Journal of Antivirals & Antiretrovirals最新文献

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A Recombinase Polymerase Amplification Lateral Flow Dipstick for Field Diagnosis of Bovine Leukemia Virus Infection and its Effectiveness Compared to iiPCR. and ELISA 牛白血病病毒感染现场诊断的重组酶聚合酶扩增侧流试纸及其与iiPCR的比较和ELISA
Journal of Antivirals & Antiretrovirals Pub Date : 2018-01-01 DOI: 10.4172/1948-5964.1000178
Po-An Tu, J. Shiu, F. Lai, Yi-Hsuan Chen, J. Shiau, V. Pang, Pei-Hwa Wang
{"title":"A Recombinase Polymerase Amplification Lateral Flow Dipstick for Field Diagnosis of Bovine Leukemia Virus Infection and its Effectiveness Compared to iiPCR. and ELISA","authors":"Po-An Tu, J. Shiu, F. Lai, Yi-Hsuan Chen, J. Shiau, V. Pang, Pei-Hwa Wang","doi":"10.4172/1948-5964.1000178","DOIUrl":"https://doi.org/10.4172/1948-5964.1000178","url":null,"abstract":"For better control and eradicate enzootic bovine leukosis (EBL) in Taiwan, a more sensitive but also convenient method for detecting proviral bovine leukemia virus (BLV) DNA is required. The retrovirus BLV establishes a persistent infection that can result in reduced milk production and reduced survival rates, causing substantial economic losses in the dairy industry. BLV replicates by integrating its proviral DNA into the host genome; therefore, the detection of proviral DNA is recommended for identifying BLV carriers to help establish BLV-free herds. The integration of recombinase polymerase amplification (RPA) and lateral flow dipstick (LFD) in this study for on-site BLV detection. The optimal amplification condition for the RPA was 30 min at 37 ̊C and followed by 5 min of LFD at room temperature. The sensitivity of this assay of 400 pg of total DNA and 10 copies of plasmid DNA. The method showed no cross-reaction with other tested viruses, including bovine foamy virus, bovine immunodeficiency virus, and caprine arthritis-encephalitis virus. For the detection of BLV field samples, the RPA-LFD was parallel tested with serological enzyme-linked immunosorbent assay (ELISA) and hydrolysis probe insulated isothermal PCR (iiPCR). The RPA-LFD assay exhibited a better sensitivity, with 83.5% of the 200 samples collected in Taiwan testing positive. A significant difference in the positive rates was found between the iiPCR and RPA-LFD methods, indicating that the RPA-LFD method for detecting BLV nucleic acid is sensitive at a lower limit. This RPA-LFD protocol can serve as an alternative tool to ELISA for the preliminary screening of BLV for its simplicity and portability, and is suitable for both laboratory and field application.","PeriodicalId":15020,"journal":{"name":"Journal of Antivirals & Antiretrovirals","volume":"13 1","pages":"35-42"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80584317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Influenza-Associated Hemophagocytic Syndrome in Adults: Case Report and Review 成人流感相关的噬血细胞综合征:病例报告和回顾
Journal of Antivirals & Antiretrovirals Pub Date : 2018-01-01 DOI: 10.4172/1948-5964.1000172
Hernando Trujillo, A. Lalueza, M. Corral-Blanco, D. Folgueira, C. Gonzalez-Gomez, C. Lumbreras
{"title":"Influenza-Associated Hemophagocytic Syndrome in Adults: Case Report and Review","authors":"Hernando Trujillo, A. Lalueza, M. Corral-Blanco, D. Folgueira, C. Gonzalez-Gomez, C. Lumbreras","doi":"10.4172/1948-5964.1000172","DOIUrl":"https://doi.org/10.4172/1948-5964.1000172","url":null,"abstract":"Hemophagocytic syndrome (HPS) is a rare, but increasingly reported disease characterized by severe dysfunction of cytotoxic T cells and NK cells, often associated with poor outcome. It has been related to multiple processes including a large variety of infections. Even though viral infections have been described as triggers of HPS, influenza associated hemophagocytic syndrome in adults has been rarely