BACKGROUND The co-occurrence of Anti-phospholipase A2 receptor-associated membranous nephropathy(anti-PLA2R-MN)and human immunodeficiency virus(HIV)infection is a rare clinical scenario,presenting significant challeng...BACKGROUND The co-occurrence of Anti-phospholipase A2 receptor-associated membranous nephropathy(anti-PLA2R-MN)and human immunodeficiency virus(HIV)infection is a rare clinical scenario,presenting significant challenges in terms of management and treatment.CASE SUMMARY A 32-year-old Chinese male diagnosed with HIV infection presented with a clinical history of proteinuria persisting for over two years.A kidney biopsy demonstrated subepithelial immune complex deposition and a thickened glomerular basement membrane,indicative of stage I-II membranous nephro-pathy.Immunofluorescence staining revealed granular deposition of PLA2R(3+)along the glomerular capillary loops,corroborated by a strongly positive anti-PLA2R antibody test(1:320).Initial treatment involving losartan potassium,rivaroxaban,tacrolimus,and rituximab was discontinued due to either poor effec-tiveness or the occurrence of adverse events.Following a regimen of weekly subcutaneous injections of telitacicept(160 mg),a marked decline in the 24 h urine protein was observed within a three-month period,accompanied by a rise in serum albumin level.No significant reductions in peripheral blood CD3+CD4+T and CD3+CD8+T cell counts were detected.The patient's physical and psychological conditions showed significant improvements,with no adverse events reported during the treatment course.CONCLUSION Telitacicept might offer a potential therapeutic avenue for patients diagnosed with anti-PLA2R-MN concomitant with HIV infection.展开更多
Curcumin improves the learning and memory deficits in rats induced by the gp120 V3 loop. The present study cultured rat hippocampal neurons with 1 nM gp120 V3 loop and 1 μM curcumin for 24 hours. The results showed t...Curcumin improves the learning and memory deficits in rats induced by the gp120 V3 loop. The present study cultured rat hippocampal neurons with 1 nM gp120 V3 loop and 1 μM curcumin for 24 hours. The results showed that curcumin inhibited the gp120 V3 loop-induced mitochondrial membrane potential decrease, reduced the mRNA expression of the pro-apoptotic gene caspase-3, and attenuated hippocampal neuronal injury.展开更多
Fatty liver, which frequently coexists with necroinflammatory and fibrotic changes, may occur in the setting of nonalcoholic fatty liver disease(NAFLD) and chronic infections due to either hepatitis C virus(HCV) or hu...Fatty liver, which frequently coexists with necroinflammatory and fibrotic changes, may occur in the setting of nonalcoholic fatty liver disease(NAFLD) and chronic infections due to either hepatitis C virus(HCV) or human immunodeficiency virus(HIV). These three pathologic conditions are associated with an increased prevalence and incidence of cardiovascular disease(CVD) and type 2 diabetes(T2D). In this multidisciplinary clinical review, we aim to discuss the ever-expanding wealth of clinical and epidemiological evidence supporting a key role of fatty liver in the development of T2 D and CVD in patients with NAFLD and in those with HCV or HIV infections. For each of these three common diseases, the epidemiological features, pathophysiologic mechanisms and clinical implications of the presence of fatty liver in predicting the risk of incident T2 D and CVD are examined in depth. Collectively, the data discussed in this updated review, which follows an innovative comparative approach, further reinforce the conclusion that the presence of fatty/inflamed/fibrotic liver might be a shared important determinant for the development of T2 D and CVD in patients with NAFLD, HCV or HIV. This review may also open new avenues in the clinical and research arenas and paves the way for the planning of future, well-designed prospective and intervention studies.展开更多
AIMTo describe factors associated with treatment failure and frequency of resistance-associated substitutions （RAS）.METHODSHuman immunodefciency virus （HIV）/hepatitis C virus （HCV） coinfected patients starting a...AIMTo describe factors associated with treatment failure and frequency of resistance-associated substitutions （RAS）.METHODSHuman immunodefciency virus （HIV）/hepatitis C virus （HCV） coinfected patients starting a first direct-acting antiviral （DAA） regimen before February 2016 and included in the French ANRS CO13 HEPAVIH cohort were eligible. Failure was defned as： （1） non-response [HCV-RNA remained detectable during treatment, at end of treatment （EOT）]; and （2） relapse （HCV-RNA suppressed at EOT but detectable thereafter）. Sequencing analysis was performed to describe prevalence of drug class-specifc RAS. Factors associated with failure were determined using logistic regression models.RESULTSAmong 559 patients, 77% had suppressed plasmaHIV-RNA 〈 50 copies/mL at DAA treatment initiation41% were cirrhotic, and 68% were HCV treatmentexperienced. Virological treatment failures occurred in22 patients and were mainly relapses （17, 77%） thenundefined failures （3, 14%） and non-responses （29%）. Mean treatment duration was 16 wk overall. Posttreatment NS3, NS5A or NS5B RAS were detected in10/14 patients with samples available for sequencinganalysis. After adjustment for age, sex, ribavirin useHCV genotype and treatment duration, low platelecount was the only factor signifcantly associated with ahigher risk of failure （OR： 6.5; 95%CI： 1.8-22.6）. CONCLUSIONOnly 3.9% HIV-HCV coinfected patients failed DAAregimens and RAS were found in 70% of those failingLow platelet count was independently associated withvirological failure.展开更多
