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Hiv vasculopathy

Luisa Helena Maia Leite, Ariel Cohen, Franck Boccara
People living with human immunodeficiency virus (HIV) infection and receiving antiretroviral therapy now have the same life expectancy as the general population. However, they have a higher risk of atherosclerotic cardiovascular events because of a complex and polyfactorial vasculopathy, combining the effects of antiretroviral therapy, the HIV virus itself, immune activation, chronic inflammation and metabolic disturbances. Whether people living with HIV infection experience increased vascular aging compared with the general population remains controversial...
April 14, 2017: Archives of Cardiovascular Diseases
Alexander Seiler, Se-Jong You, Marlies Wagner, Johannes C Klein
No abstract text is available yet for this article.
April 4, 2017: Neurology
Revery P Barnes, John Charles A Lacson, Hossein Bahrami
PURPOSE OF REVIEW: Cardiovascular disease (CVD) increasingly afflicts people living with HIV (PLWH) in the contemporary era of antiretroviral therapy (ART). Coronary artery disease (CAD) is the most widely studied cardiovascular problem in PLWH; however, less is known about other clinically relevant subtypes of CVD such as heart failure (HF), cerebrovascular disease, sudden cardiac death, pericardial diseases, and pulmonary hypertension. This paper reviews evidence of other subtypes of CVD as emerging issues in the post-ART era...
May 2017: Current Atherosclerosis Reports
Rashmi Saraf, Amrita Narang, Mahesh Kardile, Prasad Udmale
HIV and tuberculosis infections are known to be associated with vasculopathy including occlusive disease and aneurysm formation. We report a case of 43-year-old male with miliary and central nervous system (CNS) tuberculosis; recently, diagnosed as HIV seropositive, on antiretroviral and antitubercular treatment presenting with painful neck swelling. He was found to have common carotid artery (CCA) pseudoaneurysm that was managed by endovascular stent grafting. HIV vasculopathy-related CCA pseudoaneurysm is a potentially life-threatening rare entity...
January 17, 2017: British Journal of Neurosurgery
Enric Ripoll, Sergio Prieto-González, Olga Balagué, Javier Marco-Hernández, Josep M Miró, Anna Darnell, Maria C Cid, José Hernández-Rodríguez
Human immunodeficiency virus (HIV)-associated vasculitis is a rare secondary systemic vasculitis involving small and medium arteries. We report a 42-year-old man with uncontrolled HIV infection presenting with long-lasting abdominal pain. An abdominal CT angiography revealed multiple microaneurysms and stenoses in intrarenal arteries, with involvement of mesenteric and hepatic arteries. HIV-associated vasculitis was diagnosed and glucocorticoids and raltegravir-based antiretroviral therapy were administered with good initial clinical and virological response...
March 2017: Clinical and Experimental Rheumatology
Yung-Feng Yen, Marcelo Chen, Ian Jen, Yu-Ching Lan, Pei-Hung Chuang, Yen-Ling Liu, Yun Lee, Yi-Ming Arthur Chen
BACKGROUND: HIV-associated vasculopathy and opportunistic infections (OIs) might cause vascular atherosclerosis and aneurysmal arteriopathy, which could increase the risk of incident stroke. However, few longitudinal studies have investigated the link between HIV and incident stroke. This cohort study evaluated the association of HIV and OIs with incident stroke. METHODS: We identified adults with HIV infection in 2000-2012, using the Taiwan National Health Insurance Research Database...
February 1, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
B Pillay, P K Ramdial, D P Naidoo, B Sartorius, D Singh
OBJECTIVES: To evaluate outcomes after endovascular treatment of patients with aneurysmal or occlusive vasculopathy in HIV-infected patients. METHODS: Retrospective analysis of a prospective database of treatment outcomes in patients with HIV related vasculopathies between April 2005 and September 2015. RESULTS: Sixty HIV patients presented with post-traumatic pseudoaneurysm formation (n = 7), aneurysmal disease (n = 24) or occlusive disease (n = 29 (48%))...