reported. Here, we present a case of an 85 year-old man with essential thrombocytemia who developed HPS triggered by influenza A H1N1 infection and a review of the literature with special emphasis on the importance of a prompt diagnosis and an early treatment to achieve a more favourable outcome. Hemophagocytic syndrome secondary to influenza virus infection is a rare condition with high mortality that should be suspected in patients with an aggressive disease course. Early diagnosis and initiation of antiviral treatment and in some cases immunomodulatory therapy are crucial for the prognosis.","PeriodicalId":15020,"journal":{"name":"Journal of Antivirals & Antiretrovirals","volume":"104 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88106840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 4
Possible Mechanisms Underlying Epipharyngeal Abrasive Therapy (EAT) with ZnCl2 Solution for the Treatment of Autoimmune Diseases and Functional Somatic Syndrome ZnCl2溶液咽磨料治疗自身免疫性疾病和功能性躯体综合征的可能机制
Journal of Antivirals & Antiretrovirals Pub Date : 2017-12-04 DOI: 10.4172/1948-5964.1000168
O. Hotta, C. Inoue, Ayaki Tanaka, N. Ieiri
{"title":"Possible Mechanisms Underlying Epipharyngeal Abrasive Therapy (EAT) with ZnCl2 Solution for the Treatment of Autoimmune Diseases and Functional Somatic Syndrome","authors":"O. Hotta, C. Inoue, Ayaki Tanaka, N. Ieiri","doi":"10.4172/1948-5964.1000168","DOIUrl":"https://doi.org/10.4172/1948-5964.1000168","url":null,"abstract":"Chronic epipharyngitis is a common latent but serious condition that may contribute to a wide range of diseases in humans, including collagen diseases, glomerulonephritis and autonomic nervous disorders. In a previous study, we presented a putative causal role of chronic epipharyngitis in the development of functional somatic symptoms and syndromes following human papillomavirus vaccination by demonstrating a significant improvement in symptoms following abrasive therapy using ZnCl2 on the epipharynx. Since this initial study, we have expanded our clinical experience, providing epipharyngeal abrasive therapy to 988 patients with confirmed chronic epipharyngitis associated with a wide variety of clinical symptoms. These symptoms could be classified into three broad categories, namely local inflammation-referred, autoimmune-related, and neuroendocrine symptoms. Symptom alleviation was achieved in the majority of patients with repeated epipharyngeal abrasive therapy.Through an in-depth review of the literature on epipharyngeal abrasive therapy, combined with our clinical experience, we propose three mechanisms underlying the therapeutic effects of epipharyngeal abrasive therapy: the astringent anti-inflammatory effect of ZnCl2, a blood-letting effect that promotes removal of epipharyngeal activated lymphocytes and drainage of excess inflammatory fluids containing various antigens, cytokines or noxious substances, and a neuromodulation effect achieved through stimulation of the vagus nerve. These effects can be explained within the context of current understanding of immunology, lymphology and neuroscience.Our hypothesis-driven review provides a theoretical basis for the observed therapeutic effects of epipharyngeal abrasive therapy in ameliorating various diseases, including functional somatic symptoms and syndromes following human papillomavirus vaccination.","PeriodicalId":15020,"journal":{"name":"Journal of Antivirals & Antiretrovirals","volume":"31 1","pages":"81-86"},"PeriodicalIF":0.0,"publicationDate":"2017-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82592490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 10
Evolution of Resistance-Associated Variants of All-Oral Direct-Acting Antiviral Therapy of Hepatitis C in a Clinical Setting 临床环境中丙型肝炎全口服直接作用抗病毒治疗耐药相关变异的演变
