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Query: UMLS:C0019693 (HIV)
 170,526 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Infection in humans with the lentivirus HIV-1 typically results in the development of a chronic disease state characterized by the slow decline of CD4+ lymphocytes, the development of immunosuppression, and the development of opportunistic infections, ultimately leading to death. Although the average course of disease runs approximately 10 years, shorter and longer progression times have been noted. These alterations are presumed to be, at least partially, a factor of viral variation. The simian immunodeficiency viruses (SIVs) are the nonhuman primate counterparts to HIV. Several of these isolates, including SIV from sooty mangabey monkeys, induce a remarkably similar disease in Asian macaques. Recently, variants of SIV from sooty mangabey monkeys and SIV from African green monkeys have been described, which are increasingly more pathogenic. As in HIV-1 infections, this is probably due to genetic variation. On the basis of these findings, atypical viruses with tremendous pathogenic potential can arise from apathogenic or moderately pathogenic viruses.
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PMID:Simian immunodeficiency virus variants: threat of new lentiviruses. 857 84

HIV infection is a chronic disease that can occur in conjunction with a variety of renal problems. When it does, nephrology nursing care is complicated by the interactive nature of dealing with two complex disease processes. Nephrology nurses already possess the skills needed to deal with this complexity, but may need additional knowledge specific to HIV. This article focuses on HIV infection and nursing care of infected patients in renal care settings.
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PMID:The human immunodeficiency virus and nephrology nursing: implications for infected clients. 863

Erythema elevatum diutinum (EED) is a rare chronic disease of unknown origin, part of the spectrum of cutaneous leucocytoclastic vasculitis. A case of EED in a 32-year-old HIV-infected male patient, with no previous opportunistic infections and a CD4+ cell count of less than 200/mm3, is reported. Therapy with oral dapsone (100 mg/day for 15 days) resulted in clinical cure with no relapse after 6 months of follow-up. To our knowledge, only six cases of EED in HIV-positive patients have been reported to date. A brief review of these seven cases is described.
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PMID:Erythema elevatum diutinum in human immunodeficiency virus-infected patients--report of a case and review of the literature. 958 Jan 88

Our understanding of the physiopathology of HIV infection has considerably improved: the determination of HIV viral load, the impact of new antiretroviral agents (the protease inhibitors) and the discovery of various patterns of immune response (type T-helperl - T-helper2; Th1/Th2) have contributed to a comprehensive view of HIV infection from the seroconversion to the latest stage of AIDS. This new understanding allows to set up new therapeutical goals such as the rapid reduction of viral load during seroconversion or the reconstitution of Th1 pattern during clinical latency. This global individualised therapeutical strategy is now feasible. HIV infection has become a chronic disease which is presently treatable.
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PMID:[Human immunodeficiency virus infection: physiopathological approach to specific therapeutic strategies]. 892 38

