Neurosarcoidosis has not been reported in patients with HIV infection. We present the case of a patient with AIDS in whom spinal cord sarcoidosis developed years after highly active antiretroviral therapy was initiated and her immune system was reconstituted. Treatment with prednisone resulted in resolution of MRI lesions and symptoms. Since patients with HIV-1 infection who are receiving antiretroviral therapy can survive for many years, physicians should be aware of chronic immune restoration disease involving the CNS.
There is general consensus among public health authorities that the elderly are not being screened for HIV as frequently as are younger persons. But there is compelling reason to do so.
The pathogen Toxoplasma gondii is an intracellular protozoan that most commonly presents in persons with AIDS as reactivation of latent infection.
The prevalence of Kaposi sarcoma (KS) in HIV-infected persons in the pre-HAART era has been reported to be as high as 20%. Although AIDS-associated KS has declined by more than 80% since the introduction of highly active antiretroviral regimens, KS remains an important malignancy in the HIV-infected population
Much has been written about the increase in non–AIDS-defining cancers in HIV-infected persons over the past decade.
Legionella species are among the leading causes of community-acquired pneumonia (CAP) in the general population, and although rare in patients with HIV infection, Legionella pneumonia is associated with significant morbidity and mortality
In most HIV-infected persons, one or more dermatological conditions develop at some point during their lifetime.1 Among the spectrum of dermatological diseases, those associated with pruritus are among the most common.
We 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).
Mr D is a 38-year-old African American man in whom AIDS had been diagnosed in 2001; he had responded well to antiretroviral therapy, with a recent CD4+ cell count of 376/µL and an HIV RNA level less than 50 copies/mL. He presented to our clinic complaining of a mildly tender "lump" on the left side of his neck, which he first noticed a week ago. He denied fever, chills, sweats, cough, anorexia, weight loss, and urinary symptoms but had a sore throat for 2 days.
Much has been written about the increase in non–AIDS-defining cancers in HIV-infected persons over the past decade.
With the FDA approval of a new small-molecule drug to treat HIV infection by blocking the CCR5 chemokine receptor and with several other drugs of this class in development for this and other indications, there is an increased interest in determining the potential influence on tumor promotion or suppression that blocking this receptor may have. Large, long-term clinical studies would be the ideal method for evaluating the potential increase in cancer risk, and at least one such study is under way (see http://clinicaltrials.gov/show/NCT00665561?order=49).
This case study of 2 patients suggests that very early antiretroviral therapy is not enough to prevent formation of latent viral reservoirs and prevent HIV rebound on treatment discontinuation.
Research supports liver and kidney transplantation in patients with HIV infection, but referral rates are low.
A 33-year-old man from the Ivory Coast (who had been living in the United States for the past 8 years) received a diagnosis of AIDS when he presented with Pneumocystis jiroveci pneumonia. His CD4+ cell count was 6/µL, and his HIV RNA level was 575,000 copies/mL. He also presented with altered sensorium and seizure activity and was found to have obstructive hydrocephalus and ring-enhancing lesions in both cerebellar hemispheres and basal ganglia. Results of polymerase chain reaction testing of cerebrospinal fluid for Toxoplasma gondii were positive, and treatment for toxoplasmosis was started. A ventricular-peritoneal shunt was placed.
Cutaneous manifestations of immune recovery in response to highly active antiretroviral therapy may account for up to 54% to 78% of the clinical presentations of the immune reconstitution syndrome (IRS)
Patients with HIV infection are at increased risk for several types of malignancy. After Kaposi sarcoma, non-Hodgkin lymphoma (NHL) is the second most common HIV-associated cancer.1
In a recent AIDS Reader editorial, Joel E. Gallant called for clinicians who treat persons with HIV/AIDS to “become vocal advocates for routine HIV screening,
Pain is recognized as a significant disability in HIV-infected persons.