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Query: UMLS:C0019693 (HIV)
 170,526 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

End-stage renal diseases (ESRD) are becoming more frequent in HIV-infected patients. In Europe there is little information about HIV-infected patients on dialysis. A cross-sectional multicenter survey in 328 Spanish dialysis units was conducted in 2006. Information from 14,876 patients in dialysis was obtained (81.6% of the Spanish dialysis population). Eighty-one were HIV infected (0.54%; 95% CI, 0.43-0.67), 60 were on hemodialysis, and 21 were on peritoneal dialysis. The mean (range) age was 45 (28-73) years. Seventy-two percent were men and 33% were former drug users. The mean (range) time of HIV infection was 11 (1-27) years and time on dialysis was 4.6 (0.4-25) years. ESRD was due to glomerulonephritis (36%) and diabetes (15%). HIV-associated nephropathy was not reported. Eighty-five percent were on HAART, 76.5% had a CD4 T cell count above 200 cells, and 73% had undetectable viral load. Thirty-nine percent of patients met criteria for inclusion on the renal transplant (RT) waiting list but only 12% were included. Sixty-one percent had HCV coinfection. HCV-coinfected patients had a longer history of HIV, more previous AIDS events, parenteral transmission as the most common risk factor for acquiring HIV infection, and less access to the RT waiting list (p < 0.05). The prevalence of HIV infection in Spanish dialysis units in 2006 was 0.54% HCV coinfection was very frequent (61%) and the percentage of patients included on the Spanish RT waiting list was low (12%).
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PMID:Prevalence and clinical characteristics of HIV type 1-infected patients receiving dialysis in Spain: results of a Spanish survey in 2006: GESIDA 48/05 study. 1883 22

The antenatal prevalence of HIV/HCV coinfection ranges from 12% to 28% with mother-to-child transmission rates ranging from 3.6% to 9.5%. There are no guidelines detailing the most appropriate clinical management and treatment of coinfected children. We used a semi-structured questionnaire to investigate current European practices for the management and follow-up of HIV/HCV coinfected children among clinical centres contributing to the European Collaborative Study or the European Paediatric HCV Network. Clinicians from 16 out of 24 clinical centres responded and were caring for a total of 44 HIV/HCV coinfected children. We found that, although there was a high level of concordance regarding testing for HIV and/or HCV infection, monitoring practices in these European centres varied widely. Few clinicians stated they would administer HIV and HCV treatment concurrently. Limited experience in the clinical management of this group and the lack of an evidence base to guide policy may be a barrier to achieving optimal care and treatment.
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PMID:Policies and practices for the clinical management of HIV/HCV coinfected children in Europe: an epidemiological survey. 1894 77

Since 1983 (survey period returning to 1978) with support of numerous haemophilia treating centres of any size an annual survey regarding the epidemiology of patients suffering of haemophilia is performed. The actual compilation is resting upon a broad database returning to almost 30 years of inquiry well representing both the actual and retrospective status of mortality. Prompted was exclusively information about patients with haemophilia A, B and von Willebrand disease. In particular anonymous data concerning the last 12 months about number of treated patients, type and severity of illness, HIV-status and detailed information about causes of death was inquired. This data was merged with existing data and analyzed statistically. In the 2006/2007 survey, a total number of 8188 patients with bleeding disorders have been reported from 69 participating centres. Despite mortality from HIV in patients with haemophilia is decreasing, HIV still remains an important factor as a HIV/HCV coinfection seems to increase risk of progression of liver disease. Age structure in our patients has been shifting significantly over the last decades bringing age distribution into line with the entire population. This has to be considered in assessing mortality and morbidity.
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PMID:[Causes of death in patients with haemophilia in Germany 2006/2007]. 1895 38

