scholarly journals Clinical profile and mortality in patients with T. cruzi/HIV co-infection from the multicenter data base of the “Network for healthcare and study of Trypanosoma cruzi/HIV co-infection and other immunosuppression conditions”

2021 ◽  
Vol 15 (9) ◽  
pp. e0009809
Author(s):  
Maria Aparecida Shikanai-Yasuda ◽  
Mauro Felippe Felix Mediano ◽  
Christina Terra Gallafrio Novaes ◽  
Andréa Silvestre de Sousa ◽  
Ana Marli Christovam Sartori ◽  
...  
Keyword(s):  
Trypanosoma Cruzi ◽  
Chagas Disease ◽  
Opportunistic Infections ◽  
Biological Fluids ◽  
Epidemiological Surveillance ◽  
Median Viral Load ◽  
Cross Sectional ◽  
Infection Diagnosis ◽  
Life Threatening ◽  
Immunodeficiency Syndrome

Objective Chagas disease (CD) globalization facilitated the co-infection with Human Immunodeficiency Virus (HIV) in endemic and non-endemic areas. Considering the underestimation of Trypanosoma cruzi (T. cruzi)-HIV co-infection and the risk of life-threatening Chagas Disease Reactivation (CDR), this study aimed to analyze the major co-infection clinical characteristics and its mortality rates. Methods This is a cross-sectional retrospective multicenter study of patients with CD confirmed by two serological or one parasitological tests, and HIV infection confirmed by immunoblot. CDR was diagnosed by direct microscopy with detection of trypomastigote forms in the blood or other biological fluids and/or amastigote forms in inflammatory lesions. Results Out of 241 patients with co-infection, 86.7% were from Brazil, 47.5% had <200 CD4+ T cells/μL and median viral load was 17,000 copies/μL. Sixty CDR cases were observed. Death was more frequent in patients with reactivation and was mainly caused by CDR. Other causes of death unrelated to CDR were the manifestation of opportunistic infections in those with Acquired Immunodeficiency Syndrome. The time between the co-infection diagnosis to death was shorter in patients with CDR. Lower CD4+ cells count at co-infection diagnosis was independently associated with reactivation. Similarly, lower CD4+ cells numbers at co-infection diagnosis and male sex were associated with higher lethality in CDR. Additionally, CD4+ cells were lower in meningoencephalitis than in myocarditis and milder forms. Conclusion This study showed major features on T. cruzi-HIV co-infection and highlighted the prognostic role of CD4+ cells for reactivation and mortality. Since lethality was high in meningoencephalitis and all untreated patients died shortly after the diagnosis, early diagnosis, immediate antiparasitic treatment, patient follow-up and epidemiological surveillance are essentials in T. cruzi/HIV co-infection and CDR managements.

scholarly journals Toxoplasma gondii and Tuberculosis Co-infection among Tuberculosis patients at the Bamenda Regional Hospital, North West Region, Cameroon

2018 ◽  
pp. 1-8
Author(s):  
Wanabo M. Kita ◽  
Christopher B. Tume
Keyword(s):  
Opportunistic Infections ◽  
Cross Sectional Study ◽  
Regional Hospital ◽  
Reference Laboratory ◽  
Toxoplasma Infection ◽  
Cross Sectional ◽  
North West ◽  
Significant Difference ◽  
Treatment Centre ◽  
Life Threatening

Aim: To determine the prevalence of toxoplasmosis and tuberculosis co-infection among (TB) patients.  Study Design: A cross-sectional study was employed to gather data on 147 sputum positive TB patients. Place and Duration of Study:  Bamenda Regional Hospital (BRH), Tuberculosis Reference Laboratory and Treatment Centre from October 2015 to April, 2016.   Method: An epidemiological questionnaire was applied to gather data on positive-sputum pulmonary TB patients of both sexes on whom some risk factors for Toxoplasma were explored, followed by blood sampling. T. gondii IgM and IgG antibodies were researched in sera samples using indirect ELISA. Results: T. gondii antibodies prevalence amongst the TB population was 83% (122/147, 95% CI 112-130). 85.25% of the Toxoplasma infection in the study population were recent infections with T.gondii parasite while up to 53.28% of patients were reactivating, no significant difference in prevalence between HIV negative or HIV positive TB patients was established. Conclusion: The high seroprevalence of toxoplasmosis among TB subjects attending treatment at the Bamenda Regional Hospital is suggestive of co-infection. Toxoplasmosis and tuberculosis co-infection are opportunistic infections for HIV/AIDS, and life threatening to TB patients and could be the reason for unexplained deaths among these patients on treatment.

