RESUMEN
We aimed to explore the sexual health of young adults with perinatally acquired human immunodeficiency virus (PHIV). Eighteen to 25 years old PHIV participants were recruited in two tertiary care units in Paris. Sexually transmitted HIV was an exclusion criterion. Individual interviews were conducted. Transcripts were analyzed using a semio-pragmatic phenomenological method. Twenty-five participants were interviewed from March 2022 to September 2022. Some of them renounced being in any romantic relationship. Those who disclosed their HIV status to their romantic partner reported that dating was more complex and those who did not disclose reported that keeping HIV a secret was a significant mental burden. Young men tended to disclose their HIV status to their romantic partner whereas young women did not consider doing so before marriage. Many participants had to educate themselves about sexuality, through school or websites. Identified interlocutors for sexuality varied across participants. All participants were aware of U = U (Undetectable = Untransmittable) slogan. Despite that, participants remained worried about transmitting HIV to their sexual partners. That hindered their sexual satisfaction. In addition, they neglected the risk of unwanted pregnancies or sexually transmitted diseases (STDs). In our study, knowing the U = U slogan did not provide reassurance to PHIV participants regarding the risk of onward HIV transmission. Further, they showed very little concern for protecting themselves from their partner's STD.
RESUMEN
Rapid identification of SARS-CoV-2-infected individuals is a cornerstone for the control of virus spread. The sensitivity of SARS-CoV-2 RNA detection by RT-PCR is similar in saliva and nasopharyngeal swabs. Rapid molecular point-of-care tests in saliva could facilitate, broaden and speed up the diagnosis. We conducted a prospective study in two community COVID-19 screening centers to evaluate the performances of a CE-marked RT-LAMP assay (EasyCoV) designed for the detection of SARS-CoV2 RNA from fresh saliva samples, compared to nasopharyngeal RT-PCR, to saliva RT-PCR and to nasopharyngeal antigen testing. Overall, 117 of the 1718 participants (7%) tested positive with nasopharyngeal RT-PCR. Compared to nasopharyngeal RT-PCR, the sensitivity and specificity of the RT-LAMP assay in saliva were 34% and 97%, respectively. The Ct values of nasopharyngeal RT-PCR were significantly lower in the 40 true positive subjects with saliva RT-LAMP (Ct 25.9) than in the 48 false negative subjects with saliva RT-LAMP (Ct 28.4) (p = 0.028). Considering six alternate criteria for reference tests, including saliva RT-PCR and nasopharyngeal antigen, the sensitivity of saliva RT-LAMP ranged between 27 and 44%. The detection of SARS-CoV-2 in crude saliva samples with an RT-LAMP assay had a lower sensitivity than nasopharyngeal RT-PCR, saliva RT-PCR and nasopharyngeal antigen testing.Registration number: NCT04578509.
Asunto(s)
Atención Ambulatoria/métodos , Prueba de Ácido Nucleico para COVID-19/métodos , COVID-19/diagnóstico , COVID-19/metabolismo , SARS-CoV-2 , Saliva/metabolismo , Adulto , Pruebas Diagnósticas de Rutina , Reacciones Falso Negativas , Reacciones Falso Positivas , Femenino , Humanos , Masculino , Persona de Mediana Edad , Técnicas de Diagnóstico Molecular , Medicina Molecular , Nasofaringe/virología , Técnicas de Amplificación de Ácido Nucleico , Sistemas de Atención de Punto , Pruebas en el Punto de Atención , Estudios Prospectivos , ARN Viral/genética , Reacción en Cadena en Tiempo Real de la Polimerasa , Reproducibilidad de los Resultados , Sensibilidad y EspecificidadRESUMEN
Nasopharyngeal sampling for nucleic acid amplification testing (NAAT) is the standard diagnostic test of coronavirus disease 2019. Our objectives were to assess, in real-life conditions, the diagnostic accuracy of a nasopharyngeal point-of-care antigen (Ag) test and of saliva NAAT for detection of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in ambulatory care. This was a prospective cohort study from 19 October through 18 December 2020 in two community COVID-19 screening centers in Paris, France. Two nasopharyngeal swabs and one saliva sample were simultaneously collected. Diagnostic accuracies of nasopharyngeal Ag testing and of three saliva NAAT methods were assessed as compared to nasopharyngeal NAAT. A total of 1452 ambulatory children and adults were included. Overall, 129/1443 (9%) participants tested positive on nasopharyngeal NAAT (102/564 [18%] in symptomatic and 27/879 [3%] in asymptomatic participants). Sensitivity was 94%, 23%, 96%, and 94% for the three different protocols of saliva NAAT and for the nasopharyngeal Ag test, respectively. Estimates of specificity were above 95% for all methods. Diagnostic accuracy was similar in symptomatic and asymptomatic individuals. Diagnostic accuracy of nasopharyngeal Ag testing and of saliva NAAT is similar to that of nasopharyngeal NAAT, subject to compliance with specific protocols for saliva. Registration number: NCT04578509.
