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

In the last ten years, the practice of plasma volume expansion has changed significantly. Most clinicians have put a stop to the use of fresh frozen plasma because of growing concerns about hepatitis and AIDS transmission. Today, natural and synthetic colloids and crystalloids are used to a great extent. Although clinical practice varies from one institution to another, the most widely observed change was a major increase in the administration of human serum albumin (HSA). As a result, the cost of plasma volume expansion became so high that it justified finding safe and cheaper alternatives to HSA. Low molecular weight, hydroxyethylstarch (HES) are the synthetic colloids which are closest to HSA. HES are modified natural polymers whose physico-chemical properties are defined by their molecular weight and molar substitution ratio. Average molecular weights of these poly-dispersed solutions are approximately 200 to 250 kd (in weight) and 60 kd (in number). Hydroxyethylation, which slows down hydrolysis by alpha-amylase, is best quantified by the molar substitution ratio between the proportions of hydroxyethyl-ether and glucose. HES have pharmacokinetic properties which are independent of molecular weight and directly related to the molar substitution ratio. The two HES available in France are Elohes and Lomol, Elohes, at a concentration of 6%, has a colloid-osmotic effect close to that of plasma. It induces an initial plasma volume expansion greater than that of the infused volume, and has a long lasting effect (24 h) related to its molar substitution ratio (0.62). Lomol, at a concentration of 10%, is hyperoncotic.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Pharmacology of low molecular weight hydroxyethyl starch]. 128 9

We measured serum and CSF beta 2-microglobulin (beta 2M) levels in HIV-1 seropositive individuals with and without dementia to determine the frequency and diagnostic utility of elevation of CSF beta 2M. We compared 34 samples from 27 patients with HIV-1 dementia with 110 samples from 54 HIV-1 seropositive participants in the Multicenter AIDS Cohort Study, none of whom had progressive dementia. Neurosyphilis and CNS opportunistic processes were excluded in all subjects. We stratified the nondemented subjects by duration of HIV seropositivity and peripheral blood CD4 count. Compared with the nondemented group, demented subjects had significantly higher CSF total protein, IgG%, and CSF albumin/serum albumin ratios. A highly significant association was found between elevated CSF beta 2M and reduced CD4 count (p less than 0.0001). No significant differences were noted between the demented and nondemented groups in CSF WBC count or in the frequency of CSF HIV-1 isolation. The mean CSF beta 2M was 1.9 mg/l in the nondemented subjects compared with 4.2 mg/l in those with dementia (p less than 0.0001). We derived a cutoff of 3.8 mg/l from the distribution of CSF beta 2M in the nondemented group. The determination of CSF beta 2M had a sensitivity of 44%, specificity of 90%, and a positive predictive value of 88% for diagnosis of HIV dementia when compared with nondemented subjects with CD4 counts less than 200. In those without dementia, there was a strong correlation between serum and CSF beta 2M (r = 0.50, p less than 0.0001), but in demented subjects CSF beta 2M was elevated independently of serum levels, suggesting that CSF beta 2M is produced within the brain in HIV dementia. In the absence of CNS opportunistic processes, elevated CSF beta 2M greater than 3.8 mg/l is a clinically useful marker for HIV dementia.
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PMID:The diagnostic utility of elevation in cerebrospinal fluid beta 2-microglobulin in HIV-1 dementia. Multicenter AIDS Cohort Study. 135 86

Potential relationships among nutritional status, immune function and quality of life were examined in a convenience sample of 40 outpatient homosexual and bisexual males stratified into five categories, using modified Walter Reed Staging Criteria. Nutritional status was assessed by measuring height, weight, triceps skinfold thickness, arm circumference, nutrient intake and serum albumin. Immune status was evaluated by determining T-helper cell numbers and percentages. The Quality of Life test was used to obtain information about life quality. Nutritional assessment failed to show significant differences among groups with the exception that serum albumin levels were reduced in persons with AIDS. The significance of change in serum albumin in regard to nutritional status is unclear, since serum albumin is affected by a number of non-nutritional factors, such as hydration status and liver function. The study also revealed a significant decline in T-helper percentages, but not absolute T-helper cell numbers as a function of disease stage. There were no statistically significant differences between the quality of life scores with respect to each grouping. These data suggest that asymptomatic patients as well as those with ARC or stable AIDS are able to maintain body weight and composition.
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PMID:Nutritional alterations in persons with HIV infection. 138 65

