• 식품보건융합연구
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• 제6권4호
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• pp.17-19
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• 2020

HIV/AIDS disease still remain a global pandemic and it's management has undergone series of treatment changes and improvement although there is still no permanent cure.Dolutegravir belongs to a group of HIV drugs called integrase inhibitors. Integrase inhibitors block an HIV enzyme called integrase. By blocking integrase, integrase inhibitors prevent HIV from multiplying and can reduce the amount of HIV in the body.Dolutegravir combination based regimen has turned out to be very effective (antiviral) with negligible rare side effects on clients. This drug (Dolutegravir based regimen) combination has successfully increased the appetite for food of all the clients, unlike others and has shown to reduce viral load in the most shortest period ever. It can be deduced that development of resistant mutant virus will be reduced if not eliminated with dolutogravir based regimen.The role of Continuous adherence counseling has shown to improve clients treatment management. It is important to note that the availability of food has direct effect on the economic status or financial weight on the client. Hence the progress that is increase in body mass index (BMI) is a direct impact of the availability of food for the clients.

• Gut and Liver
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• 제12권6호
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• pp.694-703
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• 2018

Background/Aims: Limited data exist comparing the safety and efficacy of direct-acting antivirals (DAAs) in hepatitis C virus (HCV) monoinfected and HCV/human immunodeficiency virus (HIV) coinfected patients in the real-world clinic practice setting. Methods: All HCV monoinfected and HCV/HIV coinfected patients treated with DAAs between January 2014 and October 2017 in community clinic settings were retrospectively analyzed. Pretreatment baseline patient characteristics, treatment efficacy, factors affecting sustained virologic response at 12 weeks (SVR12) after treatment, and adverse reactions were compared between the groups. Results: A total of 327 patients were included in the study, of which 253 were HCV monoinfected, and 74 were HCV/HIV coinfected. There was a statistically significant difference observed in SVR12 when comparing HCV monoinfection and HCV/HIV coinfection (94% and 84%, respectively, p=0.005). However, there were no significant factors identified as a predictor of a reduced response. The most common adverse effect was fatigue (27%). No significant drug interaction was observed between DAA and antiretroviral therapy. None of the patients discontinued the treatment due to adverse events. Conclusions: In a real-world setting, DAA regimens have lower SVR12 in HCV/HIV coinfection than in HCV monoinfection. Further studies involving a higher number of HCV/HIV coinfected patients are needed to identify real predictors of a reduced response.

• Journal of Ginseng Research
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• 제43권2호
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• pp.312-318
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• 2019

Background: To date, no study has described disease progression in Asian patients infected with HIV-1 subtype D. Methods: To determine whether the disease progression differs in patients infected with subtypes D and B prior to starting combination antiretroviral therapy, the annual decline (AD) in $CD^{4+}$ T cell counts over $96{\pm}59months$ was retrospectively analyzed in 163 patients and compared in subtypes D and B based on the nef gene. Results: $CD^{4+}$ T cell AD was significantly higher in the six subtype D-infected patients than in the 157 subtype B-infected patients irrespective of Korean Red Ginseng (KRG) treatment (p < 0.001). Of these, two subtype D-infected patients and 116 subtype B-infected patients had taken KRG. AD was significantly lower in patient in the KRG-treated group than in those in the $KRG-na{\ddot{i}}ve$ group irrespective of subtype (p < 0.05). To control for the effect of KRG, patients not treated with KRG were analyzed, with AD found to be significantly greater in subtype D-infected patients than in subtype B-infected patients (p < 0.01). KRG treatment had a greater effect on AD in subtype D-infected patients than in subtype B-infected patients (4.5-fold vs. 1.6-fold). Mortality rates were significantly higher in both the 45 $KRG-na{\ddot{i}}ve$ (p < 0.001) and all 163 (p < 0.01) patients infected with subtype D than subtype B. Conclusion: Subtype D infection is associated with a >2-fold higher risk of death and a 2.9-fold greater rate of progression than subtype B, regardless of KRG treatment.

• Infection and chemotherapy
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• 제50권4호
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• pp.350-356
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• 2018

In acquired immunodeficiency syndrome (AIDS) patients, immune reconstitution inflammatory syndrome (IRIS) due to Mycobacterium avium complex (MAC) infection is one of the most difficult IRIS types to manage. We report an unusual case of MAC-associated IRIS. At first the patient was diagnosed human immunodeficiency virus (HIV) infection after he was admitted with pneumocystis pneumonia. After starting antiretroviral therapy he presented unmasked IRIS with MAC infection. Next, he was hospitalized with continuous loose stools and new-onset fever. Investigation included computed tomography (CT), which showed homogeneous enhancement and enlargement of the lymph nodes (LN), elevation of ferritin (>1,650 ng/mL) and lactate dehydrogenase (306 IU/L) levels, and F- fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) scan, which showed increased FDG uptake. These findings were highly indicative of lymphoma. We performed laparoscopic biopsy of the mesenteric LN, and the biopsy culture grew MAC. So we made a diagnosis of MAC-associated. Therefore, IRIS must be considered as a possible diagnosis when AIDS patients develop new symptoms or exhibit exacerbations of existing symptoms. Furthermore the biopsies should be conducted.

