scholarly journals Refractory pharyngeal ulceration due to cytomegalovirus in a patient with HIV infection: a case report and literature review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Morichika Osa ◽  
Akihiro Sato ◽  
Maki Sakagami ◽  
Masaki Machida ◽  
Takao Sato ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Pathological Examination ◽  
Cmv Infection ◽  
Case Presentation ◽  
Immunodeficiency Virus ◽  
Before And After ◽  
Infected Cells ◽  
Immunocompromised Hosts ◽  
Inflammatory Syndrome ◽  
Nonspecific Inflammation

Abstract Background Cytomegalovirus (CMV) is an important pathogen among immunocompromised hosts. Typically, CMV in human immunodeficiency virus (HIV) infection causes diseases of the retina, digestive tract, lungs and liver, but there are few cases of CMV infection of the pharynx and larynx. Case presentation A 57-year-old man with HIV infection was admitted because of pharyngeal pain. Before and after admission, pharyngeal biopsies guided by laryngeal endoscopy were performed four times, but pathological examination showed nonspecific inflammation, and the cause of pharyngeal ulceration was unclear. Additionally, the ulceration deteriorated after initiation of retroviral therapy. Laryngomicrosurgery was conducted under general anesthesia to remove tissue, and pathological diagnosis confirmed CMV infection. Pathological features included enlargement of the cytoplasm and nucleus in infected cells, and intranuclear bodies called owl’s eye inclusions. Ganciclovir dramatically improved the symptoms and laryngoscopic findings. Conclusions This case was diagnosed as pharyngitis and pharyngeal ulceration caused by CMV infection, related to immune reconstitution inflammatory syndrome. In previous reports of CMV-induced pharyngeal or laryngeal ulceration in HIV infection, we found six cases similar to our present case. All cases were diagnosed by biopsy. The present case indicates the importance of biopsy for definitive diagnosis. CMV infection should be considered as a differential diagnosis of pharyngeal ulceration in patients with HIV infection.

scholarly journals The Presentation of Multiple Perforations in the Small Bowel as Cytomegalovirus Related Immune Reconstitution Inflammatory Syndrome in an HIV-infected Patient: a Case Report

2021 ◽  
Author(s):  
Wang Yanli ◽  
Xuyong Lin ◽  
Yuji Li ◽  
Ying Wen
Keyword(s):  
Small Bowel ◽  
Immune Reconstitution Inflammatory Syndrome ◽  
Infected Patient ◽  
Immune Reconstitution ◽  
Opportunistic Infections ◽  
Exploratory Laparotomy ◽  
Pathological Examination ◽  
Case Presentation ◽  
Immunodeficiency Virus ◽  
Inflammatory Syndrome

Abstract Background: Multiple perforations in the small bowel as cytomegalovirus (CMV) related immune reconstitution inflammatory syndrome (IRIS) in an human immunodeficiency virus (HIV)-infected patient is very rare. Up to now, only five IRIS-associated cases including our case were reported. We performed pathological examination, metagenomic next-generation sequencing (mNGS), CMV and immune cells immunohistochemical staining for rapid diagnosis and differential diagnosis.Case presentation: We describe a case with multiple perforations in the small bowel as CMV related IRIS in an HIV-infected patient. The patient appeared multiple perforations in the small bowel after 26 days of antiretroviral therapy (ART). The patient underwent exploratory laparotomy. Partial resection and surgical repair of small intestine were performed. CMV enteritis was confirmed by immunohistochemistry staining and other opportunistic infections were excluded by mNGS. However, he died from intestinal obstruction and septic shock at 55 days after surgery. Conclusions: Perforations due to CMV related IRIS are very rare, and usually lack the prodromal period symptoms of abdominal pain and diarrhea. It is not easily foreseen and appears shortly after ART. The condition of intestinal perforations is lethal, and early identification and surgical treatment are lifesaving.

