Peripheral Neuropathies Under New Combined Antiretroviral Therapy in HIV Infection at Fann National University Hospital: Electrophysiological Aspects and Risk Factors

Background: The change in the prevalence of hypogonadism with age in men with human immunodeficiency virus (HIV) infection is subject to debate. Objective: To address this issue, we diagnosed hypogonadism based on serum levels of free testosterone (fTST) rather than total testosterone which is thought to be an inaccurate indicator. We also determined the relationship between age and fTST levels and identified risk factors for hypogonadism in men with HIV infection. Method: We retrospectively reviewed fTST levels and associated clinical factors in 71 wellcontrolled HIV-infected men who were treated at Teikyo University Hospital between April 2015 and March 2016 and who had data available on serum fTST levels, measured >6 months after starting antiretroviral therapy. fTST was measured using radioimmunoassay on blood samples collected in the morning. Risk factors for hypogonadism were identified using Welch’s t-test and multiple regression analysis. Results: The men had a mean (± standard deviation) age of 47.4 ± 13.6 years, and mean (± standard deviation) serum fTST level of 13.0 ± 6.1 pg/mL. Fifteen (21.1%) men had hypogonadism based on a fTST <8.5 pg/mL. Serum fTST levels significantly decreased with age (−0.216 pg/mL/year). Older age and low hemoglobin levels were identified as risk factors for hypogonadism. Conclusion: The men in the study experienced a more rapid decline in fTST levels with age than men in the general population (−0.161 pg/mL/year). Serum fTST levels in men with HIV infection should be monitored, especially in older men and those with low hemoglobin levels.

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Triad of the Ischemic Cardiovascular Disease in People Living with HIV? Association Between Risk Factors, HIV Infection, and Use of Antiretroviral Therapy

Current Atherosclerosis Reports ◽

10.1007/s11883-018-0727-9 ◽

2018 ◽

Vol 20 (6) ◽

Cited By ~ 1

Author(s):

Hugo Ribeiro Zanetti ◽

Edmar Lacerda Mendes ◽

Antonio Carlos Palandri Chagas ◽

Maria Odila Gomes Douglas ◽

Leandro Teixeira Paranhos Lopes ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Antiretroviral Therapy ◽

Hiv Infection ◽

People Living With Hiv ◽

Living With Hiv

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HIV Infection

10.1093/med/9780199937837.003.0148 ◽

2017 ◽

Author(s):

Meena Kannan ◽

Harrison Taylor ◽

William Tyor

Keyword(s):

Nervous System ◽

Differential Diagnosis ◽

Antiretroviral Therapy ◽

Hiv Infection ◽

Clinical Management ◽

Cytomegalovirus Infection ◽

Clinical Presentation ◽

Opportunistic Infections ◽

Cryptococcal Infection ◽

Combined Antiretroviral Therapy

This chapter focuses on four common opportunistic infections of the nervous system associated with HIV infection, namely cryptococcal infection, cytomegalovirus infection, progressive multifocal leukoencephalitis, and toxoplasmosis. Essential features of neurobiology, clinical presentation, differential diagnosis, diagnostic workup, clinical management, and outcome are discussed for each condition. Although combined antiretroviral therapy for HIV has generally reduced the incidence of these complications of HIV infection, they remain important considerations, especially in areas in which antiretrovirals are unavailable or have limited availability.

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Impact of HIV-1 Infection and Antiretroviral Therapy on Bone Homeostasis and Mineral Density in Vertically Infected Patients

Journal of Osteoporosis ◽

10.1155/2019/1279318 ◽

2019 ◽

Vol 2019 ◽

pp. 1-7 ◽

Cited By ~ 1

Author(s):

D. Donà ◽

E. Mozzo ◽

D. Luise ◽

R. Lundin ◽

A. Padoan ◽

...

