scholarly journals A presentation of aids-related ophthalmic disease in a severely immunocompromised patient

2010 ◽  
Vol 72 (2) ◽  
pp. 19
Author(s):  
Sally Chetrit
Keyword(s):  
Case Report ◽  
Highly Active Antiretroviral Therapy ◽  
Immune Status ◽  
Opportunistic Infections ◽  
Management Options ◽  
Cmv Retinitis ◽  
Highly Active ◽  
The Right ◽  
Immunodeficiency Syndrome ◽  
Ophthalmic Disease

Background: Human immunodeficiency virus (HIV) retinopathy is the most common ocular manifestation of the acquired immunodeficiency syndrome (AIDS), serving as an important marker for patients with significantly compromised immune status who are at risk for developing severe and visionthreatening ocular opportunistic infections. This case report describes a presentation of HIV retinopathy and cytomegalovirus (CMV) retinitis, and reviews the current management options. Case Report: A 40-year-old black male presented for a comprehensive eye exam to rule out HIV-related ophthalmic disease. At his initial visit, a dilated fundus examination revealed HIV retinopathy of the left eye. Upon subsequent examinations and as his immune status diminished, the patient developed CMV retinitis of the right eye. The patient was treated successfully with a course of highly active antiretroviral therapy (HAART) and oral valgancyclovir.  Conclusion: CMV retinitis is the most common ocular opportunistic infection associated with AIDS. Treatment with systemic HAART and concomitant anti-CMV therapy leads to reconstitution of the immune system and regression of the retinitis.  

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 Keratoconjunctivitis associated with nevirapine toxicity in HIV pregnant woman

2012 ◽  
Vol 2 (1) ◽  
pp. 6
Author(s):  
Bety Yañez
Keyword(s):  
Highly Active Antiretroviral Therapy ◽  
Stevens Johnson Syndrome ◽  
Amniotic Membrane Transplantation ◽  
Eye Drops ◽  
Highly Active ◽  
Johnson Syndrome ◽  
Immunodeficiency Virus ◽  
Acquired Immunodeficiency ◽  
The Right ◽  
Immunodeficiency Syndrome

Highly active antiretroviral therapy (HAART) is the treatment of choice for human immunodeficiency virus-acquired immunodeficiency syndrome (HIV-AIDS) patients. Severe side effects of these drugs have been described that produce generalized autoimmune blistering diseases, such as Stevens-Johnson syndrome and toxic epidermal necrosis (TEN). These complications may seriously compromise the patient’s life or cause disabling consequences such as blindness. We describe a case of 21-year old female HIV patient with a CD4 count of 126 cells/microliter. Ten days post elective caesarean delivery she restarted HAART with nevirapine and developed TEN after approximately two weeks. Nevirapine was discontinued, but despite this, ocular surface disorder persisted. She presented severe bilateral keratoconjunctivitis that was treated with free tear substitutes, moxifloxacyn, and prednisolone acethate eye drops. At 2-month follow up her visual acuity without correction was 20/160 in the right eye and 20/40 in the left. She had bilateral moderate cicatricial keratoconjunctivitis and a central corneal leukoma in the right eye. Early treatment is important and should consist of preservative-free lubricants, and amniotic membrane transplantation to decrease the frequency of severe sequelae such as keratitis and corneal leukomas that will reduce the quality of life for these patients.

scholarly journals Immune Recovery Uveitis Masked as an Endogenous Endophthalmitis in a Patient with Active CMV Retinitis

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Ligia Figueiredo ◽  
Renata Rothwell ◽  
Miguel Bilhoto ◽  
Rosário Varandas ◽  
Sofia Fonseca
Keyword(s):  
Highly Active Antiretroviral Therapy ◽  
Endogenous Endophthalmitis ◽  
Immune Recovery ◽  
Blurred Vision ◽  
Positive Polymerase Chain Reaction ◽  
Immune Recovery Uveitis ◽  
Cmv Retinitis ◽  
Highly Active ◽  
Polymerase Chain ◽  
The Right

Cytomegalovirus (CMV) retinitis may occur in profoundly immunocompromised patients and be the initial AIDS-defining infection. The incidence and prevalence of CMV retinitis has declined substantially in the era of highly active antiretroviral therapy (HAART); nevertheless, it remains a leading cause of ocular morbility. We report the case of a 40-year-old man with blurred vision and pain in the right eye, three weeks after the initiation of effective HAART treatment. Ocular examination revealed a panuveitis causing an anterior chamber reaction with hypopyon and a dense vitreous haze. An endogenous endophthalmitis was suspected and treatment was ensued, without improvement. A vitreous tap was performed, and a positive polymerase chain reaction for CMV was found. A diagnosis of immune recovery uveitis (IRU) was made, and the patient responded to treatment with valganciclovir and dexamethasone. IRU is an intraocular inflammation that develops in patients with HAART-induced immune recovery and inactive CMV retinitis, although cases of active CMV retinitis have been described. Presentation with panuveitis and hypopion is rare and may be misleading regarding diagnosis and management.

scholarly journals FEATURES OF THE FUNCTIONING OF THE THYROID GLAND IN HIV-INFECTED

2013 ◽  
Vol 68 (10) ◽  
pp. 53-56 ◽  
Author(s):  
E. V. Timofeeva ◽  
O. Ya. Leshchenko
Keyword(s):  
Thyroid Gland ◽  
Thyroid Function ◽  
Highly Active Antiretroviral Therapy ◽  
Opportunistic Infections ◽  
Negative Impact ◽  
Risk Groups ◽  
Neoplastic Processes ◽  
Highly Active ◽  
Acquired Immunodeficiency ◽  
Immunodeficiency Syndrome

