ABSTRACT
Both hyperreactive malarial splenomegaly (HMS) and HIV infection are highly prevalent in sub-Saharan Africa, but the inter-relationships between the two conditions are not clearly defined. Diagnosis of HMS is particularly difficult in HIV-infected patients, and detection of circulating malaria parasites by polymerase chain reaction (PCR) may represent a useful diagnostic tool.
Subject(s)
HIV Infections/complications , Malaria/complications , Malaria/diagnosis , Plasmodium falciparum/isolation & purification , Splenomegaly/etiology , Animals , Anti-HIV Agents/therapeutic use , Antibodies, Protozoan/blood , Antimalarials/therapeutic use , Cameroon/ethnology , Diagnosis, Differential , Female , HIV/isolation & purification , HIV Infections/diagnosis , Humans , Italy , Mefloquine/therapeutic use , Middle Aged , Plasmodium falciparum/genetics , Polymerase Chain Reaction , RNA, Ribosomal, 18S/genetics , Splenomegaly/diagnosisABSTRACT
No disponible
Subject(s)
Male , Humans , Female , Adult , Adenocarcinoma , Fatal Outcome , Lipodystrophy , Tomography, X-Ray Computed , Anti-HIV Agents , Antiretroviral Therapy, Highly Active , HIV Infections , Drug Therapy, Combination , Bronchoscopy , Lung NeoplasmsABSTRACT
HIV and HCV share common transmission pathways, but HCV is more efficiently transmitted through blood than with sexual exposure. Thus HCV coinfection is frequent in HIV seropositives, mainly in those with history of injection drug use and/or transfusion. HIV coinfection increases HCV replication rate, the rate of HCV vertical transmission and accelerates the course of hepatitis C towards cirrhosis and hepatocellular carcinoma. The evidence of an effect of HCV on HIV disease progression is less convincing. The results of several studies suggest that HCV coinfection does not hasten the progression of HIV infection towards AIDS. However two recent studies showed that HCV coinfection is independently associated with a lower restoration of CD4 counts during combination antiretroviral treatment. However this finding should be confirmed by additional studies.
Subject(s)
HIV Infections/complications , Hepatitis C/complications , Acquired Immunodeficiency Syndrome/etiology , Disease Progression , HIV/physiology , HIV Infections/transmission , Hepacivirus/physiology , Hepatitis C/transmission , Humans , Liver Diseases/etiology , Virus ReplicationABSTRACT
Treatment of HCV infection in HIV seropositives is becoming a management priority because of: the increasing HCV and stage liver disease mortality and the unfavourable impact of HCV infection on efficacy and toxicity of antiretroviral combination treatment. Treatment end points are: eradication of HCV or suppression of HCV replication in order to slow HCV disease progression and to increase efficacy and to reduce hepatotoxicity of antiretrovirals. Interferon as monotherapy and in combination with ribavirin induces eradication of HCV in respectively 17 and 28% and suppression of viral replication in 26 and 36% of treated HIV infected subjects. The impact of these drugs on HIV disease evolution and on antiretroviral treatment efficacy, toxicity and compliance needs to be established. Then the cost-effectiveness of anti HCV therapy in anti HIV infected patients still needs to be defined.
