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Patients infected with human immunodeficiency virus (HIV) are prone to renal insufficiency, which may progress into end-stage renal disease (ESRD). HIV infection has been previously considered as an absolute contraindication of transplantation. The lives of HIV-positive ESRD patients can only maintained through dialysis. With the development of medicine, transplantation practitioners at home and abroad attempt to perform kidney transplantation in HIV-positive patients. Whether kidney transplantation is feasible for HIV-positive patients, whether HIV-positive donor kidneys can be used for transplantation, and the efficacy of kidney transplantation for HIV-positive patients has always been hot topics in the field of transplantation. In this article, HIV-associated nephropathy, the conditions of kidney transplantation for HIV-positive patients, the efficacy of kidney transplantation for HIV-positive patients, use of HIV-positive donor kidneys, use of immune-inducing drugs and postoperative use of immunosuppressants for HIV-positive patients were illustrated, aiming to provide reference for kidney transplantation for HIV-positive patients in clinical practice, application of HIV-positive donor kidneys and postoperative management of HIV-positive patients.
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Objective To determine the status of HIV/AIDS-related knowledge, attitude and behavior in college students, and to provide the theoretical basis for strategy of control and prevention. Methods By using random cluster sampling method, we conducted an anonymous online questionnaire survey on a total of 917 young students in Songjiang District of Shanghai. Results The awareness rate of HIV/AIDS-related knowledge was 71.8% among 903 responders. 11.1% of the students had sexual experience, and the rate was higher in male students than in female students(χ2 = 10.549, P < 0.01). The average age of first sexual intercourse was 18.4±1.3 years old, and 60.0% of the students used condom when having sex for the first time. In this survey, only 28.2% were willing to take anonymous HIV antibody urine test, and 1.8% of the students had been tested for HIV. Conclusion The overall awareness rate of knowledge of prevention and control of HIV/AIDS, the rate of condom use, and the willingness to take anonymous HIV antibody urine test are low among young college students in Songjiang District of Shanghai. We suggest to carry out targeted health education activities and to expand coverage of HIV testing by promoting the anonymous HIV antibody urine test for control the spread of HIV/AIDS among young students.
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With the advent of highly active antiretroviral therapy (HAART), acquired immune deficiency syndrome (AIDS) has gradually evolved from an incurable terminal disease to a controllable chronic disease. Due to the extended survival of AIDS patients, chronic renal failure and (or) chronic liver failure have become the main cause of death, and AIDS patients with chronic liver failure are constantly complicated with hepatitis C virus (HCV) infection. Human immunodeficiency virus (HIV) infection was previously considered as a contraindication for liver transplantation. With the deepening of medical cognition and improvement of surgical management experience, the quantity of HIV positive liver transplantation recipients has been steadily elevated and high long-term survival rate has been achieved. Nevertheless, the 3-, 5-, and 10-year survival rates after liver transplantation of HIV combined with HCV positive patients remain extremely low. In this article, the development of liver transplantation in HIV positive patients, the disease progression of HIV combined with HCV positive patients, and the treatment for the recurrence of viral hepatitis C after the operation were summarized.
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@#Introduction: Immune reconstitution inflammatory syndrome (IRIS) is paradoxical clinical deterioration experienced by some HIV-infected patients in response to antiretroviral therapy (ART). There is still limited published data on IRIS from this region including Malaysia. This study aimed to determine IRIS prevalence, clinical manifestations and possible predictors among HIV-infected patients in an infectious disease centre in Peninsular Malaysia. Method: This retrospective study was conducted in Hospital Sungai Buloh involving secondary data of 256 HIV-infected patients who were initiated on ART in the year 2017. Medical record of each patient was reviewed for up to 12 months following ART initiation to identify IRIS diagnosis which was made by the treating physician. Relevant clinical and laboratory information were retrieved from hospital electronic database. Results: IRIS has occurred in 17.6% of patients. Infections by Mycobacterium tuberculosis (53.3%), Pneumocystis jirovecii (11.1%) and Talaromyces marneffei (6.6%) were the commonest three aetiologies of IRIS. Subacute lupus erythematosus was the only non-infectious IRIS identified. Baseline HIV viral load, CD4+ T-cell count and haemoglobin level between IRIS and non-IRIS patients were significantly different. Risk of developing IRIS was increased seven times in patients with CD4+ T-cell count < 100 cells/µL and four times in patients with HIV RNA viral load > 5.5 log10 copies/ml prior to ART initiation. Conclusion: Mycobacterium tuberculosis infections were the highest IRIS manifestation. Although rare, non-infectious IRIS does occur and should be part of the differential diagnosis. Patients with positive predictors should be appropriately monitored for possible IRIS development once initiated on ART.
