Acquired immune deficiency syndrome infection can lead to cognitive dysfunction represented by changes in the default mode network.Most recent studies have been cross-sectional and thus have not revealed dynamic chang...Acquired immune deficiency syndrome infection can lead to cognitive dysfunction represented by changes in the default mode network.Most recent studies have been cross-sectional and thus have not revealed dynamic changes in the default mode network following acquired immune deficiency syndrome infection and antiretroviral therapy.Specifically,when brain imaging data at only one time point are analyzed,determining the duration at which the default mode network is the most effective following antiretroviral therapy after the occurrence of acquired immune deficiency syndrome.However,because infection times and other factors are often uncertain,longitudinal studies cannot be conducted directly in the clinic.Therefore,in this study,we performed a longitudinal study on the dynamic changes in the default mode network over time in a rhesus monkey model of simian immunodeficiency virus infection.We found marked changes in default mode network connectivity in 11 pairs of regions of interest at baseline and 10 days and 4 weeks after virus inoculation.Significant interactions between treatment and time were observed in the default mode network connectivity of regions of interest pairs area 31/V6.R and area 8/frontal eye field(FEF).L,area 8/FEF.L and caudal temporal parietal occipital area(TPOC).R,and area 31/V6.R and TPOC.L.ART administered 4 weeks after infection not only interrupted the progress of simian immunodeficiency virus infection but also preserved brain function to a large extent.These findings suggest that the default mode network is affected in the early stage of simian immunodeficiency virus infection and that it may serve as a potential biomarker for early changes in brain function and an objective indicator for making early clinical intervention decisions.展开更多
Variable Common Immune Deficiency (VCID) is a very heterogeneous condition both clinically and immunologically. It is a group of molecular abnormalities responsible for a defect in antibody production leading to hypog...Variable Common Immune Deficiency (VCID) is a very heterogeneous condition both clinically and immunologically. It is a group of molecular abnormalities responsible for a defect in antibody production leading to hypogammaglobulinemia often associated with autoimmune and/or lymphoproliferative manifestations. Late Onset Combined Immune Deficiency (LOCID) is a type of Variable Common Immune Deficiency (VCID) defined by a defect in antibody production (IgG and IgA ± IgM type), profound CD4 T-cell lymphopenia and frequent opportunistic infections. LOCID has been considered as a distinct entity from VCID due to its particular clinical and immunological profile.展开更多
BACKGROUND Human herpesvirus type 7(HHV-7)is a less common herpes virus that usually causes mild,self-limiting illnesses.However,in recent years,there have been increasing reports of HHV-7 causing serious central nerv...BACKGROUND Human herpesvirus type 7(HHV-7)is a less common herpes virus that usually causes mild,self-limiting illnesses.However,in recent years,there have been increasing reports of HHV-7 causing serious central nervous system infections,especially meningitis.The pathogenesis and clinical features of HHV-7 meningitis,particularly in adolescents with normal immune function,remain incompletely studied.Therefore,the purpose of this report is to share a case of HHV-7 meningitis in an immunocompetent adolescent with a view to deepening our understanding of the disease.CASE SUMMARY A 12-year-old female was admitted with fever,headache,and vomiting.4 d before admission,the patient developed a fever without obvious induction,with a temperature up to 39.5℃,no convulsions,accompanied by chills,headaches,fatigue,and no muscle aches.The patient was treated with fever reduction,which could be reduced to 38℃;repeated high fever,accompanied by vomiting 7-8 times;and no abdominal pain or diarrhea.The patient was diagnosed with"acute suppurative tonsillitis"in a local hospital,and the blood routine was generally normal.The patient was given symptomatic support treatment such as"ceftriaxone sodium"and antiemetic rehydration for 2 d,and his condition did not improve.The patient's physical examination showed pharyngeal congestion,bilateral tonsil grade I hypertrophy,regression of purulent secretions,and cervical resistance.Ocular B-ultrasound:Opacity of the vitreous body and edema of the optic disc in both eyes.Optical coherence tomography examination showed that the macular fovea was generally normal in both eyes,with edema of the optic disc.DNA virus monitoring results:HHV-7.We gave ganciclovir antiviral therapy,dexamethasone anti-inflammatory treatment,mannitol to reduce cranial pressure,omeprazole to protect gastrointestinal mucosa,and calcium and potassium supplementation.CONCLUSION This study reports a case of HHV-7 meningitis in an adolescent with normal immune function.Through comprehensive analysis of the clinical manifestations,laboratory tests,and treatment methods of the patient,it is found that early identification and antiviral treatment are essential for the outcome of the disease.This case suggests that despite normal immune function,adolescents may still suffer from herpes virus type 7 meningitis,so clinicians should be vigilant and take effective treatment measures in time.展开更多
Background: Defaulting on antiretroviral therapy has been identified as the most important factor contributing to the antiretroviral therapy failure rate. This study aimed to investigate factors associated with defaul...Background: Defaulting on antiretroviral therapy has been identified as the most important factor contributing to the antiretroviral therapy failure rate. This study aimed to investigate factors associated with defaulting on antiretroviral therapy among adult patients receiving care at Chikankata Mission Hospital antiretroviral therapy clinic. Method: Cross-sectional analytical study on 385 participants selected by a computer generated random numbers technique of simple random sampling from among the patients receiving antiretroviral therapy at Chikankata Mission Hospital. Data collected were processed and analysed using Statistical Package for Social Science version 27. Univariate and backward multivariable logistic regression analysis was performed to identify factors associated with antiretroviral therapy defaulting. The level of significance was set at 5% with a confidence level of 95%. Results: Over half (58.4%) of the study participants defaulted on antiretroviral therapy. About 65.8% of study participants indicated improved health as the reason they defaulted on antiretroviral therapy. Most participants indicated that it was important to always go for antiretroviral therapy services (Adjusted Odds Ratio 1.95;95% Confidence Interval: [1.14 - 3.33], p = 0.015). Very few participants indicated poor family support for antiretroviral therapy services (Adjusted Odds Ratio 4.08;95% Confidence Interval: [2.02 - 8.23], p Conclusion: Defaulting on antiretroviral therapy continues to be a significant problem and needs to be addressed as a matter of priority. More counselling and awareness-raising programmes are required to improve knowledge and understanding on the importance of attending scheduled antiretroviral therapy clinics and services as well as the consequences of defaulting on antiretroviral therapy.展开更多
