scholarly journals How Monocytes Contribute to Increased Risk of Atherosclerosis in Virologically-Suppressed HIV-Positive Individuals Receiving Combination Antiretroviral Therapy

2019 ◽  
Vol 10 ◽  
Author(s):  
Anthony Jaworowski ◽  
Anna C. Hearps ◽  
Thomas A. Angelovich ◽  
Jennifer F. Hoy
Keyword(s):  
Antiretroviral Therapy ◽  
Hiv Positive ◽  
Combination Antiretroviral Therapy ◽  
Increased Risk

scholarly journals Risk Factors for Alanine Aminotransferase Elevations in a Prospective Cohort of HIV-Infected Tanzanian Adults Initiating Antiretroviral Therapy

2019 ◽  
Vol 18 ◽  
pp. 232595821988493
Author(s):  
Sabina F. Mugusi ◽  
David Sando ◽  
Ferdinand M. Mugusi ◽  
Claudia Hawkins ◽  
Said Aboud ◽  
...  
Keyword(s):  
Risk Factors ◽  
Antiretroviral Therapy ◽  
Alanine Aminotransferase ◽  
Prospective Cohort ◽  
Combination Antiretroviral Therapy ◽  
Demographic Information ◽  
P Values ◽  
Increased Risk ◽  
Male Sex

Introduction: Serum alanine aminotransferase (ALT) elevations are common among HIV-infected patients on combination antiretroviral therapy (cART). Approach: We conducted a prospective cohort study of 3023 HIV-infected Tanzanian adults initiating cART. We assessed risk factors for mild/moderate ALT elevations >40 IU/L and severe ALT elevations >200 IU/L. Results: We found that over a median follow-up of 32.5 months (interquartile range: 19.4-41.5), 44.8% of participants had at least 1 incident ALT elevation >40 IU/L of which 50.1% were persistent elevations. Risk factors for incident ALT elevation >40 IU/L included male sex, CD4 count <100 cells/μL, d4T+3TC+NVP cART, and triglycerides ≥150 mg/dL ( P values <.05). Hepatitis B coinfection and alcohol consumption increased the risk of severe ALT elevations >200 IU/L ( P values: <.05). Conclusion: Incident mild and moderate ALT elevations are common among Tanzanians initiating cART, and the clinical and demographic information can identify patients at increased risk.

scholarly journals Nonsurgical Management of Severe Osteonecrosis of the Knee in an HIV-Positive Patient: A Case Report

2011 ◽  
Vol 2011 ◽  
pp. 1-5
Author(s):  
Stephanie A. Nixon ◽  
Kelly K. O'Brien ◽  
Gary Rubin
Keyword(s):  
Antiretroviral Therapy ◽  
Medication Management ◽  
Management Strategies ◽  
Health Care Team ◽  
Positive Patient ◽  
Hiv Positive ◽  
Combination Antiretroviral Therapy ◽  
Nonsurgical Management ◽  
Total Knee ◽  
The Right

Due to the life-prolonging effects of combination antiretroviral therapy, many people with HIV are living longer. However, this enhanced longevity is often mirrored by increased disability resulting from HIV and/or the adverse effects of medication. Management of HIV-positive patients is further complicated by comorbidities related to aging, including bone and joint disorders. In this paper, we describe the nonsurgical management of an HIV-positive patient with premature onset of severe osteonecrosis of the knee. A 50-year-old man who had been HIV-positive for 16 years and on combination antiretroviral therapy for 11 years presented to his family physician with extreme discomfort in his right knee. He was diagnosed with osteonecrosis of the right knee, but resisted total knee arthroplasty because of potential complications under anesthesia related to comorbid advanced liver disease. Instead, a successful combination of non-surgical management strategies was employed by the patient and his health care team.

scholarly journals Higher Risk Myelodysplastic Syndromes in Patients with Well-Controlled HIV Infection: Clinical Features, Treatment, and Outcome

