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1.
Neuroimaging Clin N Am ; 33(1): 147-165, 2023 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-36404041

RESUMEN

Human immunodeficiency virus (HIV) infection causes substantial morbidity and mortality worldwide. Although antiretroviral therapy (ART) has changed the epidemiology of HIV in the last 20 years with increased survival and decreasing incidence of opportunistic infections (OI), CNS OI remain a major cause of morbidity. Improved survival has also increased neurological presentations due to co morbid conditions, treatment related side effects and inflammatory syndromes. Being familiar with the imaging findings, the impact of ART and interpretation of imaging in the context of clinical and laboratory findings is important for radiologists as well as clinicians in the management of HIV-infected patients.


Asunto(s)
Infecciones Oportunistas Relacionadas con el SIDA , Infecciones por VIH , Humanos , Infecciones Oportunistas Relacionadas con el SIDA/diagnóstico por imagen , Infecciones Oportunistas Relacionadas con el SIDA/epidemiología , Infecciones Oportunistas Relacionadas con el SIDA/tratamiento farmacológico , Infecciones por VIH/complicaciones , Infecciones por VIH/diagnóstico por imagen , Infecciones por VIH/tratamiento farmacológico , VIH
2.
Zhonghua Yu Fang Yi Xue Za Zhi ; 56(11): 1668-1674, 2022 Nov 06.
Artículo en Chino | MEDLINE | ID: mdl-36372761

RESUMEN

Self-sampling is a method by which the subject collects the own specimens for disease detection. It has the advantages of strong privacy, convenient and simple operation, free time and place, etc. It can improve the compliance of people in remote areas, affected by traditional concepts, limited by working hours and underdeveloped transportation and medical treatment to participate in disease detection and screening. With the development of "Internet+health care" and "Internet+nursing service", home-based self-sampling testing will become a developing situation for disease detection and screening. Human immunodeficiency virus and Human papillomavirus infection bring a heavy burden to individuals and society. In the absence of effective and widespread primary prevention, secondary prevention, namely "early detection, early diagnosis and early treatment" is an effective measure to control the adverse consequences. At present, there are many researches on HPV and HIV self-sampling test, whose test results are highly reliable and highly accepted in the population, and is of great significance for improving the coverage rate of cervical cancer screening and the diagnosis rate of HIV carriers.


Asunto(s)
Alphapapillomavirus , Infecciones por VIH , Infecciones por Papillomavirus , Neoplasias del Cuello Uterino , Femenino , Humanos , Papillomaviridae , Detección Precoz del Cáncer/métodos , Neoplasias del Cuello Uterino/prevención & control , Autocuidado/métodos , Infecciones por Papillomavirus/diagnóstico , Infecciones por Papillomavirus/prevención & control , Manejo de Especímenes/métodos , Tamizaje Masivo/métodos , Infecciones por VIH/diagnóstico , VIH , Frotis Vaginal/métodos
3.
Rev Gaucha Enferm ; 43: e20210230, 2022.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-36350963

RESUMEN

OBJECTIVE: To evaluate the effect of using a mobile application on knowledge about human immunodeficiency virus among university students. METHOD: A before-and-after intervention study, with 196 university students, from August to December 2018. The intervention consisted of using the educ@aids mobile application for 15 days. Univariate analyzes were performed using simple descriptive statistics and the McNemar test was used to compare knowledge before and after the intervention. RESULTS: There was an improvement in knowledge after using educ@aids in the variables related to knowledge about the transmission of the virus; knowledge about treatment, cure and prevention; knowledge of other information about human immunodeficiency virus. CONCLUSION: The use of educ@aids increased knowledge about the human immunodeficiency virus among health university students.


