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Query: UMLS:C0011570 (depression)
172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Levels of anxiety and depression were assessed for 207 HIV seropositive homosexual/bisexual men (AIDS = 34, ARC = 72, asymptomatic HIV infection = 101), and 36 seronegative controls. Lymphocyte subset enumeration, history of opportunistic infections, and occurrence of HIV-related symptoms were recorded at the time of assessment. No differences between groups were found on age, educational level, state/trait anxiety or depression scores. Neither the number of symptoms reported, their duration, severity, frequency of occurrence, nor the proportion of patients who reported a specific symptom was different between the three HIV seropositive groups. Severity of anxiety and depression was related to the magnitude of symptomatology, but not associated with either degree of immunodeficiency, number of opportunistic infections or diagnostic group. Principal component analysis extracted five symptom factors (cognitive, affective, psychosocial, neurological and physical), none of which predicted state anxiety scores. However, affective and psychosocial symptom factors predicted trait anxiety and depression scores. The results indicate that ratings of anxiety and depression are independent of stage of HIV infection, may be in part mediated by constitutional and physical symptoms of HIV disease, but are primarily associated with the presence of psychological and psychosocial symptoms.
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PMID:Anxiety, depression and HIV related symptomatology across the spectrum of HIV disease. 147 21

Many current health status instruments either are too long to use in many acquired immune deficiency syndrome (AIDS) clinical trials or omit important concepts. In this study, human immunodeficiency virus (HIV)-relevant items developed for the Medical Outcomes Study (MOS) from subscales for cognitive function, energy/fatigue, health distress, and a single quality of life item were added to a portion of the MOS Short-form General Health Survey. The resulting 30-item questionnaire reliably and distinctly measured ten aspects of health and took less than 5 minutes to complete. To test its validity, this modified measure was used to compare the health of 73 subjects with asymptomatic HIV infection and 44 with early AIDS-related complex (ARC). Compared with ARC subjects, asymptomatic individuals reported superior overall health, less pain, and better physical function, role function, cognitive function, and quality of life (rank-sum, P less than 0.02). Asymptomatic subjects' scores were higher on most subscales than the age-adjusted scores of MOS outpatients with hypertension, diabetes, recent myocardial infarction, or depression; ARC patients scored closest to hypertensive patients. This instrument, containing a subset of the MOS measures of health-related quality of life, may be a useful outcome measure for AIDS clinical trials.
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PMID:A health status questionnaire using 30 items from the Medical Outcomes Study. Preliminary validation in persons with early HIV infection. 187 45

In order to delineate the molecular pathogenesis of the increased susceptibility to CMV disease in HIV infection, the patterns of antigen responsiveness in HIV-infected and non-infected individuals were investigated. CMV was fractionated by SDS-PAGE and electroblotted onto nitrocellulose. Lymphoproliferative responses of healthy HIV-, CMV+ individuals and HIV+, CMV+ asymptomatic patients to a whole CMV antigen preparation and to 20 fractions of nitrocellulose-bound CMV were then compared. Three fractions of approximate molecular weight of 130-165, 65-75, and 55-65 kD appeared to contain the major T cell stimulating antigens for HIV-, CMV+ individuals. A statistically significant depression of responses to fractions containing antigens in the ranges of 130-165 kD and 55-65 kD but not to whole CMV was seen in HIV+ individuals compared with controls. In healthy controls, the sum of the proliferative responses as measured by 3H-thymidine uptake to these three major fractions was approximately equal to the response to a whole CMV antigen preparation, whereas it was less than half of this response in five out of six HIV+ subjects. When antibody activities to CMV antigens were analysed by immunoblotting of sera from the two subject groups and also sera of ARC and AIDS patients, a selective loss of reactivity was revealed in 10 out of 19 HIV+ subjects to a band of 26-28 kD whereas all 15 HIV-, CMV+ controls recognized this band. Serum IgG and IgM values were both significantly higher in HIV+ individuals than in controls. These findings suggest that specific lesions in the repertoire of immune responsiveness to CMV antigens occur in HIV+ individuals.
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PMID:Immune responses to fractionated cytomegalovirus (CMV) antigens after HIV infection. Loss of cellular and humoral reactivity to antigens recognized by HIV-, CMV+ individuals. 217 40

