The course of COVID-19 in four patients with HIV during the pandemic

2020 ◽  
Vol 18 ◽  
Author(s):  
Melda Turken ◽  
Hividar Altan ◽  
Sabri Atalay ◽  
Sukran Kose
Keyword(s):  
Vascular Complications ◽  
Multiple Organ ◽  
Current Evidence ◽  
Severe Illness ◽  
People Living With Hiv ◽  
Medical Problems ◽  
Case Presentation ◽  
Male Sex ◽  
Living With Hiv ◽  
Deceased Patient

Background: The clinical spectrum of SARS-CoV-2 infection may vary from simple colds to severe acute respiratory syndrome, metabolic acidosis, septic shock, and multiple organ failure. Current evidence indicates that the risk of severe illness increases with age, male sex, and with certain chronic medical problems. Many people living with HIV have other conditions that increase their risk. Case presentation: In the first 3 months of the pandemic, four patients with HIV were hospitalized in our clinic because of COVID-19. The disease severity was mild in two patients with normal CD4+ T count. However, one patient with a low CD4+T count died and the other developed retinal detachment one month after discharge. The deceased patient had a malignancy. Conclusion: In this study, the effect of the immunological status of the patients on the course of COVID-19 and the developing vascular complications were evaluated in 4 patients with HIV.

scholarly journals Prejudicial beliefs and COVID-19 disruptions among sexual minority men living with and not living with HIV in a high SARS-CoV-2 prevalence area

2021 ◽  
Author(s):  
Seth C Kalichman ◽  
Renee El-Krab ◽  
Bruno Shkembi ◽  
Moira O Kalichman ◽  
Lisa A Eaton
Keyword(s):  
African American ◽  
African American Men ◽  
People Living With Hiv ◽  
Sex Partners ◽  
Black African ◽  
Sexual Minority Men ◽  
Mediation Analyses ◽  
Personal Action ◽  
Male Sex ◽  
Living With Hiv

Abstract The COVID-19 pandemic has had profound health and social impacts. COVID-19 also affords opportunities to study the emergence of prejudice as a factor in taking protective actions. This study investigated the association of COVID-19 concerns, prejudicial beliefs, and personal actions that involve life disruptions among people not living with and people living with HIV. 338 Black/African American men not living with HIV who reported male sex partners and 148 Black/African American men living with HIV who reported male sex partners completed a confidential survey that measured COVID-19 concern, COVID-19 prejudice, and personal action and institutionally imposed COVID-19 disruptions. Participants reported having experienced multiple social and healthcare disruptions stemming from COVID-19, including reductions in social contacts, canceling medical appointments, and inability to access medications. Mediation analyses demonstrated that COVID-19 concerns and COVID-19 prejudice were associated with personal action disruptions, indicating that these social processes are important for understanding how individuals modified their lives in response to COVID-19. It is imperative that public health efforts combat COVID-19 prejudice as these beliefs undermine investments in developing healthcare infrastructure to address COVID-19 prevention.

scholarly journals An Emerging Syndemic of Smoking and Cardiopulmonary Diseases in People Living with HIV in Africa

2021 ◽  
Vol 18 (6) ◽  
pp. 3111
Author(s):  
Emmanuel Peprah ◽  
Mari Armstrong-Hough ◽  
Stephanie H. Cook ◽  
Barbara Mukasa ◽  
Jacquelyn Y. Taylor ◽  
...  
Keyword(s):  
Current Evidence ◽  
Chronic Obstructive ◽  
People Living With Hiv ◽  
African Countries ◽  
Obstructive Pulmonary Disease ◽  
Cardiopulmonary Disease ◽  
Current Trends ◽  
Significant Public Health ◽  
Artery Disease ◽  
Living With Hiv

