scholarly journals Current issues in the management of patients with HIV infection and rheumatic diseases

2021 ◽  
Vol 15 (6) ◽  
pp. 7-12
Author(s):  
G. I. Gridneva ◽  
B. S. Belov
Keyword(s):  
Hiv Infection ◽  
Rheumatic Diseases ◽  
Highly Active Antiretroviral Therapy ◽  
Medical Community ◽  
Disease Modifying Antirheumatic Drugs ◽  
Highly Active ◽  
Rheumatic Manifestations ◽  
Immunodeficiency Virus ◽  
Inflammatory Drugs ◽  
Late Stages

According to experts, the human immunodeficiency virus (HIV) epidemic has a steady downward trend, but the attention of the medical community to this problem is not waning. Before the introduction of highly active antiretroviral therapy, the prevalence of rheumatic manifestations in HIV-infected patients ranged from 3 to 71% and was associated with late stages of infection and severe immunosuppression. HIV-associated arthritis, reactive arthritis, psoriatic arthritis, arthralgias and diffuse infiltrative lymphocytosis syndrome are the most common rheumatic pathologies in HIV. Most people with HIV and musculoskeletal inflammatory disease respond well to NSAIDs, opioids, and basic anti-inflammatory drugs. In cases that are torpid to the abovementioned treatment, the use of biologic disease-modifying antirheumatic drugs may be required.The lecture summarizes modern data on the features of the course and treatment of immunoinflammatory rheumatic diseases in HIV infection.

scholarly journals FRI0435 THE CLINICAL SIGNIFICANCE OF SERUM AUTOANTIBODIES AND HLA-B27 MOLECULE TESTING IN UYGUR PATIENTS WITH HUMAN IMMUNODEFICIENCY VIRUS INFECTION

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 815.3-815
Author(s):  
X. Chen ◽  
L. Wu ◽  
X. Wu ◽  
C. N. Luo ◽  
Y. M. Shi
Keyword(s):  
Human Immunodeficiency Virus ◽  
Hiv Infection ◽  
Highly Active Antiretroviral Therapy ◽  
Molecular Mimicry ◽  
Molecular Testing ◽  
Hla B27 ◽  
Clinical Value ◽  
Rheumatic Manifestations ◽  
Immunodeficiency Virus ◽  
Positive Rate

Background:AIDS is a deadly infectious disease caused by the HIV. When HIV infects a host, it may induce production of autoantibodies due to the structural antigen similarity between viral proteins and selfantigens.The molecular mimicry between HIV protein and self-antigens could cause antibody cross-reactions and lead to development of autoimmune disease.Objectives:To explore the clinical value of serum autoantibodies and human leukocyte antigen (HLA-B27) molecular testing in Uygur patients with human immunodeficiency virus (HIV) infection.Methods:A total of 727 HIV-infected Uygur patients who visited Kuche Infectious Diseases Hospital during May 2016 to March 2017 were include in this study. The other 390 healthy people were enrolled as controls. Serum antinuclear antibodies (ANA) and ANA Profile, anti-cyclic citrullinated peptide (CCP) antibody, and HLA-B27 molecule were tested.Results:Among 727 HIV-infected Uygur patients, 317 were males and 410 were females with mean age (35.52±13.44) years old. The mean duration of disease was (6.34±3.05)years. There were 697(95.87%) patients receiving Highly active antiretroviral therapy (HAART) with mean duration of treatment (6.34±3.05)years. Rheumatic manifestations were recorded in 238 (32.74%) HIV-infected Uygur patients, mainly with dry mouth and dry eye (15.41%), alopecia (9.90%), arthralgia (8.94%), ect. Compared with the health controls, positive ANA was more common in HIV infected Uygur patients (33.42%vs.17.43%,P< 0.001) with low titers (ANA titer:1:100). HIV-infected Uygur patients had higher positive anti-u1-RNP antibodies positive rate (1.10%), but lower anti-SSA antibodies positive rate (0.14%) and anti-CCP antibodies positive rate (0.28%). Patients with positive ANA in HAART group were significantly less than that in non-treatment group (38.72%vs.50.00%,P=0.049).Only one female patient was HLA-B27 positive (0.14%), which was significantly lower than that in healthy controls (3.08%) (P<0.001). Also, only one patient was diagnosed with rheumatoid arthritis (RA).Conclusion:Rheumatic manifestations are common in HIV-infected Uygur patients. Several autoantibodies are positive, but the coincidence of rheumatic diseases is rare. It’s noted that patients with Rheumatic manifestations and low titre positive ANA should be considered as a differential diagnosis of HIV infection.Disclosure of Interests:None declared

