Manifestations In HIV-infected Patients Research Articles

Association of Gastrointestinal Manifestations with Socio-demographic, Lifestyle & Clinical Factors in HIV/AIDS Patients

Background: Gastrointestinal abnormalities in people with HIV/AIDS have been reported since the advent of AIDS. This study aimed to analyze the gastrointestinal manifestations in HIV/AIDS patients in terms of sociodemographic, lifestyle, and clinical characteristics with the association of GI manifestations. Material & Methods: This observational cross-sectional analytical study was conducted at the ART corner and Department of Gastroenterology, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka among adult HIV-infected or AIDS patients aged more than 18 years. A total of 122 patients were taken as per inclusion criteria. The study took place from March 2018 to February 2019. Continuous variables were reported as the mean ± standard deviation. The correlation of several GI symptoms with CD4 count was done by the Spearman rank test. Sociodemographic variables (gender, age, income, and education level), lifestyle variables (smoking status, risk consumption of alcohol, and physical activity level), and clinical variables (antiretroviral therapy – duration and class, duration of HIV infection) were assessed through a pre-tested and standardized questionnaire. The chi-square test was used to test the statistical significance of associations, considering a p-value ≤0.05 as statistically significant. All of the data were analyzed and calculated using the Statistical Package for Social Sciences (SPSS version 20.0) and Microsoft Excel 2016. Results: Among the patients, male preponderance was seen with the frequency of 66% (31) and 61.3% (46) with and without GI symptoms respectively. Patients aged 40-49 years old were more frequent with (31.9%) and without (25.3%) GI symptoms. The patients of primary level of education had GI symptoms and had no GI symptoms were 61.7% and 45.3% respectively of the total. Statistically significant (p=0.03) indicating that low CD4+ cell count (≤ 350 cells/mm3) can be considered as an associated risk factor for the occurrence of GI manifestations in HIV infected patients. There was less statistically significant difference in other clinical characteristics between patients with current GI manifestations and without GI manifestations. Here, the statistically significant p-value ≤0.05 is considered. Conclusion: This study concluded that, smoking and low CD4 count (<350cell/mm3) were found significantly associated with the occurrence of presenting GI symptoms. Other sociodemographic, lifestyle, and clinical factors were not significantly associated with the occurrence of GI manifestations.

Study of mucocutaneous manifestations in HIV-infected patients and its relation to cd4 count and stage of HIV disease

: HIV patients frequently have mucocutaneous manifestations, which could be the first sign of the infection and can also be prognostic markers for disease progression. This study was done to note the different mucocutaneous manifestations occurring in the people living with HIV/AIDS.: One hundred ensuent HIV seropositive patients who attended the opd were included in the study.: The bulk of the study participants were illiterate, had a mean age of 32, and a male to female ratio of 2:1. The patients' number of manifestations ranged from 01 to 05. The most typical illnesses observed in this investigation were dermatophyte infections followed by oral candidiasis. The most frequent non-infectious symptoms observed in this investigation were SD and PPE. The most prevalent STI was herpes genitalis. Inversely correlated with CD4 level were the type, number, and severity of mucocutaneous symptoms. The number of manifestations and CD4 count were found to be inversely correlated. The majority of PLHAs (55%) exhibited several manifestations. The majority of the manifestations are unusual, persistent, recurrent, and resistant to the therapy. Young patients presenting with extensive SD, PPE, OC, scrofuloderma, and HZ should encourage the clinician to investigate the patient's sero-reactivity status

