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

Although Kaposi's sarcoma (KS) has been considered a rare disease, the disease is well known at present since the onset of AIDS in 1981. The characteristics of AIDS-associated KS are a multifocal, widespread distribution that may involve lymph node, gastrointestinal tract, and visceral organs. KS may be the first sign of HIV-infection, but it can also arise in some patients who lack evidences of immune impairment. The more effective chemotherapy of AIDS-associated KS is low-dose-ABV-combination (adriamycin, bleomycin and vincristine) and its response rate is about 80%-90%. The second cancer that occurred in the AIDS-related immune impairement is malignant lymphoma. Approximately 90% of AIDS-related malignant lymphoma reported have been of high grade, B-cell types, including B immunoblastic type and small non-cleaved cell lymphoma. They have another distinguishing feature that is wide spread extent of disease at presentation, with extranodal involvement recorded in 80% to 90% of all patients. The most common sites of involvement are CNS (central nervous system) (32%), gastrointestinal tract (26%), bone marrow (25%) and liver (12%). It was reported that the median CE4 count in patients with primary-CNS lymphoma was 37 cells/dl, versus 189 cells/dl in those with systemic disease. It is important to note that approximately 17% of leptomeningeal disease is asymptomatic. The recommended treatment of AIDS-associated lymphoma by Levine is a low-dose modification of the M-BACOD (bleomycin, doxorubicin, cyclophosphamide, vincristine, dexamethasone, cytosine arabinoside, azidothymidine and helmet field radiotherapy). A complete remission (CR) rate of 46% was achieved. The median survival time of CR patients was 15 months.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[AIDS-related malignancy]. 822 66

The incidence of three malignancies has increased in conjunction with the epidemic of human immunodeficiency virus (HIV) disease, and they are currently considered acquired immunodeficiency syndrome (AIDS)-defining conditions. These are Kaposi's sarcoma, associated with AIDS since the onset of the epidemic in 1981; intermediate or high-grade B-cell lymphoma, which became AIDS-defining in 1985; and cervical carcinoma in HIV-infected women, formally recognized as an AIDS-defining diagnosis on January 1, 1993. Approximately 40% of all patients with AIDS have developed cancer during the course of HIV infection. Further, as survival has improved in HIV disease, the incidence of these malignancies has increased. It is thus expected that greater numbers of patients with AIDS-related lymphoma and cervical cancer will be diagnosed in the years ahead. The epidemiologic factors associated with neoplastic disease differ among patients with the three AIDS-related malignancies. The pathogenesis of neoplastic disease also differs. The specific etiologic steps in the development of AIDS-related Kaposi's sarcoma and lymphoma are currently unknown. However, a great deal of information has already been acquired, which may have bearing on the pathogenesis of malignant disease in general, as well as the elucidation of future therapeutic modalities. The specific epidemiologic, etiologic, and clinical characteristics of the AIDS-related malignancies will be described herein. It is hoped that this review will serve to outline our current understanding of this area, to introduce the questions and controversies which are apparent in the field, and to mention those areas in which future research might be focused.
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PMID:AIDS-related malignancies: the emerging epidemic. 835 Mar 62

More than 50% of patients with acquired immunodeficiency syndrome (AIDS) develop pulmonary disease during the course of their illness. The authors reviewed 96 computed tomographic (CT) scans of patients with AIDS in an attempt to describe disease entities by the patterns seen on the scans. Such patterns included isolated ground-glass and interstitial infiltrates, which are suggestive of Pneumocystis carinii pneumonia (PCP). If pleural effusions or parenchymal nodules are also present, AIDS-related lymphoma (ARL) or Kaposi sarcoma (KS) is more likely. Although diffuse alveolar infiltrates are most commonly present in PCP, a segmental alveolar infiltrate is suggestive of a bacterial pneumonia, especially when associated with cavitation or ipsilateral pleural effusion. Well-defined nodules are typical for ARL, whereas ill-defined nodules are more commonly suggestive of KS. Accompanying adenopathy or effusion with nodules further suggests ARL. Different combinations of parenchymal, nodular, and pleural abnormalities may be suggestive for additional diagnoses, including Mycobacterium tuberculosis, M avium-intracellulare, and Cryptococcus neoformans infections and human immunodeficiency virus adenopathy. The authors believe that a specific pattern of involvement can help suggest a likely diagnosis in many instances.
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PMID:Pattern recognition of the pulmonary manifestations of AIDS on CT scans. 835 67