Asunto(s)
Prueba de COVID-19/métodos , COVID-19/diagnóstico por imagen , Nasofaringe/virología , SARS-CoV-2/aislamiento & purificación , Saliva/virología , Manejo de Especímenes/métodos , Adulto , Estudios de Cohortes , Femenino , Humanos , Masculino , Tamizaje Masivo , Persona de Mediana Edad , Técnicas de Amplificación de Ácido Nucleico/métodos , Paris , Pruebas en el Punto de Atención , Estudios Prospectivos , Sensibilidad y EspecificidadRESUMEN
: We performed an observational prospective monocentric study in patients living with HIV (PLWH) diagnosed with COVID-19. Fifty-four PLWH developed COVID-19 with 14 severe (25.9%) and five critical cases (9.3%), respectively. By multivariate analysis, age, male sex, ethnic origin from sub-Saharan Africa and metabolic disorder were associated with severe or critical forms of COVID-19. Prior CD4 T cell counts did not differ between groups. No protective effect of a particular antiretroviral class was observed.
Asunto(s)
Infecciones por Coronavirus/epidemiología , Infecciones por VIH/complicaciones , Neumonía Viral/epidemiología , Adulto , África del Sur del Sahara/etnología , Antirretrovirales/uso terapéutico , Recuento de Linfocito CD4 , COVID-19 , Infecciones por Coronavirus/etnología , Femenino , Francia/epidemiología , Infecciones por VIH/tratamiento farmacológico , Humanos , Modelos Logísticos , Masculino , Enfermedades Metabólicas/complicaciones , Persona de Mediana Edad , Análisis Multivariante , Pandemias , Neumonía Viral/etnología , Estudios Prospectivos , Medición de Riesgo , Factores de RiesgoRESUMEN
Combination antiretroviral therapy (cART) can cause potentially stigmatizing facial lipoatrophy. Encouraging preliminary results have been reported with 2.5% polyacrylamide hydrogel for facial reconstruction. The aim of this multicenter, open-label noncomparative pilot study was to evaluate the efficacy and safety of intradermal facial injections of polyacrylamide hydrogel in HIV-infected patients with severe facial lipoatrophy. The patients received between two and six injections every 4 weeks, according to the aesthetic results. Clinical efficacy was evaluated by means of facial ultrasonography and photography at baseline and months 6, 12, and 24. Adverse events, patient satisfaction, and quality of life were also assessed. One hundred and eleven patients were enrolled and received at least one injection. Mean cheek skin thickness was 9.7 mm [95% CI: 9.1 to 10.2] at baseline. It rose by an average of 4.4 mm [95% CI: 3.9 to 4.9; p<0.001] at month 12 and a further 0.87 mm [95% CI: 0.52 to 1.23; p<0.001] at month 24. The Overall Treatment Satisfaction scale showed an improvement in more than 88% of patients at all visits, based on the appreciations of the patients, their close relatives and physicians, and on independent assessment of facial photographs. Quality of life improved significantly over time, as shown by the lipodystrophy-specific ABCD scale. No severe adverse effects related to the polyacrylamide hydrogel were noted. Polyacrylamide hydrogel injections were well tolerated and significantly improved the aesthetic aspect and quality of life of HIV-infected patients with facial lipoatrophy.
