The recent study aims to analyze the role of non-coding RNAs, particularly circRNAs, in HIV pathogenesis using construction of immune-related regulatory networks. In compliance with ethical standards and institutional guidelines, publicly available HIV-related mRNA and microRNA expression datasets were systematically retrieved from the Gene Expression Omnibus repository. These datasets underwent rigorous bioinformatics analysis employing the "limma" package in R to identify differentially expressed genes (DEGs) and microRNAs (DEmiRNAs). Validated interaction data from miRBase and ENCORI databases facilitated the construction of circRNA-DEmiRNA and DEmiRNA-DEG regulatory networks. Protein-protein interaction networks were generated through STRING database analysis, with hub genes defined as those within the highest 5% of interaction degrees. Furthermore, single-cell RNA sequencing (scRNA-seq) datasets from HIV-infected individuals were analyzed using the "Seurat" package to identify DEGs in CD4+ and CD8+ T cell subsets. Cross-validation between microarray and scRNA-seq data ensured robustness of identified hub genes. Our results revealed substantial alterations in RNA expression associated with both high viral load and low viral load HIV infections. Single-cell analyses indicated significant gene expression shifts in T cell populations: 194 upregulated and 813 downregulated genes in CD4+ T cells, and 244 upregulated and 567 downregulated genes in CD8+ T cells. Integrated analysis delineated five hub genes consistently dysregulated across T cell subsets. STAT1 and DDX39B were upregulated, whereas CXCL8, CXCL12, and PTGS2 were downregulated. The pathway enrichment analysis indicated that these genes are implicated in key regulatory pathways relevant to infectious disease mechanisms. Alongside of DEGs, our studies indicated that multiple miRNAs, such as hsa-miR-21-5p, hsa-miR-146a-5p and hsa-let-7b-5p are differentially expressed in HIV-infected samples in comparison to the normal samples. Afterward, DEmiRNA-DEGs network studies demonstrated different axes between significantly up- and down-regulated DEGs with down- and up-regulated miRNAs, respectively. Following, ceRNA regulatory network revealed circRNAs, which can interact with DEmiRNA-DEGs networks, like hsa_circ_0089761-hsa-miR-21-5p-CXCL12, hsa_circ_0003812-hsa-miR-146a-5p-PTGS2, and has_circ_0007185-has_let-7b-5p-DDX39B. Overall, this integrative analysis suggests potential circRNA-mediated regulatory mechanisms in HIV infection and highlights potential candidate circRNAs that may serve as biomarkers or therapeutic targets for further investigation.

Background Bartonella henselae and Bartonella quintana are among the most clinically relevant Bartonella species infecting humans. While B. henselae is a zoonotic pathogen maintained in animal reservoirs, B. quintana is considered a human-restricted bacterium transmitted via the human body louse. Both species can cause a wide range of manifestations, particularly in immunocompromised individuals such as those with HIV/AIDS. This study aimed to estimate the prevalence of IgG and IgM seropositivity to these two species and to identify determinants of seropositivity. Methods This cross-sectional study included 200 participants, comprising 97 HIV-positive patients, 53 patients with AIDS, and 50 healthy individuals as the control group.IgG antibodies against B. henselae and B. quintana were measured in all participants using an indirect immunofluorescence assay (IFA). In addition, IgM antibodies were assessed in a randomly selected subset of 48 participants. Results The overall seroprevalence of B. henselae and B. quintana IgG was 24.0% and 22.0%, respectively, while IgM seropositivity was 18.8% and 22.9%. No significant differences were observed in B. quintana IgG prevalence among control, HIV, and AIDS groups. Individuals with a history of drug abuse had a more than threefold increased likelihood of IgG positivity. For B. henselae, IgG prevalence was higher in the control and AIDS groups compared to HIV-positive individuals, though not statistically significant. Conclusion The significant prevalence of IgG antibodies against both Bartonella species and the presence of IgM antibodies in the selected study group, especially in HIV patients, demonstrate the clinical importance of these pathogens in at-risk populations. These findings emphasize the need for clinical vigilance in symptomatic immunocompromised patients.

