scholarly journals Colorectal Disorders in Acute Human Immunodeficiency Virus Infection: A Case Series

2016 ◽  
Vol 3 (1) ◽  
Author(s):  
Theppharit Panichsillapakit ◽  
Derek Patel ◽  
Joanne Santangelo ◽  
Douglas D. Richman ◽  
Susan J. Little ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Hiv Infection ◽  
Acute Infection ◽  
Case Series ◽  
Low Grade ◽  
Gi Tract ◽  
Acute Hiv Infection ◽  
First Case ◽  
Immunodeficiency Virus ◽  
Acute Hiv

Abstract Background.  The gastrointestinal (GI) tract is important in the pathogenesis of human immunodeficiency virus (HIV) infection. We report a case series of lower GI endoscopic and histopathologic findings of HIV-infected individuals after presentation with acute infection. Methods.  We performed a retrospective case review of individuals infected with HIV who enrolled between August 2010 and April 2013 in a primary infection treatment trial. All participants started the trial during acute infection and underwent colonoscopy with biopsies at baseline and after the start of antiretroviral treatment. Results.  Twenty acutely infected individuals were included in the study (mean age, 33 years; range, 20–54 years). All participants were male who reported having receptive anal sex as an HIV risk factor. Nine individuals (45%) had at least 1 finding by colorectal pathology; 1 person had 2 diagnoses (diverticulosis and focal active proctitis). The histopathological findings revealed anal dysplasia in 3 cases: 2 had high-grade anal intraepithelial neoplasia (AIN) and 1 had low-grade AIN. Two persons had a colorectal polyp, 1 hyperplastic and 1 adenomatous. Three persons were diagnosed with diverticulosis, and 2 persons were diagnosed with proctitis, including 1 with focal active proctitis and 1 with cytomegalovirus proctitis. Conclusions.  To our knowledge, this is the first case series report of lower GI disorders in acute HIV-infected individuals. Although the causal relationship remains uncertain, we describe the endoscopic findings that were observed during acute HIV infection among men who have sex with men. Understanding the prevalence of these pathologies may likely shed light on how acute HIV infection damages the lower GI tract.

scholarly journals Knowledge and Awareness of Acute Human Immunodeficiency Virus Infection Among Mobile App-Using Men Who Have Sex With Men: A Missed Public Health Opportunity

2015 ◽  
Vol 2 (1) ◽  
Author(s):  
Aaron J. Siegler ◽  
Travis Sanchez ◽  
R. Craig Sineath ◽  
Jeremy Grey ◽  
Erin Kahle ◽  
...  
Keyword(s):  
Public Health ◽  
Human Immunodeficiency Virus ◽  
Hiv Infection ◽  
Hiv Testing ◽  
Online Survey ◽  
Mobile App ◽  
Acute Hiv Infection ◽  
Immunodeficiency Virus ◽  
Acute Hiv ◽  
Sex With Men

Abstract In a national online survey, we assessed awareness and knowledge of acute human immunodeficiency virus (HIV) infection manifestation among 1748 men who have sex with men (MSM). Only 39% of respondents were aware that acute HIV infection may be accompanied by symptoms. Education and increased access to acute HIV testing may facilitate MSM to appropriately seek acute HIV testing.

Case 36

2020 ◽  
pp. 247-254
Author(s):  
Andrew Woodhouse
Keyword(s):  
Human Immunodeficiency Virus ◽  
Hiv Infection ◽  
Immune Function ◽  
Treatment Strategies ◽  
Current Treatment ◽  
Newly Diagnosed ◽  
Acute Hiv Infection ◽  
Immunodeficiency Virus ◽  
Acute Hiv

Human immunodeficiency virus (HIV) infection is a worldwide infection and new cases continue to occur. Recognizing features of acute HIV infection and also underlying conditions that might reflect longer-standing infection are key to diagnosis. This allows treatment to be started which can maintain or improve health and prevent further deterioration of immune function. Treatment is indicated for the majority of newly diagnosed cases irrespective of immune function status. Current treatment strategies are so effective and tolerable now compared to early antiretroviral regimens that HIV has become a long-term manageable condition for the majority of newly diagnosed people who are able to access antiretroviral therapy.

scholarly journals Incubation Time of Acute Human Immunodeficiency Virus (HIV) Infection and Duration of Acute HIV Infection Are Independent Prognostic Factors of Progression to AIDS

2000 ◽  
Vol 182 (1) ◽  
pp. 334-337 ◽  
Author(s):  
Philippe Vanhems ◽  
Bernard Hirschel ◽  
Andrew N. Phillips ◽  
David A. Cooper ◽  
Jeanette Vizzard ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Prognostic Factors ◽  
Hiv Infection ◽  
Incubation Time ◽  
Acute Hiv Infection ◽  
Immunodeficiency Virus ◽  
Acute Hiv

scholarly journals Estimating the Mutational Fitness Effects Distribution during early HIV infection

