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https://www.readbyqxmd.com/read/28820724/neurologic-complications-in-persons-with-hiv-infection-in-the-era-of-antiretroviral-therapy
#1
Dennis Kolson
Neurologic complications in persons with HIV infection are less severe in the era of potent antiretroviral therapy but remain highly prevalent. Prior to the use of antiretroviral therapy, opportunistic infections of the central nervous system (CNS) and CNS malignancy were common. Progressive multifocal leukoencephalopathy (PML), however, remains a diagnostic challenge in HIV-infected individuals, and no effective antiviral treatment for PML is currently available. Primary neurologic complications of acute HIV infection include aseptic meningitis and acute inflammatory demyelinating polyneuropathy...
July 2017: Topics in Antiviral Medicine
https://www.readbyqxmd.com/read/28820708/clinical-spectrum-etiology-and-outcome-of-neurological-disorders-in-the-rural-hospital-of-mosango-the-democratic-republic-of-congo
#2
Deby Mukendi, Jean-Roger Lilo Kalo, Alain Mpanya, Luigi Minikulu, Tharcisse Kayembe, Pascal Lutumba, Barbara Barbé, Philippe Gillet, Jan Jacobs, Harry Van Loen, Cedric P Yansouni, François Chappuis, Raffaella Ravinetto, Kristien Verdonck, Marleen Boelaert, Andrea S Winkler, Emmanuel Bottieau
There is little published information on the epidemiology of neurological disorders in rural Central Africa, although the burden is considered to be substantial. This study aimed to investigate the pattern, etiology, and outcome of neurological disorders in children > 5 years and adults admitted to the rural hospital of Mosango, province of Kwilu, Democratic Republic of Congo, with a focus on severe and treatable infections of the central nervous system (CNS). From September 2012 to January 2015, 351 consecutive patients hospitalized for recent and/or ongoing neurological disorder were prospectively evaluated by a neurologist, subjected to a set of reference diagnostic tests in blood or cerebrospinal fluid, and followed-up for 3-6 months after discharge...
August 14, 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/28809479/natural-seminal-amyloids-as-targets-for-development-of-synthetic-inhibitors-of-hiv-transmission
#3
Daniel A Sheik, Stephen Dewhurst, Jerry Yang
Amyloids refer to a class of protein or peptide aggregates that are heterogeneous in size, morphology, and composition, and are implicated to play a central role in many neurodegenerative and systemic diseases. The strong correlation between biological activity and extent of aggregation of amyloidogenic proteins and peptides has led to an explosion of research efforts to target these materials with synthetic molecules or engineered antibodies to try to attenuate their function in disease pathology. Although many of these efforts to attenuate amyloid function have shown great promise in laboratory settings, the vast majority of work has been focused on targeting amyloids associated with neurologic diseases, which has been met with significant additional challenges that preclude clinical evaluation...
August 15, 2017: Accounts of Chemical Research
https://www.readbyqxmd.com/read/28800335/an-overview-of-human-immunodeficiency-virus-type-1-associated-common-neurological-complications-does-aging-pose-a-challenge
#4
Anantha Ram Nookala, Joy Mitra, Nitish S Chaudhari, Muralidhar L Hegde, Anil Kumar
With increasing survival of patients infected with human immunodeficiency virus type 1 (HIV-1), the manifestation of heterogeneous neurological complications is also increasing alarmingly in these patients. Currently, more than 30% of about 40 million HIV-1 infected people worldwide develop central nervous system (CNS)-associated dysfunction, including dementia, sensory, and motor neuropathy. Furthermore, the highly effective antiretroviral therapy has been shown to increase the prevalence of mild cognitive functions while reducing other HIV-1-associated neurological complications...
August 9, 2017: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/28799299/a-comparative-study-of-csf-viral-rna-loads-between-hiv-positive-patients-with-neurological-manifestations-and-neurologically-asymptomatic-hiv-patients
#5
A D Mathur, S Devesh
INTRODUCTION: There are conflicting reports in literature about correlation of CSF viral RNA levels with neurological manifestations in HIV positive patients. Many studies in animals and human subjects have shown that CSF HIV-1 RNA can be useful as a specific marker of HIV induced neuropathology. To the contrary there are studies which show that neurological disease states can occur in absence of significant increase of CSF HIV RNA. MATERIALS AND METHODS: This was a prospective study conducted at Base hospital Delhi Cantt, New Delhi, a tertiary care hospitals for HIV patients...
