Refractory HIV-Associated Guillain-Barré Syndrome Responsive to Antiretroviral Therapy: A Case Report.

Guillain-Barré Syndrome (GBS) is an acute polyneuropathy commonly preceded by infection, with growing recognition of the human immunodeficiency virus (HIV) as a trigger. We present a case of a 44-year-old male with HIV-associated GBS refractory to intravenous immunoglobulin (IVIG) therapy, who achieved remission upon starting highly active antireroviral therapy (HAART). There remains a lack of consensus on the management of this condition across the spectrum of disease, and the interplay between the therapeutic options is poorly understood.

Immune Reconstitution Inflammatory Syndrome in a Case of Nonspecific Orbital Inflammation.

The immune reconstitution inflammatory syndrome is an exaggerated abnormal immune response, typically seen in HIV-positive patients following restoration of a normal CD4 count as a result of initiation of antiretroviral therapy. It has been described in relation to either occult opportunistic infections or to a paradoxical relapse of a previously successfully treated infection with negative microbiological cultures. The authors report the case of a 60-year-old HIV-positive African male who presented with 2 episodes of orbital inflammation that occurred in conjunction with improvements of CD4 count following Highly Active Antiretroviral Therapy.

Dolutegravir-induced liver injury leading to sub-acute liver failure requiring transplantation: a case report and review of literature.

A patient with human immunodeficiency virus-1 infection presented with sub-acute liver failure, temporally related to commencement of an antiretroviral therapy regimen containing dolutegravir (Triumeq). The patient was not a carrier of HLA-B5701, and abacavir hypersensitivity was unlikely. We believe this is the first report of severe dolutegravir-related hepatotoxicity resulting in sub-acute liver failure and transplantation and highlights a potential need for closer monitoring after drug initiation.

Routine HIV testing in acute medical admissions in a high prevalence area reduces morbidity and mortality of HIV: a full cycle audit.

Late HIV diagnosis in the UK remains a major cause of morbidity and mortality. In line with British HIV Association recommendations, we implemented routine HIV Screening in Croydon University Hospital Acute Medical Unit in London after an audit in 2011 revealed very high levels of late diagnosis. Our re-audit assessed the impact of Acute Medical Unit screening and found that patients identified by screening, compared to those tested due to clinical suspicion of HIV, were significantly less likely to be diagnosed late, had fewer AIDS-defining illnesses and shorter hospital admissions.

The prevalence of cryptococcal antigenemia in newly diagnosed HIV patients in a Southwest London cohort.

Objectives: To determine the prevalence of cryptococcal antigenemia in a UK HIV cohort and compare baseline characteristics of patients with and without cryptococcal antigenemia.

Methods: Stored sera were retrospectively tested for cryptococcal antigen (CRAG) among newly diagnosed HIV-infected persons with CD4 < 100 cells/μL, who presented to Croydon University and St George's Hospitals, London, between January 2004 and October 2010. We assessed risk factors for cryptococcal antigenemia and patient outcomes by extracting demographic and clinical information from medical records.