Immune reconstitution inflammatory syndrome associated with secondary syphilis: dermatologic, neurologic and ophthalmologic compromise in an HIV patient

2019 ◽  
Vol 30 (5) ◽  
pp. 509-511
Author(s):  
Sami Alcedo ◽  
Renee Newby ◽  
Juan José Montenegro ◽  
Paola Rondan ◽  
Jorge Arevalo ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Hiv Infection ◽  
Immune Reconstitution Inflammatory Syndrome ◽  
Immune Reconstitution ◽  
Secondary Syphilis ◽  
Immune Reconstitution Syndrome ◽  
Clinical Expression ◽  
Immunodeficiency Virus ◽  
Inflammatory Syndrome

The presentation of syphilis as a manifestation of immune reconstitution inflammatory syndrome in patients with human immunodeficiency virus (HIV) infection is rare and can be associated with the varied clinical expression of unusual syphilitic manifestations. We report a case of immune reconstitution syndrome with dermatologic, ophthalmologic and neurologic compromise of secondary syphilis in a patient with HIV infection.

scholarly journals Effects of Prostratin on T-Cell Activation and Human Immunodeficiency Virus Latency

2002 ◽  
Vol 76 (16) ◽  
pp. 8118-8123 ◽  
Author(s):  
Yael D. Korin ◽  
David G. Brooks ◽  
Stephen Brown ◽  
Andrew Korotzer ◽  
Jerome A. Zack
Keyword(s):  
Human Immunodeficiency Virus ◽  
T Cell ◽  
Hiv Infection ◽  
Cell Activation ◽  
Cellular Proliferation ◽  
Latent Virus ◽  
Immunodeficiency Virus ◽  
Latently Infected ◽  
Infected Cells ◽  
Latent Hiv

ABSTRACT Human immunodeficiency virus (HIV) replication is linked to cellular gene transcription and requires target cell activation. The latent reservoir of HIV-1 in quiescent T cells is thought to be a major obstacle to clearance of infection by highly active antiretroviral therapy (HAART). Thus, identification of agents that can induce expression of latent virus may, in the presence of HAART, allow elimination of the infected cells by the immune response. We previously used the SCID-hu (Thy/Liv) mouse model to establish that activation-inducible HIV can be generated at high frequency during thymopoiesis. Latently infected mature thymocytes can be exported into the periphery, providing an efficient primary cell model to determine cellular activation signals that induce renewed expression of latent virus. Here we characterized the effects of prostratin, a non-tumor-promoting phorbol ester, on primary human peripheral blood lymphocytes (PBLs) and assessed its ability to reactivate latent HIV infection from thymocytes and PBLs in the SCID-hu (Thy/Liv) model. Prostratin stimulation alone did not induce proliferation of quiescent PBLs; however, it could provide a secondary signal in the context of T-cell receptor stimulation or a primary activation signal in the presence of CD28 stimulation to induce T-cell proliferation. While prostratin alone was not sufficient to allow de novo HIV infection, it efficiently reactivated HIV expression from latently infected cells generated in the SCID-hu mouse. Our data indicate that prostratin alone is able to specifically reactivate latent virus in the absence of cellular proliferation, making it an attractive candidate for further study as an adjunctive therapy for the elimination of the latent HIV reservoir.

scholarly journals Why the HIV Reservoir Never Runs Dry: Clonal Expansion and the Characteristics of HIV-Infected Cells Challenge Strategies to Cure and Control HIV Infection

Viruses ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 2512
Author(s):  
Chuen-Yen Lau ◽  
Matthew A. Adan ◽  
Frank Maldarelli
Keyword(s):  
Hiv Infection ◽  
Clonal Expansion ◽  
Marrow Transplant ◽  
Clinical Events ◽  
Immunodeficiency Virus ◽  
Latently Infected ◽  
Hiv Eradication ◽  
Infected Cells ◽  
And Control ◽  
Number Of Individuals

Antiretroviral therapy (ART) effectively reduces cycles of viral replication but does not target proviral populations in cells that persist for prolonged periods and that can undergo clonal expansion. Consequently, chronic human immunodeficiency virus (HIV) infection is sustained during ART by a reservoir of long-lived latently infected cells and their progeny. This proviral landscape undergoes change over time on ART. One of the forces driving change in the landscape is the clonal expansion of infected CD4 T cells, which presents a key obstacle to HIV eradication. Potential mechanisms of clonal expansion include general immune activation, antigenic stimulation, homeostatic proliferation, and provirus-driven clonal expansion, each of which likely contributes in varying, and largely unmeasured, amounts to maintaining the reservoir. The role of clinical events, such as infections or neoplasms, in driving these mechanisms remains uncertain, but characterizing these forces may shed light on approaches to effectively eradicate HIV. A limited number of individuals have been cured of HIV infection in the setting of bone marrow transplant; information from these and other studies may identify the means to eradicate or control the virus without ART. In this review, we describe the mechanisms of HIV-1 persistence and clonal expansion, along with the attempts to modify these factors as part of reservoir reduction and cure strategies.

