Immunodefiency

Invasive aspergillosis is an important cause of morbidity and mortality in immunocompromised patients. Among primary immunodefiencies, chronic granulomatous disease (CGD) has the highest prevalence of invasive fungal diseases. Voriconazole is recommended for the primary treatment of invasive aspergillosis in most patients. In patients whose aspergillosis is refractory to voriconazole, therapeutic options include changing class of antifungal, for example using an amphotericin B formulation, an echinocandin, combination therapy, or further use of azoles...

BACKGROUND: Tuberculosis (TB), a dreadful disease known to mankind continues to be a problem in a developing country like India. The incidence of people getting infected with TB is on the rise due to compounding factors like coinfection with the human immunodefiency virus and multidrug-resistant strains. There is a definitive need for early diagnosis and treatment of TB to curb transmission of the infection. Direct smear microscopy, though cheap and rapid, lacks sensitivity. Isolation of Mycobacterium tuberculosis in culture requires a long time, because of which there is a need for a rapid method which has good sensitivity and specificity for the detection of M...

Mother-to-child transmission (MTCT) of human immunodefi ciency virus (HIV) is a devastating consequence of HIV infection during pregnancy and is largely preventable. Evidence-based interventions such as universal antenatal screening, provision of antiretroviral therapy, delivery by elective caesarean section and avoidance of breastfeeding have ensured that the rates of MTCT remain low in Malaysia. This review discusses the most recent advances in the management of HIV infection in pregnancy with emphasis on antiretroviral treatment strategies and obstetric care in a middle income country...

INTRODUCTION: Highly active antiretroviral therapy (HAART) has greatly changed the epidemiology of human immunodefi ciency virus (HIV) mortality. The aim of this study is to compare the causes of death and factors associated with early death in HIV-infected persons in the pre- and peri-highly active antiretroviral therapy (HAART) periods. MATERIALS AND METHODS: We conducted a retrospective review of 483 HIV-infected persons who were diagnosed with HIV from 1985 to 2000, and had died within 5 years of the diagnosis...

Ascorbic acid has been shown to kill various cancer cell lines at pharmacologic concentrations. We found that Epstein-Barr virus (EBV)-positive Burkitt lymphoma (BL) cells were more susceptible to ascorbic acid-induced cell killing than EBV-negative BL cells or EBV-transformed lymphoblastoid cells (LCLs). Ascorbic acid did not induce apoptosis in any of the tested cells but did induce the production of reactive oxygen species and cell death. Previously, we showed that bortezomib, a proteasome inhibitor, induces cell death in LCLs and EBV-positive BL cells...

CONTEXT: More than 1000 children are newly infected with Human immunodefi ciency virus (HIV) every day, and of these more than half will die as a result of AIDS due to lack of access to HIV treatment. HIV disease varies considerably in children. Among those infected prenatally, some experience few or no symptoms for years, whereas in others the disease progresses rapidly. The risk factors that influence the development of such oral manifestations include, low CD4+ T cell count, xerostomia and lack of highly active antiretroviral therapy (HAART)...

OBJECTIVE: To determine the degree of compliance with Transport Canada's Transportation of Dangerous Goods Regulations for transporting infectious substances in Canada. DESIGN: A three-phase study including observation of packages arriving at the British Columbia Centre for Disease Control (BCCDC) provincial laboratory; observation of requested samples of either an Escherichia coli culture or serum, not human immunodeficiency virus (HIV) or HbsAg positive, from laboratories; and a questionnaire concerning training and certification of packers in laboratories...

BACKGROUND: There has been considerable escalation in the incidence of HIV infection in Papua New Guinea since the first cases have been reported in 1987. OBJECTIVES: The study was to identify the genetic subtype in HIV infected patients in Papua New Guinea. It is believed that the result will not only assist in tracing and tracking the sources of the infection, but will also help to evaluate the impact of the genotypes on the natural history of HIV in Papua New Guinea...

Lentiviral Nef proteins have multiple functions and are important for viral pathogenesis. Recently, Nef proteins from many simian immunodefiency viruses were shown to antagonize a cellular antiviral protein, named Tetherin, that blocks release of viral particles from the cell surface. However, the mechanism by which Nef antagonizes Tetherin is unknown. Here, using related Nef proteins that differ in their ability to antagonize Tetherin, we identify three amino-acids in the C-terminal domain of Nef that are critical specifically for its ability to antagonize Tetherin...

Splenic lesions due to tuberculosis are extremely rare in immunocompetent indi-viduals and delays in diagnosis are frequent. Here, we describe a 49-year-woman presenting with pyrexia-of-unknown origin with no evidence of any immunodefi-ciency. Computed tomography of the abdomen showed an enlarged spleen having multiple small focal hypodense lesions; the later were confirmed to be of tubercu-lous etiology on histopathological examination. She had favorable response with anti-tubercular chemotherapy. We report this case of tuberculosis spleen in an im-munocompetent individual for its rarity and to highlight the fact that these patients can be managed by medical treatment effectively...

