scholarly journals Successful management of HIV infection in a patient with ulcerative colitis; a case report

2021 ◽  
Vol 6 (1) ◽  
pp. e17-e17
Author(s):  
Zain Majid ◽  
Shoaib Ahmed Khan ◽  
Hina Ismail ◽  
Nishat Akbar ◽  
Rajesh Mandhwani ◽  
...  

Human immunodeficiency virus (HIV) is an infectious disease that is rarely seen in ulcerative colitis patients. Both diseases commonly involve the colon. It has been shown that treating these patients with anti-tumor necrosis factor (anti-TNF) therapy leads to remission of both conditions. We hereby present the case of a 7-year-old boy who was initially managed as a case ulcerative colitis after undergoing extensive workup and later on tested positive for HIV infection and was managed via mesalamine and highly active antiretroviral therapy (HAART). Mesalamine therapy along with HAART can be used to treat ulcerative colitis patients infected with HIV infection in resource limited countries.

2020 ◽  
Author(s):  
Tamy Taianne Suehiro ◽  
Gabrielle Marconi Zago Ferreira Damke ◽  
Edilson Damke ◽  
Paloma Luana Rodrigues de Azevedo Ramos ◽  
Marcela de Andrade Pereira Silva ◽  
...  

Abstract Background: Despite the demonstrated role of human Papillomavirus (HPV) in the etiology of cervical cancer and the strong evidence suggesting the importance of HPV in the development of oropharyngeal cancer, several aspects of the interrelationship between HPV infection in both body sites remain unknown, specifically in female human immunodeficiency virus (HIV)-positive (HIV+) patients. We aimed to assess the prevalence, distribution, and concordance of cervical and oral HPV in HIV+ women and matched HIV-negative (HIV-) controls in Brazil.Material and methods: Cervical and endocervical samples for cytological screening and HPV detection and oral samples were collected from 115 HIV+ women using highly active antiretroviral therapy (HAART) and 139 HIV-matched controls (HIV-) in Maringá City, Brazil. Risk factors were assessed using a standardized questionnaire, and the data regarding HIV infection were obtained from the patients’ medical records. HPV detection and typing were performed using the Kit Multiplex XGEN Multi HPV Chip HS12.Results: HIV infection was well controlled in this cohort, but women who exhibited detectable HIV loads were significantly associated with HPV-positive status overall (P = 0.03) and in cervical mucosa (P = 0.01). HIV+ women had significantly more abnormal cytological findings (P = 0.04) than HIV- women. Of the 115 HIV+ women, 48.7% were positive for cervical and/or oral HPV DNA; of the 139 HIV- women, 41% were positive for cervical and/or oral HPV (P = 0.25). Both HIV+ and HIV- women had a statistically higher prevalence of cervical HPV infection than oral infection. The concurrent HPV infection in two anatomical sites was similar in HIV+ and HIV- women; however, HPV type concordance was not observed. HPV type distribution was different between the anatomical sites in both groups, and HIV+ women presented less common types, mainly in oral mucosa.Conclusion: Our data support the importance of testing HPV infection in HIV+ women, even when the HIV infection is well controlled. Prospective studies are required to better understand the natural history of HPV infection in both anatomical sites, specifically in HIV+ women.


2020 ◽  
Author(s):  
Tamy Taianne Suehiro ◽  
Gabrielle Marconi Zago Ferreira Damke ◽  
Edilson Damke ◽  
Paloma Luana Rodrigues de Azevedo Ramos ◽  
Marcela de Andrade Pereira Silva ◽  
...  

