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    1159 results match your criteria Prevention of Opportunistic Infections in Patients Infected With HIV

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    Cost-Effectiveness Analysis of Early vs Late Diagnosis of HIV-Infected Patients in South Carolina.
    South Med J 2018 Jun;111(6):355-358
    From the University of South Carolina-Palmetto Health Richland, Columbia, and South Carolina Department of Health and Environmental Control, Columbia.
    Objectives: It is anticipated that early diagnosis, linkage to care, initiation of antiretroviral therapy (ART), and retention in care would lead to reduced opportunistic infections, reduction in human immunodeficiency virus-related morbidity and mortality and reduced rates of HIV transmission. This would be expected to lead to a reduction in the lifetime cost of care (LCC). This study analyzed existing data to determine to what extent early-versus-late HIV diagnosis affects LCC. Read More

    Socio-economic status and risk of tuberculosis: a case-control study of HIV-infected patients in Asia.
    Int J Tuberc Lung Dis 2018 Feb;22(2):179-186
    The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia.
    Setting: Tuberculosis (TB) is the most common human immunodeficiency virus (HIV) related opportunistic infection and cause of acquired immune-deficiency syndrome related death. TB often affects those from a low socio-economic background.

    Objective: To assess the socio-economic determinants of TB in HIV-infected patients in Asia. Read More

    Treatment adherence in patients living with HIV/AIDS assisted at a specialized facility in Brazil.
    Rev Soc Bras Med Trop 2017 Sep-Oct;50(5):607-612
    Programa de Pós-graduação Stricto Sensu em Odontologia Preventiva e Social, Faculdade de Odontologia de Araçatuba, Universidade Estadual Paulista, Araçatuba, SP, Brasil.
    Introduction: In the 1990s, Brazil adopted a public policy that allowed for universal, free access to antiretroviral therapy (ART). Since then, treatment adherence has become a new challenge for administrators of sexually transmitted disease/acquired immunodeficiency syndrome (STD/AIDS) policies. This study quantified adherence to ART and verified whether there is an association between sociodemographic variables and clinical/laboratory data in human immunodeficiency virus (HIV)-infected patients. Read More

    [Treatment outcome, survival and their risk factors among new tuberculosis patients co-infected with HIV during the Ebola outbreak in Conakry].
    Rev Epidemiol Sante Publique 2017 Nov 22;65(6):419-426. Epub 2017 Oct 22.
    Service de pneumo-phtisiologie, hôpital national Ignace Deen, CHU de Conakry, Conakry, Guinée.
    Background: Mortality among TB/HIV co-infected patients remains high in Africa. The study aimed to estimate survival and associated factors in a cohort of TB/HIV co-infected patients who started tuberculosis treatment during the Ebola outbreak in Conakry, Guinea.

    Methods: A prospective cohort study was conducted from April 2014 to December 2015. Read More

    Myeloid Dendritic Cells Repress Human Cytomegalovirus Gene Expression and Spread by Releasing Interferon-Unrelated Soluble Antiviral Factors.
    J Virol 2018 01 14;92(1). Epub 2017 Dec 14.
    Immune Ageing and Chronic Infections Group, Helmholtz Centre for Infection Research, Braunschweig, Germany
    Cytomegalovirus (CMV) is a betaherpesvirus that latently infects most adult humans worldwide and is a major cause of morbidity and mortality in immunocompromised hosts. Latent human CMV (HCMV) is believed to reside in precursors of myeloid-lineage leukocytes and monocytes, which give rise to macrophages and dendritic cells (DC). We report here that human monocyte-derived DC (mo-DC) suppress HCMV infection in coculture with infected fibroblast target cells in a manner dependent on the effector-to-target ratio. Read More

    How I treat patients with HIV-related hematological malignancies using hematopoietic cell transplantation.
    Blood 2017 11 7;130(18):1976-1984. Epub 2017 Sep 7.
    Hematological Malignancies and Hematopoietic Stem Cell Transplantation Institute, City of Hope, Duarte, CA.
    Hematopoietic cell transplantation (HCT) has now been shown to be safe and effective for selected HIV-infected patients with hematological malignancies. Autologous HCT is now the standard of care for patients with HIV-related lymphomas who otherwise meet standard transplant criteria. Limited data also support use of allogeneic HCT (alloHCT) in selected HIV-infected patients who meet standard transplant criteria. Read More

    Immunological recovery in tuberculosis/HIV co-infected patients on antiretroviral therapy: implication for tuberculosis preventive therapy.
    BMC Infect Dis 2017 07 25;17(1):517. Epub 2017 Jul 25.
    Department for Infectious Disease Epidemiology, Robert Koch Institute (RKI), Seestr. 10, 13353, Berlin, Germany.
    Background: Understanding the immune response to combination antiretroviral therapy (cART) is essential for a clear approach to tuberculosis (TB) preventive therapy. We investigated the immunological recovery in cART-treated HIV-infected patients developing TB compared to those who remained free of TB.

