New Insights into Ocular Complications of Human Immunodeficiency Virus Infection

2021 ◽  
Vol 19 ◽  
Author(s):  
Luoziyi Wang ◽  
Xin Che ◽  
Jing Jiang ◽  
Yiwen Qian ◽  
Zhiliang Wang
Keyword(s):  
Highly Active Antiretroviral Therapy ◽  
Opportunistic Infections ◽  
Clinical Manifestations ◽  
Kaposi Sarcoma ◽  
Public Health Issue ◽  
People Living With Hiv ◽  
Global Public Health ◽  
Ocular Complications ◽  
Varicella Zoster ◽  
Ocular Manifestations

: HIV/AIDS continues to be a major global public health issue, affecting multiple organs such as the eyes. With the advent of highly active antiretroviral therapy (HAART), the incidence has dropped but HIV ocular complications still remain a major cause of vision impairment in HIV-positive individuals. Since modern medical interventions nowadays can change this previously fatal infection into a chronic disease and enable people living with HIV for relatively long and healthy lives, recent studies update the incidence of HIV-related ocular manifestations which has reached 70% among HIV patients. The primary ocular disorders induced by HIV are various and the clinical ocular findings are similar which may be a problem to diagnose in the setting of disease. In our discussion, these complications are classified by etiology, for example noninfectious microvasculopathy resulting from direct invasion of the HIV, HIV-associated opportunistic infections caused by virus such as cytomegalovirus and varicella-zoster virus, fungus for example candida and cryptococcus, bacteria like mycobacterium, parasites such as toxoplasma and pneumocystis, and other pathogens, and infiltration lesions like lymphoma and Kaposi sarcoma. In order to get a better understanding of HIV ocular complications, we focus on HIV-related ocular complications in the HAART era with an emphasis on current incidence, clinical manifestations, ocular examination findings, differential diagnosis, treatment, and prognosis. In addition, we discuss the possibility of virus reservoir in eyes which makes HIV-related oculopathy still ubiquitous even after successful systemic treatment.

scholarly journals A comparative study to assess the knowledge and beliefs regarding AIDS among higher secondary students in rural schools of South Kerala and South Tamil Nadu

2021 ◽  
Author(s):  
Jose P. Cyril ◽  
Baburaj Stephenson ◽  
Joy John ◽  
Anju Mirin Alex ◽  
Sony S. Paul ◽  
...  
Keyword(s):  
Secondary Students ◽  
Rural Schools ◽  
Tamil Nadu ◽  
Epidemiological Data ◽  
Public Health Issue ◽  
People Living With Hiv ◽  
Global Public Health ◽  
Knowledge And Beliefs ◽  
Living With Hiv ◽  
Self Administered Questionnaire

Background: HIV continues to be a major global public health issue, having claimed 36.3 million lives so far.  India has the third largest HIV epidemic in the world, with 2.1 million people living with HIV. Epidemiological data on AIDS suggests that in many cases, HIV infection was acquired during adolescence and lack of knowledge is one of the most important reasons.  Hence, an ardent need was felt to assess the knowledge and beliefs of adolescents regarding AIDS. The main objective of this study was to assess the knowledge and beliefs regarding AIDS among higher secondary students of rural schools in South Kerala and in South Tamil Nadu.   Methods: After getting ethical committee clearance, the study was conducted among higher secondary students of twelfth standard using a predesigned and validated self-administered questionnaire. An educational intervention regarding AIDS lasting for 30 min was given after the test. Data analysis was done using appropriate software.Results: The mean knowledge scores of students from Kerala (11.57) and Tamil Nadu (11.51) were almost same. Television, newspaper and teachers were the main source of information about AIDS. Beliefs like Whiteman’s disease can spread through mosquito bite, sharing vessels and giving shake hands/touching were highly prevalent in the study subjects.Conclusions: Proper emphasis should be given to teachers on mentoring adolescents and imparting them with the needed knowledge on HIV/AIDS to enable them to overcome this period of stress and storm.

