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BMC Infectious Diseases Dec 2022There is a high prevalence of anemia among people living with HIV in Guangxi, China. Therefore, we investigated anemia and opportunistic infections in hospitalized...
BACKGROUND
There is a high prevalence of anemia among people living with HIV in Guangxi, China. Therefore, we investigated anemia and opportunistic infections in hospitalized people living with HIV and explored the risk factors related to anemia in people living with HIV to actively prevent anemia in people living with HIV.
METHODS
We retrospectively studied people living with HIV admitted to Guangxi Chest Hospital from June 2016 to October 2021. Detailed information on the sociodemographic and clinical features of the participants was collected. The X test was used to compare the prevalence between the anemic and non-anemic groups. The logistic regression analysis was applied to exclude confounding factors and identify factors related to anemia.
RESULTS
Among 5645 patients with HIV, 1525 (27.02%) had anemia. The overall prevalence of mild, moderate, and severe anemia was 4.66%, 14.08%, and 8.27%, respectively. The factors significantly related to increased risk of anemia were CD4 count < 50 cells/µl (aOR = 2.221, 95% CI = [1.775, 2.779]), CD4 count 50-199 cells/µl (aOR = 1.659, 95% CI = [1.327, 2. 073]), female (aOR = 1.644, 95% CI = [1.436, 1.881]) co-infected with HCV (aOR = 1.465, 95% CI = [1.071, 2.002]), PM (aOR = 2.356, 95% CI = [1.950, 2.849]), or TB (aOR = 1.198, 95% CI = [1.053, 1.365]).
CONCLUSIONS
Within Guangxi of China, 27.02% of hospitalized people living with HIV presented with anemia. Most patients with anemia were in the mild to moderate stage. The low CD4 count, female gender, and concomitant infection with Penicillium marneffei, Hepatitis C virus, or Tuberculosis were independent correlates of anemia. Thus, these findings would be helpful to clinicians in preventing and intervening in anemia in people living with HIV.
Topics: Humans; Female; Retrospective Studies; China; Opportunistic Infections; Anemia; HIV Infections
PubMed: 36474196
DOI: 10.1186/s12879-022-07910-5 -
Gut and Liver Sep 2022Opportunistic infection in inflammatory bowel disease (IBD) has become a serious problem. However, its status of doctors' opinions and test equipment in hospitals are...
BACKGROUND/AIMS
Opportunistic infection in inflammatory bowel disease (IBD) has become a serious problem. However, its status of doctors' opinions and test equipment in hospitals are unclear. The aim of the study was to investigate these issues to improve the prognosis of IBD patients.
METHODS
This retrospective, multicenter study was conducted by 83 investigators who were members of the Asian Organization for Crohn's and Colitis. Data on opportunistic infection were collected from hospital databases between January 2017 and December 2017. The survey consisted of 11 items.
RESULTS
Most physicians appreciated the diagnostic value of tissue cytomegalovirus (CMV) DNA, accounting for 86.1% of members in China, 37.5% in Japan, 52.9% in South Korea, and 66.7% in Southeast Asia. Only 83.1% of hospitals had the ability to test for CMV immunohistochemistry in Asia. Hepatitis B surface antigen (HBsAg) screening was recommended by all members. However, only 66.7% in China, 70.6% in South Korea, and 66.7% in Southeast Asia agreed to routinely vaccinate IBD patients when HBsAg tested negative. Most members preferred metronidazole (74.7%) as the first choice for patients with infection. However, the proportion of stool toxin test was lower in China than in other areas (75.0% in China vs 95.8% in Japan and 100% in South Korea and Southeast Asia, p<0.05).
CONCLUSIONS
Opportunistic infection from CMV, hepatitis B virus, and should be of high concern for IBD patients. More efforts are needed, such as understanding consensus in clinical practice and improving testing facilities in hospitals.
