Progressive Worsening of Neurological Manifestations in HIV-Associated Opportunistic Central Nervous System (CNS) Infection Patients After COVID-19 Vaccinations: A Possible Co-Incidence Causality
Case series Patients: Male, 23-year-old • Male, 23-year-old Final Diagnosis: Cerebral toxoplasmosis • HIV infection • pneumonia • pulmonary tuberculosis Symptoms: Fever • headache • hemiparesis • seizure • somnolence Medication: — Clinical Procedure: — Specialty: General and Internal Medicine...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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JST
2022
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| Online Access: | https://repository.ugm.ac.id/282759/1/Faishal%20Hanif.pdf |
| _version_ | 1826050548903706624 |
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| author | Hanif, Faishal Satiti, Sekar Subagya, Subagya Retnowulan, Heni Subronto, Yanri Wijayanti Mulya, Deshinta Putri Rochmah, Mawaddah Ar |
| author_facet | Hanif, Faishal Satiti, Sekar Subagya, Subagya Retnowulan, Heni Subronto, Yanri Wijayanti Mulya, Deshinta Putri Rochmah, Mawaddah Ar |
| author_sort | Hanif, Faishal |
| collection | UGM |
| description | Case series
Patients: Male, 23-year-old • Male, 23-year-old
Final Diagnosis: Cerebral toxoplasmosis • HIV infection • pneumonia • pulmonary tuberculosis
Symptoms: Fever • headache • hemiparesis • seizure • somnolence
Medication: —
Clinical Procedure: —
Specialty: General and Internal Medicine • Neurology • Tropical Medicine
Objective: Unusual clinical course
Background: The iceberg phenomenon (in which the most of a problem is invisible) of people living with HIV/AIDS, particularly those with unknown HIV status, has been epidemiologically challenging. Central nervous system (CNS) opportunistic infections in patients with HIV/AIDS are one of the leading causes of morbidity and mortality in people living with HIV/AIDS. There are currently limited data on the immunogenicity, safety, and efficacy of COVID-19 vaccines in people living with HIV/AIDS with its associated opportunistic CNS infections as well as those without antiretroviral treatment.
Case Reports: Two young men with previously unknown HIV status and its related opportunistic infections received their first doses of COVID-19 vaccine (Vero Cell), inactivated. Both patients had the risk factor of having sex with men (men who have sex with men). Fever and first neurological symptoms occurred within the first few days after vaccination. Both patients were hospitalized and were tested positive for HIV for the first time. Both were further diagnosed from brain imaging as having CNS opportunistic infections. A presumptive diagnosis of cerebral toxoplasmosis was established as the working diagnosis according to the laboratory and epidemiological factors. Despite the treatment, neurological and clinical deficits worsened and eventually led to death in both patients.
Conclusions: The causality analyses showed that both adverse events had a possible inconsistent causal relationship to COVID-19 vaccination. Our cases may reflect the need for further studies on the safety of COVID-19 vaccines in people with HIV/AIDS-associated CNS opportunistic infection as well as people with HIV/AIDS who never receive antiretroviral treatment (ART). |
| first_indexed | 2024-03-14T00:05:44Z |
| format | Article |
| id | oai:generic.eprints.org:282759 |
| institution | Universiti Gadjah Mada |
| language | English |
| last_indexed | 2024-03-14T00:05:44Z |
| publishDate | 2022 |
| publisher | JST |
| record_format | dspace |
| spelling | oai:generic.eprints.org:2827592023-11-16T08:39:57Z https://repository.ugm.ac.id/282759/ Progressive Worsening of Neurological Manifestations in HIV-Associated Opportunistic Central Nervous System (CNS) Infection Patients After COVID-19 Vaccinations: A Possible Co-Incidence Causality Hanif, Faishal Satiti, Sekar Subagya, Subagya Retnowulan, Heni Subronto, Yanri Wijayanti Mulya, Deshinta Putri Rochmah, Mawaddah Ar Infectious Diseases Intensive Care Case series Patients: Male, 23-year-old • Male, 23-year-old Final Diagnosis: Cerebral toxoplasmosis • HIV infection • pneumonia • pulmonary tuberculosis Symptoms: Fever • headache • hemiparesis • seizure • somnolence Medication: — Clinical Procedure: — Specialty: General and Internal Medicine • Neurology • Tropical Medicine Objective: Unusual clinical course Background: The iceberg phenomenon (in which the most of a problem is invisible) of people living with HIV/AIDS, particularly those with unknown HIV status, has been epidemiologically challenging. Central nervous system (CNS) opportunistic infections in patients with HIV/AIDS are one of the leading causes of morbidity and mortality in people living with HIV/AIDS. There are currently limited data on the immunogenicity, safety, and efficacy of COVID-19 vaccines in people living with HIV/AIDS with its associated opportunistic CNS infections as well as those without antiretroviral treatment. Case Reports: Two young men with previously unknown HIV status and its related opportunistic infections received their first doses of COVID-19 vaccine (Vero Cell), inactivated. Both patients had the risk factor of having sex with men (men who have sex with men). Fever and first neurological symptoms occurred within the first few days after vaccination. Both patients were hospitalized and were tested positive for HIV for the first time. Both were further diagnosed from brain imaging as having CNS opportunistic infections. A presumptive diagnosis of cerebral toxoplasmosis was established as the working diagnosis according to the laboratory and epidemiological factors. Despite the treatment, neurological and clinical deficits worsened and eventually led to death in both patients. Conclusions: The causality analyses showed that both adverse events had a possible inconsistent causal relationship to COVID-19 vaccination. Our cases may reflect the need for further studies on the safety of COVID-19 vaccines in people with HIV/AIDS-associated CNS opportunistic infection as well as people with HIV/AIDS who never receive antiretroviral treatment (ART). JST 2022-05 Article PeerReviewed application/pdf en https://repository.ugm.ac.id/282759/1/Faishal%20Hanif.pdf Hanif, Faishal and Satiti, Sekar and Subagya, Subagya and Retnowulan, Heni and Subronto, Yanri Wijayanti and Mulya, Deshinta Putri and Rochmah, Mawaddah Ar (2022) Progressive Worsening of Neurological Manifestations in HIV-Associated Opportunistic Central Nervous System (CNS) Infection Patients After COVID-19 Vaccinations: A Possible Co-Incidence Causality. American Journal of Case Report, 23. e936257-1. ISSN 1941-5923 https://www.amjcaserep.com/abstract/index/idArt/936257 10.12659/AJCR.936257 |
| spellingShingle | Infectious Diseases Intensive Care Hanif, Faishal Satiti, Sekar Subagya, Subagya Retnowulan, Heni Subronto, Yanri Wijayanti Mulya, Deshinta Putri Rochmah, Mawaddah Ar Progressive Worsening of Neurological Manifestations in HIV-Associated Opportunistic Central Nervous System (CNS) Infection Patients After COVID-19 Vaccinations: A Possible Co-Incidence Causality |
| title | Progressive Worsening of Neurological Manifestations in HIV-Associated Opportunistic Central Nervous System (CNS) Infection Patients After COVID-19 Vaccinations: A Possible Co-Incidence Causality |
| title_full | Progressive Worsening of Neurological Manifestations in HIV-Associated Opportunistic Central Nervous System (CNS) Infection Patients After COVID-19 Vaccinations: A Possible Co-Incidence Causality |
| title_fullStr | Progressive Worsening of Neurological Manifestations in HIV-Associated Opportunistic Central Nervous System (CNS) Infection Patients After COVID-19 Vaccinations: A Possible Co-Incidence Causality |
| title_full_unstemmed | Progressive Worsening of Neurological Manifestations in HIV-Associated Opportunistic Central Nervous System (CNS) Infection Patients After COVID-19 Vaccinations: A Possible Co-Incidence Causality |
| title_short | Progressive Worsening of Neurological Manifestations in HIV-Associated Opportunistic Central Nervous System (CNS) Infection Patients After COVID-19 Vaccinations: A Possible Co-Incidence Causality |
| title_sort | progressive worsening of neurological manifestations in hiv associated opportunistic central nervous system cns infection patients after covid 19 vaccinations a possible co incidence causality |
| topic | Infectious Diseases Intensive Care |
| url | https://repository.ugm.ac.id/282759/1/Faishal%20Hanif.pdf |
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