scholarly journals Retrospective comparison of cytological and histological bone marrow morphology in adult antiretroviral-naïve and antiretroviral experienced human immunodeficiency virus-infected patients with peripheral blood cytopaenias

2016 ◽  
Vol 31 (2) ◽  
pp. 50-56
Author(s):  
Suraya Naidoo ◽  
Vincent L. Naicker
Keyword(s):  
Bone Marrow ◽  
Human Immunodeficiency Virus ◽  
Pure Red Cell Aplasia ◽  
Morphological Features ◽  
Hiv Positive ◽  
Retrospective Comparison ◽  
Immunodeficiency Virus ◽  
One Year ◽  
Compare And Contrast ◽  
Positive Population

Background: A cohort of human immunodeficiency virus (HIV)-positive patients presenting to a quaternary hospital in KwaZuluNatal, South Africa over a period of one year was identified and morphological analyses of their bone marrow aspirates and trephine biopsies (BMAT) undertaken.Aim: To compare and contrast the bone marrow morphological features of antiretroviral (ARV)-naïve and ARV-experienced HIV-positive population with cytopaenias; correlate the findings with CD4 counts; and, draw conclusions on whether ARV are associated with specific bone marrow (BM) findings.Method: Aspirate and trephine biopsy examinations to assess dysplasia of cell lineages, architectural changes, granulomas or infiltrates were performed by light microscopy.Results: 74 BMAT were examined, of which 24 were from the ARV-naïve cohort and 50 from ARV-treated cohort. Within granulomas, higher rates of marrow infiltration by acid-fast bacilli was present in the ARV-naïve cohort than the ARV-experienced cohort (6/10 (60%) versus 9/26 (35%), respectively). Higher rates of pure red cell aplasia (PRCA) were detected in the ARV-experienced than the ARV-naive cohort (14% versus 4%, respectively). No difference was seen in morphological features and overall dysplasia rates (70% and 71% of ARV-naïve and ARV-experienced cohort, respectively). At CD4 200 cells/ul, higher rates of dysplasia were seen in the ARV-naïve cohort (3/3 (100%) than in the ARV-experienced cohort (13/20 (65%)).Conclusion: Similar dysplasia rates and morphological features in both cohorts suggest ARVs do not cause myelodysplasia. BM tuberculosis is more frequently detected in granulomas of ARV-naïve than ARV-experienced samples. ARVs are implicated in causation of PRCA.

scholarly journals Indications and diagnostic value of bone marrow examination in HIV-positive individuals: A 3-year review at Tygerberg Hospital

2021 ◽  
Vol 36 (1) ◽  
Author(s):  
Ibtisam Abdullah ◽  
Nadhiya Subramony ◽  
Ernest Musekwa ◽  
Erica-Mari Nell ◽  
Fatima Alzanad ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Diagnostic Yield ◽  
Bone Marrow Examination ◽  
Pure Red Cell Aplasia ◽  
Diagnostic Value ◽  
Hiv Positive ◽  
Haematological Malignancies ◽  
Cross Sectional ◽  
Female Predominance ◽  
Immunodeficiency Virus

Background: Bone marrow examination is a useful diagnostic tool in human immunodeficiency virus (HIV)-positive patients presenting with cytopenias and fever. However, its role in the afebrile and asymptomatic patient presenting with an isolated cytopenia is not well established. This study was conducted to determine the indications for bone marrow examination and its diagnostic yield, in HIV-positive patients at Tygerberg Hospital.Methods: A retrospective, cross-sectional descriptive study was performed over a 3-year period from 01 September 2015 to 31 August 2018. The bone marrow examination reports for the HIV-positive patients who had a bone marrow examination during the study period were retrieved. Clinical and laboratory information was captured.Results: Altogether 374 bone marrow reports for HIV-positive patients were found. The indication of the bone marrow examination included investigation of unexplained cytopenias, suspected haematological malignancies, follow-up examination for patients with known haematological diseases, staging of haematological or non-haematological malignancies and investigation of suspected disseminated infection. The patients’ median age was 43 years and the interquartile range was 27–60 years. There was a slight female predominance with females 51% and males 49%. The diagnostic yield was 33.7%. Acute leukaemia and lymphoma were the most common diagnoses. Haematinic deficiency and pure red cell aplasia were found in the majority of cases with isolated anaemia. All cases with isolated thrombocytopenia were due to immune thrombocytopenia.Conclusion: Bone marrow examination is a useful investigation for HIV-positive patients with cytopenias, suspected haematological malignancy and lymphoma staging. However, its early use in patients with isolated anaemia and isolated thrombocytopenia is questionable.

scholarly journals Ocular Presentations in Human Immunodeficiency Virus (HIV)/Acquired Immune Deficiency Syndrome (AIDS) Patients undergoing highly- active antiretroviral therapy (HAART) Therapy in Jeddah, Kingdom of Saudi Arabia.

