IMPACTS OF IMMUNOSUPPRESSION ON THE GRAVITY OF COVID-19 IN INDIVIDUALS CO-INFECTED WITH THE HUMAN IMMUNODEFICIENCY VIRUS (HIV)

Viral Load ◽

Literature Review ◽

Conflict Of Interest ◽

Severe Form ◽

Hiv Positive ◽

Increased Risk ◽

Study Results ◽

Objective: To identify the levels of severity of COVID-19 in individuals co-infected with the Human Immunodeficiency Virus (HIV). Methods: Expanded summary of the literature review type. The searches were carried out in the main databases of the BVS and CAPES. The above authors declare that they do not have conflict of interest in this study. Results: Most individuals were being treated with antiretrovirals (83-100%) and, therefore, most had a TCD4 lymphocyte count above 200 cells/µL and a viral load ranging between 67-100%. Comorbidities ranged from 33-70% and deaths from 0-14%. The severity picture was mostly mild, at a minimum proportion of 63%, not significantly differing from the population with COVID-19 in general, which on average remains in a mild symptomatic picture, around 80%. Therefore, the percentage of deaths and more severe levels of the disease were lower than expected due to the immune deficiency of HIV positive people. Conclusion: It is rash to make generalizations about the topic or to safely close the hypothesis that the immunosuppression of individuals with HIV, co-infected with SARS-CoV-2 has an increased risk to acquire the most severe form of COVID-19. This is because the studies found in the literature did not have a sample of participants significant enough.

Outcomes of Coronavirus Disease 2019 (COVID-19) Related Hospitalization Among People With Human Immunodeficiency Virus (HIV) in the ISARIC World Health Organization (WHO) Clinical Characterization Protocol (UK): A Prospective Observational Study

Clinical Infectious Diseases ◽

10.1093/cid/ciaa1605 ◽

2020 ◽

Cited By ~ 3

Author(s):

Anna Maria Geretti ◽

Alexander J Stockdale ◽

Sophie H Kelly ◽

Muge Cevik ◽

Simon Collins ◽

...

Keyword(s):

World Health Organization ◽

Cox Regression ◽

World Health ◽

Rank Test ◽

Hiv Positive ◽

Protein Levels ◽

Increased Risk ◽

Immunodeficiency Virus ◽

Health Organization

Abstract Background Evidence is conflicting about how human immunodeficiency virus (HIV) modulates coronavirus disease 2019 (COVID-19). We compared the presentation characteristics and outcomes of adults with and without HIV who were hospitalized with COVID-19 at 207 centers across the United Kingdom and whose data were prospectively captured by the International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC) World Health Organization (WHO) Clinical Characterization Protocol (CCP) study. Methods We used Kaplan-Meier methods and Cox regression to describe the association between HIV status and day-28 mortality, after separate adjustment for sex, ethnicity, age, hospital acquisition of COVID-19 (definite hospital acquisition excluded), presentation date, 10 individual comorbidities, and disease severity at presentation (as defined by hypoxia or oxygen therapy). Results Among 47 592 patients, 122 (0.26%) had confirmed HIV infection, and 112/122 (91.8%) had a record of antiretroviral therapy. At presentation, HIV-positive people were younger (median 56 vs 74 years; P < .001) and had fewer comorbidities, more systemic symptoms and higher lymphocyte counts and C-reactive protein levels. The cumulative day-28 mortality was similar in the HIV-positive versus HIV-negative groups (26.7% vs. 32.1%; P = .16), but in those under 60 years of age HIV-positive status was associated with increased mortality (21.3% vs. 9.6%; P < .001 [log-rank test]). Mortality was higher among people with HIV after adjusting for age (adjusted hazard ratio [aHR] 1.47, 95% confidence interval [CI] 1.01–2.14; P = .05), and the association persisted after adjusting for the other variables (aHR 1.69; 95% CI 1.15–2.48; P = .008) and when restricting the analysis to people aged <60 years (aHR 2.87; 95% CI 1.70–4.84; P < .001). Conclusions HIV-positive status was associated with an increased risk of day-28 mortality among patients hospitalized for COVID-19.