scholarly journals The potential risk of enzootic Trypanosoma cruzi transmission inside four training and re-training military battalions (BITER) in Colombia

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Omar Cantillo-Barraza ◽  
Jeffer Torres ◽  
Carolina Hernández ◽  
Yanira Romero ◽  
Sara Zuluaga ◽  
...  
Keyword(s):  
Trypanosoma Cruzi ◽  
Chagas Disease ◽  
Military Personnel ◽  
Potential Risk ◽  
Epidemiological Surveillance ◽  
12S Rrna ◽  
Military Population ◽  
Endemic Areas ◽  
The Military ◽  
Feeding Sources

Abstract Background Colombia’s National Army is one of the largest military institutions in the country based on the number of serving members and its presence throughout the country. There have been reports of cases of acute or chronic cases of Chagas disease among active military personnel. These may be the result of military-associated activities performed in jungles and other endemic areas or the consequence of exposure to Trypanosoma cruzi inside military establishments/facilities located in endemic areas. The aim of the present study was to describe the circulation of T. cruzi inside facilities housing four training and re-training battalions [Battalions of Instruction, Training en Re-training (BITERs)] located in municipalities with historical reports of triatomine bugs and Chagas disease cases. An entomological and faunal survey of domestic and sylvatic environments was conducted inside each of these military facilities. Methods Infection in working and stray dogs present in each BITER location was determined using serological and molecular tools, and T. cruzi in mammal and triatomine bug samples was determined by PCR assay. The PCR products of the vertebrate 12S rRNA gene were also obtained and subjected to Sanger sequencing to identify blood-feeding sources. Finally, we performed a geospatial analysis to evaluate the coexistence of infected triatomines and mammals with the military personal inside of each BITER installation. Results In total, 86 specimens were collected: 82 Rhodnius pallescens, two Rhodnius prolixus, one Triatoma dimidiata and one Triatoma maculata. The overall T. cruzi infection rate for R. pallescens and R. prolixus was 56.1 and 100% respectively, while T. dimidiata and T. maculata were not infected. Eight feeding sources were found for the infected triatomines, with opossum and humans being the most frequent sources of feeding (85.7%). Infection was most common in the common opossum Didelphis marsupialis, with infection levels of 77.7%. Sylvatic TcI was the most frequent genotype, found in 80% of triatomines and 75% of D. marsupialis. Of the samples collected from dogs (n = 52), five (9.6%; 95% confidence interval: 3.20–21.03) were seropositive based on two independent tests. Four of these dogs were creole and one was a working dog. The spatial analysis revealed a sympatry between infected vectors and mammals with the military population. Conclusions We have shown a potential risk of spillover of sylvatic T. cruzi transmission to humans by oral and vectorial transmission in two BITER installations in Colombia. The results indicate that installations where 100,000 active military personnel carry out training activities should be prioritized for epidemiological surveillance of Chagas disease. Graphical abstract

scholarly journals Definition of Opportunistic Infections in Immunocompromised Children on the Basis of Etiologies and Clinical Features: A Summary for Practical Purposes

2019 ◽  
Vol 15 (4) ◽  
pp. 197-206 ◽  
Author(s):  
Niccolò Riccardi ◽  
Gioacchino Andrea Rotulo ◽  
Elio Castagnola
Keyword(s):  
Opportunistic Infections ◽  
Immunosuppressive Treatment ◽  
Solid Organ Transplantation ◽  
Solid Organ ◽  
Hospitalised Patients ◽  
Nonmalignant Disease ◽  
Life Threatening ◽  
Severe Infections ◽  
Definition Of ◽  
Immunodeficiency Syndrome