Background: Bartonella infections are emerging zoonotic pathogens, primarily transmitted through arthropod vectors or direct contact with animals. Immunocompromised individuals are at increased risk of developing severe complications. Methods: In this cross-sectional study, a total of 370 blood samples were collected from immunocompromised individuals including patients with HIV, AIDS, common variable immunodeficiency (CVID), liver and kidney transplant recipients, and a control group in Imam Khomeini Hospital in Tehran from May 2024 to February 2025. Result: Overall, Bartonella spp. were detected in 7 out of 370 participants (1.89%). All positive cases were among HIV+ (2.8) and AIDS patients (3.9%). Phylogenetic analysis identified all isolates as Bartonella quintana. Univariate analysis suggested that a history of drug abuse and flea infestation seemed to be associated with infection, but due to the rarity of events, multivariate penalized logistic regression did not confirm these as independent risk factors. Cautious interpretation is warranted. Conclusion: This study provides the first molecular evidence of Bartonella quintana infection among immunocompromised patients in Iran, with a notable prevalence observed in HIV-infected individuals, highlighting the need for increased clinical awareness in this population.

Since late 2019, the severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) pandemic has dramatically affected public health worldwide. Although systemic antibodies like Immunoglobulin G (IgG) and Immunoglobulin M (IgM)have been widely studied in Coronavirus disease 2019 (COVID-19), the role of Immunoglobulin A (IgA) in mucosal immunity remains less understood. This study evaluated whether salivary IgA levels could serve as prognostic markers for disease severity, progression, and outcomes in hospitalized patients with COVID-19. In this cross-sectional study, 61 hospitalized patients with COVID-19 were enrolled. After obtaining informed consent, saliva samples were collected at admission to measure IgA levels using an ELISA-based assay. Comprehensive clinical and laboratory data, including chest CT results, oxygen saturation, inflammatory markers, and clinical outcomes, were also recorded. Statistical tests were used to examine the association between salivary IgA levels and disease severity, progression, and outcomes. We enrolled 61 hospitalized patients with COVID-19 (30 females, 31 males; mean age: 56.20 ± 17.45 years; mean admission oxygen saturation: 89.98 ± 5.77%). At admission, 39.3% of patients reported dyspnea, and 40% demonstrated severe lung involvement on chest CT scans. The mean salivary IgA level was 1729.69 ± 391.35 mg/dL. No significant associations were found between salivary IgA levels and COVID-19 severity, disease progression, or clinical outcomes, including mortality. Our findings show that salivary IgA levels did not significantly correlate with COVID-19 severity, disease progression, or clinical outcomes in hospitalized patients. Therefore, salivary IgA alone cannot be recommended as a prognostic biomarker for COVID-19. Further research is needed to identify more reliable immunological indicators for predicting COVID-19 severity and outcomes.

Para-Kala-Azar Dermal Leishmaniasis (para-KDL) is a rare manifestation of leishmaniasis that occurs concurrently with active Visceral Leishmaniasis (VL). It is characterized by a combination of cutaneous and systemic symptoms, posing diagnostic and therapeutic challenges. This condition is even more complex in immunocompromised patients, such as those with HIV. We report a case of a 52-year-old male from south of Iran, who presented with prolonged fever, severe weight loss, pancytopenia, and massive splenomegaly. The patient was diagnosed with HIV and had been receiving antiretroviral therapy (ART). He underwent a splenectomy 1 month later and developed progressive generalized lymphadenopathy and hepatomegaly 5 months after that. Histopathological analysis of lymph node biopsies confirmed leishmaniosis, and the patient was started on Meglumine antimoniate. Shortly after, he developed widespread maculopapular skin lesions. Subsequent diagnostic evaluations, including skin biopsy, confirmed the presence of Leishman bodies. The patient was successfully treated with liposomal amphotericin B, leading to significant clinical improvement. The co-existence of active VL and PKDL can make diagnosis difficult, potentially leading to misdiagnosis and treatment, particularly in immunocompromised patients. The simultaneous occurrence of VL and PKDL-like skin lesions requires heightened clinical suspicion, especially in endemic regions. Delayed or misdiagnosed cases may lead to significant morbidity. Further research is needed to understand the pathophysiology, immune response, and optimal treatment strategies for para-KDL in HIV-infected individuals.

