Antiviral Agents ; administration & dosage ; therapeutic use ; HIV ; HIV Infections ; complications ; Hepacivirus ; Hepatitis B ; complications ; drug therapy ; Hepatitis C ; complications ; Humans ; Superinfection ; drug therapy

Hemophagocytic syndrome (HPS) is an uncommon hematological disorder that manifests as fever, splenomegaly, and jaundice, with hemophagocytosis in the bone marrow and other tissues pathologically. Secondary HPS is associated with malignancy and infection, especially viral infection. The prevalence of cytomegalovirus (CMV) infection in ulcerative colitis (UC) patients is approximately 16%. Nevertheless, HPS in UC superinfected by CMV is very rare. A 52-year-old female visited the hospital complaining of abdominal pain and hematochezia for 6 days. She was diagnosed with UC 3 years earlier and had been treated with sulfasalazine, but had stopped her medication 4 months earlier. On admission, her spleen was enlarged. The peripheral blood count revealed pancytopenia and bone marrow aspiration smears showed hemophagocytosis. Viral studies revealed CMV infection. She was treated successfully with ganciclovir. We report this case with a review of the related literature.
Antiviral Agents/therapeutic use ; Colitis, Ulcerative/*complications/drug therapy ; Cytomegalovirus Infections/*complications/drug therapy ; Female ; Ganciclovir/therapeutic use ; Gastrointestinal Agents/therapeutic use ; Gastrointestinal Hemorrhage/etiology ; Humans ; Lymphohistiocytosis, Hemophagocytic/drug therapy/*virology ; Middle Aged ; Sulfasalazine/therapeutic use ; Superinfection/*complications

OBJECTIVETo investigate the clinical features, CD4+ T and CD8+ T cell counts, HIV RNA load, HCV RNA load, CD8+ T cell responses to HCV of HIV/HCV co-infected and HCV mono-infected patients and to assess the mutual influences of the two viruses in the infection.

METHODSFifty-nine patients with HIV/HCV co-infection were enrolled in this study. Thirty-six patients with HCV mono-infection served as a comparison group. The liver function, peripheral blood CD4+ T and CD8+ T cell counts, HIV RNA load and HCV RNA load were compared between the groups. Peripheral blood mononuclear cells were analyzed by interferon-gamma ELISpot using a panel of HCV antigens.

RESULTSThe frequency of HIV/HCV co-infection in those blood donors in Henan, China was 60.8%. ALT and AST in the HIV/HCV co-infection patients were not different from those of the HCV group. Globulin in the HIV/HCV co-infection group was higher than that in the HCV group (P<0.01). CD4+ T cell counts in the HIV/HCV co-infection group were lower than those in the HCV group, but CD8+ T cell counts in the HIV/HCV co-infection group were higher than those in the HCV group (P<0.01). The HCV RNA loads were higher in the HIV/HCV co-infection group than in the HCV group(P<0.01). The magnitude of HCV-specific CTL response to HCV-NS3 overlapping peptides in the HIV/HCV co-infection group (649.34+/-685.90) was higher than that in the HCV group (1233.70+/-1085.16). Albumin was negatively correlated with HCV RNA (log10copies/ml) in the HIV/HCV co-infection group (r=-0.540). A positive correlation was found between platelet and peripheral blood CD4+ T cell counts (P<0.05). No linear correlation was found between HCV virus loads, HIV virus loads or peripheral blood CD4+ T cell counts.

CONCLUSIONThe frequency of HIV/HCV co-infection in the blood donors in Henan, China was 60.8%. HIV/HCV co-infection aggravated the progress of chronic hepatitis C.

Adult ; CD4 Lymphocyte Count ; Female ; HIV ; HIV Infections ; complications ; diagnosis ; immunology ; virology ; Hepacivirus ; Hepatitis C ; complications ; diagnosis ; immunology ; virology ; Hepatitis C, Chronic ; immunology ; virology ; Humans ; Male ; Middle Aged ; Prognosis ; Superinfection ; diagnosis ; immunology ; T-Lymphocytes, Cytotoxic ; immunology ; Viral Load

In order to investigate the susceptibility of mixed infection of Ureaplasma Urealyticum (UU) and Mycoplasma Hominis (MH) to 7 kinds of antimicrobial agents and comparison with that of UU infection in NGU patients, the in vitro susceptibility was determined by using microdilution method. The positive results were analyzed. The results showed that the sequence of susceptibility to 7 kinds of antimicrobial agents for both UU infection group and UU-MH mixed infection group was almost the same from the highest susceptibility to the lowest accordingly: Josamycin, Doxycycline, Minocycline, Sparfloxacin, Roxithromycin, Ofloxacin and Azithromycin. The total drug resistance rate for UU-MH mixed infection group (97.67%) was significantly higher than that for UU infection group (44.67%, P < 0.01). The highest drug resistance rate in UU group and UU-MH mixed infection group was 31.33% (Ofloxacin) and 90.48% (Azithromycin) respectively. UU-MH mixed infection showed an increased drug resistance and changes of drug resistance spectrum.
Adult ; Anti-Bacterial Agents ; pharmacology ; Azithromycin ; pharmacology ; Doxycycline ; pharmacology ; Drug Resistance, Bacterial ; Female ; Humans ; Josamycin ; pharmacology ; Male ; Middle Aged ; Minocycline ; pharmacology ; Mycoplasma Infections ; complications ; microbiology ; Mycoplasma hominis ; drug effects ; isolation & purification ; Ofloxacin ; pharmacology ; Superinfection ; Ureaplasma Infections ; complications ; microbiology ; Ureaplasma urealyticum ; drug effects ; isolation & purification