Immediate versus deferred antiretroviral therapy in HIV-infected patients presenting with acute AIDS-defining events (toxoplasmosis, Pneumocystis jirovecii-pneumonia): a prospective, randomized, open-label multicenter study (IDEAL-study).

CONCLUSIONS: In summary, this study supports the notion that immediate initiation of ART with a ritonavir-boosted proteinase-inhibitor and two nucleoside reverse transcriptase inhibitors is safe and has no negative effects on incidence of disease progression or IRIS, nor on immunological and virologic outcomes or on quality of life. PMID: 31729999 [PubMed - in process]
Source: AIDS Research and Therapy - Category: Infectious Diseases Authors: Tags: AIDS Res Ther Source Type: research

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To evaluate clinical outcomes after either immediate or deferred initiation of antiretroviral therapy in HIV-1-infected patients, presenting late with pneumocystis pneumonia (PCP) or toxoplasma encephalitis (TE).
Source: AIDS Research and Therapy - Category: Infectious Diseases Authors: Tags: Research Source Type: research
Human cytomegalovirus (HCMV) is a ubiquitous herpes virus (human herpes virus 5) with the highest morbidity and mortality rates compared to other herpes viruses. Risk groups include very young, elderly, transplant recipient, and immunocompromised individuals. HCMV may cause retinitis, encephalitis, hepatitis, esophagitis, colitis, pneumonia, neonatal infection sequelae, inflammatory and age-related diseases. With an arsenal of genes in its large genome dedicated to host immune evasion, HCMV can block intrinsic cellular defenses, and interfere with cellular immune responses. HCMV also encodes chemokines, chemokine receptors...
Source: Frontiers in Genetics - Category: Genetics & Stem Cells Source Type: research
Conclusions This review describes how leukocyte-heparanase can be a double-edged sword in tumor progression; it can enhance tumor immune surveillance and tumor cell clearance, but also promote tumor survival and growth. We also discuss the potential of using heparanase in leukocyte therapies against tumors, and the effects of heparanase inhibitors on tumor progression and immunity. We are just beginning to understand the influence of heparanase on a pro/anti-tumor immune response, and there are still many questions to answer. How do the pro/anti-tumorigenic effects of heparanase differ across different cancer types? Does...
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
CONCLUSION: In our study, high seronegativity was remarkable in MSM patients, particularly those who were highly educated, thus emphasizing the importance of prevention of primary infection in seronegative patients; necessity of prophylaxis in appropriate patients due to encephalitis, which has a high mortality rate and almost always develops after a latent infection; and necessity of screening for toxoplasmosis seropositivity at the time of diagnosis. PMID: 30280690 [PubMed - in process]
Source: Turkish Society for Parasitology - Category: Parasitology Authors: Tags: Turkiye Parazitol Derg 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 009 The diagnosis of HIV is no longer fatal and the term AIDS is becoming less frequent. In many countries, people with HIV are living longer than those with diabetes. This post will hopefully teach the basics of a complex disease and demystify some of the potential diseases you need to consider in those who are severely immunosuppressed. While trying to be comprehensive this post can not be exhaustive (as you can imagine any patient with ...
Source: Life in the Fast Lane - Category: Emergency Medicine Authors: Tags: Clinical Cases Tropical Medicine AIDS art cryptococcoma cryptococcus HIV HIV1 HIV2 PEP PrEP TB toxoplasma tuberculoma Source Type: blogs
Conclusions Access to EPI vaccination for children is a key example of preventative public health interventions that have been curtailed in Northern Syria since the start of the conflict. These findings demonstrate that collapse of the formal public health system has led to an increasingly large group of children who are susceptible to infectious diseases with serious consequences, with younger children most vulnerable. We call on all health actors and the international community to work towards re-establishment of EPI activities as a priority to ensure that children who have had no access to vaccination in the last five...
Source: PLOS Currents Disasters - Category: International Medicine & Public Health Authors: Source Type: research
Across China, the virus that could spark the next pandemic is already circulating. It’s a bird flu called H7N9, and true to its name, it mostly infects poultry. Lately, however, it’s started jumping from chickens to humans more readily–bad news, because the virus is a killer. During a recent spike, 88% of people infected got pneumonia, three-quarters ended up in intensive care with severe respiratory problems, and 41% died. What H7N9 can’t do–yet–is spread easily from person to person, but experts know that could change. The longer the virus spends in humans, the better the chance that i...
Source: Top Science and Health Stories - Category: Consumer Health News Authors: Tags: Uncategorized CDC Disease ebola Gates Foundation MERS outbreak pandemic Zika Source Type: news
CONCLUSIONS To our knowledge, this is the first case report of CNS vasculitis as a complication of disseminated MAC infection. An aggressive and refractory to treatment evolution were hallmarks features of this case. The underlying pathophysiology of the vasculitis is unknown and might be related either to MAC itself, the immune reconstitution due to antiretroviral initiation or most probably to a combination of both themDisclosure: Dr. Ballesteros has nothing to disclose. Dr. Garino has nothing to disclose. Dr. Consalvo has nothing to disclose. Dr. Imhoff-Jullier has nothing to disclose. Dr. Giacchino has nothing to discl...
Source: Neurology - Category: Neurology Authors: Tags: CNS Tuberculosis and Cryptococcal Meningitis Source Type: research
Conclusions. These data suggest that the currently recommended dose of atovaquone 750 mg BID for treatment of mild to moderate PCP may not be adequate in patients receiving concurrent EFV. Furthermore, doses lower than the currently recommended dose of 1500 mg BID may achieve plasma concentrations adequate to treat TE in HIV-infected patients not receiving EFV. Clinical Trials Registration. NTC01479361.
Source: Clinical Infectious Diseases - Category: Infectious Diseases Authors: Tags: HIV/AIDS Source Type: research
The Toxoplasma gondii Encephalitis section of the Guidelines for the Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents has been updated to provide clinicians with guidance on the use of trimethoprim-sulfamethoxazole for treatment of acute infection and chronic maintenance therapy for suspected or documented toxoplasmosis if pyrimethamine is not readily available.   On September 10, 2015, the OI Guidelines author panel issued this Notice of Availability of Pyrimethamine, which is guidance on what to do if pyrimethamine is unavailable to treat or prevent Toxoplasma encephalitis,...
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