Acquired Immunodeficiency Syndrome ; microbiology ; Female ; Humans ; Mycoses ; diagnosis ; Young Adult

OBJECTIVETo study the influence of Candida albicans on human immunodeficiency virus (HIV)-positive individuals susceptible to oral candidiasis.

METHODSIn vitro secreted aspartyl proteinase activities, adhesion to healthy buccal epithelial cells of Candida albicans isolates from oral cavities of subjects with and without HIV infection were measured.

RESULTSThe pathogenetic isolates of Candida albicans from HIV-positive patients were significantly lower than that from HIV-negative subjects (P < 0.01) in secreted aspartyl proteinase activities and adhesion to buccal epithelial cells. There was no difference in commensals between these two groups. In the HIV-positive group, no difference was found between the pathogenetics and the commensals. However, in the HIV-negative group, the virulence of the pathogen was significantly higher than the commensals (P < 0.01).

CONCLUSIONSThese results indicate that oral candidiasis was not correlated with some predominant strains of Candida albicans with higher virulence in HIV-positive subjects.

Acquired Immunodeficiency Syndrome ; microbiology ; Candida albicans ; pathogenicity ; Candidiasis, Oral ; microbiology ; HIV Seropositivity ; microbiology ; Humans

AIDS-Related Opportunistic Infections ; complications ; microbiology ; Acquired Immunodeficiency Syndrome ; complications ; microbiology ; Adult ; Humans ; Male ; Penicillium ; pathogenicity ; Pharyngeal Neoplasms ; complications ; microbiology ; Pharynx ; microbiology ; pathology

BACKGROUNDPenicillium marneffei (P. marneffei) is an emerging pathogenic fungus that can cause invasive mycosis in patients with AIDS. The epidemiological features of P. marneffei infection in AIDS patients in Guangdong province remain unclear so far. This study aimed to investigate the genetic diversity within a population of 163 P. marneffei isolates obtained from AIDS patients and search for the dominant clinical strains in Guangdong province.

METHODSOne hundred and sixty-three P. marneffei isolates obtained from AIDS patients in Guangdong province during January 2004 and December 2009 were studied by randomly amplified polymorphic DNA (RAPD) using two random primers (H2 and H22). The degree of similarity between samples was calculated through similarity coefficients from RAPD fragment data and the dendrogram was assessed using the unweighted pair group method with arithmetic mean (UPGMA).

RESULTSTwo primers showed a high degree of discrimination and good stability. Primer H2 yielded eight different patterns (H2-1 to H2-8) among 163 isolates with the discriminatory power being 0.413. Primer H22 identified seven types (H22-1 to H22-7) among 163 isolates with the discriminatory power being 0.467. Genetic similarity coefficients based on RAPD data among 163 P. marneffei isolates ranged from 0.681 to 0.957, 61.96% of which were no less than 0.83. The discriminatory power of the two primers was 0.524. One hundred and sixty-three P. marneffei isolates were clustered into nine distinct groups (groups I to IX) at the similarity coefficient value of 0.83 and group I was the most common, including 101 strains (61.96%).

CONCLUSIONThe RAPD analyses could provide important information as to the degree of genetic diversity and the relationship among clinical P. marneffei isolates, revealing genetic polymorphism and dominant strains.

Acquired Immunodeficiency Syndrome ; microbiology ; Genetic Variation ; genetics ; Humans ; Penicillium ; classification ; genetics ; Random Amplified Polymorphic DNA Technique ; methods

BACKGROUNDCandidal esophagitis is the primary infection among all digestive tract opportunistic ones in acquired immunodeficiency syndrome (AIDS) cases. X-ray manifestation reports of it are still rare. This study aimed to conduct a retrospective analysis on the X-ray data of 6 AIDS cases complicated with candidal esophagitis, and to study the X-ray characteristics of it combined with the findings from gastroscopy.

METHODSAmong 6 cases in this series, all cases were confirmed by Shenzhen Center for Disease Control and Prevention (CDC) to be HIV positive and all of them had CD4 cell counts less than 150 × 10(6)/L. All cases underwent X-ray and gastroscopy, and mycelium were found in the mucous membrane of the esophagus.

