Journal articles on the topic 'AIDS (Disease) – Diagnosis – Asia'
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Sanyaolu, Adekunle, Chuku Okorie, Anjali Kumar, Deja LaMoure, Mourad Rabadi, Jennings Hernandez, and George Omiloli. "Current trends of HIV/AIDS in Asia." South East Asia Journal of Public Health 7, no. 2 (November 28, 2018): 3–11. http://dx.doi.org/10.3329/seajph.v7i2.38850.
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It is very important to recognize the trends in HIV/AIDS in specific areas such as Asia because it is vital to understanding the effectiveness of current approaches towards diagnosis and treatment. It is also very important to understand the risk factors that greatly predispose people in Asia to contracting HIV/AIDS such as lifestyle, culture, and religion. This review extensively analyzes the current trends of HIV/AIDS in India, China, Thailand, Cambodia and Indonesia. Additionally, cultural diversity carries certain social and religious stigmas associated with the disease. These social stigmas also pose as a significant influence on government involvement with regards to the funding of HIV/AIDS awareness, education, prevention, and the protection of human rights. Lack of education about the methods that help people from the disease and mode of transmission remains a significant hindrance in the prevention of a further rise in epidemiological statistics. Moreover, these factors are attributed to the rising incidence or risk of HIV within several populations amongst these countries. This review also analyzes the clinical presentation, epidemiological statistics, and the financial and socioeconomic impacts of HIV/AIDS in India, China, Thailand, Cambodia and Indonesia. Financial burdens and lack of government infrastructure in the healthcare systems are largely responsible for the rapidly rising prevalence of the disease among these populations, along with the inaccessibility to prevention and treatment methods. Furthermore, the scarcity of available antiretroviral and preventative medications is discussed. Lastly, this review explores various methods of diagnosis, treatment and prevention plans that are implemented in modern medicine with respect to HIV/AIDS.South East Asia Journal of Public Health Vol.7(2) 2017: 3-11
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Baker, Jacob, Findra Setianingrum, Retno Wahyuningsih, and David W. Denning. "Mapping histoplasmosis in South East Asia – implications for diagnosis in AIDS." Emerging Microbes & Infections 8, no. 1 (January 1, 2019): 1139–45. http://dx.doi.org/10.1080/22221751.2019.1644539.
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Bath, Rachel E., Lynsey Emmett, Neville Q. Verlander, and Mark Reacher. "Risk factors for late HIV diagnosis in the East of England: evidence from national surveillance data and policy implications." International Journal of STD & AIDS 30, no. 1 (August 31, 2018): 37–44. http://dx.doi.org/10.1177/0956462418793327.
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In 2014, 42% of all HIV diagnoses in the East of England were diagnosed late. Individuals unaware of their HIV status will not benefit from lifesaving and infectious-limiting antiretroviral therapy, and they remain at risk of decreased life expectancy and onward transmission of HIV. We sought to identify risk factors associated with late HIV diagnosis in the East of England to inform future HIV testing and prevention strategies relevant to the local population. Data on all HIV infected individuals aged ≥16 years and diagnosed between 2008 and 2014 in the East of England were obtained from the national HIV and AIDS Reporting System. Late diagnosis was defined as CD4 cell count below 350 cells/mm3 within 91 days of diagnosis. Logistic regression investigated risk factors for late HIV diagnosis. A total of 2469 people were included; 1342 (54%) were late HIV diagnoses. In multivariable analysis risk factors for late diagnosis were: age ≥30 years, originating from WHO regions of South-East Asia or Europe (excluding UK), heterosexual orientation and being diagnosed as an inpatient or by a general practitioner. The odds of late diagnosis significantly reduced every year (OR 0.95, 95% CI 0.90–0.99, p = 0.042). Despite this year-on-year reduction continued high rates suggest future HIV testing and prevention strategies should be informed by local regional epidemiology to allow those at greatest risk to be targeted appropriately.
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Cao, Liang, Da-Liang Chen, Cindy Lee, Che-Man Chan, King-Man Chan, Nongnuch Vanittanakom, Dominic N. C. Tsang, and Kwok-Yung Yuen. "Detection of Specific Antibodies to an Antigenic Mannoprotein for Diagnosis of Penicillium marneffeiPenicilliosis." Journal of Clinical Microbiology 36, no. 10 (1998): 3028–31. http://dx.doi.org/10.1128/jcm.36.10.3028-3031.1998.
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The disseminated and progressive fungal disease Penicillium marneffei penicilliosis is one of the most common infectious diseases in AIDS patients in Southeast Asia. To diagnose systemic penicilliosis, we developed an enzyme-linked immunosorbent assay (ELISA)-based antibody test with Mp1p, a purified recombinant antigenic mannoprotein of P. marneffei. Evaluation of the test with guinea pig sera against P. marneffei and other pathogenic fungi indicated that this assay was specific for P. marneffei. Clinical evaluation revealed that high levels of specific antibody were detected in two immunocompetent penicilliosis patients. Furthermore, approximately 80% (14 of 17) of the documented penicilliosis patients with human immunodeficiency virus tested positive for the specific antibody. No false-positive results were found for serum samples from 90 healthy blood donors, 20 patients with typhoid fever, and 55 patients with tuberculosis, indicating a high specificity of the test. Thus, this ELISA-based test for the detection of anti-Mp1p antibody can be of significant value as a diagnostic for penicilliosis.
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Bhatia, Neha S., Jiin Ying Lim, Carine Bonnard, Jyn-Ling Kuan, Maggie Brett, Heming Wei, Breana Cham, et al. "Singapore Undiagnosed Disease Program: Genomic Analysis aids Diagnosis and Clinical Management." Archives of Disease in Childhood 106, no. 1 (August 20, 2020): 31–37. http://dx.doi.org/10.1136/archdischild-2020-319180.
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ObjectiveUse next-generation sequencing (NGS) technology to improve our diagnostic yield in patients with suspected genetic disorders in the Asian setting.DesignA diagnostic study conducted between 2014 and 2019 (and ongoing) under the Singapore Undiagnosed Disease Program. Date of last analysis was 1 July 2019.SettingInpatient and outpatient genetics service at two large academic centres in Singapore.PatientsInclusion criteria: patients suspected of genetic disorders, based on abnormal antenatal ultrasound, multiple congenital anomalies and developmental delay. Exclusion criteria: patients with known genetic disorders, either after clinical assessment or investigations (such as karyotype or chromosomal microarray).InterventionsUse of NGS technology—whole exome sequencing (WES) or whole genome sequencing (WGS).Main outcome measures(1) Diagnostic yield by sequencing type, (2) diagnostic yield by phenotypical categories, (3) reduction in time to diagnosis and (4) change in clinical outcomes and management.ResultsWe demonstrate a 37.8% diagnostic yield for WES (n=172) and a 33.3% yield for WGS (n=24). The yield was higher when sequencing was conducted on trios (40.2%), as well as for certain phenotypes (neuromuscular, 54%, and skeletal dysplasia, 50%). In addition to aiding genetic counselling in 100% of the families, a positive result led to a change in treatment in 27% of patients.ConclusionGenomic sequencing is an effective method for diagnosing rare disease or previous ‘undiagnosed’ disease. The clinical utility of WES/WGS is seen in the shortened time to diagnosis and the discovery of novel variants. Additionally, reaching a diagnosis significantly impacts families and leads to alteration in management of these patients.
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Dethier, Divya, Natasha Rybak, Priya Hirway, Mariya Bachmaha, Jennifer Carroll, Andriy Sorokolit, Timothy Flanigan, and Maryana Sluzhynska. "The changing face of women living with HIV in western Ukraine." International Journal of STD & AIDS 29, no. 4 (August 3, 2017): 318–23. http://dx.doi.org/10.1177/0956462417724708.
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Ukraine has the second largest HIV epidemic in Eastern Europe/Central Asia. This study characterizes the demographics of HIV-infected women in the Lviv region of western Ukraine, patterns in their clinical presentation, and factors associated with delays in seeking care. A retrospective chart review was conducted of 622 HIV-infected women who registered for HIV treatment at the Lviv AIDS Center between 2008 and 2013. A total of 81.6% of women were infected through heterosexual transmission and the remaining 18.4% through intravenous drug use. Slightly less than half (45.4%) was between 26 and 35 years old. Slightly more than half (56.7%) listed their residence in a city, 22.6% in villages. One-third (30.0%) of all women presented with AIDS, and 37.7% presented with symptomatic conditions. Women diagnosed with HIV during antenatal care experienced a median delay of 34 days between diagnosis and registration, compared to 87.5 days for nonpregnant women tested in the context of intravenous drug use. Overall, HIV-infected women in western Ukraine experience time delays in care, and often present with advanced HIV disease and secondary complications. Linkage to care in a timely manner is a high priority and substantial challenge for women, particularly for intravenous drug users who may face stigma and other additional barriers.
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Lanjewar, Dhaneshwar Namdeorao. "The Spectrum of Clinical and Pathological Manifestations of AIDS in a Consecutive Series of 236 Autopsied Cases in Mumbai, India." Pathology Research International 2011 (May 23, 2011): 1–12. http://dx.doi.org/10.4061/2011/547618.
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The HIV epidemic in the Asian subcontinent has a significant impact on India. The AIDS associated pathology has not been well evaluated in a representative study hence very little is known about the spectrum of HIV/AIDS associated diseases in Indian subcontinent. To determine the important postmortem findings in HIV infected individuals in Mumbai, autopsy study was carried out. The patient population included patients with AIDS who died at the tertiary care hospital over a 20 year period from 1988 to 2007. A total of 236 (182; 77% males and 54; 23%) females) patients with AIDS were autopsied. The main risk factor for HIV transmission was heterosexual contact (226 patients; 96%) and 223/236 (94%) patients died of HIV-related diseases. Tuberculosis was the prime cause of death in 149 (63%) patients, followed by bacterial pneumonia 33 (14%), cryptococcosis 18 (8%), toxoplasmosis of brain 15 (6%), pneumocystis jiroveci (PCJ) 1 (0.5%) and Non-Hodgkin's lymphoma 7 (3%) cases. The major underlying pathologies are either preventable or treatable conditions. There is an urgent need for attention towards the diagnosis, issue of therapy, and care of HIV disease in developing countries. Reducing mortality in patients with AIDS from infections must be highest public health policy in India.