Vanishing bile duct syndrome (VBDS) refers to a group of disorders characterized by prolonged cholestasis as a result of destruction and disappearance ofintrahepatic bile ducts. Multiple etiologies have been indentifi...Vanishing bile duct syndrome (VBDS) refers to a group of disorders characterized by prolonged cholestasis as a result of destruction and disappearance ofintrahepatic bile ducts. Multiple etiologies have been indentifi ed including infections, neoplastic disorders, autoimmune conditions and drugs. The natural history of this condition is variable and may involve resolution of cholestasis or progression with irreversible damage. VBDS is extremely rare in human immunodeficiency virus (HIV)-infected patients and anti-retroviral therapy has never been implicated as a cause. We encountered a young pregnant female with HIV and VBDS secondary to anti-retroviral therapy. Here, we report her clinical course and outcome.展开更多
Objective:To discover the population characteristics of the syndrome types of Acquired Immune Deficiency Syndrome.Methods:Data mining method for feature selection was used.Results:Main symptoms based on feature select...Objective:To discover the population characteristics of the syndrome types of Acquired Immune Deficiency Syndrome.Methods:Data mining method for feature selection was used.Results:Main symptoms based on feature selection are as follows,deficiency of both qi and blood(pale complexion,fear of cold,easy to catch a cold,pale tongue,weak pulse);liver depression and qi stagnation with effulgent fire(anxiety,insomnia,chest and hypochondrium,irregular menstruation,thin and whitish coating on the tongue,stringy pulse);dual deficiency of qi and yin(low-grade fever and night sweating,yellow urine,pale complexion,dysphoria with feverish sensation in chest,dry cough with less phlegm,weakness,dizziness,dry and red tongue,little coating,thread and rapid pulse);deficiency of spleen and kidney,dampness pathogen blockage(diarrhea,loose stool,eat less and abdominal nausea,abdominal pain,sallow complexion,nausea,vomiting,loss of hair,deafness and tinnitus,pale tongue with whitish coating,deep and thready pulse,slippery and rapid pulse);qi deficiency with blood stasis(weakness,spontaneous sweating,dry mouth without desire to drink,easy to catch a cold,shortness of breath,sallow complexion,eat less and loose stools,dim tongue quality,hesitant pulse).Conclusion:Based on the feature selection method,we can find the main characteristics of Acquired Immune Deficiency Syndrome,and provide objective reference for clinical diagnosis and treatment.展开更多
Purpose:To investigate the level of and factors influencing perceived stigma and discrimination among people living with human immunodeficiency virus(HIV)/acquired immune deficiency syndrome(PLWHA)in Henan Province.Me...Purpose:To investigate the level of and factors influencing perceived stigma and discrimination among people living with human immunodeficiency virus(HIV)/acquired immune deficiency syndrome(PLWHA)in Henan Province.Methods:In total,161 PLWHA from Zhengzhou and Zhenping were investigated using the Berger HIV stigma scale.Results:The mean Berger stigma scale score was 105.70±15.20,indicating a middle stigma level.Among the four subscales of the Berger stigma scale,the disclosure concerns score was highest,while the negative self-image score was lowest.Multivariate analyses showed that factors influencing perceived HIV stigma included the level of education and route of infection.Conclusion:The level of perceived HIV stigma and discrimination among PLWHA in Henan Province is moderate and was affected by the level of education and route of infection.Special intervention should be established to address this problem.展开更多
Background: Mucosal-associated invariant T(MAIT) cells are systemically depleted in human immunodeficiency virus type 1(HIV-1) infected patients and are not replenished even after successful combined antiretroviral th...Background: Mucosal-associated invariant T(MAIT) cells are systemically depleted in human immunodeficiency virus type 1(HIV-1) infected patients and are not replenished even after successful combined antiretroviral therapy(cART).This study aimed to identify the mechanism underlying MAIT cell depletion.Methods: In the present study, we applied flow cytometry, single-cell RNA sequencing and immunohistochemical staining to evaluate the characteristics of pyroptotic MAIT cells in a total of 127 HIV-1 infected individuals, including 69 treatment-naive patients, 28 complete responders, 15 immunological non-responders, and 15 elite controllers, at the Fifth Medical Center of Chinese PLA General Hospital, Beijing, China.Results: Single-cell transcriptomic profiles revealed that circulating MAIT cells from HIV-1 infected subjects were highly activated, with upregulation of pyroptosis-related genes. Further analysis revealed that increased frequencies of pyroptotic MAIT cells correlated with markers of systemic T-cell activation, microbial translocation, and intestinal damage in cART-naive patients and poor CD4+ T-cell recovery in long-term cART patients. Immunohistochemical staining revealed that MAIT cells in the gut mucosa of HIV-1 infected patients exhibited a strong active gasdermin-D(GSDMD, marker of pyroptosis) signal near the cavity side, suggesting that these MAIT cells underwent active pyroptosis in the colorectal mucosa. Increased levels of the proinflammatory cytokines interleukin-12(IL-12) and IL-18 were observed in HIV-1 infected patients. In addition, activated MAIT cells exhibited an increased pyroptotic phenotype after being triggered by HIV-1 virions, T-cell receptor signals, IL-12 plus IL-18, and combinations of these factors, in vitro.Conclusions: Activation-induced MAIT cell pyroptosis contributes to the loss of MAIT cells in HIV-1 infected patients,which could potentiate disease progression and poor immune reconstitution.展开更多
BACKGROUND Coronavirus disease 2019(COVID-19)-associated invasive pulmonary aspergillosis presents a diagnostic challenge due to its non-specific clinical/imaging features,as well as the fact that the proposed clinica...BACKGROUND Coronavirus disease 2019(COVID-19)-associated invasive pulmonary aspergillosis presents a diagnostic challenge due to its non-specific clinical/imaging features,as well as the fact that the proposed clinically diagnostic algorithms do not necessarily apply to COVID-19 patients.In addition,Fusarium spp.is a rare cause of opportunistic life-threatening fungal infections.Disseminated Fusarium infection in an immunocompromised host is intractable,with a high likelihood of resulting mortality.To our knowledge,this is the first case of secondary pulmonary infection by Fusarium solani(F.solani)and Aspergillus niger(A.niger)during systemic steroid treatment for COVID-19.CASE SUMMARY A 62-year-old male was transported to our hospital by ambulance with a complaint of fever and dyspnea.We established a diagnosis of pneumococcal pneumonia,complicated with COVID-19 and septic shock,together with acute renal failure.He was admitted to the