scholarly journals The Value of Metagenomic Next -Generation Sequence In Acquired Immunodeficiency Syndrome With Opportunistic Infections

2021 ◽  
Author(s):  
Li Liu ◽  
Mingjuan Yuan ◽  
Siqing Sun ◽  
Jinrong Wang ◽  
Yi Shi ◽  
...  
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Acquired Immunodeficiency Syndrome ◽  
Opportunistic Infections ◽  
Treatment Strategies ◽  
Diagnostic Value ◽  
Antimicrobial Treatment ◽  
Next Generation ◽  
Antibiotic Drugs ◽  
Acquired Immunodeficiency ◽  
Immunodeficiency Syndrome

Abstract Background: Metagenomic next-generation sequence (mNGS) is an emerging powerful pan-pathogen test for the diagnosis of infectious diseases. However, the application of mNGS in acquired immunodeficiency syndrome with opportunistic infections is limited to clinical cases reports and central nervous system infection.In this study, we evaluated the diagnostic value of mNGS in acquired immunodeficiency syndrome(AIDS) with opportunistic infections(OIs).Methods: From January 2018 to February 2021,86 cases were enrolled in this retrospective analysis. All patients underwent mNGS. Clinical data were recorded.Result: In the present study, mNGS identified 76 of 86 infection cases (88.37%).Human betaherpesvirus 5 (CMV) (40.70%), Human gammaherpesvirus 4 (EBV) (40.70%),pneumocystis (31.40%) were the most common pathogens detected. The sensitivity of mNGS (88.37%,76/86) was higher than that of culture (22.10%, 19/86),smear(7%,6/86) and PCR(46.51%,40/86).In the detection of viruses such as (CMV and EBV), the consistency between PCR and mNGS of CMV and EBV was 100%,73.33% respectively. All PCP cases were detected by mNGS. The consistency in detection of talaromyces between culture and mNGS was 75%.mNGS is superior to the common methods such as culture and smear in the detection of mycobacterium tuberculosis and non-mycobacterium tuberculosis. The mNGS findings led to changes in treatment strategies in 47/86 (54.65%) cases. Compared with the patients’treatment before mNGS, patients had lower rate of broad-spectrum antibiotic drugs use during clinical treatment after mNGS 78/86(90.70%) vs 34/86(39.53%)（P<0.0001). Conclusion: mNGS showed a satisfying diagnostic performance in acquired immunodeficiency syndrome with opportunistic infections. mNGS may lead to a more precise antimicrobial treatment and reduced the use of antibiotic medicine.

Bacillary Angiomatosis

1995 ◽  
Vol 104 (8) ◽  
pp. 668-672 ◽  
Author(s):  
John G. Batsakis ◽  
Jae Y. Ro ◽  
Elizabeth E. Frauenhoffer
Keyword(s):  
Head And Neck ◽  
Acquired Immunodeficiency Syndrome ◽  
Opportunistic Infections ◽  
Epidemiologic Studies ◽  
Cat Scratch Disease ◽  
Bacterial Agent ◽  
Bacillary Angiomatosis ◽  
Mucous Membranes ◽  
Acquired Immunodeficiency ◽  
Immunodeficiency Syndrome

The acquired immunodeficiency syndrome and other causes of immunosuppression have ushered in a variety of opportunistic infections. One of these is bacillary angiomatosis, a vasoproliferative lesion whose principal causative agent is Rochalimaea henselae. Bacillary angiomatosis, while preponderantly a cutaneous affliction, can be systemic, including involvement of the head and neck mucous membranes. Molecular technology and epidemiologic studies used to identify the bacterial agent of bacillary angiomatosis have also uncovered R henselae as the organism responsible for most cases of cat-scratch disease. Why the same organism promotes two different histopathologic lesions, as seen in bacillary angiomatosis and cat-scratch disease, is unknown.

Acquired Circulating Anticoagulants in Children With Acquired Immunodeficiency Syndrome

PEDIATRICS ◽  
1988 ◽  
Vol 82 (5) ◽  
pp. 763-765
Author(s):  
Edward R. Burns ◽  
Ben-Zion Krieger ◽  
Larry Bernstein ◽  
Arye Rubinstein
Keyword(s):  
Acquired Immunodeficiency Syndrome ◽  
Pediatric Patients ◽  
Opportunistic Infections ◽  
Laboratory Diagnosis ◽  
Activated Partial Thromboplastin Time ◽  
Test Results ◽  
Coagulation Test ◽  
Intrinsic Pathway ◽  
Acquired Immunodeficiency ◽  
Immunodeficiency Syndrome

The mechanism underlying the prolonged activated partial thromboplastin time (APTT) seen in some pediatric patients with acquired immunodeficiency syndrome (AIDS) and opportunistic infections was studied. A circulating inhibitor of coagulation was demonstrated in three patients. The inhibitor appears to be an immunoglobulin that interferes with some of the phospolipid-dependent coagulation reactions of the intrinsic pathway. This "AIDS anticoagulant" does not predispose the patient to clinical bleeding despite its ability to cause a marked prolongation of the APTT. As such, careful laboratory diagnosis of the cause of abnormal coagulation test results is necessary for children with AIDS.

