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https://www.readbyqxmd.com/read/28728201/-fever-and-headache-after-a-vacation-in-thailand
#1
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
#2
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
https://www.readbyqxmd.com/read/28718069/neurological-involvement-in-patients-with-acute-recent-hiv-1-infection-a-case-control-study
#3
Juan Ambrosioni, Francisca Artigues, David Nicolás, Judit Peñafiel, Fernando Agüero, Christian Manzardo, María Mar Mosquera, Sonsoles Sánchez-Palomino, Elisa De Lazzari, María A Marcos, Montserrat Plana, José M Miró
Primary HIV-1 infection is a relevant period for its virological and epidemiological consequences. Most patients present a symptomatic disease that can be potentially serious, but neurological involvement during primary HIV-1 infection has been poorly studied. The aim of this study was to describe the characteristics and outcomes of primary HIV-1 infection patients presenting neurological symptoms and to compare them with primary HIV-1 infection patients without neurological involvement. Retrospective case-control study (1:3) comparing primary HIV-1 infection patients with and without neurological involvement enrolled in the Acute/Recent Hospital Clinic PHI Cohort between 1997 and 2016...
July 17, 2017: Journal of Neurovirology
https://www.readbyqxmd.com/read/28704492/cerebrospinal-fluid-matrix-metalloproteinase-9-levels-blood-brain-barrier-permeability-and-treatment-outcome-in-tuberculous-meningitis
#4
Sharada Mailankody, Gurukiran V Dangeti, Rajendiran Soundravally, Noyal M Joseph, Jharna Mandal, Tarun K Dutta, Tamilarasu Kadhiravan
OBJECTIVES: Tuberculous meningitis is characterized by elevated levels of matrix metalloproteinase 9 (MMP9) in the cerebrospinal fluid (CSF). However, it is unclear whether elevated MMP9 levels are associated with poor treatment outcome. We tested the hypothesis that pretreatment MMP9 levels in the CSF would be higher in tuberculous meningitis patients experiencing a poor treatment outcome. METHODS: We prospectively assessed the treatment outcome in a consecutive sample of human immunodeficiency virus-negative patients with tuberculous meningitis...
2017: PloS One
https://www.readbyqxmd.com/read/28693927/risk-factors-and-outcomes-of-cerebrospinal-fluid-overdrainage-in-hiv-negative-patients-with-cryptococcal-meningitis-after-the-ventriculoperitoneal-shunting-procedure
#5
Chih-Wei Hung, Wei-Che Lin, Wen-Neng Chang, Tsung-Ming Su, Chia-Te Kung, Nai-Wen Tsai, Hung-Chen Wang, Chih-Cheng Huang, Ben-Chung Cheng, Yu-Jih Su, Ya-Ting Chang, Chih-Min Su, Sheng-Yuan Hsiao, Cheng-Hsien Lu
PURPOSE: Shunt procedures used to treat cryptococcal meningitis complicated with hydrocephalus and/or increased intracranial pressure (IICP) could result in cerebrospinal fluid (CSF) overdrainage, thereby presenting therapeutic challenges. METHODS: We analyzed the clinical features and neuroimaging findings after the ventriculoperitoneal (VP) shunt procedure in 51 HIV (Human Immunodeficiency Virus)-negative patients with cryptococcal meningitis, to assess the risk factors associated with post-shunt CSF overdrainage...
June 28, 2017: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
https://www.readbyqxmd.com/read/28684681/interplay-between-autophagy-exosomes-and-hiv-1-associated-neurological-disorders-new-insights-for-diagnosis-and-therapeutic-applications
#6
REVIEW
Chet Raj Ojha, Jessica Lapierre, Myosotys Rodriguez, Seth M Dever, Mohammad Asad Zadeh, Catherine DeMarino, Michelle L Pleet, Fatah Kashanchi, Nazira El-Hage
The autophagy-lysosomal pathway mediates a degradative process critical in the maintenance of cellular homeostasis as well as the preservation of proper organelle function by selective removal of damaged proteins and organelles. In some situations, cells remove unwanted or damaged proteins and RNAs through the release to the extracellular environment of exosomes. Since exosomes can be transferred from one cell to another, secretion of unwanted material to the extracellular environment in exosomes may have an impact, which can be beneficial or detrimental, in neighboring cells...
