scholarly journals Accommodative-Convergence Mechanism failure in HIV-Positive Non Presbyopic Patient on Highly Active Anti-Retroviral Therapy: A case report

2020 ◽  
Vol 22 (1) ◽  
pp. 44-50
Author(s):  
Sadiq Hassan ◽  
Philips I. Ebisike ◽  
Christopher O. Timothy ◽  
Basheer A.Z. Chedi ◽  
Rabi Y. Sani ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Case Report ◽  
Comprehensive Evaluation ◽  
Cranial Nerves ◽  
Hiv Positive ◽  
Highly Active ◽  
Accommodative Convergence ◽  
Refractive Correction ◽  
Low Amplitude ◽  
Convergence Mechanism

Purpose: Accommodative-convergence mechanism failure could occur in non presbyopic HIV- sero positive patients on Highly Active Anti-Retroviral  Therapy (HAART). This could be due to either direct neuronal infection by HIV, pathologic changes of the lens or the ciliary body or adverse effects of some individual drugs constituting the HAART regimen on the cranial nerves which play vital roles in the mechanism of accommodation and convergence. Case report: This is a case report of an accommodative- convergence mechanism failure in HIV positive non presbyopic 32-year-old male patient  that was on HAART for more than five years. He presented with distance visual acuity (VA) of OD: 6/9 +2, OS: 6/9, and near visual acuity (NVA) of N24 both eyes, 3Δ esophoria at distance and 4Δ esophoria at near. Amplitude of accommodation (AA) was 3.50D and accommodative  convergence/accommodation (AC/A) ratio was 6/1. Following comprehensive evaluation, his refractive correction was OD: Plano/-0.50DC X 180 6/5 and OS: Plano/-0.50DC X 90 6/5 at distance with near addition (Add) 2.50D N5. This was prescribed for regular wear in form of D-Top bifocal lens. Conclusion: These findings showed that HIV sero-positive adults on HAART could develop accommodativeconvergence mechanism failure, which may be characterized by low amplitude of accommodation, receded near point of convergence and high non presbyopic reading addition. These conditions may be under-recognized and need for reading addition of a non presbyopic age is often overlooked. Key Words: Accommodative-Convergence, HIV, Lateral Phoria, Refractive error.

scholarly journals Perianal squamous cell carcinoma with high-grade anal intraepithelial neoplasia in an HIV-positive patient using highly active antiretroviral therapy: case report

2007 ◽  
Vol 125 (5) ◽  
pp. 292-294 ◽  
Author(s):  
Sergio Carlos Nahas ◽  
Caio Sergio Rizkallah Nahas ◽  
Edesio Vieira da Silva Filho ◽  
Jose Eduardo Levi ◽  
Fabio Cesar Atui ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Case Report ◽  
Anal Canal ◽  
Squamous Cell ◽  
Highly Active Antiretroviral Therapy ◽  
Hiv Positive ◽  
High Grade ◽  
Squamous Intraepithelial Lesion ◽  
Highly Active ◽  
Intraepithelial Lesion

CONTEXT: Highly active antiretroviral therapy (HAART) has turned human immunodeficiency virus (HIV) infection into a chronic condition, and this has led to increased incidence of anal dysplasia among HIV-positive patients. Routine anal evaluation including the anal canal and perianal area is recommended for this population, especially for patients infected by oncogenic human papillomavirus (HPV) types. CASE REPORT: A 54-year-old homosexual HIV-positive man presented with a six-year history of recurrent perianal and anal warts. He had previously undergone incomplete surgical excision and fulguration in another institution on two occasions. He had been using HAART over the past two years. He presented some condylomatous spreading lesions occupying part of the anal canal and the perianal skin, and also a well-demarcated slightly painful perianal plaque of dimensions 1.0 x 1.0 cm. Both anal canal Pap smears and biopsies guided by high-resolution anoscopy revealed high-grade squamous intraepithelial lesion. Biopsies of the border of the perianal plaque also revealed high-grade squamous intraepithelial lesion. HPV DNA testing of the anus detected the presence of HPV-16 type. The patient underwent local full-thickness excision of the lesion. Histological analysis on the excised tissue revealed high-grade squamous intraepithelial lesion with one focus of microinvasive squamous cell cancer measuring 1 mm. No lymph vessel or perineural invasion was detected. The patient showed pathological evidence of recurrent anal and perianal high-grade squamous intraepithelial lesions at the sixth-month follow-up and required further ablation of those lesions. However no invasive squamous cell carcinoma recurrence has been detected so far.

