Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019693 (HIV)
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Guidelines have been prepared by the National Hemophilia Foundation, USA, for treating patients with haemophilia, these are: 1. General recommendations. The risks of withholding treatment far outweigh risks of treatment. Patients should however be educated to use appropriate clotting factor doses to minimize overuse and contain costs. 2. Factor VIIIC-deficient patients. DDAVP should be used whenever possible by patients with mild or moderate factor VIIIC deficiency. When feasible, an alternative to concentrates may be the use of cryo-precipitate prepared from one well-screened donor or from a small number of such donors. (a) Prevention of hepatitis. Hepatitis B vaccination is essential for uninfected patients. Preliminary data suggest that products that are pasteurized, solvent/detergent-treated or monoclonal antibody-purified are at a reduced risk of transmitting hepatitis viruses. (b) Prevention of HIV-1. Concentrates pasteurized, treated with solvent/detergent, purified with monoclonal antibody, heated in suspension with organic solvents, or dry heat-treated for long periods are preferred. These products carry a substantially reduced risk of transmitting HIV-1. 3. Factor IX deficiency. For patients with severe deficiency the use of virus-inactivated Factor IX concentrate is recommended. For mild to moderate patients when feasible an alternative would be fresh, frozen plasma prepared from one well-screened and repeatedly-tested donor or from a small number of such donors. In the past few years, significant progress has been made in understanding the nature of the defect in haemophilia both at the molecular and structural levels, such a foundation is necessary for definitive treatments in the future. For now, however, the dark side of replacement therapy must be accepted along with its benefits.
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PMID:HIV-1 infection in haemophilia. 210 39

After 15 years of unsuccessful efforts, the most frequent of hepatitis non-A non-B viruses has just been identified and called hepatitis C virus (HCV). The viral genome had been sequenced by an original and direct molecular biology method before the agent could be detected serologically or at electron microscopy. HCV is a small, encapsulated RNA virus, perhaps loosely related to flaviviruses. A non-structural protein, corresponding to the virus replication enzyme, is the specific component as target for ELISA tests to detect specific anti-HCV antibodies. This serology has enabled us to confirm that HCV is the most common of NANB viruses, being responsible for 60 to 80 p. 100 of all cases of post-transfusion hepatitis. The antibodies appear belatedly: in 40 p. 100 of patients they do so during convalescence, 2 to 12 months after the serum transaminase peak of primary infection. 60 to 80 p. 100 of patients with presumed NANB hepatitis are positive for anti-HCV antibodies. The same applies to cirrhosis and cancer which, in 40 p. 100 of the cases, complicates post-NB hepatitis cirrhosis. Since March 1, 1990, screening for anti-HCV antibodies has become compulsory for all blood donors in France. The prevalence of these antibodies is 0.68. Among groups of patients at risk, prevalences are 70 p. 100 in haemophiliacs, 50-75 p. 100 in drug addicts and more than 30 p. 100 in patients under haemodialysis. Sexual transmission seems to be weak but possible; 5 p. 100 of homosexuals carry anti-HCV antibodies, and this percentage is higher in HIV positive subjects. The discovery of the hepatitis C virus coincides with the finding that interferon is effective in the treatment of NANB hepatitis, and this exceptional opportunity in the field of public health should engender specific programmes. It may now be hoped that prevention by vaccine will be available in a not too distant future.
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PMID:[Hepatitis virus C: from discovery to applications in public health]. 211

Patients with acute hepatitis B and hepatitis non-A non-B-like illness seen between 1981 and 1984 were chosen for the study of the introduction of HIV among persons at highest risk for HIV infection in Norway. HIV was introduced into these risk groups in 1982, but the prevalence of HIV seropositivity increased only slightly during the following 2 years.
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PMID:The early introduction of HIV infection among Norwegians at highest risk. 212 44

