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https://www.readbyqxmd.com/read/29474356/management-of-severe-strongyloidiasis-attended-at-reference-centers-in-spain
#1
Angela Martinez-Perez, Silvia Roure Díez, Moncef Belhasen-Garcia, Diego Torrús-Tendero, Jose Luis Perez-Arellano, Teresa Cabezas, Cristina Soler, Marta Díaz-Menéndez, Miriam Navarro, Begoña Treviño, Fernando Salvador-Vélez
INTRODUCTION: Strongyloides stercoralis is a globally distributed nematode that causes diverse clinical symptoms in humans. Spain, once considered an endemic country, has experienced a recent increase in imported cases. The introduction of serology helps diagnosis and is currently replacing microbiological techniques in some settings, but its sensitivity is variable and can be low in immunocompromised patients. Diagnosis can only be confirmed by identification of larvae. Often, this "gold standard" can only be achieved in severe cases, such as disseminated S...
February 23, 2018: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/29467577/human-immunodeficiency-virus-in-the-brain-culprit-or-facilitator
#2
REVIEW
Luminita Ene
Introduction: Human immunodeficiency virus (HIV) enters the brain early, where it can persist, evolve, and become compartmentalized. Central nervous system (CNS) disease can be attributed to HIV alone or to the complex interplay between the virus and other neurotropic pathogens. Aim: The current review aims to describe the direct impact of HIV on the brain as well as its relationship with other pathogens from a practitioner's perspective, to provide a general clinical overview, brief workup, and, whenever possible, treatment guidance...
2018: Infectious Diseases
https://www.readbyqxmd.com/read/29465595/discordant-csf-plasma-hiv-1-rna-in-individuals-on-virologically-suppressive-antiretroviral-therapy-in-western-india
#3
Ameet N Dravid, Kartik Natrajan, Milind M Kulkarni, Chinmay K Saraf, Uma S Mahajan, Sachin D Kore, Niranjan M Rathod, Umakant S Mahajan, Rustom S Wadia
Aim of this study was to estimate the prevalence of cerebrospinal fluid (CSF)/Plasma HIV-1 RNA discordance in virologically suppressed individuals presenting with incident neurologic symptoms.In this retrospective cohort study conducted between March 1, 2009, and March 1, 2017, HIV-1 infected adults exposed to atleast 12 months of antiretroviral therapy (ART) and having plasma viral load (VL) <1000 copies/mL (virologically suppressed) were included. Among these, individuals presenting with neurologic symptoms during follow-up were assessed for CSF/Plasma HIV-1 RNA discordance by measuring HIV-1 RNA in collected plasma and CSF samples...
February 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29464785/astrocytes-sustain-long-term-productive-hiv-1-infection-without-establishment-of-reactivable-viral-latency
#4
Corinne Barat, Alizé Proust, Alexandre Deshiere, Mathieu Leboeuf, Jean Drouin, Michel J Tremblay
The "shock and kill" HIV-1 cure strategy proposes eradication of stable cellular reservoirs by clinical treatment with latency-reversing agents (LRAs). Although resting CD4+ T cells latently infected with HIV-1 constitute the main reservoir that is targeted by these approaches, their consequences on other reservoirs such as the central nervous system are still unknown and should be taken into consideration. We performed experiments aimed at defining the possible role of astrocytes in HIV-1 persistence in the brain and the effect of LRA treatments on this viral sanctuary...
February 21, 2018: Glia
https://www.readbyqxmd.com/read/29454181/brainstem-dysfunction-heralding-disseminated-cryptococcosis
#5
Prachaya Srivanitchapoom, Yuvadee Pitakpatapee, Panitta Sitthinamsuwan, Sith Sathornsumetee
Cryptococcal meningoencephalitis is one of the most common central nervous system infections affecting immunocompromised patients. However, brainstem involvement is extremely rare and may represent a diagnostic challenge to clinicians. We report a non-HIV infected, chronically immunosuppressed, patient with fatal disseminated cryptococcosis presented with subcutaneous masses at both thighs and progressive brainstem dysfunction. Magnetic resonance imaging demonstrated multiple brainstem infarcts likely derived from small vessel vasculopathy...