Keyword(s):

Physical Activity ◽

Antiretroviral Therapy ◽

Side Effects ◽

Hiv Infection ◽

Antiretroviral Drugs ◽

University Hospital ◽

Bone Homeostasis ◽

Mineral Density ◽

Anthropometric Data ◽

Hiv 1

Daily assumption of antiretroviral drugs and HIV-related immune activation lead to important side effects, which are particularly evident in vertically infected patients. Bone homeostasis impairment and reduction of bone mineral density (BMD) is one of the most important side effects. Primary aim of this study is to assess the prevalence of bone homeostasis alterations in a group of vertically infected patients; secondary aim is to analyze the relationship between bone homeostasis alterations and anthropometric data, severity of HIV infection, and antiretroviral therapy. We studied 67 patients with vertically transmitted HIV-1 (aged 6-31 years), followed by the Pediatric Infectious Disease Unit of the University Hospital of Padua, Italy. We analyzed bone turnover markers (P1NP and CTx) and we performed lumbar spine and femoral dual energy X-ray absorption densitometry (DXA). Personal and anthropometric data and information on HIV-infection severity and antiretroviral therapy were collected for all patients. We found that BMD values recorded by DXA showed a significant correlation with age, race, BMI, physical activity, and antiretroviral therapy duration. P1NP was increased in 43% of patients, while CTX in 61% of them. P1NP alteration was related to age, race, BMI, physical activity, therapy duration, and ever use of protease inhibitors and nucleotide reverse transcriptase inhibitors. CTX alteration was found to be correlated only with age. In conclusion, our study confirms that a wide percentage of HIV vertically infected patients show reduced BMD and impaired bone homeostasis. Strict monitoring is needed in order to early identify and treat these conditions.

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Women with HIV infection on antiretroviral therapy with low viral loads can safely opt for vaginal delivery in the absence of obstetrical risk factors

Evidence-Based Medicine ◽

10.1136/eb-2013-101641 ◽

2014 ◽

Vol 19 (4) ◽

pp. 159-159

Author(s):

Michael K Lindsay

Keyword(s):

Risk Factors ◽

Antiretroviral Therapy ◽

Hiv Infection ◽

Vaginal Delivery ◽

Viral Loads ◽

Women With Hiv

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Survival of non-Hodgkin lymphoma patients with and without HIV infection in the era of combined antiretroviral therapy

AIDS ◽

10.1097/qad.0b013e32833a0961 ◽

2010 ◽

Vol 24 (11) ◽

pp. 1765-1770 ◽

Cited By ~ 41

Author(s):

Chun Chao ◽

Lanfang Xu ◽

Donald Abrams ◽

Wendy Leyden ◽

Michael Horberg ◽

...

Keyword(s):

Antiretroviral Therapy ◽

Hiv Infection ◽

Hodgkin Lymphoma ◽

Non Hodgkin Lymphoma ◽

Combined Antiretroviral Therapy

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Arterial hypertension and dyslipidemia in a HIV-positive patient treated with antiretroviral therapy

Clinical Management Issues ◽

10.7175/cmi.v6i1.619 ◽

2012 ◽

Vol 6 (1) ◽

pp. 5-14

Author(s):

Alessandro Maloberti ◽

Paolo Villa ◽

Dario Dozio ◽

Francesca Citterio ◽

Giorgia Grosso ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Antiretroviral Therapy ◽

Hiv Infection ◽

Clinical History ◽

Organ Damage ◽

Cardiovascular Complications ◽

Specific Population ◽

Metabolic Alteration ◽

Peculiar Case

The introduction of antiretroviral therapy (ART) has substantially modified the clinical history and epidemiology of HIV infection with an important decline in infective causes of death and an increase in non-infective comorbidities particularly in cardiovascular complications. HIV infection has been related to an increased cardiovascular risk due to the presence of three factors: classic cardiovascular risk factors (shared with the general population), HIV infection itself (indirectly due to the inflammation and directly due to viral molecule) and ART-related chronic metabolic alterations. We describe a peculiar case of metabolic alteration in an HIV infected patient on ART with particular attention to the diagnosis and therapeutic aspects. Giving the higher cardiovascular risk of this specific population it is advisable that the clinician performs a frequent re-assessment of risk factors and cardiovascular organ damage. An early detection of metabolic alteration must lead to an aggressive specific therapy; this must be done by taking care of the HIV-infected subject fragility and the interactions with ART.