HIV-related pulmonary manifestations among egyptian patients

Context After description of the new first case of AIDS in 1981, the HIV pandemic expanded very rapidly to become a great global public health problem with wide health, economic, social, and developmental consequences that have not been seen with any other disease. Globally, there have been gains across the HIV testing and treatment cascade. The greatest contributor to the illness and deaths in persons infected with HIV is pulmonary disease. Aims The aim was to study the pattern of respiratory manifestations in HIV-infected patients among a sample of Egyptians. Settings and design A prospective, observational study. Patients and methods This study recruited 121 HIV patients with respiratory system involvement admitted to Abbassia Fever Hospital or Abbassia Chest Hospitals between December 2017 and March 2020. Clinical assessment included demographic data, history of chest symptoms, and comorbidities and local and general examination. Chest imaging was requested/reviewed, and procedures were performed as required. Laboratory assessment included CD4 count, and microbiological examinations of sputum and pleural fluid if found. Statistical analysis used SPSS program (Statistical Package for the Social Sciences) software, version 18.0. Results Of the participants 62 % have been receiving or previously received antiretroviral treatment. Cough was the most frequent symptom in 91.7%. Pleural collection was the most frequent radiological finding on chest radiology in 23% of patients. Tuberculosis was commonly a concomitant infection in 29.7% of patients. CD4 count ranged from 16 to 450 cells/mm3. The diagnosis of PJP and multidrug resistance tuberculosis was highly significantly associated with low CD4 count (P<0.01). Conclusion HIV infection is associated with a wide range of respiratory manifestations with infectious complications representing the majority of them. Low CD4 count, receiving antiretroviral treatment, and the source of HIV infection (sexual or intravenous drug abuse) are documented as risk factors for respiratory involvement in HIV patients.

SPECTRUM OF HIGH-RESOLUTION COMPUTED TOMOGRAPHY LUNG PARENCHYMAL CHANGES IN SYMPTOMATIC ADULT HIV-SEROPOSITIVE PATIENTS IN CORRELATION WITH CD 4 COUNT

We aimed to determine the HRCT spectrum of lung parenchymal ndings in adult HIV-infected patients presented with chest symptoms. Objective: To determine the spectrum of lung parenchymal ndings on HRCT in HIV seropositive adult patients with chest symptoms on basis of Location, Extent, Characterization of the lesion and correlate imaging ndings with CD 4 count. A cross-sectional study was carried out Methods: on 30 adult HIV-infected patients who presented with chest symptoms and fullled the inclusion criteria of our study. They underwent HRCT using a 128 slices Philips ingenuity CT scanner in SMS Medical College, Jaipur. Most of the patients belonging to the age group 31-40 years Results: with a mean age of 38.7 years out of which 24 were male and 6 were females. The different aetiologies for imaging manifestations in HIV infected patients with respiratory symptoms were found to be tuberculosis (54%), fungal infection (13%), bacterial infection (7%), and so on, in that order. Conclusion: Pulmonary tuberculosis was the most common pulmonary manifestation in HIV patients followed by pneumocystis jiroveci pneumonia (PCP) and bacterial pneumonia. So, we recommend HRCT in diagnosis, treatment and follow up of HIV/AIDS patients with pulmonary manifestations. Its non-invasive nature and relatively quicker time of scan make it a suitable choice for these patients.

Current issues in the management of patients with HIV infection and rheumatic diseases

According to experts, the human immunodeficiency virus (HIV) epidemic has a steady downward trend, but the attention of the medical community to this problem is not waning. Before the introduction of highly active antiretroviral therapy, the prevalence of rheumatic manifestations in HIV-infected patients ranged from 3 to 71% and was associated with late stages of infection and severe immunosuppression. HIV-associated arthritis, reactive arthritis, psoriatic arthritis, arthralgias and diffuse infiltrative lymphocytosis syndrome are the most common rheumatic pathologies in HIV. Most people with HIV and musculoskeletal inflammatory disease respond well to NSAIDs, opioids, and basic anti-inflammatory drugs. In cases that are torpid to the abovementioned treatment, the use of biologic disease-modifying antirheumatic drugs may be required.The lecture summarizes modern data on the features of the course and treatment of immunoinflammatory rheumatic diseases in HIV infection.

ENT manifestations in HIV infected patients in PIMS Islamabad.

