• Title/Summary/Keyword: Immunodeficiency

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Primary Immunodeficiencies in Children Initially Admitted with Gastrointestinal/Liver Manifestations

  • Murat Cakir ;Nalan Yakici ;Elif Sag ;Gulay Kaya ;Aysenur Bahadir;Alper Han Cebi ;Fazil Orhan
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.26 no.4
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    • pp.201-212
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    • 2023
  • Purpose: The gastrointestinal system is the most commonly affected organ, followed by the lungs, in patients with primary immunodeficiency disease (PID). Hence, it is common for children with PIDs to present with gastrointestinal symptoms. We aimed to analyze the clinical and histopathological findings of patients who were initially admitted to pediatric gastroenterology/hepatology clinics and subsequently diagnosed with PIDs to identify the clinical clues for PIDs. Methods: The demographic, laboratory, and histopathological findings, treatment modality, and outcomes of patients initially admitted to the pediatric gastroenterology/hepatology unit and subsequently diagnosed with PIDs were recorded. Results: The study included 24 patients (58.3% male; median age [range]: 29 [0.5-204] months). Common clinical presentations included chronic diarrhea (n=8), colitis (n=6), acute hepatitis (n=4), and acute liver failure (n=2). The association of autoimmune diseases, development of malignant diseases, and severe progression of viral diseases was observed in 20.8%, 8.3%, and 16.6% of the patients, respectively. Antibody deficiency was predominantly diagnosed in 29.2% of patients, combined immunodeficiency in 20.8%, immune dysregulation in 12.5%, defects in intrinsic and innate immunity in 4.2%, autoinflammatory disorders in 8.3%, and congenital defects of phagocytes in 4.2%. Five patients remained unclassified (20.8%). Conclusion: Patients with PIDs may initially experience gastrointestinal or liver problems. It is recommended that the association of autoimmune or malignant diseases or severe progression of viral diseases provide pediatric gastroenterologists some suspicion of PIDs. After screening using basic laboratory tests, genetic analysis is mandatory for a definitive diagnosis.

Detection of Enteropathogens in Human Immunodeficiency Virus and Non-Human Immunodeficiency Virus-Infected Children with Acute Diarrhea in an Indonesian Tertiary Hospital Using Multiplex Real-Time Polymerase Chain Reaction

  • Dewi Wulandari;Rivaldi Febrian;Pramita Gayatri Dwipoerwantoro;Nia Kurniati
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.27 no.2
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    • pp.95-103
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    • 2024
  • Purpose: Diarrhea is one of the leading causes of mortality in children living in developing countries. The etiology of acute diarrhea in each healthcare center varies depending on place, time, and population. This study aimed to identify pathogen patterns in human immunodeficiency virus (HIV)-infected and non-HIV children suffering from acute diarrhea, using multiplex real time reverse transcriptase polymerase chain reaction (RT-PCR), in an Indonesian tertiary hospital. Methods: This cross-sectional study was conducted at Dr. Cipto Mangunkusumo National Hospital from March 2019 to April 2020. Results: The study showed that multiplex RT-PCR results were positive in 58.9% of the specimens, with more positive results in HIV-infected children than in non-HIV-infected children (70% vs. 54.7%). Altogether 72 enteropathogens were detected from all specimens. Enteropathogens in non-HIV children with acute diarrhea consisted of bacteria (70.6%) and viruses (29.4%) with a predominance of enteroaggregative Escherichia coli (25.4%), followed by Campylobacter spp. (11.8%), enteropathogenic E. coli (9.8%), Norovirus GII (7.8%), and Clostridium difficile (7.8%). Enteropathogens in HIV-infected children consisted of viruses (57.1%), bacteria (28.6%), and parasites (14.3%) comprising Norovirus GII (24%), Cryptosporidium spp. (14.3%), Campylobacter spp. (14.3%), Norovirus GI (14.3%), and Astrovirus (14.3%). Cryptosporidium spp. was the only parasite found in this study and was found only in HIV-infected children. In non-HIV children with acute diarrhea, most pathogens were invasive bacteria, while in HIV-infected children, more viral and parasite infections occurred, primarily caused by opportunistic pathogens. Conclusion: The pattern of enteropathogens can help clinicians determine further examinations and appropriate empirical antimicrobial therapy for the patient.