Concerns of increased metabolic dysfunction have been heightened for HIV patients on long-term antiretroviral therapy (ART). Among first-line ART agents, Tenofovir alafenamide (TAF) may entail a marked increase in weight compared to Tenofovir disoproxil fumarate (TDF). We retrospectively evaluated changes in weight and glucose regulation among 153 treament-naïve patients. Weight-gain was more pronounced after one year of treatment with TAF versus TDF (3.5 kg versus − 1 kg, P-value < 0.001). However, weight-gain was attenuated with longer follow-up, and no increase in glucose dysregulation was noted for TAF treatment. Attribution of increased metabolic risk to treatment with TAF remains questionable.

Reduced Bone Mineral Density (BMD) has been linked to Human Immunodeficiency Virus (HIV) infection and treatment. There is a lack of information regarding the osteoporosis status of middle-aged patients with HIV in Iran, despite the fact that Antiretroviral Therapy (ART) is widely accessible. The purpose of this cross-sectional study was to assess the BMD status and low BMD risk factors in patients with HIV under ART living in Iran. Data were collected from individuals diagnosed with HIV aged 30–50, receiving ART for at least 6 months. Dual-energy X-ray absorptiometry scans assessed BMD in femoral neck, total hip, and lumbar regions. Pearson’s correlation coefficients identified relationships between BMD and demographic and laboratory predictors. Univariable and multivariable logistic regression models assessed predictors of low lumbar BMD. Among 80 HIV-infected individuals (mean age: 41.1 ± 5.6 years, 60.4

The human immunodeficiency virus (HIV) increases susceptibility to measles, mumps, and rubella (MMR) infections due to decreased cluster of differentiation 4 + T-cell levels and rapid waning of protective antibodies following vaccination, which imposes a significant impact on HIV-positive women of reproductive age, for whom MMR vaccination is a crucial preventive measure. This study aimed to shed light on the immunity status of women of childbearing age with HIV infection post-MMR-vaccination during their childhood and the necessity of further vaccination in these individuals. To evaluate seroconversion rates following vaccination through Iran’s NIP or previous infection by assessing MMR IgG levels, all Iranian women aged 18–45 years referred to our voluntary counseling center, with or without HIV infection and CD4 levels 200 cells/mm3 or higher at the time of enrollment, were invited to participate. Data were collected through the Hospital Information System and questionnaires, and blood samples were taken to evaluate the seroconversion following MMR vaccination via NIP or previous MMR infection. In this study, 150 women participated, with a mean age (± SD) of 36.49 (± 6.80). Mean rubella and measles IgG levels of HIV-positive participants (95.08 ± 79.42 IU/Ml) were higher than HIV-negative peers (8.98 ± 3.83 mg/dL) with no significant associations (p-value > 0.05). However, mumps IgG levels were significantly lower compared to HIV-negative participants (9.87 ± 28.70 mg/dL, p-value < 0.001). Additionally, HIV-positive participants significantly exhibited lower total immunity (n = 73, 97.3) compared to HIV-negative participants (n = 64, 85.3) (p-value = 0.07). HIV-positive individuals who did not have seroimmunity against mumps infection had significantly lower CD4 NADIR counts (cells/mm3) (mean ± SD = 259.00 ± 203.31, p-value: 0.025). Moreover, regression analyses demonstrated significant associations between decreased mumps IgG levels and lower CD4 NADIR counts (AOR = 1.004, 95

