MedWorm: Highly Active Antiretroviral Therapy

Human Immunodeficiency Virus Disease Severity, Psychiatric Symptoms, and Functional Outcomes in Perinatally Infected Youth [Article]

Archives of Pediatrics — Mon, 06 Feb 2012 05:00:00 +0100

Conclusion Human immunodeficiency virus illness severity markers are associated with the severity of some psychiatric symptoms and, notably, with cognitive, academic, and social functioning, all of which warrant additional study. Trial Registration clinicaltrials.gov Identifier: NCT00100542 (Source: Archives of Pediatrics)

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Enhanced levels of CCL19 in patients with advanced acquired immune deficiency syndrome (AIDS).

Clinical and Developmental Immunology — Sun, 05 Feb 2012 16:25:26 +0100

Authors: Damås JK, Oktedalen O, Ueland T, Landrø L, Barstad J, Müller F, Frøland SS, Flo TH, Aukrust P Abstract Based on the ability to recruit lymphocytes and dendritic cells to lymphoid tissue and to promote inflammation, we hypothesized a role for dysregulated CCL19 and CCL21 levels in human immunodeficiency virus (HIV)-infected patients with advanced immunodeficiency, and in particular in those with accompanying Mycobacterium avium complex (MAC) infection. The hypothesis was explored by studies in HIV-infected patients with and without MAC infection, as well as in vitro, examining the ability of proteins from MAC to promote CCL19 and CCL21 responses in peripheral blood mononuclear cells (PBMC) during highly active anti-retroviral therapy (HAART). Our main findings were: (i)...

Impaired phagocytosis among patients infected by the human immunodeficiency virus: implication for a role of highly active anti-retroviral therapy.

Clinical and Developmental Immunology — Sun, 05 Feb 2012 16:25:16 +0100

Authors: Michailidis C, Giannopoulos G, Vigklis V, Armenis K, Tsakris A, Gargalianos P Abstract In patients with human immunodeficiency virus (HIV) infection, neutrophil and monocyte functions, including phagocytosis, are impaired. The purpose of this study was to investigate changes of phagocytic function and respiratory burst occurring over the course of patients infected by the HIV-1 virus. Treatment-naive patients (group B), patients receiving highly active anti-retroviral treatment (HAART) (group C) and patients in which HAART has failed (group D) were studied and compared with healthy volunteers (group A). Phagocytosis and oxidative burst were evaluated using commercially available kits. Results clearly denote a significant decrease of the phagocytic function of both cell typ...

Impaired phagocytosis among patients infected by the human immunodeficiency virus: implication for a role of highly active anti‐retroviral therapy

Clinical and Experimental Immunology — Thu, 02 Feb 2012 11:18:43 +0100

SummaryIn patients with human immunodeficiency virus (HIV) infection, neutrophil and monocyte functions, including phagocytosis, are impaired. The purpose of this study was to investigate changes of phagocytic function and respiratory burst occurring over the course of patients infected by the HIV‐1 virus. Treatment‐naive patients (group B), patients receiving highly active anti‐retroviral treatment (HAART) (group C) and patients in which HAART has failed (group D) were studied and compared with healthy volunteers (group A). Phagocytosis and oxidative burst were evaluated using commercially available kits. Results clearly denote a significant decrease of the phagocytic function of both cell types of groups B and C compared with group A. Among group C patients, those in the upper quar...

Enhanced levels of CCL19 in patients with advanced acquired immune deficiency syndrome (AIDS)

Clinical and Experimental Immunology — Thu, 02 Feb 2012 11:18:41 +0100

SummaryBased on the ability to recruit lymphocytes and dendritic cells to lymphoid tissue and to promote inflammation, we hypothesized a role for dysregulated CCL19 and CCL21 levels in human immunodeficiency virus (HIV)‐infected patients with advanced immunodeficiency, and in particular in those with accompanying Mycobacterium avium complex (MAC) infection. The hypothesis was explored by studies in HIV‐infected patients with and without MAC infection, as well as in vitro, examining the ability of proteins from MAC to promote CCL19 and CCL21 responses in peripheral blood mononuclear cells (PBMC) during highly active anti‐retroviral therapy (HAART). Our main findings were: (i) raised serum levels of CCL19 in HIV‐infected patients with CD4+ T cell count <50 cells/µl compared with ...

In-house human immunodeficiency virus-1 genotype resistance testing to determine highly active antiretroviral therapy resistance mutations in Hong Kong.

Hong Kong Med J — Wed, 01 Feb 2012 05:00:00 +0100

CONCLUSION. Our cost-effective in-house genotypic resistance test detected no significant difference in drug resistance-related mutations frequencies between HIV-1 subtype B and CRF01_AE in Hong Kong. A drug resistance-related mutations database for different HIV-1 genotypes should be established in Hong Kong to augment guidance for HIV treatment. PMID: 22302906 [PubMed - in process] (Source: Hong Kong Med J)

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How to manage HIV-infected patients with chronic kidney disease in the HAART era

Clinical and Experimental Nephrology — Tue, 31 Jan 2012 16:47:49 +0100

Abstract As human immunodeficiency virus (HIV)-infected patients now live longer while receiving highly active antiretroviral therapy (HAART), chronic kidney disease (CKD) has emerged as a significant cause of morbidity and mortality among urban HIV population. Risk factors associated with CKD in such HIV-infected population include aging, hypertension, diabetes mellitus, co-infection with hepatitis C virus, low CD4 cell count, and high HIV viral load. Clinical experience has shown that HIV-infected individuals often have one or more concurrent risk factors for CKD. The cumulative effect of multiple risk factors on the development of CKD should be noted in this population. Glomerular disease directly related to HIV infection, so-called HIV-associated nephropathy, rema...

HIV-free survival among nine- to 24-month-old children born to HIV-positive mothers in the Rwandan national PMTCT programme: a community-based household survey

Journal of the International AIDS Society — Mon, 30 Jan 2012 05:00:00 +0100

Conclusions: HIV-free survival among HIV-exposed children aged nine to 24 months is estimated at 91.9% in Rwanda. The national PMTCT programme could achieve greater impact on child survival by ensuring access to HAART for all HIV-positive pregnant women in need, improving the quality of the programme in rural areas, and strengthening linkages with community-based support systems, including associations of people living with HIV. (Source: Journal of the International AIDS Society)

Valproic acid in association with highly active antiretroviral therapy for reducing systemic HIV‐1 reservoirs: results from a multicentre randomized clinical study

HIV Medicine — Thu, 26 Jan 2012 05:00:00 +0100

ConclusionsOur study demonstrates that adding VPA to stable HAART does not reduce the latent HIV reservoir in virally suppressed patients. (Source: HIV Medicine)

Effect of the HIV nucleoside reverse transcriptase inhibitor zidovudine on the growth and differentiation of primary gingival epithelium

HIV Medicine — Thu, 26 Jan 2012 05:00:00 +0100

ConclusionsZidovudine treatment, even when applied at low concentrations for short periods of time, deregulated the cell cycle/proliferation and differentiation pathways, resulting in abnormal epithelial repair and proliferation. Our system could potentially be developed as a model for studying the effects of HIV and highly active antiretroviral therapy in vitro. (Source: HIV Medicine)

Methicillin‐resistant Staphylococcus aureus (MRSA) infections among HIV‐infected persons in the era of highly active antiretroviral therapy: a review of the literature

HIV Medicine — Wed, 25 Jan 2012 05:00:00 +0100

ConclusionsHIV‐infected persons have a propensity for MRSA SSTI and a high rate of recurrent disease. The reasons for the elevated rates of MRSA infections among HIV‐infected persons appear to be multifactorial, but may be mitigated with optimized HIV control and reductions in associated risk factors. (Source: HIV Medicine)

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Evolution of lipid levels in HIV-infected children treated or not with HAART in Abidjan, Cote d'Ivoire

Journal of Tropical Pediatrics — Mon, 23 Jan 2012 05:00:00 +0100

Conclusions: The initiation of antiretroviral treatment was associated with a normalization of the infection-related lipid profile. (Source: Journal of Tropical Pediatrics)

Association of HIV viral load and CD4 cell count with human papillomavirus detection and clearance in HIV‐infected women initiating highly active antiretroviral therapy

HIV Medicine — Fri, 20 Jan 2012 22:35:55 +0100

ConclusionsHigh‐risk HPV types vary among studies and can affect the results of analyses. Use of HAART to improve CD4 cell count may have an impact on the control of HPV infection. The decrease in VL may also have an effect, although to a lesser degree. (Source: HIV Medicine)

HIV patients treated with low-dose prednisolone exhibit lower immune activation than untreated patients

BMC Infectious Diseases — Fri, 20 Jan 2012 05:00:00 +0100

Conclusions: Patients treated with low-dose prednisolone display significantly lower general immune activation than untreated patients. Further longitudinal studies are required to assess whether treatment with low-dose prednisolone translates into differences in HIV disease progression. (Source: BMC Infectious Diseases)

HIV-Related Cardiac Complications: CT and MRI Findings

American Journal of Roentgenology — Thu, 19 Jan 2012 05:00:00 +0100

CONCLUSION. The cardiovascular complications of HIV infection frequently overlap, making the diagnosis difficult. CT and MRI are useful for the noninvasive evaluation of these complications. (Source: American Journal of Roentgenology)

Autonomic Modulation Following Exercise is Impaired in HIV Patients

International Journal of Sports Medicine — Thu, 19 Jan 2012 05:00:00 +0100

In conclusion, HIV patients showed impaired autonomic modulation, with reduced parasympathetic activity at rest and during post-exercise recovery.[...]© Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals:Table of contents | Abstract | Full text (Source: International Journal of Sports Medicine)

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Updating Our Understanding of Pulmonary Disease Associated With HIV Infection.

Archivos de Bronconeumologia — Mon, 16 Jan 2012 05:00:00 +0100

Authors: Estébanez-Muñoz M, Soto-Abánades CI, Ríos-Blanco JJ, Arribas JR Abstract The introduction of highly active antiretroviral therapy (HAART) has resulted in a reduction of opportunistic infections associated with cellular and humoral immunosuppression. However, what is still unclear is the impact of HAART on the development of other diseases not associated with AIDS, such as lung cancer and COPD. The aim of this paper is to review the most innovative and relevant aspects of lung pathology in patients infected with HIV. PMID: 22257776 [PubMed - as supplied by publisher] (Source: Archivos de Bronconeumologia)

The importance of CD4 count, viral load and highly active antiretroviral therapy in HIV-associated thrombotic thrombocytopenic purpura (TTP)

Sexually Transmitted Infections — Sun, 15 Jan 2012 05:00:00 +0100

A case is reported of HIV-associated thrombotic thrombocytopenic purpura with normal CD4 count but high HIV viral load, developing neurological and cardiac complications up to 36 days after initiation of plasma exchange, but remitting within 18 days of the start of highly active antiretroviral therapy and steroids. In addition to plasma exchange, prompt initiation of highly active antiretroviral therapy in patients with HIV-associated thrombotic thrombocytopenic purpura may be justified despite a normal CD4 count. (Source: Sexually Transmitted Infections)

GBV-C: State of the Art and Future Prospects

Current HIV/AIDS Reports — Fri, 13 Jan 2012 17:19:11 +0100

Abstract The GB virus C is a common non-pathogenic virus, member of the Flaviviridae family with worldwide distribution. Favorable clinical course and reduced mortality among HIV-infected patients was demonstrated by several studies with patients co-infected with the GB virus C (GBV-C). This potential benefit of GBV-C has been demonstrated in the pre-HAART and post-HAART eras; however, this effect was not observed in all studies and the discrepancy may be due to changes during the course of HIV infection, characteristic of the cohort, and the degree of therapeutic response. The GBV-C has been found to decrease HIV replication in in vitro models, highlighting the interference of persistent GBV-C viremia. The mechanism of the beneficial effect of GBV-C appears to be mediated ...

Potential use of protease inhibitors as vaginal and colorectal microbicides.

Current HIV Research — Fri, 13 Jan 2012 05:00:00 +0100

Authors: Herrera C, Shattock RJ Abstract The new generation of microbicide candidates is based on the use of antiretroviral (ARV) drugs. The first compounds tested were selected among ARV classes that block the early stages of viral replication cycle, either entry/fusion or reverse transcription. Recently, an additional class of ARVs acting on a later step of viral replication has entered the microbicide pipeline, the protease inhibitors (PIs). This class of ARVs has shown strong potency in highly active antiretroviral therapy (HAART) against human immunodeficiency-1 virus (HIV-1) and lower levels of induced resistance compared to other ARV classes. As candidate microbicides, PIs will have to follow the guiding principles of microbicides being effective, safe, user-friendly and aff...