Serum specimens from 111 human immunodeficiency virus type 1 (HIV-1) infected and 183 HIV-1 seronegative patients were analysed for antibodies to hepatitis C virus (HCV), hepatitis B virus (HBV) and hepatitis A virus (HAV) by enzyme linked immunoassay (ELISA) and radioimmunoassay. Anti-HCV and anti-HBV antibodies were found in the vast majority (89 and 83%, respectively) of intravenous drug addicts (IVDA), independent of the type of drug abuse or whether the patients were HIV-1 infected or not. Anti-HAV antibodies were found in 60% of the IVDA. Anti-HCV antibodies were found in anti-HIV-1 positive homosexual men (14%) and anti-HIV-1 negative heterosexual persons (8%), but not in HIV-1 seronegative homosexual men. Also anti-HAV antibodies were found to a small extent in these groups. In contrast, anti-HBV antibodies were common in the homosexual men. The absorbance values of the positive reactions in the anti-HCV ELISA were lower for HIV-1 seropositive patients than those for HIV-1 seronegative subjects, particularly in the late stages of HIV-1 infection. These data suggest that HCV infection is transmitted as readily as HBV infection by intravenous drug abuse and that all three types of hepatitis virus infection are common in IVDA. Although transmission of HCV is primarily mediated by blood, sexual transmission may also occur. HIV-1 infection seems to be associated with unusually low levels of anti-HCV antibodies, especially in the late stages of HIV-1 infection.
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PMID:Hepatitis C virus infection in individuals with or without human immunodeficiency virus type 1 infection. 212 86

Heat treatment of lyophilized factor VIII and factor IX concentrates has been found to eliminate HIV virus infectivity in plasma-derived products. Pasteurization of factor VIII in solution has recently been used to reduce the risk of hepatitis transmission in concentrates prepared by standard fractionation methods. This report presents early experience with factor VIIIC prepared by monoclonal antibody immunoaffinity chromatography following pasteurization of the factor VIIIC/von Willebrand factor complex (Monoclate-P). Twelve patients were treated in three centers with Monoclate-P. Recovery and survival of factor VIII clotting activity were determined and patients were closely monitored for infusion safety. The mean half-life was 14.2 +/- 5.0 while recovery in predicted plasma volume was 72 +/- 12% corresponding to a response of 1.99 +/- 0.66 U/dL for every U/kg administered. These values are very similar to those found for Monoclate in previous studies indicating that pasteurized factor VIIIC purified by immunoaffinity chromatography retains satisfactory pharmacokinetic properties with an added margin of viral safety.
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PMID:Initial clinical experience with a new pasteurized monoclonal antibody purified factor VIIIC. 212 55

Many questions are raised in this review about the role of adult donor granulocyte transfusions in the setting of overwhelming bacterial neonatal sepsis. There clearly exists a number of variables, which influence the survival and morbidity associated with bacterial sepsis. The important differences in these studies highlight the need for prospective large multicenter studies to definitely clarify these issues. Important criteria, which are yet to be established and which impact significantly, include the time of administration of adjuvant granulocytes, the number of granulocytes that need to be harvested, which group of neonates require early granulocyte transfusions, the best method for optimal and easy granulocyte collection, the frequency and intervals of granulocyte transfusions, and improved methods for the early identification of neonatal candidates who would benefit from the granulocyte transfusions. The benefits of granulocyte transfusions (ie, the improvement in morbidity and mortality) in septic neutropenic neonates must be weighed against the possible and reported side effects associated with such transfusions. Adverse reactions including graft-versus-host disease, CMV, HIV and hepatitis infection, fluid retention and pulmonary edema, blood group sensitization, and pulmonary insufficiency may all result from the use of granulocyte transfusions in a host who has evidence of developmental immaturity. All future studies must continue to evaluate these potential complications to balance and analyze the true benefits of survival with reported treatment results. Recently, a number of investigators including ourselves, have begun to examine the role of alternate adjuvant immunotherapy in enhancing neonatal host defense in the clinical setting of overwhelming bacterial sepsis.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The use of granulocyte transfusion in neonatal sepsis. 213 12

