Progress in the Treatment of HIV-Associated Lymphoma When Combined With the Antiretroviral Therapies

With the wide use of combination antiretroviral therapy (cART), the life expectancy of HIV-infected individuals drastically improved. However, HIV infection and HIV-associated cancers were the most common causes of death in the HIV-infected populations. The HIV-associated cancers are divided into acquired immune deficiency syndrome (AIDS)-defining and non-AIDS-defining cancers based on the incidence among the HIV-infected patients. Among HIV-associated cancers, acquired immune deficiency syndrome-related lymphoma (ARL) is still the most common condition and the leading cause of HIV/AIDS-related deaths. Diffuse large B-cell lymphoma (DLBCL) and Burkitt’s lymphoma (BL) are the most common subtypes of the ARL. Although Hodgkin’s lymphoma (HL) is not considered as an AIDS-defining cancer, incidence of HL in HIV-infected individuals is higher than the general population. The review summarizes the new progress in the treatment of HIV-associated lymphoma.

A case of Pneumocystis jirovecii pneumonia in a patient with acquired immune deficiency syndrome who showed eosinophilia and an increased serum TARC/CCL17 level

Pneumocystis jirovecii pneumonia (PCP) in patients with acquired immune deficiency syndrome (AIDS) shows eosinophilic pneumonia like condition. The detailed mechanisms how AIDS-associated PCP causes eosinophilic pneumonia has not been elucidated, but it has been suggested that beta-D-glucan, a major component of Pneumocystis jirovecii, and T helper type 2 immunity may be involved in the mechanism of eosinophilia in the lung. We experienced the case who developed an eosinophilic pneumonia-like condition in a patient with AIDS-associated PCP, whose clinical course indicated the importance of TARC/CCL17 but not IL-4 and IL-5 as involved in eosinophilia caused by HIV and Pneumocystis jirovecii infection.

Pengaruh Pemberian Konseling Apoteker pada Pasien HIV-AIDS Di Poliklinik Rawat Jalan RS Bhayangkara TK I R. Said Sukanto

HIV-AIDS (Human Immunodeficiency Virus-Acquired Immune Deficiency Syndrome) merupakan suatu penyakit yang terus berkembang dan menjadi masalah global yang melanda dunia. HIV (Human Immunodeficiency Virus) adalah sejenis virus yang menyerang/menginfeksi limfosit yang menyebabkan turunnya kekebalan tubuh manusia. AIDS (Acquired Immune Deficiency Syndrome) adalah sekumpulan gejala penyakit yang timbul karena turunnya kekebalan yang disebabkan infeksi oleh HIV. Pengidap HIV memerlukan pengobatan dengan ARV (Antiretrovirus) untuk menurunkan jumlah virus HIV di dalam tubuh agar tidak masuk ke dalam stadium AIDS dan untuk mencegah terjadinya infeksi oportunistik dengan berbagai komplikasinya, dalam terapi pengobatan pasien. Tujuan penelitian ini yaitu untuk memperoleh gambaran karakterisitik (umur, jenis kelamin, pekerjaan, pendidikan, stadium penyakit) menganalisis pengaruh pemberian konseling Apoteker terhadap aspek pengetahuan, kepatuhan, kualitas hidup pasien dan efektivitas terapi ARV pada mengetahui pengaruh kepatuhan pasien dalam ART terhadap peningkatan kualitas hidup pasien HIV-AIDS di RS. Bhayangkara TK I R. Said Sukanto. Penelitian ini menggunakan metode quasi-eksperimental yang dilakukan secara prospektif. Penelitian ini dilakukan pada pasien HIV yang berobat di klinik rawat jalan RS Bhayangkara Tk I R. Said Sukanto. Pembagian kelompok kontrol dan kelompok intervensi menggunakan rumus sampling sederhana. Pengambilan data dan observasi dilakukan selama 6 (enam bulan) dari bulan Oktober 2019-Maret 2020. Aspek pengetahuan dan kualitas hidup diambil dengan menggunakan kuesioner, aspek kepatuhan diambil melalui obervasi data kunjungan pasien dan sisa obat sedangkan efektifitas terapi ARV diambil berdasarkan pemeriksaan CD4 pasien. Aspek pengetahuan diambil pada kunjungan pertama dan kedua, aspek kepatuhan diambil data tiap bulan, sedangkan aspek kualitas hidup dan efektifitas terapi diambil awal kunjungan dan 6 bulan kemudian. Hasil dari penelitian ini berdasarkan demografi kategori jenis kelamin yang paling dominan yaitu laki-laki sebanyak 46 responden (76,76%). Kategori usia yang paling dominan yaitu dengan rentang usia 30 tahun – 39 tahun sebanyak 29 responden (48,33%). Kategori Pendidikan yang paling dominan yaitu kategori SMA sebanyak 31 (51,67%). Status merital yang paling dominan yaitu kelompok menikah dengan total 34 (56,67%). Kepatuhan dalam terapi ODHA mempunyai pengaruh terhadap kualitas hidup pasien HIV-AIDS dengan nilai korelasi hasil uji Chi Sqaure 0,933 sebesar 0.373 > p value 0.01.