2020 ◽  
Vol 35 (3) ◽  
Author(s):  
Muhammad Abdul Rehman Akram
Keyword(s):  
Human Immunodeficiency Virus ◽  
Saudi Arabia ◽  
Retrospective Study ◽  
Hiv Positive ◽  
Western Region ◽  
Kingdom Of Saudi Arabia ◽  
Ocular Manifestations ◽  
Immunodeficiency Virus ◽  
The Western Region ◽  
One Year

Purpose: To detect the Human Immunodeficiency Virus (HIV)/Acquired Immunodeficiency Syndrome (AIDS) related ocular manifestations in Jeddah, Saudi Arabia. Study Design: Retrospective study Place and duration of study: A one-year retrospective study was conducted in Ophthalmology Clinic of East Jeddah Hospital in the western region of the Kingdom of Saudi Arabia, during 2016-2017 Material and methods A one-year retrospective study was conducted in the Ophthalmology Clinic of East Jeddah Hospital in the western region of the Kingdom of Saudi Arabia, during 2016-2017. 47 referrals of HIV-positive patient data were collected from the Infectious Diseases Department by taking history, clinical examinations and, laboratory investigations. The ophthalmological examination included adnexal examination, bestcorrected visual acuity, intraocular pressure (IOP), anterior and posterior segment examination, B-scan and, MRI. Results Out of 47 referred patients from the In and Out-patient Departments in East Jeddah Hospital, patients presented as follows: Single patient cases of retinal necrosis, anterior uveitis and neovascular glaucoma, with pterygium,sixth nerve palsy, bacterial conjunctivitis and, adenoviral conjunctivitis. Two cases presented with HIV microangiopathy, blepharitis, cortical blindness after brain abscess, herpes infection, Kaposi sarcoma and, cytomegalovirus (CMV) retinitis. Three patients presented with tuberculosis meningitis, and six with dry eyes. Eight patients presented with cataracts, and ten with refractive errors. Conclusions Ocular manifestations of HIV infection are relatively infrequent.HAART treatment is responsible for decreasing the HIV-related complications in ophthalmology. The CD4 T-lymphocyte result can be used to predict the beginning of certain eye infections in HIV-positive patients. Hidden indicators of complications of AIDS in patients confirm the strong rationale for alternating visits with those to an ophthalmologist and professionals discussing the best treatment accordingly. Keywords: Ocular, HIV, AIDS, HAART

Distinct Clinical Characteristics of Myelodysplastic Syndrome in Human Immunodeficiency Virus-Infected Patients,

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 3821-3821
Author(s):  
Koichi Takahashi ◽  
Mariko Yabe ◽  
Ilan Shapira ◽  
Mala Verma
Keyword(s):  
Bone Marrow ◽  
Human Immunodeficiency Virus ◽  
Myelodysplastic Syndrome ◽  
Clinical Characteristics ◽  
Laboratory Data ◽  
Hiv Positive ◽  
Hiv Status ◽  
Positive Group ◽  
Immunodeficiency Virus ◽  
Cytogenetic Studies

Abstract Abstract 3821 Background: Human Immunodeficiency Virus (HIV) infection has known to increase the risk of several malignancies including B-cell non-Hodgkin's lymphoma and Kaposi's sarcoma. With the prolonged survival of HIV-infected patients conferred by the use of effective anti-retroviral and prophylactic strategies, other malignancies, including Hodgkin's disease and solid tumors, have also been reported in this setting, although relationship with HIV infection is still not fully understood. HIV infected patients also can manifest multiple hematologic abnormalities and bone marrow specimens in most of those cases reveal so called myelodysplastic features. However bona fide myelodysplastic syndrome (MDS) is not common in this population and its real incidence, clinical course and outcome is yet unknown. Aim: The aim of this study is to compare the clinical characteristics and outcome of HIV associated MDS to non-HIV MDS. Methods: This is a retrospective cohort study of 81 patients who were diagnosed with MDS in our allied three teaching hospitals in New York City from 2005 to 2010. Available clinical history, pathological data, cytogenetic studies, and laboratory data were obtained through electronic medical records. HIV was confirmed by enzyme-linked immunosorbent assay (ELISA) testing with western blot confirmation as well as HIV-1/2 viral PCR. MDS diagnosis was confirmed with bone marrow morphology, laboratory data, and cytogenetic studies and was classified both according to the French-American-British (FAB) classification and World Health Organization (WHO) criteria. Results: Of 81 patients, 9 patients had confirmed HIV status and 72 were non-HIV. HIV positive group was consisted with younger patients (mean age 55.7 vs 72.7 p<0.01). Other baseline characteristics such as sex, laboratory profile, blast count and MDS classification were not significantly different between two groups. Cytogenetic studies were available in 79/81 patients (9/9 in HIV positive group and 70/72 in non-HIV group). Cytogenetic abnormalities were more frequently seen in HIV positive group compared to non HIV group (89% vs 47% p <0.05). When stratified by International Prognostic Scoring System (IPSS), HIV positive group carried worse prognostic karyotypes (67% vs 27%, p<0.05). Of those, chromosome 7 was more frequently found to be abnormal in HIV positive group (75% vs 33%, p<0.05). There was no statistically significant difference of abnormalities in other chromosomes between two groups. Survival data was available in 61/81 patients (9/9 in HIV positive group and 52/72 in non HIV group). Median survival of HIV positive group was 8 months and non-HIV MDS group was 66 months (Log rank p=0.013). Conclusions: In this retrospective analysis, when compared to non HIV-MDS, HIV-MDS is associated with a higher incidence of poor prognostic karyotype abnormalities and has poorer survival outcome after the diagnosis of MDS. To the best of our knowledge, this is the first report that compared clinical features of HIV-MDS and non HIV-MDS. Although further prospective controlled observations are needed to confirm these results, these findings suggest that HIV status can be one of the poor prognostic factors in MDS patients, and may prompt consideration of early intervention or treatment. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Influence of boarding secondary school environment on HIV positive students in South Western Uganda

