Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and Plasmodium species are the causative agents of coronavirus disease 2019 (COVID-19) and malaria respectively with similar clinical presentations. The obj...Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and Plasmodium species are the causative agents of coronavirus disease 2019 (COVID-19) and malaria respectively with similar clinical presentations. The objective of this study is to determine the burden of co-infection of SARS-CoV-2 and malaria in the general population. Five (5 mLs) of blood samples were collected for SARS-CoV-2 and malaria parasite test. The malaria test was performed using a commercially available one-step malaria antigen Plasmodium falciparum histidine-rich protein 2 (Pf HRP-II) rapid test kit. The results of the study showed that the participants that were coinfected with SARS-CoV-2 IgG and malaria were 13 (2.5%) in Lagos, 1114 (39.1%) in Delta and 49 (2.3%) in Sokoto States. The prevalence of coinfection of SARS-CoV-2 and malaria in urban areas in Lagos, Delta and Sokoto States were 7 (2.2%), 1373 (48.1%), and 5 (0.2%) respectively. In rural areas, the prevalence of coinfection of SARS-CoV-2 and malaria in Lagos, Delta and Sokoto States were 6 (0.3%), 365 (12.8%), and 44 (2.1%) respectively in this study. This suggests that participants in the urban areas were more prone to co-infections than the rural areas in Lagos and Delta states, while it was otherwise in Sokoto State. In conclusion, the co-infection of SARS-CoV-2 and malaria was very high in Delta State compared to the other States. It is important for clinics to screen for both diseases when patients present with symptoms of malaria. This is because the infections have similar symptoms and the public is quick to assume malaria infection without diagnosing for COVID-19 and vice versa.展开更多
AIM To detect infection rate of GBV-C/HGV inhepatitis C patients,to determine the methodsof higher sensitivity and the primers of higherefficiency for GBV-C/HGV RNA detection and tostudy the dominant subtype and mutat...AIM To detect infection rate of GBV-C/HGV inhepatitis C patients,to determine the methodsof higher sensitivity and the primers of higherefficiency for GBV-C/HGV RNA detection and tostudy the dominant subtype and mutation ofGBV-C/HGV.METHODS Quantitative RT-PCR for detectionpf HCV RNA concentration in serum samples,RT-nested PCR with two sets of primers fordetection of GBV-C RNA,RT-PCR ELISA with twosets of primers for detection of HGV RNA,nucleotide sequence and putative amino acidsequence analysis.RESULTS The positive rates of GBV-C RNA atthe 5’-NCR and NS3 region in 211 serums amplesfrom the patients with HCV infection were 31.8%and 22.8% respectively.The positive rates ofHGV RNA at the 5’-NCR and NS5 region in thesame samples were 47.9% and 31.8%respectively.The total positive rate of GBV-C/HGV RNA was as high as 55.5%.HCV copynumbers in the patients without GBV-C/ HGVcoinfection were statistically higher than that inthe patients with GBV-C/ HGV coinfection(P【0.01).Frequent mutation of nucleotideresidue was present in the amplificationproducts.Frameshift mutation was found in twosamples with GBV-C NS3 region nucleotidesequences.All nucleotide sequences fromamplification products showed higher homologyto HGV genome than to GBV-C genome even though part of the sequences were amplifiedwith GBV-C primers.CONCLUSION A high frequency of GBV-C/ HGV coinfection existed in the hepatitis C patients. RT-PCR ELISA was more sensitive than RT-nested PCR for detection of GBV-C/ HGV RNA. The primers derived from the 5 -NCR was more efficient than those derived from the NS3 and NS5 regions. A reverse relationship was found to exist between HCV RNA concentration and GBV-C/ HGV infection frequency. HGV was the dominant subtype of the virus in the local area. The major mutations of GBV-C/ HGV genomes were random mutation of nucleotide residue.展开更多
A case of pulmonary coinfection by Strongyloides stercoralis and Pneumocystis jiroveci has been detected in an AIDS patient treated in the Respiratory Intensive Care Unit of the Muniz Hospital.At diagnosis,the patient...A case of pulmonary coinfection by Strongyloides stercoralis and Pneumocystis jiroveci has been detected in an AIDS patient treated in the Respiratory Intensive Care Unit of the Muniz Hospital.At diagnosis,the patient presented cough with mucopurulent expectoration,dyspnea,fever,bilateral pulmonary infiltrates on the chest X-ray,negative bacilloscopy for acid fast bacteria and a CD4^+ T lymphocytes count of 52 cells/μ L.The microbiological diagnosis was achieved by microscopic observation of the respiratory secretions obtained by bronchoalveolar lavage,while the wet mount examination revealed rhabditiform and filariform larvae of the nematode and foamy exudates,pathognomonic of the pulmonary pneumocystosis.It was the unique case of this association among about 3 000 samples performed in our laboratory in the last 10 years and diagnosed by microscopy.Other complementary stains(a rapid modification of Grocott,Kinyoun and Giemsa) were applied to the smears after the diagnosis of mycotic and parasitary infections achieved by fresh microscopy.Both physicians and microbiologists should take into account the possible coexistence of respiratory pathogens in immunocompromised patients,such as those with AIDS.展开更多
Hepatitis B virus(HBV), hepatitis C virus(HCV),and human immunodeficiency virus(HIV) affect many people in Asian countries, although there are geographic differences. Both HBV and HIV(HBV/HIV) and HCV/HIV co-infection...Hepatitis B virus(HBV), hepatitis C virus(HCV),and human immunodeficiency virus(HIV) affect many people in Asian countries, although there are geographic differences. Both HBV and HIV(HBV/HIV) and HCV/HIV co-infections are highly prevalent in Asia. Hetero- and homosexual, injection drug use, and geographic area are strong predictors of HBV, HCV, and HIV serostatus. In HBV endemic regions, the prevalence and genotype distribution of HBV/HIV coinfection is almost comparable with that in the general population. In Japan, where HBV has low endemicity, the prevalence of HBV/HIV co-infection is approximately 10-fold higher than that in the general population, and HBV Ae is the most common subgenotype among HIV infected individuals. Highly active antiretroviral therapy(HAART) is an effective treatment for HIV/Acquired Immune Deficiency Syndrome. Lamivudine, a component of HAART, is an effective treatment for HBV, HIV, and HBV/HIV co-infection; however, cost, emerging drug resistance, antiretroviral-associated liver toxicity and liver-related morbidity due to HCV progression are particular concerns. HCV/HIV co-infection may accelerate the clinical progression of both HCV and HIV. The high prevalence of HBV/HIV and HCV/HIV co-infections in Asia underscores the need to improve prevention and control measures, as fewer evidencebased prevention strategies are available(compared with Western countries). In this review, the most recent publications on the prevalence of HBV/HIV and HCV/HIV co-infections and related issues, such as therapy and problems in Asia, are updated and summarized.展开更多
AIM:To assess whether schistosomiasis coinfection with chronic hepatitis C virus (HCV) influences hepatic fibrosis and pegylated-interferon/ribavirin (PEG-IFN/ RIB) therapy response. METHODS:This study was designed as...AIM:To assess whether schistosomiasis coinfection with chronic hepatitis C virus (HCV) influences hepatic fibrosis and pegylated-interferon/ribavirin (PEG-IFN/ RIB) therapy response. METHODS:This study was designed as a retrospective analysis of 3596 chronic HCV patients enrolled in the Egyptian National Program for HCV treatment with PEG-IFN/RIB. All patients underwent liver biopsy and anti-schistosomal antibodies testing prior to HCV treatment. The serology results were used to categorize the patients into group A (positive schistosomal serology) or group B (negative schistosomal serology). Patients in group A were given oral antischistosomal treatment(praziquantel, single dose) at four weeks prior to PEG-IFN/RIB. All patients received a 48-wk course of PEG-IFN (PEG-IFNα2a or PEG-IFNα2b)/RIB therapy. Clinical and laboratory follow-up examinations were carried out for 24 wk after cessation of therapy (to week 72). Correlations of positive schistosomal serology with fibrosis and treatment response were assessed by multiple regression analysis. RESULTS:Schistosomal antibody was positive in 27.3% of patients (15.9% females and 84.1% males). The patients in group A were older (P = 0.008) and had a higher proportion of males (P = 0.002) than the patients in group B. There was no significant association between fibrosis stage and positive schistosomal serology (P = 0.703). Early virological response was achieved in significantly more patients in group B than in group A (89.4% vs 86.5%, P = 0.015). However, significantly more patients in group A experienced breakthrough at week 24 than patients in group B (36.3% vs 32.3%, P = 0.024). End of treatment response was achieved in more patients in group B than in group A (62.0% vs 59.1%) but the difference did not reach statistical significance (P = 0.108). Sustained virological response occurred in significantly more patients in group B than in group A (37.6% vs 27.7%, P = 0.000). Multivariate logistic regression analysis of patient data at treatment weeks 48 and 72 showed that positive schistosomal serology was associated with failure of response to treatment at week 48 (OR = 1.3, P = 0.02) and at week 72 (OR = 1.7, P < 0.01). CONCLUSION:Positive schistosomal serology has no effect on fibrosis staging but is significantly associated with failure of response to HCV treatment despite antischistosomal therapy.展开更多