July 6, 2017: Viruses
https://www.readbyqxmd.com/read/28683720/rilpivirine-use-in-the-swiss-hiv-cohort-study-a-prospective-cohort-study
#7
Delphine Sculier, Angèle Gayet-Ageron, Manuel Battegay, Matthias Cavassini, Jan Fehr, Cedric Hirzel, Patrick Schmid, Enos Bernasconi, Alexandra Calmy
BACKGROUND: Rilpivirine is safe and effective in HIV-naïve patients with low baseline HIV-RNA or in switch strategy. It offers the advantages of few drug-drug interactions and a favourable toxicity profile. We aimed to determine the reasons for prescribing the rilpivirine (RPV)/tenofovir disoproxil (TDF)/emtricitabine (FTC) co-formulation within the Swiss HIV Cohort Study and to assess its effectiveness and safety over a 24 months period. METHODS: All individuals enrolled in the Swiss HIV Cohort Study who initiated a RPV/TDF/FTC co-formulation between April 2013 and March 2014 were included...
July 6, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28679596/peripheral-neuropathy-in-hiv-infected-and-uninfected-patients-in-rakai-uganda
#8
Deanna Saylor, Gertrude Nakigozi, Noeline Nakasujja, Kevin Robertson, Ronald H Gray, Maria J Wawer, Ned Sacktor
OBJECTIVE: To determine the prevalence, risk factors, and functional impairment associated with peripheral neuropathy in a prospective cohort of adults in rural Uganda. METHODS: Eight hundred participants (400 HIV- and 400 antiretroviral-naive HIV+) in the Rakai Community Cohort Study underwent detailed neurologic evaluations including assessment of neuropathy symptoms, functional measures (Patient Assessment of Own Functioning Inventory and Karnofsky Performance Status scores), and neurologic evaluation by a trained medical officer...
July 5, 2017: Neurology
https://www.readbyqxmd.com/read/28655682/distal-sensory-polyneuropathy-among-hiv-infected-patients-at-parakou-university-hospital-benin-2011
#9
T A Adoukonou, P Kouna-Ndouongo, A Kpangon, D Gnonlonfoun, B Kpacha, A Dovonou, D Houinato
Distal sensory polyneuropathy (DSP) is the most frequent neurological complication among HIV patients, and its risk increases with use of highly active antiretroviral therapy (HAART). We aimed to assess the prevalence of DSP and the factors associated with it among HIV-infected outpatients treated at Parakou University Hospital. This cross-sectional study took place from April 15 to July 15, 2011, and included 262 patients. All patients underwent a neurological examination by two neurologists with training and clinical experience in these examinations and in the Brief Peripheral Neuropathy Screening (BPNS), which was the primary tool used here...
June 1, 2017: Médecine et Santé Tropicales
https://www.readbyqxmd.com/read/28646196/nucleoside-reverse-transcriptase-inhibitors-nrtis-induce-proinflammatory-cytokines-in-the-cns-via-wnt5a-signaling
#10
Ting Wu, Juan Zhang, Mingxing Geng, Shao-Jun Tang, Wenping Zhang, Jianhong Shu
HAART is very effective in suppressing HIV-1 replication in patients. However, patients staying on long-term HAART still develop various HIV-associated neurological disorders, even when the viral load is low. The underlying pathogenic mechanisms are largely unknown. Emerging evidence implicated that persistent neuroinflammation plays an important role in NeuroAIDS. Although residual virus or viral proteins are commonly thought as the causal factors, we are interested in the alternative possibility that HAART critically contributes to the neuroinflammation in the central nervous system (CNS)...
June 23, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28628526/determinants-of-hiv-1-cd4-independent-brain-adaptation
#11
Madina Shakirzyanova, Xiang-Peng Kong, Cecilia Cheng-Mayer
BACKGROUND: HIV-1 is known to adapt to the local environment in its usage of receptors and it can become CD4 independent in the brain where the receptor is scarce. This adaptation is through amino acid variations, but the patterns of such variation are not yet well understood. Given that infection of long-lived CD4-low and CD4-negative cells in anatomic compartments such as the brain expand cell tropism in vivo and may serve as potential viral reservoirs that pose challenge for HIV eradication, understanding the evolution to CD4-independence and envelope conformation associated with infection in the absence of CD4 will not only broaden our insights into HIV pathogenesis, but may guide functional cure strategies as well...