Asunto(s)
Síndrome de Inmunodeficiencia Adquirida , Infecciones por VIH , Aplicaciones Móviles , Humanos , Universidades , Estudiantes , Conocimientos, Actitudes y Práctica en Salud , Infecciones por VIH/prevención & control , VIH , Encuestas y Cuestionarios
4.
J Med Case Rep ; 16(1): 429, 2022 Nov 07.
Artículo en Inglés | MEDLINE | ID: mdl-36345027

RESUMEN

BACKGROUND: Opportunistic infections are frequent in people living with the human immunodeficiency virus who either do not have access to antiretroviral therapy (ART) or use it irregularly. Tuberculosis is the most frequent infectious disease in PLHIV and can predispose patients to severe fungal infections with dire consequences. CASE PRESENTATION: We describe the case of a 35-year-old Brazilian man living with human immunodeficiency virus (HIV) for 10 years. He reported no adherence to ART and a history of histoplasmosis with hospitalization for 1 month in a public hospital in Natal, Brazil. The diagnosis was disseminated Mycobacterium tuberculosis infection. He was transferred to the health service in Recife, Brazil, with a worsening condition characterized by daily fevers, dyspnea, pain in the upper and lower limbs, cough, dysphagia, and painful oral lesions suggestive of candidiasis. Lymphocytopenia and high viral loads were found. After screening for infections, the patient was diagnosed with tuberculous pericarditis and esophageal candidiasis caused by Candida tropicalis. The isolated yeasts were identified using the VITEK 2 automated system and matrix-assisted laser desorption/ionization time-of-flight-mass spectrometry. Antifungal microdilution broth tests showed sensitivity to fluconazole, voriconazole, anidulafungin, caspofungin, micafungin, and amphotericin B, with resistance to fluconazole and voriconazole. The patient was treated with COXCIP-4 and amphotericin deoxycholate. At 12 days after admission, the patient developed sepsis of a pulmonary focus with worsening of his respiratory status. Combined therapy with meropenem, vancomycin, and itraconazole was started, with fever recurrence, and he changed to ART and tuberculostatic therapy. The patient remained clinically stable and was discharged with clinical improvement after 30 days of hospitalization. CONCLUSION: Fungal infections should be considered in patients with acquired immunodeficiency syndrome as they contribute to worsening health status. When mycoses are diagnosed early and treated with the appropriate drugs, favorable therapeutic outcomes can be achieved.


Asunto(s)
Candidiasis , Esofagitis , Micosis , Pericarditis Tuberculosa , Masculino , Humanos , Adulto , Fluconazol/uso terapéutico , Voriconazol/uso terapéutico , Pericarditis Tuberculosa/complicaciones , Pericarditis Tuberculosa/diagnóstico , Pericarditis Tuberculosa/tratamiento farmacológico , Candidiasis/tratamiento farmacológico , Micosis/tratamiento farmacológico , Antifúngicos/uso terapéutico , Esofagitis/tratamiento farmacológico , VIH
6.
BMC Public Health ; 22(1): 2026, 2022 11 05.
Artículo en Inglés | MEDLINE | ID: mdl-36335324

RESUMEN

BACKGROUND: Although several studies on hepatitis B (HBV), C (HCV) and human immunodeficiency virus (HIV) infection have been conducted in Greece, little is known on the knowledge level of the Greek population towards these three infections. Our aim was to assess the knowledge level of the adult Greek general population about the HBV, HCV and HIV. METHODS: Data were derived from the first general population health survey, Hprolipsis. The sample was selected by multistage stratified random sampling. A standardized questionnaire was administered by trained interviewers during home visits. A knowledge score was constructed based on responses to 17 per infection selected items and categorized in three levels; high (12-17 correct replies) medium (6-11) and low (0-5). Among 8,341 eligible individuals, 6,006 were recruited (response rate: 72%) and 5,878 adults (≥ 18 years) were included in the analysis. The statistical analysis accounted for the study design. RESULTS: Only 30.4%, 21.6%, and 29.6% of the participants had a high overall knowledge level of HBV, HCV and HIV, respectively. These low percentages were mainly attributed to the high levels of misconception about transmission modes (65.9%, 67.2%, and 67.9%, respectively). Results showed that increasing age and living out of the big metropolitan cities were associated with decreased odds of having higher knowledge. Female gender, higher education level, higher monthly family income, higher medical risk score, history of testing and being born in Greece or Cyprus, were associated with increased odds of having higher knowledge. CONCLUSIONS: There are significant knowledge gaps in the Greek general population regarding modes of transmission, preventive measures and treatment availability for HBV, HCV and HIV. There is an urgent need for large scale but also localized awareness activities targeted to less privileged populations, to fill the gaps in knowledge and increase population engagement in preventive measures.


