Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts: Gene/Protein Disease Symptom Drug Enzyme Compound   Target Concepts: Gene/Protein Disease Symptom Drug Enzyme Compound

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Query: EC:3.4.16.2 (PCP)
3,761 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A new study to be presented at the 12th World AIDS Conference demonstrates that IL-2 dramatically restores immune function in people with AIDS. The study group included patients with fewer than 200 CD4-cells and a history of severe AIDS-related complications including CMV retinitis, PCP, wasting syndrome, KS, and Cryptococcal meningitis. In the study, CD4 counts rose 96 percent when IL-2 was added to protease inhibitor therapy. The increases were sustained, and naive cells increased as well. Most common side effects included fever, fatigue, sinus congestion, and headache; most side effects stopped within 24 hours of completing the treatment cycle. The findings represent new hope for people whose immune systems are substantially compromised. Contact information is provided.
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PMID:New data on IL-2. 1136 33

HIV/AIDS was the subject of some of the presentations at the annual meeting of the Infectious Diseases Society of America (ISDA). The most significant presentation was by Dr. Anthony Fauci, who described the possibility of using IL-2 to purge latently-infected CD4 cells. Other presentations covered treatment of primary HIV infection, updates on developments of nucleoside inhibitors, an efavirenz (EFV) update, PCP prophylaxis, care delivery options, and co-infection with tuberculosis.
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PMID:Report on HIV/AIDS from IDSA: news from the mile high city. 1136 59

There is mounting evidence that AIDS patients on successful therapy may be able to stop taking prophylactic drugs for opportunistic infections (OIs). Draft revisions of the U.S. Public Health Service=s AGuidelines for the Prevention of Opportunistic Infections@ urges stopping primary PCP prophylaxis in people whose CD4 counts increase to above 200 cells/mm3 for at least 3 to 6 months. Results of the EuroSIDA study of 7,333 patients from across Europe and Israel show that people with rebounding CD4 counts can tolerate discontinuation of PCP prophylaxis. Results of other studies supporting this conclusion are briefly reviewed. Summary results from EuroSIDA, Swiss, and Dutch studies are presented in table form. Issues still remain regarding PCP prophylaxis, however, including brief study follow-ups, lack of controlled clinical trials and questions surrounding secondary prophylaxis.
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PMID:Stopping PCP prophylaxis after suppressing HIV. 1136 76

Although combination therapy with HAART (Highly Active AntiRetroviral Therapy) can increase CD4 (T-cell) counts, doctors have been cautious about stopping preventive treatments, or prophylaxis, for PCP (Pneumocystis carinii pneumonitis). Two studies, however, suggest that if HAART increases T-cell counts to over 200 for an extended time period, PCP prophylaxis may be safely stopped. Partly as a result of these study findings, the United States Public Health Service has rewritten guidelines on the prevention of opportunistic infections. The draft version continues to call for PCP prevention beginning when patients have T-cell counts below 200 or have a history of thrush. However, a new section states that providers may stop prophylactic treatment when T-cell counts remain over 200 for at least three to six months. Recommendations for preventing MAC (mycobacterium avium complex) and CMV (cytomegalovirus) have also changed with HAART and are briefly described.
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PMID:Stopping preventive treatments. 1136 80

