scholarly journals Efficacy of Prompt Initiation of Antiretroviral Therapy in the Treatment of Hemophagocytic Lymphohistiocytosis Triggered by Uncontrolled Human Immunodeficiency Virus

2017 ◽  
Vol 2017 ◽  
pp. 1-3 ◽  
Author(s):  
Bryan P. Fitzgerald ◽  
Amy L. Wojciechowski ◽  
Rajinder P. S. Bajwa
Keyword(s):  
Human Immunodeficiency Virus ◽  
Antiretroviral Therapy ◽  
Critically Ill ◽  
Hemophagocytic Lymphohistiocytosis ◽  
Viral Infections ◽  
Hiv Infections ◽  
Hiv Viral Load ◽  
Hematologic Disorder ◽  
Immune System Activation ◽  
Immunodeficiency Virus

Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening, rapidly progressive hematologic disorder involving uncontrolled immune system activation. HLH has been associated with viral infections, including human immunodeficiency virus (HIV) infections. We report a case of a critically ill 30-year-old female who was hospitalized with HIV-associated HLH, with a CD4 count of 4 cells/mL and HIV viral load of 1,842,730 copies/mL. After ruling out other potential infectious causes of HLH, antiretroviral therapy (ART) was initiated with darunavir, ritonavir, tenofovir, and emtricitabine. Within one week of initiation of ART, the patient began to improve clinically and hematologically and was stable enough for discharge from the hospital three weeks after starting therapy. This case suggests that treatment with ART in patients with HIV-associated HLH should be considered even in critically ill patients with low CD4 counts.

scholarly journals Longitudinal Changes in Spirometry in South African Adolescents Perinatally Infected With Human Immunodeficiency Virus Who Are Receiving Antiretroviral Therapy

2019 ◽  
Vol 70 (3) ◽  
pp. 483-490 ◽  
Author(s):  
Leah N Githinji ◽  
Diane M Gray ◽  
Sipho Hlengwa ◽  
Landon Myer ◽  
Takwanisa Machemedze ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Antiretroviral Therapy ◽  
Lung Function ◽  
Highly Active Antiretroviral Therapy ◽  
Forced Expiratory Volume ◽  
Limited Information ◽  
Hiv Viral Load ◽  
Mixed Effect ◽  
Longitudinal Changes ◽  
Immunodeficiency Virus

Abstract Background Despite increased access to highly active antiretroviral therapy (HAART), lung disease remains common in human immunodeficiency virus (HIV)–infected (HIV+) adolescents. There is limited information on changes in lung function over time in perinatally HIV+ adolescents on HAART. The objective was to investigate the progression of spirometry findings over 2 years in HIV+ adolescents on HAART in a prospective cohort, the Cape Town Adolescent Antiretroviral Cohort (CTAAC). Methods HIV+ adolescents aged 9–14 years, with at least 6 months of HAART, and a comparator group of healthy HIV-uninfected (HIV–), age-matched controls were enrolled in CTAAC. Spirometry and bronchodilator testing were done at baseline, 12 months, and 24 months. Mixed-effect models were used to compute longitudinal changes in lung function. Results Five hundred fifteen HIV+ adolescents, mean age 12 (standard deviation [SD], 1.6) years, 50.4% male, and 110 HIV– adolescents, mean age 11.8 (SD, 1.8) years, 45.6% male, were tested at baseline; 477 (93%) HIV+ and 102 (93%) HIV– adolescents at 12 months; and 473 (92%) HIV+ and 97 (88%) HIV– adolescents at 24 months. Only 5.4% of the HIV+ adolescents had HIV viral load >10 000 copies/mL at baseline. Forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) were lower in the HIV+ compared to the HIV– adolescents and tracked with no deterioration or catch-up over 2 years. Previous pulmonary tuberculosis (PTB) or lower respiratory tract infection (LRTI) was significantly associated with reduced FEV1 and FVC (P < .05 for both). Conclusions HIV+ adolescents had lower lung function over 2 years than HIV– adolescents. This study highlights the need for lung function surveillance and prevention of LRTIs and PTB in HIV+ adolescents.