Background: African countries have the highest number of people living with HIV (PWH). The continent is home to 12% of the global population, but accounts for 71% of PWH globally. Antiretroviral therapy has played an important role in the reduction of the morbidity and mortality rates for HIV, which necessitates increased surveillance of the threats from pernicious risks to which PWH who live longer remain exposed. This includes cardiopulmonary comorbidities, which pose significant public health and economic challenges. A significant contributor to the cardiopulmonary comorbidities is tobacco smoking. Indeed, globally, PWH have a 2–4-fold higher utilization of tobacco compared to the general population, leading to endothelial dysfunction and atherogenesis that result in cardiopulmonary diseases, such as chronic obstructive pulmonary disease and coronary artery disease. In the context of PWH, we discuss (1) the current trends in cigarette smoking and (2) the lack of geographically relevant data on the cardiopulmonary conditions associated with smoking; we then review (3) the current evidence on chronic inflammation induced by smoking and the potential pathways for cardiopulmonary disease and (4) the multifactorial nature of the syndemic of smoking, HIV, and cardiopulmonary diseases. This commentary calls for a major, multi-setting cohort study using a syndemics framework to assess cardiopulmonary disease outcomes among PWH who smoke. Conclusion: We call for a parallel program of implementation research to promote the adoption of evidence-based interventions, which could improve health outcomes for PWH with cardiopulmonary diseases and address the health inequities experienced by PWH in African countries.

Comorbid Medical Problems and Motivational Interviewing

2019 ◽  
pp. 97-104
Author(s):  
Sharon Connor ◽  
Hanna K. Welch
Keyword(s):  
Motivational Interviewing ◽  
Chronic Diseases ◽  
Congestive Heart Failure Patient ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Medical Problems ◽  
Patient Centered ◽  
Age Related ◽  
Social And Cultural Factors ◽  
Living With Hiv

As HIV treatments become more effective and accessible, people living with HIV (PLWH) are achieving longer lifespans; however, this aging population also faces a greater risk of age-related co-morbidities. Many chronic diseases affect people living with HIV disproportionately, including diabetes, ischemic heart disease, and congestive heart failure. Patient-centered healthcare should aim to optimize quality and length of life while also considering the person’s value system. Motivational interviewing (MI) has been effective in helping PLWH to better manage chronic diseases requiring behavioral modification in both high- and low-resource settings. MI is a useful approach in the complex care of PLWH and medical co-morbidities. MI can promote self-management integrating HIV care as well as other co-morbidities in the context of social and cultural factors. This chapter discusses the application of MI to achieve better control of co-morbid medical conditions in PLWH.

scholarly journals Contribution of the classical polymerase chain reaction in the diagnosis of a HIV-1 infected patient in Benin: a case report

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Edmond Tchiakpe ◽  
René K. Keke ◽  
Nicole Vidal ◽  
Moussa Bachabi ◽  
Flore Armande Gangbo ◽  
...  
Keyword(s):  
People Living With Hiv ◽  
Case Presentation ◽  
Complementary Method ◽  
First Response ◽  
Confirmation Test ◽  
Test Version ◽  
Version 2.0 ◽  
Living With Hiv ◽  
Card Test ◽  
Hiv 1

Abstract Background First ambitious target by 2020 of UNAIDS is that 90% of people living with HIV know their HIV status. In people older than 18 months of age, serological confirmation test is recommended to confirm HIV infection. Case presentation Here we report the case of a patient tested positive with HIV-1, ELISA, Murex® Ag⁄Ab Combination assay (OD450 = 0.802 and cutoff-OD = 0.279) and negative by using FIRST RESPONSE HIV1-2.O CARD TEST (version 2.0) RAPID HIV CARD TEST. Viral load performed with Cobas® TaqMan® 96/Cobas® Ampliprep® was 6.49log10. The virus could be sequenced in partial gag and pol genes and belonged to CRF02_AG clade. Conclusion Conventional PCR is a complementary method for the diagnosis of inconclusive HIV-1 serologies by antibodies.

