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HIV related Myelopathy

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1. HIV related Myelopathy

HIV related Myelopathy HIV related Myelopathy Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 HIV related Myelopathy HIV related (...) Myelopathy Aka: HIV related Myelopathy , HIV related Myelitis , Myelopathy in HIV , Myelitis in HIV , HIV-Associated Polymyositis , HIV Myopathy II. Causes Transverse myelitis (VZV) infection Spinal epidural or intradural infection Slowly progressive vacuolar myelopathy Spinal cord dysfunction (more common in advanced HIV) Progressive painless gait disturbance with Increased lower extremity motor tone and progressive weakness Consider MRI Spine HIV-Associated Polymyositis ( ) Similar to autoimmune

2018 FP Notebook

2. Lower-extremity Dynamometry as a Novel Outcome Measure in a Double-blind, Placebo-controlled, Feasibility Trial of Intravenous Immunoglobulin (IVIG) for HIV-associated Myelopathy. (Abstract)

Lower-extremity Dynamometry as a Novel Outcome Measure in a Double-blind, Placebo-controlled, Feasibility Trial of Intravenous Immunoglobulin (IVIG) for HIV-associated Myelopathy. Objective: Open-label data suggest that intravenous immunoglobulin (IVIG) might improve lower-extremity strength in human immunodeficiency virus (HIV)-associated myelopathy (HIVM), a rare but debilitating neurologic complication of HIV. We sought to determine the feasibility of testing the efficacy of IVIG for HIVM (...) meaningful based on its correlations with the HDMS and the two-minute timed walk test. Conclusion: We conclude that an adequately powered clinical trial of IVIG for HIVM would likely require a prolonged recruitment period and multiple participating sites. Lower limb dynamometry is a useful outcome measure for HIVM, which might also be useful in other HIV-related gait disorders.

2018 Innovations in clinical neuroscience Controlled trial quality: predicted high

3. Therapeutic guidelines for antiretroviral (ARV) treatment of adult HIV infection

of antiretroviral therapy for HIV-1 infection and tuberculosis. N Engl J Med. 2011; 365:1482-1491. 33. Meintjes G, Wilkinson R, Morroni C, et al. Randomized placebo-controlled trial of prednisone for paradoxical tuberculosis- associated immune reconstitution inflammatory syndrome. AIDS 2010; 24:2381-2390. 34. Torok ME, Nguyen TB, Tran THC, et al Timing of initiation of antiretroviral therapy in human immunodeficiency virus (HIV)-associated tuberculous meningitis. Clin Infect Dis 2011; 52:1374. 35. Hughes JP (...) HIV Study (WIHS) showed that those who started treatment early (at CD4 cell count >350/µL) were less likely to die of AIDS-related causes and more likely to die at an older age than those who started treatment late (at CD4 cell count 500 cells/µL. 3. More recently, the large, international INSIGHT START trial demonstrated the benefit of initiating ART immediately in patients with CD4 cell count >500 cells/µL as compared to deferring ART initiation until the CD4 cell count had declined to 350 cells

2020 CPG Infobase

4. HIV related Myelopathy

HIV related Myelopathy HIV related Myelopathy Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 HIV related Myelopathy HIV related (...) Myelopathy Aka: HIV related Myelopathy , HIV related Myelitis , Myelopathy in HIV , Myelitis in HIV , HIV-Associated Polymyositis , HIV Myopathy II. Causes Transverse myelitis (VZV) infection Spinal epidural or intradural infection Slowly progressive vacuolar myelopathy Spinal cord dysfunction (more common in advanced HIV) Progressive painless gait disturbance with Increased lower extremity motor tone and progressive weakness Consider MRI Spine HIV-Associated Polymyositis ( ) Similar to autoimmune

2015 FP Notebook

5. Diagnostic challenges in vacuolar myelopathy: a didactic case report Full Text available with Trip Pro

, but by no means rules out HIV-related myelopathy. Furthermore, peripheral and central viral load should always be assessed to avoid missing a possible 'CSF HIV-escape'. (...) Diagnostic challenges in vacuolar myelopathy: a didactic case report Because of the diagnostic complexity and potential pitfalls in interpreting test results, HIV-vacuolar myelopathy (HIVM) is far more often diagnosed postmortem than in vivo. In the era of highly active antiretroviral therapy (HAART), the topic of neuro-AIDS has become increasingly important. This case report covers some of the diagnostic problems encountered in vacuolar myelopathy based on magnetic resonance imaging (MRI

