• Archives of Plastic Surgery
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• v.42 no.6
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• pp.776-782
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• 2015

It is believed that surgery on human immunodeficiency virus (HIV)-positive patients is dangerous and should be avoided due to the possibility of postoperative infection of the patients or HIV occupational transmission to the medical staff. We discuss here the preparations and measures needed to conduct surgery safely on HIV-positive patients, based on our experience. We performed sex reassignment surgery on two HIV-positive patients from January 2013 to January 2015. Both of them were receiving highly active antiretroviral therapy and were asymptomatic, with a normal CD4 count ($>500cells/{\mu}L$). The HIV-RNA was undetectable within the bloodstream. All the staff wore protective clothing, glasses, and three pairs of protective gloves in the operating room because of the possibility of transmission. Prophylactic antibiotics were administered to the patients, and antiviral therapy was performed during their perioperative course. Neither of the patients had postoperative complications, and none of the medical staff experienced accidental exposure. Both patients had satisfactory surgery outcomes without complications. HIV-positive patients can undergo surgery safely without increased risk of postoperative complications or HIV transmission to the staff through the proper use of antibiotics, active antiretroviral therapy, and supplemental protective measures with post-exposure prophylaxis for the staff in case of HIV exposure.

• RED RIBBON
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• s.58
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• pp.16-19
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• 2004

에이즈는 HIV$^{human immunodeficiency virus}$라는 바이러스에 의해 유발되므로 에이즈를 치료하기 위해서는 HIV를 우리 몸속에서 박멸하여야 한다. 1987년 AZT가 최초로 FDA의 공인을 받은 이래로 현재까지 여러 가지 약제들이 에이즈 치료에 사용되고 있다. 아직까지 HIV를 박멸하여 에이즈를 완치할 수 있는 치료제는 개발되지 않고 있으나 에이즈 치료제를 3가지 이상 복용하는 강력한 항레트로바이러스 요법highly active antiretroviral therapy, HAART을 시행함으로써 손상된 면역 기능을 회복시키고 기회감염을 줄여 좋은 효과를 보인다. 에이즈 치료제는 크게 세가지로 나눌 수 있다. 첫째는 뉴클레오사이드 역전사효소 억제제이고 둘째는 비뉴클레오사이드 역전사효소 억제제, 셋째는 단백분해효소 억제제이다. 현재 우리나라에서 사용되는 에이즈 치료제에 대해 알아보도록 하자.

• The Journal of the Korean life insurance medical association
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• v.29 no.1
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• pp.4-6
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• 2010

The life expectancy of HIV-infected subjects has improved dramatically since the introduction of highly-active antiretroviral therapy (HAART). Considering that patients with HIV infection are living longer, treatment plans should include those for the accompanying co-morbidities such as cardiovascular diseases, metabolic syndrome, malignancy, etc. This review discusses the impact of HAART on the epidemiology of survival and co-morbidities (malignancy and cardiovascular diseases) among HIV-infected subjects.

• Journal of the Korean Burn Society
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• v.22 no.2
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• pp.21-24
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• 2019

Incidence of low-temperature contact burn by use of an electric pad is increased recently, especially in depressed sensory. Acquired immune deficiency syndrome patient using antiretroviral agent suffered with sensory depression as side effect. There are many limitations in wounds treatment of these patients. These patients are vulnerable to infection due to their weak immunity, so it is necessary to keep them in a state of isolation when a wound occurs. We report a case of a third degree burn by electric pad with a surface area of approximately 5% of the body surface of a patient who underwent a sensory depression, which is a side effect of antiretroviral drugs used for treatment in patients with AIDS. In this regard, we report the case with literature review, which is safely recovered using negative-pressure wound therapy and split-thickness skin graft.