Antiretroviral Treatment-Associated Labia Majora Lipohypertrophy: A Rare Case and Plastic Surgical Treatment Options

2017 ◽  
Vol 2 (1) ◽  
pp. 43
Author(s):  
Akmal Hisham ◽  
Devananthan Ilenghoven ◽  
Wan Syazli Wan Ahmad Kamal ◽  
Salina Ibrahim ◽  
Shah Jumaat Mohd Yussof
Keyword(s):  
Highly Active Antiretroviral Therapy ◽  
Daily Living ◽  
Treatment Options ◽  
Hiv Positive ◽  
Highly Active ◽  
Labia Majora ◽  
The Face ◽  
Central Fat

The emergence of highly active antiretroviral therapy (HAART) has revolutionized the prognosis of HIV-infected patients. However, the extended use of HAART is associated with a disfiguring complication termed lipodystrophy, a disorder of body fat maldistribution causing peripheral fat loss (lipoatrophy) and central fat accumulation (lipohypertrophy). Lipoatrophy commonly affects the face, legs, buttocks and arm, whilst lipohypertrophy frequently favours the abdomen, breast and dorsocervical region. To our knowledge, we present only the second documented case in the literature of a labia majora lipohypertrophy in a HIV-positive patient receiving long-term HAART. The severity of labial abnormality caused significant physical and functional morbidities. Labiaplasty with dermolipectomy of the labia majora and excisional lipectomy of the mons pubis was successfully performed. At a 6-month follow-up, patient had no recurrence with resolution of symptoms and resumption of normal activities of daily living (ADL).

scholarly journals Protease Inhibitor-Associated Dyslipidemia in HIV-Infected Patients Is Strongly Influenced by the APOA5–1131T→C Gene Variation

2006 ◽  
Vol 52 (10) ◽  
pp. 1914-1919 ◽  
Author(s):  
Montse Guardiola ◽  
Raimon Ferré ◽  
Juliana Salazar ◽  
Carlos Alonso-Villaverde ◽  
Blai Coll ◽  
...  
Keyword(s):  
General Population ◽  
Protease Inhibitor ◽  
Hdl Cholesterol ◽  
Hiv Positive ◽  
Progressive Reduction ◽  
Cholesterol Ratio ◽  
Gene Variation ◽  
Highly Active ◽  
Apolipoprotein A ◽  
Apoa5 Gene

Abstract Background: Hyperlipidemia associated with the protease inhibitor (PI) component of highly active antiretrovial treatment can lead to accelerated atherosclerosis. The apolipoprotein A-V (APOA5) gene, which affects VLDL production and lipolysis, may play a role in PI-induced hyperlipidemia, particularly in individuals with the APOA5–1131T→C genotype. Methods: We measured lipoprotein changes in HIV-positive patients (n = 229) who had been followed for 5 years. For statistical analyses, we segregated the patients with respect to PI treatment and APOA5–1131T→C genotype. Results: The frequency of the C allele was 0.08, similar to that in the general population. We found a strong effect of the APOA5–1131T→C genotype among patients receiving PIs. Carriers of the C allele had consistently increased mean (SD) triglyceride concentrations compared with noncarriers after 1 year [2.11 (1.62) vs 3.71 (4.27) mmol/L; P = 0.009], 2 years [2.48 (2.09) vs 4.02 (4.05) mmol/L, P = 0.050], 3 years [2.32 (1.71) vs 4.13 (4.26) mmol/L; P = 0.013], 4 years [2.90 (2.95) vs 5.35 (7.12) mmol/L; P was not significant], and 5 years [4.25 (5.58) vs 9.23 (9.63) mmol/L; P was not significant]. We observed the same effect on total cholesterol concentrations: after 1 year [4.93 (1.31) vs 5.87 (1.66) mmol/L; P = 0.006], 2 years [5.03 (1.12) vs 6.42 (2.48) mmol/L; P = 0.001], 3 years [5.11 (1.17) vs 6.38 (2.43) mmol/L; P = 0.009], 4 years [5.49 (1.71) vs 6.78 (3.03) mmol/L; P was not significant], and 5 years [5.56 (1.75) vs 7.90 (3.60) mmol/L; P was not significant]. HDL cholesterol showed a progressive reduction, leading to a considerably higher cholesterol/HDL cholesterol ratio after 3 years. Conclusion: Variability in the APOA5 gene predisposes patients with HIV, particularly those treated with PI, to severe hyperlipidemia.