The objective of this research was to compare the demographics, acquired immune deficiency syndrome (AIDS) progression, and survival in persons with AIDS with pulmonary tuberculosis (PTB) versus extrapulmonary tuberculosis (EPTB), because there are limited population-based data on this topic. A population-based longitudinal study with 3 years of follow-up was performed. Data were collected every 6 months from medical records of persons with AIDS and TB treated at private and public medical facilities throughout Los Angeles County (LAC). Participants included a population-based sample of 216 persons with AIDS and PTB and 166 persons with AIDS and EPTB (including 113 persons with both PTB and EPTB), with an AIDS diagnosis reported in 1993. Compared to persons with AIDS with PTB, persons with AIDS and EPTB were 2.2 times more likely to be Latino than white (95% confidence intervals [CIs]: 1.2, 4.0) and 1.7 times more likely to be foreign-born (95% CIs: 1.1, 2.5). Compared to persons with AIDS with PTB, persons with AIDS and EPTB had similar antiretroviral and PCP prophylaxis use; lower CD4 counts at time of AIDS diagnosis (p = 0.0004); no differences in CD4 counts over the total follow-up period (p = 0.4); higher rates of total opportunistic infections (OIs) (incidence density ratio [IDR] = 2.0; 95% CIs: 1.6, 2.4); and comparable survival curves (p = 0.07). Persons with AIDS and EPTB had a more complicated medical course with lower CD4 counts at time of AIDS diagnosis and more OIs over the follow-up period than persons with AIDS and PTB, however the survival profiles for the two groups were comparable.
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PMID:Comparison of AIDS progression and survival in persons with pulmonary versus extrapulmonary tuberculosis in Los Angeles. 1158 32

Patients with HIV frequently present at some time in their illness with community-acquired pneumonia (CAP). Early in the prognosis of HIV when CD4 counts are somewhat decreased, HIV patients with CAP are infected with the same pulmonary pathogen as normal hosts plus Legionella, Salmonella or Chlamydia pneumoniae. Later in HIV, when the CD4 counts are markedly reduced, Pneumocystis carinii (PCP), CMV and acid-fast organisms (TB or MAI) are important pulmonary pathogens. This article presents a clinical approach to empiric antibiotics based on chest x-ray appearance and CD4 count. This permits a rational therapeutic approach to avoid excessive coverage commonly employed by clinicians because of the multiplicity of potential pulmonary pathogens in HIV patients with CAP.
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PMID:Community-acquired pneumonia in patients with HIV. 1498 50

Surfactant protein A (SP-A), a member of the collectin family, selectively binds to Pneumocystis carinii and mediates interactions between pathogen and host alveolar macrophages in vitro. To test the hypothesis that mice lacking SP-A have delayed clearance of Pneumocystis organisms and enhanced lung injury, wild-type C57BL/6 (WT) and SP-A-deficient mice (SP-A(-/-)) with or without selective CD4(+)-T-cell depletion were intratracheally inoculated with Pneumocystis organisms. Four weeks later, CD4-depleted SP-A-deficient mice had developed a more severe Pneumocystis infection than CD4-depleted WT (P. carinii pneumonia [PCP] scores of 3 versus 2, respectively). Whereas all non-CD4-depleted WT mice were free of PCP, intact SP-A(-/-) mice also had evidence of increased organism burden. Pneumocystis infection in SP-A-deficient mice was associated histologically with enhanced peribronchial and/or perivascular cellularity (score of 4 versus 2, SP-A(-/-) versus C57BL/6 mice, respectively) and a corresponding increase in bronchoalveolar lavage (BAL) cell counts. Increases in SP-D content, gamma interferon, interleukin-4, interleukin-5, and tumor necrosis factor alpha in BAL fluid occurred but were attenuated in PCP-infected SP-A(-/-) mice compared to WT mice. There were increases in total BAL NO levels in both infected groups, but nitrite levels were higher in SP-A(-/-) mice, indicating a reduction in production of higher oxides of nitrogen that was also reflected in lower levels of 3-nitrotyrosine staining in the SP-A(-/-) group. We conclude that despite increases in inflammatory cells, SP-A-deficient mice infected with P. carinii exhibit an enhanced susceptibility to the organism and attenuated production of proinflammatory cytokines and reactive oxygen-nitrogen species. These data support the concept that SP-A is a local effector molecule in the lung host defense against P. carinii in vivo.
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PMID:Enhanced lung injury and delayed clearance of Pneumocystis carinii in surfactant protein A-deficient mice: attenuation of cytokine responses and reactive oxygen-nitrogen species. 1538 4

