Monkeypox (Mpox) has emerged as a global threat since 2022. We reported 14 cases of Mpox in 10 people with HIV (PWH) and 4 people without HIV (PWoH), of whom 64.3% had sexually transmitted co-infections. Severe complications of Mpox and prolonged viral shedding might occur in both PWH and PWoH.

Gallium-68 ( 68 Ga)-fibroblast activation protein inhibitor (FAPI) positron emission tomography (PET) images the cancer-associated fibroblast that forms a vital component of the tumor microenvironment. It is known that 68 Ga-FAPI PET can aid in differentiating reactive lymph nodes from metastatic lymph nodes. 18 F-fluorodeoxyglucose (FDG) PET/computed tomography (CT) is still the most commonly used PET radiopharmaceutical in the evaluation of a wide range of malignancies including breast carcinoma. Reactive lymph nodes may also show FDG uptake which can hinder optimal assessment for metastatic involvement. We report an interesting case of invasive ductal carcinoma of the right breast with associated World Health Organization clinical stage I acquired immunodeficiency syndrome for which 18 F-FDG PET/CT and 68 Ga-FAPI PET/CT were done.

A progresszív multifokális leukoencephalopathiát a John Cunningham-vírus reaktiválódása okozza, amely szinte kizárólag immunhiányos betegeknél fordul elő. A betegség tüneteit elsősorban a demyelinisatiós gócok lokalizációja határozza meg; a betegség a kezdeti szakaszban tünetszegény lehet, és a neurológiai tünetek csak később jelennek meg. Diagnosztikájában elsősorban a képalkotó vizsgálatok és a vírus-DNS liquorból történő kimutatása játszik fontos szerepet. Specifikus terápiája nem ismert, a cél az immunrendszer működésének helyreállítása. Kazuisztikánkban egy pszichiátriai osztályon észlelt páciens kórtörténetét ismertetjük, akinek esetében AIDS-hez köthető jobb féltekei progresszív multifokális leukoencephalopathia képe igazolódott. Korai differenciáldiagnosztikai nehézséget jelentettek a páciensnél észlelhető patológiás személyiségjegyek, illetve az élethelyzeti nehézségek és a párkapcsolati veszteség talaján kialakult krízisállapot. Esetünkkel szeretnénk felhívni a figyelmet az immunhiányos betegeknél jelentkező pszichiátriai tünetek fontosságára. Orv Hetil. 2024; 165(33): 1295–1302.

West Nile Virus (WNV) belongs to the Flaviviridae family of viruses. It was first isolated and identified in 1937. Patients typically present with flu-like symptoms or are asymptomatic; however, neuroinvasive West Nile can lead to significant neurological impairment. Herein presented is a catastrophic case of WNV rhombencephalitis in a male patient newly diagnosed with AIDS. This report sheds light on the potential for severe neurological complications in co-infected patients and emphasizes the importance of early recognition.

BACKGROUND: Mycobacterium avium complex (MAC) is an uncommon clinical pathogen, especially in the central nervous system (CNS), and carries a poor prognosis. MAC infections commonly present as immune reconstitution disease (IRD) in HIV patients. Herein, we report a case of intracranial infection caused by MAC in an AIDS patient without disseminated MAC (DMAC) and immune reconstitution inflammatory syndrome (IRIS).
METHODS: A 31-year-old HIV-positive male presented us with progressively worsening CNS symptoms, and neuroimaging revealed ring-enhancing lesions. The intracranial lesions worsened after the empirical therapy for toxoplasma encephalitis and fungal infection. Due to the rapid progression of the disease, the patient died. Mycobacterium avium was the only pathogen in brain tissue after cultures and molecular biology tests.
CONCLUSIONS: MAC infection in CNS is challenging to diagnose in HIV patients. Our findings emphasize that obtaining tissue samples and applying molecular biology methods is essential to help diagnose the patient as soon as possible to receive adequate treatment.