Kaposi's sarcoma and the acquired immunodeficiency syndrome: treatment with high and low doses of recombinant leukocyte A interferon.

1986 ◽  
Vol 4 (4) ◽  
pp. 544-551 ◽  
Author(s):  
F X Real ◽  
H F Oettgen ◽  
S E Krown
Keyword(s):  
Acquired Immunodeficiency Syndrome ◽  
Kaposi's Sarcoma ◽  
Opportunistic Infections ◽  
Kaposi’S Sarcoma ◽  
Response Duration ◽  
High Dose ◽  
Median Response ◽  
Major Response ◽  
Acquired Immunodeficiency ◽  
Immunodeficiency Syndrome

The efficacy of recombinant leukocyte A interferon (rIFN-alpha A [Roferon-A, Hoffman-La Roche, Nutley, NJ]) treatment of Kaposi's sarcoma in patients with acquired immunodeficiency syndrome was evaluated in sequential trials using high doses (36 X 10(6) units) and low doses (3 X 10(6) units) of interferon. A major response was seen in 38% of patients treated at the high dose, with a median response duration of 18 months. At the low dose, the major response rate was 3%; dose escalation to 36 X 10(6) units resulted in an additional major response rate of 17% in low-dose nonresponders, with a median response duration of 10 months. Four of 11 patients who achieved a complete response remain free of disease, whereas all partial responders have shown disease progression. Unacceptable toxicity occurred in 27% of patients initially treated at the high dose and only in 10% of those who had progressive dose escalation up to 36 X 10(6) units. Prior opportunistic infections correlated negatively with therapeutic response, whereas large tumor burden and gastrointestinal involvement did not. Responding patients showed a significantly longer survival and a lower incidence of subsequent opportunistic infections than nonresponders. However, from our study we cannot determine whether rIFN-alpha A has an effect on the natural history of Kaposi's sarcoma in patients with the acquired immunodeficiency syndrome.

scholarly journals Non-cytomegalovirus Ocular Opportunistic Infections in Patients With Acquired Immunodeficiency Syndrome

2013 ◽  
Vol 155 (2) ◽  
pp. 206-212.e5 ◽  
Author(s):  
Sapna Gangaputra ◽  
Lea Drye ◽  
Vijay Vaidya ◽  
Jennifer E. Thorne ◽  
Douglas A. Jabs ◽  
...  
Keyword(s):  
Acquired Immunodeficiency Syndrome ◽  
Opportunistic Infections ◽  
Acquired Immunodeficiency ◽  
Immunodeficiency Syndrome

Considerations in the Treatment of Acquired Immunodeficiency Syndrome Patients at Home

1990 ◽  
Vol 3 (1) ◽  
pp. 60-65
Author(s):  
Sandra A. Matsumoto ◽  
Mary Frances Seideman
Keyword(s):  
Home Care ◽  
Acquired Immunodeficiency Syndrome ◽  
Health Care Professionals ◽  
Opportunistic Infections ◽  
Treatment Options ◽  
Home Setting ◽  
Extended Care ◽  
Acquired Immunodeficiency ◽  
Immunodeficiency Syndrome ◽  
At Home

The rapidly growing acquired immunodeficiency syndrome (AIDS) population faces frequent, expensive hospitalization due to the debilitating sequelae of the disease. Home care offers these patients an opportunity to receive or complete their therapy in comfortable surroundings, allowing them to realize the psychosocial and financial benefits of outpatient care. A myriad of sophisticated drug therapies has been successfully administered in the home setting. Therapy for frequently occurring opportunistic infections often requires treatment with highly toxic drugs such as amphotericin, pentamidine, and ganciclovir. With thorough patient training and diligent monitoring by the home-care pharmacist and nurse, these agents can be safely administered at home. Conventional and investigational chemotherapy and immunomodulator therapy, such as interferon or erythropoeitin, can also be administered at home. Providing total parenteral nutrition to AIDS patients is a controversial treatment modality, but if indicated, it can also be accomplished at home. Outpatient pain management has allowed many patients with terminal or chronic illnesses to minimize time spent in hospitals or extended care facilities, and it can offer the same advantages to patients with AIDS. The psychosocial ramifications of AIDS and its impact on patients and health care professionals must be understood in order to effectively provide total patient care at home. The challenge to the homecare pharmacist is to acquire and maintain a comprehensive knowledge of the treatment options currently available for the management of AIDS.

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