2017 ◽  
Author(s):  
Eva Bons ◽  
Frederic Bertels ◽  
Roland R Regoes
Keyword(s):  
Hiv Infection ◽  
Acute Infection ◽  
Recent Analysis ◽  
Sequencing Data ◽  
Acute Hiv Infection ◽  
Beneficial Mutations ◽  
Fitness Effects ◽  
Acute Hiv ◽  
High Fraction ◽  
The Moment

AbstractThe evolution of HIV during acute infection is often considered a neutral process. Recent analysis of sequencing data from this stage of infection, however, showed high levels of shared mutations between independent viral populations. This suggests that selection might play a role in the early stages of HIV infection. We adapted an existing model for random evolution during acute HIV-infection to include selection. Simulations of this model were used to fit a global mutational fitness effects distribution (MFED) to sequencing data of the env gene of individuals with acute HIV infection. Measures of sharing between viral populations were used as summary statistics to compare the data to the simulations. We confirm that evolution during acute infection is significantly different from neutral. The distribution of mutational fitness effects is best fit by distribution with a low, but significant fraction of beneficial mutations and a high fraction of deleterious mutations. While most mutations are neutral or deleterious in this model, about 5% of mutations is beneficial. These beneficial mutations will, on average, result in a small but significant increase in fitness. When assuming no epistasis, this indicates that at the moment of transmission HIV is near, but not on the fitness peak for early infection.

scholarly journals Acute Human Immunodeficiency Virus (HIV) Syndrome After Nonadherence to Antiretroviral Therapy in a Patient With Chronic HIV Infection: A Case Report

2014 ◽  
Vol 1 (3) ◽  
Author(s):  
Seong K. Choi ◽  
Christopher J. Graber
Keyword(s):  
Human Immunodeficiency Virus ◽  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Rare Case ◽  
Acute Illness ◽  
Hiv Rna ◽  
Acute Retroviral Syndrome ◽  
Immunodeficiency Virus ◽  
Acute Hiv ◽  
Chronic Hiv Infection

Abstract We report a rare case of acute human immunodeficiency virus (HIV) syndrome in a patient with chronic HIV infection with acute illness indistinguishable from acute retroviral syndrome. The patient presented with an acute febrile mononucleosis-like illness after increasing nonadherence to antiretroviral therapy. A marked increase in HIV RNA level of 1 220 000 copies/mL from less than 20 copies/mL occurred within 3 weeks. The diagnosis of acute HIV syndrome was made after alternative causes of illness were ruled out.

Cancer in human immunodeficiency virus-infected children: a case series from the Children's Cancer Group and the National Cancer Institute.

1998 ◽  
Vol 16 (5) ◽  
pp. 1729-1735 ◽  
Author(s):  
M O Granovsky ◽  
B U Mueller ◽  
H S Nicholson ◽  
P S Rosenberg ◽  
C S Rabkin
Keyword(s):  
Human Immunodeficiency Virus ◽  
Hiv Infection ◽  
Cancer Diagnosis ◽  
National Cancer Institute ◽  
Death Rate ◽  
Proportional Hazards ◽  
Case Series ◽  
Cox Proportional Hazards ◽  
Cancer Group ◽  
Immunodeficiency Virus

PURPOSE To describe the spectrum of malignancies in human immunodeficiency virus (HIV)-infected children and the clinical outcome of patients with these tumors. METHODS We retrospectively surveyed the Children's Cancer Group (CCG) and the National Cancer Institute (NCI) for cases of cancer that occurred between July 1982 and February 1997 in children who were HIV seropositive before or at the time of cancer diagnosis. We used Kaplan-Meier survivorship curves, hazard function estimates, and Cox proportional hazards models to evaluate survival. RESULTS Sixty-four children (39 boys, 25 girls) with 65 tumors were reported. Thirty-seven children (58%) acquired HIV infection vertically (median age at cancer diagnosis, 4.3 years); 22 children (34%) acquired HIV through transfusion of blood or blood products (median age at cancer diagnosis, 13.4 years). Forty-two children (65%) had non-Hodgkin's lymphoma (NHL). Eleven children (17%) had leiomyosarcomas (or leiomyomas), which are otherwise exceptionally rare in children. Other malignancies included acute leukemia (five children), Kaposi's sarcoma (KS; three children), Hodgkin's disease (two children), vaginal carcinoma in situ (one child), and tracheal neuroendocrine carcinoma (one child). Median survival after NHL diagnosis was 6 months (range, 1 day to 89 months) and after leiomyosarcoma was 12 months (range, 10 days to 19 months). The average monthly death rate after NHL diagnosis was 12% in the first 6 months, which decreased to about 2% thereafter. In contrast, the monthly death rate after leiomyosarcoma diagnosis increased from 5% in the first 6 months to about 20% thereafter. CONCLUSION After NHL, leiomyosarcoma is the second leading cancer in children with HIV infection. Both cancers have high mortality rates; improved outcome for NHL, in particular, may depend on earlier diagnosis and therapy.

