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)

New COVID Taskforce website from ASHM

ASHM, UPDATED ON: 14 April 2020

ASHM’s Taskforce on BBVs, Sexual Health and COVID-19 was established on 20 March 2020. It provides a timely opportunity for the BBV and sexual health sectors to discuss the scientific, clinical, BBV and sexual health service delivery and social implications of COVID-19, and provides consistent and evidence-based messaging to the health workforce, sector partners and community.

The website contains interim recommendations on:

  • adults living with HIV
  • adults living with chronic hepatitis B.
  • adults living with hepatitis C, or the complications of previous hepatitis C infection
  • people who are incarcerated in criminal justice settings during the COVID-19 pandemic including those who are living with HIV, hepatitis B and hepatitis C.

 

Coronavirus disease (COVID-19), HIV & hepatitis C: What you need to know

CATIE (Canada), 17 March 2020

  • An HIV-positive person on effective treatment is not expected to be at higher risk of becoming seriously ill with COVID-19
  • A person with untreated HIV or a low CD4+ cell count may be at higher risk of becoming seriously ill with COVID-19
  • People with HIV or hepatitis C are more likely to have other conditions that carry a greater risk of becoming seriously ill with COVID-19

 

 

Update on COVID-19 for PLHIV

SAMESH, March 19, 2020

SAMESH, SHINE SA, and Thorne Harbour Health are encouraging people living with HIV (PLHIV) to take additional precautions in the face of the changing landscape around 2019 novel coronavirus (COVID-19).

We want to ensure the ongoing health and wellbeing of all PLHIV who are more vulnerable to COVID-19. This means minimising the risk of exposure to the virus.

While everyone is at risk of contracting COVID-19, the consequences of infection are more severe for some vulnerable groups. This includes PLHIV who are:

  • Aged over 60 years old
  • Living with a detectable viral load or a CD4 count below 500
  • Diabetic
  • Smokers
  • Living with hepatitis B or C
  • Living with a comorbidity such as heart or lung issues

Those PLHIV on treatment with an undetectable viral load (and no other significant health condition) are at no greater risk of serious health consequences due to COVID-19 than the general population. That being said, they should still take the advice of the health department in exercising precautions such as handwashing, working from home where possible, limiting time on public transport, and avoiding large groups or crowded areas.

Those PLHIV who fall into one of the vulnerable groups listed above should limit contact with others to avoid potential exposure to COVID-19.

If you are living with HIV and are concerned you might be at risk, you should:

  • Maintain regularly scheduled medical appointments, but consider asking your doctor about telehealth consultations
  • Ensure you have between 1-3 month supply of any medications you currently take
  • Avoid stockpiling medications beyond a 1-3 month supply as this could cause unnecessary shortages
  • Be wary of advice or articles in social media — do not modify the medications you currently take without first consulting your doctor
  • Contact your doctor about getting vaccinations for influenza and pneumococcal when available
  • Keep in touch with friends, colleagues, and family via phone calls and video chat — consider scheduling regular catch ups
  • Stay in touch – our organisations will continue to release more information and resources as the situation continues to evolve

This public health issue can be stressful, but our communities have a long history of staying informed and collective action to ensure we look after our health as well as the wellbeing of those around us. Let’s keep this legacy going as we look after ourselves and those around us

Gaps And Policy Barriers To Engagement With The HIV Cascade Of Care

Identifying and Plugging the Leaks: Gaps And Policy Barriers To Engagement With The HIV Cascade Of Care

CTAC (Canadian Treatment Action Council), 2018

This project explored what issues impact engagement by people living with HIV with healthcare in Ontario. The goal was to identify policy issues that impact treatment access for people living with HIV, and to identify opportunities to make the healthcare system more accessible.

The HIV Cascade of Care is a useful description of the different steps that a person living with HIV will need to take in order to achieve an undetectable viral load and optimal health outcomes, from infection and diagnosis through to Antiretroviral Therapy (ART) initiation and viral suppression.

We know people drop out of the HIV Cascade of Care – e.g. why those starting treatment don’t stay on it. By seeking out policy barriers and developing solutions we can enable people to live long, healthy, and happy lives.

The project has five recommendations around barriers to engagement in the HIV Cascade of Care.

Download report here