February 12, 2018: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29451598/performance-of-cryptococcal-antigen-lateral-flow-assay-in-serum-cerebrospinal-fluid-whole-blood-and-urine-in-hiv-infected-patients-with-culture-proven-cryptococcal-meningitis-admitted-at-a-brazilian-referral-center
#6
José E Vidal, Carolina Toniolo, Adriana Paulino, Arnaldo L Colombo, Marilena Dos Anjos Martins, Cristina da Silva Meira, Renata Guise Soares Azevedo, Vera Lucia Pereira-Chioccola, Hélio Rodrigues Gomes, Marcia Dos Santos Lazera, Augusto C Penalva de Oliveira, David R Boulware
Cryptococcal meningitis is the most common cause of opportunistic meningitis in HIV-infected patients in Brazil and causes unacceptable high mortality rates. In this study, HIV-infected patients with a first episode of culture-proven cryptococcal meningitis in cerebrospinal fluid (CSF) were prospectively included in order to evaluate sensitivity of cryptococcal antigen (CrAg) lateral flow assay (LFA) in serum, CSF, whole blood (fingerstick), and fresh urine. In addition, HIV-infected patients with other neurological confirmed diseases were included in order to evaluate the specificity of CrAg LFA in serum...
2018: Revista do Instituto de Medicina Tropical de São Paulo
https://www.readbyqxmd.com/read/29432047/community-acquired-meningitis-in-hiv-infected-patients-in-the-united-states
#7
Karen J Vigil, Lucrecia Salazar, Rodrigo Hasbun
We conducted a retrospective study of 549 adults admitted with community-acquired meningitis (CAM) to several hospitals in New Orleans, LA and Houston, TX between 1999 and 2014 to characterize the current epidemiology, clinical manifestations, cerebrospinal fluid (CSF) characteristics, and outcomes of CAM between HIV-infected and uninfected patients and to identify risk factors for adverse outcomes in CAM. Bivariate analysis and logistic regression analysis were used to identify prognostic factors. A total of 1022 patients with CAM were screened...
February 2018: AIDS Patient Care and STDs
https://www.readbyqxmd.com/read/29429030/nucleoside-reverse-transcriptase-inhibitors-nrtis-induce-pathological-pain-through-wnt5a-mediated-neuroinflammation-in-aging-mice
#8
Subo Yuan, Yuqiang Shi, Kaiwen Guo, Shao-Jun Tang
Highly Active Antiretroviral Therapy (HAART) has significantly contributed to the increase of HIV-infected survivors over 50 years of age. Unfortunately, patients are required to stay on long-term HAART, which may be causally related to the development of neurological problems such as chronic pain. Little is known about the contribution of HAART or its therapeutic agents to the pathogenesis of pain during aging. In this study, we determined the effect of nucleoside reverse transcriptase inhibitors (NRTIs) on the development of mechanical allodynia and the potential underlying mechanism in aging mice (15...
February 10, 2018: Journal of Neuroimmune Pharmacology: the Official Journal of the Society on NeuroImmune Pharmacology
https://www.readbyqxmd.com/read/29427049/favourable-outcome-in-a-child-with-symptomatic-diagnosis-of-glutaric-aciduria-type-1-despite-vertical-hiv-infection-and-minor-head-trauma
#9
Angeline Thomas, Els F M Dobbels, Priscilla E Springer, Christelle Ackermann, Mark F Cotton, Barbara Laughton
The first case of Glutaric aciduria Type 1(GA1) in an African child was reported in 2001. GA1 has a prevalence of 1:5000 in black South Africans. Although early diagnosis is essential for a favourable outcome, newborn screening is not routine in South Africa where an estimated 320,000 children have HIV infection. Neurodevelopmental delay and encephalopathy are complications of both HIV and GA1. In such a setting it is important to recognise that HIV and GA1 can occur simultaneously. We present an HIV-infected South African male child of Xhosa descent with macrocephaly who commenced combination antiretroviral therapy (ART) at 8 weeks of age in a clinical trial which included a neurodevelopmental sub-study...