scholarly journals Late Onset of Antiretroviral Therapy in Adults Living with HIV in an Urban Area in Brazil: Prevalence and Risk Factors

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Priscila Ribeiro Guimarães Pacheco ◽  
Ana Laura Sene Amâncio Zara ◽  
Luiz Carlos Silva e Souza ◽  
Marília Dalva Turchi
Keyword(s):  
Viral Load ◽  
Antiretroviral Therapy ◽  
Highly Active Antiretroviral Therapy ◽  
Perceived Risk ◽  
Opportunistic Infections ◽  
Late Onset ◽  
Baseline Viral Load ◽  
People Living With Hiv ◽  
Late Initiation ◽  
Living With Hiv

Introduction. Highly active antiretroviral therapy has been available since 1996. Early initiation of antiretroviral therapy (ART) leads to improved therapeutic response and reduced HIV transmission. However, a significant number of people living with HIV (PLHIV) still start treatment late. Objective. This study aimed to analyze characteristics and factors associated with late initiation of ART among HIV-infected treatment-naïve patients. Methods. This cross-sectional study included PLHIV older than 17 years who initiated ART at two public health facilities from 2009 to 2012, in a city located in Midwestern Brazil. Pregnant women were excluded. Data were collected from medical records, antiviral dispensing forms, and the Logistics Control of Medications System (SICLOM) of the Brazilian Ministry of Health. Late initiation of ART was defined as CD4+ cell count < 200 cells/mm3 or presence of AIDS-defining illness. Uni- and multivariate analysis were performed to evaluate associated factors for late ARV using SPSS®, version 21. The significance level was set at p<0.05. Results. 1,141 individuals were included, with a median age of 41 years, and 69.1% were male. The prevalence of late initiation of ART was 55.8% (95%CI: 52.9-58.7). The more common opportunistic infections at ART initiation were pneumocystosis, cerebral toxoplasmosis, tuberculosis, and histoplasmosis. Overall, 38.8% of patients had HIV viral load equal to or greater than 100,000 copies/mL. Late onset of ART was associated with higher mortality. After logistic regression, factors shown to be associated with late initiation of ARV were low education level, sexual orientation, high baseline viral load, place of residence outside metropolitan area, and concomitant infection with hepatitis B virus. Conclusion. These results revealed the need to increase early treatment of HIV infection, focusing especially on groups of people who are more socially vulnerable or have lower self-perceived risk.

4313Evolocumab rapidly reverses impaired coronary endothelial function in six weeks in people living with HIV and in patients with dyslipidemia

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
T Leucker ◽  
G Gerstenblith ◽  
M Schar ◽  
T Brown ◽  
S Jones ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Endothelial Function ◽  
Highly Active Antiretroviral Therapy ◽  
Cholesterol Metabolism ◽  
Clinical Manifestations ◽  
People Living With Hiv ◽  
Isometric Handgrip ◽  
Coronary Endothelial Function ◽  
Pcsk9 Inhibition ◽  
Living With Hiv