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Ekeng, Bassey E., Kevin Edem, Ikechukwu Amamilo, Zachary Panos, David W. Denning, and Rita O. Oladele. "Histoplasmosis in Children; HIV/AIDS Not a Major Driver." Journal of Fungi 7, no. 7 (June 30, 2021): 530. http://dx.doi.org/10.3390/jof7070530.
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The classification of histoplasmosis as an AIDS-defining illness has largely attributed its occurrence in people to the presence of HIV/AIDS especially in Africa. Prior to the advent of the HIV/AIDS epidemic, many cases of histoplasmosis were documented both in the pediatric and adult population. Our review revealed 1461 reported cases of pediatric histoplasmosis globally in the last eight decades (1939–2021). North America (n = 1231) had the highest number of cases, followed by South America (n = 135), Africa (n = 65), Asia (n = 26) and Europe (n = 4). Histoplasmosis was much more common in the non-HIV pediatric population (n = 1418, 97.1%) compared to the HIV population. The non-HIV factors implicated were, childhood malignancies (n = 207), such as leukemias and lymphomas as well as their treatment, lung diseases (n = 7), environmental exposures and toxins (n = 224), autoimmune diseases (n = 12), organ transplants (n = 12), long-term steroid therapy (n = 3), the use of immunosuppressive drugs such as TNF-alpha inhibitors (n = 7) malnutrition (n = 12), histiocytosis (n = 3), hyperimmunoglobulin M and E syndromes (n = 15, 1.2%), pancytopaenias (n = 26), diabetes mellitus (n = 1) and T-cell deficiency (n = 21). Paediatricians should always consider or rule out a diagnosis of histoplasmosis in children presenting with symptoms suggestive of the above clinical conditions.
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Mukhopadhyay, C., S. Krishna, Vandana KE, K. Saravu, and R. Balasubramaniam. "Tuberculosis or Melioidosis? - Look Twice in Southwestern Coastal India." SAARC Journal of Tuberculosis, Lung Diseases and HIV/AIDS 9, no. 2 (April 23, 2013): 15–18. http://dx.doi.org/10.3126/saarctb.v9i2.7973.
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Melioidosis is known endemic in many Southeast Asian countries, especially Thailand, and in Northern Australia. The disease was long considered under-recognized in India but has now gained the status of emerging infectious disease here. Increasing isolation of the causitive agent B. pseudomallei is encountered in the recent years from this part of western coastal India. We report one such case of pulmonary melioidosis in an elderly patient misdiagnosed as tuberculosis ending fatally. Prompt microbiological diagnosis prevents the unnecessary Anti-TB treatment or prophylaxis. This was also our first of isolation of B. pseudomallei from endotracheal aspirate. SAARC Journal of Tuberculosis, Lung Diseases & HIV/AIDS; 2012; IX(2) 15-18 DOI: http://dx.doi.org/10.3126/saarctb.v9i2.7973
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Bongomin, Kwizera, and Denning. "Getting Histoplasmosis on the Map of International Recommendations for Patients with Advanced HIV Disease." Journal of Fungi 5, no. 3 (September 2, 2019): 80. http://dx.doi.org/10.3390/jof5030080.
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Progressive disseminated histoplasmosis, caused by H. capsulatum, is a life-threatening illness and is an AIDS-defining opportunistic infection. It is neglected, worryingly under-diagnosed, and often misdiagnosed as cancer or tuberculosis with fatal consequences. Globally, over 100,000 cases of disseminated histoplasmosis have been estimated. In 2017, the World Health Organization (WHO) noted that disseminated histoplasmosis is a significant cause of mortality in AIDS patients. Through the rigorous efforts of the Global Action Fund for Fungal Infections (GAFFI) and partners, in 2019, the Histoplasma antigen test was included on the 2nd Edition of the WHO List of Essential Diagnostics. The drugs used in the treatment of histoplasmosis (amphotericin B and itraconazole) are on the WHO Essential Medicine List. The Manaus Declaration on histoplasmosis in the Americas and the Caribbean, where histoplasmosis kills more people with HIV than tuberculosis, advocates for universal access to rapid testing for histoplasmosis and availability of essential drugs for the treatment of histoplasmosis in every country by 2025. Hyperendemic areas are present in the Americas, Caribbean, Southeast Asia, and Latin America. In conclusion, histoplasmosis remains an important clinical and public health problem. To reduce HIV-associated mortality, disseminated histoplasmosis must be addressed through advocacy, increased awareness, and universal access to essential diagnostics and antifungal agents.
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Zhou, J., N. I. Paton, and R. Ditangco. "AIDS-defining illness diagnosed within 90 days after starting highly active antiretroviral therapy among patients from the TREAT Asia HIV Observational Database." International Journal of STD & AIDS 18, no. 7 (July 1, 2007): 446–52. http://dx.doi.org/10.1258/095646207781147283.
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Using data from TREAT Asia HIV Observational Database (TAHOD), this paper aims to assess the rate of, and factors associated with the diagnosis of new AIDS-defining illness (ADI) within 90 days after antiretroviral treatment. Patients starting three or more antiretroviral combinations and having subsequent follow-up were included. New ADI cases were checked for evidence of immune reconstitution syndrome (IRS). Among the 1185 patients included, 75 (6.3%) were diagnosed with a new ADI within 90 days, giving a rate of 26.8/100 person-years, compared with a further 3.6% cumulative incidence of new ADI between 90 days to one year (4.2/100 person-years). Of the 75 patients, 21 were judged as definitive or presumptive IRS, giving a rate of 7.3/100 person-years. Patients with new ADI generally had lower CD4 counts before treatment started (median, 43 cells/μL). Lower CD4 count, lower body mass index and starting treatment in the same year as the first HIV-positive test done were associated with developing a new ADI. The higher rate of new ADI within 90 days may be partly explained by IRS occurring shortly after treatment. Although it is difficult to identify IRS from observational data, it appears that in TAHOD setting IRS was relatively uncommon.
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Shridevi, Kotina, and Talikota Srigouri. "HIV awareness among first year MBBS students in a private medical college, Telangana, India." International Journal Of Community Medicine And Public Health 4, no. 6 (May 22, 2017): 1906. http://dx.doi.org/10.18203/2394-6040.ijcmph20172147.
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Background: Globally, since 1980, 70 million people were infected with HIV virus and 33.3 million people have died of HIV. In Sub-Saharan Africa, largest number of people living with HIV is Asia. In these areas 19 million of the 35 million people living with the virus globally do not know their HIV positive status. The objectives of the study were to know the awareness regarding HIV and its mode of transmission, clinical features and diagnosis of HIV, prevention and vaccine availability of HIV.Methods: Study design: cross sectional study, study area: private medical college, Telangana state, study population- 136 students in the 1st year MBBS. Methodology: The data was collected by a pre designed, pretested and semi structured questionnaire which consisted of, identification data, HIV Awareness, mode of transmission, symptoms and diagnosis, prevention and vaccine availability of HIV. The data was analyzed by using Microsoft Excel.Results: Males and females in the study were 43.38% and 56.6% respectively. Mean age of students was 18.184. 100% of the students heard about HIV, 25% of the students did not know that HIV and AIDS are different stages of the same disease. 98.52% were aware that contaminated needles and syringes as route of transmission, 87.5% were aware about vertical transmission. 93.38% of the students have a correct opinion that avoiding multiple partners’. 80.88% knew that antiretroviral drugs are available. 91.91% knew that the vaccine is not yet available for HIV.Conclusions: There is overall satisfactory level of awareness on routes of transmission and prevention of HIV/AIDS but knowledge regarding symptoms is less. There were several misconceptions regarding route and Prevention of HIV. Very few knew that immediate medical attention will prevent HIV.
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Chandak, Rakhi, Manoj Chandak, Pranali Thakare, Ramhari Sathawane, Swapnil Mohod, Runal Bansod, Pranada Deshmukh, and Zareesh Akhtar. "Trending Breakthroughs in the Advances of Detection of Oral Premalignant and Malignant Lesions - A Review." Journal of Evolution of Medical and Dental Sciences 10, no. 28 (July 12, 2021): 2122–27. http://dx.doi.org/10.14260/jemds/2021/433.