: Opportunistic Infections (OIs) still remain a major cause of morbidity and death in children with either malignant or nonmalignant disease. : OIs are defined as those infections occurring due to bacteria, fungi, viruses or commensal organisms that normally inhabit the human body and do not cause a disease in healthy people, but become pathogenic when the body's defense system is impaired. OIs can also be represented by unusually severe infections caused by common pathogens. An OI could present itself at the onset of a primary immunodeficiency syndrome as a life-threatening event. More often, OI is a therapyassociated complication in patients needing immunosuppressive treatment, among long-term hospitalised patients or in children who undergo bone marrow or solid organ transplantation. : The aim of the present review is to provide a comprehensive and ‘easy to read’ text that briefly summarises the currently available knowledge about OIs in order to define when an infection should be considered as opportunistic in pediatrics as a result of an underlying congenital or acquired immune-deficit.

scholarly journals Entomological surveillance of Chagas disease in Berilo municipality, Jequitinhonha Valley, State of Minas Gerais, Brazil

2009 ◽  
Vol 42 (6) ◽  
pp. 615-621 ◽  
Author(s):  
Girley Francisco Machado de Assis ◽  
Bernardino Vaz de Mello Azeredo ◽  
David Gorla ◽  
Liléia Diotaiuti ◽  
Marta de Lana
Keyword(s):  
Trypanosoma Cruzi ◽  
Disease Control ◽  
Chagas Disease ◽  
Control Program ◽  
Minas Gerais ◽  
Epidemiological Surveillance ◽  
Entomological Surveillance ◽  
Panstrongylus Megistus ◽  
Disease Control Program ◽  
Construction Type

This study aimed to evaluate the Chagas Disease Control Program which has operated since 1982 in the municipality of Berilo in the Jequitinhonha Valley, Minas Gerais, Brazil, based on evaluation of 5,242 domiciliary units (DUs) and 7,807 outbuildings over an eight-year period of epidemiological surveillance implanted in 1997. A total of 391 triatomines (280 Panstrongylus megistus and 111 Triatoma pseudomaculata) were captured, indicating the continued predominance of the former species. However, Triatoma pseudomaculata is clearly becoming more important in this region, with intradomiciliary colonies being detected in recent years. Entomological parameters, such as dispersion (17%) and intradomiciliary infestation (0.15%) indices, are compatible with the results of the epidemiological surveillance. The majority of DUs were of construction type A (plaster over bricks) or C (plaster over adobe). Twenty-five percent of the inhabitants of the DUs infested by triatomines were reactive in ELISA, IHA and IIF tests for Trypanosoma cruzi antigens.

scholarly journals Extensive Translational Regulation through the Proliferative Transition of Trypanosoma cruzi Revealed by Multi-Omics

mSphere ◽  
2021 ◽  
Author(s):  
Santiago Chávez ◽  
Michael D. Urbaniak ◽  
Corinna Benz ◽  
Pablo Smircich ◽  
Beatriz Garat ◽  
...  
Keyword(s):  
Latin America ◽  
Trypanosoma Cruzi ◽  
Chagas Disease ◽  
Translational Regulation ◽  
Adverse Reactions ◽  
Content Type ◽  
Life Threatening Illness ◽  
Life Threatening

Trypanosoma cruzi is an ancient eukaryotic unicellular parasite causing Chagas disease, a potentially life-threatening illness that affects 6 to 7 million people, mostly in Latin America. The antiparasitic treatments for the disease have incomplete efficacy and adverse reactions; thus, improved drugs are needed.

scholarly journals INFEKSI OPORTUNISTIK PADA ODHA (ORANG DENAGN HIV/AIDS) TERHADAP KEPATUHAN MINUM ARV (Anti Retroviral) DI KOTA PALEMBANG

2020 ◽  
Vol 8 (1) ◽  
pp. 67-74
Author(s):  
Dion Atika Framasari ◽  
Rostika Flora ◽  
Rico Januar Sitorus
Keyword(s):  
Random Sampling ◽  
Opportunistic Infections ◽  
The Body ◽  
Cd4 Cells ◽  
Cross Sectional ◽  
Pulmonary Tb ◽  
Immunodeficiency Virus ◽  
Acquired Immunodeficiency ◽  
Immunodeficiency Syndrome ◽  
Hiv Aids