Hepatitis C virus(HCV) infection is one of the mostfrequent causes of comorbidity and mortality in the human immunodeficiency virus(HIV) population, and liver-related mortality is now the second highest cause of death...Hepatitis C virus(HCV) infection is one of the mostfrequent causes of comorbidity and mortality in the human immunodeficiency virus(HIV) population, and liver-related mortality is now the second highest cause of death in HIV-positive patients, so HCV infection should be countered with adequate antiviral therapy. In 2011 began the era of directly acting antivirals(DAAs) and the HCV NS3/4A protease inhibitors telaprevir and boceprevir were approved to treat HCV-genotype-1 infection, each one in combination with pegylated interferon alfa(Peg-IFN) + ribavirin(RBV). The addition of the first generation DAAs, strongly improved the efficacy of antiviral therapy in patients with HCVgenotype 1, both for the HCV-monoinfected and HIV/HCV coinfected, and the poor response to Peg-IFN + RBV in HCV/HIV coinfection was enhanced. These treatments showed higher rates of sustained virological response than Peg-IFN + RBV but reduced tolerability and adherence due to the high pill burden and the several pharmacokinetic interactions between HCV NS3/4A protease inhibitors and antiretroviral drugs. Then in 2013 a new wave of DAAs arrived, characterized by high efficacy, good tolerability, a low pill burden and shortened treatment duration. The second and third generation DAAs also comprised IFN-free regimens, which in small recent trials on HIV-positive patients have shown comforting preliminary results in terms of efficacy, tolerability and adherence.展开更多
Hepatitis B virus(HBV)/Hepatitis C virus(HCV)coinfection is frequently observed because of the common infection routine.Despite the reciprocal inhibition exerted by HBV and HCV genomes,the coinfection of HBV and HCV i...Hepatitis B virus(HBV)/Hepatitis C virus(HCV)coinfection is frequently observed because of the common infection routine.Despite the reciprocal inhibition exerted by HBV and HCV genomes,the coinfection of HBV and HCV is associated with more severe forms of liver diseases.However,the complexity of viral interference and underlying pathological mechanism is still unclarified.With the demonstration of absence of direct viral interplay,some in vitro studies suggest the indirect effects of viral-host interaction on viral dominance outcome.Here,we comprehensively investigated the viral replication and host immune responses which might mediate the interference between viruses in HBV/HCV coinfected Huh7-NTCP cells and immunocompetent HCV human receptors transgenic ICR mice.We found that presence of HCV significantly inhibited HBV replication in vitro and in vivo irrespective of the coinfection order,while HBV did not affect HCV replication.Pathological alteration was coincidently reproduced in coinfected mice.In addition to the participation of innate immune response,an involvement of HCV in up-regulating HBV-specific immune responses was described to facilitate HBV clearance.Our systems partially recapitulate HBV/HCV coinfection and unveil the uncharacterized adaptive anti-viral immune responses during coinfection,which renews the knowledge on the nature of indirect viral interaction during HBV/HCV coinfection.展开更多
To further understand the generation and development of coinfection of Marek＇s disease virus （MDV） and reticuloendotheliosis virus （REV） in broiler breeders, and then find the method and optimal time of different...To further understand the generation and development of coinfection of Marek＇s disease virus （MDV） and reticuloendotheliosis virus （REV） in broiler breeders, and then find the method and optimal time of differential diagnosis for complex clinic multiple infection, the authors studied the pathohistological changes, apoptosis, immunohistochemistry （immunofluorescence）, and ultrastructure of tumor tissues of broiler breeders inoculated with MDV and REV. The study showed that proliferation of small lymphocytes was seen in the main organs at the age of 1 week, then immature lymphocytes, all kinds of lymphocytes, primitive reticulum cells, and Marek＇s disease cells （MDCs） were observed at 2-9 weeks. Apoptosis of lymphocytes could not be seen until the age of 10 weeks in the immune system. Immunohistochemistry detection showed that the positive signs of MDV and REV antigen were observed in the main organs at 2 weeks of age. Multi-morphology lymphocytes, MDV, and REV, mitotic figures and apoptosis of lymphocytes were observed with the help of transmission electron microscopy. MDV cooperating with REV promotes the course of disease of coinfection. Differential diagnosis can be done by immunohistochemistry in the early stage （before 2 weeks）, and histopathology in the late stage （post 4 weeks）. MDCs, primitive reticulum cells, immature lymphocytes, and two kinds of virions can serve as a basis for bistopathology differential diagnosis.展开更多
Human immunodeficiency virus(HIV) and tuberculosis(TB) coinfection is a serious public health problem. HIV and TB promote each other, accelerating development of HIV to acquired immunodeficiency syndrome(AIDS) and hei...Human immunodeficiency virus(HIV) and tuberculosis(TB) coinfection is a serious public health problem. HIV and TB promote each other, accelerating development of HIV to acquired immunodeficiency syndrome(AIDS) and heightening TB mortality. Determining interaction mechanism between HIV and Mycobacterium tuberculosis can lead to development of effective treatments. This study summarizes prevalence status of AIDS and TB coinfection and research advances concerning their interaction mechanism.展开更多
We communicate the diagnosis by microscopy of a pulmonary coinfection produced by Cryptococcus neoformans and Pneumocystis jiroveci,from a respiratory secretion obtained by bronchoalveolar lavage of an AIDS patient.Ou...We communicate the diagnosis by microscopy of a pulmonary coinfection produced by Cryptococcus neoformans and Pneumocystis jiroveci,from a respiratory secretion obtained by bronchoalveolar lavage of an AIDS patient.Our review of literature identified this coinfection as unusual presentation.Opportunistic infections associated with HIV infection are increasingly recognized.It may occur at an early stage of HIV-infection.Whereas concurrent opportunistic infections may occur,coexisting Pneumocystis jiroveci pneumonia(PCP)and disseminated cryptococcosis with cryptococcal pneumonia is uncommon.The lungs of individuals infected with HIV are often affected by opportunistic infections and tumours and over two-thirds of patients have at least one respiratory episode during the course of their disease.Pneumonia is the leading HIV-associated infection.We present the case of a man who presented dual Pneumocystis jiroveci and cryptococcal pneumonia in a patient with HIV.Definitive diagnosis of PCP and Cryptococcus requires demonstration of these organisms in pulmonary tissues or fluid.In patients with<200/microliter CD4-lymphocytes,a bronchoalveolar lavage should be performed.This patient was successfully treated with amphotericin B and trimethoprim sulfamethoxazole.After 1 week the patient showed clinical and radiologic improvement and was discharged 3 weeks later.展开更多