INTRODUCTION&#x0D; HIV is a global pandemic with estimation of 38 million active cases around the world according to WHO HIV data and statistics 2019. Despite of advancement in medical field the disease has not been tamed uptil now. In this modern era HIV is still considered a taboo in Pakistan, people are reluctant about disclosure of disease, screening of their partners and its treatment which is due to lack of awareness and socio-economic constraints.&#x0D; OBJECTIVE&#x0D; The aim of this study is to see the incidence of Ear, Nose and Throat (ENT) manifestations in HIV infected people presented in tertiary care hospital of Islamabad.&#x0D; MATERIAL AND METHOD&#x0D; A one-year observational cross-sectional study conducted in Pakistan Institute of Medical Sciences (PIMS) Islamabad between January 2019 to December 2019. All the HIV infected patients who presented with ear, nose and throat manifestations were recruited in the study. Detailed history and examination were conducted after taking written consent. Analysis included calculations of mean values of quantitative association between ENT symptoms and demographic characteristics. Statistical analysis was estimated using either Chi-square test or t-test. &#x0D; RESULTS &#x0D; Majority of the patients presented with Otological manifestation of which the most common was chronic suppurative otitis media (14.28%). Most common Rhinological/Oropharyngeal manifestation included epistaxis (12.24%) and oral candidiasis (8.16%) respectively. Among neck manifestations cervical lymph adenopathy (18.16%) showed the highest percentage.&#x0D; CONCLUSION&#x0D; The study shows a local trend of ENT manifestation in which the patient presented in later stage (WHO III) which resembled to the studies carried out in other developing countries showing ineffectiveness of current national HIV/AIDS programme.

Prevalence of Ear Nose and Throat (ENT) Manifestations Among HIV Seropositive Patients at a Tertiary Hospital in Northern Tanzania: A Descriptive Cross-Sectional Study.

BackgroundTo date, HIV/AIDS remains a threat of the 21st century. The overall rate of new HIV infection continues to decline in several countries, but there is still a remarkable burden of disease seen in sub-Saharan Africa. Several studies observed that 70% to 90% of HIV-infected patients present with ear, nose and throat symptoms. The aim of this study was to identify the magnitude of ENT manifestations among HIV-infected patients attended HIV clinics at KCMC based on age, sex, and CD4 count.MethodsThis was a descriptive cross-sectional study conducted at KCMC hospital involving HIV-infected patients who attended HIV clinics from February to July 2018. Convenient sampling was employed to get study participants, and 200 patients were recruited in the study. Data were collected through a questionnaire from patients, and results were analyzed using SPSS version 20.ResultsSixty-eight (34%) of 200 HIV-infected patients had ENT manifestations. The most affected age group was 0–9 years. ENT manifestations were more prevalent in females (23.5%) than in males (10.5%). Those with CD4 count less than 200cells/µL also it was a high prevalence (56.3%).ConclusionThis study observed that one-third of the studied population had ENT manifestations. All medical practitioners should be aware of ENT manifestations in HIV-infected patients in order to assure early and appropriate intervention.

Mucocutaneous Manifestations in HIV-Infected Patients and Their Relationship to CD4 Lymphocyte Counts.

Background More than 90% of human immunodeficiency virus- (HIV-) infected patients show at least one mucocutaneous manifestation during the course of their disease. The frequency, pattern, and associated factors of these complications vary among different populations. Objective This study was planned to evaluate the frequency of cutaneous presentations in HIV-infected patients and their association with the count of CD4 cells. Methods A cross-sectional study was conducted on eighty-four HIV-positive patients, who attended the Behavior Consultation Center of Arak University of Medical Sciences. All subjects had a complete physical examination by an expert dermatologist. Further diagnostic procedures were performed, if necessary. Counts of CD4 were determined using flow cytometry. Results From 84 patients who enrolled in this study, 95.2% manifested at least one type of mucocutaneous lesions. The most common presentation was xerosis, followed by seborrheic dermatitis, herpes simplex, and oral candidiasis. Oral candidiasis and furuncle were significantly associated with decrease in CD4 cell counts. Conclusions Cutaneous manifestations are common in HIV-positive patients, some of which (oral candidiasis and furuncle) could be applicable as useful clinical indicators to predict the immune status of the patients. Therefore, regular skin examinations are recommended as routine HIV-infected patients' healthcare programs.

