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1.
Med Mycol ; 61(8)2023 Aug 02.
Artigo em Inglês | MEDLINE | ID: mdl-37553136

RESUMO

Talaromyces marneffei (TSM) is a temperature-dependent dimorphic fungus endemic to Southeast Asia and southern China. As the number of people at risk of TSM infection continues to increase, the clinical manifestations are becoming increasingly complex, posing challenges for clinical management. In this study, we analyzed the medical records of 99 patients (71 human immunodeficiency virus [HIV]-positive and 28 HIV-negative) diagnosed with TSM infection from January 1, 2017, to December 31, 2022, in southern China and compared the clinical manifestations in HIV-positive and HIV-negative patients. Most patients (83/99, 84%) were male. The incidence of skin and soft tissue involvement (48% vs. 21%, P = .016); disseminated infection with blood circulation, hematopoietic, lymphatic, alimentary, or central nervous system involvement (69% vs. 36%, P = .002); and gastrointestinal bleeding (33% vs. 9%, P = .023) was higher in the HIV-positive group than the HIV-negative group. The HIV-positive group also had significantly higher alanine aminotransferase (ALT) levels (31 [26-42] vs. 14 [11-16] U/l, P < .001) and ALT/aspartate transaminase ratio (1.9 [1.5-2.2] vs. 1.3 [1.1-1.6], P = .006) than the HIV-negative group. The time to diagnosis (5.5 ± 1.1 vs. 5.1 ± 1.4 days, P = .103), antifungal regimen (P = .278), case fatality rate (20% vs. 21%, P = .849), and relapse/reinfection rate (11% vs. 19%, P = .576) did not differ significantly between the HIV-positive and HIV-negative groups. Poor antiretroviral therapy adherence (OR = 26.19, 95%CI 3.26-210.70, P = .002), advanced age (OR = 1.13, 95%CI 1.03-1.23, P = .010), and Epstein-Barr virus co-infection (OR = 37.13, 95%CI 3.03-455.64, P = .005) were independent risk factors for all-cause mortality from TSM infection in HIV-positive patients. Overall, the predominant infection sites, clinical manifestations, and complications of TSM infection differed by HIV status. However, with prompt diagnosis and appropriate treatment, HIV-positive patients with TSM infection can have similar outcomes to HIV-negative patients.


There are certain differences in the clinical features, sites of infection, and associated complications of Talaromyces marneffei infection between individuals with and without human immunodeficiency virus. It is necessary to accurately identify individuals at high risk to enable prompt diagnosis and standardized treatment.


Assuntos
Infecções Oportunistas Relacionadas com a AIDS , Infecções por Vírus Epstein-Barr , Infecções por HIV , Talaromyces , Animais , Humanos , Masculino , Feminino , Estudos Retrospectivos , Infecções Oportunistas Relacionadas com a AIDS/microbiologia , Infecções Oportunistas Relacionadas com a AIDS/veterinária , Infecções por Vírus Epstein-Barr/induzido quimicamente , Infecções por Vírus Epstein-Barr/complicações , Infecções por Vírus Epstein-Barr/tratamento farmacológico , Infecções por Vírus Epstein-Barr/veterinária , Herpesvirus Humano 4 , Infecções por HIV/complicações , Infecções por HIV/epidemiologia , Infecções por HIV/tratamento farmacológico , Infecções por HIV/veterinária , Antifúngicos/uso terapêutico , China/epidemiologia
2.
J Med Primatol ; 39(5): 356-60, 2010 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-20412378

RESUMO

A Chinese rhesus macaque infected with the pathogenic CCR5-tropic clade C simian-human immunodeficiency virus, SHIV-1157ipd3N4, had persistent viremia, depletion of CD4(+) T cells to <200 cells/µl, opportunistic infections, coagulopathy, and gradual development of bilateral blindness. MRI revealed marked thickening of both optic nerves. Histopathological evaluation showed diffuse cellular infiltration at necropsy and a focus of SHIV-infected cells. This is the first report of CNS pathology following chronic infection with an obligate R5 SHIV.


Assuntos
HIV-1/genética , Macaca mulatta , Doenças dos Macacos/virologia , Neurite Óptica/veterinária , Síndrome de Imunodeficiência Adquirida dos Símios/virologia , Vírus da Imunodeficiência Símia/genética , Infecções Oportunistas Relacionadas com a AIDS/veterinária , Infecções Oportunistas Relacionadas com a AIDS/virologia , Animais , Feminino , Neurite Óptica/virologia , Viremia
3.
Public Health Rep ; 123(3): 266-75, 2008.
Artigo em Inglês | MEDLINE | ID: mdl-19006969

RESUMO

Human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) is a significant cause of immunosuppression that puts infected individuals at higher risk for developing severe complications from zoonotic infections and other animal-related hazards. The number of people living with HIV grows each year, assuring that veterinary practitioners will have clients and/or employees who are afflicted with HIV/AIDS. Veterinarians need to better understand HIV/AIDS for many reasons: to dispel unfounded beliefs; to address discrimination and liability issues; to educate and protect the health of clients and employees; to help those with HIV/AIDS keep their pets; and to meet legal and professional requirements. To do this, veterinarians must become proactive in learning about HIV/AIDS and in reaching out to pet owners living with HIV/AIDS, as well as the physicians of those individuals. Through discussion on historical and contemporary issues surrounding HIV/AIDS, this article examines why veterinarians need to better understand HIV/AIDS, advocates for more time in the veterinary curriculum on the topic of HIV/AIDS, and provides resources for veterinarians and their clients.


