Slow clinical improvement after treatment initiation in Leishmania/HIV coinfected patients

INTRODUCTION: In Brazil there is a large area of overlap of visceral leishmaniasis (VL) and HIV infection, which favored a increased incidence of coinfection Leishmania/HIV. METHODS: This study evaluated 65 consecutive patients with VL and their clinical response to treatment in two health care settings in Belo Horizonte, Brazil. RESULTS: At baseline, the clinical picture was similar between both groups, although diarrhea and peripheral lymphadenomegaly were more frequent in HIV-infected subjects. HIV-positive patients had lower median blood lymphocyte counts (686/mm³ versus 948/mm³p = 0.004) and lower values of alanine aminotransferase (ALT) (48IU/L versus 75.6IU/L p = 0.016) than HIV-negative patients. HIV-positive status (hazard ratio = 0.423, p = 0.023) and anemia (HR = 0.205, p = 0.002) were independent negative predictors of complete clinical response following antileishmanial treatment initiation. CONCLUSIONS: This study reinforces that all patients with VL should be tested for HIV infection, regardless of their clinical picture. This practice would allow early recognition of coinfection with initiation of antiretroviral therapy and, possibly, reduction in treatment failure.

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Clinical outcomes of syphilis in HIV-negative and HIV-positive MSM: occurrence of repeat syphilis episodes and non-treponemal serology responses

Sexually Transmitted Infections ◽

10.1136/sextrans-2020-054887 ◽

2021 ◽

pp. sextrans-2020-054887

Author(s):

Silvia Achia Nieuwenburg ◽

Ricardo Jamie Sprenger ◽

Maarten Franciscus Schim van der Loeff ◽

Henry John Christiaan de Vries

Keyword(s):

Hiv Infection ◽

Controlled Trial ◽

Clinical Manifestations ◽

Response To Treatment ◽

Disease Stage ◽

Hiv Positive ◽

Sexual Risk Behaviour ◽

Serological Response ◽

History Of ◽

Hiv Negative

ObjectivesHIV-positive men who have sex with men (MSM) may be at a higher risk of repeat syphilis, have different clinical manifestations and have a different serological response to treatment compared with HIV-negative MSM. The objective of this study was to assess whether HIV-negative and HIV-positive MSM with infectious syphilis (primary, secondary or early latent) differed in history of previous syphilis episodes, disease stage and non-treponemal titre of initial and repeat episodes, and the titre response 6 and 12 months after treatment. Furthermore, determinants associated with an inadequate titre response after treatment were explored.MethodsThis retrospective analysis used data of five longitudinal studies (four cohorts; one randomised controlled trial) conducted at the STI clinic in Amsterdam, the Netherlands. Participants were tested for syphilis and completed questionnaires on sexual risk behaviour every 3–6 months. We included data of participants with ≥1 syphilis diagnosis in 2014–2019. Pearson’s χ² test was used to compare HIV-negative and HIV-positive MSM in occurrence of previous syphilis episodes, disease stage of initial and repeat syphilis episode and non-treponemal titre treatment responses.ResultsWe included 355 participants with total 459 syphilis episodes. HIV-positive MSM were more likely to have a history of previous syphilis episodes compared with HIV-negative MSM (68/90 (75.6%) vs 96/265 (36.2%); p<0.001). Moreover, HIV-positive MSM with repeat syphilis were less often diagnosed with primary syphilis (7/73 (9.6%) vs 36/126 (28.6%)) and more often diagnosed with secondary syphilis (16/73 (21.9%) vs 17/126 (13.5%)) and early latent syphilis (50/73 (68.5%) vs 73/126 (57.9%)) (p=0.005). While not significantly different at 12 months, HIV-negative MSM were more likely to have an adequate titre response after 6 months compared with HIV-positive MSM (138/143 (96.5%) vs 66/74 (89.2%); p=0.032).ConclusionsIn repeat syphilis, HIV infection is associated with advanced syphilis stages and with higher non-treponemal titres. HIV infection affects the serological outcome after treatment, as an adequate titre response was observed earlier in HIV-negative MSM.

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Neurocysticercosis and HIV Infection: what can we learn from the published literature?