RESULTSIn this series, the findings of the X-ray were as follows: (1) Affected areas: Four cases in the whole esophagus, 2 cases in the middle and lower part of esophagus; (2) Abnormal motivity: Six cases had decreased tension, loose walls, weakened peristalsis, decreased number of peristalsis waves and delayed emptying of barium; (3) Abnormal contour: Six cases had the sign of "decorative border" or "brush", two cases had narrowed canal; (4) Abnormal membrane and "cobblestone sign": Six cases had thickened membrane and "cobblestone sign" on the surface of the abnormal membrane. The hyperemia of mucosa was covered tightly with yellow-white pseudomembrane spots. This was in accordance with the small cobblestone-like filling defect found by X-ray.

CONCLUSIONSIf the AIDS cases have dysphagia, and X-ray shows that more than two sections of the esophagus are affected, with decreased motility, the walls in the sign of "brush" or "decorative edges", thickened membrane with "cobblestone sign", candidal esophagitis is highly possible.

Acquired Immunodeficiency Syndrome ; diagnosis ; diagnostic imaging ; Adult ; Candida ; pathogenicity ; Candidiasis ; diagnosis ; diagnostic imaging ; microbiology ; Esophagitis ; diagnosis ; diagnostic imaging ; microbiology ; Female ; Humans ; Male ; Radiography

OBJECTIVE: In this study, we investigated the changes in peripheral blood inflammatory factors and intestinal flora in acquired immune deficiency syndrome (AIDS) and human immunodeficiency virus (HIV)-positive individuals (AIDS/HIV patients), and explored the relationships among intestinal flora, peripheral blood inflammatory factors, and CD4+ T lymphocytes. METHODS: Thirty blood and stool samples from an AIDS group and a control group were collected. The levels of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) were determined by enzyme-linked immunosorbent assay (ELISA), and the number of CD4+ T lymphocytes by a FACSCount automated instrument. Quantitative real-time polymerase chain reaction (qRT-PCR) was used to determine the messenger RNA (mRNA) levels of Bifidobacterium, Lactobacillus, Escherichia coli, Enterococcus faecalis, and Enterococcus faecium. Correlations among intestinal flora, inflammatory factor levels, and CD4+ T lymphocyte values were evaluated using the Spearman correlation coefficient. RESULTS: The levels of TNF-α and IL-6 in the AIDS group were higher than those in the control group, while the number of CD4+ T lymphocytes was lower. The amounts of Bifidobacterium and Lactobacillus in the AIDS group were significantly lower than those in control group, while the amounts of E. coli, E. faecalis, and E. faecium were much higher. The amounts of Bifidobacterium and Lactobacillus were negatively correlated with the content of TNF-α and IL-6 and the CD4+ T lymphocyte count, while those correlations were reversed for E. coli, E. faecalis, and E. faecium. CONCLUSIONS The intestinal microbiota of AIDS/HIV patients were disordered, and there was a correlation between the amount of intestinal flora and the number of CD4+ T lymphocytes and the levels of TNF-α and IL-6.
Acquired Immunodeficiency Syndrome/microbiology* ; Adult ; Aged ; CD4 Lymphocyte Count ; Female ; Gastrointestinal Microbiome ; HIV Infections/microbiology* ; Humans ; Interleukin-6/blood* ; Male ; Middle Aged ; Tumor Necrosis Factor-alpha/blood*

Histoplasmosis is a very rare disease in Korea. Clinical manifestations are very similar to those of tuberculosis. This is the first case report of combined disseminated histoplasmosis and tuberculosis in a patient with HIV infection in Korea. A 42-year-old Korean with Acquired Immunodeficiency Syndrome (AIDS) was diagnosed with tuberculosis. He had lived in Guatemala for the past five years. Upon diagnosis of disseminated tuberculosis with HIV infection, he was treated with anti-tuberculosis medications and anti-retroviral agents. Fever, weakness, hepatosplenomegaly and pancytopenia were persistent despite treatment. The patient's history of living in Guatemala caused us to seek opportunistic infectious organisms other than tuberculosis. Bone marrow aspiration and biopsy were performed and the result revealed numerous intracellular organisms consistent with Histoplasma capsulatum; therefore, the diagnosis of disseminated histoplasmosis was made.
AIDS-Related Opportunistic Infections/microbiology ; Acquired Immunodeficiency Syndrome/complications/pathology ; Adult ; Bone Marrow/microbiology/pathology ; HIV Infections/*complications/drug therapy ; Histoplasma/isolation & purification ; Histoplasmosis/complications/*diagnosis/microbiology ; Humans ; Male ; Thorax/microbiology/pathology/radionuclide imaging ; Tuberculosis/complications/*diagnosis

OBJECTIVETo analyze Helicobacter pylori infection in the gastric mucosa of patients with HIV/AIDS in different clinical stages.

