Peripheral cytopenia has been reported in a number of patients with the acquired immunodeficiency syndrome (AIDS), but the mechanism of bone marrow (BM) failure is unclear. We have examined the BM morphology and cytokinetics of 16 untreated HIV-positive patients whose clinical condition ranged from asymptomatic (stage 1 WR and II CDC classifications) to overt AIDS (stage 6 WR and IV CDC classifications). BM aspirates and iliac crest threphine biopsies were obtained for myelogram and histologic examination, as well as for propidium iodide flow cytometric (FMC) DNA analysis. FCM data were compared with those from the BM of patients with solid tumors without BM involvement. Four patients had normal peripheral blood counts, 2 were anemic, 2 had granulocytopenia, 2 thrombocytopenia, 4 bicytopenia and 2 pancytopenia. BM cellularity was normal or increased, but only 2/16 patients had normal BM morphology. Ten patients had atypical lymphoid aggregates, relative plasmacytosis and eosinophilia, and 4 had typical myelodysplastic changes. There was no correlation between morphology and WR or CDC grade. The mean proliferative fraction (i.e. the percentage of cells in the S phase of the cell cycle) of the HIV-positive patients was 11% (range 5.5-18.3%). The mean value for the control patients was 15.1% (range 7.7-26.9%) (p less than 0.05). All patients had modal diploid DNA content without aneuploid clones. These data suggest that the mechanism of BM failure in HIV-positive patients lies in a reduced proliferative activity whose exact cause is still unclear.
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J Family Med Prim Care
December 2024
Center for Health Policy Studies, School of Public Health, Zhejiang University School of Medicine, Hangzhou, China.
Background: Previous studies have found that people with low participation in social activities and living alone were prone to have risky sexual behaviors, while people with high participation in social activities were less prone to have risky sexual behaviors. Based on the above assumptions, we conducted an analysis on elderly population's social networks and human immunodeficiency virus (HIV) risky behaviors in China. In the survey study, considering the sensitivity of sexual behavior, HIV risk behavior of the elderly population is more difficult to measure, so the intermediate variable of HIV perceptions was used instead of the sexual behavioral variable.
View Article and Find Full Text PDFBackground: Malawians, in Sub-Saharan Africa (SSA), face the double burden of HIV and Alzheimer's disease and related dementia (ADRD). The life expectancy among HIV-positive people on antiretroviral therapy has increased consistently over the past 25 years. The purpose of the study was to determine the prevalence of dementia among people living with HIV (PLWHIV) and the general population without HIV as a comparison group in Malawi.
View Article and Find Full Text PDFCureus
December 2024
General and Oncological Dermatology Ward with a Day Care Unit, Provincial Hospital, Opole, POL.
The diagnostic process and discrimination of mucosal lesions present a formidable challenge for numerous clinicians, primarily attributable to the common overlap of clinical manifestations observed across various categories, including infectious, autoimmune, connective tissue, and systemic vascular inflammatory diseases. In cases of mucosal lesions, syphilis presents distinctive characteristics that can help clinicians differentiate it from other conditions. The most common manifestation of primary syphilis is mostly a painless, firm, indurated ulcer known as a chancre, which typically appears at the site of inoculation, with enlargement of regional lymph nodes.
View Article and Find Full Text PDFContingency management (CM), an evidence-based behavioral strategy that rewards positive behavior change including tobacco cessation, is rarely offered to support people with HIV (PWH) who smoke. In this study, we explored perspectives among patients and research staff engaged in a multi-site randomized clinical trial involving clinical pharmacist-delivered CM within HIV clinics. Between February and September 2023, we conducted 1:1 interviews with 12 PWH randomized to receive CM and one focus group with 8 staff (i.
View Article and Find Full Text PDFPLoS One
January 2025
Faculty of Health Sciences, Department of Public and Global Health, University of Nairobi, Nairobi, Kenya.
The absence of an accurate reference test complicates the evaluation of tuberculosis (TB) diagnostic tests among people living with Human Immunodeficiency Virus (PLWHIV). The objective of this study was to estimate (using Bayesian latent class models [BLCM]) the sensitivity (Se), specificity (Sp) and negative and positive predictive values (NPV and PPV) of sputum smear microscopy (SSM), Xpert Ultra and lipoarabinomannan antigen (LAM) tests for TB among PLWHIV in Nairobi, Kenya. This cross-sectional study enrolled a total of 190 patients aged ≥ 18 years with presumptive TB seeking treatment at the Kibra Community Health Center Comprehensive Care Centre (CCC) clinic between September 2022 and March 2023.
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