scholarly journals Post SARS-CoV-2 infection reactive arthritis: a brief report of two pediatric cases

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Reza Sinaei ◽  
Sara Pezeshki ◽  
Saeedeh Parvaresh ◽  
Roya Sinaei ◽  
Reza Shiari ◽  
...  
Keyword(s):  
Tract Infection ◽  
Severe Acute Respiratory Syndrome ◽  
Reactive Arthritis ◽  
Pediatric Rheumatology ◽  
Joint Effusion ◽  
Severe Illness ◽  
Medical Problems ◽  
Case Presentation ◽  
Inflammatory Drugs ◽  
Coronavirus Infection

Abstract Background Although, preliminary reports of Severe Acute Respiratory Syndrome (SARS)-CoV-2 infection suggest that the infection causes a less severe illness in children, there is now growing evidence of other rare or even serious complications of disease. Case presentation During the recent COVID-19 pandemic in Kerman, Iran, two children (an 8 year-old boy and a 6 year-old girl) were referred to outpatient Clinic of Pediatric Rheumatology with complaints of limping. Both children had experienced fever and mild respiratory tract infection. At the beginning of the second week of infection, they developed joint effusion. They both tested positive for coronavirus infection and were therefore diagnosed with post Coronavirus reactive arthritis. Both children were treated successfully with rest and Non-Steroidal Anti-Inflammatory Drugs (NSAID). They did not have any medical problems in the two months fallow up. Conclusions These two cases suggest that COVID-19 may be rheumatogenic. Highlighting the need for awareness of physicians, especially pediatricians, regarding the pathogenesis margins of this virus, as late presentations are of great importance.

scholarly journals Mental health and well-being of older adults living with HIV in sub-Saharan Africa: a systematic review

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e052810
Author(s):  
Patrick Nzivo Mwangala ◽  
Adam Mabrouk ◽  
Ryan Wagner ◽  
Charles R J C Newton ◽  
Amina A Abubakar
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Cognitive Impairment ◽  
Well Being ◽  
Sub Saharan Africa ◽  
Current Evidence ◽  
People Living With Hiv ◽  
Sub Saharan ◽  
Living With Hiv

ObjectiveIn this systematic review, we aimed to summarise the empirical evidence on common mental disorders (CMDs), cognitive impairment, frailty and health-related quality of life (HRQoL) among people living with HIV aged ≥50 years (PLWH50 +) residing in sub-Saharan Africa (SSA). Specifically, we document the prevalence and correlates of these outcomes.Design, data sources and eligibility criteriaThe following online databases were systematically searched: PubMed, CINAHL, PsycINFO, Embase and Scopus up to January 2021. English-language publications on depression, anxiety, cognitive function, frailty and quality of life among PLWH50+ residing in SSA were included.Data extraction and synthesisWe extracted information, including study characteristics and main findings. These were tabulated, and a narrative synthesis approach was adopted, given the substantial heterogeneity among included studies.ResultsA total of 50 studies from fifteen SSA countries met the inclusion criteria. About two-thirds of these studies emanated from Ethiopia, Uganda and South Africa. Studies regarding depression predominated (n=26), followed by cognitive impairment (n=13). Overall, PLWH50+ exhibited varying prevalence of depression (6%–59%), cognitive impairments (4%–61%) and frailty (3%–15%). The correlates of CMDs, cognitive impairment, frailty and HRQoL were rarely investigated, but those reported were sociodemographic variables, many of which were inconsistent.ConclusionsThis review documented an increasing number of published studies on HIV and ageing from SSA. However, the current evidence on the mental and well-being outcomes in PLWH50+ is inadequate to characterise the public health dimension of these impairments in SSA, because of heterogeneous findings, few well-designed studies and substantial methodological limitations in many of the available studies. Future work should have sufficiently large samples of PLWH50+, engage appropriate comparison groups, harmonise the measurement of these outcomes using a standardised methodology to generate more robust prevalence estimates and confirm predictors.PROSPERO registration numberCRD42020145791.