intensive care unit,to be treated with piperacillin/tazobactam,vancomycin,and 6.6 mg per day of dexamethasone sodium phosphate,along with noradrenaline as a vasopressor,ventilator management,and continuous hemodiafiltration.His condition improved,and we finished the vasopressor on the fifth hospital day.We administered dexamethasone for ten days,and finished the course of treatment.On the eleventh day,patient respiratory deterioration was observed,and a computed tomography scan showed an exacerbation of bilateral ground-glass-opacity-like consolidation,together with newly appeared cavitary lesions in the lung.we changed antibiotics to meropenem plus vancomycin.In addition,a fungal infection was considered as a possibility based on microscopic findings of sputum,and we began coadministration of voriconazole.However,the pneumonia worsened,and the patient died on the seventeenth day of illness.Later,F.solani and A.niger were identified from sputum collected on the twelfth day.It was believed that he developed a cell-mediated immune deficiency during COVID-19 treatment,which led to the complication of pneumonia caused by the above-mentioned fungi,contributing to his death.CONCLUSION Because early initiation of intense antifungal therapy offers the best chance for survival in pulmonary fusariosis,computed tomography scans and appropriate microbiologic investigations should be obtained for severely immunocompromised patients.展开更多
Thymosin alpha 1 is a peptide naturally occurring in the thymus that has long been recognized for modifying,enhancing,and restoring immune function.Thymosin alpha 1 has been utilized in the treatment of immunocompromi...Thymosin alpha 1 is a peptide naturally occurring in the thymus that has long been recognized for modifying,enhancing,and restoring immune function.Thymosin alpha 1 has been utilized in the treatment of immunocompromised states and malignancies,as an enhancer of vaccine response,and as a means of curbing morbidity and mortality in sepsis and numerous infections.Studies have postulated that thymosin alpha 1 could help improve the outcome in severely ill corona virus disease 2019 patients by repairing damage caused by overactivation of lymphocytic immunity and how thymosin alpha 1 could prevent the excessive activation of T cells.In this review,we discuss key literature on the background knowledge and current clinical uses of thymosin alpha 1.Considering the known biochemical properties including antibacterial and antiviral properties,timehonored applications,and the new promising findings regarding the use of thymosin,we believe that thymosin alpha 1 deserves further investigation into its antiviral properties and possible repurposing as a treatment against severe acute respiratory syndrome coronavirus-2.展开更多
Vitamin D plays an important role in maintaining normal bone metabolism. Recent studies have suggested that vitamin D influences many other physiological processes, including muscle function, cardiovascular homeostasi...Vitamin D plays an important role in maintaining normal bone metabolism. Recent studies have suggested that vitamin D influences many other physiological processes, including muscle function, cardiovascular homeostasis, nerve function, and immune response. Furthermore, accumulated evidence suggests that vitamin D also mediates the immune system response to infection. Critical neurosurgical patients have higher infection and mortality rates. To correlate vitamin D deficiency to the immunological status of neurosurgical intensive care unit patients, we detected serum vitamin D level in 15 patients with clinically suspected infection and 10 patients with confirmed infection. Serum level of 25-hydroxyvitamin D, the primary circulating form of vitamin D, was significantly decreased in patients with suspected or confirmed infection after a 2-week neurosurgical intensive care unit hospitalization, while serum level of 1,25-dihydroxyvitamin D, the active form of vitamin D, was significantly decreased in patients after a 4-week neurosurgical intensive care unit hospitalization. These findings suggest that vitamin D deficiency is linked to the immunological status of neurosurgical intensive care unit patients and vitamin D supplementation can improve patient's immunological status.展开更多
By using cell cloning technique, 4 sublines (A,C,D,E) were isolated from a cell line of human lung giant cell carcinoma (PLA-801). After subcutaneous inoculation in T-cell deficient BALB/c nude mice, the incidence of ...By using cell cloning technique, 4 sublines (A,C,D,E) were isolated from a cell line of human lung giant cell carcinoma (PLA-801). After subcutaneous inoculation in T-cell deficient BALB/c nude mice, the incidence of tumor growth and spontaneous metastasis were the highest in subline D, moderate in sublines A and E, and lowest in subline C. Tumor cells of subline C also showed similar low tumorigenicity in another T-cell deficient 615/ PB1 nude mice.However, in 615/PB1 beige nude mice with con-genitally combined immune-deficiency in both T and NK cell activity, tumor cells of the rarely metastatic subline C do produce significantly high frequency of tumor growth and spontaneous metastasis.Morphological studies (light microscope, electron microscope and immunohistochemistry) showed rich microfilaments and Vimentin positive in the cytoplasm of metastatic tumor cells. This may imply a possibility that tumor cells differentiate towards the direction favourable to spreading and metastasis.展开更多
<strong>Background:</strong><span style="font-family:Verdana;"> Primary Immune Deficiencies (PID) are rare, under-determined </span><span style="font-family:"">&l...<strong>Background:</strong><span style="font-family:Verdana;"> Primary Immune Deficiencies (PID) are rare, under-determined </span><span style="font-family:""><span style="font-family:Verdana;">diseases particularly in sub-Saharan Africa. The diagnosis is often suspected with uncommon clinical signs. Infections are the main diagnostic circumstances in infants. Confirmation is often difficult because some additional examinations are unavailable in many of our countries. </span><b><span style="font-family:Verdana;">Aim: </span></b><span style="font-family:Verdana;">Our aim was to share the challenge of diagnosis and treatment in PID. </span><b><span style="font-family:Verdana;">Case Presentation:</span></b><span style="font-family:Verdana;"> It is about two infants, a boy and a girl, with early several infections. Both of them presented a hypo-gammaglobulinemia and to the boy, the immuno-phenotyping lymphocyte showed a decrease</span></span><span style="font-family:Verdana;">d</span><span style="font-family:Verdana;"> level of lymphocytes CD19. We are looking for genetic confirmation but it is not easy. The treatment of these infants require</span><span style="font-family:Verdana;">s</span><span style="font-family:Verdana;"> a substitution for life of immunoglobulin w</span><span style="font-family:Verdana;">h</span><span style="font-family:Verdana;">ich </span><span style="font-family:Verdana;">is</span><span style="font-family:""><span style="font-family:Verdana;"> unavailable in our countries. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> PID are suspected with atypical clinical signs. Confirmation genetic diagnosis is difficult in low income countries. To improve the follow up, we need to strengthen clinical-biological collaboration.</span></span>展开更多
