scholarly journals Cutaneous Symptoms and Rashes in Patients with HIV-Positive Infections (A Review Article)

Author(s):  
Mohammad Ali Shakeri Hosseinabad ◽  
Farzad Abdolhazadeh

Identifying the cutaneous symptom associated with HIV positive disease and investigating the kind of rashes can be helpful in early diagnosis of the disease. The extensity of skin disorders in HIV infection is widespread. Examination of the skin of these patients can be a good indicator of the status of the immune system as well as the patient's psychological status and also in early diagnosis can make a worthy help. We carried out a literature search (From 1990 to 2016) related to this issue through Google Scholar, Pub-MED, Scopus, Science Direct, and Iran DOC, by using keywords cutaneous symptoms, HIV positive, skin infection, warts, early diagnosis. Among 124 articles only 51 papers were related to skin infections. Review of the associated research, investigation the skin infections in HIV patients and early diagnosis made a great help in the treatment process, particularly in people with high-risk behaviors which leads to diagnosis the HIV in the early stages. The results of this study suggest the importance of cutaneous symptom in patients with HIV infection and early diagnosis to start the medical procedures.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 3112-3112
Author(s):  
Chris M. Bacon ◽  
Robert F. Miller ◽  
Mahdad Noursadeghi ◽  
Christopher McNamara ◽  
Ming-Qing Du ◽  
...  

Abstract Human Herpes virus 8 (HHV8) associated multicentric Castleman’s disease (MCD) is an unusual multifocal lymphoid hyperplasia induced by HHV8 infected B cells and associated with a characteristic systemic syndrome attributed to raised levels of IL-6. Most cases develop on a background of immunosuppression, often as a result of human immunodeficiency virus (HIV) infection. Despite the haematological problems at presentation and the difficulties in initial diagnosis, the bone marrow appearances of MCD have not been so far described. In this study we examined the pathology of bone marrow in 13 patients with MCD, 11 of whom had HIV infection, with a view to identifying features that may be helpful in early diagnosis. Patients typically presented with fever, lymphadenopathy, hepatosplenomegaly and cytopaenias. Bone marrow aspirates showed mild to moderate trilineage dysplasia, a mild plasmacytosis, and a mild eosinophilia similar to that seen in HIV infected patients without MCD. Bone marrow biopsies showed hypercellularity, architectural disorganisation, variably prominent dysplasia especially in megakaryocytes, mild eosinophilia, and a polytypic plasmacytosis representing 5–20% of all cells. Interestingly, two cases showed marked megakaryocytic and granulocytic hyperplasia with reticulin fibrosis, similar to the effects of IL-6 on the marrow in experimental systems. Importantly, in 3 cases there were small lymphoid follicles typical of MCD in diagnostic nodal specimens. Depleted germinal centres were surrounded by mantle zones containing scattered large plasmablasts which expressed HHV8 latent nuclear antigen (LNA) and showed lambda immunoglobulin light chain restriction. Furthermore, varying numbers of dispersed interstitial HHV8-LNA positive plasmablasts were present in 11/13 cases. Double immunohistochemical staining confirmed the B cell phenotype of these plasmablasts. The presence of these cells was highly specific for MCD as rare single HHV8 positive cells were identified in only 4 of 66 control bone marrow biopsies from HIV positive patients. Each of these 4 patients had Kaposi’s sarcoma and 1 also had a primary effusion lymphoma. HHV8 positive cells were not identified in bone marrow biopsies from 23 other HIV positive patients with lymphoma. These results suggest that the presence of HHV8 positive plasmablasts in bone marrow biopsies, within characteristic lymphoid follicles and/or the interstitium, is highly specific and sensitive for MCD. As the examination of bone marrow is the first diagnostic test performed in virtually all MCD patients, the features described in this study should greatly enhance the chances of early diagnosis by either providing the tissue diagnosis or prompting a lymph node biopsy and further investigations. Furthermore, the HHV8 positive cells within the bone marrow may play an important pathogenetic role in the haematological disturbances typically seen in MCD.


2020 ◽  
Vol 6 (1) ◽  
pp. 5-11
Author(s):  
Bala Augustine Nalah ◽  
Azlinda Azman ◽  
Paramjit Singh Jamir Singh

Harmful cultural practices have psychosocial implications on stigmatization and vulnerability to HIV infection among HIV positive living in North Central Nigeria. To understand this, we conducted qualitative interviews with purposively selected 20 diagnosed HIV positive to explore how culture influences stigmatization and HIV transmission. Data was collected using audio-recorder, transcribed, and analyzed through thematic analysis using ATLAS.ti8 software to code and analyze interview transcripts. The coded data were presented using thematic network analysis to visualize the theme, sub-themes, and quotations in a model. The findings reveal that lack of education was a significant determinant for the continual practice of harmful cultural rites, thereby increasing the risk of HIV infection and stigmatization. Hence, six cultural facilitators have been identified to include female genital mutilation, lack of education, tribal marks and scarification, postpartum sexual abstinence during breastfeeding, sexual intercourse during menstruation, and gender inequality, polygamy, and inheritance law. We conclude that educational teachings and advocacy campaigns be organized in rural schools and public places on the implications of harmful cultural practice to health and psychological well-being. We recommend that the social workers and behavioral scientists should collaborate with other agencies to employ a behavioral-based intervention in eliminating cultural practices and HIV stigma.