Interferon-gamma (IFN-gamma) has been shown to inhibit proliferation and differentiation of erythroid progenitor cells and to produce apoptosis of erythroid cells, but IFN-gamma receptors are not present on red cells and have never been demonstrated on erythroid progenitor cells. We obtained highly purified day 6 erythroid colony-forming cells (ECFCs) from human blood in sufficient quantity and purity to measure binding of radioiodinated recombinant human IFN-gamma ([125I]rhIFN-gamma). When [125I]rhIFN-gamma was incubated with day 6 ECFC, 77% of the binding was inhibited by excess unlabeled rhIFN-gamma, but no inhibition occurred with a variety of growth factors and glycoproteins. Specific binding was directly proportional to the cell concentration with a straight line passing through the origin, and equilibrium was reached at 0 degree C by 24-48 hours. Saturation of specific binding occurred at a [125I]rhIFN-gamma concentration of 1.0 nM and internalization was demonstrated with further incubation at 37 degrees C. Scatchard analysis showed a single class of binding sites and at a high ECFC cell purity of 80-89%, 1910-2070 binding sites per ECFC were present with a Kd of 0.01-0.02 nM. As day 5 ECFC developed into more mature day 7-day 12 cells, with incubation at 37 degrees C in vitro, specific binding for [125I]IFN-gamma greatly decreased. These experiments delineate specific binding sites for IFN-gamma on human erythroid progenitor cells and indicate that the enhanced sensitivity to rhIFN-gamma inhibition of mature day 3-day 6 burst-forming units-erythroid may be a result of enhanced specific binding. Human IFN-gamma is a multifunctional lymphokine, secreted by activated T lymphocytes and NK cells, which exerts antiviral, antiproliferative, and immunomodulatory activities on a wide variety of cells [1,2]. With regard to hematopoietic cells, IFN-gamma has been reported to inhibit the growth of granulocyte-macrophage colony-forming units, burst-forming units-erythroid (BFU-E) and colony-forming units-erythroid (CFU-E) in vitro [3-7]. Most recently, mature day 3 to day 6 BFU-E have been shown to be most sensitive to the inhibitory effect of recombinant human (rh) IFN-gamma, while primitive day 1 to day 2 cells and later day 7 cells were less affected [7]. Incubation of rhIFN-gamma with mature BFU-E inhibits hemoglobin accumulation and produces apoptosis of the maturing erythroid cells [7]. Moreover, since blood IFN-gamma levels are elevated and vary directly with the degree of the anemia, in patients with hematologic malignancies [8] and HIV-seropositivity [9], IFN-gamma appears to have a prominent role in producing the anemia associated with chronic disease [10,11]. Although characterization of human IFN-gamma receptors has been extensively performed for a variety of human cells including fibroblasts, lymphocytes, monocytes, granulocytes, eosinophiles, platelets, and many tumor cells [12-17], IFN-gamma receptors have not been identified on red cells [12] and the presence plus the extent of IFN-gamma receptors on progenitor cells, including human erythroid progenitor cells, remains unknown. A method has been reported from our laboratory by which human erythroid colony-forming cells (ECFC) can be highly purified, starting with peripheral blood BFU-E, in a sufficient amount for analysis of cytokine binding [18-20]. In this paper, we report the results of [125I]rhIFN-gamma binding to day 6 ECFC in vitro and demonstrate the presence of specific binding that is saturable at 1.0 nM. Scatchard analysis reveals that there are 1910-2070 rhIFN-gamma binding sites per ECFC with a Kd of 0.01-0.02 nM and, as with erythropoietin (EP) and insulin-line growth factor I (IGF-I) receptors, specific binding is highest with the earliest BFU-E studied and declines progressively as the erythroid progenitors mature.
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PMID:Specific binding of interferon-gamma to high affinity receptors on human erythroid colony-forming cells. 909 Dec 93

Transgenic mice carrying an HIV provirus, with selective deletion of all three structural genes, developed extensive lymphoid depletion which was detected not only in the spleen and lymph nodes but also in the thymus. Mice with a high level of HIV gene expression developed acute disease which resulted in premature death, and mice with a low level of viral transcripts developed chronic disease with long-term survival. Neither HIV replication nor the envelope glycoprotein (gp120) was required for T cell depletion. Despite abundant viral gene expression early in life, cell death did not become evident until about the time of full lymphoid maturation, suggesting that thymopoiesis was not affected. The more mature T cells in the peripheral lymphoid organs and in the thymic medulla were less sensitive to the apoptotic process than the immature T cells in the thymic cortex. Gradual depletion of the T cell compartment in the peripheral lymphoid organs was intimately accompanied by the reciprocal expansion of the B cell compartment, resulting in the almost complete replacement of T lymphocytes with B immunoblasts in lymph nodes. Unlike T cells, which showed abundant HIV gene expression, B cells did not. The transgenic approach may help identify the HIV nonstructural gene(s) responsible for immune deficiency and help facilitate dissection of its role in inducing apoptosis.
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PMID:Transgenic dissection of HIV genes involved in lymphoid depletion. 920 54