Epstein-Barr Encephalitis in a Child with Congenital Human Immunodeficiency Virus Infection: A Case Report Calling for No Forgetfulness

2020 ◽  
Vol 18 (1) ◽  
pp. 63-66
Author(s):  
Olga Tsiatsiou ◽  
Savvas Papachristou ◽  
Eleni Papadimitriou ◽  
Elisavet Michailidou ◽  
Dimitrios Chatzidimitriou ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Hiv Infection ◽  
Epstein Barr Virus ◽  
Preventive Strategies ◽  
Child Transmission ◽  
Case Presentation ◽  
Barr Virus ◽  
Immunodeficiency Virus ◽  
Epstein Barr ◽  
Mother To Child

Background: In resource-rich settings, the rate of mother-to-child transmission of human immunodeficiency virus (HIV) has dramatically decreased by virtue of a combination of preventive strategies during the last two decades. Case Presentation: We present a case of progressive developmental milestone loss in a toddler with previously unknown congenitally acquired human immunodeficiency virus (HIV) infection, complicated by an Epstein-Barr virus (EBV) coinfection. Conclusion: Our report underscores the differential diagnosis between HIV encephalopathy and EBV encephalitis and the vertical transmission of the HIV infection, which constitutes an alarming issue in terms of public health.

Immunocytochemical characteristic of the endometrial mucosa HIV-infected women

GYNECOLOGY ◽  
2020 ◽  
Vol 22 (6) ◽  
pp. 62-67
Author(s):  
Irina N. Vorobtsova ◽  
Natalya I. Tapilskaya ◽  
Elena S. Orlova ◽  
Nikolay N. Rukhlyada ◽  
Sergei N. Proshin ◽  
...  
Keyword(s):  
Epithelial Cells ◽  
Hiv Infection ◽  
Immunocytochemical Study ◽  
Uterine Epithelial Cells ◽  
Chronic Endometritis ◽  
Expression Levels ◽  
Parallel Group ◽  
Immunodeficiency Virus ◽  
Before And After ◽  
Hiv Negative

Relevance. Human immunodeficiency virus (HIV) infection is an independent factor in reduced fertility and a risk factor for miscarriage. There are some date an endometrial receptivity of HIV-infected patients has changed that plays an important role in embryo invasion, but the true reasons for the decrease in fertility rate in HIV infection remain unknown. Aim. Study of the expression of CD20, CD56 and TLR9 antigens on uterine epithelial cells of HIV-infected patients and the effectiveness of treatment for chronic endometritis by sodium nucleospermate. Materials and methods. This parallel-group study was done at two centres in the Russia. Participants were adults women aged 26 to 49 years (mean age 33.352.9 years), who were HIV-infected (n=12) and HIV-negative (22). An immunocytochemical study of endometrial biopsies taken on the 710th day of the menstrual cycle before and after treatment was done. The course of treatment with sodium nucleospermate was 42 days. Results. The expression level of CD56 and TLR9 in HIV-infected patients was 7.640.92% and 0.330.18%, respectively, and significantly differed from the expression levels in HIV-seronegative patients. There was a decrease in the expression levels of CD20 and CD56 and an increase in the expression levels of TLR9 in all groups of patients after treatment with sodium nucleospermate. Conclusion. A decrease TLR9 expression on uterine epithelial cells in HIV-infected patients showing lack of ability of innate immunity to eliminate pathogens associated with subclinical inflammation and it correlates with an increase in the expression of markers of chronic endometritis.