• Journal of the Korean neurological association
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• v.36 no.4
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• pp.337-340
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• 2018

Human immunodeficiency virus (HIV) infection can result in ischemic stroke via several mechanisms, including opportunistic infection, vasculopathy, cardioembolism, and coagulopathy. HIV-vasculopathy is related to endothelial dysfunction, stenosis and aneurysm formation, infectious vasculitis, dissection and accelerated atherosclerosis during highly active antiretroviral therapy (HAART). We represent a case of HIV infection manifested as an acute ischemic stroke attack. After 4 months during HAART, our patient experienced a recurrent ischemic stroke with progression of middle cerebral artery stenosis.

• Journal of Preventive Medicine and Public Health
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• v.49 no.6
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• pp.394-405
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• 2016

Objectives: The survival outcomes of antiretroviral treatment (ART) programs have not been systematically evaluated at the state level in India. This retrospective study assessed the survival rates and factors associated with survival among adult human immunodeficiency virus (HIV)-infected patients in Andhra Pradesh, India. Methods: The present study used data from 139 679 HIV patients aged ${\geq}15$ years on ART who were registered from 2007 to 2011 and were followed up through December 2013. The primary end point was death of the patient. Mortality densities (per 1000 person-years) were calculated. Kaplan-Meier and Cox-regression models were used to estimate survival and explore the factors associated with survival. Results: The overall median follow-up time was 16.0 months (2.0 months for the deceased and 14.0 months for those lost to follow-up). Approximately 13.2% of those newly initiated on ART died during follow-up. Of those deaths, 56% occurred in the first three months. The crude mortality rate was 80.9 per 1000 person-years at risk. The CD4 count (adjusted hazard ratio [aHR],4.88; 95% confidence interval [CI], 4.36 to 5.46 for < $100cells/mm^3$ vs. > $350cells/mm^3$), functional status (aHR, 3.05; 95% CI, 2.82 to 3.30 for bedridden vs. normal), and body weight (aHR, 3.69; 95% CI, 3.42 to 3.97 for <45 kg vs. >60 kg) were strongly associated with the survival of HIV patients. Conclusions: The study findings revealed that high mortality was observed within the first three months of ART initiation. Patients with poor baseline clinical characteristics had a higher risk of mortality. Expanded testing and counseling should be encouraged, with the goal of ensuring early enrollment into the program followed by the initiation of ART in HIV-infected patients.

• Biomolecules & Therapeutics
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• v.22 no.6
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• pp.532-539
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• 2014

Peripheral neuropathy induced by human immunodeficiency virus (HIV) infection and antiretroviral therapy is not only difficult to distinguish in clinical practice, but also difficult to relieve the pain symptoms by analgesics because of the severity of the disease at the later stage. Hence, to explore the mechanisms of HIV-related neuropathy and find new therapeutic options are particularly important for relieving neuropathic pain symptoms of the patients. In the present study, primary cultured embryonic rat dorsal root ganglion (DRG) neurons were used to determine the neurotoxic effects of HIV-gp120 protein and/or antiretroviral drug dideoxycytidine (ddC) and the therapeutic actions of insulin-like growth factor-1 (IGF-1) on gp120- or ddC-induced neurotoxicity. DRG neurons were exposed to gp120 (500 pmol/L), ddC ($50{\mu}mol/L$), gp120 (500 pmol/L) plus ddC ($50{\mu}mol/L$), gp120 (500 pmol/L) plus IGF-1 (20 nmol/L), ddC ($50{\mu}mol/L$) plus IGF-1 (20 nmol/L), gp120 (500 pmol/L) plus ddC ($50{\mu}mol/L$) plus IGF-1 (20 nmol/L), respectively, for 72 hours. The results showed that gp120 and/or ddC caused neurotoxicity of primary cultured DRG neurons. Interestingly, the severity of neurotoxicity induced by gp120 and ddC was different in different subpopulation of DRG neurons. gp120 mainly affected large diameter DRG neurons (> $25{\mu}m$), whereas ddC mainly affected small diameter DRG neurons (${\leq}25{\mu}m$). IGF-1 could reverse the neurotoxicity induced by gp120 and/or ddC on small, but not large, DRG neurons. These data provide new insights in elucidating the pathogenesis of HIV infection- or antiretroviral therapy-related peripheral neuropathy and facilitating the development of novel treatment strategies.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.42 no.3
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• pp.169-172
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• 2016