The limitations of liver biopsy (invasive procedure, sampling errors, inter-observer variability and nondynamic fibrosis evaluation) have stimulated the search for noninvasive approaches for the assessment of liver fibrosis in patients with viral hepatitis. A variety of methods including the measurement of liver stiffness, using transient elastography, and serum markers, ranging from routine laboratory tests to more complex algorithms or indices combining the results of panels of markers, have been proposed. Among serum indices, Fibrotest has been the most extensively studied and validated. Transient elastography appears as a promising method but has been mostly validated in chronic hepatitis C with performance equivalent to that of serum markers for the diagnosis of significant fibrosis. The combination of both approaches as first-line assessment of liver fibrosis could avoid the performance of liver biopsy in the majority of patients with chronic hepatitis C, a strategy that deserves further evaluation in patients with hepatitis B or HIV-HCV coinfection. Transient elastography also appears to be an excellent tool for early detection of cirrhosis and may have prognostic value in this setting. Guidelines are now awaited for the use of noninvasive methods in clinical practice.
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PMID:Transient elastography and other noninvasive tests to assess hepatic fibrosis in patients with viral hepatitis. 1925 51

The effect of highly active antiretroviral therapy (HAART) on hepatitis C virus (HCV) infection remains uncertain. This report describes the case of a man with hemophilia with HIV-HCV coinfection with persistent disappearance of HCV RNA after changing the HAART regimen. He had been treated with zidovudine, lamivudine, and indinavir for initial HAART and the HIV RNA level had been undetectable for more than 8 years. He had suffered from chronic active hepatitis. The HAART regimen was changed to emtricitabine/tenofovir, atazanavir, and ritonavir because the patient preferred a once daily regimen. The HCV RNA level fell immediately and thereafter became undetectable by quantitative and qualitative assay at 5 and 7 months after the change of the HAART regimen, respectively. In contrast to other reported cases, he experienced neither increase of CD4+ T cells count nor ALT flare-ups before HCV RNA clearance. The HCV RNA disappearance in this case may be due to the direct effect of HAART against HCV rather than restoration of cellular immunity to HCV.
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PMID:Case report: clearance of hepatitis C virus after changing the HAART regimen in a patient infected with hepatitis C virus and the human immunodeficiency virus. 1938 59

Shared transmission routes of HCV and HIV mean parenteral HIV/HCV coinfection still occurs, often in resource-limited settings. The extent to which coinfection and treatment impact on morbidity and mortality in HIV/HCV coinfected children remains unknown thus optimal management and treatment is difficult to achieve. Using data from a unique, large, prospective cohort of parenterally HIV/HCV coinfected children in Libya we determine the immunological, virological and clinical profiles of HIV/HCV coinfected children documenting the natural and treated history of parenterally acquired coinfection for the first time in such a large group. 160 parenterally HIV/HCV coinfected children were analysed. Thirty-three (21%) received antiretroviral treatment (ART) for HIV disease during follow-up. In children receiving ART, HIV RNA viral load decreased in two-thirds 6-12 months after initiation. 85% (17/20) experienced a positive immunological response to ART with a median increase in CD4 cell count z-score of 131%. Half had progressed to moderate or severe immunosuppression and/or moderate or severe clinical symptoms three years after infection. In those who progressed during follow-up, 85% had done so within three years of infection. Children progressing to moderate or severe immunosuppression and/or clinical symptoms were significantly more likely to be receiving ART. This novel investigation of the natural and treated history of parenterally HIV/HCV coinfected children in a large prospectively followed group demonstrates minimal clinical symptoms and immunosuppression to date, despite low prevalence of treatment, and a response to ART similar to vertically HIV-only infected children.
Curr HIV Res 2009 May
PMID:HIV and HCV progression in parenterally coinfected children. 1944 33

Non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatosis (NASH) are common conditions in the setting of HIV infection, especially if HCV coinfection or metabolic syndrome's features are present. The factors that contribute to the progression of NAFLD to NASH and fibrosis are not completely known and the role of antiretroviral therapy is especially controversial. Although the natural history of NASH in the setting of HIV infection is unknown, it may emerge as one of the leading causes of liver disease over the long term in these patients. Liver biopsy is still the gold standard for the diagnosis of NASH. Indeed, although non-invasive techniques are promising tools for the diagnosis of NAFLD, they do not assess liver damage. There is no specific therapy for NASH in HIV infection, as the role of glitazones has not been evaluated in these patients.
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PMID:[Non alcoholic steatosis in HIV infection]. 1951 91

