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HIV allergy

Steven A Safren, C Andres Bedoya, Conall O'Cleirigh, Katie B Biello, Megan M Pinkston, Michael D Stein, Lara Traeger, Erna Kojic, Gregory K Robbins, Jonathan A Lerner, Debra S Herman, Matthew J Mimiaga, Kenneth H Mayer
BACKGROUND: Depression is highly prevalent in people with HIV and has consistently been associated with poor antiretroviral therapy (ART) adherence. Integrating cognitive behavioural therapy (CBT) for depression with adherence counselling using the Life-Steps approach (CBT-AD) has an emerging evidence base. The aim of this study was to test the efficacy of CBT-AD. METHODS: In this three-arm randomised controlled trial in HIV-positive adults with depression, we compared CBT-AD with information and supportive psychotherapy plus adherence counselling using the Life-Steps approach (ISP-AD), and with enhanced treatment as usual (ETAU) including Life-Steps adherence counselling only...
September 19, 2016: Lancet HIV
Gideon Amanyire, Fred C Semitala, Jennifer Namusobya, Richard Katuramu, Leatitia Kampiire, Jeanna Wallenta, Edwin Charlebois, Carol Camlin, James Kahn, Wei Chang, David Glidden, Moses Kamya, Diane Havlir, Elvin Geng
BACKGROUND: In Africa, up to 30% of HIV-infected patients who are clinically eligible for antiretroviral therapy (ART) do not start timely treatment. We assessed the effects of an intervention targeting prevalent health systems barriers to ART initiation on timing and completeness of treatment initiation. METHODS: In this stepped-wedge, non-blinded, cluster-randomised controlled trial, 20 clinics in southwestern Uganda were randomly assigned in groups of five clinics every 6 months to the intervention by a computerised random number generator...
August 27, 2016: Lancet HIV
Larry W Chang, Mary K Grabowski, Robert Ssekubugu, Fred Nalugoda, Godfrey Kigozi, Betty Nantume, Justin Lessler, Sean M Moore, Thomas C Quinn, Steven J Reynolds, Ronald H Gray, David Serwadda, Maria J Wawer
BACKGROUND: Understanding the extent to which HIV burden differs across communities and the drivers of local disparities is crucial for an effective and targeted HIV response. We assessed community-level variations in HIV prevalence, risk factors, and treatment and prevention service uptake in Rakai, Uganda. METHODS: The Rakai Community Cohort Study (RCCS) is an open, population-based cohort of people aged 15-49 years in 40 communities. Participants are HIV tested and interviewed to obtain sociodemographic, behavioural, and health information...
August 2016: Lancet HIV
Johanna T Crane, Theresa M Rossouw
In 2013, physician-researchers announced that a baby in Mississippi had been 'functionally cured' of HIV [Persaud, D., Gay, H., Ziemniak, C. F., Chen, Y. H., Piatak, M., Chun, T.-W., … Luzuriaga, K. (2013b, March). Functional HIV cure after very early ART of an infected infant. Paper presented at the 20th conference on retroviruses and opportunistic infections, Atlanta, GA]. Though the child later developed a detectable viral load, the case remains unprecedented, and trials to build on the findings are planned [National Institute of Allergy and Infectious Diseases...
