BK virus associated meningoencephalitis in an AIDS patient treated with HAART

A severely immune-suppressed AIDS patient was suspected of suffering from BK virus (BKV) meningoencephalitis, after being studied for common causes of neurological complications of co-infectious origin. Polymerase chain reaction (PCR) and sequence analysis of cerebrospinal fluid and brain samples, confirmed the presence of BKV. His clinical condition improved along with the regression of brain lesions, after modifications on his antiretroviral regime. Five months after discharge, the patient was readmitted because of frequent headaches, and a marked inflammatory reaction was evidenced by a new magnetic resonance imaging (MRI). The symptoms paralleled a rising CD4+ lymphocyte count, and immune reconstitution syndrome was suspected. This is the first non-postmortem report of BKV meningoencephalitis in an AIDS patient, showing clinical and radiographic improvement solely under HAART

New insights into HIV-1-primary skin disorders

Since the first reports of AIDS, skin involvement has become a burdensome stigma for seropositive patients and a challenging task for dermatologist and infectious disease specialists due to the severe and recalcitrant nature of the conditions. Dermatologic manifestations in AIDS patients act as markers of disease progression, a fact that enhances the importance of understanding their pathogenesis

Gliomas and brain lymphomas in HIV-1/AIDS patients: reflections from a 20-year follow up in Mexico and Brazil

Opportunistic infections and invasive primary tumors represent major causes of morbidity and mortality in HIV-1-infected individuals. HIV-1 involvement of the central nervous system (CNS) affects nearly half of seropositive patients, being the primary CNS lymphoma (PCNSL) a hallmark neoplasia of this population. Interestingly, the incidence of other brain tumors (e.g. gliomas) is exceedingly rare in AIDS patients, and their co-morbidity has been limited to case reports. Here, we share our 20-year experience following brain tumors in HIV-1/AIDS patients from major referral hospitals in Mexico and Brazil. Additionally, we provide the most updated compilation of reported glioma cases in AIDS patients, with a thorough epidemiological analysis. Furthermore, we discuss HIV-1-driven mechanisms that would theoretically increase malignant transformation of glial cells; while offering newly reported explanations as to why protease inhibitors, key components of multi-drug anti-retroviral schemes, may be responsible for such a low co-incidence of gliomas in HIV-1 infected individuals.<p> </p

Improved pruritus correlates with lower levels of IL-31 in CTCL patients under different therapeutic modalities

Pruritus is one of the cardinal symptoms found in patients with leukemic cutaneous T cell lymphoma (CTCL). The nature of the pruritus experienced by CTCL patients is complex, involving different pathways and cell mediators, thus making it poorly responsive to conventional anti-itch therapies. Recent reports highlight the role of interleukin 31 (IL-31) as a novel cytokine involved in the pathogenesis of pruritus in atopic dermatitis and CTCL. Here we provide both in vivo and in vitro evidence suggesting that histone deacetylase (HDAC) inhibitors may mitigate itch through lowering of levels of IL-31-expressing T cells. Furthermore, we demonstrate that chemokine receptor type-4 (CCR4)-bearing T cells are a main source of IL-31 in CTCL, and that neutralizing the IL-31 pathway through targeting of the CCR4-expressing T cells may represent a promising therapeutic strategy for symptomatic relief in CTCL