{"title":"Ocular complications of cryptococcal meningitis in patients with HIV: report of two cases and review of the literature.","authors":"Joan Duggan, Heather M Walls","doi":"10.1177/1545109712448537","DOIUrl":"https://doi.org/10.1177/1545109712448537","url":null,"abstract":"<p><p>AIDS-related cryptococcal meningitis can result in significant vision loss, but the risk factors, prognostic features, and optimal management of patients with ocular complications is unknown. We present 2 cases of blindness associated with cryptococcal meningitis and review the literature for associated cases. Twenty-six additional cases of vision deterioration or loss as a result of HIV-associated cryptococcal meningitis were reviewed. Irreversible and complete loss of vision occurred in 14 patients (50%). Permanent vision loss was more likely to occur in patients with ocular symptoms and neurologic signs at presentation. Nearly all patients with permanent visual loss experienced blindness within the first week after hospital admission. Visual complications are not uncommon in cryptococcal meningitis, and once vision loss occurs, it is often irreversible regardless of control of infection or intracranial pressure. Visual complaints in cryptococcal meningitis should be considered a potentially poor prognostic sign.</p>","PeriodicalId":86092,"journal":{"name":"Journal of the International Association of Physicians in AIDS Care (Chicago, Ill. : 2002)","volume":"11 5","pages":"283-8"},"PeriodicalIF":0.0,"publicationDate":"2012-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1545109712448537","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30702002","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}
{"title":"Increased adolescent HIV infection during pregnancy leads to increase in perinatal transmission at urban referral center.","authors":"Sahar Faghih, Elizabeth Secord","doi":"10.1177/1545109712446175","DOIUrl":"https://doi.org/10.1177/1545109712446175","url":null,"abstract":"<p><strong>Background: </strong>Undiagnosed HIV during pregnancy leads to increased perinatal infection. Four cases of adolescents/young adults with HIV contracted during pregnancy, after initial negative HIV testing, led to 4 cases of perinatal HIV, which were diagnosed only after AIDS-defining illness occurred in infants. These cases were missed despite HIV testing during pregnancy. This identifies a change in pattern for perinatal infection: increased adolescent/young adult HIV leading to increased perinatal risk.</p><p><strong>Methods: </strong>A 10-year retrospective chart review on HIV-positive infants in an urban referral center. Charts were reviewed for timing of maternal HIV testing and reason for infant HIV diagnosis.</p><p><strong>Results: </strong>Twenty infected infants were referred over a 10-year period. Four HIV-infected infants were identified within a 2-year time frame at the end of the 10-year period. The 4 mothers were HIV negative, based on early peripartum testing (3 in first trimester and 1 in second trimester) and became infected or seroconverted during pregnancy after initial HIV test. The mothers diagnosed were all under the age of 25.</p><p><strong>Conclusions: </strong>Rapid HIV testing at the time of delivery, despite a negative HIV result in early pregnancy, will prevent the delay in HIV diagnosis in both the mother and the infant and thus decrease HIV transmission from mother to child.</p>","PeriodicalId":86092,"journal":{"name":"Journal of the International Association of Physicians in AIDS Care (Chicago, Ill. : 2002)","volume":"11 5","pages":"293-5"},"PeriodicalIF":0.0,"publicationDate":"2012-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1545109712446175","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30643802","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}
Guerino Chalamilla, Claudia Hawkins, James Okuma, Donna Spiegelman, Akum Aveika, Beatrice Christian, Happiness Koda, Sylvia Kaaya, Deo Mtasiwa, Wafaie Fawzi
{"title":"Mortality and treatment failure among HIV-infected adults in Dar Es Salaam, Tanzania.","authors":"Guerino Chalamilla, Claudia Hawkins, James Okuma, Donna Spiegelman, Akum Aveika, Beatrice Christian, Happiness Koda, Sylvia Kaaya, Deo Mtasiwa, Wafaie Fawzi","doi":"10.1177/1545109711406733","DOIUrl":"https://doi.org/10.1177/1545109711406733","url":null,"abstract":"<p><strong>Objectives: </strong>Monitoring antiretroviral treatment (ART) outcomes is essential for assessing the success of HIV care and treatment programs in resource-limited settings (RLS).</p><p><strong>Methods: </strong>Longitudinal analyses of clinical and immunologic parameters in HIV-infected adults initiated on ART between November 2004 and June 2008 at Management and Development for Health (MDH)-Presidents Emergency Plan For AIDS Relief PEPFAR supported HIV care and treatment clinics in Tanzania.