BACKGROUND Pneumocystis jirovecii pneumonia(PJP)is an infectious disease common in immunocompromised hosts.However,the currently,the clinical characteristics of non-HIV patients with PJP infection have not been fully ...BACKGROUND Pneumocystis jirovecii pneumonia(PJP)is an infectious disease common in immunocompromised hosts.However,the currently,the clinical characteristics of non-HIV patients with PJP infection have not been fully elucidated.AIM To explore efficacy of trimethoprim–sulfamethoxazole(TMP-SMX)and caspofungin for treatment of non-human immunodeficiency virus(HIV)-infected PJP patients.METHODS A retrospective study enrolled 22 patients with non-HIV-infected PJP treated with TMP-SMX and caspofungin from 2019 to 2021.Clinical manifestations,treatment and prognosis of the patients were analyzed.RESULTS Five patients presented with comorbidity of autoimmune diseases,seven with lung cancer,four with lymphoma,two with organ transplantation and four with membranous nephropathy associated with use of immunosuppressive agents.The main clinical manifestations of patients were fever,dry cough,and progressive dyspnea.All patients presented with acute onset and respiratory failure.The most common imaging manifestation was ground glass opacity around the hilar,mainly in the upper lobe.All patients were diagnosed using next-generation sequencing,and were treated with a combination of TMP-SMX and caspofungin.Among them,17 patients received short-term adjuvant glucocorticoid therapy.All patients recovered well and were discharged from hospital.CONCLUSION Non-HIV-infected PJP have rapid disease progression,high risk of respiratory failure,and high mortality.Combination of TMP-SMX and caspofungin can effectively treat severe non-HIVinfected PJP patients with respiratory failure.展开更多
BACKGROUND Inflammatory bowel disease(IBD)is an autoimmune condition treated with immunosuppressive drugs.However,the need for immune system suppression becomes questionable when infection with the human immunodeficie...BACKGROUND Inflammatory bowel disease(IBD)is an autoimmune condition treated with immunosuppressive drugs.However,the need for immune system suppression becomes questionable when infection with the human immunodeficiency virus(HIV)occurs simultaneously and impacts the course of IBD.Our reported case represents the clinical course,prescribed treatment and its effect,as well as clinical challenges faced by physicians in a combination of such diseases.We also present a comprehensive literature review of similar cases.CASE SUMMARY A 49-year-old woman suffering from a newly diagnosed Crohn’s disease was hospitalized due to exacerbated symptoms(abdominal pain,fever,and weight loss).During her hospital stay,she tested positive for HIV.With conservative treatment,the patient improved and was discharged.In the outpatient clinic,her HIV infection was confirmed as stage C3,and antiretroviral treatment was initiated immediately.That notwithstanding,soon the patient was rehospitalized with pulmonary embolism and developed a series of complications because of the subsequent coexistence of IBD and HIV.After intensive and meticulous treatment,the patient’s condition has improved and she remains in remission.CONCLUSION The paucity of studies and data on the coexistence of HIV and IBD leaves clinicians doubting the optimal treatment options.展开更多
Mother-to-child-transmission of human immunodeficiency virus(HIV) is a primary cause of pediatric infections with HIV. Many of these infections involve women who were not tested early enough in pregnancy, or who didno...Mother-to-child-transmission of human immunodeficiency virus(HIV) is a primary cause of pediatric infections with HIV. Many of these infections involve women who were not tested early enough in pregnancy, or who didnot receive prevention services. HIV testing of pregnant women is considered to be one of the key strategies for preventing mother-to-child-transmission of HIV, but HIV testing rates among pregnant women in various countries remain suboptimal. Understanding the factors relating to women's willingness to be tested for HIV during pregnancy is critical for developing strategies to increase HIV testing rates among pregnant women. Extensive research points to various factors relating to women's willingness to be tested for HIV during pregnancy, and various recommendations aimed at improving testing rates among pregnant women have been suggested based on the research. In light of the goals set by the United Nations to reduce the rate of infants infected with HIV, it is necessary to summarize what is currently known regarding factors related to women's willingness to be tested for HIV during pregnancy. The purpose of this review is therefore to examine factors related to women's willingness to be tested for HIV during pregnancy, and to summarize recommendations for practice and further research.展开更多