Rationale: Microbial keratitis caused by coinfection with more than one species of pathogens is a severe condition with an unfavorable prognosis. Patient concerns: An immunocompetent Nepali woman complained of pain in...Rationale: Microbial keratitis caused by coinfection with more than one species of pathogens is a severe condition with an unfavorable prognosis. Patient concerns: An immunocompetent Nepali woman complained of pain in the left eye, redness, watering and decreased vision for 5 months. Interventions: The patient was discarded and accurately diagnosed with coinfection with Fusarium sp. and Acanthamoeba sp. The habit of washing the eyes with tap water from a domestic storage tank was the most likely source of infection since it was found to be contaminated with cysts of Acanthamoeba sp. The woman received eye drops of fluconazole and natamycin(5%), cefazoline(50 mg/m L), atropine, and tablets of itraconazole(100 mg), which were later switched to eye drops of clotrimazole(1%), natamycin(5%) and voriconazole(1%), and tablets of itraconazole. A full thickness penetrating keratoplasty was performed followed by treatment with eye drops of voriconazole(1%), natamet(5%), ofloxacin, atropine and carboxymethylcellulose for one week.Outcomes: After treatment, the condition of the patient significantly improved and was discharged one week after keratoplasty. Lessons: This is the first report of Acanthamoeba keratitis in Nepal and the first report of coinfection with Fusarium in this country and highlights the importance of early diagnosis of microbial keratitis both in single microorganism infections and coinfections, even in no contact lens wearers.展开更多
BACKGROUND Spinal epidural abscess(SEA)is a rare condition that mostly results from infection with either bacteria or tuberculosis.However,coinfection with bacteria and tuberculosis is extremely rare,and it results in...BACKGROUND Spinal epidural abscess(SEA)is a rare condition that mostly results from infection with either bacteria or tuberculosis.However,coinfection with bacteria and tuberculosis is extremely rare,and it results in delays in diagnosis and antimicrobial treatment causing unfavorable outcomes.CASE SUMMARY A 75-year-old female visited the hospital with low back pain,and magnetic resonance imaging(MRI)revealed an SEA at the lumbosacral segment.Staphylococcus hominis and methicillin-resistant Staphylococcus epidermidis were identified from preoperative blood culture and intraoperative abscess culture,respectively.Thus,the patient underwent treatment with vancomycin medication for 9 wk after surgical drainage of the SEA.However,the low back pain recurred 2 wk after vancomycin treatment.MRI revealed an aggravated SEA in the same area in addition to erosive destruction of vertebral bodies.Second surgery was performed for SEA removal and spinal instrumentation.The microbiological study and pathological examination confirmed Mycobacterium tuberculosis as the pathogen concurrent with the bacterial SEA.The patient improved completely after 12 mo of antitubercular medication.CONCLUSION We believe that the identification of a certain pathogen in SEAs does not exclude coinfection with other pathogens.Tubercular coinfection should be suspected if an SEA does not improve despite appropriate antibiotics for the identified pathogen.展开更多
Hepatitis B virus (HBV) co-infection with HIV is high among Nigerians. Some studies have suggested impaired CD4 recovery among coinfected patients compared to the HIV mono infected. This retrospective study of treatme...Hepatitis B virus (HBV) co-infection with HIV is high among Nigerians. Some studies have suggested impaired CD4 recovery among coinfected patients compared to the HIV mono infected. This retrospective study of treatment-na?ve HIV infected patients was aimed at determining the trend of changes in CD4+ counts, HIV-RNA and renal and liver function tests in response to combined antiretroviral therapy (CART). A questionnaire was utilised to extract clinical and laboratory data of HBV co infected HIV/AIDS patients before treatment and at six, twelve and eighteen months of therapy with CART. Findings were compared to those of HIV mono infected. Relevant statistical instruments were used to analyse for comparisons of means of Log10 HIV viral load and CD4 count using SPSS package 15.0. All levels of sig-nificance were at 5 %. Two thousand five hundred and sixty two patients were analysed. Of these, 354(13.8%) were HBsAg positive. Majority (63.1%) were females. Most of the recruited patients were on combivir and nevirapine. The median CD4 count for the HBsAg negative was 104 cells/mm3 (IQR 34 – 171) and it was significantly higher than those of the positive (91 cells/mm3) (p < 0.05). ALT and AST were higher among HBsAg positives, while urea and creatinine levels were similar. The median change in CD4 count from baseline and during the course of therapy were similar in the two groups. Similarly, virological responses were not different in the two groups at the various time points. In con-clusion no significant difference in the rate of CD4 recovery and HIV-RNA decline in among coinfected and monoin-fected HIV patients at different stages of therapy.展开更多
The case we present here is a man who lives in a dengue-endemic area.Initially,the patient was diagnosed with dengue fever by clinical evaluation and laboratorial confirmation.Subsequently,he presented respiratory sym...The case we present here is a man who lives in a dengue-endemic area.Initially,the patient was diagnosed with dengue fever by clinical evaluation and laboratorial confirmation.Subsequently,he presented respiratory symptoms,and a concomitant severe acute respiratory syndrome coronavirus 2 infection was confirmed.He was hospitalized for 17 d and had a satisfactory recovery.展开更多
Background: Many older adults (50 - 64 years) in Botswana with HIV do not know they are infected with TB. Some with TB disease are unaware of their HIV status, yet HIV/TB coinfection is high. The study aims to determi...Background: Many older adults (50 - 64 years) in Botswana with HIV do not know they are infected with TB. Some with TB disease are unaware of their HIV status, yet HIV/TB coinfection is high. The study aims to determine the prevalence of TB among older adults with HIV, their HIV/AIDS knowledge and vulnerability to hypertension, diabetes and asthma using the 2013 BAIS IV data. Material and Methods: The BAIS IV study, from which the data for this article is derived, used a stratified two-stage probability sampling design. The first stage was the selection of 297 Enumeration Areas (EAs) as Primary Sampling Units and second stage was selection of households (5,415) in the EAs. The study targeted all usual members of the selected households aged 6 weeks and above for the Biomarker or testing for HIV and those aged 10 - 64 years old for the behavioral questionnaire. Results: The study shows that the older adults (50 - 64 years) with TB have a low level of education and HIV prevalence is very high (44% for age 50 - 54, 40.6% for age 55 - 59 and 68.4% for age 60 - 64 years). The rate of HIV/TB coinfection, 21.9%, is high and prevalence of TB among the older adults is 8.6% (13%, males and 5.3%, females) while only 0.8% are currently on treatment. Only 67.2% know that if a pregnant mother is infected with HIV, there is a way of preventing transmission of the virus to the child. Age, level of education, marital status and employment status significantly (p Conclusion: The study concludes that lower education seems to be an obstacle to accessing TB treatment. Therefore, older adults’ awareness and knowledge of the symptoms of both diseases (TB and HIV), mode of infection and treatment need to adequately improve through increased education to overcome health challenges when infected with asthma, diabetes and high blood pressure/hypertension.展开更多