scholarly journals Successful management of HIV infection in a patient with ulcerative colitis; a case report

2021 ◽  
Vol 6 (1) ◽  
pp. e17-e17
Author(s):  
Zain Majid ◽  
Shoaib Ahmed Khan ◽  
Hina Ismail ◽  
Nishat Akbar ◽  
Rajesh Mandhwani ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Ulcerative Colitis ◽  
Hiv Infection ◽  
Highly Active Antiretroviral Therapy ◽  
Tumor Necrosis ◽  
Successful Management ◽  
Highly Active ◽  
Resource Limited ◽  
Immunodeficiency Virus ◽  
Necrosis Factor

Human immunodeficiency virus (HIV) is an infectious disease that is rarely seen in ulcerative colitis patients. Both diseases commonly involve the colon. It has been shown that treating these patients with anti-tumor necrosis factor (anti-TNF) therapy leads to remission of both conditions. We hereby present the case of a 7-year-old boy who was initially managed as a case ulcerative colitis after undergoing extensive workup and later on tested positive for HIV infection and was managed via mesalamine and highly active antiretroviral therapy (HAART). Mesalamine therapy along with HAART can be used to treat ulcerative colitis patients infected with HIV infection in resource limited countries.

scholarly journals Cervical and oral human papillomavirus infection in women living with human immunodeficiency virus (HIV) and matched HIV-negative controls in Brazil

2020 ◽  
Author(s):  
Tamy Taianne Suehiro ◽  
Gabrielle Marconi Zago Ferreira Damke ◽  
Edilson Damke ◽  
Paloma Luana Rodrigues de Azevedo Ramos ◽  
Marcela de Andrade Pereira Silva ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Hiv Infection ◽  
Highly Active Antiretroviral Therapy ◽  
Hpv Infection ◽  
Hpv Dna ◽  
Highly Active ◽  
Immunodeficiency Virus ◽  
Oral Hpv ◽  
Hiv Women ◽  
Hiv Negative

Abstract Background: Despite the demonstrated role of human Papillomavirus (HPV) in the etiology of cervical cancer and the strong evidence suggesting the importance of HPV in the development of oropharyngeal cancer, several aspects of the interrelationship between HPV infection in both body sites remain unknown, specifically in female human immunodeficiency virus (HIV)-positive (HIV+) patients. We aimed to assess the prevalence, distribution, and concordance of cervical and oral HPV in HIV+ women and matched HIV-negative (HIV-) controls in Brazil.Material and methods: Cervical and endocervical samples for cytological screening and HPV detection and oral samples were collected from 115 HIV+ women using highly active antiretroviral therapy (HAART) and 139 HIV-matched controls (HIV-) in Maringá City, Brazil. Risk factors were assessed using a standardized questionnaire, and the data regarding HIV infection were obtained from the patients’ medical records. HPV detection and typing were performed using the Kit Multiplex XGEN Multi HPV Chip HS12.Results: HIV infection was well controlled in this cohort, but women who exhibited detectable HIV loads were significantly associated with HPV-positive status overall (P = 0.03) and in cervical mucosa (P = 0.01). HIV+ women had significantly more abnormal cytological findings (P = 0.04) than HIV- women. Of the 115 HIV+ women, 48.7% were positive for cervical and/or oral HPV DNA; of the 139 HIV- women, 41% were positive for cervical and/or oral HPV (P = 0.25). Both HIV+ and HIV- women had a statistically higher prevalence of cervical HPV infection than oral infection. The concurrent HPV infection in two anatomical sites was similar in HIV+ and HIV- women; however, HPV type concordance was not observed. HPV type distribution was different between the anatomical sites in both groups, and HIV+ women presented less common types, mainly in oral mucosa.Conclusion: Our data support the importance of testing HPV infection in HIV+ women, even when the HIV infection is well controlled. Prospective studies are required to better understand the natural history of HPV infection in both anatomical sites, specifically in HIV+ women.