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Raymond Bernard Kihumuro ◽  
David Jolly Muganzi ◽  
Elton George Wandira ◽  
Racheal Alinaiswe ◽  
Jovitah Joselyne Nanyunja ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Secondary School ◽  
Secondary Schools ◽  
School Environment ◽  
Coping Mechanisms ◽  
Hiv Positive ◽  
Key Informants ◽  
Immunodeficiency Virus ◽  
Negative Coping ◽  
Depth Interviews

Abstract Background The number of human immunodeficiency virus (HIV) positive adolescents in secondary school has increased over the years. Little is known on how the students cope to the pressures and demands of their academic and health lives in the boarding secondary schools. This study explored the factors surrounding their anti-retroviral therapy adherence as well as their experiences. Methods We did a qualitative study that employed in-depth interviews amongst purposively selected 19 HIV positive adolescent students in boarding secondary school and seven key informants. Key informants were members of boarding secondary school staff directly taking care of the adolescents living with human immune virus and had spent at least two academic terms in that school. The study participants were recruited from four health facilities in Bushenyi district, southwestern Uganda, and key informants from five boarding secondary schools in Bushenyi. These were engaged in in-depth interviews using an interview guide. Data was transcribed, coded and the content analyzed thematically. Results Adolescents living with human immunodeficiency virus in boarding secondary school face challenges similar to adolescents outside boarding school settings. However, some challenges are unique to them. Students faced numerous barriers which made it difficult to adhere to their medication. Stigmatization in its different forms was also a major challenge amongst students. Willingness disclosure of serostatus was beneficial to the students since it guaranteed support while at school; facilitating adherence and better living. However, students were uneasy to disclose their status. Some students adopted negative coping mechanisms such as telling lies, escaping from school, and class to access medication. Conclusions Adolescents in boarding secondary schools face similar challenges as compared to their counterparts with some being unique to them. Few school mechanisms help these students to cope while at school. Limited disclosure has proven useful but some adolescents have opted not to disclose their status and hence used negative coping mechanisms. These challenges need to be addressed and a safe environment to encourage limited disclosure should be made.

Pneumocystis carinii infection in bilateral aural polyps in a human immunodeficiency virus-positive patient

2002 ◽  
Vol 116 (4) ◽  
pp. 288-290 ◽  
Author(s):  
C. V. Praveen ◽  
R. M. Terry ◽  
M. Elmahallawy ◽  
C. Horsfield
Keyword(s):  
Human Immunodeficiency Virus ◽  
Opportunistic Infection ◽  
Pneumocystis Carinii ◽  
Lymphatic Vessels ◽  
Blood Stream ◽  
Positive Patient ◽  
Hiv Positive ◽  
Immunodeficiency Virus ◽  
History Of ◽  
Pneumocystis Carinii Infection

Pneumocystis carinii is an opportunistic infection found in patients with impaired immunity. Under favourable conditions the parasite can spread via the blood stream or lymphatic vessels and cause extrapulmonary dissemination. We report a case of P carinii infection presenting as bilateral aural polyps, otitis media and mastoiditis in human immunodeficiency (HIV)-positive patient with no history of prior or concomitant P carinii infection.