    Methods: We extracted data of HIV-infected patients from a multicenter cohort for the HIV clinical surveillance in Germany. Read More

    Enhanced Prophylaxis plus Antiretroviral Therapy for Advanced HIV Infection in Africa.
    N Engl J Med 2017 07;377(3):233-245
    From the University of Zimbabwe Clinical Research Center, Harare, Zimbabwe (J.H., M.B.-D., G.M., K.N.); Joint Clinical Research Center, Kampala (V.M., C.K., P.M.), Mbarara (A.L.), and Fort Portal (S. Kabahenda) - all in Uganda; Medical Research Council Clinical Trials Unit at University College London (A.J.S., S.L.P., A.G., M.J.T., A.S.W., D.M.G.), Wellcome Trust Centre for Clinical Tropical Medicine and Department of Paediatrics, Imperial College (K.M.), and Queen Mary University of London (A.J.P.), London, and the Centre for Health Economics, University of York, York (S.W.) - all in the United Kingdom; the Department of Medicine and Malawi-Liverpool-Wellcome Trust Clinical Research Program, Blantyre, Malawi (J.M., S. Kaunda); and Moi University School of Medicine, Eldoret (A.S., M.K.), and the Kenya Medical Research Institute (KEMRI) Wellcome Trust Research Program, Kilifi (C.A., K.M.) - both in Kenya.
    Background: In sub-Saharan Africa, among patients with advanced human immunodeficiency virus (HIV) infection, the rate of death from infection (including tuberculosis and cryptococcus) shortly after the initiation of antiretroviral therapy (ART) is approximately 10%.

    Methods: In this factorial open-label trial conducted in Uganda, Zimbabwe, Malawi, and Kenya, we enrolled HIV-infected adults and children 5 years of age or older who had not received previous ART and were starting ART with a CD4+ count of fewer than 100 cells per cubic millimeter. They underwent simultaneous randomization to receive enhanced antimicrobial prophylaxis or standard prophylaxis, adjunctive raltegravir or no raltegravir, and supplementary food or no supplementary food. Read More

    Assessment of isoniazid preventive therapy in the reduction of tuberculosis among ART patients in Arba Minch Hospital, Ethiopia.
    Ther Clin Risk Manag 2017 24;13:361-366. Epub 2017 Mar 24.
    Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia.
    Background: Tuberculosis (TB) is the most frequent life-threatening opportunistic disease among people living with HIV and remains a leading cause of mortality, even among persons receiving antiretroviral therapy (ART). Isoniazid preventive therapy (IPT) and cotrimoxazole prophylaxis have been recommended for the benefit of HIV/AIDS-infected individuals to prevent opportunistic infections. The aim of this study was to assess IPT prophylaxis in the reduction of TB among ART patients. Read More

    Primary Prophylaxis for Cryptococcosis With Fluconazole in Human Immunodeficiency Virus-Infected Patients With CD4 T-Cell Counts <100 Cells/µL and Receiving Antiretroviral Therapy.
    Clin Infect Dis 2017 Apr;64(7):967-970
    Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
    A prospective observational cohort study was conducted in 302 human immunodeficiency virus-infected patients who had a CD4 T-cell count <100 cells/µL and negative serum cryptococcal antigen initiating antiretroviral therapy in a resource-limited setting. During 2-year follow-up, there were no differences of survival rates and occurrences of newly diagnosed cryptococcosis between patients with and without fluconazole for primary prophylaxis of cryptococcosis. Read More

    Health systems in the Republic of Congo: challenges and opportunities for implementing tuberculosis and HIV collaborative service, research, and training activities.
    Int J Infect Dis 2017 Mar 27;56:62-67. Epub 2016 Oct 27.
    Fondation Congolaise pour la Recherche Médicale, Cité OMS, villa D6, Djoué, Brazzaville, Republic of Congo; Faculty of Sciences and Techniques, University Marien Ngouabi, Brazzaville, Republic of Congo; Institute for Tropical Medicine, University of Tübingen, Tübingen, Germany. Electronic address:
    The Republic of Congo is on the World Health Organization (WHO) list of 'high burden' countries for tuberculosis (TB) and HIV. TB is the leading cause of death among HIV-infected patients in the Republic of Congo. In this viewpoint, the available data on TB and HIV in the Republic of Congo are reviewed, and the gaps and bottlenecks that the National TB Control Program (NTCP) faces are discussed. Read More

    Cost-effectiveness of CRAG-LFA screening for cryptococcal meningitis among people living with HIV in Uganda.
    BMC Infect Dis 2017 03 23;17(1):225. Epub 2017 Mar 23.
    Johns Hopkins University School of Medicine, 725 N. Wolfe St. PCTB building-224, Baltimore, MD, 21205, USA.
    Background: Cryptococcal meningitis (CM) constitutes a significant source of mortality in resource-limited regions. Cryptococcal antigen (CRAG) can be detected in the blood before onset of meningitis. We sought to determine the cost-effectiveness of implementing CRAG screening using the recently developed CRAG lateral flow assay in Uganda compared to current practice without screening. Read More