Context: Depression and the prevalence of some deadly illnesses, such as human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), have become major issues in both industrialized and developing nations. Objectives: Therefore, the aim of the present study was to estimate the prevalence of depression among Iranians living with HIV/AIDS, without time limits, up until October 18, 2024. Methods: The preferred reporting items for systematic reviews and meta-analyses (PRISMA) 2020 standards for systematic review and meta-analysis research served as the foundation for this review study. Using English MeSH keywords, we searched the following databases for epidemiological research conducted up until October 18, 2024: PubMed/Medline, Web of Science, Embase, Scientific Information Database (SID), Maglran, Medlib, Medline, Scopus, and Google Scholar. STATA version 14 software was used to analyze the study results. Results: Overall, 20 studies including 4,471 Iranians with HIV/AIDS were included in the meta-analysis. The pooled prevalence of depression was 56% (95% CI: 49% to 64%). The significant heterogeneity of 96.65% was caused by variations in methods, study populations, and regional characteristics. The prevalence of depression varied greatly across different regions of Iran. The southern region had the highest prevalence at 73%, followed by the southeast and southwest with 63% and 62%, respectively. However, the northwest region had the lowest occurrence rate at 34%. Conclusions: The findings of this study indicate that depression is significantly more prevalent among Iranians living with HIV/AIDS. Iranian health policymakers may find this evidence useful in developing appropriate preventive and treatment strategies to prevent and control depression among Iranians living with HIV/AIDS by improving access to mental health services, social and economic support, and utilizing technology and innovation.

Women living with Human immunodeficiency virus (HIV) have reduced ability to clear human papillomavirus (HPV) infections due to decreased levels of CD4+ T lymphocytes. This study aimed to determine the Prevalence and Distribution of Human Papillomavirus Genotypes in Women Living with HIV: A Cross-Sectional Study in Iran. Eighty women living with HIV participated in this study. HPV DNA was extracted and universal primers (MY09/11 and GP5+/6+) were used in a single polymerase chain reaction (PCR) to detect HPV. Negative samples were re-amplified using GP5+/6+ primers in nested PCR. Finally, HPV-positive samples were genotyped using a Real-Time PCR kit. The data collected in this study were statistically analyzed using GraphPad Prism version 10.4 software. HPV prevalence among women living with HIV was 76.25

BACKGROUND:The increased risk ofmetabolic syndrome (MetS) and its subcomponents among people living with HIV/AIDS, especially in developing countries, is well documented with the global pooled prevalence of the related risk factors in this population. OBJECTIVE:This study aimed to explore the prevalence of MetS among Iranian People living with HIV according to the ATP III and Iranian criteria. METHODS:The cross-sectional study was conducted on consecutive patients who visited THE referral centre for AIDS/HIV between May to December 2023. A total of 130 participants (n=83; 63.8%male) were investigated based on the inclusion criteria, which included having a minimum age of 25 and a maximum of 65 years and following a stable ART treatment regimen for at least six months. A Chi-square test was used to determine the relationship between the categorical variables. Uni/Multi-variable linear regression analysis was used to quantify the associations between MetS and HIV by the independent variables. RESULTS:The incidence of MetS according to ATP III and Iranian criteria were 42 (32.3%) and 45 (34.6%), which was higher in older patients (p=0.001) and those with more duration since HIV diagnosis (p=0.02). Around 33.1% and 16.1% were overweight and obese, respectively. Among the components of MetS, the highest prevalence (50.8%) was related to low HDL, and the lowest was related to fasting blood sugar (21.5%). The average body fat mass, protein mass, Soft lean mass, and percentage body fat were 18.54 ± 9.46 kg, 10.91 ± 2.17 kg, 51.31 ± 9.61 kg, and 24.86±10.25% that were higher in MetS group (p<0.05). CONCLUSION:Our study points out the high prevalence of MetS in an Iranian population living with HIV, especially those suffering from the underlying disease for a longer time. Conducting multi-centric studies with larger sample sizes is needed to confirm our results and determine the most effective measures.

