Publications by authors named "Mihoko Yotsumoto"
Background: The two-drug regimen of dolutegravir/lamivudine (DTG/3TC) is currently an optional antiretroviral therapy (ART). Despite its reported advantages on body weight and lipid profile, the same effects have not yet been reported for Asian population.
Methods: We conducted a single-center retrospective study involving Japanese people living with HIV (PLWH).
Article Synopsis
- A study was conducted on Japanese people living with HIV to compare body weight changes when switching from tenofovir disoproxil fumarate (TDF) to tenofovir alafenamide fumarate (TAF) while on antiretroviral therapy.
- The results showed no significant overall difference in weight gain between TDF and TAF; however, younger patients (<50 years) experienced greater weight gain on TAF compared to older patients.
- The study concludes that while switching to TAF does not generally lead to weight gain, using it alongside dolutegravir (DTG) may correlate with increased weight gain, especially in younger populations.
Article Synopsis
- * A study in Japan found that only 8.2% of individuals with acute or recent HIV infection received rapid ART, and many others had prolonged times before achieving viral suppression.
- * For those with advanced HIV diseases, 36.2% experienced delays in ART initiation, indicating a need for further research to determine barriers preventing timely treatment in Japan.
Article Synopsis
- A 51-year-old man admitted for visual field narrowing and papilledema was diagnosed with right transverse and sigmoid sinus thrombosis after undergoing brain MRI; he initially received intravenous heparin therapy.
- His condition worsened on day 9 with a seizure and decreased platelet count, leading to suspicion of heparin-induced thrombocytopenia (HIT), despite negative immunological antibody tests.
- Treatment switched from heparin to argatroban due to HIT diagnosis, followed by warfarin, and eventually to rivaroxaban to manage anticoagulation without complications.
Article Synopsis
- A Japanese patient with HIV-related Kaposi sarcoma presented with multiple skin lesions and significant swelling in both groin areas.
- The patient underwent extensive treatment with pegylated liposomal doxorubicin (PLD) over 10 years, exceeding the standard lifetime dosage without experiencing serious side effects.
- Ultimately, the patient passed away from pancreatic cancer rather than complications from the KS or the treatments received.
Article Synopsis
- No comparative clinical studies have specifically examined the differences in clinical features of Epstein-Barr virus (EBV) Hodgkin lymphoma (HL) between HIV-positive and HIV-negative patients until this investigation, which analyzed 16 EBV+ HIV HL cases in Japan.
- The study found that EBV+ HIV HL was more common in younger patients and was less frequently associated with the nodular sclerosis subtype in individuals under 40, while also showing a higher rate of extra-nodal involvement.
- Despite the presence of HIV, the complete remission rates and survival outcomes for those with EBV+ HIV HL were similar to those without HIV, indicating that standard chemotherapy is effective and well-tolerated regardless of HIV status.
[Investigation of the Pathophysiology and Diagnostic Methods Through a Case of Acute HIV Infection in which the Western Blot Method Remained Negative Over the Long Term and the 4th Generation Screening Assay Became Negative for a Certain Period of Time after Initiating Antiretroviral Therapy].
Kansenshogaku Zasshi
January 2017
Unlabelled: Confirmatory tests using Western blot (WB) and HIV-1 nucleic acid testing (HIV-1 RNA) following a positive screening test are required for the diagnosis of HIV-1 infection according to the current Japanese guidelines for HIV-1/2 diagnosis. We report herein on a rare case in a patient who remained negative for WB over 10 months in spite of being positive by fourth-generation immunoassays (4thGIA) and who subsequently seroreverted by 4thGIA for three months after initiating antiretroviral therapy.
Case: A man in his early twenties previously visited a hospital because of fever in October 2012.
[Syphilis Testing and High Rate of Infection Among HIV-infected Patients].
Kansenshogaku Zasshi
November 2016
Article Synopsis
- * A study at Tokyo Medical University Hospital analyzed data from 1,000 HIV-infected male patients, finding that 77.4% were tested for syphilis multiple times, with 61.3% reactive to syphilis tests.
- * Among those who tested reactive, 12.9% were either newly diagnosed with syphilis or had repeated infections, indicating the need for regular STD screening as recommended by guidelines.
Plasmablastic lymphoma (PBL) is a rare AIDS-related malignancy with a poor prognosis. Little is known about this entity, and no standard treatment regimen has been defined. To establish an adequate treatment strategy, we investigated 24 cases of PBL arising in human immunodeficiency virus-positive individuals.
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- The study evaluates end-of-life care for HIV patients with cancers in Japan, emphasizing the growing need for palliative care in this population.
- Around 59.8% of surveyed hospitals provide some care, but only 24.3% specifically cater to HIV patients with malignancies.
- Many palliative care units struggle with accepting these patients due to insufficient experience and knowledge regarding their unique needs.
Article Synopsis
- Lung cancer is a significant health issue for individuals with HIV in Japan, with increasing cases and high mortality rates among this population.
- A study from 1986 to 2013 identified 43 HIV-positive lung cancer patients, revealing that most were male, with a median age of 60, and the majority developed cancer during the antiretroviral treatment era.
- The findings show that lung cancer incidence is rising in Japan, with similar EGFR mutation rates to the general population and distinct clinical characteristics compared to HIV patients in Western countries.