Very late initiation of HAART impairs treatment response at 48 and 96 weeks: results from a meta-analysis of randomized clinical trials

Journal of Antimicrobial Chemotherapy — Tue, 10 Jan 2012 05:00:00 +0100

Conclusions We found that initiation of antiretroviral therapy with very low CD4 lymphocyte counts is consistently associated with poorer outcomes of HAART. This effect could be modulated by HBV/HCV coinfection, but not by the individual components of the HAART regimen. (Source: Journal of Antimicrobial Chemotherapy)

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Inter- and intra-patient variability of raltegravir pharmacokinetics in HIV-1-infected subjects

Journal of Antimicrobial Chemotherapy — Tue, 10 Jan 2012 05:00:00 +0100

Conclusions The pharmacokinetics of raltegravir in HIV-1-infected subjects are characterized not only by inter-patient variability but also by high intra-patient variability. This condition limits the application of TDM for raltegravir, and might potentially affect patient outcome. (Source: Journal of Antimicrobial Chemotherapy)

Systemic exposure to rifampicin in patients with tuberculosis and advanced HIV disease during highly active antiretroviral therapy in Burkina Faso

Journal of Antimicrobial Chemotherapy — Tue, 10 Jan 2012 05:00:00 +0100

Conclusions Rifampicin systemic exposure increased during combined TB and HIV therapy, possibly due to increased drug absorption or decreased oral clearance, but remained invariably low in this population. Studies to define the Cmax rifampicin concentrations, which are associated with a significantly increased risk of treatment failure, are urgently warranted. (Source: Journal of Antimicrobial Chemotherapy)

Development of Anti-HIV Agents Based on Chemical Biology.

Yakugaku Zasshi : Journal of the Pharmaceutical Society of Japan — Sat, 07 Jan 2012 06:00:04 +0100

Authors: Tamamura H Abstract Recently, highly active anti-retroviral therapy (HAART), which involves a combinational use of reverse transcriptase inhibitors and HIV protease inhibitors, has brought us a great success in the clinical treatment of AIDS patients. However, HAART has several serious clinical problems. These drawbacks encouraged us to find novel drugs and increase repertoires of anti-HIV agents with various action mechanisms. The recent disclosing of the dynamic supramolecular mechanism in HIV-entry has provided potentials to find a new type of drugs. To date, we have synthesized HIV-entry inhibitors, especially coreceptor CXCR4 antagonists. In addition, CD4 mimics in consideration of synergic effects with other entry inhibitors or neutralizing antibodies have been devel...

Psychosocial Impact of Poverty on Antiretroviral Nonadherence Among HIV-TB Coinfected Patients in Lima, Peru - Shin S, Muñoz M, Espiritu B, Zeladita J, Sanchez E, Callacna M, Rojas C, Arevalo J, Ying Wu, Caldas A, Sebastian JL.

SafetyLit: All (Unduplicated) — Fri, 06 Jan 2012 15:21:09 +0100

Objective . Tuberculosis and HIV coinfection poses unique clinical and psychosocial complexities that can impact nonadherence to highly active antiretroviral treatment (HAART). Methods. This was a prospective case series to identify risk factors for HAART ... (Source: SafetyLit: All (Unduplicated))

A Fatal Case of Kaposi Sarcoma Due to Immune Reconstitution Inflammatory Syndrome.

The American Journal of the Medical Sciences — Fri, 06 Jan 2012 05:00:00 +0100

This report describes a fatal case of IRIS-KS. A 32-year-old man with HIV/AIDS was initiated on HAART and experienced rapid immunological and virological response to therapy. He subsequently experienced progressively severe dyspnea and papulonodular skin lesions and was admitted to the hospital with hypoxic respiratory failure. Bronchoscopy revealed numerous friable endobronchial lesions. Histopathology of a skin lesion was consistent with KS. The relatively rapid progression of disease in the setting of improvement in immune function after initiating HAART suggested IRIS-KS. This report reviews previously published cases of IRIS-KS and describes risk factors, immunopathogenesis and treatment options. PMID: 22227511 [PubMed - as supplied by publisher] (Source: The American Journal of t...

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Discontinuation Rate of Nevirapine-Based Highly Active Antiretroviral Therapy

AIDS Research and Human Retroviruses — Thu, 05 Jan 2012 21:44:48 +0100

AIDS Research and Human Retroviruses Jan 2012, Vol. 28, No. 1: 82-82. (Source: AIDS Research and Human Retroviruses)

Mucocutaneous manifestations of HIV‐infected patients in the era of HAART in Guangxi Zhuang Autonomous Region, China

Journal of the European Academy of Dermatology and Venereology — Tue, 03 Jan 2012 05:00:00 +0100

Conclusions A wide range of mucocutaneous disorders were observed in HIV‐infected Chinese patients. Oral candidiasis, P. marneffei infection and PPE may be the signs of advanced HIV infection. HAART had an impact on the spectrum of HIV‐associated mucocutaneous disorders. (Source: Journal of the European Academy of Dermatology and Venereology)

Management of Needlestick Injuries: A House Officer Who Has a Needlestick [Clinical Crossroads]

JAMA — Tue, 03 Jan 2012 05:00:00 +0100

Since its identification in 1985, human immunodeficiency virus (HIV) has challenged several aspects of health care delivery. Because HIV is a blood-borne infectious disease, from the early days of the epidemic, concern was raised about risks of occupational exposures and infections among health care workers. Despite the development of highly active antiretroviral therapy, which has effectively modulated HIV into a chronic disease in many settings, risks of occupational infection with 3 blood-borne pathogens remain in the health care workplace. Using the case of a house officer who has a needlestick during a resuscitation attempt, prevention of needlesticks including universal precautions and postexposure management of occupational HIV, hepatitis B, and hepatitis C exposures is discussed. (...

Mucocutaneous manifestations of HIV-infected patients in the era of HAART in Guangxi Zhuang Autonomous Region, China.

Herpes — Tue, 03 Jan 2012 05:00:00 +0100

Conclusions A wide range of mucocutaneous disorders were observed in HIV-infected Chinese patients. Oral candidiasis, P. marneffei infection and PPE may be the signs of advanced HIV infection. HAART had an impact on the spectrum of HIV-associated mucocutaneous disorders. PMID: 22212015 [PubMed - as supplied by publisher] (Source: Herpes)

Severe transaminitis after interferon–ribavirin therapy in HIV/HCV‐coinfected patients: influence of a sustained HCV response

Journal of Viral Hepatitis — Sun, 01 Jan 2012 05:00:00 +0100

Summary. Chronic hepatitis C is an independent risk factor for severe drug hepatotoxicity. Successful treatment of chronic hepatitis C may modulate drug hepatotoxicity, as it is associated with a decline in hepatic enzyme release and halts fibrosis progression in HIV/HCV‐coinfected patients. The aim of this study was to determine biological and/or clinical determinants of alanine aminotransferase and/or aspartate aminotransferase elevation (>five‐fold above the upper limit of normal in patients with normal baseline levels or >3.5‐fold increase from baseline in those with increased baseline levels) in a large prospective cohort of HIV/HCV‐coinfected patients on HAART who had previously been treated for HCV infection. Median follow‐up exceeded five years. Cox proportional ...

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Noncirrhotic portal hypertension associated with Didanosine: a case report and literature review.

Japanese Journal of Infectious Diseases — Sun, 01 Jan 2012 05:00:00 +0100

Authors: Chang HM, Tsai HC, Lee SS, Wann SR, Chen YS Abstract Noncirrhotic portal hypertension (NCPH) has recently been reported as a liver complication in human immunodeficiency virus (HIV)-infected patients and has been found to be associated with exposure to didanosine. Here, we describe the case of an HIV-infected patient with portal hypertension who initially presented with massive ascites and portal vein thrombosis. The patient's HIV-1 infection was well-controlled with highly active antiretroviral therapy (lamivudine/didanosine plus nevirapine) for 3 years since its diagnosis in 2007. He had no history of alcoholism, drug abuse, or liver diseases. An extensive work-up for other possible causes of liver disease was performed, but the results were inconclusive. In addition to ...

Epidemiology of Bloodstream Infections and Predictive Factors of Mortality among HIV-Infected Adult Patients in Thailand in the Era of Highly Active Antiretroviral Therapy.

Japanese Journal of Infectious Diseases — Sun, 01 Jan 2012 05:00:00 +0100

In conclusion, opportunistic infections are still the leading causes of BSI among HIV-infected patients in the HAART era. PMID: 22274154 [PubMed - in process] (Source: Japanese Journal of Infectious Diseases)

Review of Screening Guidelines for Non-AIDS-Defining Malignancies: Evolving Issues in the Era of Highly Active Antiretroviral Therapy.

AIDS Reviews — Sun, 01 Jan 2012 05:00:00 +0100

Authors: Tyerman Z, Aboulafia DM Abstract HIV-associated morbidity and mortality have declined dramatically in the era of HAART. Through direct and indirect benefits of HAART, people with HIV/AIDS are living longer, developing less AIDS-defining cancers and more cancers commonly seen in the seronegative population. Herein, we review cancer screening strategies for people living with HIV and compare and contrast them with those of the general population. The most noticeable differences occur in anal and cervical cancer screening. Although anal cancer is uncommon in the general population, it is more prevalent in men who have sex with men and people at high risk for human papillomavirus infection, especially those infected with HIV. To address this, we recommend that a digital rectal...

The Effect of a 12-Week Course of Omega-3 Polyunsaturated Fatty Acids on Lipid Parameters in Hypertriglyceridemic Adult HIV-infected Patients Undergoing HAART: A Randomized, Placebo-Controlled Pilot Trial.

Clinical Therapeutics — Sat, 31 Dec 2011 05:00:00 +0100

CONCLUSIONS: PUFA therapy with DHA/EPA reduced triglyceride levels significantly compared with placebo in HIV-infected patients with HAART-associated hypertriglyceridemia. ClinicalTrials.gov identifier: NCT00598910. PMID: 22212377 [PubMed - as supplied by publisher] (Source: Clinical Therapeutics)

Implications of RNA Helicases in HIV-1 replication: Possible roles in latency.

Current HIV Research — Fri, 30 Dec 2011 05:00:00 +0100

Authors: Ajamian L, Mouland AJ Abstract HAART treatment has greatly improved life expectancy of HIV-1-infected individuals. Unfortunately, latency still remains the major barrier towards HIV-1 eradication. Efforts to identify viral and host cell proteins involved in latency remain important research areas to win this war against HIV-1. Here, we review the contributions of several factors in the establishment of latently infected cells. In addition, we also raise the possibility that RNA helicases, while playing important roles at almost every step of the HIV-1 replication cycle, could be implicated in the processes governing the establishment of these latent reservoirs. PMID: 22211663 [PubMed - as supplied by publisher] (Source: Current HIV Research)

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Does GSS Still Maintain Relevance on HAART Outcome After the Introduction of Newest Active Antiretroviral Drugs? 48 Weeks Results.

Current HIV Research — Fri, 30 Dec 2011 05:00:00 +0100

Conclusions: Single drugs belonging to new antiretroviral classes did not correlate to viroimmunological success for any GSS. High frequency and recurrence over GRTs for specific mutations confirms their key role following the exposure to ARVs classes. A baseline HIV-RNA <50,000 cp/ml is a predictor of therapeutic success and a carefully selected HAART based upon the evaluation of GRTs can favorably influence the immunovirologic response. PMID: 22211659 [PubMed - as supplied by publisher] (Source: Current HIV Research)

HIV Drug Resistance on HAART Despite an Undetectable Viral Load.

Current HIV Research — Fri, 30 Dec 2011 05:00:00 +0100

We present the case of an HIV-infected patient who developed mutations of resistance to nevirapine although he always had an undetectable viral load and without context of inobservance. The concepts of undetectability and virological success in HIV infection must be balanced by the possible appearance of resistance under a treatment considered as effective. PMID: 22211655 [PubMed - as supplied by publisher] (Source: Current HIV Research)

The spectrum of HIV-related nephropathy in children

Pediatric Nephrology — Thu, 29 Dec 2011 06:42:24 +0100

Conclusions This study, one of the largest series of children reported from Africa, demonstrates that nephrotic syndrome due to HIV-associated nephropathy (HIVAN) is the commonest presentation of HIV-related nephropathy in childhood. Highly active anti-retroviral therapy in combination with angiotensin-converting enzyme antagonists is highly effective in decreasing proteinuria and preserving renal function. Content Type Journal ArticleCategory Original ArticlePages 1-7DOI 10.1007/s00467-011-2074-8Authors Duran Ramsuran, Optics and Imaging Centre, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, KwaZulu-Natal, South AfricaRajendra Bhimma, Department of Paediatrics and Child Health, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Pr...