June 15, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28626255/underlying-cause-of-death-recorded-during-2013-to-2015-at-a-tertiary-general-hospital-in-vientiane-capital-lao-pdr
#12
Bounfeng Phoummalaysith, Viengsakhone Louangpradith, Tavanh Manivon, Bounxou Keohavong, Eiko Yamamoto, Nobuyuki Hamajima
In Lao People's Democratic Republic (Lao PDR), the cause of death is not registered in death reports. As a result, the government cannot produce official reports that show mortality according to cause of death. This study aimed to report the underlying cause of death in a tertiary general hospital (Mittaphab Hospital) in Vientiane capital. Mittaphab hospital is a governmental teaching hospital with 300 beds for inpatient services specialized in orthopedics, neurology, and hemodialysis. Since a children hospital exists beside Mittaphab Hospital, severe pediatric cases are referred to the child hospital...
February 2017: Nagoya Journal of Medical Science
https://www.readbyqxmd.com/read/28620498/diabetes-insipidus-and-hypopituitarism-in-hiv-an-unexpected-cause
#13
Carlos Tavares Bello, Francisco Sousa Santos, João Sequeira Duarte, Carlos Vasconcelos
Central diabetes insipidus (DI) is a rare clinical entity characterized by low circulating levels of antidiuretic hormone (ADH) presenting with polyuria and volume depletion. Pituitary surgery is the most common cause of central DI in adults. Pituitary and hypothalamic disease, particularly invasive neoplasms, rarely cause DI, being idiopathic cases responsible for the majority of non-surgical cases. HIV patients, especially those with poor virulogical control, are prone to the development of CNS neoplasms, particularly lymphomas...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/28612507/hiv-and-drug-abuse-mediate-astrocyte-senescence-in-a-%C3%AE-catenin-dependent-manner-leading-to-neuronal-toxicity
#14
Chunjiang Yu, Srinivas D Narasipura, Maureen H Richards, Xiu-Ti Hu, Bryan Yamamoto, Lena Al-Harthi
Emerging evidence suggests that cell senescence plays an important role in aging-associated diseases including neurodegenerative diseases. HIV leads to a spectrum of neurologic diseases collectively termed HIV-associated neurocognitive disorders (HAND). Drug abuse, particularly methamphetamine (meth), is a frequently abused psychostimulant among HIV+ individuals and its abuse exacerbates HAND. The mechanism by which HIV and meth lead to brain cell dysregulation is not entirely clear. In this study, we evaluated the impact of HIV and meth on astrocyte senescence using in vitro and several animal models...
June 13, 2017: Aging Cell
https://www.readbyqxmd.com/read/28606402/clinical-histological-and-radiological-responses-to-methylprednisolone-in-hiv-associated-rod-myopathy
#15
André M S Silva, Rodrigo H Mendonça, Cristiane A M Moreno, Eduardo P Estephan, Paulo V P Helito, Mary S Carvalho, Edmar Zanoteli
Skeletal muscle involvement as a neurologic manifestation in individuals with HIV is rare, especially as rod myopathy. We describe a 41-year-old male with HIV infection who presented progressive proximal muscle weakness and limb-girdle atrophy. A muscle magnetic resonance image showed bilateral fatty infiltration and post-contrast enhancement in the arm and thigh muscles. The muscle biopsy revealed intracytoplasmic aggregates with appearance of nemaline rod bodies with Gomori trichrome staining and electron microscopy in most fibers...
May 12, 2017: Neuromuscular Disorders: NMD
https://www.readbyqxmd.com/read/28598791/croi-2017-neurologic-complications-of-hiv-infection
#16
Serena S Spudich, Beau M Ances
The brain is a major target for HIV infection and is a potential viral reservoir even in virologically well-controlled HIV-infected individuals. Data presented at the 2017 Conference on Retroviruses and Opportunistic Infections (CROI) suggested that during early HIV infection, CD4+ T cells in the meninges and choroid plexus serve as an important early site of HIV infection in the central nervous system (CNS), with brain macrophages and microglial cells becoming an important source of viral replication with advancing disease...
