The Use of Methylphenidate for Cognitive Decline Associated with HIV Disease

1995 ◽  
Vol 25 (1) ◽  
pp. 21-37 ◽  
Author(s):  
George R. Brown
Keyword(s):  
Side Effects ◽  
Hiv Infection ◽  
Early Stage ◽  
Case Reports ◽  
English Literature ◽  
Pharmacokinetic Data ◽  
Hiv Disease ◽  
Cognitive Changes ◽  
Persons Living With Hiv ◽  
Hiv Aids

Objective: Complaints of cognitive changes are often expressed by patients at all stages of HIV infection. Such changes include decreased memory and attention span, diminished concentration, apathy, and “slowing.” Methylphenidate (MPD) has been used in several clinical studies in men with late-stage HIV disease in an attempt to ameliorate these difficulties. The objectives of this review article are to review salient psychopharmacological characteristics of MPD and to describe the research and clinical literature supporting the use of MPD in patients at all stages of HIV infection. Methods: Seven studies, case reports, or abstracts from International Conferences on AIDS were available in the English literature through August, 1993, directly addressing the use of MPD in patients with HIV disease. Twenty-nine papers were reviewed for pharmacokinetic data, eighteen for safety and side effects issues, and seventeen for relevant contributions from the neuropsychological testing literature. Results: Studies in clinical settings have used doses ranges from 10–90 mg. per day in two or three divided doses with reportedly good results in improving both affective and cognitive symptoms associated with HIV disease. Side effects have been relatively mild and patient satisfaction with treatment has been high. However, no studies have been conducted in early stage HIV disease, where a significant minority of patients have similar complaints in the absence of clinically apparent immunosuppression. Likewise, placebo-controlled, dose-finding studies in AIDS patients are entirely lacking, and no studies in women with HIV disease and cognitive changes have been published. Conclusions: In spite of these important research shortcomings, clinical experience with MPD treatment of cognitive changes in men with HIV/AIDS is consistent with the notion that this medication holds significant promise to improve the quality of life for persons living with HIV/AIDS. Controlled studies to test this hypothesis are warranted.

scholarly journals Human Herpesviruses as Copathogens of HIV Infection, Their Role in HIV Transmission, and Disease Progression

2016 ◽  
Vol 8 (01) ◽  
pp. 005-018 ◽  
Author(s):  
Arshi Munawwar ◽  
Sarman Singh
Keyword(s):  
Hiv Infection ◽  
Disease Progression ◽  
Highly Active Antiretroviral Therapy ◽  
Significant Risk ◽  
Hiv Disease ◽  
Mortality And Morbidity ◽  
Human Herpesviruses ◽  
Hsv 1 ◽  
Hiv Aids

ABSTRACTOf eight human herpesviruses (HHVs), often, only herpes simplex virus types 1 (HSV-1) and 2 (HSV-2) find mention in medical literature as both of these viruses are commonly associated with genital lesions and oral ulcers, commonly known as cold sores. However, role of human herpesviruses as copathogens and in aggravation and in the transmission of other human diseases, especially the Acquired immunodeficiency syndrome (HIV/AIDS) has only very recently been recognized. Therefore, screening and treating subclinical HHV infections may offer slowing of HIV infection, disease progression, and its transmission. Beside HSV-1 and HSV-2, HHV-3 a causative agent of herpes zoster remained one of the first manifestations of HIV disease before the era of highly active antiretroviral therapy (HAART). HHV-5 also known as human Cytomegalovirus infection remains a significant risk factor for HIV-associated mortality and morbidity even in HAART era. It is proposed that Cytomegalovirus viremia could be a better predictor of HIV disease progression than CD4+ T-lymphocyte count. The role of HHV-4 or Epstein–Burr virus and HHV-6, HHV-7, and HHV-8 is still being investigated in HIV disease progression. This review provides insight into the current understanding about these 8 HHVs, their co-pathogenesis, and role in HIV/ AIDS disease progression. The review also covers recent literature in favor and against administering anti-HHV treatment along with HAART for slower AIDS progression and interrupted sexual transmission.

scholarly journals A case series of efavirenz induced gynaecomastia

2021 ◽  
Vol 8 (7) ◽  
pp. 984
Author(s):  
Balakrishna Teli ◽  
Sneha Biradar ◽  
Sheshan V. S.
Keyword(s):  
Side Effects ◽  
Hiv Infection ◽  
Side Effect ◽  
Case Reports ◽  
Case Series ◽  
Drug Adherence ◽  
Resource Limited Settings ◽  
Highly Active ◽  
Resource Limited ◽  
Haart Therapy

The prognosis of HIV infection has significantly changed following the introduction of highly active anti-retroviral therapy by reducing AIDS related morbidity and mortality. At the same time, HAART is documented for its side effects. Gynaecomastia is a less documented side effect of a commonly used ART drug efavirenz. There are only few case reports of HAART-induced gynaecomastia in resource limited settings. Initially gynaecomastia related to HAART in HIV patients was thought due to lipodystrophy and was termed as pseudogynaecomastia. Later, few case reports of efavirenz related gynaecomastia were published after ruling out other causes of gynaecomastia. All other causes of gynaecomastia were ruled out in our patients too. The incidence of gynaecomastia is increasing in men with HIV on HAART therapy, proper identification and management will promote better drug adherence. The present study presented a series of two cases that developed ultrasound confirmed gynaecomastia following efavirenz containing HAART.