Abstract Background/Introduction Proprotein convertase subtilisin/kexin type 9 (PCSK9) is well recognized for its importance in cholesterol metabolism. Elevated levels are associated with increased cardiovascular risk and inhibition with PCSK9 antibodies lowers cardiovascular events in patients with known coronary disease. PCSK9 levels are also elevated in people living with HIV (PLWH), and we previously reported that increased PCSK9 in PLWH is associated with impaired coronary endothelial function (CEF), a major driver for the development, progression, and clinical manifestations of coronary artery disease. Purpose Here we investigate the hypothesis that PCSK9 inhibition improves impaired CEF in PLWH and in patients with dyslipidemia (DL). Methods Cine 3T MRI was used to noninvasively measure CEF, assessed as the change in coronary cross-sectional area (CSA) from rest to isometric handgrip exercise (IHE), a known endothelial-dependent vasodilator. Eight HIV+ subjects on stable highly active antiretroviral therapy and with undetectable HIV RNA (mean age 53±9 yrs, LDLC 98±18 mg/dL, 38% on statins) and ten patients with dyslipidemia (DL) without HIV receiving evolocumab for clinical reasons (mean age 56±10 yrs, LDLC 130±28 mg/dL, 50% on statins) underwent MRI studies before and six weeks following the initiation of evolocumab 420 mg. MRI readers were blinded to group and timepoint. MRI data are presented as mean±SD for % change rest vs IHE. Results Prior to evolucumab, resting CSA in the two groups did not differ and IHE did not induce normal coronary vasodilation in either group; mean stress-induced CSA changes were −2.1±6.4% in HIV (p=0.27) and −0.6±4.1% in DL (p=0.46). Notably, CEF significantly improved following six weeks of evolocumab with IHE-induced CSA changes of 7.6±5.7% (p=0.006) and 5.0±3.6% (p=0.002) in the HIV and DL groups, respectively. The %-LDLC reduction with evolocumab was profound and comparable in the HIV and DL groups, 73±5% and 60±6% (p=0.19 HIV vs. DL). There was no significant correlation between the extents of LDLC reduction and of CEF improvement in either of these modest sized groups. Conclusion PCSK9 inhibition with evolocumab significantly improves abnormal coronary endothelial function after only six weeks in HIV+ people with normal LDLC and in HIV- people with DL. To our knowledge, these data represent the earliest (6 weeks) evidence for improvement in human coronary artery health by PCSK9 inhibition. Acknowledgement/Funding Amgen provided the PCSK9 monoclonal antibody (evolocumab) for this study.

scholarly journals Coexistence of Kaposi sarcoma and Molluscum contagiosum on the same site in a HIV-AIDS patient: A very rare occurrence

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Kabir Abdullahi ◽  
Yahaya Mohammed ◽  
Saddiku A. Sahabi ◽  
Mahmood M. Dalhat
Keyword(s):  
Antiretroviral Therapy ◽  
Highly Active Antiretroviral Therapy ◽  
Opportunistic Infections ◽  
Kaposi Sarcoma ◽  
Skin Lesions ◽  
Molluscum Contagiosum ◽  
University Teaching ◽  
Therapy Regimen ◽  
Highly Active ◽  
Hiv Aids

Introduction: There have been numerous reported opportunistic infections among HIV/AIDS patients. However, coexistence of Kaposi sarcoma and Molluscum contagiosum on the same site is a rare finding.Case presentation: A 37-year-old man poorly adherent to antiretroviral therapy presented with Molluscum contagiosum and Kaposi sarcoma occurring simultaneously on numerous skin lesions around mid-2017 at Usmanu Danfodiyo University Teaching Hospital, Sokoto State, Nigeria.Management and outcome: The patient was counselled and re-initiated on a second-line highly active antiretroviral therapy regimen. The patient’s lesions resolved three months later.Discussion: The case is presented to improve the index of suspicion among clinicians and pathologists on such rare occurrences.

scholarly journals Hemophagocytic Syndrome Associated with Immune Reconstitution Inflammatory Syndrome in a Patient with AIDS Related Burkitt’s Leukemia/Lymphoma

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Metin Kanıtez ◽  
Mahir Kapmaz ◽  
Nilufer Alpay ◽  
Fatih Selcukbiricik ◽  
Atahan Çağatay ◽  
...  
Keyword(s):  
Immune Function ◽  
Immune Reconstitution Inflammatory Syndrome ◽  
Highly Active Antiretroviral Therapy ◽  
Immune Reconstitution ◽  
Hemophagocytic Syndrome ◽  
Opportunistic Infections ◽  
Rare Complication ◽  
Clinical Manifestations ◽  
High Dose ◽  
Inflammatory Syndrome