February 9, 2018: Metabolic Brain Disease
https://www.readbyqxmd.com/read/29424786/no-neurocognitive-advantage-for-immediate-antiretroviral-treatment-in-adults-with-greater-than-500-cd4-t-cell-counts
#10
Edwina J Wright, Birgit Grund, Kevin R Robertson, Lucette Cysique, Bruce J Brew, Gary L Collins, Mollie Poehlman-Roediger, Michael Vjecha, Augusto Penalva de Oliveira, Barbara Standridge, Cate Carey, Anchalee Avihingsanon, Eric Florence, Jens D Lundgren, Alejandro Arenas-Pinto, Nicolas J Mueller, Alan Winston, Moses Supercharger Nsubuga, Luxi Lal, Richard W Price
OBJECTIVE: To compare the effect of immediate versus deferred antiretroviral treatment (ART) on neuropsychological test performance in treatment-naive HIV-positive adults with >500 CD4+ cells/μL. DESIGN: Randomized trial. METHODS: The START parent study randomized participants to commence immediate versus deferred ART until CD4+ <350 cells/μL. The START Neurology substudy used 8 neuropsychological tests, at baseline, months 4, 8, 12 and annually, to compare groups for changes in test performance...
February 8, 2018: AIDS
https://www.readbyqxmd.com/read/29410787/a-secondary-syphilis-rash-with-scaly-target-lesions
#11
Xavier Marchand-Senécal, Sapha Barkati, Danielle Bouffard, Valérie Martel-Laferrière
A 40-year-old man reported a 5-day history of fever and malaise, followed by a pruritic generalized rash. He had well-demarcated erythematous papules and plaques with scaling. The patient was diagnosed with secondary syphilis. The skin biopsy showed a psoriasiform lichenoid dermatitis with plasma cells. The anti-T. pallidum antibody confirmed the presence of spirochetes. He was also found to be hepatitis C virus and human immunodeficiency virus positive. The characteristic rash of secondary syphilis may appear as maculopapular, evolving initially from macules to small reddish-brown papules with minor scaling later...
February 2018: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/29381995/cxcl13-and-th1-th2-cytokines-in-the-serum-and-cerebrospinal-fluid-of-neurosyphilis-patients
#12
Yongxing Yan, Jun Wang, Bin Qu, Yan Zhang, Yingnan Wei, Huili Liu, Chunli Wu
Neurosyphilis is a chronic infectious disease with involvement of central nervous system infection by Treponema pallidum. This study was to investigate the contents of B lymphocyte chemokine 1 (BLC-1/chemokine [C-X-C motif] ligand 13), Th1 cytokines (Interleukin [IL]-2, IL-12, and Interferon [IFN]-γ), and Th2 cytokines (IL-6 and IL-10) in serum and cerebrospinal fluid (CSF) of HIV-negative patients with neurosyphilis before and after treatment, aiming to elucidate roles of CXCL13 and Th1/Th2 cytokines in immune response to and pathogenesis of neurosyphilis...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29377008/blood-brain-barrier-breakdown-in-alzheimer-disease-and-other-neurodegenerative-disorders
#13
REVIEW
Melanie D Sweeney, Abhay P Sagare, Berislav V Zlokovic
The blood-brain barrier (BBB) is a continuous endothelial membrane within brain microvessels that has sealed cell-to-cell contacts and is sheathed by mural vascular cells and perivascular astrocyte end-feet. The BBB protects neurons from factors present in the systemic circulation and maintains the highly regulated CNS internal milieu, which is required for proper synaptic and neuronal functioning. BBB disruption allows influx into the brain of neurotoxic blood-derived debris, cells and microbial pathogens and is associated with inflammatory and immune responses, which can initiate multiple pathways of neurodegeneration...
January 29, 2018: Nature Reviews. Neurology
https://www.readbyqxmd.com/read/29373764/-wernicke-korsakoff-syndrome-secondary-to-cytomegalovirus-encephalitis-a-case-report
#14
Luis Guillermo Uribe, María Alejandra Pérez, Camilo Andrés Lara, Natalia Rueda, Javier Augusto Hernández
Cytomegalovirus (CMV) is one of the opportunistic microorganisms with the highest prevalence in immunocompromised patients. Reactivation has decreased after the introduction of highly active antiretroviral therapy (HAART). Encephalitis has been reported in the coinfection as one of the most frequent presentations.We present the case of a young adult patient with HIV infection and rapid neurological deterioration due to classic clinical symptoms and signs of the Wernicke-Korsakoff syndrome, with no risk factors for thiamine deficiency, with images by nuclear magnetic resonance typical of the syndrome, and identification of cytomegalovirus in cerebrospinal fluid...
