HIV-positive Ukrainian refugees in the Czech Republic.

OBJECTIVE: Over 480 000 Ukrainian refugees have arrived in the Czech Republic since the Russian invasion of Ukraine in 2022, including over 500 people with HIV. This study describes the demographics, characteristics, and management of Ukrainian refugees with HIV in the Czech Republic. DESIGN: Retrospective, observational, noninterventional study. METHODS: Ukrainian nationals registering at HIV centers in the Czech Republic with war refugee status were included. Data were collected from medical records between 1 March and 31 July 2022. The study was registered with the Czech State Institute for Drug Control, ID number 2301200000. RESULTS: Four hundred and eighty-two patients were included in the study. Most patients were female (69.5%; n  = 335/482) with well-controlled HIV. The median [interquartile range] CD4 + cell count was 597 [397] cells/µl of blood, and 79.3% ( n  = 361/455) of patients had HIV RNA <40 copies/ml. Coinfections of hepatitis C virus, hepatitis B virus, and/or tuberculosis were reported for 17.4% ( n  = 78/449), 9% ( n  = 40/446) and 1.3% ( n  = 6/446) of patients, respectively. In Ukraine, 85.7% ( n  = 384/448) of patients had been receiving an integrase strand transfer inhibitor-based regimen and most (69.7%; n  = 310/445) did not switch therapy upon arrival in the Czech Republic. CONCLUSION: Migration from Ukraine is changing the characteristics of HIV epidemiology in the Czech Republic. Ukrainian refugees with HIV have been provided with a high standard of medical care in the Czech Republic. Improved coordination between medical services within the Czech Republic and between countries in the European Union is necessary to optimize patient care.

Preliminary report on the provision of HIV care to war refugees with HIV who are migrating from Ukraine: data from the ECEE Network Group.

The ECEE Network Group investigated early provision of HIV care to war refugees migrating from Ukraine in Central and Eastern Europe (CEE) through an online survey. Fourteen countries admitting war refugees from Ukraine on March 31, 2022, completed the survey. Most centers (86%) organized provision of same day antiretroviral therapy (ART) for at least 30 days (77%), but indicated that it may affect the local HIV care. CEE countries put effective emergency mechanisms, which need continuation with international support.

Monkeypox and Herpes Simplex Virus Type 2 Coinfection: Case Report of Perianal Lesions in HIV-Positive Patient.

ABSTRACT: We report a case of monkeypox and herpes simplex type 2 coinfection in an HIV-positive male patient who has sex with men. This case report describes a diagnostic approach for papular rash in the anal area of the male patient who has sex with men with a history of sexually transmitted disease. This is also the first documented case of monkeypox in the Czech Republic, which was confirmed after a retrospective review of swab samples from a previously hospitalized HIV-positive patient.

Retrospective Analysis Revealed an April Occurrence of Monkeypox in the Czech Republic.

Herein, we present our findings of an early appearance of the Monkeypox virus in Prague, Czech Republic. A retrospective analysis of biological samples, carried out on the 28th of April, revealed a previously unrecognized case of Monkeypox virus (MPxV) infection. Subsequent data analysis confirmed that the virus strain belongs to the ongoing outbreak. Combined with clinical and epidemiological investigations, we extended the roots of the current outbreak at least back to 16th of April, 2022.

Acute phase of COVID-19 is associated with elevated plasmablasts in the blood.

OBJECTIVES: The study was aimed at the characterization of humoral immunity in acute SARS-CoV-2 infection. BACKGROUND: Humoral immunity plays a central role in the protection from infection due to SARS-CoV-2, causative agent of coronavirus diseases 2019 (COVID-19). PATIENTS AND METHODS: In 24 adult patients hospitalized with COVID-19, the functional subsets of circulating B-lymphocytes and SARS-CoV-2 specific IgA and IgG antibodies were analyzed using a flow cytometry and immunoassays, respectively. RESULTS: Circulating plasmablasts and memory B-lymphocytes were significantly elevated and regulatory B-lymphocytes significantly decreased in the patients in comparison with 11 age- and sex-matched SARS-CoV-2 seronegative healthy adults. Next, circulating plasmablasts correlated negatively with the levels of SARS-CoV-2 specific IgG antibodies, which were detectable in 9 out of 15 tested patients. In addition, SARS-CoV-2 specific IgA antibodies were detectable in 13 of 15 tested patients and did not demonstrate correlation with any B-lymphocyte subset. CONCLUSION: Severe course of COVID-19 is associated with significant changes of phenotypes of circulating B-lymphocytes and elevated circulating plasmablasts correlate with decreased SARS-CoV-2-specific IgG antibodies (Tab. 2, Fig. 3, Ref. 14).