Highly active antiretroviral therapy (HAART) has markedly decreased human immunodeficiency virus- (HIV-) related mortality and the incidence of opportunistic infections. The dramatic reduction in HIV-1 RNA and increase in CD4 lymphocyte count mean a recovery in immune function. This restoration in immune function may be associated with paradoxical deterioration in subclinical opportunistic infections in some patients, a condition called immune reconstitution inflammatory syndrome (IRIS). IRIS, a “paradoxical” inflammatory response to either previously treated or subclinical infections or noninfectious diseases, can manifest during the restoration phase of immunity hemophagocytic syndrome (HS) which is a very rare complication in patients with acquired immune deficiency syndrome (AIDS). We describe a case of hemophagocytic syndrome associated with IRIS in a patient with AIDS related Burkitt’s leukemia/lymphoma (BL). IRIS was probably the cause of hemophagocytosis for our patient. Zoster infection may facilitate to IRIS. With the increasing number of people with HIV infection and the accompanying use of HAART, much more clinical manifestations of IRIS will be experienced especially in patients given high dose chemotherapy, just like in our case.

scholarly journals Trends of HIV/AIDS Infection in Arsi Zone from 2002-2008 E.C (2010 to 2016 G.C), Oromia Region Ethiopia: Evidence from VCT Registry

2020 ◽  
Author(s):  
Mesfin Segni Tafa ◽  
Hailu Fekadu ◽  
Martha Aseffa ◽  
Hirpo Teno
Keyword(s):  
Logistic Regression ◽  
Hiv Prevalence ◽  
Health Facilities ◽  
Sub Saharan Africa ◽  
Public Health Issue ◽  
P Value ◽  
People Living With Hiv ◽  
Global Public Health ◽  
Arsi Zone ◽  
Hiv Aids

Abstract Introduction: HIV continues to be a major global public health issue, having claimed more than 35 million lives so far. Globally, about 36.7 million people living with HIV currently, more than two third of the infection is the burden of Sub-Saharan Africa. Knowing the status of HIV/AIDS has the great value to individual health of treatment with ART and in terms of reductions in individual morbidity and mortality, and is equally cost-effective. Therefore, the aim of this study was to assess trends and associated factor of HIV infection in Arsi zone from 2010 to 2016.Methodology: A retrospective study was conducted in Arsi zone. Thirty health facilities (27 health centers and 3 Hospitals) were selected for the study from all woreda in the Zone. A total of 205,691 data was collected from VCT registration book. Data were entered into computer using Epi info 3.5.4 and exported for analysis to SPSS 21. Data were presented using tables and figures using line graphs. Logistic regression was used to see the association and significance was declared at P-value<0.05 Result: The study showed a total of 4300 HIV positive cases were reported between 2002(2009 G.C) to 2008(2016 G.C) according to available VCT registration book during survey at 30 health facilities. The trends of HIV of infection were not properly defined, it was 3.4% in 2002(2010 G.C ) and mean while a gradual drop has been observed in the next five consecutive years, almost which was less than 2% prevalence and in 2008 the prevalence was raised to 2.4% compared to 2007 and before. The changes in HIV prevalence were uneven among districts. Findings from logistic regression analysis indicated that the fitted demographic characteristics like, marital status, age and occupation were significantly associated with HIV positivity in both bivariate and multivariate analysis.Conclusion: There are no encouraging indications that the HIV prevalence has decreasing since there were variation among districts. Therefore there is a need of designing comprehensive strategy to combat the spread of HIV infections among all individuals. It is also important to strengthening VCT services at all level with strict follow up.

scholarly journals Ophthalmological profile of patients living with HIV/AIDS

2010 ◽  
Vol 67 (10) ◽  
pp. 856-860
Author(s):  
Katarina Jankovic-Terzic ◽  
Vera Begic ◽  
Bojana Dacic-Krnjaja
Keyword(s):  
Opportunistic Infections ◽  
Hiv Positive ◽  
People Living With Hiv ◽  
Ocular Complications ◽  
Economic Implications ◽  
Active Involvement ◽  
The Individual ◽  
Living With Hiv ◽  
Hiv Aids