Abstract Background: Despite the demonstrated role of human Papillomavirus (HPV) in the etiology of cervical cancer and the strong evidence suggesting the importance of HPV in the development of oropharyngeal cancer, several aspects of the interrelationship between HPV infection in both body sites remain unknown, specifically in female human immunodeficiency virus (HIV)-positive (HIV+) patients. We aimed to assess the prevalence, distribution, and concordance of cervical and oral HPV in HIV+ women and matched HIV-negative (HIV-) controls in Brazil.Material and methods: Cervical and endocervical samples for cytological screening and HPV detection and oral samples were collected from 115 HIV+ women using highly active antiretroviral therapy (HAART) and 139 HIV-matched controls (HIV-) in Maringá City, Brazil. Risk factors were assessed using a standardized questionnaire, and the data regarding HIV infection were obtained from the patients’ medical records. HPV detection and typing were performed using the Kit Multiplex XGEN Multi HPV Chip HS12.Results: HIV infection was well controlled in this cohort, but women who exhibited detectable HIV loads were significantly associated with HPV-positive status overall (P = 0.03) and in cervical mucosa (P = 0.01). HIV+ women had significantly more abnormal cytological findings (P = 0.04) than HIV- women. Of the 115 HIV+ women, 48.7% were positive for cervical and/or oral HPV DNA; of the 139 HIV- women, 41% were positive for cervical and/or oral HPV (P = 0.25). Both HIV+ and HIV- women had a statistically higher prevalence of cervical HPV infection than oral infection. The concurrent HPV infection in two anatomical sites was similar in HIV+ and HIV- women; however, HPV type concordance was not observed. HPV type distribution was different between the anatomical sites in both groups, and HIV+ women presented less common types, mainly in oral mucosa.Conclusion: Our data support the importance of testing HPV infection in HIV+ women, even when the HIV infection is well controlled. Prospective studies are required to better understand the natural history of HPV infection in both anatomical sites, specifically in HIV+ women.


2019 ◽  
Vol 144 (5) ◽  
pp. 572-579 ◽  
Author(s):  
Sobia Nizami ◽  
Cameron Morales ◽  
Kelly Hu ◽  
Robert Holzman ◽  
Amy Rapkiewicz

Context.— With increasing use and efficacy of antiretroviral therapy for human immunodeficiency virus (HIV) infection, deaths from acquired immunodeficiency syndrome (AIDS)–defining conditions have decreased. Objective.— To examine trends in the cause of death of HIV-infected patients who underwent autopsy at a major New York City hospital from 1984 to 2016, a period including the major epochs of the AIDS epidemic. Design.— Retrospective review of autopsy records and charts with modeling of trends by logistic regression using polynomial models. Results.— We identified 252 autopsies in adult patients with AIDS (by 1982 definition) or HIV infection. Prior to widespread use of highly active antiretroviral therapy, in 1984–1995, on average 13 autopsies per year were done. Post–highly active antiretroviral therapy, the average number of autopsies declined to 4.5 per year. The fitted mean age at death was 35 years in 1984 and increased curvilinearly to 46 years (95% CI, 43–49) in 2016 (P < .001). By regression analysis, mean CD4+ T-cell count increased from 6 in 1992 to 64 in 2016 (P = .01). The proportion of AIDS-defining opportunistic infections decreased, from 79% in 1984–1987 to 41% in 2008–2011 and 29% in 2012–2016 (P = .04). The frequency of nonopportunistic infections, however, increased from 37% in 1984–1987 to 73% in 2008–2011 and 57% in 2012–2016 (P = .001). The frequency of AIDS-defining and other malignancies did not change significantly during the study period. The prevalence of atherosclerosis at autopsy rose dramatically, from 21% in 1988–1991 to 54% in 2008–2011 (P < .001). Conclusions.— Despite limitations of autopsy studies, many trends in the evolution of the HIV/AIDS epidemic are readily discernable.


2003 ◽  
Vol 10 (5) ◽  
pp. 821-825 ◽  
Author(s):  
Adriana Weinberg ◽  
Gregory B. Pott

ABSTRACT Our objective was to describe the CD4-mediated human immunodeficiency virus (HIV)-specific cell-mediated immunity (CMI) and its virologic and immunologic correlates in children with chronic HIV infection on highly active antiretroviral therapy (HAART). Twelve HIV-infected children on stable antiretroviral therapy with a median level of CD4+ lymphocytes (CD4%) of 25.5% and a median viral load (VL) of 786 HIV RNA copies/ml were enrolled in this study. Nine of these children were also cytomegalovirus (CMV) seropositive. Blood mononuclear cells, stimulated with HIV and CMV antigens, were used to measure lymphocyte proliferation and to enumerate gamma interferon (IFN-γ)-producing CD4+ cells. HIV CMI and CMV CMI were detected in similar proportions of patients and correlated with each other, although the HIV responses were less robust. HIV lymphocyte proliferation significantly increased with lower HIV VL and showed a trend to increase with higher CD4% and longer time on HAART. The in vitro IFN-γ response to HIV or CMV was not affected by CD4%, VL, or HAART. Pediatric patients with established HIV infection on HAART frequently exhibit HIV CMI despite undetectable HIV replication. We concluded that the association between HIV CMI and CMV CMI indicates that the same factors govern responsiveness to either antigen.