Beyond Stigma: Persons Living with HIV/AIDS and Their Problems

2018 ◽  
Vol 9 (2) ◽  
pp. 98
Author(s):  
. Rajnish
Keyword(s):  
Hiv Infection ◽  
Immune Deficiency Syndrome ◽  
Control Programme ◽  
Primary Data ◽  
Power Relationship ◽  
Primary Concern ◽  
Persons Living With Hiv ◽  
Clinical Background ◽  
Living With Hiv ◽  
Hiv Aids

Background: Acquired Immune Deficiency Syndrome (AIDS) caused by human immunodeficiency virus (HIV). In India, National AIDS Control and Organization (NACO) is primary concern Governmental agency which is deal with it in phase wise manner. During the all four phases of national AIDS control programme (NACP) concentration has been drawn on creation of amiable environment for persons living with HIV/AIDS (PLHA) by spreading awareness about different aspects of HIV/AIDS, reduction in high risk behaviour, (safe sex, usage of disposable syringes), free test of HIV infection and distribution of Anti-Retroviral Treatment (ART). All these efforts have their own advantage but still, the needs of PLHA are not fully met. They are many changes need to overcome yet, stigma is the biggest one and many others are increasing the problems of PLHA which have not been addressed adequately till date. This situation has been discussed in the paper. Methodology: Primary data has been collected from 213 respondents along with some secondary sources. Interview schedule and an interview guide were used as a tool. Result: This study reflects that despite the four complete phases of NACP the problem of PLHA has not been addressed in a holistic way. Concentration has been drawn mainly on the medical/clinical background of HIV/AIDS. The level of awareness among PLHA about ongoing programs is not very much good in condition. Particularly female PLHA and PLHA who were residing in remote areas like rural or slum had poor access to awareness. But the condition of PLHA who were well educated, belonging to a sound economic background, a resident of the urban or semi-urban area was also not better and had been found to be dissatisfied with arrangements. Conclusion: Â In the field of prevention and control of HIV/AIDS the role of NACO cannot be ignored. Because of the vigorous effort of NACO, the rate of new HIV infection has declined and in many parts has stabilized almost. This achievement does not permit us to ignore the diverse nature of needs, requirements and problems of the existing population of PLHA. In Indian health care system, in terms of a power relationship, PLHA share a subordinate position in which due to the absence of a bilateral interaction and unequal participation, they get less attention. Different nature of their problem has not been given adequate recognition but attention has been drawn on the medical/clinical background of HIV/AIDS. For that social difference, administrative negation is responsible. Therefore PLHA is the victim of poor pathological, biological condition and social arrangements that have victimized them in multiple ways.

scholarly journals A Patient with Non-Hodgkin Lymphoma and Nonspecific Interstitial Pneumonia during Ibrutinib Therapy

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Sven Jungmann ◽  
Wolf-Dieter Ludwig ◽  
Nicolas Schönfeld ◽  
Torsten-Gerriet Blum ◽  
Claudia Großwendt ◽  
...  
Keyword(s):  
Side Effects ◽  
Lung Disease ◽  
Interstitial Pneumonia ◽  
Early Stage ◽  
Case Reports ◽  
Individual Case ◽  
Close Monitoring ◽  
Non Hodgkin Lymphoma ◽  
First Case ◽  
Nonspecific Interstitial Pneumonia

We present a 74-year-old male with nonspecific interstitial pneumonia (NSIP) during treatment with ibrutinib for mantle cell lymphoma. Previously, the patient had received six cycles of bendamustine and rituximab and six cycles of R-CHOP, followed by rituximab maintenance therapy. Respiratory tract complications of ibrutinib other than infectious pneumonia have not been mentioned in larger trials, but individual case reports hinted to a possible association with the development of pneumonitis. In our patient, the onset of alveolitis that progressed towards NSIP together with the onset of ibrutinib treatment suggests causality. One week after ibrutinib was discontinued, nasal symptoms resolved first. A follow-up CT showed a reduction in the reticular hyperdensities and ground-glass opacities, suggestive of restitution of the lung disease. To our knowledge, this is the first case showing a strong link between ibrutinib and interstitial lung disease, strengthening a previous report on subacute pneumonitis. Our findings have clinical implications because pulmonary side effects were reversible at this early stage. We, therefore, suggest close monitoring for respiratory side effects in patients receiving ibrutinib.

scholarly journals HIV in Ecuador: A Current Perspective of the Epidemics from a Major HIV Care Center.