August 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28798420/hiv-1-tat-induced-diarrhea-evokes-an-enteric-glia-dependent-neuroinflammatory-response-in-the-central-nervous-system
#6
Giuseppe Esposito, Elena Capoccia, Stefano Gigli, Marcella Pesce, Eugenia Bruzzese, Alessandra D'Alessandro, Carla Cirillo, Alessandro di Cerbo, Rosario Cuomo, Luisa Seguella, Luca Steardo, Giovanni Sarnelli
Despite the effectiveness of combined anti-retroviral therapy, human immunodeficiency virus (HIV) infected-patients frequently report diarrhea and neuropsychological deficits. It is claimed that the viral HIV-1 Trans activating factor (HIV-1 Tat) protein is responsible for both diarrhea and neurotoxic effects, but the underlying mechanisms are not known. We hypothesize that colonic application of HIV-1 Tat activates glial cells of the enteric nervous system (EGCs), leading to a neuroinflammatory response able to propagate to the central nervous system...
August 10, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28798382/chronic-low-level-expression-of-hiv-1-tat-promotes-a-neurodegenerative-phenotype-with-aging
#7
Alex M Dickens, Seung Wan Yoo, Alfred C Chin, Jiadi Xu, Tory P Johnson, Amanda L Trout, Kurt F Hauser, Norman J Haughey
The widespread use of combinational antiretroviral therapies (cART) in developed countries has changed the course of Human Immunodeficiency Virus (HIV) infection from an almost universally fatal disease to a chronic infection for the majority of individuals. Although cART has reduced the severity of neurological damage in HIV-infected individuals, the likelihood of cognitive impairment increases with age, and duration of infection. As cART does not suppress the expression of HIV non-structural proteins, it has been proposed that a constitutive production of HIV regulatory proteins in infected brain cells may contribute to neurological damage...
August 10, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28793057/noninvasive-intracranial-pressure-monitoring-for-hiv-associated-cryptococcal-meningitis
#8
V R Bollela, G Frigieri, F C Vilar, D L Spavieri, F J Tallarico, G M Tallarico, R A P Andrade, T M de Haes, O M Takayanagui, A M Catai, S Mascarenhas
Mortality and adverse neurologic sequelae from HIV-associated cryptococcal meningitis (HIV-CM) remains high due to raised intracranial pressure (ICP) complications. Cerebrospinal fluid (CSF) high opening pressure occurs in more than 50% of HIV-CM patients. Repeated lumbar puncture with CSF drainage and external lumbar drainage might be required in the management of these patients. Usually, there is a high grade of uncertainty and the basis for clinical decisions regarding ICP hypertension tends to be from clinical findings (headache, nausea and vomiting), a low Glasgow coma scale score, and/or fundoscopic papilledema...
August 7, 2017: Brazilian Journal of Medical and Biological Research, Revista Brasileira de Pesquisas Médicas e Biológicas
https://www.readbyqxmd.com/read/28792504/common-gene-network-signature-of-different-neurological-disorders-and-their-potential-implications-to-neuroaids
#9
Vidya Sagar, S Pilakka-Kanthikeel, Paola C Martinez, V S R Atluri, M Nair
The neurological complications of AIDS (neuroAIDS) during the infection of human immunodeficiency virus (HIV) are symptomized by non-specific, multifaceted neurological conditions and therefore, defining a specific diagnosis/treatment mechanism(s) for this neuro-complexity at the molecular level remains elusive. Using an in silico based integrated gene network analysis we discovered that HIV infection shares convergent gene networks with each of twelve neurological disorders selected in this study. Importantly, a common gene network was identified among HIV infection, Alzheimer's disease, Parkinson's disease, multiple sclerosis, and age macular degeneration...
2017: PloS One
https://www.readbyqxmd.com/read/28790866/incidence-clinical-presentation-and-outcome-of-hiv-1-associated-cryptococcal-meningitis-during-the-highly-active-antiretroviral-therapy-era-a-nationwide-cohort-study
#10
Madeleine Touma, Line D Rasmussen, Raquel Martin-Iguacel, Frederik Neess Engsig, Nina Breinholt Stærke, Mette Stærkind, Niels Obel, Magnus Glindvad Ahlström
BACKGROUND: Human immunodeficiency virus (HIV) infection with advanced immunosuppression predisposes to cryptococcal meningitis (CM). We describe the incidence, clinical presentation, and outcome of CM in HIV-infected individuals during the highly active antiretroviral therapy (HAART) era. METHODS: A nationwide, population-based cohort of HIV-infected individuals was used to estimate incidence and mortality of CM including risk factors. A description of neurological symptoms of CM at presentation and follow-up in the study period 1995-2014 was included in this study...