IgG Subclass Levels and Antibody Responses to the 2009 Influenza A (H1N1) Monovalent Vaccine among HIV‐Infected and HIV‐Uninfected Adults

Clinical and Experimental Immunology — Thu, 29 Dec 2011 05:00:00 +0100

Conclusion: Prevaccination IgG subclass levels did not correlate with the ability to develop robust antibody responses to the 2009 influenza A (H1N1) monovalent vaccine. IgG2 deficiencies were common among HIV‐infected persons but did not correlate with poor influenza vaccine responses. Further investigations into the etiology of disparate vaccine responses are needed. (Source: Clinical and Experimental Immunology)

Costs and benefits of multidrug, multidose antiretroviral therapy for prevention of mother-to-child transmission of HIV in the Dominican Republic

International Journal of Gynaecology and Obstetrics — Mon, 26 Dec 2011 05:00:00 +0100

Conclusion: Despite the high costs, use of MD-ARVs, such as HAART, for PMTCT offer societal savings because fewer perinatally acquired infections are anticipated to require treatment. (Source: International Journal of Gynaecology and Obstetrics)

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Factors associated with non-adherence to highly active antiretroviral therapy in Nairobi, Kenya.

AIDS Research and Therapy — Sun, 25 Dec 2011 09:30:02 +0100

CONCLUSIONS: The study found better adherence to HAART in Nairobi compared to previous studies in Kenya. However, this can be improved further by employing fitting strategies to improve patients' ability to fit therapy in own lifestyle and cue-dose training to impact forgetfulness. Further work to determine why patients accessing therapy from ARV clinics within walking distance from their residence did not adhere is recommended. PMID: 22141425 [PubMed - in process] (Source: AIDS Research and Therapy)

Emergence of HBV resistance to lamivudine (3TC) in HIV/HBV co-infected patients in The Gambia, West Africa

BMC Research Notes — Fri, 23 Dec 2011 05:00:00 +0100

Background: Lamivudine (3TC) is a potent inhibitor of both Hepatitis B virus (HBV) and Human Immunodeficiency Virus (HIV) replication and is part of first-line highly active antiretroviral therapy (HAART) in the Gambia. Unfortunately, the effectiveness of 3TC against HBV is limited by the emergence of resistant strains.Aim: The aim of this retrospective study was to characterise 3TC-resistant mutations in HBV from co-infected patients receiving HAART, by generating HBV polymerase sequence data and viral loads from HBV genotype E infected patients, both at initiation and during a course of 3TC therapy.MethodSamples from 21 HBV chronic carriers co-infected with HIV-1 (n=18), HIV-2 (n=2) and HIV-dual (n=1) receiving HAART for a period of 3-52 months were analysed for the emergence of 3TC-resi...

Effects of HAART on Platelet-Activating Factor Metabolism in Naive HIV-Infected Patients I: Study of the Tenofovir-DF/Emtricitabine/Efavirenz HAART Regimen

AIDS Research and Human Retroviruses — Thu, 22 Dec 2011 20:04:15 +0100

AIDS Research and Human Retroviruses , Vol. 0, No. 0. (Source: AIDS Research and Human Retroviruses)

Lymph nodes harbor viral reservoirs that cause rebound of plasma viremia in SIV-infected macaques upon cessation of combined antiretroviral therapy.

Virology — Wed, 21 Dec 2011 05:00:00 +0100

Authors: Horiike M, Iwami S, Kodama M, Sato A, Watanabe Y, Yasui M, Ishida Y, Kobayashi T, Miura T, Igarashi T Abstract Attempts to find a cure for HIV infection are hindered by the presence of viral reservoirs that resist highly active antiretroviral therapy. To identify the properties of these reservoirs, four SIV239-infected Rhesus macaques were treated with combined antiretroviral therapy (cART) for 1year. While plasma viral RNA (vRNA) was effectively suppressed, a systemic analysis revealed that vRNA was distributed in the following order: lymphatic tissues>lungs and intestine>other tissues. Histochemistry yielded no cells with viral signals. To increase the chance of detection, two additional SIV-infected animals were treated and analyzed on Day 10 after the cessation o...

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Simultaneous HAART improves survival in children coinfected with HIV and TBL’initiation simultanée de la thérapie HAART améliore la survie chez les enfants coinfectés par le VIH et la TBEl TAR simultáneo mejora la supervivencia de niños coinfectados con VIH y TB

Tropical Medicine and International Health — Tue, 20 Dec 2011 21:24:46 +0100

Conclusions Starting HAART during tuberculosis therapy significantly improves survival and provides further impetus for the integration of TB and HIV services.Objectifs: Cette étude évalue les résultats des directives actuelles de traitement et les effets de la thérapie HAART sur la survie des patients coinfectés par le VIH et la TB dans un cadre à ressources limitées.Méthodes: Etude de cohorte observationnelle dans la clinique pédiatrique du VIH, à l’Hôpital RML, à Delhi. Tous les patients atteints du VIH qui ont visité la clinique avec un diagnostic de TB entre 2002 et 2006 ont été observés jusqu’au 31 mars 2010. La TB a été diagnostiquée soit au moment de l’inscription ou au cours des visites de suivi. Les données cliniques et épidémiologiques ont é...

Chemoradiotherapy for anal cancer in HIV patients causes prolonged CD4 cell count suppression

Annals of Oncology — Tue, 20 Dec 2011 05:00:00 +0100

Conclusions: The management of anal cancer with CRT achieves similar outcomes as the general population. CRT is associated with significant prolonged CD4 suppression that may contribute to late deaths of patients in remission. (Source: Annals of Oncology)

Rituximab in combination with chemotherapy versus chemotherapy alone in HIV‐associated non‐Hodgkin lymphoma: A pooled analysis of 15 prospective studies

American Journal of Hematology — Mon, 19 Dec 2011 10:28:57 +0100

Impaired CD4+ cell recovery during antiretroviral therapy in patients with HIV resistance mutations

Archives of Virology — Sat, 17 Dec 2011 06:45:44 +0100

In this study, we investigated HIV polymorphisms and mutations and assessed their influence on the outcome of highly active antiretroviral therapy (HAART). We focused on viral load and CD4+ cell counts as the most important parameters for therapy response. Resistance mutations were present in 19% of all patients prior to antiretroviral treatment. Mutations causing direct antiretroviral drug resistance were observed in 10%. Analyzing therapy response, we found a significant correlation between resistance mutations and impaired CD4+ cell recovery six months after the initiation of antiretroviral treatment. Lower CD4+ cell counts were also observed in a subgroup of patients infected with a virus presenting mutations that directly lowered drug susceptibility. Content Type Jour...

Can highly active antiretroviral therapy unmask leprosy? A case of type 1 lepra reaction in a HIV-seropositive patient

Indian Journal of Dermatology, Venereology and Leprology — Sat, 17 Dec 2011 05:00:00 +0100

G Raghurama Rao, A Amareswar, S SandhyaIndian Journal of Dermatology, Venereology, and Leprology 2012 78(1):101-103 (Source: Indian Journal of Dermatology, Venereology and Leprology)

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Risk Factors for Default from Tuberculosis Treatment in HIV-Infected Individuals in the State of Pernambuco, Brazil: a prospective cohort study.

BMC Infectious Diseases — Fri, 16 Dec 2011 05:00:00 +0100

Conclusion: The results point to the need for more specific actions, aiming to reduce the default from TB treatment in males, younger adults with low education, smokers and people with CD4 T-cellcounts (Source: BMC Infectious Diseases)

Surgical treatment for locally advanced lung cancer in a human immunodeficiency virus-infected patient

General Thoracic and Cardiovascular Surgery — Thu, 15 Dec 2011 16:44:35 +0100

We present a 60-year-old HIV-infected man with locally advanced lung cancer with a helper T-lymphocyte count of 195 cells/μl at the time of lung cancer diagnosis. HAART was initiated before surgery, and extended resection was performed without discontinuance of HAART. The patient successfully recovered from surgery without complication. Content Type Journal ArticleCategory Case ReportPages 822-825DOI 10.1007/s11748-010-0774-9Authors Sumiko Maeda, Department of Thoracic Surgery, Tohoku University Hospital, 4-1 Seiryomachi, Aoba-ku, Sendai, Miyagi, 980-8575 JapanYoshinori Okada, Department of Thoracic Surgery, Tohoku University Hospital, 4-1 Seiryomachi, Aoba-ku, Sendai, Miyagi, 980-8575 JapanAkira Sakurada, Department of Thoracic Surgery, Tohoku University Hospital, 4-1 Seiryomac...

Multicenter assessment of HIV‐1 RNA quantitation in semen in the CREAThE network

Journal of Medical Virology — Wed, 14 Dec 2011 19:13:50 +0100

AbstractDetection of HIV‐1 RNA in semen is used commonly to determine the safety of semen processing procedures before assisted reproductive technology (ART). Using two panels of prepared semen samples containing HIV‐1 the performances of protocols from 14 centers have been compared. No false‐positive results were detected but false‐negative results were frequent when the concentration was below 500 HIV‐1 RNA copies/ml of seminal plasma. Frequency of HIV‐1 RNA detection was higher on seminal cells than on seminal plasma. Assays (or protocols) for quantifying HIV‐1 RNA in semen performed less well than standardized blood plasma assays. The HIV load in seminal plasma could be a useful marker of the risk of sexual transmission of the virus. Its use as a marker of global HAART ef...

Disseminated Rhodococcus equi infection in HIV infection despite highly active antiretroviral therapy

BMC Infectious Diseases — Wed, 14 Dec 2011 05:00:00 +0100

Conclusions: Our report highlights the importance of an effective immune recovery, despite fully suppressive HAART, along with anti-rhodococcal therapy, in order to clear rhodococcal infection. (Source: BMC Infectious Diseases)

Meningoencephalitis Due to HIV Replication Despite Plasmatic Viral Control

Journal of the International Association of Physicians in AIDS Care (JIAPAC) — Mon, 12 Dec 2011 05:00:00 +0100

We report a symptomatic case of HIV replication in CSF (Cerebro Spinal Fluid) despite low plasmatic viral load. The patient, known HIV positive since 3 years, under HAART (Highly Active Antiretroviral therapy), presented an acute meningoencephalitis which was improved by optimization of treatment for a better CNS (Central Nervous System) penetration according to the CHARTER's (CNS HIV Antiretroviral Therapy Effects Research) score. CNS can be considered as a specific compartment for HIV replication and can be involved in acute or chronic neurologic impairment. As showed in this observation, CHARTER score could be helpful to optimize HAART penetration in CNS, but indication and use remain uncertain in current practice. (Source: Journal of the International Association of Physicians in AIDS ...

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Tuberculoid leprosy and cytomegalovirus retinitis as immune restoration disease in a patient with AIDS

International Journal of Infectious Diseases — Mon, 12 Dec 2011 05:00:00 +0100

Summary: Here we report a unique case of tuberculoid leprosy and cytomegalovirus retinitis in a 27-year-old female patient with AIDS, suggestive of highly active antiretroviral therapy (HAART)-induced immune restoration disease. After initiation of HAART, the patient presented with decreased visual acuity, hypoesthetic patch with local nerve thickening, and an increase in her CD4+ T cell count. On further investigations cytomegalovirus retinitis and tuberculoid leprosy were confirmed. To our knowledge no case with such a co-existence has previously been reported. (Source: International Journal of Infectious Diseases)

Reversible progressive supranuclear palsy-like phenotype as an initial manifestation of HIV infection

Neurological Sciences — Thu, 08 Dec 2011 18:22:41 +0100

We describe a patient who displayed a progressive parkinsonian phenotype fulfilling the criteria for PSP over a period of a year. The parkinsonism was the initial manifestation of HIV infection and was eliminated by highly active antiretroviral therapy. This case report indicates that one should consider HIV infection as a cause of PSP-like parkinsonism. Content Type Journal ArticleCategory Case ReportPages 1-3DOI 10.1007/s10072-011-0875-yAuthors Wooyoung Jang, Department of Neurology, College of Medicine, Hanyang University, 17 Haengdangdong, Seongdong-gu, Seoul, 133-792 KoreaJoong-Seok Kim, Department of Neurology, The Catholic University College of Medicine, Seoul, KoreaJin Young Ahn, Department of Neurology, Seoul Medical Center, Seoul, KoreaHee-Tae Kim, Department of Neurolog...

