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Hiv related thrombocytopenia

Clovis Nkoke, Engelbert Bain Luchuo, Denis Teuwafeu, Ines Nepetsoun, Cyrille Nkouonlack
Hematological abnormalities including thrombocytopenia are common in patients living with HIV infection. Patients with HIV infection related thrombocytopenia present generally with only minor bleeding problems. But cases of subdural hematoma are very rare. A 61-year-old female with a history of HIV infection of 9 years' duration presented with a 3-month history of generalized headache associated with visual blurring and anterograde amnesia. There was no history of trauma or fever. She was treated empirically for cerebral toxoplasmosis for 6 weeks without any improvement of the symptoms...
2017: Case Reports in Neurological Medicine
Hannah M Sebitloane, Dhayendre Moodley
HIV is the leading cause of maternal and neonatal morbidity and mortality in resource constrained countries. Highly active antiretroviral treatment (HAART) initiated in pregnancy has now almost eliminated mother to child transmission of the virus, and is beginning to show the desired effect of reducing HIV related maternal mortality. By modulating host immunological responses HAART has the potential to alter infections during pregnancy, in addition to modifying clinical conditions such as preeclampsia. There is increasing evidence of the benefits of HAART given to pregnant women, however there is paucity of data that distinguishes HIV or HAART as the cause or exacerbation of pre-existing medical conditions or conditions specific to pregnancy...
December 9, 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
(no author information available yet)
Multicentric Castleman's disease is a rare lymphoproliferative disorder characterised by disseminated lymphadenopathy. Symptoms and outcomes differ widely from one patient to another. The median survival time is about 2.5 years. There is no consensus on treatment. Siltuximab, a monoclonal antibody that antagonises interleukin-6, has been authorised in the European Union for patients with multicentric Castleman's disease who are not infected with HIV or HHV-8. In a randomised, double-blind trial in 79 patients, most of whom had mild or moderate symptoms, the estimated one-year survival rate was 100% in the siltuximab group versus 92% in the placebo group after a median follow-up of 60 weeks...
March 2016: Prescrire International
Philip Bolduc, Navid Roder, Emily Colgate, Sarah H Cheeseman
Care of patients with HIV infection starts with diagnosis as soon as possible, preferably at or near the time of acute infection. Opportunistic infections, malignancies, and other conditions develop progressively over time, particularly in untreated patients. The AIDS-defining opportunistic infections most common in the United States include Pneumocystis jirovecii pneumonia, Candida esophagitis, toxoplasmic encephalitis, tuberculosis, disseminated Mycobacterium avium complex, cryptococcal meningitis, and cytomegalovirus retinitis...
April 2016: FP Essentials
Clémence Hollande, Vincent Mallet, Stéphane Darbeda, Anaïs Vallet-Pichard, Hélène Fontaine, Virginie Verkarre, Philippe Sogni, Benoit Terris, Hervé Gouya, Stanislas Pol
HIV-associated obstructive portopathy (HIVOP) is an obstruction of the hepatic microvasculature of unknown origin. The purpose of this study was to describe the clinical and paraclinical presentation of the disease and its impact in terms of morbidity. Twenty-nine HIV1-infected patients (average 12 years of infection, nadir of CD4 210/mm, including 7 patients with a history of opportunistic infection) with a biopsy-proven or likely HIVOP have been followed up for an average of 6.1 years. Modes of revelation of the HIVOP were: cytolysis and/or cholestasis (60%), occult (14%) or symptomatic (37%) portal hypertension (esophageal varices 17%, ascites 10%, cytopenia 10%), or fortuitous (8%)...
March 2016: Medicine (Baltimore)
Tetsuya Horino, Fumiya Sato, Tetsuro Kato, Yumiko Hosaka, Akihiro Shimizu, Shinji Kawano, Tokio Hoshina, Kazuhiko Nakaharai, Yasushi Nakazawa, Koji Yoshikawa, Masaki Yoshida, Seiji Hori
OBJECTIVES: This study was conducted to clarify the rate of late diagnosis of HIV infection and to identify relationships between the reasons for HIV testing and a late diagnosis. METHODS: This retrospective cohort study was conducted among HIV-positive patients at the Jikei University Hospital between 2001 and 2014. Patient characteristics from medical records, including age, sex, sexuality, the reason for HIV testing and the number of CD4-positive lymphocytes at HIV diagnosis, were assessed...
February 2016: Clinics
Aya Sugimoto, Shoichi Nakazuru, Yuko Sakakibara, Kumiko Nishio, Takuya Yamada, Hisashi Ishida, Keishiro Yajima, Tomoko Uehira, Kiyoshi Mori, Eiji Mita
Since the introduction of combination antiretroviral therapy (ART), the life expectancy has increased for patients infected with human immunodeficiency virus (HIV). This has been associated with reductions in the incidences of some AIDS-defining malignancies, such as Kaposi sarcoma and non-Hodgkin lymphoma, but has coincided with an increased incidence of non-AIDS-defining malignancies, such as anal cancer. However, anal cancers are rare in patients with HIV in Japan. We report the case of an HIV-infected patient with anal cancer treated with chemoradiotherapy...