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Oral cancer is the sixth most common malignant tumour, and it is the leading cause of morbidity and mortality due to its capacity to spread and invade. Oral cancer occurs at a different rate in different areas of the world, ranging from 2 to 10 per 100,000 people each year. Oral cancer is prevalent in South Asian nations such as Sri Lanka, India, Pakistan, and Bangladesh. In India, the frequency is 7-17 per 100,000 people each year, with 75,000 - 80,000 new cases per year. Identifying oral cancer in its early stages has a significant impact on survival rates when compared to detecting it later. Despite this, almost half of all diagnosed patients die within five years. A variety of well-established cancer screening programmes have been demonstrated to lower the patient morbidity and mortality dramatically. Regular check-ups, which include a thorough inspection of the whole mouth, are critical for detecting malignant and pre-cancerous problems early on. Unfortunately, early detection of oral precancerous and cancerous lesions has proved difficult due to the lesions' asymptomatic nature, doctors' casual approach to benign lesions, and the fact that 50 % of patients had regional or distant metastases at the time of diagnosis. Oral cancer is one of the most common cancers that leads to defacement and death. Despite recent advancements in therapeutic modalities, the prognosis has not improved. Patient’s mortality rates are positively associated with the point of presentation, with 60 % of people diagnosed with late-stage illness. Early diagnosis is important for oral cancer patient’s survival rate, as it decreases morbidity and mortality. According to the World Health Organization, the bulk of oral cancer patients are diagnosed late in the disease's progression, with a mediocre 5 - year survival rate of 50 %. As a result, careful treatment of oral cancer necessitates early diagnosis and intervention. Surgical biopsy is the gold standard for medical purposes, but it requires clinical assistance. Other screening methods that are simple to use, non-invasive, and expensive are the norms for any test to be accepted as a histopathology choice. The older cancer diagnosis modalities took longer, had more inter-observer bias, and were less descriptive. A standard oral examination with digital palpation is used in traditional techniques of screening for oral possibly malignant illnesses and oral cancers. Conventional inspection has been shown to be a poor discriminator of oral mucosal lesions. A variety of visual aids have been developed to help clinicians spot anomalies in the oral mucosa and in recent years, scientific and clinical developments have aided in the early detection and treatment of this disease. This review reflects on some of the older diagnostic modalities and screening methods for oral cancer diagnosis, as well as some of the recent more sophisticated techniques. KEY WORDS Diagnostic Aids, Oral Cancer, Premalignant Lesions
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Utami, Sri, Anak Agung Sagung Sawitri, Luh Putu Lila Wulandari, I. wayan Gede Artawan Eka Putra, Putu Ayu Swandewi Astuti, Dewa Nyoman Wirawan, Louise Causer, and Bradley Mathers. "Mortality among people living with HIV on antiretroviral treatment in Bali, Indonesia: incidence and predictors." International Journal of STD & AIDS 28, no. 12 (February 15, 2017): 1199–207. http://dx.doi.org/10.1177/0956462417692942.
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Indonesia has the third highest number of people living with HIV/AIDS (PLWH) and the greatest increase in proportion of AIDS-related mortality in the Asia Pacific region between 2005 and 2013. Longitudinal mortality data among PLWH in Indonesia are limited. We conducted a retrospective cohort study from medical records of antiretroviral treatment (ART) recipients attending Badung General Hospital (BGH) and Bali Medica Clinic (BMC) between 2006 and 2014. We explored incidence of mortality by Kaplan–Meier analysis and identified predictors using a Cox proportional hazard model. In total, 575 patients were included in the analysis; the majority were male. The overall mortality rate was 10% per year. Multivariate analysis suggested that being male (adjusted hazard ratio [aHR]: 2.74; 95% confidence interval [CI]: 1.34–5.59), having a lower education (aHR: 2.17; 95%CI: 1.31–3.61), having heterosexual (aHR: 7.40; 95% CI: 2.61–21.00) or injecting drug use (aHR: 13.20; 95% CI: 3.17–55.00) as the likely transmission risk category, starting treatment with low CD4 cell counts (aHR: 3.18; 95% CI: 1.16–8.69), and not having a treatment supervisor (aHR: 4.02; 95% CI: 2.44–6.65) were independent predictors of mortality. The mortality was high, particularly in the first three months after initiating ART. These findings highlight the need to encourage HIV testing and early diagnosis and prompt treatment. Applying aspects of BMCs targeted HIV services model in more generalised services such as BGH may be beneficial. Providing adherence support as part of ART services is key to promoting adherence to ART.
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O'Donovan, James, Misha Verkerk, Niall Winters, Shelly Chadha, and Mahmood F. Bhutta. "The role of community health workers in addressing the global burden of ear disease and hearing loss: a systematic scoping review of the literature." BMJ Global Health 4, no. 2 (March 2019): e001141. http://dx.doi.org/10.1136/bmjgh-2018-001141.
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IntroductionCommunity health workers (CHWs) have the potential to improve access to ear and hearing services for people across low-income or middle-income countries, remote, underserved, or resource-poor areas of the world. We performed a systematic scoping review to identify evidence on how CHWs are currently deployed in the prevention, screening, diagnosis, treatment and management of ear disease and hearing loss; methods to train and support CHWs in this context; and cost-effectiveness of CHWs.MethodsWe performed a systematic search of the literature from September 1978 to 18 March 2018 from 11 major databases and the grey literature.ResultsWe identified 38 original studies that met the inclusion criteria, taking place across South Asia (n=13), Oceania (n=7), North America (n=7), South America (n=6) and Africa (n=5). 23 studies showed CHWs can increase community participation in screening. They can conduct screening using whispered voice tests, noisemakers for neonatal screening, automated audiological tests and otoscopy. Eight studies focused specifically on the evaluation of programmes to train CHWs, and three provided a general programme description. Three studies documented a role of CHWs in the treatment of ear disease or hearing loss, such as performing ear washouts, instillation of topical antibiotics or fitting of hearing aids. Only one study provided an indepth cost-utility analysis regarding the use of CHWs to conduct hearing screening, and no studies commented on the role of CHWs in the prevention of hearing loss.ConclusionCHWs have been employed in diverse ways to address the global burden of ear disease and hearing loss. Future research needs to explore the role of CHWs in preventative strategies, identify optimum methods to train and support CHWs, and explore their cost-effectiveness.
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Osakwe, Nonso, Diane Johnson, Natalie Klein, and Dalia Abdel Azim. "A Rare Case of HHV-8 Associated Hemophagocytic Lymphohistiocytosis in a Stable HIV Patient." Case Reports in Infectious Diseases 2019 (April 28, 2019): 1–3. http://dx.doi.org/10.1155/2019/3297463.
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Background. Hemophagocytic lymphohistiocytosis (HLH) is a rare condition associated with viral infections including HIV. Cases have been reported mainly in advanced HIV/AIDS. This is a rare case that reports HLH associated with human herpes virus-8 (HHV-8) associated multicentric Castleman disease in a stable HIV patient. Case Presentation. A 70-year-old Asian male patient with history of stable HIV on medications with CD 4 cell count above 200 presented with cough and fever and was initially treated for pneumonia as an outpatient. Persisting symptoms prompted presentation to the hospital. The patient was found to have anemia which persisted despite repeated transfusion of packed red cells. A bone marrow biopsy to investigate anemia revealed hemophagocytosis. A CT scan revealed multiple enlarged lymph nodes and hepatosplenomegaly. An excisional lymph node biopsy revealed HHV-8 associated multicentric Castleman disease. The patient deteriorated despite initiation of treatment. Conclusion. HLH can occur at any stage of HIV, rapid diagnosis to identify possible underlying reactive infectious etiology and prompt initiation of treatment is crucial to survival.
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Castillo, Jorge, and Liron Pantanowitz. "HIV-Associated NK/T-Cell Lymphomas: A Review of 93 Cases." Blood 110, no. 11 (November 16, 2007): 3457. http://dx.doi.org/10.1182/blood.v110.11.3457.3457.
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Abstract Introduction: NK/T-cell lymphomas (NKTCL) are being reported with increased frequency in HIV-infected patients in the HAART era. However, there has been no comprehensive review of these emerging HIV-associated lymphomas. We present, to our knowledge, the first comprehensive review of the epidemiology, clinical and pathologic features, therapeutic options, and outcome in HIV-associated NKTCL. Methods: A total of 93 cases of NKTCL in HIV-infected individuals were identified in a literature review using PubMed and cited articles from 1996 until March 2007. Data regarding epidemiology (country), demographics (age, gender), clinical features (presentation, tumor location), HIV status (CD4, AIDS-defining illness, coinfections), lymphoma (WHO/EORTC subtype, immunophenotype, Ann Arbor stage), treatment, and outcome were extracted. Results: Cases were reported worldwide (USA, Europe, South America, Asia), with a 15x increased incidence compared to the general population. Patients were of median age 38 years (range 1–63) at presentation, exhibited a 4:1 male predominance, and had a median CD4 count of 184 cells/mm3. Up to 54% had a prior AIDS-defining illness. The most common clinical findings were lymphadenopathy, B symptoms, erythroderma and pruritus. All subtypes were noted including Peripheral T-cell (n=36), Cutaneous T-cell including Mycosis fungoides (n=25), Anaplastic Large Cell (n=13), Adult T-cell Leukemia/Lymphoma (n=8), NK cell (n=4), and other lymphomas (2 AILD, 2 Enteropathy-associated, 1 PEL, 1 Intravascular). Most expressed CD45RO and CD3 antigens, CD4>CD8, CD30 in a subset (n=23), and EBV was detected in 20 cases (mainly extranodal PTCL, cutaneous ALCL, and NK cells). Most (74%) were extranodal (50% involving skin) and 26% nodal. Staging (60 patients) overall showed stage I (27%), II (3%), III (17%), and IV (53%).There was no standard therapeutic approach, with 46% given one modality, 17% multimodal treatment, and 12% were untreated in reported cases. HAART was rarely used. Death occurred in 55% of patients and median overall survival (83 patients) was 1.1 years from the time of diagnosis. Conclusions: NKTCL afflicted HIV-infected persons are likely to be young males with AIDS who have a CD4 count under 200 cells/mm3 at presentation. They are also prone to present with extranodal disease, skin involvement, and at an advanced stage. Although a standard treatment approach is still required, the prognosis of HIV-associated NKTCL remains poor. The role of HAART needs to be further explored.
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Demir, Tülin, Dilara Yıldıran, and Selçuk Kılıç. "Yeni HIV Tanı Algoritmasına Geçiş Sürecinde Ulusal HIV-AIDS Referans Merkezi’nin Deneyimi: Line-İmmunoassay Test ve Bio-Rad Geenius™ HIV-1/2 Antikor Ayırt Edici Hızlı Doğrulama Testleri Karşılaştırmalı Analizi." Mikrobiyoloji Bulteni 55, no. 1 (January 27, 2021): 17–29. http://dx.doi.org/10.5578/mb.20028.