    Association between enteric protozoan parasites and gastrointestinal illness among HIV- and tuberculosis-infected individuals in the Chowke district, southern Mozambique.
    Acta Trop 2017 Jun 14;170:197-203. Epub 2017 Mar 14.
    Department of Parasitology, Pharmacy Faculty, Valencia University, Av. Vicente Andrés Estellés s/n, 46100, Burjassot, Valencia, Spain. Electronic address:
    Human immune deficiency virus (HIV) and tuberculosis (TB) infections remain major public health issues globally, particularly in sub-Saharan Africa. Impairment of both cell-mediated and humoral immunity by HIV and/or TB infections may limit the host's defences against other pathogens, including the diarrheagenic protozoan Cryptosporidium spp., Giardia intestinalis, and Entamoeba histolytica. Read More

    Seroprevalence of among HIV Patients in Jahrom, Southern Iran.
    Korean J Parasitol 2017 Feb 28;55(1):99-103. Epub 2017 Feb 28.
    Department of Microbiology, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.
    is an important opportunistic agent especially in immunocompromised hosts and can cause significant morbidity and mortality. Hence, detection and monitoring of anti- antibodies are of a great interest in HIV-infected patients. A study on the prevalence of toxoplasmosis and associated risk factors was carried out among HIV-infected patients in Jahrom, southern Iran. Read More

    An association between decreasing incidence of invasive non-typhoidal salmonellosis and increased use of antiretroviral therapy, Gauteng Province, South Africa, 2003-2013.
    PLoS One 2017 6;12(3):e0173091. Epub 2017 Mar 6.
    Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, United States of America.
    Background: HIV-infected persons are at increased risk of opportunistic infections, including invasive nontyphoidal Salmonella (iNTS) infections; antiretroviral therapy (ART) reduces this risk. We explored changing iNTS incidence associated with increasing ART availability in South Africa.

    Methods: Laboratory-based surveillance for iNTS was conducted in Gauteng Province, South Africa, with verification using the National Health Laboratory Service's Central Data Warehouse (CDW), between 2003 and 2013. Read More

    Early use of corticosteroids in infants with a clinical diagnosis of Pneumocystis jiroveci pneumonia in Malawi: a double-blind, randomised clinical trial.
    Paediatr Int Child Health 2017 May 1;37(2):121-128. Epub 2017 Feb 1.
    a College of Medicine, University of Malawi , Blantyre , Malawi.
    Background: Pneumocystis jiroveci pneumonia (PJP) is the most common opportunistic infection in infants with vertically acquired HIV infection and the most common cause of death in HIV-infected infants.

    Objectives: To determine whether early administration of adjuvant corticosteroids in addition to standard treatment reduces mortality in infants with vertically acquired HIV and clinically diagnosed PJP when co-infection with cytomegalovirus and other pathogens cannot be excluded.

    Methods: A double-blind placebo-controlled trial of adjuvant prednisolone treatment in HIV-exposed infants aged 2-6 months admitted to Queen Elizabeth Central Hospital, Blantyre who were diagnosed clinically with PJP was performed. Read More

    Concurrent Plasmodium infection, anemia and their correlates among newly diagnosed people living with HIV/AIDS in Northern Ethiopia.
    Acta Trop 2017 May 21;169:8-13. Epub 2017 Jan 21.
    Department of public health, College of Health Sciences, Bahir Dar University, P.o. Box: 75, Bahir Dar, Ethiopia.
    The magnitude of concurrent malaria infection and the impact it has on hematological abnormalities, such as anemia in people living with HIV/AIDS, is not well studied in Ethiopian set up. In this cross sectional study, therefore, we assessed the prevalence of concurrent malaria infection and anemia among highly active anti-retroviral therapy (HAART) naive people living with HIV/AIDS between October, 2012 to May, 2013 in Northern Ethiopia. After obtaining consent, socio demographic, clinical, immunological and behavioural data was obtained. Read More

    Venous Thromboembolism Requiring Extended Anticoagulation Among HIV-Infected Patients in a Rural, Resource-Constrained Setting in Western Kenya.
    Ann Pharmacother 2017 May 6;51(5):380-387. Epub 2017 Jan 6.
    2 Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya.
    Background: HIV-infected patients are at an increased risk of developing venous thromboembolism (VTE), and minimal data are available to describe the need for extended treatment.

    Objective: To evaluate the frequency of and determine predictive risk factors for extended anticoagulation of VTE in HIV-infected patients in rural, western Kenya.

    Methods: A retrospective chart review was conducted at the Anticoagulation Monitoring Service affiliated with Moi Teaching and Referral Hospital and the Academic Model Providing Access to Healthcare. Read More

    Classical and alternative macrophages have impaired function during acute and chronic HIV-1 infection.
    Braz J Infect Dis 2017 Jan - Feb;21(1):42-50. Epub 2016 Nov 29.
    Universidade de São Paulo, Faculdade de Ciências Farmacêuticas, Laboratório de Imunologia e Epigenética, São Paulo, SP, Brazil. Electronic address:
    Objectives: Three decades after HIV recognition and its association with AIDS development, many advances have emerged - especially related to prevention and treatment. Undoubtedly, the development of Highly Active Antiretroviral Therapy (HAART) dramatically changed the future of the syndrome that we know today. In the present study, we evaluate the impact of Highly Active Antiretroviral Therapy on macrophage function and its relevance to HIV pathogenesis. Read More

