HIV retinopathy is an ocular affection occurring especially in HIV positive patients with deep immunodeficiency. Because of benign character the HIV retinopathy does not require any specific therapy, but it must be carefully distinguished from other ocular diseases, which can seriously damage sight, e.g. CMV retinitis. The presence of HIV retinopathy can also be a symptom of progression of HIV infection and should be perceived as a signal for considering the initiation of antiretroviral therapy in treatment naive patients.

• MeSH
• HIV infekce komplikace   MeSH
• lidé MeSH
• nemoci retiny komplikace   diagnóza   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• přehledy MeSH

Treatment of HIV infection has modified the initially fatal infection into a typically chronic disease requiring lifelong treatment. However, there is no complete normalization of immune activation, signs of inflammation and prothrombotic state in treated patients. This condition is the result of many factors, but the main cause is thought to be the residual production of HIV-1 RNA and viral proteins by infected cells in cellular reservoirs. Persistence of immune activation/inflammation/prothrombotic state leads to the pathophysiology of "sterile inflammation" and so-called non-AIDS diseases, which manifest one to two decades earlier in those infected. Despite all the pitfalls and unwanted secondary manifestations of antiretroviral drugs, the treatment of HIV infection has managed to reverse the trajectory of a fatal pandemic and has made it possible to approach therapeutic modalities that were absolutely unimaginable just a few years ago. Solid organ transplantation is now a completely legitimate therapeutic method for patients living with HIV, and highly suppressive treatment even allows transplantation from an HIV-infected donor. The text below presents a brief overview of the basic pitfalls, but also of the successes, of the current highly suppressive treatment of HIV infection.

• Klíčová slova
• Antiretroviral therapy, HIV, HIV reservoir, Transplantation, immune activacion, non-AIDS diseases, transplantation,
• MeSH
• antiretrovirové látky terapeutické užití   MeSH
• HIV infekce * komplikace   farmakoterapie   MeSH
• HIV-1 * genetika   MeSH
• lidé MeSH
• zánět farmakoterapie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• antiretrovirové látky MeSH

In all groups of patients--HIV, ARC, AIDS carriers--elevated serum concentration of IgG, IgA, IgM were found. In the group of HIV carriers a significant increase of the serum concentration of IgG at the 5% level was observed and of IgM at the 1% level. In patients with ARC a significant increase of IgG and IgA was found at the 5% level and of IgM at the 1% level. In patients with AIDS significantly raised IgG values at the 5% level were recorded, and of IgA and IgM at the 1% level. In IgA a permanent increase of values occurs in AIDS carriers. In the AIDS stage 86% of the patients have values higher than mean +/- SD of controls. In all three stages of HIV infection a rise of concentrations of circulating immunocomplexes was observed (p < 0.01). The highest levels were recorded in patients with AIDS. In none of the patients the presence of antinuclear antibodies was detected. The authors discuss also possible causes of hypergammaglobulinaemia in HIV infection.

• MeSH
• AIDS komplikace   imunologie   MeSH
• dospělí MeSH
• HIV infekce komplikace   imunologie   MeSH
• HIV séropozitivita komplikace   imunologie   MeSH
• hypergamaglobulinemie komplikace   MeSH
• komplex příbuzný AIDS komplikace   imunologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• senioři MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• senioři MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH

OBJECTIVES: The number of HIV-infected individuals from developed countries travelling to tropical and subtropical areas has increased as a result of the clinical and survival benefits of combination antiretroviral therapy. The aim of our study was to describe the traveler population in the SHCS and to determine the frequency of viral rebound in virologically suppressed individuals after a travel episode to the tropics compared to non-travelers. METHODS: Swiss HIV Cohort Study participants with at least one follow-up visit between 1 January 1989 and 28 February 2015 were eligible for inclusion in the study. The primary outcome was the occurrence of viral rebound (viral load > 200 HIV-1 RNA copies/mL) after a travel episode compared with a nontravel episode in previously suppressed individuals (≤ 200 copies/mL). All virologically suppressed patients contributed multiple travel or nontravel episodes to the analysis. Logistic regression was performed including factors associated with viral rebound. RESULTS: We included 16 635 patients in the study, of whom 6084 (36.5%) had ever travelled to the tropics. Travel frequency increased over time, with travellers showing better HIV parameters than nontravellers [less advanced Centers for Disease Control and Prevention (CDC) stage and higher CD4 count nadir]. Viral rebound was seen in 477 (3.9%) of 12 265 travel episodes and in 5121 (4.5%) of 114 884 nontravel episodes [unadjusted odds ratio (OR) 0.87; 95% confidence interval (CI) 0.78-0.97]. Among these 477 post-travel viral rebounds, 115 had a resistance test performed and 51 (44%) of these showed new resistance mutations. Compared with European and North American patients, the odds for viral rebound were significantly lower in Southeast Asian (OR 0.67; 95% CI 0.51-0.88) and higher in sub-Saharan African (SSA) patients (OR 1.41; 95% CI 1.22-1.62). Travel further increased the odds of viral rebound in SSA patients (OR 2.00; 95% CI 1.53-2.61). CONCLUSIONS: Region of origin is the main risk factor for viral rebound rather than travel per se. Pre-travel adherence counselling should focus on patients of SSA origin.

• Klíčová slova
• HIV, adherence, travel, virological failure, visiting friends and relatives,
• MeSH
• adherence k farmakoterapii psychologie   MeSH
• cestování * MeSH
• dospělí MeSH
• etnicita * MeSH
• HIV infekce farmakoterapie   virologie   MeSH
• HIV-1 izolace a purifikace   MeSH
• kohortové studie MeSH
• lidé MeSH
• prospektivní studie MeSH
• RNA virová krev   MeSH
• virová nálož * MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Švýcarsko MeSH
• Názvy látek
• RNA virová MeSH

As life expectancy of patients infected by Human Immunodeficiency Virus (HIV) has prolonged, they are treated by physicians of different specialities. This article focuses on urologic complications of HIV infection. Urinary tract infections in HIV positive patients are more frequent than in otherwise healthy individuals and less common microorganisms can be involved. Sexually transmitted diseases are a commonplace. Certain malignancies of the genitourinary tract are more often diagnosed in HIV positive than in HIV negative population. Impairment of kidney function is usually caused by HIV-associated nephropathy. Acute renal failure can also occur. Indinavir causes urinary stones formation. Male circumcision is an effective method of HIV transmission prevention.

• MeSH
• HIV infekce komplikace   prevence a kontrola   MeSH
• infekce močového ústrojí komplikace   MeSH
• lidé MeSH
• nefropatie doprovázející AIDS komplikace   MeSH
• urogenitální nádory komplikace   MeSH
• urologické nemoci komplikace   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• přehledy MeSH

Acute HIV infection occurs in 85% of people recently infected with HIV-1 after an incubation period of 2-6 weeks. Diagnosing the acute HIV infection is difficult because the symptoms are non-characteristic and include fever, pharyngitis, and skin rash. Early recognition of HIV infection is, of course, maximally desirable in order to prevent further transmission of the infection and because the early treatment can slow down later progression of the disease.

• MeSH
• akutní nemoc MeSH
• diferenciální diagnóza MeSH
• dospělí MeSH
• HIV infekce diagnóza   farmakoterapie   MeSH
• HIV-1 * MeSH
• lidé MeSH
• mladiství MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mladiství MeSH
• ženské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• kazuistiky MeSH
• práce podpořená grantem MeSH
• přehledy MeSH

The authors present instructions for providing antiretroviral therapy in the Czech health care system, based partly on recommendations from abroad and partly on their own experiences of caring for HIV /AIDS patients. The structure and content are similar to those in the 2010 edition, with new study outcomes and modern trends in treatment strategy being taken into consideration. The guidelines are based on systematic patient assessment and aimed at making an accurate diagnosis and formulating recommendations according to individual criteria. The document provides specific instructions for decisions on initiating antiretroviral therapy, selection of individual drugs, monitoring of treatment effect and adverse reactions, and reaction to potential therapy failure. Special attention is paid to administration of antiretroviral drugs to pregnant women and patients with comorbidities, especially tuberculosis, hepatitis or renal insufficiency. The new version includes procedures for postexposure prophylaxis for HIV infection. The guidelines are supplemented by a table summary of antiretroviral drugs. The presented document is to be used in negotiations between the association,state authorities and health care payers.