Background Blastocystis hominis(Bh)is zoonotic parasitic pathogen with a high prevalent globally,causing opportunistic infections and diarrhea disease.Human immunodeficiency virus(HIV)infection disrupts the immune sys...Background Blastocystis hominis(Bh)is zoonotic parasitic pathogen with a high prevalent globally,causing opportunistic infections and diarrhea disease.Human immunodeficiency virus(HIV)infection disrupts the immune system by depleting CD4^(+)T lymphocyte(CD4^(+)T)cell counts,thereby increasing Bh infection risk among persons living with HIV(PLWH).However,the precise association between Bh infection risk and HIV-related biological markers and treatment processes remains poorly understood.Hence,the purpose of the study was to explore the association between Bh infection risk and CD4^(+)T cell counts,HIV viral load(VL),and duration of interruption in antiviral therapy among PLWH.Methods A large-scale multi-center cross-sectional study was conducted in China from June 2020 to December 2022.The genetic presence of Bh in fecal samples was detected by real-time fluorescence quantitative polymerase chain reaction,the CD4^(+)T cell counts in venous blood was measured using flowcytometry,and the HIV VL in serum was quantified using fluorescence-based instruments.Restricted cubic spline(RCS)was applied to assess the non-linear association between Bh infection risk and CD4^(+)T cell counts,HIV VL,and duration of interruption in highly active antiretroviral therapy(HARRT).Results A total of 1245 PLWH were enrolled in the study,the average age of PLWH was 43 years[interquartile range(IQR):33,52],with 452(36.3%)being female,50.4%(n=628)had no immunosuppression(CD4^(+)T cell counts>500 cells/μl),and 78.1%(n=972)achieved full virological suppression(HIV VL<50 copies/ml).Approximately 10.5%(n=131)of PLWH had interruption.The prevalence of Bh was found to be 4.9%[95%confidence interval(CI):3.8-6.4%]among PLWH.Significant nonlinear associations were observed between the Bh infection risk and CD4^(+)T cell counts(Pfor nonlinearity<0.001,L-shaped),HIV VL(Pfor nonlinearity<0.001,inverted U-shaped),and duration of interruption in HARRT(Pfor nonlinearity<0.001,inverted U-shaped).Conclusions The study revealed that VL was a better predictor of Bh infection than CD4^(+)T cell counts.It is crucial to consider the simultaneous surveillance of HIV VL and CD4^(+)T cell counts in PLWH in the regions with high level of socioeconomic development.The integrated approach can offer more comprehensive and accurate understanding in the aspects of Bh infection and other opportunistic infections,the efficacy of therapeutic drugs,and the assessment of preventive and control strategies.展开更多
Background The infection of Kaposi＇s sarcoma-associated herpes virus （KSHV） is most likely the cause of clinical Kaposi＇s sarcoma,primary effusion lymphoma,and multi-center Castleman＇s disease.KSHV infection has ...Background The infection of Kaposi＇s sarcoma-associated herpes virus （KSHV） is most likely the cause of clinical Kaposi＇s sarcoma,primary effusion lymphoma,and multi-center Castleman＇s disease.KSHV infection has very limited epidemiological survey data in China,and its definite mode of transmission remains controversial.This study aimed to determine the infection status and the main transmission route of KSHV in Chinese population.Methods An enzyme-linked immunosorbent assay （ELISA） utilizing KSHV ORF65 recombinant protein was employed to analyze the antibody response to KSHV ORF65 in sera from 122 healthy physical examination people,107intravenous drug users,135 non-intravenous drug users,211 hepatitis B （HBV） patients infected via blood transmission,107 kidney transplant recipients,and 72 female sex workers in Zhejiang Province in Southeast China.Results KSHV infection occurred relatively common （13.1%） in healthy population in Zhejiang,China.Infection rate was 16.7% in female sex workers,but significantly elevated in intravenous drug addicts （58.9%）,blood-transmitted HBV patients （28.0%） and kidney transplant patients （41.1%）.Conclusion Blood borne transmission of KSHV is probably the main route of infection in Zhejiang Province.展开更多
