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TropicalMed
Special Issues
Living with HIV: Support, Care, and Treatment for Vulnerable Populations
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Living with HIV: Support, Care, and Treatment for Vulnerable Populations

A special issue of Tropical Medicine and Infectious Disease (ISSN 2414-6366).

Deadline for manuscript submissions: closed (30 April 2024) | Viewed by 19445

Special Issue Editors

Dr. James Ayieko

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Guest Editor
Kenya Medical Research Institute, Kisumu, Kenya
Interests: HIV; mobility, HIV cascade
Dr. Marguerite Thorp

E-Mail Website
Guest Editor
David Geffen School of Medicine, University of California, Los Angeles, CA, USA
Interests: mobility; migration; HIV
Prof. Dr. Musie Ghebremichael

E-Mail Website
Guest Editor
Harvard Medical School & Ragon Institute of Massachusetts Institute of Technology, Massachusetts General Hospital and Harvard, Cambridge, MA, USA
Interests: biostatistics; immunology; infectious diseases; tuberculosis; malaria; HIV; herpes; statistical modeling

Special Issue Information

Dear Colleagues,

Immense progress has been made in HIV care and treatment with a large scale up in the number of individuals diagnosed and put on life-saving antiretroviral treatment. Impressive progress has been made towards ending the HIV epidemic; however, in achieving the final step in controlling HIV, vulnerable populations must not be left behind. Vulnerable groups, such as children and adolescents, mobile individuals and migrants, and men who are susceptible to disengagement from care, must be the focus in the final step. For this Special Issue, we invite articles addressing HIV care engagement of these and other vulnerable populations as we seek to end the epidemic.

Dr. James Ayieko
Dr. Marguerite Thorp
Prof. Dr. Musie Ghebremichael
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Tropical Medicine and Infectious Disease is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • adolescents
  • children
  • mobile populations
  • migration
  • men
  • HIV care engagement
  • key populations

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Published Papers (11 papers)

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Editorial

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4 pages, 178 KiB  
Editorial
Renewing Our Focus on Vulnerable Populations Among People Living with HIV
by James Ayieko, Marguerite Thorp and Musie Ghebremichael
Trop. Med. Infect. Dis. 2024, 9(11), 278; https://doi.org/10.3390/tropicalmed9110278 - 14 Nov 2024
Viewed by 488
Abstract
The global HIV landscape has changed over the past few decades, with great milestones achieved in both HIV treatment and prevention [...] Full article
(This article belongs to the Special Issue Living with HIV: Support, Care, and Treatment for Vulnerable Populations)