Journal of Antivirals & Antiretrovirals Pub Date : 2017-12-04 DOI: 10.4172/1948-5964.1000169
A. Lai, L. Milazzo, A. Bergna, Maurizio Polano, F. Binda, M. Franzetti, V. Micheli, P. Ronzi, G. Zehender, S. Sollima, M. Galli, C. Balotta
{"title":"Evolution of Resistance-Associated Variants of All-Oral Direct-Acting Antiviral Therapy of Hepatitis C in a Clinical Setting","authors":"A. Lai, L. Milazzo, A. Bergna, Maurizio Polano, F. Binda, M. Franzetti, V. Micheli, P. Ronzi, G. Zehender, S. Sollima, M. Galli, C. Balotta","doi":"10.4172/1948-5964.1000169","DOIUrl":"https://doi.org/10.4172/1948-5964.1000169","url":null,"abstract":"Because of the high variability of Hepatitis C virus (HCV), it might be important to characterize in vivo the evolution of resistance-associated mutations (RAVs) to direct-acting antivirals (DAAs) in different genotypes. NS3-, NS5A- and NS5B-HCV substitutions were studied by next generation sequencing (NGS) on 74 HCVinfected patients who started a DAA regimen. RAVs with frequencies of 1% and 15% were analyzed. Globally, 43, 15, 12 and 4 patients were infected with subtype 1a, 1b, genotype 4 and subtype 3a, respectively. The majority of patients (64.8%) had cirrhosis, 70.3% were HIV-coinfected and 14.9% were DAA-experienced. Overall baseline prevalence of RAVs was 74.3%, 52.2%, 45.9% and 36.8% to any NS3, NS5B and NS5A inhibitors available at that time, respectively, and dropped to 39.2%, 26.1%, 22.8% and 16.2%, respectively, when only mutations associated with the ongoing regimen were considered. The highest proportion of mutations was detected in subtype 1a (81.4%, p=.026), particularly in NS3 region (76.9%, p<.001). Among the 7 failing patients, 57.1% had a baseline sequence showing substitutions as majority species. At the time of viral relapse two patients accumulated further RAVs that were missing even as minority variants at baseline Although almost half of the patients showed natural substitutions at baseline, these substitutions did not induce resistance to DAAs. A limited role of NGS with a low cut-off was suggested by our study, as the detection of minor species seems not to predict the selection for resistant variants at the time of failure. The impact of pre-treatment RAVs on the achievement of sustained virologic response with DAA is limited.","PeriodicalId":15020,"journal":{"name":"Journal of Antivirals & Antiretrovirals","volume":"79 1","pages":"87-95"},"PeriodicalIF":0.0,"publicationDate":"2017-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73336055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
An impact of synthetic virology: Recoding arboviruses for vaccine development 合成病毒学的影响:为疫苗开发重新编码虫媒病毒
Journal of Antivirals & Antiretrovirals Pub Date : 2017-11-02 DOI: 10.4172/1948-5964-C1-035
Eckard Wimmer
{"title":"An impact of synthetic virology: Recoding arboviruses for vaccine development","authors":"Eckard Wimmer","doi":"10.4172/1948-5964-C1-035","DOIUrl":"https://doi.org/10.4172/1948-5964-C1-035","url":null,"abstract":"","PeriodicalId":15020,"journal":{"name":"Journal of Antivirals & Antiretrovirals","volume":"60 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88394352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Optimal Conditions for the Control of Ebola Viral Disease 控制埃博拉病毒病的最佳条件
Journal of Antivirals & Antiretrovirals Pub Date : 2017-08-24 DOI: 10.4172/1948-5964.1000165
S. Hussain, S. Maroof, A. Zeb, N. Rehman
