This paper summarized professor LI Xiuhui's experience in treating acquired immune deficiency syndrome(AIDS) complicated with opportunistic infections(OIs) using the methodology of “turbid toxins entering the blo...This paper summarized professor LI Xiuhui's experience in treating acquired immune deficiency syndrome(AIDS) complicated with opportunistic infections(OIs) using the methodology of “turbid toxins entering the blood and expelling pathogens outwardly”. OIs are significant cause of morbidity and mortality among AIDS patients. Professor LI Xiuhui believes that the pathogenesis of OIs lies in turbid toxins entering the blood, infecting the Sanjiao, damaging the nutrient Qi and defensive Qi, consuming Qi and essence, and impairing the primordial Qi. As a result, the five organs are weakened, pathogenic toxins overflow, leading to the occurrence of some related opportunistic infectious diseases in various systems throughout the body. Therefore, in treatment, the “penetrating and supporting method” and the “tonifying and supporting method” are used to consolidate and support the healthy Qi, allowing the pathogenic toxins to be expelled smoothly,so that the opportunistic infectious diseases can be cured or controlled.展开更多
Penicillium marneffei （R marneffei） infection usually occurs with skin, bone marrow, lung or hepatic involve- ment. However, no cases of P. mameffei infection with chylous ascites have been reported thus far. In thi...Penicillium marneffei （R marneffei） infection usually occurs with skin, bone marrow, lung or hepatic involve- ment. However, no cases of P. mameffei infection with chylous ascites have been reported thus far. In this re- port, we describe the first case of acquired immune de- ficiency syndrome （AIDS） which has been complicated by a P. marneffei infection causing chylous ascites. We describe the details of the case, with an emphasis on treatment regimen. This patient was treated with am- photericin B for 3 mo, while receiving concomitant ther- apy with an efavirenz-containing antiretroviral regimen, but cultures in ascitic fluid were persistently positive for P. marneffei. The infection resolved after treatment with high-dose voriconazole （400 mg every 12 h） for 3 too. R marneffei should be considered in the differential di- agnosis of chylous ascites in human immunodeficiency virus patients. High-dose voriconazole is an effective, well-tolerated and convenient option for the treatment of systemic infections with R marneffei in AIDS patients on an efavirenz-containing antiretroviral regimen.展开更多
Health related quality of life(HRQOL) can better reflect changes in acquired immune deficiency syndrome(AIDS) patients and inform economic evaluation of AIDS treatment services,and the assessment of HRQOL can help us ...Health related quality of life(HRQOL) can better reflect changes in acquired immune deficiency syndrome(AIDS) patients and inform economic evaluation of AIDS treatment services,and the assessment of HRQOL can help us to detect problems that may influence the progression of the disease,hence HRQOL has become a particularly important assessment indictor for HIV comprehensive interventions.Being a multi-angle,multi-level,and diversified complex intervention,roles of Chinese medicine(CM) in AIDS treatment have been recognized and accepted by more and more patients,and HRQOL has been widely used to evaluate the comprehensive management effects of CM on AIDS.In this article,the authors analyze the definition and measurement of HRQOL,measurement of HRQOL of HIV/AIDS patients and effects of CM on AIDS,and give some reasonable advices for the usage of the scale of HRQOL.The authors hold that some new HRQOL instruments specific for CM treatment of AIDS should be developed and further prospective studies should be carried out to demonstrate the practicality,reliability and validity of HRQOL as an evaluation indictor for CM treatment of AIDS.展开更多
Objective:To discover the population characteristics of the syndrome types of Acquired Immune Deficiency Syndrome.Methods:Data mining method for feature selection was used.Results:Main symptoms based on feature select...Objective:To discover the population characteristics of the syndrome types of Acquired Immune Deficiency Syndrome.Methods:Data mining method for feature selection was used.Results:Main symptoms based on feature selection are as follows,deficiency of both qi and blood(pale complexion,fear of cold,easy to catch a cold,pale tongue,weak pulse);liver depression and qi stagnation with effulgent fire(anxiety,insomnia,chest and hypochondrium,irregular menstruation,thin and whitish coating on the tongue,stringy pulse);dual deficiency of qi and yin(low-grade fever and night sweating,yellow urine,pale complexion,dysphoria with feverish sensation in chest,dry cough with less phlegm,weakness,dizziness,dry and red tongue,little coating,thread and rapid pulse);deficiency of spleen and kidney,dampness pathogen blockage(diarrhea,loose stool,eat less and abdominal nausea,abdominal pain,sallow complexion,nausea,vomiting,loss of hair,deafness and tinnitus,pale tongue with whitish coating,deep and thready pulse,slippery and rapid pulse);qi deficiency with blood stasis(weakness,spontaneous sweating,dry mouth without desire to drink,easy to catch a cold,shortness of breath,sallow complexion,eat less and loose stools,dim tongue quality,hesitant pulse).Conclusion:Based on the feature selection method,we can find the main characteristics of Acquired Immune Deficiency Syndrome,and provide objective reference for clinical diagnosis and treatment.展开更多
Purpose:To investigate the level of and factors influencing perceived stigma and discrimination among people living with human immunodeficiency virus(HIV)/acquired immune deficiency syndrome(PLWHA)in Henan Province.Me...Purpose:To investigate the level of and factors influencing perceived stigma and discrimination among people living with human immunodeficiency virus(HIV)/acquired immune deficiency syndrome(PLWHA)in Henan Province.Methods:In total,161 PLWHA from Zhengzhou and Zhenping were investigated using the Berger HIV stigma scale.Results:The mean Berger stigma scale score was 105.70±15.20,indicating a middle stigma level.Among the four subscales of the Berger stigma scale,the disclosure concerns score was highest,while the negative self-image score was lowest.Multivariate analyses showed that factors influencing perceived HIV stigma included the level of education and route of infection.Conclusion:The level of perceived HIV stigma and discrimination among PLWHA in Henan Province is moderate and was affected by the level of education and route of infection.Special intervention should be established to address this problem.展开更多
Variable Common Immune Deficiency (VCID) is a very heterogeneous condition both clinically and immunologically. It is a group of molecular abnormalities responsible for a defect in antibody production leading to hypog...Variable Common Immune Deficiency (VCID) is a very heterogeneous condition both clinically and immunologically. It is a group of molecular abnormalities responsible for a defect in antibody production leading to hypogammaglobulinemia often associated with autoimmune and/or lymphoproliferative manifestations. Late Onset Combined Immune Deficiency (LOCID) is a type of Variable Common Immune Deficiency (VCID) defined by a defect in antibody production (IgG and IgA ± IgM type), profound CD4 T-cell lymphopenia and frequent opportunistic infections. LOCID has been considered as a distinct entity from VCID due to its particular clinical and immunological profile.展开更多