The serological response to a monoclonal antibody-defined phosphatidylinositol mannoside (L4-PIM) present in all mycobacteria was examined in patients with various mycobacterial diseases and healthy subjects from different populations. IgG but not IgM antibodies were detected in most patients with untreated lepromatous (84%) or borderline lepromatous (65%) leprosy, but in only a minority of those with disease at the tuberculoid end of the leprosy spectrum (< 17% positive). The response to L4-PIM was correlated with the IgM response to disaccharide octyl-bovine serum albumin (dBSA), and decreased with successful treatment. On the other hand, the test proved to be of little value in the diagnosis of untreated tuberculosis (4/15 positive) or atypical mycobacterial infection in patients with AIDS (0/11 positive). IgG antibodies to L4-PIM were also found in a significant proportion of healthy individuals, irrespective of their Mantoux status. These antibodies were shown to be specific for L4-PIM on immunoblotting, and their incidence increased with age in random donors from both urban Australia and rural Papua New Guinea. Despite the limited value of the assay in diagnosis of any particular mycobacterial disease, the presence of antibodies to L4-PIM appears to be a sensitive indicator of subclinical infection with environmental mycobacteria in subjects with an intact immune system.
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PMID:Serological response to purified mycobacterial phosphatidylinositol mannoside in healthy controls and in patients with tuberculosis and leprosy. 147 76

A peptide containing amino acid residues 41-84 of the CD4 molecule was synthesized and coupled through a thioether bond to human serum albumin. This conjugate bound to gp120 with an affinity that was half that of CD4 and blocked the HIV infection in vitro with an efficacy tenfold lower than that of CD4. More importantly, the CD4 peptide-human serum albumin conjugate could bind to gp120 in the presence of HIV+ sera from 18 Walter Reed stage 1-6 patients.
AIDS Res Hum Retroviruses 1992 Nov
PMID:A CD4-derived peptide carrier blocks acute HIV-1 infection in vitro and binds to gp120 in the presence of Walter-Reed stage 1-6 HIV+ sera. 148 81

The effect of lipid-based parenteral nutrition was assessed in eight patients with AIDS and weight loss of 10% or greater. All patients received home parenteral nutrition consisting of a lipid-based system with 50% of nonprotein calories given as fat. Measurements were made of body weight, serum albumin, and immune function as assessed by mitogen responses, P24 antigen levels and T-cell counts. Over a period of 2 months, weight gain and improved well-being were noted in all patients. An improved in vitro lymphocyte mitogenic response to phytohemagglutinin and to concanavalin A was also noted. No change in T-cell subsets was observed. Viral cultures and P24 serum levels also remained unchanged. Lipid-based parenteral nutrition is safe and probably efficacious in AIDS.
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PMID:Clinical and immunologic effects of lipid-based parenteral nutrition in AIDS. 143 90

One class of potential acquired immunodeficiency syndrome therapeutics are derivatives of recombinant CD4 (rCD4). Therefore, the present investigations use in vivo techniques to measure the rate at which [3H]rCD4 is transported through the blood-brain barrier (BBB). In addition, the binding of labeled rCD4 to isolated human and bovine brain capillaries is measured. These studies show that [3H]CD4 is removed rapidly from the bloodstream with a half-time of 12.6 +/- 0.9 min. The volume of distribution (Vd) of the protein in brain increases with time and reaches a Vd that is 11.1 +/- 1.1-fold greater than the brain Vd of plasma marker, native rat serum albumin. In addition, [3H]rCD4 is extracted rapidly by the kidney and the ratio of rCD4 Vd to native rat serum albumin Vd in the rat kidney reaches 99 +/- 5 at 60 min after i.v. injection. rCD4 is shown to undergo transcytosis through the BBB using an internal carotid artery perfusion/capillary depletion method coupled with gel filtration fast protein liquid chromatography. In conclusion, these studies report the unexpected finding that rCD4 is transportable through the BBB. rCD4 is a cationic protein and the mechanism of rCD4 transport through the BBB may be analogous to the absorptive-mediated transcytosis of other polycationic proteins.
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PMID:Transport of recombinant CD4 through the rat blood-brain barrier in vivo. 160 82