• 대한영상의학회지
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• 제79권6호
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• pp.359-364
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• 2018

크립토코쿠스 수막염 면역재구성 염증증후군은 역설적 크립토코쿠스 수막염 면역재구성 염증증후군과 증상이 드러나는 크립토코쿠스 수막염 면역재구성 염증증후군의 두 가지 형태가 있다. 역설적 크립토코쿠스 수막염 면역재구성 염증증후군과 크립토코쿠스 수막염 재발을 구별하는 것은 중요하다. 왜냐하면 면역재구성 염증증후군 없는 크립토코쿠스 수막염보다 면역재구성 염증증후군이 있는 크립토 코쿠스 수막염의 사망율이 더 높고, 역설적 크립토코쿠스 수막염 면역재구성 염증증후군과 크립토코쿠스 수막염 재발은 다른 치료를 요구하기 때문이다. 우리는 인간면역결핍바이러스 감염환자의 3년의 추적기간 동안 임상 소견과 자기공명영상 소견이 잘 대조된 역설적 크립토코쿠스 수막염 면역재구성 염증증후군의 사례와 감별에 도움이 되는 새로운 자기공명영상 소견을 보고하고자 한다.

• Journal of Ginseng Research
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• 제46권6호
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• pp.731-737
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• 2022

Background: The number of primary human immunodeficiency virus (HIV)-1 non-B subtype infections (non-B) and that of reports regarding the differences in the pathogenesis of subtype B and non-B infections are increasing. However, to the best of our knowledge, there have been no reports on gross deletion in the nef gene (g∆nef) in non-B infections. Methods: To determine whether there is a difference in the change in CD4⁺ T cells after treatment with Korean Red Ginseng (KRG) between patients with subtype B and non-B infections, we retrospectively analyzed and compared the annual decrease in CD4⁺ T cells (AD) and the proportion of g∆nef in 77 patients who were followed for more than 10 years in the absence of combination antiretroviral therapy. Results: Overall, AD was significantly faster in patients with non-B infections than in those with subtype B infections. Survival analysis showed that the survival probability was significantly higher in subtype B than in non B-infected patients. These differences mainly resulted from significant differences in the amount of KRG and age. In the patients treated with KRG, there was a significant correlation between the amount of KRG and the AD in both subtypes. Interestingly, there was a significant correlation between the amount of KRG and the proportion of g∆nef in patients infected with subtype B, but not in those infected with non-B. The same phenomenon was observed when the KRG dose was adjusted. Conclusion: Our results suggest that non-B may be biologically more stable than subtype B.

• Journal of Preventive Medicine and Public Health
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• 제56권3호
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• pp.238-247
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• 2023

Objectives: Low adherence to antiretroviral (ARV) therapy in pregnant women with human immunodeficiency virus (HIV) increases the risk of virus transmission from mother to newborn. Increasing mothers' knowledge and motivation to access treatment has been identified as a critical factor in prevention. Therefore, this research aimed to explore barriers and enablers in accessing HIV care and treatment services. Methods: This research was the first phase of a mixed-method analysis conducted in Kupang, a remote city in East Nusa Tenggara Province, Indonesia. Samples were taken by purposive sampling of 17 people interviewed, consisting of 6 mothers with HIV, 5 peer facilitators, and 6 health workers. Data were collected through semi-structured interviews, focus group discussions, observations, and document review. Inductive thematic analysis was also performed. The existing data were grouped into several themes, then relationships and linkages were drawn from each group of informants. Results: Barriers to accessing care and treatment were lack of knowledge about the benefits of ARV; stigma from within and the surrounding environment; difficulty in accessing services due to distance, time, and cost; completeness of administration; drugs' side effects; and the quality of health workers and HIV services. Conclusions: There was a need for a structured and integrated model of peer support to improve ARV uptake and treatment in pregnant women with HIV. This research identified needs including mini-counseling sessions designed to address psychosocial barriers as an integrated approach to support antenatal care that can effectively assist HIV-positive pregnant women in improving treatment adherence.

• 대한영상의학회지
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• 제81권5호
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• pp.1260-1265
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• 2020

카포시 육종은 후천성 면역 결핍 증후군(acquired immunodeficiency syndrome; 이하 AIDS)와 연관되어, 피부, 점막과 여러 장기를 침범하는 다발성의 혈관성 결절로 나타나는 신생물을 일컫는다. AIDS와 연관되어 생기는 위장관 카포시 육종은 내장에 파종성 질환으로 가장 흔하게 발생한다. 우리는 다양한 장기를 침범하여 복통과 함께 장관 내 출혈을 유발한 드문 카포시 육종의 영상 소견에 대해 보고한다. 회장 대장내시경을 통해 말단 회장, S자 결장, 직장 내 다양한 병변이 발견되었으며 소장 투시검사로 공장과 회장의 병변을 확인할 수 있었다. 복부 골반 전산화단층촬영에서 회장 내 조영증강된 다양한 납작한 병변과 복강 내 크기가 커진 림프절을 발견하였다. 조직병리학 검사에서 카포시 육종으로 최종 진단이 된 환자는 항레트로바이러스제로 치료를 시행 받았다. 최근 AIDS 환자의 수가 늘고 있는 상황에서, AIDS와 연관된 Kaposi's sarcoma의 영상학적 소견을 숙지하는 것은 영상의학과 의사를 비롯한 임상의사들에게 빠른 진단과 치료뿐만이 아니라 예상치 못한 AIDS의 감염 위험에 노출될 수 있는 의료진의 안전을 위해서도 필수적이다.