HIV-positive Patient Research Articles

Rapid onset of neurological symptoms in an HIV-positive patient with progressive multifocal leukoencephalopathy: a case report

Introduction and importance: Progressive multifocal leukoencephalopathy (PML) is a rare demyelinating disease of the central nervous system caused by substantial damage to oligodendrocytes. It clinically presents as movement impairment, cognitive disability, language aphasia, dysarthria, and visual impairments. It was first identified in 1958. It is commonly associated with either Hodgkin’s lymphoma or chronic lymphocytic leukemia. Case presentation: A 40-year-old male Asian farmer presented with altered behavior, fever, and weakness on the right side of his body after suffering a widespread tonic-clonic seizure. His medical background included a tonsillectomy, treatment for pulmonary tuberculosis, and hepatitis C (negative polymerase chain reaction). On admission, he had asymmetric plantar responses, pallor, brisk deep tendon reflexes, an oral thrush, and decreased strength and tone in the muscles on his right side. The findings of the laboratory tests revealed elevated pH, red blood cells, lymphocytes, and protein in the cerebrospinal fluid, as well as an elevated erythrocyte sedimentation rate, abnormal liver function tests, and no bacterial growth. Magnetic resonance imaging (MRI) showed bilateral parietal, temporal, and frontal lobe high signal lesions (T2W, FLAIR sequences), with more severe lesions in the left lobe and no contrast enhancement, consistent with the imaging features of PML. According to the spinal tap, the patient was JC virus-positive. HIV testing indicated a significant viral load, and electroencephalogram recorded seizures. Clinical discussion: JC virus reactivation causes PML, a serious brain condition in patients with weak immune systems. HIV and immunosuppressive drugs are thought to be the potential risk factors behind the reactivation of the JC virus and the appearance of PML. Symptoms like seizures and fever are not usually associated with PML, but the presence of these symptoms hints toward the complexity of the diagnosis of this case. Doctors should focus on treating the root cause of the weakened immune system to help patients. PML was identified by combining the results of an MRI scan with the patient’s HIV status and the results of a spinal tap. The patient’s health deteriorated even after receiving corticosteroids, acyclovir, nutritional supplements, and palliative therapy. As time passed, he developed neurological complications, respiratory failure, and ultimately death. Conclusion: This case highlights the more aggressive and unique course of PML in HIV patients, it underscores the importance of assessment of the neurological symptoms in high-risk individuals. As PML carries high mortality risk it necessitates prompt diagnosis and treatment with antiretroviral drugs to slow the disease progression.

Evaluation of a cost-effective gating strategy for CD4+ T lymphocyte enumeration in HIV-infected individuals via flow cytometry.

Evaluation of a cost-effective gating strategy for CD4+ T lymphocyte enumeration in HIV-infected individuals via flow cytometry.

Unexpected mild course of COVID-19 in HIV-positive patient with various risk factors: a case report

Unexpected mild course of COVID-19 in HIV-positive patient with various risk factors: a case report

Colitis as a clinical manifestation of disseminated histoplasmosis in HIV-positive patient: a case report

Colitis as a clinical manifestation of disseminated histoplasmosis in HIV-positive patient: a case report

Management of an Oral Ranula in a HIV positive patient: Case report

Background: Ranula is a cyst resulting from obstruction of the major salivary gland which is a phenomenon of duct retention in the sublingual gland located at the floor of the mouth, resulting in swelling under the tongue and bluish. Ranula may occur in association with HIV. This article reports the management of ranula cases in HIV patients. Case Presentation: A 20-year-old male patient came with complaints of a lump under his tongue 1 month ago, often recurrence. The patient has a history of HIV. Extraoral examination showed a painless lump in the left submandibular region. On intraoral examination, it was found a translucent lump in the sublingual region, mobile, and painless. Diagnostic tests including OPG, thorax radiography, and MRI. Treatment was carried out by marsupialization under general anesthesia. Conlussion: Persistent chronic inflammation caused by HIV can lead to blockage of the small ducts, followed by distension that can lead to rupture of the ducts and extravasation of mucus into the surrounding tissue. The treatment was marsupialization under general anesthesia.

