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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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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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Psychiatric Aspects of HIV/AIDSIn the era of rapid transmittal of health information and frequent educational updates via the Internet, hardcover medical texts still have a place. A worthy newcomer in this regard is Psychiatric Aspects of HIV/AIDS, edited by Fernandez and Ruiz, a comprehensive sourcebook with contributions by a panel of experts.
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Current Health Disparities in HIV/AIDSThe CDC and other public health organizations have identified numerous disparities in the incidence and outcomes of HIV disease among different population groups
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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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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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Antiretroviral Treatment Update From the 17th International AIDS ConferenceThe 17th International AIDS Conference was held in Mexico City from August 3 to 8, 2008. This conference attracted more than 20,000 participants and provided some significant new insights into HIV therapeutics.
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An HIV-Infected Patient With Fever, Pancytopenia, and Renal Failure: Is This End-Stage AIDS?Histoplasmosis is a fungal infection caused by Histoplasma capsulatum. Although immunocompetent persons with H capsulatum infections are usually asymptomatic, several clinical syndromes can manifest in immunocompromised patients.
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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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HIV and Hypertension: The Need to Pay More HeedAbout a third of HIV-positive patients have high blood pressure. Is this a predictable consequence of ordinary aging, or do their history of HIV infection and treatment play a role? Whatever the explanation, many of these patients don't take the problem seriously enough.
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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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Neurosarcoidosis in a Patient With AIDSNeurosarcoidosis 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.
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HIV Infection in the ElderlyThere 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.
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Subacute Onset of Paralysis in a Person With AIDSThe pathogen Toxoplasma gondii is an intracellular protozoan that most commonly presents in persons with AIDS as reactivation of latent infection.
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Progression of Kaposi Sarcoma Associated With Iatrogenic Cushing Syndrome in a Person With HIV/AIDSThe 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
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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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Legionnaires Disease in a Patient With AIDSLegionella 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
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Severe Pruritus After Completing Pegylated Interferon for Hepatitis CIn 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.
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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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A "Usual" Case of SyphilisMr 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.
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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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CCR5 Antagonists in the Treatment of HIV-Infected Persons: Is Their Cancer Risk Increased, Decreased, or Unchanged?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).
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Very Early ART: Does a Curative Window Exist?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.
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HIV-Positive Organ TransplantResearch supports liver and kidney transplantation in patients with HIV infection, but referral rates are low.
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Schistosoma mansoni Colitis in an AIDS PatientA 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.
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Extensive Development of Flat Warts as a Cutaneous Manifestation of Immune Reconstitution SyndromeCutaneous 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)
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Lymphoma Presenting as Cranial Nerve Neuropathies in HIV-Infected PatientsPatients 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
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Expanding HIV Testing: Overcoming Physician BarriersIn 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,
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Psychiatric Aspects of Comorbid HIV/AIDS and Pain, Part 2Pain is recognized as a significant disability in HIV-infected persons.
