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Lymphadenopathy in HIV

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141. Tuberculosis Immune Reconstitution Inflammatory Syndrome in A5221 STRIDE: Timing, Severity and Implications for HIV-TB programs. Full Text available with Trip Pro

Tuberculosis Immune Reconstitution Inflammatory Syndrome in A5221 STRIDE: Timing, Severity and Implications for HIV-TB programs. Earlier initiation of antiretroviral therapy (ART) in HIV-tuberculosis (TB) is associated with increased immune reconstitution inflammatory syndrome (IRIS). The severity, frequency, and complications of TB IRIS were evaluated in A5221, a randomized trial of earlier ART (within 2 weeks after TB treatment initiation) vs. later ART (8-12 weeks after TB treatment) in HIV (...) interaction was significant, P = 0.014, with 44.3% of TB IRIS occurring with CD4 <50 and earlier ART. TB IRIS occurred sooner with earlier vs. later ART initiation, at a median of 29 vs. 82 days after TB treatment initiation (P < 0.001). IRIS manifestations included lymphadenopathy (59.0%), constitutional symptoms (54.1%), and radiographic changes (41.0%); central nervous system TB IRIS was uncommon (6.6%). TB IRIS was mild in 27.9%, moderate in 41.0%, and severe in 31.1%. No TB IRIS-associated deaths

2014 Journal of acquired immune deficiency syndromes (1999) Controlled trial quality: uncertain

142. HIV prevalence in the Israeli tuberculosis cohort, 1999-2011. Full Text available with Trip Pro

/HIV co-infection.TB/HIV co-infected patients with extra-pulmonary TB had a higher proportion of infection in lymphatic, miliary and abdominal sites than those with extra-pulmonary TB who were HIV-negative.Most TB/HIV co-infected patients were migrants originating in high-burden countries. Despite the moderate 4.6% TB/HIV co-infection rate in Israel, these patients had worse treatment outcomes and higher mortality rates. This study illustrates the importance of integrating TB with HIV (...) HIV prevalence in the Israeli tuberculosis cohort, 1999-2011. Tuberculosis (TB) patients who are co-infected with HIV are at greater risk of mortality. Nevertheless, not all countries achieved sustainable and TB and HIV collaboration to describe the burden of both diseases at a national scale. This study aims to describe HIV prevalence among TB-patients in Israel and identify variable associated with TB/HIV co-infection.This retrospective study was conducted by cross-matching the National HIV

2014 BMC Public Health

143. Acute HIV infection presenting as fulminant meningoencephalitis with massive CSF viral replication Full Text available with Trip Pro

Acute HIV infection presenting as fulminant meningoencephalitis with massive CSF viral replication A 22-year-old man presented to the emergency department with 10 days of malaise, generalized rash, sore throat, oral ulcers, headache, nausea, and vomiting. On examination he had fever (101.5°F), hepatosplenomegaly, generalized maculopapular rash, and lymphadenopathy. He rapidly became obtunded, requiring intubation. Initial laboratory studies showed mild transaminitis, increased lactate (...) dehydrogenase, and 4,600 leukocytes per μL with 61% bands and 18% lymphocytes. Bacterial and fungal blood cultures were negative as well as a rapid HIV test, additional serologies (including rapid plasma reagin and Treponema pallidum particle agglutination), quantitative PCRs (for viruses other than HIV), and urine and blood toxicology. CSF, on hospital day 4, showed a lymphocytic pleocytosis (total leukocytes: 100), high protein, borderline hypoglycorrhachia, and negative Gram stain and culture. Brain MRI

2014 Neurology: Clinical Practice

144. Haemophagocytic syndrome and elevated EBV load as initial manifestation of Hodgkin lymphoma in a HIV patient: case report and review of the literature. Full Text available with Trip Pro

Haemophagocytic syndrome and elevated EBV load as initial manifestation of Hodgkin lymphoma in a HIV patient: case report and review of the literature. In HIV patients, haemophagocytic syndrome (HPS) may occur in the presence of cancer, concomitant viral infection, HIV primo-infection or at the initiation of highly active antiretroviral therapy (HAART). Hodgkin lymphoma remains a rare cause of HPS. We describe a case of HPS with very high Epstein Barr virus (EBV) load in a HIV patient (...) as initial manifestation of Hodgkin lymphoma.A 29-year-old HIV positive man, successfully treated with HAART with an undetectable viral load and CD4 cells count of 438/µl, was admitted for high fever of unknown origin. Laboratory results showed a pancytopenia with haemoglobin at 82 g/l, lymphocyte count at 0.36G/l and platelets count at 47G/l; a highly elevated ferritine >7500 µg/l; increased lactate dehydrogenase at 885U/l and soluble IL2 receptor (CD25) >60 ng/ml. EBV load was measured and confirmed

