Current Issue : July - September Volume : 2018 Issue Number : 3 Articles : 5 Articles
Here, we report a case of 24-year-old female who experienced fever, weight\nloss, and headache by the termination of her pregnancy after 24 weeks. She\nwas admitted due to multiple generalized tonic clonic (GTC) seizures and loss\nof consciousness. Her lab data and histological findings were insignificant as\nwell as negative mycobacterium culture. Her brain MRI detected multiple enhanced\nbrain lesions on T2 weighted images. Overall, she went under empiric\nanti-TB treatment for a year and had a complete recovery. To our knowledge,\nthis is the first reported case of brain tuberculoma with negative histological\nfindings and brain tissue culture who responded to an empiric anti-TB regimen....
Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease\nof the central nervous system due to the reactivation of the JC virus, which\nusually occurs in immunocompromised patients and is a major opportunistic\ninfection associated with HIV infection. We report a case of a previously\nhealthy patient who was diagnosed with PML....
Introduction: The psoriasis is one of the inflammatory dermatoses with unknown\netiology, with chronic evolution having episodic appearance and disappearance.\nIts prevalence in HIV patients varied from 2% to 5% in most of\nthe times. Objective of this study was to describe the demographic, clinical\nand therapeutic characteristics of psoriasis patients infected with HIV. Methods:\nIt is a descriptive retrospective study done from January 2003 to December\n2013 based on the information from the hospital card of hospitalized\npatients and outpatients taken care in the department of Dermatology-STD\nfor psoriasis at the University hospital center in Donka Conakry. We included\nall the cases of psoriasis associated with HIV infection diagnosed from clinical\nand paraclinical elements. Results: We recorded 23 (24.73%) cases of psoriasis\nassociated with HIV infection among 93 patients observed for psoriasis in\nwhich there are 4 cases of psoriasis vulgaris, 10 cases of erythrodermic psoriasis\nand 9 cases of arthropathic form among these numbers. We had 7 women\nand 16 men. The medium age of our patients was 44.5 �± 12 years 27 - 62\nyears. The delayed duration time of consultation varied from 30 to more than\n180 days. The psoriasis was the circumstance of the discovery of the HIV infection\namong 55% of cases. The pruritus was the functional sign which is the\nmost frequent in 20 cases among 23 cases and 71.4% of cases were accompanied\nwith pain. Family history was found in 7.10% of cases. Anxiety was the\ndominant factor cause in 42% and the infection 38%. The cutaneous alteration\nwas noted in all patients; 92.9% of patients had nails alteration and intertrigineous\nassociation in 78.6% of cases. The clinical forms found were psoriasis vulgaris 4/23 cases, arthropathic psoriasis 9/23 cases, erythrodermic psoriasis\n10/23. More than half (13/23) cases of our patients were diagnosed stage III of\nthe classification of WHO. The complicated forms like erythrodermic and\narthropathic psoriasis were frequent in patients whose total CD4 < 350 cells/�¼l\nabout 65%. The most frequently encountered co-morbidity was tuberculosis\n(9 cases). The use of traditional therapeutic means was noted in 50% of cases.\nThe local treatment was based on dermocorticoid and keratolylic drugs. The\ngeneral treatment received by all patients was antiretroviral medication and\nMethotrexate. Discussion: Our results are of course not representing all the\ncases of psoriasis in Guinea but it gives us an idea of the importance of HIV\nand psoriasis association and the influence of immunodepression inducted by\nHIV during the evolution of psoriasis. The demographic, clinical and therapeutic\ncharacteristics described in our patients were near those reported by\nmore authors. Conclusion: HIV-associated psoriasis does not appear to be\nfamilial. Serious clinical forms occur in highly immunocompromised patients....
Kaposiââ?¬â?¢s sarcoma-associated herpesvirus or Human herpesvirus-8 (KSHV/HHV-8),\nan oncogenic human herpesvirus and the leading cause of cancer in HIV-infected individuals, is a major\npublic health concern with recurring reports of epidemics on a global level. The early detection of\nKSHV virus and subsequent activation of the antiviral immune response by the hostââ?¬â?¢s immune system\nare crucial to prevent KSHV infection. The hostââ?¬â?¢s immune system is an evolutionary conserved\nsystem that provides the most important line of defense against invading microbial pathogens,\nincluding viruses. Viruses are initially detected by the cells of the host innate immune system,\nwhich evoke concerted antiviral responses via the secretion of interferons (IFNs) and inflammatory\ncytokines/chemokines for elimination of the invaders. Type I IFN and cytokine gene expression are\nregulated by multiple intracellular signaling pathways that are activated by germline-encoded host\nsensors, i.e., pattern recognition receptors (PRRs) that recognize a conserved set of ligands, known\nas ââ?¬Ë?pathogen-associated molecular patterns (PAMPs)ââ?¬â?¢. On the contrary, persistent and dysregulated\nsignaling of PRRs promotes numerous tumor-causing inflammatory events in various human cancers.\nBeing an integral component of the mammalian innate immune response and due to their constitutive\nactivation in tumor cells, targeting PRRs appears to be an effective strategy for tumor prevention\nand/or treatment. Cellular PRRs are known to respond to KSHV infection, and KSHV has been\nshown to be armed with an array of strategies to selectively inhibit cellular PRR-based immune\nsensing to its benefit. In particular, KSHV has acquired specific immunomodulatory genes to\neffectively subvert PRR responses during the early stages of primary infection, lytic reactivation and\nlatency, for a successful establishment of a life-long persistent infection. The current review aims to\ncomprehensively summarize the latest advances in our knowledge of role of PRRs in KSHV infections....
Objective. To determine the cost-effectiveness of universal maternal HIV screening at time of delivery to decrease mother-to-child\ntransmission (MTCT), by comparing the cost and quality-adjusted life years (QALYs) of universal rapid HIV screening at time\nof delivery to two current standards of care for prenatal HIV screening in the United States. Study Design. We conducted a costeffectiveness\nanalysis to compare the cost and QALY of universal intrapartum rapid HIV screening with two current standards of\ncare: (I) opt-out rapid HIV testing limited to patients without previous third-trimester screening and (II) opt-out rapid HIV testing\nlimited to patients without any prenatal screening. We developed a decision-tree model and performed sensitivity analyses to\nestimate the impact of variances in QALY, estimated lifetime medical costs, HIV prevalence, and cumulative incidence. Results.The\nincremental cost-effectiveness ratio for universal screening was $7,973.45/QALY.The results remained robust to sensitivity analysis,\nexcept for annual cumulative incidence. In areas with an annual cumulative incidence rate of <0.02% for reproductive-age women,\nthe incremental cost-effectiveness ratio for the expanded program would exceed $89,926.94/QALY, approaching the commonly\napplied cost-effectiveness thresholds ($100,000/QALY). Conclusions. Intrapartumuniversal rapid HIV screening to decreaseMTCT\nappears cost-effective in populations with high HIV incidence in the United States...
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