Research

Jump to: Editorial, Other

10 pages, 222 KiB  
Article
Can Support Groups Improve Treatment Adherence and Reduce Sexual Risk Behavior among Young People Living with HIV? Results from a Cohort Study in South Africa
by Tonya R. Thurman, Brian Luckett, Babalwa Zani, Johanna Nice and Tory M. Taylor
Trop. Med. Infect. Dis. 2024, 9(7), 162; https://doi.org/10.3390/tropicalmed9070162 - 19 Jul 2024
Cited by 2 | Viewed by 1044
Abstract
Adolescents and young adults living with HIV (AYLHIV) in sub-Saharan Africa experience poorer HIV outcomes than adults, including lower ART adherence and virologic suppression. They also have high rates of unprotected sex, increasing the risk of adverse sexual health outcomes and onward transmission. [...] Read more.
Adolescents and young adults living with HIV (AYLHIV) in sub-Saharan Africa experience poorer HIV outcomes than adults, including lower ART adherence and virologic suppression. They also have high rates of unprotected sex, increasing the risk of adverse sexual health outcomes and onward transmission. This one-arm, pre–post study investigates a structured 14-session support group aiming to boost treatment adherence and sexual protective behavior for AYLHIV in South Africa. Logistic and Poisson regression analyses were performed on self-reported pre- and post-intervention survey data collected approximately 7.5 months apart from a cohort of 548 AYLHIV. Participants were significantly more likely to report at least 95% adherence at follow-up and rate their health as “good;” they also demonstrated greater treatment knowledge and had fewer absences from school overall and due to illness. Among sexually active AYLHIV, contraception use at last sex increased significantly, while condom use did not. Effects were small, and greater programmatic emphasis on adherence and multifaceted service packages is likely necessary to promote viral suppression. Nonetheless, the intervention addresses an important gap in service provision for AYLHIV in South Africa. Findings denote the potential for incorporating care and treatment components into sexual and reproductive health interventions tailored for AYLHIV. Full article
(This article belongs to the Special Issue Living with HIV: Support, Care, and Treatment for Vulnerable Populations)
12 pages, 1316 KiB  
Article
Consistency of Multi-Month Antiretroviral Therapy Dispensing and Association with Viral Load Coverage among Pediatric Clients Living with HIV in Mozambique
by Ivete Meque, Nicole Herrera, Michelle M. Gill, Rui Guilaze, Amancio Nhangave, Jaciara Mussá, Nilesh Bhatt, Mahoudo Bonou and Lauren Greenberg
Trop. Med. Infect. Dis. 2024, 9(7), 141; https://doi.org/10.3390/tropicalmed9070141 - 26 Jun 2024
Viewed by 2172
Abstract
With the increase in uptake of multi-month antiretroviral therapy dispensing (MMD) for children, little is known about consistency of MMD receipt over time and its association with virological outcomes. This analysis aims to assess the uptake of 3-month MMD among children, consistent receipt [...] Read more.
With the increase in uptake of multi-month antiretroviral therapy dispensing (MMD) for children, little is known about consistency of MMD receipt over time and its association with virological outcomes. This analysis aims to assess the uptake of 3-month MMD among children, consistent receipt of MMD after uptake, and clinical outcomes following transition to MMD in 16 health facilities in Gaza and Inhambane Provinces. This is a secondary analysis involving children <15 years living with HIV with clinical visits during the period from September 2019 to August 2020. Of 4383 children, 82% ever received MMD (at least one pickup of a 3-month MMD supply) during the study period but only 40% received it consistently (defined as MMD at every visit during the study period). Consistent MMD was most common among older children and children without indications of clinical instability. Overall viral load (VL) coverage was 40% (733/1851). Consistent MMD was significantly associated with lower odds of having a VL (0.78, 95% CI: 0.64–0.95). In conclusion, while receipt of a multi-month supply was common particularly during the early days of the COVID-19 pandemic, only a minority of children received consistent MMD; however, there is a need to ensure children with fewer visits still receive timely VL monitoring. Full article
(This article belongs to the Special Issue Living with HIV: Support, Care, and Treatment for Vulnerable Populations)
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11 pages, 268 KiB  
Article
Determinants of Immunovirological Response among Children and Adolescents Living with HIV-1 in the Central Region of Cameroon
by Rodolphe Steven Dobseu Soudebto, Joseph Fokam, Nelly Kamgaing, Nadine Fainguem, Ezechiel Ngoufack Jagni Semengue, Michel Carlos Tommo Tchouaket, Rachel Kamgaing, Aubin Nanfack, Yagai Bouba, Junie Yimga, Collins Chenwi Ambe, Hyacinthe Gouissi, Jeremiah Efakika Gabisa, Krystel Nnomo Zam, Alex Durand Nka, Samuel Martin Sosso, Gregory-Edie Halle-Ekane, Marie-Claire Okomo and Alexis Ndjolo
Trop. Med. Infect. Dis. 2024, 9(2), 48; https://doi.org/10.3390/tropicalmed9020048 - 14 Feb 2024