Objective:Intimate partner violence(IPV)among people living with the human immune deficiency virus(PLHIV)poses a significant threat to efforts to reduce the spread of human immune deficiency virus(HIV)and achieve the ...Objective:Intimate partner violence(IPV)among people living with the human immune deficiency virus(PLHIV)poses a significant threat to efforts to reduce the spread of human immune deficiency virus(HIV)and achieve the sustainable development goals.In Ghana,scholarly research on the forms and prevalence of IPV is available,however knowledge of the prevalence of IPV among PLHIV is limited.To understand the prevalence of IPV among PLHIV and the intersectional factors that contribute to it,this study examined the overall prevalence of IPV among PLHIV and the associated sociodemographic factors across ten regions of Ghana.Methods:We administered face-to-face survey questionnaires to 661 randomly selected antiretroviral therapy(ART)clients using Research Electronic Data Capture tools.We used descriptive statistics(mean,standard deviation,minimum,and maximum),pairwise correlation,and multivariate regression analysis to look at the data.Results:The clients of ART experienced various forms of IPV,including sexual,physical,emotional,and economic violence and controlling behaviour.The overall prevalence of IPV among PLHIV was 27.5%.This result,although on par with the global IPV average(27%),is 1.5%higher than the national rate(26%).The Upper West Region had the highest prevalence in all the categories of IPV analysed,followed by Oti Region in second place and the Upper East Region in third,except for the prevalence of sexual violence,where Greater Accra Region ranks second.In specific regions of Ghana,sociodemographic factors shaped by patriarchal and economic considerations contribute to a higher prevalence of IPV among people living with HIV.Conclusion:The findings have implications for developing policies and interventions that address the specific factors associated with HIV-induced IPV in different regions of Ghana.These interventions should also include screening PLHIV receiving ART for their IPV status regardless of gender and deploying culturally appropriate education at the community level to foster empathy towards intimate partners living with HIV.展开更多
Henan Province in China has a major epidemic of human immunodeficiency virus/acquired immune deficiency syndrome （HIV/AIDS）. Chinese medicine （CM） has been used throughout the last decade, and a management modalit...Henan Province in China has a major epidemic of human immunodeficiency virus/acquired immune deficiency syndrome （HIV/AIDS）. Chinese medicine （CM） has been used throughout the last decade, and a management modality was developed, which can be described by unified-planning, graded- administration, and centralized-controlling （UGC）. The UGC modality has one primary concept （patient-centered medicine from CM theory）, four basic foundations （classifying administrative region, characteristics of CM on disease treatment, health resource conditions, and distribution of patients living with HIV）, six important relationships （the ＂three uniformities and three combinations,＂ and the six relationships therein guide the treatment of AIDS with CM）, and four key sections （management, operation, records, and evaluation）. In this article, the authors introduce the UGC modality, which could be beneficial to developing countries or resource-limited areas for the management of chronic infectious disease.展开更多
Acquired immune deficiency syndrome （AIDS） is a chronic infectious disease,which the patients are infected with human immunodeficiency virus （HIV）.HIV damages the human＇s immune function and causes CD4 cell decli...Acquired immune deficiency syndrome （AIDS） is a chronic infectious disease,which the patients are infected with human immunodeficiency virus （HIV）.HIV damages the human＇s immune function and causes CD4 cell decline in the number and function.Immune reconstitution is an important treatment to AIDS.Bone marrow transplantation,adoptive immune cell therapy and cytokines infusion can all assist the immune reconstitution;highly active antiretroviral therapy （HAART） can effectively control the virus replication and benefit the immune reconstitution.HAART combined with immunotherapy is an important method of immune reconstitution in AIDS patients.Chinese medicine is playing a more and more important role in immune reconstitution.Immune reconstitution has always been effective in the whole treatment of AIDS.展开更多
The International Conference on Prevention and Treatment of Acquired Immune Deficiency Syndrome （AIDS） with Chinese Medicine （CM） was held in Beijing International Hotel from October 16 to 17, 2010. It was cospons...The International Conference on Prevention and Treatment of Acquired Immune Deficiency Syndrome （AIDS） with Chinese Medicine （CM） was held in Beijing International Hotel from October 16 to 17, 2010. It was cosponsored by Guang＇anmen Hospital, China Academy of Chinese Medical Sciences （CACMS）, and the First Affiliated Hospital of Henan University of Traditional Chinese Medicine.展开更多
Diarrhea can occur at an early or advanced stage of acquired immunodeficiency syndrome(AIDS)as a usual symptom in people with human immunodeficiency virus(HIV)infection.While it is usually not fatal,it can influence p...Diarrhea can occur at an early or advanced stage of acquired immunodeficiency syndrome(AIDS)as a usual symptom in people with human immunodeficiency virus(HIV)infection.While it is usually not fatal,it can influence patients’quality of life seriously.It has shown to be efficacious and improves people’s immune status to a certain extent to treat HIV/AIDS-related diarrhea on the basis of syndrome differentiation and treatment or Chinese herbs plus conventional treatment.Therefore,it may have a good application potential.Here,we outline a protocol for the systematic review of this health-care intervention,with the aim to evaluate the beneficial effects and safety of Traditional Chinese Medicine(TCM)for patients who suffer from HIV/AIDS-associated diarrhea.Randomized controlled trials that compare Chinese herbs with placebo or other effective treatments will be searched and included,in spite of publication status or language.The primary outcomes include diarrhea frequency and fecal character.The databases we will search as follows:China Science and Technology Journal Database(VIP),Chinese Biomedical Literature Database(Sino Med),Wanfang Data,China National Knowledge Infrastructure,Pub Med and the CENTRAL in Cochrane Library.Two authors will respectively conduct the screening of trials,data extraction,and use the Cochrane risk of bias tool to assess the methodological quality.We will analyze the data and perform a meta-analysis if possible.We intend to identify potential therapeutic modalities that may be of benefit to inform clinical practice by supplying existing evidence of the helpful effects and safety of TCM to treat patients suffering from HIV/AIDS-associated diarrhea.展开更多