Henan Province in China has a major epidemic of human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS). Chinese medicine (CM) has been used throughout the last decade, and a management modalit...Henan Province in China has a major epidemic of human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS). Chinese medicine (CM) has been used throughout the last decade, and a management modality was developed, which can be described by unified-planning, graded- administration, and centralized-controlling (UGC). The UGC modality has one primary concept (patient-centered medicine from CM theory), four basic foundations (classifying administrative region, characteristics of CM on disease treatment, health resource conditions, and distribution of patients living with HIV), six important relationships (the "three uniformities and three combinations," and the six relationships therein guide the treatment of AIDS with CM), and four key sections (management, operation, records, and evaluation). In this article, the authors introduce the UGC modality, which could be beneficial to developing countries or resource-limited areas for the management of chronic infectious disease.展开更多
The International Conference on Prevention and Treatment of Acquired Immune Deficiency Syndrome (AIDS) with Chinese Medicine (CM) was held in Beijing International Hotel from October 16 to 17, 2010. It was cospons...The International Conference on Prevention and Treatment of Acquired Immune Deficiency Syndrome (AIDS) with Chinese Medicine (CM) was held in Beijing International Hotel from October 16 to 17, 2010. It was cosponsored by Guang'anmen Hospital, China Academy of Chinese Medical Sciences (CACMS), and the First Affiliated Hospital of Henan University of Traditional Chinese Medicine.展开更多
Diarrhea can occur at an early or advanced stage of acquired immunodeficiency syndrome(AIDS)as a usual symptom in people with human immunodeficiency virus(HIV)infection.While it is usually not fatal,it can influence p...Diarrhea can occur at an early or advanced stage of acquired immunodeficiency syndrome(AIDS)as a usual symptom in people with human immunodeficiency virus(HIV)infection.While it is usually not fatal,it can influence patients’quality of life seriously.It has shown to be efficacious and improves people’s immune status to a certain extent to treat HIV/AIDS-related diarrhea on the basis of syndrome differentiation and treatment or Chinese herbs plus conventional treatment.Therefore,it may have a good application potential.Here,we outline a protocol for the systematic review of this health-care intervention,with the aim to evaluate the beneficial effects and safety of Traditional Chinese Medicine(TCM)for patients who suffer from HIV/AIDS-associated diarrhea.Randomized controlled trials that compare Chinese herbs with placebo or other effective treatments will be searched and included,in spite of publication status or language.The primary outcomes include diarrhea frequency and fecal character.The databases we will search as follows:China Science and Technology Journal Database(VIP),Chinese Biomedical Literature Database(Sino Med),Wanfang Data,China National Knowledge Infrastructure,Pub Med and the CENTRAL in Cochrane Library.Two authors will respectively conduct the screening of trials,data extraction,and use the Cochrane risk of bias tool to assess the methodological quality.We will analyze the data and perform a meta-analysis if possible.We intend to identify potential therapeutic modalities that may be of benefit to inform clinical practice by supplying existing evidence of the helpful effects and safety of TCM to treat patients suffering from HIV/AIDS-associated diarrhea.展开更多
Acquired immune deficiency syndrome (AIDS) is a chronic infectious disease,which the patients are infected with human immunodeficiency virus (HIV).HIV damages the human's immune function and causes CD4 cell decli...Acquired immune deficiency syndrome (AIDS) is a chronic infectious disease,which the patients are infected with human immunodeficiency virus (HIV).HIV damages the human's immune function and causes CD4 cell decline in the number and function.Immune reconstitution is an important treatment to AIDS.Bone marrow transplantation,adoptive immune cell therapy and cytokines infusion can all assist the immune reconstitution;highly active antiretroviral therapy (HAART) can effectively control the virus replication and benefit the immune reconstitution.HAART combined with immunotherapy is an important method of immune reconstitution in AIDS patients.Chinese medicine is playing a more and more important role in immune reconstitution.Immune reconstitution has always been effective in the whole treatment of AIDS.展开更多
Acquired immune deficiency syndrome(AIDS)is caused by human immunodeficiency virus(HIV),which was found by French scientists 40 years ago,12 years after AIDS was firstly reported by US scientists.2 TheHIV/AIDS pandemi...Acquired immune deficiency syndrome(AIDS)is caused by human immunodeficiency virus(HIV),which was found by French scientists 40 years ago,12 years after AIDS was firstly reported by US scientists.2 TheHIV/AIDS pandemic has spread to every country of theworldwith over 84 million infections and more than 40 million deaths since the start of the epidemic.3 According to Joint United Nations Programme on HIV/AIDS(UNAIDS),there are 38.4 million people living with HIV/AIDS(PLWHA)in 2021.4 In order to realize the Ending AIDS Plan by 2030,the UNAIDS made the intermediate target of less than 500,000 new HIV infections and 500,000 AIDS-related deaths in 2020.5 In the 2021 United Nations(UN)75th General Assembly,the General Secretary reported that the 2020 target of Ending AIDS Plan was not reached,6 with 1.7 million HIV infections and 690,000 AIDS-related deaths in 2019.7 In order to bring the Ending AIDS Plan back on track,UNAIDS setup a higher goal of“95-95-95,”meaning the percentage for all PLWHA who know their HIV status.展开更多
AIDS is the most severe infectious disease that has appeared in the second half of the 20th century.Since the United States Center of Disease Control & Prevention (US CDC) reported the first case of HIV carrier in ...AIDS is the most severe infectious disease that has appeared in the second half of the 20th century.Since the United States Center of Disease Control & Prevention (US CDC) reported the first case of HIV carrier in the men who had sex with men (MSM)population in 1981, HIV/AIDS had spread globally. By the end of December 2008, UNAIDS and WHO estimated that there were 3340 million (3110-3580 million)infected with HIV/AIDS worldwide.1 While the HIV/AIDS epidemic in Asia began later than the epidemic in Europe, America and Africa, experts predict that countries in Asia, especially in three countries, China,India and Indonesia, which have a population of more than 100 million, will have the world's largest number of HIV/AIDS in the near future.展开更多
基金supported by the National Natural Science Foundation of China,Nos.82271963(to HJL),81771806(to HJL),61936013(to HJL),82001914(to ZCT),81871511(to HZ)National Key R&D Program of China,No.2021YFA1301603(to ZCT)the Natural Science Foundation of Beijing,No.7212051(to HJL).