2020 ◽  
Vol 26 (37) ◽  
pp. 4738-4746
Author(s):  
Mohan K. Ghanta ◽  
P. Elango ◽  
Bhaskar L. V. K. S.

Parkinson’s disease is a progressive neurodegenerative disorder of dopaminergic striatal neurons in basal ganglia. Treatment of Parkinson’s disease (PD) through dopamine replacement strategies may provide improvement in early stages and this treatment response is related to dopaminergic neuronal mass which decreases in advanced stages. This treatment failure was revealed by many studies and levodopa treatment became ineffective or toxic in chronic stages of PD. Early diagnosis and neuroprotective agents may be a suitable approach for the treatment of PD. The essentials required for early diagnosis are biomarkers. Characterising the striatal neurons, understanding the status of dopaminergic pathways in different PD stages may reveal the effects of the drugs used in the treatment. This review updates on characterisation of striatal neurons, electrophysiology of dopaminergic pathways in PD, biomarkers of PD, approaches for success of neuroprotective agents in clinical trials. The literature was collected from the articles in database of PubMed, MedLine and other available literature resources.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiang Mao ◽  
Sequoia I. Leuba ◽  
Qinghai Hu ◽  
Hongjing Yan ◽  
Zhe Wang ◽  
...  

Abstract Background There is limited information about the types of recreational drugs used by men who have sex with men (MSM) in China or the consequent impact on sexual health and human immunodeficiency virus (HIV) acquisition. Methods We recruited MSM from seven cities in China between 2012 and 2013 using multiple approaches including advertisements on gay websites, collaborating with local MSM community-based organizations, peer referrals, and venues such as gay bars and bathrooms visited by MSM. We divided participants into four subgroups based on the number of recreational drugs (RDs) used in the previous 6 months. We defined use of multiple RDs as use of ≥2 types of RDs. Demographics and HIV-related high-risk behaviors were collected, and blood samples were tested for recent HIV infection by the HIV-1 subtypes B, E, and D immunoglobulin G capture enzyme immunoassay (BED-CEIA). We used multivariable logistic regression adjusted for sociodemographics to determine the adjusted odds ratios (aORs) and associated 95% confidence intervals (CIs) of the subgroups of RD use for recent or established HIV infection. Results A total of 4496 Chinese MSM participated; 28.4% used RDs, and 5% used multiple types of RDs. The prevalence of each RD use was as follows: poppers (25.9%), ecstasy (2.4%), ketamine (1.2%), amphetamine (0.6%), tramadol (0.4%), methamphetamine (3.8%), and codeine (1.9%). Users of multiple RDs commonly used poppers combined with one or more other types of RDs. Multiple RD users were likely to be aged 26–30 years (vs. 18–25 and > 30 years), live in non-local cities (vs. local cities), never married (vs. married), have a high monthly income (vs. no income and 1–599 USD), use versatile positions during anal intercourse (vs. top or bottom), and have inadequate HIV-related prevention knowledge (vs. adequate). As the number of RDs used in the previous 6 months increased, the prevalence of HIV-related high-risk behaviors increased (P < 0.05 for all). The odds of recent HIV infection were higher among those who used one type (aOR = 2.2, 95% CI: 1.5–3.0) or two types of RD (aOR=2.3, 95% CI: 1.0-5.2) in the previous 6 months compared to the odds among those who did not use RDs. Conclusion The level and pattern of multiple RD use among Chinese MSM were different from high-income countries. MSM who used more RDs are more likely to engage in high-risk sexual behaviors, and these behaviors may be associated with increases in new HIV infections.


2021 ◽  
pp. sextrans-2020-054887
Author(s):  
Silvia Achia Nieuwenburg ◽  
Ricardo Jamie Sprenger ◽  
Maarten Franciscus Schim van der Loeff ◽  
Henry John Christiaan de Vries

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.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Li Wei Ang ◽  
Carmen Low ◽  
Chen Seong Wong ◽  
Irving Charles Boudville ◽  
Matthias Paul Han Sim Toh ◽  
...  