2016: Nihon Shokakibyo Gakkai Zasshi, the Japanese Journal of Gastro-enterology
H M Sebitloane
UNLABELLED:  Background. Thrombocytopenia (TCP) complicates 5 - 8% of pregnancies. Most cases of TCP are gestational, and the condition is usually mild and occurs in the latter part of pregnancy. Apart from pregnancy-associated medical complications such as pre-eclampsia, HIV infection is a recognised cause of TCP, and a relatively high prevalence of TCP during pregnancy would be expected in a setting with a high antenatal seroprevalence of HIV. METHODS: This was a sub-analysis of the data from a prospective trial in which the incidence of postpartum sepsis in HIV-infected women was compared with that in HIV-uninfected women...
February 2016: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
Samir K Gupta, Grace A McComsey, John Lombaard, Juan Echevarría, Catherine Orrell, Anchalee Avihingsanon, Olayemi Osiyemi, Mario Santoscoy, Neelanjana Ray, David A Stock, Samit R Joshi, George J Hanna, Max Lataillade
BACKGROUND: BMS-986001 is a thymidine analogue nucleoside reverse transcriptase inhibitor (NRTI) designed to maintain in-vitro antiviral activity while minimising off-target effects. We assessed the efficacy and safety of BMS-986001 versus tenofovir disoproxil fumarate in treatment-naive patients with HIV-1. METHODS: In this phase 2b, randomised, active-controlled trial (AI467003), we recruited treatment-naive (no current or previous exposure to an antiretroviral drug for >1 week) adults (aged at least 18 years) with HIV-1 from 47 sites across Asia, Australia, Europe, North America, South Africa, and South America...
January 2016: Lancet HIV
Alexei Shimanovsky, Devbala Patel, Jeffrey Wasser
Immune thrombocytopenic purpura (ITP) is characterized by a decreased platelet count caused by excess destruction of platelets and inadequate platelet production. In many cases, the etiology is not known, but the viral illness is thought to play a role in the development of some cases of ITP. The current (2011) American Society of Hematology ITP guidelines recommend initial diagnostic studies to include testing for HIV and Hepatitis C. The guidelines suggest that initial treatment consist of observation, therapy with corticosteroids, IVIG or anti D...
2016: Mediterranean Journal of Hematology and Infectious Diseases
Lara Gurgel Fernandes Távora, Marina Bizerril Nogueira, Sofia Teixeira Gomes
UNLABELLED: Since the beginning of the HIV burden, Visceral Leishmaniasis (VL)/HIV co-infection has been diagnosed not only in areas where VL is endemic (Latin America, India, Asia, Southern Europe), but also in North America, were it is considered an opportunistic disease. Clinical presentation, diagnostic tests sensitivity and treatment response in this population differs from VL alone. OBJECTIVES: To evaluate factors related to an unfavorable outcome in patients with VL/HIV diagnosis in a reference center in northeast Brazil...
November 2015: Brazilian Journal of Infectious Diseases
Edward J D Greenwood, Fabian Schmidt, Ivanela Kondova, Henk Niphuis, Vida L Hodara, Leah Clissold, Kirsten McLay, Bernadette Guerra, Sharon Redrobe, Luis D Giavedoni, Robert E Lanford, Krishna K Murthy, François Rouet, Jonathan L Heeney
The virus-host relationship in simian immunodeficiency virus (SIV) infected chimpanzees is thought to be different from that found in other SIV infected African primates. However, studies of captive SIVcpz infected chimpanzees are limited. Previously, the natural SIVcpz infection of one chimpanzee, and the experimental infection of six chimpanzees was reported, with limited follow-up. Here, we present a long-term study of these seven animals, with a retrospective re-examination of the early stages of infection...
September 2015: PLoS Pathogens
J A Mira, K Neukam, L F López-Cortés, A Rivero-Juárez, F Téllez, J A Girón-González, I de los Santos-Gil, G Ojeda-Burgos, D Merino, M J Ríos-Villegas, A Collado, A Torres-Cornejo, J Macías, A Rivero, M Pérez-Pérez, J A Pineda
The aim of this study was to assess the efficacy of and the risk of major bleeding during pegylated interferon (peg-IFN)/ribavirin (RBV) treatment among human immunodeficiency virus (HIV)/hepatitis C virus (HCV)-coinfected patients according to the pretreatment platelet count. Two hundred and seventy-four HCV/HIV-coinfected, previously naïve individuals with compensated cirrhosis enrolled in one Spanish prospective cohort who received peg-IFN/RBV were included in this study. The frequency of severe bleeding and sustained virological response (SVR) rate were compared between patients with a pretreatment platelet count ≤70,000/mm(3) and >70,000/mm(3), respectively...