Atherosclerotic Cardiovascular Events in Patients Infected With Human Immunodeficiency Virus and Hepatitis C Virus

Clinical Infectious Diseases ◽

10.1093/cid/ciaa1014 ◽

2020 ◽

Author(s):

Boun Kim Tan ◽

Mathieu Chalouni ◽

Dominique Salmon Ceron ◽

Alexandre Cinaud ◽

Laure Esterle ◽

...

Keyword(s):

Hepatitis C Virus ◽

Cardiovascular Risk ◽

Viral Load ◽

Hepatitis C ◽

Baseline Viral Load ◽

Hiv Viral Load ◽

Factors Associated ◽

Increased Risk ◽

Abstract Background An increased risk of cardiovascular disease (CVD) was reported in patients coinfected with human immunodeficiency virus (HIV) and hepatitis C virus (HCV), without identifying factors associated with atherosclerotic CVD (ASCVD) events. Methods HIV–HCV coinfected patients were enrolled in the ANRS CO13 HEPAVIH nationwide cohort. Primary outcome was total ASCVD events. Secondary outcomes were coronary and/or cerebral ASCVD events, and peripheral artery disease (PAD) ASCVD events. Incidences were estimated using the Aalen-Johansen method. Factors associated with ASCVD were identified using cause-specific Cox proportional hazards models. Results At baseline, median age of the study population (n=1213) was 45.4 (interquartile range [IQR] 42.1−49.0) years and 70.3% were men. After a median follow-up of 5.1 (IQR 3.9−7.0) years, the incidence was 6.98 (95% confidence interval [CI] 5.19−9.38) per 1000 person-years for total ASCVD events, 4.01 (2.78−6.00) for coronary and/or cerebral events, and 3.17 (2.05−4.92) for PAD ASCVD events. Aging (hazard ratio [HR] 1.06, 95% CI 1.01−1.12), prior CVD (HR 8.48, 95% CI 3.14−22.91), high total cholesterol (HR 1.43, 95% CI 1.11−1.83), high-density lipoprotein cholesterol (HR 0.22, 95% CI 0.08−0.63), statin use (HR 3.31, 95% CI 1.31−8.38), and high alcohol intake (HR 3.18, 95% CI 1.35−7.52) were independently associated with total ASCVD events, while undetectable baseline viral load (HR 0.41, 95%CI 0.18−0.96) with coronary and/or cerebral events. Conclusion HIV–HCV coinfected patients experienced a high incidence of ASCVD events. Some traditional cardiovascular risk factors were the main determinants of ASCVD. Controlling cholesterol abnormalities and maintaining undetectable HIV viral load are essential to control cardiovascular risk.

HUMAN IMMUNODEFICIENCY VIRUS AND PREGNANCY: PATHOMORPHOLOGICAL FEATURES AND OBSTETRIC AND GYNECOLOGICAL TACTICS

"Medical & pharmaceutical journal "Pulse" ◽

10.26787/nydha-2686-6838-2021-23-8-178-184 ◽

2021 ◽

pp. 178-184

Author(s):

Spiridenko G.Yu. ◽

Petrov Yu.A. ◽

Bragina T.V.

Keyword(s):

Viral Load ◽

Antiretroviral Therapy ◽

Hiv Infection ◽

Reverse Transcriptase ◽

Reproductive Age ◽

Risk Of Infection ◽

Pathological Effect ◽

Increased Risk ◽

Currently, due to the increase in the incidence of HIV infection in women of reproductive age, the number of desired pregnancies in such patients has increased. This makes it necessary to study the pathological effect of the human immunodeficiency virus on the placenta, fetus and the female body as a whole. HIV belongs to retroviruses and contributes to the discoordination of a woman's immune mechanisms. Using the gp41 and gp120 glycoproteins, reverse transcriptase, integrase, and protease, the virus destroys CD4 cells and increases the viral load. It founded that the risk of infection of the fetus decreases from 45% to 1% with HIV infection before pregnancy and with antiretroviral therapy throughout its duration. Vertical infection is possible in the intrauterine, intranatal and postnatal periods, the main of which is the period of childbirth-up to 70%. Viral, maternal, placental, fetal, obstetric and neonatal factors contribute to an increased risk of transmission of the pathogen to the fetus. High viral load and antiretroviral therapy lead in the 3rd trimester of pregnancy to the development of chronic placental insufficiency due to the formation of focal and diffuse deciduitis, membranitis, intervillusitis and chorionamnionitis and damage to the hematoplacental barrier. Early diagnosis before 12 weeks of gestation, timely therapy with nucleoside and non-nucleoside reverse transcriptase inhibitors, as well as protease inhibitors during pregnancy, childbirth and in the postpartum period are the main aspects of preventing HIV infection and further disorders of the child's growth and development. The timely choice of the method of delivery, indications and contraindications to delivery through the natural birth canal helps to reduce the risk of infection in a particularly dangerous period - the intrapartum.