Sixty male outpatients with no past neuropsychiatric history were examined for evidence of early HIV-related neuropsychological impairment. Significant cognitive deficit, as measured by the RAVLT and WAIS-R Digit Symbol Substitution tests, and moderate correlation with indices of immune function, were observed in a group of patients with AIDS-Related Complex [ARC]. Patients with asymptomatic HIV-infection demonstrated no significant differences in performance compared to a group of HIV-seronegative controls. No significant group differences in age, education, predicted-IQ or self-rated depression and anxiety were observed. These results support the hypothesis that HIV-related cognitive disturbance occurs within the context of immunosuppression.
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PMID:Early HIV-related neuropsychological impairment: relationship to stage of viral infection. 225 36

Expression of tumor necrosis factor (TNF alpha), tissue factor (TF), and interleukin 1-beta (IL-1 beta) mRNA was evaluated in monocytes isolated from patients infected with human immunodeficiency virus (HIV). There was a significant depression (66%) of the induced level of TF mRNA expression in response to lipopolysaccharide. Conversely, the response of TNF alpha and IL-1 beta, following LPS induction, was "normal." TF mRNA reduction was also observed to a lesser degree in AIDS-related complex patients (20%) but not in asymptomatic seropositives. TF is necessary for initiation of the coagulation protease cascade, leading to thrombin production and fibrin deposition, which play a role in inflammatory responses. Its selective reduction may be a factor in the diminished resistance to secondary infections observed in AIDS. Further, since the TF defect increases as patients progress toward AIDS, it may serve as a marker for disease progression.
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PMID:A selective defect in tissue factor mRNA expression in monocytes from AIDS patients. 229 2

Monocytes/macrophages play a central role in the afferent and efferent limbs of the immune system. Macrophages perform several immunological functions both in vivo and in vitro, including antigen presentation, tumor cell killing, phagocytosis, and bacterial and viral killing. Acquired immunodeficiency syndrome (AIDS), a disease characterized by a profound immunodeficiency, induces a wide range of neuropsychological abnormalities. The occurrence of severe psychological disturbances, including stress, depression, and anxiety increase psychological and physical indices of morbidity among patients. Stress influences several immunological responses in man and animals and is usually accompanied by altered blood levels of various CNS-related peptides or neurohormones. Monocytes/macrophages express surface receptors for different CNS-secreted molecules. In ARC and AIDS patients abnormal neuropeptide levels may be related to severe psychological disturbances. Neuropeptides and neurohormones may play a central role in stressed HIV-1-infected patients by affecting monocyte-macrophage functions, which may further trigger disease progression and immunologic deficiency. It is hypothesized that stress reactions lead to altered release of neurohormones and/or neuropeptides which affect monocyte-macrophage functions and favor progression of HIV-1-related disease.
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PMID:Stress-related neuroimmunomodulation of monocyte-macrophage functions in HIV-1 infection. 240 70

Mandatory testing for AIDS is controversial. Such screening has been suggested for prisoners, immigrants, prostitutes, military personnel, and persons contemplating marriage or pregnancy. Quarantining and even tatooing have also been recommended for persons with AIDS. The advent of mass testing raises the issues of (1) proper allocation of scarce AIDS resources; (2) the need for confidentiality of examination reports; (3) the value of this assessment without the existence of a definitive treatment; (4) the possibility of both false positive and false negative results; and (5) the provision of counseling for people with positive testing. Other concerns involve public health needs versus individual rights, and the confidentiality of the doctor-patient relationship. Past epidemics serve as paradigms for the role of mandatory screening and quarantine in a public health crisis. As testing for AIDS is expanded, anticipate that adverse reactions such as panic, depression, grief, compulsive behavior, and suicide attempts will increase. The physician must provide counsel on such matters as "safe sex" practices, avoidance of needle sharing, and early warning signs of AIDS and ARC.
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PMID:What about mandatory AIDS testing? 272 20

