Is Sjögren's syndrome a retroviral disease?

Circumstantial evidence suggests that retroviruses play a role in the pathogenesis of Sjögren's syndrome. Such evidence, derived from studies of patients with Sjögren's syndrome, includes the following: the presence of serum antibodies cross-reactive with retroviral Gag proteins; the occurrence of reverse transcriptase activity in salivary glands; the detection of retroviral antigens, retrovirus-like particles, or novel retroviral sequences in salivary glands; the occurrence of Sjögren's syndrome-like illnesses in patients having confirmed systematic infections with retroviruses such as human immunodeficiency virus-1 (HIV-1) and human T lymphotropic virus type 1; and the beneficial effect of anti-retroviral treatment on the occurrence of HIV-1-associated sicca syndrome. Additional evidence is provided by animal models

Sexually Transmitted Infections in a Cohort of 15,921 Refugees (1926-1940) in the Region of Imathia, Northern Greece

This historical epidemiological study evaluates sexually transmitted infections (STIs) among Greek refugees during the Interwar period in the region of Imathia, Central Macedonia, Greece, as a part of the effort against sexually transmitted infections in Greece (1910-1940). We examined the archives of the Refugee Hospital of Veroia – the capital of the regional unit of Imathia (March 5, 1926 to October 27, 1940). This is a report of previously unpublished primary material comprising a cohort of 15,921 cases, among whom 41 patients were hospitalized on account of syphilis and 19 on account of gonococcal infection. Descriptive statistics were estimated. Primary (n=4), secondary (n=2), tertiary (n=13), congenital (n=7), and not further specified (n=15) cases of syphilis were identified, whereas a variety of differential diagnosis problems arose. Syphilis and gonococcal infection/gonorrhea seemed to affect various social groups, as evidenced by the variety of professions involved. Refugee patients originated from various areas such as Caucasus, Thrace, Constantinople, Bithynia, and Pontus. Lack of information and poor healthcare led to spreading of STIs in Greece. Law 3032/1922 was crucial for the Greek effort against sexually transmitted infection

Sexually Transmitted Infections in a Cohort of 15,921 Refugees (1926-1940) in the Region of Imathia, Northern Greece

This historical epidemiological study evaluates sexually transmitted infections (STIs) among Greek refugees during the Interwar period in the region of Imathia, Central Macedonia, Greece, as a part of the effort against sexually transmitted infections in Greece (1910-1940). We examined the archives of the Refugee Hospital of Veroia – the capital of the regional unit of Imathia (March 5, 1926 to October 27, 1940). This is a report of previously unpublished primary material comprising a cohort of 15,921 cases, among whom 41 patients were hospitalized on account of syphilis and 19 on account of gonococcal infection. Descriptive statistics were estimated. Primary (n=4), secondary (n=2), tertiary (n=13), congenital (n=7), and not further specified (n=15) cases of syphilis were identified, whereas a variety of differential diagnosis problems arose. Syphilis and gonococcal infection/gonorrhea seemed to affect various social groups, as evidenced by the variety of professions involved. Refugee patients originated from various areas such as Caucasus, Thrace, Constantinople, Bithynia, and Pontus. Lack of information and poor healthcare led to spreading of STIs in Greece. Law 3032/1922 was crucial for the Greek effort against sexually transmitted infection

HIV patients treated with low-dose prednisolone exhibit lower immune activation than untreated patients