2017: Clinical Epidemiology
https://www.readbyqxmd.com/read/28777205/rapid-accurate-identification-of-tuberculous-meningitis-among-south-african-children-using-a-novel-clinical-decision-tool
#11
Anu Goenka, Prakash M Jeena, Koleka Mlisana, Tom Solomon, Kevin Spicer, Rebecca Stephenson, Arpana Verma, Barnesh Dhada, Michael J Griffiths
INTRODUCTION: Early diagnosis of tuberculous meningitis (TBM) is crucial to achieve optimum outcomes. There is no effective rapid diagnostic test for use in children. We aimed to develop a clinical decision tool to facilitate the early diagnosis of childhood TBM. METHODS: Retrospective case control study across 7 hospitals in KwaZulu-Natal, South Africa (2010-2014). We identified the variables most predictive of microbiologically confirmed TBM in children (3 months-15 years) by univariate analysis...
August 1, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28768983/longitudinally-extensive-transverse-myelitis-and-optic-neuropathy-associated-with-syphilitic-meningomyelitis-and-human-immunodeficiency-virus-infection-a-case-report-and-review-of-the-literature
#12
Rie Tohge, Yuya Shinoto, Makio Takahashi
The incidence of co-infection with Treponema pallidum and human immunodeficiency virus (HIV) is increasing in developing and developed countries. The neurological complications of both infections occasionally occur simultaneously during a clinical course. We herein report the case of an HIV carrier with syphilitic meningomyelitis and subclinical optic neuropathy. The patient presumably had latent syphilis and slowly developed longitudinally extensive transverse myelitis (LETM). A cerebrospinal fluid examination confirmed the diagnosis of active neurosyphilis based on an elevated T...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28768859/identification-of-emerging-mac-tropic-hiv-1-r5-variants-in-brain-tissue-of-patients-without-severe-neurological-complications
#13
Maria Paz Gonzalez-Perez, Paul J Peters, Olivia O'Connell, Nilsa Silva, Carole Harbison, Sheila Cummings Macri, Saravanan Kaliyaperumal, Katherine Luzuriaga, Paul R Clapham
Untreated HIV-1+ individuals frequently suffer from HIV associated neurocognitive disorders (HAND), with about 30% of AIDS patients suffering severe HIV associated dementias (HAD). Antiretroviral therapy has greatly reduced the incidence of HAND and HAD. However, there is a continuing problem of milder neurocognitive impairments in treated HIV+ patients that may be increasing with long term therapy.Here, we investigated whether envelope (env) genes could be amplified from proviral DNA or RNA derived from brain tissue of 12 individuals with normal neurology or minor neurological conditions (N/MC individuals)...
August 2, 2017: Journal of Virology
https://www.readbyqxmd.com/read/28765048/diabetes-changes-symptoms-cluster-patterns-in-persons-living-with-hiv
#14
Julie Ann Zuniga, Eliezer Bose, Jungmin Park, M Danet Lapiz-Bluhm, Alexandra A García
Approximately 10-15% of persons living with HIV (PLWH) have a comorbid diagnosis of diabetes mellitus (DM). Both of these long-term chronic conditions are associated with high rates of symptom burden. The purpose of our study was to describe symptom patterns for PLWH with DM (PLWH+DM) using a large secondary dataset. The prevalence, burden, and bothersomeness of symptoms reported by patients in routine clinic visits during 2015 were assessed using the 20-item HIV Symptom Index. Principal component analysis was used to identify symptom clusters...
July 15, 2017: Journal of the Association of Nurses in AIDS Care: JANAC
https://www.readbyqxmd.com/read/28762691/hiv-associated-complications-a-systems-based-approach
#15
REVIEW
Carolyn Chu, Lealah C Pollock, Peter A Selwyn
Persons with human immunodeficiency virus (HIV) infection often develop complications related directly to the infection, as well as to treatment. Aging, lifestyle factors, and comorbidities increase the risk of developing chronic conditions such as diabetes mellitus and chronic kidney disease. HIV-associated neurologic complications encompass a wide spectrum of pathophysiology and symptomatology. Cardiovascular and pulmonary conditions are common among persons with HIV infection. Although some specific antiretroviral medications have been linked to disease development, traditional risk factors (e...