Introduction. Serbia has 2.287 registered HIV positive persons. A certain number has ocular complications which are mainly the result of opportunistic infections accompanying this illness. Due to a highly stigmatizing environment for people living with HIV/AIDS in Serbia, they do not always seek doctors assistance despite the fear of losing their sight. Case report. We presented ophthalmologic status of nine HIV positive persons, all at the different phases of the illness. The decrease in the visual acuity was the first symptom which led to the diagnosis of HIV infection in two of our patients. Conclusion. Ophthalmologist has an important role in the multidisciplinary approach to patients with HIV/AIDS from introducing the diagnosis to the follow-up and the treatment of ocular complications which may accompany this chronic illness. With the active involvement of eye professionals serious consequences can be prevented, which have not only medical but also social and economic implications on the individual and the society as a whole.

AIDS-related lymphoproliferative disease

Blood ◽  
2006 ◽  
Vol 107 (1) ◽  
pp. 13-20 ◽  
Author(s):  
Willis H. Navarro ◽  
Lawrence D. Kaplan
Keyword(s):  
Highly Active Antiretroviral Therapy ◽  
Hematopoietic Cell Transplantation ◽  
Opportunistic Infections ◽  
Kaposi Sarcoma ◽  
Lymphoproliferative Disease ◽  
Barr Virus ◽  
Highly Active ◽  
Extranodal Disease ◽  
Epstein Barr ◽  
Cd4 Lymphocyte

Abstract Not long after the recognition of HIV as the causative agent of AIDS, it was evident that individuals infected with HIV developed lymphoma at a greater rate than the population at large. Approximately two thirds of AIDS-related lymphoma (ARL) cases are categorized as diffuse large B-cell type, with Burkitt lymphomas comprising 25% and other histologies a much smaller proportion. Typically, these individuals have presented with advanced extranodal disease and CD4+ lymphocyte counts of less than 200/mm3. Recent clinical trials have demonstrated a better outcome with chemotherapy for ARL since the introduction of combination antiretroviral treatment, termed highly active antiretroviral therapy (HAART). For patients with relapses, solid evidence points to the safety and utility of hematopoietic-cell transplantation as a salvage modality. Coinfection with other viruses such as Epstein-Barr virus and Kaposi sarcoma-associated herpesvirus have led to the genesis of previously rare or unrecognized lymphoma subtypes such as plasmablastic and primary effusion lymphomas. The immunosuppressive impact of treatment for patients with ARL receiving chemotherapy with HAART appears transient and opportunistic infections have become less problematic than prior to HAART. Significant progress has been made in the understanding and management of ARL but outcomes still remain inferior compared to those achieved in HIV- individuals.

scholarly journals Alcohol Consumption, Progression of Disease and Other Comorbidities, and Responses to Antiretroviral Medication in People Living with HIV

2012 ◽  
Vol 2012 ◽  
pp. 1-14 ◽  
Author(s):  
Manuela G. Neuman ◽  
Michelle Schneider ◽  
Radu M. Nanau ◽  
Charles Parry
Keyword(s):  
South Africa ◽  
Alcohol Consumption ◽  
Low Income ◽  
Health Care Professionals ◽  
Highly Active Antiretroviral Therapy ◽  
World Literature ◽  
Opportunistic Infections ◽  
Positive Influence ◽  
People Living With Hiv ◽  
Resource Poor