Objective:To assess the effects of moxibustion on immune reconstitution inflammatory syndrome(IRIS)in patients with acquired immune deficiency syndrome(AIDS)by tracking T-cell subsets over a 48-week prospective cohort...Objective:To assess the effects of moxibustion on immune reconstitution inflammatory syndrome(IRIS)in patients with acquired immune deficiency syndrome(AIDS)by tracking T-cell subsets over a 48-week prospective cohort study.Methods:Patients with AIDS who had low viral loads and weakened immune systems were divided into a moxibustion group and a non-moxibustion group.The non-moxibustion group received standard western treatment,including 48 weeks of antiretroviral therapy(ART).The moxibustion group received ART combined with moxibusion therapy,administered three times weekly.Each treatment lasted 10 weeks,with four courses completed over 48 weeks,separated by 2-week breaks.At different time points,plasma levels of CD4^(+),CD8^(+),CD45RAt,CD45RO^(+),CD4^(+)CD28^(+),CD8^(+)CD38^(+),and CD4^(+)CD38^(+)were compared between the two groups.Results:A total of 200 eligible patients were included and divided into two groups,with 100 in the non-moxibustion group and 100 in the moxibustion group.At Week 24,the CD4^(+)T cell count was(180.71±79.62)cells/μL in the non-moxibustion group and(218.22±82.02)cells/μL in the moxibustion group.By Week 36,the counts were(204.83±96.78)cells/μuL and(239.35±81.90)cells/μL,respectively.At Weeks 24 and 48,the CD8^(+)T cell and CD45RO^(+)counts were higher in the moxibustion group than in the non-moxibustion group(P<0.05).By Week 48,the CD45RA^(+)count was also higher in the moxibustion group(P<0.05).At Week 24,the CD4^(+)CD25^(+)count was lower in the moxibustion group than in the non-moxibustion group(P<0.05).展开更多
BACKGROUND Human herpesvirus type 7(HHV-7)is a less common herpes virus that usually causes mild,self-limiting illnesses.However,in recent years,there have been increasing reports of HHV-7 causing serious central nerv...BACKGROUND Human herpesvirus type 7(HHV-7)is a less common herpes virus that usually causes mild,self-limiting illnesses.However,in recent years,there have been increasing reports of HHV-7 causing serious central nervous system infections,especially meningitis.The pathogenesis and clinical features of HHV-7 meningitis,particularly in adolescents with normal immune function,remain incompletely studied.Therefore,the purpose of this report is to share a case of HHV-7 meningitis in an immunocompetent adolescent with a view to deepening our understanding of the disease.CASE SUMMARY A 12-year-old female was admitted with fever,headache,and vomiting.4 d before admission,the patient developed a fever without obvious induction,with a temperature up to 39.5℃,no convulsions,accompanied by chills,headaches,fatigue,and no muscle aches.The patient was treated with fever reduction,which could be reduced to 38℃;repeated high fever,accompanied by vomiting 7-8 times;and no abdominal pain or diarrhea.The patient was diagnosed with"acute suppurative tonsillitis"in a local hospital,and the blood routine was generally normal.The patient was given symptomatic support treatment such as"ceftriaxone sodium"and antiemetic rehydration for 2 d,and his condition did not improve.The patient's physical examination showed pharyngeal congestion,bilateral tonsil grade I hypertrophy,regression of purulent secretions,and cervical resistance.Ocular B-ultrasound:Opacity of the vitreous body and edema of the optic disc in both eyes.Optical coherence tomography examination showed that the macular fovea was generally normal in both eyes,with edema of the optic disc.DNA virus monitoring results:HHV-7.We gave ganciclovir antiviral therapy,dexamethasone anti-inflammatory treatment,mannitol to reduce cranial pressure,omeprazole to protect gastrointestinal mucosa,and calcium and potassium supplementation.CONCLUSION This study reports a case of HHV-7 meningitis in an adolescent with normal immune function.Through comprehensive analysis of the clinical manifestations,laboratory tests,and treatment methods of the patient,it is found that early identification and antiviral treatment are essential for the outcome of the disease.This case suggests that despite normal immune function,adolescents may still suffer from herpes virus type 7 meningitis,so clinicians should be vigilant and take effective treatment measures in time.展开更多
Background:Chronic rhinosinusitis(CRS)is a prevalent inflammatory disease of the nasal and paranasal sinuses,affecting millions worldwide and significantly impacting quality of life.The pathogenesis of CRS involves co...Background:Chronic rhinosinusitis(CRS)is a prevalent inflammatory disease of the nasal and paranasal sinuses,affecting millions worldwide and significantly impacting quality of life.The pathogenesis of CRS involves complex interactions between environmental and host factors,leading to chronic inflammation and tissue remodeling.Purpose of review:This narrative review synthesizes recent research on the predisposing factors of CRS and their potential influence on disease endotypes,aiming to enhance understanding of this multifaceted condition.Recent findings:Identified predisposing factors include allergy,asthma,immune deficiency,gastroesophageal reflux,nasal anatomical variations,microbial infections,and others.Bacteria and biofilms,particularly Staphylococcus aureus,are significant in disease onset and severity.Immune deficiency may predispose individuals to CRS,and NSAID-exacerbated respiratory disease(N-ERD)is associated with more severe symptoms.Gastroesophageal reflux disease(GERD)and primary ciliary dyskinesia(PCD)also contribute to CRS development,with PCD leading to impaired mucociliary clearance and chronic inflammation.Conclusion:CRS is a multifactorial disease with various predisposing factors influencing its development and endotypic classification.Understanding these factors and their interactions with the immune system is crucial for developing targeted treatments and improving patient outcomes.展开更多
Debate regarding the premature aging of knee joints in acquired immune deficiency syndrome(AIDS)patients has remained contentious,with conjectures pointing towards its correlation with distinct antiviral regimes.Prote...Debate regarding the premature aging of knee joints in acquired immune deficiency syndrome(AIDS)patients has remained contentious,with conjectures pointing towards its correlation with distinct antiviral regimes.Protease inhibitors(PIs)stand as a prominent class of antiviral agents frequently utilized in AIDS management and have been significantly linked to premature senescence.This study aimed to investigate whether PI-containing regimens would accelerate osteoarthritis(OA)development and explore the molecular mechanisms underlying this association.A retrospective cohort of 151 HIV-infected individuals,categorized into PI and non-PI groups,was established.Patients in PI group exhibited lower KOOS and a higher prevalence of radiological knee OA than those in non-PI group.Additionally,25 anti-HIV drugs were screened and among all antiviral drugs,lopinavir had the most detrimental impact on cartilage anabolism,accelerating cartilage senescence and promoting mouse OA development.Mechanistically,lopinavir accelerated cellular senescence by inhibiting Zmpste24 and interfering nuclear membrane stability,which leads to decreased binding between nuclear membrane-binding protein Usp7 and Mdm2 and activates Usp7/Mdm2/p53 pathway.Zmpste24 overexpression reduces OA severity in mice.These findings suggest that PI-containing regimens accelerate cartilage senescence and OA development through Zmpste24 inhibition,which provides new insights into the selection of HIV regimens.展开更多
Vanishing bile duct syndrome (VBDS) refers to a group of disorders characterized by prolonged cholestasis as a result of destruction and disappearance ofintrahepatic bile ducts. Multiple etiologies have been indentifi...Vanishing bile duct syndrome (VBDS) refers to a group of disorders characterized by prolonged cholestasis as a result of destruction and disappearance ofintrahepatic bile ducts. Multiple etiologies have been indentifi ed including infections, neoplastic disorders, autoimmune conditions and drugs. The natural history of this condition is variable and may involve resolution of cholestasis or progression with irreversible damage. VBDS is extremely rare in human immunodeficiency virus (HIV)-infected patients and anti-retroviral therapy has never been implicated as a cause. We encountered a young pregnant female with HIV and VBDS secondary to anti-retroviral therapy. Here, we report her clinical course and outcome.展开更多
