Internal Medicine Commons^™

Manajemen Koinfeksi Malaria Berat Dengan Hiv Belum Mendapat Terapi Antiretrovirus Di Era Pandemi Covid-19: Sebuah Laporan Kasus, Paul Harijanto, Rosye Mawuntu, Novia Rusli, Randy Adiwinata, Agung Nugroho

Jurnal Penyakit Dalam Indonesia

Severe malaria is a serious infectious disease that required immediate diagnosis and prompt treatment. Severe malaria may result several organ failures which is similar with other infectious diseases like SARS-CoV-2, sepsis, dengue, and HIV infection. Most of those infection have similar symptoms such as fever, myalgia, and headache, therefore physician should have high suspicion regarding co-infection with other infectious agents. The overlapping symptoms of co-infections may become a challenge for physician in diagnosing and delivering prompt therapy. Failure to deliver prompt treatment may lead to fatal outcome such as in severe malaria case. Stigmatization of all patients with fever and …

Tenofovir Induced Hypokalaemia - A Case Report, Ankisha Gupta, Kiran P. K, Rajendra Prasad S

Digital Journal of Clinical Medicine

Tenofovir, an important medication for HIV/AIDS, carries the risk of hypokalemia in patients receiving treatment. Factors such as dietary deficits, vomiting, or diarrhea further increase this risk. Tenofovir acts as a mitochondrial toxin by inhibiting the DNA polymerase gamma enzyme, crucial for mitochondrial DNA replication. Consequently, ATP generation is depleted through the aerobic pathway, leading to dysfunction in the proximal tubule. This dysfunction manifests as renal acidosis type 2, which involves reduced bicarbonate excretion by the proximal tubule, resulting in renal bicarbonate wasting and decreased serum bicarbonate levels. Consequently, the lumen of the distal nephron becomes negatively charged, leading to …

Use Of Long-Acting Injectable Cabotegravir And Rilpivirine As An Alternative For Treatment In Hiv Positive Patients, Aravindh Nirmalan

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using

Mantsios A, Murray M, Karver TS, et al. Efficacy and Freedom: Patient Experiences with the Transition from Daily Oral to Long-Acting Injectable Antiretroviral Therapy to Treat HIV in the Context of Phase 3 Trials. AIDS Behav. 2020;24(12):3473-3481. https://doi.org/10.1007/s10461-020-02918-x

for a young adult patient struggling with adherence.

Characterization Of Age-Associated Gut Microbial Dysbiosis And Plasma Metabolite Alterations In People Living With Hiv (Plwh)., R. Sighal, Smita Ghare, Vaughn Bryant, Sabina Gautam, Chanakya Charan Tirumala, Andrea Reyes-Vega, Craig J. Mcclain, Ronald Cohen, Varand Govind, R L. Cook, Shirish Barve

Faculty Scholarship

Background: HIV-1 infection and aging are independently associated with gut microbial dysbiosis and neurocognitive impairment. However, the interactive effects of HIV-infection and aging on the development of specific pathogenic features of gut microbial dysbiosis and consequent metabolic abnormalities associated with neurocognitive dysfunction remain largely undetermined and were examined in the present study

Signs Of Psychosis Leading To A Diagnosis Of Progressive Multifocal Leukoencephalopathy: A Case Report, Bryan L. Walker, Christina Holt Md, Msc

Journal of Maine Medical Center

Introduction: Progressive multifocal leukoencephalopathy (PML) is a rare demyelinating process of the central nervous system that occurs in in the setting of severe immunocompromise. Patients with PML develop varying focal neurological deficits and mental status changes that have not been well-described previously.

Clinical findings: We present a patient who was found by security wandering the lobby of this hospital. He was oriented only to self and unable to state a reason for presentation. Medical records were limited and included a visit to an outside hospital that documented a past medical history of HIV infection. He exhibited multiple signs of psychosis …

Anidulafungin: A Noninferior Alternative To Fluconazole For Treatment Of Esophageal Candidiasis, Blake S. Sanford

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Krause DS, Simjee AE, van Rensburg C, et al. A randomized, double-blind trial of anidulafungin versus fluconazole for the treatment of esophageal candidiasis. Clin Infect Dis. 2004;39(6):770-775. doi: 10.1086/423378.

A Sex-Positive Approach To Healthcare, And Truvada As Hiv Pre-Exposure Prophylaxis (Prep), Michael Ohkura, Nicholas Bonefant, Michael D. Upton

Larner College of Medicine Faculty Publications

Nationally, incidence of new HIV infections has hovered around over 50,000 per year and men who have sex with men (MSM) carry the largest burden. In Vermont, 56% of individuals newly diagnosed are MSM, with 25% of diagnoses among youth ages 13-24 years old. Despite the proven efficacy and approval of daily Truvada (emtricitabine + tenofovir) as Pre-Exposure Prophylaxis (PrEP) against HIV infection, provider understanding and awareness of its use has remained extremely limited in Vermont with last estimates at just over 9 providers familiar with PrEP (excluding UVM Student Health, Planned Parenthood, and UVM Medical Center infectious disease department). …

Persistence Of Macrocytosis After Discontinuation Of Zidovudine In Hiv-Infected Patients, Inski Yu, Richard N. Greenberg, Timothy N. Crawford, Alice C. Thornton, Thein Myint

Internal Medicine Faculty Publications

The duration of macrocytosis after stopping zidovudine (ZDV) is unknown. Among 104 HIV-infected patients treated with ZDV for more than 1 year, 84 patients had macrocytosis at ZDV discontinuation. The median mean corpuscular volume (MCV) was 114.6 fL (range 100-128 fL). Patients were divided into 2 groups: those who did (resolved macrocytosis, n = 36) and did not (persistent macrocytosis, n = 48) normalize MCV at 3 to 6 months after ZDV discontinuation. Alcohol use (P = .02), smoking (P = .03), and lower (but within normal range) folic acid levels (P = .05) were related to …

Retention In Continuous Care And Sustained Viral Suppression: Examining The Association Among Individuals Living With Hiv, Timothy N. Crawford, Alice C. Thornton

Internal Medicine Faculty Publications

Objectives: To examine the relationship between retention in continuous care and sustained viral suppression.

Methods: The authors retrospectively followed 653 persons who were virally suppressed and seeking care at an infectious disease clinic in Kentucky for an average of 6 years to determine the rates of retention in medical care (≥2 visits separated by ≥3 months within a 12-month period) and sustained viral suppression (<400 copies/mL). A generalized linear mixed model was used to determine an association between retention and suppression over time.

Results: Approximately 61% of the study population were retained in continuous care and 75% had sustained viral suppression for all patient-years. Persons retained in care were 3 times the odds of sustaining viral suppression over …

Facilitating Hiv Pre-Exposure Prophylaxis (Prep) Familiarity Among Vermont Primary Care Providers, Michael Ohkura

Family Medicine Clerkship Student Projects

Please see the updated version of this presentation: Ohkura, Michael; Bonefant, Nicholas; and Upton, Michael D., "A Sex-Positive Approach to Healthcare, and Truvada as HIV Pre-Exposure Prophylaxis (PrEP)" (2018). College of Medicine Faculty Publications. 3. https://scholarworks.uvm.edu/comfac/3

Nationally, incidence of new HIV infections has hovered around over 50,000 per year and men who have sex with men (MSM) carry the largest burden. In Vermont, 56% of individuals newly diagnosed are MSM, with 25% of diagnoses among youth ages 13-24 years old. Despite the proven efficacy and approval of daily Truvada (emtricitabine + tenofovir) as Pre-Exposure Prophylaxis (PrEP) against HIV infection, …