    Cardiac Disease Associated with Human Immunodeficiency Virus Infection.
    Cardiol Clin 2017 Feb;35(1):59-70
    Feinberg School of Medicine, Northwestern University, 420 East Superior Street, Chicago, IL 60611, USA.
    Over the last 2 decades human immunodeficiency virus (HIV) infection has become a chronic disease requiring long-term management. Aging, antiretroviral therapy, chronic inflammation, and several other factors contribute to the increased risk of cardiovascular disease in patients infected with HIV. In low-income and middle-income countries where antiretroviral therapy access is limited, cardiac disease is most commonly related to opportunistic infections and end-stage manifestations of HIV/acquired immunodeficiency syndrome, including HIV-associated cardiomyopathy, pericarditis, and pulmonary arterial hypertension. Read More

    Prevalence and determinants of HIV in tuberculosis patients in Wuxi City, Jiangsu province, China: a cross-sectional study.
    Int J STD AIDS 2016 11 18;27(13):1204-1212. Epub 2015 Oct 18.
    Department of Medical affairs, the Lixin People's Hospital, Bozhou, Anhui, P.R. China.
    At least one-third of the 34 million people living with human immunodeficiency virus (HIV) worldwide are infected with latent tuberculosis (TB). The aim of this study was to determine the rate of HIV infection in TB patients and its determinants in Wuxi City, China. TB patients attending health institutions (12 selected sites) for TB diagnosis and treatment were enrolled in this study. Read More

    Asymptomatic cryptococcal antigen prevalence detected by lateral flow assay in hospitalised HIV-infected patients in São Paulo, Brazil.
    Trop Med Int Health 2016 12 24;21(12):1539-1544. Epub 2016 Oct 24.
    University of Minnesota, Minneapolis, MN, USA.
    Objective: To determine the prevalence of asymptomatic cryptococcal antigen (CRAG) using lateral flow assay (LFA) in hospitalised HIV-infected patients with CD4 counts <200 cells/μl.

    Methods: Hospitalised HIV-infected patients were prospectively recruited at Instituto de Infectologia Emilio Ribas, a tertiary referral hospital to HIV-infected patients serving the São Paulo State, Brazil. All patients were >18 years old without prior cryptococcal meningitis, without clinical suspicion of cryptococcal meningitis, regardless of antiretroviral (ART) status, and with CD4 counts <200 cells/μl. Read More

    Predictors of Treatment Failure among Adult Antiretroviral Treatment (ART) Clients in Bale Zone Hospitals, South Eastern Ethiopia.
    PLoS One 2016 7;11(10):e0164299. Epub 2016 Oct 7.
    Department of Nursing, College of Medicine and Health Sciences, Madda Walabu University, Bale Goba, Ethiopia.
    Background: Treatment failure defined as progression of disease after initiation of ART or when the anti-HIV medications can't control the infection. One of the major concerns over the rapid scaling up of ART is the emergence and transmission of HIV drug resistant strains at the population level due to treatment failure. This could lead to the failure of basic ART programs. Read More

    Patterns and trends in mortality among HIV-infected and HIV-uninfected patients in a major Internal Medicine Unit in Yaoundé, Cameroon: a retrospective cohort study.
    JRSM Open 2016 Sep 1;7(9):2054270416654859. Epub 2016 Sep 1.
    Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, PO Box 1364, Yaoundé, Cameroon; Internal Medicine Unit, Yaoundé University Hospital Centre, PO Box 4806, Yaoundé, Cameroon.
    Objective: To describe the trends in mortality and the spectrum of disease in HIV-infected and -uninfected inpatients in a population in Yaoundé.

    Design: A retrospective study.

    Setting: Internal Medicine Unit, University Hospital Centre, Yaoundé, Cameroon. Read More

    [Prevalence and factors associated with cryptococcal antigenemia in HIV-infected patients in Cotonou/Benin].
    J Mycol Med 2016 Dec 15;26(4):391-397. Epub 2016 Sep 15.
    Laboratoire de parasitologie-mycologie, centre national hospitalier universitaire Koutoukou Maga (CNHU/HKM), 03BP386, Cotonou, Benin.
    Objective: Determine the prevalence of cryptococcal antigenemia and associated factors in HIV-infected patients in Cotonou in order to introduce systematic screening in national guidelines.

    Patients And Methods: This is a cross-sectional, descriptive and analytical study conducted from June to September 2015 in four outpatient treatment centers with adult patients infected with HIV, receiving or not antiretroviral treatment with a number of CD4≤200cell/μL and who have given their informed consent to participate in the study. For each enrolled patient, after signing the informed consent form, it was made a clinical examination and administration of a questionnaire to collect general information, treatment and biological data. Read More

    Prescription of Pneumocystis Jiroveci Pneumonia Prophylaxis in HIV-Infected Patients.
    J Int Assoc Provid AIDS Care 2016 11 14;15(6):455-458. Epub 2016 Sep 14.
    Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC, Atlanta, GA, USA.
    The US treatment guidelines recommend Pneumocystis jiroveci pneumonia (PCP) prophylaxis for all HIV-infected persons with a CD4 count <200 cells/mm (ie, eligible for PCP prophylaxis). However, some studies suggest PCP prophylaxis may be unnecessary in virally suppressed patients. Using national data of HIV-infected adults receiving medical care in the United States during 2009 to 2012, the authors assessed the weighted percentage of eligible patients who were prescribed PCP prophylaxis and the independent association between PCP prophylaxis prescription and viral suppression. Read More