scholarly journals Cervical and oral human papillomavirus infection in women living with human immunodeficiency virus (HIV) and matched HIV-negative controls in Brazil

2020 ◽  
Author(s):  
Tamy Taianne Suehiro ◽  
Gabrielle Marconi Zago Ferreira Damke ◽  
Edilson Damke ◽  
Paloma Luana Rodrigues de Azevedo Ramos ◽  
Marcela de Andrade Pereira Silva ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Hiv Infection ◽  
Highly Active Antiretroviral Therapy ◽  
Hpv Infection ◽  
Hpv Dna ◽  
Highly Active ◽  
Immunodeficiency Virus ◽  
Oral Hpv ◽  
Hiv Women ◽  
Hiv Negative

Abstract Background: Despite the demonstrated role of human Papillomavirus (HPV) in the etiology of cervical cancer and the strong evidence suggesting the importance of HPV in the development of oropharyngeal cancer, several aspects of the interrelationship between HPV infection in both body sites remain unknown, specifically in female human immunodeficiency virus (HIV)-positive (HIV+) patients. We aimed to assess the prevalence, distribution, and concordance of cervical and oral HPV in HIV+ women and matched HIV-negative (HIV-) controls in Brazil.Material and methods: Cervical and endocervical samples for cytological screening and HPV detection and oral samples were collected from 115 HIV+ women using highly active antiretroviral therapy (HAART) and 139 HIV-matched controls (HIV-) in Maringá City, Brazil. Risk factors were assessed using a standardized questionnaire, and the data regarding HIV infection were obtained from the patients’ medical records. HPV detection and typing were performed using the Kit Multiplex XGEN Multi HPV Chip HS12.Results: HIV infection was well controlled in this cohort, but women who exhibited detectable HIV loads were significantly associated with HPV-positive status overall (P = 0.03) and in cervical mucosa (P = 0.01). HIV+ women had significantly more abnormal cytological findings (P = 0.04) than HIV- women. Of the 115 HIV+ women, 48.7% were positive for cervical and/or oral HPV DNA; of the 139 HIV- women, 41% were positive for cervical and/or oral HPV (P = 0.25). Both HIV+ and HIV- women had a statistically higher prevalence of cervical HPV infection than oral infection. The concurrent HPV infection in two anatomical sites was similar in HIV+ and HIV- women; however, HPV type concordance was not observed. HPV type distribution was different between the anatomical sites in both groups, and HIV+ women presented less common types, mainly in oral mucosa.Conclusion: Our data support the importance of testing HPV infection in HIV+ women, even when the HIV infection is well controlled. Prospective studies are required to better understand the natural history of HPV infection in both anatomical sites, specifically in HIV+ women.