<b>Background: </b>In Togo, as in all sub-Saharan countries, the burden of HIV infection remains high. The registration of new cases of Buruli ulcer every year also remains a major public health problem. B...<b>Background: </b>In Togo, as in all sub-Saharan countries, the burden of HIV infection remains high. The registration of new cases of Buruli ulcer every year also remains a major public health problem. Buruli ulcer (BU) is a disabling disease and the presentation of lesions is frequently severe. A feature of BU and HIV coinfection is the rarity of cases, which makes its study difficult, but, nevertheless, important to study its seroprevalence, biological data, risk factors and genetic diversity. The purpose of this study is to explore the comorbidity of Buruli ulcer and HIV by evaluating HIV seroprevalence in BU patients, assessing demographic data, reviewing biological data including CD4+ T cell count, hemoglobin levels, and viral loads, and evaluating clinical and therapeutic data. <b>Methods: </b>This is a cross-sectional study including only BU patients confirmed by Ziehl Neelsen staining and IS 2404 PCR. The patients were hospitalized in the National Reference Center for Tsevie. They were recovered patients and patients undergoing outpatient treatment in the Gati and Tchekpo Deve treatment centers, respectively, within the Sanitary Districts of Zio and Yoto of the Maritime Region during the period from August 2015 to March 2017. <b>Results: </b>The number of HIV-positive BU patients is 4 out of a total of 83 BU patients. All patients are HIV-1 positive. HIV prevalence among BU patients is 4.8% compared to 2.5% nationally and 3% at regional level. Three BU patients are seropositive out of a total of 46 female patients while one patient under 15 years is seropositive out of a total of 37 male BU patients. There are a greater proportion of female patients with BU/HIV coinfections. Half of the BU/HIV positive patients (BU/HIV+) have a CD4+ TL of fewer than 500 cells/μl and the difference is significant between those of the BU HIV- and those of the BU/HIV+ patients. Two patients have undetectable viral loads while the other two have more than 1000 copies/ml (33,000 and 1,100,000 copies/ml). Anemia is significantly present in BU/HIV+ patients with a p-value = 0.003. Half of BU patients have primary education, while three-quarters of BU/HIV+ patients have no education. All patients are either in stage I or stage II of the AIDS WHO classification. All patients are on first line ARV therapy and only ARV nucleoside reverse transcriptase inhibitors (NRTIs) are used. <b>Conclusion: </b>In Togo, the prevalence of HIV in BU patients, although higher, is not significantly different from that of national and regional. The relatively high CD4+ LT levels of relatively high BU HIV + patients, undetectable viral loads, and AIDS WHO stages I and II indicate good quality management. <b>Author Summary: </b>Buruli ulcer disease (BUD) is a mycobacterial skin disease that leads to extensive ulcerations and causes disabilities in approximately 25% of the patients. Co-infection with HIV is described by the authors through the prism of risk factors and the severity of ulcerations. Healing time is described as longer than in BU/HIV- patients. The scarcity of cases seems to be an obstacle for further study. Noteworthy are the study of cases in Benin and the study of cohort cases in Cameroon. However, no study appears to be based on the seroprevalence of this morbid association, the biological data and the antiretroviral regimens. These regimens, if poorly instituted, conflict with antimycobacterial drugs against Buruli ulcer. This study, although confronted with the particular configuration of Togo, a country with a low HIV prevalence of 2.8% national prevalence and an average of 55 cases of Buruli ulcer per year, is studying the biological aspects of co-infection HIV/BU, including seroprevalence of HIV, CD4+ LT levels, patient viral load and hemoglobin levels and ARV regimens. This study shows the need for future studies, including the study of the genetic diversity of circulating <i>Mycobacterium ulcerans</i> strains in Togo and the study of Buruli ulcer co-infection/HIV and tuberculosis.展开更多
Background: Malaria and HIV are endemic in Cameroon. But data on the prevalence of coinfection with malaria and HIV in Cameroonian children are essentially absent. This study was aimed at determining the prevalence of...Background: Malaria and HIV are endemic in Cameroon. But data on the prevalence of coinfection with malaria and HIV in Cameroonian children are essentially absent. This study was aimed at determining the prevalence of coinfection with malaria and HIV among children in Yaoundé, so as to advice control policies. Methods: In a cross-sectional survey, children (≤15 years) were recruited from 3 communities in Yaoundé namely: Efoulan, Biyem-assi and Cité-verte. A semi-structured questionnaire was used to collect demographic data. Participants were screened for malaria parasites by the examination of Giemsa-stained blood films meanwhile participants were screened for HIV following Cameroon’s national algorithm. The Pearson’s chi-square test was performed as part of the statistical analyses. Statistical significance was set at p Result: Three hundred and ten (310) children took part in the study. The mean age (±SD) of the participants was 75.64 (±63.23) months and a majority of them were males (56.1%). The prevalence was 19.7%, 4.8% and 1.2% for malaria, HIV, and coinfection with malaria and HIV respectively. The prevalence of malaria was associated with age (p = 0.009) meanwhile the prevalence of HIV was associated with study site (p = 0.024). Plasmodium falciparum was the only species identified as causing malaria in the target population. Conclusion: A substantial prevalence of malaria, HIV and coinfection with malaria and HIV was observed in this study. Efforts should be strengthened to control and eventually eliminate these diseases in the target population.展开更多
Background: Since 2019, Covid-19 pandemic has afflicted the world and countries of Africa. Despite the limited resources, these countries already disturbed by multiple diseases that have not yet been controlled such a...Background: Since 2019, Covid-19 pandemic has afflicted the world and countries of Africa. Despite the limited resources, these countries already disturbed by multiple diseases that have not yet been controlled such as malaria, must face this pandemic whose success in the management depends on the early detection of the disease. The objective of this study was to determine the prevalence of Malaria-Covid-19 coinfection in our environment. Methods: This was a retrospective analysis of patients’ data with Covid-19 infection from May to July 2021 at the International Hospital center of Kinshasa “CHIK”. We collected data and analysis was performed on the sociodemographic parameters, the notion of anticovid-19 vaccination as well as the duration of the symptomatology before the consultation, the clinical manifestations and the laboratory data available while including the data of the thick drop. Results: A total of 84 patients were registered with an average age of 35.23 ± 12.74 years. The male sex was predominant (82.1%). The Indian community was the most affected (44.2%). The average of days elapsed before the consultation of 3.63 days. The anti-Covid-19 vaccination rate was 20.3%. The prevalence of Malaria-Covid-19 coinfection was 29.76%. In coinfected patients, fever and cough were more reported (64%). Regarding biological and inflammatory parameters, 31.8% of coinfected patients had a platelet count less than 150,000 elements/mm<sup>3</sup> compared to 11.6% in non-Co-infected (p = 0.046). Conclusion: The Malaria-Covid-19 comorbidity prevalence is high in Malaria endemic country like Democratic Republic of Congo (DRC). It is necessary to make better distinction, to detect early the comorbidity in order to better guide care and not be limited to treating malaria, letting the Covid-19 evolve.展开更多
Summary What is already known about this topic?Human respiratory syncytial virus(HRSV)coinfection with other respiratory pathogens frequently occurs in young children with acute respiratory illness.However,the epidemi...Summary What is already known about this topic?Human respiratory syncytial virus(HRSV)coinfection with other respiratory pathogens frequently occurs in young children with acute respiratory illness.However,the epidemiological patterns and associated disease burden of HRSV coinfections in pediatric populations remain poorly characterized.展开更多