In the article the current literature, devoted to the peculiarities of functioning of the thyroid gland in patients with HIV infection, is analyzed. Based on the analysis of literature data bases demonstrated the structure of thyroid function disorders in HIV-infected, as well as the mechanisms of the pathogenesis of these disorders. In the structure of thyroid function is dominated by hypothyroidism, euthyroid pathological syndrome, Graves' disease, for which the opportunistic infections are triggers immune activation.  It should be noted that the step of acquired immunodeficiency syndrome is accompanied by the development of inflammatory and neoplastic processes in the thyroid gland. Convincingly demonstrated the negative impact of highly active antiretroviral therapy in HIV-positive for the development of thyroid dysfunction, in connection which the expediency of forming risk groups and the timely correction of the projected thyroid diseases. 

scholarly journals Disseminated Mycobacterium avium complex in an adolescent with perinatally-acquired HIV infection

2017 ◽  
Vol 9 (2) ◽  
Author(s):  
Nurul I. Hariadi ◽  
R. Alexander Blackwood
Keyword(s):  
Hiv Infection ◽  
Mycobacterium Avium ◽  
Highly Active Antiretroviral Therapy ◽  
Mycobacterium Avium Complex ◽  
Opportunistic Infections ◽  
Cd4 Cell Count ◽  
Gm Csf ◽  
Highly Active ◽  
Perinatally Acquired ◽  
Immunodeficiency Syndrome

<em>Mycobacterium avium complex</em> (MAC) is the most frequent nontuberculous mycobacteria implicated in opportunistic infections that define acquired immunodeficiency syndrome. With highly active antiretroviral therapy, disseminated MAC (dMAC) has become a rare entity. This unique case of dMAC was diagnosed in an adolescent with newly diagnosed perinatally- acquired HIV infection whose initial CD4 cell count was severely depleted and viral load was extremely high. While maximized treatment regimen had not been able to control his dMAC, improvement was noted when granulocyte macrophage colony-stimulating factor (GM-CSF) was added. GM-CSF should be considered as an adjunctive therapy in patients with refractory dMAC.

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.

A case of HIV associated cholangiopathy (CAS) - A case report

2021 ◽  
Vol 12 (2) ◽  
pp. 77-80
Author(s):  
Sahil Gandhi ◽  
Keyword(s):  
Highly Active Antiretroviral Therapy ◽  
Opportunistic Infections ◽  
Biliary Tree ◽  
Endoscopic Management ◽  
Highly Active ◽  
Poor Access ◽  
Acquired Immunodeficiency ◽  
Hepatobiliary Complications ◽  
Cas A ◽  
Immunodeficiency Syndrome

Diseases of the liver and biliary tree have been described with significant frequency among patients with human immunodeficiency virus (HIV), and its advanced state, acquired immunodeficiency syndrome (AIDS). Through a variety of mechanisms, HIV/AIDS has been shown to affect hepatic parenchyma and biliary tree, leading to liver inflammation and biliary strictures. One of the potential hepatobiliary complications of this viral infection is AIDS cholangiopathy, a syndrome of biliary obstruction and liver damage due to infection-related strictures of the biliary tract. AIDS cholangiopathy is highly associated with opportunistic infections and advanced immunosuppression in AIDS patients, and due to the increased availability of highly active antiretroviral therapy, is now primarily seen in instances of poor access to anti-retroviral therapy and medication non-compliance. Current published literature describes well the clinical, biochemical, and endoscopic management of AIDS-related cholangiopathy. We present a case of 23 year male, presented with the complains of jaundice and severe abdominal pain associated with vomiting which on further investigations and imaging work up turned out to be AIDS cholangiopathy.

scholarly journals Unilateral Frosted Branch Angiitis in An Immunocompromised Patient With Concurrent Coronavirus Disease 2019 Infection

2021 ◽  
Author(s):  
TSU HONG LIM ◽  
Yong Zheng WAI ◽  
Jia Cherng CHONG
Keyword(s):  
Highly Active Antiretroviral Therapy ◽  
Immunocompromised Patient ◽  
Signs And Symptoms ◽  
Intravenous Ganciclovir ◽  
Frosted Branch Angiitis ◽  
Highly Active ◽  
First Case ◽  
Uncommon Disease ◽  
The Right ◽  
Immunodeficiency Syndrome

Abstract Background Frosted branch angiitis is an uncommon ocular sign with multiple causes. With the advent of coronavirus disease 2019 (COVID-19) pandemic, more and more cases of ocular manifestation with COVID-19 has been reported. These poses great challenges to clinicians when handling COVID-19 patients with ocular signs and symptoms. The challenges are even greater when dealing with uncommon disease that co-exists with COVID-19 as both diseases are not well understood. Finding We report the first case of frosted branch angiitis in a patient with coexisting cytomegalovirus and COVID-19 infection. A 33- year-old gentleman with underlying acquired immunodeficiency syndrome who was newly started on highly active antiretroviral therapy, complained of gradual blurring of vision one month after he was diagnosed positive for COVID-19. Upon clinical examination, fundus findings demonstrated extensive perivascular sheathing of both artery and vein, suggestive of frosted branch angiitis of the right eye. Laboratory investigations revealed both nasal swab for COVID-19 polymerase chain reaction and serum cytomegalovirus antibody was positive. The patient was then admitted to COVID-19 ward and treated with intravenous ganciclovir. Conclusion The challenges remain when handling Covid-19 patients with FBA. However, clinicians need to be aware of the possible coexistence of COVID-19 in an immunocompromised patient with frosted branch angiitis.

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