A case of lichen pigmentosus and oral lichen in an HIV positive patient

A case of lichen pigmentosus and oral lichen in an HIV positive patient

ИНФОРМИРОВАННОСТЬ ВРАЧЕЙ-СТОМАТОЛОГОВ О ВИЧ-ПОЗИТИВНЫХ ПАЦИЕНТАХ

Introduction. Dentists' awareness of HIV-positive patients plays an important role in improving the quality of care for this group of patients. Objective: to assess the knowledge of practicing dentists about HIV-positive patients taking antiretroviral drugs. Materials and methods of the study. To achieve the goal of the study, the data obtained from an online survey of 181 doctors of dental specialties were analyzed. Statistical processing of the data was carried out using Microsoft Excel 2023 software. Results of the study. A large proportion (80.7%) of the surveyed dentists encounter HIV-positive patients at their appointments, 93.9% of the respondents know the difference between HIV and AIDS, but only 59.1% of them have heard/know about HAART drugs. According to 40.3% of the respondents, an HIV-positive patient taking HAART can transmit the virus to a doctor in an emergency situation, while 29.8% answered negatively and 29.8% do not know the answer to this question. More than 24% of dentists believe that HIV infection is transmitted through saliva. When an HIV-positive patient on therapy (HAART) is approached, a large proportion of dentists (50.8%) do not offer them routine procedures. 3.3% of dentists refused to admit an HIV-positive patient. 68.5% of respondents know what viral load is, but only 28.7% of dentists clarify its presence in a patient with HIV. 68.5% of dentists recommend HIV testing to their patients only in cases of atypical SOPS diseases. A patient was refused at the appointment stage or after counseling because of his HIV status in every 10th case. Conclusion. The vast majority of dentists are poorly informed about HIV infection and the drugs used to reduce viral load. We consider it necessary to recommend planning and conducting separate lecture sessions on HIV infection and the rules of safe reception of patients receiving antiretroviral therapy at universities and courses of additional professional education.

Ocular Manifestations of Kaposi Sarcoma: Insights from an HIV-Positive Patient and an Immunocompetent HIV-Negative Patient.

Kaposi sarcoma (KS) is a vascular neoplasm caused by human herpes virus-8 and is commonly associated with immunocompromised states such as acquired immunodeficiency syndrome. While ocular involvement is rare and typically occurs in human immunodeficiency virus (HIV)-positive patients, it can exceptionally present in HIV-negative, immunocompetent individuals. This report presents two cases of conjunctival KS: One in an HIV-positive patient and another in an HIV-negative patient. The patients were diagnosed and followed up at Istanbul Medeniyet University Göztepe Prof. Dr. Süleyman Yalçın City Hospital. Written informed consent was obtained from the patients for the preparation of this case report. A 35-year-old HIV-positive male with a history of cutaneous and genital KS presented with a painless, reddish, hemorrhagic mass on the left inferior fornix and a firm mass on the lower eyelid. Surgical excision with adjuvant cryotherapy and amniotic membrane transplantation was performed. One year postoperatively, no recurrence or new lesions were observed. A 76-year-old immunocompetent female presented with a painless, progressively enlarging mass in the left inferior fornix. She underwent surgical excision, adjuvant cryotherapy, and amniotic membrane transplantation. Histopathology confirmed the diagnosis of KS, and at the 1-year follow-up, no recurrence or new lesions were observed. Ocular KS, though rare, can occur in both immunocompromised and immunocompetent individuals. This report highlights the importance of considering KS in the differential diagnosis of subconjunctival hemorrhage, even in patients without underlying immunosuppressive conditions. Both cases were successfully managed with surgical excision, adjuvant cryotherapy, and amniotic membrane transplantation, with no recurrence during follow-up.