ABSTRACT Background : Human immunodeficiency virus (HIV) is a virus that damages the immune system and CD4 cells. The stronger the virus in destroying CD4 cells, the body has a higher risk for various types of infections and some cancers. There is no cure for HIV / AIDS, but there are several drugs that can reduce or inhibit the multiplication of HIV in the body with antiretroviral therapy (ARV). Opportunistic infections (OI) are the leading cause of death in 90% of people living with AIDS (Acquired Immunodeficiency Syndrome). The massive increasing number of death from opportunistic infections contributes to AIDS. The purpose of this study was to analysis the relationship of oportunitical infections in PLWHA on arvs compliance within palembang city Method : This research was an observational study, with a cross sectional study design on februari until maret 2020. Data samples of 235 People with Hiv and Aids (PLWHA)  in Palembang were chosen by purposive random sampling. Results: The results showed that the proportion of adherence ARV in Palembang was 83%. respondents found 83% were male, age ranged between age 26-45 years as much as 72.3% with the most high school education 48.9%, entrepreneurs 34.5% and 54% are single. There is no significant relationship between opportunistic infections (OIs) experienced by PLWHAs against ARV compliance in the city of Palembang with (Pvalue 0.381;OR:0,675;95%CI: 0.328-1.392). There are as many as 62% of PLWHA who have comorbidities in the form of pulmonary TB out of all who have OIs Conclution : opportunitis infections (OIs) are not associated with ARV compliance, pulmonary tuberculosis is an opportunitis infection that was found in many of these studies Keyword : relationship; adherence; antiretroviral; ARV; HIV;AIDS; oportunistik infections; IO; pulmonary TB       ABSTRAK Latar belakang: Human immunodeficiency virus (HIV) adalah virus yang merusak sistem kekebalan dan sel CD4. Semakin kuat virus dalam menghancurkan sel CD4, tubuh memiliki risiko lebih tinggi untuk berbagai jenis infeksi. Tidak ada obat untuk HIV / AIDS, tetapi ada beberapa obat yang dapat mengurangi atau menghambat multiplikasi HIV dalam tubuh dengan terapi antiretroviral (ARV). Infeksi oportunistik (OI) adalah penyebab utama kematian pada 90% orang yang hidup dengan AIDS (Acquired Immunodeficiency Syndrome). Meningkatnya jumlah kematian karena infeksi oportunistik berkontribusi pada AIDS. Tujuan dari penelitian ini adalah untuk menganalisis hubungan infeksi oportunistik terhadap kepatuhan minum ARV pada Orang Dengan HIV dan AIDS (ODHA) di kota palembang   Metode: Penelitian ini adalah penelitian observasional, dengan rancangan penelitian cross sectional pada bulan Februari sampai Maret 2020. Sampel data dari 235 ODHA di Palembang dipilih secara purposive random sampling. Hasil: Hasilnya menunjukkan bahwa proporsi kepatuhan terhadap ARV di Palembang adalah 83%. sebanyak 83% adalah laki-laki, usia berkisar antara usia 26-45 tahun sebanyak 72,3% dengan pendidikan sekolah tinggi 48,9%, mayoritas Wiraswasta 34,5% dan 54% berstatus  lajang.Tidak ada hubungan yang signifikan antara infeksi oportunistik (IO) yang dialami oleh Odha dengan kepatuhan ARV di kota Palembang dengan (Pvalue 0,381; OR: 0,675; 95% CI: 0,328-1,392). Ada sebanyak 62% ODHA yang memiliki penyakit penyerta berupa TB paru dari semua yang memiliki IO Kesimpulan: infeksi oportunistik (IO) tidak terkait dengan kepatuhan ARV, TB paru adalah infeksi oportunistik yang ditemukan dalam banyak penelitian ini. Kata kunci: hubungan; ketaatan; antiretroviral; ARV; HIV; AIDS; infeksi oportunistik; IO; TB paru

scholarly journals Domiciliation of Triatoma pseudomaculata (Corrêa e Espínola 1964) in the Jequitinhonha Valley, State of Minas Gerais