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Shortly after the first detection of human immundeficiency virus (HIV) infection in USA in 1981, the number of cases have increased gradually from all around the world. Turkey’s high capacity for tourism and the unique geographic location extending between Europe and Asia, provides convenience for the passage of individuals across the countries and sexually transmitted infections including HIV, as well. According to the official data of the Ministry of Health; there are 25809 HIV positive and 1958 AIDS cases as of November 30, 2020, after the epidemic started in 1985 in Turkey. Despite the decrease in the number of newly detected HIV cases as a result of serious measures taken for the transmission of infection worldwide, the increase in the number of cases still continues in our country. Shortening the reporting period and starting treatment as soon as possible in the diagnosis of infection is critical for the control of the epidemic. For this purpose, Centers for Disease Control and Prevention (CDC) published a new test algorithm in 2010, which suggested the use of the Geenius™ HIV ½ supplemental assay test instead of western blot tests, which have been used for many years to verify HIV screening test positivity. In this study, we aimed to report the experience of the National HIV-Acquiner Immundeficiency Syndrome (AIDS) and Viral Hepatitis Reference Laboratories of Turkey in the first year of transition to the new HIV algorithm and to evaluate the diagnostic performance of Geenius™ HIV ½ and line immunassay (LIA) s. A total of 2090 anti-HIV positive patient sera sent to National HIV-AIDS and Viral Hepatitis Reference Laboratories of Turkey, Ankara for HIV confirmation were included in the study. All samples were retested with a fourth-generation enzyme linked immunosorbent assay (ELISA) test (VIDAS® HIV-1/2 Duo Ultra assay, BioMerieux, France) followed by the confirmatory tests; Geenius™ HIV 1/2 confirmatory assay (BioRad, Redmond, WA) and Line-immunoassay (INNO-LIA HIV ½ Score, Fujirebio, Belgium). Indeterminate/negative test results or discrepancies between the confirmatory tests were resolved with HIV-1 RNA reverse transcriptase polymerase chain reaction (RT-PCR) (artus HI Virus-1 RT-PCR, Qiagen, Germany) test and in-house HIV-2 RNA and proviral DNA PCR. The sensitivity, specificity, and the agreement of the each assay were compared. Cohen’s Kappa analysis was used for the evaluation of the agreement between the tests. According to the new algorithm which recommended Geenius™ test besides HIV-1 RNA test, 1707 (81.7%) HIV-1 positive samples were identified. Of these samples; 95.9% and 95.02% were identified as HIV-1 positive by GeeniusTM and INNO-LIA, respectively. However, 2.5% of the positive samples were negative with Geenius™ and 3.5% with INNO-LIA. One and a half percentage (1.5%) of these samples were detected with Geenius™ and 1.4% with INNO-LIA as indeterminant. When all the positive samples determined with ELISA were evaluated; it was detected that,1.3% were indeterminate by Geenius™ test and 2.4% by the INNO-LIA test. When the INNO-LIA test was regarded as the gold standard method; sensitivity, specificity, positive predictive and negative predictive values of the Geenius™ test were as follows; 99.7%, 96.1%, 98.9%, and 99.1%. The agreement between INNO-LIA and Geenius™ tests was found to be 98.95% (κ= 0.969; very good). When the Geenius™ and HIV-1 PCR tests were evaluated together for the confirmation; the sensitivities of Geenius™ and INNO-LIA tests were 99.8% and 98.3%, specificities were 89.8% and 85.3%, respectively. Slight positive bands were detected in the gp36 or gp140 bands, the HIV-2 specific envelope proteins, were detected in seven samples, However, the positivity disappeared after the dilution of the samples and it was accepted as false positivite reaction due to the absence of HIV-2 RNA and proviral DNA in these samples. In conclusion; we concluded that Geenius™ and INNO-LIA tests have a perfect agreement in HIV diagnosis and due to the rapid and reliable results provided for the HIV test protocol, Geenius™ test can be used safely as an alternative to the immunoblot tests. HIV-1 RNA testing must be performed in all HIV confirmation centers in order to detect acute HIV cases in the fast and early period which are the main reason for the updates in HIV diagnosis.
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Wisniewski, Piotr, Evan C. Ewers, and Ryan C. Maves. "1179. Septic shock in Coccidioides immitis Infection." Open Forum Infectious Diseases 7, Supplement_1 (October 1, 2020): S614—S615. http://dx.doi.org/10.1093/ofid/ofaa439.1365.
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Abstract Background Coccidiodes can cause severe or disseminated disease in a minority of patients, but coccidioidomycosis resulting in septic shock is rare. We describe a case of fulminant C. immitis infection whose diagnosis was delayed by a markedly elevated serum procalcitonin. We review the published literature of coccidioidomycosis complicated by septic shock. Case Report A 74-year-old man presented with cough, fever, and three weeks of progressive decline. He was febrile at 39.1°C, tachycardic, and tachypneic with crackles in the left lung; an initial procalcitonin (PCT) was 1.73 ng/mL. Broad-spectrum antibacterials were administered. His condition worsened on the 2nd day, requiring vasopressors, endotracheal intubation, and hemodialysis. PCT rose to > 400 ng/mL. Respiratory cultures grew fungi consistent with Coccidioides. Liposomal amphotericin B (AmB) was initiated. His shock progressed, and he died on hospital day 6. Methods We performed a MEDLINE and Google Scholar search using the terms “coccidioidomycosis”, “Coccidioides”, “sepsis”, and “septic shock”. Indexed articles and conference abstracts were included if the patient had confirmed coccidioidomycosis and vasopressor-dependent shock with no alternate cause. Data on age, sex, ethnicity, comorbidities, antifungal therapy, and outcome were tabulated. Results We identified 18 reports describing 31 patients with vasopressor-dependent septic shock due to Coccidioides since 1993 (table 1). Of these cases, 23/31 (74.2%) died. Of those with reported race/ethnicity, 20/23 were Latino, 4/23 of African descent, 5/23 Asian-Pacific Islander, and 3/23 white. 27/31 (87.1%) were male. All but two were adults (median age 51.5 years). 21/31 (67.7%) had reported comorbid conditions. 20/31 patients (64.5%) and all of the survivors received AmB-based therapy. Table 1 - Published cases of coccidioidomycosis complicated by septic shock. All ages are in years. Abbreviations: HIV/AIDS = human immunodeficiency virus/acquired immunodeficiency syndrome; CAD = coronary artery disease; COPD = chronic obstructive pulmonary disease; ESRD = End stage renal disease; SLE = Systemic Lupus Erythematosus; APC = recombinant human activated protein C (drotrecogin alfa). Conclusion Coccidioidomycosis is an elusive diagnosis in critically-ill patients due to its rarity, the lack of rapid diagnostics, and its propensity to mimic other infections. Mortality is high, potentially due to delays in diagnosis. The marked elevation in PCT has not been previously noted in coccidioidomycosis and may further confound diagnosis. Improved diagnostics and the rapid institution of AmB may reduce mortality in patients with coccidioidal sepsis. Disclosures All Authors: No reported disclosures
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Vanittanakom, Nongnuch, Chester R. Cooper, Matthew C. Fisher, and Thira Sirisanthana. "Penicillium marneffei Infection and Recent Advances in the Epidemiology and Molecular Biology Aspects." Clinical Microbiology Reviews 19, no. 1 (January 2006): 95–110. http://dx.doi.org/10.1128/cmr.19.1.95-110.2006.
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SUMMARY Penicillium marneffei infection is an important emerging public health problem, especially among patients infected with human immunodeficiency virus in the areas of endemicity in southeast Asia, India, and China. Within these regions, P. marneffei infection is regarded as an AIDS-defining illness, and the severity of the disease depends on the immunological status of the infected individual. Early diagnosis by serologic and molecular assay-based methods have been developed and are proving to be important in diagnosing infection. The occurrence of natural reservoirs and the molecular epidemiology of P. marneffei have been studied; however, the natural history and mode of transmission of the organism remain unclear. Soil exposure, especially during the rainy season, has been suggested to be a critical risk factor. Using a highly discriminatory molecular technique, multilocus microsatellite typing, to characterize this fungus, several isolates from bamboo rats and humans were shown to share identical multilocus genotypes. These data suggest either that transmission of P. marneffei may occur from rodents to humans or that rodents and humans are coinfected from common environmental sources. These putative natural cycles of P. marneffei infection need further investigation. Studies on the fungal genetics of P. marneffei have been focused on the characterization of genetic determinants that may play important roles in asexual development, mycelial-to-yeast phase transition, and the expression of antigenic determinants. Molecular studies have identified several genes involved in germination, hyphal development, conidiogenesis, and yeast cell polarity. A number of functionally important genes, such as the malate synthase- and catalase-peroxidase protein-encoding genes, have been identified as being upregulated in the yeast phase. Future investigations pertaining to the roles of these genes in host-fungus interactions may provide the key knowledge to understanding the pathogenicity of P. marneffei.
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Upadhyay Banskota, Shristi, Andres E. Mendez-Hernandez, Hafeez Shaka, Prasanth Lingamaneni, Binav Baral, Garima Pudasaini, and Maryam Zia. "Adult Hemophagocytic Lymphohistiocytosis(HLH): Experience of an Urban, Public Hospital over Two Decades." Blood 136, Supplement 1 (November 5, 2020): 19. http://dx.doi.org/10.1182/blood-2020-141947.