Objectives:Mycoplasma pneumoniae(MP)is a key cause of community-acquired pneumonia,and coinfections lead to varied patient outcomes.A comprehensive understanding of the outcome characteristics and associated etiologie...Objectives:Mycoplasma pneumoniae(MP)is a key cause of community-acquired pneumonia,and coinfections lead to varied patient outcomes.A comprehensive understanding of the outcome characteristics and associated etiologies of coinfections in MP patients is lacking.Methods and results:We analyzed 121,357 MP cases from 522,292,680 visits in Wuhan,China,in 2023(the final year of the COVID-19 pandemic).Children aged 1e10 years had the highest incidence,whereas those over 60 years had elevated hospitalization,severe infection,and fatality rates.Coinfection patterns differed by age,with bacterial-viral-Chlamydia pneumoniae(C.pneumoniae)/other pathogens prevalent in infants,bacterialviral pathogens prevalent in preschoolers,and viral-viral pathogens prevalent in schoolaged children.Bacterial coinfections were most common in MP-infected patients,especially those who were hospitalized.Coinfection,especially with C.pneumoniae,Pseudomonas aeruginosa(P.aeruginosa),Haemophilus influenzae(H.influenzae),and Streptococcus pneumoniae(S.pneumoniae),increased hospitalization rates.The most severe outcomes and deaths occurred in patients coinfected with C.pneumoniae-severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),influenza A-parainfluenza virus(PIV)or adenovirus-PIV.Logistic regression analysis demonstrated that male sex and adult age(particularly≥40 years)were significantly associated with adverse outcomes in MP monoinfection.For coinfections,significantly higher hospitalization rates were reported among very young children(0-5 years)and adults aged40 years,whereas adults presented an increased risk of severe disease.Coinfection outcomes were significantly associated with seasons of the year(winter,spring,and summer),specific age groups(3-5 years,18-39 years,40-50 years,and 60 years and over),gender(male),and longer onsetto-diagnosis periods.Middle-aged and elderly patients,coinfection,spring and summer,gender(male),and longer onset-to-diagnosis periods were significantly associated with increased hospitalization and serious illness risk.Coinfection,winter,older(adult)age,and gender(male)were significantly associated with an increased risk of death.Conclusions:Compared with adults,children with MP have a greater morbidity risk,whereas middle-aged and older adults face greater risks of hospitalization,serious illness,and death.Coinfection with other pathogens heightens hospitalization and death risks.These insights are crucial for etiological screening,diagnosing multiple pathogens,and preventing and treating infections.展开更多
文摘Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and Plasmodium species are the causative agents of coronavirus disease 2019 (COVID-19) and malaria respectively with similar clinical presentations. The objective of this study is to determine the burden of co-infection of SARS-CoV-2 and malaria in the general population. Five (5 mLs) of blood samples were collected for SARS-CoV-2 and malaria parasite test. The malaria test was performed using a commercially available one-step malaria antigen Plasmodium falciparum histidine-rich protein 2 (Pf HRP-II) rapid test kit. The results of the study showed that the participants that were coinfected with SARS-CoV-2 IgG and malaria were 13 (2.5%) in Lagos, 1114 (39.1%) in Delta and 49 (2.3%) in Sokoto States. The prevalence of coinfection of SARS-CoV-2 and malaria in urban areas in Lagos, Delta and Sokoto States were 7 (2.2%), 1373 (48.1%), and 5 (0.2%) respectively. In rural areas, the prevalence of coinfection of SARS-CoV-2 and malaria in Lagos, Delta and Sokoto States were 6 (0.3%), 365 (12.8%), and 44 (2.1%) respectively in this study. This suggests that participants in the urban areas were more prone to co-infections than the rural areas in Lagos and Delta states, while it was otherwise in Sokoto State. In conclusion, the co-infection of SARS-CoV-2 and malaria was very high in Delta State compared to the other States. It is important for clinics to screen for both diseases when patients present with symptoms of malaria. This is because the infections have similar symptoms and the public is quick to assume malaria infection without diagnosing for COVID-19 and vice versa.
文摘AIM To detect infection rate of GBV-C/HGV inhepatitis C patients,to determine the methodsof higher sensitivity and the primers of higherefficiency for GBV-C/HGV RNA detection and tostudy the dominant subtype and mutation ofGBV-C/HGV.METHODS Quantitative RT-PCR for detectionpf HCV RNA concentration in serum samples,RT-nested PCR with two sets of primers fordetection of GBV-C RNA,RT-PCR ELISA with twosets of primers for detection of HGV RNA,nucleotide sequence and putative amino acidsequence analysis.RESULTS The positive rates of GBV-C RNA atthe 5’-NCR and NS3 region in 211 serums amplesfrom the patients with HCV infection were 31.8%and 22.8% respectively.The positive rates ofHGV RNA at the 5’-NCR and NS5 region in thesame samples were 47.9% and 31.8%respectively.The total positive rate of GBV-C/HGV RNA was as high as 55.5%.HCV copynumbers in the patients without GBV-C/ HGVcoinfection were statistically higher than that inthe patients with GBV-C/ HGV coinfection(P【0.01).Frequent mutation of nucleotideresidue was present in the amplificationproducts.Frameshift mutation was found in twosamples with GBV-C NS3 region nucleotidesequences.All nucleotide sequences fromamplification products showed higher homologyto HGV genome than to GBV-C genome even though part of the sequences were amplifiedwith GBV-C primers.CONCLUSION A high frequency of GBV-C/ HGV coinfection existed in the hepatitis C patients. RT-PCR ELISA was more sensitive than RT-nested PCR for detection of GBV-C/ HGV RNA. The primers derived from the 5 -NCR was more efficient than those derived from the NS3 and NS5 regions. A reverse relationship was found to exist between HCV RNA concentration and GBV-C/ HGV infection frequency. HGV was the dominant subtype of the virus in the local area. The major mutations of GBV-C/ HGV genomes were random mutation of nucleotide residue.
基金Supported by Scientific Research Fund for Education Departmentof the the School of Medicine-Buenos Aires University(No:J500798759)
文摘A case of pulmonary coinfection by Strongyloides stercoralis and Pneumocystis jiroveci has been detected in an AIDS patient treated in the Respiratory Intensive Care Unit of the Muniz Hospital.At diagnosis,the patient presented cough with mucopurulent expectoration,dyspnea,fever,bilateral pulmonary infiltrates on the chest X-ray,negative bacilloscopy for acid fast bacteria and a CD4^+ T lymphocytes count of 52 cells/μ L.The microbiological diagnosis was achieved by microscopic observation of the respiratory secretions obtained by bronchoalveolar lavage,while the wet mount examination revealed rhabditiform and filariform larvae of the nematode and foamy exudates,pathognomonic of the pulmonary pneumocystosis.It was the unique case of this association among about 3 000 samples performed in our laboratory in the last 10 years and diagnosed by microscopy.Other complementary stains(a rapid modification of Grocott,Kinyoun and Giemsa) were applied to the smears after the diagnosis of mycotic and parasitary infections achieved by fresh microscopy.Both physicians and microbiologists should take into account the possible coexistence of respiratory pathogens in immunocompromised patients,such as those with AIDS.
基金Supported by The Japan Initiative for Global Research Network on Infectious Diseases(J-GRID)program from the Ministry of Education,Culture,Sports,Science and Technology,Japan
文摘Hepatitis B virus(HBV), hepatitis C virus(HCV),and human immunodeficiency virus(HIV) affect many people in Asian countries, although there are geographic differences. Both HBV and HIV(HBV/HIV) and HCV/HIV co-infections are highly prevalent in Asia. Hetero- and homosexual, injection drug use, and geographic area are strong predictors of HBV, HCV, and HIV serostatus. In HBV endemic regions, the prevalence and genotype distribution of HBV/HIV coinfection is almost comparable with that in the general population. In Japan, where HBV has low endemicity, the prevalence of HBV/HIV co-infection is approximately 10-fold higher than that in the general population, and HBV Ae is the most common subgenotype among HIV infected individuals. Highly active antiretroviral therapy(HAART) is an effective treatment for HIV/Acquired Immune Deficiency Syndrome. Lamivudine, a component of HAART, is an effective treatment for HBV, HIV, and HBV/HIV co-infection; however, cost, emerging drug resistance, antiretroviral-associated liver toxicity and liver-related morbidity due to HCV progression are particular concerns. HCV/HIV co-infection may accelerate the clinical progression of both HCV and HIV. The high prevalence of HBV/HIV and HCV/HIV co-infections in Asia underscores the need to improve prevention and control measures, as fewer evidencebased prevention strategies are available(compared with Western countries). In this review, the most recent publications on the prevalence of HBV/HIV and HCV/HIV co-infections and related issues, such as therapy and problems in Asia, are updated and summarized.