2007 ◽  
Vol 40 (4) ◽  
pp. 391-396 ◽  
Author(s):  
Girley Francisco Machado de Assis ◽  
Bernardino Vaz de Mello Azeredo ◽  
Ana Laura Carbajal de la Fuente ◽  
Liléia Diotaiuti ◽  
Marta de Lana
Keyword(s):  
Trypanosoma Cruzi ◽  
Vector Control ◽  
Chagas Disease ◽  
Control Program ◽  
Minas Gerais ◽  
The Other ◽  
Epidemiological Surveillance ◽  
Brazilian State ◽  
Vector Control Program ◽  
Didelphis Albiventris

Impact of the vector control program was evaluated eight years after implantation of epidemiological surveillance for Chagas’ disease in Berilo, a municipality in the Jequitinhonha Valley of the Brazilian State of Minas Gerais. In all 5,242 domiciliary units (96% of the total) were inspected and 10 found to be infested by the triatomine bug Triatoma pseudomaculata. Triatomines were found associated with bats inside one house and in the peridomiciles of the other nine. None of the 111 Triatoma pseudomaculata captured was infected with Trypanosoma cruzi. Noireau et al16 traps were installed in (n=8) and around (n=100) the infested house but no Trypanpsoma cruzi-infected triatomines were found. None bat, opossums (Didelphis albiventris) and rat captured in the peridomicile were infected with Trypanosoma cruzi although 24% of the inhabitants of the house infested by Triatoma pseudomaculata were seropositive for the parasite, based on ELISA, IHA and IIF.

scholarly journals 333. Weight Gain Among HIV-Infected Patients in Southern India on Treatment with Integrase Strand Transfer Inhibitor-based Antiretroviral Therapy

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S177-S177
Author(s):  
Rifa Khan ◽  
Amrose Pradeep ◽  
Chithra Devaraja ◽  
Bala Krishnan
Keyword(s):  
Weight Gain ◽  
Viral Suppression ◽  
Opportunistic Infections ◽  
Oral Candidiasis ◽  
Cross Sectional Study ◽  
Strand Transfer ◽  
Median Viral Load ◽  
Cross Sectional ◽  
Initiation Of Therapy ◽  
Hiv 1

Abstract Background Addition of integrase strand transfer-inhibitors (mainly dolutegravir) has strengthened anti-retroviral therapy (ART), to sustain viral suppression in HIV-1 and 2-infected patients. For judicious use in the future, we examine weight gain in ART-naïve, and those exposed to INSTI-based regimens as first, second, and third-line ART. Methods We undertook a retrospective cross-sectional study of patients initiated on INSTI-based regimens from 15 January 2017 to 22 December 2018 (n = 333). Descriptive statistical analyses were performed using STATA 15.1. Cross-tabulation and stratification were conducted to measure the strength of association. A linear regression model was used to study the increase in weight per unit of time. Results 331 patients are infected with HIV-1 and 2 with HIV-2. 66% are male, median age= 38 years (IQR 31–44). Median CD4 count at INSTI initiation was 226 cell/cubic mL (IQR 87–395). Median viral load at initiation of INSTI-based therapy was log104.768 copies/mL (IQR 2.9—5.63). Most common opportunistic infections were pulmonary tuberculosis (n = 97), oral candidiasis (n = 84), and herpes zoster (n = 44). Median hemeoglobin was 12gm% (IQR 10.5–13.8). 39% were initiated on TDF+3TC+DTG and 32% were initiated on TDF+FTC+DTG. 74% experienced weight gain; average increase was 3.69 Kg (SD 3.56) at 3 months. 19.5% gained >4 kg; median BMI at initiation of therapy was 22.56 kg/m2 (IQR 19.8–25.1) and 25.4 kg/m2 (IQR 22.5–28.7) at an average of 9.5 months post initiation of dolutegravir-based ART. 70% of ART naïve (n = 73) experienced weight gain; 17.8% gained 8.36 kg at 9 months. Higher weight gain was observed in patients with opportunistic infections. Association with gender (OR = 0.9 95%, CI 0.54 -1.5; P = 0.70) and age (OR=0.9, 95% CI 0.97–1.01;P = 0.71) was not significant. Weight gain was positively correlated with time (r=+1); predicted increase in weight per 0.1 months after initiation of INSTI-based regimen (F=4.62, P = 0.032). Conclusion Access and adherence to INSTI have positively influenced viral suppression of HIV-infection.To ensure the prevention of obesity and apt use of ART for malnourished patients, it is imperative to monitor weight gain in patients who are initiated on INSTI-based regimens. Further research to study the mechanism of weight gain is warranted. Disclosures All authors: No reported disclosures.