文摘Acquired immune deficiency syndrome infection can lead to cognitive dysfunction represented by changes in the default mode network.Most recent studies have been cross-sectional and thus have not revealed dynamic changes in the default mode network following acquired immune deficiency syndrome infection and antiretroviral therapy.Specifically,when brain imaging data at only one time point are analyzed,determining the duration at which the default mode network is the most effective following antiretroviral therapy after the occurrence of acquired immune deficiency syndrome.However,because infection times and other factors are often uncertain,longitudinal studies cannot be conducted directly in the clinic.Therefore,in this study,we performed a longitudinal study on the dynamic changes in the default mode network over time in a rhesus monkey model of simian immunodeficiency virus infection.We found marked changes in default mode network connectivity in 11 pairs of regions of interest at baseline and 10 days and 4 weeks after virus inoculation.Significant interactions between treatment and time were observed in the default mode network connectivity of regions of interest pairs area 31/V6.R and area 8/frontal eye field(FEF).L,area 8/FEF.L and caudal temporal parietal occipital area(TPOC).R,and area 31/V6.R and TPOC.L.ART administered 4 weeks after infection not only interrupted the progress of simian immunodeficiency virus infection but also preserved brain function to a large extent.These findings suggest that the default mode network is affected in the early stage of simian immunodeficiency virus infection and that it may serve as a potential biomarker for early changes in brain function and an objective indicator for making early clinical intervention decisions.
文摘Variable Common Immune Deficiency (VCID) is a very heterogeneous condition both clinically and immunologically. It is a group of molecular abnormalities responsible for a defect in antibody production leading to hypogammaglobulinemia often associated with autoimmune and/or lymphoproliferative manifestations. Late Onset Combined Immune Deficiency (LOCID) is a type of Variable Common Immune Deficiency (VCID) defined by a defect in antibody production (IgG and IgA ± IgM type), profound CD4 T-cell lymphopenia and frequent opportunistic infections. LOCID has been considered as a distinct entity from VCID due to its particular clinical and immunological profile.
文摘BACKGROUND Human herpesvirus type 7(HHV-7)is a less common herpes virus that usually causes mild,self-limiting illnesses.However,in recent years,there have been increasing reports of HHV-7 causing serious central nervous system infections,especially meningitis.The pathogenesis and clinical features of HHV-7 meningitis,particularly in adolescents with normal immune function,remain incompletely studied.Therefore,the purpose of this report is to share a case of HHV-7 meningitis in an immunocompetent adolescent with a view to deepening our understanding of the disease.CASE SUMMARY A 12-year-old female was admitted with fever,headache,and vomiting.4 d before admission,the patient developed a fever without obvious induction,with a temperature up to 39.5℃,no convulsions,accompanied by chills,headaches,fatigue,and no muscle aches.The patient was treated with fever reduction,which could be reduced to 38℃;repeated high fever,accompanied by vomiting 7-8 times;and no abdominal pain or diarrhea.The patient was diagnosed with"acute suppurative tonsillitis"in a local hospital,and the blood routine was generally normal.The patient was given symptomatic support treatment such as"ceftriaxone sodium"and antiemetic rehydration for 2 d,and his condition did not improve.The patient's physical examination showed pharyngeal congestion,bilateral tonsil grade I hypertrophy,regression of purulent secretions,and cervical resistance.Ocular B-ultrasound:Opacity of the vitreous body and edema of the optic disc in both eyes.Optical coherence tomography examination showed that the macular fovea was generally normal in both eyes,with edema of the optic disc.DNA virus monitoring results:HHV-7.We gave ganciclovir antiviral therapy,dexamethasone anti-inflammatory treatment,mannitol to reduce cranial pressure,omeprazole to protect gastrointestinal mucosa,and calcium and potassium supplementation.CONCLUSION This study reports a case of HHV-7 meningitis in an adolescent with normal immune function.Through comprehensive analysis of the clinical manifestations,laboratory tests,and treatment methods of the patient,it is found that early identification and antiviral treatment are essential for the outcome of the disease.This case suggests that despite normal immune function,adolescents may still suffer from herpes virus type 7 meningitis,so clinicians should be vigilant and take effective treatment measures in time.
文摘Background: Defaulting on antiretroviral therapy has been identified as the most important factor contributing to the antiretroviral therapy failure rate. This study aimed to investigate factors associated with defaulting on antiretroviral therapy among adult patients receiving care at Chikankata Mission Hospital antiretroviral therapy clinic. Method: Cross-sectional analytical study on 385 participants selected by a computer generated random numbers technique of simple random sampling from among the patients receiving antiretroviral therapy at Chikankata Mission Hospital. Data collected were processed and analysed using Statistical Package for Social Science version 27. Univariate and backward multivariable logistic regression analysis was performed to identify factors associated with antiretroviral therapy defaulting. The level of significance was set at 5% with a confidence level of 95%. Results: Over half (58.4%) of the study participants defaulted on antiretroviral therapy. About 65.8% of study participants indicated improved health as the reason they defaulted on antiretroviral therapy. Most participants indicated that it was important to always go for antiretroviral therapy services (Adjusted Odds Ratio 1.95;95% Confidence Interval: [1.14 - 3.33], p = 0.015). Very few participants indicated poor family support for antiretroviral therapy services (Adjusted Odds Ratio 4.08;95% Confidence Interval: [2.02 - 8.23], p Conclusion: Defaulting on antiretroviral therapy continues to be a significant problem and needs to be addressed as a matter of priority. More counselling and awareness-raising programmes are required to improve knowledge and understanding on the importance of attending scheduled antiretroviral therapy clinics and services as well as the consequences of defaulting on antiretroviral therapy.