基金Supported by The Science and Technology Development Fund,No.1708
文摘AIM:To assess whether schistosomiasis coinfection with chronic hepatitis C virus (HCV) influences hepatic fibrosis and pegylated-interferon/ribavirin (PEG-IFN/ RIB) therapy response. METHODS:This study was designed as a retrospective analysis of 3596 chronic HCV patients enrolled in the Egyptian National Program for HCV treatment with PEG-IFN/RIB. All patients underwent liver biopsy and anti-schistosomal antibodies testing prior to HCV treatment. The serology results were used to categorize the patients into group A (positive schistosomal serology) or group B (negative schistosomal serology). Patients in group A were given oral antischistosomal treatment(praziquantel, single dose) at four weeks prior to PEG-IFN/RIB. All patients received a 48-wk course of PEG-IFN (PEG-IFNα2a or PEG-IFNα2b)/RIB therapy. Clinical and laboratory follow-up examinations were carried out for 24 wk after cessation of therapy (to week 72). Correlations of positive schistosomal serology with fibrosis and treatment response were assessed by multiple regression analysis. RESULTS:Schistosomal antibody was positive in 27.3% of patients (15.9% females and 84.1% males). The patients in group A were older (P = 0.008) and had a higher proportion of males (P = 0.002) than the patients in group B. There was no significant association between fibrosis stage and positive schistosomal serology (P = 0.703). Early virological response was achieved in significantly more patients in group B than in group A (89.4% vs 86.5%, P = 0.015). However, significantly more patients in group A experienced breakthrough at week 24 than patients in group B (36.3% vs 32.3%, P = 0.024). End of treatment response was achieved in more patients in group B than in group A (62.0% vs 59.1%) but the difference did not reach statistical significance (P = 0.108). Sustained virological response occurred in significantly more patients in group B than in group A (37.6% vs 27.7%, P = 0.000). Multivariate logistic regression analysis of patient data at treatment weeks 48 and 72 showed that positive schistosomal serology was associated with failure of response to treatment at week 48 (OR = 1.3, P = 0.02) and at week 72 (OR = 1.7, P < 0.01). CONCLUSION:Positive schistosomal serology has no effect on fibrosis staging but is significantly associated with failure of response to HCV treatment despite antischistosomal therapy.
文摘Hepatitis C virus(HCV) infection is one of the mostfrequent causes of comorbidity and mortality in the human immunodeficiency virus(HIV) population, and liver-related mortality is now the second highest cause of death in HIV-positive patients, so HCV infection should be countered with adequate antiviral therapy. In 2011 began the era of directly acting antivirals(DAAs) and the HCV NS3/4A protease inhibitors telaprevir and boceprevir were approved to treat HCV-genotype-1 infection, each one in combination with pegylated interferon alfa(Peg-IFN) + ribavirin(RBV). The addition of the first generation DAAs, strongly improved the efficacy of antiviral therapy in patients with HCVgenotype 1, both for the HCV-monoinfected and HIV/HCV coinfected, and the poor response to Peg-IFN + RBV in HCV/HIV coinfection was enhanced. These treatments showed higher rates of sustained virological response than Peg-IFN + RBV but reduced tolerability and adherence due to the high pill burden and the several pharmacokinetic interactions between HCV NS3/4A protease inhibitors and antiretroviral drugs. Then in 2013 a new wave of DAAs arrived, characterized by high efficacy, good tolerability, a low pill burden and shortened treatment duration. The second and third generation DAAs also comprised IFN-free regimens, which in small recent trials on HIV-positive patients have shown comforting preliminary results in terms of efficacy, tolerability and adherence.
基金supported by National Key Research and Development Program of China(2018YFA0507201 to X.C)the grants from the National Natural Science Foundation of China(81672021 to R.P,31770180 to C.W)。
文摘Hepatitis B virus(HBV)/Hepatitis C virus(HCV)coinfection is frequently observed because of the common infection routine.Despite the reciprocal inhibition exerted by HBV and HCV genomes,the coinfection of HBV and HCV is associated with more severe forms of liver diseases.However,the complexity of viral interference and underlying pathological mechanism is still unclarified.With the demonstration of absence of direct viral interplay,some in vitro studies suggest the indirect effects of viral-host interaction on viral dominance outcome.Here,we comprehensively investigated the viral replication and host immune responses which might mediate the interference between viruses in HBV/HCV coinfected Huh7-NTCP cells and immunocompetent HCV human receptors transgenic ICR mice.We found that presence of HCV significantly inhibited HBV replication in vitro and in vivo irrespective of the coinfection order,while HBV did not affect HCV replication.Pathological alteration was coincidently reproduced in coinfected mice.In addition to the participation of innate immune response,an involvement of HCV in up-regulating HBV-specific immune responses was described to facilitate HBV clearance.Our systems partially recapitulate HBV/HCV coinfection and unveil the uncharacterized adaptive anti-viral immune responses during coinfection,which renews the knowledge on the nature of indirect viral interaction during HBV/HCV coinfection.
基金supported by grants from the National Science Foundation for Post-Doctoral of China(2005038258)
文摘To further understand the generation and development of coinfection of Marek＇s disease virus （MDV） and reticuloendotheliosis virus （REV） in broiler breeders, and then find the method and optimal time of differential diagnosis for complex clinic multiple infection, the authors studied the pathohistological changes, apoptosis, immunohistochemistry （immunofluorescence）, and ultrastructure of tumor tissues of broiler breeders inoculated with MDV and REV. The study showed that proliferation of small lymphocytes was seen in the main organs at the age of 1 week, then immature lymphocytes, all kinds of lymphocytes, primitive reticulum cells, and Marek＇s disease cells （MDCs） were observed at 2-9 weeks. Apoptosis of lymphocytes could not be seen until the age of 10 weeks in the immune system. Immunohistochemistry detection showed that the positive signs of MDV and REV antigen were observed in the main organs at 2 weeks of age. Multi-morphology lymphocytes, MDV, and REV, mitotic figures and apoptosis of lymphocytes were observed with the help of transmission electron microscopy. MDV cooperating with REV promotes the course of disease of coinfection. Differential diagnosis can be done by immunohistochemistry in the early stage （before 2 weeks）, and histopathology in the late stage （post 4 weeks）. MDCs, primitive reticulum cells, immature lymphocytes, and two kinds of virions can serve as a basis for bistopathology differential diagnosis.
文摘Human immunodeficiency virus(HIV) and tuberculosis(TB) coinfection is a serious public health problem. HIV and TB promote each other, accelerating development of HIV to acquired immunodeficiency syndrome(AIDS) and heightening TB mortality. Determining interaction mechanism between HIV and Mycobacterium tuberculosis can lead to development of effective treatments. This study summarizes prevalence status of AIDS and TB coinfection and research advances concerning their interaction mechanism.
基金Supported by the"Scientific Research Fund for Neglected Tropical Diseases"(Project Grant number J500798759)the Argentinian Institutes for Health System Improvement-a Public Health Agency.through a scholarship(Grant numbers300820891)
文摘We communicate the diagnosis by microscopy of a pulmonary coinfection produced by Cryptococcus neoformans and Pneumocystis jiroveci,from a respiratory secretion obtained by bronchoalveolar lavage of an AIDS patient.Our review of literature identified this coinfection as unusual presentation.Opportunistic infections associated with HIV infection are increasingly recognized.It may occur at an early stage of HIV-infection.Whereas concurrent opportunistic infections may occur,coexisting Pneumocystis jiroveci pneumonia(PCP)and disseminated cryptococcosis with cryptococcal pneumonia is uncommon.The lungs of individuals infected with HIV are often affected by opportunistic infections and tumours and over two-thirds of patients have at least one respiratory episode during the course of their disease.Pneumonia is the leading HIV-associated infection.We present the case of a man who presented dual Pneumocystis jiroveci and cryptococcal pneumonia in a patient with HIV.Definitive diagnosis of PCP and Cryptococcus requires demonstration of these organisms in pulmonary tissues or fluid.In patients with<200/microliter CD4-lymphocytes,a bronchoalveolar lavage should be performed.This patient was successfully treated with amphotericin B and trimethoprim sulfamethoxazole.After 1 week the patient showed clinical and radiologic improvement and was discharged 3 weeks later.