Arquivos de Neuro-Psiquiatria ◽

10.1590/0004-282x20190054 ◽

2019 ◽

Vol 77 (5) ◽

pp. 357-365 ◽

Cited By ~ 4

Author(s):

Omar Herrera Vazquez ◽

Matthew L. Romo ◽

Agnès Fleury

Keyword(s):

Hiv Infection ◽

Immune Status ◽

Taenia Solium ◽

Response To Treatment ◽

Hiv Positive ◽

Historical Series ◽

Immunodeficiency Virus ◽

The Central Nervous System ◽

Published Research ◽

Hiv Negative

ABSTRACT Infections caused by the human immunodeficiency virus (HIV) and by the larvae of Taenia solium (i.e., cysticercosis) are still widespread in many developing countries. Both pathologies modify host immune status and it is possible that HIV infection may modulate the frequency and pathogeny of cysticercosis of the central nervous system (i.e., neurocysticercosis [NCC]). Objective: To describe published cases of NCC among HIV-positive patients and to evaluate whether the characteristics of NCC, including frequency, symptoms, radiological appearance, and response to treatment differed between HIV-positive and HIV-negative patients. Methods: Forty cases of NCC/HIV co-infected patients were identified in the literature. Clinical and radiological characteristics, as well as response to treatment, were compared with non-matching historical series of NCC patients without HIV infection. Results: Most of these patients had seizures and multiple vesicular parasites located in parenchyma. Clinical and radiological characteristics were similar between HIV-positive and HIV-negative patients with NCC, as well as between immunocompromised and non-immunocompromised HIV-positive patients. Conclusion: Our review did not reveal clear interactions between HIV and NCC. This may be partially due to the small number of cases and reliance on published research. A systematic, multi-institutional effort aiming to report all the cases of this dual pathology is needed to confirm this finding and to clarify the possible relationship between both pathogens.

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Immune response to influenza A(H1N1)v in HIV-infected patients

The Journal of Infection in Developing Countries ◽

10.3855/jidc.3147 ◽

2014 ◽

Vol 8 (01) ◽

pp. 101-109 ◽

Cited By ~ 4

Author(s):

Paola Sansonetti ◽

Michela Sali ◽

Massimiliano Fabbiani ◽

Matteo Morandi ◽

Rosa Martucci ◽

...

Keyword(s):

Immune Response ◽

Hiv Infection ◽

Clinical Picture ◽

Influenza A ◽

Geometric Mean ◽

Haemagglutination Inhibition ◽

Hiv Positive ◽

Upper Respiratory Tract ◽

Influenza A H1n1 ◽

Hiv Negative

Introduction: HIV infection is considered a risk factor for severe outcomes of influenza A(H1N1)v infection. However, data on immune response against influenza A(H1N1)v virus in HIV-infected patients are lacking. Methodology: Data from seven HIV-positive and 14 HIV-negative patients infected with A(H1N1)v and from 23 HIV-positive and six HIV-negative asymptomatic controls were analyzed to evaluate the clinical picture, A(H1N1)v viral shedding, and the immune response against the virus. Results: Patients displayed mainly upper respiratory tract diseases (57.1%), while pneumonia was diagnosed only in HIV-negative patients (23.8% of subjects, of which 4.8% required intensive care unit admission). At day seven, 29% of HIV-infected patients were still positive for A(H1N1)v by RT-PCR on nasopharyngeal swabs. Interestingly, a persistence of CXCL10 secretion at high level and lower IL-6 levels was observed in HIV-positive subjects. The geometric mean haemagglutination inhibition titer (HI-GMT) and anti-influenza IgM levels were lower in HIV-positive individuals while anti-influenza IgG levels remained similar in the two groups. Conclusions: The immune impairment due to HIV infection could affect A(H1N1)v clearance and could lead to a lower antibody response and a persistent secretion of CXCL10 at high levels. However, the lower IL-6 secretion and treatment with highly active antiretroviral therapy (HAART) could result in a milder clinical picture.

