[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

[Isosporosis in AIDS, about five Tunisian cases]

Isosporosis is a digestive parasitosis that occurs on a sporadic basis in our country. It is caused by a protozoan of coccidia class: Isospora belli. Between the years 2000 and 2004, five cases of isosporosis were diagnosed in our laboratory in five AIDS patients. Its prevalence among tunisian patients suffering from Human Iminunodeficiency Virus [HIV] infection in our series is about 1.41%. Main clinical manifestations consisted of acute diarrhea, with malabsorption syndrome in one case. Medical management based on specific antibiotics [sulfamethoxazole-trimethoprime], is efficient in avoiding recurrent episodes. However, recurrency remain frequent as long as immunity remains compromised

[Study of psychosocial factors of HIV infected patients in Tunisia]

We conducted a prospective study using an anonymous questionnaire and semistructured interviews on 60 patients with HIV to assess the psychological and socioenvironmental factors that may result in risk-taking behaviour. The patients were mainly young males [mean age 33.1 +/- 7.0 years] [sex ratio 2.3] deprived in both social and educational terms. Injecting drug use was the predominant risk factor and was characteristic of a first group of young men raised in large families shattered by rural-urban migration, with an antisocial personality. A second group consisted of women, mostly illiterate from traditional rural settings. They had been infected by their spouses who had worked abroad, whether drug users or not. Approaches for the prevention of HIV infection are proposed