Asunto(s)
Infecciones por VIH , Hepatitis B , Hepatitis C , Adulto , Humanos , Femenino , Grecia/epidemiología , Prevalencia , Hepatitis B/epidemiología , Infecciones por VIH/epidemiología , Virus de la Hepatitis B , Encuestas y Cuestionarios , VIH , Hepatitis C/epidemiología
7.
Artículo en Inglés | MEDLINE | ID: mdl-36360701

RESUMEN

Artisanal and small-scale mining is characterized by an excessive exposure to silica-containing dust, overcrowding, poor living conditions and limited access to primary health services. This poses a risk to tuberculosis, HIV infection and silicosis. The main purpose of the study is to evaluate the burden of tuberculosis, HIV and silicosis among artisanal and small-scale miners. We conducted a cross sectional study on 3821 artisanal and small-scale miners. We found a high burden of silicosis (19%), tuberculosis (6.8%) and HIV (18%) in a relatively young population, with the mean age of 35.5 years. Men were 1.8 times more likely to be diagnosed with silicosis compared to women, adjusted prevalence ratio [aPR = 1.75 (95% CI: 1.02-2.74)]. Artisanal and small-scale miners who were living with HIV were 1.25 times more likely to be diagnosed with silicosis compared to those who were negative, [aPR = 1.25 (1.00-1.57)]. The risk of silicosis increased with both duration as a miner and severity of exposure to silica dust. The risk of tuberculosis increased with the duration as a miner. Zimbabwe is currently experiencing a high burden of TB, silicosis and HIV among artisanal and small-scale miners. Multi-sectoral and innovative interventions are required to stem this triple epidemic in Zimbabwe.


Asunto(s)
Infecciones por VIH , Mineros , Exposición Profesional , Silicosis , Tuberculosis , Masculino , Femenino , Humanos , Adulto , Infecciones por VIH/epidemiología , Estudios Transversales , Zimbabwe/epidemiología , Oro , Silicosis/epidemiología , Tuberculosis/epidemiología , Polvo , Dióxido de Silicio/efectos adversos , VIH , Exposición Profesional/efectos adversos
8.
Washington, D.C.; OPAS; 2022-11-17. (OPAS/CDE/HT/22-0008).
en Portugués | PAHO-IRIS | ID: phr-56729

RESUMEN

A infecção pelo vírus linfotrópico de células T humanas (HTLV) afeta principalmente grupos populacionais vulneráveis: pessoas vivendo em situação de pobreza em áreas com índices de desenvolvimento humano muito baixos, profissionais do sexo, homens que fazem sexo com homens, pessoas que injetam drogas e grupos populacionais epidemiologicamente fechados e semifechados, incluindo populações tradicionais e indígenas. Esse vírus e suas consequências foram negligenciados por décadas, apesar da alta morbidade e mortalidade atribuíveis à infecção pelo HTLV. As políticas públicas de saúde para o HTLV-1/2 são consideradas escassas na região das Américas e geralmente se limitam à triagem de doadores de sangue. A expansão da testagem para HTLV-1/2 deve ser priorizado, e o aconselhamento das pessoas que vivem com HTLV é uma oportunidade para evitar a transmissão. A testagem de gestantes, seguido de interrupção ou limitação da amamentação, deve ser uma prioridade, e testes direcionados para aqueles grupos de populações com alto risco de infecção deve ser considerados. A falta de conscientização sobre a HTLV é um grande desafio, e o engajamento da OPAS/OMS é crucial para superar esse obstáculo. A inclusão do HTLV em programas existentes, como IST e saúde materna, e programas focados na eliminação de doenças infecciosas e infecções negligenciadas, foi identificada como uma oportunidade para facilitar a implementação de políticas de saúde relativas ao HTLV-1/2 na Região. O investimento em pesquisa é necessário para fechar lacunas no conhecimento e desenvolver políticas e ferramentas econômicas que apoiem o avanço de respostas bem-sucedidas em saúde pública, como testes de ponto de cuidado de baixo custo para o diagnóstico HTLV-1/2. A infecção por HTLV também tem impacto negativo nos desfechos de coinfecções comuns na Região, incluindo tuberculose, strongyloidiasis, ISTs e micose. Aspectos genéticos, ambientais e socioculturais podem influenciar os desfechos de agrupamento ou doenças do HTLV-1 na Região. A agregação familiar também é importante e deve ser considerada ao avaliar o impacto das infecções pelo HTLV-1 e projetar políticas de combate a esse vírus. HTLV-2 é o tipo de vírus predominante entre populações indígenas nas américas. Políticas bem-sucedidas para controlar essa infecção devem contar com uma abordagem combinada para superar barreiras linguísticas, culturais e geográficas. Este relatório destaca algumas das principais intervenções disponíveis para a prevenção e controle da infecção pelo vírus linfotrópico de células T humanas (HTLV) e suas consequências e resume experiências nacionais e institucionais, discussões, sucessos e desafios associados à implementação de políticas públicas de saúde para a eliminação da infecção pelo HTLV. Esses temas foram apresentados no webinar "HTLV World Day 2021: Fórum Internacional de Política de Saúde para a eliminação do HTLV – Avanço das políticas de saúde HTLV em todo o mundo".


