Medical Management of HIV—Hepatitis C Virus Coinfection in Injection Drug Users

Khalsa, Jag H.; Kresina, Tom; Sherman, K.E.; Vocci, Francis

doi:10.1086/429488

Cited by 11 publications

(5 citation statements)

References 34 publications

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“…Clinical, veterinary, and environmental surveys have shown that bacteria harboring MIs are often associated with multidrug-resistant (MDR) phenotypes (Bass et al, 1999; Leverstein-van Hall et al, 2003; Biyela et al, 2004; Nijssen et al, 2005; Laroche et al, 2009). However, the MDR profile could not be linked only to the antibiotic-resistance GCs carried by the MIs, but also to other resistance genes located on MIs-containing plasmids and transposons.…”

Section: Mis Dissemination and Their Involvement In Antibiotic Resistmentioning

confidence: 99%

Integron Involvement in Environmental Spread of Antibiotic Resistance

Stalder¹,

Barraud²,

Casellas³

et al. 2012

Front. Microbio.

321

212

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The spread of antibiotic-resistant bacteria is a growing problem and a public health issue. In recent decades, various genetic mechanisms involved in the spread of resistance genes among bacteria have been identified. Integrons – genetic elements that acquire, exchange, and express genes embedded within gene cassettes (GC) – are one of these mechanisms. Integrons are widely distributed, especially in Gram-negative bacteria; they are carried by mobile genetic elements, plasmids, and transposons, which promote their spread within bacterial communities. Initially studied mainly in the clinical setting for their involvement in antibiotic resistance, their role in the environment is now an increasing focus of attention. The aim of this review is to provide an in-depth analysis of recent studies of antibiotic-resistance integrons in the environment, highlighting their potential involvement in antibiotic-resistance outside the clinical context. We will focus particularly on the impact of human activities (agriculture, industries, wastewater treatment, etc.).

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Section: Mis Dissemination and Their Involvement In Antibiotic Resistmentioning

confidence: 99%

Integron Involvement in Environmental Spread of Antibiotic Resistance

Stalder¹,

Barraud²,

Casellas³

et al. 2012

Front. Microbio.

321

212

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“…Alcohol potentiates the effects of some drugs and may lead to an adverse outcome, such as coma (Buttner and Weis 2004). Drugs used intravenously carry the added risk of septicemia, thromboses, and exposure to blood-borne viruses including HIV and hepatitis B and C (Buttner and Weis 2004;Khalsa et al 2005;Thomas et al 2000). Intravenous drug users have a high prevalence of co-infection with hepatitis viruses and may suffer from resulting liver damage, which predisposes to hepatic encephalopathy (Butterworth 2003;Karch 2002;Khalsa et al 2003).…”

Section: Brain Disorders Induced By Drugs Of Abusementioning

confidence: 99%

Neurobiology of Multiple Insults: HIV-1-Associated Brain Disorders in Those Who Use Illicit Drugs

Bell

Arango

Anthony

2006

Jrnl NeuroImmune Pharm

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Despite two decades of research, certain aspects of HIV-related central nervous system (CNS) disease remain poorly understood. HIV targets microglia and macrophages within the CNS and enters the brain compartment early. However, HIV is there held in check apparently until the onset of significant immune compromise, when viral replication, microglial activation, neuronal damage, and cognitive impairment are likely to ensue. Illicit drug abuse continues to be a significant risk factor for HIV transmission worldwide. Whether HIV-related CNS disease is more prevalent or more severe in this risk group has long been debated. Drugs of abuse can of themselves cause immune suppression, blood-brain barrier breakdown, microglial activation, and neuronal injury. This review presents evidence that HIV associated CNS disorders are indeed accentuated in drug abusers. However, the advent of effective therapy has added a new dimension, which must be taken into consideration. Treated individuals are surviving much longer and HIV encephalitis and HIV-associated dementia have become much less common. However, more subtle forms of CNS damage are emerging. Examination of the brains of individuals who have been treated long term with highly active antiretroviral therapy (HAART) reveals a surprising degree of microglial activation, comparable at times to that seen formerly in milder cases of HIV encephalitis. In addition, these individuals show evidence of increased deposition of neurodegenerative proteins, particularly hyperphosphorylated tau. Similar observations have been made in young opiate abusers who are HIV negative. Taken together, these results suggest that neuroinflammation and neurodegeneration, which are clinically silent at present, may cause problems in the future in HAART-treated subjects.

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“…The resulting disturbance of glutamate homeostasis and other metabolic changes including the accumulation of ammonia results in cognitive and motor dysfunction. This is a not insignificant problem in HIV infected drug users since it is estimated that up to 90% of HIV positive IVDUs are hepatitis C virus (HCV) positive (90). HIV positivity appears to accelerate HCVrelated liver damage and the resulting complications for the CNS (15,91).…”

Section: In the Absence Of Hivmentioning

confidence: 99%

The effects of illicit drugs on the HIV infected brain

et al. 2008

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Evidence accumulating from clinical observations, neuroimaging and neuropathological studies suggests that illicit drug abuse accentuates the adverse effects of HIV on the central nervous system (CNS). Experimental investigation in cell culture models supports this conclusion. Injecting drug abuse is also a risk factor for the acquisition of HIV infection, the incidence of which continues to rise in intravenous drug users (IVDU) even in countries with access to effective therapy. In order to understand the interactions of drug abuse and HIV infection, it is necessary to examine the effects of each insult in isolation before looking for their combined effects. This review traces progress in understanding the pathogenesis of HIV related CNS disorders before the introduction of effective therapy and compares the state of our knowledge now that effective therapy has significantly modified disease progression. The additional impact of intravenous drug abuse on HIV-associated brain disease, then and now, is also reviewed. Predictions for the future are discussed, based on what is known at present and on recently emerging data.

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Medical Management of HIV—Hepatitis C Virus Coinfection in Injection Drug Users

Cited by 11 publications

References 34 publications

Integron Involvement in Environmental Spread of Antibiotic Resistance

Integron Involvement in Environmental Spread of Antibiotic Resistance

Neurobiology of Multiple Insults: HIV-1-Associated Brain Disorders in Those Who Use Illicit Drugs

The effects of illicit drugs on the HIV infected brain

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