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Although people living with HIV (PLWH) were considered to be at increased risk of SARS-CoV-2 infection, the driving force among this group of individuals is still not clear. We investigated 1,709 PLWH through a telephone interview and identified 11 COVID-19 patients in four districts of Wuhan, China. The demographic features and major clinical characteristics of these patients were retrieved from the information management systems for COVID-19 patients of the four districts' CDC. Statistical analysis was performed to find out the driving force of COVID-19 among PLWH. The prevalence of COVID-19 in PLWH is 0.6% (95% CI: 0.2% - 1.0%), which is comparable to the overall population prevalence in Wuhan city (0.6%). Nine out of the 11 COVID-19 patients had relatively high CD4+ T lymphocyte count (>200/μl) and undetectable HIV viral load (<20 copies/ml), and ten of them were on antiretroviral therapy. Older PLWH with low CD4 + count, got HIV infected through homosexual activity, and had been diagnosed with HIV for a long time, were more likely to develop COVID-19. COVID-19 related morbidity rates were comparable between PLWH and the general population. Older age with low CD4 count, an extended period of HIV diagnosis, and treatment-naivety were potential driving forces of COVID-19 prevalence among PLWH. Strategies for preventing SARS-CoV-2 infection among PLWH with weak immune responses are required. [ABSTRACT FROM AUTHOR]

Background: Human immunodeficiency virus (HIV)-infected individuals are at high risk of contracting tuberculosis (TB) disease, and current methods for diagnosing TB infection are less effective in this population. We developed and evaluated a new interferon-gamma release assay (IGRA), named A.TB, in HIV-infected individuals, with and without active TB, in a setting of high TB burden and low HIV prevalence. Methods: A total of 255 subjects were divided into 3 groups according to their HIV and TB status: HIV + without active TB (n = 123), HIV +/TB + (n = 79), and HIV-/TB + (n = 65). The A.TB assay was performed in parallel with the QuantiFERON-TB Gold In-Tube (QFT-GIT) and tuberculin skin test (TST). Results: The positive rate was 59.3% (n = 123) by A.TB and 53.8% (n = 106) by QFT-GIT. We observed a strong concordance of 81.2% (k = 0.612) between the two IGRAs. The QFT-GIT results were affected by low CD4+ cell count (p= 0.013), while A.TB results were not. A.TB was also performed in patients with active TB (n = 65) and patients with active TB and HIV co-infection (n = 79). The sensitivity of A.TB in these groups was 80.0% and 81.0%, respectively. Conclusion: The A.TB results were not affected by low CD4+ cell count in the co-infected cohort. With further evaluation,A.TB may prove to be a valuable tool for diagnosing TB in HIV-infected patients. [ABSTRACT FROM AUTHOR]

Summary Objectives To investigate the prevalence, incidence of abnormal liver function tests (LFTs), and mortality during anti-TB treatment in patients multi-infected with HIV, tuberculosis (TB), and hepatitis virus (hepatitis B virus (HBV) and hepatitis C virus (HCV)). Methods Three hundred and sixty-one HIV-positive TB patients were enrolled and divided into an HIV/TB group, HIV/TB/HBV group, and HIV/TB/HCV group; 1013 HIV-negative TB patients were selected randomly as controls. Results One hundred and seventeen (32.4%) HIV-positive TB patients were infected with HBV and/or HCV, compared with 90 (8.9%) HIV-negative TB patients ( p = 0.000). HIV-positive TB patients had a higher incidence of anti-TB drug-induced hepatotoxicity than HIV-negative TB patients (4.2% vs. 1.0%, odds ratio (OR) 4.348, 95% confidence interval (CI) 1.935–9.769, p = 0.000). The incidence of abnormal LFTs in the HIV/TB/HBV group and HIV/TB/HCV group were significantly higher than in the HIV/TB group (40.7% vs. 11.1%, OR 5.525, 95% CI 2.325–13.131, p = 0.000; 20.0% vs. 11.1%, OR 2.009, 95% CI 1.057–3.820, p = 0.031). A total of 68.4% of patients with HBV-DNA >1.0 × 10 5 copies/ml and 42.9% of patients with HCV-RNA >1.0 × 10 5 copies/ml had abnormal LFTs. Twenty-three (19.7%) patients multi-infected with HIV, TB, and hepatitis virus died during anti-TB treatment. Conclusions HIV, HBV, and HCV are risk factors for the development of abnormal LFTs and mortality during anti-TB treatment. TB patients co-infected with HIV and hepatitis virus need close follow-up. [ABSTRACT FROM AUTHOR]

Background: AIDS-related KS generally involves cutaneous lesions, that slowly progress over months to years. Neither rapidly progressing of KS nor KS complicated with hemophagocytic syndrome (HPS) has rarely been reported. Case presentation: We report a rare case of rapid progression of Kaposi's sarcoma complicated with hemophagocytic syndrome in a severely immunosuppressed patient with HIV-infection. The symptoms of this patient were atypical, showing only persistent high fever and rapid progressed to hemophagocytic syndrome. This patient was successfully treated with antiretroviral therapy combined with liposomal doxorubicin. Conclusions: The condition of the KS patient could deteriorate rapidly over a period of days and even developeded into HPS, which was life-threatening. However, chemotherapy initiated in a timely manner might improve prognosis. [ABSTRACT FROM AUTHOR]