2014 Journal of the International AIDS Society

145. Ongoing epidemic of lymphogranuloma venereum in HIV-positive men who have sex with men: how symptoms should guide treatment. Full Text available with Trip Pro

with genital symptoms as urethritis, genital ulcer or inguinal lymphadenopathy. Of 283 CT-positive patients with anorectal symptoms, genotype L was detected in 205 (72%), while non-L genotypes (D-K) were found in 78 (28%). In contrast, genotype L was found in only 6% of patients with genital symptoms (11/177), whereas 94% (166/177) were infected with non-L genotypes only.The epidemic of LGV among predominantly HIV+ MSM is ongoing. LGV might be underdiagnosed, especially in patients with anorectal symptoms (...) Ongoing epidemic of lymphogranuloma venereum in HIV-positive men who have sex with men: how symptoms should guide treatment. Lymphogranuloma venereum (LGV) is a sexually transmitted infection (STI) caused by chlamydia trachomatis (CT) genotype L (L1, L2 and L3). Recent outbreaks of LGV in Europe and North America affected mainly men who have sex with men (MSM). Infections with CT serotypes D-K are mostly associated with mild symptoms or may be clinically silent. However, infections with L

2014 Journal of the International AIDS Society

146. Diagnostic ultrasound patterns of parotid glands in human immunodeficiency virus-positive patients in Mulago, Uganda Full Text available with Trip Pro

Diagnostic ultrasound patterns of parotid glands in human immunodeficiency virus-positive patients in Mulago, Uganda The purpose of this study was to determine sonographically, in parotid glands of human immunodeficiency virus-positive patients, the condition of glands with or without enlargement, and propose a classification system for the patterns observed using diagnostic ultrasound imaging.In this prospective clinical study, ultrasound scans were performed on 200 patients aged 4-62 years (...) at Mulago Hospital, Uganda.There were four main distinct ultrasound pathological patterns in the parotids, i.e. lymphocytic aggregations (LAs), lymphoepithelial cysts (LECs), fatty infiltration (FI) and lymphadenopathy only. There were additional subdivisions depending on the presence of echogenic foci and intraparotid lymphadenopathy. Of those patients (n = 64) without parotid enlargement, only 8% showed normal ultrasound features, whereas 34% showed LECs and 31% showed LAs. Of those (n = 136

2010 Dentomaxillofacial Radiology

147. Ocular Manifestations of HIV (Diagnosis)

=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTIxNjE3Mi1vdmVydmlldw== processing > Ocular Manifestations of HIV Infection Updated: Nov 12, 2018 Author: Robert A Copeland, Jr, MD; Chief Editor: Hampton Roy, Sr, MD Share Email Print Feedback Close Sections Sections Ocular Manifestations of HIV Infection Overview Overview Ocular manifestations of human immunodeficiency virus (HIV) infection have historically been common. While approximately 70-80% of HIV-infected patients have been treated for an HIV-associated eye disorder during the course of their illness (...) with the following: Retinal or conjunctival microvasculopathy Cytomegalovirus (CMV) retinitis Varicella-zoster virus (VZV) retinitis Mycobacterium avium complex infection Cryptococcosis Microsporidiosis HIV encephalopathy Progressive multifocal leukoencephalopathy The predictive value of the CD4 + T-cell count for ocular complications in HIV infection has been called into question by reports of CMV retinitis in patients with CD4 + cell counts higher than 200 cells/mL. These patients reportedly were taking highly

2014 eMedicine.com

148. Ocular Manifestations of HIV (Overview)

=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTIxNjE3Mi1vdmVydmlldw== processing > Ocular Manifestations of HIV Infection Updated: Nov 12, 2018 Author: Robert A Copeland, Jr, MD; Chief Editor: Hampton Roy, Sr, MD Share Email Print Feedback Close Sections Sections Ocular Manifestations of HIV Infection Overview Overview Ocular manifestations of human immunodeficiency virus (HIV) infection have historically been common. While approximately 70-80% of HIV-infected patients have been treated for an HIV-associated eye disorder during the course of their illness (...) with the following: Retinal or conjunctival microvasculopathy Cytomegalovirus (CMV) retinitis Varicella-zoster virus (VZV) retinitis Mycobacterium avium complex infection Cryptococcosis Microsporidiosis HIV encephalopathy Progressive multifocal leukoencephalopathy The predictive value of the CD4 + T-cell count for ocular complications in HIV infection has been called into question by reports of CMV retinitis in patients with CD4 + cell counts higher than 200 cells/mL. These patients reportedly were taking highly