We retrospectively reviewed 205 HIV-infected patients, who came at first entry from January 2001 to December 2002 to the Hospital Kuala Lumpur, Kuala Lumpur, Malaysia. The aged range was 21-69 years [mean 37.25 years (+/- SD) 8.1]. Subjects were mainly in the age group 35-44 years. The majority of patients were male (82%), Chinese (55.1%), single (55.6%), resided in Kuala Lumpur (55.1%), and were unemployed (57.1%). The most frequent routes of transmission were sexual contact (78.5%), followed by IDUs (30%), blood transfusion (5%), and unknown (0.5%). Oral candidiasis was the most common mucocutaneous disease and significant co-existence was found with the main opportunistic systemic diseases, such as TB, PCP, toxoplasmic encephalitis, penicillosis, and CMV retinitis (p < 0.05). In this study, the range of CD4 counts was 0-910, with a median of 35 cells/mm3. Significant associations between a CD4 level less than 100 cells/mm3 at the time of diagnosis, and the occurrence of major opportunistic diseases, such as candidiasis, TB, PCP, TE, herpes simplex infection, CMV retinitis, penicillosis, and histoplasmosis were found (p < 0.05) in this study.
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PMID:Spectrum of opportunistic infections among HIV-infected patients in Malaysia. 1590 30

In recent years, the proportion of individuals who are unaware of being infected with HIV when diagnosed with AIDS (defined as 'late testers') has dramatically increased in several European countries, including Italy. We evaluated the extent and determinants of late testing and its impact in terms of AIDS-defining illnesses among AIDS cases reported to the Italian National AIDS Registry since 1996. Late testers were defined as those persons whose first positive HIV test result was within six months of the AIDS diagnosis. Late testers were more likely to be heterosexual contacts or MSWM, as opposed to IDUs. They were also more likely to come from low prevalence areas of Italy or from foreign countries. At AIDS diagnosis, late testers were less likely to be undergoing HAART or prophylaxis against PCP/toxoplasmosis, compared to non-late testers. The mean CD4 cell count at AIDS diagnosis was significantly lower among late testers. PCP, toxoplasmosis and Kaposi's sarcoma were more frequently diagnosed as an AIDS-defining illness in late testers, who also had a significantly higher risk of presenting with multiple concomitant AIDS-defining illnesses. In conclusion, late testing results in missed opportunities for preventing and treating HIV infection, leading to an increased risk of developing preventable opportunistic infections and death.
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PMID:Increasing proportion of late testers among AIDS cases in Italy, 1996-2002. 1612 May

The clinical, microbiologic, and immunologic parameters in HIV-infected subjects first presenting with disseminated Mycobacterium avium complex (DMAC) were determined. Four HIV-positive groups not yet on DMAC treatment were enrolled: 19 subjects with CD4 lymphocyte counts < or =50/microl thought to have DMAC on clinical grounds; 18 subjects newly found to have a positive blood culture for MAC; 25 asymptomatic controls (CD4 cell counts < or =50); and 25 asymptomatic controls (CD4 counts 100-250/microl). Outcome measures include comparisons between groups for clinical characteristics; results of cultures from blood, marrow, and gastrointestinal and respiratory tracts; immunological markers from staining of marrow and flow cytometry of circulating lymphocytes; and cytokine production of PBMCs. Only 21% of the 19 patients entered on suspicion of having DMAC grew MAC from blood or marrow. Neither clinical presentation nor laboratory tests differentiated those culture-positive from those culture-negative patients. However, prior PCP or multiple other opportunistic infections were more common in the DMAC group. MAC was isolated from 82% of marrow and 50% of blood specimens from the DMAC group. Respiratory or gastrointestinal colonization was present in 36% of DMAC subjects, but only 5% of non-DMAC subjects with CD4 counts <50 cells/microl. CD8+ cells were more frequent in bone marrow, and CD4 cells recognizing MAC antigen were more frequent in blood from DMAC subjects vs. controls. Results suggest an early stage of tissue dissemination preceding persistent bacteremia, and mucosal entry without persistence of colonization. MAC-specific T cell responses apparently develop and persist during DMAC, but are dysfunctional or too infrequent to prevent persistence.
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PMID:Clinical, microbiological, and immunological characteristics in HIV-infected subjects at risk for disseminated Mycobacterium avium complex disease: an AACTG study. 1613 7


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