Kidney And Pancreas Transplant Available To HIV-Infected Patients At Mayo Clinic

Health News from Medical News Today — Thu, 08 Dec 2011 09:00:00 +0100

Mayo Clinic in Florida is now offering kidney and pancreas transplants to HIV positive patients with advanced kidney disease and diabetes. Evidence is now solid that HIV-positive patients have the same favorable outcome in terms of patient and allograft survival as non-HIV positive organ transplant recipients, says Mary Prendergast, M.D., a kidney specialist whose focus is the care of patients who receive kidney and pancreas transplants. "With the utilization of HAART therapy to control HIV disease, it is very clear that solid organ transplant is both feasible and successful," she says... (Source: Health News from Medical News Today)

Prolonged control of replication-competent dual tropic human immunodeficiency virus-1 following cessation of highly active antiretroviral therapy

Retrovirology — Mon, 05 Dec 2011 05:00:00 +0100

This report suggests that some patients may be capable of controlling pathogenic HIV-1 isolates for extended periods of time after the cessation of HAART through a mechanism that is distinct from the potent cytotoxic T lymphocyte (CTL) mediated suppression that has been reported in many ES. (Source: Retrovirology)

Factors associated with Non-adherence to Highly Active Antiretroviral Therapy in Nairobi, Kenya

AIDS Research and Therapy — Mon, 05 Dec 2011 05:00:00 +0100

Conclusions: The study found better adherence to HAART in Nairobi compared to previous studies in Kenya. However, this can be improved further by employing fitting strategies to improve patients' ability to fit therapy in own lifestyle and cue-dose training to impact forgetfulness. Further work to determine why patients accessing therapy from ARV clinics within walking distance from their residence did not adhere is recommended. (Source: AIDS Research and Therapy)

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In vivo Enhancement in Bioavailability of Atazanavir in the Presence of Proton-Pump Inhibitors using Mesoporous Materials.

ChemMedChem — Mon, 05 Dec 2011 05:00:00 +0100

Authors: Xia X, Zhou C, Ballell L, Garcia-Bennett AE Abstract Matters of the HAART! The current treatment for human immunodeficiency virus (HIV), HAART, makes use of a combination of antiretroviral drugs, which are poorly soluble in aqueous media. Enhancing the solubility of such drugs through the use of mesoporous materials could lead to improved treatment efficiency and might provide a solution to the drug-drug interaction problems associated with these types of therapeutic regimes. PMID: 22144293 [PubMed - as supplied by publisher] (Source: ChemMedChem)

HIV/AIDS in Women and Racial/Ethnic Minorities in the U.S.

Current Infectious Disease Reports — Fri, 02 Dec 2011 18:09:44 +0100

Abstract The clinical issues affecting women with HIV/AIDS differ little from those affecting men. However, current research shows that treatment and outcome disparities affect many women with HIV, hypothesized to result from a complex interplay of socioeconomic and gender role influences. These disparities are also a reflection of racial/ethnic differences in treatment and outcome, since 80% of women with HIV/AIDS are black or Hispanic. Women have unique needs for HIV prevention — both prevention of sexual transmission to or from sexual partners and prevention of perinatal transmission. Racial/ethnic minorities continue to be disproportionately affected by the HIV/AIDS epidemic in the U.S. Minorities are less likely to be in care and on HAART than others with HIV/AIDS. ...

Short-term additional enfuvirtide therapy is associated with a greater immunological recovery in HIV very late presenters: a controlled pilot study

Infection — Thu, 01 Dec 2011 19:21:32 +0100

Conclusions In this pilot study, the addition of enfuvirtide to a lopinavir-based HAART was shown to be associated with a significantly faster and greater immunological recovery in newly discovered HIV-positive patients with very low CD4+ cell counts. Induction strategies using an enfuvirtide-based approach in such subjects warrant further investigation. Content Type Journal ArticleCategory Brief ReportPages 1-7DOI 10.1007/s15010-011-0223-4Authors S. Bonora, Department of Infectious Diseases, University of Torino, Ospedale Amedeo di Savoia, C.so Svizzera 164, 10159 Turin, ItalyA. Calcagno, Department of Infectious Diseases, University of Torino, Ospedale Amedeo di Savoia, C.so Svizzera 164, 10159 Turin, ItalyC. Cometto, Department of Infectious Diseases, University ...

Dysregulation of glucose metabolism in HIV patients: epidemiology, mechanisms, and management

Endocrine — Thu, 01 Dec 2011 19:20:48 +0100

Abstract HIV-infected patients on highly active antiretroviral therapy (HAART) have increased prevalence of a number of chronic metabolic disorders of multifactorial but unclear etiology. These include disorders of lipid metabolism with or without lipodystrophy, insulin resistance, and an increased prevalence of impaired glucose tolerance, diabetes mellitus, and cardiometabolic syndrome. While much attention has been focused on the lipid and cardiovascular disorders, few investigations have attempted to characterize the prevalence, incidence, etiology, mechanisms, and management of glycemic disorders in HIV patients. In this review, we have focused specifically on a comprehensive assessment of dysglycemia in the context of HIV infection and HAART. Content Type Journal ...

Benign and malignant neoplasias in 261 necropsies for HIV-positive patients in the period of 1989 to 2008.

Revista do Instituto de Medicina Tropical de Sao Paulo — Thu, 01 Dec 2011 05:00:00 +0100

Authors: Micheletti AR, Macedo AC, Silva GB, Silva AC, Silva-Vergara ML, Murta EF, Adad SJ Abstract Considering that there are some studies with autopsies from AIDS describing only malignant neoplasias and that changes can occur after the introduction of Highly Active Antiretroviral Therapy (HAART), our objectives were to analyze the frequency of benign and malignant neoplasms in AIDS patients in the periods of both pre- and post-HAART. This is a retrospective study with 261 autopsies of HIV-positive patients between 1989 and 2008 in Uberaba, Brazil. Sixty-six neoplasms were found (39 benign, 21 malignant and six premalignant) in 58 patients. The most frequent malignant neoplasms were lymphoid, in 2.7% (four Non-Hodgkin lymphoma, one Hodgkin, one multiple myeloma and one plasmablas...

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Oxidative Stress and Mitochondrial Impairment After Treatment with Anti-HIV Drugs: Clinical Implications.

Current Pharmaceutical Design — Thu, 01 Dec 2011 05:00:00 +0100

Authors: Blas-Garcia A, Apostolova N, Esplugues JV Abstract Thirty years after the discovery of HIV infection, there are numerous antiretroviral drugs that control the disease when administered in a potent combination referred to as Highly Active Antiretroviral Therapy (HAART). This therapy reduces the viral load and improves immune system reconstitution, leading to a significant reduction of HIV-related morbidity and mortality. However, HAART does not completely eliminate HIV, so treatment must continue throughout the patient's life. Prolonged use of HAART has been related to long-term adverse events that can compromise patient health. These deleterious effects have been reported for the majority of antiretroviral drugs and are the most common causes for therapy discontinuation. I...

Mother-to-child transmission of Human Immunodeficiency Virus in a ten years period.

Reproductive Health — Wed, 30 Nov 2011 05:00:00 +0100

Conclusion: Use of HAART and caesarian delivery are protective factors for mother-to-child transmission of HIV. Maternal coinfecctions and other conditions were risk factors for MTCT. (Source: Reproductive Health)

HIV-associated PML: Changing epidemiology and clinical approach

Cleveland Clinic Journal of Medicine — Mon, 28 Nov 2011 05:00:00 +0100

Despite the availability of highly active antiretroviral therapy (HAART) for the treatment of human immunodeficiency virus (HIV) infection, there has not been a dramatic decrease in the frequency of progressive multifocal leukoencephalopathy (PML) in the HIV-infected population. Usually a multifocal progressive disease of nonenhancing lesions in white matter, PML can have distinct characteristics in HIV-infected patients, including unifocal static lesions of faint contrast enhancement on imaging and involvement of gray matter. A syndrome of cerebellar degeneration has been described in association with HIV infection in patients positive for JC virus, the papovavirus responsible for PML. The standard of care for HIV-associated PML is HAART to achieve immunologic recovery and optimal HIV vir...

A rational approach to PML for the clinician

Cleveland Clinic Journal of Medicine — Mon, 28 Nov 2011 05:00:00 +0100

The first step in the management of progressive multifocal leukoencephalopathy (PML) is awareness of the disease. Patients vulnerable to PML are those with immunosuppression, either through their disease or use of immune-modulating therapy. In patients susceptible to PML who exhibit focal neurologic signs and symptoms, brain magnetic resonance imaging can detect the telltale PML brain lesions—subcortical white matter hyperintense areas on T2-weighted images and fluid-attenuated inversion recovery sequences and hypointensity on T1-weighted images, typically without enhancement. Demonstration of JC virus DNA by ultrasensitive polymerase chain reaction in cerebrospinal fluid is diagnostic for PML. Immune restoration whenever possible is the cornerstone of treatment. Highly active antire...

How prepared are our future doctors for HIV/AIDS?

Public Health — Mon, 28 Nov 2011 05:00:00 +0100

Summary: Three cohorts (n = 391) of final-year medical students in Hong Kong were evaluated on their preparedness to provide HIV care. Through a self-administered questionnaire, half (53%) were assessed to be better prepared and had a lower perceived risk of infection at work, though unwillingness to manage HIV patients was reported in a minority (4.6%). For a majority of medical students (72.8%), a specially-designed clinic attachment offered the only opportunity to come face-to-face with HIV patients for the first time. With continued improvement in treatment effectiveness, HIV/AIDS is evolving to become a new chronic disease in most societies. Curriculum development in HIV medicine remains a challenge in this HAART era. (Source: Public Health)

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Duplicate HIV-1 viral load testing in HAART-treated patients with low level viraemia on the Roche COBAS Ampliprep Taqman assay: Category: Scientific free paper

Journal of Infection — Fri, 25 Nov 2011 11:05:46 +0100

The aim of highly-active antiretroviral therapy (HAART) is to suppress HIV-1 viral load (VL) to undetectable levels. All patients on HAART should have a VL measured at regular intervals in order to monitor the success of therapy. In October 2006 the Newcastle Health Protection Agency (HPA) laboratory replaced the Roche COBAS HIV-1 Ampliprep Amplicor Monitor (CAP/CA) assay with the more-sensitive Roche COBAS Ampliprep Taqman HIV-1 (CAP/CTM1) assay. Both locally and internationally the introduction of the CAP/CTM1 assay was associated with a significant unexplained increase in the detection of low level HIV-1 viraemia (VL 50 to 1000 copies/ml). (Source: Journal of Infection)

A pain in the neck: Category: Clinical lesson

Journal of Infection — Fri, 25 Nov 2011 11:05:46 +0100

A severely immunocompromised Zimbabwean man with advanced HIV disease diagnosed 10 years previously presented with a three week history of sore throat, dysphagia, right ear discharge and fever. He was not on anti-retroviral treatment at the time, having been previously unable to comply with numerous Highly Active Anti-Retroviral Therapy (HAART) regimens, and had a CD4 count of 5 cells/ml and HIV viral load of 946,106 copies/ml. His other active HIV related problems included recurrent peri-anal herpes, HIV dermopathy and recurrent folliculitis, chronic suppurative otitis media, co-infection with Hepatitis B, renal dysfunction, peripheral neuropathy and impotence. His most recent travel had been to Zimbabwe five years earlier. On examination he had a temperature of 38oC, a tender, enlarged r...

The significance of very low-level viraemia detected by sensitive viral load assays in HIV positive patients on HAART: Category: Scientific free paper

Journal of Infection — Fri, 25 Nov 2011 11:05:46 +0100

Viral load (VL) measurement is critical for monitoring the effectiveness of highly-active antiretroviral therapy (HAART). HAART aims to achieve and maintain HIV RNA levels at undetectable levels. A VL less than 50 copies/ml was previously considered to be undetectable. Following the introduction of the more sensitive Cobas Ampliprep/ Cobas TaqMan HIV-1 (CAP/CTM1) assay in Newcastle in August 2006 many patients with a previously undetectable VL were found to have low-level viraemia. The purpose of this study was to determine the clinical and virological significance of this very low-level HIV viraemia (VLLV, VL detectable at (Source: Journal of Infection)

Acute kidney injury in hospitalized HIV-infected patients: a cohort analysis

Nephrology Dialysis Transplantation — Fri, 25 Nov 2011 05:00:00 +0100

Conclusion. AKI occurred in 18% of hospitalized HIV-infected patients and it was independently associated with increased in-hospital mortality. (Source: Nephrology Dialysis Transplantation)

E17A mutation in HIV-1 Vpr confers resistance to didanosine in association with thymidine analog mutations.