For the purpose of developing an immune function on production accidents in a petrochemical enterprise, a new cultivation-evolution approach of preventive mechanism is suggested by analyzing various factors relating t...For the purpose of developing an immune function on production accidents in a petrochemical enterprise, a new cultivation-evolution approach of preventive mechanism is suggested by analyzing various factors relating to immune deficiency syndrome and by referring to immunity genetic algorithm and relevant concepts applied in medicine science. Accident-immunity system for highly hazardous petrochemical enterprise, which is made up of its productive system＇s Safety Organ and Safety Organization, is typically an evolution-cultivation progress for immune function, The new B immune cell is generated after several layers＇ screening, clone expanding, receptor editing, organizing in immune system of work accident in petrochemical enterprise. There is a B immune cell with high appetency and a manipulative function chain for accident-immunity. Taking the antigen of accidents in industry as the target function and the immune antibody as the solution, the authors carried out a computation diagram for prediction of appetency between the antigen and antibody.展开更多
Acquired immune deficiency syndrome infection can lead to cognitive dysfunction represented by changes in the default mode network.Most recent studies have been cross-sectional and thus have not revealed dynamic chang...Acquired immune deficiency syndrome infection can lead to cognitive dysfunction represented by changes in the default mode network.Most recent studies have been cross-sectional and thus have not revealed dynamic changes in the default mode network following acquired immune deficiency syndrome infection and antiretroviral therapy.Specifically,when brain imaging data at only one time point are analyzed,determining the duration at which the default mode network is the most effective following antiretroviral therapy after the occurrence of acquired immune deficiency syndrome.However,because infection times and other factors are often uncertain,longitudinal studies cannot be conducted directly in the clinic.Therefore,in this study,we performed a longitudinal study on the dynamic changes in the default mode network over time in a rhesus monkey model of simian immunodeficiency virus infection.We found marked changes in default mode network connectivity in 11 pairs of regions of interest at baseline and 10 days and 4 weeks after virus inoculation.Significant interactions between treatment and time were observed in the default mode network connectivity of regions of interest pairs area 31/V6.R and area 8/frontal eye field(FEF).L,area 8/FEF.L and caudal temporal parietal occipital area(TPOC).R,and area 31/V6.R and TPOC.L.ART administered 4 weeks after infection not only interrupted the progress of simian immunodeficiency virus infection but also preserved brain function to a large extent.These findings suggest that the default mode network is affected in the early stage of simian immunodeficiency virus infection and that it may serve as a potential biomarker for early changes in brain function and an objective indicator for making early clinical intervention decisions.展开更多
By using cell cloning technique, 4 sublines (A,C,D,E) were isolated from a cell line of human lung giant cell carcinoma (PLA-801). After subcutaneous inoculation in T-cell deficient BALB/c nude mice, the incidence of ...By using cell cloning technique, 4 sublines (A,C,D,E) were isolated from a cell line of human lung giant cell carcinoma (PLA-801). After subcutaneous inoculation in T-cell deficient BALB/c nude mice, the incidence of tumor growth and spontaneous metastasis were the highest in subline D, moderate in sublines A and E, and lowest in subline C. Tumor cells of subline C also showed similar low tumorigenicity in another T-cell deficient 615/ PB1 nude mice.However, in 615/PB1 beige nude mice with con-genitally combined immune-deficiency in both T and NK cell activity, tumor cells of the rarely metastatic subline C do produce significantly high frequency of tumor growth and spontaneous metastasis.Morphological studies (light microscope, electron microscope and immunohistochemistry) showed rich microfilaments and Vimentin positive in the cytoplasm of metastatic tumor cells. This may imply a possibility that tumor cells differentiate towards the direction favourable to spreading and metastasis.展开更多
<strong>Background:</strong><span style="font-family:Verdana;"> Primary Immune Deficiencies (PID) are rare, under-determined </span><span style="font-family:"">&l...<strong>Background:</strong><span style="font-family:Verdana;"> Primary Immune Deficiencies (PID) are rare, under-determined </span><span style="font-family:""><span style="font-family:Verdana;">diseases particularly in sub-Saharan Africa. The diagnosis is often suspected with uncommon clinical signs. Infections are the main diagnostic circumstances in infants. Confirmation is often difficult because some additional examinations are unavailable in many of our countries. </span><b><span style="font-family:Verdana;">Aim: </span></b><span style="font-family:Verdana;">Our aim was to share the challenge of diagnosis and treatment in PID. </span><b><span style="font-family:Verdana;">Case Presentation:</span></b><span style="font-family:Verdana;"> It is about two infants, a boy and a girl, with early several infections. Both of them presented a hypo-gammaglobulinemia and to the boy, the immuno-phenotyping lymphocyte showed a decrease</span></span><span style="font-family:Verdana;">d</span><span style="font-family:Verdana;"> level of lymphocytes CD19. We are looking for genetic confirmation but it is not easy. The treatment of these infants require</span><span style="font-family:Verdana;">s</span><span style="font-family:Verdana;"> a substitution for life of immunoglobulin w</span><span style="font-family:Verdana;">h</span><span style="font-family:Verdana;">ich </span><span style="font-family:Verdana;">is</span><span style="font-family:""><span style="font-family:Verdana;"> unavailable in our countries. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> PID are suspected with atypical clinical signs. Confirmation genetic diagnosis is difficult in low income countries. To improve the follow up, we need to strengthen clinical-biological collaboration.</span></span>展开更多
文摘This paper summarized professor LI Xiuhui's experience in treating acquired immune deficiency syndrome(AIDS) complicated with opportunistic infections(OIs) using the methodology of “turbid toxins entering the blood and expelling pathogens outwardly”. OIs are significant cause of morbidity and mortality among AIDS patients. Professor LI Xiuhui believes that the pathogenesis of OIs lies in turbid toxins entering the blood, infecting the Sanjiao, damaging the nutrient Qi and defensive Qi, consuming Qi and essence, and impairing the primordial Qi. As a result, the five organs are weakened, pathogenic toxins overflow, leading to the occurrence of some related opportunistic infectious diseases in various systems throughout the body. Therefore, in treatment, the “penetrating and supporting method” and the “tonifying and supporting method” are used to consolidate and support the healthy Qi, allowing the pathogenic toxins to be expelled smoothly,so that the opportunistic infectious diseases can be cured or controlled.