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Objective: In this study, we investigated the changes in peripheral blood inflammatory factors and intestinal flora in acquired immune deficiency syndrome (AIDS) and human immunodeficiency virus (HIV)-positive individuals (AIDS/HIV patients), and explored the relationships among intestinal flora, peripheral blood inflammatory factors, and CD4+ T lymphocytes. Methods: Thirty blood and stool samples from an AIDS group and a control group were collected. The levels of tumor necrosis factor-a (TNF-a) and interleukin-6 (IL-6) were determined by enzyme-linked immunosorbent assay (ELISA), and the number of CD4+ T lymphocytes by a FACSCount automated instrument. Quantitative real-time polymerase chain reaction (qRT-PCR) was used to determine the messenger RNA (mRNA) levels of Bifidobacterium, Lactobacillus, Escherichia coli, Enterococcus faecalis, and Enterococcus faecium. Correlations among intestinal flora, inflammatory factor levels, and CD4+ T lymphocyte values were evaluated using the Spearman correlation coefficient. Results: The levels of TNF-a and IL-6 in the AIDS group were higher than those in the control group, while the number of CD4+ T lymphocytes was lower. The amounts of Bifidobacterium and Lactobacillus in the AIDS group were significantly lower than those in control group, while the amounts of E. coli, E. faecalis, and E. faecium were much higher. The amounts of Bifidobacterium and Lactobacillus were negatively correlated with the content of TNF-a and IL-6 and the CD4+ T lymphocyte count, while those correlations were reversed for E. coli, E. faecalis, and E. faecium. Conclusions: The intestinal microbiota of AIDS/HIV patients were disordered, and there was a correlation between the amount of intestinal flora and the number of CD4+ T lymphocytes and the levels of TNF-a and IL-6.
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<p><b>OBJECTIVE</b>To compare the effects of moxibustion combined with highly active antiretroviral therapy (HAART) and simple HAART for human immunodeficiency virus (HIV) infected patients.</p><p><b>METHODS</b>A total of 100 patients with HIV receiving HAART were randomized into an observation group and a control group, 50 cases in each one. In the observation group, moxibustion was used at Zusanli (ST 36), Guanyuan (CV 4) and Sanyinjiao (SP 6), etc. combined with HAART of zidovudine, lamivudine, nevirapine and efavirenzone, etc. Simple HAART was used in the control group. The patients were observed for 18 months. The indexes were CD, CD/CD, interleukin 2 (IL-2), interleukin 7 (IL-7), the incidence of side effects and the score of quality of life.</p><p><b>RESULTS</b>After treatment, CD, CD/CD, serum IL-2 and the scores of quality of life (physiological, psychological, social relation fields and comprehensive score) increased and serum IL-7 decreased compared with those before treatment in the two groups (<0.01,<0.05), with better results except CDin the observation group (<0.01,<0.05). The incidences of gastrointestinal side effects and total side effects in the observation group were lower than those in the control group (14% (7/50) vs 32% (16/50), 58% (29/50) vs 80% (40/50), both<0.05).</p><p><b>CONCLUSION</b>Moxibustion combined with HAART for HIV infected patients could reduce the incidence of side effects, improve medication compliance, CD/CD, IL-2, IL-7 and the quality of life.</p>
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A very few health care providers look after HIV/AIDS people because of their poor knowledge and either their lack of positive attitude or usually both. The rationale of this study was to evaluate the knowledge and attitudes of health care providers (tertiary care hospitals in Lahore, having HIV/AIDS Treatment Facility) towards patients with HIV/AIDS. In this cross sectional study, a random sample of 180 healthcare providers was assessed for their knowledge and attitudes. In the questionnaire of knowledge, items were measured in the form of dichotomous scale. Whereas in the five domains of attitudes, items were measured as a five-point likert scale ranging from strongly disagree to strongly agree. Results were discussed in the outlook of two variables which showed that the presence of negative attitude and lack of awareness increase the level of stigma and discrimination. HIV in our country needs positive attitude of rendering care and effective control measures by creating awareness in the community. The study reinforced the need for an ongoing education focused on experiential learning, and professional socialization.
