The study investigated markers of inflammation and endothelial activation in HIV infected patients after 12 years of successful combination antiretroviral treatment (cART).
Inflammation and ...endothelial activation were assessed by measuring levels of immunoglobulins, β2-microglobulin, interleukin (IL) 8, tumor necrosis factor α (TNFα), vascular cell adhesion molecule-1 (sVCAM-1), intercellular adhesion molecule-1 (sICAM-1), sE-Selectin, and sP-Selectin.
HIV infected patients had higher levels of β2-microglobulin, IL-8, TNFα, and sICAM-1 than uninfected controls, and HIV infected patients lacked correlation between platelet counts and sP-Selectin levels found in uninfected controls.
Discrete signs of systemic and vascular inflammation persist even after very long term cART.
Important paradigms of pulmonary disease with nontuberculous mycobacteria (NTM) are currently shifting based on an increasing attention within the field of cystic fibrosis (CF). These shifts are ...likely to benefit the management of all patients with pulmonary NTM, regardless of underlying pathology. Currently several key areas are being revised: The first outbreak of human NTM transmission has been proven and new evidence of biofilm growth in vivo has been demonstrated. A better understanding of the clinical impact of NTM infection has led to increased diagnostic vigilance and new recommendations for lung transplantation are under way. While recent changes have reinvigorated the interest in NTM disease, the challenge remains, whether such advances can be successfully translated into improved management and care.
Fever in a traveler returning from Kenya Christensen, Christoffer Ellegård; Katzenstein, Terese L.; Helleberg, Marie
Travel medicine and infectious disease,
11/2024, Letnik:
62
Journal Article
The risk of severe adult respiratory coronavirus-2 (SARS-CoV-2) infection and the course of the infection among individuals with common variable immunodeficiency (CVID) relative to the general ...population have been a matter of debate. We conducted a Danish nationwide study comparing the timing of SARS-CoV-2 vaccination, the risk of first confirmed SARS-CoV-2 infection, re-infection, and the outcome of infection among individuals with CVID relative to an age- and gender matched control group. Cox regression was used to calculate incidence rate ratios. The CVID patients received SARS-CoV-2 vaccinations earlier than those included in the population control group. Even so, the risks of both first infection and re-infection were increased among the individuals with CVID. The CVID group also had increased risk for hospital contacts due to SARS-CoV-2 infection relative to the general population. However, reassuringly, the risk of mechanical ventilation and death did not differ between the groups, but the numbers were low in both groups, making the estimates uncertain. Though this is the largest study to investigate the risk of SARS-CoV-2 infections and outcomes hereof among individuals with CVID relative to the general population, we cannot rule out minor differences in severity, which might only be detectable with an even larger sample size.
The aim of this study was to describe the clinical symptoms, including affection of sense of smell and taste, among participants in a party held in Copenhagen after which many participants reported ...symptoms compatible with coronavirus disease 2019 (COVID-19).
A 37-item questionnaire was sent electronically to all 95 participants seven weeks after the party. The questionnaire included questions about the type, timing and duration of COVID-19 symptoms.
In total, 65 of 95 (68%) participants responded, among whom 51/65 (78%) had symptoms compatible with COVID-19; 53% (27/51) had affection of their sense of smell and taste; 70% (19/27) reported a total loss of taste. These symptoms continued for 1-3 weeks for 78% and 3-6 weeks for 22% (6/27). Interestingly, 11/27 (41%) reported that they had not fully regained their sense of taste and 3/27(11%) were still very affected by this symptom. Moreover, 44% of the respondents who had lost their sense of taste perceived this symptom as moderate to severe. Eighty-one percent (22/27) reported a total loss of smell. This symptom continued for 1-3 and > 3 weeks in 74% and 26%, respectively. At the time of the investigation, 48% had not fully regained their sense of smell and 7% were still very affected. More than half of the respondents who lost their sense of smell perceived this symptom as moderate to severe.
Many patients with clinically diagnosed COVID-19 report an affected sense of smell and taste. The duration of these symptoms currently remains unknown.
none.
not relevant.
Exposures to human immunodeficiency (HIV) and antiretroviral therapy in utero may have adverse effects on infant growth. Among children born in Denmark and aged 0-5 years, we aimed to compare ...anthropometric outcomes in HIV-exposed but uninfected (HEU) children with those in children not exposed to HIV.
In a nationwide register-based study we included all singleton HEU children born in Denmark in 2000-2016. HEU children were individually matched by child sex, parity, and maternal place of birth to 5 singleton controls born to mothers without HIV. Weight-for-age z (WAZ) scores, length-for-age z (LAZ) scores, and weight-for-length or body mass index-for-age z scores were generated according to the World Health Organization standards and the Fenton growth chart for premature infants. Differences in mean z scores were analyzed using linear mixed models, both univariate and adjusted for social and maternal factors.
In total, 485 HEU children and 2495 HIV-unexposed controls were included. Compared with controls, HEU children were smaller at birth, with an adjusted difference in mean WAZ and LAZ scores of -0.29 (95% confidence interval CI, -.46 to -.12) and -0.51 (95% CI, -.71 to -.31), respectively (both P ≤ .001). Over time, there was a trend toward increasing WAZ and LAZ scores in HEU children, and there was no significant difference in adjusted WAZ scores after age 14 days (-0.13 95% CI, -.27 to .01; P = .07) and LAZ scores after age 6 months (-0.15 95% CI, -.32 to .02; P = .08).