Asunto(s)
VIH , Poblaciones Vulnerables , Enfermedades Transmisibles , Enfermedades de Transmisión Sexual , Infecciones por HTLV-II , Infecciones por HTLV-I
9.
Washington, D.C.; OPS; 2022-11-02.
en Español | PAHO-IRIS | ID: phr-56632

RESUMEN

Para lograr y mantener la validación de la eliminación de la transmisión maternoinfantil (ETMI) del VIH, la sífilis y el virus de la hepatitis B es necesario contar con el liderazgo de los ministerios de salud, realizar análisis rigurosos de los datos, llevar a cabo evaluaciones de los programas y colaborar en múltiples niveles. En esta guía de gobernanza se describen las estructuras y los procesos estandarizados que se utilizan para validar la ETMI a nivel nacional, regional y mundial. Esta edición revisada, que reemplaza la versión anterior publicada en junio del 2020, complementa la actualización de las Orientaciones mundiales sobre los criterios y procesos para la validación de la eliminación de la transmisión maternoinfantil del VIH, la sífilis y el virus de la hepatitis B, en las que la OMS establece criterios para la validación de la triple eliminación.


Asunto(s)
VIH , Sífilis , Virus de la Hepatitis B , Transmisión Vertical de Enfermedad Infecciosa
10.
Obstet Gynecol Clin North Am ; 49(4): 693-712, 2022 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-36328675

RESUMEN

Efforts to prevent mother-to-child transmission of human immunodeficiency virus (HIV) have led to dramatic reductions in pediatric HIV worldwide. New advances in HIV treatment and prevention, focused on pregnant and breastfeeding women living with HIV, have improved maternal health while decreasing vertical and horizontal HIV transmission. In this article, we describe how such interventions-including antiretroviral therapy and HIV pre-exposure prophylaxis-can be incorporated into antepartum and postpartum care in global settings.


Asunto(s)
Fármacos Anti-VIH , Infecciones por VIH , Complicaciones Infecciosas del Embarazo , Embarazo , Femenino , Humanos , Transmisión Vertical de Enfermedad Infecciosa/prevención & control , Fármacos Anti-VIH/uso terapéutico , Complicaciones Infecciosas del Embarazo/tratamiento farmacológico , Complicaciones Infecciosas del Embarazo/prevención & control , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/epidemiología , Infecciones por VIH/prevención & control , Periodo Posparto , Lactancia Materna , VIH
11.
Clin Infect Dis ; 75(Supplement_4): S562-S570, 2022 Nov 21.
Artículo en Inglés | MEDLINE | ID: mdl-36410381

