Exploration of adaptation process and experience among the HIV/AIDS patients based on the comprehensive task-based adaptation model / 中南大学学报(医学版)

OBJECTIVES@#Patients with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) confront multiple difficulties during the disease adaptation process. Based on the comprehensive task-based adaptation model, this study aims to explore the process and experience of adapting to living with HIV among HIV/AIDS patients and to provide evidence for promoting the adaptation of this population.@*METHODS@#With the design of the phenomenon study, we purposefully recruited 43 HIV/AIDS patients and conducted semi-structural interviews. The qualitative data was analyzed by Van Manen method.@*RESULTS@#There were 1 307 significant quotes and 6 themes with 14 sub-themes. "The shadow comes along with the sunshine" was proposed to describe the process of adapting to life with HIV. Another 5 themes emerged to represent the tasks as follows: the direction of the mental anchor, the management of physical tasks, social network and support, the occupational dilemma and benefits, and the consideration of the future.@*CONCLUSIONS@#The adapting process possesses both common and personalized characteristics. Future intervention development should address the integrality and interaction of the adaptation tasks, contributing to the positive adaptation outcomes of HIV/AIDS patients.

Linfomas en pacientes con VIH: una asociación compleja y frecuente. Revisión narrativa de la literatura / HIV-related lymphomas: a complex and frequent association. A narrative review of the literature

En Colombia, la infección por el virus de la inmunodeficiencia humana (VIH) es una epidemia en aumento. Ante la mejoría de la supervivencia general con la terapia antirretroviral altamente efectiva, la aparición de neoplasias malignas ha ido desplazando las complicaciones infecciosas como principal problema en esta población. Los linfomas no Hodgkin son las neoplasias malignas definitorias de síndrome de inmunodeficiencia adquirida (SIDA) más frecuentes después del sarcoma de Kaposi, siendo el linfoma B difuso de células grandes y el linfoma de Burkitt las variantes más comunes; por otra parte, el riesgo de desarrollar linfoma de Hodgkin clásico es 5 a 20 veces mayor en pacientes positivos para VIH en comparación con la población general. Realizar un diagnóstico temprano es un reto, debido a infecciones oportunistas y a la presentación atípica de la enfermedad en este grupo de pacientes. El tratamiento de la enfermedad también supone un desafío debido a las comorbilidades y el estado funcional de los pacientes al momento del diagnóstico; sin embargo, en conjunto con esquemas combinados de quimioterapia y al uso concomitante de la terapia antirretroviral, se ha mejorado considerablemente el pronóstico, el cual actualmente se acerca al de los pacientes seronegativos. Por medio de esta revisión, se pretende describir las principales características de los linfomas asociados al VIH, de tal forma que permita a los trabajadores en salud, tener mayores elementos para el abordaje integral de esta población en nuestro país

In Colombia, human immunodeficiency virus (HIV) infection is a growing epidemic. Given the improvement in overall survival with highly effective antiretroviral therapy, cancer has been displacing infectious complications in this population. Non-Hodgkin's lymphoma is the most common AIDS defining malignancy after Kaposi's sarcoma. Diffuse large B-cell lymphoma and Burkitt's lymphoma are the most common variants; meanwhile, the risk of developing classical Hodgkin lymphoma is 5 to 20-fold higher compared to HIV-negative individuals. Making an early diagnosis is a challenge, due to opportunistic infections and the atypical presentation of the disease in this group of patients. Treatment of the disease is also a challenge given the comorbidities and patient condition at diagnosis; however, in conjunction with combined chemotherapy regimens and the concomitant use of antiretroviral therapy, the outcome of patients with AIDS-related lymphomas has significantly improved, currently approaching that of seronegative patients. The aim of this review article is to describe the main characteristics of the disease, in such a way that it allows health workers to have more elements for a comprehensive approach in patients with AIDS-related lymphomas in our country

Seroprevalence of Toxoplasmosis at a Tertiary Care Centre in North India from 2004 to 2014