METHODSThis study involved 170 patients with HIV/AIDS and 34 HIV-negative patients. All the patients underwent upper endoscopy and antral gastric biopsy to determine the status of Helicobacter pylori infection using aniline red staining and rapid urease test. The patients with HIV/AIDS were stratified based on CD4(+)T lymphocyte counts and clinical setting into asymptomatic HIV infection (A1, A2) group, symptomatic HIV infection (B1, B2) group and AIDS (A3, B3, C1-3) group.

RESULTSThe prevalence of Helicobacter pylori infection in HIV/AIDS patients was 16.5% (28/170), and in the 3 groups classified, the infection rates were 23.4% (11/47), 14.0% (8/57), and 13.6% (9/66), respectively; the infection rate was 47.1% (16/34) in the control group. Helicobacter pylori infection rate in the gastric mucosa of the patients with HIV/AIDS in different clinical stages was significantly lower than that of the control group (P<0.05); the infection rates in symptomatic HIV-infected (B1, B2) group and AIDS (A3, B3, C1-3) group were significantly lower than that in asymptomatic HIV-infected (A1, A2) group (P<0.05).

CONCLUSIONThe low Helicobacter pylori infection rate in HIV/AIDS patients may result from severe immunodeficiency in the gastric mucosa.

AIDS-Related Opportunistic Infections ; microbiology ; pathology ; Acquired Immunodeficiency Syndrome ; microbiology ; pathology ; Adult ; Female ; Gastric Mucosa ; microbiology ; Gastroscopy ; HIV Infections ; microbiology ; pathology ; Helicobacter Infections ; epidemiology ; pathology ; Helicobacter pylori ; Humans ; Male ; Middle Aged

AIDS-Related Opportunistic Infections ; diagnosis ; microbiology ; Acquired Immunodeficiency Syndrome ; diagnosis ; microbiology ; Bronchoalveolar Lavage Fluid ; microbiology ; Female ; Humans ; Immunohistochemistry ; Male ; Methenamine ; Pneumocystis carinii ; isolation & purification ; Pneumonia, Pneumocystis ; diagnosis ; microbiology ; Polymerase Chain Reaction ; Silver Staining ; methods

BACKGROUNDT-SPOT.TB is a novel test for tuberculosis infection with higher sensitivity and specificity than the traditional tuberculin skin test (TST). However, there are no longitudinal data in the literature evaluating T-SPOT.TB for Mycobacterium tuberculosis in patients with acquired immune deficiency syndrome (AIDS) on highly active antiretroviral therapy (HAART). The objective of this study was to assess the value of T-SPOT.TB longitudinally in AIDS patients on HAART without prophylaxis for tuberculosis.

METHODSA prospective observational study was conducted in 50 AIDS patients on HAART. None of the subjects had evidence of active tuberculosis. T-SPOT.TB, a T-cell-based interferon gamma released assay, was performed at the onset of the study and repeated 24 months thereafter. Subjects were evaluated every 6 months during the 36-month follow-up.

RESULTSTwenty-one (42%) AIDS patients on HAART tested positive by T-SPOT.TB (95%CI 28.3% - 55.7%). The pooled spot-forming cells of early secretory antigenic target-6 (ESAT-6) and culture filtrate protein-10 (CFP-10) peptides were 68/million peripheral blood mononuclear cell (PBMC) (interquartile range 44 - 220). The average number of CD4 cells in subjects was (305 +/- 152) cells/microl, and there was no significant difference in T-SPOT.TB response rates between subjects with CD4 cell counts < 200 cells/microl (7/15 (46.7%), 95%CI 21.5% - 71.9%) and those with CD4 cell counts >/= 200 cells/microl (14/35 (40.0%), 95%CI 23.8% - 56.2%, P = 0.662). In the 32 subjects who completed the 24-month follow-up, 10 underwent T-SPOT.TB reversion, one had T-SPOT.TB conversion, six remained positive and 15 remained negative. None of them advanced to active tuberculosis during the 36-month follow-up.

CONCLUSIONThe inactive status of tuberculosis infection may be maintained for a long period in AIDS patients on HAART.

Acquired Immunodeficiency Syndrome ; drug therapy ; immunology ; microbiology ; Adult ; Antiretroviral Therapy, Highly Active ; Female ; Humans ; Interferon-gamma ; secretion ; Male ; Middle Aged ; Mycobacterium tuberculosis ; pathogenicity ; Prospective Studies ; Tuberculosis ; diagnosis ; immunology