Case report: HIV-associated neurocognitive disorder & myelopathy in patient with preserved CD4, but high viral load

HIV-associated neurocognitive disorder and HIV-associated myelopathy in a patient with a preserved CD4, but high viral load-a rarely reported phenomenon: a case report and literature review. 

Ayele, B.A., Amogne, W. & Gemechu, L.

BMC Infect Dis 20, 574 (2020). https://doi.org/10.1186/s12879-020-05297-9

This case supports the current understanding regarding the persistent occurrence of HIV-associated neurocognitive disorder and HIV-associated myelopathy even decades after introduction of cART. Therefore, it’s important to screen HIV+ patients for the HAND and HAM even if they have relatively preserved immunity.

Because patient can be easily shifted to ART drugs with better CNS penetrating potential to achieve acceptable virological suppression level, to observe sound clinical improvement.

Diagnosis and Management of Syphilis in Patients With HIV Co-infection

Khaw, C., Malden, C., Ratnayake, M. et al. Diagnosis and Management of Syphilis in Patients With HIV Co-infectionCurr Treat Options Infect Dis (2020). https://doi.org/10.1007/s40506-020-00225-6

Published

Purpose of review

Syphilis cases are on the increase especially in men who have sex with men (MSM) in urban areas of high-income countries.

There is a strong association between syphilis and HIV infections.

We review the more recent literature regarding the epidemiology, clinical manifestations, diagnostic investigations, treatment and follow-up of syphilis in HIV infection.

  • Read abstract here (For full text access you can purchase from the publisher or see your librarian)

The everyday experiences of LGBTI people living with disability

GLHV@ARCSHS, La Trobe University,  July 2018

This report documents the effects of systemic discrimination on the health and wellbeing of LGBTI people with disability.

It is divided into two key sections. The first reviews the national and international research and policy literatures on the impacts of systemic discrimination, disadvantage and social exclusion on the health and wellbeing of LGBTI people with disability and their access to services.

The second, smaller section presents preliminary analyses of unpublished data on LGBT people with disability from Private lives 2: The second national survey of the health and wellbeing of LGBT Australians (2012).

KEY FINDINGS:

The review found that research, policy and practice on the health and wellbeing of LGBTI people with disability in Australia is fragmented, under-resourced and relies on different, sometimes contrary definitions of ‘disability’.

The review documents higher rates of discrimination and reduced service access among LGBTI people with disability compared with people with disability and LGBTI people without disability; greater restrictions on freedom of sexual expression (particularly for LGBTI people with intellectual disability); and reduced social support and connection from both LGBTI and disability communities.

It documents a lack of professional training, resources and support for disability and allied health care workers for LGBTI people with disability. It also found that many disability services and workers are unwilling to address the sexual and gender identity rights and freedoms of LGBTI people with disability.

PEP after Non-Occupational and Occupational Exposure to HIV: Australian Guidelines revised

Our apologies to those who tried to access SASHA while it was down. The technical difficulties have now been resolved.

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Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine, August 2016

The Second edition of the Post-Exposure Prophylaxis after Non-Occupational and Occupational Exposure to HIV: Australian National Guidelines is now available.

These guidelines outline the management of individuals who have been exposed (or suspect they have been exposed) to HIV in non-occupational and occupational settings.

There are currently no data from randomised controlled trials of the use of post-exposure prophylaxis (PEP) and evidence for use has been extrapolated from animal data, mother to child transmission, occupational exposure and small prospective studies of PEP regimens in HIV-negative men. Accordingly, assumptions are made about the direction of management.

Every presentation for PEP should be assessed on a case-by-case basis, balancing the potential harms and benefits of treatment.

Recommendations following non-occupational exposure have been updated, and information about PEP in the context of pre-exposure prophylaxis (PrEP), PEP and children, renal disease, and gender identity and history has been added.

  • Download the revised guidelines (PDF) here
  • Updates to the supplementary documents, as well as a navigable website for the guidelines, will soon be available. At present, the 2013 literature review and checklist are still available, linked below:

    PEP Checklist (2013)

    Literature Review (2013)

 

Tinea genitalis: a new entity of sexually transmitted infection?

Sex Transm Infect 2015;91:493-496 doi:10.1136/sextrans-2015-052036

Case series and review of the literature

Abstract:

Objective Investigation on recent cases of tinea genitalis after travelling to South East Asia.

Methods Patients with tinea in the genital region, which emerged after sex in South East Asia, underwent further assessment including microscopy, cultures and DNA analyses.

Results The case series includes seven patients. In six patients, Trichophyton interdigitale (former Trichophyton mentagrophytes) was detected. Three patients suffered from a severe inflammatory reaction of the soft tissue and two of them needed hospitalisation due to severe pain. In four patients, cicatrising healing was noticed. Five patients were declared incapacitated for work.

Conclusions Sexual activity should be considered as a potentially important and previously underappreciated means of transmission of T. interdigitale. To avoid irreversible scarring alopecia, prompt initiation of antifungal treatment is essential and adequate isolation and identification of the pathogen is mandatory.

Read article here (open access, PDF version optional)