Cited by 1 | Viewed by 1877
Abstract
About 90% of new HIV-1 infections in children occur in sub-Saharan Africa, where treatment monitoring remains suboptimal. We sought to ascertain factors associated with immunovirological responses among an ART-experienced paediatric population in Cameroon. A laboratory-based and analytical study was conducted from January 2017 [...] Read more.
About 90% of new HIV-1 infections in children occur in sub-Saharan Africa, where treatment monitoring remains suboptimal. We sought to ascertain factors associated with immunovirological responses among an ART-experienced paediatric population in Cameroon. A laboratory-based and analytical study was conducted from January 2017 throughout December 2020 wherein plasma viral load (PVL) analyses and CD4 cell counts were performed. Viral suppression (VS) was defined as PVL < 1000 copies/mL and immunological failure (IF) as CD4 < 500 cells/µL for participants ≤5 years and CD4 < 250 cells/µL for those >5 years; p < 0.05 was considered statistically significant. Overall, 272 participants were enrolled (median age: 13 [9–15.5] years; 54% males); median ART duration 7 [3–10] years. Globally, VS was achieved in 54.41%. VS was 56.96% in urban versus 40.48% in rural areas (p = 0.04). IF was 22.43%, with 15.79% among participants ≤5 years and 22.92% among those >5 years (p = 0.66). IF was 20.43% in urban versus 33.33% in rural areas (p = 0.10). Following ART, IF was 25.82% on first-line (non-nucleoside reverse transcriptase inhibitors; NNRTI-based) versus 10.17% on second-line (protease inhibitor-based) regimens (p = 0.01). Interestingly, IF was 7.43% among virally suppressed versus 40.32% among virally unsuppressed participants (p < 0.0001). A low VS indicates major challenges in achieving AIDS’ elimination in this paediatric population, especially in rural settings and poor immune statuses. Scaling up NNRTI-sparing regimens alongside close monitoring would ensure optimal therapeutic outcomes. Full article
(This article belongs to the Special Issue Living with HIV: Support, Care, and Treatment for Vulnerable Populations)
14 pages, 569 KiB  
Article
Correlates of Depression in ART Adherence among Youths in Lilongwe, Malawi
by Mary Carolyne Msefula and Eric Umar
Trop. Med. Infect. Dis. 2024, 9(1), 2; https://doi.org/10.3390/tropicalmed9010002 - 19 Dec 2023
Viewed by 2075
Abstract
Despite collaborative efforts to improve mental health services among youths living with HIV (YLHIVs) aged 15–24, evidence shows that many suffer from depression. We established the correlates of depression and how it affects ART adherence. Structured questionnaires, a Patient Health Questionnaire 9 depression [...] Read more.
Despite collaborative efforts to improve mental health services among youths living with HIV (YLHIVs) aged 15–24, evidence shows that many suffer from depression. We established the correlates of depression and how it affects ART adherence. Structured questionnaires, a Patient Health Questionnaire 9 depression scale assessment, in-depth interviews, and Electronic Medical Record reviews were conducted at the Lighthouse Trust Martin Preus Centre (MPC) ART clinic in Lilongwe from April 2021 to October 2022. A total of 303 YLHIVs aged 15–24 were on ART, and 7 key informants were recruited. Bivariate and multivariate logistic regression analyses were performed using STATA V14.1. A thematic content analysis was used for qualitative data. Forty-six per cent of recruits were male, and fifty-four per cent were female. Seventy-one per cent were aged 20–24, and twenty-nine per cent were aged 15–19. Twenty-three per cent of the YLHIVs had depression symptoms, of whom seventy-nine per cent were aged 20–24 years. Twenty-two per cent had an unsuppressed viral load (non-adherent). Sixty-seven per cent of non-adherent participants were aged 20–24. There was no factor associated with ART non-adherence. Source of income (p = 0.003), alcohol consumption (p = 0.010), and sexual behaviour (p = 0.014) were associated with depression. Sexual behaviour was statistically significantly associated with depression (p = 0.024. The themes were a lack of basic needs, a lack of privacy, psychological trauma, incomplete disclosure, a shortage of psychosocial providers, and a knowledge deficit of ART providers to screen for depression. This study shows that depression is considerably high among YLHIVs in Malawi and linked to ART non-adherence. Strengthening mental health training for providers and routinely screening YLHIVs for depression would help in the early identification and management of depression, thereby improving ART adherence. Full article
(This article belongs to the Special Issue Living with HIV: Support, Care, and Treatment for Vulnerable Populations)
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11 pages, 250 KiB  
Article
Successful Implementation Strategies in iCARE Nigeria—A Pilot Intervention with Text Message Reminders and Peer Navigation for Youth Living with HIV
by Aima A. Ahonkhai, Kehinde M. Kuti, Lisa R. Hirschhorn, Lisa M. Kuhns, Robert Garofalo, Amy K. Johnson, Adedotun Adetunji, Baiba Berzins, Ogochukwu Okonkwor, Olutosin Awolude, Olayinka Omigbodun and Babafemi O. Taiwo
