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hiv and liver disease

Zelalem A Mekonnen, Branka Grubor-Bauk, Makutiro G Masavuli, Ashish C Shrestha, Charani Ranasinghe, Rowena A Bull, Andrew R Lloyd, Eric J Gowans, Danushka K Wijesundara
Human immunodeficiency virus (HIV)-1 and hepatitis C virus (HCV) are major contributors to the global disease burden with many experts recognizing the requirement of an effective vaccine to bring a durable end to these viral epidemics. The most promising vaccine candidates that have advanced into pre-clinical models and the clinic to eliminate or provide protection against these chronic viruses are viral vectors [e.g., recombinant cytomegalovirus, Adenovirus, and modified vaccinia Ankara (MVA)]. This raises the question, is there a need to develop DNA vaccines against HIV-1 and HCV? Since the initial study from Wolff and colleagues which showed that DNA represents a vector that can be used to express transgenes durably in vivo , DNA has been regularly evaluated as a vaccine vector albeit with limited success in large animal models and humans...
2019: Frontiers in Cellular and Infection Microbiology
Sebastiano Rizzardo, Massimiliano Lanzafame, Emanuela Lattuada, Damiano Bragantini, Stefano Nicolè, Leonardo Calza, Evelina Tacconelli
Raltegravir (RAL) is an HIV-1 integrase strand transfer inhibitor that is well established as a component of highly active antiretroviral therapy regimens for the treatment of adults living with human immunodeficiency virus (HIV), due to its high virological efficacy and good tolerability profile. To date, limited data are available on the use of RAL with abacavir/lamivudine (ABC/3TC). We investigated retrospectively 62 HIV-1 infected patients managed by three Italian Infectious Diseases Outpatient Departments, including 57 treatment-experienced patients and 5 treatment-naïve patients, treated with ABC/3TC plus RAL...
April 2019: International Journal of STD & AIDS
Jessie Torgersen, Kaku So-Armah, Matthew S Freiberg, Matthew B Goetz, Matthew J Budoff, Joseph K Lim, Tamar Taddei, Adeel A Butt, Maria C Rodriguez-Barradas, Amy C Justice, Jay R Kostman, Vincent Lo Re
BACKGROUND: Hepatic steatosis is prevalent in Western countries, but few studies have evaluated whether the frequency and severity of steatosis are greater in the setting of HIV infection. We compared the prevalence and severity of hepatic steatosis between HIV-infected (HIV+) and uninfected persons and identified factors associated with greater steatosis severity within both groups. METHODS: We performed a cross-sectional study among participants without cardiovascular disease who participated in a substudy of the Veterans Aging Cohort Study...
April 15, 2019: BMC Gastroenterology
Megan B Cole, Omar Galárraga, Momotazur Rahman, Ira B Wilson
Background: As antiretroviral therapy has become more effective, persons with HIV live longer and develop conditions that are characteristic of older populations. Understanding changes in comorbid conditions has important implications for the complexity and cost of care, particularly for Medicaid programs and their enrollees, which comprise about 40% of all persons with HIV. Thus, our objective was to examine trends in comorbid conditions for Medicaid enrollees with HIV. Methods: Using 2001-2012 administrative claims data from the 14 states (NY, CA, FL, TX, MD, NJ, PA, IL, GA, NC, VA, LA, OH, MA) with the highest HIV prevalence, we identified 494 322 unique Medicaid enrollees with HIV, representing 5...
April 2019: Open Forum Infectious Diseases
P Vidal-Cortés, L A Álvarez-Rocha, P Fernández-Ugidos, M A Pérez-Veloso, I M Suárez-Paul, A Virgós-Pedreira, S Pértega-Díaz, Á C Castro-Iglesias
PURPOSE: To describe the epidemiology of critical disease in HIV-infected patients during the current highly active antiretroviral therapy (HAART) era and to identify hospital mortality predictors. METHODS: A longitudinal, retrospective observational study was made of HIV-infected adults admitted to the ICU in two Spanish hospitals between 1 January 2000 and 31 December 2014. Demographic and HIV-related variables were analyzed, together with comorbidities, severity scores, reasons for admission and need for organ support...
April 7, 2019: Medicina Intensiva
Mamta K Jain, Nicole E Rich, Chul Ahn, Barbara J Turner, Joanne M Sanders, Brian Adamson, Lisa Quirk, Patrice Perryman, Noel O Santini, Amit G Singal
BACKGROUND: Hepatitis C virus (HCV) testing in persons born from 1945 to 1965 has had limited adoption despite guidelines, particularly among racial/ethnic minorities and socioeconomically disadvantaged patients, who have a higher prevalence of disease burden. We examined the effectiveness of a multifaceted intervention to improve HCV screening in a large safety-net health system. METHODS: We performed a multifaceted intervention that included provider and patient education, an EMR-enabled best practice alert, and increased HCV treatment capacity...