RESUMEN

Long-acting antiretroviral products have the potential to transform human immunodeficiency virus (HIV) prevention and treatment approaches in pediatric populations. Broadly neutralizing antibodies and/or long-acting antiretroviral formulations by injection could dramatically improve provision of HIV prophylaxis and/or early treatment to newborns and infants at risk of HIV infection. Challenges in daily oral antiretroviral administration to toddlers and school age children living with HIV may be relieved by use of long-acting formulations, but the pharmacokinetics and safety of these products in children must be studied before they can enter routine clinical use. Although some initial studies of broadly neutralizing antibodies and injectable long-acting agents in infants and young children are underway, more studies of these and other long-acting products are needed. For many adolescents, compliance with daily medication administration is especially challenging. Long-acting products hold particular promise for adolescents living with HIV as well as those at high risk of HIV acquisition, and adolescents can usually be included in the drug development pipeline simultaneously with adults. Long-acting products have the potential to provide alternatives to lifelong daily oral drug administration across the pediatric age spectrum, leading to more effective prevention and treatment of HIV infection in infants, children, and adolescents.


Asunto(s)
Infecciones por VIH , Lactante , Adulto , Adolescente , Recién Nacido , Niño , Humanos , Preescolar , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/prevención & control , Anticuerpos ampliamente neutralizantes , Antirretrovirales/uso terapéutico , Inyecciones , VIH
12.
Clin Infect Dis ; 75(Supplement_4): S541-S548, 2022 Nov 21.
Artículo en Inglés | MEDLINE | ID: mdl-36410385

RESUMEN

Long-acting injectable antiretroviral therapy (LAI-ART) for the treatment and prevention of human immunodeficiency virus (HIV) holds great potential to shift treatment paradigms by offering an alternative to daily oral medication. However, significant challenges at the drug, patient, and system levels risk impeding the uptake and implementation of LAI-ART. This review aims to describe the known and anticipated barriers to uptake of LAI-ART in high-income countries, as well as the ongoing research addressing some of these barriers to improve the delivery and uptake of LAI-ART products.


Asunto(s)
Antirretrovirales , Infecciones por VIH , Humanos , Países Desarrollados , Antirretrovirales/uso terapéutico , Renta , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/prevención & control , VIH
13.
J Cancer Res Ther ; 18(6): 1537-1540, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36412406

RESUMEN

Objective: To find out the epidemiological factors and oncology treatment outcome in human immunodeficiency virus-positive cancer cervix patients (HPCCP). Materials and Methods: After institutional ethics committee approval, hospital case records of HPCCP registered at the radiation oncology department from January 2011 to December 2018 were retrospectively studied. Results: The case records of 22 eligible HPCCP were studied. Median age at presentation was 42.5 years. 90.90% of the patients were below 55 years of age. The duration of symptom was <3 months in 63.64% of patients. 68.18% of the patients were FIGO Stage III. Only 11 patients completed the planned treatment. Total target equivalent dose of 2 Gy per fraction delivered was 66 Gy. Seven patients had complete response. Four patients had local recurrence. Median disease-free and overall survival was 27 (14-38) and 18 months (2-48), respectively. Conclusion: HPCCP present at relatively early age and advanced stage despite short symptom duration. Poor patient compliance and treatment alteration have led to suboptimal outcome.


Asunto(s)
Seropositividad para VIH , Neoplasias del Cuello Uterino , Femenino , Humanos , Adulto , Estudios Retrospectivos , Cuello del Útero , Neoplasias del Cuello Uterino/radioterapia , Neoplasias del Cuello Uterino/tratamiento farmacológico , Resultado del Tratamiento , VIH
14.
BMC Health Serv Res ; 22(1): 1268, 2022 Oct 20.
Artículo en Inglés | MEDLINE | ID: mdl-36261837