Assuntos
Infecções Oportunistas Relacionadas com a AIDS/imunologia , Infecções Oportunistas Relacionadas com a AIDS/veterinária , Animais Domésticos , Educação em Veterinária , Educação em Saúde/normas , Hospedeiro Imunocomprometido , Saúde Pública/educação , Medicina Veterinária/normas , Zoonoses/virologia , Infecções Oportunistas Relacionadas com a AIDS/transmissão , Animais , Animais Domésticos/microbiologia , Animais Domésticos/virologia , Patógenos Transmitidos pelo Sangue , Comportamento Cooperativo , Currículo , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Defesa do Paciente , Competência Profissional , Saúde Pública/normas , Fatores de Risco , Estados Unidos , Precauções Universais , Zoonoses/transmissão
4.
AIDS ; 14(17): F129-35, 2000 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-11125908

RESUMO

OBJECTIVE: To look for a virus related to Kaposi's sarcoma-associated herpesvirus (KSHV) or human herpesvirus 8 (HHV8) in chimpanzees and to investigate phylogenetic and biological similarities to KSHV. METHODS: Peripheral blood mononuclear cell (PBMC) DNA samples from chimpanzees (Pan troglodytes troglodytes) were screened with newly designed consensus oligonucleotide primers for the DNA polymerase gene of KSHV-related gamma2-herpesviruses (rhadinoviruses). Samples from HIV-1-infected and -uninfected chimpanzees were screened with virus-specific primers. Antibodies to KSHV structural and latent antigens were measured by immunofluorescence, enzyme-linked immunosorbent assay (ELISA) and Western blot. RESULTS: We identified 972 base pairs (bp) of a new viral DNA polymerase sequence with 81.6% (nucleotides) and 93.2% (protein) identity to that of KSHV/HHV8. It was detected in 15/37 (41%) animals experimentally infected with HIV-1, but only in one out of 30 uninfected animals (P<0.001). Antibodies were found by immunofluorescence to structural, but not latent, KSHV antigens in nearly all HIV-1-infected and uninfected animals. CONCLUSION: Like man and two other Old World primate species, chimpanzees harbour a virus closely related to KSHV/HHV8, termed Pan troglodytes rhadinovirus-1 (PtRV-1). Like KSHV, PtRV-1 is more easily detected by polymerase chain reaction (PCR) in the PBMC of HIV-1-infected than of HIV-1-uninfected individuals, suggesting increased viral load. Despite the close phylogenetic relationship and biological similarities between KSHV and PtRV-1, Kaposi's sarcoma (KS) has not been reported in HIV-1-infected chimpanzees. PtRV-1 may lack some of the pathogenic determinants of KSHV, or humans and chimpanzees may differ in how they control the infection with their respective rhadinoviruses.


Assuntos
Infecções por HIV/virologia , Infecções por Herpesviridae/veterinária , Infecções por Herpesviridae/virologia , Herpesvirus Humano 8/genética , Pan troglodytes/virologia , Rhadinovirus/genética , Rhadinovirus/isolamento & purificação , Infecções Oportunistas Relacionadas com a AIDS/complicações , Infecções Oportunistas Relacionadas com a AIDS/imunologia , Infecções Oportunistas Relacionadas com a AIDS/veterinária , Infecções Oportunistas Relacionadas com a AIDS/virologia , Animais , Anticorpos Antivirais/imunologia , Antígenos Virais de Tumores/imunologia , Western Blotting , Células Cultivadas , Sequência Consenso/genética , Primers do DNA , DNA Polimerase Dirigida por DNA/química , DNA Polimerase Dirigida por DNA/genética , Ensaio de Imunoadsorção Enzimática , Imunofluorescência , Infecções por HIV/complicações , HIV-1/fisiologia , Infecções por Herpesviridae/complicações , Infecções por Herpesviridae/imunologia , Herpesvirus Humano 8/química , Herpesvirus Humano 8/enzimologia , Herpesvirus Humano 8/imunologia , Humanos , Leucócitos Mononucleares/virologia , Pan troglodytes/imunologia , Filogenia , Reação em Cadeia da Polimerase , Rhadinovirus/química , Rhadinovirus/imunologia , Carga Viral , Proteínas Virais/química , Proteínas Virais/genética , Proteínas Virais/imunologia
5.
AIDS Res Hum Retroviruses ; 17(8): 745-51, 2001 May 20.
Artigo em Inglês | MEDLINE | ID: mdl-11429114
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