Influence of Blood Products Administration in HIV Adult Patients on Inflammatory Markers

Abstract One of the most common manifestations in HIV infected patients are hematological. Few studies on these manifestations have been conducted in Romania and worldwide. Anemia and infections occur frequently among people living with HIV and reflect the immune suppression of the host. Besides, the etiology of anemia in HIV infection often remains unclear. Therefore, C Reactive Protein (CRP) and fibrinogen can be used as markers of the degree of immune suppression. It is noteworthy that anti-anemic therapies may accelerate the progression of HIV disease. Primary infection or reactivation of known or unknown pathogens is still a major concern associated with blood transfusions and possibly lead to a reduced prognosis. Existing data suggest that severe anemia is one of the main factors. Chronic inflammation and increased hemostasis in HIV-infected persons are thought to be a consequence of viral replication or persistence and it is associated with poor prognostic in HIV-infected patients. Whether low levels of viremia predispose to increased inflammation is unclear. We investigated the relationship between anemia, inflammatory markers, and blood transfusions. The present study is an effort to evaluate correlation as well as the association between inflammatory markers and blood products administration in HIV/AIDS patients.

A prevalence study of ocular manifestations in HIV positive patients on highly active anti-retroviral therapy

Background: Among 40 million cases worldwide, 50-75% of patients have at least one ocular manifestation in their lifetime. Many of ocular infections are treatable with therapeutic agents. Ocular manifestations invariably reflect systemic disease and can be the initial manifestations of HIV in many cases. Understanding of ocular sequel of HIV infection can lead to the early diagnosis and effective treatment. This study emphasizes on the need of developing a specific ophthalmic examination for the management of ocular manifestations in HIV infected patients. Methods: Cross sectional and observational study of 100 HIV positive participants on HAART were done irrespective of presence or absence of ocular symptoms. Participants were examined for complete ocular examination. Prevalence find out using chi-square test, find p values and ensuring statistical significance. Results: In our study, prevalence of ocular manifestation in HIV positive patients receiving HAART was 39%. Out of them, 20% adnexal involvement, 28% anterior segment involvement, 33% posterior segment involvement, 11% neuro-ophthalmic abnormality, 4% orbital involvement were present. 76% patients belonged to WHO clinical stage 2 and 3. 51% had CD4+ T cell counts <200 cells/µl. Conclusions: Posterior segment followed by anterior segment are the most commonly encountered ocular manifestations of HIV infection. Low CD4 count is good predictor for ocular manifestations in HIV positive patients. Higher WHO stage is also directly related with the severity of the ocular symptoms. Routine baseline ophthalmic screening to all HIV positive patients are necessary to prevent ocular morbidity.

Prevalence of pruritic papular eruption among HIV patients: A cross-sectional study.

Introduction:Pruritic papular eruption (PPE) remains as one of the most common cutaneous manifestations in HIV-infected patients. Proper knowledge about understanding the risk factors associated with this disease may help to decrease the prevalence of PPE.Objective:The present study was conducted to determine the prevalence of PPE in HIV-infected patients and to correlate between the severity of PPE and individual CD4 count.Materials and Methods:This was a cross-sectional study, conducted in Palakkad Antiretroviral Therapy Centre, Kerala, between March 2017 and April 2017. A total of 100 HIV patients with evidence of multiple itchy skin lesions of 1-month duration were included in the study. Severity of lesion was evaluated using an objective “rash severity scale” for PPE. Data were coded and analyzed.Results:Prevalence of PPE was 11.35% in our study. The mean age of the study population was 41.17 ± 12. Male-to-female ratio was 1:2. In our study, 97% of the patients were giving history of mosquito bite. Most of the patients (40%) had moderate type of PPE. In our study, majority (86%) had a CD4 count of more than 200, and the incidence of PPE was more frequently seen in patients with CD4 count more than 200 cells which was statistically significant.Conclusion:PPEs are unique dermatosis, which is having a devastating impact on the quality of life, stigmatizing them in their communities. Thus, recognizing those lesions helps in allowing better treatment of this distressing condition.