In human immunodef iciency virus(HIV)-infected people kidney disease is as an important cause of morbidity and mortality. Clinical features of kidney damage in HIV-infected patients range from asymptomatic microalbumi...In human immunodef iciency virus(HIV)-infected people kidney disease is as an important cause of morbidity and mortality. Clinical features of kidney damage in HIV-infected patients range from asymptomatic microalbuminuria to nephrotic syndrome. The lack of specif ic clinical features despite the presence of heavy proteinuria may mask the renal involvement. Indeed, it is important in HIV patients to monitor renal function to early discover a possible kidney injury. After the introduction of antiretroviral therapy, mortality and morbidity associated to HIV-infection have shown a substantial reduction, although a variety of side effects for longterm use of highly active antiretroviral therapy, including renal toxicity, has emerged. Among more than 20 currently available antiretroviral agents, many of them can occasionally cause reversible or irreversible nephrotoxicity. At now, three antiretroviral agents, i.e., indinavir, atazanavir and tenofovir disoproxil fumarate have a well established association with direct nephrotoxicity. This review focuses on major causes of proteinuria and other pathological f indings related to kidney disease in HIV-infected children and adolescents.展开更多
The Mayo human immunodeficiency virus(HIV) Clinic has been providing patient centered care for persons living with HIV in Minnesota and beyond for the past 20 years. Through multidisciplinary engagement, vital clinica...The Mayo human immunodeficiency virus(HIV) Clinic has been providing patient centered care for persons living with HIV in Minnesota and beyond for the past 20 years. Through multidisciplinary engagement, vital clinical outcomes such as retention in care, initiation of antiretroviral therapy and virologic suppression are maximized. In this commentary, we describe the history of the Mayo HIV Clinic and its best practices, providing a "Mayo Model" of HIV care that exceeds national outcomes and may be applicable in other settings.展开更多
The availability of highly potent antiretroviral treatmentduring the last decades has transformed human immunodeficiency virus(HIV) infection into a chronic disease. Children that were diagnosed during the first month...The availability of highly potent antiretroviral treatmentduring the last decades has transformed human immunodeficiency virus(HIV) infection into a chronic disease. Children that were diagnosed during the first months or years of life and received treatment, are living longer and better and are presently reaching adolescence and adulthood. Perinatally HIV-infected adolescents(PHIV) and young adults may present specific clinical, behavior and social characteristics and demands. We have performed a literature review about different aspects that have to be considered in the care and follow-up of PHIV. The search included papers in the MEDLINE database via PubM ed, located using the keywords "perinatally HIV-infected" AND "adolescents". Only articles published in English or Portuguese from 2003 to 2014 were selected. The types of articles included original research, systematic reviews, and quantitative or qualitative studies; case reports and case series were excluded. Results are presented in the following topics: "Puberal development and sexual maturation", "Growth in weight and height", "Bone metabolism during adolescence", "Metabolic complications", "Brain development, cognition and mental health", "Reproductive health", "Viral drug resistance" and "Transition to adult outpatient care". We hope that this review will support the work of pediatricians, clinicians and infectious diseases specialists that are receiving these subjects to continue treatment.展开更多
Objective: To test the hypothesis that Human Immunodeficiency Virus (HIV) infection in Black patients is associated with increased cardiometabolic risk factors that may increase aortic stiffness assessed by pulse wave...Objective: To test the hypothesis that Human Immunodeficiency Virus (HIV) infection in Black patients is associated with increased cardiometabolic risk factors that may increase aortic stiffness assessed by pulse wave velocity (PWV). Methods: We matched 96 Cameroonian Controls to 238 (Un) treated HIV-positive patients [HIV] for age. In each participant, aortic PWV (ComplioR), blood pressures (BP), lipid profile and fasting blood glucose (FPG) were measured. Results: Waist circumference was lower in HIV than in Controls (both p g·dl-1), and of diabetes (FPG > 125 mg·dl-1) were higher in HIV than in the Controls (50% vs 27%, and 23% vs 1%, respectively;both p < 0.0001). HDL-C was lower in HIV as compared to the Control (p = 0.02). Fasting triglycerides (TG) and the atherogenic dyslipidemia ratio [log(TG)/HDL-C] were higher in HIV than in the Controls (both p < 0.05). Hypertension prevalence was high but comparable in the two groups (48% vs 44% respectively, p > 0.05). HIV patients exhibited a twice-higher prevalence of MetS (AHA/NHLBI score 33/5) than that of the Controls (41% vs 21%;p 0.01). Similarly, severity of MetS phenotype was higher in HIV as compared to the Controls (2.14% vs 1.59%;p < 0.0001). PWV adjusted for age, mean BP and gender was faster in HIV in comparison to the controls (7.33 m/s vs 6.86 m/s, respectively;p = 0.036). Conclusions: HIV infection is associated with higher prevalence of MetS and its phenotype in Black African patients that may induce increased aortic stiffness.展开更多