People living with HIV (PLHIV) are at an increased risk of type 2 diabetes mellitus (T2DM) due to aging, lifestyle, and antiretroviral therapy-related factors. This systematic review and meta-analysis estimated the pooled incidence, prevalence, and risk factors for T2DM among PLHIV globally, focusing on older populations. This systematic review and meta-analysis was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We conducted a comprehensive literature search in PubMed, Embase, Web of Science, and Scopus for English-language articles published by December 25, 2024. The I² index and Cochrane’s Q statistic were also used to assess study heterogeneity. A random effects model was used to compute the pooled measure of association with 95

As the effects of immunosuppression are not still clear on COVID-19 patients, we conducted this study to identify clinical and laboratory findings associated with pulmonary involvement in both immunocompromised and immunocompetent patients. A case-control of 107 immunocompromised and 107 immunocompetent COVID-19 patients matched for age and sex with either positive RT-PCR or clinical-radiological findings suggestive of COVID-19 enrolled in the study. Their initial clinical features, laboratory findings, chest CT scans, and short-term outcomes (hospitalization time and intensive care unit [ICU] admission) were recorded. In addition, pulmonary involvement was assessed with the semi-quantitative scoring system (0−25). Pulmonary involvement was significantly lower in immunocompromised patients in contrast to immunocompetent patients, especially in RLL ( p  = 0.001), LUL ( p  = 0.023), and both central and peripheral ( p  = 0.002), and peribronchovascular ( p  = 0.004) sites of lungs. Patchy ( p  < 0.001), wedged ( p  = 0.002), confluent ( p  = 0.002) lesions, and ground glass with consolidation pattern ( p  < 0.001) were significantly higher among immunocompetent patients. Initial signs and symptoms of immunocompromised patients including dyspnea ( p  = 0.008) and hemoptysis ( p  = 0.036), respiratory rate of over 25 ( p  < 0.001), and spo2 of below 93% ( p  = 0.01) were associated with higher pulmonary involvement. Total chest CT score was also associated with longer hospitalization ( p  = 0.016) and ICU admission ( p  = 0.04) among immunocompromised patients. Pulmonary involvement score was not significantly different among immunocompromised and immunocompetent patients. Initial clinical findings (dyspnea, hemoptysis, higher RR, and lower Spo 2 ) of immunocompromised patients could better predict pulmonary involvement than laboratory findings.

Introduction: Castleman's disease (CD) is characterized by non-neoplastic lymph node hyperplasia, and may be localized in a single lymph node (unicentric) or occurs systemically (multicentric). Nowa days, multicentric CD is most commonly observed in individuals infected with human immunodeficiency virus (HIV) type 1, in association with Kaposi's sarcoma. Histopathologic and immunohistochemical evaluation of excised lymph node as well as imaging modalities, such as computed tomography (CT) and magnetic resonance imaging, are required for the diagnosis of CD. Case description: We present a case of 46-year-old HIV-infected woman with fever, weakness, weight loss, and splenomegaly in the past 18 months. On physical examination, pale conjunctiva, jaundice, multiple cervical, inguinal, and axillary lymphadenopathies as well as hepatosplenomegaly were detected. Chest CT scan showed alveolar opacity in the lower lobe of the right lung and multiple lymph nodes in the mediastinum and bilateral perivascular, cervical, and axillary areas. Abdominopelvic CT scan showed huge splenomegaly, hepatomegaly, and multiple bilateral para-aortic, celiac, and inguinal lymphadenopathies, which were further confirmed as CD in pathological examination. Conclusions: Huge splenomegaly is a rare manifestation in CD. Among the more prevalent differential diagnoses, CD in patients with HIV and huge splenomegaly was emphasized as important differential diagnosis.

