An Update on Adverse Cutaneous Drug Reactions in HIV/AIDS

Background: The global mortality from HIV and the cutaneous burden of infective, inflammatory and malignant diseases in the setting of AIDS have significantly declined following the advent of highly active antiretroviral therapy. Regrettably, there has been a contemporaneous escalation in the incidence of adverse cutaneous drug reactions (ACDR), with studies attesting that HIV-positive individuals are a hundred times more susceptible to drug reactions than the general population, and advanced immunodeficiency portending an even greater risk. Several variables are accountable for this amplified risk in HIV.Summary: Adverse reactions to trimethoprim-sulfamethoxazole are the most common, increasing from approximately 2 –8% in the general population over to 43% amongst HIV-positive individuals to approximately 69% in subjects with AIDS. Antituberculosis drugs and antiretrovirals are also well-known instigators of ACDR. Cutaneous reactions range from mild morbilliform eruptions to severe, life-threatening manifest ations in the form of Stevens-Johnson syndrome/toxic epidermal necrolysis. Histological features vary from vacuolar interface changes to full-thickness epidermal necrosis with subepidermal blister formation. A precipitous diagnosis of the ACDR, clinically and histologically if necessary, together wi th the isolation of the causative drug is critical. The identification process, however, is often complex and multifaceted due to polypharmacy and inconclusive data on ...
Source: Dermatopathology - Category: Pathology Source Type: research

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Authors: Nassoro DD, Mkhoi ML, Sabi I, Meremo AJ, Lawala PS, Mwakyula IH Abstract Adrenal insufficiency (AI) is one of the most common endocrine disease in patients with HIV/AIDS, leading to high morbidity and mortality in HIV patients who become critically ill. Various etiologies are associated with the condition, including cytomegalovirus (CMV), Mycobacterium tuberculosis, lymphoma, Kaposi's sarcoma, and drugs such as rifampin, among others. HIV patients with advanced disease develop relative cortisol deficiency largely due to the reduction of cortisol reserve, which predisposes patients to adrenal crisis in peri...
Source: International Journal of Endocrinology - Category: Endocrinology Tags: Int J Endocrinol Source Type: research
This study aimed to analyze characteristics and factors associated with late initiation of ART among HIV-infected treatment-naïve patients. Methods: This cross-sectional study included PLHIV older than 17 years who initiated ART at two public health facilities from 2009 to 2012, in a city located in Midwestern Brazil. Pregnant women were excluded. Data were collected from medical records, antiviral dispensing forms, and the Logistics Control of Medications System (SICLOM) of the Brazilian Ministry of Health. Late initiation of ART was defined as CD4+ cell count
Source: Journal of Tropical Medicine - Category: Tropical Medicine Tags: J Trop Med Source Type: research
Conclusions Toxoplasma gondii infection induces a strong innate and adaptive immune response. While the innate immunity is important for controlling the early stages of the infection (Yarovinsky, 2014), the adaptive immunity is critical for restricting the parasite replication during the later stages (Gazzinelli et al., 1992). Amongst the adaptive immune subsets, CD8 T cells are the primary effector cells while CD4 T cells play an essential helper role to maintain long-term immunity (Casciotti et al., 2002). Notwithstanding, a robust CD8 T cell immunity induced during acute phase of infection, does not result in the total...
Source: Frontiers in cellular and infection microbiology - Category: Microbiology Source Type: research
CONCLUSIONS: AIDS patients in the Santos region had high rates of late diagnosis and low treatment adherenc e.
Source: Revista da Sociedade Brasileira de Medicina Tropical - Category: Tropical Medicine Source Type: research
In this study, we investigated the immunological changes in the levels of monocytes and Tregs and the associations between these cell types in HIV-1-infected MSM with syphilis. Methods Study Participants We enrolled 81 participants in this study. These individuals were assigned to four groups on the basis of serologic testing and HIV-1 results, namely, the rapid plasma reagin (RPR+) group, the CHI group, the CHI&RPR+ group, and the healthy control group. HIV-1 infection status was determined with the HIV-1/2 antigen/antibody combo enzyme immunoassay (Beijing Wantai Biological Medical Company, Beijing, China). Positive ...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
ConclusionThe introduction of Highly Active Anti Retroviral Therapy (HAART) has lead to a decline in the incidence of HIV related infections and neoplasms. Nevertheless, these are conditions are still seen. Imaging diagnosis relies to the radiological findings coupled with serological and CSF analysis. The radiologist should be aware of the changing epidemiology of HIV complications in correlation with immune status of the patient which helps establish the correct diagnosis and improve management and prognosis.
Source: Journal of Neuroradiology - Category: Radiology Source Type: research
This article details the epidemiology and clinical manifestations of central nervous system (CNS) tuberculosis (TB), provides guidance for diagnostic imaging and CSF testing, and recommends treatment strategies for tuberculous meningitis and other forms of CNS TB, illustrating key aspects of diagnosis and management with case presentations. RECENT FINDINGS Although improvements in our understanding of the pathogenesis and management of CNS TB have occurred over the past 50 years, the emergence of multidrug-resistant and extensively drug-resistant TB, the advent of acquired immunodeficiency syndrome (AIDS), and the subse...
Source: CONTINUUM: Lifelong Learning in Neurology - Category: Neurology Tags: Review Articles Source Type: research
LITFL • Life in the Fast Lane Medical Blog LITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog aka Tropical Travel Trouble 008 Peer Reviewer Dr McBride ID physician, Wisconsin TB affects 1/3rd of the population and one patient dies every 20 seconds from TB. Without treatment 50% of pulmonary TB patients will be dead in 5 years. In low to middle income countries both TB and HIV can be ubiquitous, poor compliance can lead to drug resistance and malnourished infants are highly susceptible. TB can be very complex and this post will hopefully give you the backbone t...
Source: Life in the Fast Lane - Category: Emergency Medicine Authors: Tags: Clinical Cases Tropical Medicine Genexpert meningitis TB TB meningitis Tuberculosis Source Type: blogs
CONCLUSIONS: The number of patients who changed ARV drug in our resource constrained setting present a challenge to the restricted treatment choices that we currently own. Less toxic and better-tolerated HIV treatment options should be available and used more frequently. PMID: 29871665 [PubMed - in process]
Source: BMC Pharmacology and Toxicology - Category: Drugs & Pharmacology Tags: BMC Pharmacol Toxicol Source Type: research
To determine the short-term and long-term effects of highly active antiretroviral therapy (HAART) on incident tuberculosis (TB) in people living with HIV/AIDS (PLWHA).
Source: Annals of Epidemiology - Category: Epidemiology Authors: Tags: Original article Source Type: research
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