RESUMEN

BACKGROUND: India reports the highest number of tuberculosis (TB) and second-highest number of the human immunodeficiency virus (HIV) globally. We hypothesize that HIV might increase the existing financial burden of care among patients with TB. We conducted this study to estimate the costs incurred by patients with TB co-infected with HIV and to explore the perspectives of patients as well as program functionaries for reducing the costs. METHODS: We conducted a descriptive cross-sectional study among 234 co-infected TB-HIV patients notified in the Bhavnagar region of western India from 2017 to 2020 to estimate the costs incurred, followed by in-depth interviews among program functionaries and patients to explore the solutions for reducing the costs. Costs were estimated in Indian rupees (INR) and expressed as median (interquartile range IQR). The World Health Organization defines catastrophic costs as when the total costs incurred by patients exceed 20% of annual household income. The in-depth interviews were audio-recorded, transcribed, and analyzed as codes grouped into categories. RESULTS: Among the 234 TB-HIV co-infected patients, 78% were male, 18% were sole earners in the family, and their median (IQR) monthly family income was INR 9000 (7500-11,000) [~US$ 132 (110-162)]. The total median (IQR) costs incurred for TB were INR 4613 (2541-7429) [~US$ 69 (37-109)], which increased to INR 7355 (4337-11,657) [~US$ 108 (64-171)] on adding the costs due to HIV. The catastrophic costs at a 20% cut-off of annual household income for TB were 4% (95% CI 2-8%), which increased to 12% (95% CI 8-16%) on adding the costs due to HIV. Strengthening health systems, cash benefits, reducing costs through timely referral, awareness generation, and improvements in caregiving were some of the solutions provided by program functionaries and the patients. CONCLUSION: We conclude that catastrophic costs due to TB-HIV co-infection were higher than that due to TB alone in our study setting. Bringing care closer to the patients would reduce their costs. Strengthening town-level healthcare facilities for diagnostics as well as treatment might shift the healthcare-seeking of patients from the private sector towards the government and thereby reduce the costs incurred.


Asunto(s)
Coinfección , Infecciones por VIH , Tuberculosis , Humanos , Masculino , Femenino , Coinfección/epidemiología , Infecciones por VIH/complicaciones , Infecciones por VIH/epidemiología , Estudios Transversales , Tuberculosis/complicaciones , Tuberculosis/epidemiología , India/epidemiología , VIH
15.
Trop Med Int Health ; 27(11): 990-998, 2022 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-36183175

RESUMEN

OBJECTIVES: Until late 2015, Botswana recommended preventive treatment for pregnant women in malarial regions with chloroquine and proguanil (CP). The guideline change provided an opportunity to evaluate CP and adverse birth outcomes. METHODS: The Tsepamo Study performed birth outcomes surveillance at large delivery centres throughout Botswana. We evaluated adverse birth outcomes from 2015 to 2017 at three hospitals where 93% of CP use was recorded. Outcomes included neonatal death (NND), small for gestational age (SGA), very SGA, stillbirth (SB), preterm delivery (PTD) and very PTD. Logistic regression analysis (unadjusted and adjusted) was conducted for each adverse birth outcome. RESULTS: During the study period, 5883 (26%) of 23,033 deliveries were exposed to CP, with the majority (65%) in the most malaria-endemic region. At this site, there was a trend or an association between CP use and reduction of three adverse birth outcomes: PTD (aOR 0.85, 95% CI 0.76-0.96), vPTD (aOR 0.83, 95% CI 0.68-1.01) and NND (aOR 0.65, 95% CI 0.42-1.00). However, at the least malaria-endemic site, the association was in the opposite direction for SB (aOR 1.54, 95% CI 1.08-2.22), SGA (aOR 1.24, 95% CI 1.06-1.44) and vSGA (aOR 1.42, 95% CI 1.14-1.77). The association between CP and reduced PTD was present among women without HIV (aOR 0.77, 95% CI 0.67-0.89) but not among women with HIV (aOR 1.09, 95% CI 0.78-1.35). CONCLUSIONS: Antimalarial prophylaxis was associated with improved birth outcomes in the most malaria-endemic region of Botswana, but not elsewhere. This finding supports current WHO guidance to use prophylaxis strategies among pregnant women in highly malaria-endemic regions. Further studies of the risks and benefits of specific antimalarial regimens in pregnancy are warranted, particularly in areas with lower incidence of malaria.