Antiviral Research — Fri, 25 Nov 2011 05:00:00 +0100

CONCLUSION: These findings highlight a novel role of Vpr in HIV-1 drug resistance. Vpr E17A confers resistance to didanosine when associated with TAMs. Whether Vpr E17A facilitates excision of didanosine is still to be determined. PMID: 22138483 [PubMed - as supplied by publisher] (Source: Antiviral Research)

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Opportunistic infections in relation to antiretroviral status among AIDS patients from south India

Indian Journal of Medical Microbiology — Thu, 24 Nov 2011 05:00:00 +0100

Conclusion: Tuberculosis is the most important OI before initiation of HAART. Both EFV and NVP-based regimens are equally efficacious in controlling OIs. (Source: Indian Journal of Medical Microbiology)

Central Nervous System Antiretroviral Efficacy in HIV infection: A Qualitative and Quantitative Review and implications for future research

BioMed Central — Tue, 22 Nov 2011 05:00:00 +0100

Conclusions: Studies assessed as using more rigorous methods found that neuroHAART was effective in improving neurocognitive function and decreasing CSF viral load, but only two of those studies were adequately statistically powered. Because all of these studies were observational, they represent a less compelling evidence base than randomised control trials for assessing treatment effect. Therefore, large randomised trials are needed to determine the robustness of any neuroHAART effect. However, such trials must be longitudinal, include the full spectrum of HAND, ideally carefully control for co-morbidities, and be based on optimal neuropsychology methods. (Source: BioMed Central)

Educational level and HIV disease progression before and after the introduction of HAART: a cohort study in 989 HIV seroconverters in Spain

Sexually Transmitted Infections — Tue, 22 Nov 2011 05:00:00 +0100

Conclusions Results suggest that, despite similar access to HAART, persons with low educational level are at increased risk of HIV disease progression, highlighting the impact of social inequities on health. The availability of more effective treatments over time will strengthen the protective effect of higher education on the development of AIDS. (Source: Sexually Transmitted Infections)

Non‐uptake of highly active antiretroviral therapy among patients with a CD4 count

HIV Medicine — Tue, 22 Nov 2011 05:00:00 +0100

ConclusionA substantial minority of patients with a CD4 count < 350 cells/μL remain untreated despite its indication. (Source: HIV Medicine)

Treatment limitations imposed by antiretroviral drug resistance mutations: implication for choices of first line regimens in resource‐limited settings

HIV Medicine — Tue, 22 Nov 2011 05:00:00 +0100

ConclusionThe use of NNRTI‐based first‐line ART regimens may limit the options for second‐line treatment when the number of available drugs is limited. (Source: HIV Medicine)

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Coccidioidomycosis of cervical lymph nodes in an HIV-infected patient with immunologic reconstitution on potent HAART: a rare observation in a nonendemic area

Diagnostic Microbiology and Infectious Disease — Mon, 21 Nov 2011 05:00:00 +0100

We report a case of coccidioidomycosis of cervical lymph nodes that occurred early after the introduction of highly active antiretroviral therapy during the phase of immune system recovery, demonstrating a rare disease in a nonendemic area. (Source: Diagnostic Microbiology and Infectious Disease)

Symptomatic Mixed Cryoglobulinemia during HIV Primary Infection: A Case Report

EURASIP Journal on Bioinformatics and Systems Biology — Sun, 20 Nov 2011 15:42:17 +0100

We report a patient who developed during HIV primary infection a symptomatic mixed cryoglobulinemia. The patient suffered from arthralgias, vascular purpura of the legs, and proteinuria. Cryoglobulinemia progressively disappeared in several months after HAART. (Source: EURASIP Journal on Bioinformatics and Systems Biology)

Impaired phagocytosis among patients infected by the human immunodeficiency virus: implication for a role of highly‐active antiretroviral therapy

Clinical and Experimental Immunology — Fri, 18 Nov 2011 23:50:01 +0100

Conclusions: Innate immunity defects appear to be present in HIV positive patients, regarding phagocytic activity and oxidative burst of monocytes and neutrophils. These defects are greatly influenced by the level of treatment efficacy, with emphasis on CD4 cell counts and viral load. (Source: Clinical and Experimental Immunology)

Prevalence and impact of hepatitis B and C virus co‐infections in antiretroviral treatment naïve patients with HIV infection at a major treatment center in Ghana

Journal of Medical Virology — Fri, 18 Nov 2011 07:58:28 +0100

AbstractData on the effects of the presence of hepatitis B virus (HBV) and hepatitis C virus (HCV) in patients co‐infected with these viruses and HIV in West Africa are conflicting and little information is available in Ghana. A cohort of 138 treatment naïve individuals infected with HIV was screened for HBV and HCV serologic markers; HBsAg positive patients were tested for HBeAg, anti‐HBe, and anti‐HBc IgM. The viral load of HIV‐1 in the plasma was determined in 81 patients. Eighteen of the 138 patients (13%) and 5 (3.6%) had HBsAg and anti‐HCV, respectively. None of the patients had anti‐HBc IgM, but 10 (55.6%) and 8 (44.4%) of the 18 patients who were HBsAg positive had HBeAg and anti‐HBe, respectively. In patients with measurement of CD4+ undertaken within 1 month (n =...

Long-Term Resolution of Viral Breakthrough after Changing HIV Viral Load Assay

Journal of the International Association of Physicians in AIDS Care (JIAPAC) — Fri, 18 Nov 2011 05:00:00 +0100

Conclusion: Transient viremia after changing VL assay reflects the different sensitivity of these assays with no impact on patients' outcomes compared to controls. (Source: Journal of the International Association of Physicians in AIDS Care (JIAPAC))

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Human papillomavirus coinfection in the oral cavity of HIV-infected children

Journal of Clinical Pathology — Thu, 17 Nov 2011 05:00:00 +0100

Conclusions Based upon the results, it is concluded that HPV DNA may be present in HIV disease, but no association with immunosuppression, delivery, or medical records (CD4 cell count, viral load and use of highly active antiretroviral therapy) was observed, and no differences could be observed between the groups either. (Source: Journal of Clinical Pathology)

BK virus infection in human immunodeficiency virus-infected patients

European Journal of Clinical Microbiology and Infectious Diseases — Wed, 16 Nov 2011 06:47:22 +0100

Abstract The aim of this study is to evaluate the prevalence of BK virus (BKV) infection in HIV-positive patients receiving highly active antiretroviral therapy (HAART) in our hospital. The presence of BKV was analysed in urine and plasma samples from 78 non-selected HIV-infected patients. Clinical data were recorded using a pre-established protocol. We used a nested PCR to amplify a specific region of the BKV T-large antigen. Positive samples were quantified using real-time PCR. Mean CD4 count in HIV-infected patients was 472 cells/mm3 and median HIV viral load was <50 copies/mL. BKV viraemia was detected in only 1 HIV-positive patient, but 57.7% (45 out of 78) had BKV viruria, which was more common in patients with CD4 counts >500 cells/mm3 (74.3% vs 25.7%; p = ...

Enhanced levels of CCL19 in patients with advanced AIDS

Clinical and Experimental Immunology — Wed, 16 Nov 2011 05:39:09 +0100

Conclusions: Our findings suggest the involvement of CCL19 in AIDS patients with advanced immunodeficiency, potentially mediating both adaptive and maladaptive responses. (Source: Clinical and Experimental Immunology)

Nutrition and disease progression pre-highly active antiretroviral therapy (HAART) and post-HAART: can good nutrition delay time to HAART and affect response to HAART?

The American Journal of Clinical Nutrition — Wed, 16 Nov 2011 05:00:00 +0100

Authors: Chandrasekhar A, Gupta A Abstract Several studies have investigated a variety of nutritional supplementation interventions in adults with HIV. In this narrative review, we summarize the evidence from 31 clinical trials that explore clinical benefits of macronutrient and micronutrient supplementation in this population while attempting to answer the question of whether good nutrition can delay the time to highly active antiretroviral therapy (HAART) initiation and response. We focused on trials published in English between 1990 and 2010 that reported on CD4 count, viral load, and disease progression or survival. Among 9 macronutrient and 22 micronutrient trials, we found that evidence for improved CD4 count and HIV viral load with nutritional supplementation was limited; on...

Effect of CD4+ T-lymphocyte count on hospital outcome of elective general thoracic surgery patients with human immunodeficiency virus

General Thoracic and Cardiovascular Surgery — Mon, 14 Nov 2011 17:03:43 +0100

Conclusion Our retrospective study demonstrates that the indicator for elective general thoracic surgery is not the CD4-positive T-lymphocyte count and that the initiation of HAART may reduce the 12-month mortality rates. In HIV-positive patients, regardless of the CD4-positive T-lymphocyte count, surgeons can operate in the same manner as they would with HIV-negative patients. Content Type Journal ArticleCategory Original ArticlePages 743-747DOI 10.1007/s11748-011-0808-yAuthors Satoshi Nagasaka, Department of Thoracic Surgery, National Centre for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655 JapanHirohisa Yazaki, AIDS Clinical Centre, National Centre for Global Health and Medicine, Tokyo, JapanHideyuki Ito, Department of Thoracic Surgery, ...

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Effect of accompanying antiretroviral drugs on virological response to pegylated interferon and ribavirin in patients co-infected with HIV and hepatitis C virus

Journal of Antimicrobial Chemotherapy — Mon, 14 Nov 2011 05:00:00 +0100

Conclusions Our results suggest that, with the exception of regimens including zidovudine, accompanying antiretroviral drugs have little effect on the virological response to pegylated interferon plus ribavirin in HIV/HCV-co-infected patients. (Source: Journal of Antimicrobial Chemotherapy)

The persisting burden of invasive pneumococcal disease in HIV patients: an observational cohort study

BMC Infectious Diseases — Fri, 11 Nov 2011 05:00:00 +0100

We describe the burden and risk factors for pneumococcal disease in the modern era of HIV care and evaluate the use of a 23-valent pneumococcal polysaccharide vaccine (PPV-23). Methods: The incidence of invasive pneumococcal disease (IPD) between January 1st, 2000 and January 1st, 2010 in a regional HIV population in Southern Alberta, Canada was determined by linking comprehensive laboratory and hospital surveillance data. Clinical and epidemiologic data including risk factors for S. pneumoniae, history of pneumococcal immunization, serotypes of infections, and length of any hospitalizations for pneumococcal disease were evaluated with multivariate analysis. CD4 count and viral load at immunization were evaluated with a nested case-control analysis. Results: In 1946 HIV-patients with 11,09...

Headache Among Patients With HIV Disease: Prevalence, Characteristics, and Associations

Headache: The Journal of Head and Face Pain — Fri, 11 Nov 2011 05:00:00 +0100

Conclusions.— Problematic headache is highly prevalent among patients with HIV/AIDS, most of which conform to the semiology of chronic migraine, although with some atypical features such as bilateral location and pressing/tightening quality. A low frequency of identifiable secondary causes is likely attributable to reduced frequency of opportunistic infections in the current era of HAART. Disease severity is strongly predictive of headache, highlighting the importance of physician attention to headache symptoms and of patient adherence to treatment. (Source: Headache: The Journal of Head and Face Pain)

Headache Among Patients With HIV Disease: Prevalence, Characteristics, and Associations.

Headache — Fri, 11 Nov 2011 05:00:00 +0100

Conclusions.- Problematic headache is highly prevalent among patients with HIV/AIDS, most of which conform to the semiology of chronic migraine, although with some atypical features such as bilateral location and pressing/tightening quality. A low frequency of identifiable secondary causes is likely attributable to reduced frequency of opportunistic infections in the current era of HAART. Disease severity is strongly predictive of headache, highlighting the importance of physician attention to headache symptoms and of patient adherence to treatment. PMID: 22077887 [PubMed - as supplied by publisher] (Source: Headache)

Histoplasmosis-associated immune reconstitution inflammatory syndrome

Anais Brasileiros de Dermatologia — Thu, 10 Nov 2011 07:13:02 +0100

Paciente masculino, 27 anos, portador de HIV, com quadro de histoplasmose cutânea disseminada. Terapia antirretroviral oral e anfotericina B por via EV (dose total acumulada 0,5g) foram introduzidas, verificando-se rápida cicatrização das lesões após duas semanas. A anfotericina B foi substituída por itraconazol (200mg/dia). O paciente interrompeu voluntariamente os tratamentos. A terapia antirretroviral foi reintroduzida, havendo aumento da contagem de células T CD4-positivas (No restante do texto, a autora usa o símbolo "+" (T CD4+) ao invés da palavra "positiva". O que fazer neste caso? Seguimos o padrão do restante do texto ou acatamos essa opção da autora no resumo?!). Neste momento, diagnosticou-se histoplasmose ganglionar. O aumento da contagem de células T CD4-positiv...