Infection ◽  
1991 ◽  
Vol 19 (S2) ◽  
pp. S93-S97 ◽  
Author(s):  
G. Hess ◽  
S. Rossol ◽  
R. Rossol ◽  
K. -H. Meyer zum Büschenfelde

2011 ◽  
Vol 101 (1) ◽  
pp. 35-40 ◽  
Author(s):  
James Johnston ◽  
Christy M. King ◽  
Sky Shanks ◽  
Saieh Khademi ◽  
Joseph Nelson ◽  
...  

Background: Since the implementation of highly active antiretroviral therapy (HAART), the life expectancy of patients with human immunodeficiency virus (HIV) has significantly increased. This is likely to cause changes in podiatric medical manifestations, such as plantar verrucae, in this population. Methods: Attendees at a San Francisco street fair in 2008 provided information about HIV status and the presence of verrucae via a survey. A total of 504 surveys were analyzed and compared with 1995 data, before HAART implementation. We examined if there was a statistically significant change in the increased likelihood of plantar verrucae in HIV-positive patients from 1995 to 2008. Then we examined the likelihood of HIV-positive patients (compared to HIV-negative patients) presenting with plantar verrucae in 2008, by using logistic regression, and controlling for age, sex, and race/ethnicity. Results: Patients with HIV infection were 5.2 times more likely to present with plantar verrucae compared to patients without HIV infection in 2008 (95% confidence interval, 2.5–11.0, P < .0001) and 10.0 times more likely in 1995 (95% confidence interval, 3.4–29.0, P < .0001). This decrease in likelihood over time was not statistically significantly different (P = .33). Logistic regression analysis controlling for the covariates of age, race, and sex showed that patients with HIV in 2008 were 4.5 times more likely to present with verrucae compared to patients without HIV (95% confidence interval, 2.1–9.9, P = .0002). Conclusions: Patients with HIV infection in 2008 are still significantly more likely to present with plantar verrucae after controlling for age, race, and sex. This increased likelihood has not changed significantly across time. Because HAART has increased the life expectancy of patients with HIV, this group of patients with plantar verrucae will continue to represent a significant population in the practice of podiatric medicine. (J Am Podiatr Med Assoc 101(1): 35–40, 2011)


2020 ◽  
Vol 11 (1) ◽  
pp. 156-160 ◽  
Author(s):  
Christopher B. Toomey ◽  
Jeffrey Lee ◽  
Doran B. Spencer

We report a novel case of severe bilateral panuveitis with hypopyon secondary to rifabutin and cobicistat drug interaction in the setting of human immunodeficiency virus (HIV) infection and latent tuberculosis (TB). A 63-year-old woman presented with bilateral conjunctival injection and decreasing vision of 5 days’ duration. She had a history of well-controlled HIV infection, latent TB, and non-alcoholic steatohepatitis for which she was inadvertently being treated, due to a pharmacy error, concurrently with the anti-TB medicine rifabutin and the highly active antiretroviral therapy combination Genvoya® (elvitegravir 150 mg – cobicistat 150 mg – emtricitabine 200 mg – tenofovir alafenamide 10 mg). Ocular examination was significant for bilateral panuveitis with hypopyon. Blood, cerebrospinal fluid, and vitreous analysis were negative for infectious or rheumatologic abnormalities. Rifabutin was discontinued and the patient was treated with intravenous followed by oral steroids as an outpatient with eventual resolution of symptoms. This unique case of rifabutin-cobicistat drug interaction highlights the association between rifabutin drug levels and ocular inflammation and expands the potential presentation of rifabutin-associated uveitis to include bilateral panuveitis with hypopyon.


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