    A SOA-Based Solution to Monitor Vaccination Coverage Among HIV-Infected Patients in Liguria.
    Stud Health Technol Inform 2016 ;228:327-31
    Department of Informatics, Bioengineering, Robotics and System Engineering (DIBRIS), University of Genoa, Via Opera Pia 13, 16145 Genoa, Italy.
    Vaccination in HIV-infected patients constitutes an essential tool in the prevention of the most common infectious diseases. The Ligurian Vaccination in HIV Program is a proposed vaccination schedule specifically dedicated to this risk group. Selective strategies are proposed within this program, employing ICT (Information and Communication) tools to identify this susceptible target group, to monitor immunization coverage over time and to manage failures and defaulting. Read More

    Incidence of AIDS-Defining Opportunistic Infections in a Multicohort Analysis of HIV-infected Persons in the United States and Canada, 2000-2010.
    J Infect Dis 2016 Sep 18;214(6):862-72. Epub 2016 Apr 18.
    Divisions of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia.
    Background: There are few recent data on the rates of AIDS-defining opportunistic infections (OIs) among human immunodeficiency virus (HIV)-infected patients in care in the United States and Canada.

    Methods: We studied HIV-infected participants in 16 cohorts in the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD) during 2000-2010. After excluding 16 737 (21%) with any AIDS-defining clinical events documented before NA-ACCORD enrollment, we analyzed incident OIs among the remaining 63 541 persons, most of whom received antiretroviral therapy during the observation. Read More

    ECIL guidelines for preventing Pneumocystis jirovecii pneumonia in patients with haematological malignancies and stem cell transplant recipients.
    J Antimicrob Chemother 2016 09 12;71(9):2397-404. Epub 2016 May 12.
    Department of Haematology, Henri Mondor Teaching Hospital, Assistance Publique-Hôpitaux de Paris, and Université Paris-Est-Créteil, Créteil, France
    The 5th European Conference on Infections in Leukaemia (ECIL-5) meeting aimed to establish evidence-based recommendations for the prophylaxis of Pneumocystis jirovecii pneumonia (PCP) in non-HIV-infected patients with an underlying haematological condition, including allogeneic HSCT recipients. Recommendations were based on the grading system of the IDSA. Trimethoprim/sulfamethoxazole given 2-3 times weekly is the drug of choice for the primary prophylaxis of PCP in adults ( A-II: ) and children ( A-I: ) and should be given during the entire period at risk. Read More

    Pneumocystis jirovecii pneumonia: still a concern in patients with haematological malignancies and stem cell transplant recipients.
    J Antimicrob Chemother 2016 09 12;71(9):2379-85. Epub 2016 May 12.
    Department of Haematology, Acute Leukaemia and Stem Cell Transplantation Unit, University Hospitals Leuven, Campus Gasthuisberg, Leuven, Belgium.
    Pneumocystis jirovecii can cause life-threatening pneumonia following treatment for haematological malignancies or after HSCT. The mortality rate of P. jirovecii pneumonia (PCP) in these patients is 30%-60%, especially after HSCT. Read More

    Forecast analysis of any opportunistic infection among HIV positive individuals on antiretroviral therapy in Uganda.
    BMC Public Health 2016 08 11;16(1):766. Epub 2016 Aug 11.
    Department of Epidemiology and Biostatistics, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda.
    Background: Predicting future prevalence of any opportunistic infection (OI) among persons infected with the human immunodeficiency virus (HIV) on highly active antiretroviral therapy (HAART) in resource poor settings is important for proper planning, advocacy and resource allocation. We conducted a study to forecast 5-years prevalence of any OI among HIV-infected individuals on HAART in Uganda.

    Methods: Monthly observational data collected over a 10-years period (2004-2013) by the AIDS support organization (TASO) in Uganda were used to forecast 5-years annual prevalence of any OI covering the period 2014-2018. Read More

    Human Immunodeficiency Virus as a Chronic Disease: Evaluation and Management of Nonacquired Immune Deficiency Syndrome-Defining Conditions.
    Open Forum Infect Dis 2016 Apr 12;3(2):ofw097. Epub 2016 May 12.
    Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria and Universidad de Alcalá , Madrid.
    In the modern antiretroviral therapy (ART) era, motivated people living with human immunodeficiency virus (HIV) who have access to therapy are expected to maintain viral suppression indefinitely and to receive treatment for decades. Hence, the current clinical scenario has dramatically shifted since the early 1980s, from treatment and prevention of opportunistic infections and palliative care to a new scenario in which most HIV specialists focus on HIV primary care, ie, the follow up of stable patients, surveillance of long-term toxicities, and screening and prevention of age-related conditions. The median age of HIV-infected adults on ART is progressively increasing. Read More

    Antiretroviral Drugs for Treatment and Prevention of HIV Infection in Adults: 2016 Recommendations of the International Antiviral Society-USA Panel.
    JAMA 2016 Jul;316(2):191-210
    University of California San Francisco.
    Importance: New data and therapeutic options warrant updated recommendations for the use of antiretroviral drugs (ARVs) to treat or to prevent HIV infection in adults.