BACKGROUND: HIV/AIDS is a chronic disease that challenges public health worldwide and causes morbidity and mortality in humans. The main purpose of this study was to investigate the determinants of longitudinal changes in CD4 cell count and survival time to death among HIV/AIDS patients as adults from January 2016 to December 2019 at Yabelo General Hospital. The intellectual gap in this study was focused on the study area, which means that the study related to joint modeling doesn\'t exist in the pastoralist community of Borena.
METHODS: This study involved 293 adult HIV-infected adults that could be collected from the recorded patient chart data, and the study design is a retrospective cohort design. The study used a Cox proportional hazard model, a linear mixed effect model, and a joint model, which is the combination of both model processes.
RESULTS: The joint model showed that longitudinal CD4 cell count is significantly associated with survival time (p-value = 0.0253). Covariates such as visiting time, age, weight, educational status, ART adherence, and functional status were statistically significant factors associated with mean changes in the CD4 cell count of HIV patients. WHO stage, educational status, place of residence, TB, family history, and opportunistic infection disease had a significant effect on the survival time of HIV patients.
CONCLUSIONS: The estimated association parameter is a negative value, which indicates both outcomes are negatively associated, and higher values of the CD4 cell count are associated with better survival.

In Ethiopia, even though there is an effort to increase ART services, different challenges remain in the provision of HIV/AIDS treatment and care services, and little has been done to evaluate patient satisfaction levels. The purpose of this study is to assess the determinants of HIV/AIDS treatment and care service quality. A facility-based cross-sectional study was conducted during from October 2023 to November 2023 in Woliso Town. The total sample size was generated using a systematic random sampling method from the source population. The results of the study showed that client satisfaction with HIV/AIDS treatment and care service quality was 272 (81.4%) with 95% CI: 76.9-85.3%. Government employees were 67% less likely to be satisfied with HIV/AIDS treatment and care service quality (AOR = 0.33 95% CI: 0.11, 0.99) when compared to unemployed clients. The odds of client satisfaction were 6.72 times higher among study participants who do not have health insurance membership cards (AOR = 6.72 95% CI: 3.42, 13.91) compared to those who have health insurance membership cards. The odds of client satisfaction were 2.77 times higher among study participants who reported the availability of community referral for any social support (AOR = 2.77 95% CI: 1.12, 6.84) when compared to those who did not report. Those study participants for whom privacy was kept during the examination were 8.67 times higher to be satisfied (AOR = 8.67 95% CI: 2.53, 29.68) compared to those for whom privacy was not kept during the examination. In conclusion, the client satisfaction on HIV/AIDS treatment and care service quality was relatively high in the study area. Occupational status, health insurance membership cards, availability of community referral for any social support and keeping privacy during examination have significant associations with HIV/AIDS treatment and care service quality in terms of client satisfaction.

Primary colonic lymphoma is an infrequent malignancy among other large bowel malignancies, and the risk of the spread of tumor cells through a spleno-colic fistula is a unique finding and hence noteworthy. We report a case of a 55-year-old man living with HIV on anti-retroviral treatment for 12 years, who presented to the emergency room with complaints of generalized weakness and left-sided abdominal discomfort. Further examination and evaluation revealed massive splenomegaly with a thickened splenic flexure of the colon and spleno-colic fistula. The diagnosis of lymphoma with spread was made following laparotomy and histopathological examination of the colon and spleen.