scholarly journals Cyotkines as Potential Therapies for Human Immunodeficiency Virus Infections

1994 ◽  
Vol 5 (suppl a) ◽  
pp. 28A-35A
Author(s):  
Robert W Sidwell ◽  
John D Morrey ◽  
Reed P Warren
Keyword(s):  
Human Immunodeficiency Virus ◽  
Viral Infections ◽  
Biological Effects ◽  
Antiviral Agents ◽  
Biological Response ◽  
Hiv Infections ◽  
Hiv Disease ◽  
Virus Infections ◽  
Immunodeficiency Virus ◽  
The Many

Cytokines are attracting increased interest as potential therapies for human immunodeficiency virus (HIV) infections. This attraction has particularly arisen as these cytokines have become more commercially available through recombinant technologies. This review focuses on the effects of these biological response modifiers on preclinical HIV and related retrovirus infections. Cytokines that have particularly been considered for HIV disease control include: interferons -α , -β and -γ, interleukins-2. -3. -4. -6 and -7; tumour necrosis factors -α and -β; and the colony stimulating factors. Efficacy has especially been seen when these cytokines have been used in combination with the more conventional antiviral agents. Due to the many biological functions exerted by cytokines and their interweaving of biological effects with other cytokines, they appear to have the potential to both inhibit as well as enhance viral infections, depending upon how they are used, and caution is therefore urged in their use.

scholarly journals Remission of progressive multifocal leukoencephalopathy in HIV- positive patient after multidisciplinary rehabilitation: a case report

2020 ◽  
pp. 74-79
Author(s):  
Elena DUMEA ◽  
Raluca MIHAI ◽  
Mihaela MAVRODIN ◽  
Gabriela DOGARU ◽  
PASCU Corina
Keyword(s):  
Human Immunodeficiency Virus ◽  
Antiretroviral Therapy ◽  
Progressive Multifocal Leukoencephalopathy ◽  
Highly Active Antiretroviral Therapy ◽  
Jc Virus ◽  
Hiv Positive ◽  
Hiv Viral Load ◽  
Multidisciplinary Rehabilitation ◽  
Truncal Ataxia ◽  
Immunodeficiency Virus

Introduction: One of the most common neurologic disease in Acquired Immunodeficiency Syndrome (AIDS) caused by Human Immunodeficiency Virus (HIV) is represented by progressive multifocal leukoencephalopathy (PML), being caused by John Cunningham (JC) polyoma virus. Case presentation: We report a case of a 27 years old women, HIV-positive since childhood, under specific antiretroviral therapy with good adherence to it in that period but starting with adolescence adherence to highly active antiretroviral therapy (HAART) decreased. In this context her HIV viral load increased to a 690.000 copies/ml, and CD4 collapsed at 57 cells/mmc. She presented in our clinic with ataxic left hemiparesis, truncal ataxia and left hemi-hypoesthesia. Cerebrospinal fluid (CSF) showed a slightly pleocytosis and polymerase chain reaction performed from CSF diagnosed John Cunningham (JC) virus. Once diagnosis established, we reinitiated HAART, but some neurologic disorders persisted like difficulty of the left upper member, having the modified Rankin scale (mRS) of 5. The patient started a multidisciplinary rehabilitation (MDR) treatment, specifically adapted. It consisted of 4 sessions of neuromotor treatments, 20 sessions of massages, and 12 sessions of occupational therapy. According to MDR, the patient improved the ataxic walking, without support, presenting an improvement mRS of 3. Conclusions: AIDS patients with PML could require a prolonged MDR treatment for neurological disorders and rehabilitation treatment promptly should be applied when such diagnosis is suspected. Key words: progressive multifocal leukoencephalopathy, human immunodeficiency virus, neurological disorder, multidisciplinary rehabilitation,

scholarly journals Comparative Analysis of Salivary Mycobiome Diversity in Human Immunodeficiency Virus-Infected Patients