Introduction: Disseminated nocardiosis is a rare but life-threatening infectious disease that occurs most often in immunocompromised individuals. This report presents a human immunodeficiency virus (HIV)-infected patient with disseminated nocardiosis in the liver, lung, and brain. Case Presentation: A 38-year-old woman who had recently been diagnosed with HIV infection complained of fever, abdominal pain, productive coughs, and occasional headaches from 2 months ago. Imaging findings of her abdomen and lungs displayed evidence of pyogenic liver abscess and lobar pneumonia with abscess formation, respectively. The patient underwent percutaneous liver abscess drainage and bronchoalveolar lavage (BAL). Using reverse transcription-polymerase chain reaction (RT-PCR), the genome of Nocardia farcinica was detected in the specimens obtained from both procedures. Besides, she had seizures during hospitalization. Based on cerebrospinal fluid (CSF) analysis, the specimen was positive for N. farcinica. Brain imaging also revealed evidence of multiple bacterial abscess formation. She was diagnosed with disseminated nocardiosis and treated with intravenous imipenem, trimethoprim/sulfamethoxazole, and amikacin, followed by appropriate oral agents. After a 6-month follow-up, the patient had no symptoms. Additionally, the lesions improved on brain imaging. Conclusions: Patients who are HIV-positive are particularly prone to opportunistic infections. Health care providers should consider all pathogens, even rare ones, like Nocardia spp., to establish a diagnosis if they're present. Furthermore, in cases initially diagnosed with localized nocardiosis, other body organs should also be reviewed so that the disseminated form of the disease can be diagnosed and treated immediately.

Introduction: This randomized clinical study was conducted to compare the adherence of post-exposure human immunodeficiency virus (HIV) prophylaxis (PEP) in full 28-day course of antiretroviral (ARV) treatment versus weekly therapy, and to find reasons for insufficient compliance among people referred to HIV clinic of Imam Khomeini Hospital, a teaching, and referral university hospital in Tehran, from 2018 to 2019. Material and methods: This study determined the most suitable PEP protocol between full 28-day and weekly courses. After obtaining informed consent from 293 participants with exposure to HIV (both sexual and non-sexual), 106 and 111 individuals were randomly divided into two groups of a 28-day course and weekly PEP protocol, respectively, by simple randomization method, and the remaining 76 persons were lost to follow-up during the study. Adherence to PEP was defined as taking 95% of the prescribed antiretroviral therapy (ART) in each group. Chi-square test (Fisher exact test) and t-test were performed using SPSS software considering other variables, including age, gender, marital status, educational level, occupation, and distance from work or residence to a hospital. Results: After analyzing data and possible factors affecting treatment adherence, it was found that 28-day PEP protocol increased ARV compliance (OR = 4.14; 95% CI: 1.79-9.58%; p = 0.001) compared with weekly protocol. Furthermore, no associations between adherence and demographic characteristics, such as gender, age, education level, occupation, income, marital status, and factors, including distance from people's place of residence or work, were found. Conclusions: Adherence to PEP was much higher in the 28-day protocol than the weekly course of treatment.

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes coronavirus disease 2019 (COVID-19) with significant morbidity and mortality. We reported and compared the clinical and para-clinical findings of immunocompromised and immunocompetent COVID-19 patients in a case-control study at the Imam Khomeini hospital in Tehran, Iran.Methods: In this study, 107 immunocompromised COVID-19 patients were recruited as the case group, and 107 immunocompetent COVID-19 patients as the control group. The participants were matched based on age and sex. The patients' information was retrieved from the hospital records in an information sheet. Associations between clinical and para-clinical findings with the immune status were assessed using bivariate and multivariate analyses.Results: The initial pulse rate and recovery time were significantly higher in immunocompromised patients (p < .05). Myalgia, nausea/vomiting, loss of appetite, headache, and dizziness were more frequently reported by the control group (p < .05). Regarding the prescribed medications' duration, Sofosbovir was used longer in the case group, while Ribavirin was used longer in the control groups (p < .05). The most common complication in the case group was acute respiratory distress syndrome, although no major complications were observed in the control group. According to the multivariate analysis, recovery time and Lopinavir/Ritonavir (Kaletra) prescription were significantly higher in the immunocompromised compared to the immunocompetent group.Conclusion: Recovery time was significantly longer in the immunocompromised compared to the immunocompetent group, which emphasizes the necessity of prolonged care in these high-risk patients. Also, it is recommended to investigate the effect of novel therapeutic interventions to reduce the recovery time in addition to improving the prognosis of immunodeficient patients with COVID-19.