July 25, 2016: Global Public Health
Myron S Cohen, Ying Q Chen, Marybeth McCauley, Theresa Gamble, Mina C Hosseinipour, Nagalingeswaran Kumarasamy, James G Hakim, Johnstone Kumwenda, Beatriz Grinsztejn, Jose H S Pilotto, Sheela V Godbole, Suwat Chariyalertsak, Breno R Santos, Kenneth H Mayer, Irving F Hoffman, Susan H Eshleman, Estelle Piwowar-Manning, Leslie Cottle, Xinyi C Zhang, Joseph Makhema, Lisa A Mills, Ravindre Panchia, Sharlaa Faesen, Joseph Eron, Joel Gallant, Diane Havlir, Susan Swindells, Vanessa Elharrar, David Burns, Taha E Taha, Karin Nielsen-Saines, David D Celentano, Max Essex, Sarah E Hudelson, Andrew D Redd, Thomas R Fleming
BACKGROUND: An interim analysis of data from the HIV Prevention Trials Network (HPTN) 052 trial showed that antiretroviral therapy (ART) prevented more than 96% of genetically linked infections caused by human immunodeficiency virus type 1 (HIV-1) in serodiscordant couples. ART was then offered to all patients with HIV-1 infection (index participants). The study included more than 5 years of follow-up to assess the durability of such therapy for the prevention of HIV-1 transmission. METHODS: We randomly assigned 1763 index participants to receive either early or delayed ART...
September 1, 2016: New England Journal of Medicine
Naporn Khamanarong, Somchai Insiripong
The CD4 lymphocytes are an important part of the immune system. Besides HIV Infection, other conditions can cause a low CD4 count. We report the case of a 82-year-old female who presented with a markedly low CD4 count during a severe lower respiratory tract infection and respiratory failure without HIV infection. The total lymphocyte and the absolute CD4 counts are 255/mm³ and 109/mm³, respectively. Sputum and bronchial lavage fluid were both negative for acid-fast bacilli. The anti-HIV antibody test was negative...
May 2016: Southeast Asian Journal of Tropical Medicine and Public Health
Vikram Mehraj, Rosalie Ponte, Jean-Pierre Routy
UNLABELLED: Interleukin 33 (IL-33), a member of the IL-1 family, is constitutively expressed in epithelial and in endothelial cells at barrier sites, acting as a danger signal and adjuvanting the immune response following tissue damage and infection. Originally implicated in allergy, IL-33 is also known to be involved in innate and adaptive immune responses by enhancing natural killer, Th1, and CD4 and CD8 T-cell functions. The nature of the antiviral immune response orchestrated by IL-33 depends on the site of infection, the duration of the disease and the cytokine milieu...
July 2016: EBioMedicine
P Kuecuekbalaban, S Schmidt, H Muehlan
Aim of the study: The aim of the current study was to provide an overview of medical-diagnostic self-tests which can be purchased without a medical prescription on German language websites. Method: From September 2014 to March 2015, a systematic internet research was conducted with the following search terms: self-test, self-diagnosis, home test, home diagnosis, quick test, rapid test. Results: 513 different self-tests for the diagnostics of 52 diverse diseases or health risks were identified, including chronic diseases (e...
June 29, 2016: Das Gesundheitswesen
Robert Ali, Julio Perez-Downes, Firas Baidoun, Bashar Al Turk, Carmen Isache, Girish Mohan, Charles Perniciaro
Syphilis is a sexually transmitted infection that remains fairly commonplace. The introduction of penicillin aided in curbing the incidence of disease; however, with the advent of the human immunodeficiency virus (HIV), syphilis is now on a resurgence with sometimes curious presentations. We present a case of a 36-year-old Caucasian gentleman with untreated HIV who complained of a skin eruption and joint pains for 6 weeks, prompting the diagnosis of secondary syphilis osteitis. Skin lesions were reminiscent of "malignant" syphilis...
2016: Case Reports in Infectious Diseases
Catherine Godfrey, Gail Tauscher, Sally Hunsberger, Melissa Austin, Lesley Scott, Jeffrey T Schouten, Anne F Luetkemeyer, Constance Benson, Robert Coombs, Susan Swindells
BACKGROUND: Health care associated transmission of Mycobacterium tuberculosis (TB) is well described. A previous survey of infection control (IC) practices at clinical research sites in low and middle income countries (LMIC) funded by the National Institute of Allergy and Infectious Diseases (NIAID) conducting HIV research identified issues with respiratory IC practices. A guideline for TB IC based on international recommendations was developed and promulgated. This paper reports on adherence to the guideline at sites conducting or planning to conduct TB studies with the intention of supporting improvement...