Trop. Med. Infect. Dis. 2023, 8(11), 498; https://doi.org/10.3390/tropicalmed8110498 - 16 Nov 2023
Cited by 1 | Viewed by 2061
Abstract
To address poor outcomes among adolescents and young adults living with HIV (AYA-HIV), iCARE Nigeria successfully piloted two-way text message antiretroviral therapy (ART) reminders together with peer navigation. Study participants had significant improvement in ART adherence and viral suppression at 48 weeks. Understanding [...] Read more.
To address poor outcomes among adolescents and young adults living with HIV (AYA-HIV), iCARE Nigeria successfully piloted two-way text message antiretroviral therapy (ART) reminders together with peer navigation. Study participants had significant improvement in ART adherence and viral suppression at 48 weeks. Understanding facto of this intervention. We used explanatory, mixed methods to assess implementation outcomes (feasibility, acceptability, and adoption) and identify implementation strategies used or adapted to promote intervention success. Quantitative data included participant surveys, program records, and back-end mHealth data, and were summarized using descriptive statistics. Qualitative data were collected from key informants and focus group discussions with program staff and summarized using directed content analysis. iCARE Nigeria was feasible as evidenced by ease of recruitment, high retention of patients and peer navigators (PN), and successful deployment of initial text message reminders (99.9%). Most participants (95%) and PN (90%) found text message reminders were not bothersome or intrusive. Implementation strategies employed to facilitate intervention success included: (1) selecting, training, supervising, and matching of PN to patients; (2) tailoring frequency (daily to weekly) and mode of communication between PN and patients according to patient need; (3) routine screening for adherence challenges; (4) changing phone airtime stipends from monthly to weekly in response to rapid depletion; and (5) conducting telecommunication needs assessments, to identify and troubleshoot implementation barriers (issues with mobile devices, power availability). iCARE Nigeria was feasible and acceptable with high adoption by stakeholders. The implementation strategies identified here can be tailored for intervention scale-up in similar environments to promote ART adherence for AYA-HIV. Full article
(This article belongs to the Special Issue Living with HIV: Support, Care, and Treatment for Vulnerable Populations)
11 pages, 228 KiB  
Article
Geographic Mobility and HIV Care Engagement among People Living with HIV in Rural Kenya and Uganda
by James Ayieko, Marguerite Thorp, Monica Getahun, Monica Gandhi, Irene Maeri, Sarah A. Gutin, Jaffer Okiring, Moses R. Kamya, Elizabeth A. Bukusi, Edwin D. Charlebois, Maya Petersen, Diane V. Havlir, Carol S. Camlin and Pamela M. Murnane
Trop. Med. Infect. Dis. 2023, 8(11), 496; https://doi.org/10.3390/tropicalmed8110496 - 10 Nov 2023
Viewed by 1652
Abstract
Introduction: Human mobility is a critical aspect of existence and survival, but may compromise care engagement among people living with HIV (PLHIV). We examined the association between various forms of human mobility with retention in HIV care and antiretroviral treatment (ART) interruptions. Methods: [...] Read more.
Introduction: Human mobility is a critical aspect of existence and survival, but may compromise care engagement among people living with HIV (PLHIV). We examined the association between various forms of human mobility with retention in HIV care and antiretroviral treatment (ART) interruptions. Methods: In a cohort of adult PLHIV in Kenya and Uganda, we collected surveys in 2016 about past 6-month travel and lifetime migration histories, including reasons and locations, and engagement in HIV care defined as (1) discontinuation of care, and (2) history of a treatment interruption among those who remained in care. We estimated associations between mobility and these care engagement outcomes via logistic regression, adjusted for sex, prior mobility, age, region, marital status, household wealth, and education. Results: Among 1081 participants, 56 (5%) reported having discontinued care; among those in care, 104 (10%) reported treatment interruption. Past-year migration was associated with a higher risk of discontinuation of care (adjusted odds ratio [aOR] 1.98, 95% CI 1.08–3.63). In sex-stratified models, the association was somewhat attenuated in women, but remained robust among men. Past-year migration was associated with reduced odds of having a treatment interruption among men (aOR 0.51, 95% CI 0.34–0.77) but not among women (aOR 2.67, 95% CI 0.78, 9.16). Travel in the past 6 months was not associated with discontinuation of care or treatment interruptions. Conclusions: We observed both negative and protective effects of recent migration on care engagement and ART use that were most pronounced among men in this cohort. Migration can break ties to ongoing care, but for men, who have more agency in the decision to migrate, may foster new care and treatment strategies. Strategies that enable health facilities to support individuals throughout the process of transferring care could alleviate the risk of care disengagement. Full article