September 2015: European Journal of Clinical Microbiology & Infectious Diseases
Ivan M Taremwa, Winnie R Muyindike, Enoch Muwanguzi, Yap Boum, Bernard Natukunda
AIMS/OBJECTIVES: We aimed to determine the prevalence and correlates of thrombocytopenia among people living with human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) and to assess occurrence of antiplatelet antibodies, among thrombocytopenic HIV clients at Mbarara Regional Referral Hospital, southwestern Uganda. MATERIALS AND METHODS: This was a retrospective review of hematologic results at enrollment to HIV care from 2005 to 2013. The prevalence and correlates of thrombocytopenia were estimated based on the Immune Suppressed Syndrome (ISS) Clinic electronic database...
2015: Journal of Blood Medicine
Yuwei Zhou, Fang Jing, Ning Shen, Min Liu, Jing Wang, Tao Hong, Suying Dang, Wei Zhang
Unique autologous antibodies (Abs) against platelet integrin GPIIIa49-66 (CAPESIEFPVSEARVLED) have been detected in patients with HIV-1 immune-related thrombocytopenia (HIV-1-ITP), which is capable of inducing complement-independent platelet fragmentation through reactive oxygen species (ROS) release. However, the efficiency of inducing platelet fragmentation is inconsistent among the different patient Abs or similar rabbit polyclonal Abs against the region and the reason remains unclear. In this study, we developed a batch of murine monoclonal antibodies (mAbs) against different locus of GPIIIa49-66 region by hybridoma technology...
2015: Platelets
Mi-ji-ti Peierdun, Wen-xian Liu, Ai-ze-zi Renaguli, Amat Nurmuhammat, Xiao-chun Li, Ka-ha-er Gulibaier, Wu-la-mu Ainivaer, Upur Halmurat
OBJECTIVE: To investigate the distribution of abnormal hilit syndromes in traditional Uighur medicine (TUM) among human immunodeficiency virus infection and acquired immune deficiency syndrome (HIV/AIDS) patients, and to find out the clinical characteristics of abnormal savda syndrome type HIV/AIDS patients. METHODS: Between June and July in 2012, 307 eligible HIV/AIDS patients from in-patient department and out-patient clinics of Xinjiang Uighur Autonomous Region the Sixth People's Hospital in Urumqi were investigated...
December 2015: Chinese Journal of Integrative Medicine
Mark Kowalczyk, Paul G Rubinstein, David M Aboulafia
HIV-associated immune thrombocytopenic purpura (ITP) has decreased in incidence 10-fold since the advent of highly active antiretroviral therapy (HAART). For patients with detectable HIV viral loads, first-line treatment approaches involve optimizing HAART followed by standard ITP options used to treat those without HIV infection. In the general population, the thrombopoetin receptor agonists (TRAs), eltrombopag and romiplostim, are effective when used as salvage ITP therapy. In addition, eltrombopag has been used effectively in patients with thrombocytopenia secondary to hepatitis C--a virus seen commonly in HIV-infected patients, especially in those who also have a history of intravenous drug use...
May 2015: Journal of the International Association of Providers of AIDS Care
Rama Prosad Goswami, Rudra Prosad Goswami, Mehebubar Rahman, Yogiraj Ray, Santanu Kumar Tripathi
The current standard treatment for cerebral toxoplasmosis (pyrimethamine/sulfadiazine) often encounters problems of poor tolerability, adverse effects, frequent dropouts and non-availability of pyrimethamine/sulfadiazine in some parts of India. We have had to use the combination of two effective alternative agents for toxoplasmosis, cotrimoxazole and clindamycin, on compassionate grounds. This retrospective observational study reports superior efficacy and better tolerability of cotrimoxazole/clindamycin compared to the recommended regimen...
October 2015: International Journal of STD & AIDS
Marco Franzetti, Fulvio Adorni, Letizia Oreni, Lorena Van Den Bogaart, Chiara Resnati, Laura Milazzo, Spinello Antinori, Massimo Galli, Anna L Ridolfo
BACKGROUND: Severe thrombocytopenia (TCP, platelets <50 × 10⁹/L) is relatively frequent during HIV infection and is associated with bleeding risk and disease progression. We investigated the changes in the incidence of severe TCP and its predisposing conditions in a cohort of HIV-positive subjects. METHODS: The incidence and predictors of platelet counts <50 × 10⁹/L were investigated in all patients enrolled at our institution between 1985 and 2012. Three different periods were considered on the basis of the available antiretroviral regimens: P1 (1985-1989), P2 (1990-1996), and P3 (1997-2012)...
December 15, 2014: Journal of Acquired Immune Deficiency Syndromes: JAIDS
Rachel Kyeyune, Elmar Saathoff, Amara E Ezeamama, Thomas Löscher, Wafaie Fawzi, David Guwatudde
BACKGROUND: Cytopenias are the most common HIV-associated hematological abnormality. Cytopenias have been associated with several factors including sex, race/ethnicity, geographical location and comorbidities such as tuberculosis, hepatitis B infection, fever and oral candidiasis. Cytopenias become more prevalent as HIV progresses and are often fatal. Data from resource-limited settings about the prevalence and correlates of cytopenia are limited. Therefore we conducted this cross-sectional study to assess the prevalence and correlates of cytopenia among adult AIDS patients at initiation of HAART in Uganda...
2014: BMC Infectious Diseases
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