The need for an integrated pharmacological response to the treatment of HIV/AIDS and depression

Introduction: The coexistence of depression and HIV infection affects more than 9 million people worldwide. A literature review revealed a large gap regarding the pharmacotherapy of depression among patients dually diagnosed with HIV and depression. Areas covered:In this review, the authors covered the various dimensions of deploying integrated pharmacological treatment of HIV/AIDS and depression. This topic was addressed in two ways; first, the direct results of integrated pharmacotherapy in syndemic patients; second, the indirect effects of the integrated model on other outcomes of HIV care. Expert opinion: An integrated pharmacological response to the treatment of HIV and depression can bring substantial benefits to HIV outcomes and reduce the burden of both diseases. The direct advantages regarding pharmacological response to the treatment of depression along with HIV care are improving adherence to antiretroviral therapy, optimizing pharmacotherapy, minimizing drug interaction, and prevention of additive adverse drug reactions. Furthermore, in some cases, medication can target both depression and other neuropsychiatric or somatic comorbidities among people living with HIV/AIDS. The integrated pharmacotherapy also has some potential indirect advantages on HIV care outcomes like minimizing loss of care, reducing ongoing HIV transmission, and improving the outcomes of both diseases

Vitamin C and kidney transplantation: Nutritional status, potential efficacy, safety, and interactions

Background and aim: There are several observational and interventional studies regarding the advantages of sufficient serum levels of vitamin C and the evaluation of the effects of vitamin C supplementation post kidney transplantation. These studies have been put together to investigate the role of vitamin C post-kidney transplantation and make suggestions for designing future studies based on the use of vitamin C supplements or nutritional interventions among these patients. Methods: This narrative review was done by searching in the Embase, PubMed, and SCOPUS databases. Results: The results are presented in several sections as follows; nutritional status, potential protective effects, safety concerns, and medications/laboratory tests interactions of vitamin C. Conclusions: Kidney transplant recipients are prone to vitamin C deficiency, which is related to higher mortality based on several long-term observational studies. Vitamin C supplementation improves endothelial function and creatinine clearance. Vitamin C is considered as a safe supplement, however, side effects such as kidney stones, pro-oxidant effect, hemolysis in patients with glucose-6-phosphate dehydrogenase deficiency, impact on lymphocytic activity, acid-base disturbance, and increased sodium load following its administration have been reported. Interaction of vitamin C and cyclosporine is the most important interaction with post-renal transplant medications. Vitamin C also interferes with creatinine assay using Jaffe and enzymatic methods

Antineutrophil Cytoplasmic Antibody (ANCA)-associated vasculitis following COVID-19 BBIBP-CorV vaccine: A case report

COVID-19 and its vaccination could initiate autoimmunity including ANCA-associated vasculitis that could mimic COVID-19 infection symptoms. This misdiagnosis could increase the morbidity of AAV. Herein a case of AAV post-BBIBP-CorV (Sinopharm) COVID-19 vaccine was reported. A 32-years-old woman was admitted with flu-like symptoms, flank pain, hemoptysis, hematuria, and oliguria following the second dose of BBIBP-CorV vaccination. Due to her severe clinical course, she needed ICU care while plasma exchange, renal replacement therapy, corticosteroid pulse, and tocilizumab were the primary therapies that improved her symptoms. After more evaluation, she was diagnosed with AAV, and conservative therapy was initiated. Her pulmonary condition and renal function were resolved gradually. Reports of post-COVID-19 vaccination raised the need for assessment of the immune response caused by these vaccines. Physicians also should be aware of the misdiagnosis of AAV and other infectious diseases