(This article belongs to the Special Issue Living with HIV: Support, Care, and Treatment for Vulnerable Populations)
10 pages, 1510 KiB  
Article
High Diversity and Transmission Dynamics of HIV-1 Non-C Subtypes in Bangladesh
by Md. Safiullah Sarker and Rubiyat Jahan
Trop. Med. Infect. Dis. 2023, 8(9), 451; https://doi.org/10.3390/tropicalmed8090451 - 17 Sep 2023
Viewed by 1958
Abstract
Genetic diversity and molecular epidemiology of HIV are directly relevant to HIV transmission. We report here the genetic diversity and transmission dynamics of non-C subtypes of HIV-1 strains detected in Bangladeshi key populations. Sequence analysis of gag gene revealed four subtypes A1, B, [...] Read more.
Genetic diversity and molecular epidemiology of HIV are directly relevant to HIV transmission. We report here the genetic diversity and transmission dynamics of non-C subtypes of HIV-1 strains detected in Bangladeshi key populations. Sequence analysis of gag gene revealed four subtypes A1, B, D, G, and nine CRFs (01_AE, 02_AG, 09_cpx, 10_CD, 15_AE/B, 13_cpx, 14_BG, 22_01_A1, and 25_AGU). Most of these non-C strains were detected in returnee migrant workers from different parts of the world. Phylogenetic analysis showed that the Bangladeshi HIV-1 strains detected in migrant workers and their wives and local sex workers shared common ancestries. The identification of the multiple subtypes indicates high diversity of non-C HIV-1 variants circulating in Bangladesh which might have been imported by migrant workers from multiple geographical areas. Full article
(This article belongs to the Special Issue Living with HIV: Support, Care, and Treatment for Vulnerable Populations)
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12 pages, 277 KiB  
Article
How Hypertension Rates and HIV Treatment Outcomes Compare between Older Females and Males Enrolled in an HIV Treatment Program in Southern Nigeria: A Retrospective Analysis
by Uduak Akpan, Moses Bateganya, Otoyo Toyo, Esther Nwanja, Chiagozie Nwangeneh, Onwah Ogheneuzuazo, Augustine Idemudia, Ezekiel James, Dolapo Ogundehin, Adeoye Adegboye, Okezie Onyedinachi and Andy Eyo
Trop. Med. Infect. Dis. 2023, 8(9), 432; https://doi.org/10.3390/tropicalmed8090432 - 31 Aug 2023
Viewed by 1600
Abstract
Studies show that treatment outcomes may vary among persons living with HIV. To fast-track the attainment of epidemic control across gender and age groups, the Accelerating Control of the HIV Epidemic (ACE-5) Project implemented in Akwa Ibom and Cross Rivers States, Nigeria, examined [...] Read more.
Studies show that treatment outcomes may vary among persons living with HIV. To fast-track the attainment of epidemic control across gender and age groups, the Accelerating Control of the HIV Epidemic (ACE-5) Project implemented in Akwa Ibom and Cross Rivers States, Nigeria, examined the hypertension rates and treatment outcomes of older adults living with HIV. The demographic and treatment characteristics of males and females ≥ 50 years living with HIV, who initiated antiretroviral therapy (ART) as of September 2021, were abstracted from medical records across 154 health facilities and community sites in Akwa Ibom and Cross River states, Nigeria. We compared these characteristics by sex using the chi-square test. The log-rank test was used to compare differences in their retention (i.e., being on treatment) and viral suppression (VS) rates [<1000 copies/Ml] in September 2022. Of the 16,420 older adults living with HIV (10.8% of the treatment cohort) at the time of the study, 53.8%, and 99.5% were on a first-line ART regimen. Among the 3585 with baseline CD4 documented (21.8% of the cohort), the median [IQR] CD4 count was 496 [286–699] cells/mm3, with more males having lower baseline CD4 than females [13.4% of males vs. 10.2% of females, p-value = 0.004]. In total, 59.9% received treatment at out-of-facility locations, with more males receiving treatment in this setting than females [65.7% vs. 54.8% p-value < 0.001]. Of those in whom blood pressure was assessed (65.9% of the treatment cohort), 9.6% were hypertensive, with males being less likely to be hypertensive [8.0% vs. 11.1% p-value < 0.001] than females. Overall, retention as of September 2022 was 96.4%, while VS was 99.0% and did not differ significantly by sex [retention: p = 0.901; VS: p = 0.056]. VS was slightly but not significantly higher among females than males (98.8% versus 99.2%; Aor = 0.79, 95%CI = 0.58–1.10, p = 0.17). Although older males and females living with HIV had similar treatment outcomes, hypertension screening was suboptimal and could impact long-term morbidity and mortality. Our study emphasizes the need to integrate noncommunicable disease screening and the management of hypertension in the care of older persons living with HIV. Full article
(This article belongs to the Special Issue Living with HIV: Support, Care, and Treatment for Vulnerable Populations)

