ABSTRACT
The primary objective of antiretroviral therapy has recently evolved from a virologic endpoint towards the achievement of normal CD4T cell count (greater than 500/mm(3)) to avoid progression to AIDS. This shift in the primary objective is supported by many clinical and epidemiological studies. Recent data have shown that HIV-infected adults with a CD4T cell count greater than 500cells/mm(3) on long-term combination antiretroviral therapy reach same mortality rates as the general population. However, less than 50% of patients receiving long-term suppressive antiretroviral combination reach such a CD4T cell level. New antiretroviral strategies to improve immune reconstitution, such as specific or non-specific immune-based therapy on one hand and the use of novel antiretroviral drugs from new classes on the other hand are currently under investigation. Here we review several current strategies that may improve immune reconstitution, keeping in mind that the best way to reach normal CD4T cell count is an early treatment initiation.
Subject(s)
HIV Infections/drug therapy , HIV Infections/immunology , Anti-Retroviral Agents/therapeutic use , CD4 Lymphocyte Count , Humans , Interleukin-2/therapeutic use , Interleukin-7/therapeutic useABSTRACT
We describe a case of an HIV-infected man on effective combined antiretroviral therapy, presenting with bilateral gynaecomastia revealing breast carcinoma. Gynaecomastia was first considered to be related to efavirenz and/or didanosine. Although breast carcinoma is rare among HIV-infected men, it should be considered as a potential cause of breast enlargement.
Subject(s)
Breast Neoplasms, Male/diagnosis , Carcinoma, Intraductal, Noninfiltrating/diagnosis , Gynecomastia/etiology , HIV Infections/drug therapy , Reverse Transcriptase Inhibitors/adverse effects , Alkynes , Benzoxazines/administration & dosage , Benzoxazines/adverse effects , Breast Neoplasms, Male/surgery , Carcinoma, Intraductal, Noninfiltrating/surgery , Cyclopropanes , Didanosine/administration & dosage , Didanosine/adverse effects , Drug Therapy, Combination , Humans , Lamivudine/administration & dosage , Lamivudine/adverse effects , Male , Middle Aged , Reverse Transcriptase Inhibitors/administration & dosageABSTRACT
We report a second observation of autoimmune myelofibrosis associated with an inflammatory myositis in a 30-year-old female. The links between myelofibrosis and autoimmunity are discussed.
