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Sexually Transmitted Diseases
Published in Ayşe Serap Karadağ, Lawrence Charles Parish, Jordan V. Wang, Roxburgh's Common Skin Diseases, 2022
Aarthy K. Uthayakumar, Christopher B. Bunker
Overview: The global health burden of sexually transmitted infections (STIs) remains large and increasing. In developed countries, education and sexual health are more widely available, but the burden is greatest in resource-poor countries where health care is limited. STIs are caused by a wide range of microorganisms, and many have asymptomatic early infection which favors onward transmission. They are a potential cause of serious morbidity and mortality, with late complications including in pregnancy. Furthermore, coinfection with HIV affects transmission rates. Ease of diagnostic testing, combined with early and effective treatment and increased public education, are vital for gaining control.
Viral hepatitis in pregnancy
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
Numerous studies have suggested that the vertical risk of transmission for hepatitis C is increased in the following setting: HIV–hepatitis C coinfection.HCV viremia—mothers with positive virus load have increased risk of transmission, compared with mothers with undetectable viral load (suggesting resolved infection). The overwhelming majority of infants with HCV infection have mothers with positive hepatitis C virus in the blood.Prolonged rupture of membrane for more than 6 hours has been associated with increased risk of perinatal transmission.Obstetric procedures and intrapartum exposure to maternal blood infected by HCV—Steininger et al. have shown that invasive monitoring of fetus with scalp electrode increases the risk of transmission [14].
Neuroinfectious Diseases
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Jeremy D. Young, Jesica A. Herrick, Scott Borgetti
Wound botulism occurs when soft tissue is colonized by C. botulinum, usually the result of skin trauma, and the organism germinates and elaborates toxin. An emerging cause of wound botulism in the United States is injection drug use, specifically from “skin popping” (i.e. subcutaneous instead of IV injection of drugs).5 It is presumed that the drugs themselves, particularly “black tar” heroin, are contaminated with the organism. Wounds typically do not have the cardinal features of cellulitis, such as erythema, warmth, or purulent drainage, and they may appear to be healing while neurologic symptoms are progressing. Any of these signs, combined with fever, would suggest wound coinfection with another organism.
Case report: nanopore targeted sequencing in the diagnosis of invasive pulmonary Aspergillus infection in a patient with acute promyelocytic leukemia
Published in Hematology, 2023
Qiuxia Huang, Yaohui Wu, Xuan Lu, Linghui Xia
In the present case, we first suspected bacterial and fungal coinfection; however, the corresponding treatment was not effective. The NTS of blood samples detected Aspergillus flavus and several other pathogens, and that of pleural effusion samples confirmed this infection. The patient's symptoms improved after adjusting the antifungal regimen. Ten days thereafter, the patient presented with new-onset fever and dyspnea, and CT scan findings showed increased levels of pleural fluid. However, the second pleural effusion NTS presented no evidence of Aspergillus flavus. Adjustments to the antibacterial regimen improved the patient’s symptoms. Clinical practice guidelines suggest voriconazole as the primary treatment for most IPA cases [1]. However, voriconazole showed poor efficacy in the present case. Finally, we combined micafungin and amphotericin B to achieve a better therapeutic effect [13,19].
Immunogenicity and safety of 4 intramuscular standard-dose and high-dose hepatitis B vaccine in people living with HIV: a randomized, parallel-controlled trial
Published in Expert Review of Vaccines, 2022
Yongliang Feng, Zhuanzhuan Chen, Ruixue Xie, Tian Yao, Yuanting Wu, Feng Yang, Chenli Yuan, Xiaoyong Nie, Fuzhen Wang, Xiaofeng Liang, Suping Wang
Coinfection with HBV and HIV is common because of the shared modes of transmission. The hepatitis B vaccine is generally accepted as an essential part of preventing HBV infection among PLHIV. However, compared with healthy adults, PLHIV have lower seroconversion rate and faster decline of protective antibody (anti-HBs) after completion of routine vaccination schemes [11]. To determine the optimal regimen for hepatitis B vaccination, we explored the immunogenicity of the hepatitis B vaccine by increasing the dose (60 µg) and/or the number of vaccinations (four doses) in this study. To our knowledge, this study is the first randomized controlled trial to assess the immunogenicity of the IM60 × 4 and IM20 × 4 groups of hepatitis B vaccine regimens versus the IM20 × 3 group hepatitis B vaccine regimen in PLHIV.
Novel therapeutic approaches for targeting TB and HIV reservoirs prevailing in lungs
Published in Expert Opinion on Drug Delivery, 2019
Mrunal Jadhav, Tabassum Khan, Chintan Bhavsar, Munira Momin, Abdelwahab Omri
Tuberculosis is one of the leading causes of mortality in HIV positive people. The replication rate of HIV is higher in HIV-TB coinfection with higher viral and bacterial load in the lungs. The therapeutic regimen available for treatment of coinfection suffers from drawbacks of toxicity and poor patient compliance due to long duration of treatment regimen. There are few new drug combinations currently in clinical trials which could provide new options of therapeutic intervention in management of this coinfection. Nanotechnology offers a viable platform for development of existing and new therapeutic interventions into pulmonary targeted drug delivery systems that specifically and effectively target both viral and bacterial reservoirs in the lungs. Additionally, recent evidence on gallium nanoparticles for simultaneous targeting of HIV and M. tuberculosis has opened up new vistas for development of dual targeting drug delivery systems. However further studies are needed to provide mechanistic insight for its selective toxicity in the coinfection.