Purpose: This study was carried out to determine the seroprevalence of anti-Toxoplasma gondii antibodies in different groups of patients at a tertiary care hospital in North India. Materials and Methods: Clinical and demographic data such as age and gender of patients who had undergone testing for the presence of anti-T. gondii IgG and IgM antibodies between January 2004 and October 2014 were retrospectively analysed. Results: Amongst the 8397 serum samples, an overall seropositivity of 21% (n = 1763) and IgG and IgM seropositivity of 5.7% (n = 481) and 15.3% (n = 1282) were respectively observed. Compared to the period of 2004–2012 (median seroprevalence: 23.6%), a decline in seropositivity to 9.7% in 2013 and 8.1% in 2014 was noted. A rising seroprevalence with age and a higher seroprevalence in females versus males (29.5%, n = 1179 vs. 13.3%, n = 584) were recorded. The highest seroprevalence was observed in suspected ocular toxoplasmosis (47.2%, n = 47), followed by neurological (26.8%, n = 77), human immunodeficiency virus/acquired immunodeficiency syndrome (18.9%, n = 267), post-transplant (17.1%, n = 12) and congenital (7.2%, n = 144) toxoplasmosis. In patients screened for Toxoplasma exposure, the seropositivity was 47.8% (n = 11) in transplant screening and 44.9% (n = 781) in antenatal screening. Conclusion: Toxoplasma infection is highly prevalent in the population of North India across various clinical categories of patients. Future studies focusing on continuous monitoring of seroprevalence trends and elucidation of the risk factors associated with seropositivity in more defined groups of patients are needed.

Plasmablastic lymphoma in HIV patients: Experience at a tertiary care hospital in eastern India.

BACKGROUND: Plasmablastic lymphoma (PBL), a rare non‑Hodgkin’s lymphoma (NHL) variant specifically associated with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), expresses well‑differentiated plasma cell markers like CD138, bright CD38, and MUM1; but not conventional B‑cell markers. It occurs at unusual sites like oral cavity and orbit, and has poor survival rates. AIMS: This study serves as a review of a clinical experience with six HIV patients with PBL and observes the spectrum of clinical presentations, histopathologies, and 1‑year outcomes in PBL patients. MATERIALS AND METHODS: This review of six PBL patients was conducted at a tertiary care hospital in eastern India using relevant radiological, histopathogical, and immunohistological studies. RESULTS: Incidence of PBL among HIV patients was 0.58% (6/1,028). Mean CD4 count at presentation was 125.5 ± 71.1 cells/μL. Sites of involvement included pleura, lung parenchyma, suprarenal gland, pelvic cavity, and retroorbital space (one each). Immunohistopathology of biopsied sample in each patient revealed PBL (positive plasma cell markers MUM‑1/ IRF4, CD38, and CD138/syndecan; and negative of B‑cell markers CD3, CD20, and CD30). Three (60%) were positive for Epstein Barr virus (EBV) immunoglobulin G (IgG). Five surviving patients received CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) regimen and attained partial remission (PR) after six cycles. Subsequently, three patients were started on EPOCH (etoposide, cyclophosphamide, doxorubicin, vincristine, prednisone) therapy; two attained near total regression after 6 months (four cycles). Overall, four patients remained alive with good quality of life at the end of 1 year of follow‑up. CONCLUSION: PBL in HIV occurs at unusual sites with varying aggressivity. This study is too small to comment on the long‑term outcomes of PBL in HIV; however, coadministration of antiretroviral therapy (ART) with standard chemotherapy may improve survival.

Behavioral surveillance survey regarding human immunodeficiency virus/acquired immunodeficiency syndrome among high school and junior college students.

Background and Aims: It is necessary to know the baseline knowledge, attitude, and practices about human immunodeficiency virus/acquired immunodeficiency syndrome among young people and the changes in these with intervention to guide prevention efforts. Methods: A cross-sectional pre- and post-survey with health education as a method of intervention was carried out in four different randomly selected schools and junior colleges among the Class IX-XII students of both sex. Instrument developed by the World Health Organization (WHO)/UNAIDS in their best practice recommendations was used for data collection. Results: Knowledge about all correct methods was present in 61.23% of the respondents. Knowledge of at least two methods of prevention was present in 70.31% of the respondents. Misconceptions about prevention were that good diet (33.42%), avoiding mosquito bite (49.71%) and avoiding public toilets (65.14%) could help in the prevention. With intervention, there was an improvement in the knowledge. However, the proportion of students with misconceptions did not come down. Correct knowledge about two methods of prevention also did not reach the WHO recommendation of 90%. Conclusion: It is very difficult to change the attitude and practices by a single health educational intervention and an ongoing behavior change communication is recommended.