The incidence of and risk factors for Jarisch-Herxheimer (JH) reaction were investigated prospectively among 240 human immunodeficiency virus (HIV)-infected and 115 HIV-uninfected patients with syphilis who received penicillin treatment. The overall rate of JH reaction was 31.5% (34.6% in HIV-infected patients and 25.2% in HIV-uninfected patients). In multivariate analysis, risk factors for JH reaction included high rapid plasma reagin (RPR) titers (per log(2) RPR increase, risk ratio [RR], 1.19; 95% confidence interval [CI], 1.04-1.37), early syphilis (RR, 8.59; 95% CI, 4.75-15.56), and prior penicillin treatment (RR, 0.39; 95% CI, 0.20-0.78).

Approximately one-fourth of HIV-infected Taiwanese patients developed metabolic syndrome in the HAART era. Receipt of HAART and prolonged exposure to PI and nucleoside reverse transcriptase inhibitor(s) were associated with metabolic syndrome.

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Three doses versus 2 doses of HAV vaccine improve the durability of immune responses in terms of higher concentrations of specific IgG, which take longer to decay to subthreshold levels.

ObjectivesRecent studies suggest that patients with HIV infection are at increased risk for incident diabetes mellitus (DM). We investigated the incidence and risk factors of DM among HIV-infected patients receiving combination antiretroviral therapy (CART) in Taiwan. MethodsIncident cases of DM were identified among HIV-infected patients at the National Taiwan University Hospital between 1993 and 2006. A retrospective case-control study was conducted after matching cases with controls for sex, age at HIV diagnosis, year of HIV diagnosis, mode of HIV transmission and baseline CD4 lymphocyte count. A multivariate analysis was performed to identify risk factors for incident DM among HIV-infected patients. ResultsIn 824 HIV-infected patients eligible for analysis, 50 cases of incident DM were diagnosed, resulting in an incidence of 13.1 cases per 1000 person-years of follow-up. In total, 100 matched controls were identified. Risk factors for incident DM were a family history of DM [odds ratio (OR) 2.656; 95% confidence interval (CI) 1. 209-5.834], exposure to zidovudine (OR 3.168;) and current use of protease inhibitors (OR 2.528; 95% CI 1.186-5.389). ConclusionsIncident DM was associated with a family history of DM, exposure to zidovudine and current use of protease inhibitors in HIV-infected patients receiving CART in Taiwan.Keywords: antiretroviral therapy, case-control study, diabetes mellitus, HIV infection IntroductionCombination antiretroviral therapy (CART) has greatly improved survival in patients with HIV infection [1,2]. However, as HIV-infected patients exposed to antiretroviral agents experience prolonged survival and ageing, we have observed the emergence of CART-associated metabolic complications that include impaired glucose tolerance, diabetes mellitus (DM) and lipid disorders, which may subsequently result in increased risk for cardiovascular diseases [3][4][5][6].Glucose intolerance and DM are becoming more common in HIV-infected patients in the era of CART [5,[7][8][9]. Previous studies reported a 6-7% risk of incident DM among patients receiving protease inhibitors (PIs) [9]. Cohort studies showed that HIV-infected individuals on CART had a higher incidence of DM than those not on CART or their HIV-uninfected counterparts [10][11][12]. The incidence of DM among patients receiving CART shows wide variation, from 4.4 per 1000 person-years of followup (PYFU) in the Swiss Cohort Study to 34 per 1000 PYFU in the Women's Interagency HIV Study (WIHS) and 47 per 1000 PYFU in the Multicenter AIDS Cohort Study (MACS) [11][12][13][14]. The discrepancies may result from the enrolment of study populations of different race and ethnicity and from differences in the definition of DM [11][12][13][14].With respect to the factors associated with the development of DM in HIV-infected individuals receiving CART, several cohort studies yielded inconsistent results in terms of the relationship between DM and exposure to specific Correspondence: Dr Chien-Ching Hung, Department of Internal Medicine, National Taiwan U...