Here we reported a Chinese case of bilateral peripheral facial paralysis (PFP) in human immunodeficiency virusc (HIV) infected population. A 38-year-old homosexual male patient was referred to our hospital for bilateral facial paralysis. 21 days prior to admission he had developed high fever, chills, headache, fatigue, general malaise, nausea and vomiting. Neurological examination revealed bilateral ptosis of lower lip and cheeks, as well as failure of bilateral eyes closure. Analysis of cerebrospinal fluid (CSF) revealed pleocytosis, a marked rise of micro total protein and a marked rise of intrathecal lgG synthesis. The result of HIV-1 serology was positive by ELISA and that was confirmed by western blot. His CD4 cell count was 180 cells/mm . HIV-1 viral load in CSF was almost 10 times higher than that in plasma. The patient's condition improved steadily and experienced complete resolution of bilateral PFP after 2 months.
Adult ; Facial Paralysis ; blood ; pathology ; physiopathology ; HIV Infections ; blood ; pathology ; physiopathology ; HIV-1 ; Humans ; Male ; Meningitis ; blood ; pathology ; physiopathology

OBJECTIVETo assess changes of liver function in HIV-positive children with/without HBV/ HCV co-infection after 1 year of highly active antiretroviral therapy (HARRT).

METHODSSeventy-eight pediatric AIDS patients with HBV/HCV co-infection,19 pediatric AIDS patients with HBV co-infection and 44 pediatric AIDS patients without HBV/HCV co-infection who received HAART at least for 1 year were enrolled. HIV-1 viral load was quantitatively detected using a standardized reverse transcriptase-polymerase chain reaction assay, and blood cells were determined by three-color flow cytometry. Anti-HCV antibody and HBsAg was detected using an enzyme-linked immunosorbent technique, and ALT, AST and TBIL were detected by automatic biochemical analyzer.

RESULTSAfter 1 year-HAART, the viral load was decreased to the lowest limit of detection in 90.34% patients (t=2.61, P<0.01), and CD4+ T cell counts were increased from 170.187±132.405/ μl to 796.014±158.491/ μl (t=3.17, P<0.01). The levels of ALT and AST were elevated (t=2.02, P<0.05), while the ALT and AST levels in patients receiving nevirapine (NVP) based HAART increased from 18.28±13.74 U/L and 24.23±8.09 U/L to 55.35±22.40 U/L and 69.97±26.72 U/L, respectively(t=3.80,t=4.11;Ps<0.01). The increment of ALT and AST in NVP based HAART were significantly higher than that in the efavirenz based HAART (ALT:46.28±13.35 U/L vs 37.70±15.25 U/L and AST:19.53±7.23 U/L vs 1.25±0.21 U/L, respectively; t=4.53, t=5.79; Ps<0.01), particularly in patients co-infected with HIV/HBV/HCV (ALT:54.32±22.85 U/L vs 16.89±14.42 U/L and AST:41.71±19.26 U/L vs -3.44±15.59 U/L, respectively; t=3.42, t=2.98, Ps<0.01).

CONCLUSIONHARRT can repress HIV-1 replication effectively, but it also cause the damage of liver function, especially in patients with HBV and/or HCV co-infection.

Antiretroviral Therapy, Highly Active ; Child ; Coinfection ; drug therapy ; Female ; HIV Infections ; complications ; drug therapy ; physiopathology ; Hepatitis B ; complications ; Hepatitis C ; complications ; Humans ; Liver ; physiopathology ; Male

OBJECTIVETo investigate if immunological factors associated with rheumatoid arthritis (RA) affect the result of human immunodeficiency virus (HIV) screening by electrochemiluminescence immunoassay (ECLIA) and enzyme-linked immunosorbent assay (ELISA).