April 4, 2019: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
Marcela Osovská, Andrea Janíková, Leoš Křen, Andrea Marečková
Chronic benign CD8+ proliferation is a rare syndrome that can take the form of a variety of other diseases. Peripheral adenopathy, cytopenia, and infiltration of the liver, kidneys, bowels, or other organs are the most common clinical presentations of the syndrome. CD8+ expansion can be clonal and nonclonal. It generally occurs in patients with innate or acquired immunodeficiency (HIV+) or in patients receiving immunosuppressive therapy. It has been found repeatedly in patients who developed severe hypogammaglobulinemia after treatment with rituximab...
2019: Case Reports in Hematology
Seyed Mohammad Ali Hashemi, Jamal Sarvari, Mohammad Reza Fattahi, Razieh Dowran, Amin Ramezani, Seyed Younes Hosseini
Aim: The purpose of this study was to evaluate the expression level of Interferon-stimulated Gene 15 (ISG15), Interleukin28B (IL28B) or IFN-lambda-3 and Ubiquitin specific peptidase 18 (USP18) genes in Peripheral Blood Mononuclear Cells (PBMCs) of patients with chronic active and inactive hepatitis B in comparison with healthy individuals. Background: Despite the presence of the vaccine for hepatitis B virus (HBV), it remains a public health challenge. The effort to uncover the immune genes attributed to infection outcome is going through...
2019: Gastroenterology and Hepatology From Bed to Bench
Katerina G Oikonomou, Eugenia Tsai, Dost Sarpel, Douglas T Dieterich
Liver disease in human immunodeficiency virus (HIV) remains a main cause of morbidity and mortality. Liver-related morbidity and mortality can be caused by multiple etiologic factors, including opportunistic infections, direct and indirect effects of antiretrovirals, direct and indirect effects of HIV, and viral hepatitides. These factors present with varied liver pathophysiologic mechanisms that lead to abnormalities in liver enzymes and synthetic function test, followed by distinct clinical presentations...
May 2019: Clinics in Liver Disease
Sapna S Humar, Jingqian Liu, Natalia Pinzon, Deepali Kumar, Mamatha Bhat, Les Lilly, Nazia Selzner
BACKGROUND: Increased Risk Donors (IRDs) are a significant proportion of the deceased organ donor pool but may be declined by patients on the liver transplant waiting list due to various factors. We conducted a survey of patients with end-stage liver disease awaiting a liver transplant in order to determine the factors leading to the acceptance of an IRD organ, and what strategies we could use to better inform and increase this rate of acceptance. METHODS: Adult liver transplant candidates who were outpatients completed a survey consisting of 51 questions on a 5-point Likert scale, with categories related to demographics, knowledge of IRDs, and likelihood of acceptance...
April 4, 2019: Liver Transplantation
Nadine Kronfli, Sahir R Bhatnagar, Mark W Hull, Erica E M Moodie, Joseph Cox, Sharon Walmsley, John Gill, Curtis Cooper, Valérie Martel-Laferrière, Neora Pick, Marina B Klein
OBJECTIVE: Hepatitis C virus (HCV) treatment may reduce liver-related mortality but with competing risks, other causes of mortality may undermine benefits. We examined changes in cause-specific mortality among HIV-HCV coinfected patients before and after scale-up of HCV treatment. DESIGN: Prospective multicentre HIV-HCV cohort study in Canada. METHODS: Cause-specific deaths, classified using a modified 'Coding of Cause of Death in HIV' protocol, were determined for two time periods, 2003-2012 and 2013-2017, stratified by age (20-49; 50-80 years)...
May 1, 2019: AIDS
Fengxiang Qin, Junjun Jiang, Chunwei Qin, Yunxuan Huang, Bingyu Liang, Yuexiang Xu, Jiegang Huang, Zhiliang Xu, Chuanyi Ning, Yanyan Liao, Ning Zang, Jingzhen Lai, Wudi Wei, Jun Yu, Li Ye, Xionglin Qin, Hao Liang
OBJECTIVE: To characterise the association between duration of exposure to antiretroviral treatment (ART) and liver damage in HIV patients with an initially normal baseline liver function and without hepatitis B virus (HBV)/hepatitis C virus (HCV) infection. METHODS: A retrospective cohort study was conducted in HIV-infected individuals with normal liver function parameters at ART initiation and without HBV/HCV infection, from 14 April 2004 to 13 April 2015 in Guigang city, Guangxi, China...
April 2, 2019: BMJ Open
L Taramasso, F Liggieri, G Cenderello, F Bovis, B Giannini, A Mesini, M Giacomini, G Cassola, C Viscoli, A Di Biagio
Retrospective multicentre study aiming at analysing the etiology, characteristics and outcome of bloodstream infections (BSI) in people living with HIV (PLWHIV) in an era of modern antiretroviral therapy. Between 2008 and 2015, 79 PLWHIV had at least 1 BSI, for a total of 119 pathogens isolated. Patients were mainly male (72.1%), previous intravenous drug users (55.7%), co-infected with HCV or HBV (58.2%) and in CDC stage C (60.8%). Gram-positive (G+) pathogens caused 44.5% of BSI, followed by Gram-negative (G-), 40...