</p><p><strong>Results: </strong>A total of 12 842 patients were analyzed (65.9% female, median baseline CD4 count, 106 cells/mm(3)). Significant improvements in immunologic status were observed with an increase in CD4 count to 298 (interquartile range [IQR] 199-416), 372 (256-490) and 427 (314-580) cells/mm(3), at 1, 2, and 3 years, respectively. Overall mortality was 13.1% (1682 of 12 842). Male sex, World Health Organization (WHO) stage III/IV, CD4 <200 cells/mm(3), hemoglobin (Hgb) <8.5 g/dL, and stavudine (d4T)-containing regimens were independently associated with early and overall mortality.</p><p><strong>Conclusions: </strong>Closer monitoring of males and patients with advanced HIV disease following ART initiation may improve clinical and immunologic outcomes in these individuals.</p>","PeriodicalId":86092,"journal":{"name":"Journal of the International Association of Physicians in AIDS Care (Chicago, Ill. : 2002)","volume":"11 5","pages":"296-304"},"PeriodicalIF":0.0,"publicationDate":"2012-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1545109711406733","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29937258","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}
{"title":"Prevalence of lipodystrophy and dyslipidemia among patients with HIV infection on generic ART in rural South India.","authors":"Annie Phoebe Kalyanasundaram, Saramma Mini Jacob, Ramachandran Hemalatha, Mampakkam Rajappa Sivakumar","doi":"10.1177/1545109711401750","DOIUrl":"https://doi.org/10.1177/1545109711401750","url":null,"abstract":"<p><p>As antiretroviral therapy (ART) becomes more available to the HIV-infected population, it is important to determine the prevalence of its long-term complications. In this cross-sectional study, 145 HIV-positive patients on ART, 146 HIV-positive patients not on ART, and 72 HIV-negative individuals visiting the Namakkal District Head Quarters Hospital, Tamil Nadu, India, were recruited from February 2007 to April 2009. Among the patients on ART, the prevalence of lipodystrophy was 60.7%; 22.7% with lipohypertrophy, 51.1% with lipoatrophy, and 22.7% with mixed pattern. The proportion of patients with dyslipidemia was significantly higher in the treatment group when compared to ART-naive and HIV-negative controls (P = .00). Total duration of ART was significantly associated with lipodystrophy (P = .04) and dyslipidemia (P = .01). Also, by logistic regression, abnormal metabolic levels were a risk factor in lipodystrophy (P = .02). This study highlights the need for development of inexpensive and accessible treatments for the reduction of lipodystrophy.</p>","PeriodicalId":86092,"journal":{"name":"Journal of the International Association of Physicians in AIDS Care (Chicago, Ill. : 2002)","volume":"11 5","pages":"329-34"},"PeriodicalIF":0.0,"publicationDate":"2012-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1545109711401750","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29828070","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}
Leandro Sereno, Fabio Mesquita, Masaya Kato, David Jacka, Thi Thuy Van Nguyen, Thien Nga Nguyen
{"title":"Epidemiology, responses, and way forward: the silent epidemic of viral hepatitis and HIV coinfection in Vietnam.","authors":"Leandro Sereno, Fabio Mesquita, Masaya Kato, David Jacka, Thi Thuy Van Nguyen, Thien Nga Nguyen","doi":"10.1177/1545109712453939","DOIUrl":"https://doi.org/10.1177/1545109712453939","url":null,"abstract":"<p><p>Viral hepatitis is a disease of great concern to public health that is now met by a favorable momentum to combat the global epidemic. This article is intended to highlight the importance of viral hepatitis in the Vietnam population as well in the group of people living with HIV/AIDS (PLWHA). We reviewed available data on epidemiology and response on hepatitis B virus (HBV) and hepatitis C virus (HCV) and HIV coinfection in Vietnam. The hepatitis B surface antigen (HBsAg) prevalence in the general population ranged from 5.7% to 24.7%. The anti-HCV prevalence ranged from 0.38% to 4.3% in the general population, while among people who inject drugs (PWIDs) it ranged from 31% to 97.2%. The HBV prevalence among PLWHA is similar to the general population, while HCV/HIV coinfection is concentrated in some groups. Anti-HCV prevalence among HIV-infected PWIDs can be as high as 98.5%. Developing policies for diagnosis and treatment of chronic HBV and HCV infections are critical priorities in order to prevent clinical progression to cirrhosis and liver cancer.</p>","PeriodicalId":86092,"journal":{"name":"Journal of the International Association of Physicians in AIDS Care (Chicago, Ill. : 2002)","volume":"11 5","pages":"311-20"},"PeriodicalIF":0.0,"publicationDate":"2012-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1545109712453939","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30786654","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}