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Bradley T. Williamson ◽  
Heather A. Leitch
Keyword(s):  
Bone Marrow ◽  
Viral Load ◽  
Antiretroviral Therapy ◽  
Myelodysplastic Syndromes ◽  
Hiv Positive ◽  
Combination Antiretroviral Therapy ◽  
Hiv Viral Load ◽  
Hiv Patients ◽  
Age Of Diagnosis ◽  
Hiv Negative

Introduction. In advanced HIV prior to combination antiretroviral therapy (ART), dysplastic marrow changes occurred and resolved with ART. Few reports of myelodysplastic syndromes (MDS) in well-controlled HIV exist and management is undefined.Methods. Patients with well-controlled HIV and higher risk MDS were identified; characteristics, treatment, and outcomes were reviewed.Results. Of 292 MDS patients since 1996, 1 (0.3%) was HIV-positive. A 56-year-old woman presented with cytopenias. CD4 was 1310 cells/mL and HIV viral load <40 copies/mL. Bone marrow biopsy showed RCMD and karyotype included del(5q) and del(7q); IPSS was intermediate-2 risk. She received azacitidine at 75% dose. Cycle 2, at full dose, was complicated by marrow aplasia and possible AML; she elected palliation. Three additional HIV patients with higher risk MDS, aged 56–64, were identified from the literature. All had deletions involving chromosomes 5 and 7. MDS treatment of 2 was not reported and one received palliation; all died of AML.Conclusion. Four higher risk MDS in well-controlled HIV were below the median age of diagnosis for HIV-negative patients; all had adverse karyotype. This is the first report of an HIV patient receiving MDS treatment with azacitidine. Cytopenias were profound and dosing in HIV patients should be considered with caution.

scholarly journals HIV antiretroviral therapy and prevention use in US blood donors: a new blood safety concern

Blood ◽  
2020 ◽  
Vol 136 (11) ◽  
pp. 1351-1358 ◽  
Author(s):  
Brian Custer ◽  
Claire Quiner ◽  
Richard Haaland ◽  
Amy Martin ◽  
Mars Stone ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Blood Donors ◽  
Blood Donation ◽  
Safety Concern ◽  
Time Frame ◽  
Transmission Risk ◽  
Hiv Positive ◽  
Increased Risk ◽  
First Time

Abstract Antiretroviral therapy (ART) to treat and pre-exposure prophylaxis (PrEP) to prevent HIV infection are effective tools to help end the HIV epidemic. However, their use could affect HIV transfusion-transmission risk. Three different ART/PrEP prevalence analyses in blood donors were conducted. First, blood samples from HIV-positive and a comparison group of infection-nonreactive donors were tested under blind using liquid chromatography-tandem mass spectrometry for ART. Second, blood donor samples from infection-nonreactive, 18- to 45-year-old, male, first-time blood donors in 6 US locations were tested for emtricitabine and tenofovir. Third, in men who have sex with men (MSM) participating in the 2017 Centers for Disease Control and Prevention National HIV Behavioral Surveillance (NHBS) from 5 US cities, self-reported PrEP use proximate to donation was assessed. In blind testing, no ART was detected in 300 infection-nonreactive donor samples, but in 299 HIV confirmed-infected donor samples, 46 (15.4%; 95% confidence interval [CI], 11.5% to 20.0%) had evidence of ART. Of the 1494 samples tested from first-time male donors, 9 (0.6%; 95% CI, 0.03% to 1.1%) had tenofovir and emtricitabine. In the NHBS MSM survey, 27 of 591 respondents (4.8%; 95% CI, 3.2% to 6.9%) reported donating blood in 2016 or 2017 and PrEP use within the same time frame as blood donation. Persons who are HIV positive and taking ART and persons taking PrEP to prevent HIV infection are donating blood. Both situations could lead to increased risk of HIV transfusion transmission if blood screening assays are unable to detect HIV in donations from infected donors.

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