文摘Rationale: Microbial keratitis caused by coinfection with more than one species of pathogens is a severe condition with an unfavorable prognosis. Patient concerns: An immunocompetent Nepali woman complained of pain in the left eye, redness, watering and decreased vision for 5 months. Interventions: The patient was discarded and accurately diagnosed with coinfection with Fusarium sp. and Acanthamoeba sp. The habit of washing the eyes with tap water from a domestic storage tank was the most likely source of infection since it was found to be contaminated with cysts of Acanthamoeba sp. The woman received eye drops of fluconazole and natamycin(5%), cefazoline(50 mg/m L), atropine, and tablets of itraconazole(100 mg), which were later switched to eye drops of clotrimazole(1%), natamycin(5%) and voriconazole(1%), and tablets of itraconazole. A full thickness penetrating keratoplasty was performed followed by treatment with eye drops of voriconazole(1%), natamet(5%), ofloxacin, atropine and carboxymethylcellulose for one week.Outcomes: After treatment, the condition of the patient significantly improved and was discharged one week after keratoplasty. Lessons: This is the first report of Acanthamoeba keratitis in Nepal and the first report of coinfection with Fusarium in this country and highlights the importance of early diagnosis of microbial keratitis both in single microorganism infections and coinfections, even in no contact lens wearers.
文摘BACKGROUND Spinal epidural abscess(SEA)is a rare condition that mostly results from infection with either bacteria or tuberculosis.However,coinfection with bacteria and tuberculosis is extremely rare,and it results in delays in diagnosis and antimicrobial treatment causing unfavorable outcomes.CASE SUMMARY A 75-year-old female visited the hospital with low back pain,and magnetic resonance imaging(MRI)revealed an SEA at the lumbosacral segment.Staphylococcus hominis and methicillin-resistant Staphylococcus epidermidis were identified from preoperative blood culture and intraoperative abscess culture,respectively.Thus,the patient underwent treatment with vancomycin medication for 9 wk after surgical drainage of the SEA.However,the low back pain recurred 2 wk after vancomycin treatment.MRI revealed an aggravated SEA in the same area in addition to erosive destruction of vertebral bodies.Second surgery was performed for SEA removal and spinal instrumentation.The microbiological study and pathological examination confirmed Mycobacterium tuberculosis as the pathogen concurrent with the bacterial SEA.The patient improved completely after 12 mo of antitubercular medication.CONCLUSION We believe that the identification of a certain pathogen in SEAs does not exclude coinfection with other pathogens.Tubercular coinfection should be suspected if an SEA does not improve despite appropriate antibiotics for the identified pathogen.
文摘Hepatitis B virus (HBV) co-infection with HIV is high among Nigerians. Some studies have suggested impaired CD4 recovery among coinfected patients compared to the HIV mono infected. This retrospective study of treatment-na?ve HIV infected patients was aimed at determining the trend of changes in CD4+ counts, HIV-RNA and renal and liver function tests in response to combined antiretroviral therapy (CART). A questionnaire was utilised to extract clinical and laboratory data of HBV co infected HIV/AIDS patients before treatment and at six, twelve and eighteen months of therapy with CART. Findings were compared to those of HIV mono infected. Relevant statistical instruments were used to analyse for comparisons of means of Log10 HIV viral load and CD4 count using SPSS package 15.0. All levels of sig-nificance were at 5 %. Two thousand five hundred and sixty two patients were analysed. Of these, 354(13.8%) were HBsAg positive. Majority (63.1%) were females. Most of the recruited patients were on combivir and nevirapine. The median CD4 count for the HBsAg negative was 104 cells/mm3 (IQR 34 – 171) and it was significantly higher than those of the positive (91 cells/mm3) (p < 0.05). ALT and AST were higher among HBsAg positives, while urea and creatinine levels were similar. The median change in CD4 count from baseline and during the course of therapy were similar in the two groups. Similarly, virological responses were not different in the two groups at the various time points. In con-clusion no significant difference in the rate of CD4 recovery and HIV-RNA decline in among coinfected and monoin-fected HIV patients at different stages of therapy.
文摘The case we present here is a man who lives in a dengue-endemic area.Initially,the patient was diagnosed with dengue fever by clinical evaluation and laboratorial confirmation.Subsequently,he presented respiratory symptoms,and a concomitant severe acute respiratory syndrome coronavirus 2 infection was confirmed.He was hospitalized for 17 d and had a satisfactory recovery.
文摘Background: Many older adults (50 - 64 years) in Botswana with HIV do not know they are infected with TB. Some with TB disease are unaware of their HIV status, yet HIV/TB coinfection is high. The study aims to determine the prevalence of TB among older adults with HIV, their HIV/AIDS knowledge and vulnerability to hypertension, diabetes and asthma using the 2013 BAIS IV data. Material and Methods: The BAIS IV study, from which the data for this article is derived, used a stratified two-stage probability sampling design. The first stage was the selection of 297 Enumeration Areas (EAs) as Primary Sampling Units and second stage was selection of households (5,415) in the EAs. The study targeted all usual members of the selected households aged 6 weeks and above for the Biomarker or testing for HIV and those aged 10 - 64 years old for the behavioral questionnaire. Results: The study shows that the older adults (50 - 64 years) with TB have a low level of education and HIV prevalence is very high (44% for age 50 - 54, 40.6% for age 55 - 59 and 68.4% for age 60 - 64 years). The rate of HIV/TB coinfection, 21.9%, is high and prevalence of TB among the older adults is 8.6% (13%, males and 5.3%, females) while only 0.8% are currently on treatment. Only 67.2% know that if a pregnant mother is infected with HIV, there is a way of preventing transmission of the virus to the child. Age, level of education, marital status and employment status significantly (p Conclusion: The study concludes that lower education seems to be an obstacle to accessing TB treatment. Therefore, older adults’ awareness and knowledge of the symptoms of both diseases (TB and HIV), mode of infection and treatment need to adequately improve through increased education to overcome health challenges when infected with asthma, diabetes and high blood pressure/hypertension.