2016: BMC Infectious Diseases
Merlin L Robb, Leigh A Eller, Hannah Kibuuka, Kathleen Rono, Lucas Maganga, Sorachai Nitayaphan, Eugene Kroon, Fred K Sawe, Samuel Sinei, Somchai Sriplienchan, Linda L Jagodzinski, Jennifer Malia, Mark Manak, Mark S de Souza, Sodsai Tovanabutra, Eric Sanders-Buell, Morgane Rolland, Julie Dorsey-Spitz, Michael A Eller, Mark Milazzo, Qun Li, Andrew Lewandowski, Hao Wu, Edith Swann, Robert J O'Connell, Sheila Peel, Peter Dawson, Jerome H Kim, Nelson L Michael
BACKGROUND: Acute human immunodeficiency virus type 1 (HIV-1) infection is a major contributor to transmission of HIV-1. An understanding of acute HIV-1 infection may be important in the development of treatment strategies to eradicate HIV-1 or achieve a functional cure. METHODS: We performed twice-weekly qualitative plasma HIV-1 RNA nucleic acid testing in 2276 volunteers who were at high risk for HIV-1 infection. For participants in whom acute HIV-1 infection was detected, clinical observations, quantitative measurements of plasma HIV-1 RNA levels (to assess viremia) and HIV antibodies, and results of immunophenotyping of lymphocytes were obtained twice weekly...
June 2, 2016: New England Journal of Medicine
Justin T Okano, Danielle Robbins, Laurence Palk, Jan Gerstoft, Niels Obel, Sally Blower
BACKGROUND: Worldwide, approximately 35 million individuals are infected with HIV; about 25 million of these live in sub-Saharan Africa. WHO proposes using treatment as prevention (TasP) to eliminate HIV. Treatment suppresses viral load, decreasing the probability an individual transmits HIV. The elimination threshold is one new HIV infection per 1000 individuals. Here, we test the hypothesis that TasP can substantially reduce epidemics and eliminate HIV. We estimate the impact of TasP, between 1996 and 2013, on the Danish HIV epidemic in men who have sex with men (MSM), an epidemic UNAIDS has identified as a priority for elimination...
July 2016: Lancet Infectious Diseases
Ruanne V Barnabas, Heidi van Rooyen, Elioda Tumwesigye, Justin Brantley, Jared M Baeten, Alastair van Heerden, Bosco Turyamureeba, Philip Joseph, Meighan Krows, Katherine K Thomas, Torin T Schaafsma, James P Hughes, Connie Celum
BACKGROUND: Male circumcision decreases HIV acquisition by 60%, and antiretroviral therapy (ART) almost eliminates HIV transmission from HIV-positive people who are virally suppressed; however, coverage of these interventions has lagged behind targets. We aimed to assess whether community-based HIV testing with counsellor support and point-of-care CD4 cell count testing would increase uptake of ART and male circumcision. METHODS: We did this multisite, open-label, randomised controlled trial in six research-naive communities in rural South Africa and Uganda...
May 2016: Lancet HIV
Andreas D Haas, Lyson Tenthani, Malango T Msukwa, Kali Tal, Andreas Jahn, Oliver J Gadabu, Adrian Spoerri, Frank Chimbwandira, Joep J van Oosterhout, Olivia Keiser
BACKGROUND: Studies of Malawi's option B+ programme for HIV-positive pregnant and breastfeeding women have reported high loss to follow-up during pregnancy and at the start of antiretroviral therapy (ART), but few data exist about retention during breastfeeding and after weaning. We examined loss to follow-up and retention in care in patients in the option B+ programme during their first 3 years on ART. METHODS: We analysed two data sources: aggregated facility-level data about patients in option B+ who started ART between Oct 1, 2011, and June 30, 2012, at 546 health facilities; and patient-level data from 20 large facilities with electronic medical record system for HIV-positive women who started ART between Sept 1, 2011, and Dec 31, 2013, under option B+ or because they had WHO clinical stages 3 or 4 disease or had CD4 counts of less than 350 cells per μL...