Objective To evaluate liver injury in patients with hepatitis C virus(HCV)/human immunodeficiency virus(HIV)coinfection in Dehong Prefecture,Yunnan Province.Methods A total of 4 784 HIV-infected patients were enrolled...Objective To evaluate liver injury in patients with hepatitis C virus(HCV)/human immunodeficiency virus(HIV)coinfection in Dehong Prefecture,Yunnan Province.Methods A total of 4 784 HIV-infected patients were enrolled in this study.Baseline aspartate aminotransferase(AST),alanine aminotransferase(ALT)展开更多
文摘BACKGROUND Pneumocystis jirovecii pneumonia(PJP)is an infectious disease common in immunocompromised hosts.However,the currently,the clinical characteristics of non-HIV patients with PJP infection have not been fully elucidated.AIM To explore efficacy of trimethoprim–sulfamethoxazole(TMP-SMX)and caspofungin for treatment of non-human immunodeficiency virus(HIV)-infected PJP patients.METHODS A retrospective study enrolled 22 patients with non-HIV-infected PJP treated with TMP-SMX and caspofungin from 2019 to 2021.Clinical manifestations,treatment and prognosis of the patients were analyzed.RESULTS Five patients presented with comorbidity of autoimmune diseases,seven with lung cancer,four with lymphoma,two with organ transplantation and four with membranous nephropathy associated with use of immunosuppressive agents.The main clinical manifestations of patients were fever,dry cough,and progressive dyspnea.All patients presented with acute onset and respiratory failure.The most common imaging manifestation was ground glass opacity around the hilar,mainly in the upper lobe.All patients were diagnosed using next-generation sequencing,and were treated with a combination of TMP-SMX and caspofungin.Among them,17 patients received short-term adjuvant glucocorticoid therapy.All patients recovered well and were discharged from hospital.CONCLUSION Non-HIV-infected PJP have rapid disease progression,high risk of respiratory failure,and high mortality.Combination of TMP-SMX and caspofungin can effectively treat severe non-HIVinfected PJP patients with respiratory failure.
文摘BACKGROUND Inflammatory bowel disease(IBD)is an autoimmune condition treated with immunosuppressive drugs.However,the need for immune system suppression becomes questionable when infection with the human immunodeficiency virus(HIV)occurs simultaneously and impacts the course of IBD.Our reported case represents the clinical course,prescribed treatment and its effect,as well as clinical challenges faced by physicians in a combination of such diseases.We also present a comprehensive literature review of similar cases.CASE SUMMARY A 49-year-old woman suffering from a newly diagnosed Crohn’s disease was hospitalized due to exacerbated symptoms(abdominal pain,fever,and weight loss).During her hospital stay,she tested positive for HIV.With conservative treatment,the patient improved and was discharged.In the outpatient clinic,her HIV infection was confirmed as stage C3,and antiretroviral treatment was initiated immediately.That notwithstanding,soon the patient was rehospitalized with pulmonary embolism and developed a series of complications because of the subsequent coexistence of IBD and HIV.After intensive and meticulous treatment,the patient’s condition has improved and she remains in remission.CONCLUSION The paucity of studies and data on the coexistence of HIV and IBD leaves clinicians doubting the optimal treatment options.
文摘Mother-to-child-transmission of human immunodeficiency virus(HIV) is a primary cause of pediatric infections with HIV. Many of these infections involve women who were not tested early enough in pregnancy, or who didnot receive prevention services. HIV testing of pregnant women is considered to be one of the key strategies for preventing mother-to-child-transmission of HIV, but HIV testing rates among pregnant women in various countries remain suboptimal. Understanding the factors relating to women's willingness to be tested for HIV during pregnancy is critical for developing strategies to increase HIV testing rates among pregnant women. Extensive research points to various factors relating to women's willingness to be tested for HIV during pregnancy, and various recommendations aimed at improving testing rates among pregnant women have been suggested based on the research. In light of the goals set by the United Nations to reduce the rate of infants infected with HIV, it is necessary to summarize what is currently known regarding factors related to women's willingness to be tested for HIV during pregnancy. The purpose of this review is therefore to examine factors related to women's willingness to be tested for HIV during pregnancy, and to summarize recommendations for practice and further research.