September 2016: European Journal of Vascular and Endovascular Surgery
Laura A Benjamin, Alan Bryer, Sebastian Lucas, Alan Stanley, Theresa J Allain, Elizabeth Joekes, Hedley Emsley, Ian Turnbull, Colin Downey, Cheng-Hock Toh, Kevin Brown, David Brown, Catherine Ison, Colin Smith, Elizabeth L Corbett, Avindra Nath, Robert S Heyderman, Myles D Connor, Tom Solomon
HIV infection, and potentially its treatment, increases the risk of an arterial ischemic stroke. Multiple etiologies and lack of clear case definitions inhibit progress in this field. Several etiologies, many treatable, are relevant to HIV-related stroke. To fully understand the mechanisms and the terminology used, a robust classification algorithm to help ascribe the various etiologies is needed. This consensus paper considers the strengths and limitations of current case definitions in the context of HIV infection...
August 2016: Neurology® Neuroimmunology & Neuroinflammation
Sumeet R Dhawan, Anju Gupta, Vivek Gupta, Pratibha D Singhi
Neurological findings in HIV are common and include cognitive impairment, microcephaly, nonspecific white matter lesions and seizures. Cerebral vasculopathy and stroke are uncommon and may be due to primary HIV vasculopathy or opportunistic infections such as tuberculosis and cryptococcal meningitis. The authors describe a 7-y-old boy who presented with severe headache and was detected to have aneurysmal bleed due to intracranial aneurysm.
August 2016: Indian Journal of Pediatrics
Grace C Haser, Bauer Sumpio
OBJECTIVE: Patients infected with human immunodeficiency virus (HIV) have higher rates of dyslipidemia, atherosclerosis, and chronic inflammation that can damage the vascular system compared with the general population. This can be attributed both to HIV itself and to highly active antiretroviral therapy (HAART) they receive. This review outlines the mechanisms by which HIV and HIV medications can cause vascular complications and identifies strategic areas of research to treat these dysfunctions...
March 2017: Journal of Vascular Surgery
Charles K Hammond, Alexander Shapson-Coe, Rajeshree Govender, Ronald van Toorn, Alvin Ndondo, Nicky Wieselthaler, Brian Eley, Lawrence Mubaiwa, Jo M Wilmshurst
A national multicenter study identified 17 South African children with vertically acquired HIV-1 infection and HIV-associated vasculopathy. Five of the children (all indigenous African ancestry) had progressive vascular disease, consistent with moyamoya syndrome. Median presentation age 5.8 years (range 2.2-11). The children with moyamoya syndrome presented with abnormal CD4 counts and raised viral loads. Clinical features included motor deficits, neuroregression, and intellectual disability. Neuroimaging supported progressive vascular disease with preceding clinically silent disease course...
July 2016: Journal of Child Neurology
Charles K Hammond, Brian Eley, Nicky Wieselthaler, Alvin Ndondo, Jo M Wilmshurst
An estimated 3.2 million children worldwide have human immunodeficiency virus (HIV) infection. Antiretroviral therapy (ART) has resulted in prolonged survival, leading to an increase in complications previously recognized in adults. Children with HIV infection have increased risk of cerebrovascular disease from multiple aetiologies including HIV-associated vasculopathy, opportunistic vasculitis, cardioembolism or coagulopathy, all of which may be secondary to the infection. Prevalence of cerebrovascular disease in HIV-infected children is underestimated because of limited neuroimaging in low and middle income countries, silent events without overt motor manifestations, and mislabeling as HIV encephalopathy for non-motor manifestations such as behavioural and cognitive difficulties...
May 2016: Developmental Medicine and Child Neurology
Charlotte Hurabielle, Gwendoline Sebille, Benoît Barrou, Philippe Moguelet, Camille Francès, Stéphane Barete
is missing (Short communication).
August 23, 2016: Acta Dermato-venereologica
Eliza C Miller, Mitchell S V Elkind
The role of infection in cerebrovascular disease is complex and remains incompletely understood. Over the last 5 years, investigators have made notable inroads in untangling this thorny topic. In this review, we examine these recent developments, concentrating on four aspects of the relationship between infection and stroke. We first discuss specific infectious agents as direct causes of stroke, focusing on recent work implicating herpesviruses and HIV in cerebral vasculopathy. We then discuss systemic infection of any type as a stroke trigger, focusing on the relationship of infection to timing of acute stroke, both in children and adults, as well as the role of vaccination in stroke prevention...
