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Query: UMLS:C0001175 (AIDS)
 120,706 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Amantadine is well established as the preferred antiviral agent for the prophylaxis of influenza A and may also be beneficial therapeutically when used early in the course of the disease. Idoxuridine is applicable only in the treatment of herpetic keratitis. Currently, acyclovir is the most effective agent for the treatment of herpes simplex and varicella-zoster virus infections. Ribavirin has recently been released for use in aerosol form for severe respiratory syncytial virus infections that occur in infants and young children. Vidarabine, which previously was the drug of choice in the treatment of severe herpetic infections, has now been replaced by the more effective acyclovir. Ganciclovir, an experimental agent, has shown promise against cytomegalovirus infections in patients who have undergone kidney or liver transplantation, but its effects are only temporary in patients who have undergone bone marrow transplantation and patients with acquired immunodeficiency syndrome (AIDS) who have cytomegalovirus infections.
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PMID:Antiviral agents. 350 Mar 76

Remarkable progress has been made in antiviral chemotherapy. Six approved antiviral drugs are now available for the treatment of various viral infections. Trifluridine, idoxuridine and vidarabine are all effective in patients with herpes keratitis; trifluridine is preferred due to its low toxicity. Acyclovir is the drug of choice in patients with infections due to herpes simplex viruses, including genital herpes, herpes encephalitis, and neonatal herpes, and infections due to varicella-zoster virus. Amantadine is the only drug currently available for prophylaxis and treatment of influenza A, but an investigational drug, rimantadine, appears to be equally effective and less toxic than amantadine. Ribavirin is the most recently approved antiviral agent for the treatment of respiratory syncytial virus infections. Numerous antiviral drugs are being studied in patients with acquired immunodeficiency syndrome. Although currently available drugs have improved our ability to manage a variety of viral illnesses, much needs to be learned about specific dosage guidelines based on the studies of pharmacokinetics, pharmacodynamics, potential adverse effects and viral resistance, and the role of combination therapy to optimize therapy.
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PMID:Clinical use of antiviral drugs. 355 26

Antibody responses after immunization with 23-valent pneumococcal polysaccharide and trivalent influenza virus vaccines were evaluated in 30 adults with hemophilia and in 17 healthy controls. The 30 patients with hemophilia included 13 who were human immunodeficiency virus (HIV) antibody positive with acquired immune deficiency syndrome (AIDS) or AIDS-related complex (group 1), 11 who were asymptomatic HIV antibody positive (group 2), and six who were asymptomatic HIV antibody negative (group 3). Sera were obtained before and 4 weeks after immunization, and levels of antibody were measured by enzyme-linked immunoassay or by hemagglutination inhibition assay. All three groups of patients with hemophilia showed significantly higher preimmunization geometric mean titers of antibodies (groups 1 and 2, fivefold, group 3, 2.8-fold higher), with little increase after pneumococcal vaccine, when compared with controls. Defective humoral responses were noted in groups 1 and 2, with depressed antibody responses after influenza vaccine, significantly elevated levels of IgG and IgM, and depressed blastogenic responsiveness to pokeweed mitogen. Group 3 demonstrated normal responses to pokeweed mitogen, normal antibody responses to influenza vaccine, and normal level of IgG and IgM, although levels of IgG and IgM were higher than those of controls. These data suggest that humoral immune abnormalities are found frequently in patients with hemophilia who are HIV antibody positive. Further, prolonged administration of blood products, regardless of the recipient's HIV status, appears to be associated with polyclonal activation of B cells for T-independent but not T-dependent antigens.
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PMID:Antibody responses to immunization of patients with hemophilia with and without evidence of human immunodeficiency virus (human T-lymphotropic virus type III) infection. 357 1

An epidemic form of Kaposi's sarcoma associated with the acquired immune deficiency syndrome has been recently described. Seven homosexual men with biopsy-documented epidemic Kaposi's sarcoma were treated with a human interferon-gamma preparation. All patients had generalized disease. Only one patient had received prior chemotherapy, and one other patient had recovered from a prior opportunistic infection. Interferon-gamma was administered in a dose of 500,000 U intramuscularly daily, with two 10-day induction courses, separated by a 2-week medication-free period. This was followed by maintenance therapy in the same dose twice weekly. Toxicities consisted of a flu-like illness with high fevers, shaking chills, myalgias, and arthralgias. There were no complete or partial responses. All patients exhibited disease progression, with a rapid progression of previously stable disease necessitating discontinuation of therapy in three patients. We conclude that low doses of this human interferon-gamma preparation are ineffective in epidemic Kaposi's sarcoma.
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PMID:Therapeutic trial of interferon-gamma in patients with epidemic Kaposi's sarcoma. 392 25