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Prevalence and factors associated with traditional herbal medicine use among patients on highly active antiretroviral therapy in Uganda

BMC Public Health - Latest articles — Thu, 10 Nov 2011 05:00:00 +0100

Conclusion: The prevalence of THM use among participants on HAART was high. This raises clinical and pharmacological concerns that need attention by the health care service providers. (Source: BMC Public Health - Latest articles)

Photolichenoid plaques with associated vitiliginous pigmentary changes.

Dermatol Online J — Tue, 08 Nov 2011 04:35:03 +0100

Authors: Tran K, Hartman R, Tzu J, Meehan S, Sanders SE, Pomeranz MK, Sanchez M Abstract A 49-year-old man with advanced HIV/AIDS on anti-retroviral therapy (HAART) and trimethoprim-sulfamethoxazole (TMP-SMX) presented with a several-month history of pruritic, erythematous, lichenified papules that coalesced into hyperkeratotic plaques on the trunk and extremities in a sun-exposed distribution. He shortly thereafter developed a progressive depigmentation over more than 80 percent of his body surface area. A biopsy specimen of an erythematous plaque on the trunk showed a superficial and mid-dermal infiltrate of lymphocytes with eosinophils, most consistent with either chronic lichenoid drug eruption or atypical lymphoproliferative disorder (ACLD) of HIV. The patient's lichenoid skin...

Morphometric analysis of dendritic cells from anal mucosa of HIV-positive patients and the relation to intraepithelial lesions and cancer seen at a tertiary health institution in Brazil.

Acta Cirurgica Brasileira — Fri, 04 Nov 2011 01:45:44 +0100

CONCLUSIONS: Our data support an enhancement of the synergistic action caused by HIV-HPV co-infection on the anal epithelium, weakening the DC for its major role in immune surveillance. Notoriously in patients with severe anal intraepithelial neoplasia, the density of CD1a+ epithelial dendritic cells was influenced by the viral load of HIV-1. Our study describes for the first time the density of subepithelial DC-SIGN+ dendritic cells in patients with anal severe anal intraepithelial neoplasia and points to the possibility that a specific therapy for HIV induces the recovery of the density of epithelial DC. PMID: 22042118 [PubMed - in process] (Source: Acta Cirurgica Brasileira)

The antiretroviral efficacy of highly active antiretroviral therapy and plasma nevirapine concentrations in HIV-TB co-infected Indian patients receiving rifampicin based antituberculosis treatment.

AIDS Research and Therapy — Wed, 02 Nov 2011 04:00:00 +0100

CONCLUSIONS: Good immunological and clinical response can be obtained in HIV-TB co-infected patients receiving rifampicin and nevirapine concomitantly despite somewhat lower nevirapine trough concentrations. This suggests that rifampicin-containing ATT may be co administered in resource limited setting with nevirapine-containing HAART regimen without substantial reduction in antiretroviral effectiveness. Larger sample sized studies and longer follow-up are required to identify populations of individuals where the reduction in nevirapine concentration may result in lower ART response or shorter response duration. PMID: 22047185 [PubMed - as supplied by publisher] (Source: AIDS Research and Therapy)

Body fat distribution in perinatally HIV-infected and HIV-exposed but uninfected children in the era of highly active antiretroviral therapy: outcomes from the Pediatric HIV/AIDS Cohort Study.

The American Journal of Clinical Nutrition — Wed, 02 Nov 2011 04:00:00 +0100

CONCLUSION: Although BMI and total body fat were significantly lower in the HIV-infected children than in the HEU children, body fat distribution in the HIV-infected children followed a pattern associated with cardiovascular disease risk and possibly related to specific antiretroviral drugs. PMID: 22049166 [PubMed - as supplied by publisher] (Source: The American Journal of Clinical Nutrition)

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[Prevalence of proteinuria and its association with HIV/AIDS in Congolese children living in Kinshasa, Democratic Republic of Congo.]

Nephrologie and Therapeutique — Wed, 02 Nov 2011 04:00:00 +0100

CONCLUSION: Proteinuria is common in Congolese children. The HIV infection rises significantly the probability to present proteinuria in children of this study, more so among those with important immunosuppression. This raises the question about the ideal time to initiate HAART in order to reduce the prevalence of kidney injury and to provide the best outcome. PMID: 22056079 [PubMed - as supplied by publisher] (Source: Nephrologie and Therapeutique)

The antiretroviral efficacy of highly active antiretroviral therapy and plasma nevirapine concentrations in HIV-TB co-infected Indian patients receiving rifampicin based antituberculosis treatment

AIDS Research and Therapy — Wed, 02 Nov 2011 04:00:00 +0100

Conclusions: Good immunological and clinical response can be obtained in HIV-TB co-infected patients receiving rifampicin and nevirapine concomitantly despite somewhat lower nevirapine trough concentrations. This suggests that rifampicin-containing ATT may be co administered in resource limited setting with nevirapine-containing HAART regimen without substantial reduction in antiretroviral effectiveness. Larger sample sized studies and longer follow-up are required to identify populations of individuals where the reduction in nevirapine concentration may result in lower ART response or shorter response duration. (Source: AIDS Research and Therapy)

Factors associated with paradoxical immune response to antiretroviral therapy in HIV infected patients: a case control study.

BMC Infectious Diseases — Wed, 02 Nov 2011 04:00:00 +0100

Background: A paradoxical immunologic response (PIR) to Highly Active Antiretroviral Therapy (HAART), defined as viral suppression without CD4 cell-count improvement, has been reported in the literature as 8 to 42%, around 15% in most instances. The present study aims to determine, in a cohort of HIV infected patients in Brazil, what factors were independently associated with such a discordant response to HAART. Methods: A case-control study (1:4) matched by gender was conducted among 934 HIV infected patients on HAART in Brazil. Cases: patients with PIR, defined as CD4 (Source: BMC Infectious Diseases)

Optimal HAART adherence over time and time interval between successive visits: their association and determinants

AIDS Care — Wed, 02 Nov 2011 00:53:37 +0100

(Source: AIDS Care)

Adherence to Highly Active Antiretroviral Therapy (HAART): A Meta-Analysis

AIDS and Behavior — Wed, 02 Nov 2011 00:53:35 +0100

(Source: AIDS and Behavior)

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Informal Care and Reciprocity of Support are Associated with HAART Adherence Among Men in Baltimore, MD, USA

AIDS and Behavior — Wed, 02 Nov 2011 00:53:35 +0100

(Source: AIDS and Behavior)

HIV Patients on HAART Have a Plethora of Ocular DiseasesHIV Patients on HAART Have a Plethora of Ocular Diseases

Medscape Today Headlines — Tue, 01 Nov 2011 12:18:11 +0100

The prevalence of cataracts among HIV-positive patients receiving HAART is 10 times higher than in the rest of the American population, and the cataracts develop at a much younger age. Medscape Medical News (Source: Medscape Today Headlines)

Imported Acquired Immunodeficiency Syndrome-Related Histoplasmosis in Metropolitan France: A Comparison of Pre-Highly Active Anti-Retroviral Therapy and Highly Active Anti-Retroviral Therapy Eras.

The American Journal of Tropical Medicine and Hygiene — Tue, 01 Nov 2011 04:00:00 +0100

Authors: Peigne V, Dromer F, Elie C, Lidove O, Lortholary O Abstract Abstract. Histoplasma capsulatum var. capsulatum infection is rare outside disease-endemic areas. Clinical presentation and outcome of acquired immunodeficiency syndrome-related histoplasmosis are unknown in non-endemic areas with wide access to highly active anti-retroviral therapy (HAART). Retrospective analysis of cases recorded at the French National Reference Center for Mycoses and Antifungals during two decades: pre-HAART (1985-1994) and HAART (1997-2006). Clinical features and outcome of all adults with proven acquired immunodeficiency syndrome-related histoplasmosis were compared between the two periods. One hundred four patients were included (40 during the pre-HAART era and 64 during the HAART era). Diag...

Undiagnosed clinician

Dental Abstracts — Tue, 01 Nov 2011 04:00:00 +0100

HIV-positive dentists in the United Kingdom are obligated to suspend clinical practicing exposure-prone procedures (EPPs) in dentistry practice. Although the risk of transmission to a patient is extremely slim, there is a real risk, as demonstrated by Dr Acer in Florida who infected six patients. This transmission was verified by epidemiologic and laboratory investigations that found no other likely source of HIV for these patients, and their HIV strains closely resembled the DNA sequences of the dentist’s strain. The mode of transmission and the reasons for transmission remain unknown. Since Dr Acer’s time, highly active antiretroviral therapy has produced a decline in mortality and morbidity in patients infected with HIV, enough that HIV/AIDS is considered a chronic illness rather th...

Clinical outcomes of HIV‐infected patients with Kaposi's sarcoma receiving nonnucleoside reverse transcriptase inhibitor‐based antiretroviral therapy in Uganda

HIV Medicine — Tue, 01 Nov 2011 04:00:00 +0100

ConclusionPrevalent or incident KS was associated with 30% mortality. The resolution of KS lesions among individuals who initiated HAART with NNRTI‐based regimens was similar to that found in studies using only protease inhibitor‐based HAART. (Source: HIV Medicine)

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New caesarean guidelines proposed

NHS News Feed — Mon, 31 Oct 2011 17:00:00 +0100

Several newspapers have reported that all pregnant women will “get the right to a caesarean”, regardless of whether there is a medical reason for having one. Currently, around one in four UK babies is delivered by caesarean. The reports are based on new draft guidelines from the National Institute for Health and Clinical Excellence (NICE), the national body that evaluates which treatments should be available for specific conditions. The proposed guidelines are the first major update from NICE on caesarean sections since 2004, and take into account the latest research on the procedure. What do the guidelines recommend? Although newspapers focused on caesareans potentially being available to a wider range of women, the draft guidelines cover all aspects of caesarean sections, includin...

Intensive Care Usage by HIV-Positive Patients in the HAART Era

Clinical and Developmental Immunology — Sun, 30 Oct 2011 22:52:59 +0100

In the 1980s the outlook for patients with the acquired immunodeficiency syndrome (AIDS) and critical illness was poor. Since then several studies of outcome of HIV+ patients on ICU have shown improving prognosis, with anti-retroviral therapy playing a large part. We retrospectively examined intensive care (ICU) admissions in a large HIV unit in London. Between April 2001 and April 2006 43 patients were admitted to the ICU. The mean age of patients was 44 years and 74% were male. Fifty-six percent of admissions were receiving anti-retroviral therapy and 44% had an AIDS defining diagnosis. The median CD4 count was 128 cells/mL and the median APACHE II score was 21. The commonest diagnostic ICU admission category was respiratory disease. This group experienced higher mortalit...

Correlation analysis on total lymphocyte count and CD4 count in HIV-infected patients: A retrospective evaluation

Journal of Huazhong University of Science and Technology -- Medical Sciences -- — Fri, 28 Oct 2011 16:51:13 +0100

This study examined the correlation between total lymphocyte count (TLC) and CD4 count of HIV-infected patients before and after HAART, and assessed the thresholds of TLC for making decisions about the initiation and for monitoring HAART. A retrospective study was performed, and 665 HIV-infected patients with TLC and CD4 count from four counties (Shangcai, Queshan, Shenqiu and Weishi) were included in the study. Pearson correlation and receiver operating characteristic (ROC) were used. TLC and CD4 count after HAART was significantly increased as compared with pre-HAART (P<0.01). An overall positive correlation was noted between TLC and CD4 count (pre-HAART, r=0.73, P=0.0001; follow-up HAART, r=0.56, P=0.0001). The ROC curve between TLC and CD4 count showed that TLC ≤ 1200 cells/m...

