Search

People living with HIV infection are at high risk for cardiovascular events due to inflammation and atherosclerosis. Also, some antiretroviral therapies may contribute to the risk of cardiovascular complications. Immune status is highly dependent on the level of lymphocyte T helper CD4+. There are data suggesting that immune status and CD4+ cell count may be involved in the development of cardiovascular complications in these patients. Our study is longitudinal and retrospective and included a total number of 50 patients with HIV infection associated with acute coronary syndrome, divided into two subgroups based on the nadir of CD4+ cells. This study analyzes the relationship between the immune status of HIV patients, assessed by the nadir of the CD4+ T-cell count, and the outcome of these patients. Also, secondary endpoints were the assessment of the magnitude of coronary lesions and of thrombotic and bleeding risk assessed by specific scores. Clinical and biological parameters and also the extension and complexity of coronary lesions were assessed. Although patients with poor immune status had more complex coronary lesions and increased operative risk and bleeding risk at one year, this was not associated with significant differences in major adverse cardiac and cerebrovascular events at the 30-day and 1-year outcomes. [ABSTRACT FROM AUTHOR]

The incidence of Mycobacterium avium Complex (MAC) Disease in HIV-infected individuals has significantly decreased in recent years due to the introduction of Highly Active Antiretroviral Therapy (HAART) and the initiation of Clarithromycin prophylaxis. We present the case of a patient with advanced AIDS, with generalized lymphadenopathy and digestive symptoms, diagnosed with disseminated MAC, a diagnosis which was based on the results obtained from axillary lymph node and intestinal biopsies. Considering the time of the MAC diagnosis in relation to the recent introduction of antiretroviral (ARV) therapy, we considered immune reconstitution inflammatory syndrome (IRIS) with good evolution under azithromycin, ethambutol and moxifloxacin treatment. [ABSTRACT FROM AUTHOR]

Objective. To determine the prevalence of acquired drug resistance (ADR) and of resistance patterns in treatment-experienced HIV infected patients from Constanta in order to establish the best therapeutic options in NRTI class. Material and methods. A retrospective study which included 144 treatment-experienced HIV patients with confirmed viral failure. The strains isolated from these patients were analysed in the Molecular Genetic Laboratory of „Matei Bals“ National Institute of Infectious Diseases, Bucharest and the resulting sequences were saved in FASTA format. The HIV-1 subtyping was based on „REGA HIV01&2 Automated subtyping tool version 2.0“ algorithm. „Stanford HIVdb Program version 8.4“ was used in order to determine the therapeutic options. For statistical calculations, the R-Project software was used. Graphic representations were performed using GNUPLOT program. Results. The prevalence of the acquired drug resistance was 92.36%. The most frequent mutation occurred at the level of the codon 184. The TAM-2 path was more frequently selected compared to TAM-1. Association between TAM1 and TAM 2 were also found, mutation K65R being rarely met. Conclusions. The prevalence of the acquired drug resistance in our study was high, The most valuable therapeutic option in the INRT class remains tenofovir, due to the mutational profile, which was selected on account of the extensive use of thymidine analogues. [ABSTRACT FROM AUTHOR]

Copyright of Infectio.ro is the property of MEDICHUB MEDIA, S.R.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: We evaluated the long term evolution of liver disease among patients receiving HAART. Methods: We followed-up 72 HIV/HBV co-infected patients treated with HAART, during five years. Clinical and biological data were collected every 3 months, immunological and virological data every six months, ultrasound every year. In the last year we perform ed transient elastography (Fibroscan) for every patient. Determ ination ofH BV drug resistance was performed in cases w ith detectable serum HBV-DNA level. Results: A fter five years o f follow-up, advanced liver disease was diagnosed in 8/72 patients during follow up: 5 cirrhosis, 2 hepatocellular carcinom a (HCC), and 1 fulminant hepatitis. All these patients had high level of serum HBV-DNA, lamivudine resistance and undetectable serum level o f HIV. Five o f these patients died. The rest of 64 patients had no signs of active liver diseases (normal or less than 2 x upper limits of normal level of ALT, and FO-F1 according to Fibroscan). Lamivudine resistance in these patients was founded in 10 cases. Conclusions: In HIV/HBV co-infected patients treated with HAART, lam ivudine resistance is less frequent (25%) than in immunocom petent patients (higher than 60%), but when occurred, was associated with an accelerated course of liver disease, with faster progression to cirrhosis, liver insufficiency and HCC. Appropriate monitoring of chronic viral hepatitis B in HIV positive patients include the recognition of lam ivudine resistance in every case of detectable HBV-DNA level1” . [ABSTRACT FROM AUTHOR]

Copyright of Infectio.ro is the property of MEDICHUB MEDIA, S.R.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