Timeliness of Human Immunodeficiency Virus Diagnosis and Antiretroviral Treatment Initiation in the Era of Universal Testing and Treatment

2019 ◽  
Vol 220 (4) ◽  
pp. 648-656 ◽  
Author(s):  
McKaylee M Robertson ◽  
Sarah L Braunstein ◽  
Donald R Hoover ◽  
Sheng Li ◽  
Denis Nash
Keyword(s):  
Human Immunodeficiency Virus ◽  
Hiv Infection ◽  
Antiretroviral Treatment ◽  
Proportional Hazards ◽  
Treatment Initiation ◽  
Hiv Diagnosis ◽  
Acute Hiv Infection ◽  
Art Initiation ◽  
Universal Testing ◽  
Immunodeficiency Virus

Abstract Background We describe the timing of human immunodeficiency virus (HIV) diagnosis and antiretroviral treatment (ART) initiation after implementation of universal testing and treatment policies in New York City (NYC). Methods Using NYC population-based HIV registry data for persons with HIV diagnosed from 2012 through 2015 and followed up through June 2017, we examined trends in the proportion with diagnosis soon after HIV infection (ie, with CD4 cell count ≥500/μL or with acute HIV infection) and used Kaplan-Meier plots and proportional hazards regression to examine the timing of ART initiation after diagnosis. Results Among 9987 NYC residents with HIV diagnosed from 2012 to 2015, diagnosis was early in 35%, and 87% started ART by June 2017. The annual proportion of persons with early diagnosis did not increase appreciably (35% in 2012 vs 37% in 2015; P = .08). By 6 months after diagnosis, 62%, 67%, 72% and 77% of persons with HIV diagnosed in 2012, 2013, 2014, or 2015, respectively, had started ART, with median (interquartile range) times to ART initiation of 3.34 (1.34–12.75), 2.62 (1.28–10.13), 2.16 (1.15–7.11), and 2.03 (1.11–5.61) months, respectively. Conclusions Although recommendations for ART initiation on diagnosis are increasingly being implemented, the findings of the current study suggest that immediate treatment initiation is not universal. Continued efforts are needed to expand and better target HIV testing to promote earlier diagnosis.

scholarly journals Impact of Acute HIV Infection and Early Antiretroviral Therapy on the Human Gut Microbiome

2019 ◽  
Vol 7 (12) ◽  
Author(s):  
Ornella Sortino ◽  
Nittaya Phanuphak ◽  
Alexandra Schuetz ◽  
Alexandra M Ortiz ◽  
Nitiya Chomchey ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Inflammatory Markers ◽  
Acute Infection ◽  
Fecal Microbiota ◽  
Acute Hiv Infection ◽  
Gut Dysbiosis ◽  
Art Initiation ◽  
Rdna Sequencing ◽  
Acute Hiv

Abstract Background Intestinal microbial dysbiosis is evident in chronic HIV-infected individuals and may underlie inflammation that persists even during antiretroviral therapy (ART). It remains unclear, however, how early after HIV infection gut dysbiosis emerges and how it is affected by early ART. Methods Fecal microbiota were studied by 16s rDNA sequencing in 52 Thai men who have sex with men (MSM), at diagnosis of acute HIV infection (AHI), Fiebig Stages 1–5 (F1-5), and after 6 months of ART initiation, and in 7 Thai MSM HIV-uninfected controls. Dysbiotic bacterial taxa were associated with relevant inflammatory markers. Results Fecal microbiota profiling of AHI pre-ART vs HIV-uninfected controls showed a mild dysbiosis. Transition from F1-3 of acute infection was characterized by enrichment in pro-inflammatory bacteria. Lower proportions of Bacteroidetes and higher frequencies of Proteobacteria and Fusobacteria members were observed post-ART compared with pre-ART. Fusobacteria members were positively correlated with levels of soluble CD14 in AHI post-ART. Conclusions Evidence of gut dysbiosis was observed during early acute HIV infection and was partially restored upon early ART initiation. The association of dysbiotic bacterial taxa with inflammatory markers suggests that a potential relationship between altered gut microbiota and systemic inflammation may also be established during AHI.