Article Synopsis
- - Primary effusion lymphoma (PEL) is a rare and aggressive form of B-cell non-Hodgkin's lymphoma that often shows malignant effusions instead of typical tumor masses, commonly related to HHV-8/KSHV, with many cases also involving Epstein-Barr virus.
- - It primarily affects patients with weakened immune systems, such as those with HIV or after organ transplants, and is treated with chemotherapy regimens like CHOP, but generally shows resistance to these treatments and has a short median survival of less than six months.
- - Newer chemotherapy approaches like dose-adjusted EPOCH and molecular targeting therapies are being explored, focusing on disrupting the specific molecular processes involved in the cancer driven by HHV-8
Background: Human herpesvirus 8 (HHV8)-positive plasmablastic lymphoma is a disease which correlates with acquired immunodeficiency syndrome (AIDS). Little is known about the pathogenesis of the disease due to its rarity. We report an autopsy case about AIDS related HHV-8-positive plasmablastic lymphoma and presents an examination about HHV8 related proteins for the disease by using immunohistochemical techniques.
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- Atovaquone is recognized as an effective treatment and prevention method for mild to moderate Pneumocystis pneumonia (PCP), and it became officially available in Japan after being supplied via a clinical study group for years.
- A retrospective study from 1997 to 2012 analyzed its usage and side effects, finding a significant increase in applications and reporting 57 adverse events among 39 patients.
- The most common side effects included drug eruptions, cytopenia, fever, and liver dysfunction, with caution advised due to potential severe liver issues, though no unique side effects were observed in the Japanese population.
Background: The improved survival of subjects with human immunodeficiency virus (HIV) has been accompanied by an increased prevalence of chronic kidney disease (CKD). Epidemic of CKD among those with HIV has not yet been evaluated in multiple tertiary hospitals in Japan.
Methods: A cross-sectional study was conducted in 2011 at Tokyo Metropolitan Komagome Hospital (TMKH) and Tokyo Medical University Hospital (TMUH).
Article Synopsis
- An epidemiological study evaluated the incidence and clinical outcomes of non-AIDS-defining hematological malignancies (NADHMs) among HIV-infected patients in Japan, excluding non-Hodgkin's lymphomas.
- Over a span from 1991 to 2010, 47 cases of NADHMs were identified, primarily in young adult males, with the average time from HIV diagnosis to the development of these malignancies being about 28 months.
- The findings showed a significant increase in NADHM cases in the past decade, with treatment outcomes being comparable to those of HIV-negative patients, suggesting standard chemotherapy is a viable option for these individuals.
The incidence of Hodgkin lymphoma (HL) is paradoxically increasing in the combination anti-retroviral therapy (cART) era. However, there has been no nationwide survey of human immunodeficiency virus (HIV)-associated HL (HIV-HL) in Japan. We retrospectively examined the clinical characteristics and outcomes of 19 newly diagnosed HIV-HL patients at 11 HIV/AIDS and hematology regional hospitals in Japan between 1991 and 2010.
View Article and Find Full Text PDFWe encountered a human immunodeficiency virus (HIV)-1 in which the viral load was undetectable with the Cobas TaqMan HIV-1 ver. 1.0 (CTM v.
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- * In 47% of test specimens, TaqMan detected HIV-1 RNA levels above 50 copies/ml when AMPLICOR reported them as undetectable (<50 copies/ml), indicating TaqMan may show higher viral loads.
- * The findings suggest that while monitoring HIV with these assays is crucial for treatment, the TaqMan assay's reliability is still questionable, as it does not always align with clinical conditions or the effects of antiretroviral drugs.
Primary central nervous system lymphoma (PCNSL) related to acquired immunodeficiency syndrome (AIDS) is a lethal disorder, but the recent application of highly active antiretroviral therapy (HAART) has significantly improved prognosis. This retrospective cohort study of AIDS-related PCNSL examined the actual clinical outcomes and prognostic variables affecting overall survival (OS) in the HAART era. Twenty-three newly diagnosed AIDS-related PCNSL at 12 regional centre hospitals for HIV/AIDS in Japan between 2002 and 2008 were consecutively enrolled.
View Article and Find Full Text PDFA 49-year-old HIV-positive Japanese man was referred to our hospital for multiple skin nodules. Many plasmablastic atypical lymphocytes were observed in the peripheral blood. He was diagnosed with diffuse large B cell lymphoma (DLBCL) by a biopsy of the inguinal lymph node.
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- * Around day 59, he experienced significant weakness in his left arm, which was diagnosed as immune-mediated demyelinating neuropathy, leading to the administration of intravenous immunoglobulin (IVIG) therapy.
- * Although the patient faced complications like chronic skin GVHD and recurrent CMV infection, his neurological condition stabilized and began to improve about 50 days after the final IVIG treatment, highlighting potential links between post-transplant neuropathies and GVHD or infections.
Article Synopsis
- A 72-year-old man experienced severe oral bleeding due to an acquired factor V inhibitor affecting his blood clotting.
- Laboratory tests showed extreme abnormalities in prothrombin and activated partial thromboplastin times, very low factor V activity, and decreased levels of Factors II and X.
- Treatment with prednisolone successfully stopped the bleeding and improved his blood coagulation, highlighting that high levels of factor V inhibitor can influence coagulation tests despite normal factor activity.