The Experts below are selected from a list of 360 Experts worldwide ranked by ideXlab platform

Olivier Lortholary - One of the best experts on this subject based on the ideXlab platform.

  • pneumocystis jirovecii pneumonia
    Infectious Disease Clinics of North America, 2010
    Co-Authors: Emilie Catherinot, Fanny Lanternier, Marieelisabeth Bougnoux, Marc Lecuit, L J Couderc, Olivier Lortholary
    Abstract:

    Pneumocystis jirovecii has gained attention during the last decade in the context of the AIDS epidemic and the increasing use of cytotoxic and immunosuppressive therapies. This article summarizes current knowledge on biology, pathophysiology, epidemiology, diagnosis, prevention, and treatment of pulmonary P jirovecii Infection, with a particular focus on the evolving pathophysiology and epidemiology. Pneumocystis pneumonia still remains a severe Opportunistic Infection, associated with a high mortality rate.

  • invasive aspergillosis as an Opportunistic Infection in nonallografted patients with multiple myeloma a european organization for research and treatment of cancer
    Clinical Infectious Diseases, 2000
    Co-Authors: Olivier Lortholary, Sibel Ascioglu, Philippe Moreau, Raoul Herbrecht, Ann Marinus, Philippe Casassus, Ben E De Pauw, David W Denning
    Abstract:

    We report the occurrence of invasive aspergillosis (IA) in nonallografted patients with multiple myeloma (MM) who were treated at hematology or oncology centers in Europe during 1984‐1996. Thirty-one cases met the criteria for definitive (21 [68%]) or probable (10 [32%]) IA. Of these cases, 23 (74%) were reported during 1992‐1996. Twenty-nine cases (94%) occurred in patients with Durie-Salmon stage 3 MM, and 2 (6%) occurred in patients with Durie-Salmon stage 2 MM. The median time between MM and IA diagnoses was 8 months (range, 1‐75 months). Sixteen patients (51%) had a neutrophil count <500/mm 3 for a median duration of 19 days (range, 10‐37 days). Fourteen patients (45%) had recently received corticosteroid therapy, and 11 (36%), high doses of melphalan. Twenty-eight patients had primary pulmonary IA, and 3 had primary sinus IA. Forty-five percent of patients were considered to have died of IA. IA occurs as a potentially lethal Opportunistic Infection in intensively treated nonallografted patients with myeloma. Multiple myeloma (MM) is a hematologic malignancy for which the incidence and mortality rate increase with age [1]. During the past years, there has been a trend toward intensification of chemotherapeutic regimens [2] with allogeneic bone marrow transplantation [3] or autologous stem cell transplantation [4, 5] and the use of high doses of steroids [6]. Recent

J P Cassuto - One of the best experts on this subject based on the ideXlab platform.

Irini Sereti - One of the best experts on this subject based on the ideXlab platform.

  • immune reconstruction inflammatory syndrome in hiv Infection beyond what meets the eye
    Topics in antiviral medicine, 2020
    Co-Authors: Irini Sereti
    Abstract:

    A high proportion of individuals with HIV Infection currently are diagnosed at an advanced stage of disease (late presenters), increasing their risk for immune reconstitution inflammatory syndrome (IRIS). IRIS typically occurs within 6 months of initiation of antiretroviral therapy (ART) in patients with low CD4+ cell counts and can occur before any marked elevation in CD4+ count is achieved on ART. In addition to low CD4+ count at ART initiation, 2 other major clinical predictors of IRIS are preexisting Opportunistic Infection (including subclinical Infection) and shorter treatment period for Opportunistic Infection prior to starting ART. Mycobacterial Infection-associated IRIS, including tuberculosis (TB)-associated IRIS, and cryptococcal Infection-associated IRIS are the most common forms of the syndrome. Corticosteroid prophylaxis and early treatment can be effective in reducing incidence of TB-IRIS and severity of symptoms in select patients. Sterilization of the cerebrospinal fluid should be achieved prior to starting ART in patients with TB meningitis and cryptococcal meningitis. This article summarizes a presentation by Irini Sereti, MD, MHS, at the International Antiviral Society-USA (IAS-USA) continuing education program held in Washington, DC, in April 2019.

  • risk factor analyses for immune reconstitution inflammatory syndrome in a randomized study of early vs deferred art during an Opportunistic Infection
    PLOS ONE, 2010
    Co-Authors: Philip M Grant, Lauren Komarow, Janet Andersen, Irini Sereti, Savita Pahwa, Michael M Lederman, Joseph J Eron, Ian Sanne, William G Powderly, Evelyn Hogg
    Abstract:

    Background: Immune reconstitution inflammatory syndrome (IRIS) is reported widely in patients initiating antiretroviral therapy (ART). However, few studies are prospective, and no study has evaluated the impact of the timing of ART when allocated randomly during an acute Opportunistic Infection (OI). Methodology/Principal Findings: A5164 randomized 282 subjects with AIDS-related OIs (tuberculosis excluded), to early or deferred ART. IRIS was identified prospectively using pre-defined criteria. We evaluated associations between IRIS and baseline variables in subjects with follow-up on ART using Wilcoxon and Fisher’s exact tests, logistic regression, and Cox models with time-varying covariates. Twenty of 262 (7.6%) subjects developed IRIS after a median of 33 days on ART. Subjects with fungal Infections (other than pneumocystis) developed IRIS somewhat more frequently (OR = 2.7; 95% CI: 1.02, 7.2; p-value = 0.06 (using Fisher’s exact test)). In Cox models, lower baseline and higher on-treatment CD4+ T-cell counts and percentage were associated with IRIS. Additionally, higher baseline and lower on-treatment HIV RNA levels were associated with IRIS. Corticosteroids during OI management and the timing of ART were not associated with the development of IRIS. Implications: In patients with advanced immunosuppression and non-tuberculous OIs, the presence of a fungal Infection, lower CD4+ T-cell counts and higher HIV RNA levels at baseline, and higher CD4+ T-cell counts and lower HIV RNA levels on treatment are associated with IRIS. Early initiation of ART does not increase the incidence of IRIS, and concern about IRIS should not prompt deferral of ART. Trial Registration: ClinicalTrials.gov NCT00055120

Paolo Ferrari - One of the best experts on this subject based on the ideXlab platform.

  • travel related disseminated penicillium marneffei Infection in a renal transplant patient
    Transplant Infectious Disease, 2012
    Co-Authors: J Hart, J R Dyer, B M Clark, D G Mclellan, S Perera, Paolo Ferrari
    Abstract:

    Penicillium marneffei is a thermally dimorphic fungus that causes severe human immunodeficiency virus-related Opportunistic Infection in endemic areas of Southeast Asia and has rarely been reported in solid organ transplant (SOT) recipients. We report here the case of an Australian renal transplant patient who presented with disseminated P. marneffei Infection shortly after a 10-day holiday to Vietnam, and review all previously published cases of penicilliosis associated with renal transplantation. This is the first reported case, to our knowledge, of P. marneffei Infection in an SOT recipient acquired during travel to an endemic country, and highlights the importance of an accurate travel history when Opportunistic Infection is suspected, as well as giving appropriate health advice to transplant patients who travel.

Sirventvon A Bueltzingsloewen - One of the best experts on this subject based on the ideXlab platform.