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Non–AIDS-Defining Cancers: Should Antiretroviral Therapy Be Initiated Earlier?Much has been written about the increase in non–AIDS-defining cancers in HIV-infected persons over the past decade.
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Substance Abuse and HIV: Treatment ChallengesSubstance abuse, especially injection drug abuse, is often associated with chronic infectious diseases, including HIV infection, hepatitis B, hepatitis C, and tuberculosis. Delivery of effective treatment for these chronic conditions can be very challenging in patients who continue to abuse substances.
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Mycobacterium avium-intracellulare Complex Immune Reconstitution Inflammatory Syndrome in HIV/AIDS Presenting as OsteomyelitisWe report a case of osteomyelitis due to Mycobacterium avium-intracellulare complex (MAC) in an AIDS patient shortly after the initiation of antiretroviral therapy with subsequent immune reconstitution inflammatory syndrome (IRIS).
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Severe Psoriasis in Advanced HIV InfectionA 50-year-old African American man with HIV infection had a CD4+ T-cell count of 18/μL (1%), CD8+ cell count of 1035/μL (69%), and CD4:CD8 ratio of 0.01 at the time of diagnosis. He had multiple erythematosquamous skin lesions over his forehead, face, chest, back, and extremities
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Routine HIV Screening, Part 2: Beyond Testing and ReferralJake” was a 17-year-old high school student who came to see me with his supportive but anxious mother. Four months earlier, Jake’s pediatrician, having read the CDC recommendations for routine testing of all patients aged 13 to 64,
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An HIV-Infected Patient With Nocardia asteroides Bilateral PneumoniaPneumonia remains a concern for persons with long-standing HIV infection. We present a case of a 43-year-old HIV-infected woman with bilateral pneumonia whose presentation suggested the cause was a bacterial pathogen.
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HSV-1 Encephalitis Complicated by Cerebral Hemorrhage in an HIV-Positive PersonHerpes simplex virus type 1 (HSV-1) is the most common cause of sporadic encephalitis worldwide. In the California Encephalitis Project, 24% of the cases of viral encephalitis were caused by HSV-1 and 3% were caused by HSV-2.1
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Severe Psoriasis in Advanced HIV InfectionA 50-year-old African American man with HIV infection had a CD4+ T-cell count of 18/μL (1%), CD8+ cell count of 1035/μL (69%), and CD4:CD8 ratio of 0.01 at the time of diagnosis. He had multiple erythematosquamous skin lesions over his forehead, face, chest, back, and extremities
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Recurrent Urothelial Bladder Cancer Among HIV-Infected PatientsWe report 4 cases of bladder cancer in an ethnically diverse population of about 2500 HIV-infected patients. These patients were younger than the median age at diagnosis of bladder cancer in the United States.
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Mycobacterium avium-intracellulare Complex Immune Reconstitution Inflammatory Syndrome in HIV/AIDS Presenting as OsteomyelitisWe report a case of osteomyelitis due to Mycobacterium avium-intracellulare complex (MAC) in an AIDS patient shortly after the initiation of antiretroviral therapy with subsequent immune reconstitution inflammatory syndrome (IRIS).
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Recurrent Urothelial Bladder Cancer Among HIV-Infected PatientsWe report 4 cases of bladder cancer in an ethnically diverse population of about 2500 HIV-infected patients. These patients were younger than the median age at diagnosis of bladder cancer in the United States.
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HIV-Associated Intestinal SpirochetosisA 33-year-old, sexually active homosexual HIV-positive man, with a CD4+ T-lymphocyte count of 258/µL and HIV-1 RNA level of 7079 copies/mL, presented to his primary care physician with left upper quadrant pain, urgency to defecate, and non-bloody watery diarrhea.
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Oral Plasmablastic LymphomaA previously healthy 43-year-old man was referred to the hospital for the diagnosis of a nodular lesion in the mandibular gingiva.
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Disseminated Mycobacterium avium-intracellulare Infection in a Person With AIDS With Cutaneous and CNS LesionsWe present the case of a 55-year-old man with AIDS who had disseminated Mycobacterium avium-intracellulare (MAI) infection who was nonadherent to antiretroviral treatment and prophylaxis for opportunistic infections.