文摘Penicillium marneffei （R marneffei） infection usually occurs with skin, bone marrow, lung or hepatic involve- ment. However, no cases of P. mameffei infection with chylous ascites have been reported thus far. In this re- port, we describe the first case of acquired immune de- ficiency syndrome （AIDS） which has been complicated by a P. marneffei infection causing chylous ascites. We describe the details of the case, with an emphasis on treatment regimen. This patient was treated with am- photericin B for 3 mo, while receiving concomitant ther- apy with an efavirenz-containing antiretroviral regimen, but cultures in ascitic fluid were persistently positive for P. marneffei. The infection resolved after treatment with high-dose voriconazole （400 mg every 12 h） for 3 too. R marneffei should be considered in the differential di- agnosis of chylous ascites in human immunodeficiency virus patients. High-dose voriconazole is an effective, well-tolerated and convenient option for the treatment of systemic infections with R marneffei in AIDS patients on an efavirenz-containing antiretroviral regimen.
基金Supported by the National Special Science&Technology Program on Major Infectious Diseases(No.2012ZX-10005010-001)Research Project for Practical Development of National TCM Clinical Research Bases(No.JDZX2012023)+1 种基金Henan Province Education Science Programs in 11th Fiveyear Plan for 2010 Year Subjects(No.2010-JKGHAZ0047)Henan Province Colleges and Universities Key Youth Teachers Scheme(No.2013GGJS-095)
文摘Health related quality of life(HRQOL) can better reflect changes in acquired immune deficiency syndrome(AIDS) patients and inform economic evaluation of AIDS treatment services,and the assessment of HRQOL can help us to detect problems that may influence the progression of the disease,hence HRQOL has become a particularly important assessment indictor for HIV comprehensive interventions.Being a multi-angle,multi-level,and diversified complex intervention,roles of Chinese medicine(CM) in AIDS treatment have been recognized and accepted by more and more patients,and HRQOL has been widely used to evaluate the comprehensive management effects of CM on AIDS.In this article,the authors analyze the definition and measurement of HRQOL,measurement of HRQOL of HIV/AIDS patients and effects of CM on AIDS,and give some reasonable advices for the usage of the scale of HRQOL.The authors hold that some new HRQOL instruments specific for CM treatment of AIDS should be developed and further prospective studies should be carried out to demonstrate the practicality,reliability and validity of HRQOL as an evaluation indictor for CM treatment of AIDS.
基金National Key Research and Development Program of the Ministry of Science and Technology (2017YFC1703503):Innovative Research on Data Collection Of Medical Record Homepage and TCM Medical Quality Evaluation SystemNational Natural Science Foundation of China National Natural Science(NO. 81674101):Research on The Method of Discovering the Dynamic Target Relationship Between AIDS Prescriptions Based on Multi-example and Multi-marker LearningSpecial Fund for Basic Scientific Research Business Expenses of Central Public Welfare Scientific Research Institutes (NO. ZZ11-063):Exploring Research Based on The Performance Evaluation Method of DRG Chinese Medicine Hospitals
文摘Objective:To discover the population characteristics of the syndrome types of Acquired Immune Deficiency Syndrome.Methods:Data mining method for feature selection was used.Results:Main symptoms based on feature selection are as follows,deficiency of both qi and blood(pale complexion,fear of cold,easy to catch a cold,pale tongue,weak pulse);liver depression and qi stagnation with effulgent fire(anxiety,insomnia,chest and hypochondrium,irregular menstruation,thin and whitish coating on the tongue,stringy pulse);dual deficiency of qi and yin(low-grade fever and night sweating,yellow urine,pale complexion,dysphoria with feverish sensation in chest,dry cough with less phlegm,weakness,dizziness,dry and red tongue,little coating,thread and rapid pulse);deficiency of spleen and kidney,dampness pathogen blockage(diarrhea,loose stool,eat less and abdominal nausea,abdominal pain,sallow complexion,nausea,vomiting,loss of hair,deafness and tinnitus,pale tongue with whitish coating,deep and thready pulse,slippery and rapid pulse);qi deficiency with blood stasis(weakness,spontaneous sweating,dry mouth without desire to drink,easy to catch a cold,shortness of breath,sallow complexion,eat less and loose stools,dim tongue quality,hesitant pulse).Conclusion:Based on the feature selection method,we can find the main characteristics of Acquired Immune Deficiency Syndrome,and provide objective reference for clinical diagnosis and treatment.
文摘Purpose:To investigate the level of and factors influencing perceived stigma and discrimination among people living with human immunodeficiency virus(HIV)/acquired immune deficiency syndrome(PLWHA)in Henan Province.Methods:In total,161 PLWHA from Zhengzhou and Zhenping were investigated using the Berger HIV stigma scale.Results:The mean Berger stigma scale score was 105.70±15.20,indicating a middle stigma level.Among the four subscales of the Berger stigma scale,the disclosure concerns score was highest,while the negative self-image score was lowest.Multivariate analyses showed that factors influencing perceived HIV stigma included the level of education and route of infection.Conclusion:The level of perceived HIV stigma and discrimination among PLWHA in Henan Province is moderate and was affected by the level of education and route of infection.Special intervention should be established to address this problem.
