scholarly journals Physical Therapy for Chronic Pain Mitigation and Opioid Use Reduction Among People Living with Human Immunodeficiency Virus in Atlanta, GA: A Descriptive Case Series

2020 ◽  
Vol 36 (8) ◽  
pp. 670-675 ◽  
Author(s):  
Sara D. Pullen ◽  
Christi Acker ◽  
Haemi Kim ◽  
Morgan Mullins ◽  
Payton Sims ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Human Immunodeficiency Virus ◽  
Physical Therapy ◽  
Case Series ◽  
Opioid Use ◽  
Immunodeficiency Virus ◽  
Pain Mitigation

Abacavir/lamivudine/dolutegravir single tablet regimen in patients with human immunodeficiency virus and end-stage renal disease on hemodialysis

2018 ◽  
Vol 30 (2) ◽  
pp. 181-187 ◽  
Author(s):  
Sarah M Michienzi ◽  
Christopher A Schriever ◽  
Melissa E Badowski
Keyword(s):  
Human Immunodeficiency Virus ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Case Series ◽  
Drug Discontinuation ◽  
Immunodeficiency Virus ◽  
Before And After ◽  
Clinically Significant ◽  
Stage Renal Disease ◽  
End Stage

No single-tablet antiretroviral (ARV) regimens (STRs) are approved for patients with human immunodeficiency virus (HIV) and end-stage renal disease (ESRD) on hemodialysis (HD). Based on known pharmacokinetic (PK) properties, abacavir (ABC)/lamivudine (3TC)/dolutegravir (DTG) STR may represent a promising option. This case series presents the safety and efficacy of ABC/3TC/DTG STR in patients with HIV and ESRD on HD. Patients were included if they were HIV-positive, maintained on intermittent HD for ESRD, switched to an ARV regimen containing ABC/3TC/DTG, and had at least one set of virologic data before and after the switch. Average age (±standard deviation) was 59 (±8) years. The majority of patients were cis-gender male and non-Hispanic Black. Only one demonstrated clinically significant resistance at baseline. All were on multiple-tablet regimens prior to the switch. Five patients (83%) achieved undetectable HIV-RNA after the switch while only four patients (46%) were undetectable immediately prior. No decline in immune function was noted. ABC/3TC/DTG STR was well tolerated. Only one patient self-reported an adverse event (nausea), which resolved without drug discontinuation. Based on these data, it appears that ABC/3TC/DTG may be a safe and effective ARV-STR option for patients with HIV and ESRD on HD. A larger trial including a PK analysis is needed to confirm these findings.

scholarly journals Cryptoccal meningitis in non-HIV, non-organ transplant diabetic patients

2021 ◽  
Vol 8 (4) ◽  
pp. 591
Author(s):  
Sneha Biradar ◽  
Balakrishna Teli
Keyword(s):  
Human Immunodeficiency Virus ◽  
Organ Transplant ◽  
Case Series ◽  
Central Nervous System Disease ◽  
Diabetic Patients ◽  
Immunocompromised Patients ◽  
Current Case ◽  
Infected People ◽  
System Disease ◽  
Immunodeficiency Virus

Cryptococcosis is an important opportunistic fungal infection and also cause of death due to central nervous system disease among patients with human immunodeficiency virus worldwide. Most of the cases occur in immunocompromised patients like HIV infected people, people with organ transplants and on immunosuppressants. Nowdays there is increase in cases of cryptoccal meningitis among diabetic patients. Current case series includes cryptococcal meningitis among diabetic patients after ruling out of other immunocompromised states. 

HIV-1-Associated Neuropathies

CNS Spectrums ◽  
2000 ◽  
Vol 5 (5) ◽  
pp. 66-72 ◽  
Author(s):  
Ashok Verma ◽  
Walter G. Bradley
Keyword(s):  
Chronic Pain ◽  
Human Immunodeficiency Virus ◽  
Peripheral Neuropathy ◽  
Patient Population ◽  
Peripheral Neuropathies ◽  
Toxic Neuropathy ◽  
Immunodeficiency Virus ◽  
Hiv 1 ◽  
Sensory Polyneuropathy

AbstractPeripheral neuropathy associated with human immunodeficiency virus type 1 (HIV-1) infection is a major cause of morbidity in this patient population. Due to the associated chronic pain, its management has come within the purview of neuropsychiatrists. This paper will focus on the primary pathogenic aspects of HIV-1–associated peripheral neuropathies. The specific syndromes of greatest concern are distal sensory polyneuropathy, toxic neuropathy, inflammatory demyelinating polyradiculoneuropathy, and cytomegalovirus-related progressive polyradiculoneuropathy. The treatments available for these conditions and their efficacy are discussed.