This article reports a case of needlestick transmission of human T-lymphotropic virus type III (HTLV-III) infection to a health care worker in the UK from a patient who was presumably infected while in Africa. The patient, a white woman who had lived in central southern Africa, presented at the hospital with general malaise, dry cough, and fever. Lung biopsy revealed Pneumocystis carinii pneumonia infection, and the patient was seropositive for HTLV-III infection with a titer of 260. The patient reported that she had been unwell for 2-3 years. She had none of the accepted risk factors for acquired immunodeficiency syndrome (AIDS), and neither she nor her husband had visited the US, the Caribbean, or Zaire. Serum from the husband was positive for HTLV-III antibodies at a titer of 450. Despite intensive management and treatment with pentamidine, the patient died. During management of this case, a nursing staff member sustained a needlestick injury to the finger while resheathing a hypodermic needle. A small amount of blood was probably injected. 13 days later, the health care worker developed a severe flu-like illness with sore throat, headache, myalgia, and facial neuralgia. A macular rash and generalized lymphadenopathy were also noted. Serum drawn 27 days after the incident was negative for anti-HTLV-III infection, but titers on days 49 and 57 were 12 and 24, respectively. This contrasts with experience in the US, where needlestick injuries in health care workers have not resulted in either disease or transmission. It is assumed that the patient acquired AIDS in Africa, and that the infection was transmitted heterosexually. This case raises the possibility of differences in infectivity and other characteristics between HTLV-III viruses of US and African origin.
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PMID:Needlestick transmission of HTLV-III from a patient infected in Africa. 615 Mar 72

This article presents preliminary 24-month findings from a prospective study initiated in San Francisco in 1981 with the following objectives: to refine the clinical definition of the lymphadenopathy syndrome; to compare these patients to patients with Category A acquired immunodeficiency syndrome (AIDS) with regard to epidemiologic, virologic, and immunologic variables; to follow a cohort of these patients to establish the natural history of the syndrome; and to evaluate screening variables for early transformation to more malignant manifestations of AIDS. It was hypothesized that the lymph node syndrome is prodromal AIDS, and that such patients are at risk of developing Kaposi's sarcoma, lymphoma, Pneumocystis carinii pneumonia, and other opportunistic infections. 200 homosexual lymphadenopathy patients, with a mean age of 33 years, have been enrolled in the study. These men have had an average of 800 sexual partners, and have a history of past sexually transmitted diseases. The graph of the year of onset of adenopathy parallels the exponentially increasing number of new AIDS cases over the past 4 years. Systemic symptoms seen in these patients resemble those in patients with Kaposi's sarcoma and P. carinii pneumonia. 1/3 of lymphadenopathy patients give a history of antecedent flu-like illness, often with fever, diarrhea, and upper respiratory symptoms lasting for 1 week, that occurred 1-2 months before the appearance of their nodes. Involvement of inguinal and axillary nodes has been observed in 100% of patients, while 80% have enlarged posterior cervical nodes. The average patient has 10 nodal groups involved. Immunologic testing reveals a reversal of the T-lymphocyte helper:suppressor ratio (mean of 0.7), and 2/3 of patients have both decreased absolute number and percentage of helper cells with increased suppressors. 198 of these patients have remained with persistent generalized lymphadenopathy without transformation to AIDS, yielding a 1% conversion rate. It is concluded that the lymphadenopathy syndrome is a distinct new syndrome most certainly AIDS-related. Further study will reveal whether it is truly prodromal or an alternate phenotypic response to a common inciting insult.
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PMID:Lymphadenopathy: endpoint or prodrome? Update of a 24-month prospective study. 633 51

