Had Human Immunodeficiency Virus Infection Research Articles

Primary Esophageal Lymphoma: A Histopathological Experience from Two Tertiary Hospitals, Western Saudi Arabia.

Primary esophageal lymphoma (PEL) is a rare disorder. The objective of this study was to document the clinicopathological features of PEL at two tertiary hospitals in the western region of the Kingdom of Saudi Arabia. All PELs diagnosed between May 2002 and June 2022 were retrieved. Histopathological and immunohistochemical slides were reviewed. Additional immunohistochemistry stains were performed in selected cases. Follow-up data were collected. There were only eight cases of PEL in the records of the two hospitals. The age of the patients ranged between 50 and 74 years (median 62 years and mean 62.5 years). There were six males (80%) and two females (20%). None of the patients were immunocompromised or had human immunodeficiency virus (HIV) infection. The clinical manifestation included dysphagia and loss of weight. Six cases were diffuse large B-cell lymphoma (DLBCL), and two were low-grade mucosa-associated lymphoid tissue lymphoma. PEL is an extremely rare disease with male predominance. DLBCL is the most common pathological type in our community. There was no relation to immune status or HIV infection in this series. Clinical presentations were typically dysphagia with weight loss. Further reporting of PEL cases might help explain this disease and improve its diagnosis and management.

Abstract C021: Characteristics of malignancy in lesbian, gay, bisexual, and transgender/transsexual (LGBT) population

Abstract Background: LGBT people account for 4.5% of adult population in U.S. and face multiple challenges across different aspects of life. Although malignancy is the second most common cause of death in the U.S., only few studies that analyzed the characteristics of malignancies in the LGBT community exist. We aim to provide an overview of malignancy affecting LGBT patients. Methods: A retrospective chart review of LGBT patients with a diagnosis of malignancy treated at Medstar Health Hospitals was performed. Natural language processing with strings was utilized to retrieve patient charts with ICD-9 and ICD-10 codes for LGBT status and cancer. Results: A total of sixty-one patients (pts) were identified; (5 lesbian female, 49 gay male, 6 female transgenders and 1 male transgender). The median age was 49 (range: 19-79). 30 pts (49%) were Caucasian, 26 (43%) were African American and 5 (8%) were Hispanic. Among the female transgender patients, 3 received hormonal therapy for gender change and no patient underwent surgery to change the biological gender. 18 pts had human immunodeficiency virus (HIV) infection, 1 pt hepatitis B virus (HBV), 2 pts hepatitis C virus (HCV), 8 pts HIV/HCV, 2 pts HIV/HBV, and 1 pt HIV/HBV/HCV. Among the patients with HIV infection (n=29), 26 (90%) were receiving anti-retroviral treatment at last follow-up. 27 (44%) pts were active smokers, 10 (16%) pts former smokers and 24 (40%) never smoker. 27 (44%) reported a history of substance abuse with 9 (15%) pts with active substance abuse and 25 (41%) never used it. Employment status was employed (n=32), unemployed (n=20), retired (n=6), and not available (n=3). Tumor types included anal squamous cell carcinoma (anal SCC; n=15), Non-Hodgkin lymphoma (NHL; n=12), non-small-cell lung cancer (NSCLC; n=9), colorectal cancer (CRC; n=7), Kaposi sarcoma (n=4), brain cancer (n=3), breast carcinoma, small-cell lung cancer and pancreatic cancer (2 each), prostate carcinoma, testicular carcinoma, head and neck cancer, Hodgkin lymphoma and mesothelioma (1 each). Among the HIV-infected patients, tumor types include [NHL n=8, anal SCC n=6, NSCLC n=4, CRC n=4, Kaposi sarcoma n=3, head and neck cancer =1, prostate cancer n=1, pancreatic cancer n=1, Hodgkin lymphoma n=1]. Among the anal SCC group (n=15), 6 pts had human papilloma (HPV)-associated cancer, while 1 pt had non-HPV associated cancer and HPV status was not available in 8 pts. Conclusion: LGBT people with cancer have a high incidence of chronic viral infection and appear to have distinct patterns of malignancy compared to those in the general population. Larger studies are needed to verify the findings and to understand unique challenges facing the LGBT population. Citation Format: Ghassan Al-Shbool, Saira Farid, Ahmad Nassar, Chul Kim. Characteristics of malignancy in lesbian, gay, bisexual, and transgender/transsexual (LGBT) population [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr C021.

Vital Signs: HIV Transmission Along the Continuum of Care - United States, 2016.