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Introduction:HLH is a rare, life-threatening disorder, characterized by hyperstimulation of immune system leading to systemic inflammation and multi-organ failure. It is categorized as primary and secondary HLH. Secondary HLH usually affects adolescents and adults. It results from acquired immune dysregulation secondary to a number of etiologies, including infections, malignancy, and autoimmune diseases. Owing to less epidemiological data, adult HLH is thought to be underdiagnosed, making a true assessment difficult, however, some observational data suggest 40% of HLH cases occurs in adults. Disease presentation includes fever, cytopenias, organomegaly, liver function anomalies, elevated ferritin levels, and/or demonstration of macrophage activation in hematopoietic organs. In 2014, Fardet et al proposed the H-Score, a novel diagnostic score derived from 162 adult patients with HLH.We aim to report a retrospective review of Adult HLH in an urban safety-net hospital over the course of two decades along with predictive value of H-score in our patient population. Methods:We conducted a retrospective review of patients diagnosed with HLH at Cook County Health, Chicago between January 2000 and January 2019 after approval by the Institutional Review Board. Patients were identified from electronic records using ICD-10 codes D76.1, D76.2, and ICD-9 code 288.4. Patients under 18 years were excluded. MS excel was used for data collection and further descriptive statistics were calculated with frequencies and percentage. Results:After initial review, 12 confirmed and eligible cases were included in the study. Mean age at diagnosis of adult HLH at our center was 37, with male predominance(7 males, 4 females, and 1 female transgender). 5 were African-American, 6 were Hispanic, and 1 was Asian. Most common presentation was fever, seen in 10 out of 12 cases, along with variety of symptoms like fatigue, sore throat and jaundice.4 out of 12 patients (33%) had HIV/AIDS, with CD4 counts between 79 to 180. 3 were already receiving anti-retroviral therapy at the time of HLH diagnosis, while 1 was diagnosed with HIV/AIDS at the time of HLH diagnosis. Etiologic spectrum mainly included infectious (4 HIV and 3 EBV) and autoimmune (2 systemic lupus erythematous, 1 cold immune hemolytic anemia with immune thrombocytopenic purpura) causes. 1 patient had an underlying malignancy (diffuse large B-cell lymphoma). Etiology was not established in 1patient with no familial associations found in subsequent genetic evaluation. All patients had elevated liver enzymes. The mean ferritin level in our cohort was 19,198 ng/ml. Leucopenia was seen among most cases, 11 out of 12. The 1 patient noted to have a high white cell count was actually receiving corticosteroid therapy for cold immune hemolytic anemia. Most common bone marrow findings were hemophagocytosis (9 patients) and hypocellularity (7 patients). 2 had hypercelullar marrow and 1 had normal marrow. Genetic testing was performed in 4 patients; chromosomal abnormalities were not observed in any. Specific lab parameters in our cohort as included in HLH-2004 criteria is shown in Table 1. Calculated H scores in our cohort is shown in table 2. 11 patients fall under high probability for HLH. Conclusion:The most widely used diagnostic criteria for HLH is the HLH-2004 diagnostic criteria, derived from pediatric HLH study. It is often extrapolated for use in adults. There are several limitations to the HLH-2004 diagnostic criteria. sIL2r and NK function testing is not available in all centers, and many of the manifestations of HLH in adults are not included in the criteria. When using H score, a cutoff value of 169, corresponds to sensitivity of 93% and specificity of 86% in diagnosing HLH. In our study, 11 out of 12 patients (91.66) scored higher than 169, which is highly suggestive of HLH. The remaining 1 patient with H score of only 118, however, met the diagnosis of HLH by HLH-2004 criteria (score: 5/8). Therefore, although our study population was small, results of our study were in favor of using H-score as an appropriate diagnostic tool in adult-onset HLH, which also helps mitigate the restrictions of HLH-2004 criteria in adult population. Disclosures No relevant conflicts of interest to declare.
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Gantumur, Gantuya, Munkhbayar Rentsenbat, Sarangerel Jambal, and Byambasuren Dagvajantsan. "Electrophysiological features of Guillain-Barré syndrome in Mongolian adult patients." Neuroscience Research Notes 4, no. 3Suppl (August 26, 2021): 1–7. http://dx.doi.org/10.31117/neuroscirn.v4i3suppl.98.
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The Guillain-Barré syndrome (GBS) is a rare but severe disorder that affects peripheral nerves and is classified into several subtypes based on clinical presentation and electrophysiological abnormalities. Incidence and predominant subtypes of GBS differ geographically. The diagnosis is made upon clinical features and confirmed by nerve conduction studies (NCSs) which can differentiate subtypes such as demyelinated and axonal. Demyelinating subtypes in Europe and North America and axonal subtypes in Asia are predominant. Electrophysiological subtypes have not been determined in Mongolia. Therefore, we aimed to determine common electrophysiological subtypes of Guillain-Barré syndrome in Mongolia. In our study, 75 patients referred to Reflex Neurological Clinic between 2016 and 2019 were retrospectively reviewed. After excluding the cases by the criteria, patients were classified as demyelinating, axonal, normal and equivocal subtypes based on Hadden criteria. We compared the electrophysiological features of axonal and demyelinating subtypes. SPSS-23 was used for statistical analysis. The results are expressed in averages (standard deviations) and percentages (numbers). The difference between the mean and the group of variables was calculated using the T-test and the Chi-square test. Patients were 44% male (33), and the mean age was 46.4±15.1. There was no significant association between seasonal factors and electrophysiological subtypes. Among 75 patients with Guillain-Barré syndrome, a nerve conduction study was performed in the first week on 36% of patients, 33.3% in the 2nd week, and others in the 3rd-4th week after symptom onset. Electrophysiology subtypes were classified as demyelinating (65.3%), axonal (20%), within the normal range (5.4%) and equivocal (9.3%) based on Hadden criteria. The absence of F-waves on electrophysiological examination was higher in patients within 14 days of the disease onset, whereas non-sensory changes were higher in patients after 14 days. We conclude that acute inflammatory demyelinating neuropathy (AIDP) was the most frequent subtype of GBS in Mongolia.
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Green, Kimberly, Heather-Marie A. Schmidt, Andrew J. Vallely, Lei Zhang, Angela Kelly-Hanku, Rena Janamnuaysook, and Jason J. Ong. "Ending AIDS in the Asia–Pacific region by 2030: are we on track? Policy, epidemiological and intervention insights." Sexual Health 18, no. 1 (2021): 1. http://dx.doi.org/10.1071/sh20226.
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The Asia–Pacific region is home to nearly 6 million people living with HIV. Across the region, key populations – men who have sex with men, transgender women, people who inject drugs, sex workers, prisoners – and their sexual partners make up the majority of those living with HIV. While significant progress has been made in the past 5 years towards UNAIDS’s 90–90–90 goals (90% of people with HIV diagnosed, 90% on antiretroviral therapy, 90% virologically suppressed), significant gaps remain. The papers in this Special Issue address important questions: are we on track to end the AIDS epidemic in the Asia–Pacific region? And can countries in this region reach the new UNAIDS targets for 2030?
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Mönkemüller, Klaus E., and C. Mel Wilcox. "Diagnosis and Treatment of Colonic Disease in AIDS." Gastrointestinal Endoscopy Clinics of North America 8, no. 4 (October 1998): 889–911. http://dx.doi.org/10.1016/s1052-5157(18)30238-1.
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Wong, Stephenie Y. N., and K. F. Wong. "Penicillium marneffei Infection in AIDS." Pathology Research International 2011 (February 10, 2011): 1–10. http://dx.doi.org/10.4061/2011/764293.
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Penicillium marneffei is a dimorphic fungus which is endemic in Southeast Asia. It is an opportunistic pathogen which has emerged to become an AIDS-defining illness in the endemic areas. Early diagnosis with prompt initiation of treatment is crucial for its management. Prompt diagnosis can often be established through careful cytological and histological examination of clinical specimens although microbiological culture remains the gold standard for its diagnosis. Standard antifungal treatment for AIDS patients with penicilliosis is well established. Highly active antiretroviral therapy should be started early together with the antifungal treatment. Special attention should be paid to potential drug interaction between antiretroviral and antifungal treatments. Secondary prophylaxis may be discontinued with a low risk of relapse of the infection once the immune dysfunction has improved.
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Cheong, I., P. J. Flegg, R. P. Brettle, P. D. Welsby, S. M. Burns, B. Dhillon, C. L. S. Leen, and J. A. Gray. "Cytomegalovirus Disease in AIDS: The Edinburgh Experience." International Journal of STD & AIDS 3, no. 5 (September 1992): 324–28. http://dx.doi.org/10.1177/095646249200300504.
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Retrospective analysis of medical records of 557 HIV positive patients (including 113 with AIDS) revealed 17 patients with an antemortem clinical diagnosis of cytomegalovirus (CMV) disease. This group comprised 7 injection drug users (2 male and 5 female) and 10 homosexual men. Males were significantly older than females, and homosexual men were significantly older than drug users at the time of diagnosis of CMV. All 17 patients had evidence of retinitis, and 6 also had evidence of extraocular disease. CMV retinitis was the AIDS defining diagnosis in two patients, and the attack rate of CMV in all AIDS patients progressively increased with time, with a 3-year CMV-free survival of 57%. Fifteen patients with CMV disease had evidence of previous CMV infection (CMV IgG positive), with 7 also having a positive CMV IgM and 10 a positive viral culture. The mean CD4+ lymphocyte count at diagnosis of CMV was 17 cells/mm3, compared with 68 cells/mm3 at diagnosis of AIDS. Therapy was unsatisfactory, often being complicated by marrow suppression. Relapse occurred in 11 patients after initial improvement but despite this only 3 patients died with severe visual impairment. The mean survival after a diagnosis of CMV was 10.5 months. This study confirms that disease caused by CMV is usually a late manifestation of AIDS, and the increasing prevalence among patients with AIDS implies that, the longer the survival, the greater the risk of disease. Frequent fundoscopy in HIV positive patients is of paramount importance particularly in patients who have a CD4+ lymphocyte count of less than 100 cells/mm3.
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van Griensven, Frits, Jan Willem de Lind van Wijngaarden, Patrick Castillo Eustaquio, Stephen Wignall, Iskandar Azwa, Vanessa Veronese, Laurent Ferradini, Nittaya Phanuphak, and Stephen Mills. "The continuing HIV epidemic among men who have sex with men and transgender women in the ASEAN region: implications for HIV policy and service programming." Sexual Health 18, no. 1 (2021): 21. http://dx.doi.org/10.1071/sh20134.