Reduction in Size and Number of Plantar Verrucae in Human Immunodeficiency Virus–Infected Individuals After the Implementation of Highly Active Antiretroviral Therapy

Journal of the American Podiatric Medical Association ◽

10.7547/14-044 ◽

2015 ◽

Vol 105 (5) ◽

pp. 401-406 ◽

Cited By ~ 2

Author(s):

Endri Afesllari ◽

Timothy J. Miller ◽

Michael J. Huchital ◽

Christy M. King ◽

James S. Johnston ◽

...

Keyword(s):

Antiretroviral Therapy ◽

Highly Active Antiretroviral Therapy ◽

Clinical Manifestations ◽

Hiv Positive ◽

Highly Active ◽

Clinical Type ◽

Size Number ◽

Study Results ◽

Background Implementation of highly active antiretroviral therapy (HAART) significantly increased the life expectancy of those living with human immunodeficiency virus (HIV). Except for prevalence, scientific reports regarding clinical manifestations of plantar verrucae in the post-HAART era are lacking. The objective of this study was to compare clinical manifestations of plantar verrucae between HIV-infected and noninfected individuals and then to compare these findings with those observed before the implementation of HAART. Methods Nineteen patients with plantar verrucae (ten with HIV and nine without HIV) were examined to determine the size, number, and clinical type of verrucae present. The two groups were first compared with each other and then with previously collected data from a similar analysis conducted in 1995, before the implementation of HAART. Statistical significance was determined using the Fisher exact test or the Wilcoxon rank sum test. Results No significant differences were observed in the size, number, or clinical type of verrucae between HIV-negative and HIV-positive patients. Compared with the 1995 data, there was a significant decrease in the number of verrucae lesions per individual and a nonsignificant decrease in the average size of verrucae in HIV-positive patients. Conclusions Study results indicate that the implementation of HAART has impacted the clinical manifestations of plantar verrucae in HIV-positive individuals. Further analyses with a larger number of patients are required to confirm and substantiate these findings.

A VH clonal deficit in human immunodeficiency virus-positive individuals reflects a B-cell maturational arrest [published erratum appears in Blood 1991 Oct 1;78(7):1899]

Blood ◽

10.1182/blood.v78.1.175.175 ◽

1991 ◽

Vol 78 (1) ◽

pp. 175-179 ◽

Cited By ~ 56

Author(s):

L Berberian ◽

Y Valles-Ayoub ◽

N Sun ◽

O Martinez-Maza ◽

J Braun

Keyword(s):

B Cells ◽

B Cell ◽

Germinal Center ◽

Cell Function ◽

Elevated Serum ◽

Definitive Treatment ◽

Hiv Positive ◽

Increased Risk ◽

Abstract A major feature of human immunodeficiency virus (HIV) infection is disordered B-cell function, which paradoxically includes both pathologic overactivity (elevated serum antibodies, lymphadenopathy, and increased risk for lymphoma) and underactivity (impaired antibody immunity, particularly to bacterial polysaccharide antigens). B-cell immune dysfunction contributes significantly to HIV-related morbidity and also represents an obstacle to eventual definitive treatment by anti-HIV immunization. Our laboratory has recently identified in normal B-cell populations certain VH gene subfamilies with a developmentally regulated pattern of utilization. In particular, B cells bearing rearranged VH3L were rare in the germinal center but uniformly abundant in the blood and lymphoid mantle zone. We used this index gene subfamily as a clonal criterion for the pattern of B-cell development in lymphocytes of HIV-positive individuals. In a series of 19 HIV- positive subjects, a striking deficit of VH3L B cells was observed; in contrast, none of the 16 normal subjects showed this abnormality. Other VH subfamilies (VH1N, VH4/6, and VH5N) were unaffected in the HIV- positive patients. This VH3L clonal deficit and other recent phenotype and histopathologic findings suggest that the general B-cell dysfunction in HIV is due to a discreet maturational arrest at the germinal center stage.