April 2016: Lancet HIV
Mina C Hosseinipour, Gregory P Bisson, Sachiko Miyahara, Xin Sun, Agnes Moses, Cynthia Riviere, Fredrick K Kirui, Sharlaa Badal-Faesen, David Lagat, Mulinda Nyirenda, Kogieleum Naidoo, James Hakim, Peter Mugyenyi, German Henostroza, Paul D Leger, Javier R Lama, Lerato Mohapi, Jorge Alave, Vidya Mave, Valdilea G Veloso, Sandy Pillay, Nagalingeswaran Kumarasamy, Jing Bao, Evelyn Hogg, Lynne Jones, Andrew Zolopa, Johnstone Kumwenda, Amita Gupta
BACKGROUND: Mortality within the first 6 months after initiating antiretroviral therapy is common in resource-limited settings and is often due to tuberculosis in patients with advanced HIV disease. Isoniazid preventive therapy is recommended in HIV-positive adults, but subclinical tuberculosis can be difficult to diagnose. We aimed to assess whether empirical tuberculosis treatment would reduce early mortality compared with isoniazid preventive therapy in high-burden settings. METHODS: We did a multicountry open-label randomised clinical trial comparing empirical tuberculosis therapy with isoniazid preventive therapy in HIV-positive outpatients initiating antiretroviral therapy with CD4 cell counts of less than 50 cells per μL...
March 19, 2016: Lancet
Brian Owens
No abstract text is available yet for this article.
March 26, 2016: Lancet
Somying Indradat, Jittima Veskitkul, Punchama Pacharn, Orathai Jirapongsananuruk, Nualanong Visitsunthorn
BACKGROUND: Adverse drug reactions (ADRs) are a common healthcare problem. The drug provocation test (DPT) is a gold standard for ADR diagnosis. OBJECTIVES: To evaluate a correlation between history of ADRs, skin prick test (SPT), intradermal test (ID) and DPT in Thai children. METHODS: This was a retrospective review of 211 children under 16 years of age who had a history of ADRs and underwent DPT from January 2006 to December 2012. RESULTS: Two hundred and thirty six (236) DPTs were performed in 211 children with a history of ADRs...
March 2016: Asian Pacific Journal of Allergy and Immunology
C Pitsios
Erythema multiforme is mainly caused by drug allergy and infections. This is the case of a HIV-positive, 49-year-old male, recently cured for syphilis, that presented erythema multiforme minor, five days after taking sildenafil. He had a fast recovery, only with the use of antihistamines. Cell-mediated allergy to sildenafil was confirmed six months later, with the use of patch-tests.
March 2016: European Annals of Allergy and Clinical Immunology
Timothy E Sweeney, Lindsay Braviak, Cristina M Tato, Purvesh Khatri
BACKGROUND: Active pulmonary tuberculosis is difficult to diagnose and treatment response is difficult to effectively monitor. A WHO consensus statement has called for new non-sputum diagnostics. The aim of this study was to use an integrated multicohort analysis of samples from publically available datasets to derive a diagnostic gene set in the peripheral blood of patients with active tuberculosis. METHODS: We searched two public gene expression microarray repositories and retained datasets that examined clinical cohorts of active pulmonary tuberculosis infection in whole blood...
March 2016: Lancet Respiratory Medicine
Tshepo Malesela Mafokwane, Amidou Samie
BACKGROUND: Chlamydia is a bacterial infection that has long plagued humanity as the most commonly contracted STD and is caused by Chlamydia trachomatis. With the emergence of HIV/AIDS, sexually transmitted diseases have also re-emerged as a grave public health problem, particularly in developing countries. Updated Information about the relative frequencies in developing countries is sparse. This study aims at establishing the relative occurrence of chlamydia using real time PCR technique in the Vhembe District of South Africa where reports on the prevalence of chlamydia are not available...
2016: BMC Research Notes
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