BACKGROUND: Injection drug users (IDUs) are at risk for acquiring human immunodefiency virus (HIV) and hepatitis C virus (HCV) via parenteral and sexual transmission. We determined the seroprevalence and correlates of HIV and HCV for IDUs recruited in Edmonton, Alberta. METHODS: Edmonton was one site of a multi-site, national survey (I-Track Study). From April to June 2005, IDUs were recruited and administered a questionnaire collecting information on demographics, drug use, sexual behaviours, and HIV/HCV testing behaviours...

Patients with hepatitis C virus (HCV) infection develop a number of hematologic disorders, with benign and malignant B-cell proliferations being the most common. HCV-infected patients are also prone to developing peripheral cytopenias, the etiologies of which are multifactorial and include hypersplenism and/or antiviral medications. Some of these patients may undergo bone marrow biopsy but no study has systematically recorded the bone marrow findings in this patient group. Here, we report on the range of bone marrow findings in 47 adult HCV-infected patients...

Human immunodefi ciency virus type-1 integrase (IN) is a new and novel target for inhibitors. Strand transfer inhibitors effectively prevent concerted integration of viral DNA by IN into the host chromosomes. Raltegravir is the fi rst approved strand transfer inhibitor for the treatment of HIV-1/AIDS. We propose a mechanistic hypothesis as to "when and where" these inhibitors are active in virus-infected cells. Using native agarose gel electrophoresis, we identified a transient synaptic complex (SC) wherein IN non-covalently juxtaposes two viral DNA ends...

This case-control study examines whether chronic diarrhea at initiation of antiretroviral therapy (ART) affects survival of human immunodefiency virus-infected patients. Cases (288) were treatment-naive, non-pregnant, adults with self report of frequent loose stool for > 3 weeks at the time ART was initiated. One-third of patients had an enteric pathogen identified including Cryptosporidium spp., Giardia spp., Isospora belli, Cyclospora cayetanensis, and Entamoeba histolytica. Control patients (400) did not have diarrhea when initiating ART...

The development of antiretroviral therapy has led to a major reduction in human immunodeficiency virus (HIV)-related mortality. There are now six antiretroviral drug classes, with more than 20 unique antiretroviral drugs. However, HIV drug resistance occurs with all antiretroviral agents. Drug resistance can affect the response to antiretroviral therapy and is associated with increased mortality. The emergence of resistance in persons on antiretroviral therapy and the transmission of drug-resistant HIV strains to newly infected persons are now major public health concerns...

INTRODUCTION: Healthcare workers (HCWs) are at substantial risk of acquiring blood-borne infections through contact with body fluids of patients. The main objectives of this study were to determine the epidemiological characteristics and risk factors of the occupational exposures to body fluids. METHODS: This cross-sectional study was conducted from December 2004 to June 2005 among HCWs from three University hospitals in Tehran, Iran, who had the potential for high risk exposures during the year preceding the study...

BACKGROUND: Recently there has been an increasing interest and appreciation for the gut as both a viral reservoir as well as an important host-pathogen interface in human immunodefiency virus type 1 (HIV-1) infection. The gut associated lymphoid tissue (GALT) is the largest lymphoid organ infected by HIV-1. In this study we examined if different HIV-1 quasispecies are found in different parts of the gut of HIV-1 infected individuals. RESULTS: Gut biopsies (esophagus, stomach, duodenum and colorectum) were obtained from eight HIV-1 infected preHAART (highly active antiretroviral therapy) patients...

Clostridium perfringens (C. perfringens) has been developed as a potential oral delivery vehicle to deliver antigens or therapeutic compounds to Gut-Associated Lymphoid Tissue (GALT). However, this recombinant C. perfringens carries a plasmid-encoded expression system, which raises several safety concerns regarding possible horizontal plasmid transfer and spread of plasmid-associated antibiotic resistant genes. Furthermore, this bacterium produces the extracellular theta toxin, which poses a potential safety issue for general administration...

In this study, Malawian midwives' perceptions of occupational risk of human immunodefiency virus (HIV) infection are described. Knowledge of perceptions of HIV risk in developing countries and consequences on patient care is limited. A qualitative approach using purposive sampling was undertaken with 7 midwives. Participants considered their occupational risk to be high, encompassing these four themes: exposure to body fluids, availability of resources, hand washing practices, and support from management. Additional themes related to the impact of high risk on clinical practice: working in a climate of fear, refraining from touch, loss of interest in midwifery, and improvising care practices...

OBJECTIVE: We sought to project the lifetime cost of medical care for human immunodefiency virus (HIV)-infected adults using current antiretroviral therapy (ART) standards. METHODS: Medical visits and hospitalizations for any reason were from the HIV Research Network, a consortium of high-volume HIV primary care sites. HIV treatment drug regimen efficacies were from clinical guidelines and published sources; data on other drugs used were not available. In a computer simulation model, we projected HIV medical care costs in 2004 U...