文摘Vanishing bile duct syndrome (VBDS) refers to a group of disorders characterized by prolonged cholestasis as a result of destruction and disappearance ofintrahepatic bile ducts. Multiple etiologies have been indentifi ed including infections, neoplastic disorders, autoimmune conditions and drugs. The natural history of this condition is variable and may involve resolution of cholestasis or progression with irreversible damage. VBDS is extremely rare in human immunodeficiency virus (HIV)-infected patients and anti-retroviral therapy has never been implicated as a cause. We encountered a young pregnant female with HIV and VBDS secondary to anti-retroviral therapy. Here, we report her clinical course and outcome.
基金National Key Research and Development Program of the Ministry of Science and Technology (2017YFC1703503):Innovative Research on Data Collection Of Medical Record Homepage and TCM Medical Quality Evaluation SystemNational Natural Science Foundation of China National Natural Science(NO. 81674101):Research on The Method of Discovering the Dynamic Target Relationship Between AIDS Prescriptions Based on Multi-example and Multi-marker LearningSpecial Fund for Basic Scientific Research Business Expenses of Central Public Welfare Scientific Research Institutes (NO. ZZ11-063):Exploring Research Based on The Performance Evaluation Method of DRG Chinese Medicine Hospitals
文摘Objective:To discover the population characteristics of the syndrome types of Acquired Immune Deficiency Syndrome.Methods:Data mining method for feature selection was used.Results:Main symptoms based on feature selection are as follows,deficiency of both qi and blood(pale complexion,fear of cold,easy to catch a cold,pale tongue,weak pulse);liver depression and qi stagnation with effulgent fire(anxiety,insomnia,chest and hypochondrium,irregular menstruation,thin and whitish coating on the tongue,stringy pulse);dual deficiency of qi and yin(low-grade fever and night sweating,yellow urine,pale complexion,dysphoria with feverish sensation in chest,dry cough with less phlegm,weakness,dizziness,dry and red tongue,little coating,thread and rapid pulse);deficiency of spleen and kidney,dampness pathogen blockage(diarrhea,loose stool,eat less and abdominal nausea,abdominal pain,sallow complexion,nausea,vomiting,loss of hair,deafness and tinnitus,pale tongue with whitish coating,deep and thready pulse,slippery and rapid pulse);qi deficiency with blood stasis(weakness,spontaneous sweating,dry mouth without desire to drink,easy to catch a cold,shortness of breath,sallow complexion,eat less and loose stools,dim tongue quality,hesitant pulse).Conclusion:Based on the feature selection method,we can find the main characteristics of Acquired Immune Deficiency Syndrome,and provide objective reference for clinical diagnosis and treatment.
文摘Purpose:To investigate the level of and factors influencing perceived stigma and discrimination among people living with human immunodeficiency virus(HIV)/acquired immune deficiency syndrome(PLWHA)in Henan Province.Methods:In total,161 PLWHA from Zhengzhou and Zhenping were investigated using the Berger HIV stigma scale.Results:The mean Berger stigma scale score was 105.70±15.20,indicating a middle stigma level.Among the four subscales of the Berger stigma scale,the disclosure concerns score was highest,while the negative self-image score was lowest.Multivariate analyses showed that factors influencing perceived HIV stigma included the level of education and route of infection.Conclusion:The level of perceived HIV stigma and discrimination among PLWHA in Henan Province is moderate and was affected by the level of education and route of infection.Special intervention should be established to address this problem.
基金supported by the Peking University Clinical Scientist Program Special(BMU2019LCKXJ013)the National Natural Science Foundation Innovation Research Group Project(81721002)+2 种基金the Sanming Project of Medicine Project in Shenzhen(SZSM201612014)the Yunnan Applied Basic Research Projects-Union Foundation by Yunnan Provincial Department of Science and Technology and Kunming Medical University(202001AY070001-154)the Scientific Research Fund of Education Department of Yunnan Province(2021J0297)。
文摘Background: Mucosal-associated invariant T(MAIT) cells are systemically depleted in human immunodeficiency virus type 1(HIV-1) infected patients and are not replenished even after successful combined antiretroviral therapy(cART).This study aimed to identify the mechanism underlying MAIT cell depletion.Methods: In the present study, we applied flow cytometry, single-cell RNA sequencing and immunohistochemical staining to evaluate the characteristics of pyroptotic MAIT cells in a total of 127 HIV-1 infected individuals, including 69 treatment-naive patients, 28 complete responders, 15 immunological non-responders, and 15 elite controllers, at the Fifth Medical Center of Chinese PLA General Hospital, Beijing, China.Results: Single-cell transcriptomic profiles revealed that circulating MAIT cells from HIV-1 infected subjects were highly activated, with upregulation of pyroptosis-related genes. Further analysis revealed that increased frequencies of pyroptotic MAIT cells correlated with markers of systemic T-cell activation, microbial translocation, and intestinal damage in cART-naive patients and poor CD4+ T-cell recovery in long-term cART patients. Immunohistochemical staining revealed that MAIT cells in the gut mucosa of HIV-1 infected patients exhibited a strong active gasdermin-D(GSDMD, marker of pyroptosis) signal near the cavity side, suggesting that these MAIT cells underwent active pyroptosis in the colorectal mucosa. Increased levels of the proinflammatory cytokines interleukin-12(IL-12) and IL-18 were observed in HIV-1 infected patients. In addition, activated MAIT cells exhibited an increased pyroptotic phenotype after being triggered by HIV-1 virions, T-cell receptor signals, IL-12 plus IL-18, and combinations of these factors, in vitro.Conclusions: Activation-induced MAIT cell pyroptosis contributes to the loss of MAIT cells in HIV-1 infected patients,which could potentiate disease progression and poor immune reconstitution.