Topics: Asia; Clostridioides difficile; Cytomegalovirus Infections; Hepatitis B Surface Antigens; Humans; Inflammatory Bowel Diseases; Opportunistic Infections; Retrospective Studies; Surveys and Questionnaires
PubMed: 35611664
DOI: 10.5009/gnl210217 -
Transplantation Mar 2016Cytomegalovirus (CMV) is a highly complex pathogen which, despite modern prophylactic regimens, continues to affect a high proportion of thoracic organ transplant...
Cytomegalovirus (CMV) is a highly complex pathogen which, despite modern prophylactic regimens, continues to affect a high proportion of thoracic organ transplant recipients. The symptomatic manifestations of CMV infection are compounded by adverse indirect effects induced by the multiple immunomodulatory actions of CMV. These include a higher risk of acute rejection, cardiac allograft vasculopathy after heart transplantation, and potentially bronchiolitis obliterans syndrome in lung transplant recipients, with a greater propensity for opportunistic secondary infections. Prophylaxis for CMV using antiviral agents (typically oral valganciclovir or intravenous ganciclovir) is now almost universal, at least in high-risk transplants (D+/R-). Even with extended prophylactic regimens, however, challenges remain. The CMV events can still occur despite antiviral prophylaxis, including late-onset infection or recurrent disease, and patients with ganciclovir-resistant CMV infection or who are intolerant to antiviral therapy require alternative strategies. The CMV immunoglobulin (CMVIG) and antiviral agents have complementary modes of action. High-titer CMVIG preparations provide passive CMV-specific immunity but also exert complex immunomodulatory properties which augment the antiviral effect of antiviral agents and offer the potential to suppress the indirect effects of CMV infection. This supplement discusses the available data concerning the immunological and clinical effects of CMVIG after heart or lung transplantation.
Topics: Antiviral Agents; Consensus Development Conferences as Topic; Cytomegalovirus; Cytomegalovirus Infections; Ganciclovir; Heart Transplantation; Host-Pathogen Interactions; Humans; Immunization, Passive; Immunocompromised Host; Immunoglobulins; Immunoglobulins, Intravenous; Immunosuppressive Agents; Lung Transplantation; Opportunistic Infections; Treatment Outcome; Valganciclovir; Virus Activation
PubMed: 26900989
DOI: 10.1097/TP.0000000000001094 -
Sarcoidosis, Vasculitis, and Diffuse... 2020Sarcoidosis is a systemic inflammatory disease characterized by granuloma formation in affected organs and caused by dysregulated immune response to an unknown antigen.... (Review)
Review
Sarcoidosis is a systemic inflammatory disease characterized by granuloma formation in affected organs and caused by dysregulated immune response to an unknown antigen. Sarcoidosis patients receiving immunosuppressive medications are at increased risk of infection. Lymphopenia is also commonly seen among patient with sarcoidosis. In this review, risk of infections, including opportunistic infections, will be outlined. Recommendations for vaccinations and prophylactic therapy based on literature review will also be summarized. .
Topics: Host-Pathogen Interactions; Humans; Immunization Schedule; Immunocompromised Host; Immunosuppressive Agents; Opportunistic Infections; Risk Factors; Sarcoidosis; Treatment Outcome; Vaccination
PubMed: 33093774
DOI: 10.36141/svdld.v37i2.9599 -
Journal of Feline Medicine and Surgery Jul 2013Phaeohyphomycoses and hyalohyphomycoses are rare opportunistic infections acquired from the environment. More cases have been reported in recent years in humans and cats. (Review)
Review
OVERVIEW
Phaeohyphomycoses and hyalohyphomycoses are rare opportunistic infections acquired from the environment. More cases have been reported in recent years in humans and cats.
DISEASE SIGNS
Single or multiple nodules or ulcerated plaques (which may be pigmented) in the skin are the typical lesions. In some cases the infection disseminates or involves the central nervous system (CNS).
DIAGNOSIS
Diagnosis is based on fungal detection by cytology and/or histology. Culture provides definitive diagnosis and species identification.
