scholarly journals Modern approach to neurorehabilitation of children with hiv-encephalopathy

2020 ◽  
Vol 19 (4) ◽  
pp. 220-226
Author(s):  
Saida N. Saidkhodjaeva ◽  
Yakutkhon N. Madjidova ◽  
Каhramon H. Yuldashev
Keyword(s):  
Virtual Reality ◽  
Highly Active Antiretroviral Therapy ◽  
Neurocognitive Disorders ◽  
Initial Examination ◽  
Modern Approach ◽  
Hiv Encephalopathy ◽  
Highly Active ◽  
Relative Dynamics ◽  
Status Assessment

Background. Currently, there is no standardized and evidence-based medicine specific therapy for HIV-associated neurocognitive disorders. The aim of the study was to evaluate the effectiveness of various neurorehabilitation programs, including the use of memantine hydrochloride and the virtual reality feedback method (NIRVANA) in children with HIV encephalopathy (HIVE) in the aspect of neurocognitive status. Material and methods. The study included 260 children with HIV-positive status and receiving highly active antiretroviral therapy (НAART) according to an individually selected scheme for at least 6 months. All the children included in the study showed signs of HIVE. After the initial examination, all patients were divided into 4 groups: only НAART, НAART + memantine, НAART + NIRVANA and НAART + memantine + NIRVANA. The follow-up period was 3 months. The neurological study included a standard neurological examination, as well as various psychometric scales and questionnaires. Results. In the groups of active neurorehabilitation, there were significant positive changes in the neurocognitive status: the score of all components of neurocognitive disorders decreased in all three groups with comparable relative dynamics. As a result, by the end of the 3rd month of follow-up in children taking memantine (НAART group + M and НAART + M + H) achieved a significantly lower IQ score compared to children who were only on НAART (p 0.001 for both comparisons). Also in children who received complex neurorehabilitation (НAART + M + H) by the end of the 3rd month of observation, a significantly lower integral score of neurocognitive status assessment was achieved compared to children of the НAART group (p 0.05). Conclusion. Thus, in the course of this study, it was found that children with HIVE, despite the ongoing НAART, have a tendency to progress HIVE. Children with HIV-associated dementia are most susceptible to progression. The use of active neurorehabilitation, especially a combination of memantine and virtual reality techniques, can significantly improve the indicators of neurocognitive status.

Antiretroviral Treatment-Associated Labia Majora Lipohypertrophy: A Rare Case and Plastic Surgical Treatment Options

2017 ◽  
Vol 2 (1) ◽  
pp. 43
Author(s):  
Akmal Hisham ◽  
Devananthan Ilenghoven ◽  
Wan Syazli Wan Ahmad Kamal ◽  
Salina Ibrahim ◽  
Shah Jumaat Mohd Yussof
Keyword(s):  
Highly Active Antiretroviral Therapy ◽  
Daily Living ◽  
Treatment Options ◽  
Hiv Positive ◽  
Highly Active ◽  
Labia Majora ◽  
The Face ◽  
Central Fat

The emergence of highly active antiretroviral therapy (HAART) has revolutionized the prognosis of HIV-infected patients. However, the extended use of HAART is associated with a disfiguring complication termed lipodystrophy, a disorder of body fat maldistribution causing peripheral fat loss (lipoatrophy) and central fat accumulation (lipohypertrophy). Lipoatrophy commonly affects the face, legs, buttocks and arm, whilst lipohypertrophy frequently favours the abdomen, breast and dorsocervical region. To our knowledge, we present only the second documented case in the literature of a labia majora lipohypertrophy in a HIV-positive patient receiving long-term HAART. The severity of labial abnormality caused significant physical and functional morbidities. Labiaplasty with dermolipectomy of the labia majora and excisional lipectomy of the mons pubis was successfully performed. At a 6-month follow-up, patient had no recurrence with resolution of symptoms and resumption of normal activities of daily living (ADL).

scholarly journals Overt Lower Gastrointestinal Bleeding and Pseudotumor: A Rare Presentation of Cytomegalovirus Infection

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Akanksha Agrawal ◽  
Deepanshu Jain ◽  
Sameer Siddique
Keyword(s):  
Highly Active Antiretroviral Therapy ◽  
The Body ◽  
Cmv Infection ◽  
Rare Presentation ◽  
Multiple Organs ◽  
Highly Active ◽  
History Of ◽  
Acquired Immunodeficiency ◽  
Immunodeficiency Syndrome

Cytomegalovirus (CMV) is a ubiquitous organism which can infect multiple organs of the body. In an immunocompromised patient, it can have a myriad of gastrointestinal manifestations. We report a case of recurrent hematochezia and concomitant pseudotumor in an AIDS (acquired immunodeficiency syndrome) patient attributable to CMV infection. A 62-year-old man with a history of AIDS, noncompliant with highly active antiretroviral therapy (HAART), presented with bright red blood per rectum. Index colonoscopy showed presence of multiple ulcers, colonic stenosis, and mass-like appearing lesion. Biopsy confirmed CMV infection and ruled out malignancy. Cessation of dual antiplatelet therapy and compliance with HAART lead to clinical cessation of bleeding and endoscopic healing of ulcers with complete resolution of colon mass on follow-up colonoscopy.