AbstractBackgroundEarly diagnosis is crucial in securing optimal outcomes in the HIV care cascade. Recent HIV infection (RHI) serves as an indicator of early detection in the course of HIV infection. Surveillance of RHI is important in uncovering at-risk groups in which HIV transmission is ongoing. The study objectives are to estimate the proportion of RHI among persons newly-diagnosed in 2013–2017, and to elucidate epidemiological factors associated with RHI in Singapore.MethodsAs part of the National HIV Molecular Surveillance Programme, residual plasma samples of treatment-naïve HIV-1 positive individuals were tested using the biotinylated peptide-capture enzyme immunoassay with a cutoff of normalized optical density ≤ 0.8 for evidence of RHI. A recent infection testing algorithm was applied for the classification of RHI. We identified risk factors associated with RHI using logistic regression analyses.ResultsA total of 701 newly-diagnosed HIV-infected persons were included in the study. The median age at HIV diagnosis was 38 years (interquartile range, 28–51). The majority were men (94.2%), and sexual route was the predominant mode of HIV transmission (98.3%). Overall, 133/701 (19.0, 95% confidence interval [CI] 16.2–22.0%) were classified as RHI. The proportions of RHI in 2015 (31.1%) and 2017 (31.0%) were significantly higher than in 2014 (11.2%). A significantly higher proportion of men having sex with men (23.4, 95% CI 19.6–27.6%) had RHI compared with heterosexual men (11.1, 95% CI 7.6–15.9%). Independent factors associated with RHI were: age 15–24 years (adjusted odds ratio [aOR] 4.18, 95% CI 1.69–10.31) compared with ≥55 years; HIV diagnosis in 2015 (aOR 2.36, 95% CI 1.25–4.46) and 2017 (aOR 2.52, 95% CI 1.32–4.80) compared with 2013–2014; detection via voluntary testing (aOR 1.91, 95% CI 1.07–3.43) compared with medical care; and self-reported history of HIV test(s) prior to diagnosis (aOR 1.72, 95% CI 1.06–2.81).ConclusionAlthough there appears to be an increasing trend towards early diagnosis, persons with RHI remain a minority in Singapore. The strong associations observed between modifiable behaviors (voluntary testing and HIV testing history) and RHI highlight the importance of increasing the accessibility to HIV testing for at-risk groups.


1993 ◽  
Vol 73 (3) ◽  
pp. 391-422 ◽  
Author(s):  
KENNETH C. HAAS

Intravenous drug use is both a common aspect of the pre-imprisonment lifestyles of many American prisoners and a leading risk factor for contracting HIV—the virus that causes AIDS. Moreover, incarcerated inmates frequently engage in behavior that can spread the disease, particularly homosexual activity and intravenous drug use. Correctional officials face increasing pressure to protect inmates and staff from HIV infection, and some have responded by implementing policies requiring all inmates to undergo HIV testing and by housing HIV-positive inmates in separate units. Screening and segregation policies, however, have been challenged on constitutional grounds by HIV-positive prisoners. This article examines the leading constitutional developments in this emerging area of law and finds that most courts so far have been inclined to reject constitutional challenges to mandatory testing and segregation policies. There are enough unsettled issues, however, to warrant expanded appellate review and eventual U.S. Supreme Court resolution of the key constitutional questions.


1997 ◽  
Vol 81 (2) ◽  
pp. 635-639
Author(s):  
Motoko Hayashi ◽  
Isao Fukunishi

This study examined what kinds of social support are related to mood states in a sample of 50 HIV-positive patients without AIDS (46 men and 4 women; M age 36.5 yr., SD = 9.8). In the early stage of HIV infection, HIV patients without AIDS may be prone to depressive symptoms although none of these HIV-positive patients' symptoms fulfilled the DSM-III-R Mood Disorders including Major Depression. The depressive symptoms were not significantly related to lack of ordinary social support such as friends and family but were significantly associated with dissatisfaction with HIV/AIDS-related medical support


2000 ◽  
Vol 11 (4) ◽  
pp. 254-256 ◽  
Author(s):  
A E Naburi ◽  
Barbara Leppard

Two hundred consecutive patients with herpes zoster attending the skin clinic at the Kilimanjaro Christian Medical Centre (KCMC) were examined and checked for HIV infection. They ranged in age from 10 months to 86 years with the majority in their 20s and 30s. The dermatomes involved were thoracic (97), trigeminal (50), cervical (37), lumbar (19) and sacral (3). Six (3%) had more than one dermatome involved and 2 (1%) had disseminated disease. Only 2 (1%) had severe ulceration of the skin and all healed in less than 4 weeks. In children under the age of 10 years and in adults between the ages of 20 and 49 years virtually 100% were HIV positive; even in the age group 50-59 more than three-quarters were HIV positive. We conclude that the presence of herpes zoster at any site is a good indication that the patient is HIV positive except in the teens and the very elderly.


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