Mucocutaneous manifestations among persons receiving highly active anti-retroviral therapy

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; &lt;span lang="EN-IN"&gt;Mucocutaneous manifestations in patients positive for HIV are helpful in the diagnosis as well as treatment of the disease. Consequent to the introduction of Highly Active Anti-Retroviral Therapy (HAART), there seems to be an increase in the presentation of non-infective diseases. It was aimed to analyse the mucocutaneous manifestations in HIV infected patients taking HAART and correlate with age and CD4 lymphocyte count.&lt;/span&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; A retrospective analysis of 125 People Living With HIV (PLWH) having mucocutaneous manifestations receiving HAART who attended a tertiary care city hospital over a period of ten months from January 2016 to October 2016 was carried out. The findings were correlated with CD4 count and age. The data were collected from the patient follow up cards maintained by qualified Dermatovenereologist.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; &lt;span lang="EN-IN"&gt;There was no major gender difference in our study. The trans genders presented with only non-infectious skin diseases. Younger patients had a higher CD4 count (p=0.01%) which was statistically significant. Candidiasis and pruritic papular eruption were the commonest infective and non-infective diseases observed respectively. The mean CD4 count comparison was statistically significant (p=0.04). The count was highest for insect bite allergy and lowest for oral hairy leukoplakia. The mean age of disease manifestation was highest for Herpes zoster and lowest for aphthous ulcers 45 and 29 years respectively. All the adverse reactions observed were to efavirenz. &lt;/span&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; &lt;span lang="EN-IN"&gt;With the improvement of CD4 count in PLWH receiving HAART, the proportion of non-infectious inflammatory disease manifestations are on the rise. Awareness about this fact is very important for effective management.&lt;/span&gt;&lt;/p&gt;

IMMUNITY ACTIVATION IN HIV INFECTION

This review article concerns a challenging problem of HIV infection, immune activation. The processes of immune activation largely determine CD4+T cell depletion, leading to development of AIDS-associated and non-AIDS-related diseases. Immune activation indices are also strong predictors of the clinical outcome. Activation in HIV-infection affects both innate and adaptive immune cells, leads to increased proinflammatory cytokine production and blood coagulation. The reasons for immune activation may include different pathogens (HIV, cytomegalovirus, Epstein–Barr virus, hepatitis C virus), lymphopenia and lymphopenia-induced T lymphocyte homeostatic proliferation, transfer of microbial products from the gut, due to profound CD4+T cell deficiency in lamina propria and altered permeability of intestinal barrier. Other factors that promote the process of immune activation are as follows: T lymphocyte "bystander" activation, increased T cell turnover, and systemic inflammation development. The review covers pathogenic mechanisms HIV-infection associated with immune activation, like as description of different laboratory parameters characterizing its manifestations in HIV-infected patients. Significance and prognostic role of these parameters in assessing efficiency of antiretroviral therapy, development of complications, and adverse outcomes of infection are presented as well.

