Immune Reconstitution for HIV Disease

2015 ◽  
pp. 233-239
Author(s):  
Sandra H. Bridges
Keyword(s):  
Immune Reconstitution ◽  
Hiv Disease

scholarly journals A Tale of Two Viruses: Immunological Insights Into HCV/HIV Coinfection

2021 ◽  
Vol 12 ◽  
Author(s):  
Samaa T. Gobran ◽  
Petronela Ancuta ◽  
Naglaa H. Shoukry
Keyword(s):  
Disease Progression ◽  
Immune Reconstitution ◽  
Acute Infection ◽  
People Living With Hiv ◽  
Hiv Disease ◽  
Hiv Reservoir ◽  
Cell Counts ◽  
Hiv Coinfection ◽  
Hcv Coinfection ◽  
The Impact

Nearly 2.3 million individuals worldwide are coinfected with human immunodeficiency virus (HIV) and hepatitis C virus (HCV). Odds of HCV infection are six times higher in people living with HIV (PLWH) compared to their HIV-negative counterparts, with the highest prevalence among people who inject drugs (PWID) and men who have sex with men (MSM). HIV coinfection has a detrimental impact on the natural history of HCV, including higher rates of HCV persistence following acute infection, higher viral loads, and accelerated progression of liver fibrosis and development of end-stage liver disease compared to HCV monoinfection. Similarly, it has been reported that HCV coinfection impacts HIV disease progression in PLWH receiving anti-retroviral therapies (ART) where HCV coinfection negatively affects the homeostasis of CD4+ T cell counts and facilitates HIV replication and viral reservoir persistence. While ART does not cure HIV, direct acting antivirals (DAA) can now achieve HCV cure in nearly 95% of coinfected individuals. However, little is known about how HCV cure and the subsequent resolution of liver inflammation influence systemic immune activation, immune reconstitution and the latent HIV reservoir. In this review, we will summarize the current knowledge regarding the pathogenesis of HIV/HCV coinfection, the effects of HCV coinfection on HIV disease progression in the context of ART, the impact of HIV on HCV-associated liver morbidity, and the consequences of DAA-mediated HCV cure on immune reconstitution and HIV reservoir persistence in coinfected patients.

scholarly journals A Rare Case of Cryptococcus gattii Meningitis in Advanced HIV Disease, Sagittal Thrombosis, and Immune Reconstitution Syndrome, Resolved With Isavuconazonium

2020 ◽  
Vol 8 ◽  
pp. 232470962095988
Author(s):  
Jerome Okudo ◽  
Valerie F. Civelli ◽  
Vishal K. Narang ◽  
Royce H. Johnson ◽  
Nadir Khan ◽  
...  
Keyword(s):  
Immune Reconstitution Inflammatory Syndrome ◽  
Immune Reconstitution ◽  
Superior Sagittal Sinus ◽  
Sinus Thrombosis ◽  
Hiv Disease ◽  
Sagittal Sinus ◽  
Advanced Hiv Disease ◽  
Inflammatory Syndrome ◽  
Sagittal Sinus Thrombosis ◽  
Superior Sagittal Sinus Thrombosis

Cryptococcus gattii is a species that has received more recognition in the recent past as distinct from Cryptococcus neoformans. C gattii is known to cause meningeal disease in both immunocompetent and immunosuppressed hosts. Patients may be clinically asymptomatic until immunosuppressive conditions occur such as corticosteroid treatment or an HIV infection. HIV-associated cryptococcal infections are most often due to C neoformans. C gattii is found in a minority. Speciation and subtyping of Cryptococcus are not always accomplished. In many parts of the world, there is no availability for speciation of Cryptococcus. Travel history may provide a clue to the most probable species. This case demonstrates a case of C gattii meningitis with a multiplicity of complications. These include advanced HIV disease secondary to nonadherence, immune reconstitution inflammatory syndrome, and superior sagittal sinus thrombosis. The patient represented diagnostic and therapeutic dilemmas over time. Headache was the primary symptom in cryptococcal meningitis, immune reconstitution inflammatory syndrome, and superior sagittal sinus thrombosis. All are discussed in detail as potential etiologies for the primary disease. Isavuconazonium is a relatively new broad-spectrum antifungal azole that was used as salvage therapy.