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Cryptic HBV Replicative Activity Is Frequently Revealed in Anti-HBc-Positive/HBsAg-Negative Patients with HIV Infection by Highly Sensitive Molecular Assays, and Can Be Predicted by Integrating Classical and Novel Serological HBV Markers

Microorganisms ◽

10.3390/microorganisms8111819 ◽

2020 ◽

Vol 8 (11) ◽

pp. 1819

Author(s):

Romina Salpini ◽

Vincenzo Malagnino ◽

Lorenzo Piermatteo ◽

Tiziana Mulas ◽

Mohammad Alkhatib ◽

...

Keyword(s):

Antiretroviral Therapy ◽

Hiv Infection ◽

Digital Pcr ◽

Hbv Dna ◽

Cd4 Cell Count ◽

Hbv Replication ◽

Positive Hbsag ◽

Hbv Markers ◽

Highly Sensitive ◽

Combined Antiretroviral Therapy

The anti-HBc-positive/HBsAg-negative status is frequent in HIV-infection and correlates with poor survival. Here, by highly-sensitive assays, we evaluate cryptic HBV replication and factors correlated with its detection in 81 anti-HBc-positive/HBsAg-negative HIV-infected patients. Patients were treated for >12 months with HBV-active modern combined antiretroviral-therapy (cART) and had serum HBV-DNA < 20 IU/mL by commercial Real-Time PCR. Serum HBV-DNA was quantified by droplet digital PCR, serum HBV-RNA by an Abbott research assay, and anti-HBc titer (proposed to infer intrahepatic cccDNA) by Lumipulse/Fujirebio. Cryptic serum HBV-DNA was detected in 29.6% of patients (median (IQR): 4(1–15) IU/mL) and serum HBV-RNA in 3.7% of patients despite HBsAg-negativity and HBV-active cART. Notably, cryptic serum HBV-DNA correlated with an advanced CDC-stage (p = 0.01) and a lower anti-HBs titer (p = 0.05), while serum HBV-RNA correlated with lower nadir CD4+ cell-count (p = 0.01). By analyzing serological HBV-markers, the combination of anti-HBs < 50 mIU/mL (indicating lower immune response) plus anti-HBc > 15COI (reflecting higher HBV replicative activity) was predictive of cryptic serum HBV-DNA (OR: 4.7(1.1–21.7), p = 0.046, PPV = 62.5%, and NPV = 72%). In conclusion, cryptic HBV-replication (not detected by classical assays) characterizes a conspicuous set of anti-HBc-positive HIV-infected patients despite HBsAg-negativity and HBV-active combined antiretroviral therapy (cART). The integration of classical and novel markers may help identify patients with cryptic HBV-replication, thus optimizing the monitoring of anti-HBc-positive/HBsAg-negative HIV-infected patients.

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The Risks of Surgery in HIV-Infected Patients

Journal of Perioperative Practice ◽

10.1177/175045890701701003 ◽

2007 ◽

Vol 17 (10) ◽

pp. 470-484

Author(s):

Lisa Nelson ◽

Mike Fried ◽

Kenneth Stewart

Keyword(s):

Risk Factors ◽

Human Immunodeficiency Virus ◽

Antiretroviral Therapy ◽

Hiv Infection ◽

Surgical Procedures ◽

Healthcare Professionals ◽

Optimal Outcome ◽

Surgical Risk ◽

Surgical Interventions ◽

Immunodeficiency Virus

There are increasing demands for surgical interventions in Human Immunodeficiency Virus (HIV)-infected patients as a consequence of antiretroviral therapy. This article will discuss various risk factors involved in the surgical management of patients with HIV infection including: anaesthetic and surgical risk to patients with HIV infection undergoing surgical procedures; risk to healthcare professionals involved in the treatment of HIV-infected patients; and measures taken to ensure a safe and optimal outcome from surgery.

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