The present paper describes the possible connection between alcohol consumption and adherence to medicine used to treat human deficiency viral (HIV) infection. Highly active antiretroviral therapy (HAART) has a positive influence on longevity in patients with HIV, substantially reducing morbidity and mortality, including resource-poor settings such as South Africa. However, in a systematic comparison of HAART outcomes between low-income and high-income countries in the treatment of HIV-patients, mortality was higher in resource-poor settings. Specifically, in South Africa, patients often suffer from concomitant tuberculosis and other infections that may contribute to these results. Alcohol influences the use of medicine for opportunistic infections (e.g., pneumonia, tuberculosis), or coinfections HIV-hepatitis viruses-B (HBV) and C (HCV), cytomegalovirus, or herpes simplex virus. Furthermore, alcohol use may negatively impact on medication adherence contributing to HIV progression. The materials used provide a data-supported approach. They are based on analysis of published (2006–2011) world literature and the experience of the authors in the specified topic. Intended for use by health care professionals, these recommendations suggest approaches to the therapeutic and preventive aspects of care. Our intention was to fully characterize the quality of evidence supporting recommendations, which are reflecting benefit versus risk, and assessing strength or certainty.

scholarly journals IMMUNE RECONSTITUTION INFLAMMATORY SYNDROME IN HIV INFECTION

2018 ◽  
Vol 8 (2) ◽  
pp. 139-149 ◽  
Author(s):  
E. V. Boeva ◽  
N. A. Belyakov
Keyword(s):  
Risk Factors ◽  
Hiv Infection ◽  
Immune Reconstitution Inflammatory Syndrome ◽  
Immune Reconstitution ◽  
Opportunistic Infections ◽  
Clinical Manifestations ◽  
Antiretroviral Drugs ◽  
People Living With Hiv ◽  
Hiv Rna ◽  
Inflammatory Syndrome

Antiretroviral therapy (ART) leads to suppression of HIV replication, contributes to increase in the number of CD4-lymphocytes count and  partial restoration or activation of the immune system. The  consequence is a reduction of incidence of opportunistic diseases,  increase in the duration and quality of life of people living with HIV  (PLHIV). However, in some patients with severe immunosuppression, this may be accompanied by a worsening of the condition and risks  of formation of the immune reconstitution inflammatory syndrome  (IRIS), which manifests itself in the development of new or  previously treated opportunistic, secondary and exacerbating non- infectious diseases against a virologically effective ART. The  frequency of the development of IRIS varies widely, in cases of  tuberculosis-associated manifestation it can reach 50%. Risk factors  for the development of IRIS are low initial CD4-lymphocyte count  and a high load of HIV RNA in the blood, the presence of  opportunistic infections during the initiation of ART. Discussed terminology issues, other possible risk factors for the  development of the syndrome, regularities of the pathological process are considered. Epidemiological statistics of  IRIS, pathogenetic bases, variants of clinical and laboratory  manifestations of complications are given. The criteria for diagnosis  of the syndrome, as well as the necessary conditions for its  occurrence, are considered. Particular attention is paid to the most  common opportunistic infections that cause the manifestation of  IRIS, the peculiarities and polymorphism of clinical manifestations  and the prevention of their occurrence. Currently, there is an  increasing incidence of HIV infection in the late stages. Laboratory  and clinical differences in the manifestations of acquired  immunodeficiency syndrome (AIDS) and IRIS have been sanctified. In view of the blurring of the diagnostic criteria, in the  Russian Federation specialists rarely expose IRIS to clinical or pathological diagnoses, therefore it is rather difficult to trace the  frequency of occurrence of this condition. Clinical and laboratory  manifestations are systematized, which allows to formulate this  diagnosis on the basis of their totality. Prevention of IRIS is the  prudent prescription of antiretroviral drugs. It is neces sary to  conduct a qualitative and timely diagnosis of concomitant diseases of infectious and non-infectious nature before the initiation of ART and  during treatment, the appointment of effective etiotropic therapy for  opportunistic and secon dary infections. In order to improve the  prognosis of HIV infection, preferably early onset of ART with stable  CD4-lym phocyte counts and low HIV RNA levels in the blood.

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