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HIV AIDS Neurology

Talia M Nir, Neda Jahanshad, Christopher R K Ching, Ronald A Cohen, Jaroslaw Harezlak, Giovanni Schifitto, Hei Y Lam, Xue Hua, Jianhui Zhong, Tong Zhu, Michael J Taylor, Thomas B Campbell, Eric S Daar, Elyse J Singer, Jeffry R Alger, Paul M Thompson, Bradford A Navia
Growing evidence points to persistent neurological injury in chronic HIV infection. It remains unclear whether chronically HIV-infected individuals on combined antiretroviral therapy (cART) develop progressive brain injury and impaired neurocognitive function despite successful viral suppression and immunological restoration. In a longitudinal neuroimaging study for the HIV Neuroimaging Consortium (HIVNC), we used tensor-based morphometry to map the annual rate of change of regional brain volumes (mean time interval 1...
February 14, 2019: Journal of Neurovirology
Richard Stephen Mpango, Godfrey Zari Rukundo, Sylvia Kiwuwa Muyingo, Kenneth D Gadow, Vikram Patel, Eugene Kinyanda
BACKGROUND: The aim of this study was to determine the prevalence of neurological disorders and their associated correlates and relations with clinical and behavioural problems among children and adolescents with HIV/AIDS (CA-HIV). METHODS: This study involved a sample of 1070 CA-HIV/caregiver dyads who were evaluated at their 6-month follow-up visit as part of their participation in the longitudinal study, 'Mental health among HIV infected CHildren and Adolescents in KAmpala and Masaka, Uganda (the CHAKA study)'...
January 21, 2019: BMC Psychiatry
Andres M Alvarez-Pinzon, Jose E Valerio, Heather N Swedberg, Sammer M Elwasila, Aizik Wolf, Jose Ramon Alonso Pena
A 66-year-old male presented with acute cephalalgia, disorientation, and lethargy. The patient was evaluated in the ER and admitted with probable hydrocephalus. Brain-MRI revealed multiple nonspecific brain lesions, predominantly involving the right temporal lobe, which on biopsy proved a diagnosis of Primary Central Nervous System Lymphoma (PCNSL). Subsequent laboratory studies demonstrated active HIV infection with a CD4 count of 21 cells/ microliter and HIV viral load (VL) of greater than 400,000 copies/milliliter...
January 14, 2019: World Neurosurgery
Davide Fiore Bavaro, A Calamo, L Lepore, C Fabrizio, A Saracino, G Angarano, L Monno
PURPOSE: We aimed to evaluate HIV-1 compartmentalization between the cerebrospinal fluid (CSF) and plasma and investigate as to which extent HIV-1 strains in CSF differ from those in blood and whether a correlation with either plasma viral load (pVL) or an altered blood-brain barrier (BBB) does exist. STUDY DESIGN: We retrospectively evaluated paired CSF/blood samples collected from 86 HIV+ patients. HIV-RNA quantification, pol (PR/RT), and V3 sequencing were performed...
January 16, 2019: Infection
Duaa Z Sakabumi, Raeanne C Moore, Bin Tang, Patrick A Delaney, John R Keltner, Ronald J Ellis
BACKGROUND: Medical comorbidities accumulate in older persons living with HIV (PLWH), causing disability and reduced quality of life. Sensory neuropathy and polypharmacy may contribute to balance difficulties and falls. The contribution of neuropathy is understudied. OBJECTIVE: To evaluate the contribution of chronic distal sensory polyneuropathy (cDSPN) to balance disturbances among PLWH. METHODS: Ambulatory PLWH and HIV- adults (N=3,379) were prospectively studied...
January 3, 2019: Journal of Acquired Immune Deficiency Syndromes: JAIDS
Carole Khaw, Daniel Richardson, Gail Matthews, Tim Read
Patients who are HIV-positive and co-infected with other sexually transmitted infections (STIs) are at risk of increased morbidity and mortality. This is of clinical significance. There has been a dramatic increase in the incidence of STIs, particularly syphilis, gonorrhoea, Mycoplasma genitalium and hepatitis C virus (HCV) in HIV-positive patients. The reasons for this are multifactorial, but contributing factors may include effective treatment for HIV, increased STI testing, use of HIV pre-exposure prophylaxis and use of social media to meet sexual partners...
December 21, 2018: AIDS Research and Therapy
Melissa A Elafros, Joseph C Gardiner, Izukanji Sikazwe, Jason F Okulicz, Nigel Paneth, Elwyn Chomba, Gretchen L Birbeck
Background and purpose: Stigma hinders care for patients with neurologic illness. Layered stigma due to comorbid disease is common yet poorly characterized due to lack of instruments. Epilepsy and HIV are prototypical stigmatized conditions widespread in sub-Saharan Africa. Methods: We assessed layered stigma among people with HIV and epilepsy (n = 21), epilepsy only (n = 88), and HIV only (n = 40) in Zambia. Epilepsy-associated stigma was assessed using the Stigma Scale of Epilepsy and Jacoby's Stigma Scale...
