranial magnetic stimulation (nTMS) is widely used to chart lesions in eloquent areas, successfully guiding maximal safe resection, while its potential role in aiding with the planning of a stereotactic biopsy is so far unexplored. CLINICAL PRESENTATION Magnetic resonance imaging of a 67-yr-old woman presenting with dysphasia revealed a noncontrast enhancing left-sided lesion in the frontal and parietal pars opercularis. Due to the location of the lesion, nTMS was used to chart both primary motor and language cortex, utilizing this information to plan a safe SB trajectory and sampling area according to the initial work-up recommendations from the multidisciplinary neuro-oncology board. The SB was uneventful, with histology revealing a ganglioglioma, WHO I. The patient was discharged the following day, having declined to proceed with tumor resection (awake surgery) due to the non-negligible risk of morbidity. Upon 1- and 3-mo follow-up, she showed no signs of any procedure-related deficits. CONCLUSION nTMS can be implemented to aid with the planning of a stereotactic biopsy procedure in eloquent areas of the brain, and should be considered part of the neurosurgical armamentarium.

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 Trends in Mortality From Human Immunodeficiency Virus Infection, 1984–2016: An Autopsy-Based Study

2019 ◽  
Vol 144 (5) ◽  
pp. 572-579 ◽  
Author(s):  
Sobia Nizami ◽  
Cameron Morales ◽  
Kelly Hu ◽  
Robert Holzman ◽  
Amy Rapkiewicz
Keyword(s):  
New York ◽  
Human Immunodeficiency Virus ◽  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Highly Active Antiretroviral Therapy ◽  
Opportunistic Infections ◽  
City Hospital ◽  
Aids Epidemic ◽  
Highly Active ◽  
Immunodeficiency Virus

Context.— With increasing use and efficacy of antiretroviral therapy for human immunodeficiency virus (HIV) infection, deaths from acquired immunodeficiency syndrome (AIDS)–defining conditions have decreased. Objective.— To examine trends in the cause of death of HIV-infected patients who underwent autopsy at a major New York City hospital from 1984 to 2016, a period including the major epochs of the AIDS epidemic. Design.— Retrospective review of autopsy records and charts with modeling of trends by logistic regression using polynomial models. Results.— We identified 252 autopsies in adult patients with AIDS (by 1982 definition) or HIV infection. Prior to widespread use of highly active antiretroviral therapy, in 1984–1995, on average 13 autopsies per year were done. Post–highly active antiretroviral therapy, the average number of autopsies declined to 4.5 per year. The fitted mean age at death was 35 years in 1984 and increased curvilinearly to 46 years (95% CI, 43–49) in 2016 (P < .001). By regression analysis, mean CD4+ T-cell count increased from 6 in 1992 to 64 in 2016 (P = .01). The proportion of AIDS-defining opportunistic infections decreased, from 79% in 1984–1987 to 41% in 2008–2011 and 29% in 2012–2016 (P = .04). The frequency of nonopportunistic infections, however, increased from 37% in 1984–1987 to 73% in 2008–2011 and 57% in 2012–2016 (P = .001). The frequency of AIDS-defining and other malignancies did not change significantly during the study period. The prevalence of atherosclerosis at autopsy rose dramatically, from 21% in 1988–1991 to 54% in 2008–2011 (P < .001). Conclusions.— Despite limitations of autopsy studies, many trends in the evolution of the HIV/AIDS epidemic are readily discernable.

scholarly journals HIV/AIDS treatment failure and associated factors in Ethiopia: Meta-analysis

2020 ◽  
Author(s):  
Aklilu Endalamaw ◽  
Mengistu Mekonnen ◽  
Demeke Geremw ◽  
Fekadu Ambaw ◽  
Hiwot Tesera ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Confidence Interval ◽  
Treatment Failure ◽  
Highly Active Antiretroviral Therapy ◽  
Opportunistic Infections ◽  
Clinical Stage ◽  
Contributing Factors ◽  
Human Immunodeficiency Virus Treatment ◽  
Highly Active ◽  
Immunodeficiency Virus

Abstract Background: The national burden of human immunodeficiency virus treatment failure and associated factors in the Ethiopian context is required to provide evidence towards a renewed ambitious future goal. Methods: We accessed Ethiopian Universities’ online repository library, Google Scholar, PubMed, Web of Science, and Scopus to get the research articles. We run I-squared statistics to see heterogeneity. Publication bias was checked by using Egger’s regression test. The pooled prevalence was estimated using the DerSimonian-Laird random-effects model. We employed the sensitivity analysis to see the presence of outlier result in the included studies. Results: The overall human immunodeficiency treatment failure was 15.9% (95% confidence interval: 11.6%-20.1%). Using immunological, virological, and clinical definition, human immunodeficiency treatment failure was 10.2% (95% confidence interval: 6.9%-13.6%), 5.6% (95% confidence interval: 2.9%-8.3%), and 6.3% (95% confidence interval: 4.6%-8.0%), respectively. The pooled effects of World Health Organization clinical stage III/IV (Adjusted Odd Ratio=1.9; 95% CI: 1.3-2.6), presence of opportunistic infections (Adjusted Odd Ratio= 1.8; 95% CI: 1.2-2.4), and poor adherence to highly active antiretroviral therapy (Adjusted Odd Ratio= 8.1; 95% CI: 4.3-11.8) on HIV treatment failure were estimated. Conclusions: Human immunodeficiency virus treatment failure in Ethiopia found to be high. Being on advanced clinical stage, presence of opportunistic infections, and poor adherence to highly active antiretroviral therapy were the contributing factors of human immunodeficiency virus treatment failure. Human immunodeficiency virus intervention programs need to address the specified contributing factors of human immunodeficiency virus treatment failure. Behavioral intervention to prevent treatment interruption is required to sustain human immunodeficiency virus treatment adherence. Protocol Registration: It has been registered in the PROSPERO database with a registration number of CRD42018100254.

Immune-Based Therapies for the Management of HIV Infection: Highly Active Antiretroviral Therapy and Beyond

2000 ◽  
Vol 13 (6) ◽  
pp. 515-532
Author(s):  
Aimee F. Ansari ◽  
Joseph V. Etzel
Keyword(s):  
Antiretroviral Therapy ◽  
Highly Active Antiretroviral Therapy ◽  
Potential Role ◽  
Opportunistic Infections ◽  
Normal Function ◽  
Highly Active ◽  
Immunodeficiency Virus ◽  
Acquired Immunodeficiency ◽  
Immunodeficiency Syndrome ◽  
Improve Patient

The widespread use of highly active antiretroviral therapy (HAART) has had a significant impact on reducing the incidence of opportunistic infections in patients with the Acquired Immunodeficiency Syndrome (AIDS) and reducing the overall morbidity and mortality associated with this disease. However, the use of HAART is often associated with adverse effects, significant drug interactions, high cost and the emergence of viral resistance in a significant percentage of treatment recipients. In addition, the clinical efficacy of HAART in terms of viral eradication appears to be limited due to the presence of reservoirs of latent virus within HAART-experienced patients. Because of these and other limitations associated with antiretroviral therapies, new therapeutic strategies are being developed to restore the normal function of the immune system and improve patient outcomes. The purpose of this article is to review some of the more promising investigational immune-based therapies and their potential role in the management of Human Immunodeficiency Virus infection.

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