    Objective: To provide updated recommendations for the use of antiretroviral therapy in adults (aged ≥18 years) with established HIV infection, including when to start treatment, initial regimens, and changing regimens, along with recommendations for using ARVs for preventing HIV among those at risk, including preexposure and postexposure prophylaxis.

    Evidence Review: A panel of experts in HIV research and patient care convened by the International Antiviral Society-USA reviewed data published in peer-reviewed journals, presented by regulatory agencies, or presented as conference abstracts at peer-reviewed scientific conferences since the 2014 report, for new data or evidence that would change previous recommendations or their ratings. Read More

    Screening HIV-Infected Patients with Low CD4 Counts for Cryptococcal Antigenemia prior to Initiation of Antiretroviral Therapy: Cost Effectiveness of Alternative Screening Strategies in South Africa.
    PLoS One 2016 8;11(7):e0158986. Epub 2016 Jul 8.
    National Institute for Communicable Diseases - Centre for Opportunistic, Tropical and Hospital Infections, Johannesburg, South Africa.
    Background: In 2015 South Africa established a national cryptococcal antigenemia (CrAg) screening policy targeted at HIV-infected patients with CD4+ T-lymphocyte (CD4) counts <100 cells/ μl who are not yet on antiretroviral treatment (ART). Two screening strategies are included in national guidelines: reflex screening, where a CrAg test is performed on remnant blood samples from CD4 testing; and provider-initiated screening, where providers order a CrAg test after a patient returns for CD4 test results. The objective of this study was to compare costs and effectiveness of these two screening strategies. Read More

    Bacterial infections in HIV-infected children admitted with severe acute malnutrition in Durban, South Africa.
    Paediatr Int Child Health 2017 Feb 4;37(1):6-13. Epub 2016 Jul 4.
    a King Edward VIII Hospital , Durban.
    Background: Bacterial infections in HIV-infected children admitted with severe acute malnutrition (SAM) contribute to higher mortality and poorer outcomes. This study describes the spectrum of bacterial infections in antiretroviral treatment (ART)-naïve, HIV-infected children admitted with SAM.

    Methods: Between July 2012 and February 2015, 82 children were prospectively enrolled in the King Edward VIII Hospital, Durban. Read More

    Liver involvement in human immunodeficiency virus infection.
    Indian J Gastroenterol 2016 Jul 3;35(4):260-73. Epub 2016 Jun 3.
    Department of Internal Medicine, Armed Forces Medical College, Pune, 411 040, India.
    The advances in management of patients with acquired immunodeficiency syndrome (AIDS) with highly effective anti-retroviral therapy (HAART) have resulted in increased longevity of patients with human immunodeficiency virus (HIV) infection. AIDS-related illnesses now account for less than 50 % of the deaths, and liver diseases have emerged as the leading cause of death in patients with HIV infection. Chronic viral hepatitis, drug-related hepatotoxicity, non-alcoholic fatty liver disease, and opportunistic infections are the common liver diseases that are seen in HIV-infected individuals. Read More

    Pneumocystis jirovecii Pneumonia in the Non-HIV-Infected Population.
    Ann Pharmacother 2016 Aug 30;50(8):673-9. Epub 2016 May 30.
    Ohio Northern University, Ada, OH, USA
    Objective: Summarize data on the pathophysiology, treatment, and prevention options for non-AIDS immunocompromised patients who have Pneumocystis jirovecii pneumonia (PJP); review the epidemiology of patients presenting with PJP; and discuss the first and second-line pharmacological options for treatment and prophylaxis of PJP in this population.

    Data Sources: MEDLINE (1989-February 2016) searched. Terms searched included combinations of Pneumocystis jirovecii, Pneumocystis carinii, non-HIV, infected, patients, prevention, prophylaxis, Bactrim, treatment, AIDS, opportunistic, immunocompromised, cancer, and pathophysiology

    Study Selection And Data Extraction: Articles included had the most relevant information on PJP pathophysiology, and first-/second-line treatment and prophylactic options. Read More

    Integration of outpatient infectious diseases clinic pharmacy services and specialty pharmacy services for patients with HIV infection.
    Am J Health Syst Pharm 2016 Jun 28;73(11):757-63. Epub 2016 Apr 28.
    Department of Pharmacy, Northwestern Memorial Hospital, Chicago, IL
    Purpose: The integration of specialty pharmacy services and existing outpatient clinical pharmacy services within an infectious diseases (ID) clinic to optimize the care of patients with human immunodeficiency virus (HIV) infection is described.