BackgroundIn 2016, an estimated 1.1 million persons had human immunodeficiency virus (HIV) infection in the United States; 38,700 were new infections. Knowledge of HIV infection status, behavior change, and antiretroviral therapy (ART) all prevent HIV transmission. Persons who achieve and maintain viral suppression (achieved by most persons within 6 months of starting ART) can live long, healthy lives and pose effectively no risk of HIV transmission to their sexual partners.MethodsA model was used to estimate transmission rates in 2016 along the HIV continuum of care. Data for sexual and needle-sharing behaviors were obtained from National HIV Behavioral Surveillance. Estimated HIV prevalence, incidence, receipt of care, and viral suppression were obtained from National HIV Surveillance System data.ResultsOverall, the HIV transmission rate was 3.5 per 100 person-years in 2016. Along the HIV continuum of care, the transmission rates from persons who were 1) acutely infected and unaware of their infection, 2) non-acutely infected and unaware, 3) aware of HIV infection but not in care, 4) receiving HIV care but not virally suppressed, and 5) taking ART and virally suppressed were 16.1, 8.4, 6.6, 6.1, and 0 per 100 person-years, respectively. The percentages of all transmissions generated by each group were 4.0%, 33.6%, 42.6%, 19.8%, and 0%, respectively.ConclusionApproximately 80% of new HIV transmissions are from persons who do not know they have HIV infection or are not receiving regular care. Going forward, increasing the percentage of persons with HIV infection who have achieved viral suppression and do not transmit HIV will be critical for ending the HIV epidemic in the United States.

Sexually Transmitted Infections: Experience in a Multidisciplinary Clinic in a Tertiary Hospital (2010-2013)

BackgroundThe number of consultations for sexually transmitted infections (STIs) is increasing in Spain. The aim of this study was to describe and analyze the epidemiological, behavioral, clinical, and microbiological characteristics of patients registered at the STI unit of a tertiary hospital. MethodsThis was a retrospective, single-center descriptive study carried out between 2010 and 2013 in a multidisciplinary unit specialized in STIs, situated in a tertiary hospital. Epidemiological, clinical, and behavioral data were gathered using a face-to-face interview and a standardized questionnaire. Samples were collected for microbiology analysis. ResultsThe study included 546 patients: 96% were men, 41% had human immunodeficiency virus (HIV) infection, and 56% were men who have sex with men. The reasons for consultation were the following: urethritis; genital, anal, or perianal ulcers; proctitis; oral ulcers; sexual contact with a person with a known STI; and high-risk sexual contact. The most common microbiological diagnoses were Neisseria gonorrhoeae in urethritis, Treponema pallidum in genital and anal or perianal ulcers, and Chlamydia trachomatis lymphogranuloma venereum serovars in proctitis. The highest prevalences of the main STIs studied occurred in homosexual men with HIV infection. ConclusionThis study confirms the increase in the incidence of STIs in recent years and the epidemiological characteristics of the HIV/STI epidemic in Spain.

Infecciones de transmisión sexual: experiencia de una consulta multidisciplinar en un hospital terciario (2010-2013)

IntroductionThe number of consultations for sexually transmitted infections (STIs) is increasing in Spain. The aim of this study was to describe and analyze the epidemiological, behavioral, clinical, and microbiological characteristics of patients registered at the STI unit of a tertiary hospital. MethodsThis was a retrospective, single-center descriptive study carried out between 2010 and 2013 in a multidisciplinary unit specialized in STIs, situated in a tertiary hospital. Epidemiological, clinical, and behavioral data were gathered using a face-to-face interview and a standardized questionnaire. Samples were collected for microbiology analysis. ResultsThe study included 546 patients: 96% were men, 41% had human immunodeficiency virus (HIV) infection, and 56% were men who have sex with men. The reasons for consultation were the following: urethritis; genital, anal, or perianal ulcers; proctitis; oral ulcers; sexual contact with a person with a known STI; and high-risk sexual contact. The most common microbiological diagnoses were Neisseria gonorrhoeae in urethritis, Treponema pallidum in genital and anal or perianal ulcers, and Chlamydia trachomatis lymphogranuloma venereum serovars in proctitis. The highest prevalences of the main STIs studied occurred in homosexual men with HIV infection. ConclusionThis study confirms the increase in the incidence of STIs in recent years and the epidemiological characteristics of the HIV/STI epidemic in Spain.