January 2016: Current Neurology and Neuroscience Reports
Saleh S Baeesa, Mohamad Bakhaidar, Mohammed A Almekhlafi, Tariq A Madani
BACKGROUND: Human immunodeficiency virus (HIV)-associated cerebral aneurysmal vasculopathy is a rare complication of HIV affecting pediatric and adult patients and has been the subject of many case reports and case series. METHODS: We performed a systematic literature search of PubMed, EMBASE, Scopus, Web of Science, Science Direct, and Google Scholar up to April 10, 2015. Our inclusion criteria encompassed all reported original case series and reports of HIV-associated cerebral aneurysms diagnosed radiologically...
March 2016: World Neurosurgery
Andrew T Hale, Chris T Longenecker, Ying Jiang, Sara M Debanne, Danielle E Labatto, Norma Storer, Anne Hamik, Grace A McComsey
OBJECTIVE: To determine the relationships between Krüppel-like factors (KLF) 2 and 4, immune-activation, and subclinical vascular disease in HIV-infected patients on antiretroviral therapy (ART). DESIGN: Double-blind, randomized, placebo-controlled trial. METHODS: We studied 74 HIV-infected adults on ART enrolled in a randomized clinical trial of statin therapy. KLF2 and KLF4 gene expression was measured by quantitative PCR from peripheral blood mononuclear cells (PBMCs) at baseline and after 24 weeks of 10 mg daily rosuvastatin or placebo...
August 24, 2015: AIDS
Mohamad G Bakhaidar, Naushad A Ahamed, Mohammed A Almekhlafi, Saleh S Baeesa
Human immunodeficiency virus (HIV) infection associated aneurysmal vasculopathy is a rare complication of HIV infection affecting the pediatric and adult population. We present a case of a 7-year-old male child known to have a congenitally acquired HIV infection presenting with a ruptured left distal internal carotid artery fusiform aneurysm that was diagnosed on MRI scans 6 months prior to his presentation. He underwent craniotomy and successful aneurysm reconstruction. He had uncomplicated postoperative course and experienced a good recovery...
July 2015: Neurosciences: the Official Journal of the Pan Arab Union of Neurological Sciences
Jayesh P Thawani, Nikhil R Nayak, Jared M Pisapia, Dmitriy Petrov, Bryan A Pukenas, Robert W Hurst, Michelle J Smith
BACKGROUND: Intracranial vasculopathy in adult patients with human-acquired immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) is a rare but increasingly recognized disease entity. OBJECTIVE: We aimed to contribute to and summarize the adult literature describing patients with HIV/AIDS who have intracranial vasculopathy. METHODS: A retrospective review of adult patients with HIV/AIDS undergoing diagnostic cerebral angiography at our institution from 2007-2013 was performed...
August 2015: Interventional Neuroradiology
Joseph B Cantey, Julide Sisman
Lenticulostriate vasculopathy (LSV) refers to increased echogenicity of the penetrating vessels that supply the basal ganglia and segments of the internal capsule seen on cranial ultrasound. Initially identified in infants with congenital infection, LSV has now been associated with a variety of infectious and non-infectious conditions. Although robust epidemiologic studies are lacking, the available evidence does not support broad evaluation for multiple congenital infections when LSV is identified. We propose screening infants with LSV for congenital cytomegalovirus infection and ensuring that prenatal screening included appropriate testing for syphilis, human immunodeficiency virus, and rubella-immune status...
July 2015: Early Human Development
Balasoobramanien Pillay, Pratistadevi K Ramdial, Datshana P Naidoo
An established relationship exists between human immunodeficiency virus (HIV) and the vascular system, which is characterised by clinical expressions of aneurysmal and occlusive disease that emanate from a common pathological process. The exact pathogenesis is currently unknown; attempts to implicate opportunistic pathogens have been futile. Theories converge on leucocytoclastic vasculitis with the vaso vasora as the vasculopathic epicentre. It is thought that the virus itself or viral proteins trigger the release of inflammatory mediators that cause endothelial dysfunction and smooth muscle proliferation leading to vascular injury and thrombosis...
March 2015: Cardiovascular Journal of Africa
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