2016 Spinal cord series and cases

6. Diffusion MRI in Cervical Spondylotic Myelopathy (CSM)

of amyotrophic lateral sclerosis, multiple sclerosis, rheumatoid arthritis, concomitant thoracic and/or lumbar stenosis, spine tumor or HIV-related myelopathy and having systemic instability or being deemed unable to tolerate standard MRI sequencing. Contacts and Locations Go to Information from the National Library of Medicine To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor. Please refer to this study by its (...) Enrollment : 70 participants Observational Model: Cohort Time Perspective: Prospective Official Title: Predictive Value of Diffusion MRI in Cervical Spondylotic Myelopathy Actual Study Start Date : January 29, 2018 Estimated Primary Completion Date : June 2022 Estimated Study Completion Date : June 2022 Resource links provided by the National Library of Medicine related topics: Groups and Cohorts Go to Group/Cohort Intervention/treatment Investigational subjects Patients who have been diagnosed

2017 Clinical Trials

7. HIV-1 Associated Vacuolar Myelopathy (Diagnosis)

Considerations Other problems to be considered in the differential diagnosis of HIV-related VM include the following: HIV-associated transverse myelitis during seroconversion [ ] Herpes simplex (HSV) or zoster (VZV) virus infection Cytomegalovirus (CMV) infection Neurosyphilis Cervical disk syndromes Other HIV-associated conditions (eg, Kaposi sarcoma, lymphoma, toxoplasmosis) in the spinal canal Mycobacterium tuberculosis infection Compressive myelopathy (eg, tumor, abscess, herniated disc, arteriovenous (...) specialist for spinal cord treatment and follow-up care. Previous Next: Questions & Answers Overview Previous References Goudreau G, Carpenter S, Beaulieu N, Jolicoeur P. Vacuolar myelopathy in transgenic mice expressing human immunodeficiency virus type 1 proteins under the regulation of the myelin basic protein gene promoter. Nat Med . 1996 Jun. 2 (6):655-61. . Di Rocco A, Bottiglieri T, Werner P, et al. Abnormal cobalamin-dependent transmethylation in AIDS-associated myelopathy. Neurology . 2002. 58

2014 eMedicine.com

8. HIV-1 Associated Vacuolar Myelopathy (Treatment)

Considerations Other problems to be considered in the differential diagnosis of HIV-related VM include the following: HIV-associated transverse myelitis during seroconversion [ ] Herpes simplex (HSV) or zoster (VZV) virus infection Cytomegalovirus (CMV) infection Neurosyphilis Cervical disk syndromes Other HIV-associated conditions (eg, Kaposi sarcoma, lymphoma, toxoplasmosis) in the spinal canal Mycobacterium tuberculosis infection Compressive myelopathy (eg, tumor, abscess, herniated disc, arteriovenous (...) specialist for spinal cord treatment and follow-up care. Previous Next: Questions & Answers Overview Previous References Goudreau G, Carpenter S, Beaulieu N, Jolicoeur P. Vacuolar myelopathy in transgenic mice expressing human immunodeficiency virus type 1 proteins under the regulation of the myelin basic protein gene promoter. Nat Med . 1996 Jun. 2 (6):655-61. . Di Rocco A, Bottiglieri T, Werner P, et al. Abnormal cobalamin-dependent transmethylation in AIDS-associated myelopathy. Neurology . 2002. 58

2014 eMedicine.com

9. HIV-1 Associated Vacuolar Myelopathy (Overview)

Considerations Other problems to be considered in the differential diagnosis of HIV-related VM include the following: HIV-associated transverse myelitis during seroconversion [ ] Herpes simplex (HSV) or zoster (VZV) virus infection Cytomegalovirus (CMV) infection Neurosyphilis Cervical disk syndromes Other HIV-associated conditions (eg, Kaposi sarcoma, lymphoma, toxoplasmosis) in the spinal canal Mycobacterium tuberculosis infection Compressive myelopathy (eg, tumor, abscess, herniated disc, arteriovenous (...) specialist for spinal cord treatment and follow-up care. Previous Next: Questions & Answers Overview Previous References Goudreau G, Carpenter S, Beaulieu N, Jolicoeur P. Vacuolar myelopathy in transgenic mice expressing human immunodeficiency virus type 1 proteins under the regulation of the myelin basic protein gene promoter. Nat Med . 1996 Jun. 2 (6):655-61. . Di Rocco A, Bottiglieri T, Werner P, et al. Abnormal cobalamin-dependent transmethylation in AIDS-associated myelopathy. Neurology . 2002. 58