Detection of novel DNA sequences in Kaposi's sarcoma (KS) and AIDS-related body cavity-based, non-Hodgkin's lymphomas suggests that these neoplasms are caused by a previously unidentified human herpesvirus. We have characterized this agent using a continuously infected B-lymphocyte cell line derived from an AIDS-related lymphoma and a genomic library made from a KS lesion. In this cell line, the agent has a large episomal genome with an electrophoretic mobility similar to that of 270-kb linear DNA markers during clamped homogeneous electric field gel electrophoresis. A 20.7-kb region of the genome has been completely sequenced, and within this region, 17 partial and complete open reading frames are present; all except one have sequence and positional homology to known gammaherpesvirus genes, including the major capsid protein and thymidine kinase genes. Phylogenetic analyses using both single genes and combined gene sets demonstrated that the agent is a gamma-2 herpesvirus (genus Rhadinovirus) and is the first member of this genus known to infect humans. Evidence for transient viral transmission from infected to uninfected cells is presented, but replication-competent virions have not been identified in infected cell lines. Sera from patients with KS have specific antibodies directed against antigens of infected cell lines, and these antibodies are generally absent in sera from patients with AIDS without KS. These studies define the agent as a new human herpesvirus provisionally assigned the descriptive name KS-associated herpesvirus; its formal designation is likely to be human herpesvirus 8.
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PMID:Primary characterization of a herpesvirus agent associated with Kaposi's sarcomae. 852 68

The aim of this manuscript is to review the CT findings of pulmonary complications seen in acquired immunodeficiency syndrome (AIDS) and in non-AIDS immunocompromised patients. The most common pulmonary complications in patients with AIDS include infection, Kaposi's sarcoma, and AIDS-related lymphoma. The most common complications seen in non-AIDS immunocompromised patients include infection, drug-induced lung disease, diffuse pulmonary hemorrhage, and pulmonary edema.
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PMID:Acute lung disease in the immunocompromised host: differential diagnosis at high-resolution CT. 852 68

The role of zidovudine and other antiretroviral agents in the pathogenesis of acquired immunodeficiency syndrome (AIDS)-related lymphomas has been somewhat controversial. In an attempt to elucidate the precise role of antiretroviral agents in the subsequent development of AIDS-related lymphoma, we performed a population-based, case-control study of human immunodeficiency virus (HIV)-seropositive patients with intermediate- or high-grade lymphoma in Los Angeles County, California, in which information regarding use of antiretroviral medications was ascertained. Diagnostic biopsy material was reviewed to confirm intermediate-or high-grade lymphoma. A structured interview, conducted with all cases and controls, included information about use of zidovudine and other antiretroviral agents. A total of 112 HIV-infected homosexual/bisexual men with lymphoma were matched to 112 homosexual/bisexual men with asymptomatic HIV infection; 49 of the lymphoma cases were also matched to 49 additional controls with AIDS, as defined by conditions other than lymphoma. Positive histories of zidovudine use were reported by 44 (39%) lymphoma cases, 24 (21%) asymptomatic HIV controls, and 21 (42%) AIDS controls. The average duration of zidovudine use up to 12 months before lymphoma diagnosis was 19.0 +/- 13.0 months (mean +/- SD) for the lymphoma cases, 12.6 +/- 10.5 months for the asymptomatic controls, and 11.0 +/- 7.1 months for the AIDS controls. When comparing the 49 HIV-positive lymphoma cases with their 49 matched AIDS controls, all of whom were diagnosed with AIDS during the same time period, the matched relative odds of lymphoma associated with prior use of zidovudine was 0.43 (95% confidence interval [CI] = 0.17 to 1.12). In comparing all 112 lymphoma cases with 49 AIDS controls, the unmatched relative odds of lymphoma associated with zidovudine use was 0.93 (95% confidence interval = 0.47 to 1.83). One lymphoma case and no AIDS control cases had a history of didanosine use; no lymphoma case or AIDS control cases had taken zalcitabine. We conclude that zidovudine is not associated with an increased risk of development of lymphoma among HIV-infected homosexual or bisexual men.
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PMID:Role of zidovudine antiretroviral therapy in the pathogenesis of acquired immunodeficiency syndrome-related lymphoma. 854 52

While there is a clear association between several types of immunodeficiency-related lymphomas and Epstein-Barr virus (EBV), the association of EBV infection in AIDS-related lymphoma in Brazil, where the incidence of AIDS is high, has remained unknown. The authors report their findings from an analysis of tissue samples from 24 cases of AIDS-related lymphoma in Brazil. The samples were analyzed for morphologic classification, immunophenotype, and EBV association. 20 cases were classified as non-Hodgkin's lymphoma, while 4 were Hodgkin's disease. 11 non-Hodgkin's lymphomas were classified as diffuse large cell type, 5 as small, non-cleaved cell, Burkitt-type, and 4 as large cell immunoblastic non-Hodgkin's lymphoma. 18 cases were of B-cell phenotype; one was a T-cell lymphoma and one was classified as null. EBV was demonstrated in the tumor cells of 11 of the 20 non-Hodgkin's lymphoma cases and in 3 of the 4 cases of non-Hodgkin's disease.
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PMID:AIDS-related lymphoma in Brazil. Histopathology, immunophenotype, and association with Epstein-Barr virus. 860 50