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Establishing an Anal Dysplasia Clinic for HIV-Infected Men: Initial ExperienceProlonged exposure to high-risk strains of human papillomavirus (HPV) and the dysplastic effects that HPV exerts on cells of the squamocolumnar transitional junction of the anal canal lead to anal intraepithelial neoplasia (AIN), which is a precursor to squamous cell carcinoma of the anus (SCCA).1 Anal HPV infection is present in 93% of HIV-positive men who have anoreceptive intercourse.2 Furthermore, anal dysplasia of any grade has been reported in 56% of HIV-infected men who participate in anoreceptive intercourse.3,4
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Recent Highlights in Clinical AIDS ResearchLast month I reviewed key findings in HIV that were published within a 2-month interval near the end of 2007. I have extended that review here, reporting highlights of research announced in the last few weeks of 2007.
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Isolated Unilateral Acute Retinal Necrosis Syndrome as the Initial Manifestation of HIV InfectionThe lifetime cumulative risk of at least 1 abnormal ocular lesion for an HIV-positive person ranges from 52% to 100%. Ophthalmic involvement can occur during the early phase of HIV infection, and ocular lesions are mainly noted in the posterior segment.1,2
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Severe Psoriasis in Advanced HIV InfectionA 50-year-old African American man with HIV infection had a CD4+ T-cell count of 18/μL (1%), CD8+ cell count of 1035/μL (69%), and CD4:CD8 ratio of 0.01 at the time of diagnosis. He had multiple erythematosquamous skin lesions over his forehead, face, chest, back, and extremities
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Keloid After Herpes Zoster in an HIV-Infected PersonIt results from reactivation of latent varicella-zoster virus (VZV) within the
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The Changing Face of Anal CancerCancer of the anal canal is a relatively uncommon disease in the United States. It accounts for about 2% of the cancers of the GI tract; about 5000 cases will be diagnosed this year. Squamous cell carcinoma of the anus (anal SCC) is of particular interest to the infectious disease specialist because it is one of the cancers associated with HIV infection in men who have sex with men (MSM).
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Men with HIV Take Testosterone at High RatesHIV-infected men appear to be using testosterone replacement without adequate baseline evaluation and establishment of recommended indications.
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HIV Infection Raises Risk of Heart and Kidney Disease"What we need to do now is to help people with HIV realize the full potential of their much-extended life expectancy."
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Acute MI With Long-Standing AIDS: A Perfect Storm of Risk Factors for Premature Coronary Artery DiseaseThe patient is a 54-year-old man, a native of Poland who has lived in the United States for many years. A diagnosis of AIDS was made in 1994, when Hodgkin disease (nodular sclerosing Hodgkin lymphoma) was found in an enlarged cervical lymph node and he tested positive for HIV during his workup.
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Pill Impaction Mimicking Appendicitis in an HIV-Positive PatientA 45-year-old Hispanic man who acquired HIV infection in April 2003 presented with a 24-hour history of worsening right lower quadrant pain accompanied by fever, decreased appetite, nausea, and vomiting.
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HIV Testing in the Emergency DepartmentIn a recent editorial in The AIDS Reader, the “burden of responsibility for routine HIV testing” was accurately described as now falling on all clinicians, including those in emergency departments (EDs). Routine HIV testing in the ED seems logical because patients who seek health care in the ED are often underinsured and have low incomes, the very populations with a higher prevalence of undiagnosed HIV.
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Ryan White: An Unintentional Home BuilderAs Indiana native John Mellencamp might say, “Ryan White was born in a small town.” Kokomo, Ind, in 1971 indeed was a thriving, relatively small community in America’s Heartland. A town founded on family values, hard work, and a full belief in the American Dream,
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Pill Impaction Mimicking Appendicitis in an HIV-Positive PatientA 45-year-old Hispanic man who acquired HIV infection in April 2003 presented with a 24-hour history of worsening right lower quadrant pain accompanied by fever, decreased appetite, nausea, and vomiting.
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African American Women and HIV/AIDS: A National Call for Targeted Health Communication Strategies to Address a DisparityIn 1998, President Clinton declared HIV/AIDS to be a "severe and ongoing crisis" in the African American community and launched the
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Oral Plasmablastic LymphomaA previously healthy 43-year-old man was referred to the hospital for the diagnosis of a nodular lesion in the mandibular gingiva.