Outcomes for critically ill patients with HIV and severe sepsis in the era of highly active antiretroviral therapy

Journal of Critical Care — Fri, 28 Oct 2011 04:00:00 +0100

Conclusions: In this large cohort study, nosocomial/health care–associated infections were common in ICU patients with HIV and severe sepsis. Hospital mortality was associated with acute illness severity, but not clearly associated with variables related to HIV infection. Interventions that aim to prevent or more effectively treat nosocomial infections in critically ill patients with HIV may favorably impact clinical outcomes. (Source: Journal of Critical Care)

Med Sci Monit 2011; 17(11):BR312-318 "Nordihydroguaiaretic acid (NDGA) inhibits ritonavir-induced endothelial dysfunction in porcine pulmonary arteries"

Medical Science Monitor — Wed, 26 Oct 2011 17:52:00 +0100

Conclusions: NDGA effectively inhibits the detrimental effects of HIV protease inhibitor RTV on vasomotor functions in porcine PAs. NDGA also blocks RTV-induced decrease of eNOS expression and increase of oxidative stress in both porcine PAs and HPAECs. This study may provide valuable information for the development of effective strategies for the prevention and treatment of HAART-associated cardiovascular complications. (Source: Medical Science Monitor)

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Immunologic and virologic failure after first-line NNRTI-based antiretroviral therapy in Thai HIV-infected children

AIDS Research and Therapy — Wed, 26 Oct 2011 04:00:00 +0100

We examined the incidence rate of immunologic failure (IF) and virologic failure (VF) and the accuracy of using IF to predict VF in Thai HIV-infected children using first-line NNRTI-based HAART.Clinicaltrials.gov identification number NCT00476606 Methods: Antiretroviral (ART)-naive HIV-infected children from 2 prospective cohorts treated with NNRTI-based HAART during 2001-2008 were included. CD4 counts were performed every 12 weeks and plasma HIV-RNA measured every 24 weeks. Immune recovery was defined as CD4%[greater than or equal to]25%. IF was defined as persistent decline of [greater than or equal to]5% in CD4% in children with CD4%1,000 copies/ml after at least 24 weeks of HAART. Clinical and laboratory parameter changes were assessed using a paired t-test, and a time to event approac...

Immunologic and virologic failure after first-line NNRTI-based antiretroviral therapy in Thai HIV-infected children.

AIDS Research and Therapy — Wed, 26 Oct 2011 04:00:00 +0100

CONCLUSION: Immunologic failure, as defined here, had low sensitivity compared to VF and should not be recommended to detect treatment failure. Plasma HIV-RNA should be performed twice, at weeks 24 and 48, to detect early treatment failure. PMID: 22026962 [PubMed - as supplied by publisher] (Source: AIDS Research and Therapy)

HAART for Prevention of Mother-to-Child Transmission of HIVHAART for Prevention of Mother-to-Child Transmission of HIV

Medscape Today Headlines — Tue, 25 Oct 2011 12:02:17 +0100

HAART initiation and perinatal HIV transmission - timing of therapy could make the difference. JAIDS: Journal of Acquired Immune Deficiency Syndromes (Source: Medscape Today Headlines)

Attitudes and practices towards HAART among people living with HIV/AIDS in a resource-limited setting in northern Burkina Faso

Public Health — Mon, 24 Oct 2011 04:00:00 +0100

Conclusions: HAART was well accepted in this resource-poor region. Community education and supportive approaches may be critical for an effective preventive programme. (Source: Public Health)

Modulatory effects of the CCR5 antagonist maraviroc on microglial pro‐inflammatory activation elicited by gp120.

Journal of Neurochemistry — Fri, 21 Oct 2011 04:00:00 +0100

AbstractDespite important clinical benefits of the highly active antiretroviral therapy, neurological disorders affect approximately 50% of AIDS patients. In the brain, infected microglia release pro‐inflammatory mediators as well as HIV‐1 proteins, like the envolope protein gp120, that sustain inflammation and mediate neuronal damage. Gp120 allows the virus entry in the host cells via binding to the CD4 receptor together with a specific co‐receptor (CCR5/CXCR4). The antiretroviral drug maraviroc is a CCR5 receptor antagonist, approved for the treatment of HIV‐experienced patients. By interfering with a chemokine receptor, highly expressed in microglia, maraviroc has the potential to modulate their activation during HIV‐1 infection. To test this hypothesis, primary cultures of ra...

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Modulatory effects of the CCR5 antagonist maraviroc on microglial pro‐inflammatory activation elicited by gp120

Journal of Neurochemistry — Fri, 21 Oct 2011 04:00:00 +0100

J. Neurochem. (2011) 10.1111/j.1471‐4159.2011.07549.xAbstractDespite important clinical benefits of the highly active antiretroviral therapy, neurological disorders affect approximately 50% of AIDS patients. In the brain, infected microglia release pro‐inflammatory mediators as well as human immunodeficiency virus type 1 (HIV‐1) proteins, like the envelope protein gp120, that sustain inflammation and mediate neuronal damage. Gp120 allows the virus entry in the host cells via binding to the CD4 receptor together with a specific co‐receptor (CCR5/CXCR4). The antiretroviral drug maraviroc is a CCR5 receptor antagonist, approved for the treatment of HIV‐experienced patients. By interfering with a chemokine receptor, highly expressed in microglia, maraviroc has the potential to modula...

Sexual Dysfunctions of HIV-Positive Men: Associated Factors, Pathophysiology Issues, and Clinical Management

Computational Intelligence and Neuroscience — Fri, 21 Oct 2011 03:01:09 +0100

Sexual dysfunctions in HIV-positive men are associated with an increase in risky sexual behavior and decreased adherence to antiretroviral drug regimens. Because of these important public health issues, we reviewed the literature on the pathophysiology, associated factors and clinical management of sexual dysfunction in HIV-positive men. The goal was to investigate the current research on these issues. Literature searches were performed in June 2011 on PubMed, Web of Science, and PsycInfo databases with the keywords “AIDS” and “sexual dysfunction” and “HIV” and “sexual dysfunction”, resulting in 54 papers. Several researchers have investigated the factors associated with sexual dysfunction in HIV-positive men. The association between sexual d...

Records linkage of electronic databases for the assessment of adverse effects of antiretroviral therapy in sub‐Saharan Africa

Pharmacoepidemiology and Drug Safety — Tue, 18 Oct 2011 04:00:00 +0100

ConclusionProbabilistic record linkage methods were effective for records linkage in this sub‐Saharan African setting. Copyright © 2011 John Wiley & Sons, Ltd. (Source: Pharmacoepidemiology and Drug Safety)

Analysis of undiagnosed tuberculosis-related deaths identified at post-mortem among HIV- infected patients in Russia: a descriptive study.

BMC Infectious Diseases — Tue, 18 Oct 2011 04:00:00 +0100

Conclusions: We conclude that introduction of prompt and accurate diagnostics tests, adequate treatment protocols and intensive training of physicians in management of AIDS and TB is vital. This should include reviewing standards of care for HIV-positive individuals with accompanying social problems. (Source: BMC Infectious Diseases)

Computer simulation of structured treatment interruption for HIV infection

Computer Methods and Programs in Biomedicine — Sun, 16 Oct 2011 18:10:43 +0100

Abstract: The use of highly active antiretroviral therapy (HAART) for suppression of measurable levels of virus in the body has greatly contributed to restoration and preservation of the immune system in HIV positive patients. However, short and long term problems associated with HAART have led to proposals for alternative treatment strategies for controlling HIV infection. In particular, structured treatment interruptions (STIs) that consist of therapy withdrawal and re-initiation according to specific criteria have been considered. The aim of these STIs was one or both of: (i) to stimulate the immune system to react to HIV, (ii) to allow re-emergence of wild-type virus and thereby reduce problems of drug resistance. However, a number of clinical trials of STIs have shown adverse outcomes...

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Reliability of the Lay Adherence Counsellor Administered Substance Abuse and Mental Illness Symptoms Screener (SAMISS) and the International HIV Dementia Scale (IHDS) in a Primary care HIV Clinic in Cape Town, South Africa

AIDS and Behavior — Fri, 14 Oct 2011 15:44:40 +0100

Abstract HIV infection is associated with an increased prevalence of common mental disorders and with the development of HIV associated neurological disorders (HAND). The aim of this research was to determine the reliability of lay adherence counsellors in the administration of the substance abuse and mental illness symptom screener (SAMISS) for common mental disorders and International HIV Dementia Scale (IHDS) for HAND in a South African sample of 269 people living with HIV/AIDS and on HAART in a primary healthcare setting. We used a cross-sectional design with each patient assessed by a mental health nurse and counsellor, 1 week apart. Reliability was fair for the SAMISS overall (κ = 0.39, CI95 0.29–0.49, P < 0.01), but was higher for the s...

Kidney tubular damage in the absence of glomerular defects in HIV-infected patients on highly active antiretroviral therapy

Nephrology Dialysis Transplantation — Fri, 14 Oct 2011 04:00:00 +0100

Conclusions. A quarter of HIV-infected patients receiving HAART had subclinical tubular damage, which was associated with a near-term decline in eGFR and higher incidence of proteinuria. Periodic monitoring of urinary biomarkers might facilitate the early identification of HAART patients predisposed to significant kidney disease. (Source: Nephrology Dialysis Transplantation)

The Unrealized Potential of Addiction Science in Curbing the HIV Epidemic.

Current HIV Research — Fri, 14 Oct 2011 04:00:00 +0100

Authors: Volkow ND, Baler RD, Normand JL Abstract The stubbornly high incidence of new HIV infections belies the overwhelming evidence showing that sustained highly active antiretroviral therapy (HAART) has the power to dramatically reduce the spread of HIV infection and forever change the face of this devastating epidemic. One of the main contributors to this public health paradox is the ongoing HIV epidemic among substance users who contribute significantly to HIV infection rates through injection drug use and high-risk sexual behaviours. Current evidence clearly shows that, in order to fill this gap, we need to integrate substance abuse treatment with HIV treatment programmes and provide substance abusers with universal access to HIV treatment through a focussed effort to seek, ...

The impact of facial lipoatrophy treatment with polymethyl methacrylate in AIDS patients as measured by four quality-of-life questionnaires

International Journal of STD and AIDS — Thu, 13 Oct 2011 04:00:00 +0100

Life-expectancy increased in patients infected with HIV/AIDS with the advent of highly active antiretroviral therapy (ART). Facial lipoatrophy is a common complication in these patients, eventually leading to stigma, segregation and a negative impact in quality of life (QOL). We measured the impact of the treatment of facial lipoatrophy with polymethyl methacrylate (PMMA) in the QOL of patients with HIV/AIDS by using four questionnaires that address QOL. Forty consecutive patients on ART referred for facial lipoatrophy treatment were enrolled in this study. The first 20 were allocated to the intervention group and were treated with tissue augmentation with PMMA. The other 20 were allocated to the control group, which received treatment only after six months. At baseline, four questionnaire...

HAART initiation helpful when CD4 counts are below 500: study

Modern Medicine — Thu, 13 Oct 2011 04:00:00 +0100

NEW YORK (Reuters Health) - Newly published data can help time the start of highly active antiretroviral therapy (HAART) for HIV: they show that starting treatment at CD4 counts below 500 will slow disease progression. (Source: Modern Medicine)

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Rescue of HIV-1 long-time archived X4 strains to escape maraviroc.

Antiviral Research — Thu, 13 Oct 2011 04:00:00 +0100

Authors: Baatz F, Struck D, Lemaire M, De Landtsheer S, Servais JY, Arendt V, Schmit JC, Perez Bercoff D Abstract Entry of Human Immunodeficiency Virus type 1 (HIV-1) into target cells is mediated by the CD4 receptor and a coreceptor, CCR5 or CXCR4. Maraviroc interferes with HIV entry by binding the CCR5 coreceptor. Virological failure to maraviroc-containing regimens can occur through the emergence of resistance, or through tropism evolution and broadened coreceptor usage. In the latter case, the physiological relevance of minority strains is a major concern. Here we report a retrospective analysis of coreceptor-usage and evolution based on 454-ultra-deep-sequencing of plasma and Peripheral Blood Mononuclear Cell (PBMC)-derived envelope V3-loops, accounting for coreceptor usage, f...