2014 eMedicine.com

149. Cutaneous Manifestations of HIV Disease (Overview)

=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTEzMzc0Ni1vdmVydmlldw== processing > Cutaneous Manifestations of HIV Updated: Apr 03, 2018 Author: Robert A Schwartz, MD, MPH; Chief Editor: William D James, MD Share Email Print Feedback Close Sections Sections Cutaneous Manifestations of HIV Overview Overview Cutaneous manifestations of human immunodeficiency virus (HIV) disease may result from HIV infection itself or from opportunistic disorders secondary to the decline in immunocompetence from the disease. [ ] Cutaneous disorders may be the initial signs of HIV (...) AIDS Soc . 2011 Jan 24. 14:5. . . Altman K, Vanness E, Westergaard RP. Cutaneous manifestations of human immunodeficiency virus: a clinical update. Curr Infect Dis Rep . 2015 Mar. 17(3):464. . Smith KJ, Skelton HG, Yeager J, Ledsky R, McCarthy W, Baxter D, et al. Cutaneous findings in HIV-1-positive patients: a 42-month prospective study. Military Medical Consortium for the Advancement of Retroviral Research (MMCARR). J Am Acad Dermatol . 1994 Nov. 31(5 Pt 1):746-54. . Zampogna JC, Flowers FP

2014 eMedicine.com

150. Cutaneous Manifestations of HIV Disease (Treatment)

=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTEzMzc0Ni1vdmVydmlldw== processing > Cutaneous Manifestations of HIV Updated: Apr 03, 2018 Author: Robert A Schwartz, MD, MPH; Chief Editor: William D James, MD Share Email Print Feedback Close Sections Sections Cutaneous Manifestations of HIV Overview Overview Cutaneous manifestations of human immunodeficiency virus (HIV) disease may result from HIV infection itself or from opportunistic disorders secondary to the decline in immunocompetence from the disease. [ ] Cutaneous disorders may be the initial signs of HIV (...) AIDS Soc . 2011 Jan 24. 14:5. . . Altman K, Vanness E, Westergaard RP. Cutaneous manifestations of human immunodeficiency virus: a clinical update. Curr Infect Dis Rep . 2015 Mar. 17(3):464. . Smith KJ, Skelton HG, Yeager J, Ledsky R, McCarthy W, Baxter D, et al. Cutaneous findings in HIV-1-positive patients: a 42-month prospective study. Military Medical Consortium for the Advancement of Retroviral Research (MMCARR). J Am Acad Dermatol . 1994 Nov. 31(5 Pt 1):746-54. . Zampogna JC, Flowers FP

2014 eMedicine.com

151. Childhood HIV Disease (Overview)

Updated: Nov 16, 2018 Author: Delia M Rivera, MD; Chief Editor: Russell W Steele, MD Share Email Print Feedback Close Sections Sections Pediatric HIV Infection Overview Practice Essentials Since the first cases of human immunodeficiency virus (HIV) infection were identified, the number of children infected with HIV has risen dramatically in developing countries, the result of an increased number of HIV-infected women of childbearing age in these areas. HIV is a retrovirus and can be transmitted (...) vertically, sexually, or via contaminated blood products or IV drug abuse. Vertical HIV infection occurs before birth, during delivery, or after birth. The genome layouts of HIV-1 and HIV type 2 (HIV-2) are shown in the image below. Genome layout of human immunodeficiency virus (HIV)–1 and HIV-2. Essential update: Study suggests benefits to starting HAART earlier in HIV-infected children In a study of HIV-1-infected, highly active antiretroviral therapy (HAART)-naive children, Yin et al found

2014 eMedicine.com

152. Early Symptomatic HIV Infection (Treatment)

disorders such as aseptic meningitis; and dermatologic disorders such as varicella-zoster virus (shingles). The clinical effects of human immunodeficiency virus (HIV) infection are diverse, ranging from an acute retroviral syndrome associated with primary HIV infection to a prolonged asymptomatic state to advanced HIV disease. Experts regard HIV disease as beginning at the time of primary (acute) HIV infection and progressing through numerous stages of chronic infection. Acute HIV infection is defined (...) infection, see , , and . Next: Pathophysiology Acute HIV infection (also known as seroconversion) is defined as the period between exposure to the virus and completion of the initial immune responses (when an antibody test becomes positive for HIV). After infection, HIV is able to replicate at an exponential rate using CD4 cells. See the image below. Electron microscopy of human immunodeficiency virus (HIV)–1 virions. Courtesy of CDC/Dr. Edwin P. Ewing, Jr. The following is a simplified outline