An emerging severe leukoencephalopathy: is it due to HIV disease or highly active antiretroviral therapy?

2006 ◽  
Vol 17 (3) ◽  
pp. 205-207 ◽  
Author(s):  
Simon Rackstraw ◽  
Jeanette Meadway ◽  
James Bingham ◽  
Safa Al-Sarraj ◽  
Ian Everall
Keyword(s):  
Viral Load ◽  
Antiretroviral Therapy ◽  
Clinical Response ◽  
Highly Active Antiretroviral Therapy ◽  
Immune Reconstitution ◽  
Undetectable Viral Load ◽  
Hiv Disease ◽  
Good Clinical Response ◽  
Highly Active ◽  
The Brain

We report an individual who had HIV-associated dementia, but a good clinical response to antiretroviral therapy, with a rising CD4 count and undetectable viral load. A severe leukoencephalopathy was noted at postmortem; however, no HIV immunopositive cells were found in the brain, suggesting that this new severe leukoencephalopathy is associated with immune reconstitution.

scholarly journals Does CD4+CD25+foxp3+ cell (Treg) and IL-10 profile determine susceptibility to immune reconstitution inflammatory syndrome (IRIS) in HIV disease?

2008 ◽  
Vol 5 (1) ◽  
pp. 2 ◽  
Author(s):  
Esaki Shankar ◽  
Ramachandran Vignesh ◽  
Vijayakumar Velu ◽  
Kailapuri G Murugavel ◽  
Ramalingam Sekar ◽  
...  
Keyword(s):  
Immune Reconstitution Inflammatory Syndrome ◽  
Immune Reconstitution ◽  
Hiv Disease ◽  
Inflammatory Syndrome

scholarly journals Graves’ disease associated with HIV disease and late immune reconstitution inflammatory syndrome following the initiation of antiretroviral therapy

2021 ◽  
Vol 2021 ◽  
Author(s):  
S Ludgate ◽  
S P Connolly ◽  
D Fennell ◽  
M F Muhamad ◽  
I Welaratne ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Immune Reconstitution Inflammatory Syndrome ◽  
Immune Reconstitution ◽  
Cd4 Count ◽  
Graves Disease ◽  
High Dose ◽  
List Type ◽  
Delayed Presentation ◽  
Hiv Disease ◽  
Inflammatory Syndrome

Summary Both human immunodeficiency virus (HIV) and antiretroviral therapy (ART) are associated with endocrine dysfunction (1). The term 'immune reconstitution inflammatory syndrome' (IRIS) describes an array of inflammatory conditions that occur during the return of cell-mediated immunity following ART. Graves’ disease (GD) occurs rarely as an IRIS following ART. In this study, we describe the case of a 40-year-old Brazilian female who was diagnosed with HIV following admission with cryptococcal meningitis and salmonellosis. At this time, she was also diagnosed with adrenal insufficiency. Her CD4 count at diagnosis was 17 cells/µL which rose to 256 cells/µL over the first 3 months of ART. Her HIV viral load, however, consistently remained detectable. When viral suppression was finally achieved 21 months post diagnosis, an incremental CD4 count of 407 cells/µL over the following 6 months ensued. Subsequently, she was diagnosed with a late IRIS to cryptococcus 32 months following initial ART treatment, which manifested as non-resolving lymphadenitis and resolved with high-dose steroids. Following the initiation of ART for 45 months, she developed symptomatic Graves’ hyperthyroidism. At this time, her CD4 count had risen to 941 cells/µL. She has been rendered euthyroid on carbimazole. This case serves to remind us that GD can occur as an IRIS post ART and typically has a delayed presentation. Learning points Endocrinologists should be aware of the endocrine manifestations of HIV disease, in particular, thyroid pathology. Endocrinologists should be aware that IRIS can occur following the initiation of ART. Thyroid dysfunction can occur post ART of which Graves' disease (GD) is the most common thyroid manifestation. GD as a manifestation of ART-induced IRIS can have a delayed presentation. Infectious disease physicians should be aware of endocrine manifestations associated with HIV and ART.

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