{"title":"Optimal Conditions for the Control of Ebola Viral Disease","authors":"S. Hussain, S. Maroof, A. Zeb, N. Rehman","doi":"10.4172/1948-5964.1000165","DOIUrl":"https://doi.org/10.4172/1948-5964.1000165","url":null,"abstract":"In this paper, we discuss the asymptotic behavior of the optimal condition to control Ebola virus by considering the SEIRS model. First, we show stability and dynamical behavior of the model. Then, we find the conditions on parameters used in model which would minimize number of infected individuals. Finally, we give the graphical representations for different data.","PeriodicalId":15020,"journal":{"name":"Journal of Antivirals & Antiretrovirals","volume":"90 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2017-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76305228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Expansion of HLA-G-Expressing Myeloid-Derived Suppressor Cells in Patients with Chronic Hepatitis B Virus Infection 表达hla - g的髓源性抑制细胞在慢性乙型肝炎病毒感染患者中的扩增
Journal of Antivirals & Antiretrovirals Pub Date : 2017-07-24 DOI: 10.4172/1948-5964.1000163
Hai‐Yan Lu, Jing-Bo Li, A. Lin, Dan Xu, Bao‐guo Chen, Huazhong Chen, Wei-Hua Yan
{"title":"Expansion of HLA-G-Expressing Myeloid-Derived Suppressor Cells in Patients with Chronic Hepatitis B Virus Infection","authors":"Hai‐Yan Lu, Jing-Bo Li, A. Lin, Dan Xu, Bao‐guo Chen, Huazhong Chen, Wei-Hua Yan","doi":"10.4172/1948-5964.1000163","DOIUrl":"https://doi.org/10.4172/1948-5964.1000163","url":null,"abstract":"Both human leukocyte antigen-G (HLA-G) and myeloid-derived suppressor cells (MDSCs) was associated with the pathogenesis of infectious diseases. Whether peripheral MDSCs express HLA-G during virus infection remains unknown. We investigated the frequency of HLA-G+ MDSCs and its subsets in patients infected with chronic hepatitis B (CHB). In this study, frequencies of peripheral MDSCs (Lin1-HLA-DR-CD33+CD11b+) and HLA-G expressing subsets from 50 CHB patients and 27 normal controls were analyzed using flow cytometry. Data revealed the median percentage of MDSCs was not significantly different between the CHB patients and controls (0.30% vs. 0.29%; p=0.884). Among MDSCs, similar frequency was observed for CD14+ monocytic MDSC (mMDSCs; 31.25% vs. 23.35%; p=0.063) and CD15+ granulocytic MDSC (gMDSCs; 22.60% vs. 21.55%; p=0.558) between the two groups. However, HLA-G+ MDSCs was significantly increased in CHB patients compared with that of controls (3.30% vs. 0.50%; p<0.001). Furthermore, both HLA-G+ mMDSCs (0.99% vs. 0.00%; p<0.001) and HLAG+ gMDSC (0.78% vs. 0.00%; p<0.001) were also dramatically increased in CHB patients. Particularly, HLA-G+ gMDSC was inversely correlated to the viral DNA loads and significantly increased in HBeAb positive patients. Summary, this work reports for the first time HLA-G+ MDSCs, a new population of peripheral MDSCs, were expanded in CHB patients; however, its clinical relevance yet to be further explored.","PeriodicalId":15020,"journal":{"name":"Journal of Antivirals & Antiretrovirals","volume":"4 1","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2017-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80816964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A Case Report: Patient with the History of Hepatitis C Virus 有丙型肝炎病毒病史的患者1例报告
Journal of Antivirals & Antiretrovirals Pub Date : 2017-06-30 DOI: 10.4172/1948-5964.1000162
T. Bashir, M. Asim, Muhammad Ahsan, M. Z. Zafar, Kashif Hussain
{"title":"A Case Report: Patient with the History of Hepatitis C Virus","authors":"T. Bashir, M. Asim, Muhammad Ahsan, M. Z. Zafar, Kashif Hussain","doi":"10.4172/1948-5964.1000162","DOIUrl":"https://doi.org/10.4172/1948-5964.1000162","url":null,"abstract":"Hepatitis c virus is a RNA virus cause’s inflammation of liver. Hepatitis C virus (HCV) is a major cause of liver disease worldwide, About 10 million Pakistani populations is infected with Hepatitis C virus. A male who is 19 years of age was indulged in fever and he visited the physician with the symptoms of stomach irritation and high temperature. Doctor advised him some lab tests like Complete blood count test and liver functioning test (LFTs), after the laboratory reports came he was diagnosed with increased