文摘BACKGROUND The co-occurrence of Anti-phospholipase A2 receptor-associated membranous nephropathy(anti-PLA2R-MN)and human immunodeficiency virus(HIV)infection is a rare clinical scenario,presenting significant challenges in terms of management and treatment.CASE SUMMARY A 32-year-old Chinese male diagnosed with HIV infection presented with a clinical history of proteinuria persisting for over two years.A kidney biopsy demonstrated subepithelial immune complex deposition and a thickened glomerular basement membrane,indicative of stage I-II membranous nephro-pathy.Immunofluorescence staining revealed granular deposition of PLA2R(3+)along the glomerular capillary loops,corroborated by a strongly positive anti-PLA2R antibody test(1:320).Initial treatment involving losartan potassium,rivaroxaban,tacrolimus,and rituximab was discontinued due to either poor effec-tiveness or the occurrence of adverse events.Following a regimen of weekly subcutaneous injections of telitacicept(160 mg),a marked decline in the 24 h urine protein was observed within a three-month period,accompanied by a rise in serum albumin level.No significant reductions in peripheral blood CD3+CD4+T and CD3+CD8+T cell counts were detected.The patient's physical and psychological conditions showed significant improvements,with no adverse events reported during the treatment course.CONCLUSION Telitacicept might offer a potential therapeutic avenue for patients diagnosed with anti-PLA2R-MN concomitant with HIV infection.
基金supported by the Natural Science Foundation of Guangdong Province, No. 9151040701000, 061050246the Science and Technology Project of Guangdong Province, No. 2010B030700016+1 种基金the Science and Technology Project of Guangzhou, No. 2010Y1-C291the National Natural Science Foundation of China, No. 81171134
文摘Curcumin improves the learning and memory deficits in rats induced by the gp120 V3 loop. The present study cultured rat hippocampal neurons with 1 nM gp120 V3 loop and 1 μM curcumin for 24 hours. The results showed that curcumin inhibited the gp120 V3 loop-induced mitochondrial membrane potential decrease, reduced the mRNA expression of the pro-apoptotic gene caspase-3, and attenuated hippocampal neuronal injury.
文摘Fatty liver, which frequently coexists with necroinflammatory and fibrotic changes, may occur in the setting of nonalcoholic fatty liver disease(NAFLD) and chronic infections due to either hepatitis C virus(HCV) or human immunodeficiency virus(HIV). These three pathologic conditions are associated with an increased prevalence and incidence of cardiovascular disease(CVD) and type 2 diabetes(T2D). In this multidisciplinary clinical review, we aim to discuss the ever-expanding wealth of clinical and epidemiological evidence supporting a key role of fatty liver in the development of T2 D and CVD in patients with NAFLD and in those with HCV or HIV infections. For each of these three common diseases, the epidemiological features, pathophysiologic mechanisms and clinical implications of the presence of fatty liver in predicting the risk of incident T2 D and CVD are examined in depth. Collectively, the data discussed in this updated review, which follows an innovative comparative approach, further reinforce the conclusion that the presence of fatty/inflamed/fibrotic liver might be a shared important determinant for the development of T2 D and CVD in patients with NAFLD, HCV or HIV. This review may also open new avenues in the clinical and research arenas and paves the way for the planning of future, well-designed prospective and intervention studies.
基金Supported by Inserm-ANRS(French National Institute for Health and Medical Research-ANRS/France REcherche Nord and Sud Sida-hiv Hépatites)
文摘AIMTo describe factors associated with treatment failure and frequency of resistance-associated substitutions （RAS）.METHODSHuman immunodefciency virus （HIV）/hepatitis C virus （HCV） coinfected patients starting a first direct-acting antiviral （DAA） regimen before February 2016 and included in the French ANRS CO13 HEPAVIH cohort were eligible. Failure was defned as： （1） non-response [HCV-RNA remained detectable during treatment, at end of treatment （EOT）]; and （2） relapse （HCV-RNA suppressed at EOT but detectable thereafter）. Sequencing analysis was performed to describe prevalence of drug class-specifc RAS. Factors associated with failure were determined using logistic regression models.RESULTSAmong 559 patients, 77% had suppressed plasmaHIV-RNA 〈 50 copies/mL at DAA treatment initiation41% were cirrhotic, and 68% were HCV treatmentexperienced. Virological treatment failures occurred in22 patients and were mainly relapses （17, 77%） thenundefined failures （3, 14%） and non-responses （29%）. Mean treatment duration was 16 wk overall. Posttreatment NS3, NS5A or NS5B RAS were detected in10/14 patients with samples available for sequencinganalysis. After adjustment for age, sex, ribavirin useHCV genotype and treatment duration, low platelecount was the only factor signifcantly associated with ahigher risk of failure （OR： 6.5; 95%CI： 1.8-22.6）. CONCLUSIONOnly 3.9% HIV-HCV coinfected patients failed DAAregimens and RAS were found in 70% of those failingLow platelet count was independently associated withvirological failure.