TREATMENT
Treatment involves surgical excision in cases of localised skin disease followed by systemic antifungal therapy, with itraconazole as the agent of first choice. Relapses after treatment are common. Itraconazole and other systemic antifungal agents have been used to treat systemic or neurological cases, but the response is unpredictable. The prognosis is guarded to poor in cats with multiple lesions and systemic or neurological involvement. ZOONOTIC RISK: There is no zoonotic risk associated with contact with infected cats.
Topics: Animals; Antifungal Agents; Cat Diseases; Cats; Hyalohyphomycosis; Opportunistic Infections; Phaeohyphomycosis
PubMed: 23813829
DOI: 10.1177/1098612X13489227 -
Der Internist May 2022Infections are an important warning sign for a weakened immune system. In the internal medical practice acquired (secondary), particularly drug-induced... (Review)
Review
Infections are an important warning sign for a weakened immune system. In the internal medical practice acquired (secondary), particularly drug-induced immunodeficiencies, are much more frequent than congenital (primary) immunodeficiencies. The management starts as early as the planning phase before initiation of immunosuppression. The risk of infection should be individually stratified and protective vaccinations should be completed. Depending on the immunosuppressive treatment, there can be a necessity for preventive treatment, e.g. for latent tuberculosis infection or hepatitis B. The serological results on varicella zoster virus and JC polyomavirus must also be considered. The basic immunological diagnostics include differential blood count and the determination of immunoglobulins (IgG, IgA, IgM) prior to and during immunosuppressive treatment. Relevant conspicuous laboratory results before initiation of treatment should prompt advanced immunological work-up for the identification of primary immunodeficiencies, which are often accompanied by clinical signs of immune dysregulation. Depending on the type of pathogen, localization, frequency and duration as well as the severity of the infection, prophylactic antibiotic treatment may be required. Patients with chronic severe lymphocytopenia, in particular with CD4 positive T (helper) cells < 200/µl, are at increased risk for opportunistic infections so that an antibiotic prophylaxis is recommended. In patients with significantly increased proneness to infections and detection of a relevant quantitative (IgG < 4 g/l) and/or qualitative antibody deficiency (impaired vaccine response), additional immunoglobulin replacement therapy may be necessary and can be administered intravenously (IVIG) or subcutaneously (SCIG) as home treatment. In accordance with the localization of the infection, multidisciplinary clarification and management is warranted.
Topics: Humans; Immunization, Passive; Immunoglobulin G; Immunologic Deficiency Syndromes; Opportunistic Infections; Vaccination
PubMed: 35412057
DOI: 10.1007/s00108-022-01326-8 -
Medicina (Kaunas, Lithuania) May 2018. The immunosuppression used after transplantation (Tx) is associated with an increased risk of opportunistic infections. In Europe, parasitic infections after Tx are... (Review)
Review
. The immunosuppression used after transplantation (Tx) is associated with an increased risk of opportunistic infections. In Europe, parasitic infections after Tx are much less common than viral, bacterial and fungal ones. However, diseases caused by parasites are very common in tropical countries. In the last years the number of travellers with immunosuppression visiting tropical countries has increased. . We performed a literature review to evaluate a risk of parasitic infections after Tx in Europe. . There is a real risk of parasitic infection in patients after Tx travelling to tropical countries. Malaria, leishmaniasis, strongyloidiasis and schistosomiasis are the most dangerous and relatively common. Although the incidence of these tropical infections after Tx has not increased, the course of disease could be fatal. There are also some cosmopolitan parasitic infections dangerous for patients after Tx. The greatest threat in Europe is toxoplasmosis, especially in heart and bone marrow recipients. The most severe manifestations of toxoplasmosis are myocarditis, encephalitis and disseminated disease. Diarrhoea is one of the most common symptoms of parasitic infection. In Europe the most prevalent pathogens causing diarrhoea are and . . Solid organ and bone marrow transplantations, blood transfusions and immunosuppressive treatment are associated with a small but real risk of parasitic infections in European citizens. In patients with severe parasitic infection, i.e., those with lung or brain involvement or a disseminated disease, the progression is very rapid and the prognosis is bad. Establishing a diagnosis before the patient's death is challenging.