Abstract WP426: Subarachnoid Hemorrhage in patients infected with Human Immunodeficiency Virus

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Haralabos Zacharatos ◽  
Malik M Adil ◽  
Ameer E Hassan ◽  
Sarwat I Gilani ◽  
Adnan I Qureshi
Keyword(s):  
Human Immunodeficiency Virus ◽  
Subarachnoid Hemorrhage ◽  
Blood Transfusion ◽  
Hospital Mortality ◽  
Hiv Infection ◽  
The United States ◽  
Hiv Positive ◽  
Published Data ◽  
Immunodeficiency Virus ◽  
Hiv Negative

Background: There is limited data regarding the unique attributes of ischemic stroke among patients infected with human immunodeficiency virus (HIV). There is no published data regarding the occurrence and outcomes of subarachnoid hemorrhage (SAH) among HIV infected persons. Methods: The largest all-payer Nationwide Inpatient Sample (NIS 2002-2010) data was used to identify and analyze all patients presenting with the primary diagnosis of SAH in the United States. Among this cohort, we identified the patients who were not HIV positive and those who were HIV positive. Patient demographics, medical co-morbidities, in-hospital complications, in-hospital procedures, and discharge disposition were compared between the two groups. The association between HIV infection and outcomes was evaluated in multivariate analysis after adjusting for potential confounders. Results: Of the 351,491 patients admitted with SAH, 1367 (0.39%) were infected with HIV. HIV infected patients were younger, mean age [±SD] of 45 ±14.2 years versus those who were not 58±19 years, (p<0.0001). The rate of blood transfusion [27,286 (7.8%) versus 245.6 (18%), p=0.0003], mechanical ventilation [51,199 (14.6%) versus 316.1(23.1%), p=0.008], and sepsis [14,644 (4.2%) versus 236.1 (17.3%), p<0.0001] was significantly higher among HIV infected patients. After adjusting for age, gender, hypertension, coagulopathy, atrial fibrillation, renal failure, and dyslipidemia, HIV negative patients had a significantly higher rate of discharge to home (odds ratio [OR] 1.9, 95% CI: 1.4-2.6, p<0.0001) and lower in-patient mortality (OR 0.4, 95% CI: 0.3-0.5, p<0.001). Further adjustment for blood transfusion and sepsis reduced the odds of discharge to home for the HIV negative patients, from 1.9 to 1.7 but did not affect in-hospital mortality. Conclusion: The in-hospital mortality in HIV infected patients with SAH is higher despite these patients being younger than non-HIV infected patients. We believe that this study provides a nationwide perspective which may have some important implications for early recognition and diagnosis of HIV-infection in SAH patients.

Antimalarial drug resistance markers in human immunodeficiency virus (HIV)-positive and HIV-negative adults with asymptomatic malaria infections in Port Harcourt, Nigeria

2021 ◽  
Author(s):  
Ifeyinwa Chijioke-Nwauche ◽  
Mary C Oguike ◽  
Chijioke A Nwauche ◽  
Khalid B Beshir ◽  
Colin J Sutherland
Keyword(s):  
Human Immunodeficiency Virus ◽  
Drug Resistance ◽  
Drug Susceptibility ◽  
Blood Film ◽  
University Hospital ◽  
Hiv Positive ◽  
Asymptomatic Malaria ◽  
Immunodeficiency Virus ◽  
Before And After ◽  
Hiv Negative

Abstract Background In Nigeria, indiscriminate use of antimalarial drugs may contribute to the threat of drug resistance, but this has not been evaluated among people living with human immunodeficiency virus (HIV). Methods HIV-positive adults attending a university hospital HIV clinic and HIV-negative adult volunteers from the university hospital community with a positive blood film were treated with artemether–lumefantrine. Parasite DNA from before and after treatment was polymerase chain reaction amplified to identify molecular markers of drug susceptibility. Results The pfcrt76T genotype was prevalent among both HIV-positive and HIV-negative participants (78.6% and 68.2%, respectively). Three new mutations in the pfmdr1 gene—F73S, S97L and G165R—and the uncommon pfdhps S436F variant were detected, whereas pfdhps K540E and pfdhfr I164L were absent. The A437G allele of pfdhps predominated (62/66 [94%]). The I431 V mutation was found in 19 of 66 pretreatment pfdhps sequences (28.8%). The pfmdr1 86N allele was significantly more common at day 3 post-treatment than at baseline (odds ratio 8.77 [95% confidence interval 1.21 to 380]). Conclusions We found evidence of continued chloroquine use among HIV-positive individuals. Selection for the pfmdr1 86N after artemether–lumefantrine treatment was observed, indicating a possible threat to antimalarial efficacy in the study area. The complexity of pfdhps haplotypes emphasises the need for careful monitoring of anti-folate susceptibility in Nigeria.

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