    Summary: The management of HIV-infected patients is a highly specialized area of practice, often requiring use of complex medication regimens for reduction of HIV-associated morbidity and mortality prophylaxis and treatment of opportunistic infections, and prevention of HIV transmission. To maximize the effectiveness and safety of treatment with antiretroviral agents and associated pharmacotherapies, an interdisciplinary team is often involved in patient care. Read More

    Opportunistic diseases among HIV-infected patients: a multicenter-nationwide Korean HIV/AIDS cohort study, 2006 to 2013.
    Korean J Intern Med 2016 Sep 27;31(5):953-60. Epub 2016 Apr 27.
    Division of Infectious Disease, Department of Internal Medicine, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.
    Background/aims: The frequencies of opportunistic diseases (ODs) vary across countries based on genetic, environmental, and social differences. The Korean HIV/AIDS cohort study was initiated in 2006 to promote research on human immunodeficiency virus (HIV) infection in Korea, and to provide a logistical network to support multicenter projects on epidemiological, clinical, and laboratory aspects of HIV infection. This study evaluated the prevalence of ODs among HIV-infected patients in the era of highly active antiretroviral therapy, and the risk factors associated with ODs. Read More

    Executive summary: Prevention and treatment of opportunistic infections and other coinfections in HIV-infected patients: May 2015.
    Enferm Infecc Microbiol Clin 2016 Oct 5;34(8):517-23. Epub 2016 Apr 5.
    Opportunistic infections continue to be a cause of morbidity and mortality in HIV-infected patients. They often arise because of severe immunosuppression resulting from poor adherence to antiretroviral therapy, failure of antiretroviral therapy, or unawareness of HIV infection by patients whose first clinical manifestation of AIDS is an opportunistic infection. The present article is an executive summary of the document that updates the previous recommendations on the prevention and treatment of opportunistic infections in HIV-infected patients, namely, infections by parasites, fungi, viruses, mycobacteria, and bacteria, as well as imported infections. Read More

    Rev Inst Med Trop Sao Paulo 2015 Dec;57(6):531-5
    Instituto de Infectologia Emílio Ribas, São Paulo, SP, Brasil.
    The reactivation of Chagas disease in HIV infected patients presents high mortality and morbidity. We present the case of a female patient with confirmed Chagasic meningoencephalitis as AIDS-defining illness. Interestingly, her TCD4+ lymphocyte cell count was 318 cells/mm3. Read More

    Successful Orthotopic Heart Transplantation and Immunosuppressive Management in 2 Human Immunodeficiency Virus-Seropositive Patients.
    Tex Heart Inst J 2016 Feb 1;43(1):69-74. Epub 2016 Feb 1.
    Few orthotopic heart transplantations have been performed in patients infected with the human immunodeficiency virus since the first such case was reported in 2001. Since that time, advances in highly active antiretroviral therapy have resulted in potent and durable suppression of the causative human immunodeficiency virus-accompanied by robust immune reconstitution, reversal of previous immunodeficiency, a marked decrease in opportunistic and other infections, and near-normal long-term survival. Although human immunodeficiency virus infection is not an absolute contraindication, few centers in the United States and Canada have performed heart transplantations in this patient population; these patients have been de facto excluded from this procedure in North America. Read More

    HIV-Associated Neuroretinal Disorder in Patients With Well-Suppressed HIV-Infection: A Comparative Cohort Study.
    Invest Ophthalmol Vis Sci 2016 Mar;57(3):1388-97
    Department of Ophthalmology, Academic Medical Center Amsterdam, Amsterdam, The Netherlands 9Department of Biomedical Engineering and Physics, Academic Medical Center, Amsterdam, The Netherlands 10Department of Ophthalmology, VU University Medical Center.
    Purpose: Loss of neuroretinal structure and function, ascribed to a 'HIV-associated Neuroretinal Disorder' (HIV-NRD), in the absence of ocular opportunistic infections, has been reported in HIV-infected individuals treated with combination antiretroviral therapy (cART). Whether HIV-infected individuals with prolonged well-suppressed infection remain at risk for HIV-NRD, is unknown.

    Methods: Ninety-two HIV-infected men with suppressed viremia on cART for at least 12 months (HIV+) and 63 HIV-uninfected, highly comparable, male controls (HIV-), aged at least 45 years, underwent functional measurements of spatial (Pelli Robson contrast sensitivity [PR CS]) and temporal contrast sensitivity (TCS) and straylight, as well as spectral-domain optical coherence tomography analysis measured total and individual retinal layer thickness. Read More

    Predictors of opportunistic illnesses incidence in post combination antiretroviral therapy era in an urban cohort from Rio de Janeiro, Brazil.
    BMC Infect Dis 2016 Mar 22;16:134. Epub 2016 Mar 22.
    Instituto de Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Avenida Brasil 4365, Manguinhos, CEP: 21045-900, Rio de Janeiro, Brazil.
    Background: Opportunistic illnesses still account for a huge proportion of hospitalizations and deaths among HIV-infected patients in the post combination antiretroviral therapy (cART) era, particularly in middle- and low-income countries. The aim of this study was to assess predictors of the top four most incident opportunistic illnesses (tuberculosis, esophageal candidiasis, cerebral toxoplasmosis and Pneumocystis jiroveci pneumonia) in an HIV clinical cohort from a middle-income country in the post cART era.