The Palliative Care and Hospice for the People Living with HIV (HIV 감염인을 위한 완화의료와 호스피스)

  • Choi, Jae-Phil
    • Journal of Hospice and Palliative Care
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    • v.20 no.3
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    • pp.159-166
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    • 2017
  • According to the advance of antiretroviral regimen and the early treatment strategy, people living with human immunodeficiency virus (PLWH) are achieving the goal of virologic suppression and immune restoration. Most of them no more die of acquired immunodeficiency syndrome (AIDS) defining illnesses, and become older with chronic comorbidities such as cardiovascular, metabolic, hepatic, renal and neurological diseases. However some PLWH still visit hospitals as late presenters with very low CD4+ T cell counts, so that they suffer AIDS defining illnesses to die or experience severe neurological complications resulting in disabilities. Early palliative interventions are needed on the various symptoms of PLWH. Thus far chronic pains such as distal symmetric sensory polyneuropathies have been underevaluated. Active pain-relieving interventions are important to them. Recently we define end of life condition of human immunodeficiency virus (HIV) or eligibility to hospice care after adjusting current status of HIV treatment. Hospice teams should pay attention to the specific medical conditions, psychological needs, and social circumstances of PLWH. With just standard precautions as common infection control measures, general hospice cares can be provided to them like to other hospices subjects. For giving PLWH opportunities to have the end of life with value and dignity, hospice multidisciplinary team should intervene them early and aggressively. Now we need more clinical experiences and institutional improvements.

The Roles of Immune Regulatory Factors FoxP3, PD-1, and CTLA-4 in Chronic Viral Infection (만성 바이러스 감염에서 면역조절인자 FoxP3, PD-1 및 CTLA-4의 역할)

  • Cho, Hyosun
    • Korean Journal of Microbiology
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    • v.49 no.3
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    • pp.221-227
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    • 2013
  • Human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) cause viral infections that lead to chronic diseases. When they invade human body, virus specific T cells play an important role in antiviral effector functions including killing virus-infected cells and helping B cells to produce specific antibodies against viral proteins. The antiviral activity of T cells is usually affected by immune-regulatory factors that express on surface of T cells. Recently, many researchers have investigated the relationship between effector functions of virus specific T cells and characteristics of immune regulatory factors (e.g., CD28, CD25, CD45RO, FoxP3, PD-1, CTLA-4). In particular, Immune inhibitory molecules such as forkhead box P3 (FoxP3), programmed death-1 (PD-1), and cytotoxic T lymphocyte-associated antigen 4 (CTLA-4) are associated with T-cell dysfunction. They are shown to be up-regulated in chronic viral diseases such as hepatitis B, hepatitis C or human immunodeficiency virus infection. Therefore, the positive correlation between viral persistence and expression of immune regulatory factors (FoxP3, PD-1, and CTLA-4) has been suggested. In this review, the roles of immune regulatory factors FoxP3, PD-1, and CTLA-4 were discussed in chronic viral diseases such as HIV, HBV, or HCV.

Ultra-Rapid Real-Time PCR for the Detection of Human Immunodeficiency Virus (HIV) (Ultra Rapid Real-Time PCR에 의한 Human Immunodeficiency Virus (HIV)의 신속진단법)

  • Lee, Dong-Woo;Kim, Eul-Hwan;Yoo, Mi-Sun;Han, Sang-Hoon;Yoon, Byoung-Su
    • Korean Journal of Microbiology
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    • v.43 no.2
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    • pp.91-99
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    • 2007
  • For the detection of Human Immunodeficiency Virus (HIV), multiple and ultra-rapid real-time PCR methods were developed. The target DNA sequences were deduced from HIV-1 specific 495bp partial env gene (gi_1184090) and from HIV-2 specific 294 bp partial env gene (gi_1332355), and were synthesized by using PCR-based gene synthesis on the reason of safety. Ultra-rapid real-time PCR was performed by $Genspector^{TM}$ using microchip-based, $1\;{\mu}l$ of reaction volume with extremely short time in each 3 step in PCR. The detection including DNA-amplification and melting temperature analysis was completed inner 15 minutes. The HIV-1 specific 117 bp-long and HIV-2 specific 119 bp-long PCR products were successfully amplified from minimum of template,2.3 molecules of each env gene. This kind of real-time PCR was designated as ultra-rapid real-time PCR in this study and it could be applied not only an alternative detection method against HIV, but also other pathogens using PCR-based detection.

