Interventions for treating tuberculous pericarditisSeptember 14, 2017
Researchers from South Africa and Canada have carried out a Cochrane review update to assess the safety and effectiveness of corticosteroids for treating tuberculous pericarditis.
Tuberculosis (TB) infection of the pericardium, the membrane around the heart, is not common but can restrict the function of the heart and is fatal in some cases. Current treatment involves doctors prescribing anti-TB drugs for six months, draining fluid from the pericardium or removing it in some situations, and in some cases corticosteroids are prescribed to reduce inflammation. However, there has been some concern that steroids have the potential to cause harm to patients with HIV, a common TB co-infection.
The review authors included seven trials, six looking at the use of corticosteroids and the other at different treatments. All trials were based in sub-Saharan Africa and included 1959 participants in total.
"Given the seriousness of TB pericarditis it was important that we were able to assess the effectiveness of using corticosteroids as a treatment," said Professor Charles Shey Wiysonge, Director of Cochrane South Africa and lead author of the review, "it was also especially important to look at their safety in cases of HIV coinfections, as there has previously been an impression that treatment could cause a rise in HIV-related cancers."
The review authors found that in people without HIV, corticosteroids drugs may reduce the number of people dying overall by 20%, as well as probably reducing deaths from pericarditis, although the confidence intervals include the possibility of both large beneficial effects and small increases in harm. The results also show that in HIV-positive patients, corticosteroids may reduce constriction of the pericardium membrane, but the confidence intervals include the possibility of both large beneficial effects and small increases in harm.
"This systematic review, which stratified patients into HIV-positive and HIV-negative participants and excluded those who received dual immunotherapy with corticosteroids and Mycobacterium indicus pranii, showed promising effects of corticosteroids on major outcomes but generally the confidence intervals include the possibility of both large beneficial effects and small increases in harm, and there was no evidence of an increase in cancer" added Professor Bongani Mayosi, senior author of the review and lead author of the largest trial carried out on this topic. The patients on a combination of corticosteroids and Mycobacterium indicus pranii were excluded from the analysis because of the possibility of an interaction between the two agents resulting in the increased incidence of cancer in this group.
Liverpool School of Tropical Medicine
Related Hiv Articles:
A new study finds defective HIV proviruses, long thought to be harmless, produce viral proteins and distract the immune system from killing intact proviruses needed to reduce the HIV reservoir and cure HIV.
Almost 30,000 newly diagnosed HIV infections were reported by the 31 European Union and European Economic Area (EU/EEA) countries in 2015, according to data published today by ECDC and the WHO Regional Office for Europe.
A new study led by researchers at Massachusetts General Hospital finds that cigarette smoking substantially reduces the lifespan of people living with HIV in the US, potentially even more than HIV itself.
HIV-positive individuals who smoke cigarettes may be more likely to die from smoking-related disease than the infection itself, according to a new study published in the Journal of Infectious Diseases.
An estimated 1.2 million people live with HIV in the United States, with nearly 13 percent being unaware of their infection.
A major new analysis from the Global Burden of Disease 2015 study, published today in The Lancet HIV journal, reveals that although deaths from HIV/AIDS have been steadily declining from a peak in 2005, 2.5 million people worldwide became newly infected with HIV in 2015, a number that hasn't changed substantially in the past 10 years.
Investigators from the National Institutes of Health have discovered that cells from HIV-infected people whose virus is suppressed with treatment harbor defective HIV DNA that can nevertheless be transcribed into a template for producing HIV-related proteins.
Among nearly 900 serodifferent (one partner is HIV-positive, one is HIV-negative) heterosexual and men who have sex with men couples in which the HIV-positive partner was using suppressive antiretroviral therapy and who reported condomless sex, during a median follow-up of 1.3 years per couple, there were no documented cases of within-couple HIV transmission, according to a study appearing in the July 12 issue of JAMA, an HIV/AIDS theme issue.
Researchers from UAB, Emory and Microsoft demonstrate that HIV has evolved to be pre-adapted to the immune response, worsening clinical outcomes in newly infected patients.
Actor Charlie Sheen's public disclosure in November 2015 that he has the human immunodeficiency virus (HIV) corresponded with the greatest number of HIV-related Google searches ever recorded in the United States, according to an article published online by JAMA Internal Medicine.
Related Hiv Reading:
HIV Essentials 2017
by Paul E. Sax (Author), Calvin J. Cohen (Author), Daniel R. Kuritzkes (Author)
The world's leading experts provide all the 'essentials' needed to manage HIV patients in the office, on the ward, and in the ICU.
Completely revised and updated, HIV Essentials 2017 incorporates the latest clinical guidelines into a step-by-step guide to the diagnosis, evaluation, management, and prevention of HIV infection and its complications. Topics include: opportunistic infections and other HIV complications, treatment of HIV and pregnancy, antiretroviral drug summaries, post-exposure prophylaxis, as well as commercially available dosage forms for all ARVs. View Details
Fundamentals of HIV Medicine: (CME edition)
by American Academy of HIV Medicine (Compiler), W. David Hardy (Compiler)
Completely updated for 2017, Fundamentals of HIV Medicine is a comprehensive clinical care publication for the treatment of HIV/AIDS. Published by the American Academy of HIV Medicine, the book offers physicians, pharmacists, nurse practitioners, and other care providers the most up-to-date overview of the latest HIV treatments and guidelines plus online access to CME. The online access expires August 2018.