2014 eMedicine.com

10. HIV-1 Associated Vacuolar Myelopathy (Follow-up)

Considerations Other problems to be considered in the differential diagnosis of HIV-related VM include the following: HIV-associated transverse myelitis during seroconversion [ ] Herpes simplex (HSV) or zoster (VZV) virus infection Cytomegalovirus (CMV) infection Neurosyphilis Cervical disk syndromes Other HIV-associated conditions (eg, Kaposi sarcoma, lymphoma, toxoplasmosis) in the spinal canal Mycobacterium tuberculosis infection Compressive myelopathy (eg, tumor, abscess, herniated disc, arteriovenous (...) specialist for spinal cord treatment and follow-up care. Previous Next: Questions & Answers Overview Previous References Goudreau G, Carpenter S, Beaulieu N, Jolicoeur P. Vacuolar myelopathy in transgenic mice expressing human immunodeficiency virus type 1 proteins under the regulation of the myelin basic protein gene promoter. Nat Med . 1996 Jun. 2 (6):655-61. . Di Rocco A, Bottiglieri T, Werner P, et al. Abnormal cobalamin-dependent transmethylation in AIDS-associated myelopathy. Neurology . 2002. 58

2014 eMedicine.com

11. A Double-Blind, Placebo Controlled Study of Intravenous Immunoglobulin for HIV-Associated Myelopathy

A Double-Blind, Placebo Controlled Study of Intravenous Immunoglobulin for HIV-Associated Myelopathy A Double-Blind, Placebo Controlled Study of Intravenous Immunoglobulin for HIV-Associated Myelopathy - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please (...) remove one or more studies before adding more. A Double-Blind, Placebo Controlled Study of Intravenous Immunoglobulin for HIV-Associated Myelopathy The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT01561755 Recruitment Status : Terminated (Difficulty with enrollment) First Posted : March 23, 2012

2012 Clinical Trials

12. Immunotherapy of Natural Killer(NK) Cells in Human T Lymphotropic Virus Type 1(HTLV-1) Associated Myelopathy(HAM)

Immunotherapy of Natural Killer(NK) Cells in Human T Lymphotropic Virus Type 1(HTLV-1) Associated Myelopathy(HAM) Immunotherapy of Natural Killer(NK) Cells in Human T Lymphotropic Virus Type 1(HTLV-1) Associated Myelopathy(HAM) - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved (...) studies (100). Please remove one or more studies before adding more. Immunotherapy of Natural Killer(NK) Cells in Human T Lymphotropic Virus Type 1(HTLV-1) Associated Myelopathy(HAM) The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT02961712 Recruitment Status : Unknown Verified November 2016

2016 Clinical Trials

13. HIV-1 Encephalopathy and AIDS Dementia Complex (Diagnosis)

. [ , ] Human immunodeficiency virus (HIV) enters the central nervous system (CNS) early in the course of the infection and causes several important CNS conditions over the course of the disease, such as HIV encephalopathy and AIDS dementia complex. [ ] As part of the acute HIV syndrome during seroconversion, patients may experience HIV encephalopathy. HIV-associated progressive encephalopathy (HPE) is a syndrome complex with cognitive, motor, and behavioral features seen in children. [ ] Prior (...) , these patients are likely to be less inhibited and are more prone to HIV-related risk behavior (eg, unprotected intercourse), and they therefore pose a greater risk of transmission of the virus. In addition to HIV itself, other causes of neurologic complications in HIV-infected individuals include opportunistic infections, tumors, and antiretroviral drugs. Other neurologic complications that arise from primary HIV infection include vacuolar myelopathy, peripheral neuropathies, and polymyositis. For other