Interactions between Human Endogenous Retrovirus (HERV) and Human Immunodeficiency Virus (HIV) (인간 내성 리트로 바이러스(HERV)와 인간 면역 결핍 바이러스(HIV)의 상관관계)

  • Ock, Mee Sun;Kim, Heui-Soo;Cha, Hee-Jae
    • Journal of Life Science
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    • v.25 no.4
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    • pp.481-485
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    • 2015
  • Retroviruses genes have been inserted into the human genome for millions of years. These retroviruses are now inactive due to mutations such as deletions or nonsense mutations. After mutation, retroviruses eventually became fixed in the genome in their endogenous forms and existed as traces of ancient viruses. These retroviruses are called endogenous retroviruses (ERVs), with the human form known as human endogenous retrovirus. HERV cannot become a fully active virus, but a number of viral proteins or even virus particles are expressed under various conditions. Compared to endogenous retroviruses, some exogenous retroviruses are still infectious and can threaten human life. Among these, human immunodeficiency virus (HIV) is one of the most well-known and best-studied. Recent studies have shown some elements of HERV were activated by HIV infection and interact with HIV-derived proteins. In addition, many studies have attempted to use HERV as vaccination against HIV infection. This review will describe the regulation and interaction between HERV and HIV infection and mention the development of vaccines and therapeutic agents against HIV infection by using HERV elements.

Epidemiology of AIDS (AIDS의 역학)

  • 김정순
    • Korean Journal of Health Education and Promotion
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    • v.5 no.1
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    • pp.6-11
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    • 1988
  • AIDS, 즉 후천성면역결핍증은 인간면역결핍바이러스(Human Immunodeficiency Virus : HIV)라고 불리우는 바이러스에 의한 인간면역체계의 붕괴로 발생하는 질환이다. 1979년 최초로 새로운 임상적특징을 가진 증후군으로 의학학술지에 발표되어 의료계의 주목을 끌어오다가 1981년 봄 로스앤절레스에 있는 남성동성연애자에게 발생한 AIDS의 첫 예가 보고되어 본격적 연구가 시작되었다.

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HIV 감염인에서의 기생충질환 발생빈도 낮으나 생명 위협

  • Kim, Nam-Jung
    • RED RIBBON
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    • s.67
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    • pp.14-15
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    • 2005
  • 인간면역결핍바이러스(Human Immunodeficiency Virus: 이하 HIV로 표기) 감염환자에서 발생하는 기회감염은 다양한 미생물에 의해 발생한다. 기생충이 일으키는 감염질환은 세균이나 곰팡이, 바이러스가 일으키는 감염질환에 비해 발생빈도가 낮아 중요성이 간과되는 경우가 흔하지만, HIV 감염환자에게는 여전히 중요한 감염질환이다.

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Human immunodeficiency virus(HIV) 감염의 혈청학적 검사

  • 김태규
    • The Microorganisms and Industry
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    • v.18 no.2
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    • pp.19-25
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    • 1992
  • 본문에서는 현재 주로 사용되고 있는 혈청학적 방법을 주로 소개하고자 한다. HIV 감염의 특성상 헌혈 혈액 등과 같이 많은 시료를 신속하게 검사하여야 하고 또한 검사결과가 개인에게 매우 중요한 의미를 지니므로 HIV에 대한 혈청학적 검사는 일차적으로 민감도가 높은 검색용 검사를 우선 시행하고 이차적으로 특이도가 높은 확인용 검사를 실시하여 판정하는 것을 원칙으로 하고 있다.

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