METHODS100 RA cases were enrolled from January 2012 to February 2013 into this study. HIV screening was conducted with ECLIA detecting both HIV-1 p24 antigen, HIV-1 and HIV-2 antibodies, with ELISA and colloidal gold method detecting HIV-1 and HIV-2 antibodies. The samples producing positive results were submitted to the Center for Disease Control for confirmation using Western blotting method. The antibody titers of rheumatoid factors (RF) including RF-IgG, RF-IgM, RF-IgA, and CCP-IgG were analyzed by ELISA.

RESULTSThe HIV positive-rate determined by ECLIA was significantly higher than that by ELISA and colloidal gold method (P<0.01). The false-positive rate of HIV screening was associated with antibody titers of RF-IgG, RF-IgM, RF-IgA, and CCP-IgG in RA (P<0.01).

CONCLUSIONSImmunological factors, including RF and anti-CCP antibody, may influence the screening of HIV by ECLIA, producing false-positive result.

Adult ; Aged ; Arthritis, Rheumatoid ; physiopathology ; Enzyme-Linked Immunosorbent Assay ; False Positive Reactions ; HIV Antibodies ; blood ; HIV Antigens ; blood ; HIV Infections ; diagnosis ; Humans ; Middle Aged ; Rheumatoid Factor ; physiology

PURPOSE: HIV-infected patients are at increased risk for cardiovascular disease, which may be mediated in part by inflammation. This study aimed to evaluate the risk factors of carotid plaque, and clinical factors associated with carotid atherosclerosis measured by carotid intima-medial thickness (cIMT) in HIV patients. MATERIALS AND METHODS: Clinical and cardiometabolic factors as well as cIMT were prospectively measured in 145 HIV-infected participants who had received combined antiretroviral therapy for > or =6 months. The mean value of the bilateral average cIMT level was used as Mean-IMT in the analysis, and the greatest value among the measured cIMT levels was used as Max-IMT. RESULTS: Among 145 patients, 34 (23.4%) had carotid plaque. Multivariate logistic regression analysis revealed three independent risk factors of carotid plaque: old age [odds ratio (OR) 6.16, 95% confidence interval (CI) 1.09-34.88; p=0.040], hypertension (OR 12.62, 95% CI 1.72-92.49; p=0.013) and higher low-density lipoprotein cholesterol (LDL-C) (OR 1.08, 95% CI 1.01-1.16; p=0.039). Levels of estimated glomerular filtration rate were inversely associated with Mean-IMT (r=-0.379, p<0.001) and Max-IMT (r=-0.389, p<0.001). Stepwise multivariate regression analyses revealed that age, total cholesterol and fasting glucose were positively correlated with cIMT, independent of other risk factors. CONCLUSION: The presence of hypertension, old age and a higher level of LDL-C were independent risk factors of carotid plaque among HIV-infected subjects.
Adult ; Age Factors ; Blood Glucose/analysis ; Carotid Artery Diseases/*etiology/*ultrasonography ; Carotid Intima-Media Thickness ; Cholesterol, LDL/blood ; Female ; Glomerular Filtration Rate ; HIV Infections/*complications/drug therapy/physiopathology ; Humans ; Hypertension/complications/physiopathology ; Logistic Models ; Male ; Middle Aged ; Odds Ratio ; Prospective Studies ; Risk Factors

Acute Kidney Injury ; blood ; etiology ; therapy ; Anti-Retroviral Agents ; administration & dosage ; CD4 Lymphocyte Count ; Disease Progression ; Embolization, Therapeutic ; methods ; Fatal Outcome ; Gastrointestinal Hemorrhage ; diagnostic imaging ; etiology ; physiopathology ; therapy ; Glucocorticoids ; administration & dosage ; HIV Infections ; complications ; diagnosis ; immunology ; HIV-1 ; drug effects ; isolation & purification ; Humans ; Male ; Middle Aged ; Purpura, Schoenlein-Henoch ; complications ; diagnosis ; physiopathology ; Radiography ; Renal Dialysis ; methods

