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Deals with a study which described the evolution of infections in a group of HIV-infected patients with latent visceral leishmaniasis (VL) who received antiretroviral therapy after VL was diagnosed. Background on the introduction of highly active antiretroviral therapy; Methodology; Results and discussion.

The article analyzes the predictive capacity of thymic volume in CD4 T-cell loss after prolonged treatment interruption in a group of immunologically preserved HIV-infected patients with nadir CD4 count greater than 250 cells/µL. Multivariate Cox proportional hazards regression models were used to analyze all variables with statistical association with CD4 T-cell loss. Twenty-three percent of the patients had a reduction in CD4 count to less than 350 cells/µL. Thymic volume and CD4 T-cell loss were independently associated using the model.

Genotyping of human immunodeficiency virus type 1 (HIV-1) for antiretroviral drug resistance is routinely used both in clinical practice, to guide the selection of options for an individual's antiretroviral therapy, and in epidemiological studies, to estimate levels of antiretroviral drug resistance in a patient population. However, reliance on results of a single test can result in an underestimation of antiretroviral drug resistance. In the present study, we quantified the prevalence of resistance-associated mutations found in recent genotypic tests of 1734 HIV-1-infected, treatment-experienced subjects who had at least 3 genotypic tests ( genotypic np11,404 tests total; median, 5 tests/subject) and compared it with that of resistance-associated mutations ever detected in these subjects between 1996 and 2004. Single-point analyses underestimated antiretroviral drug resistance, particularly for nucleoside analogues, in both individuals and patient populations. For example, the prevalence of resistance-associated mutation M184V/I was 25.5% in the most recent genotypes and 58.8% in available historical genotypes. Our results suggest that analysis of a combined historical genotype rather than of a crosssectional genotype may lead to more accurate estimates of antiretroviral drug resistance in individual patients and in patient populations. [ABSTRACT FROM AUTHOR]