This paper describes a method of psychosocial counseling that was used with HIV-infected patients in Lusaka, Zambia between February to August 1987 which aims to enable HIV patients to avoid behaviors that would damage their own health, minimize further HIV transmission, and prolong period of asymptomatic infection and life expectancy. The study population was composed of 130 patients (either asymptomatic, with AIDS-related complex or AIDS). The protocol included providing patients with factual information about HIV infection, understanding the concept of their illness, teaching the need to change sexual behavior, reduce alcohol intake, prevent stress, and adjust to family changes. Although all the patients stated that they had heard about AIDS, more than 90% and 60%, respectively, do not have any knowledge regarding the symptoms and mode of transmission. Moreover, promiscuity was found to be associated with excessive alcohol consumption, which was reduced because of illness. Reactions to HIV diagnosis during the second counseling session include denial, anger or fear, bargaining and depression, and acceptance and resignation. In conclusion, counseling helps HIV patients to behave in ways that could delay progression of the disease and reduce transmission. It could also help them cope better with their situation.
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PMID:Psychosocial counselling of patients infected with human immunodeficiency virus (HIV) in Lusaka, Zambia. 221 27

In a 6-week clinical trial 4 dose regimens of 3'-azido-3'-deoxythymidine (AZT), a thymidine analogue with potent anti-viral activity against HTLV-III in vitro, were examined in 19 patients with the acquired immunodeficiency syndrome (AIDS) or AIDS-related complex (ARC). AZT was given intravenously for 2 weeks, then orally for 4 weeks at twice the intravenous dose. AZT was well absorbed from the gut and crossed the blood-brain barrier. Therapeutic levels were maintained with 5 mg given intravenously or 10 mg given orally every 4 h. Treatment was not limited by side-effects, the commonest of which were headaches and depression of white-cell counts. 15 of the 19 patients had increases in their numbers of circulating helper-inducer T lymphocytes (p less than 0.001) during therapy, 6 who were anergic at entry showed positive delayed type hypersensitivity skin test reactions during treatment, 2 had clearance of chronic fungal nailbed infections without specific anti-fungal therapy, 6 had other evidence of clinical improvement, and the group as a whole had a weight gain of 2.2 kg. Also, with the highest dose regimen cultures of peripheral blood mononuclear cells for HTLV III became negative.
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PMID:Administration of 3'-azido-3'-deoxythymidine, an inhibitor of HTLV-III/LAV replication, to patients with AIDS or AIDS-related complex. 286 2

Zoster is uncommon before the age of 50 years in immunologically normal individuals, but it occurs with increased frequency in people who are immunosuppressed. A retrospective review of 300 patients with acquired immunodeficiency syndrome associated with Kaposi's sarcoma, revealed that 8% had prior zoster, a rate that is sevenfold greater than historic controls of the same age. We prospectively examined forty-eight patients, with no known immunodeficiency or signs of AIDS or AIDS related complex (ARC), who presented with zoster localized to the thoracic region. Forty-one patients had known risk factors for AIDS and thirty-five had antibody to the AIDS-associated virus (AAV) at the time of presentation. One seropositive subject had no known risk factors. Absolute lymphocyte counts, lymphocyte OKT4/OKT8 ratios, and lymphocyte mitogen responses were all depressed in subjects with antibody to AAV when compared with seronegative individuals. Seven of thirty-three AAV antibody-positive subjects, who could be followed longitudinally, developed AIDS from 1 to 28 months (mean = 13) after zoster. One antibody-negative subject seroconverted to become AAV seropositive 16 months after zoster and developed Kaposi's sarcoma 1 month later. These eight subjects had persistently low lymphocyte OKT4/OKT8 ratios and elevated beta-2 microglobulin. In patients at risk for AIDS, the occurrence of zoster may be one sign that heralds the marked depression of cellular immunity associated with AIDS or ARC.
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PMID:Herpes zoster: a possible early clinical sign for development of acquired immunodeficiency syndrome in high-risk individuals. 301 55


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