Although there have been a few reports of simultaneous infections and neoplasm in patients with acquired immune deficiency syndrome, no reports of coexistent lymphoma with tuberculosis and Kaposi's sarcoma with tuberculosis occurring in the same lymph node have been described. In this article, we describe coexistent lymphoma with tuberculosis in one case and Kaposi's sarcoma with tuberculosis in another case of human immune deficiency virus-infected individuals.
INTRODUCTIONAlcohol consumption has gone up in urban India due to increased social acceptance. Alcohol per capita in 15+ years has increased from 3.6 in 2005 to 4.3 (in litres of pure alcohol) during the year 2010. The prevalence of heavy episodic drinking is 11 % in drinkers and 1.7 % in population as per WHO data.Alcohol use in an individual causes mitochondrial damage. The increase in reactive oxygen species (ROS) production associated with ethanol metabolism damages mitochondrial components and also affects hepatocyte viability. Both protein oxidation and increases in mtDNA fragmentation can be considered consequences of increased ROS production associated with ethanol consumption. As the age advances the damage due to the alcohol increases, due to increased susceptibility of the mitochondrial genome to oxidative damage in older individuals. Indeed, in the alcoholic, large deletions of mtDNA similar to those seen in very old individuals are observed, suggesting that alcohol abuse leads to ABSTRACT Background: Chronic Alcohol consumption is immunosuppressant and HIV causes immunodeficiency. Both in same patient can have detrimental effect. HIV can progress rapidly in an alcoholic patient. This study is looking for adverse effects of alcoholism on CD4 response, adherence and adverse drug reactions on patients who are on highly active antiretroviral therapy. Methods: A prospective observational study done over period of one year after local institutional ethics committee approval was obtained. All consecutive HIV infected male patients presenting for first time and indicated to start on HAART above age of 18 years who were willing to give consent were recruited for this study. Patients with Hepatitis B and Hepatitis C were excluded from the study. Results were analyzed using ANOVA and paired T test. Results: The CD4 counts remained lower in habitual alcoholics compared to social alcoholic and nonalcoholic study groups, P value being 0.0385 (habitual alcoholic); 0.0291 (social alcoholic) and 0.0251 (non-alcoholic) respectively. It was found (13%) alcoholic patients; 12 (8%) social alcoholic and 4 (2.7%) Non-alcoholic patients were not maintaining pill counts. 36 (24.5%) of total Patients were not maintaining pill counts. Patients consuming alcohol even did not follow up nor followed instructions, P value being 0.000. Conclusions: Alcoholic patients were not following regularly for treatment. Hence we can conclude that alcohol has negative effect on adherence to HAART. Therefore in our part of country alcoholics should be considered as high risk groups for HIV care.
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