Malacoplakia of the cranium and cerebrum in a human immunodeficiency virus–infected man

2006 ◽  
Vol 104 (3) ◽  
pp. 432-435 ◽  
Author(s):  
Edna Toubes-Klingler ◽  
Vikram C. Prabhu ◽  
Kerry Bernal ◽  
David Poage ◽  
Susan Swindells
Keyword(s):  
Human Immunodeficiency Virus ◽  
Hiv Infection ◽  
Chronic Inflammatory Disease ◽  
Pathological Examination ◽  
Temporalis Muscle ◽  
Sagittal Sinus ◽  
Appropriate Treatment ◽  
Immunodeficiency Virus ◽  
Salutary Effect ◽  
Adjacent Brain

✓Malacoplakia is a rare chronic inflammatory disease associated with infection and immunosuppression, and very few occurrences have been reported in the cerebrum. The authors describe the case of a 41-year-old man with advanced human immunodeficiency virus (HIV) infection who presented with a very aggressive malacoplakia lesion that had extended through the scalp, temporalis muscle, skull bone, and deep through the dura mater into the superior sagittal sinus and adjacent brain. Pathological examination revealed sheets of histiocytes invading these structures, and macrophages containing numerous round bodies known as Michaelis–Guttmann bodies, pathognomic for malacoplakia. Because of the rarity of this phenomenon, appropriate treatment and management of malacoplakia are speculative. A complete resection of the lesion, antibiotic therapy, and treatment of his underlying HIV infection had a salutary effect, with the patient faring well more than 9 months postoperatively.

A comparison of bioimpedance methods for detection of body cell mass change in HIV infection

2000 ◽  
Vol 88 (3) ◽  
pp. 944-956 ◽  
Author(s):  
Carrie P. Earthman ◽  
James R. Matthie ◽  
Phyllis M. Reid ◽  
Ingeborg T. Harper ◽  
Eric Ravussin ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Cell Mass ◽  
Body Cell Mass ◽  
Extracellular Water ◽  
Multiple Frequency ◽  
Body Cell ◽  
Immunodeficiency Virus ◽  
Measuring Change ◽  
Before And After ◽  
Total Body

The maintenance of body cell mass (BCM) is critical for survival in human immunodeficiency virus (HIV) infection. Accuracy of bioimpedance for measuring change (Δ) in intracellular water (ICW), which defines BCM, is uncertain. To evaluate bioimpedance-estimated ΔBCM, the ICW of 21 weight-losing HIV patients was measured before and after anabolic steroid therapy by dilution (total body water by deuterium − extracellular water by bromide) and bioimpedance. Multiple-frequency modeling- and dilution-determined ΔICW did not differ. The ΔICW was predicted poorly by 50-kHz parallel reactance, 50-kHz impedance, and 200 − 5-kHz impedance. The ΔICW predicted by 500 − 5-kHz impedance was closer to, but statistically different from, dilution-determined ΔICW. However, the effect of random error on the measurement of systematic error in the 500 − 5-kHz method was 12–13% of the average measured ΔICW; this was nearly twice the percent difference between obtained and threshold statistics. Although the 500 − 5-kHz method cannot be fully rejected, these results support the conclusion that only the multiple-frequency modeling approach accurately monitors ΔBCM in HIV infection.

scholarly journals Immune Reсоnstitution Inflammatory Syndrome neuroradiologic features in HIV Infection

2020 ◽  
Vol 11 (1) ◽  
pp. 38-45
Author(s):  
E. G. Bakulina ◽  
T. N. Trofimova ◽  
A. S. Shelomov ◽  
G. V. Kataeva ◽  
N. A. Belyakov
Keyword(s):  
Central Nervous System ◽  
Human Immunodeficiency Virus ◽  
Nervous System ◽  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Clinical Status ◽  
Diagnostic Algorithm ◽  
Immunodeficiency Virus ◽  
Paradoxical Worsening ◽  
Inflammatory Syndrome

The introduction of antiretroviral therapy has changed the human immunodeficiency virus pandemic. Some patients with HIV infection after starting or resuming ART develop a paradoxical worsening of clinical status, called Immune Reсоnstitution Inflammatory Syndrome (IRIS). However, if clinical and laboratory criteria for the diagnosis of this syndrome have been formulated, IRIS neuroradiological criteria do not exist yet. The present study presents neuroradiological features and diagnostic algorithm for identification of IRIS involving central nervous system.

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