P0247 Clinical and Colonoscopic Features of Colitis in HIV-Positive Patients Mimicking Inflammatory Bowel Disease Over the Past 12 Years

Abstract Background Not only the incidence of inflammatory bowel disease(IBD) but also that of HIV-positive colitis is increasing as individual freedom is emphasized, making the diagnosis of IBD more challenging nowadays. Methods We reviewed the data of 75 HIV-positive patient at Daehang Hospital, Seoul, from January 2012 to October 2024. Ten patients were filtered from retrospective medical records analysis who were suspected to have IBD before the HIV-positive diagnosis. Results Among the 10 patients suspected to have IBD, all were men with a median age of 27, ranging from 22 to 62. Symptom complaints started 2 week ago(2 men), 1 month ago(6 men), 2months ago(1 man), 6month ago(1 man). Initial diagnoses from personal history were ulcerative colitis(5 men), Crohn’s disease(3 men), irritable bowel syndrome(1 man), infectious colitis(1 man). Anal sex history could be obtained from 5 patients. Colonoscopy revealed rectal ulcers(4 men), whole colon ulcers or erosions(4 men), left colon erythema, edema (1 man), and anal abscess(1 man). One patient was found to have amebiasis from cecum tissue. Conclusion HIV-positive colitis is very rare but now increasing, necessitating differential diagnosis. Initial suspicion through careful history taking and close observation of colonic mucosal lesions could reduce the misdiagnosis of IBD. Further large-scale cases are needed to identify the characteristics of HIV-positive colitis to exclude the diagnosis of IBD.

Intestinal Spirochetosis as a Cause of Persistent Rectal Abscess in a Patient With HIV/AIDS

Abstract Brachyspira is a rare spirochetal infection that can cause a variety of gastrointestinal symptoms. Individuals with HIV/AIDS are at increased risk of developing persistent and severe infection. To our knowledge, rectal abscess due to Brachyspira have not previously been described. Here, we present a case of a HIV-positive patient presenting with chronic rectal pain and drainage over the span of 2 years, who was diagnosed with Brachyspira rectal abscess. We discuss the diagnostic challenge of Brachyspira rectal abscesses mimicking sexually transmitted disease and discuss the utility of prolonged metronidazole treatment due to both antibacterial and anti-inflammatory effects.

Malignant varicella and tuberculosis co-infections in a 15-year-old HIV-positive patient at Brazzaville University Hospital

Tuberculosis and chickenpox are two infectious, contagious diseases, transmitted mainly by the respiratory route, and associated with promiscuity, often reflecting low socio-economic status. These two diseases continue to pose a real public health problem in tropical environments such as the Congo. While diagnosis is often straightforward in the case of chickenpox, it requires careful input when associated with tuberculosis, certain symptoms of which may be confused with complications of chickenpox, as in the case of a 15-year-old non-immunosuppressed HIV patient hospitalized in the infectious diseases department of Brazzaville University Hospital.

Detection of Human Immunodeficiency Virus in Saliva Using a Nickel-Based Electrocatalyst

Acquired immunodeficiency syndrome (AIDS) is an ongoing and chronic condition caused by the human immunodeficiency virus (HIV). Early detection is one way to minimize the spread of AIDS. Current methods cannot reliably detect HIV in saliva samples due to the low concentration of viral particles in oral fluid. A simple, label-free, rapid response and unprecedented nickel-based electrochemical biosensor was developed to detect HIV in saliva using a NiOOH electrocatalyst. The current response difference at an applied potential vs a reference electrode in the presence of HIV was the trait of this sensor. It is hypothesized that the HIV p24 protein blocks the active surface area of the sensor, causing the current response to drop, which increases as the concentration of HIV increases in saliva. Comparative analyses using proteins with varying chemical moieties demonstrated that the sensor’s response was triggered by the functional group’s presence in the HIV p24 protein. The sensor’s limit of detection in saliva is ∼48.40 × 10–5 TCID50 ml−1 HIV culture fluid. The sensor was utilized to successfully distinguish the current response of HIV in saliva from twelve different pathogens. Finally, the sensor replicated similar attributes with HIV-positive patient’s saliva during a clinical study, which makes it a state-of-the-art non-invasive rapid response HIV sensor.