文摘Background Blastocystis hominis(Bh)is zoonotic parasitic pathogen with a high prevalent globally,causing opportunistic infections and diarrhea disease.Human immunodeficiency virus(HIV)infection disrupts the immune system by depleting CD4^(+)T lymphocyte(CD4^(+)T)cell counts,thereby increasing Bh infection risk among persons living with HIV(PLWH).However,the precise association between Bh infection risk and HIV-related biological markers and treatment processes remains poorly understood.Hence,the purpose of the study was to explore the association between Bh infection risk and CD4^(+)T cell counts,HIV viral load(VL),and duration of interruption in antiviral therapy among PLWH.Methods A large-scale multi-center cross-sectional study was conducted in China from June 2020 to December 2022.The genetic presence of Bh in fecal samples was detected by real-time fluorescence quantitative polymerase chain reaction,the CD4^(+)T cell counts in venous blood was measured using flowcytometry,and the HIV VL in serum was quantified using fluorescence-based instruments.Restricted cubic spline(RCS)was applied to assess the non-linear association between Bh infection risk and CD4^(+)T cell counts,HIV VL,and duration of interruption in highly active antiretroviral therapy(HARRT).Results A total of 1245 PLWH were enrolled in the study,the average age of PLWH was 43 years[interquartile range(IQR):33,52],with 452(36.3%)being female,50.4%(n=628)had no immunosuppression(CD4^(+)T cell counts>500 cells/μl),and 78.1%(n=972)achieved full virological suppression(HIV VL<50 copies/ml).Approximately 10.5%(n=131)of PLWH had interruption.The prevalence of Bh was found to be 4.9%[95%confidence interval(CI):3.8-6.4%]among PLWH.Significant nonlinear associations were observed between the Bh infection risk and CD4^(+)T cell counts(Pfor nonlinearity<0.001,L-shaped),HIV VL(Pfor nonlinearity<0.001,inverted U-shaped),and duration of interruption in HARRT(Pfor nonlinearity<0.001,inverted U-shaped).Conclusions The study revealed that VL was a better predictor of Bh infection than CD4^(+)T cell counts.It is crucial to consider the simultaneous surveillance of HIV VL and CD4^(+)T cell counts in PLWH in the regions with high level of socioeconomic development.The integrated approach can offer more comprehensive and accurate understanding in the aspects of Bh infection and other opportunistic infections,the efficacy of therapeutic drugs,and the assessment of preventive and control strategies.
基金This study was supported by a grant from the National Natural Science Foundation of China （No.30972592）.
文摘Background The infection of Kaposi＇s sarcoma-associated herpes virus （KSHV） is most likely the cause of clinical Kaposi＇s sarcoma,primary effusion lymphoma,and multi-center Castleman＇s disease.KSHV infection has very limited epidemiological survey data in China,and its definite mode of transmission remains controversial.This study aimed to determine the infection status and the main transmission route of KSHV in Chinese population.Methods An enzyme-linked immunosorbent assay （ELISA） utilizing KSHV ORF65 recombinant protein was employed to analyze the antibody response to KSHV ORF65 in sera from 122 healthy physical examination people,107intravenous drug users,135 non-intravenous drug users,211 hepatitis B （HBV） patients infected via blood transmission,107 kidney transplant recipients,and 72 female sex workers in Zhejiang Province in Southeast China.Results KSHV infection occurred relatively common （13.1%） in healthy population in Zhejiang,China.Infection rate was 16.7% in female sex workers,but significantly elevated in intravenous drug addicts （58.9%）,blood-transmitted HBV patients （28.0%） and kidney transplant patients （41.1%）.Conclusion Blood borne transmission of KSHV is probably the main route of infection in Zhejiang Province.