The tetraspanin TSPAN5 regulates AMPARs exocytosis by interacting with the AP-4 complex

Intracellular trafficking of AMPA receptors is a tightly regulated process which involves several adaptor proteins, and is crucial for the activity of excitatory synapses in both basal conditions and during synaptic plasticity. We found that, in rat hippocampal neurons, an intracellular pool of the tetraspanin TSPAN5 specifically promotes exocytosis of newly synthesised GluA2-containing AMPA receptors without affecting their internalisation. TSPAN5 mediates this function by interacting with AP-4 and Stargazin and possibly using recycling endosomes as a delivery route. This work highlights TSPAN5 as a new adaptor regulating AMPA receptor trafficking. In addition, it provides a possible mechanism for the intellectual disability symptoms that occur in AP-4 deficiency syndrome.

Factors Associated with Knowledge, Attitudes, and Prevention towards HIV/AIDS among Adults 15–49 Years in Mizoram, North East India: A Cross-Sectional Study

Despite a campaign of effective educational interventions targeting knowledge, attitudes, and prevention, Human Immunodeficiency-Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) continues to be a significant public health issue in India, with Mizoram reporting the highest HIV/AIDS cases in 2018–2019. In this study, we extracted Mizoram state from the National Family Health Survey Fourth Series (NFHS-4) 2015–2016 datasets and investigated factors associated with respondents’ knowledge, attitudes, and prevention towards HIV/AIDS. The sample included 3555 adults aged 15–49 years residing in Mizoram, North-east India. Respondents who reported having ever heard of HIV/AIDS was 98%. Multivariate analysis indicated that the probability of having inadequate knowledge of HIV/AIDS was higher among those with no schooling, who were illiterate, of non-Christian faiths, belonging to backward tribes or caste, from poor households, and those who lived in rural areas, not exposed to media. The odds of mother-to-child transmission (PMTCT) of HIV/AIDS transmission was high among females (AOR = 3.12, 95% CI 2.34–4.16), respondents aged 35–39 years (AOR = 1.74, 95% CI 1.05–2.87) and those belonging to other backward class. The HIV/AIDS knowledge of respondents was found to be encouraging as the majority (98%) were considered to have a good level of understanding of the condition. An educational intervention to reduce the number of adults 15–49 years infected with HIV/AIDS in Mizoram should target those from low socioeconomic groups, those from non-Christian religions, and those from other backward classes.

Provocation Testing and Therapeutic Response in a Newly Described Channelopathy: RyR2 Calcium Release Deficiency Syndrome

Background: A novel familial arrhythmia syndrome, RyR2 calcium release deficiency syndrome (CRDS), has recently been described. We evaluated a large and well characterized family to assess provocation testing, risk factor stratification and response to therapy in CRDS. Methods: We present a family with multiple unheralded sudden cardiac deaths and aborted cardiac arrests, primarily in children and young adults, with no clear phenotype on standard clinical testing. Results: Genetic analysis, including whole genome sequencing, firmly established that a missense mutation in RYR2 , Ala4142Thr, was the underlying cause of disease in the family. Functional study of the variant in a cell model showed RyR2 loss-of-function, indicating that the family was affected by CRDS. EPS (Electrophysiological Study) was undertaken in 9 subjects known to carry the mutation, including a survivor of aborted sudden cardiac death, and the effects of flecainide alone and in combination with metoprolol were tested. There was a clear gradation in inducibility of nonsustained and sustained ventricular arrhythmia between subjects at EPS, with the survivor of aborted sudden cardiac death being the most inducible subject. Administration of flecainide substantially reduced arrhythmia inducibility in this subject and abolished arrhythmia in all others. Finally, the effects of additional metoprolol were tested; it increased inducibility in 4/9 subjects. Conclusions: The Ala4142Thr mutation of RYR2 causes the novel heritable arrhythmia syndrome CRDS, which is characterized by familial sudden death in the absence of prior symptoms or a recognizable phenotype on ambulatory monitoring or exercise stress testing. We increase the experience of a specific EPS protocol in human subjects and show that it is helpful in establishing the clinical status of gene carriers, with potential utility for risk stratification. Our data provide evidence that flecainide is protective in human subjects with CRDS, consistent with the effect previously shown in a mouse model.

Commentary to the article “Multiple hormonal and metabolic deficiency syndrome predicts outcome in heart failure: the T.O.S.CA. Registry”, Antonio Cittadini et al. Eur J Prev Cardiol. 2021

: Chronic heart failure represents a relevant concern for public health. The endocrine system is heavily involved in the induction and progression of chronic heart failure. Among endocrine dysfunction, the most relevant alterations are related to the growth hormone-insulin like growth factor 1 axis, serum testosterone, dehydroepiandrosterone sulfate, triiodothyronine levels, insulin resistance, and type 2 diabetes mellitus. It is currently debated whether these changes might be simple adaptive mechanisms or, instead, they may deteriorate myocardial pump function over time. Medical management of patients exhibiting one or more hormonal deficiencies or metabolic disorders, including insulin resistance and diabetes mellitus, may have a therapeutic role.