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Abstract WP426: Subarachnoid Hemorrhage in patients infected with Human Immunodeficiency Virus

Stroke ◽

10.1161/str.44.suppl_1.awp426 ◽

2013 ◽

Vol 44 (suppl_1) ◽

Author(s):

Haralabos Zacharatos ◽

Malik M Adil ◽

Ameer E Hassan ◽

Sarwat I Gilani ◽

Adnan I Qureshi

Keyword(s):

Human Immunodeficiency Virus ◽

Subarachnoid Hemorrhage ◽

Blood Transfusion ◽

Hospital Mortality ◽

Hiv Infection ◽

The United States ◽

Hiv Positive ◽

Published Data ◽

Immunodeficiency Virus ◽

Hiv Negative

Background: There is limited data regarding the unique attributes of ischemic stroke among patients infected with human immunodeficiency virus (HIV). There is no published data regarding the occurrence and outcomes of subarachnoid hemorrhage (SAH) among HIV infected persons. Methods: The largest all-payer Nationwide Inpatient Sample (NIS 2002-2010) data was used to identify and analyze all patients presenting with the primary diagnosis of SAH in the United States. Among this cohort, we identified the patients who were not HIV positive and those who were HIV positive. Patient demographics, medical co-morbidities, in-hospital complications, in-hospital procedures, and discharge disposition were compared between the two groups. The association between HIV infection and outcomes was evaluated in multivariate analysis after adjusting for potential confounders. Results: Of the 351,491 patients admitted with SAH, 1367 (0.39%) were infected with HIV. HIV infected patients were younger, mean age [±SD] of 45 ±14.2 years versus those who were not 58±19 years, (p<0.0001). The rate of blood transfusion [27,286 (7.8%) versus 245.6 (18%), p=0.0003], mechanical ventilation [51,199 (14.6%) versus 316.1(23.1%), p=0.008], and sepsis [14,644 (4.2%) versus 236.1 (17.3%), p<0.0001] was significantly higher among HIV infected patients. After adjusting for age, gender, hypertension, coagulopathy, atrial fibrillation, renal failure, and dyslipidemia, HIV negative patients had a significantly higher rate of discharge to home (odds ratio [OR] 1.9, 95% CI: 1.4-2.6, p<0.0001) and lower in-patient mortality (OR 0.4, 95% CI: 0.3-0.5, p<0.001). Further adjustment for blood transfusion and sepsis reduced the odds of discharge to home for the HIV negative patients, from 1.9 to 1.7 but did not affect in-hospital mortality. Conclusion: The in-hospital mortality in HIV infected patients with SAH is higher despite these patients being younger than non-HIV infected patients. We believe that this study provides a nationwide perspective which may have some important implications for early recognition and diagnosis of HIV-infection in SAH patients.

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Anolunula in Fingernails among Patients Infected with HIV

ISRN Dermatology ◽

10.1155/2014/271230 ◽

2014 ◽

Vol 2014 ◽

pp. 1-6

Author(s):

Pratik Gahalaut ◽

Nitin Mishra ◽

Sandhya Chauhan ◽

Mir Mubashir Ali ◽

Madhur Kant Rastogi ◽

...

Keyword(s):

Hiv Infection ◽

Cross Sectional Study ◽

Negative Control ◽

Hiv Positive ◽

Control Group ◽

Cross Sectional ◽

Significant Difference ◽

Stage 1 ◽

And Control ◽

Hiv Negative

Lunula is the white, half-moon shaped area seen in proximal ends of some nails. Though a few studies have described the nail changes that can occur in association with HIV infection, none of these paid much attention to lunula. Aims and Objectives. To study the lunula in fingernails among HIV infected patients. Materials and Methods. An observational, cross-sectional study to record presence of lunula in 168 HIV-positive patients and compare it with age and sex matched 168 healthy HIV-negative control. Anolunula (absence of lunula) in HIV-positive patients was correlated with CD4 counts, stages of HIV infection, time since patient was diagnosed as HIV-positive, and status of antiretroviral therapy. Results. Anolunula was present in significantly more fingernails in HIV-positive patients compared to HIV-negative controls. There was a highly significant difference for total anolunula (anolunula in all fingernails) in study and control group. Incidence of total anolunula was directly proportional to the stage of HIV infection, increasing progressively as the HIV infection advances from stage 1 to stage 4. Conclusion. Absence of lunula is related to not only HIV infection per se but also the stages of HIV infection.