A whole blood method requiring less than 4 ml of heparinized blood was developed to assess the practicality of preparing whole blood samples that could be easily stored, transported and readily used to determine the lymphocyte phenotypes and proliferation responses of individuals from remote areas who are infected with the human immunodeficiency virus. Minor modifications in standard whole blood procedure for lymphocyte phenotyping have significantly increased the stability of light scatter and fluorescence intensity of the cells for subsequent flow cytometry (FC) analysis. These changes include removal of lysis solution prior to fixation, fixation of monoclonal antibody-stained cells in 1% paraformaldehyde for 30 minutes and storage of fixed samples in medium containing 1% bovine serum albumin. Lymphocyte subsets and their functional subsets could reliably be determined on samples stored for up to 4 weeks. Further, blood samples could be kept at room temperature for up to 96 hours or at ambient temperature during transportation from Africa before staining for FC without affecting their quantitation. While samples could be processed for FC analysis under field-laboratory conditions, proliferation assays could only be performed on samples that were transported within 48 hours of their collection. The whole blood method saves time and expense and decreases the volumes of blood required to perform phenotypic analysis and functional assays on specimens collected in remote areas.
Int J STD AIDS 1990 Jan
PMID:Long-term preservation of whole blood samples for flow cytometry analysis in normal and HIV-infected individuals from Africa. 171 4

The N-terminal region of the human immunodeficiency virus type 1 (HIV-1) gp41 appears to be involved in virus-cell membrane fusion. To study the influence of fusion domain structure on gp41 interaction with artificial lipid membranes, two families of peptides were synthesized. The peptides of the first family starting from the C-terminal Gly-532 of gp160 (BRU isolate) were assembled in a stepwise manner to N-terminus of gp41(Ala-517). These hydrophobic peptides, containing 10-16 amino acid residues (a.a.), were able to form channel-like current fluctuation through planar lipid membranes, and the longest 15-16 a.a. peptides lysed the liposomes. Peptides of the second family beginning from the C-terminal Arg-538 and continuing to Val-510 contained several hydrophilic amino acid residues. These 15-22 a.a. peptides also increased the conductance of planar lipid bilayers and lysed liposomes. The degree of liposome lysis depended upon peptide length and concentration. The attachment of gp120 C-terminal amino acid or peptides to N-terminus of 517-538 peptide resulted in complete loss of activity. The effects of the second family of peptides on membranes were reduced to a great extent at acidic pH. The conjugation of 22 a.a. Lys peptide with bovine serum albumin decreased its lytic activity. The circular dichroism study of these peptides revealed alpha-helix configuration in hydrophobic and aqueous media only for deca- and longer peptides. The electron microscopy of 22 a.a. peptide performed in the aqueous medium showed large spherical aggregates about 0.5-0.7 micron in diameter consisting of long filaments approximately 5 nm in diameter. Other tested peptides could generate only short strings. Thus, the effects of fusion peptides on lipid membranes depends on their sequence and length, secondary and tertiary structures, and freedom of their N-terminus.
AIDS Res Hum Retroviruses 1992 Jan
PMID:Investigation of human immunodeficiency virus fusion peptides. Analysis of interrelations between their structure and function. 173 43

A series of 55 patients with AIDS and opportunistic infections were admitted a total of 75 times to Robert Wood Johnson University Hospital over a 4-year period, and supplemental nutrition support--intravenous (IV), enteral, or both--was given during 32 of these admissions. Use of nutrition support was correlated retrospectively with pretreatment nutritional status, length of hospital stay (LOS), and survival and was found to be positively correlated with weight loss greater than or equal to 10% or weight less than or equal to 90% of ideal body weight (p less than 0.001), admission hemoglobin less than or equal to 10g (p less than 0.001), and LOS less than or equal to 21 days (p less than or equal to 0.003). Nutrition support intervention did not correlate with survival, admission total lymphocyte count (TLC), or serum albumin level. Survival was negatively correlated with LOS (p less than or equal to 0.04) and continuous daily fever for greater than or equal to 6 days (p less than 0.001). Survival was also significantly lower in patients who received IV rather than enteral nutrition support (p less than or equal to 0.03). Weight loss, admission TLC, albumin, and hemoglobin levels did not correlate with survival. These results suggest that nutrition support generally was given to the sickest patients with AIDS. There was no measurable benefit associated with use of supplemental nutritional support in this series. Properly designed trials will be necessary to define the optimum route, timing, and type of nutritional support for patients with AIDS.
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PMID:Use of nutrition support in patients with AIDS: a four-year retrospective review. 180 80


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