    Methods: A total of 2835 HIV infected participants aged ≥ 18 years at enrollment were followed from January 2000 to December 2012 until the occurrence of their first opportunistic illness, death or end of study, whichever occurred first. Read More

    Prevention and treatment of opportunistic infections and other coinfections in HIV-infected patients: May 2015.
    Enferm Infecc Microbiol Clin 2016 Oct 11;34(8):516.e1-516.e18. Epub 2016 Mar 11.
    Despite the huge advance that antiretroviral therapy represents for the prognosis of infection by the human immunodeficiency virus (HIV), opportunistic infections (OIs) continue to be a cause of morbidity and mortality in HIV-infected patients. OIs often arise because of severe immunosuppression resulting from poor adherence to antiretroviral therapy, failure of antiretroviral therapy, or unawareness of HIV infection by patients whose first clinical manifestation of AIDS is an OI. The present article updates our previous guidelines on the prevention and treatment of various OIs in HIV-infected patients, namely, infections by parasites, fungi, viruses, mycobacteria, and bacteria, as well as imported infections. Read More

    Epidemiology of HIV-Associated Lung Disease in the United States.
    Semin Respir Crit Care Med 2016 Apr 14;37(2):181-98. Epub 2016 Mar 14.
    Division of Global HIV and TB, Centers for Disease Control and Prevention, Atlanta, Georgia.
    The epidemiology of HIV infection and its pulmonary complications in the United States has evolved significantly over nearly 20 years since the advent of combination antiretroviral therapy. While infectious complications are less of a threat to patients whose immune systems have been restored, many HIV-infected persons in the United States remain at high risk for opportunistic infection because they are unaware of their HIV infection, have difficulty maintaining linkage to care, or maintain inadequate viral control. Bacterial pneumonia and Pneumocystis pneumonia remain significantly more prevalent among HIV-infected persons, and together with seasonal influenza are areas where public health efforts to increase antiretroviral therapy, appropriate prophylaxis, and vaccination may decrease burden of disease. Read More

    [Highlights of the third edition of Chinese guidelines for AIDS diagnosis and treatment(2015)].
    Zhejiang Da Xue Xue Bao Yi Xue Ban 2015 Nov;44(6):597-602
    Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai 200040, China.
    The third edition of Chinese guidelines for AIDS diagnosis and treatment was launched in 2015 by AIDS Professional Group, Society of Infectious Diseases, Chinese Medical Association. New edition emphasizes the importance of timely initiation of anti-retroviral therapy(ART). Like other guidelines, this edition recommends that once the HIV infection is confirmed, the ART should be initiated timely. Read More

    Efavirenz but Not Atazanavir/Ritonavir Significantly Reduces Atovaquone Concentrations in HIV-Infected Subjects.
    Clin Infect Dis 2016 Apr 20;62(8):1036-1042. Epub 2016 Jan 20.
    Critical Care Medicine Department, NIH Clinical Center, Bethesda, Maryland.
    Background: The current study was conducted to determine if efavirenz (EFV) or atazanavir/ritonavir (ATV/r)-based combination antiretroviral therapy (cART) impacted steady-state atovaquone plasma concentrations in human immunodeficiency virus (HIV)-infected patients receiving treatment doses of atovaquone.

    Methods: Thirty HIV-infected volunteers were recruited, 10 taking no cART and 10 each taking cART that included EFV or ATV/r. Subjects were randomly assigned to atovaquone 750 mg twice daily (BID) for 14 days followed by atovaquone 1500 mg BID for 14 days, or vice-versa, with a washout period in between. Read More

    HIV infection and immune activation: the role of coinfections.
    Curr Opin HIV AIDS 2016 Mar;11(2):191-200
    HIV Pathogenesis Section, Laboratory of Immunoregulation, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA.
    Purpose Of Review: This article explores new data from recent studies addressing the role of coinfections in immune activation in HIV-1-infected patients, with a focus on immune reconstitution inflammatory syndrome (IRIS), an aberrant inflammatory response occurring shortly after antiretroviral therapy (ART) initiation.

    Recent Findings: Chronic HIV infection is associated with several coinfections that contribute to immune activation in various settings including early after ART initiation in the most noticeable form of IRIS and also in chronic-treated infection, with chronic viral infections like cytomegalovirus and hepatitis C or hepatitis B virus contributing to immune activation and also morbidity and mortality. Expanding on older studies, the role of T cells in IRIS has been further elucidated with evidence of more pronounced effector activity in patients with IRIS that may be leading to excessive tissue disorder. Read More

    HIV-Associated Toxic Epidermal Necrolysis at San Francisco General Hospital.
    J Int Assoc Provid AIDS Care 2017 Jan/Feb;16(1):37-41. Epub 2016 Jul 7.
    3 Department of Dermatology, Temple University School of Medicine, Philadelphia, PA, USA.
    Objectives: We sought to characterize recent cases of toxic epidermal necrolysis (TEN) in HIV-infected patients at San Francisco General Hospital (SFGH), a large HIV referral center.

    Methods: This was a retrospective analysis of HIV-infected patients diagnosed with TEN from January 2001 to May 2014 at SFGH.

    Results: Ten cases of TEN were identified, 50% of which occurred in HIV-infected individuals. Read More

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