文摘BACKGROUND Coronavirus disease 2019(COVID-19)-associated invasive pulmonary aspergillosis presents a diagnostic challenge due to its non-specific clinical/imaging features,as well as the fact that the proposed clinically diagnostic algorithms do not necessarily apply to COVID-19 patients.In addition,Fusarium spp.is a rare cause of opportunistic life-threatening fungal infections.Disseminated Fusarium infection in an immunocompromised host is intractable,with a high likelihood of resulting mortality.To our knowledge,this is the first case of secondary pulmonary infection by Fusarium solani(F.solani)and Aspergillus niger(A.niger)during systemic steroid treatment for COVID-19.CASE SUMMARY A 62-year-old male was transported to our hospital by ambulance with a complaint of fever and dyspnea.We established a diagnosis of pneumococcal pneumonia,complicated with COVID-19 and septic shock,together with acute renal failure.He was admitted to the intensive care unit,to be treated with piperacillin/tazobactam,vancomycin,and 6.6 mg per day of dexamethasone sodium phosphate,along with noradrenaline as a vasopressor,ventilator management,and continuous hemodiafiltration.His condition improved,and we finished the vasopressor on the fifth hospital day.We administered dexamethasone for ten days,and finished the course of treatment.On the eleventh day,patient respiratory deterioration was observed,and a computed tomography scan showed an exacerbation of bilateral ground-glass-opacity-like consolidation,together with newly appeared cavitary lesions in the lung.we changed antibiotics to meropenem plus vancomycin.In addition,a fungal infection was considered as a possibility based on microscopic findings of sputum,and we began coadministration of voriconazole.However,the pneumonia worsened,and the patient died on the seventeenth day of illness.Later,F.solani and A.niger were identified from sputum collected on the twelfth day.It was believed that he developed a cell-mediated immune deficiency during COVID-19 treatment,which led to the complication of pneumonia caused by the above-mentioned fungi,contributing to his death.CONCLUSION Because early initiation of intense antifungal therapy offers the best chance for survival in pulmonary fusariosis,computed tomography scans and appropriate microbiologic investigations should be obtained for severely immunocompromised patients.
文摘Thymosin alpha 1 is a peptide naturally occurring in the thymus that has long been recognized for modifying,enhancing,and restoring immune function.Thymosin alpha 1 has been utilized in the treatment of immunocompromised states and malignancies,as an enhancer of vaccine response,and as a means of curbing morbidity and mortality in sepsis and numerous infections.Studies have postulated that thymosin alpha 1 could help improve the outcome in severely ill corona virus disease 2019 patients by repairing damage caused by overactivation of lymphocytic immunity and how thymosin alpha 1 could prevent the excessive activation of T cells.In this review,we discuss key literature on the background knowledge and current clinical uses of thymosin alpha 1.Considering the known biochemical properties including antibacterial and antiviral properties,timehonored applications,and the new promising findings regarding the use of thymosin,we believe that thymosin alpha 1 deserves further investigation into its antiviral properties and possible repurposing as a treatment against severe acute respiratory syndrome coronavirus-2.
文摘Vitamin D plays an important role in maintaining normal bone metabolism. Recent studies have suggested that vitamin D influences many other physiological processes, including muscle function, cardiovascular homeostasis, nerve function, and immune response. Furthermore, accumulated evidence suggests that vitamin D also mediates the immune system response to infection. Critical neurosurgical patients have higher infection and mortality rates. To correlate vitamin D deficiency to the immunological status of neurosurgical intensive care unit patients, we detected serum vitamin D level in 15 patients with clinically suspected infection and 10 patients with confirmed infection. Serum level of 25-hydroxyvitamin D, the primary circulating form of vitamin D, was significantly decreased in patients with suspected or confirmed infection after a 2-week neurosurgical intensive care unit hospitalization, while serum level of 1,25-dihydroxyvitamin D, the active form of vitamin D, was significantly decreased in patients after a 4-week neurosurgical intensive care unit hospitalization. These findings suggest that vitamin D deficiency is linked to the immunological status of neurosurgical intensive care unit patients and vitamin D supplementation can improve patient's immunological status.
文摘By using cell cloning technique, 4 sublines (A,C,D,E) were isolated from a cell line of human lung giant cell carcinoma (PLA-801). After subcutaneous inoculation in T-cell deficient BALB/c nude mice, the incidence of tumor growth and spontaneous metastasis were the highest in subline D, moderate in sublines A and E, and lowest in subline C. Tumor cells of subline C also showed similar low tumorigenicity in another T-cell deficient 615/ PB1 nude mice.However, in 615/PB1 beige nude mice with con-genitally combined immune-deficiency in both T and NK cell activity, tumor cells of the rarely metastatic subline C do produce significantly high frequency of tumor growth and spontaneous metastasis.Morphological studies (light microscope, electron microscope and immunohistochemistry) showed rich microfilaments and Vimentin positive in the cytoplasm of metastatic tumor cells. This may imply a possibility that tumor cells differentiate towards the direction favourable to spreading and metastasis.
