HIV AIDS

NEW YORK -- HIV patients should not take drug holidays. That's the unambiguous warning emerging from the randomized Strategies for Management of Antiretroviral Therapy (SMART) study.

ABSTRACT: Painful recurrent ulceration of gingival tissue suggests a secondary intraoral presentation of herpes simplex virus (HSV) infection. Unlike the lesions of HSV, lesions associated with coxsackievirus do not erupt in the anterior mouth but rather on the soft palate and pharynx. Furthermore, unlike HSV infection, coxsackie infections may recur, because there is considerable viral variation. Patients with atrophic or erythematous candidiasis report burning pain and a metallic taste. The typical patient with benign mucous membrane pemphigoid is a woman older than 50 years; the condition usually involves the attached gingiva around the teeth. The lesions of erythema multiforme may erupt on any intraoral mucosa; biopsy may be required to rule out other conditions with similar presentations.

RENNES, France -- HIV can infect immune cells in the testis and produce infectious viral particles that, in turn, can re-infect cells in the blood, according to French researchers.

NIJMEGEN, The Netherlands -- Occupational therapy for patients with dementia and their caregivers improves the ability of both to cope with consequences of the condition, Dutch researchers found.

PHILADELPHIA -- When inhaled corticosteroids don't adequately control a patient's asthma, as often happens, the choice of the next-best add-on therapy is open to debate.

VANCOUVER, British Columbia -- Previous infection with hepatitis C virus and spontaneous clearance of the virus appear to confer protection against re-infection, reported researchers here.

LONDON -- The social forces shaping sexual behaviors among young people worldwide and are strikingly similar, according to a systematic review by a British team.

A 28-year-old man is hospitalized because of highfever with rigors and chills and rapid weight loss(5.4 kg [12 lb] in 2 weeks). During the past 48 hours,generalized throbbing headache, intermittent vomiting,blurry vision, and seizures have developed. The progressiveseizures started in the left hand and have becomegeneralized grand mal.

BOSTON -- Drug-resistant viral strains developed rapidly when exposed to telaprevir, the investigational protease inhibitor against hepatitis C virus (HCV), but both wild-type virus and mutants were controlled by follow-on therapy with interferon and Rebetol.

The NIH’s National Institute of Mental Health is fundinga $60 million effort to find treatments to counteract HIV’seffects on the human brain.

Although it has been evident since the early days of the HIV epidemic that a dementing illness often accompanies HIV infection and that the virus invades the nervous system soon after systemic infection, the clinical syndrome has evolved with the introduction of antiretroviral therapy.

Abstract: Our understanding of the pathobiology of pulmonary arterial hypertension (PAH) has evolved considerably over the past 2 decades, with increasing recognition of the important role that aberrant vasoproliferative responses play in conjunction with disordered vasoconstriction. Classification of the many forms of PAH into categories sharing a similar pathophysiology and clinical presentations help the practicing clinician approach a complex differential diagnosis. Noninvasive tests can be used to narrow this differential but must be applied with an appreciation for their limitations. Transthoracic echocardiography is the screening tool of choice; the workup should also include chest radiography and electrocardiography. However, right heart catheterization is ultimately required to establish the diagnosis. While PAH remains a progressive and generally fatal disease, existing therapies have a significant impact on survival and new therapeutic targets offer great hope for improving the prognosis. (J Respir Dis. 2006;27(11):487-493)

A 38-year-old African American man with HIV infection presents with numerous dyspigmented macules and patches on the extremities, abdomen, and chest; the lesions are smooth, nontender, and minimally pruritic. He has been noncompliant with antiretroviral therapy since his diagnosis 3 years earlier.

A 26-year-old woman with dull left-sided chest pain, nausea, body aches, and low-grade fever is admitted to the hospital. She has been to other emergency departments (EDs) in the area recently with similar complaints and was sent home with diagnoses of anxiety and costochondritis.

Generalized papular, erythematous, nonpruritic, hyperpigmented lesions had appeared on the face, arms (A), chest, and abdomen of a 25-year-old homosexual man with AIDS during the previous month. Anupama Ravi, MD, of Atlanta also noted purple-red, nodular lesions in the right conjunctiva (B) and oral cavity, especially the lower gingiva (C). Other pertinent physical findings included facial edema and hepatosplenomegaly.

A 38-year-old African American man with HIV infection presents with numerous dyspigmented macules and patches on the extremities, abdomen, and chest; the lesions are smooth, nontender, and minimally pruritic.

A 26-year-old woman with dull left-sided chest pain, nausea, body aches, and low-grade fever is admitted to the hospital. She has been to other emergency departments (EDs) in the area recently with similar complaints and was sent home with diagnoses of anxiety and costochondritis.

Generalized papular, erythematous, nonpruritic, hyperpigmented lesions had appeared on the face, arms, chest, and abdomen of a 25-year-old homosexual man with AIDS during the previous month. Anupama Ravi, MD, of Atlanta also noted purple-red, nodular lesions in the right conjunctiva and oral cavity, especially the lower gingiva. Other pertinent physical findings included facial edema and hepatosplenomegaly.

SAN DIEGO -- For a variety of factors, HIV-infected children appear to have more psychiatric problems than uninfected children, researchers reported here.

BOSTON -- An investigational drug that inhibits programmed cell death could help to prevent fibrosis in hepatitis C-infected livers, even when standard therapies fail to clear the virus, researchers reported here.

ROCHESTER, Minn. -- A lifetime of infections with rhinoviruses, enteroviruses, or other members of the picornavirus family could lead to cumulative memory loss, according to Mayo Clinic neuroscientists.

SAN FRANCISCO -- HIV patients in their 50s do not have a higher prevalence of metabolic syndrome than others of that age, researchers reported here.

SAN FRANCISCO -- In highly treatment-experienced HIV patients, an investigational integrase inhibitor sharply reduced viral loads compared with placebo, researchers reported here.

In recent months, the widely publicized outbreak of Fusarium keratitis has called attention to the serious consequences of contamination of ocular solutions. Although contact lens solution was implicated in the recent outbreak, other ocular products can also pose the risk of infection (Box).

In recent months, the widely publicized outbreak of Fusarium keratitis has called attention to the serious consequences of contamination of ocular solutions. Although contact lens solution was implicated in the recent outbreak, other ocular products can also pose the risk of infection

TORONTO -- Experience in treating tuberculosis, even if it is outside a physician's main area of expertise, appears to play a key role in patient survival, according to researchers here.

Atlanta -- The CDC recommended last week that HIV testing should become a routine part of office exams for all patients ages 13 to 64, irrespective of risk, without any pretest requirements. MedPage Today would like your opinion on this dramatic change in public health thinking.

SHEFFIELD, England -- Smoking cigarettes seems to be an independent risk factor for HIV infection, according to researchers here. But smoking doesn't appear to be a risk factor in progression to AIDS.

ATLANTA -- An HIV test should be a routine part of health care for all Americans between the ages of 13 and 64, not just those thought to be at high risk for the disease, the CDC said today.

OKLAHOMA CITY -- A strategy for transfusion-free liver transplantation, developed for Jehovah's Witness patients, reduced overall blood use when applied to all patients, researchers here reported.