scholarly journals Aetiology, Clinical Presentation, and Outcome of Meningitis in Patients Coinfected with Human Immunodeficiency Virus and Tuberculosis

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Smita Bhagwan ◽  
Kogieleum Naidoo
Keyword(s):  
South Africa ◽  
Human Immunodeficiency Virus ◽  
Tuberculous Meningitis ◽  
Clinical Presentation ◽  
Case Series ◽  
Antituberculous Therapy ◽  
Endemic Region ◽  
Neck Stiffness ◽  
Immunodeficiency Virus ◽  
Poor Outcomes

We conducted a retrospective review of confirmed HIV-TB coinfected patients previously enrolled as part of the SAPiT study in Durban, South Africa. Patients with suspected meningitis were included in this case series. From 642 individuals, 14 episodes of meningitis in 10 patients were identified. For 8 patients, this episode of meningitis was the AIDS defining illness, with cryptococcus (9/14 episodes) and tuberculosis (3/14 episodes) as the commonest aetiological agents. The combination of headache and neck stiffness (78.6%) was the most frequent clinical presentation. Relapsing cryptococcal meningitis occurred in 3/7 patients. Mortality was 70% (7/10), with 4 deaths directly due to meningitis. In an HIV TB endemic region we identified cryptococcus followed by tuberculosis as the leading causes of meningitis. We highlight the occurrence of tuberculous meningitis in patients already receiving antituberculous therapy. The development of meningitis heralded poor outcomes, high mortality, and relapsing meningitis despite ART.

scholarly journals Hepatic tuberculosis in human immunodeficiency virus co-infected adults: a case series of South African adults

2017 ◽  
Vol 17 (1) ◽  
Author(s):  
Lilishia Gounder ◽  
Pravikrishnen Moodley ◽  
Paul K. Drain ◽  
Andrew J. Hickey ◽  
Mahomed-Yunus S. Moosa
Keyword(s):  
Human Immunodeficiency Virus ◽  
South African ◽  
Case Series ◽  
Hepatic Tuberculosis ◽  
Immunodeficiency Virus

scholarly journals Clinical Manifestations and Treatment Outcomes of Syphilitic Uveitis in a Chinese Population

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Rui Zhang ◽  
Jiang Qian ◽  
Jie Guo ◽  
Yifei Yuan ◽  
Kang Xue ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Treatment Outcomes ◽  
Chinese Population ◽  
Retinal Vasculitis ◽  
Clinical Manifestations ◽  
Case Series ◽  
Posterior Uveitis ◽  
Retrospective Case ◽  
Serological Tests ◽  
Immunodeficiency Virus

Purpose. To describe the clinical manifestations and treatment outcomes of syphilitic uveitis in a Chinese population.Methods. This is a retrospective case series of 15 consecutive patients with syphilitic uveitis treated at a uveitis referral center between 2012 and 2015.Results. Fifteen patients were diagnosed with syphilitic uveitis based on positive serological tests. Nine patients were male. Coinfection with human immunodeficiency virus was detected in two patients. Twenty eyes presented with panuveitis and all patients had posterior involvement. The most frequent manifestations were retinal vasculitis and papillitis, while syphilitic posterior placoid chorioretinitis was only found in three eyes. All patients received systemic penicillin therapy according to CDC guidelines. Nine patients were misdiagnosed before presenting to our center and the delay in treatment with penicillin was associated with poor final visual outcomes (P<0.05).Conclusions. In our series, both male and female were almost equally affected and coinfection of syphilis with human immunodeficiency virus was uncommon. All patients in this study had posterior involvement and the most common manifestations were retinal vasculitis and papillitis. Syphilis should be considered as an important differential diagnosis especially for posterior uveitis and panuveitis. Early diagnosis and appropriate treatment are important for visual prognosis.

scholarly journals Nontuberculous Mycobacterial Osteomyelitis in Human Immunodeficiency Virus-Negative Patients: A Case Series

2016 ◽  
Vol 69 (2) ◽  
pp. 149-150 ◽  
Author(s):  
Tetsuro Kobayashi ◽  
Eriko Morino ◽  
Jin Takasaki ◽  
Yoshinori Nagahara ◽  
Haruhito Sugiyama
Keyword(s):  
Human Immunodeficiency Virus ◽  
Case Series ◽  
Immunodeficiency Virus

scholarly journals Safety and Efficacy Concerns of Lopinavir/Ritonavir in COVID-19 Affected Patients: A Retrospective Series