Human immunodeficiency virus type 1 (HIV-1) RNA was measured in total lymph node (LN) tissue and isolated LN mononuclear cells (LNMC) in sequential LN biopsy samples from 1 patient with primary HIV-1 infection and from 5 previously untreated patients with chronic disease. HIV-1 RNA levels were an average of 210-fold higher in total LN tissue compared with levels in LNMC, even during primary infection, when circulating antibodies were absent. After the patients were treated with a three- or four-drug regimen, total HIV-1 RNA decreased exponentially in total LN tissue and in LNMC (mean half-lives of 8.5 +/- 1.8 and 7.9 +/- 2.2 days, respectively). In addition, the evolution of the infectious virus in LNMC was analyzed for the 5 patients with chronic disease: Titers decreased, with a mean half-life of 7.5 +/- 2.3 days. Extracellular virions are the most important virus compartments in LNs; however, they exhibit the same dynamics as virions situated in LNMC, with a mean virus decay half-life of approximately 1 week.
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PMID:Human immunodeficiency virus type 1 dynamics in different lymphoid tissue compartments. 929 39

A combination treatment has recently become available for HIV-infected patients; it consists of two reverse transcriptase inhibitors and one protease inhibitor. This combination therapy has consequences for primary medical care as regards diagnostics, treatment, follow-up and counselling of patients with HIV and AIDS, education of patients requiring the HIV test, information of seropositive patients not yet being treated and the cooperation and task distribution between GPs and AIDS specialists. The new combination method creates new problems for patients, such as medicalization of their lives, side effects and compliance; it also affects their prospects (social reintegration, resumed occupational activity). In the medical management, the focus shifts to early start of treatment, stimulating compliance, monitoring of effect and side effects, if any, of the treatment and coping with the patients' uncertainty about durability of the effect. If the new treatment proves to be successful in the long run as well, HIV infection/AIDS will become a chronic disease, so that the needs of care and the care methods will increasingly resemble those of other chronic diseases. There will be a growing need of extramural care, leading to new requirements regarding the study of medicine and postgraduate instruction of GPs.
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PMID:[AIDS; new developments. IV. Changes in primary medical care due to new possibilities of treating HIV-infected patients]. 934 May 62

Human immunodeficiency virus type 1 (HIV-1) RNA was measured in lymph node (LN) mononuclear cells of 50 patients with sustained plasma RNA of <200 copies/mL with therapy. Six patients had received a combination of three reverse transcriptase inhibitors (RTIs) since primary infection, 11 received this same combination during chronic disease, 21 received a combination of two RTIs plus a protease inhibitor (PI), and 12 received three RTIs plus a PI. The mean overall duration of therapy was 8.9 +/- 0.5 months (range, 5-24), with no significant difference between groups. LN HIV-1 RNA levels varied from undetectable to 1.7 million copies/10(6) cells according to cases. The mean LN HIV-1 RNA level was 2.99 +/- 0.42 log10 copies/10(6) cells in the 17 patients receiving three RTIs compared with 1.93 +/- 0.25 log10 copies/10(6) cells in the 33 patients receiving a PI (t test, P = .02). These data demonstrate that highly active antiretroviral regimens have unequivalent effects on LNs and invite redefinition of suboptimal therapy at this level.
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PMID:Residual human immunodeficiency virus type 1 RNA in lymphoid tissue of patients with sustained plasma RNA of <200 copies/mL. 941 97

The impact of HIV infection on Taiwan's tuberculosis epidemic was investigated in a prospective study of all 378 pulmonary tuberculosis patients (mean age, 53.5 years) admitted to the Taiwan Provincial Chronic Disease Control Bureau in 1996. Bacteriologic or pathologic evidence of pulmonary tuberculosis was obtained in 306 cases (81%); the remaining 72 patients had chest radiographs and clinical courses consistent with a tuberculosis diagnosis. In the former group, the sputum smear yielded acid-fast bacilli in 279 patients (73.8%) and sputum cultures grew Mycobacterium tuberculosis in 263 (69.6%). Only 1 patient, an overseas Chinese man with a history of encounters with prostitutes, was HIV-positive. His symptoms included cough, weight loss, and malaise of 4 months' duration. His sputum culture was positive for M. tuberculosis and the chest radiograph revealed diffuse non-cavity infiltration lesions over the bilateral lung parenchyma and mediastinum lymphadenopathy. These findings suggest that the impact of HIV infection on Taiwan's tuberculosis epidemic is not significant at present, in part because HIV remains uncommon. However, continued monitoring of dual infection is essential to guide tuberculosis control efforts.
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PMID:Screening of human immunodeficiency virus infection in pulmonary tuberculosis patients in Taiwan. 948 Oct 69


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