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Men who have sex with men (MSM) in Western urban areas have seen substantive decreases in new diagnoses of HIV infection. This paper explores whether such declines are present among MSM and transgender women (TGW) in Southeast Asia and discusses implications for HIV policies and programming. A scoping review was conducted of scientific publications and selected documents regarding the spread of HIV infection among MSM and TGW in major urban centres of the Association of Southeast Asian Nations (ASEAN) region. Continued high HIV prevalence and incidence among MSM are found in integrated behavioural and biological surveillance (IBBS) and research studies. HIV prevalence among MSM under IBBS decreased only in Bangkok from 28.6% in 2014 to 10.3% in 2018, whereas it was increasing in Kuala Lumpur, Ho Chi Minh City, Vientiane, and Phnom Penh. HIV/AIDS case reports regarding new HIV infection diagnoses among MSM have started to decrease in Singapore since 2011 and have been plateauing in Metropolitan Manila since 2017. Where data were available, it was found that HIV prevalence among TGW was high and if IBBS was conducted, it was increasing. HIV prevalence among TGW under IBBS in Jakarta had risen to 34.0% (2015) and 14.0% (2019) in Phnom Penh. These findings suggest that most ASEAN member states have so far failed to effectively implement and scale-up scientifically proven biomedical HIV prevention measures and counter stigma and discrimination that impedes access to appropriate HIV prevention and treatment services for MSM and TGW.
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Bonacini, Maurizio, and Loren A. Laine. "Esophageal Disease in Patients with AIDS: Diagnosis and Treatment." Gastrointestinal Endoscopy Clinics of North America 8, no. 4 (October 1998): 811–23. http://dx.doi.org/10.1016/s1052-5157(18)30233-2.
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Li, Yue, and Jia-ming Qian. "The Challenge of Inflammatory Bowel Disease Diagnosis in Asia." Inflammatory Intestinal Diseases 1, no. 4 (2016): 159–64. http://dx.doi.org/10.1159/000448384.
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Foran, James M., Laura A. McClure, Christina A. Clarke, and Theresa H. M. Keegan. "Impact of Socioeconomic Status & Race/Ethnicity On Survival in Diffuse Large B-Cell Lymphoma (DLBCL): A Population-Based Study." Blood 114, no. 22 (November 20, 2009): 1954. http://dx.doi.org/10.1182/blood.v114.22.1954.1954.
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Abstract Abstract 1954 Poster Board I-977 Introduction: Despite advances in treatment and a well-characterized prognostic index, significant heterogeneity remains in DLBCL survival. Preliminary data suggest a potential survival disparity based on race/ethnicity or socioeconomic status (SES). To evaluate the impact of these and other variables on survival we performed an analysis in the ethnically diverse population-based California Cancer Registry (CCR). We utilized Neighborhood SES, an index of 7 census measures of education, income, occupation & cost of living, based on the residential census-block group at diagnosis. Each census-block group comprises ∼1500 residents. Neighborhood SES has been shown to be significantly associated with survival after Follicular Lymphoma (JCO 27:3044, 2009). Methods: All pts with DLBCL (ICD-O-3 codes 9680 & 9684) diagnosed from Jan 1988 to Dec 2007 and reported to CCR were included in the analysis, including n=16,892 diagnosed from 1988-2000, and n=11,916 from 2001-2007 (total study pop'n =28,808). HIV/AIDS pts were excluded, as were n=63 with Mediastinal LBCL & n=10 with primary effusion lymphoma. The mean age was 63 yrs, and the cohort was 53% male. Between time periods, there was a relative increase in Hispanic pts [15.4% (1988-2000) to 20.8% (2001-2007), p<0.001], and a 4% increase in advanced stage from 42% (1988-2000) to 46% (2001-2007) (p<0.001). Neighborhood SES was stratified into quintiles from lowest (SES-1) to highest (SES-5), the pt distribution was: SES-1, 14%; SES-2, 18%; SES-3, 21%; SES-4, 23%; and SES-5, 24%. To evaluate the impact of prognostic factors (particularly diagnosis period, SES, and race/ethnicity) on overall survival (OS) & disease-specific survival (DSS) we used Cox proportional hazards regression to calculate hazard ratios (HR) for death with 95% CI's. Multivariate regression models included variables significant at p<0.15 in univariate models or with a priori hypotheses for inclusion. Results are presented by stage at diagnosis [Localized/Regional (LocReg) vs. Advanced (ADV)]. Results: There was a significant improvement in OS in patients diagnosed after 2001 for both LocReg (HR 0.87, 95%CI 0.82-0.91, p<0.001) and ADV stage (HR 0.69, 95%CI 0.66-0.72, p<0.001), which correlates with the introduction of rituximab into therapy for DLBCL. As expected, age >60 years was associated with a significantly worse OS for LocReg (HR 3.06, 95%CI 2.90-3.24) and ADV stage (2.02, 95%CI 1.93-2.12). Females also had significantly better OS compared with males (Loc-Reg - HR 0.90, 95%CI 0.86-0.94; ADV - HR 0.89, 95%CI 0.85-0.93). There was no significant impact of race/ethnicity on survival with the exception of non-Hispanic Asian/Pacific Islanders (NH A/PI) with ADV stage, for whom OS was significantly inferior compared with whites (HR 1.18, 95%CI 1.09-1.27, p<0.001). Compared with the highest quintile (SES-5), there was a significant effect of lower neighborhood SES on OS and DSS (see Table). Conclusion: There has been a significant improvement in survival after DLBCL since 2001, but patients in the lowest SES-1 quintile have a 34% higher risk of death from any cause and 20% higher risk for death from lymphoma than those in the highest SES-5. In this model, race/ethnicity did not have a significant impact on survival with the exception of NH A/PI with ADV stage. Studies to understand and address these socioeconomic disparities are urgently required in order to extend the improvements in DLBCL survival more effectively. Disclosures: Foran: Genentech: Honoraria, Research Funding.
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Gottlieb, M. S., R. Detels, and J. L. Fahey. "T-cell phenotyping in the diagnosis and management of AIDS and AIDS-related disease." Annales de l'Institut Pasteur / Immunologie 138, no. 2 (January 1987): 235–43. http://dx.doi.org/10.1016/s0769-2625(87)80074-0.
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Guccion, J. "Aids/Opportunistic Infections." Microscopy and Microanalysis 5, S2 (August 1999): 1096–97. http://dx.doi.org/10.1017/s1431927600018808.
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Use of TEM in the diagnosis of opportunistic infections in AIDS patients is indicated in three situations. First, when an opportunistic infection is suspected, but an infectious agent is not visible in tissue sections studied by light microscopy (LM). This situation is illustrated by the following case.(1) A 33-year-old man with AIDS presented with fever, nightsweats, generalized lymphadenopathy, and a 30 lb. weight loss. An inguinal lymph node biopsy was performed. There was no consensus as to the diagnosis among the pathologists who studied H&E sections of the biopsy. An obscure infectious disease, a B-cell lymphoma with amyloid stroma, and possibly Hodgkin's disease were the major considerations. TEM study revealed unexpected clusters of small, pleomorphic, coccobacillary bacteria in vascular walls typical of cat scratch disease. These bacteria were later further identified by polymerase chain reaction as belonging to the genus Rochalimaea(now Bartonella), an important cause of cat scratch disease.
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DOUGAN, SARAH, LARA J. C. PAYNE, ALISON E. BROWN, BARRY G. EVANS, and O. NOEL GILL. "Past it? HIV and older people in England, Wales and Northern Ireland." Epidemiology and Infection 132, no. 6 (November 16, 2004): 1151–60. http://dx.doi.org/10.1017/s0950268804002961.
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The majority of those infected and affected by HIV are younger adults. The ability of highly active antiretroviral therapies (HAART) to extend survival means that those infected when younger may reach older age, and future increases in numbers of older individuals living with HIV in England, Wales and Northern Ireland (E,W&NI) are expected. Evidence that older individuals engage in risky sexual behaviours suggests potential for HIV transmission. Data from national HIV/AIDS surveillance systems were reviewed (1997–2001). An older individual is defined as aged 45 years or over. Between 1997 and 2001, 2290 older individuals were diagnosed with HIV; 361 in 1997, rising to 648 in 2001. Heterosexual acquisition accounted for 1073 (47%) infections; 662 were male. Where reported, 666 (65%) older heterosexuals were probably infected in Africa, 144 (14%) in the United Kingdom and 113 (11%) in Asia. There were 1020 (45%) new diagnoses acquired homosexually; white (92%), infected in the United Kingdom (78%). Numbers of older individuals accessing HIV-related services more than doubled between 1997 (2488) and 2001 (5175). In 2001, 2270 (53%) were London residents. Between 1997 and 2001, among HIV-infected older individuals attending genitourinary medicine (GUM) clinics, the proportions previously undiagnosed were 60% and 82% in heterosexual males and females respectively, and for men who have sex with men (MSM), 42%. Numbers of older individuals newly diagnosed with HIV have increased in recent years. The increase in numbers of older individuals accessing HIV-related services were in excess of younger adults. A significant proportion of older HIV-infected female heterosexuals and MSM were undiagnosed. Awareness must be raised among clinicians, and an ‘aged response’ to HIV is required.
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Uchiyama, Shinichiro, Masako Yamazaki, Tatsuya Ishikawa, Koji Yamaguchi, and Takakazu Kawamata. "Diagnosis and Management of Moyamoya Disease." Case Reports in Neurology 12, Suppl. 1 (December 14, 2020): 137–42. http://dx.doi.org/10.1159/000505967.
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Moyamoya disease is an uncommon vascular disease, which causes obstruction and stenosis of arteries of the circle of Willis, and preferentially affects children and young adults. This disease is seen across the world, but is more common in East Asia. It may cause hemorrhagic or ischemic stroke, or transient ischemic attack. If symptoms or cerebral blood flow become worse, revascularization surgery is recommended. We present 2 cases of moyamoya disease who underwent bypass surgery. We also discuss the epidemiology, pathology, genomics, and symptomatology as well as diagnosis, and management of moyamoya disease.