December 2018: ENeurologicalSci
Davide De Francesco, Sebastiaan O Verboeket, Jonathan Underwood, Emmanouil Bagkeris, Ferdinand W Wit, Patrick W G Mallon, Alan Winston, Peter Reiss, Caroline A Sabin
Background: The aims of this study were to identify common patterns of comorbidities observed in people living with HIV (PLWH), using a data-driven approach, and evaluate associations between patterns identified. Methods: A wide range of comorbidities were assessed in PLWH participating in 2 independent cohorts (POPPY: UK/Ireland; AGEh IV: Netherlands). The presence/absence of each comorbidity was determined using a mix of self-reported medical history, concomitant medications, health care resource use, and laboratory parameters...
November 2018: Open Forum Infectious Diseases
Elena Chiappini, Martina Bianconi, Annalisa Dalzini, Maria Raffaella Petrara, Luisa Galli, Carlo Giaquinto, Anita De Rossi
BACKGROUND: Premature aging and related diseases have been documented in HIV-infected adults. Data are now emerging also regarding accelerated aging process in HIV-infected children. METHODS: A narrative review was performed searching studies on PubMed published in English language in 2004-2017, using appropriate key words, including "aging", "children", "HIV", "AIDS", "immunosenescence", "pathogenesis", "clinical conditions"...
November 11, 2018: Aging
Abbas Ali, Abhishek Kalla
Burkitt lymphoma is a late complication of HIV, and bilateral cranial nerve palsies are extremely rare in patients with AIDS. A twenty year old Caucasian male with known congenital HIV who had been non-adherent with anti-retroviral therapy presented with multiple cranial nerve palsies and was eventually diagnosed with Burkitt lymphoma. Before chemotherapy, he was started on radiation therapy to the brain, meninges, and base of skull with the intent of improving cranial nerve palsies and preventing further neurological sequelae since the cranial nerve palsies were dense and there was concern that intrathecal chemotherapy would have less penetration than radiation...
2018: Journal of Community Hospital Internal Medicine Perspectives
Rachel R Atherton, Jayne Ellis, Fiona V Cresswell, Joshua Rhein, David R Boulware
Cryptococcal meningitis is a leading cause of morbidity and mortality among HIV-infected persons, accounting for 15% of AIDS-related deaths. Visual disturbance is commonly reported, and a wide range of ophthalmic signs may be present on examination. There is limited published literature to date describing the range and incidence of ophthalmic signs in HIV-associated cryptococcal meningitis. Nested within the Adjunctive Sertraline for the Treatment of HIV-Associated Cryptococcal Meningitis (ASTRO-CM) trial (ClinicalTrials...
2018: Wellcome Open Research
Asher J Albertson, Alexander R Dietz, John R Younce, Arun S Varadhachary
Here we report the challenging case of a 41-year-old man with HIV complicated by AIDS and a history of prior neurologic injury from progressive multifocal leukoencephalopathy who presented with headache, fevers, lower extremity weakness, hyperreflexic upper extremities, and diminished lower extremity reflexes. We review the clinical decision-making and differential diagnosis for this presentation as the physical examination evolved and diagnostic testing changed over time.
October 2018: Neurohospitalist
Ángel H Álvarez, Moisés Martínez Velázquez, Ernesto Prado Montes de Oca
Human β-defensin 1 (hBD-1) is a multifaceted antimicrobial peptide being a tumour suppressor and, depending on call of duty, capable of inducing self-nets and neutrophil extracellular traps (NETs) to capture and/or kill bacteria, participates in inflammatory responses in chronic diseases including hBD-3 upregulation and also capable of up/downregulation in the presence of certain species of Lactobacillus sp. Thus, is regulated by host microbiota. Alleles, genotypes and/or altered gene expression of its coding gene, DEFB1, have been associated with several human diseases/conditions ranging from metabolic/chronic (e...
November 2018: International Journal of Biochemistry & Cell Biology
Kevin R Robertson, Hongyu Jiang, Johnstone Kumwenda, Khuanchai Supparatpinyo, Christina M Marra, Baiba Berzins, James Hakim, Ned Sacktor, Thomas B Campbell, Jeff Schouten, Katie Mollan, Srikanth Tripathy, Nagalingeswaran Kumarasamy, Alberto La Rosa, Breno Santos, Marcus T Silva, Cecilia Kanyama, Cindy Firhnhaber, Robert Murphy, Colin Hall, Cheryl Marcus, Linda Naini, Reena Masih, Mina C Hosseinipour, Rosie Mngqibisa, Sharlaa Badal-Faesen, Sarah Yosief, Alyssa Vecchio, Apsara Nair
Background: Neurocognitive impairment remains a common complication of HIV despite effective antiretroviral therapy (ART). We previously reported improved neurocognitive functioning with ART initiation in seven resource limited settings (RLS) countries for HIV+ participants from AIDS Clinical Trials Group (ACTG) 5199 (International Neurological Study (INS)). Here we apply normative data from the International Neurocognitive Normative Study (INNS) to INS, to provide previously unknown rates of neurocognitive impairment...