文摘Variable Common Immune Deficiency (VCID) is a very heterogeneous condition both clinically and immunologically. It is a group of molecular abnormalities responsible for a defect in antibody production leading to hypogammaglobulinemia often associated with autoimmune and/or lymphoproliferative manifestations. Late Onset Combined Immune Deficiency (LOCID) is a type of Variable Common Immune Deficiency (VCID) defined by a defect in antibody production (IgG and IgA ± IgM type), profound CD4 T-cell lymphopenia and frequent opportunistic infections. LOCID has been considered as a distinct entity from VCID due to its particular clinical and immunological profile.
基金supported by the Christian Health Association of Ghana under Global Fund New Funding Model 3(NFM 3)HIV/TB Community Systems Strengthening programme(CSS)。
文摘Objective:Intimate partner violence(IPV)among people living with the human immune deficiency virus(PLHIV)poses a significant threat to efforts to reduce the spread of human immune deficiency virus(HIV)and achieve the sustainable development goals.In Ghana,scholarly research on the forms and prevalence of IPV is available,however knowledge of the prevalence of IPV among PLHIV is limited.To understand the prevalence of IPV among PLHIV and the intersectional factors that contribute to it,this study examined the overall prevalence of IPV among PLHIV and the associated sociodemographic factors across ten regions of Ghana.Methods:We administered face-to-face survey questionnaires to 661 randomly selected antiretroviral therapy(ART)clients using Research Electronic Data Capture tools.We used descriptive statistics(mean,standard deviation,minimum,and maximum),pairwise correlation,and multivariate regression analysis to look at the data.Results:The clients of ART experienced various forms of IPV,including sexual,physical,emotional,and economic violence and controlling behaviour.The overall prevalence of IPV among PLHIV was 27.5%.This result,although on par with the global IPV average(27%),is 1.5%higher than the national rate(26%).The Upper West Region had the highest prevalence in all the categories of IPV analysed,followed by Oti Region in second place and the Upper East Region in third,except for the prevalence of sexual violence,where Greater Accra Region ranks second.In specific regions of Ghana,sociodemographic factors shaped by patriarchal and economic considerations contribute to a higher prevalence of IPV among people living with HIV.Conclusion:The findings have implications for developing policies and interventions that address the specific factors associated with HIV-induced IPV in different regions of Ghana.These interventions should also include screening PLHIV receiving ART for their IPV status regardless of gender and deploying culturally appropriate education at the community level to foster empathy towards intimate partners living with HIV.
基金Supported by the National Special Science and Technology Program on Major Infectious Diseases(No.2013ZX10005001-001,No.2012ZX10005001-005)Henan Province Colleges and Universities Key Youth Teachers Scheme(No.2013GGJS-095)Plan For Scientific Innovation Talent of Henan Province(No.2015-025)
文摘Henan Province in China has a major epidemic of human immunodeficiency virus/acquired immune deficiency syndrome （HIV/AIDS）. Chinese medicine （CM） has been used throughout the last decade, and a management modality was developed, which can be described by unified-planning, graded- administration, and centralized-controlling （UGC）. The UGC modality has one primary concept （patient-centered medicine from CM theory）, four basic foundations （classifying administrative region, characteristics of CM on disease treatment, health resource conditions, and distribution of patients living with HIV）, six important relationships （the ＂three uniformities and three combinations,＂ and the six relationships therein guide the treatment of AIDS with CM）, and four key sections （management, operation, records, and evaluation）. In this article, the authors introduce the UGC modality, which could be beneficial to developing countries or resource-limited areas for the management of chronic infectious disease.
基金Supported by the National Key Technologies Special-purpose Program (No.2008ZX10005-004)
文摘Acquired immune deficiency syndrome （AIDS） is a chronic infectious disease,which the patients are infected with human immunodeficiency virus （HIV）.HIV damages the human＇s immune function and causes CD4 cell decline in the number and function.Immune reconstitution is an important treatment to AIDS.Bone marrow transplantation,adoptive immune cell therapy and cytokines infusion can all assist the immune reconstitution;highly active antiretroviral therapy （HAART） can effectively control the virus replication and benefit the immune reconstitution.HAART combined with immunotherapy is an important method of immune reconstitution in AIDS patients.Chinese medicine is playing a more and more important role in immune reconstitution.Immune reconstitution has always been effective in the whole treatment of AIDS.
文摘The International Conference on Prevention and Treatment of Acquired Immune Deficiency Syndrome （AIDS） with Chinese Medicine （CM） was held in Beijing International Hotel from October 16 to 17, 2010. It was cosponsored by Guang＇anmen Hospital, China Academy of Chinese Medical Sciences （CACMS）, and the First Affiliated Hospital of Henan University of Traditional Chinese Medicine.
基金supported by the National Natural Science Foundation of China(Grant No.81673828)
文摘Diarrhea can occur at an early or advanced stage of acquired immunodeficiency syndrome(AIDS)as a usual symptom in people with human immunodeficiency virus(HIV)infection.While it is usually not fatal,it can influence patients’quality of life seriously.It has shown to be efficacious and improves people’s immune status to a certain extent to treat HIV/AIDS-related diarrhea on the basis of syndrome differentiation and treatment or Chinese herbs plus conventional treatment.Therefore,it may have a good application potential.Here,we outline a protocol for the systematic review of this health-care intervention,with the aim to evaluate the beneficial effects and safety of Traditional Chinese Medicine(TCM)for patients who suffer from HIV/AIDS-associated diarrhea.Randomized controlled trials that compare Chinese herbs with placebo or other effective treatments will be searched and included,in spite of publication status or language.The primary outcomes include diarrhea frequency and fecal character.The databases we will search as follows:China Science and Technology Journal Database(VIP),Chinese Biomedical Literature Database(Sino Med),Wanfang Data,China National Knowledge Infrastructure,Pub Med and the CENTRAL in Cochrane Library.Two authors will respectively conduct the screening of trials,data extraction,and use the Cochrane risk of bias tool to assess the methodological quality.We will analyze the data and perform a meta-analysis if possible.We intend to identify potential therapeutic modalities that may be of benefit to inform clinical practice by supplying existing evidence of the helpful effects and safety of TCM to treat patients suffering from HIV/AIDS-associated diarrhea.