scholarly journals LB-6. Increased Diagnoses of Acute HIV Infection through Routine ED Screening and Rapid Linkage to Care and initiation of HAART During the COVID-19 Pandemic

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S846-S846
Author(s):  
Kimberly Stanford ◽  
Jessica Schmitt ◽  
Michelle M Taylor ◽  
Dylan Eller ◽  
Eleanor Friedman ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Linkage To Care ◽  
Cook County ◽  
Hiv Screening ◽  
Acute Hiv Infection ◽  
Screening Programs ◽  
First Case ◽  
Number Of Patients ◽  
Advanced Planning ◽  
Acute Hiv

Abstract Background The COVID-19 pandemic has negatively impacted routine HIV screening in healthcare settings. This has serious implications, especially for patients with acute HIV infection (AHI) presenting with symptoms suggesting COVID-19 infection. This is a high priority population for rapid linkage to care (LTC) and initiation of HAART. Methods We reviewed data from our eXpanded HIV Testing and LTC (X-TLC) Program, a collaboration effort between 13 healthcare centers on the South and West Sides of Chicago. Since 2016, most sites had 4th or 5th generation HIV Ag/Ab testing available. Results Most sites experienced reductions in HIV screens during the COVID-19 pandemic. Advanced planning by our ED incorporated blood draws for HIV screens as part of COVID-19 evaluations. UCM performed 19,111 HIV screens (11,133 in the ED) between 1/1/20 and 8/17/20, along with 100,635 COVID PCRs (14,754 in ED) between 3/17/20 and 8/17/20. Nine patients were diagnosed with AHI after the first case of COVID-19 in Chicago (1/24/20), and 7 were diagnosed after the first case of community transmission in Cook County (3/8/20). All cases of AHI were diagnosed in the ED. The rate of AHI was significantly higher in 2020 versus the prior 4 years (14.4 vs 6.8 per year, p < 0.05). AHI patients comprised 25.7 % (9/35) of all new diagnoses, the highest percent ever. There were 7 men (6 identified as MSM) and 2 cis-gender women, median age of 25 years (21 to 28 years). The median viral load was 6 million (115,000 to > 6 million) copies/mL. Eight of 9 patients presented with an illness indistinguishable from COVID-19, including 1co-infected patient. All were LTC and started on HAART from time of PCR result within a median of 1 day (0–38), but 3 days (range 1–41) from sample collection as a result of delayed reflex PCR confirmatory testing due to high demands on lab personnel and scarcity of reagents due to COVID-19 PCR volumes (since resolved). HIV Screening and COVID-19 Testing in the ED During COVID-19 Conclusion Continued HIV screening in our ED during the COVID-19 pandemic identified an increased number of patients with AHI. These individuals may be more likely to present for care due to fear of COVID-19 infection. We achieved rapid LTC and initiation of HAART without any incremental increases in resources. All HIV screening programs should incorporate blood-based HIV screening into their COVID-19 testing programs. Disclosures Moira McNulty, MD, MS, Gilead Sciences (Grant/Research Support)

Acute hepatitis and pancytopenia related to non-typhoidal salmonella infection in a human immunodeficiency virus-infected patient

2019 ◽  
Vol 30 (10) ◽  
pp. 1034-1036
Author(s):  
A Atahan Çağatay ◽  
Rabia Deniz ◽  
Ramazan Gözüküçük ◽  
Ezgi Özbek ◽  
Seniha Başaran
Keyword(s):  
Human Immunodeficiency Virus ◽  
Hiv Infection ◽  
Acute Hepatitis ◽  
Infected Patient ◽  
Organ Involvement ◽  
Opportunistic Pathogens ◽  
Laboratory Findings ◽  
First Case ◽  
Food Borne ◽  
Immunodeficiency Virus

Non-typhoidal salmonella (NTS) are food-borne pathogens resulting in self-limiting acute gastroenteritis, but also more severe, invasive and sometimes recurrent bacteremia with atypical organ involvement in immunocompromised adults, particularly with human immunodeficiency virus (HIV) infection. Here we present a case of acute hepatitis and pancytopenia related to a non-typhoidal agent, Salmonella enterica subspecies enterica serovar Enteritidis, in an HIV-infected patient, the first case in the literature. As presented in our case, in management of NTS infection in immunocompromised patients, the first target is the control of bacteremia and then administration of antiretroviral therapy to improve patients’ immunity. Therefore, underlying immunosuppression should be excluded in patients presenting with NTS bacteremia, especially in the absence of gastroenteritis. On the other hand, atypical organ involvement and abnormal laboratory findings in HIV infection should prompt investigations for opportunistic pathogens.

Sign in / Sign up

Export Citation Format

Share Document