2014 eMedicine.com

153. Childhood HIV Disease (Treatment)

=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvOTY1MDg2LXRyZWF0bWVudA== processing > Pediatric HIV Infection Treatment & Management Updated: Nov 16, 2018 Author: Delia M Rivera, MD; Chief Editor: Russell W Steele, MD Share Email Print Feedback Close Sections Sections Pediatric HIV Infection Treatment Approach Considerations ART is the mainstay in human immunodeficiency virus (HIV) treatment. Appropriate antiretroviral therapy (ART) and treatment of specific infections and malignancies are critical in treating patients who are HIV positive. Intervening early may (...) . The most current guidelines may be viewed at the Web site, a service of the US Department of Health and Human Services. Although current HAART regimens have substantially and dramatically decreased AIDS-related opportunistic infections (OIs) and deaths, prevention and management of OIs remain critical components of care for HIV-infected children. [ ] The Centers for Disease Control and Prevention (CDC), the National Institutes of Health, the HIV Medicine Association of the Infectious Diseases Society

2014 eMedicine.com

154. Ocular Manifestations of HIV (Treatment)

=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTIxNjE3Mi1vdmVydmlldw== processing > Ocular Manifestations of HIV Infection Updated: Nov 12, 2018 Author: Robert A Copeland, Jr, MD; Chief Editor: Hampton Roy, Sr, MD Share Email Print Feedback Close Sections Sections Ocular Manifestations of HIV Infection Overview Overview Ocular manifestations of human immunodeficiency virus (HIV) infection have historically been common. While approximately 70-80% of HIV-infected patients have been treated for an HIV-associated eye disorder during the course of their illness (...) with the following: Retinal or conjunctival microvasculopathy Cytomegalovirus (CMV) retinitis Varicella-zoster virus (VZV) retinitis Mycobacterium avium complex infection Cryptococcosis Microsporidiosis HIV encephalopathy Progressive multifocal leukoencephalopathy The predictive value of the CD4 + T-cell count for ocular complications in HIV infection has been called into question by reports of CMV retinitis in patients with CD4 + cell counts higher than 200 cells/mL. These patients reportedly were taking highly

2014 eMedicine.com

155. HIV (Overview)

Manifestations of HIV Infection Updated: Nov 12, 2018 Author: Robert A Copeland, Jr, MD; Chief Editor: Hampton Roy, Sr, MD Share Email Print Feedback Close Sections Sections Ocular Manifestations of HIV Infection Overview Overview Ocular manifestations of human immunodeficiency virus (HIV) infection have historically been common. While approximately 70-80% of HIV-infected patients have been treated for an HIV-associated eye disorder during the course of their illness, recently, these numbers have appeared (...) microvasculopathy Cytomegalovirus (CMV) retinitis Varicella-zoster virus (VZV) retinitis Mycobacterium avium complex infection Cryptococcosis Microsporidiosis HIV encephalopathy Progressive multifocal leukoencephalopathy The predictive value of the CD4 + T-cell count for ocular complications in HIV infection has been called into question by reports of CMV retinitis in patients with CD4 + cell counts higher than 200 cells/mL. These patients reportedly were taking highly active antiretroviral therapy (HAART

2014 eMedicine.com

156. Early Symptomatic HIV Infection (Overview)

disorders such as aseptic meningitis; and dermatologic disorders such as varicella-zoster virus (shingles). The clinical effects of human immunodeficiency virus (HIV) infection are diverse, ranging from an acute retroviral syndrome associated with primary HIV infection to a prolonged asymptomatic state to advanced HIV disease. Experts regard HIV disease as beginning at the time of primary (acute) HIV infection and progressing through numerous stages of chronic infection. Acute HIV infection is defined (...) infection, see , , and . Next: Pathophysiology Acute HIV infection (also known as seroconversion) is defined as the period between exposure to the virus and completion of the initial immune responses (when an antibody test becomes positive for HIV). After infection, HIV is able to replicate at an exponential rate using CD4 cells. See the image below. Electron microscopy of human immunodeficiency virus (HIV)–1 virions. Courtesy of CDC/Dr. Edwin P. Ewing, Jr. The following is a simplified outline