基金Supported by National Major Science and Technology Projects:2017zX10205501National Public Welfare Industry Scientific Research Special:201507005+1 种基金2023 Beijing TCM Science and Technology Development Fund Project-Youth Project:BjzYQN-2023-05China Academy of Chinese Medical Sciences Outstanding Youth Program:ZZ15-YQ-048.
文摘Objective:To assess the effects of moxibustion on immune reconstitution inflammatory syndrome(IRIS)in patients with acquired immune deficiency syndrome(AIDS)by tracking T-cell subsets over a 48-week prospective cohort study.Methods:Patients with AIDS who had low viral loads and weakened immune systems were divided into a moxibustion group and a non-moxibustion group.The non-moxibustion group received standard western treatment,including 48 weeks of antiretroviral therapy(ART).The moxibustion group received ART combined with moxibusion therapy,administered three times weekly.Each treatment lasted 10 weeks,with four courses completed over 48 weeks,separated by 2-week breaks.At different time points,plasma levels of CD4^(+),CD8^(+),CD45RAt,CD45RO^(+),CD4^(+)CD28^(+),CD8^(+)CD38^(+),and CD4^(+)CD38^(+)were compared between the two groups.Results:A total of 200 eligible patients were included and divided into two groups,with 100 in the non-moxibustion group and 100 in the moxibustion group.At Week 24,the CD4^(+)T cell count was(180.71±79.62)cells/μL in the non-moxibustion group and(218.22±82.02)cells/μL in the moxibustion group.By Week 36,the counts were(204.83±96.78)cells/μuL and(239.35±81.90)cells/μL,respectively.At Weeks 24 and 48,the CD8^(+)T cell and CD45RO^(+)counts were higher in the moxibustion group than in the non-moxibustion group(P<0.05).By Week 48,the CD45RA^(+)count was also higher in the moxibustion group(P<0.05).At Week 24,the CD4^(+)CD25^(+)count was lower in the moxibustion group than in the non-moxibustion group(P<0.05).
文摘BACKGROUND Human herpesvirus type 7(HHV-7)is a less common herpes virus that usually causes mild,self-limiting illnesses.However,in recent years,there have been increasing reports of HHV-7 causing serious central nervous system infections,especially meningitis.The pathogenesis and clinical features of HHV-7 meningitis,particularly in adolescents with normal immune function,remain incompletely studied.Therefore,the purpose of this report is to share a case of HHV-7 meningitis in an immunocompetent adolescent with a view to deepening our understanding of the disease.CASE SUMMARY A 12-year-old female was admitted with fever,headache,and vomiting.4 d before admission,the patient developed a fever without obvious induction,with a temperature up to 39.5℃,no convulsions,accompanied by chills,headaches,fatigue,and no muscle aches.The patient was treated with fever reduction,which could be reduced to 38℃;repeated high fever,accompanied by vomiting 7-8 times;and no abdominal pain or diarrhea.The patient was diagnosed with"acute suppurative tonsillitis"in a local hospital,and the blood routine was generally normal.The patient was given symptomatic support treatment such as"ceftriaxone sodium"and antiemetic rehydration for 2 d,and his condition did not improve.The patient's physical examination showed pharyngeal congestion,bilateral tonsil grade I hypertrophy,regression of purulent secretions,and cervical resistance.Ocular B-ultrasound:Opacity of the vitreous body and edema of the optic disc in both eyes.Optical coherence tomography examination showed that the macular fovea was generally normal in both eyes,with edema of the optic disc.DNA virus monitoring results:HHV-7.We gave ganciclovir antiviral therapy,dexamethasone anti-inflammatory treatment,mannitol to reduce cranial pressure,omeprazole to protect gastrointestinal mucosa,and calcium and potassium supplementation.CONCLUSION This study reports a case of HHV-7 meningitis in an adolescent with normal immune function.Through comprehensive analysis of the clinical manifestations,laboratory tests,and treatment methods of the patient,it is found that early identification and antiviral treatment are essential for the outcome of the disease.This case suggests that despite normal immune function,adolescents may still suffer from herpes virus type 7 meningitis,so clinicians should be vigilant and take effective treatment measures in time.
基金supported by the Health Science and Technology Development Project of Huaiyin District,Huai’an,Jiangsu Province(HYWJ2024009)of China.
文摘Background:Chronic rhinosinusitis(CRS)is a prevalent inflammatory disease of the nasal and paranasal sinuses,affecting millions worldwide and significantly impacting quality of life.The pathogenesis of CRS involves complex interactions between environmental and host factors,leading to chronic inflammation and tissue remodeling.Purpose of review:This narrative review synthesizes recent research on the predisposing factors of CRS and their potential influence on disease endotypes,aiming to enhance understanding of this multifaceted condition.Recent findings:Identified predisposing factors include allergy,asthma,immune deficiency,gastroesophageal reflux,nasal anatomical variations,microbial infections,and others.Bacteria and biofilms,particularly Staphylococcus aureus,are significant in disease onset and severity.Immune deficiency may predispose individuals to CRS,and NSAID-exacerbated respiratory disease(N-ERD)is associated with more severe symptoms.Gastroesophageal reflux disease(GERD)and primary ciliary dyskinesia(PCD)also contribute to CRS development,with PCD leading to impaired mucociliary clearance and chronic inflammation.Conclusion:CRS is a multifactorial disease with various predisposing factors influencing its development and endotypic classification.Understanding these factors and their interactions with the immune system is crucial for developing targeted treatments and improving patient outcomes.
基金supported by Natural Science Foundation of China(82472476)Fundamental Research Funds for the Central Universities(YG2023ZD15)+2 种基金The Youth Talent Program from Shanghai Health System(2022YQ020)AI-Driven Reform of Research Paradigms Empowers Discipline Advancement Initiatives from Shanghai Municipal Education Commission(Grant No.JWAIZD-7)the Natural Science Foundation of Shanghai(23ZR1437300).
