Main Opportunistic Infections Research Articles

Aspects épidémiologiques et cliniques de l'infection par le VIH-2 à Dakar

Objective The aim of this article was to describe the epidemiological and clinical aspects of HIV-2 infection in Dakar. Design and methods This retrospective study was made on 217 HIV-2 infected patients hospitalized between 1986 and 2003; the epidemiological, clinical, and paraclinical data was collected and analyzed using the Epi-Info software version 6.04. Results The mean age was 40 years ± 9.6 and the male to female sex ratio was 1.33. The mode of transmission was primarily heterosexual. Some risk factors (travel abroad, heterosexual multi-partners, and unprotected sexual intercourse) were more frequently observed in men while others (blood transfusion, HIV positive partners) were noted among HIV-2 infected women. The most frequent symptoms were weight loss (88%), diarrhea (77%), fever (72.4%), asthenia (70.5%), chronic cough, and dermatosis (50.7%). The main opportunistic infections were oral candidiasis (61.8%), tuberculosis (26.3%), intestinal parasitosis (20.3%). The lethality rate was 33.2% and it was correlated with a low CD4 rate. Meningoencephalitis and bacterial infections were associated with a high lethality rate. Conclusions The epidemiological and clinical aspects of HIV-2 infection were the same as in HIV-1 infected patients. However the lethality rate remained high among patients hospitalized with a low CD4 cell count. Early HIV testing and improving the diagnostic approach for opportunistic infections remains a high priority.

Collagen diseases with opportunistic infections

Treatment of opportunistic infections emerging in collagen diseases is very important as well as the therapy of original diseases. Lung tuberculosis, Pneumocystis carinii and lung fungal infections are main opportunistic infections. There is effective prophylaxis against them, though the cases for their administration should be carefully chosen because of their adverse effects. We have administrated INH and ST (Sulphomethoxazole and Trimethoprim) more than 15 years as the prophylaxis against tuberculosis and P. carinii to the cases who are treated more than 60 mg of prednisolone per day as an initial dose until less than 30 mg per day and completely succeeded. Infliximab treatment has been reported that it often induces tuberculosis in abroad and lots of occurrence was anticipated in Japan where high incidence of tuberculosis is observed. So far, however, there are only few patients, maybe due to the selection of the patients and actively utilizing prophylaxis.

The Use of Backcalculation to Estimate the Prevalence of Severe Immunodeficiency Induced by Human Immunodeficiency Virus in England and Wales

As patients infected with the human immunodeficiency virus (HIV) become more severely immunosuppressed, they are at increased risk of developing one of a number of opportunistic infections or lymphomas, which define them as suffering from the acquired immune deficiency syndrome (AIDS). Estimates of the number of individuals who could benefit from antiretroviral treatment and prophylactic therapies against the main opportunistic infections are not readily available, as many individuals infected with HIV are asymptomatic and unaware of their infection. Using the method of backcalculation, we suggest that there are currently at least 2161 individuals with severe immunodeficiency but not AIDS in England and Wales. We demonstrate that this figure is sensitive to the choice of model for the severe immunodeficiency period and to the assumed effect of pre‐AIDS therapy. Using a definition of severe immunodeficiency based on a single CD4 count rather than two consecutive counts leads to substantially increased estimates of the prevalence of severe immunodeficiency.