Mucocutaneous Disorders of Pediatric HIV in South West Nigeria

Nigeria has the world's highest burden of pediatric HIV. In the face of paucity of monitoring tests in Nigeria, we studied the spectrum of pediatric mucocutaneous manifestations and evaluated their clinical utility as surrogate markers for immunodeficiency and plasma viral load levels. Cross-sectional study comparing mucocutaneous manifestations in 155 HIV-positive children aged 12 weeks to 14 years with 155 HIV-negative children. Relationships between mucocutaneous manifestations in HIV-infected patients and their immunologic and virologic indices were analyzed. Mucocutaneous lesions were seen in 53.5% of HIV-infected children compared with 18.1% of the controls. Prevalence of lesions increased with worsening levels of immunodeficiency and increasing viral loads (P < .01). Oral candidiasis, angular stomatitis, and fluffy hair were associated with more severe degrees of immunodeficiency. Mucocutaneous disorders are common in HIV-infected children. Oral candidiasis and nutritional dermatoses can be used as surrogates for advanced or severe immunodeficiency.

English

BACKGROUND AND OBJECTIVES: Mucocutaneous manifestations are extremely common and varied in HIV infected patients. The present study was done to know the overall prevalence of mucocutaneous manifestations in HIV infected patients and to know the frequency of individual manifestations. METHODS: A total of 150 HIV seropositive patients from voluntary counseling and testing center were included in the study. Detailed history, thorough physical examination and relevant investigations were done to confirm the mucocutaneous manifestations when present. RESULTS: Ninety two percent (92%) of 150 positives had mucocutaneous manifestations at presentation. Majority (75.34%) of the patients belonged to the age group 25 - 49 years and male to female ratio was 1.08:1. Oral candidiasis was the most common (33.33%) manifestation. Other common infectious conditions seen were HSV (16.67%) dermatophytosis (12.67%), genital candidiasis (9.33%), herpes genitalis (10%). Common non-infectious disorders included generalized xerosis and ichthyosis (14.66%), generalized hyperpigmentation (11.33%) and seborrheic dermatitis (6.67%). Hair and nail changes included diffuse alopecia (18%), trichomegaly (6.67%) and melanonychia (32%).Pruritic papular dermatitis was seen in 16%. INTERPRETATION AND CONCLUSION: This study thus emphasizes the need for dermatological evaluation of all patients with HIV infection for early management and improved quality of life.

MANIFESTASI ORAL PADA PASIEN TERINFEKSI VIRUS HIV/AIDS

Acquired immunodeficiency syndrome (AIDS) epidemic is increasing all over the world. The first AIDS case in Indonesia was found in 1987 in Bali, but the spread of HIV in Indonesia increased after 1995. Based on data from the Ministry of Health until the year 2012 as many as 21 511 cases of HIV and AIDS as many as 5,686 people and the number of patients who died as many as 1,146 people. This literature study aims to describe the oral manifestations in HIV-infected patients and its management. Oral lesions are most commonly found in HIV-infected patients is candidiasis. Other oral lesions that might be found that necrotizing ulcerative gingivitis, linear gingival erythema, hairy leukoplakia, Kaposi's sarcoma, herpes simplex virus infections, Recurrent Aphthous Ulcers, Varicella Zoster Virus (VZV), Citomegalo Virus (CMV), Human Papilloma Virus (HPV), Condyloma Akumilatum, Lymphoma Non-Hodgkins B-cell and squamous cell carcinoma, and Sarcoma Kapossi. The best management is through preventive measures and oral routine exam to maintain oral health and achieve a better quality of life.

P2.124 Dermatological Conditions in HIV Infected Patients in Turkey

BackgroundDermatological conditions are common manifestations in HIV infected patients. They may appear as the initial presentation of HIV infection, during the course of the infection or as adverse events due...

