Significance of Increased Rapid Treatment from HIV Diagnosis to the First Antiretroviral Therapy in the Recent 20 Years and Its Implications: the Korea HIV/AIDS Cohort Study

From December 2006 to December 2016, 1,429 patients enrolled in the Korea human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) Cohort Study were investigated. Based on the year of diagnosis, the time interval between HIV diagnosis and initiation of antiretroviral therapy (ART) was analyzed by dividing it into 2 years. The more recent the diagnosis, the more likely rapid treatment was initiated (P < 0.001) and the proportion of patients starting ART on the same day of HIV diagnosis was increased in 2016 (6.5%) compared to that in 2006 (1.7%). No significant difference in the median values of CD4+ cell counts according to the diagnosis year was observed. In the past 20 years, the time from the HIV diagnosis to the initiation of ART was significantly reduced. Rapid treatment was being implemented at the HIV diagnosis, regardless of CD4+ cell count. Considering the perspective “treatment is prevention,” access to more rapid treatment is necessary at the time of HIV diagnosis.

Mode of Human Immunodeficiency Virus Transmission in Korea: The Korea HIV/AIDS Cohort Study / 대한내과학회지

BACKGROUND/AIMS: Global efforts to prevent human immunodeficiency virus (HIV) infection and strengthen treatment programs have reduced the annual incidence of HIV infection. However, the incidence recently increased unexpectedly in Korea. Therefore, to understand the cause of the increase in HIV infection incidence in Korea, it is important to identify the mode of HIV transmission. METHODS: We included HIV-infected individuals enrolled in the Korea HIV/AIDS (acquired immune deficiency syndrome) Cohort from December 2006 to January 2018. The subjects were older than 18 years and were receiving care at 21 participating hospitals. They were interviewed by their physician at enrollment, and an epidemiological survey was conducted using a standardized questionnaire provided by a professional counseling nurse. RESULTS: There were 1,474 subjects: 1,377 men and 97 women. Their mean age was 41.4 ± 12.6 years, and the male-to-female ratio was 14.2. The transmission modes were as follows: homosexual and bisexual contacts in 885 (60.1%), heterosexual contacts in 508 (34.6%), blood transfusion and blood products in 5 (0.3%), and injected drug use in 1 (0.0%). Regarding age, the proportion infected by homosexual and bisexual contacts was higher in the younger age groups: 71.5% in subjects aged 18-29 years. When this age group was further subdivided, 92.9% of those aged 18–19 years were determined to be infected via homosexual and bisexual contacts. CONCLUSIONS: In Korea, HIV is transmitted predominantly via homosexual and bisexual contacts, which is more common among younger age groups and the cause of infections in most teenagers.

Human Immunodeficiency Virus (HIV) and Hepatitis Virus Coinfection among HIV-Infected Korean Patients: The Korea HIV/AIDS Cohort Study / 감염과화학요법

BACKGROUND: Despite declines in mortality and morbidity rates of patients with human immunodeficiency virus (HIV) infection as the result of highly active antiretroviral therapy, liver diseases due to chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are a leading cause of death among HIV-infected patients. However, HIV and HBV or HCV coinfection is still poorly documented, and more information is needed to better understand the characteristics of HIV-infected patients in Korea. MATERIALS AND METHODS: A cross-sectional study was performed to investigate clinical characteristics and prevalence of HBV and HCV infection in HIV patients enrolled in the Korea HIV/acquired immune deficiency syndrome (AIDS) cohort study from 17 institutions between December 2006 and July 2013. RESULTS: Among the 1,218 HIV-infected participants, 541 were included in this study. The prevalence of HBV-HIV and HCV-HIV coinfection was 5.0% (27/541) and 1.7% (9/541), respectively. There was no patient who was positive for both HBs antigen and HCV antibody. In multivariate logistic regression analysis, HBV unvaccinated status was a significant risk factor for HBV-HIV coinfection (odds ratio = 4.95, 95% confidence interval = 1.43–17.13). CONCLUSIONS: HBV and HCV infection was more common in HIV-infected persons enrolled in the Korean HIV/AIDS cohort, than in the general population in Korea.