Other

Jump to: Editorial, Research

8 pages, 183 KiB  
Opinion
Persons Living with HIV as a Vulnerable Group: An Argument to Ensure Treatment, Care, and Support
by Michelle Brotherton
Trop. Med. Infect. Dis. 2024, 9(7), 155; https://doi.org/10.3390/tropicalmed9070155 - 11 Jul 2024
Viewed by 723
Abstract
Generally, human rights documents are to be applied universally. However, certain groups are identified for special treatment due to vulnerabilities faced; these are often referred to as vulnerable groups or populations. While human rights literature and public health literature make a case for [...] Read more.
Generally, human rights documents are to be applied universally. However, certain groups are identified for special treatment due to vulnerabilities faced; these are often referred to as vulnerable groups or populations. While human rights literature and public health literature make a case for particular sensitivity regarding vulnerable populations living with HIV, there is perhaps a case to be made for people living with HIV to be recognised as a vulnerable group in and of itself. It is often other vulnerabilities, such as poverty, disability, or discrimination, that render persons living with HIV legally vulnerable. But what happens if these other vulnerabilities are not present? Persons living with HIV could benefit from being recognised as a vulnerable group, in that it could prioritise their health rights and promote their access to healthcare and services. This article considers how identifying persons living with HIV as a vulnerable group could impact their treatment, care, and support. By looking at examples of countries where people living with HIV have been identified as vulnerable, and at how vulnerable groups are defined, an argument is made that it could be beneficial to persons living with HIV to be identified as a vulnerable group in terms of accessing treatment, care, and support. Full article
(This article belongs to the Special Issue Living with HIV: Support, Care, and Treatment for Vulnerable Populations)
12 pages, 2816 KiB  
Case Report
Unusual Localization of AIDS-Related Kaposi’s Sarcoma in a Heterosexual Male during the COVID-19 Pandemic: A Case Report
by Manuela Arbune, Monica-Daniela Padurariu-Covit, Carmen Tiutiuca, Raul Mihailov, Elena Niculet, Anca-Adriana Arbune and Alin-Laurentiu Tatu
Trop. Med. Infect. Dis. 2024, 9(2), 47; https://doi.org/10.3390/tropicalmed9020047 - 13 Feb 2024
Viewed by 2364
Abstract
Kaposi’s sarcoma is an AIDS-defining illness and remains the most frequent tumor arising in HIV-infected patients with multifactorial etiology. We present a case of a 30-year-old Caucasian male with an 18-year history of HIV infection. The patient was presented with a one-week history [...] Read more.
Kaposi’s sarcoma is an AIDS-defining illness and remains the most frequent tumor arising in HIV-infected patients with multifactorial etiology. We present a case of a 30-year-old Caucasian male with an 18-year history of HIV infection. The patient was presented with a one-week history of fever, non-productive cough, and skin lesions. There was an associated weakness and weight loss in a duration of 6 months. Clinical examination showed fever, generalized lymphadenopathy, lower limb edema, ascites, and violaceous cutaneous eruption comprising patches, plaques, and nodules. He also had a red nodule on the left conjunctiva, as well as on his oral mucosa. His CD4+ count was below 10/mm3 and ARN-HIV viral load was above 100,000 c/mL, in relation to the antiretroviral failure after five drug regimens. The role of co-infections in oncogenesis and the course of Kaposi’s sarcoma were considered in recent studies. Delayed diagnosis of Kaposi’s sarcoma in the present case resulted in a negative impact for this patient during the COVID-19 pandemic. Full article
(This article belongs to the Special Issue Living with HIV: Support, Care, and Treatment for Vulnerable Populations)
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