The incidence of specific intracranial parenchymal lesions of HIV-infected patients varies considerably between countries. In the Republic of Korea, the number of HIV-infected patients is increasing, but little is known regarding the spectrum of intracranial parenchymal lesions in these patients. The aim of the present study was to obtain this information. To identify HIV patients with intracranial parenchymal lesions, the electronic database of radiological reports for 1,167 HIV-infected patients, seen from 1999 to 2008 at the Seoul National University Hospital, were reviewed. Neuroradiologic studies were performed on 165 of these patients, and intracranial parenchymal lesions were detected in 40 (3.4%) of them. Thirty-seven were male, and median age was 41 yr (range, 26-61). At the time of the diagnosis of intracranial parenchymal lesions, median CD4+ lymphocyte count was 40 cells/microL (range 5-560) and in 33 (82.5%) patients, it was less than 200 cells/microL. Progressive multifocal leukoencephalopathy (12 patients) is the most frequent intracranial parenchymal lesions, followed by intracranial tuberculoma (7 patients), primary central nervous system lymphoma (7 patients), intracranial cryptococcoma (4 patients), Toxoplasma encephalitis (4 patients), and disseminated non-tuberculous mycobacterial infection (3 patients).
AIDS-Related Opportunistic Infections/epidemiology/*pathology/physiopathology/virology ; Adult ; Central Nervous System Diseases/epidemiology/*pathology/physiopathology/*virology ; Female ; HIV Infections/*pathology/physiopathology/virology ; Humans ; Male ; Middle Aged ; Republic of Korea/epidemiology

Adult ; Female ; HIV Infections ; physiopathology ; virology ; HIV-1 ; Hepatitis B ; physiopathology ; virology ; Hepatitis B virus ; Humans ; Liver ; pathology ; physiopathology ; Liver Function Tests ; Male ; Middle Aged ; Superinfection ; pathology ; virology ; Viral Load

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Female ; HIV Infections ; physiopathology ; Humans ; Liver Diseases ; physiopathology ; virology ; Male ; Middle Aged ; Risk Factors ; Young Adult

INTRODUCTIONMycotic aneurysms are associated with high mortality rates and are managed in the local setting with extra-anatomical bypass followed by ligation, exclusion and debridement of the aneurysm. This is the first case of successful endovascular stenting in an immunocompromised patient with Salmonella mycotic aneurysm.

CLINICAL PICTUREA middle-aged man who was HIV positive had Salmonella septicaemia. He developed abdominal pain 5 days after admission and a computed tomography (CT) scan of the abdomen revealed infrarenal aortitis. He developed a mycotic aneurysm 3 weeks later.

TREATMENTHe opted for endovascular stenting and after prolonged antibiotic therapy and negative blood cultures, he underwent the procedure using a Talent stent, with an iliac extension.

OUTCOMEHe was discharged 1 week after stenting and maintained on oral bactrim based on sensitivity. At 1-year follow-up, he remains well symptomatically and CT scan showed no endoleak or collection.

CONCLUSIONEndovascular stenting, though a fairly new procedure, can be successfully deployed even in a mycotic aneurysm in the right setting.

Aneurysm, Infected ; drug therapy ; surgery ; therapy ; HIV Infections ; physiopathology ; Humans ; Male ; Middle Aged ; Salmonella Infections ; drug therapy ; microbiology ; surgery ; Salmonella enteritidis ; Stents ; Trimethoprim, Sulfamethoxazole Drug Combination ; therapeutic use

Adult ; African Continental Ancestry Group ; ethnology ; C-Reactive Protein ; metabolism ; Calcinosis ; complications ; Coronary Disease ; complications ; Female ; HIV Infections ; complications ; pathology ; physiopathology ; HIV-1 ; Heart Diseases ; pathology ; physiopathology ; Humans ; Lipid Metabolism ; Male ; Middle Aged ; Myocardium ; pathology