2020 ◽  
Author(s):  
Marc-Antoine Lepage ◽  
Nicholas Rozza ◽  
Richard Kremer ◽  
Ami Grunbaum
Keyword(s):  
Human Immunodeficiency Virus ◽  
Side Effects ◽  
Liver Enzyme ◽  
Gastrointestinal Symptoms ◽  
Case Series ◽  
Hiv Patients ◽  
Therapeutic Concentration ◽  
Safety And Efficacy ◽  
Immunodeficiency Virus ◽  
Trough Concentrations

Context: Originally developed for the treatment of human immunodeficiency virus (HIV), the antiviral combination lopinavir/ritonavir (LPV/r) is being investigated for use against coronavirus disease (COVID-19). We present a case series raising safety and efficacy concerns in COVID-19 affected patients. Methods: We measured LPV trough concentrations in 12 patients treated at our center and reviewed their clinical charts for side effects known to occur in HIV patients. Results: Compared to established LPV trough concentrations in HIV treated patients, concentrations in COVID-19 affected patients were 3-fold greater (20.64 +/- 10.14 mcg/mL versus 6.25 mcg/mL). In addition, cholestasis and dyslipidemia toxicity thresholds were exceeded in 12/12 and 11/12 patients respectively. No patients achieved the presumed therapeutic concentration. The side effects noted were mainly gastrointestinal symptoms (5/12, 42%), electrolytes imbalances (4/12, 33%), liver enzyme disturbances (5/12, 42%), and triglyceride elevations (2/12, 17%). Conclusion: None of our patients reached presumed therapeutic LPV concentrations despite experiencing side effects and exceeding cholestasis and dyslipidemia toxicity thresholds. This raises concerns for the safety and efficacy of LPV/r. Clinicians should consider closely monitoring for side effects and not necessarily attribute them to COVID-19 itself.

scholarly journals Opioids in the Management of HIV-Related Pain

2012 ◽  
Vol 3S;15 (3S;7) ◽  
pp. ES157-ES168 ◽  
Author(s):  
Daniel Krashin
Keyword(s):  
Chronic Pain ◽  
Human Immunodeficiency Virus ◽  
Opioid Dependence ◽  
Scientific Literature ◽  
Pain Treatment ◽  
Opioid Analgesics ◽  
Hiv Patients ◽  
Comprehensive Review ◽  
Opioid Treatment ◽  
Immunodeficiency Virus

Background: Human Immunodeficiency Virus (HIV) patients have an increased rate of chronic pain, particularly peripheral neuropathy. This disease burden causes considerable disability and negatively affects quality of life. Pain is undertreated and more complex to manage in these patients for a number of reasons, including complex anti-retroviral drug regimens, higher risks of side effects, and higher rates of comorbid psychiatric illness and substance abuse. Pain management must take these factors into account and use all available modalities, including nonopioid pain relievers, adjuvant medications, and psychosocial therapies in addition to opioid analgesics. Here we review recent recommendations regarding acute and chronic opioid treatment of pain and the treatment of opioid dependence in HIV-infected patients, and provide suggestions regarding aberrant behavior in pain treatment. Objectives: The objective of this comprehensive review is to assess and summarize the complicating factors involved in treating HIV patients’ pain with opioid analgesics. Study Design: This is a narrative review without a systematic quality assessment of the literature discussion. Methods: A comprehensive review of the literature relating to pain and pain treatment in HIV patients. The literature was collected from electronic databases, textbooks, and other sources. The scientific literature reviewed includes randomized trials, observational studies, systematic reviews, guidelines, and government reports. Results: This patient population is heterogeneous and diverse in their medical issues and comorbidities, but a systematic, stepwise approach to assessing and managing pain in HIV patients is described. Chronic opioid treatment has proven to be problematic and considerations and alternatives to this treatment are described. Management of pain in patients with opioid addiction, a frequent comorbidity of HIV infection, requires special awareness and different prescribing practices. Screening and identifying patients who are at special risk for developing medical or behavior complications of pain treatment is essential, and approaches to this, and common forms of aberrant behavior, are described. Limitations: The scientific literature on opioid treatment in this population is limited. The population of HIV patients is heterogeneous and differs in significant ways based on ethnicity, national origin, and mode of transmission, making it difficult to generalize about pain treatment in such a diverse group. Conclusions: Pain management in HIV patients must take these factors into account and use all available modalities for treatment, including nonopioid analgesics, adjuvant medications, and psychosocial therapies. Opioid analgesics should be prescribed with caution in accordance with current guidelines and after careful risk assessment. Key words: HIV, Human Immunodeficiency Virus, acute pain, chronic pain, psychiatric comorbidity, opioid dependence, opioids, chronic opioid therapy, substance abuse.

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