Safety and efficacy of human papillomavirus vaccination for people living with HIV: A systematic review and meta-analysis

2019 ◽  
Vol 30 (11) ◽  
pp. 1105-1115 ◽  
Author(s):  
Yongle Zhan ◽  
Xuan Liu ◽  
Yahui Feng ◽  
Sansan Wu ◽  
Yu Jiang
Keyword(s):  
Human Papillomavirus ◽  
Adverse Events ◽  
Geometric Mean ◽  
Hpv Vaccination ◽  
Current Evidence ◽  
Cochrane Library ◽  
Hiv Positive ◽  
People Living With Hiv ◽  
Human Papillomavirus Vaccination ◽  
Living With Hiv

The current evidence regarding the safety and immunogenicity of human papillomavirus (HPV) vaccinations for people living with HIV (PLWH) is unclear. We searched PubMed, Embase, Cochrane Library and Web of Science databases from inception to 23 November 2018. The pooled proportion, relative risk (RR) and the standardized mean difference (SMD) with 95% confidence intervals (CIs) were calculated. Twenty-four studies consisting of 7507 participants were identified. The pooled proportion of adverse events in HIV-infected vaccinees was 60% and the antibody seroconversion rates in HPV-6, -11, -16, -18 subtypes were all above 90%. When compared with the placebo groups, the risk of adverse events was not different except for the injection site reactions (RR: 2.63, 95% CI: 1.72–4.01, p < 0.001), and the level of CD4 was relatively lower (SMD: −0.17, 95% CI: −0.29 to −0.04, p = 0.01) in the HIV-positive vaccinees groups. When compared with HIV-negative vaccinees, the risk of adverse events was not different, but the pooled RR and SMD indicated that antibody seroconversion and geometric mean titer for HPV-18 in HIV-positive groups was lower (RR: 0.91, 95% CI: 0.87–0.95, p < 0.001; SMD: −0.43, 95% CI: −0.62 to −0.24, p < 0.001). The study proves that HPV vaccine is safe and efficacious for PLWH and has important implications for international guidelines and strategies for HPV vaccination.

Colonic cryptococcosis as a rare presentation in HIV infection: a case report and review of the literature

2020 ◽  
Vol 31 (14) ◽  
pp. 1414-1419
Author(s):  
Alvaro Quincho-Lopez ◽  
Juan Montenegro-Idrogo ◽  
Rogger Oscar Verona-Rubio
Keyword(s):  
Histopathological Examination ◽  
Epigastric Pain ◽  
Case Reports ◽  
Multiple Organ ◽  
People Living With Hiv ◽  
Rare Presentation ◽  
Antituberculosis Treatment ◽  
History Of ◽  
Cryptococcus Spp ◽  
Living With Hiv

Colonic cryptococcal infection is unusual in people living with HIV (PLWH) and even more so without concomitant neurological compromise. Published case reports describe diarrhea and other intestinal manifestations that are often confused with systemic tuberculosis infection. We describe an Peruvian woman living with HIV on antiretroviral therapy who presented hypotensive with a 6-month history of fever and epigastric pain, in addition to episodes of sporadic diarrhea. Due to the suspicion of systemic tuberculosis, antituberculosis treatment was started. Days later, without clinical improvement, colonoscopy revealed ulcers in the transverse colon. Histopathological examination of biopsied tissue was compatible with Cryptococcus spp. She received antifungal therapy with amphotericin B and fluconazole. Despite the treatment, the patient died six days later from multiple organ failure.

scholarly journals Blood–Brain Barrier Impairment in Patients Living with HIV: Predictors and Associated Biomarkers