BACKGROUND: Hepatitis B virus (HBV) infection can cause liver failure, while individuals with Acquired Immunodeficiency Virus Disease (AIDS) are highly susceptible to various opportunistic infections, which can occur concurrently. The treatment process is further complicated by the potential occurrence of immune reconstitution inflammatory syndrome (IRIS), which presents significant challenges and contributes to elevated mortality rates.
METHODS: The 50-year-old male with a history of chronic hepatitis B and untreated human immunodeficiency virus (HIV) infection presented to the hospital with a mild cough and expectoration, revealing multi-drug resistant pulmonary tuberculosis (MDR-PTB), which was confirmed by XpertMTB/RIF PCR testing and tuberculosis culture of bronchoalveolar lavage fluid (BALF). The patient was treated with a regimen consisting of linezolid, moxifloxacin, cycloserine, pyrazinamide, and ethambutol for tuberculosis, as well as a combination of bictegravir/tenofovir alafenamide/emtricitabine (BIC/TAF/FTC) for HBV and HIV viral suppression. After three months of treatment, the patient discontinued all medications, leading to hepatitis B virus reactivation and subsequent liver failure. During the subsequent treatment for AIDS, HBV, and drug-resistant tuberculosis, the patient developed disseminated cryptococcal disease. The patient\'s condition worsened during treatment with liposomal amphotericin B and fluconazole, which was ultimately attributed to IRIS. Fortunately, the patient achieved successful recovery after appropriate management.
CONCLUSIONS: Enhancing medical compliance is crucial for AIDS patients, particularly those co-infected with HBV, to prevent HBV reactivation and subsequent liver failure. Furthermore, conducting a comprehensive assessment of potential infections in patients before resuming antiviral therapy is essential to prevent the occurrence of IRIS. Early intervention plays a pivotal role in improving survival rates.

Presented is the case of a nurse who had 4 occupational exposures to potentially infectious material between December 2020 and June 2022. In 2 of the cases, the source patient was unknown, so pharmacological HIV post-exposure prophylaxis was implemented (in 1 of these cases, the nurse developed weakness and increased dyspeptic symptoms, necessitating a change in the antiretroviral medications used). During the interview collection, the nurse reported that multiple exposures to potentially infectious material are common in her work environment, but most of these are not reported. This is supported by the results of several studies devoted to the problem of non-reporting of occupational exposures by health care workers. However, there is significant discrepancy in the results of these studies, which may be due to different methods. The authors of this article believe that after 10 years since the entry into force of the regulation of the Minister of Health standardizing procedures for dealing with injuries caused by sharp instruments used in the provision of health care services, a serious problem remains of non-reporting of cases by employees (resulting in a lack of post-exposure prophylaxis). The authors call for the introduction of a nationwide reporting system. There is also a need to increase the importance of prophylaxis of stabbings and to improve the quality of training of medical personnel in post-exposure prophylaxis procedures. Med Pr Work Health Saf. 2024;75(2):173-179.
Opisano przypadek pielęgniarki, u której między grudniem 2020 r. a czerwcem 2022 r. czterokrotnie wystąpiła ekspozycja zawodowa na materiał potencjalnie zakaźny. W 2 przypadkach pacjent źródłowy był nieznany, więc wdrożono farmakologiczną profilaktykę poekspozycyjną HIV (w jednym z tych przypadków u pielęgniarki wystąpiło osłabienie i nasilone objawy dyspeptyczne, co spowodowało konieczność zmiany stosowanych leków przeciwretrowirusowych). W czasie zbierania wywiadu pielęgniarka zgłosiła, że wielokrotne ekspozycje na materiał potencjalnie zakaźny są powszechne w jej środowisku pracy, jednak większość z nich nie jest raportowana. Potwierdzają to wyniki kilku badań poświęconych problemowi niezgłaszania przypadków ekspozycji zawodowych przez pracowników ochrony zdrowia. Ich wyniki są znacząco rozbieżne, co może wynikać z różnej metodyki. Autorzy niniejszego artykułu uważają, że po 10 latach od wejścia w życie rozporządzenia Ministra Zdrowia ujednolicającego procedury postępowania po zranieniu ostrymi narzędziami używanymi przy udzielaniu świadczeń zdrowotnych poważnym problemem pozostaje niezgłaszanie przypadków przez pracowników (skutkiem tego jest brak profilaktyki poekspozycyjnej). Autorzy postulują wprowadzenie ogólnopolskiego systemu raportowania. Konieczne jest również zwiększenie znaczenia profilaktyki zakłuć oraz poprawa jakości szkolenia personelu medycznego w zakresie procedur profilaktyki poekspozycyjnej. Med Pr Work Health Saf. 2024;75(2):173–179.