文摘Debate regarding the premature aging of knee joints in acquired immune deficiency syndrome(AIDS)patients has remained contentious,with conjectures pointing towards its correlation with distinct antiviral regimes.Protease inhibitors(PIs)stand as a prominent class of antiviral agents frequently utilized in AIDS management and have been significantly linked to premature senescence.This study aimed to investigate whether PI-containing regimens would accelerate osteoarthritis(OA)development and explore the molecular mechanisms underlying this association.A retrospective cohort of 151 HIV-infected individuals,categorized into PI and non-PI groups,was established.Patients in PI group exhibited lower KOOS and a higher prevalence of radiological knee OA than those in non-PI group.Additionally,25 anti-HIV drugs were screened and among all antiviral drugs,lopinavir had the most detrimental impact on cartilage anabolism,accelerating cartilage senescence and promoting mouse OA development.Mechanistically,lopinavir accelerated cellular senescence by inhibiting Zmpste24 and interfering nuclear membrane stability,which leads to decreased binding between nuclear membrane-binding protein Usp7 and Mdm2 and activates Usp7/Mdm2/p53 pathway.Zmpste24 overexpression reduces OA severity in mice.These findings suggest that PI-containing regimens accelerate cartilage senescence and OA development through Zmpste24 inhibition,which provides new insights into the selection of HIV regimens.
文摘Vanishing bile duct syndrome (VBDS) refers to a group of disorders characterized by prolonged cholestasis as a result of destruction and disappearance ofintrahepatic bile ducts. Multiple etiologies have been indentifi ed including infections, neoplastic disorders, autoimmune conditions and drugs. The natural history of this condition is variable and may involve resolution of cholestasis or progression with irreversible damage. VBDS is extremely rare in human immunodeficiency virus (HIV)-infected patients and anti-retroviral therapy has never been implicated as a cause. We encountered a young pregnant female with HIV and VBDS secondary to anti-retroviral therapy. Here, we report her clinical course and outcome.
文摘For the purpose of developing an immune function on production accidents in a petrochemical enterprise, a new cultivation-evolution approach of preventive mechanism is suggested by analyzing various factors relating to immune deficiency syndrome and by referring to immunity genetic algorithm and relevant concepts applied in medicine science. Accident-immunity system for highly hazardous petrochemical enterprise, which is made up of its productive system＇s Safety Organ and Safety Organization, is typically an evolution-cultivation progress for immune function, The new B immune cell is generated after several layers＇ screening, clone expanding, receptor editing, organizing in immune system of work accident in petrochemical enterprise. There is a B immune cell with high appetency and a manipulative function chain for accident-immunity. Taking the antigen of accidents in industry as the target function and the immune antibody as the solution, the authors carried out a computation diagram for prediction of appetency between the antigen and antibody.
基金supported by the National Natural Science Foundation of China,Nos.82271963(to HJL),81771806(to HJL),61936013(to HJL),82001914(to ZCT),81871511(to HZ)National Key R&D Program of China,No.2021YFA1301603(to ZCT)the Natural Science Foundation of Beijing,No.7212051(to HJL).
文摘Acquired immune deficiency syndrome infection can lead to cognitive dysfunction represented by changes in the default mode network.Most recent studies have been cross-sectional and thus have not revealed dynamic changes in the default mode network following acquired immune deficiency syndrome infection and antiretroviral therapy.Specifically,when brain imaging data at only one time point are analyzed,determining the duration at which the default mode network is the most effective following antiretroviral therapy after the occurrence of acquired immune deficiency syndrome.However,because infection times and other factors are often uncertain,longitudinal studies cannot be conducted directly in the clinic.Therefore,in this study,we performed a longitudinal study on the dynamic changes in the default mode network over time in a rhesus monkey model of simian immunodeficiency virus infection.We found marked changes in default mode network connectivity in 11 pairs of regions of interest at baseline and 10 days and 4 weeks after virus inoculation.Significant interactions between treatment and time were observed in the default mode network connectivity of regions of interest pairs area 31/V6.R and area 8/frontal eye field(FEF).L,area 8/FEF.L and caudal temporal parietal occipital area(TPOC).R,and area 31/V6.R and TPOC.L.ART administered 4 weeks after infection not only interrupted the progress of simian immunodeficiency virus infection but also preserved brain function to a large extent.These findings suggest that the default mode network is affected in the early stage of simian immunodeficiency virus infection and that it may serve as a potential biomarker for early changes in brain function and an objective indicator for making early clinical intervention decisions.
文摘By using cell cloning technique, 4 sublines (A,C,D,E) were isolated from a cell line of human lung giant cell carcinoma (PLA-801). After subcutaneous inoculation in T-cell deficient BALB/c nude mice, the incidence of tumor growth and spontaneous metastasis were the highest in subline D, moderate in sublines A and E, and lowest in subline C. Tumor cells of subline C also showed similar low tumorigenicity in another T-cell deficient 615/ PB1 nude mice.However, in 615/PB1 beige nude mice with con-genitally combined immune-deficiency in both T and NK cell activity, tumor cells of the rarely metastatic subline C do produce significantly high frequency of tumor growth and spontaneous metastasis.Morphological studies (light microscope, electron microscope and immunohistochemistry) showed rich microfilaments and Vimentin positive in the cytoplasm of metastatic tumor cells. This may imply a possibility that tumor cells differentiate towards the direction favourable to spreading and metastasis.
文摘<strong>Background:</strong><span style="font-family:Verdana;"> Primary Immune Deficiencies (PID) are rare, under-determined </span><span style="font-family:""><span style="font-family:Verdana;">diseases particularly in sub-Saharan Africa. The diagnosis is often suspected with uncommon clinical signs. Infections are the main diagnostic circumstances in infants. Confirmation is often difficult because some additional examinations are unavailable in many of our countries. </span><b><span style="font-family:Verdana;">Aim: </span></b><span style="font-family:Verdana;">Our aim was to share the challenge of diagnosis and treatment in PID. </span><b><span style="font-family:Verdana;">Case Presentation:</span></b><span style="font-family:Verdana;"> It is about two infants, a boy and a girl, with early several infections. Both of them presented a hypo-gammaglobulinemia and to the boy, the immuno-phenotyping lymphocyte showed a decrease</span></span><span style="font-family:Verdana;">d</span><span style="font-family:Verdana;"> level of lymphocytes CD19. We are looking for genetic confirmation but it is not easy. The treatment of these infants require</span><span style="font-family:Verdana;">s</span><span style="font-family:Verdana;"> a substitution for life of immunoglobulin w</span><span style="font-family:Verdana;">h</span><span style="font-family:Verdana;">ich </span><span style="font-family:Verdana;">is</span><span style="font-family:""><span style="font-family:Verdana;"> unavailable in our countries. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> PID are suspected with atypical clinical signs. Confirmation genetic diagnosis is difficult in low income countries. To improve the follow up, we need to strengthen clinical-biological collaboration.</span></span>