[A Case of a patient with AIDS and pneumocystis pneumonia complicated by cytomegalovirus pneumonitis].

We report a case of a 39-year-old male admitted for respiratory failure. On admission, the patient was diagnosed with advanced HIV infection and Pneumocystis jirovecii pneumonia (PJP). The patient's condition improved following specific PJP therapy but then deteriorated. The patient was subsequently diagnosed with cytomegalovirus pneumonitis and treated with ganciclovir. The severe course of both opportunistic infections required long-term care at an intensive care unit. Despite complications, the patient was discharged after 108 inpatient days in a stable clinical condition. The case demonstrates a rare coincidence of PJP and cytomegalovirus pneumonitis while also emphasizing the importance of correct diagnosis, treatment and interdisciplinary care which, despite poor prognosis, may lead to successful cure of serious simultaneous opportunistic infections in AIDS.

Antiretroviral treatment of HIV infection does not influence HIV-specific immunity but has an impact on non-specific immune activation.

HIV-specific and non-specific immune responses are crucial in the immunopathogenesis of HIV infection. Therefore, the objective of our study was to analyse the frequency and functional status of HIV-specific CD8+ T cells and the expression of non-specific activation markers on CD8+ T cells in HIV+ patients, and to assess the effects of combined antiretroviral treatment (cART). We examined 28 HIV+ patients, including 13 patients not receiving therapy and 15 patients on cART therapy using ELISpot assay and flow cytometry with intracellular and MHC tetramer staining. MHC tetramers detected HIV-specific CD8+ T cells in 6 HIV+ patients on cART and in 7 untreated individuals; the ELISpot method detected these cells in 5 untreated HIV+ individuals only. Reduced intracellular IFN-γ and IL-2 production by HIV-specific CD8+ T cells was detected in both treated and untreated HIV+ patients, and multifunctional CD8+ T cells simultaneously producing these cytokines were not found in any patient. In contrary to these findings, the percentage of CD8+ T cells expressing CD38 and HLA-DR was significantly higher in untreated patients as compared to HIV+ patients on cART. Together, these results suggest that the alterations of HIV-specific immunity are not influenced by the therapy of HIV infection; whereas, the non-specific chronic immune activation is down-regulated by cART.

[Selected aspects of the immunopathogenesis of HIV infection]. / Vybrané aspekty imunopatogeneze HIV infekce.

This review describes a current view on immunopathogenesis of HIV infection including potential causes of immune failure in control of the infection. Above all, the role of different components of immune system is being discussed. Their interplay is disturbed during interaction with the virus and determines the course of the infection. HIV primary infection causes depletion of CD4+ effector memory T cells in extra-lymphoid compartments that are first replaced by CD4+ T cells proliferation. However, at the end the regenerative capacity is exhausted and opportunistic infections occur. A crucial role in controlling HIV replication is played by HIV-specific cytotoxic CD8+ T cells that eliminate virus-infected cells and delay progression of the infection. Thus, the majority of vaccination strategies is based on stimulation of a potent cytotoxic response. Chronic nonspecific immune activation that gradually destroys functional organization of immune system has been well documented in HIV+ patients. Also, several circulating microbial products from gastrointestinal tract have been recently suggested as a cause of chronic immune activation following depletion of mucosal CD4+ T cells and intestinal mucosa damage. Better understanding of immunopathogenetic mechanisms of HIV infection is necessary to determine further aims for immunotherapeutic interventions and vaccination strategies.