To determine whether healthy homosexual men are immunologically impaired, peripheral blood leukocytes (PBL) from 20 male homosexuals were compared prospectively with PBL from 14 age-matched male heterosexual donors with respect to: (a) the capacity of their PBL to generate functional T cell immune responses in vitro; and (b) the content of total T cells and T cell subsets in their peripheral blood. The homosexual donors studied indicated moderate sexual life styles in that all but one of the donors had less than five current sexual partners. The percentages of OKT3+, OKT4+, and OKT8+ T cells were similar to those of heterosexual controls. T cell function was assessed by measuring cytotoxic T cell responses to influenza virus and to allogeneic cells. Approximately one-third of the homosexual donors consistently exhibited weak cytotoxic T lymphocyte (CTL) responses to influenza virus, whereas all of the heterosexual donors generated strong CTL responses to influenza. There was no correlation between the strength of CTL responsiveness to influenza virus and the strength of CTL responses to allogeneic cells. These results suggest that the influenza-specific CTL response may be a sensitive indicator of immunologic defects in asymptomatic homosexuals. If acquired immune deficiency syndrome results from an infectious agent, it remains to be seen if such immunosuppression predisposes to the infection, or if it reflects early consequences of infection.
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PMID:Functional T lymphocyte immune deficiency in a population of homosexual men who do not exhibit symptoms of acquired immune deficiency syndrome. 661 54

Previously we identified the highly conserved amino acids Glu-Leu-Asp-Lys-Trp-Ala (ELDKWA) on the ecto-domain of gp41 as the epitope of a neutralizing monoclonal antibody (2F5) directed against human immunodeficiency virus type 1. In the present study, the sequence defining the epitope was introduced into the loop of antigenic site B of the influenza virus hemagglutinin. The resulting chimeric virus was able to elicit ELDKWA-specific immunoglobulins G and A in antisera of mice. Moreover, the distantly related human immunodeficiency virus type 1 isolates MN, RF, and IIIB were neutralized by these antisera. These data suggest that this conserved B-cell epitope is a promising candidate for inclusion in a vaccine against AIDS. The results also show that influenza virus can be used to effectively present the antigenic structure of this B-cell epitope.
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PMID:Cross-neutralizing activity against divergent human immunodeficiency virus type 1 isolates induced by the gp41 sequence ELDKWAS. 751 84

AIDS-related research has documented overreactions to casual contact and underreactions to sexual risk. This contradiction is explained by "magical contagion", a principle of thinking common in traditional societies, wherein contagion is considered socially discriminating, such that harmfulness depends on the nature of the relationship between source and recipient. In Study 1, 100 undergraduate participants drew germs described as their own, a stranger's, their lover's, or a disliked peer's. Lovers' germs were depicted as less threatening than disliked peers' germs. In Study 2, scenarios described contact with a flu-infected lover, stranger, or disliked peer. New undergraduate participants (N = 133) rated how likely they were to become ill and how severely. Although likelihood ratings did not differ, severity ratings followed a linear trend, effects of lover contact being least severe and contact with disliked peer most severe. Behavioral implications of the blurring of feelings about germ source with estimates of germ virulence are discussed.
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PMID:Magical thinking about illness virulence: conceptions of germs from "safe" versus "dangerous" others. 778 50

Human immunodeficiency virus type 1 (HIV-1)-infected patients (n = 335) in the US Air Force HIV Natural History Program were followed for 3 years (mean) after skin testing, immunophenotyping of CD4+ cell subsets, and measurement of in vitro interleukin-2 production after stimulation by phytohemagglutinin, alloantigens, tetanus toxoid, and influenza A virus. The T cell functional assay predicted survival time (P < .001) and time for progression to AIDS (P = .014). Skin testing for tetanus, mumps, and Candida antigen and the total number of positive tests (P < .001 for each) stratified patients for survival time. In a multivariable proportional hazards model, the T cell functional assay (P = .008), the absolute number of CD4+ T cells (P = .001), the percentage of CD4+ CD29+ cells (P = .06), and the number of reactive skin tests (P < .001) predicted survival time. Thus, cellular immune functional tests have significant predictive value for survival time in HIV-1-infected patients independent of CD4+ cell count.
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PMID:In vitro T cell function, delayed-type hypersensitivity skin testing, and CD4+ T cell subset phenotyping independently predict survival time in patients infected with human immunodeficiency virus. 779 48


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