文摘<b>Background: </b>In Togo, as in all sub-Saharan countries, the burden of HIV infection remains high. The registration of new cases of Buruli ulcer every year also remains a major public health problem. Buruli ulcer (BU) is a disabling disease and the presentation of lesions is frequently severe. A feature of BU and HIV coinfection is the rarity of cases, which makes its study difficult, but, nevertheless, important to study its seroprevalence, biological data, risk factors and genetic diversity. The purpose of this study is to explore the comorbidity of Buruli ulcer and HIV by evaluating HIV seroprevalence in BU patients, assessing demographic data, reviewing biological data including CD4+ T cell count, hemoglobin levels, and viral loads, and evaluating clinical and therapeutic data. <b>Methods: </b>This is a cross-sectional study including only BU patients confirmed by Ziehl Neelsen staining and IS 2404 PCR. The patients were hospitalized in the National Reference Center for Tsevie. They were recovered patients and patients undergoing outpatient treatment in the Gati and Tchekpo Deve treatment centers, respectively, within the Sanitary Districts of Zio and Yoto of the Maritime Region during the period from August 2015 to March 2017. <b>Results: </b>The number of HIV-positive BU patients is 4 out of a total of 83 BU patients. All patients are HIV-1 positive. HIV prevalence among BU patients is 4.8% compared to 2.5% nationally and 3% at regional level. Three BU patients are seropositive out of a total of 46 female patients while one patient under 15 years is seropositive out of a total of 37 male BU patients. There are a greater proportion of female patients with BU/HIV coinfections. Half of the BU/HIV positive patients (BU/HIV+) have a CD4+ TL of fewer than 500 cells/μl and the difference is significant between those of the BU HIV- and those of the BU/HIV+ patients. Two patients have undetectable viral loads while the other two have more than 1000 copies/ml (33,000 and 1,100,000 copies/ml). Anemia is significantly present in BU/HIV+ patients with a p-value = 0.003. Half of BU patients have primary education, while three-quarters of BU/HIV+ patients have no education. All patients are either in stage I or stage II of the AIDS WHO classification. All patients are on first line ARV therapy and only ARV nucleoside reverse transcriptase inhibitors (NRTIs) are used. <b>Conclusion: </b>In Togo, the prevalence of HIV in BU patients, although higher, is not significantly different from that of national and regional. The relatively high CD4+ LT levels of relatively high BU HIV + patients, undetectable viral loads, and AIDS WHO stages I and II indicate good quality management. <b>Author Summary: </b>Buruli ulcer disease (BUD) is a mycobacterial skin disease that leads to extensive ulcerations and causes disabilities in approximately 25% of the patients. Co-infection with HIV is described by the authors through the prism of risk factors and the severity of ulcerations. Healing time is described as longer than in BU/HIV- patients. The scarcity of cases seems to be an obstacle for further study. Noteworthy are the study of cases in Benin and the study of cohort cases in Cameroon. However, no study appears to be based on the seroprevalence of this morbid association, the biological data and the antiretroviral regimens. These regimens, if poorly instituted, conflict with antimycobacterial drugs against Buruli ulcer. This study, although confronted with the particular configuration of Togo, a country with a low HIV prevalence of 2.8% national prevalence and an average of 55 cases of Buruli ulcer per year, is studying the biological aspects of co-infection HIV/BU, including seroprevalence of HIV, CD4+ LT levels, patient viral load and hemoglobin levels and ARV regimens. This study shows the need for future studies, including the study of the genetic diversity of circulating <i>Mycobacterium ulcerans</i> strains in Togo and the study of Buruli ulcer co-infection/HIV and tuberculosis.
文摘Background: Malaria and HIV are endemic in Cameroon. But data on the prevalence of coinfection with malaria and HIV in Cameroonian children are essentially absent. This study was aimed at determining the prevalence of coinfection with malaria and HIV among children in Yaoundé, so as to advice control policies. Methods: In a cross-sectional survey, children (≤15 years) were recruited from 3 communities in Yaoundé namely: Efoulan, Biyem-assi and Cité-verte. A semi-structured questionnaire was used to collect demographic data. Participants were screened for malaria parasites by the examination of Giemsa-stained blood films meanwhile participants were screened for HIV following Cameroon’s national algorithm. The Pearson’s chi-square test was performed as part of the statistical analyses. Statistical significance was set at p Result: Three hundred and ten (310) children took part in the study. The mean age (±SD) of the participants was 75.64 (±63.23) months and a majority of them were males (56.1%). The prevalence was 19.7%, 4.8% and 1.2% for malaria, HIV, and coinfection with malaria and HIV respectively. The prevalence of malaria was associated with age (p = 0.009) meanwhile the prevalence of HIV was associated with study site (p = 0.024). Plasmodium falciparum was the only species identified as causing malaria in the target population. Conclusion: A substantial prevalence of malaria, HIV and coinfection with malaria and HIV was observed in this study. Efforts should be strengthened to control and eventually eliminate these diseases in the target population.
文摘Background: Since 2019, Covid-19 pandemic has afflicted the world and countries of Africa. Despite the limited resources, these countries already disturbed by multiple diseases that have not yet been controlled such as malaria, must face this pandemic whose success in the management depends on the early detection of the disease. The objective of this study was to determine the prevalence of Malaria-Covid-19 coinfection in our environment. Methods: This was a retrospective analysis of patients’ data with Covid-19 infection from May to July 2021 at the International Hospital center of Kinshasa “CHIK”. We collected data and analysis was performed on the sociodemographic parameters, the notion of anticovid-19 vaccination as well as the duration of the symptomatology before the consultation, the clinical manifestations and the laboratory data available while including the data of the thick drop. Results: A total of 84 patients were registered with an average age of 35.23 ± 12.74 years. The male sex was predominant (82.1%). The Indian community was the most affected (44.2%). The average of days elapsed before the consultation of 3.63 days. The anti-Covid-19 vaccination rate was 20.3%. The prevalence of Malaria-Covid-19 coinfection was 29.76%. In coinfected patients, fever and cough were more reported (64%). Regarding biological and inflammatory parameters, 31.8% of coinfected patients had a platelet count less than 150,000 elements/mm<sup>3</sup> compared to 11.6% in non-Co-infected (p = 0.046). Conclusion: The Malaria-Covid-19 comorbidity prevalence is high in Malaria endemic country like Democratic Republic of Congo (DRC). It is necessary to make better distinction, to detect early the comorbidity in order to better guide care and not be limited to treating malaria, letting the Covid-19 evolve.
基金Supported by the Zhejiang Provincial Program for the Cultivation of High-Level Innovative Health Talents and Zhejiang Provincial Disease Control and Prevention Administration(2025JK008)as well as the Key Program of Health Commission of Zhejiang Province/Science Foundation of National Health Commission(WKJ-ZJ-2523)the Key Projects of the National Natural Science Foundation of China(U23A20496).
文摘Summary What is already known about this topic?Human respiratory syncytial virus(HRSV)coinfection with other respiratory pathogens frequently occurs in young children with acute respiratory illness.However,the epidemiological patterns and associated disease burden of HRSV coinfections in pediatric populations remain poorly characterized.
基金supported by Guangzhou Laboratory(Grant No.SRPG22-007)Major Project of Guangzhou National Laboratory(Grant No.GZNL2024A01004)The National Natural Science Foundation of China(Grant No.82341034).
文摘Objectives:Mycoplasma pneumoniae(MP)is a key cause of community-acquired pneumonia,and coinfections lead to varied patient outcomes.A comprehensive understanding of the outcome characteristics and associated etiologies of coinfections in MP patients is lacking.Methods and results:We analyzed 121,357 MP cases from 522,292,680 visits in Wuhan,China,in 2023(the final year of the COVID-19 pandemic).Children aged 1e10 years had the highest incidence,whereas those over 60 years had elevated hospitalization,severe infection,and fatality rates.Coinfection patterns differed by age,with bacterial-viral-Chlamydia pneumoniae(C.pneumoniae)/other pathogens prevalent in infants,bacterialviral pathogens prevalent in preschoolers,and viral-viral pathogens prevalent in schoolaged children.Bacterial coinfections were most common in MP-infected patients,especially those who were hospitalized.Coinfection,especially with C.pneumoniae,Pseudomonas aeruginosa(P.aeruginosa),Haemophilus influenzae(H.influenzae),and Streptococcus pneumoniae(S.pneumoniae),increased hospitalization rates.The most severe outcomes and deaths occurred in patients coinfected with C.pneumoniae-severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),influenza A-parainfluenza virus(PIV)or adenovirus-PIV.Logistic regression analysis demonstrated that male sex and adult age(particularly≥40 years)were significantly associated with adverse outcomes in MP monoinfection.For coinfections,significantly higher hospitalization rates were reported among very young children(0-5 years)and adults aged40 years,whereas adults presented an increased risk of severe disease.Coinfection outcomes were significantly associated with seasons of the year(winter,spring,and summer),specific age groups(3-5 years,18-39 years,40-50 years,and 60 years and over),gender(male),and longer onsetto-diagnosis periods.Middle-aged and elderly patients,coinfection,spring and summer,gender(male),and longer onset-to-diagnosis periods were significantly associated with increased hospitalization and serious illness risk.Coinfection,winter,older(adult)age,and gender(male)were significantly associated with an increased risk of death.Conclusions:Compared with adults,children with MP have a greater morbidity risk,whereas middle-aged and older adults face greater risks of hospitalization,serious illness,and death.Coinfection with other pathogens heightens hospitalization and death risks.These insights are crucial for etiological screening,diagnosing multiple pathogens,and preventing and treating infections.