Syphilis in Men Who Have Sex With Men: A Warning Sign for HIV Infection

ObjectiveTo describe the clinical and epidemiological characteristics of syphilis in men who have sex with men (MSM) in an area of Mallorca, Spain. MethodsWe performed a retrospective analysis of syphilis cases in MSM seen at a hospital in Mallorca between January 2005 and June 2013. ResultsFifty-five cases of syphilis were recorded in MSM during the study period (34.3% of all cases diagnosed), and 74.5% of these patients had human immunodeficiency virus (HIV) coinfection. The two diseases had been diagnosed simultaneously in 70.7% of this population. Patients with HIV coinfection had a median CD4 count of 456cells/μL (range, 29-979 cells/μL). Syphilis was diagnosed clinically in 49.1% of cases and by screening in the remaining 50.9%. The most common form of syphilis was late latent or indeterminate syphilis (41.9% of cases). In the group of men with syphilis, MSM had a higher risk of HIV infection. ConclusionsA majority of MSM with syphilis had HIV coinfection. HIV screening is therefore essential in this population and could even result in early diagnosis.

Sífilis en hombres que tienen sexo con hombres: una alarma para la detección de infección por VIH

ObjectiveTo describe the clinical and epidemiological characteristics of syphilis in men who have sex with men (MSM) in an area of Mallorca, Spain. MethodsWe performed a retrospective analysis of syphilis cases in MSM seen at a hospital in Mallorca between January 2005 and June 2013. ResultsFifty-five cases of syphilis were recorded in MSM during the study period (34.3% of all cases diagnosed), and 74.5% of these patients had human immunodeficiency virus (HIV) coinfection. The two diseases had been diagnosed simultaneously in 70.7% of this population. Patients with HIV coinfection had a median CD4 count of 456cells/μL (range, 29-979 cells/μL). Syphilis was diagnosed clinically in 49.1% of cases and by screening in the remaining 50.9%. The most common form of syphilis was late latent or indeterminate syphilis (41.9% of cases). In the group of men with syphilis, MSM had a higher risk of HIV infection. ConclusionsA majority of MSM with syphilis had HIV coinfection. HIV screening is therefore essential in this population and could even result in early diagnosis.

Sexual assault in Lagos, Nigeria: a five year retrospective review.

BackgroundCases of sexual assault are increasingly reported. However, Nigerian researchers have not given adequate attention to this subject despite its attendant social, physical and psychological consequences.This study assessed survivors’ characteristics, circumstances of assault and treatment offered with a view to reducing the incidence as well as improving evaluation and management.MethodsA retrospective review of survivors’ case records at Lagos State University Teaching Hospital, Ikeja, between January 2008 and December 2012. Data was analysed using the Epi-info 3.5 statistical software of the Centre for Disease Control and Prevention, Atlanta U S A.ResultsOf the 39,770 new gynaecological cases during this period, 304 were alleged sexual assault giving an incidence of 0.76% among hospital gynaecological consultations. Only 287 case notes had sufficient information for statistical analysis. Of these, 83.6% were below 19 years, 73.1% knew their assailants (majority were neighbours), most assaults (54.6%) occurred in the neighbours’ homes and over 60% of victims presented after 24 hours of assault.Although 77.3% were assaulted at daytime, teenagers were likely to be raped during the day and non-teenagers at night (P < 0.001). Threat and physical violence were mostly used to overcome victims. Seventy three point six percent had Human Immunodeficiency Virus (HIV) screening with one positive at onset. Post Exposure Prophylaxis for HIV was given in 29.4% of those eligible and emergency contraception in 22.4% of post-menarcheal victims (n = 125).There were neither referrals for psychotherapy nor forensic specimen collected. No record of post-assault conception or HIV infection was found during follow-up.ConclusionsAdolescents remain the most vulnerable requiring life skills training for protection. Survivors delay in presenting for care. Therefore, public enlightenment on the benefits of early interventions and comprehensive care of survivors with the use of standardized protocols are recommended.

Cytological Diagnosis of Penicillium marneffei Infection

Penicillium marneffei is an emerging opportunistic pathogen. The goal of this study was to study its clinical and radiographic presentation, and the diagnostic value of a cytological study of penicilliosis. A total of 24 patients with penicilliosis were found by culture in an 8-year period. Thirteen patients had cytological examination, which were retrospectively reviewed to analyze the morphological characteristics of P. marneffei and diagnostic yields of different cytological specimens. Twenty (83%) of the 24 patients (20 males) had human immunodeficiency virus (HIV) infection. In eight (40%) patients, penicilliosis was the initial manifestation of HIV infection. Penicilliosis was diagnosed in all patients antemortem from culture of blood or other body sites. One (4%) died. Six of 13 patients who had cytological study had intra- or extracellular yeast-like organisms with transverse septum found in fine needle aspirate, imprint or sputum cytology studies. The cytological diagnostic yields for P. marneffei from lung biopsy imprint smears, lung aspirates, neck lymph node aspirates and sputum were 2/2, 2/4, 2/2 and 2/4, respectively. The cytological diagnosis could be made immediately after aspiration, much quicker than diagnosis from cultures. P. marneffei causes disseminated infection, and can be the initial manifestation in HIV-infected patients in Taiwan. Penicilliosis can be diagnosed rapidly with cytological study of lung biopsy imprint smears, lung aspirates, neck lymph node aspirates or sputum.