MANIFESTASI ORAL PADA PASIEN TERINFEKSI VIRUS HIV/AIDS

Acquired immunodeficiency syndrome (AIDS) epidemic is increasing all over the world. The first AIDS case in Indonesia was found in 1987 in Bali, but the spread of HIV in Indonesia increased after 1995. Based on data from the Ministry of Health until the year 2012 as many as 21 511 cases of HIV and AIDS as many as 5,686 people and the number of patients who died as many as 1,146 people. This literature study aims to describe the oral manifestations in HIV-infected patients and its management. Oral lesions are most commonly found in HIV-infected patients is candidiasis. Other oral lesions that might be found that necrotizing ulcerative gingivitis, linear gingival erythema, hairy leukoplakia, Kaposi's sarcoma, herpes simplex virus infections, Recurrent Aphthous Ulcers, Varicella Zoster Virus (VZV), Citomegalo Virus (CMV), Human Papilloma Virus (HPV), Condyloma Akumilatum, Lymphoma Non-Hodgkins B-cell and squamous cell carcinoma, and Sarcoma Kapossi. The best management is through preventive measures and oral routine exam to maintain oral health and achieve a better quality of life.

Otolaryngological, head and neck manifestations in HIV-infected patients seen at Steve Biko Academic Hospital in Pretoria, South Africa

Sub-Saharan Africa has the highest incidence of HIV infection. According to recent census statistics, 5.6 million people in South Africa (SA) are HIV-positive, the highest number of infected individuals worldwide. Over 80% of HIV-infected individuals will present with ear, nose and throat (ENT) manifestations. Previous studies show that oral diseases seem to be the most common ENT-related manifestation, reported in about 40 - 50% of HIV-infected patients. In SA, there is lack of local information regarding the otolaryngological and head and neck manifestations in HIV-infected individuals. To ascertain our local trends of ENT and head and neck manifestations in HIV-infected patients seen at our specialised ENT-HIV Clinic, Steve Biko Academic Hospital, Pretoria, Gauteng Province, SA. A 1-year prospective study involving 153 HIV-infected patients was conducted in the clinic from January to December 2011. Patient history was taken and examinations were performed based on the World Health Organization (WHO) HIV/AIDS classification system. Data analysis was performed using Epi Info 7 software. The most common manifestations were adenoid hypertrophy/hyperplasia followed by cervical lymphadenopathy, chronic suppurative otitis media, otitis media with effusion and sensory-neural hearing loss. Patients typically presented with early manifestations during symptomatic WHO stages I and II in contrast to results reported in similar developing world studies from Iran, Nigeria and India. A possible explanation may lie in the SA government HIV Counselling and Testing campaign and the antiretroviral rollout programme, the effectiveness of which is becoming evident.

The Role of Human Herpesvirus 8 Molecular Characterization in the Management of HIV Infected Patients Diagnosed with Malignancies Associated with Its Infection

Despite the progress has been reached with Human herpesvirus 8 (HHV-8) research, there are gaps in the knowledge of viral induced oncogenesis. The aim of the present study was to identify possible associations between HHV-8 subtypes, HHV-8 loads and clinical manifestations of HIV infected patients diagnosed with different malignancies associated with HHV-8 infection. Forty six HIV-1 infected individuals diagnosed with different HHV-8 associated diseases were studied [37 epidemic Kaposi’s sarcoma (KS), 3 pleural effusion lymphoma (PEL); 5 peripheral lymphadenopathies (PL); 1 Hodgkin’s lymphoma (HL); 1 non Hodgkin’s lymphoma (NHL)]. HHV-8 loads were determined by quantitative real time PCR (qRT-PCR) whilst HHV-8 subtypes were determined by open-reading frame (ORF)-K1 gen genotyping. HHV-8 subtypes B, A, C, A5 and E were exhibited by 31.8%, 23.4%, 19.1%, 17% and 8.5% of the studied patients, respectively. The median HHV-8 viral load did not differ between subtypes (p > 0.05) but HHV-8 viral loads were significantly higher in PEL than in epidemic KS lesion or lymph nodes (p = 0.04). Subtype B was detected in 60% of patients with B cell lymphoma (NHL, PEL and HL) whereas subtype E was only detected in patients with epidemic KS diagnosis. Our data suggest that HHV-8 DNA quantification instead of subtype identification could be used as a surrogate marker for monitoring its infection, not only in epidemic KS patients but also in HIV infected individuals with lymphoproliferative disorders.