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Indo Global Journal of Pharmaceutical Sciences ; 11(3):28-32, 2021.
Article in English | EMBASE | ID: covidwho-1819111


In the light of the recent events in the world concerning COVID-19 virus, it is important to review the challenges faced by the world by another pandemic, AIDS. The painstaking research by the scientists, the pharmaceutical companies, the medical professionals have led to this day when AIDS patients are living their whole life span. Though we do not have any vaccine for AIDS but by intelligent use of medication, we have been able to combat the disease to a large extent. HIV is a RNA virus, whose treatment is mainly done by finding the structure and function of the proteins that are vital to its life cycle. Designing a drug/inhibitor to make those proteins ineffective constitutes the next step. WHO has recognized AIDS as a pandemic almost 40 years back but the world is yet to find a cure or a vaccine. The current treatment method is called HAART, Highly Active Anti Retroviral Therapy, where different types of inhibitors,eg. Reverse Transcriptase inhibitors, Protease inhibitors;each arresting a different important protein are given in combination. The virus replicates very fast and forms mutations which render it ineffective to the inhibitors thus resistance to the inhibitors develop. Hence development of new types of inhibitors is crucial to the problem. There are certain similarities between AIDS and COVID-19, both in terms of the attacking virus and effective medication, which make it more important than ever that the research on HIV is revisited and knowledge we gain from it is used to battle the new pandemic.

Chest ; 161(1):A163, 2022.
Article in English | EMBASE | ID: covidwho-1636362


TYPE: Case Report TOPIC: Chest Infections INTRODUCTION: Kaposi sarcoma (KS) is very commonly associated with Human Immunodeficiency Virus (HIV) infection. The clinical course of HIV associated KS could be indolent with muco-cutaneous or aggressive with visceral organ system involvement. It is extremely uncommon for the visceral involvement to occur in the absence of mucocutaneous manifestations. CASE PRESENTATION: A 45-year male with HIV, presented with fatigue, exertional dyspnea, cough. Vital signs showed low grade fever and hypoxia. On physical exam the pertinent positive finding was diffuse inspiratory crackles. The CT chest showed multiple irregular nodular infiltrates in the lungs. Blood and sputum cultures were collected, and the patient was started on empiric antibiotics and fluconazole. The viral load and the absolute CD4 count were 64,360 and 17, respectively. The transesophageal echocardiogram was negative for vegetations. SARS-COVID19, blood culture and three sputum acid fast bacilli were negative. The patient continued to worsen. The bronchoscopy showed a friable mass in the left lower trachea. The immunohistochemistry analysis of the lesions was positive for CD34, CD31, HHV-8, FLI-1 which was diagnostic of KS. The patient was started on Highly Active Antiretroviral Therapy (HAART) and was discharged on HAART with a scheduled follow up. DISCUSSION: The introduction of HAART has decreased the incidence of KS to 0.03 per 1000 patient years in the HAART era. 15.5 % of patients have pulmonary KS in the absence of mucocutaneous lesions. These rates of pulmonary KS in autopsy findings were noted in the pre-HAART era. CONCLUSIONS: To establish a diagnosis of pulmonary KS in the absence of the characteristic cutaneous lesions is challenging. DISCLOSURE: Nothing to declare. KEYWORD: Kaposi Sarcoma

Cogent Medicine ; 8, 2021.
Article in English | EMBASE | ID: covidwho-1617062


Background: COVID-19 has changed the perspective through which medical staff look at dyspnea and hypoxemia cases. Epidemiological links are frequently missing, and clinical and imagological findings are often unspecific, overlapping substantially with other respiratory infections. Case summary: We report the case of an 11-year-old girl with a known history of asthma who had recently moved from Guinea-Bissau with her mother. Although the mother reported being Ag HBs positive, no serologic studies had ever been performed on the child. The patient was admitted to the Emergency Room after 4 days of cough and the feeling of thoracic oppression, without fever. No contact with suspected or confirmed individuals infected with SARS-CoV-2 or other respiratory viruses was reported. She presented with peripheral oxygen saturation of 90%, costal retractions and a prolonged expiratory phase. After an unsuccessful course of bronchodilators and prednisolone, she was admitted to the Pediatric Intermediate Care Unit because of a sustained need for oxygen therapy. Polymerase chain reaction analysis for SARS CoV-2 came back negative. A chest radiograph displayed a bilateral reticular infiltrate, and therapy with azithromycin was started. Due to a deterioration of the dyspnea, a chest tomography was eventually performed, revealing an exuberant and bilateral ground glass-like densification suggestive of alveolar injury. Echocardiogram and e electrocardiogram were both normal. After a positive serologic result for HIV, the patient was transferred to a Level III hospital, and Pneumocystis jirovecii was identified in bronchoalveolar lavage. T cell count was 12/mm3. Highly active antiretroviral therapy and cotrimoxazole were started, prompting clinical and analytical recovery. Discussion: Pneumocystis jirovecii can cause fatal pneumonia in immunocompromised children. Even though an asthma exacerbation and atypical bacterial or viral infections, namely COVID-19, present as more usual causes of dyspnea, a low suspicion index is warranted in children coming from HIV-endemic countries, particularly those who are unresponsive to conventional bronchodilator and antibiotic therapy.