Peculiarities of Chronic Diarrhea in Enugu, Southeastern Nigeria.

Adult patients admitted with chronic diarrhea to the various wards of the University of Nigeria Teaching Hospital, Enugu, from August 1996 to October 1997 were evaluated further by detailed history-taking, thorough physical examination, serological testing for HIV infection, and stool microscopy. Of 189 patients with chronic diarrhea seen during the study period, 161 had human immunodeficiency virus (HIV) infection (85.2%) whereas 28 were HIV negative (14.9%). Other clinical findings such as weight loss, persistent cough, skin rash prolonged fever, genital ulcers, sore throat, chronic ear discharge, chronic vaginal discharge, oral thrush, herpes zoster, and sinusitis were significantly more frequent in the HIV-infected group. Diarrhea was equally more severe in this group than in the HIV-negative controls. Only Entamoeba histolytica (E. histolytica) was significantly more frequently identified in the HIV- infected patients compared with the HIV-negative group. However, since the E. histolytica was present mainly in its cyst form, it cannot be said to have any pathogenic role in the diarrhea. No acid-fast organism was identified. The microbial causes of chronic diarrhea in HIV-infected patients in Enugu may be significantly different from those reported in other parts of Africa and the developed world.

Effect of hepatitis C genotype on mother-to-infant transmission of virus

We evaluated vertical transmission of hepatitis C virus (HCV) in 37 pregnant women, 20 of whom also had human immunodeficiency virus (HIV) antibody. The HCV subtypes 1a and 3a were prevalent among pregnant women with HIV infection. Infection with HCV was transmitted from 30.7% of the 13 mothers with HCV ribonucleic acid (RNA) and HIV antibody and from 25% of the 8 with HCV RNA alone. No mother with HCV antibody but no HCV RNA transmitted HCV to her infant. Subtypes 1b and 3a seemed to be the most common HCV genotypes transmitted. (J P EDIATR 1995;127:278-80)

The spectrum of pathological changes in the lung in children with the acquired immunodeficiency syndrome: An autopsy study of 36 cases

We present the pulmonary findings in 36 autopsies of children affected by the acquired immunodeficiency syndrome (AIDS). Twenty-three patients were male and 13 were female, ranging in age between 3 days and 13 years. Twenty children had human immunodeficiency virus (HIV)-positive parents or parents who were at high risk of exposure (intravenous drug abusers and prostitutes), five had a history of transfusion, and one had a history of renal transplantation and blood transfusion. Clinically, the patients presented with recurrent infections, failure to thrive, hepatosplenomegaly, fever, cough, and/or hemoptysis. Histologically, specific infectious processes were the most common finding (75% of cases), with Pneumocystis carinii pneumonia being the most prevalent type of infection, followed by bacterial pneumonia. Neoplastic conditions and lymphoid interstitial pneumonia were less frequent (approximately 10% of cases). In addition, in approximately 10% of the cases the pulmonary findings were nonspecific (ie, pulmonary edema and atelectasis) and probably unrelated to HIV infection. Our findings suggest that specific infectious conditions constitute the most common type of pulmonary pathology in children with AIDS. However, because there is a small percentage of children with nonspecific findings, a transbronchial biopsy is important for proper evaluation before institution of therapy.

HIV Antibody Testing in Hospitalized Patients

We retrospectively reviewed the charts of 190 hospitalized patients who had human immunodeficiency virus (HIV) antibody testing at our medical center in 1986 and 1987. From 1986 to 1987, HIV antibody testing increased fourfold based on total hospital discharges. Nine patients (5%) tested positive by enzyme immunoassay and the Western blot method. No risk factor for HIV infection was identified in 30% of cases. Documentation of patients' consent for testing was found in 14% of cases. We conclude that HIV antibody testing of hospitalized patients has increased. However, the indication for testing is often not clear by chart review, and consent for testing is poorly documented in the absence of a formal hospital policy requiring consent before testing. Further physician education and establishment of hospital policies addressing these important aspects of HIV antibody testing are indicated.