2021 ◽  
Vol 11 ◽  
Author(s):  
Shenghua Chang ◽  
Haiying Guo ◽  
Jin Li ◽  
Yaoting Ji ◽  
Han Jiang ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Viral Load ◽  
Comparative Analysis ◽  
Antiretroviral Therapy ◽  
Correlation Analysis ◽  
Hiv Infections ◽  
The Body ◽  
Healthy Controls ◽  
Cell Counts ◽  
Immunodeficiency Virus

Reports on alterations in the oral mycobiome of HIV-infected patients are still limited. This study was designed to compare the salivary mycobiome between 30 human immunodeficiency virus (HIV) infections and 30 healthy controls and explore the effect of antiretroviral therapy (ART) administration on the oral mycobiome of HIV infections. Results showed that the diversity and richness of salivary mycobiome in HIV-infected individuals were higher than those of controls (P < 0.05). After ART, the diversity and richness of salivary mycobiome in HIV-infected patients were reduced significantly (P < 0.05). Candida, Mortierella, Malassezia, Simplicillium, and Penicillium were significantly enriched in the HIV group and dramatically decreased after ART. While the relative abundance of Verticillium, Issatchenkia, and Alternaria significantly increased in patients with HIV after ART. Correlation analysis revealed that Mortierella, Malassezia, Simplicillium, and Chaetomium were positively correlated with viral load (VL), whereas Thyrostroma and Archaeorhizomyces were negatively related to VL and positively related to CD4+ T-cell counts. All results showed that HIV infection and ART administration affected the composition of salivary mycobiome communities. Furthermore, differences of salivary mycobiome in HIV infections after ART were complex and might mirror the immune state of the body.

scholarly journals Food Insecurity and T-cell Dysregulation in Women Living With Human Immunodeficiency Virus on Antiretroviral Therapy

2020 ◽  
Author(s):  
Brandilyn A Peters ◽  
Lila A Sheira ◽  
David B Hanna ◽  
Qibin Qi ◽  
Anjali Sharma ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
T Cells ◽  
Viral Load ◽  
T Cell ◽  
Antiretroviral Therapy ◽  
Food Insecurity ◽  
Cd8 T Cells ◽  
Disease Risk ◽  
Hiv Viral Load ◽  
Immunodeficiency Virus

Abstract Background Food insecurity is associated with increased morbidity and mortality in people with human immunodeficiency virus (HIV) on antiretroviral therapy, but its relationship with immune dysregulation, a hallmark of HIV infection and comorbidity, is unknown. Methods In 241 women participating in the Women’s Interagency HIV Study, peripheral blood mononuclear cells were characterized by flow cytometry to identify cell subsets, comprising surface markers of activation (%CD38+HLADR+), senescence (%CD57+CD28−), exhaustion (%PD-1+), and co-stimulation (%CD57− CD28+) on CD4+ and CD8+ T cells. Mixed-effects linear regression models were used to assess the relationships of food insecurity with immune outcomes, accounting for repeated measures at ≤3 study visits and adjusting for sociodemographic and clinical factors. Results At the baseline study visit, 71% of participants identified as non-Hispanic Black, 75% were virally suppressed, and 43% experienced food insecurity. Food insecurity was associated with increased activation of CD4+ and CD8+ T cells, increased senescence of CD8+ T cells, and decreased co-stimulation of CD4+ and CD8+ T cells (all P < .05), adjusting for age, race/ethnicity, income, education, substance use, smoking, HIV viral load, and CD4 count. In stratified analyses, the association of food insecurity with CD4+ T-cell activation was more pronounced in women with uncontrolled HIV (viral load >40 copies/mL and CD4 <500 cells/mm3) but remained statistically significant in those with controlled HIV. Conclusions Food insecurity may contribute to the persistent immune activation and senescence in women with HIV on antiretroviral therapy, independently of HIV control. Reducing food insecurity may be important for decreasing non–AIDS-related disease risk in this population.

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