We analyzed a total of 412 adult patients diagnosed with toxoplasmosis in the Clinical Infectious Diseases Hospital Constanta between 01Jan 2010 - 01 Jan 2015. Of these patients, 82.03% were from urban area, 74% female, majority aged 30-48 years. 3.15% were diagnosed with HIV infection (13 patients), in four of these patients, toxoplasmosis was the primary clinical manifestation. The most common clinical manifestation in nonHIV infected patients was painless cervical adenopathy (106 patients), 49 patients had associated infection with Toxocara and in HIV infected patients prevailed cerebral toxoplasmosis (toxoplasmic encephalitis, with or without focal CNS lesions). 59 pregnant women (6 with acute infection and 53 with chronic infection) were followed during pregnancy. Reporting the number of cases of toxoplasma infection in Constanta population (254.693 inhabitants), we obtain a prevalence of 161.76 cases/100.000 inhabitants. Most of the patients were female and their supervision is required for possible implications in pregnancy. We believe that Toxoplasma infection is underdiagnosed in our county. [ABSTRACT FROM AUTHOR]

Introduction The purpose of our study was to evaluate clinical and pathological characteristics as well as treatment outcomes in HIV-infected patients with disseminated tuberculosis from the Regional HIV/AIDS Center Constanţa, Romania, and to determine associated risk factors. Methods We analyzed HIV-infected adults diagnosed with disseminated tuberculosis (TB) over the past two years, monitored in the Regional HIV/AIDS Center Constanţa. Results Out of a total number of 956 HIV-infected patients, 42 had been diagnosed with tuberculosis over the past two years (2011-2013) (4.39%) and 16 of them developed disseminated TB (38%). At the time of diagnosis, we recorded abnormal chest X-rays in 8 (50%), and positive sputum cultures in 4 (25%) of them. The median CD4 count was 40 cells/μL with a range of 5-85 cells/μL; HIV-RNA was detectable in all cases. Multidrug-resistant tuberculosis (MDR-TB) was identified in 6 cases. The outcome was unfavorable in 15 patients. Conclusion In our study, disseminated tuberculosis appeared to be a common pattern of evolution of HIV-TB co-infection (38%). Sputum smear positivity was low and chest X-ray images did not follow a typical pattern. HIV-TB co-infected patients with CD4 lymphocyte cell count <50 cells/μL were more likely to have disseminated TB. The severity of cases, proved by a high mortality rate, requires consideration of this diagnosis early in patients with advanced AIDS, even if laboratory investigations are not suggestive. [ABSTRACT FROM AUTHOR]

Introduction. Although HAARTtherapy has radically changed the prognosis of HIV infected patients, decreasing their morbidity and mortality, theARV medication produced other clinical manifestations due to their toxicity. For many years there was no data in the literature attesting link between metabolic syndrome and renal disease development. Recent epidemiological studies have found that patients with metabolic syndrome have a high risk of developing chronic kidney disease: chronic renal failure and nephrolithiasis. Aim. Evaluation of the relationship between metabolic syndrome and the occurrence of nephrolithiasis in HIV infected patients. Method. The study involved 112 patients with known HIV-AIDS infection and metabolic syndrome in the evidence of the Regional HIV Centre Constanta, Romania, which were compared with 100 matched control group. The parameters analyzed were: demographic characteristics, weight, height, body mass index, blood pressure, medical history, examination of urine, urea, creatinine, Na, K, CI, Mg, P, total serum calcium, glucose, serum triglycerides, LDH cholesterol, HDL cholesterol, CD4+ lymphocytes, HIV-RNA. Nephrolithiasis was diagnosed by ultrasound examination. No patient had a history of treatmentwith Indinavir. Results. Of the 112 patients studied, 67 patients developed nephrolithiasis (59.82%) in comparison with only 24% in the control group (p < 0.01). The age of these patients was between 20 and 67years, with a mean age of 43.5, sex ratio F:M =1.09. The predominant form was bilateral (69%) and asymptomatic (58%). The analysis of kidney stones revealed that the major component was uric acid (48%). Ultrasound revealed hydronephrosis in 18 patients (26.8%). Urinary tract infection was diagnosed in 23 patients (34.3%); the most common etiology was £ coli (39%). PCR HIV-RNA was undetectable in 90 patients (80.3%), and 46 patients had a CD4+ cell count > 500 cells/ mm3andonly 10 patients CD4+< 200 cells/mm3. Themajority ofpatients(55.3%)received 2INRTandPI/rasARVtreatment. Conclusions. In HIV infected patients with metabolicsyn-drome under ARV treatment, nephrolithiasis is 2.5 times more frequent compared to general population. The presence of kidney stones is a risk factor for developing hydronephrosis and urinary tract infection. Because patients with HIV infection and chronic renal failure have a decreased survival, the screening for nephrolithiasis is mandatory in these patients. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article "Spontaneous clearance of hepatitis C virus in a patient co-infected with hepatitis C virus and human immunodeficiency virus: a case report," by A. Kaung, V. Sundaram, and T. T. Tran in the 2014 issue.