During the period from January to December 1987, 2,191 serum samples were collected from different groups of the population in the Ivory Coast (1,126 healthy people selected from the general population, 416 blood donors, 112 healthy anti-HIV carriers, 173 AIDS patients, and 364 patients suffering from icterigenic hepatitis) and tested for anti-HIV (HIV-1 and HIV-2) antibodies, HBsAg, HBeAg, delta antigen (HDAg), and anti-delta (anti-HD) antibody. Anti-HIV antibodies were found in 30 (2.6%) of the general population. 55 (13.2%) blood donors, and 93 (25.5%) patients suffering from icterigenic hepatitis. HBsAg was observed in 103 (9.1%) of the general population, 45 (10.8%) blood donors, 15 (13.4%) healthy anti-HIV carriers, 59 (34.1%) AIDS patients, and 45 (40%) icterigenous hepatitis patients. The simultaneous presence of anti-HIV and HBsAg was noted in 4 (0.4%) of the general population, 8 (2%) blood donors, 15 (13.4%) healthy anti-HIV carriers, 59 (34.1%) AIDS cases, and 36 (10%) patients suffering from icterigenic hepatitis. A high prevalence of HBeAg and serological markers of infection by the delta agent were noted in the different groups. HDAg was noted only among AIDS patients or those suffering from icterigenic hepatitis, with a higher frequency among anti-HIV carriers. Our conclusion from this study is that healthy anti-HIV carriers are no more likely to be HBsAg carriers than the HIV-seronegative subjects. However, immunodeficiency induced previously by HIV infection is likely to be responsible for the high prevalence of HBsAg among AIDS patients.
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PMID:Increase of the prevalence of hepatitis B virus surface antigen related to immunodeficiency inherent in acquired immune deficiency syndrome (AIDS). 215 78

Simultaneous primary infection with HIV and CMV in an 18-year-old woman led to an acute cytotoxic reaction, manifesting as pancytopenia, hepatitis, nephritis, perimyocarditis, and myositis. Within 14 days parameters indicating acute cell damage reverted to normal. Two weeks later transient alopecia totalis developed. Initially, HIV-antigen but no HIV antibodies were present. Within 3 weeks HIV-IgG antibodies appeared while HIV antigen disappeared. Anti-CMV-IgM was clearly and anti-CMV-IgG questionably positive; IgM persisted further, while IgG remained definitely undetectable. We speculate that a particular HIV-induced imbalance of the immune system led to a generalized severe cytotoxic reaction to a simultaneous infection with CMV.
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PMID:Simultaneous primary infection with HIV and CMV leading to severe pancytopenia, hepatitis, nephritis, perimyocarditis, myositis, and alopecia totalis. 215 7

Disseminated adenovirus infection with fatal hepatic necrosis has been reported in 16 patients, 15 of whom had immunocompromising conditions. Herein we report three patients with AIDS and fatally disseminated adenovirus infection with hepatic necrosis. The median age of these 16 patients was 4.7 years, and their illness was characterized by fever (13 of 16 patients), coagulopathy (10 of 16), lower respiratory tract disease (10 of 16), and gastrointestinal hemorrhage (five of 16) in addition to clinical evidence of hepatitis. The adenoviruses isolated were the commonly found serotypes 1, 2, 3, 5, and 7 for 13 of the 15 cases for which this determination was available. With the high frequency of adenovirus infection in humans and the increasing prevalence of human immunodeficiency virus infection in children, it seems likely that this syndrome will continue to be seen.
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PMID:Disseminated adenovirus infection with hepatic necrosis in patients with human immunodeficiency virus infection and other immunodeficiency states. 215 68

382 i.v. drug abusers were tested for a past or ongoing infection with the hepatitis viruses A (HAV), B (HBV), the newly discovered C (HCV) and with the Aids virus HIV. The cohort studied was representative for i.v. drug users of the Zurich street scene including occasional users, weekend users and severe drug addicts. 56% of the drug users tested showed HBV markers. 21% had an ongoing infection. 32% were naturally HBV immune and 4% showed immunity due to vaccination. HAV markers were detected in 50% of the individuals tested, with an ongoing infection present in 8%. 48% of the individuals tested showed signs of HCV contact. 15% of the i.v. drug users were HIV infected. 22% of these individuals were HIV-antigen positive. The data confirm that i.v. drug users have the highest rates of infection within the total population. The prevalence of viral markers correlated positively with the duration and intensity of i.v. drug use and with the practice of needle sharing. In comparison to comparable earlier studies, the present viral prevalence data were lower. This is thought to be due to an Aids prevention campaign undertaken in the Zurich street drug scene, including free distribution of injection material and condoms.
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PMID:[Infection with hepatitis viruses HAV, HBV and HCV as well as with AIDS virus HIV in drug addicts of the Zurich street scene--a prevalence study]. 216 Jan 23


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