Incidence of Active Tuberculosis Among Human Immunodeficiency Virus (HIV)-Positive Patients and Evaluation of Their Responses to Usual Anti-Tuberculosis Medications in Shiraz, South West of Iran

Galen Medical Journal ◽

10.31661/gmj.v4i2.260 ◽

2015 ◽

Vol 4 (2) ◽

pp. 115-20

Author(s):

Mohammad Ali Davarpanah ◽

Seyed Mohammad Hoseini

Keyword(s):

Complex Disease ◽

Opportunistic Infections ◽

International Health ◽

The Body ◽

Cd4 Count ◽

Hiv Positive ◽

Cross Sectional ◽

Study Results ◽

Background: Human Immunodeficiency Virus (HIV) makes infected cases prone to opportunistic infections like Tuberculosis (TB) due to impaired immunity of the body, especially Multi Drug Resistant (MDR) ones which are a major concern. With HIV outbreak starting late in the 20th century, the international health community is observing a huge rise in the incidence of this complex disease. Herein, we estimated the incidence of TB among HIV-positive individuals and their responses to anti-tuberculosis medications in Shiraz, Southwest of Iran. Materials and Methods: 840 HIV-positive patients were included in this cross-sectional study. During the first examination CD4+ count and PPD test was obtained, patients were checked for other symptoms too. Patients, if diagnosed with TB, received proper medication. If therapy failed, second-line therapy was prescribed for them. Type of resistance was studied and recorded. Patients continued their routine anti-viral therapy during the study. Results: Of 840 participants, 29 were diagnosed with Active TB (3.4%), 76% of them were diagnosed with PCR and culture and other with acid fast. Males were the majority of TB positives (82.8%). Most patients suffering from TB had CD4+ count lower than 200 (55.1%); 17.2% of the cases were MDR-TB. Conclusion: Low CD4+ count makes the patient vulnerable to TB. It is necessary to maintain patient’s immunity in order to treat and prevent tuberculosis; so, anti-viral therapies still play important roles in preventing TB in HIV-positive patients.[GMJ.2015;4(2):115-20]

A VH clonal deficit in human immunodeficiency virus-positive individuals reflects a B-cell maturational arrest [published erratum appears in Blood 1991 Oct 1;78(7):1899]

Blood ◽

10.1182/blood.v78.1.175.bloodjournal781175 ◽

1991 ◽

Vol 78 (1) ◽

pp. 175-179 ◽

Cited By ~ 1

Author(s):

L Berberian ◽

Y Valles-Ayoub ◽

N Sun ◽

O Martinez-Maza ◽

J Braun

Keyword(s):

B Cells ◽

B Cell ◽

Germinal Center ◽

Cell Function ◽

Elevated Serum ◽

Definitive Treatment ◽

Hiv Positive ◽

Increased Risk ◽

A major feature of human immunodeficiency virus (HIV) infection is disordered B-cell function, which paradoxically includes both pathologic overactivity (elevated serum antibodies, lymphadenopathy, and increased risk for lymphoma) and underactivity (impaired antibody immunity, particularly to bacterial polysaccharide antigens). B-cell immune dysfunction contributes significantly to HIV-related morbidity and also represents an obstacle to eventual definitive treatment by anti-HIV immunization. Our laboratory has recently identified in normal B-cell populations certain VH gene subfamilies with a developmentally regulated pattern of utilization. In particular, B cells bearing rearranged VH3L were rare in the germinal center but uniformly abundant in the blood and lymphoid mantle zone. We used this index gene subfamily as a clonal criterion for the pattern of B-cell development in lymphocytes of HIV-positive individuals. In a series of 19 HIV- positive subjects, a striking deficit of VH3L B cells was observed; in contrast, none of the 16 normal subjects showed this abnormality. Other VH subfamilies (VH1N, VH4/6, and VH5N) were unaffected in the HIV- positive patients. This VH3L clonal deficit and other recent phenotype and histopathologic findings suggest that the general B-cell dysfunction in HIV is due to a discreet maturational arrest at the germinal center stage.