values of liver enzymes then the physician recommended him polymerase chain reaction test and by this test his hepatitis confirmed and genotype of infection identified by other test and identified genotype is 3. Then the physician prescribed him drug therapy for six months, different adverse effects were observed during the course of treatment. After six months he got rid of hepatitis c but he felt weakness in his after the completion of drug therapy. Hepatitis C is caused by the hepatitis C virus. It is spread by contact with an infected person's blood, contaminated syringes and can also be sexually transmitted. There should be public awareness regarding disease to the patient, thus physician can play a vital role in the prevention of disease by the counseling the patients about Hepatitis C dangers. Now a day’s its effective and useful therapy is available.","PeriodicalId":15020,"journal":{"name":"Journal of Antivirals & Antiretrovirals","volume":"123 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2017-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83507863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 5
Identification and Titration of Hydro Pericardium Syndrome Virus (HPSV) by using Modified Counter-Current Immuno-Electrophoresis (MCCIE) 改良逆流免疫电泳法(MCCIE)鉴定和定量心包积水综合征病毒(HPSV)
Journal of Antivirals & Antiretrovirals Pub Date : 2017-05-31 DOI: 10.4172/1948-5964.1000161
S. Manzoor, Sajjad-ur-Rahman, I. Khan
{"title":"Identification and Titration of Hydro Pericardium Syndrome Virus (HPSV) by using Modified Counter-Current Immuno-Electrophoresis (MCCIE)","authors":"S. Manzoor, Sajjad-ur-Rahman, I. Khan","doi":"10.4172/1948-5964.1000161","DOIUrl":"https://doi.org/10.4172/1948-5964.1000161","url":null,"abstract":"A rapid, simple, and accurate Modified Counter Current Immuno-electrophoresis (MCCIE) technique was developed and compared with the Reverse Passive Heamagglutination Assay (RPHA) for the titration of HPS virus. The MCCIE test had 100% correlation with the conventional RPHA and correctly titrated 116 samples which were already titrated with RPHA. Instead of horizontal electrophoresis chamber used in counter current Immuno-electrophoresis test, a modification in Counter Current Immuno-Electrophoresis (CCIE) test was made by using 1% melted agarose gel filled in 8 cm long and 3 mm narrow U-shaped glass tubing for the detection as well as quantification & titration of HPS virus. Results of Liver samples of 116 poultry birds including 16 broilers (6 livers were from clinically positive), 50 Desi and 50 commercial layers (adult) obtained through modified counter current Immuno-electrophoresis (MCCIE) were found similar to those found though CCIE and titres obtained through MCCIE were found similar to RPHA tests. The titres in MCCIE test were expressed as appearance of hazy colored precipitation band in the twelve U-shaped tubes. All of the six clinically positive liver samples gave positive results with titres ranging from 1:32 to 1:128. Of these 6 positive, 3 samples had 1:32, 2 samples had 1:64 and 1 sample had 1:128 titres. While none of desi and commercial layer was found to be positive. The results indicated that MCCIE is simple and inexpensive test as compared to CCIE & RPHA to detect and titrate HPS virus in the infected poultry liver samples. All the HPS virus isolates from HPS infected broiler livers and adenovirus group-I obtained from NARC, Islamabad and VRI, Lahore showed MCCIE & RPHA titre (1:64) with specific HPS antibodies.","PeriodicalId":15020,"journal":{"name":"Journal of Antivirals & Antiretrovirals","volume":"2 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2017-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75914917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