Asunto(s)
Antimaláricos , Infecciones por VIH , Malaria , Complicaciones Infecciosas del Embarazo , Nacimiento Prematuro , Recién Nacido , Femenino , Embarazo , Humanos , Antimaláricos/uso terapéutico , Mujeres Embarazadas , Botswana/epidemiología , Infecciones por VIH/complicaciones , Infecciones por VIH/prevención & control , Infecciones por VIH/tratamiento farmacológico , Complicaciones Infecciosas del Embarazo/tratamiento farmacológico , Complicaciones Infecciosas del Embarazo/prevención & control , Malaria/complicaciones , Mortinato/epidemiología , Cloroquina/uso terapéutico , VIH , Nacimiento Prematuro/epidemiología , Nacimiento Prematuro/prevención & control , Nacimiento Prematuro/inducido químicamente , Resultado del Embarazo/epidemiología
16.
Int J Mycobacteriol ; 11(3): 241-248, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36260441

RESUMEN

Background: Mortality from tuberculosis (TB) sepsis is common among patients living with human immunodeficiency virus (PLHIV). We aimed to detect M. tuberculosis (MTB) and additional sepsis etiologies, and mortality determinants in PLHIV. Methods: This prospective cohort study consented and followed-up PLHIV for 28 days in northern Tanzania. From May through December 2021, patients provided urine and sputum for TB testing in lateral-flow lipoarabinomannan (LF-LAM) and Xpert® MTB/RIF. Bacterial blood culture, cryptococcal antigen, malaria rapid diagnostic, C-reactive-protein (CRP), and international normalized ratio (INR) tests were also performed. Sepsis severity was clinically measured by Karnofsky and modified early warning signs (MEWS) scores. Anti-TB, broad-spectrum antibiotics, and antimalarial and antifungal agents were prescribed in accordance with Tanzania treatment guideline. An independent t-test and Chi-square or Fisher's exact tests compared means and proportions, respectively. P < 0.05 was statistically significant. Results: Among 98 patients, 59 (60.2%) were female. Their mean (standard deviation) age was 44 (12.9) years. TB detection increased from 24 (24.5%) by Xpert® MTB/RIF to 36 (36.7%) when LF-LAM was added. In total, 23 (23.5%) patients had other than TB etiologies of sepsis, including Staphylococcus aureus, Streptococcus pneumoniae, Cryptococcus spp., and Plasmodium spp. Twenty-four (94.4%) of 36 patients with TB had higher CRP (≥10 mg/l) compared to 25 (40.3%) non-TB patients (P < 0.001). Nine (9.2%) patients died and almost all had INR ≥1.8 (n = 8), Karnofsky score <50% (n = 9), MEWS score >6 (n = 8), and malnutrition (n = 9). Conclusions: MTB and other microbes contributed to sepsis in PLHIV. Adding non-TB tests informed clinical decisions. Mortality was predicted by conventional sepsis and severity scoring, malnutrition, and elevated INR.


Asunto(s)
Antimaláricos , Infecciones por VIH , Desnutrición , Mycobacterium tuberculosis , Sepsis , Tuberculosis Ganglionar , Humanos , Femenino , Adulto , Masculino , Estudios Prospectivos , Antifúngicos , Tanzanía/epidemiología , Infecciones por VIH/complicaciones , Infecciones por VIH/diagnóstico , Estudios de Cohortes , Antibacterianos , VIH
18.
J Otolaryngol Head Neck Surg ; 51(1): 37, 2022 Oct 04.
Artículo en Inglés | MEDLINE | ID: mdl-36192808

RESUMEN

BACKGROUND: Advanced squamous cell carcinoma (SCCa) of the oral cavity is often not amenable to curative-intent therapy due to tumor location, tumor size, or comorbidities. CASE PRESENTATION: A 51-year-old male patient with human immunodeficiency virus and on highly active antiretroviral therapy (HAART) presented with a cT4aN2c SCCa of the tongue. He received a preoperative single course of Quad-Shot radiation therapy to 14 Gy in 4 fractions followed by surgical resection. Patient had no residual carcinoma on surgical pathology and no evidence of disease on subsequent clinical and radiological exams. CONCLUSIONS: To our knowledge, this is the first case of pathologic complete response for a patient on HAART following a single cycle of the Quad-Shot regimen for advanced oral cavity SCCa. Protease inhibitors in HAART can induce spontaneous tumor regression via inhibition of proteasome function and activation of apoptosis, and thus act as a cancer therapeutic.