April 1, 2019: Scientific Reports
Shukaib Arslan, Mark R Litzow, Nathan W Cummins, Stacey A Rizza, Andrew D Badley, Willis Navarro, Shahrukh K Hashmi
Allogeneic hematopoietic cell transplantation (allo-HCT) is a potentially curative therapy for hematologic malignancies in persons living with HIV (PLHIV), however, uncertainties exist in many domains related to their care, including optimal donor selection, conditioning regimen, immunosuppression for graft-versus-host disease (GVHD), and long-term outcomes. We undertook a comprehensive systematic review from multiple databases to evaluate the foregoing uncertainties. The final sample comprised 49 patients (median age at HCT, 34 years; 46 males [93...
March 26, 2019: Biology of Blood and Marrow Transplantation
Saurabh Dawra, Harshal S Mandavdhare, Harjeet Singh, Kaushal K Prasad, Usha Dutta, Vishal Sharma
Aim of the study: Incidence and predictors of antitubercular therapy (ATT)-related hepatitis in abdominal tuberculosis are not known. The aim of the study was to identify the incidence and predictors of ATT-induced hepatitis in abdominal tuberculosis. Material and methods: A retrospective analysis of patients who received ATT for suspected abdominal tuberculosis with complete follow-up was done. We excluded patients with underlying chronic or acute liver disease necessitating an alteration in the usual ATT at start...
March 2019: Clinical and Experimental Hepatology
Anna-Barbara Moscicki, Lisa Flowers, Megan J Huchko, Margaret E Long, Kathy L MacLaughlin, Jeanne Murphy, Lisa Beth Spiryda, Michael A Gold
EXECUTIVE SUMMARY: The risk of cervical cancer (CC) among women immunosuppressed for a variety of reasons is well documented in the literature. Although there is improved organ function, quality of life and life expectancy gained through use of immunosuppressant therapy, there may be increased long-term risk of cervical neoplasia and cancer and the need for more intense screening, surveillance, and management. Although guidance for CC screening among HIV-infected women (see Table 1) has been supported by evidence from retrospective and prospective studies, recommendations for CC screening among non-HIV immunosuppressed women remains limited because quality evidence is lacking...
April 2019: Journal of Lower Genital Tract Disease
Carlos Esteban Coronel-Castillo, Xingshun Qi, Jocelyn Contreras-Carmona, Oscar Lenin Ramirez-Perez, Nahum Mendez-Sanchez
With the successes of antiretroviral therapy, patients infected with human immunodeficiency virus (HIV) living longer. Regarding this, the common diseases of HIV population (i.e., opportunistic infections) are now losing ground in front of metabolic alterations. This phenomenon is related to the delay in progression to acquired immune deficiency syndrome (AIDS), making it so that patients live in a chronic inflammatory state which, combined with other mechanisms such infectious ones, cause metabolic diseases...
March 23, 2019: Expert Review of Gastroenterology & Hepatology
Ruth Simmons, Georgina Ireland, Samreen Ijaz, Mary Ramsay, Sema Mandal
Through record linkage we describe causes of death among persons with diagnosis of HCV in England. Persons ≥1yrs with anti-HCV/HCV-PCR tests reported to PHE sentinel surveillance during 2002-2016 were linked to death registrations from the Office for National Statistics during 2008-2016. We fouind that 8.6% of the 204,265 with evidence of HCV during the study period died. Among them, external causes (accidental poisoning from drugs) and liver disease (end stage liver disease, liver cancer, hepatitis, alcohol and non-alcohol related) were the leading underlying causes of death (18% and 34...
March 21, 2019: Journal of Viral Hepatitis
Leticia Lemos Jardim, Johanna G van der Bom, Camila Caram-Deelder, Samantha Claudia Gouw, Mariangela Leal Cherchiglia, Suely Meireles Rezende
INTRODUCTION: Brazil has the fourth largest world population of patients with haemophilia. However, mortality rates in this population are unknown. AIM: To analyse mortality and its causes in Brazilian patients with haemophilia from 2000 to 2014. METHODS: The number of deceased patients with haemophilia and causes of death were obtained from the Brazilian National Mortality Information System (SIM), according to the 10th International Classification of Diseases (ICD-10)...
March 15, 2019: Haemophilia: the Official Journal of the World Federation of Hemophilia
Ricardo Andrade Carmo, Marina Lobato Martins, Daniel Gonçalves Chaves, Lorenza Nogueira Campos Dezanet
People with haemophilia represent a population with a high prevalence of HCV infection due to the use of blood components and plasma-derived clotting factor concentrates before the introduction of viral-inactivating procedures (in the 1980s) and screening for HCV (in the 1990s). About 80% of HCV-infected patients have chronic HCV infection, and at least 20% develop end-stage liver disease. The aim of the study was to assess current anti-HCV positivity in a large cohort of Brazilian haemophilia patients and to determine associated factors with HCV exposure...
March 13, 2019: Haemophilia: the Official Journal of the World Federation of Hemophilia
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