Comparison of Clinical Result of LASIK using between Femtosecond Laser and Microkeratome for Correction of Myopia

PURPOSE: To compare results between in femtosecond laser and microkeratome LASIK correction of myopia METHODS: We retrospectively analyzed the result of 94 eyes of 47 patients in the femtosecond group (F) and 103 eyes of 52 patients in the microkeratome group (M). All patients had undergone LASIK using either a femtosecond laser or a microkeratome for making of flap. Patients were divided into groups I (6D or =6D) according to preoperative myopia. Each patient was followed up for over 6 months with measurements of uncorrected visual acuity and manifest refraction at 1 week and 1, 3, and 6 months after operation. Complications during and after the operation were reviewed retrospectively in two groups 6month after the operation. RESULTS: In groups F-I, F-II, M-I, and M-II, postoperative 6-month uncorrected visual acuity was 0.98+/-0.08, 0.96+/-0.09, 0.97+/-0.03, 0.98+/-0.09. At the 6-month follow-up, there were no significant differences between the two groups in uncorrected visual acuity and mean spherical equivalent. Corneal opacity was found in 3 eyes in group M and complication related with flap was found 1 eye in group F and 4 eyes in group M. CONCLUSIONS: During a 6-month follow up, LASIK using either a femtosecond laser or a microkeratome has an similar effect in uncorrected visual acuity and mean spherical equivalent. Thus LASIK for using femtosecond laser can be used as an alternative procedure to correct myopia.

A Study about IgG Subclasses Concentration of Chronic Cough Patient and Changes of Immunoglobulin Levels after RU 41.740 Administration

PURPOSE: People who suffer from chronic or recurrent respiratory disease have immunoglobulin deficiency due to hypofunction of B cell. Among these immunoglobulin deficiency, it has been reported that only one or two subclass of IgG are deficient with normal quantity of IgG and IgA. Therefore it is necessary to measure IgG subclasses in chronic or recurrent respiratory infection for diagnosis. The purpose of this study is to measure IgG subclass in children with chronic respiratory disease and administration of RU 41.740 which was obtained from Klebsiella pneumonia, K2O strain(it has proven role in control of immunity) comparing the changes of immunoglobulin levels and IgG subclasses with the control group. So that better therapeutic approaches can be made for these diseases. Subjectsand METHODS: Thirty-six patients who visited to Konkuk university hospital due to chronic and recurrent coughing from January 1993 to June 1994, were selected for this research. Their age ranged from 2~13 year old and patients with evident history of allergy or tuberculosis were excluded. RU 41.740 with antibiotics were given to 31 subjects and 5 subjects were given placebo with antibiotics. For all subjects IgG, A, M, E, IgG1, G2, G3, G4 were measured. Immunoglobulins were remeasured from 15 subjects who received RU 41.740 and from 5 subjects who received placebo. Results : 1) Five subjects out of 36 were low or low-normal IgG group and all combined with IgG subclass deficiency, and all of low or low-normal IgG group had IgG3 deficiency. Eighteen subjects out of 31 normal IgG group accompanied IgG subclass deficiency and 12 subjects had IgG3 deficiency, which is most common IgG subclass deficiency. 2) Four subjects out of 36 were IgA deficiency group. Three subjects from 4 accompanied IgG subclass deficiency and had IgG4 subclass eficiency. 3) After the RU 41.740 administration, the levels of IgG and IgG subclasses increased significantly in study group. There were no significant change in IgG and IgG subclasses levels in placebo group CONCLUSIONS: In patients with chronic or recurrent respiratory disease, it is necessary to measure IgG subclass. These diseases tend to be chronic and recurrent and can be severely complicated causing bronchiectasis and incurable otitis media. Generally these diseases are not responsive to antibiotics. Therefore therapies should be directed to increasing immunological function for better results.