[Acute coronary syndrome during antiretroviral treatment]

The aim of this study is to determine epidemiological, clinical, therapeutic and outcome characteristics of acute coronary syndrome in AIDS patients under HAART. The charts of 5 patients were reviewed. The mean age, at the time of the discovery of HIV infection, was 35 years. Three patients were smokers and one had a family history of diabetes and acute coronary syndrome [ACS]. Three patients received 2 nucleoside reverse transcriptase inhibitors [NRTIs] with indinavir. The 2 others received 2 NRTIs with efavirenz with good immunovirologic response. Four patients developed mixed dyslipidemia after an average period of 26 months. Tow patients developed diabetes and one a hypertension. A specific treatment was initiated in all cases. These five patients developed an ACS after respectively 51, 95, 96,103 and 145 months of ART [median=98 months]. ACS occurred in 3 patients receiving 2 NRTIs and PI and two others 2 NRTIs with efavirenz. The mean age at the onset of ACS was 46 years. One patient underwent a triple bypass surgery, tow a stenting of the stenotic coronary and the last 2 patients received medical treatment with a good clinical outcome. The PI was replaced by efavirenz in two patients. Four patients had a recurrence of ACS respectively after 2months, 3 months, 12 months, and 62 months after the first episode. The five patients are still followed with good clinical and biological outcome

Flowcytometric analysis of T-lymphocytes and serum tumour necrosis factor alpha [TNF- alpha] levels in schistosoma mansoni patients

Analysis of T-lymphocytes by flowcytometry, estimation of serum TNF-alpha level by solid phase enzyme amplified sensitivity immunoassay [EASIA] and IHAT were done for chronic schistosomiasis mansoni patients without hepatic fibrosis, with hepatosplenomegaly and 20 healthy controls. The sensitivity and specificity of IHAT in schistosomiasis mansoni were 85% and 90% respectively. Chronic schistosomiasis mansoni patients showed increase in CD8% [27.3 +/- 5.3] and decrease in CD4% [44.2 +/- 4.68]. Hepatosplenomegaly cases showed increase in CD4% [46.5 +/- 4.1] and decrease in CD8% [23.2 +/- 2.18]. Serum level of TNF-alpha was significantly higher in cases with hepatosplenomegaly compared to either cases of chronic schistosomiasis mansoni or controls. No significant difference was between chronic schistosomiasis mansoni patients and controls. A correlation between hepatosplenomegaly and increase of CD4 and/or decrease of CD8 and significant high level of TNF-alpha indicated TNF-alpha role in granuloma formation