2014 eMedicine.com

14. HIV-1 Associated CNS Complications (Diagnosis) (Diagnosis)

=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTE2NzAwOC1vdmVydmlldw== processing > Central Nervous System Complications in HIV Updated: Apr 12, 2018 Author: Regina Krel, MD; Chief Editor: Niranjan N Singh, MBBS, MD, DM, FAHS, FAANEM Share Email Print Feedback Close Sections Sections Central Nervous System Complications in HIV Overview Overview Based on current World Health Organization (WHO) statistics, there are more than 36 million people living with human immunodeficiency virus (HIV) today. More than 19 million of them receive antiretroviral therapy (ART (...) With HIV Infection in the Era of Antiretroviral Therapy. Top Antivir Med . 2017 Jul/Aug. 25 (3):97-101. . Nath A. Neurologic Complications of Human Immunodeficiency Virus Infection. Continuum (Minneap Minn) . 2015 Dec. 21 (6 Neuroinfectious Disease):1557-76. . Schacker T, Collier AC, Hughes J, Shea T, Corey L. Clinical and epidemiologic features of primary HIV infection. Ann Intern Med . 1996 Aug 15. 125 (4):257-64. . Valcour V, Chalermchai T, Sailasuta N, Marovich M, Lerdlum S, Suttichom D, et al

2014 eMedicine.com

15. HIV-1 Associated Cerebrovascular Complications (Diagnosis)

=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTE2NzAwOC1vdmVydmlldw== processing > Central Nervous System Complications in HIV Updated: Apr 12, 2018 Author: Regina Krel, MD; Chief Editor: Niranjan N Singh, MBBS, MD, DM, FAHS, FAANEM Share Email Print Feedback Close Sections Sections Central Nervous System Complications in HIV Overview Overview Based on current World Health Organization (WHO) statistics, there are more than 36 million people living with human immunodeficiency virus (HIV) today. More than 19 million of them receive antiretroviral therapy (ART (...) With HIV Infection in the Era of Antiretroviral Therapy. Top Antivir Med . 2017 Jul/Aug. 25 (3):97-101. . Nath A. Neurologic Complications of Human Immunodeficiency Virus Infection. Continuum (Minneap Minn) . 2015 Dec. 21 (6 Neuroinfectious Disease):1557-76. . Schacker T, Collier AC, Hughes J, Shea T, Corey L. Clinical and epidemiologic features of primary HIV infection. Ann Intern Med . 1996 Aug 15. 125 (4):257-64. . Valcour V, Chalermchai T, Sailasuta N, Marovich M, Lerdlum S, Suttichom D, et al

2014 eMedicine.com

16. HIV-1 Associated Opportunistic Infections: CNS Toxoplasmosis (Diagnosis)

-related opportunistic infections. Drugs . 1997 Jan. 53(1):40-73. . Marra MC. Infections of the central nervous sytem in patients infected with human immunodeficiency virus. Continuum . 2006. 12:111-32. Offiah CE, Turnbull IW. The imaging appearances of intracranial CNS infections in adult HIV and AIDS patients. Clin Radiol . 2006 May. 61(5):393-401. . Verma A. Neurological manifestations of human immunodeficiency virus infection in adults. Neurology in Clinical Practice . 2004. Vol 2: 1581-1601 (...) Jan 19 . . Mesquita RT, Ziegler AP, Hiramoto RM, Vidal JE, Pereira-Chioccola VL. Real-time quantitative PCR in cerebral toxoplasmosis diagnosis of Brazilian human immunodeficiency virus-infected patients. J Med Microbiol . 2010 Jun. 59:641-7. . Alfonso Y, Fraga J, Fonseca C, et al. Molecular diagnosis of Toxoplasma gondii infection in cerebrospinal fluid from AIDS patients. Cerebrospinal Fluid Res . 2009 Mar 6. 6:2. . . Mahadevan A, Ramalingaiah AH, Parthasarathy S, Nath A, Ranga U, Krishna SS