2014 eMedicine.com

157. Ocular Manifestations of HIV (Follow-up)

=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTIxNjE3Mi1vdmVydmlldw== processing > Ocular Manifestations of HIV Infection Updated: Nov 12, 2018 Author: Robert A Copeland, Jr, MD; Chief Editor: Hampton Roy, Sr, MD Share Email Print Feedback Close Sections Sections Ocular Manifestations of HIV Infection Overview Overview Ocular manifestations of human immunodeficiency virus (HIV) infection have historically been common. While approximately 70-80% of HIV-infected patients have been treated for an HIV-associated eye disorder during the course of their illness (...) with the following: Retinal or conjunctival microvasculopathy Cytomegalovirus (CMV) retinitis Varicella-zoster virus (VZV) retinitis Mycobacterium avium complex infection Cryptococcosis Microsporidiosis HIV encephalopathy Progressive multifocal leukoencephalopathy The predictive value of the CD4 + T-cell count for ocular complications in HIV infection has been called into question by reports of CMV retinitis in patients with CD4 + cell counts higher than 200 cells/mL. These patients reportedly were taking highly

2014 eMedicine.com

158. Childhood HIV Disease (Follow-up)

=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvOTY1MDg2LXRyZWF0bWVudA== processing > Pediatric HIV Infection Treatment & Management Updated: Nov 16, 2018 Author: Delia M Rivera, MD; Chief Editor: Russell W Steele, MD Share Email Print Feedback Close Sections Sections Pediatric HIV Infection Treatment Approach Considerations ART is the mainstay in human immunodeficiency virus (HIV) treatment. Appropriate antiretroviral therapy (ART) and treatment of specific infections and malignancies are critical in treating patients who are HIV positive. Intervening early may (...) . The most current guidelines may be viewed at the Web site, a service of the US Department of Health and Human Services. Although current HAART regimens have substantially and dramatically decreased AIDS-related opportunistic infections (OIs) and deaths, prevention and management of OIs remain critical components of care for HIV-infected children. [ ] The Centers for Disease Control and Prevention (CDC), the National Institutes of Health, the HIV Medicine Association of the Infectious Diseases Society

2014 eMedicine.com

159. Cutaneous Manifestations of HIV Disease (Follow-up)

=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTEzMzc0Ni1vdmVydmlldw== processing > Cutaneous Manifestations of HIV Updated: Apr 03, 2018 Author: Robert A Schwartz, MD, MPH; Chief Editor: William D James, MD Share Email Print Feedback Close Sections Sections Cutaneous Manifestations of HIV Overview Overview Cutaneous manifestations of human immunodeficiency virus (HIV) disease may result from HIV infection itself or from opportunistic disorders secondary to the decline in immunocompetence from the disease. [ ] Cutaneous disorders may be the initial signs of HIV (...) AIDS Soc . 2011 Jan 24. 14:5. . . Altman K, Vanness E, Westergaard RP. Cutaneous manifestations of human immunodeficiency virus: a clinical update. Curr Infect Dis Rep . 2015 Mar. 17(3):464. . Smith KJ, Skelton HG, Yeager J, Ledsky R, McCarthy W, Baxter D, et al. Cutaneous findings in HIV-1-positive patients: a 42-month prospective study. Military Medical Consortium for the Advancement of Retroviral Research (MMCARR). J Am Acad Dermatol . 1994 Nov. 31(5 Pt 1):746-54. . Zampogna JC, Flowers FP

2014 eMedicine.com

160. Early Symptomatic HIV Infection (Follow-up)

disorders such as aseptic meningitis; and dermatologic disorders such as varicella-zoster virus (shingles). The clinical effects of human immunodeficiency virus (HIV) infection are diverse, ranging from an acute retroviral syndrome associated with primary HIV infection to a prolonged asymptomatic state to advanced HIV disease. Experts regard HIV disease as beginning at the time of primary (acute) HIV infection and progressing through numerous stages of chronic infection. Acute HIV infection is defined (...) infection, see , , and . Next: Pathophysiology Acute HIV infection (also known as seroconversion) is defined as the period between exposure to the virus and completion of the initial immune responses (when an antibody test becomes positive for HIV). After infection, HIV is able to replicate at an exponential rate using CD4 cells. See the image below. Electron microscopy of human immunodeficiency virus (HIV)–1 virions. Courtesy of CDC/Dr. Edwin P. Ewing, Jr. The following is a simplified outline

2014 eMedicine.com

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