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S437-S437
Author(s):  
Leonardo Cano Cevallos ◽  
Edison Cano Cevallos ◽  
Andrea Vélez Vera ◽  
Nathalie Suárez ◽  
Maryuri Delgado ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Hiv Care ◽  
Health Concern ◽  
Rapid Progression ◽  
Female Ratio ◽  
First Case ◽  
Persons Living With Hiv ◽  
A Current ◽  
Hiv Aids

Abstract Background Human Immunodeficiency Virus (HIV) infection is estimated to affect 36.7 million people (persons living with HIV [PLWH]). In Latin America and Caribbean exist around 2 million of PLWH. Ecuador estimates are close to 35.000 PLWH with prevalence of 3 cases per 1000 population, being 31.4% woman. Since the first case of HIV reported in the country in 1983 the efforts have been made to improve prevention and treatment of the disease being epidemiology paramount in planning. Herein we present a current panorama of HIV in Ecuador from a major center serving approximately 2 million people in the coastal zone. Methods Patients with diagnosis of HIV/AIDS (ICD-10 B24) from January to December 2015 were included from a database comprising 346.386 visits to outpatient clinics. The variables we consider were demographics, newly vs. previously diagnosed, type of antiretroviral regimen, AIDS-defining conditions, CD4 count and viral load. The statistical analysis was made on Microsoft Excel. Results A total of 3776 HIV positive patients were found during the study period. Median age was 37 ± 15, 37 ± 15 for males and 38 ± 15 for females (P > 0.05). Male to female ratio was 4.72:1. More than half patients (2588, 68.5%) were receiving antiretroviral therapy. The most common therapy used was tenofovir + emtricitabine + efavirenz, followed zidovudine + lamivudine + efavirenz for 472 (18.2%). Most patients (91.97%) with HIV infection were not in AIDS stage. Newly diagnosed HIV was seen in 824 patients (21.82%), of which 59 (7%) were on AIDS stage at time of diagnosis. There was only 45 cases in this group (5.46%) with CD4 <200 cells/mm3 possibly suggesting rapid progression or advanced disease. Conclusion HIV infection is a public health concern in Ecuador affecting mostly young males. More than half patients are on antiretroviral therapy and most patients are not in AIDS stage. This study comprises a current view of the epidemiological situation of HIV/AIDS in the coast of Ecuador and allows for planning and further research. Disclosures All authors: No reported disclosures.

scholarly journals Analysis of HIV/Aids notifications in a municipality of national health between 2007 and 2017: gender, age, race, schooling, neighborhood of origin, notifying units and treatment units

2019 ◽  
Vol 31 (4) ◽  
Author(s):  
Rodrigo Alberton da Silva ◽  
Alexander Acauan de Aquino ◽  
Matheus Henrique Benin Lima ◽  
Ana Victória Coletto Reichert ◽  
Augusto Poloniato Gelain ◽  
...  
Keyword(s):  
Primary Care ◽  
Hiv Infection ◽  
Case Reports ◽  
Care Service ◽  
Epidemiological Data ◽  
Adult Men ◽  
Specialized Care ◽  
Acquired Immunodeficiency ◽  
Immunodeficiency Syndrome ◽  
Hiv Aids

Introduction: Both human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS) are part of the National List of Compulsory Notification of Diseases. Despite the compulsory reporting of HIV infection from 2014, there has been a drop in the detection of new cases in the last five years. Objective: Analyze the epidemiological data of HIV/AIDS case reports in the city of Passo Fundo, Rio Grande do Sul, from 2007 to 2017 in relation to gender, neighborhoods, notifying units and treatment units. Methods: Retrospective descriptive study, accomplished at the Health Surveillance Sector from the compulsory notifications available in the Information System of Notifiable Diseases (Sistema de Informação de Agravos de Notificação – SINAN). A spreadsheet was made in the Microsoft Excel® Program (2016). Data were analyzed using the SPSS® Program, descriptively through measures of prevalence, incidence and distribution. Results: There were 1,068 notifications. There was a predominance of males (55.5%) and in the age group from 27 to 43 years. Of the 31 notifying health units, three concentrated 95% of the cases: Specialized Care Service (74.7%); Hospital São Vicente de Paulo (16%); and Hospital das Clínicas of Passo Fundo (4%). The same three units concentrated 98.0% of the treatments: 88, 9 and 1%, respectively. The primary care accounted for 5.0% of the notifications. Conclusion: The higher prevalence in young adult men denotes the importance of prevention aimed at this audience. Notifications were mostly from hospitals and a public referral center, with little involvement of primary care in reporting HIV/AIDS.

Operation Teddy

2003 ◽  
Vol 1 (1) ◽  
pp. 20-28
Author(s):  
Lyndall Ellingson
Keyword(s):  
Health Education ◽  
Service Learning ◽  
Hiv Infection ◽  
Aids Prevention ◽  
Education Curriculum ◽  
Infection Rates ◽  
Community Members ◽  
Education Students ◽  
Prevention Education ◽  
Hiv Aids

Current adolescent HIV infection rates support the need for early HIV/AIDS prevention education. This article describes a successful service-learning project in which undergraduate health education students developed and taught an elementaryschool HIV/AIDS prevention education curriculum that included a compassion component involving donation of teddy bears to community members affected with HIV/AIDS.

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