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Rukmini, Ni Ketut Prami, Nia Kurniati, and Dadi Suyoko. "Pendekatan Diagnosis dan Tata Laksana Acquired Immunodeficiency Syndrome (AIDS) pada Anak: laporan kasus." Sari Pediatri 9, no. 2 (November 30, 2016): 101. http://dx.doi.org/10.14238/sp9.2.2007.101-11.
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Acquired immune deficiency syndrome (AIDS) pertama kali dilaporkan pada awal tahun 1980-an,merupakan infeksi human immunodeficiency virus (HIV). Penyakit ini telah menjadi pandemi yang meluassecara cepat khususnya di Afrika dan Asia. Pada tahun 2005 terdapat 40,3 juta orang di seluruh duniahidup dengan HIV/AIDS, termasuk diantaranya 4,9 juta infeksi baru dan 3,1 juta tercatat meninggaldunia.1-3 Selama tahun 2005, diperkirakan 700.000 anak di seluruh dunia baru terinfeksi HIV. Sekitar90% memperoleh infeksi dari ibunya selama kehamilan, kelahiran atau menyusui.4,5 Di Rumah SakitCipto Mangunkusumo (RSCM) Jakarta, prevalens anak yang terinfeksi HIV 46 anak sepanjang tahun2005. Manifestasi klinis HIV/AIDS ini bermacam-macam sesuai dengan derajat penyakit yang telah terjadi.5Dijumpai beberapa sistem klasifikasi untuk mendiagnosis infeksi HIV pada anak sehingga diharapkandapat menjadi pedoman tata laksana pasien HIV/AIDS.5-9 Tujuan laporan kasus ini untuk mendiskusikantentang anak yang dicurigai terinfeksi HIV, bagaimana menegakkan diagnosis, dan tata laksana AIDSpada anak
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Aye, Kyi-Phyu, Sabai Phyu, Thet-Su Mon, and Thwe-Zin Soe. "#21: Pattern and Outcome of Opportunistic Infections in Hospitalized HIV-Infected Patients in Specialist Hospital Waibargi, Myanmar." Journal of the Pediatric Infectious Diseases Society 10, Supplement_1 (March 1, 2021): S19. http://dx.doi.org/10.1093/jpids/piaa170.059.
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Abstract Background Human immunodeficiency virus/ acquired immune deficiency syndrome (HIV/AIDS) constitutes a major global public health concern. There are an estimated 237,000 people living with HIV in Myanmar with prevalence of 0.57%, the fourth highest in South East Asia region. Specialist Hospital Waibargi (SHW) is one of the 3 main hospitals in Myanmar for HIV care and support with a cohort of nearly 2000 patients. This study was performed in SHW to evaluate the pattern and hospital outcome of various opportunistic infections (OI) in HIV-infected patients which are the principal cause of morbidity and mortality. Methods We conducted a retrospective records review study involving 370 HIV-infected patients hospitalized from October 2018 to September 2019 (1-year period). Disseminated tuberculosis (TB) was defined by concurrent involvement in at least two noncontiguous organs or miliary TB in a chest radiograph. Suggested Mycobacterium avium complex (MAC) was defined by the presence of prolonged fever not responding to anti-TB treatment and presence of generalized lymphadenopathy, hepatosplenomegaly, and pancytopenia in patients with CD4 <50 cells/mm3. Invasive fungal infection was defined by the presence of diffuse infiltrates on chest radiograph and/or generalized lymphadenopathy, hepatosplenomegaly, and pancytopenia with a response to antifungal therapy. Frequencies of individual OI were expressed as percentages. Results Among 370 patients, antiretroviral therapy (ART) was initiated in 150 patients during admission, 153 patients were already on ART (first-line/second-line/third-line/ default and restart patients), 67 were about to be initiated at a follow-up visit and 9 were defaulters. The mean age was 38.2 ± 11 years, 224 male and 146 female patients were admitted (ratio 1.5:1). Mean CD4 is 111 cells/mm3 (range 4–627 cells/mm3). In total, 322 patients (87%) had CD4 <350 cells/mm3. A total of 823 OI occurred in 370 patients. One hundred and twenty-nine patients had ≥ 2 OI. Among 823 episodes, pulmonary TB accounted 32.8% (270 patients) with 13% confirmed cases including 12 multi-drug-resistant cases. Extrapulmonary TB was 22% including 48 TB meningitis cases. Disseminated TB was found in 15.3%. The rest were sepsis (19.6%), acute gastroenteritis (4%), cryptococcal meningitis/cryptococcaemia (3%), Pneumocystis jiroveci pneumonia (PCP) (3.2%), skin fungal infection (4%), invasive fungal infection (4%), esophageal candidiasis (2.3%), Cytomegalovirus retinitis (0.6%), suggested MAC (1.7%), cerebral toxoplasmosis (0.7%), progressive multifocal leukoencephalopathy (0.8%), encephalitis (0.7%), Herpes zoster infection (0.6%). Eighty-six hospitalized patients died with a mortality rate of 23.2% mostly due to disseminated TB or fungal infection, PCP, sepsis, cryptococcal meningitis, and immune reconstitution inflammatory syndrome. The mean duration of hospitalization was 14 ± 11 days. Sixteen children (age 12–22 years) with CD4 <350 cells/mm3 were included, half were infected congenitally and mortality was 50% mostly due to disseminated TB and sepsis. Conclusion Even in the test and treat era of ART, most HIV-infected patients in the study were late presenters with advanced disease. It highlights the importance of increasing testing awareness in the community and eliminating mother to child transmission. TB was the commonest OI among HIV-infected patients and early TB diagnosis, anti-TB treatment, good adherence, and latent TB prophylaxis are the major tools to improve HIV/TB-related morbidity and mortality.
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Ismail, R. "Sexually transmitted disease (STD) and acquired immunodeficiency syndrome (AIDS) in South East Asia." Clinics in Dermatology 17, no. 2 (March 4, 1999): 127–35. http://dx.doi.org/10.1016/s0738-081x(99)00005-x.
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Zhou, Yanli, Lantao Liu, Yuanqiang Hao, and Maotian Xu. "Detection of Aβ Monomers and Oligomers: Early Diagnosis of Alzheimer's Disease." Chemistry - An Asian Journal 11, no. 6 (February 4, 2016): 805–17. http://dx.doi.org/10.1002/asia.201501355.
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ZAYERI, F., E. TALEBI GHANE, and N. BORUMANDNIA. "Assessing the trend of HIV/AIDS mortality rate in Asia and North Africa: an application of latent growth models." Epidemiology and Infection 144, no. 3 (July 6, 2015): 548–55. http://dx.doi.org/10.1017/s0950268815001351.
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SUMMARYOver the last 30 years, HIV/AIDS has emerged as a major global health challenge. This study evaluates the change of HIV/AIDS mortality rates in Asian and North African countries from 1990 to 2010 using the Global Burden of Disease (GBD) study. HIV/AIDS mortality rates were derived from the GBD database from 1990 to 2010, for 52 countries in Asia and North Africa. First, a Latent Growth Model was employed to assess the change in AIDS mortality rate over time in six different regions of Asia, and also the change in AIDS mortality rate over time for males and females in Asia and North Africa. Finally, Latent Growth Mixture Models (LGMMs) were applied to identify distinct groups in which countries within each group have similar trends over time. Our results showed that increase in mortality rate over time for males is about three times greater than for females. The highest and lowest trend of AIDS mortality rates were observed in South-East Asia and high-income Asia-Pacific regions, respectively. The LGMM allocated most countries in the South and South-East region into two classes with the highest trend of AIDS mortality rates. Although the HIV/AIDS mortality rates are decreasing in some countries and clusters, the general trend in the Asian continent is upwards. Therefore, it is necessary to provide programmes to achieve the goal of access to HIV prevention measures, treatment, care, and support for high-risk groups, especially in countries with a higher trend of AIDS mortality rates.
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Vrabec, Tamara R. "Advances in the diagnosis and management of AIDS-related eye disease." Current Opinion in Ophthalmology 9, no. 6 (December 1998): 93–99. http://dx.doi.org/10.1097/00055735-199812000-00017.
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Cerezo, Lizardo, Marcelino Alvarez, and George Price. "Electron microscopic diagnosis of cerebral toxoplasmosis." Journal of Neurosurgery 63, no. 3 (September 1985): 470–72. http://dx.doi.org/10.3171/jns.1985.63.3.0470.
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✓ Rapid and specific diagnosis of infections involving patients with acquired immunodeficiency syndrome (AIDS) is imperative. Toxoplasmosis is one of the most frequent causes of central nervous system disease in these patients. The authors present a case of cerebral toxoplasmosis in an AIDS patient, diagnosed by electron microscopy of brain biopsy tissue using rapid techniques.
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Johanson, John F. "Diagnosis and Management of AIDS-related Diarrhea." Canadian Journal of Gastroenterology 10, no. 7 (1996): 461–68. http://dx.doi.org/10.1155/1996/739845.
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The spectrum of illness associated with the acquired immunodeficiency syndrome (AIDS) has been increasing since the initial description in 1981. While virtually all organ systems may be affected, the gastrointestinal tract appears to be a major target. Diarrhea is the most common symptom, affecting up to half of all AIDS patients during the course of their disease. Although diarrhea occurs frequently, its optimal management remains controversial. An extensive evaluation including stool studies and endoscopic biopsies of both the colon and small intestine has been widely recommended to identify all potential pathogenic organisms. An alternative approach is a more limited evaluation consisting of stool and blood cultures followed by symptomatic treatment with antidiarrheal agents if no specific organisms are identified. The clinical presentation of the most common opportunistic pathogens are reviewed, including several recently discovered organisms. Recommendations for treatment are followed by a brief discussion of management strategies used to care for patients with AIDS-related diarrhea.