The continuous replication of HIV-1 in the central nervous system, in particular the brain, and its potential long-term deleterious effect is the focus of this review. Cognitive deficits are observed in a significant percentage of HIV-1-infected patients. That may occur despite successful peripheral suppression of the HIV-1 replication. Compartmentalisation of HIV-1 in the brain, genetic mutation of HIV-1, age, HCV coinfection and poor intracerebral penetration, as well as possibly a direct toxic effect of antiretroviral drugs, are factors that may account for potential creeping damage of the brain after many years of treatment. Patients with neurological symptoms or cognitive deficits may require another approach to the treatment of their HIV infection.
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PMID:Should antiretroviral therapy for HIV infection be tailored for intracerebral penetration? 1974 89

Since 1978 an annual multicentric survey regarding the epidemiology of patients suffering of haemophilia is performed with support of haemophilia treating centres of any size. Again the actual compilation is resting upon a broad database returning to over 30 years of inquiry well representing both the actual and retrospective status of mortality. Prompted was exclusively information about patients with haemophilia A, B and von Willebrand disease. In particular anonymous data concerning the last 12 months about number of treated patients, type and severity of illness, HIV-status and detailed information about causes of death was inquired. This data was merged with existing data and analyzed statistically. In the 2007/2008 survey, a total number of 8904 patients with bleeding disorders have been reported from 63 participating centres. Despite mortality from HIV in patients with haemophilia is keeping on decreasing, HIV still remains an important factor as an HIV/HCV coinfection seems to increase risk of progression of severe liver disease. Age structure in our patients has been shifting significantly over the last decades bringing age distribution into line with the entire population. This has to be considered assessing mortality and morbidity.
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PMID:[Morbidity and mortality of patients with haemophilia in Germany 2007/2008]. 1976 54

HIV infection is associated with left ventricular (LV) dysfunction and accelerated atherosclerosis. These conditions result in elevation of plasma natriuretic peptide (NP) levels. The present study compares N-terminal-pro-BNP (NT-pro-BNP) levels in HIV-infected and -uninfected women and identifies factors influencing NT-pro-BNP levels in HIV-infected women. A total of 454 HIV-infected and 200 HIV-uninfected participants from the Women's Interagency HIV Study (WIHS) had NT-pro-BNP determination. Elevated NT-pro-BNP level was defined using previously determined age stratified cut-off values of >164 ng/liter (age <60 years) and >225 (age > or = 60 years). HIV-infected women were older (41.6 +/- 8.9 vs. 38.9 +/- 10.5 years, p < 0.01) and were more likely to have anemia, hepatitis C virus (HCV) antibodies, and kidney dysfunction than HIV-uninfected women. HIV-infected women had significantly higher NT-pro-BNP levels (142.4 +/- 524.8 vs. 73.6 +/- 115.1 ng/liter, p = 0.01) and a higher prevalence of elevated NT-pro-BNP (12.1% vs. 7.5%; p = 0.08). In univariate analyses, elevated NT-pro-BNP was significantly associated with age, systolic BP, hypertension, anemia, triglyceride levels, kidney disease, and HCV seropositivity, but not HIV infection. In multivariate analysis, elevated NT-pro-BNP levels were significantly associated with anemia and kidney function, and had a borderline association with the presence of HCV antibodies. Among HIV-infected women, NT-pro-BNP levels were not independently associated with measures of severity of infection or with HAART use. Although HIV-infected women have higher NT-pro-BNP levels than HIV-uninfected women, the differences are due to non-HIV factors such as anemia, kidney disease, and HCV coinfection. These findings suggest that natriuretic peptide levels are a global marker of comorbidity in the setting of HIV infection.
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PMID:Elevated NT-pro-BNP levels are associated with comorbidities among HIV-infected women. 1980 14


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