Diagnostics ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 867
Author(s):  
Giulia Caligaris ◽  
Mattia Trunfio ◽  
Valeria Ghisetti ◽  
Jessica Cusato ◽  
Marco Nigra ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Blood Brain Barrier ◽  
Opportunistic Infections ◽  
Brain Barrier ◽  
People Living With Hiv ◽  
Cross Sectional ◽  
Hiv Rna ◽  
Blood Brain ◽  
Male Sex ◽  
Living With Hiv

Despite the substantial changes resulting from the introduction of combination antiretroviral therapy (cART), the prevalence of HIV-associated neurocognitive disorders (HAND) remains substantial. Blood–brain barrier impairment (BBBi) is a frequent feature in people living with HIV (PLWH) and it may persist despite effective antiretroviral treatment. A cross-sectional study was performed in PLWH who underwent lumbar puncture for clinical reasons or research protocols and several cerebrospinal fluid biomarkers were studied. BBBi was defined as cerebrospinal fluid-to-serum albumin ratio (CSAR) >6.5 (<40 years) or >8 (>40 years). We included 464 participants: 147 cART-naïve and 317 on cART. Male sex was prevalent in both groups (72.1% and 72.2% respectively); median age was 44 (38–52) years in naïve and 49 (43–57) years in treated subjects. BBBi was observed in 35.4% naïve and in 22.7% treated participants; the use of integrase inhibitors was associated with a lower prevalence (18.3 vs. 30.9%, p = 0.050). At multivariate binary logistic regression (including age and sex) nadir CD4 cell count (p = 0.034), presence of central nervous system (CNS) opportunistic infections (p = 0.024) and cerebrospinal fluid (CSF) HIV RNA (p = 0.002) in naïve participants and male sex (p = 0.021), a history of CNS opportunistic infections (p = 0.001) and CSF HIV RNA (p = 0.034) in treated patients were independently associated with BBBi. CSF cells and neopterin were significantly higher in participants with BBBi. BBBi was prevalent in naïve and treated PLWH and it was associated with CSF HIV RNA and neopterin. Systemic control of viral replication seems to be essential for BBB integrity while sex and treatment influence need further studies.

Prevalence and risk of subclinical carotid atherosclerosis in the global population with HIV: a systematic review and meta-analysis

2021 ◽  
pp. 095646242097285
Author(s):  
Xuan Liu ◽  
Yang Sun ◽  
Yongle Zhan ◽  
Yu Jiang
Keyword(s):  
Health Care Providers ◽  
Carotid Atherosclerosis ◽  
Meta Analysis ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Current Evidence ◽  
People Living With Hiv ◽  
Care Providers ◽  
Living With Hiv ◽  
Global Population

The current evidence regarding the prevalence of subclinical carotid atherosclerosis (SCA) for people living with HIV(PLWH) is inconsistent. In this study, we aimed to synthesize data on the prevalence and association of SCA patients with HIV infection. We searched PubMed, EMBASE, Web of Science, Medline, SinoMed, and CNKI from inception to March 2, 2020. The pooled proportion, odds ratio (OR) with 95% confidence intervals (CIs) were calculated. For inclusion, SCA was measured by carotid intima-media thickness (CIMT), with a B-mode ultrasound machine. Twenty-six studies consisting of 6590 participants were identified. The overall prevalence of SCA was 31.6% (95% CI 13.4‐53.3; I2 = 99%; 4 studies) according to CIMT ≥ 0.78 mm criteria, and 32.3% (19.6‐46.4; 97%; 10 studies) according to CIMT ≥ 0.90 mm criteria. SCA prevalence was higher in Europe, over 40 years old and male. What’s more, PLWH have a higher likelihood of developing SCA comorbidity than HIV-negative controls (pooled OR 2.66, 95% CI 1.57‐4.50, I2 = 74%; 9 studies), even after sensitivity analysis (pooled OR 2.58, 1.54‐4.31, 73%). This study suggests a high prevalence and risk of SCA in the global population with HIV. As a result, subclinical carotid atherosclerosis deserves more attention from policymakers, HIV health-care providers, researchers, and stakeholders.

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