scholarly journals Extensive colonic lithobezoar in an HIV positive Rwandan child: a case report

2008 ◽  
Vol 32 (4) ◽  
Author(s):  
A M Tabaro ◽  
M B Armiya'u ◽  
F Lambert ◽  
S Van Bastelaere ◽  
M Mukhtar-Yola
Keyword(s):  
Case Report ◽  
Hiv Positive

scholarly journals Concurrent Glossopharyngeal Neuralgia and Hemi-Laryngopharyngeal Spasm (HeLPS): A Case Report and a Review of the Literature

Neurosurgery ◽  
2019 ◽  
Vol 87 (5) ◽  
pp. E573-E577
Author(s):  
C Michael Honey ◽  
Marie T Krüger ◽  
Alan R Rheaume ◽  
Josue M Avecillas-Chasin ◽  
Murray D Morrison ◽  
...  
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Microvascular Decompression ◽  
Medical Condition ◽  
Posterior Inferior Cerebellar Artery ◽  
Cranial Nerves ◽  
Conversion Disorder ◽  
Glossopharyngeal Neuralgia ◽  
Neurovascular Compression ◽  
Patient Reported

Abstract BACKGROUND AND IMPORTANCE Hemi-laryngopharyngeal spasm (HeLPS) has been recently described but is not yet widely recognized. Patients describe intermittent coughing and choking and can be cured following microvascular decompression of their Xth cranial nerve. This case report and literature review highlight that HeLPS can co-occur with glossopharyngeal neuralgia (GN) and has been previously described (but not recognized) in the neurosurgical literature. CLINICAL PRESENTATION A patient with GN and additional symptoms compatible with HeLPS is presented. The patient reported left-sided, intermittent, swallow-induced, severe electrical pain radiating from her ear to her throat (GN). She also reported intermittent severe coughing, throat contractions causing a sense of suffocation, and dysphonia (HeLPS). All her symptoms resolved following a left microvascular decompression of a loop of the posterior inferior cerebellar artery that was pulsating against both the IXth and Xth cranial nerves. A review of the senior author's database revealed another patient with this combination of symptoms. An international literature review found 27 patients have been previously described with symptoms of GN and the additional (but not recognized at the time) symptoms of HeLPS. CONCLUSION This review highlights that patients with symptoms compatible with HeLPS have been reported since 1926 in at least 4 languages. This additional evidence supports the growing recognition that HeLPS is another neurovascular compression syndrome. Patients with HeLPS continue to be misdiagnosed as conversion disorder. The increased recognition of this new medical condition will require neurosurgical treatment and should alleviate the suffering of these patients.

Long-term effect of highly active antiretroviral therapy on cervical lesions in HIV-positive women

AIDS ◽  
2003 ◽  
Vol 17 (14) ◽  
pp. 2136-2138 ◽  
Author(s):  
Caterina Uberti-Foppa ◽  
Davide Ferrari ◽  
Sara Lodini ◽  
Salvatore Reina ◽  
Franco Ameglio ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Highly Active Antiretroviral Therapy ◽  
Term Effect ◽  
Hiv Positive ◽  
Cervical Lesions ◽  
Highly Active ◽  
Hiv Positive Women ◽  
Long Term Effect

scholarly journals Disseminated toxoplasmosis in an immunocompetent patient from Peruvian Amazon

2010 ◽  
Vol 52 (2) ◽  
pp. 107-110 ◽  
Author(s):  
Juan Nunura ◽  
Tania Vásquez ◽  
Sergio Endo ◽  
Daniela Salazar ◽  
Alejandrina Rodriguez ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Case Report ◽  
Muscle Biopsy ◽  
Blood Smear ◽  
Immunocompetent Patient ◽  
Peruvian Amazon ◽  
Thick Blood Smear ◽  
First Case ◽  
Hip Extension

We report a case of severe toxoplasmosis in an immunocompetent patient, characterized by pneumonia, retinochoroiditis, hepatitis and myositis. Diagnosis was confirmed by serology, T. gondii in thick blood smear and presence of bradyzoites in muscle biopsy. Treatment with pyrimethamine plus sulfadoxine was successful but visual acuity and hip extension were partially recovered. This is the first case report of severe toxoplasmosis in an immunocompetent patient from Peru.

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