Characteristics of Patients Co-infected with Severe Acute Respiratory Syndrome Coronavirus 2 and Dengue Virus, Buenos Aires, Argentina, March-June 2020.

An epidemic of dengue virus and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) co-infections occurred in Argentina during 2020. We describe the clinical characteristics and outcomes in a cohort of patients hospitalized because of co-infection. We retrospectively identified 13 patients from different hospitals in Buenos Aires who had confirmed infection with SARS-CoV-2 and dengue virus and obtained clinical and laboratory data from clinical records. All patients had febrile disease when hospitalized. Headache was a common symptom. A total of 8 patients had respiratory symptoms, 5 had pneumonia, and 3 had rash. Nearly all patients had lymphopenia when hospitalized. No patients were admitted to an intensive care unit or died during follow up. Co-infection with SARS-CoV-2 and dengue virus can occur in patients living in areas in which both viruses are epidemic. The outcome of these patients did not seem to be worse than those having either SARS-CoV-2 or dengue infection alone.

Unusual case of plasmablastic non-Hodgkin's lymphoma located in the liver. First case reported in an AIDS patient.

Plasmablastic lymphoma is a rare and a relatively new entity that was first described in the jaws and the oral cavity of HIV-AIDS patients. We report a case of plasmablastic lymphoma involving the liver in an AIDS patient. Plasmablastic lymphoma is considered a diffuse large B-cell lymphoma with a unique phenotype and predilection for the oral cavity. The case presented had a unique hepatic lesion, localized in the left lobe of the liver. Diagnosis was confirmed by hepatic biopsy guided by Computerized Tomography scan and histopathology. The smears showed a dense infiltrate composed by atypical lymphocytes with numerous plasmocytes expressing the plasma cell markers MUM-1 and CD138 and negative for the B-cell markers CD3, CD20 and CD45. Immunohistochemical and in situ hybridization revealed the Epstein-Barr virus genome in the atypical cells. Polymerase chain reaction was negative for HHV-8 RNA.

Neuromanías bacterianas en pacientes con enfermedad HIV/SIDA: análisis epidemiológico, clínico, diagnóstico y evolutivo de 283 pacientes / Bacterial pneumonia in HIV/Aids patients: epidemiological, clinical, diagnostic evaluation and outcome of a 283 patients series

Introducción: La neumonía bacteriana (NB) es una de las infecciones oportunistas (IO) más frecuentes en pacientes infectados por el virus de la inmunodeficiencia humana (VIH) y Sida. Desde el advenimiento de la terapia antirretroviral de gran actividad (TARGA), la incidencia de la mayoría de las IO ha disminuido, aunque la NB representa, según frecuencia, la segunda enfermedad definidora de Sida en nuestro medio. Objetivos: Determinar la incidencia, patrones radiológicos, hallazgos microbiológicos, humorales y factores pronósticos de NB en una serie de pacientes con HIV/Sida. Métodos: Estudio retrospectivo de pacientes adultos con infección por HIV/Sida con diagnóstico de NB, desde el mes de mayo de 2003 a junio de 2006 en un hospital de enfermedades infecciosas de la ciudad de Buenos Aires, Argentina. Resultados: En el período considerado se identificaron 283 episodios de NB. Todos los pacientes eran de sexo masculino. La mediana de edad fue de 36 años y la mediana del recuento de linfocitos T CD4 + en el momento del diagnóstico de la NB, fue de 91 cél/μL. El diagnóstico microbiológico fue confirmado en 151 casos (54,9%). Los tres agentes etiológicos más frecuentes fueron: Streptococcus pneumoniae (77 casos), Haemophilus influenzae (21 casos) y Staphylococcus aureus resistente a meticilina (SARM - 18 casos). La mortalidad tuvo una asociación estadísticamente significativa con la infección por SARM, Pseudomonas aeruginosa y Acinetobacter baumannii y con la presencia de muy bajos recuentos linfocitarios CD4+ (< 200 cél/μL). Conclusiones: A pesar que la incidencia de IO ha descendido considerablemente en la era de la TARGA, la NB representa una importante causa de morbimortalidad. SARM y los bacilos intranosocomiales representan una gran proporción entre los agentes causales.

Update on primary HIV-1 resistance in Argentina: emergence of mutations conferring high-level resistance to nonnucleoside reverse transcriptase inhibitors in drug-naive patients.

Here we present a survey including 52 drug-naive recently HIV-1-infected subjects from Buenos Aires City and province (79%) and 3 other regions in Argentina (21%). Recent infections were established from previous negative serology (32/52), indeterminate Western blot (12/52), or acute retroviral syndrome after high-risk HIV exposure (8/52) within 9 months before genotyping (median time, 4.2 months). Genotyping was performed from plasma by sequencing both protease and reverse transcriptase. Phylogenetic analysis combined with bootscanning resulted in 21 subtype B sequences and 31 B/F recombinants (RecBF). On protease, minor resistance-related mutations were found in both subtype B and RecBF with low frequencies. The substitution L89M, recently suggested as a resistance-related mutation in some subtype F viruses, was observed in 1 RecBF. On reverse transcriptase, major resistance-related mutations were found in 4 of 52 (7.7%) patients from different health centers: M41L (subtype B) and K103N+/-P225H (1 RecBF and 2 subtype B). The greater than 5% resistance threshold found indicates a need for sentinel resistance surveillances calling for an update in the current resistance testing guidelines in Argentina.