2014 eMedicine.com

17. Dementia Due to HIV Disease (Treatment)

inhibited and are more prone to HIV-related risk behavior (eg, unprotected intercourse), and they therefore pose a greater risk of transmission of the virus. In addition to HIV itself, other causes of neurologic complications in HIV-infected individuals include opportunistic infections, tumors, and antiretroviral drugs. Other neurologic complications that arise from primary HIV infection include vacuolar myelopathy, peripheral neuropathies, and polymyositis. For other discussions of HIV infection, see (...) : Bradley WG, Daroff RB, Fenichel GM. Neurologic manifestations of human immunodeficiency virus infection in children. Neurology in Clinical Practice . 2004. 2: 1603-1611. Ances BM, Ellis RJ. Dementia and neurocognitive disorders due to HIV-1 infection. Semin Neurol . 2007 Feb. 27(1):86-92. . World Health Organization. AIDS Epidemic, 2009. Available at . Accessed: June 30, 2011. Navia BA. Clinical and biologic features of the AIDS dementia complex. Neuroimaging Clin N Am . 1997 Aug. 7(3):581-92

2014 eMedicine.com

18. HIV-1 Encephalopathy and AIDS Dementia Complex (Treatment)

. [ , ] Human immunodeficiency virus (HIV) enters the central nervous system (CNS) early in the course of the infection and causes several important CNS conditions over the course of the disease, such as HIV encephalopathy and AIDS dementia complex. [ ] As part of the acute HIV syndrome during seroconversion, patients may experience HIV encephalopathy. HIV-associated progressive encephalopathy (HPE) is a syndrome complex with cognitive, motor, and behavioral features seen in children. [ ] Prior (...) , these patients are likely to be less inhibited and are more prone to HIV-related risk behavior (eg, unprotected intercourse), and they therefore pose a greater risk of transmission of the virus. In addition to HIV itself, other causes of neurologic complications in HIV-infected individuals include opportunistic infections, tumors, and antiretroviral drugs. Other neurologic complications that arise from primary HIV infection include vacuolar myelopathy, peripheral neuropathies, and polymyositis. For other

2014 eMedicine.com

19. HIV-1 Associated Opportunistic Infections: CNS Toxoplasmosis (Treatment)

-related opportunistic infections. Drugs . 1997 Jan. 53(1):40-73. . Marra MC. Infections of the central nervous sytem in patients infected with human immunodeficiency virus. Continuum . 2006. 12:111-32. Offiah CE, Turnbull IW. The imaging appearances of intracranial CNS infections in adult HIV and AIDS patients. Clin Radiol . 2006 May. 61(5):393-401. . Verma A. Neurological manifestations of human immunodeficiency virus infection in adults. Neurology in Clinical Practice . 2004. Vol 2: 1581-1601 (...) Jan 19 . . Mesquita RT, Ziegler AP, Hiramoto RM, Vidal JE, Pereira-Chioccola VL. Real-time quantitative PCR in cerebral toxoplasmosis diagnosis of Brazilian human immunodeficiency virus-infected patients. J Med Microbiol . 2010 Jun. 59:641-7. . Alfonso Y, Fraga J, Fonseca C, et al. Molecular diagnosis of Toxoplasma gondii infection in cerebrospinal fluid from AIDS patients. Cerebrospinal Fluid Res . 2009 Mar 6. 6:2. . . Mahadevan A, Ramalingaiah AH, Parthasarathy S, Nath A, Ranga U, Krishna SS

2014 eMedicine.com

20. HIV-1 Associated CNS Complications (Treatment) (Treatment)

=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTE2NzAwOC1vdmVydmlldw== processing > Central Nervous System Complications in HIV Updated: Apr 12, 2018 Author: Regina Krel, MD; Chief Editor: Niranjan N Singh, MBBS, MD, DM, FAHS, FAANEM Share Email Print Feedback Close Sections Sections Central Nervous System Complications in HIV Overview Overview Based on current World Health Organization (WHO) statistics, there are more than 36 million people living with human immunodeficiency virus (HIV) today. More than 19 million of them receive antiretroviral therapy (ART (...) With HIV Infection in the Era of Antiretroviral Therapy. Top Antivir Med . 2017 Jul/Aug. 25 (3):97-101. . Nath A. Neurologic Complications of Human Immunodeficiency Virus Infection. Continuum (Minneap Minn) . 2015 Dec. 21 (6 Neuroinfectious Disease):1557-76. . Schacker T, Collier AC, Hughes J, Shea T, Corey L. Clinical and epidemiologic features of primary HIV infection. Ann Intern Med . 1996 Aug 15. 125 (4):257-64. . Valcour V, Chalermchai T, Sailasuta N, Marovich M, Lerdlum S, Suttichom D, et al

2014 eMedicine.com

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