Rabia Ahmed, Ryan Cooper, Michelle Foisy, Evelina Der, Dennis Kunimoto
{"title":"Factors associated with reduced antituberculous serum drug concentrations in patients with HIV-TB coinfection.","authors":"Rabia Ahmed, Ryan Cooper, Michelle Foisy, Evelina Der, Dennis Kunimoto","doi":"10.1177/1545109712454454","DOIUrl":"https://doi.org/10.1177/1545109712454454","url":null,"abstract":"<p><p>We describe correlates of reduced antituberculous serum drug concentrations (SDCs) in HIV-infected patients receiving treatment for active tuberculosis (TB). Cross-sectional analysis of individuals diagnosed with HIV and active TB in Northern Alberta, Canada, was performed. Of the 30 HIV-TB cases, 27 underwent measurement of SDCs. Rates of low SDCs were 9 of 26 (34%) for isoniazid (INH) and 16 of 25 (64%) for rifamycins. Increased weight and elevated body mass index (BMI) correlated with low SDCs for rifampin (P < .05) and increased weight also correlated with reduced SDCs for INH (P < .05). This suggests that conventional antituberculous dosing may be too low and consideration should be given to increase the maximum initial weight-based doses in HIV-infected patients.</p>","PeriodicalId":86092,"journal":{"name":"Journal of the International Association of Physicians in AIDS Care (Chicago, Ill. : 2002)","volume":"11 5","pages":"273-6"},"PeriodicalIF":0.0,"publicationDate":"2012-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1545109712454454","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30820990","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}
Raja Krishnaraj, Chandrasekar Chockalingam, O R Krishnarajasekhar, Mahilmaran Ayyamperumal, Ravichandran Narayanan, Kumar Satagopan
{"title":"Immune Reconstitution Inflammatory Syndrome (IRIS) with acute tuberculous osteomyelitis and disseminated mutilating tuberculous dactylitis in a person living with HIV and AIDS (PLHA): a case report.","authors":"Raja Krishnaraj, Chandrasekar Chockalingam, O R Krishnarajasekhar, Mahilmaran Ayyamperumal, Ravichandran Narayanan, Kumar Satagopan","doi":"10.1177/1545109712449866","DOIUrl":"https://doi.org/10.1177/1545109712449866","url":null,"abstract":"<p><p>HIV infection changed the scenario of infectious diseases. The pre-HAART (highly active antiretroviral therapy) era had resulted in new opportunistic infections. HIV and tuberculosis together had high mortality in countries with high prevalence of tuberculosis. Disseminated and extra pulmonary tuberculosis is common in PLHA (People Living with HIV and AIDS). IRIS (Immune Reconstitution Inflammatory Syndrome) after HAART is common (10% to 25%) in PLHA. Pott's spine is the most common presentation in PLHA of bone and skeletal system. IRIS tuberculosis, especially extra pulmonary tuberculosis, is the most common. In this case, we are presenting an IRIS disseminated tuberculosis in the form of acute osteomyelitis and mutilating dactylitis involving many joints of the fingers. Of 37 cases (9 from India) reported worldwide multiple dactylitis was never presented in the medical journals. This might be the first multiple dactylitis with extensive mutilation to the dactyls due to IRIS in a patient on ART.</p>","PeriodicalId":86092,"journal":{"name":"Journal of the International Association of Physicians in AIDS Care (Chicago, Ill. : 2002)","volume":"11 5","pages":"289-92"},"PeriodicalIF":0.0,"publicationDate":"2012-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1545109712449866","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30781649","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}
Carmen Bayón, Esteban Ribera, Esther Cabrero, Laura Griffa, Ángel Burgos
{"title":"Prevalence of depressive and other central nervous system symptoms in HIV-infected patients treated with HAART in Spain.","authors":"Carmen Bayón, Esteban Ribera, Esther Cabrero, Laura Griffa, Ángel Burgos","doi":"10.1177/1545109712448217","DOIUrl":"https://doi.org/10.1177/1545109712448217","url":null,"abstract":"<p><p>This study was conducted to assess the prevalence of depressive symptoms, sleep disturbances, and subjective cognitive complaints in patients with HIV receiving highly active antiretroviral therapy. Participants completed the \"Center for Epidemiological Studies Depression Scale\" (CES-D) and a questionnaire on sleep disturbances and subjective cognitive complaints. Mean age of the 799 participants was 43.7 years and 67% were men. Adjusted prevalence of CES-D was 35.4% (95% confidence interval [CI]: 32.0-38.7), with no significant differences between gender and age groups. Sleep disturbances were more prevalent in older versus younger participants (74.0% [95% CI: 70.4-77.7] versus 63.3% [95% CI: 56.8-69.8]). Cognitive complaints were more prevalent in women (52.3% [95% CI: 46.4-58.2]) when compared with men (48.2% [95% CI: 44.7-51.6]). Hepatitis C virus coinfection was a strong predictor of depressive symptoms. Male gender and detectable viral load were independent risk factors for sleep disturbance. A higher CES-D score was an independent risk factor for sleep disturbance and cognitive complaints.</p>","PeriodicalId":86092,"journal":{"name":"Journal of the International Association of Physicians in AIDS Care (Chicago, Ill. : 2002)","volume":"11 5","pages":"321-8"},"PeriodicalIF":0.0,"publicationDate":"2012-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1545109712448217","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30702617","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}