August 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/28752495/changing-clinical-phenotypes-of-hiv-associated-neurocognitive-disorders
#16
Ned Sacktor
HIV-associated neurocognitive disorder (HAND) remains a common cause of cognitive impairment and persists in 15-55% of HIV+ individuals in the combination antiretroviral therapy (CART) era. CART is now the primary treatment for HAND, but it is effective in only a subset of patients. In the pre-CART era, HIV-associated dementia was the most common form of HAND. However, in CART-treated patients, the prevalence of HIV-associated dementia has declined substantially, and milder stages of HAND, i.e., ANI and MND predominate...
July 27, 2017: Journal of Neurovirology
https://www.readbyqxmd.com/read/28750777/prevalence-of-periodontitis-dental-caries-and-peri-implant-pathology-and-their-relation-with-systemic-status-and-smoking-habits-results-of-an-open-cohort-study-with-22009-patients-in-a-private-rehabilitation-center
#17
Miguel de Araújo Nobre, Paulo Maló
OBJECTIVES: This investigation, based on a 3-year epidemiological surveillance open cohort study, aimed to provide an insight of the prevalence of periodontitis, dental caries and peri-implant pathology and to compare inferentially between healthy and systemic compromised patients. METHODS: A total of 22009 patients were observed consisting in 9035 men (41.1%) and 12974 women (58.9%) with an average age of 48.5 years (standard deviation of 15.6 years). The prevalence of the 3 chronical oral diseases was calculated...
July 24, 2017: Journal of Dentistry
https://www.readbyqxmd.com/read/28737365/vim-thalamotomy-in-the-treatment-of-holmes-tremor-secondary-to-hiv-associated-midbrain-lesion-a-case-report
#18
José O Oliveira, Soraya A Jorge Cecilio, Matheus Fernandes Oliveira, Leonardo R Takahashi, Alexandro R Galassi, Vanessa M Holanda, José M Rotta
Holmes' tremor (rubral tremor, cerebellar outflow tremor) is characterized by rest, intention and postural tremor, often localized to one upper extremity, associated with ipsilateral dysmetria and dysdiadochokinesia. We describe a case of successful treatment of Holmes' tremor with unilateral nucleus ventralis intermedius (VIM) thalamotomy. The subject is a 43-year-old woman with unremarkable previous medical history. She presented with complete left hemiparesis in the context of human immunodeficiency syndrome and the magnetic resonance image disclosed a contrast-enhancing lesion in right brain peduncle, in topography of red nucleus...
October 2017: Journal of Neurosurgical Sciences
https://www.readbyqxmd.com/read/28728201/-fever-and-headache-after-a-vacation-in-thailand
#19
Benedikt Schwermer, Daniel Eschle, Constantine Bloch-Infanger
History 50 year-old man with fever and headache starting one week after returning from his vacation in Thailand. His general practitioner prescribed amoxicillin/clavulanic acid, without further analyses to pinpoint the infection. Examinations The examination of cerebro-spinal fluid was crucial for the final diagnosis. Lumbar puncture demonstrated a predominantly mononuclear pleocytosis of 80 cells/µl (< 5) with an elevated protein of 782 mg/l (< 450); glucose and lactate were within normal limits...
July 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28719495/late-onset-hiv-encephalopathy-in-children-with-long-standing-virologic-suppression-followed-by-slow-spontaneous-recovery-despite-no-change-in-antiretroviral-therapy-four-case-reports
#20
Steve Innes, Ronald van Toorn, Kennedy Otwombe, Els Dobbels, Gert van Zyl, Mark F Cotton, Barbara Laughton
We describe four CHER (Children with HIV Early antiRetroviral therapy) trial participants with late-onset HIV encephalopathy despite long-standing viral suppression in blood and undetectable HIV DNA and RNA PCR in cerebrospinal fluid. Extensive investigations revealed no alternative etiology. Reassuringly, all four experienced slow spontaneous recovery despite no change in antiretroviral therapy. Virally-suppressed HIV-infected children remain at risk for fluctuating neurologic signs and symptoms.
July 15, 2017: Pediatric Infectious Disease Journal
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