A 9 Year Old Female Ethiopian Patient with Stage IV Retroviral Infection and Right Side Hemiparesis 一名9岁埃塞俄比亚女患者,患有IV期逆转录病毒感染和右侧偏瘫
Journal of Antivirals & Antiretrovirals Pub Date : 2017-05-13 DOI: 10.4172/1948-5964.1000160
M. Woldu, Melaku Tileku Tamiru, Belete Ayalneh Worku
{"title":"A 9 Year Old Female Ethiopian Patient with Stage IV Retroviral Infection and Right Side Hemiparesis","authors":"M. Woldu, Melaku Tileku Tamiru, Belete Ayalneh Worku","doi":"10.4172/1948-5964.1000160","DOIUrl":"https://doi.org/10.4172/1948-5964.1000160","url":null,"abstract":"A 9-year-old, 17 kg, female patient was admitted to pediatric ward of a large, teaching referral hospital in Addis Ababa, Ethiopia because of high grade fever (HGF), severe headache & abnormal body movement (ABM) of 1 month duration. The child was taking unspecified Highly Active Antiretroviral Therapy (HAART) regimen from another government hospital ART clinic and unspecified per os (PO) medicines and herbs ordered from private clinics and traditional herbalists, respectively. She was put on Tenofovir/Lamivudine/Efavirenz (TDF/3TC/EFV) fixed dose combination therapy since 8 months back and has been taking phenytoin 50mg PO BID for the last one and half year. The patient has no known drug allergy (NKDA) or allergic diseases. Brain Computed Tomography (CT) scan was done on 27/02/2017 and revealed the presence of Pyogenic Brain Abscess (PBA) with subfalcine Herniation. Abdominal ultrasound was done on 08/03/2017 and showed Hepatomegaly. Head Magnetic Resonant Imaging (MRI) was done on 09/03/2017 and showed Left Frontoparietal Multiloculated Ring Enhancing Lesion with calcification and extensive vasogenic edema & mass effect more likely a Tuberculosis Brain Abscess (TBA). Chest X-ray (CXR) was done on 09/03/2017 with anterioposterior & left lateral position and revealed Left Upper Lobe Opacity more likely Tuberculosis (TB). Patient’s hemoglobin (Hgb), mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH) all were below normal on two consecutive measurements indicating that patient was suffering from moderate microcytic anemia. The Erythrocyte sedimentation rate (ESR) was also elevated as indication of non specific chronic inflammatory conditions most probably due to TB. Urinalysis was done on date 06/03/2017 and showed slight elevation in Red Blood Cells (RBCs) and White Blood Cells (WBCs) count and serum electrolyte assessment showed potassium was slightly below normal and chloride was increased and serum pH was slightly high causing metabolic alkalosis. Furthermore, alkaline phosphatase (ALP) was slightly elevated indicating involvement of cranial bone and focal hepatic lesions. Based on the clinical, laboratory and imaging evidences, the final working diagnosis was Stage IV RVI on HAART plus Right Sided Hemiparesis Secondary to TBA and PBA plus Focal Seizure. The gradual worsening of ABM of right lower and upper extremities could be due to lack of appropriate titration of the dose of phenytoin. The Initial dose of phenytoin has to be initiated with 5 mg/kg/day orally in 2 or 3 equally divided doses, with subsequent dosage individualized to a maximum of 300 mg PO daily. The maintenance dose should be 4 to 8 mg/kg and for children over 6 years old and adolescents may require the minimum adult dose (300 mg/day). The major drug therapy problems identified in this case was the prescription of rifampin with dexamethasone or prednisolone. Rifampin has been known to decrease the level or effect of dexamethasone-prednisolone by affecting hep","PeriodicalId":15020,"journal":{"name":"Journal of Antivirals & Antiretrovirals","volume":"28 1","pages":"42-51"},"PeriodicalIF":0.0,"publicationDate":"2017-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84652743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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