Embodying the AAHIVM's commitment to promoting uniform excellence in care of seropositive patients, Fundamentals of HIV Medicine 2017 empowers health... View Details
2018 ADULT HIV/AIDS TREATMENT POCKET GUIDE (2018 edition)
by John G Bartlett (Author), Paul A Pham (Author)
This HIV/AIDS summarizes National Clinical Guidelines with an attempt to achieve brevity, clarity and accuracy in guiding clinical decisions relevant to the management of adult patients with HIV/AIDS. This guide includes expanded drug-drug interactions tables, antiretroviral pictures tables, and summary of treatment guidelines.View Details
100 Questions & Answers About HIV and AIDS
by Joel E. Gallant (Author)
Whether you're a newly diagnosed patient or a friend or relative of someone suffering from HIV or AIDS, this book can help. Offering both doctor and patient perspectives, 100 Questions & Answers About HIV and AIDS, Fourth Edition provides authoritative and practical answers to the most commonly asked questions by patients and their loved ones. What is the difference between HIV and AIDS? How can HIV infection be prevented? How do I find the right medical care?
Along with the answers to these and other questions, this book provides information on diagnosis, treatment, living with HIV... View Details
Taking Turns: Stories from HIV/AIDS Care Unit 371 (Graphic Medicine)
by MK Czerwiec (Author)
In 1994, at the height of the AIDS epidemic in the United States, MK Czerwiec took her first nursing job, at Illinois Masonic Medical Center in Chicago, as part of the caregiving staff of HIV/AIDS Care Unit 371. Taking Turns pulls back the curtain on life in the ward.
A shining example of excellence in the treatment and care of patients, Unit 371 was a community for thousands of patients and families affected by HIV and AIDS and the people who cared for them. This graphic novel combines Czerwiec’s memories with the oral histories of patients, family members, and staff. It... View Details
Living a Healthy Life with HIV
by Allison Webel RN Ph.D (Author), Kate Lorig DrPH (Author), Diana Laurent MPH (Author), Virginia González MPH (Author), Allen L. Gifford MD (Author), David Sobel MD MPH (Author), Marian Minor PT PhD (Author)
Completely updated to the current care guidelines from the Centers for Disease Control and elsewhere, this book addresses the current emphasis on managing medications for HIV treatment and many of the illnesses that commonly occur along with HIV. Combining the latest medical advice with the ideas of hundreds of people living with HIV, the book is helpful for adults living with HIV, and for friends, family members, and others who support anyone struggling with HIV. New additions to this edition include topics such as aging with HIV and coping with the emotions brought about by being a... View Details
HIV Pharmacotherapy: The Pharmacist's Role in Care & Treatment
by Jason J. Schafer (Author), Jennifer Cocohoba (Author), Elizabeth Sherman (Author), Alice Tseng (Author)
Pharmacists now have a new resource to help expand their HIV knowledge, guide their treatment, and provide comprehensive care. This book is the first of its kind to provide pharmacists with a consolidated resource for offering care to patients with HIV infection, including diagnosis, primary care, pharmacological management of co-infections, and more. This resource will help prepare pharmacists to take a lead role in the care and treatment of patients with HIV, and will be a valuable guide for students, residents, and clinical pharmacists to build expertise in tailoring antiretroviral... View Details
HIV & AIDS: A Very Short Introduction (Very Short Introductions)
by Alan Whiteside (Author)
In 2008 it was believed that HIV/AIDS was without doubt the worst epidemic to hit humankind since the Black Death. The first case was identified in 1981; by 2004 it was estimated that about 40 million people were living with the disease, and about 20 million had died. Yet the outlook today is a little brighter. Although HIV/ AIDS continues to be a pressing public health issue the epidemic has stabilised globally, and it has become evident it is not, nor will it be, a global issue. The worst affected regions are southern and eastern Africa. Elsewhere, HIV is found in specific, usually,... View Details
Sanford Guide to HIV/AIDS Therapy 2017
by Michael S., M.D. Saag (Editor), Andrew T., M.D. Pavia (Editor), Henry F., M.D. Chambers (Editor), George M., M.D. Eliopoulos (Editor), David N., M.D. Gilbert (Editor)
HIV: Challenges and Concerns
by Chris Stinson (Editor)
HIV and AIDS are diseases that currently have no cure. Therapies that slow down the effects of the disease as well as its progression into AIDS are proving to be very successful. Drugs that can combat HIV viruses are collectively called antiretroviral therapies. These can reduce the multiplication of the virus by blocking its mutation. The concept of “treatment as prevention” has also become a recommended practice to reduce cross-infection. The topics covered in this book offer the readers new insights in this field. It is a vital tool for all researching or studying HIV treatment and... View Details