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Human Immunodeficiency Virus–Associated Squamous Cell Cancer of the Anus: Epidemiology and Outcomes in the Highly Active Antiretroviral Therapy Era

Journal of Clinical Oncology ◽

10.1200/jco.2007.14.2810 ◽

2008 ◽

Vol 26 (3) ◽

pp. 474-479 ◽

Cited By ~ 83

Author(s):

Elizabeth Y. Chiao ◽

Thomas P. Giordano ◽

Peter Richardson ◽

Hashem B. El-Serag

Keyword(s):

Antiretroviral Therapy ◽

Hiv Infection ◽

Squamous Cell ◽

Highly Active Antiretroviral Therapy ◽

Cell Cancer ◽

Cox Proportional Hazards ◽

Administrative Databases ◽

Hiv Positive ◽

Highly Active ◽

Hiv Negative

Purpose To evaluate and determine predictors of squamous cell carcinoma of the anus (SCCA) outcomes in the highly active antiretroviral therapy (HAART) era for HIV-positive and -negative individuals using large national Veterans Affairs (VA) Administration databases. Patients and Methods We used the VA administrative databases to perform a retrospective cohort study in 1,184 veterans diagnosed with SCCA between 1998 and 2004. We calculated HIV infection rates and used logistic regression to identify epidemiologic factors that were associated with HIV infection. Kaplan-Meier curves and Cox proportional hazards models were calculated to compare survival between HIV-positive and HIV-negative veterans. Results In our cohort, 175 patients (15%) were HIV positive. The median age of the HIV-negative and -positive patients was 63 and 49 years, respectively (P < .001). Individuals with HIV were eight times more likely to be male (P = .01) and three times more likely to be African American (P < .001). There were no differences between HIV-positive and HIV-negative individuals in the receipt of treatment. The 2-year observed survival rates were 77% and 75% among HIV-positive and HIV-negative individuals, respectively. In multivariate Cox analysis, significant predictors of survival were age, sex, metastasis at diagnosis, and comorbidity score. HIV infection did not affect survival. Conclusion A noteworthy proportion of individuals with SCCA in the VA system are HIV positive. HIV-associated SCCA seems mainly to be a disease among younger men. Survival of SCCA is equivalent between HIV-positive and HIV-negative individuals in the HAART era. Treatment should not be withheld or deintensified based on HIV status.

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Levels of Macrophage Inflammatory Protein 1α (MIP-1α) and MIP-1β in Intervillous Blood Plasma Samples from Women with Placental Malaria and Human Immunodeficiency Virus Infection

Clinical and Diagnostic Laboratory Immunology ◽

10.1128/cdli.10.4.631-636.2003 ◽

2003 ◽

Vol 10 (4) ◽

pp. 631-636 ◽

Cited By ~ 29

Author(s):

Sujittra Chaisavaneeyakorn ◽

Julie M. Moore ◽

Lisa Mirel ◽

Caroline Othoro ◽

Juliana Otieno ◽

...

Keyword(s):

Human Immunodeficiency Virus ◽

Hiv Infection ◽

Blood Plasma ◽

Plasma Levels ◽

Placental Malaria ◽

Hiv Positive ◽

Inflammatory Protein ◽

Immunodeficiency Virus ◽

Macrophage Inflammatory Protein ◽

Hiv Negative

ABSTRACT Macrophage inflammatory protein-1α (MIP-1α) and MIP-1β play an important role in modulating immune responses. To understand their importance in immunity to placental malaria (PM) and in human immunodeficiency virus (HIV)-PM coinfection, we investigated levels of these chemokines in the placental intervillous blood plasma (IVB plasma) and cord blood plasma of HIV-negative PM-negative, HIV-negative PM-positive, HIV-positive PM-negative, and HIV-positive PM-positive women. Compared to HIV-negative PM-negative women, the MIP-1β concentration in IVB plasma was significantly elevated in HIV-negative PM-positive women and HIV-positive PM-positive women, but it was unaltered in HIV-positive PM-negative women. Also, PM-infected women, irrespective of their HIV status, had significantly higher levels of MIP-1β than HIV-positive PM-negative women. The MIP-1α level was not altered in association with either infection. The IVB plasma levels of MIP-1α and MIP-1β positively correlated with the cord blood plasma levels of these chemokines. As with IVB plasma, only cord plasma from PM-infected mothers had significantly elevated levels of MIP-1β compared to PM-negative mothers, irrespective of their HIV infection status. MIP-1β and MIP-1α levels in PM-positive women were positively associated with parasite density and malaria pigment levels. Regardless of HIV serostatus, the IVB MIP-1β level was significantly lower in women with PM-associated anemia. In summary, an elevated level of MIP-1β was associated with PM. HIV infection did not significantly alter these two chemokine levels in IVB plasma.