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Martin, Stephen K., and Lillian M. Range. "Extenuating Circumstances in Perceptions of Suicide: Disease Diagnosis (Aids, Cancer), Pain Level, and Life Expectancy." OMEGA - Journal of Death and Dying 22, no. 3 (May 1991): 187–97. http://dx.doi.org/10.2190/cx7q-lq1y-bg6k-8xkf.
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If a person is terminally ill, people are more tolerant of the suicide. To see if illness type, pain level, and life expectancy affected reactions toward a terminal illness suicide, 160 undergraduates completed community support, social interaction, and suicide scales about Pat, who had either AIDS or cancer, a lot or a little pain, and six months or two years to live. A 2 (Diagnosis) × 2 (Pain Level) × 2 (Life Expectancy) MANOVA yielded significant main effects for diagnosis and pain level, a trend for life expectancy, and no interactions. Follow-up ANOVAs indicated more social stigma associated with AIDS and a lot of pain, but less social stigma associated with AIDS and a lot of pain suicides. Increased education about AIDS may help alleviate the social stigma associated with the disease and diminish tolerance towards AIDS-related suicides.
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Maclean, Hunter, and Baljean Dhillon. "Cytomegalovirus Retinitis: Diagnosis and Treatment." International Journal of STD & AIDS 4, no. 6 (November 1993): 322–25. http://dx.doi.org/10.1177/095646249300400603.
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Cytomegalovirus (CMV) is a non-pathogenic organism in the immunocompetent, but is a major cause of morbidity and mortality amongst patients with AIDS, and the retina is the commonest site of infection1. If left untreated, patients with CMVR will develop disease in their second eye and ultimately become blind2. However, with correct diagnosis and treatment useful vision can be maintained in the majority of cases. Fifteen to 20% of patients with AIDS will contract cytomegalovirus retinitis (CMVR)3−7 and this may be the AIDS-defining diagnosis though more commonly it occurs months after the diagnosis of AIDS. Given the increasing number of HIV positive patients and their longer survival, it is likely that CMVR will become an increasingly prevalent condition. In these patients loss of sight from CMVR has devastating consequences in terms of loss of independence and quality of life and therefore ophthalmologists and physicians should be aware of the presenting characteristics of CMVR, be familiar with therapy and its complications, and be able to recognize relapsing infection.
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Bishwajit, Ghose, Seydou Ide, and Sharmistha Ghosh. "Social Determinants of Infectious Diseases in South Asia." International Scholarly Research Notices 2014 (October 30, 2014): 1–10. http://dx.doi.org/10.1155/2014/135243.
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South Asian countries have developed infectious disease control programs such as routine immunization, vaccination, and the provision of essential drugs which are operating nationwide in cooperation with many local and foreign NGOs. Most South Asian countries have a relatively low prevalence of HIV/AIDS until now, but issues like poverty, food insecurity, illiteracy, poor sanitation, and social stigma around AIDS are widespread and are creating formidable challenges to prevention of further spread of this epidemic. Besides that, resurgence of tuberculosis along with the emergence of the drug resistant (MDR-TB and XDRTB) strains and the coepidemic of TB and HIV are posing ever-growing threats to the underdeveloped healthcare infrastructure. The countries are undergoing an epidemiological transition where the disease burden is gradually shifting to noncommunicable diseases, but the infectious diseases still account for almost half of the total disease burden. Despite this huge burden of infectious diseases in South Asia, which is second only to Africa, there is yet any study on the social determinants of infectious diseases in a local context. This paper examines various issues surrounding the social determinants of infectious diseases in South Asian countries with a special reference to HIV and tuberculosis. And, by doing so, it attempts to provide a framework for formulating more efficient prevention and intervention strategies for the future.
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Coker, R. J., and D. M. Mitchell. "The Role of Bronchoscopy in Patients with HIV Disease." International Journal of STD & AIDS 5, no. 3 (May 1994): 172–76. http://dx.doi.org/10.1177/095646249400500303.
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Pulmonary involvement is a frequent feature of patients infected with the human immunodeficiency virus (HIV). Pneumocystis carinii pneumonia (PCP) is still the commonest AIDS defining diagnosis despite the advent of effective prophylaxis and antiretroviral treatment. Other pulmonary manifestations of AIDS, including tuberculosis, may pose a greater problem in the future. The clinical manifestations of HIV-disease are many and varied, and changing as the disease is modified by therapeutic interventions. With specific and increasingly effective treatments the need for definitive diagnosis is obvious. Fibreoptic bronchoscopy is a well established tool for the diagnosis of HIV-related pulmonary complications. This article aims to give an account on the use of bronchoscopy in a unit providing care for many HIV seropositive patients.
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Thornton, S., M. Troop, A. P. Burgess, J. Button, R. Goodall, R. Flynn, B. G. Gazzard, J. Catalán, and P. J. Easterbrook. "The relationship of psychological variables and disease progression among long-term HIV-infected men." International Journal of STD & AIDS 11, no. 11 (November 1, 2000): 734–42. http://dx.doi.org/10.1258/0956462001915165.
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This study investigated the contribution of psychological factors to disease progression among long-term HIV-1 infected gay men. Participants completed self-report measures including coping strategies, life events, social support, personality and psychological morbidity and were followed clinically for up to 30 months. Cox proportional hazards survival analyses were carried out to CD4 < 200 × 106/l and AIDS-related complex (ARC) or AIDS diagnosis controlling for viral load, antiretroviral drug use and CD4 count. Only acceptance coping was a significant predictor of time to ARC or AIDS diagnosis: the risk of ARC or AIDS was almost 5 times greater for those scoring within the lowest tertile compared with those scoring in the highest tertile (HR = 4.7, 95% CI 1.8-12.3).
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Dlamini, Zodwa, Mzwandile Mbele, Tshepiso J. Makhafola, Rodney Hull, and Rahaba Marima. "HIV-Associated Cancer Biomarkers: A Requirement for Early Diagnosis." International Journal of Molecular Sciences 22, no. 15 (July 29, 2021): 8127. http://dx.doi.org/10.3390/ijms22158127.
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Globally, HIV/AIDS and cancer are increasingly public health problems and continue to exist as comorbidities. The sub-Saharan African region has the largest number of HIV infections. Malignancies previously associated with HIV/AIDS, also known as the AIDS-defining cancers (ADCs) have been documented to decrease, while the non-AIDS defining cancer (NADCs) are on the rise. On the other hand, cancer is a highly heterogeneous disease and precision oncology as the most effective cancer therapy is gaining attraction. Among HIV-infected individuals, the increased risk for developing cancer is due to the immune system of the patient being suppressed, frequent coinfection with oncogenic viruses and an increase in risky behavior such as poor lifestyle. The core of personalised medicine for cancer depends on the discovery and the development of biomarkers. Biomarkers are specific and highly sensitive markers that reveal information that aid in leading to the diagnosis, prognosis and therapy of the disease. This review focuses mainly on the risk assessment, diagnostic, prognostic and therapeutic role of various cancer biomarkers in HIV-positive patients. A careful selection of sensitive and specific HIV-associated cancer biomarkers is required to identify patients at most risk of tumour development, thus improving the diagnosis and prognosis of the disease.
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Chen, Can, and Yanni Xiao. "Modeling Saturated Diagnosis and Vaccination in Reducing HIV/AIDS Infection." Abstract and Applied Analysis 2014 (2014): 1–12. http://dx.doi.org/10.1155/2014/414383.
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A mathematical model is proposed to consider the effects of saturated diagnosis and vaccination on HIV/AIDS infection. By employing center manifold theory, we prove that there exists a backward bifurcation which suggests that the disease cannot be eradicated even if the basic reproduction number is less than unity. Global stability of the disease-free equilibrium is investigated for appropriate conditions. When the basic reproduction number is greater than unity, the system is uniformly persistent. The proposed model is applied to describe HIV infection among injecting drug users (IDUs) in Yunnan province, China. Numerical studies indicate that new cases and prevalence are sensitive to transmission rate, vaccination rate, and vaccine efficacy. The findings suggest that increasing vaccination rate and vaccine efficacy and enhancing interventions like reducing share injectors can greatly reduce the transmission of HIV among IDUs in Yunnan province, China.
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Antunes, Apio Claudio Martins, Felipe Martins de Lima Cecchini, Fernando von Bock Bolli, Patricia Polanczyk de Oliveira, Ricardo Gurgel Rebouças, Thais Lampert Monte, and Daniele Fricke. "Cerebral trypanosomiasis and AIDS." Arquivos de Neuro-Psiquiatria 60, no. 3B (September 2002): 730–33. http://dx.doi.org/10.1590/s0004-282x2002000500009.
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A 36 year-old black female, complaining of headache of one month's duration presented with nausea, vomiting, somnolence, short memory problems, loss of weight, and no fever history. Smoker, intravenous drugs abuser, promiscuous lifestyle. Physical examination: left homonimous hemianopsia, left hemiparesis, no papilledema, diffuse hyperreflexia, slowness of movements. Brain CT scan: tumor-like lesion in the splenium of the corpus calosum, measuring 3.5 x 1.4 cm, with heterogeneous enhancing pattern, sugesting a primary CNS tumor. Due to the possibility of CNS infection, a lumbar puncture disclosed an opening pressure of 380 mmH(2)0; 11 white cells (lymphocytes); glucose 18 mg/dl (serum glucose 73 mg/dl); proteins 139 mg/dl; presence of Trypanosoma parasites. Serum Elisa-HIV tests turned out to be positive. Treatment with benznidazole dramatically improved clinical and radiographic picture, but the patient died 6 weeks later because of respiratory failure. T. cruzi infection of the CNS is a rare disease, but we have an increasing number of cases in HIV immunecompromised patients. Diagnosis by direct observation of CSF is uncommon, and most of the cases are diagnosed by pathological examination. It is a highly lethal disease, even when properly diagnosed and treated. This article intends to include cerebral trypanosomiasis in the differential diagnosis of intracranial space-occupying lesions, especially in immunecompromised patients from endemic regions.