Spontaneous regression of cutaneous T cell lymphoma in an HIV-positive patient

Spontaneous regression of cutaneous T cell lymphoma in an HIV-positive patient

Differential diagnostic approach of an HIV-positive patient with invasive head and neck carcinoma.Our experience

Differential diagnostic approach of an HIV-positive patient with invasive head and neck carcinoma.Our experience

P28 Immune reconstitution-induced sarcoidosis following initiation of antiretroviral therapy in an HIV-positive patient

P28 Immune reconstitution-induced sarcoidosis following initiation of antiretroviral therapy in an HIV-positive patient

Successful Management of Progressive Multifocal Leukoencephalopathy in an HIV/AIDS Patient: A Therapeutic Case Report

Background: Progressive multifocal leukoencephalopathy (PML), a rare and devastating opportunistic infection caused by JC virus reactivation, typically carries a poor prognosis in immunocompromised individuals, particularly those with HIV. Aim: To report a remarkable case of full recovery in an HIV-positive patient with PML and highlight the significance of prompt recognition, diagnosis, and combination antiretroviral therapy (cART). Case Summary: A 34-year-old HIV-positive male presented with progressive disturbances of consciousness and movement. MRI revealed multifocal white matter lesions, and JC virus DNA was detected in cerebrospinal fluid. Despite initial deterioration, the patient achieved full recovery with cART. Conclusion: This exceptional outcome emphasizes the critical importance of vigilant monitoring, prompt diagnosis, and effective management strategies for PML in HIV patients, highlighting the potential for full recovery with optimal cART.

Comparative Analysis of Diagnostic Methods for Tuberculosis in an HIV-Positive Patient with Acute Respiratory Failure

Aims: To compare the diagnostic utility of TB LAM testing against the gold standard BAL with GeneXpert in a critically ill patient with advanced HIV. Methodology: A case report of a 28-year-old man with severe respiratory distress, confirmed HIV (CD4 count of 12 cells/cc³), and negative TB LAM test. Initial treatments included caspofungin, ampicillin-sulbactam, and cotrimoxazole forte. Imaging showed alveolar consolidations, and blood cultures were negative. Results: Notwithstanding the application of empirically validated therapeutic interventions targeting tuberculosis (TB), fungal infections, and Pneumocystis jirovecii, the patient's clinical status progressively deteriorated, culminating in fatality. Scientific Novelty: This case highlighted the need for combining urine LAM testing with GeneXpert for accurate TB diagnosis in advanced HIV patients. Conclusion: GeneXpert is essential for confirming TB and rifampicin resistance, while urine LAM should be complemented with additional tests when clinical suspicion remains high. Incorporating these assessments elevates diagnostic precision and improves patient prognoses.

Plasmablastic lymphoma in an HIV positive patient: colonic disease as an unusual presentation.

Plasmablastic lymphoma (PBL) is an aggressive and rare variant of diffuse large B-cell lymphoma associated with human immunodeficiency virus (HIV) infection. Here, we describe a case of PBL of the ascending colon in an HIV positive patient.

Bilateral tuberculosis psoas abscess in a human immunodeficiency virus-positive patient: a case report

BackgroundWorldwide, there is an increase in the frequency of reports of psoas abscesses due to advances in imaging technology, which has led to early diagnosis and treatment. A bilateral psoas abscess is rare and, when it occurs, is usually secondary and in immunocompromised patients. We present a case of a bilateral tuberculosis psoas abscess in a human immunodeficiency virus-positive patient.Case presentationA 21-year-old Ugandan female undergraduate who contracted human immunodeficiency virus through vertical transmission and has been on highly active antiretroviral drugs presented with bilateral lower abdominal pain with associated fever and headache. Clinical examination revealed abdominal tenderness in both iliac fossae with palpable masses. Ultrasonography revealed fluid collection in both psoas muscles confirming bilateral abscesses. The aspirate was acid-fast bacilli positive. A diagnosis of bilateral tuberculosis psoas abscess was made. Open drainage was performed and antituberculosis drugs were commenced.ConclusionsBilateral tuberculosis psoas abscesses occurring in human immunodeficiency virus-positive patients, although uncommon, is not unexpected. It is a form of secondary psoas abscess in immunocompromised patients. Here, the outcome was successful with a combination of early surgical drainage and appropriate medical therapy.

Hypopigmented papules in a HIV-positive patient

Hypopigmented papules in a HIV-positive patient