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Objective To evaluate effect of intervention on acquired immune deficiency syndrome(AIDS) high-risk sexual behavior of males who have sex with males(MSM)population in Jilin,and to provide a basis for establishing apropriate intervention strategy for this population.Methods A cross-sectional survey was carried out on the MSM population of young students with the method of classification.Comprehensive intervention strategy included health education via new media,behavioral intervention,voluntary conseling and testing,peer education,condom promotion and standardized services for clinic of sexually transmitted diseases(STDs)and other comprehensive interventions.Before and after intervention,300 MSM were enrolled,and their demographic characteristics,knowledge of AIDS prevention and control,high risk behaviors and intervention measures were investigated and analyzed.Results Before and after the intervention,the awareness rate of AIDS related knowledge was 67.67％ and 94.33％,respectively,the condom usage rate was 23.57％ and 11.79％ in the most recent and the last 6 months before the intervention,and it was 76.21％ and 62.10 ％ after the intervention,respectively.The proportion for those who used condom every time in heterosexual sex behavior was increased from 23.53％ (before intervention) to 69.60 ％ (after intervention),and the condom usage rate in the last 6 months was increased from 15.44％ to 66.40％.Proportion of the MSM who had STDs related symptoms was decreased from 21.33％ to 7.67％ after the intervention.Conclusion After the comprehensive intervention,the awareness rate of AIDS related knowledge among MSM in Jilin is significantly increased,the incidence of highrisk sexual behavior is decreased and the condom usage rate is improved.Intervention by use of new media is low-cost,easy to operate,and can be used as a good supplementary strategy for traditional behavioral intervention.
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Objective To investigate the clinical features and risk factors of cytomegalovirus (CMV)infection in AIDS patients.Methods A total of 471 AIDS patients,including 173 with CMV infection and 298 without CMV infection were enrolled from Zhongnan Hospital of Wuhan University from June 2015 to August 2016.Multivariate Logistic regression was performed to analyze the risk factors for AIDS patients infected with CMV.Results Among 173 patients co-infected with CMV,103 (59.54%)were diagnosed as CMV viremia,70(40.46%)were CMV end-organ diseases (EOD),in which CMV pneumonia (n =33)and CMV retinitis (n =22)were the most frequent diseases.Univariate analysis showed that sexual transmission,low CD4 +T lymphocyte counts,first visit,tuberculosis,pneumococcal pneumonia (PCP), long hospital stay and septicemia were risk factors of cytomegalovirus infection among patients with AIDS (P <0.05).Multivariate Logistic regression analysis demonstrated that CD4 +T lymphocyte <50 cells/μL (OR =3.897,95%CI 2.354-6.453),concomitant tuberculosis(OR =4.619,95%CI 2.501 -8.529),PCP (OR =4.062,95%CI 2.345-7.038),sepsis (OR =2.553,95%CI 1 .098-5.936)were independent risk factors for CMV infection,while antiretroviral therapy (OR =0.559,95%CI 0.342-0.912)was a protective factor.Conclusions Hospitalized AIDS patients have a high incidence of CMV infection which has a tendency to induce multiple organ damage,and relevant risk factors should be avoid to accentuate disease as much as possible.
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People living with Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) (PLH/PLHA) are increasing worldwide (29.8 million in 2001 and 36.9 million in 2014) mainly owing to the aversion of AIDS related deaths by effective antiretroviral therapy (ART). Although the prevalence is increasing, the new HIV infections decreased from 3.4 million in 2001 to 2 million in 2014, and AIDS-related deaths were decreased from the peak of 2.4 million in 2005 to 1.2 million in 2014. Implementation of ART with wide coverage and free access, especially in low- and middle-income countries is an important reason for the decline of AIDS-related deaths. Further, it is expected that the recent understanding in the mechanisms of latent infection and importance of reservoir could help to achieve a "functional cure" from HIV infection in near future.
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Se presenta caso clínico de paciente con lesiones blanquecinas en bordes laterales de lengua de 1 año de evolución aproximadamente; clínicamente asintomático, sin hábitos tóxicos ni antecedentes médicos de importancia. Actualmente bajo tratamiento ortodóntico, en donde el especialista lo alerta sobre la importancia de interconsultar con el Patólogo Bucal. Luego de una exhaustiva historia clínica, se toma muestra de la lesión y el examen histopatológico arrojó: hiperplasia epitelial exofítica, paraqueratosis excesiva y células superficiales en forma de globo con típica fragmentación nuclear, indicativo de inclusión viral (Cuerpos de Cowdry). Con estos hallazgos, la correlación con las características clínicas de la lesión y los exámenes serológicos (positivo para VIH), se llega a un diagnóstico conclusivo de Leucoplasia Pilosa Bucal (LPB). Se remitió el paciente al Instituto Anzoatiguense de la Salud (SALUDANZ), entidad encargada de problemas de Salud Pública en el Edo. Anzoátegui. La Leucoplasia Pilosa Bucal (LPB) se presenta comúnmente en pacientes VIH+ y representa un factor informativo y predictivo para el odontólogo, estomatólogo y cualquier especialista de la rama de la salud, en cuanto al tratamiento, diagnóstico y pronóstico bucal y sistémico del paciente.