HIV-associated general immune activation is a strong predictor for HIV disease progression, suggesting that chronic immune activation may drive HIV pathogenesis. Consequently, immunomodulating agents may decelerate HIV disease progression. In an observational study, we determined immune activation in HIV patients receiving low-dose (5 mg/day) prednisolone with or without highly-active antiretroviral therapy (HAART) compared to patients without prednisolone treatment. Lymphocyte activation was determined by flow cytometry detecting expression of CD38 on CD8(+) T cells. The monocyte activation markers sCD14 and LPS binding protein (LBP) as well as inflammation markers soluble urokinase plasminogen activated receptor (suPAR) and sCD40L were determined from plasma by ELISA. CD38-expression on CD8+ T lymphocytes was significantly lower in prednisolone-treated patients compared to untreated patients (median 55.40% [percentile range 48.76-67.70] versus 73.34% [65.21-78.92], p = 0.0011, Mann-Whitney test). Similarly, we detected lower levels of sCD14 (3.6 μg/ml [2.78-5.12] vs. 6.11 μg/ml [4.58-7.70]; p = 0.0048), LBP (2.18 ng/ml [1.59-2.87] vs. 3.45 ng/ml [1.84-5.03]; p = 0.0386), suPAR antigen (2.17 μg/ml [1.65-2.81] vs. 2.56 μg/ml [2.24-4.26]; p = 0.0351) and a trend towards lower levels of sCD40L (2.70 pg/ml [1.90-4.00] vs. 3.60 pg/ml [2.95-5.30]; p = 0.0782). Viral load in both groups was similar (0.8 × 105 ng/ml [0.2-42.4 × 105] vs. 1.1 × 105 [0.5-12.2 × 105]; p = 0.3806). No effects attributable to prednisolone were observed when patients receiving HAART in combination with prednisolone were compared to patients who received HAART alone.\ud Patients treated with low-dose prednisolone display significantly lower general immune activation than untreated patients. Further longitudinal studies are required to assess whether treatment with low-dose prednisolone translates into differences in HIV disease progression

CD4 cell count response to first-line combination ART in HIV-2+patients compared with HIV-1+patients: a multinational, multicohort European study

BACKGROUND: CD4 cell recovery following first-line combination ART (cART) is poorer in HIV-2+ than in HIV-1+ patients. Only large comparisons may allow adjustments for demographic and pretreatment plasma viral load (pVL). METHODS: ART-naive HIV+ adults from two European multicohort collaborations, COHERE (HIV-1 alone) and ACHIeV2e (HIV-2 alone), were included, if they started first-line cART (without NNRTIs or fusion inhibitors) between 1997 and 2011. Patients without at least one CD4 cell count before start of cART, without a pretreatment pVL and with missing a priori-defined covariables were excluded. Evolution of CD4 cell count was studied using adjusted linear mixed models. RESULTS: We included 185 HIV-2+ and 30321 HIV-1+ patients with median age of 46 years (IQR 36–52) and 37 years (IQR 31–44), respectively. Median observed pretreatment CD4 cell counts/mm3 were 203 (95% CI 100–290) in HIV-2+ patients and 223 (95% CI 100–353) in HIV-1+ patients. Mean observed CD4 cell count changes from start of cART to 12 months were +105 (95% CI 77–134) in HIV-2+ patients and +202 (95% CI 199–205) in HIV-1+ patients, an observed difference of 97 cells/mm3 in 1 year. In adjusted analysis, the mean CD4 cell increase was overall 25 CD4 cells/mm3/year lower (95% CI 5–44; P = 0.0127) in HIV-2+ patients compared with HIV-1+ patients. CONCLUSIONS: A poorer CD4 cell increase during first-line cART was observed in HIV-2+ patients, even after adjusting for pretreatment pVL and other potential confounders. Our results underline the need to identify more potent therapeutic regimens or strategies against HIV-2

Lactobacillus rhamnosus endocarditis complicating colonoscopy

We report the first case of endocarditis caused by Lactobacillus after an uneventful colonoscopy. The initial empiric treatment with the standard regimen of penicillin-aminoglycoside failed; Subsequent treatment with a combination of antibiotics, selected according to the in vitro studies, was successful. (C) 2001 The British Infection Society

Fatal nucleoside-associated lactic acidosis in an obese woman with human immunodeficiency virus type 1 infection on a very low-calorie diet

This study reports the case of an obese woman with human immunodeficiency virus type 1 (HIV-1) infection who developed fatal nucleoside-associated lactic acidosis 10 d after she started a weight-loss dietary regimen containing 600 kcal/d. This case suggests that very low-calorie diets may be life threatening for HIV-infected patients receiving nucleoside analogues