May 2017: Topics in Antiviral Medicine
https://www.readbyqxmd.com/read/28598205/neurofilament-light-chain-protein-as-a-marker-of-neuronal-injury-review-of-its-use-in-hiv-1-infection-and-reference-values-for-hiv-negative-controls
#17
Aylin Yilmaz, Kaj Blennow, Lars Hagberg, Staffan Nilsson, Richard W Price, Judith Schouten, Serena Spudich, Jonathan Underwood, Henrik Zetterberg, Magnus Gisslén
Several CSF biomarkers of neuronal injury have been studied in people living with HIV. At this time, the most useful is the light subunit of the neurofilament protein (NFL). This major structural component of myelinated axons is essential to maintain axonal caliber and to facilitate effective nerve conduction. CSF concentrations of NFL provide a sensitive marker of CNS injury in a number of neurological diseases, including HIV-related neuronal injury. Areas Covered: In this review, the authors describe CSF NFL concentrations across the spectrum of HIV-infection, from its early acute phase to severe immunosuppression, with and without neurological conditions, and with and without antiretroviral treatment (n = 516)...
August 2017: Expert Review of Molecular Diagnostics
https://www.readbyqxmd.com/read/28596187/functional-connectivity-in-virally-suppressed-patients-with-hiv-associated-neurocognitive-disorder-a-resting-state-analysis
#18
J R Chaganti, A Heinecke, T M Gates, K J Moffat, B J Brew
BACKGROUND AND PURPOSE: HIV-associated neurocognitive disorder still occurs despite virally suppressive combination antiretroviral therapy. In the pre-combination antiretroviral era and in patients without HIV suppression, HIV-associated neurocognitive disorder was caused by synaptodendritic injury resulting in impairment of neural networks, characterized by decreased attention, psychomotor slowing, and working memory deficits. Whether similar pathogenesis is true for HIV-associated neurocognitive disorder in the context of viral suppression is not clear...
June 8, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28594894/micrornas-upregulated-during-hiv-infection-target-peroxisome-biogenesis-factors-implications-for-virus-biology-disease-mechanisms-and-neuropathology
#19
Zaikun Xu, Eugene L Asahchop, William G Branton, Benjamin B Gelman, Christopher Power, Tom C Hobman
HIV-associated neurocognitive disorders (HAND) represent a spectrum neurological syndrome that affects up to 25% of patients with HIV/AIDS. Multiple pathogenic mechanisms contribute to the development of HAND symptoms including chronic neuroinflammation and neurodegeneration. Among the factors linked to development of HAND is altered expression of host cell microRNAs (miRNAs) in brain. Here, we examined brain miRNA profiles among HIV/AIDS patients with and without HAND. Our analyses revealed differential expression of 17 miRNAs in brain tissue from HAND patients...
June 2017: PLoS Pathogens
https://www.readbyqxmd.com/read/28588577/immune-reconstitution-inflammatory-syndrome-unmasking-or-worsening-aids-related-progressive-multifocal-leukoencephalopathy-a-literature-review
#20
REVIEW
Anna Fournier, Guillaume Martin-Blondel, Emmanuèle Lechapt-Zalcman, Julia Dina, Apolline Kazemi, Renaud Verdon, Emmanuel Mortier, Arnaud de La Blanchardière
Incidence of progressive multifocal leukoencephalopathy (PML) in HIV-infected patients has declined in the combined antiretroviral therapy (cART) era although a growing number of acquired immunodeficiency syndrome (AIDS)-related PML-immune reconstitution inflammatory syndromes (PML-IRIS) have been published during the same period. Therapeutic management of PML-IRIS is not consensual and mainly relies on corticosteroids. Our main aim was, in addition to provide a thoughtful analysis of published PML-IRIS cases, to assess the benefit of corticosteroids in the management of PML-IRIS, focusing on confirmed cases...
2017: Frontiers in Immunology
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