We report the clinical case of a patient with whitish lesions on lateral tongue edges with 1 year of evolution approximately, clinically asymptomatic, without toxic habits or important medical history. The patient was in orthodontic treatment, when the specialist warns the importance of Bucal Pathologist review. After a thorough medical history, biopsy was taken and histopathological examination showed: exophytic epithelial hyperplasia, excessive parakeratosis and superficial balloon cells with typical nuclear fragmentation, indicative of viral inclusion (Cowdry Body´s). With these findings and correlation with lesion clinical features and serological tests (HIV positive), the final diagnosis was Bucal Hairy leukoplakia (OHL). The patient was referred Anzoatiguense Health Institute (Saludanz), entity responsible of public health problems in the Anzoátegui State, Venezuela. The Bucal Hairy Leukoplakia (OHL) occurs commonly in HIV patients and represents an informative and predictive factor for the dentist, stomatologist and any health branch specialist for treatment, diagnosis and prognosis of the patient.
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Humans , Male , Adult , Mouth Diseases/complications , Mouth Diseases/etiology , Leukoplakia, Oral/pathology , Acquired Immunodeficiency Syndrome/pathology , Carcinoma, Squamous Cell , Oral Medicine , Pathology, OralABSTRACT
Perinatal transmission of Human immunodeficiency virus(HIV),also called mother-to-child transmission(MTCT),accounts for 90% of infections in infants worldwide and occurs in 30%-45% of children born to untreated HIV-1 infected mothers.Among HIV-1 infected mothers,some viruses are transmitted from mothers to their infants while others are not.The relationship between virologic properties and the pathogenesis caused by HIV-1 remains unclear.Previous studies have demonstrated that one obvious source of selective pressure in the perinatal transmission of HIV-1 is maternal neutralizing antibodies.Recent studies have shown that viruses which are successfully transmitted to the child have growth advantages over those not transmitted,when those two viruses are grown together.Furthermore,the higher fitness is determined by the gp120 protein of the virus envelope.This suggests that the selective transmission of viruses with higher fitness occurred exclusively,regardless of transmission routes.There are many factors contributing to the selective transmission and HIV replicative fitness is an important one that should not be neglected.This review summarizes current knowledge of the role of HIV replicative fitness in HIV MTCT transmission and the determinants of viral fitness upon MTCT.
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Patients with AIDS frequently present with pulmonary complications which are associated with a high mortality rate and infections are the most important cause of lung infiltrates. In addition to pneumonia caused by Pneumocystis carinii, which was noted in early reports of the syndrome, a variety of other severe pulmonary disorders may occur. Frequently more than one organism is found in a single patient and among these, combined infections of Pneumocystis carinii and cytomegalovirus are the most common. We experienced a case of combined Pneumosytis carinii and Mycobacterium tuberculosis infection as a pulmonary manifestation of AIDS in a 38-year-old man. In bronchoalveolar larvage, bronchial washing and brushing, and sputum smear specimens, Pneumocystis carinii organisms were recognized, especially in Gomori's methenamine silver stains. Transbronchial lung biopsy specimen revealed intra-alveolar frothy exudates composed of collections of Pneumocystis carinii organisms as well as several granulomas with central caseous necroses.
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Mortality , BiopsyABSTRACT
The status and progress in research of anti-AIDS agents at home and abroad are reviewed, some suggestions have been made for further steps in this research work.
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Authors report the first autopsy case of acquired immune deficiency syndrome in Korea. The patient was a 26 years old Korean male who died of respiratory failure due to mixed pulmonary infections. He had history of homosexual contacts with partners of both domestic and foreign nationalities. Initial presentation was unexplained fever for two months. Serological test and western blot test for anti-HIV were positive and T-cell subset analysis revealed T3/T4/T8 to be 73/8/67%. Pulmonary tuberculosis with mediastinal lymphadenopathy and esophagonadal fistula and oral candidiasis were presented. Respiratory infection progressed gradually and he died seven months after the initial symptom. Autopsy findings were generalized severe lymphoid cell depletion, especially of T-cell population and mixed pulmonary infections with Pneumocystis carinii and cytomegalovirus (CMV). The CMV infection involved lungs and adrenals. Oral candidiasis was also demonstrated.