Effects of highly active antiretroviral therapy on cognitive functions in severely immune-compromised HIV-seropositive patients

Journal of the Neurological Sciences — Thu, 13 Oct 2011 04:00:00 +0100

This study assessed the effects of highly active antiretroviral therapy on the cognitive performances of HIV seropositive patients with severe immune depression.Methods: It is a prospective longitudinal interventional study of 69 anti-retroviral naïve HIV-seropositive adult patients with CD4 levels≤350/μl. The cognitive assessment was done at initiation and 12months after anti-retroviral treatment using the Community Screening Instrument for Dementia (CSID) and the computer-assisted Iron Psychology (FePsy). The impact of therapy on CD4 levels and cognitive scores of the patients before and after therapy were compared and tested for statistical significance using Student t test and one-way ANOVA.Results: The mean age of the patients was 36.6±8.8years. There was a significant increase i...

Women and Vulnerability to HAART Non-Adherence: A Literature Review of Treatment Adherence by Gender from 2000 to 2011

Current HIV/AIDS Reports — Tue, 11 Oct 2011 15:54:59 +0100

Abstract A literature review of original research articles on adherence to antiretroviral therapy (ART) in developed countries, covering January 2000 to June 2011, was conducted to determine if gender differences exist in the prevalence of nonadherence to ART. Of the 1,255 articles reviewed, only 189 included data on the proportion of the study population that was adherent and only 57 (30.2%) of these reported proportional adherence values by gender. While comparing articles was challenging because of varied reporting strategies, women generally exhibit poorer adherence than men. Thirty of the 44 articles (68.2%) that reported comparative data on adherence by gender found women to be less adherent than men. Ten articles (17.5%) reported significant differences in proportio...

Rapid clinical change in lesions of atypical cutaneous lymphoproliferative disorder in an HIV patient: A case report and review of the literature.

Dermatol Online J — Mon, 10 Oct 2011 11:40:02 +0100

CONCLUSION: The working-theory of a reactive etiology for this condition might explain the evolution in appearance following initiation of HAART. The presence of papules with a dusky targetoid center suggests that this condition should be considered in the differential diagnosis with syphilis or atypical erythema multiforme in HIV patients. PMID: 21971269 [PubMed - in process] (Source: Dermatol Online J)

The expansion ability but not the quality of HIV-specific CD8(+) T cells is associated with protective human leucocyte antigen class I alleles in long-term non-progressors.

Immunology — Sun, 09 Oct 2011 23:05:56 +0100

The expansion ability but not the quality of HIV-specific CD8(+) T cells is associated with protective human leucocyte antigen class I alleles in long-term non-progressors. Immunology. 2011 Nov;134(3):305-13 Authors: López M, Peris A, Soriano V, Lozano S, Vicario JL, Rallón NI, Restrepo C, Benito JM Abstract Studies in long-term non-progressors (LTNP) have suggested that the quality of the CD8(+) response may involve protective human leucocyte antigen (HLA) class I alleles. However, studies examining the expansion ability of different functional CD8(+) T cells and their association with HLA class I alleles are lacking. LTNP, untreated typical progressors (TP) and patients successfully on highly active retroviral therapy (HAART) during 1 year (HP) were included. HLA clas...

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Body satisfaction and lipodystrophy characteristics in HIV/AIDS children and teenagers undergoing highly active antiretroviral therapy

Revista Paulista de Pediatria — Sun, 09 Oct 2011 17:48:24 +0100

OBJETIVO: Verificar a presença de alterações metabólicas e corporais e satisfação corporal em crianças e adolescentes em uso de terapia antirretroviral. MÉTODOS: Estudo transversal de 38 jovens entre seis e 18 anos infectados por HIV e atendidos entre dezembro de 2009 e maio de 2010. A satisfação corporal foi avaliada por escala de silhuetas, composta por 11 figuras. O estado nutricional foi avaliado por meio de mensurações de peso, altura, circunferências e pregas cutâneas. A presença de características de lipodistrofia foi avaliada pelo exame físico e o perfil lipídico e glicêmico foi solicitado no dia da consulta. Na análise estatística, aplicou-se o teste t e do qui-quadrado, sendo significante p

Morphological and Metabolic Components of Lipodystrophy in Various Nevirapine-Based Highly Active Antiretroviral Therapy (HAART) Regimens: A Cross-Sectional, Observational Study

Clinical Drug Investigation — Sun, 09 Oct 2011 06:22:41 +0100

(Source: Clinical Drug Investigation)

Distinct AIDS Viruses Found In Cerebrospinal Fluid Of People With HIV Dementia

Health News from Medical News Today — Fri, 07 Oct 2011 09:00:00 +0100

When the virus that causes AIDS infects the central nervous system, it can lead to the development of a severe neurological disease called HIV- associated dementia (HAD). The advent of highly active antiretroviral therapy, or HAART, has helped reduce HAD. But some studies show that HAART may not offer complete protection from less severe HIV-associated neurological problems, nor might it always help to reverse it. As people live longer with AIDS, their risk of developing neurological problems may increase... (Source: Health News from Medical News Today)

Study Examines Timing of Treatment Initiation and Clinical Outcomes in HIV-Infected People

Fri, 07 Oct 2011 04:00:00 +0100

“[The purpose of the study is to] estimate the clinical benefit of highly active antiretroviral therapy (HAART) initiation vs deferral in a given month in patients with CD4 cell counts less than 800/μL. … “In this observational cohort study of human immunodeficiency virus type 1 seroconverters from CASCADE (Concerted Action on SeroConversion to AIDS and Death in Europe), we constructed monthly sequential nested subcohorts between January 1996 and May 2009, including all eligible HAART-naive, AIDS-free individuals with a CD4 cell count less than 800/μL. The primary outcome was time to AIDS or death in those who initiated HAART in the baseline month compared with those who did not, pooled across subcohorts and stratified by CD4 cell count. … “Of 9455 p...

Ocular Complications of Human Immunodeficiency Virus Infection in Eastern China

American Journal of Ophthalmology — Fri, 07 Oct 2011 04:00:00 +0100

Conclusions: The study shows a high rate of treatable ocular complications among patients with HIV/AIDS in eastern China. HIV/AIDS treatment programs in China must be prepared to identify ocular complications and refer patients to the correct treatment facilities. (Source: American Journal of Ophthalmology)

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Impact of antiretroviral therapy on fertility desires among HIV-infected persons in rural Uganda

BioMed Central — Thu, 06 Oct 2011 04:00:00 +0100

Conclusions: The conclusions from this study are that the HAART treatment status of HIV patients did not influence the desire for children. The non-significant association between the desire for more children and the HAART treatment status could be caused by a lack of knowledge in HIV-infected persons/couples about the positive impact of HAART in reducing HIV transmission from mother-to-child. We recommend that the health care system ensures proper training of staff and appropriate communication to those living with HIV as well as to the general community. (Source: BioMed Central)

Clinical trial uncovers potential 'functional cure' for HIV/AIDS

UCLA Newsroom: Health Sciences — Tue, 04 Oct 2011 18:50:50 +0100

Data from a clinical trial involving UCLA researchers suggest that a new therapy may potentially serve as a "functional cure" for HIV/AIDS. The therapy, called SB-728-T, involves the modification of both copies of a patient's CCR5 gene, which encodes the major co-receptor used by HIV to infect immune system cells. In the Sangamo BioSciences' phase 1 trial, SB-728-T was given to HIV patients who were on highly active antiretroviral therapy (HAART) but were considered to be "non-responders" — that is, their CD4+ T-cell levels, a key measure of immune system health, remained low. The patients' HAART therapy was interrupted when they received the SB-728-T therapy. The researchers found a statistically significant relationship between the suppression of HIV viral load...

Determination of efavirenz in diluted alkaline electrolyte by cathodic adsorptive stripping voltammetry at the mercury film electrode

Journal of the Brazilian Chemical Society — Tue, 04 Oct 2011 05:45:59 +0100

A stripping method for the determination of the antiretroviral drug efavirenz at the submicromolar concentration levels in diluted alkaline electrolyte is described. Optimum experimental conditions were: 2.0 × 10-3 mol L-1 NaOH, accumulation potential of -0.10 V, pulse amplitude of 50 mV and scan rate of 50 mV s-1. The response is linear over the concentration range of 0.01-0.25 ppm. For an accumulation time of 10 min, the limit of detection was 1.0 ppb (3.0 × 10-9 mol L-1). The most convenient conditions to measure the efavirenz concentration in the presence of ATP, DNA, several metals, and other antiviral drugs was also investigated. The utility of the method is demonstrated by the determination of efavirenz in a synthetic mixture containing both lamivudine and zidovudine, which are fr...

Antiphospholipid Antibodies in Black South Africans with HIV and Acute Coronary Syndromes: Prevalence and Clinical Correlates

BMC Research Notes — Tue, 04 Oct 2011 04:00:00 +0100

Background: HIV infection is associated with a high prevalence of antiphospholipid antibodies (aPL) and increased thrombotic events but the aetiopathogenic link between the two is unclear.FindingsProspective single centre study from Soweto, South Africa, comparing the prevalence of aPL in highly active anti-retroviral therapy (HAART) naive HIV positive and negative patients presenting with Acute Coronary Syndromes (ACS). Between March 2004 and February 2008, 30 consecutive black South African HIV patients with ACS were compared to 30 black HIV negative patients with ACS .The HIV patients were younger (43 +/- 7 vs. 54 +/- 13, p=0.004) and besides smoking (73% vs. 33%, p=0.002) and lower HDL levels (0.8 +/- 0.3 vs. 1.1 +/- 0.4, p=0.001) had fewer risk factors than the control group. HIV pati...

Simultaneous HAART improves survival in children coinfected with HIV and TB

Tropical Medicine and International Health — Mon, 03 Oct 2011 04:00:00 +0100

Conclusions Starting HAART during tuberculosis therapy significantly improves survival and provides further impetus for the integration of TB and HIV services. (Source: Tropical Medicine and International Health)

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Kaposi's Sarcoma: Imaging Overview

Seminars in Ultrasound CT and MRI — Sat, 01 Oct 2011 04:00:00 +0100

Kaposi's sarcoma (KS), a low-grade malignancy that is associated with human herpesvirus-8 (HHV-8), is a multifocal tumor that most commonly affects mucocutaneous sites. It might also involve lymph nodes and visceral organs, in particular of the respiratory and gastrointestinal tract, but it can affect every organ system. Four forms of the disease have been recognized: the classic, the endemic, the transplant-associated, and the epidemic form. The endemic form, or African KS, currently accounts for 10%-50% of all cancers in adults and up to 25% of cancers in children in certain parts of Africa. The epidemic form or acquired immune deficiency syndrome (AIDS)–associated KS is a frequent neoplasm in bisexual and homosexual men with AIDS in the United States. Even though in North America and ...

Current Treatment Strategies, Complications and Considerations for the Use of HIV Antiretroviral Therapy during Pregnancy.

AIDS Reviews — Sat, 01 Oct 2011 04:00:00 +0100

Authors: Senise JF, Castelo A, Martínez M Abstract The global prevalence of HIV infection in the female population presents a significant healthcare burden in terms of mother-to-child transmission (MTCT) of the disease. This review aims to discuss current trends and treatment guidelines for the use of antiretroviral therapy during pregnancy and associated complications in this population. Historically, antiretroviral monotherapy with zidovudine was commonly used for preventing MTCT, and monotherapy with single-dose nevirapine is still used for prevention in resource-limited settings. Evidence suggests that combination therapy with HAART is a more effective treatment option than monotherapy when managing HIV in pregnant women. Current treatment guidelines recommend the use of HAART...

Cervical cancer screening among HIV‐infected women: An economic evaluation in a middle‐income country

International Journal of Cancer — Fri, 30 Sep 2011 04:00:00 +0100

This study evaluates the optimal cervical cancer screening strategy for HIV‐infected women in a middle‐income country. We developed a mathematical model which simulates the natural history of the HPV infection, as well as the HIV‐mediated immunosupression among women in Brazil. Our model was calibrated using data from the IPEC/FIOCRUZ Women's HIV‐infected cohort. The model compares the lifetime effects, costs, and cost‐effectiveness of strategies combining cytology, HPV DNA test, and colposcopy at different screening intervals for different CD4 count strata (27 strategies in total). We found that the strategy with the best cost‐effectiveness profile (cost‐effectiveness ratio – U$4,911/year of life saved [YLS] and probability of being cost‐effective – 86%) was HPV testin...

Cardiac Effects of Antiretroviral Therapy in HIV-Negative Infants Born to HIV-Positive Mothers: NHLBI CHAART-1 (National Heart, Lung, and Blood Institute Cardiovascular Status of HAART Therapy in HIV-Exposed Infants and Children Cohort Study)

PEDIATRICS — Fri, 30 Sep 2011 04:00:00 +0100

(Source: PEDIATRICS)