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Liver Damage in Patients with HCV/HIV Coinfection Is Linked to HIV-Related Oxidative Stress

Oxidative Medicine and Cellular Longevity ◽

10.1155/2016/8142431 ◽

2016 ◽

Vol 2016 ◽

pp. 1-11 ◽

Cited By ~ 6

Author(s):

Xiangbo Huang ◽

Hua Liang ◽

Xueying Fan ◽

Liyan Zhu ◽

Tao Shen

Keyword(s):

Oxidative Stress ◽

Hiv Infection ◽

Liver Damage ◽

Central China ◽

Hiv Positive ◽

Liver Ultrasound ◽

Hiv Coinfection ◽

Chronic Hcv ◽

Hcv Coinfection ◽

Hiv Negative

HIV infection aggravates the progression of liver damage in HCV-coinfected patients, with the underlying pathogenesis being multifactorial. Although high level of oxidative stress has been observed frequently in patients infected with HIV or HCV, the status of oxidative stress in HIV/HCV coinfection and its contribution to HCV liver damage have not been determined. This study involved 363 HBsAg-negative, anti-HCV-positive former blood donors recruited from a village in central China in July 2005; of these, 140 were positive for HIV. Of these 363 subjects, 282 were successfully followed up through July 2009. HIV/HCV-coinfected subjects had higher rates of end-stage liver disease-related death than those monoinfected with HCV. Liver ultrasound manifestations were poor in HIV-positive than in HIV-negative individuals, in both chronic HCV carriers and those with resolved HCV. Serum concentrations of total glutathione (tGSH), malondialdehyde (MDA), glutathione peroxidase (GSH-Px), GSSG, and reduced GSH were higher in HIV-positive than HIV-negative subjects. GSSG concentrations were higher in HIV-infected subjects with abnormal ALT/AST levels than in those with normal ALT/AST levels and were associated with poorer liver ultrasound manifestations. These finding indicated that HIV infection accelerated HCV-associated liver damage in HIV/HCV-coinfected individuals. Increased oxidative stress, induced primarily by HIV coinfection, may contribute to aggravated liver damage.

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HIV infection in families of HIV-positive and 'at-risk' HIV-negative women

AIDS Care ◽

10.1080/09540120020027378 ◽

2001 ◽

Vol 13 (2) ◽

pp. 209-214 ◽

Cited By ~ 4

Author(s):

T. Fiore ◽

T. Flanigan ◽

J. Hogan ◽

R. Cram ◽

P. Schuman ◽

...

Keyword(s):

At Risk ◽

Hiv Infection ◽

Hiv Positive ◽

Hiv Negative

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Emotional deficit: an adaptative and evolutive process in HIV infection

European Psychiatry ◽

10.1016/0924-9338(96)80335-x ◽

1995 ◽

Vol 10 (7) ◽

pp. 345-351 ◽

Cited By ~ 6

Author(s):

C Bungener ◽

JJ Lefrère ◽

D Widlöcher ◽

R Jouvent

Keyword(s):

Hiv Infection ◽

Well Being ◽

Structured Interview ◽

Emotional Disturbances ◽

Hiv Positive ◽

Homosexual Men ◽

Immunodeficiency Virus ◽

Advanced Stages ◽

Hiv Negative ◽

Asymptomatic Hiv

SummaryThe objective of the present study was to evaluate emotional disturbances and psychopathological symptoms in early stages of human immunodeficiency virus (HIV) infection. Seventy-one homosexual subjects, positive to HIV and two groups of HIV-negative subjects (32 homosexuals and 26 heterosexuals) were evaluated in a semi-structured interview by two trained raters. The results showed the presence of emotional perturbations already in asymptomatic HIV-positive individuals even in the absence of caracterized depression and/or anxiety. This emotional deficit seemed to be more important in more advanced stages of the disease. Depressive and anxious symptoms appeared to be slightly but significantly present in both groups of homosexual men. This emotional deficit could be the reflect of an adaptative process to the threatening consequences of HIV-infection. Emotional perturbations, even mild should not be neglected, because their reduction contributes to the psychological well being of HIV-positive subjects.

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