• MeSH
• dospělí MeSH
• HIV infekce farmakoterapie   moč   MeSH
• infekční komplikace v těhotenství farmakoterapie   MeSH
• látky proti HIV terapeutické užití   MeSH
• lidé MeSH
• těhotenství MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• látky proti HIV MeSH

Many outstanding discoveries accompany the existence of HIV infections. International teams of scientists cooperate and in their work they use a great many methods from haematology and immunology to methods of molecular biology that pass into methods of molecular virology. These, in turn, open new prospects for methods of molecular epidemiology. The development of sensitive and specific antibody tests made possible the testing of blood intended for transfusions and helped map the epidemilogical situation, describe the clinical course of the disease and, in particular, diagnose the asymptomaic stage of infection. Gradually, the jigsaw puzzle of the pathogenesis of HIV infections was completed. The tremendous advances in antiretrovirus treament meant a turning point in the mortality and morbidity of HIV infection. Clinical trials of therapeutic vaccines are in progress. Yet despite all the advances and prevention efforts the HIV/AIDS pandemic continues.

• MeSH
• AIDS diagnóza   epidemiologie   terapie   MeSH
• HIV infekce * diagnóza   epidemiologie   terapie   virologie   MeSH
• HIV genetika   MeSH
• lidé MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH

AIM OF THE STUDY: Analysis of treatment possibilities of infertility in HIV positive patients and solution of child desire in discordant pairs. Authors also present their own case. TYPE OF STUDY: Literature review and two case report. NAME AND SETTING OF DEPARTMENT: Department of Obstetrics and Gynaecology, The First Medical Faculty of Charles University in Prague. MATERIALS AND METHODS: Review of papers published on risk of HIV transmission during sexual intercourse, fertility of HIV positive patients and possible solution of their child desire. Summary of papers published on safety and effectivity of artificial insemination and IVF ET in HIV discordant pairp. Analysis of our own cases of artificial insemination in pairs of HIV negative female and HIV positive male. CONCLUSION: Artificial insemination seems to be safe, relatively cheap and effective solution of child desire in HIV discordant pair.

• MeSH
• HIV infekce MeSH
• HIV séropozitivita * MeSH
• lidé MeSH
• těhotenství MeSH
• umělá inseminace metody   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH

Combined antiretroviral therapy results in extraordinary decrease of morbidity and mortality of HIV-infected patients and in an essential change of the HIV/AIDS disease prognosis. However, long-term intake of antiretroviral medicaments is related to occurrence of metabolic and morphological abnormalities, of which some have been combined into a new syndrome--the so called HIV lipodystrophy. The HIV lipodystrophy syndrome covers metabolic and morphological changes. Metabolic changes include dyslipidaemia with hypercholesterolaemia and/or hypertriglyceridaemia, insulin resistance with hyperinsulinaemia and hyperlaktataemia. Morphological changes have the nature of lipoatrophia (loss of subcutaneous fat--on the cheeks, on extremities, on buttocks and marked prominence of surface veins) or lipohypertrophia (growth of fat tissue--on the chest, in the dorsocervical area, lipomatosis of visceral tissues and organs, fat accumulation in the abdominal area). Several HIV lipodystrophy features are very similar to the metabolic syndrome of the general population. That is why this new syndrome represents a prospective risk of premature atherosclerosis and increase of the cardiovascular risk in young HIV positive individuals. The article mentions major presented studies dealing with the relation of antiretroviral treatment and the cardiovascular risk. The conclusions of the studies are not unequivocal--this is, among others, given by the reason that their length is short from the viewpoint of atherogenesis. The major risk of subclinical atherosclerosis acceleration seems to be related to the deep immunodeficiency and low number of CD4+ lymphocytes and florid, uncontrolled HIV infection with a high number of HIV-1 RNA copies actually circulating in the plasma. The question, whether metabolic and morphological changes related to HIV and cART carry a similar atherogenic potential as in the general population, remains open for future.

• MeSH
• antiretrovirové látky škodlivé účinky   MeSH
• lidé MeSH
• syndrom lipodystrofie spojený s HIV * chemicky indukované   diagnóza   patofyziologie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• přehledy MeSH
• Názvy látek
• antiretrovirové látky MeSH