Compared with a matched control group, HEU children were smaller at birth, but this difference decreased with time and is not considered to have a negative effect on the health and well-being of HEU children during early childhood.
Many patients exhibit persistently reduced pulmonary diffusing capacity after coronavirus disease 2019 (COVID‐19). In this study, dual test gas diffusing capacity for carbon monoxide and nitric oxide ...(DL,CO,NO) metrics and their relationship to disease severity and physical performance were examined in patients who previously had COVID‐19. An initial cohort of 148 patients diagnosed with COVID‐19 of all severities between March 2020 and March 2021 had a DL,CO,NO measurement performed using the single‐breath method at 5.7 months follow‐up. All patients with at least one abnormal DL,CO,NO metric (n = 87) were revaluated at 12.5 months follow‐up. The DL,CO,NO was used to provide the pulmonary diffusing capacity for nitric oxide (DL,NO), the pulmonary diffusing capacity for carbon monoxide (DL,CO,5s), the alveolar–capillary membrane diffusing capacity and the pulmonary capillary blood volume. At both 5.7 and 12.5 months, physical performance was assessed using a 30 s sit‐to‐stand test and the 6 min walk test. Approximately 60% of patients exhibited a severity‐dependent decline in at least one DL,CO,NO metric at 5.7 months follow‐up. At 12.5 months, both DL,NO and DL,CO,5s had returned towards normal but still remained abnormal in two‐thirds of the patients. Concurrently, improvements in physical performance were observed, but with no apparent relationship to any DL,CO,NO metric. The severity‐dependent decline in DL,NO and DL,CO observed at 5.7 months after COVID‐19 appears to be reduced consistently at 12.5 months follow‐up in the majority of patients, despite marked improvements in physical performance.
What is the central question of this study?
To what extent do changes in pulmonary diffusing capacity observed 6 months after coronavirus disease 2019 (COVID‐19) persist after a year?
What is the main finding and its importance?
In patients who have had COVID‐19, the changes in pulmonary diffusing capacity for carbon monoxide and nitric oxide, the alveolar–capillary membrane diffusing capacity and pulmonary capillary blood volume observed at approximately 6 months follow‐up largely persist 1 year after the acute disease, despite a marked improvement in physical performance.
PurposeThe purpose of the Danish HIV Birth Cohort (DHBC) is to investigate the significance of HIV-1 infection in pregnancy and after delivery in women living with HIV (WLWH) in Denmark and their ...children, in the era of antiretroviral therapy and other interventions for treatment and prophylaxis.ParticipantsAll WLWH giving birth to one or more children in Denmark after 31 December 1999 are included, with consecutive ongoing enrolment, if they are living with HIV and pregnant, or if they are diagnosed with HIV in relation to pregnancy, delivery or shortly after delivery.Findings to dateDHBC has been used to describe trends in the management of pregnancies in WLWH and their outcomes on a nationwide basis, mode of delivery and predictors of emergency caesarean section as well as risk factors during pregnancy in WLWH for birth-related complications compared with women from the general population (WGP). We have found that HIV-exposed, but uninfected (HEU) children born to WLWH had a lower median birth weight and gestational age and were at higher risk of intrauterine growth retardation than children born to WGP. We have investigated risk of in-hospital admission and use of antibiotics during the first 4 years of life among HEU children and showed that HEU children had an increased risk of overall hospital admission compared with a matched control group of unexposed children.Further, we compared anthropometric outcomes in children with a matched control group of children not exposed to HIV.Future plansTo continuously investigate the significance of HIV infection and antiretroviral therapy in pregnancy and after delivery in WLWH in Denmark and their HEU children and compare these findings with children born to WGP.
The success of antiretroviral therapy has normalized pregnancy among women living with HIV (WWH) with a very low risk of perinatal transmission of HIV. Despite these advances, WWH still face complex ...medical and psychosocial issues during pregnancy and postpartum. The aim of this study was to assess differences in psychosocial health outcomes between pregnant WWH, non-pregnant WWH, and pregnant women without HIV, and further identify factors associated with probable depression in the third trimester and postpartum.
In a longitudinal survey study, participants were included from sites in Denmark, Finland, and Sweden during 2019-2020. Data was collected in the 3rd trimester, 3 and 6 months postpartum using standardized questionnaires assessing depression, perceived stress, loneliness, and social support. Mixed regression models were used to assess changes over time within and between groups. Logistic regression models were used to identify factors associated with depression in pregnancy and postpartum.
A total of 47 pregnant WWH, 75 non-pregnant WWH, and 147 pregnant women without HIV were included. The prevalence of depression was high among both pregnant and non-pregnant WWH. There was no significant difference between pregnant and non-pregnant WWH in depression scores, perceived stress scores, or social support scores at any time point. Compared to pregnant women without HIV, pregnant WWH reported worse outcomes on all psychosocial scales. Social support and loneliness were associated with an increased odds of depressive symptoms in the adjusted analysis.
A high burden of adverse psychosocial outcomes was observed in both pregnant and non-pregnant women living with HIV compared to pregnant women without HIV. Loneliness and inadequate social support were associated with increased odds of depression in pregnancy and should be a focus in future support interventions.
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