Pneumocystosis in patients with acquired immunodeficiency syndrome

1992 ◽  
Vol 12 (7) ◽  
pp. 64-71 ◽  
Author(s):  
BK Timby
Keyword(s):  
Opportunistic Infections ◽  
Specific Treatment ◽  
Critically Ill Patient ◽  
Severe Hypoxemia ◽  
Capillary Membranes ◽  
Pentamidine Isethionate ◽  
Life Threatening ◽  
Mixed Messages ◽  
Microbial Defense ◽  
Immunodeficiency Syndrome

Nurses need to be aware that pneumocystosis is one of the most common and lethal opportunistic infections among AIDS patients. They are extremely susceptible because HIV impairs physiological mechanisms for microbial defense. Patients exhibit only minor symptomatology while the unchecked P carinii organisms accumulate and replicate. Eventually as the sporozoans create a physical barrier between the alveolar-capillary membranes, ventilation becomes impaired and severe hypoxemia develops. Early clinical and diagnostic studies mimic the findings characteristic of ARDS. Unless correct staining techniques are used on sputum specimens, the organism often escapes identification. Thus, the diagnosis and specific treatment of PCP is often delayed. While supporting ventilation, the treatment of choice is administration of antimetabolite drugs, either trimethoprim-sulfame-thoxazole or pentamidine isethionate. The search for more effective, as well as safer, treatment of PCP continues. Life-threatening nursing diagnoses such as impaired gas exchange urgently require priority attention. Besides physical care, the severe hypoxemia demands nursing approaches to help the critically ill patient deal with fear and powerlessness. The nurse also assumes a surrogate role to patients abandoned by family and friends. The psychosocial aspects of nursing care require enormous skill and finesse, because the blood and respiratory isolation precautions can communicate mixed messages to lonely, frightened patients.

scholarly journals Kissing Bug Intrusions into Homes in the Southwest United States

Insects ◽  
2021 ◽  
Vol 12 (7) ◽  
pp. 654
Author(s):  
Stephen A. Klotz ◽  
Shannon L. Smith ◽  
Justin O. Schmidt
Keyword(s):  
United States ◽  
Trypanosoma Cruzi ◽  
Chagas Disease ◽  
Home Environment ◽  
Sonoran Desert ◽  
Fecal Matter ◽  
Skin Reactions ◽  
Desert Southwest ◽  
Life Threatening ◽  
Current Behavior

Kissing bugs readily enter homes in the Sonoran Desert and bite the residents. Their saliva is highly antigenic, causing local and systemic skin reactions and life-threatening anaphylaxis. We attempted to determine what characteristics of homesites may have contributed to home intrusion by kissing bugs. Extensive and detailed information about the homes and the home environment was collected from 78 homeowners in Tucson who suffered kissing bug intrusions. Homeowners collected 298 Triatoma rubida in and around their homes. Of the homes entered by kissing bugs, 29 of 46 (63%) contained bugs harboring Trypanosoma cruzi. Although in the aggregate, homeowners were bitten > 2200 times, no individual tested positive for Chagas disease (N = 116). Although yearly intrusion likely occurs in some homes, T. rubida does not domiciliate within homesites in the Desert Southwest. We conclude there is little risk to homeowners for Chagas disease given the current behavior of resident kissing bugs and absent ingesting kissing bug fecal matter.

Sign in / Sign up

Export Citation Format

Share Document