University of the Ryukyus · Faculty of Medicine · 助教

Research keywords呼吸器感染症・性感染症・HIV/AIDS・COVID-19・肺免疫学

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• 特集 十二指腸・小腸疾患アトラス Ⅱ.炎症性疾患 感染症:細菌性 非結核性抗酸菌による十二指腸・小腸炎2024 · 伊良波 淳, 仲村 秀太, 玉城 智子, 金城 徹, 山本 和子
• 直腸炎を呈した皮疹の有無の異なるエムポックスの2症例2022 · <p>Mpox (formerly known as monkeypox) is caused by monkeypox virus (MPXV), a member of the orthopoxvirus genus of viruses. Historically, it is endemic to Central and West Africa. Since 2022, however, a sharp rise in the number of mpox cases has been reported from non-endemic regions such as Europe and the United States. As compared with the traditional cases of mpox reported from the endemic regions, the majority of the patients in the new cases of mpox from non-endemic regions are gay, bisexual, and/or people living with HIV (PLWH), and anogenital skin lesions are a predominant clinical feature. Herein, we report two cases of mpox in PLWH. While case 1 had typical anogenital skin rashes with hemorrhagic proctitis, case 2 manifested proctitis without a skin rash. MPXV was detected by polymerase-chain reaction of scrapings from the skin rash in case 1, and from an anal swab in case 2. Our cases highlight the fact that in the recent outbreak of mpox, proctitis could be the sole presenting feature. Clinicians should consider the possibility of mpox in patients presenting with proctitis, irrespective of the presence/absence of skin lesions.</p>
• Late diagnosis of HIV in 2022: Why so little change?2022 · Background: The proportion of people who are diagnosed late is a key metric to measure the public health response to HIV. But this percentage remains stubbornly high in nearly every country. Delays in accessing antiretroviral therapy affects both (i) individual health, due to a higher risk of mortality, and (ii) population-based health, due to continued risk of transmission. Despite huge efforts to increase testing, late diagnosis continues to be an indication of a public health failure. Outline: This short review includes community perspectives on why late diagnosis continues and how it may be reduced. We discuss both structural barriers that prevent people from testing earlier and personal reasons why some people still refuse testing when offered. We note that late diagnosis is reported in all countries and in all demographic groups and that sex, gender, age, and sexuality all affect these rates. However, even in groups with high HIV awareness, such as in gay and bisexual men in the UK, more than one in three people with HIV continue to be diagnosed late. Fears and prejudice about HIV based on outdated information are still common among both health workers and people using health services. For example, testing is still not offered in primary or emergency care settings, and even free testing might not be accepted if someone fears the outcome might jeopardize their resident status, employment, relationship, or health. Summary: In addition to developing targeted projects to reach the highest-risk groups, a positive mainstream public campaign could make testing more acceptable at a broad population level across all demographics. This could challenge and repair the media campaigns from the 1980s that still contribute to the stigma that frightens people away from testing now. We hope that an effective approach in one country might also help others.
• Mpox in people with HIV: A narrative review2022 · Objective: The 2022 global mpox outbreak disproportionately impacted people living with HIV. This review explores recent evidence on mpox in this group, focusing on clinical presentation, complications, treatment modalities and vaccine strategies. Recent findings: Recent studies have suggested that people with HIV diagnosed with mpox have a greater risk of proctitis and hospitalization compared with people without HIV. In addition, those with advanced immunosuppression face an elevated risk of severe mpox infection, which can lead to mortality. Comprehensive and prompt supportive care using antiretrovirals and mpox antivirals is crucial in this group. Although results from randomized clinical trials are still forthcoming, recent studies suggest that early initiation of tecovirimat can prevent disease progression in people with HIV. The non-replicative attenuated smallpox vaccine is well tolerated and effective in preventing monkeypox virus infections in people with HIV. Further studies are needed regarding long-term vaccine effectiveness for this population. Conclusion: Evaluating the risk of severe mpox in people living with HIV requires assessing the level of immune suppression and viral control. Universal access to vaccination is imperative to prevent the resurgence of future outbreaks.

• 腸内細菌叢異常はHIV感染者の認知フレイル発症を加速させるのか？2024 · 基盤研究(C)
• HIV流行株の遺伝子変異動向調査とHIV感染対策への応用に関する研究
• HIV 検査と医療へのアクセス向上に資する多言語対応モデルの構築に関する研究
• MSMに対する有効なHIV検査提供とハイリスク層への介入に関する研究

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