文摘In human immunodef iciency virus(HIV)-infected people kidney disease is as an important cause of morbidity and mortality. Clinical features of kidney damage in HIV-infected patients range from asymptomatic microalbuminuria to nephrotic syndrome. The lack of specif ic clinical features despite the presence of heavy proteinuria may mask the renal involvement. Indeed, it is important in HIV patients to monitor renal function to early discover a possible kidney injury. After the introduction of antiretroviral therapy, mortality and morbidity associated to HIV-infection have shown a substantial reduction, although a variety of side effects for longterm use of highly active antiretroviral therapy, including renal toxicity, has emerged. Among more than 20 currently available antiretroviral agents, many of them can occasionally cause reversible or irreversible nephrotoxicity. At now, three antiretroviral agents, i.e., indinavir, atazanavir and tenofovir disoproxil fumarate have a well established association with direct nephrotoxicity. This review focuses on major causes of proteinuria and other pathological f indings related to kidney disease in HIV-infected children and adolescents.
基金Supported by CTSA(in part)from the National Center for Advancing Translational Sciences(NCATS),No.UL1 TR000135a component of the National Institutes of Health(NIH),as well as NIH,No.1R01AI110173-01its contents are solely the responsibility of the authors and do not necessarily represent the official view of NIH
文摘The Mayo human immunodeficiency virus(HIV) Clinic has been providing patient centered care for persons living with HIV in Minnesota and beyond for the past 20 years. Through multidisciplinary engagement, vital clinical outcomes such as retention in care, initiation of antiretroviral therapy and virologic suppression are maximized. In this commentary, we describe the history of the Mayo HIV Clinic and its best practices, providing a "Mayo Model" of HIV care that exceeds national outcomes and may be applicable in other settings.
文摘The availability of highly potent antiretroviral treatmentduring the last decades has transformed human immunodeficiency virus(HIV) infection into a chronic disease. Children that were diagnosed during the first months or years of life and received treatment, are living longer and better and are presently reaching adolescence and adulthood. Perinatally HIV-infected adolescents(PHIV) and young adults may present specific clinical, behavior and social characteristics and demands. We have performed a literature review about different aspects that have to be considered in the care and follow-up of PHIV. The search included papers in the MEDLINE database via PubM ed, located using the keywords "perinatally HIV-infected" AND "adolescents". Only articles published in English or Portuguese from 2003 to 2014 were selected. The types of articles included original research, systematic reviews, and quantitative or qualitative studies; case reports and case series were excluded. Results are presented in the following topics: "Puberal development and sexual maturation", "Growth in weight and height", "Bone metabolism during adolescence", "Metabolic complications", "Brain development, cognition and mental health", "Reproductive health", "Viral drug resistance" and "Transition to adult outpatient care". We hope that this review will support the work of pediatricians, clinicians and infectious diseases specialists that are receiving these subjects to continue treatment.
文摘Objective: To test the hypothesis that Human Immunodeficiency Virus (HIV) infection in Black patients is associated with increased cardiometabolic risk factors that may increase aortic stiffness assessed by pulse wave velocity (PWV). Methods: We matched 96 Cameroonian Controls to 238 (Un) treated HIV-positive patients [HIV] for age. In each participant, aortic PWV (ComplioR), blood pressures (BP), lipid profile and fasting blood glucose (FPG) were measured. Results: Waist circumference was lower in HIV than in Controls (both p g·dl-1), and of diabetes (FPG > 125 mg·dl-1) were higher in HIV than in the Controls (50% vs 27%, and 23% vs 1%, respectively;both p < 0.0001). HDL-C was lower in HIV as compared to the Control (p = 0.02). Fasting triglycerides (TG) and the atherogenic dyslipidemia ratio [log(TG)/HDL-C] were higher in HIV than in the Controls (both p < 0.05). Hypertension prevalence was high but comparable in the two groups (48% vs 44% respectively, p > 0.05). HIV patients exhibited a twice-higher prevalence of MetS (AHA/NHLBI score 33/5) than that of the Controls (41% vs 21%;p 0.01). Similarly, severity of MetS phenotype was higher in HIV as compared to the Controls (2.14% vs 1.59%;p < 0.0001). PWV adjusted for age, mean BP and gender was faster in HIV in comparison to the controls (7.33 m/s vs 6.86 m/s, respectively;p = 0.036). Conclusions: HIV infection is associated with higher prevalence of MetS and its phenotype in Black African patients that may induce increased aortic stiffness.
文摘Objective To evaluate liver injury in patients with hepatitis C virus(HCV)/human immunodeficiency virus(HIV)coinfection in Dehong Prefecture,Yunnan Province.Methods A total of 4 784 HIV-infected patients were enrolled in this study.Baseline aspartate aminotransferase(AST),alanine aminotransferase(ALT)