Topics: Europe; Humans; Immunocompromised Host; Immunosuppression Therapy; Opportunistic Infections; Parasitic Diseases; Postoperative Complications; Transplant Recipients; Travel; Treatment Outcome
PubMed: 30344258
DOI: 10.3390/medicina54020027 -
Clinical Microbiology Reviews Jan 2005Aspergillus infections are occurring with an increasing frequency in transplant recipients. Notable changes in the epidemiologic characteristics of this infection have... (Review)
Review
Aspergillus infections are occurring with an increasing frequency in transplant recipients. Notable changes in the epidemiologic characteristics of this infection have occurred; these include a change in risk factors and later onset of infection. Management of invasive aspergillosis continues to be challenging, and the mortality rate, despite the use of newer antifungal agents, remains unacceptably high. Performing molecular studies to discern new targets for antifungal activity, identifying signaling pathways that may be amenable to immunologic interventions, assessing combination regimens of antifungal agents or combining antifungal agents with modulation of the host defense mechanisms, and devising diagnostic assays that can rapidly and reliably diagnose infections represent areas for future investigations that may lead to further improvement in outcomes.
Topics: Antifungal Agents; Aspergillosis; Aspergillus; Hematopoietic Stem Cell Transplantation; Humans; Opportunistic Infections; Organ Transplantation
PubMed: 15653818
DOI: 10.1128/CMR.18.1.44-69.2005 -
World Journal of Gastroenterology Nov 2014Tumor necrosis factor-α (TNF-α) inhibitors are biological agents introduced in the late 1990s for the treatment of different immune-mediated diseases as inflammatory... (Review)
Review
Tumor necrosis factor-α (TNF-α) inhibitors are biological agents introduced in the late 1990s for the treatment of different immune-mediated diseases as inflammatory bowel disease, rheumatoid arthritis and psoriasis. The most commonly used TNF-α antagonists are infliximab, adalimumab, and certolizumab pegol, and though highly effective in lowering inflammation, the efficacy must be weighed against the potential for adverse events. The treatment-induced immunosuppression is suspected to increase the risk of infections, including the risk of reactivation of latent tuberculosis, as the TNF-α cytokine plays an important role in the immune function. In this topic highlight a short overview of the infection risk associated with TNF-α inhibiter therapy is outlined with a focus on the overall risk of serious infections, mycobacterial infection and latent viral infections.
Topics: Anti-Inflammatory Agents; Biological Products; Humans; Immunocompromised Host; Inflammatory Bowel Diseases; Latent Tuberculosis; Opportunistic Infections; Prognosis; Risk Assessment; Risk Factors; Tumor Necrosis Factor-alpha; Virus Diseases
PubMed: 25473153
DOI: 10.3748/wjg.v20.i43.16014 -
Journal of the Pediatric Infectious... Sep 2017Invasive fungal diseases (IFDs) are devastating opportunistic infections that result in significant morbidity and death in a broad range of pediatric patients,... (Review)
Review
Invasive fungal diseases (IFDs) are devastating opportunistic infections that result in significant morbidity and death in a broad range of pediatric patients, particularly those with a compromised immune system. Recognizing them can be difficult, because nonspecific clinical signs and symptoms or isolated fever are frequently the only presenting features. Therefore, a high index of clinical suspicion is necessary in patients at increased risk of IFD, which requires knowledge of the pediatric patient population at risk, additional predisposing factors within this population, and the clinical signs and symptoms of IFD. With this review, we aim to summarize current knowledge regarding the recognition and clinical presentation of IFD in neonates and children.
Topics: Aspergillosis; Candidiasis; Child; Critical Illness; Cross Infection; Hematologic Neoplasms; Hospitalization; Humans; Immunocompromised Host; Immunologic Deficiency Syndromes; Infant, Newborn; Infant, Premature; Infant, Premature, Diseases; Intensive Care Units, Pediatric; Invasive Fungal Infections; Mucormycosis; Opportunistic Infections; Risk Factors; Transplant Recipients
PubMed: 28927201
DOI: 10.1093/jpids/pix053