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 &lt; .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 &lt; .001). Conclusions.— Despite limitations of autopsy studies, many trends in the evolution of the HIV/AIDS epidemic are readily discernable.

scholarly journals Immunity to Human Immunodeficiency Virus (HIV) in Children with Chronic HIV Infection Receiving Highly Active Antiretroviral Therapy

2003 ◽  
Vol 10 (5) ◽  
pp. 821-825 ◽  
Author(s):  
Adriana Weinberg ◽  
Gregory B. Pott
Keyword(s):  
Human Immunodeficiency Virus ◽  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Highly Active Antiretroviral Therapy ◽  
Lymphocyte Proliferation ◽  
Specific Cell ◽  
Highly Active ◽  
Immunodeficiency Virus ◽  
Ifn Γ ◽  
Chronic Hiv Infection

ABSTRACT Our objective was to describe the CD4-mediated human immunodeficiency virus (HIV)-specific cell-mediated immunity (CMI) and its virologic and immunologic correlates in children with chronic HIV infection on highly active antiretroviral therapy (HAART). Twelve HIV-infected children on stable antiretroviral therapy with a median level of CD4+ lymphocytes (CD4%) of 25.5% and a median viral load (VL) of 786 HIV RNA copies/ml were enrolled in this study. Nine of these children were also cytomegalovirus (CMV) seropositive. Blood mononuclear cells, stimulated with HIV and CMV antigens, were used to measure lymphocyte proliferation and to enumerate gamma interferon (IFN-γ)-producing CD4+ cells. HIV CMI and CMV CMI were detected in similar proportions of patients and correlated with each other, although the HIV responses were less robust. HIV lymphocyte proliferation significantly increased with lower HIV VL and showed a trend to increase with higher CD4% and longer time on HAART. The in vitro IFN-γ response to HIV or CMV was not affected by CD4%, VL, or HAART. Pediatric patients with established HIV infection on HAART frequently exhibit HIV CMI despite undetectable HIV replication. We concluded that the association between HIV CMI and CMV CMI indicates that the same factors govern responsiveness to either antigen.

Prevalence of Plantar Verrucae in Patients with Human Immunodeficiency Virus Infection During the Post–Highly Active Antiretroviral Therapy Era

2011 ◽  
Vol 101 (1) ◽  
pp. 35-40 ◽  
Author(s):  
James Johnston ◽  
Christy M. King ◽  
Sky Shanks ◽  
Saieh Khademi ◽  
Joseph Nelson ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Logistic Regression ◽  
Antiretroviral Therapy ◽  
Life Expectancy ◽  
Confidence Interval ◽  
Hiv Infection ◽  
Highly Active Antiretroviral Therapy ◽  
Hiv Positive ◽  
Highly Active ◽  
Immunodeficiency Virus

Background: Since the implementation of highly active antiretroviral therapy (HAART), the life expectancy of patients with human immunodeficiency virus (HIV) has significantly increased. This is likely to cause changes in podiatric medical manifestations, such as plantar verrucae, in this population. Methods: Attendees at a San Francisco street fair in 2008 provided information about HIV status and the presence of verrucae via a survey. A total of 504 surveys were analyzed and compared with 1995 data, before HAART implementation. We examined if there was a statistically significant change in the increased likelihood of plantar verrucae in HIV-positive patients from 1995 to 2008. Then we examined the likelihood of HIV-positive patients (compared to HIV-negative patients) presenting with plantar verrucae in 2008, by using logistic regression, and controlling for age, sex, and race/ethnicity. Results: Patients with HIV infection were 5.2 times more likely to present with plantar verrucae compared to patients without HIV infection in 2008 (95% confidence interval, 2.5–11.0, P &lt; .0001) and 10.0 times more likely in 1995 (95% confidence interval, 3.4–29.0, P &lt; .0001). This decrease in likelihood over time was not statistically significantly different (P = .33). Logistic regression analysis controlling for the covariates of age, race, and sex showed that patients with HIV in 2008 were 4.5 times more likely to present with verrucae compared to patients without HIV (95% confidence interval, 2.1–9.9, P = .0002). Conclusions: Patients with HIV infection in 2008 are still significantly more likely to present with plantar verrucae after controlling for age, race, and sex. This increased likelihood has not changed significantly across time. Because HAART has increased the life expectancy of patients with HIV, this group of patients with plantar verrucae will continue to represent a significant population in the practice of podiatric medicine. (J Am Podiatr Med Assoc 101(1): 35–40, 2011)

scholarly journals Rifabutin-Cobicistat Drug Interaction Resulting in Severe Bilateral Panuveitis