Evaluating health-related wellbeing outcomes among outpatient adults with human immunodeficiency virus infection in the HAART era

2002 ◽  
Vol 13 (10) ◽  
pp. 683-690 ◽  
Author(s):  
Douglas S Saunders ◽  
Robert W Burgoyne
Keyword(s):  
Highly Active Antiretroviral Therapy ◽  
Longitudinal Research ◽  
Opportunistic Infections ◽  
Short Form ◽  
Disease Stage ◽  
Highly Active ◽  
Sf 36 ◽  
Study Results ◽  
Clinical Changes

Quality of life (QoL) changes among 56 adult patients living with HIV/AID (PHA) were assessed following two years of care in which most had received highly active antiretroviral therapy (HAART). The sample was stratified by initial disease stage; subjects were classified 'asymptomatic' if they had no HIV-related constitutional symptoms, 'symptomatic' if they had at least one symptom, and 'AIDS' if symptomatic with a history of opportunistic infections and/or CD4 count less than 200 cells/ µL. For the overall group, changes in mean QoL (Medical Outcomes Study Short-Form-36 [SF-36]) ratings were non-significant, irrespective of initial disease stage or prior HAART exposure. Although overall there were health status improvements over the two-year period, clinical changes were generally unrelated to changes in QoL ratings. Patients with better immunologic/virologic outcomes showed slight improvements in mean QoL ratings, while those with poorer clinical outcomes showed slight deterioration. These within-group changes over time were statistically non-significant. The corresponding between-group differences in changes in SF-36 social and psychological dimensions were significant. Statistically significant differences among the three disease stage groups on a number of subscales at baseline (Physical Function, Body Pain, Vitality, Role Limitations due to Physical Problems) became non-significant (i.e. nullified) at follow-up. Significant increases in mean number of symptoms for the asymptomatic and symptomatic groups were not associated with two-year changes in QoL ratings. Overall, wellbeing was moderately stable over the two-year follow-up period, although somewhat affected by symptom changes and immunologic/virologic outcome. The study results contrast with pre-HAART longitudinal research, in which deterioration in all areas of QoL occurred.

Treatment with Rituximab, CHOP and Highly Active Antiretroviral Therapy (HAART) in AIDS-Related Diffuse Large B-Cell Lymphomas (DLBCL). Study of 60 Patients.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 774-774
Author(s):  
Josep-María Ribera ◽  
Albert Oriol ◽  
Mireia Morgades ◽  
Eva González-Barca ◽  
Pilar Miralles ◽  
...  
Keyword(s):  
Highly Active Antiretroviral Therapy ◽  
Multiorgan Failure ◽  
Multicenter Trial ◽  
Highly Active ◽  
Response To Chemotherapy ◽  
Grade Ii ◽  
High Age ◽  
Cd4 Lymphocyte ◽  
Prospective Multicenter Trial

Abstract Background and objective. Rituximab and CHOP (R-CHOP) is the most employed treatment for DLBCL, but pts with AIDS-related lymphomas are usually excluded from clinical trials. The objective of this open, prospective multicenter trial is to evaluate the feasibility, efficacy and toxicity R-CHOP and HAART in AIDS-related DLBCL. Patients and methods. Between April 2001 and July 2005, 60 consecutive HIV-infected pts with newly diagnosed DLBCL were included in 20 Spanish hospitals. HAART was given to all patients from diagnosis if they were not already receiving it. Six cycles of R-CHOP were administered, IT CNS prophylaxis (MTX, ARA-C and hydrocortisone) was given in every cycle to all patients. G-CSF support was recommended Response to chemotherapy, toxicity, OS and DFS for complete responders were recorded. Results. Median age 42 yr (range 26–64), 49 (82%) males, 30 (50%) with previous known diagnosis of HIV infection (median from dx HIV to NHL 10 yr, range 0.5–19). Median CD4 lymphocyte count 152/mL (range 0–905), median HIV load 19x103 copies/mL (range 0–2x106). 36 pts were receiving HAART at the time of NHL dx (median 3.5 yr, range 0.5–9). Extranodal involvement 43 (72%), stage III-IV 38 (63%) and 36/56 had intermediate-high or high age-adjusted IPI score. 10 patients are under treatment, 1 (2%) withdrawal, 6 (12%) induction death (infection 3, hepatic failure 2, multiorgan failure 1), 10 (20%) resistant, CR 33 (66%). After a median follow-up of 2 yr, 2-yr survival probability was 63% (95%CI 50–76). The probability of remaining alive and in first CR at 2 yr for complete responders was 89% (95%CI 77–100). Three patients died in first CR (opportunistic infection, sudden death and violent death) and no relapses have occurred to date. Virologic and immunologic responses to HAART at 6 months after the completion of treatment were maintained or achieved in 17/21 (81%) and 14/22 (64%) of patients, respectively. Out of 245 R-CHOP cycles analysed the most frequent grade II-IV toxicities were infections (30, 12%), gastrointestinal (21, 9%) and neurologic (5, 2%). Conclusion. In patients with AIDS-related DLBCL the combination of HAART and R-CHOP is feasible and effective. In this trial the response rate and survival are comparable to those obtained in immunocompetent patients treated with R-CHOP.

Response to highly active antiretroviral therapy in HIV-infected patients aged 60 years or older after 24 months follow-up

AIDS ◽  
2001 ◽  
Vol 15 (12) ◽  
pp. 1591-1593 ◽  
Author(s):  
Hernando Knobel ◽  
Ana Guelar ◽  
Gabriel Valldecillo ◽  
Alexia Carmona ◽  
Alicia González ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Highly Active Antiretroviral Therapy ◽  
Highly Active
Sign in / Sign up

Export Citation Format

Share Document