文摘<strong>Background:</strong><span style="font-family:Verdana;"> Primary Immune Deficiencies (PID) are rare, under-determined </span><span style="font-family:""><span style="font-family:Verdana;">diseases particularly in sub-Saharan Africa. The diagnosis is often suspected with uncommon clinical signs. Infections are the main diagnostic circumstances in infants. Confirmation is often difficult because some additional examinations are unavailable in many of our countries. </span><b><span style="font-family:Verdana;">Aim: </span></b><span style="font-family:Verdana;">Our aim was to share the challenge of diagnosis and treatment in PID. </span><b><span style="font-family:Verdana;">Case Presentation:</span></b><span style="font-family:Verdana;"> It is about two infants, a boy and a girl, with early several infections. Both of them presented a hypo-gammaglobulinemia and to the boy, the immuno-phenotyping lymphocyte showed a decrease</span></span><span style="font-family:Verdana;">d</span><span style="font-family:Verdana;"> level of lymphocytes CD19. We are looking for genetic confirmation but it is not easy. The treatment of these infants require</span><span style="font-family:Verdana;">s</span><span style="font-family:Verdana;"> a substitution for life of immunoglobulin w</span><span style="font-family:Verdana;">h</span><span style="font-family:Verdana;">ich </span><span style="font-family:Verdana;">is</span><span style="font-family:""><span style="font-family:Verdana;"> unavailable in our countries. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> PID are suspected with atypical clinical signs. Confirmation genetic diagnosis is difficult in low income countries. To improve the follow up, we need to strengthen clinical-biological collaboration.</span></span>
基金Supported by the National Special Science and Technology Program on Major Infectious Diseases(No.2013ZX10005001-001,No.2012ZX10005001-005)Henan Province Colleges and Universities Key Youth Teachers Scheme(No.2013GGJS-095)Plan For Scientific Innovation Talent of Henan Province(No.2015-025)
文摘Henan Province in China has a major epidemic of human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS). Chinese medicine (CM) has been used throughout the last decade, and a management modality was developed, which can be described by unified-planning, graded- administration, and centralized-controlling (UGC). The UGC modality has one primary concept (patient-centered medicine from CM theory), four basic foundations (classifying administrative region, characteristics of CM on disease treatment, health resource conditions, and distribution of patients living with HIV), six important relationships (the "three uniformities and three combinations," and the six relationships therein guide the treatment of AIDS with CM), and four key sections (management, operation, records, and evaluation). In this article, the authors introduce the UGC modality, which could be beneficial to developing countries or resource-limited areas for the management of chronic infectious disease.
文摘The International Conference on Prevention and Treatment of Acquired Immune Deficiency Syndrome (AIDS) with Chinese Medicine (CM) was held in Beijing International Hotel from October 16 to 17, 2010. It was cosponsored by Guang'anmen Hospital, China Academy of Chinese Medical Sciences (CACMS), and the First Affiliated Hospital of Henan University of Traditional Chinese Medicine.
基金supported by the National Natural Science Foundation of China(Grant No.81673828)
文摘Diarrhea can occur at an early or advanced stage of acquired immunodeficiency syndrome(AIDS)as a usual symptom in people with human immunodeficiency virus(HIV)infection.While it is usually not fatal,it can influence patients’quality of life seriously.It has shown to be efficacious and improves people’s immune status to a certain extent to treat HIV/AIDS-related diarrhea on the basis of syndrome differentiation and treatment or Chinese herbs plus conventional treatment.Therefore,it may have a good application potential.Here,we outline a protocol for the systematic review of this health-care intervention,with the aim to evaluate the beneficial effects and safety of Traditional Chinese Medicine(TCM)for patients who suffer from HIV/AIDS-associated diarrhea.Randomized controlled trials that compare Chinese herbs with placebo or other effective treatments will be searched and included,in spite of publication status or language.The primary outcomes include diarrhea frequency and fecal character.The databases we will search as follows:China Science and Technology Journal Database(VIP),Chinese Biomedical Literature Database(Sino Med),Wanfang Data,China National Knowledge Infrastructure,Pub Med and the CENTRAL in Cochrane Library.Two authors will respectively conduct the screening of trials,data extraction,and use the Cochrane risk of bias tool to assess the methodological quality.We will analyze the data and perform a meta-analysis if possible.We intend to identify potential therapeutic modalities that may be of benefit to inform clinical practice by supplying existing evidence of the helpful effects and safety of TCM to treat patients suffering from HIV/AIDS-associated diarrhea.
基金Supported by the National Key Technologies Special-purpose Program (No.2008ZX10005-004)
文摘Acquired immune deficiency syndrome (AIDS) is a chronic infectious disease,which the patients are infected with human immunodeficiency virus (HIV).HIV damages the human's immune function and causes CD4 cell decline in the number and function.Immune reconstitution is an important treatment to AIDS.Bone marrow transplantation,adoptive immune cell therapy and cytokines infusion can all assist the immune reconstitution;highly active antiretroviral therapy (HAART) can effectively control the virus replication and benefit the immune reconstitution.HAART combined with immunotherapy is an important method of immune reconstitution in AIDS patients.Chinese medicine is playing a more and more important role in immune reconstitution.Immune reconstitution has always been effective in the whole treatment of AIDS.
基金This work was supported by a grant(B2022011-3-2020)of NationalMedical Center for Infectious Diseases.
文摘Acquired immune deficiency syndrome(AIDS)is caused by human immunodeficiency virus(HIV),which was found by French scientists 40 years ago,12 years after AIDS was firstly reported by US scientists.2 TheHIV/AIDS pandemic has spread to every country of theworldwith over 84 million infections and more than 40 million deaths since the start of the epidemic.3 According to Joint United Nations Programme on HIV/AIDS(UNAIDS),there are 38.4 million people living with HIV/AIDS(PLWHA)in 2021.4 In order to realize the Ending AIDS Plan by 2030,the UNAIDS made the intermediate target of less than 500,000 new HIV infections and 500,000 AIDS-related deaths in 2020.5 In the 2021 United Nations(UN)75th General Assembly,the General Secretary reported that the 2020 target of Ending AIDS Plan was not reached,6 with 1.7 million HIV infections and 690,000 AIDS-related deaths in 2019.7 In order to bring the Ending AIDS Plan back on track,UNAIDS setup a higher goal of“95-95-95,”meaning the percentage for all PLWHA who know their HIV status.
文摘AIDS is the most severe infectious disease that has appeared in the second half of the 20th century.Since the United States Center of Disease Control & Prevention (US CDC) reported the first case of HIV carrier in the men who had sex with men (MSM)population in 1981, HIV/AIDS had spread globally. By the end of December 2008, UNAIDS and WHO estimated that there were 3340 million (3110-3580 million)infected with HIV/AIDS worldwide.1 While the HIV/AIDS epidemic in Asia began later than the epidemic in Europe, America and Africa, experts predict that countries in Asia, especially in three countries, China,India and Indonesia, which have a population of more than 100 million, will have the world's largest number of HIV/AIDS in the near future.