{"title":"Characterization of HIV-associated Hodgkin's lymphoma in HIV-infected patients: a single-center experience.","authors":"Marco Ruiz, Christopher Parsons, John Cole","doi":"10.1177/1545109711431492","DOIUrl":"https://doi.org/10.1177/1545109711431492","url":null,"abstract":"<p><strong>Introduction: </strong>Although the incidence and prevalence of AIDS-defining malignancies has decreased in the era of highly active antiretroviral therapy (HAART), the incidence and prevalence of Hodgkin's lymphoma (HL) in the HIV-infected population continues to rise. Compared with the general population, HIV-infected patients exhibit a 5-10-fold increased risk for developing HL.</p><p><strong>Methods: </strong>A retrospective review of charts and electronic records from 2000-2010 at the HIV outpatient clinic (HOP)-Louisiana State University in New Orleans was conducted, and pathologically confirmed cases of HIV-HL were identified within this cohort.</p><p><strong>Results: </strong>We found a prevalence of 6.3 cases per 1,000 patients per year of HIV-HL over a period of 10 years in our HIV outpatient clinic. The mean absolute CD4 count before treatment was 284 cells/mm(3) and after treatment was 194 cells/mm(3). The average time from the diagnosis of HIV infection to the diagnosis of HIV-HL was 7.6 years. The most common histopathologic type was mixed cellularity followed by lymphocytic predominance. The majority of patients had 6 cycles delivered. In terms of HL staging 87% presented with advanced stages (III B or IV). To the best of our knowledge 5 out of the 14 patients remain alive.</p><p><strong>Conclusions: </strong>Patients in our cohort were older than most patients identified in other cohorts. All of our patients had coexisting chronic illnesses associated with inflammation, as well as detectable HIV viral loads and CD4 count >200, suggesting a role for both HIV- and non-HIV-associated inflammation in HIV-HL pathogenesis in this population. The role of HIV virus and other oncogenic viruses (EBV, HPV, and others) in the pathogenesis of Hodgkin's lymphoma in this group of patients needs to be elucidated.</p>","PeriodicalId":86092,"journal":{"name":"Journal of the International Association of Physicians in AIDS Care (Chicago, Ill. : 2002)","volume":"11 4","pages":"234-8"},"PeriodicalIF":0.0,"publicationDate":"2012-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1545109711431492","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30433550","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}
{"title":"Provider and patient correlates of provider decisions to recommend HCV treatment to HIV co-infected patients.","authors":"Glenn Wagner, Karen Chan Osilla, Jeffrey Garnett, Bonnie Ghosh-Dastidar, Laveeza Bhatti, Mallory Witt, Matthew Bidwell Goetz","doi":"10.1177/1545109712444163","DOIUrl":"https://doi.org/10.1177/1545109712444163","url":null,"abstract":"<p><p>Despite low uptake of hepatitis C virus (HCV) treatment among HIV co-infected patients, few studies have examined the factors that contribute to provider decisions to recommend treatment. Surveys of 173 co-infected patients and their primary care providers, as well as patient chart data, were collected at 3 HIV clinics in Los Angeles; 73% of the patients had any history of being recommended HCV treatment. Multivariate predictors of being offered treatment included being Caucasian, greater HCV knowledge, receiving depression treatment if depressed, and one's provider having a lower weekly patient load and more years working at the study site. These findings suggest that provider decisions to recommend HCV treatment are influenced by patient factors including race and psychosocial treatment readiness, as well as characteristics of their own practice and treatment philosophy. With changes to HCV treatment soon to emerge, further evaluation of factors influencing treatment decisions is needed to improve HCV treatment uptake.</p>","PeriodicalId":86092,"journal":{"name":"Journal of the International Association of Physicians in AIDS Care (Chicago, Ill. : 2002)","volume":"11 4","pages":"245-51"},"PeriodicalIF":0.0,"publicationDate":"2012-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1545109712444163","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30599083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}