2020 ◽  
Vol 11 (1) ◽  
pp. 156-160 ◽  
Author(s):  
Christopher B. Toomey ◽  
Jeffrey Lee ◽  
Doran B. Spencer
Keyword(s):  
Drug Interaction ◽  
Hiv Infection ◽  
Highly Active Antiretroviral Therapy ◽  
Latent Tuberculosis ◽  
Highly Active ◽  
Immunodeficiency Virus ◽  
Oral Steroids ◽  
History Of ◽  
Latent Tb ◽  
Tenofovir Alafenamide

We report a novel case of severe bilateral panuveitis with hypopyon secondary to rifabutin and cobicistat drug interaction in the setting of human immunodeficiency virus (HIV) infection and latent tuberculosis (TB). A 63-year-old woman presented with bilateral conjunctival injection and decreasing vision of 5 days’ duration. She had a history of well-controlled HIV infection, latent TB, and non-alcoholic steatohepatitis for which she was inadvertently being treated, due to a pharmacy error, concurrently with the anti-TB medicine rifabutin and the highly active antiretroviral therapy combination Genvoya® (elvitegravir 150 mg – cobicistat 150 mg – emtricitabine 200 mg – tenofovir alafenamide 10 mg). Ocular examination was significant for bilateral panuveitis with hypopyon. Blood, cerebrospinal fluid, and vitreous analysis were negative for infectious or rheumatologic abnormalities. Rifabutin was discontinued and the patient was treated with intravenous followed by oral steroids as an outpatient with eventual resolution of symptoms. This unique case of rifabutin-cobicistat drug interaction highlights the association between rifabutin drug levels and ocular inflammation and expands the potential presentation of rifabutin-associated uveitis to include bilateral panuveitis with hypopyon.

scholarly journals Dynamics of Intermittent Viremia during Highly Active Antiretroviral Therapy in Patients Who Initiate Therapy during Chronic versus Acute and Early Human Immunodeficiency Virus Type 1 Infection

2004 ◽  
Vol 78 (19) ◽  
pp. 10566-10573 ◽  
Author(s):  
Michele Di Mascio ◽  
Martin Markowitz ◽  
Michael Louie ◽  
Arlene Hurley ◽  
Christine Hogan ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Human Immunodeficiency Virus Type ◽  
Highly Active Antiretroviral Therapy ◽  
Chronic Infection ◽  
Highly Active ◽  
Immunodeficiency Virus ◽  
Hiv 1

ABSTRACT The meaning of viral blips in human immunodeficiency virus type 1 (HIV-1)-infected patients treated with seemingly effective highly active antiretroviral therapy (HAART) is still controversial and under investigation. Blips might represent low-level ongoing viral replication in the presence of drug or simply release of virions from the latent reservoir. Patients treated early during HIV-1 infection are more likely to have a lower total body viral burden, a homogenous viral population, and preserved HIV-1-specific immune responses. Consequently, viral blips may be less frequent in them than in patients treated during chronic infection. To test this hypothesis, we compared the occurrence of viral blips in 76 acutely infected patients (primary HIV infection [PHI] group) who started therapy within 6 months of the onset of symptoms with that in 47 patients who started HAART therapy during chronic infection (chronic HIV infection [CHI] group). Viral blip frequency was approximately twofold higher in CHI patients (0.122 ± 0.12/viral load [VL] sample, mean ± standard deviation) than in PHI patients (0.066 ± 0.09/VL sample). However, in both groups, viral blip frequency did not increase with longer periods of observation. Also, no difference in viral blip frequency was observed between treatment subgroups, and the occurrence of a blip was not associated with a recent change in CD4+ T-cell count. Finally, in PHI patients the VL set point was a significant predictor of blip frequency during treatment.

Sign in / Sign up

Export Citation Format

Share Document