“My baby has a fever”

HIV infection should be considered in any infant with recurrent illness, developmental delay, or failure to thrive who is high risk, that is, born to a mother with HIV who did not receive intrapartum or antepartum antiretroviral therapy, mothers who received only intrapartum antiretroviral therapy, mothers who received antiretroviral therapy but did not experience virologic suppression at the time of delivery, or mothers who had HIV seroconversion during pregnancy. In these patients, Pneumocystis jirovecii pneumonia prophylaxis should be considered starting at 4–6 weeks of age, and PJP should be considered in the differential diagnosis of infants with HIV with hypoxia and respiratory distress. Diagnosis of HIV infection is made using HIV-1 RNA or HIV DNA polymerase chain reaction testing rather than HIV antibody testing because of the presence of maternal antibodies in this age. There are unique issues related to adherence and the treatment of HIV in growing and immunologically immature children.

Clinical Characteristics of a Case Series of Ocular Syphilis With 3 Cases Requiring Multiple Vitrectomies After Late Diagnosis

Purpose: This work describes the characteristics and unique features of ocular syphilis. Methods: Ten serologically proven cases of ocular syphilis were retrospectively analyzed. Results: Eighteen eyes of 10 patients were affected. Nine of 10 patients were male and the mean age was 58 years (range, 36-81 years). HIV antibody testing was positive in 3 patients (30%). Five cases were first diagnosed by an ophthalmologist. One patient presented with a syphilitic rash. The most common ocular findings were panuveitis (n = 6) and cystoid macular edema (n = 4). Ocular involvement was unilateral in 2 cases and bilateral in 8. Best-corrected visual acuity improved in 13 of 18 eyes (72%) after treatment. Three cases developed recurrent retinal detachments that required repair with silicone oil. Conclusions: Most cases were HIV negative. Syphilitic uveitis can be the initial presentation of syphilis without classic systemic manifestation. Ophthalmologists play an important role in the diagnosis and treatment of syphilis.

High HIV incidence among young black men who have sex with men: constructing a retrospective cohort from a community health programme

ObjectivesWe sought to calculate HIV incidence in a retrospective cohort of young (13–29 years old) black men who have sex with men (YBMSM) accessing repeated HIV-antibody testing in a mid-size city in the USA.MethodsWe aggregated site-specific HIV-antibody testing results from the project's inception among YBMSM who received an initial negative result and accessed at least one additional HIV-antibody test. From these data, we assessed number of seroconversions and person-years and calculated HIV incidence using a mid-P exact test to estimate 95% CIs.ResultsFive seroconversions were documented over 42.3 person-years (the mean age at first onsite test: 19.7 years), resulting in an HIV incidence rate of 11.8% (95% CI 4.3% to 26.2%). The mean age at seroconversion was 20.4 (±3.0) years.ConclusionsEven in mid-size cities with low HIV prevalence rates in the general population, HIV incidence among YBMSM may be high. Community-based HIV-antibody testing organisations serving YBMSM should be encouraged and trained to track repeated HIV testing and calculate HIV incidence rates. Increased resources should be deployed to develop and encourage regular HIV testing in community health sites serving YBMSM.

Adaptação e validação para português da HIV Antibody Testing Attitude Scale

Resumo Objetivo Adaptar culturalmente e validar uma versão em Português Europeu da HIV Antibody Testing Attitude Scale. Métodos Estudo referido a investigação metodológica, para adaptação e validação de instrumento de medida atitudinal. Realizou-se a tradução, retrotradução. Seguiu-se pré-teste. Amostra de 317 sujeitos que pertencendo à comunidade académica na qualidade de estudantes e funcionários docentes e não docentes que foram abordados no campus. Foram observados os princípios éticos. Resultados Realizaram-se três ensaios de análise fatorial de componentes principais a cinco, quatro e três fatores. Redundou numa solução a três fatores que que explica 50,82% da variância. Na análise da correlação inter-itens observaram-se valores entre -0,018 e 0,749. A consistência interna revela coeficientes de alfa de Cronbach de 0,860 no global e entre 0,865 e 0,659 nos três fatores. Conclusão A versão do instrumento mostra propriedades psicométricas que permitem a sua aplicação em países lusófonos.