The purpose of this study was to determine the in situ distribution of PCR-amplified HIV-1 and EBV DNA in hyperplastic lymph nodes and in AIDS-related lymphomas. PCR amplified HIV-1 DNA was detected, on average, in about 30% and 20% of the CD4 and CD21 dendritic cells, respectively, in and around the expanded germinal centers of hyperplastic lymph nodes in seropositive, asymptomatic people. PCR-amplified EBV DNA was noted, on average, in about 20% of L26 B-cells. The amplified HIV-1 DNA was noted in rare non-neoplastic cells in five AIDS-related lymphomas; the other three cases were negative for the viral DNA. Amplified EBV DNA was detected in five of eight lymphomas but in only three of these tissues did the viral DNA localize to the malignant cells. We conclude that although many cells in hyperplastic lymph nodes from people with early HIV-1 infection contain HIV-1 and EBV DNA, these viruses are of ten absent in the malignant cells of AIDS-related lymphoma. This suggests that although infection by these viruses and the concomitant lymphoid hyperplasia may predispose to lymphoma, the viruses are not required for maintenance of the malignant phenotype.
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PMID:In situ detection of PCR-amplified HIV-1 and EBV nucleic acids in hyperplastic lymph nodes and in AIDS-related lymphoma. 881 72

Specific infections and neoplasms that are complications of acquired immunodeficiency syndrome (AIDS) occur within various CD4 lymphocyte count ranges. Knowledge of how these counts correlate with radiographic appearances of these entities can limit the differential diagnosis because certain conditions are uncommon above a specific count. In patients with CD4 lymphocyte counts above 200 cells/mm3 and radiographic findings of cavitary and noncavitary consolidation, bacterial pneumonia and Mycobacterium tuberculosis are the major diagnostic considerations. As the CD4 lymphocyte count falls, these infections are still common; however, cavitation is seen less frequently with Mycobacterium tuberculosis, and unusual bacterial infections, including those caused by Rhodococcus equi and Nocardia asteroides, should be considered. In patients with counts below 200 cells/mm3, Pneumocystis carinii pneumonia is the most common infection, usually manifesting radiographically as a reticular interstitial pattern. At CD4 lymphocyte counts of 50-200 cells/mm3, disseminated fungal infection and Kaposi sarcoma become prevalent. In patients with advanced AIDS and counts below 50 cells/mm3, radiographic nodular or reticular patterns may indicate AIDS-related lymphoma and cytomegalovirus and Mycobacterium avium-intracellulare infections. When CD4 lymphocyte counts are applied to interpretation of chest radiographs in AIDS patients, the working differential diagnosis of a radiographic pattern can be tailored to the clinical situation of a given patient.
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PMID:Interpretation of chest radiographs in AIDS patients: usefulness of CD4 lymphocyte counts. 901 98

The incidence of non-Hodgkin's lymphoma is greatly increased in human immunodeficiency virus (HIV)-infected individuals. Most are clinically aggressive B-cell lymphomas exhibiting Burkitt-type, immunoblastic or large-cell morphology. Approximately 80% arise systemically (nodal or extranodal), and the remaining 20% arise in the central nervous system. A small proportion are body cavity-based (primary effusion) lymphomas associated with Kaposi's sarcoma-associated herpesvirus (KSHV) infection. Possible factors contributing to lymphoma development include HIV-induced immunosuppression, chronic antigenic stimulation, and cytokine overproduction. These phenomena are associated with the development of oligoclonal B-cell expansions. The appearance of malignant lymphoma is characterized by the presence of a monoclonal B-cell population displaying a variety of genetic lesions including Epstein-Barr virus (EBV) infections, c-myc gene rearrangement, bcl-6 gene rearrangement, ras gene mutations, and p53 gene mutations/deletions. The number and type of genetic lesions varies according to anatomic site of origin and histopathology. In the case of Burkitt-type lymphoma, virtually 100% exhibit c-myc gene rearrangement, two thirds display p53 gene mutations, one third contain EBV, and none exhibit bcl-6 gene rearrangements. In contrast, in the case of immunoblastic lymphoma, virtually 100% contain EBV, 25% display c-myc gene rearrangements, 20% display bcl-6 gene rearrangements, and few exhibit p53 gene mutations. These findings suggest that more than one pathogenetic mechanism is operational in the development and progression of acquired immunodeficiency syndrome (AIDS)-related lymphoma. Further work is necessary to develop a thorough understanding of the origin and pathogenesis of malignant lymphoma in the setting of HIV infection. AIDS-related lymphoma remains an important biologic model for investigating the development and progression of high-grade non-Hodgkin lymphomas as well as malignant lymphomas that develop in immune-deficient hosts.
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PMID:Molecular pathology of acquired immunodeficiency syndrome-related non-Hodgkin's lymphoma. 904 11


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