September 13, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Haijun Han, Zhongli Yang, Sulie L Chang, Ming D Li
Nicotine, one of the key active ingredients in tobacco smoke, exerts its effects via binding to nicotinic acetylcholine receptors (nAChRs). Although both negative and positive pharmacological effects of nicotine have been shown in numerous animals and human studies, its interaction with human immunodeficiency virus-1 (HIV-1) have not been fully elucidated. Even though combined anti-retroviral therapy (cART) limits the progression of HIV-1 to acquired immune deficiency syndrome (AIDS), HIV-associated neurocognitive disorders (HAND) remain prevalent...
December 2018: Journal of Neuroimmune Pharmacology: the Official Journal of the Society on NeuroImmune Pharmacology
Mihaja Raberahona, Tiana Razafinambinintsoa, Volatiana Andriananja, Njaratiana Ravololomanana, Juliana Tongavelona, Rado Rakotomalala, Johary Andriamamonjisoa, Radonirina Lazasoa Andrianasolo, Rivonirina Andry Rakotoarivelo, Mamy Jean de Dieu Randria
BACKGROUND: During the last few years, significant efforts have been made to improve access to antiretroviral therapy which led to dramatic reduction in AIDS-related events and mortality in HIV positive patients at the global level. However, current data in Africa suggested modest impact of widespread antiretroviral therapy scale-up especially regarding HIV-related hospitalization. In this study, we aimed to describe causes of hospitalization and factors associated with AIDS-defining events and inpatient mortality...
2018: PloS One
Mvr Ratnam, Abhishek Singh Nayyar, D Santhosh Reddy, B Ruparani, K V Chalapathi, Sania Md Azmi
Context: Acquired immunodeficiency syndrome (AIDS) is an acronym for AIDS caused by a retrovirus known as human immunodeficiency virus (HIV) which breaks down the body's immune system leaving a patient vulnerable to a host of life-threatening opportunistic infections, neurological disorders or unusual malignancies. According to estimates by the World Health Organization and UNAIDS, 35 million people were living with HIV globally at the end of 2013. The first AIDS case in India was detected in 1986...
May 2018: Journal of Oral and Maxillofacial Pathology: JOMFP
K Robertson, B Oladeji, H Jiang, J Kumwenda, K Supparatpinyo, T Campbell, J Hakim, S Tripathy, M Hosseinipour, C M Marra, N Kumarasamy, S Evans, A Vecchio, A La Rosa, B Santos, M T Silva, S Montano, C Kanyama, C Firnhaber, R Price, C Marcus, B Berzins, R Masih, U Lalloo, I Sanne, S Yosief, A Walawander, A Nair, N Sacktor, C Hall
Background: AIDS Clinical Trial Group (ACTG) 5199 compared neurological and neuropsychological (NP) test performance of HIV-1+ participants in resource-limited settings (RLS) treated with three WHO recommended antiretroviral (ART) regimens. We investigated the impact of tuberculosis (TB) on neurological and neuropsychological outcomes. Methods: Standardized neurological and brief NP examinations were administered to participants every 24 weeks. Generalized estimating equation (GEE) models assessed the association between TB with neurological and NP performance...
August 20, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Elena Bruzzesi, Irini Sereti
The introduction of combination antiretroviral therapy (cART) in the 1990s has dramatically changed the course of HIV infection, decreasing the risk for both AIDS- and non-AIDS-related events. Cancers, cardiovascular disease (CVD), liver and kidney disease, neurological disorders and frailty have become of great importance lately in the clinical management as they represent the principal cause of death in people living with HIV who receive cART (Kirk et al. in Clin Infect Dis 45(1):103-10, 2007; Strategies for Management of Antiretroviral Therapy Study et al...
August 14, 2018: Current Topics in Microbiology and Immunology
R B Bassey, S N Chapman, M Pessu, A Jayam-Trouth, M C Gondré-Lewis
Background: Human immunodeficiency virus (HIV) infection remains a serious immunological disease with new infections in the U.S. disproportionately reported in minority populations. For many years, the District of Columbia (DC) has reported the highest HIV infection rate in the nation. Drug abuse and addiction is also prevalent in DC and has traditionally been linked to HIV/AIDS because of the likelihood for opportunistic infections. Despite this data, the relationship between HIV status, drugs of abuse, and the incidence of neurological disorders are scarcely reported for minority populations...
2018: Journal of Neurology and Neuroscience
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