Following anti-retroviral therapy (ART) or highly active antiretroviral therapy, there is an increased response to latent infections such as herpes zoster, which may lead to their reactivation. This is a result of improved immunity brought about by ART, also termed immune recovery syndrome. A 75-yearold male patient arrived at our institute with widespread vesicles and scabs on the right half of his face and oral cavity, suggesting the involvement of the trigeminal nerve. The patient had a history of being on ART two months earlier and a history of tooth extraction eight days prior to his arrival at our institute. The incidence of human immunodeficiency virus (HIV)-positive cases amongst herpes zoster cases is high, and these patients become susceptible to infections following ART. Therefore, regardless of the presence of risk factors, every herpes zoster patient should be tested for HIV infection, and high anti-retroviral therapy should be commenced/reinstituted as soon as possible. In addition, the treating physician should maintain a high level of vigilance for the patient during the first few months of ART, the peak incidence of immune recovery inflammatory disease.

• RED RIBBON
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• s.75
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• pp.5-7
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• 2007

에이즈 치료제로 강력한 항레트로바이러스 치료(highly active antiretroviral therapy;HAART)가 시작된 지 10년이 지났다. 그동안 효과적인 항레트로바이러스제의 가지 수도 늘었지만 좀 더 먹기 편하고, 부작용이 적은 약제 개발로 많은 발전이 있어왔다. HIV감염에 대한 최상의 치료는 효과적인 항레트로바이러스제를 적어도 3가지 약제 이상, 또한 2가지 계열 이상 병용하여 사용하는 칵테일요법이다. 현재의 이 약물치료는 효과적으로 에이즈 바이러스를 억제하고 기회 질환의 발생이나 사망을 현저하게 줄이는데 공헌하였다. 그러나 아직까지는 완치의 개념에는 도달하지 못하고 있다. 항레트로바이러스제의 적절한 사용은 혈중 HIV를 검출한계 미만으로 억제할 수 있고, CD4+ 림프구의 수를 증가시키는 치료효과를 보이지만 부수적으로 소수의 부작용이 동반될 수 있다. 여기서는 최근 국내에 들어와 있지 않거나 임상시험이 진행 중인 신약들과 기존 약제들 간의 차이점을 소개하고자 한다.

• Archives of Plastic Surgery
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• v.48 no.6
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• pp.685-690
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• 2021

Background Human immunodeficiency virus (HIV)-associated lipodystrophy is a known consequence of long-term highly active antiretroviral therapy (HAART). However, a significant number of patients on HAART therapy were left with the stigmata of complications, including fat redistribution. Few studies have described the successful removal of focal areas of lipohypertrophy with successful outcomes. This manuscript reviews the outcomes of excisional lipectomy versus liposuction for HIV-associated cervicodorsal lipodystrophy. Methods We performed a 15-year retrospective review of HIV-positive patients with lipodystrophy. Patients were identified by query of secure operative logs. Data collected included demographics, medications, comorbidities, duration of HIV, surgical intervention type, pertinent laboratory values, and the amount of tissue removed. Results Nine male patients with HIV-associated lipodystrophy underwent a total of 17 procedures. Of the patients who underwent liposuction initially (n=5), 60% (n=3) experienced a recurrence. There were a total of three cases of primary liposuction followed by excisional lipectomy. One hundred percent of these cases were noted to have a recurrence postoperatively, and there was one case of seroma formation. Of the subjects who underwent excisional lipectomy (n=4), there were no documented recurrences; however, one patient's postoperative course was complicated by seroma formation. Conclusions HIV-associated lipodystrophy is a disfiguring complication of HAART therapy with significant morbidity. Given the limitations of liposuction alone as the primary intervention, excisional lipectomy is recommended as the primary treatment. Liposuction may be used for better contouring and for subsequent procedures. While there is a slightly higher risk for complications, adjunctive techniques such as quilting sutures and placement of drains may be used in conjunction with excisional lipectomy.