Asunto(s)
Síndrome de Inmunodeficiencia Adquirida/terapia , Resinas Acrílicas/uso terapéutico , Síndrome de Lipodistrofia Asociada a VIH/terapia , Satisfacción del Paciente , Síndrome de Inmunodeficiencia Adquirida/complicaciones , Síndrome de Inmunodeficiencia Adquirida/psicología , Adulto , Estética , Cara , Femenino , Síndrome de Lipodistrofia Asociada a VIH/inducido químicamente , Síndrome de Lipodistrofia Asociada a VIH/psicología , Humanos , Inyecciones Intradérmicas , Masculino , Persona de Mediana Edad , Paris/epidemiología , Satisfacción del Paciente/estadística & datos numéricos , Proyectos Piloto , Calidad de Vida , Encuestas y Cuestionarios , Resultado del TratamientoRESUMEN
We report the case of a 36-year-old patient who experienced an isolated acute pulmonary homograft endocarditis two years after a Ross procedure for aortic valve infective endocarditis.
Asunto(s)
Válvula Aórtica/cirugía , Bioprótesis/efectos adversos , Endocarditis Bacteriana/etiología , Enterococcus faecalis/aislamiento & purificación , Infecciones por Bacterias Grampositivas/etiología , Prótesis Valvulares Cardíacas/efectos adversos , Infecciones Relacionadas con Prótesis/etiología , Válvula Pulmonar/trasplante , Adulto , Ampicilina/uso terapéutico , Terapia Combinada , Quimioterapia Combinada , Endocarditis Bacteriana/tratamiento farmacológico , Endocarditis Bacteriana/cirugía , Enterococcus faecalis/clasificación , Gentamicinas/uso terapéutico , Infecciones por Bacterias Grampositivas/tratamiento farmacológico , Infecciones por Bacterias Grampositivas/cirugía , Infecciones por VIH/complicaciones , Hepatitis C Crónica/complicaciones , Humanos , Masculino , Metadona/uso terapéutico , Infecciones Relacionadas con Prótesis/tratamiento farmacológico , Infecciones Relacionadas con Prótesis/cirugía , Válvula Pulmonar/cirugía , Rifampin/uso terapéutico , Abuso de Sustancias por Vía Intravenosa/rehabilitación , Trasplante AutólogoRESUMEN
Enterocytozoon bieneusi is an agent of intestinal microsporidiosis leading to chronic diarrhoea in AIDS patients. Pulmonary involvement may occur but remains rare with only 4 cases reported in the literature. We report here the fifth case of pulmonary localization of E. bieneusi in a severe immunocompromized HIV-infected patient with intestinal and pulmonary symptoms.
Asunto(s)
Infecciones Oportunistas Relacionadas con el SIDA/diagnóstico , Enterocytozoon/aislamiento & purificación , Enfermedades Pulmonares Fúngicas/diagnóstico , Microsporidiosis/diagnóstico , Infecciones Oportunistas Relacionadas con el SIDA/tratamiento farmacológico , Antifúngicos/uso terapéutico , Terapia Antirretroviral Altamente Activa/métodos , Diarrea/diagnóstico , Diarrea/etiología , Quimioterapia Combinada , Enterocytozoon/efectos de los fármacos , Estudios de Seguimiento , Humanos , Enfermedades Pulmonares Fúngicas/tratamiento farmacológico , Masculino , Microsporidiosis/tratamiento farmacológico , Persona de Mediana Edad , Medición de Riesgo , Índice de Severidad de la Enfermedad , Tomografía Computarizada por Rayos X , Resultado del TratamientoRESUMEN
INTRODUCTION: Tolosa-Hunt's syndrome is characterised by a painful, uni or bilateral, recurrent ophthalmoplegia, involving one or several ocular motor nerves. It is secondary to non-specific granulomatous infiltration of the cavernous sinus. It regresses rapidly with systemic corticosteroid therapy. Lymphomas involving the cavernous sinus may mimic a Tolosa-Hunt syndrome and hence delay diagnosis. OBSERVATION: A 39 year-old HIV-seropositive male consulted for a painful ophthalmoplegia revealing a generalised Burkitt lymphoma evoking Tolosa-Hunts' syndrome. The outcome was unfavourable. CONCLUSION: When confronted with a clinical picture evoking Tolosa-Hunt's syndrome, thorough examination is required to eliminate the localisation of a lymphoma or meningioma.