Background Oral candidiasis is a common opportunistic infection in patients with human immunodeficiency virus (HIV). In addition, most of these patients suffer from vitamin D deficiency. This study aimed to investigate the association between vitamin D levels and oral candidiasis in patients with HIV infection. Methods This case‒control study was conducted on HIV-infected patients. Cases were patients with oral candidiasis diagnosed based on physical examinations. Controls were age- and sex-matched individuals without oral candidiasis. The levels of 25-OH vitamin D and other laboratory markers (CD4 count and viral load) were compared between the case and control groups. Results A total of 104 cases and 102 controls were included in the study. The cases had significantly lower 25-OH vitamin D 3 levels (MD = 33.86 ng/mL, 95% CI= (31.85, 35.87), P < 0.001) and CD4 counts (MD = 267.48 cells/mm 3 , 95% CI= (189.55, 345.41), P < 0.001) than the controls. In addition, viral load was significantly higher in cases than in controls (MD = 7.03 × 10 5 copies/mL, 95% CI= (4.46 × 10 5 , 9.61 × 10 5 ), P < 0.001). The multivariate logistic regression analysis revealed that educational status (OR = 0.032, 95% CI= (0.002, 0.100), P < 0.001), current HAART (OR = 0.005, 95% CI= (0.001, 0.014), P < 0.001), history of oral candidiasis (OR = 20.114, 95% CI= (18.135, 21.957), P < 0.001), CD4 count (OR = 0.004, 95% CI= (0.001, 0.006), P < 0.001), viral load (OR = 12.181, 95% CI= (1.108, 133.392), P < 0.001), and vitamin D level (OR = 0.011, 95% CI= (0.008, 0.015), P < 0.001) were significantly associated with the risk of developing oral candidiasis. Conclusions Based on the findings, most patients with HIV infection suffer from vitamin D deficiency, especially those with oral candidiasis. Hypovitaminosis D was significantly associated with an increased risk of oral candidiasis. Thus, vitamin D supplementation may assist HIV-positive patients in improving their oral health and preventing oral candidiasis.

BACKGROUND:Immunodeficient patients, particularly HIV patients, are at risk of opportunistic infections. Nontuberculous mycobacteria can cause severe complications in immunodeficient patients.CASE PRESENTATION:We describe a 57-year-old HIV patient, primarily presented with coughs and constitutional symptoms, with a unique Mycobacterium genavense abdominal, pulmonary, and central nervous system infection, accompanied by intracranial masses.CONCLUSION:The diagnosis of NTM, including M. genavense, must always be considered by clinicians in immunodeficient patients, especially those with HIV, who have a compromised immune system.

Cryptococcal meningitis (CM) is an uncommon and severe infection that tends to affect both immunocompromised and immunocompetent hosts. To gain insights into the clinical and epidemiological characteristics of CM in Iran, this study evaluated patients with subacute or chronic meningitis referred to 15 Iranian hospitals. Relevant clinical and epidemiological characteristics of the patients were analyzed. Diagnosis of CM cases was performed by microscopic examination, culture, latex agglutination assay, lateral flow assay, and multiplex PCR on cerebrospinal fluid (CSF) samples. The isolates were processed and subjected to molecular identification and in vitro susceptibility antifungal profile. Among the 272 evaluated patients, 7 (2.6 %) CM cases were diagnosed. Out of seven CM cases, 6 (86 %) were male with a median age of 36 years. The most common neurological signs were headache (100 %), followed by nausea and vomiting (71.4 %). All CSF samples from CM patients exhibited positive results across all mycological tests conducted. The isolates were identified as Cryptococcus neoformans (86 %) and Cryptococcus gattii (14 %). All isolates were susceptible to voriconazole and fluconazole, while resistance was observed with itraconazole (MIC value of 0.5 μg/mL) and amphotericin B (MIC values of 4 and 1 μg/mL). The highest mortality (6/7, 86 %) was observed among patients. While a comprehensive study on this subject is currently lacking in Iran, the data acquired through this research play a crucial role in enhancing the clinical and epidemiological understanding of this infection, particularly within low-income countries. Moreover, these findings will serve as a cornerstone for future international comparative studies in this field.