Asunto(s)
Carcinoma de Células Escamosas , Infecciones por VIH , Neoplasias de la Boca , Carcinoma de Células Escamosas/tratamiento farmacológico , Carcinoma de Células Escamosas/radioterapia , Terapia Combinada , VIH , Infecciones por VIH/complicaciones , Infecciones por VIH/tratamiento farmacológico , Humanos , Masculino , Persona de Mediana Edad , Neoplasias de la Boca/radioterapia , Inhibidores de Proteasas/uso terapéutico , Complejo de la Endopetidasa Proteasomal/uso terapéutico
19.
J Biomed Sci ; 29(1): 79, 2022 Oct 09.
Artículo en Inglés | MEDLINE | ID: mdl-36209077

RESUMEN

Viruses are naturally endowed with the capacity to transfer genetic material between cells. Following early skepticism, engineered viruses have been used to transfer genetic information into thousands of patients, and genetic therapies are currently attracting large investments. Despite challenges and severe adverse effects along the way, optimized technologies and improved manufacturing processes are driving gene therapy toward clinical translation. Fueled by the outbreak of AIDS in the 1980s and the accompanying focus on human immunodeficiency virus (HIV), lentiviral vectors derived from HIV have grown to become one of the most successful and widely used vector technologies. In 2022, this vector technology has been around for more than 25 years. Here, we celebrate the anniversary by portraying the vector system and its intriguing properties. We dive into the technology itself and recapitulate the use of lentiviral vectors for ex vivo gene transfer to hematopoietic stem cells and for production of CAR T-cells. Furthermore, we describe the adaptation of lentiviral vectors for in vivo gene delivery and cover the important contribution of lentiviral vectors to basic molecular research including their role as carriers of CRISPR genome editing technologies. Last, we dwell on the emerging capacity of lentiviral particles to package and transfer foreign proteins.


Asunto(s)
Infecciones por VIH , Lentivirus , Terapia Genética , Vectores Genéticos/genética , VIH , Humanos , Lentivirus/genética , Transducción Genética
20.
Cells ; 11(19)2022 Oct 02.
Artículo en Inglés | MEDLINE | ID: mdl-36231066

RESUMEN

During chronic SIV/HIV infection, adipose tissue (AT) is the target of both antiretroviral treatment (ART) and the virus. AT might subsequently contribute to the low-grade systemic inflammation observed in patients on ART. To evaluate the inflammatory profile of AT during chronic SIV/HIV infection, we assayed subcutaneous and visceral abdominal AT from non-infected (SIV-, control), ART-naïve SIV-infected (SIV+) and ART-controlled SIV-infected (SIV+ART+) cynomolgus macaques for the mRNA expression of genes coding for factors related to inflammation. Significant differences were observed only when comparing the SIV+ART+ group with the SIV+ and/or SIV- groups. ART-treated infection impacted the metabolic fraction (with elevated expression of PPARγ and CEBPα), the extracellular matrix (with elevated expression of COL1A2 and HIF-1α), and the inflammatory profile. Both pro- and anti-inflammatory signatures were detected in AT, with greater mRNA expression of anti-inflammatory markers (adiponectin and CD163) and markers associated with inflammation (TNF-α, Mx1, CCL5 and CX3CL1). There were no intergroup differences in other markers (IL-6 and MCP-1). In conclusion, we observed marked differences in the immune and metabolic profiles of AT in the context of an ART-treated, chronic SIV infection; these differences were related more to ART than to SIV infection per se.


Asunto(s)
Infecciones por VIH , Síndrome de Inmunodeficiencia Adquirida del Simio , Virus de la Inmunodeficiencia de los Simios , Adiponectina , Tejido Adiposo/metabolismo , Animales , Antiinflamatorios/uso terapéutico , Antirretrovirales/farmacología , Antirretrovirales/uso terapéutico , VIH , Inflamación/complicaciones , Interleucina-6 , Macaca fascicularis , Macaca mulatta , PPAR gamma , ARN Mensajero/uso terapéutico , Síndrome de Inmunodeficiencia Adquirida del Simio/tratamiento farmacológico , Factor de Necrosis Tumoral alfa
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