December 1, 2017: Biomédica: Revista del Instituto Nacional de Salud
https://www.readbyqxmd.com/read/29368400/cerebrospinal-fluid-hiv-rna-in-persons-living-with-hiv
#15
M Di Carlofelice, A Everitt, D Muir, A Winston
OBJECTIVES: Despite adequate suppression of plasma HIV RNA, viral escape in cerebrospinal fluid (CSF) is widely reported. Rates of CSF HIV RNA escape vary in the literature. In persons living with HIV (PLWH) undergoing lumbar puncture examination for clinical reasons, we assessed rates of CSF HIV RNA escape. METHODS: Persons living with HIV attending a designated HIV neurology service undergoing CSF assessment for clinical reasons between January 2015 and April 2017 were included in the study...
January 25, 2018: HIV Medicine
https://www.readbyqxmd.com/read/29364535/potential-impacts-of-poor-communication-on-early-diagnosis-of-hiv-associated-neurocognitive-disorder
#16
Denise Cummins, Donna Waters, Christina Aggar, Catherine C O'Connor
AIM: To ascertain whether community-based health care providers were collecting appropriate information to identify patients at risk of HIV associated neurocognitive disorder and whether related documentation was complete. BACKGROUND: HIV associated neurocognitive disorder is a treatable neurological condition that can affect more than 20% of those infected with the HIV. Signs and symptoms of cognitive impairment may be subtle; therefore, documentation of medical and social information could be beneficial in identifying those at risk DESIGN: Cross sectional descriptive study...
January 24, 2018: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/29353489/racial-and-socioeconomic-disparities-in-the-symptom-reporting-of-persons-living-with-hiv
#17
Rebecca Schnall, Karolynn Siegel, Haomiao Jia, Susan Olender, Sabina Hirshfield
Persons living with HIV (PLWH) today can survive decades with the disease, making the symptom experience much more relevant to their lifestyle and health outcomes. The goal of the research reported here was to assess the symptom reporting of PLWH in the Unites States (US) in the combined antiretroviral therapy (cART) age of the epidemic. We conducted an anonymous online survey of symptomatic PLWH in the US and asked participants to report the frequency and intensity of 28 frequently occurring symptoms in the past 30 days...
January 22, 2018: AIDS Care
https://www.readbyqxmd.com/read/29352633/current-concerns-and-perspectives-on-zika-virus-co-infection-with-arboviruses-and-hiv
#18
REVIEW
Hussin A Rothan, Mehdi R M Bidokhti, Siddappa N Byrareddy
Dissemination of vector-borne viruses, such as Zika virus (ZIKV), in tropical and sub-tropical regions has a complicated impact on the immunopathogenesis of other endemic viruses such as dengue virus (DENV), chikungunya virus (CHIKV) and human immunodeficiency virus (HIV). The consequences of the possible co-infections with these viruses have specifically shown significant impact on the treatment and vaccination strategies. ZIKV is a mosquito-borne flavivirus from African and Asian lineages that causes neurological complications in infected humans...
January 16, 2018: Journal of Autoimmunity
https://www.readbyqxmd.com/read/29350164/cerebral-syphilitic-gumma-in-immunocompetent-man-japan
#19
Tatsuya Kodama, Hidenori Sato, Morichika Osa, Yuji Fujikura, Akihiko Kawana
Although cerebral syphilitic gummas are generally considered to be rare manifestations of tertiary syphilis, many reports exist of early cerebral syphilitic gumma. Our finding of cerebral syphilitic gumma in an HIV-negative man within 5 months after syphilis infection suggests that this condition should be considered in syphilis patients who have neurologic symptoms.
February 2018: Emerging Infectious Diseases
https://www.readbyqxmd.com/read/29345598/dolutegravir-related-neurological-adverse-events-a-case-report-of-successful-management-with-therapeutic-drug-monitoring
#20
Francois Parant, Patrick Miailhes, Florence Brunel, Marie-Claude Gagnieu
Dolutegravir (DTG), a highly effective second-generation HIV integrase inhibitor with high genetic barrier to resistance, has shown excellent tolerability and safety profiles in clinical trials. However, some patients may experience neurological or psychiatric adverse effects leading to DTG discontinuation. This report describes a case of 29-year-old woman who developed neurological adverse events after starting the DTG-based antiretroviral therapy. Serum DTG concentrations were supra-therapeutic which has required a dosing interval adjustment...
January 16, 2018: Current Drug Safety
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