Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019693 (HIV)
 170,526 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Substantial losses of total body protein (TBP) can occur in chronic diseases and in aging. Such losses impact negatively on immunity and quality of life, and on growth rates in children. Direct measurements of total body nitrogen (TBN) monitor the integrated changes in TBP over time and allow comparison with normal subjects. TBN assessment via neutron capture analysis is therefore the gold-standard method of TBP estimation, so that risk factors for protein deficit can be identified and patient management optimized. The nitrogen index (NI) can be used to predict prognostic outcome: an NI < 0.9 is associated with substantial wasting in HIV disease, an NI < 0.8 predicts significant pathophysiology in chronic renal failure, and a low NI is predictive of neutropenia in breast-cancer patients. These findings emphasize the central importance of adequate protein stores in recovery from disease or in maintaining quality of life. Aging appears to involve a gradual loss of TBP throughout adulthood. Cross-sectional data suggest that TBP declines curvilinearly with age, such that there is an accelerated decline after 65 years of age. However, longitudinal data are scarce, and little is known about the relative loss of visceral protein, as opposed to skeletal muscle protein. More clearly-defined data are essential if the effects of aging per se are to be separated from the effects of chronic disease. A further complication is the knowledge that physical activity also declines with age. Thus sarcopenia, the loss of skeletal muscle mass, could primarily result from disuse rather than aging. The economic impact of unsuccessful aging places a pressing need for multicompartment data in longitudinal study designs.
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PMID:Total body protein in chronic diseases and in aging. 1086 69

Collapsing glomerulopathy is an aggressive form of glomerular disease defined for its histopathological features of glomerular collapse, visceral epithelial cell damage and tubulointerstitial changes that are characteristic. Patients with collapsing glomerulopathy present with severe nephrotic syndrome, marked proteinuria, generally more than 10 g/day and rapid progression to chronic renal failure, or death due to complications of nephrotic syndrome, despite any form of treatment. Collapsing glomerulopathy presents as de novo or recurrent disease in the renal allograft. There is slight predominance in males and strong predominance in blacks as renal diseases in general. Collapsing glomerulopathy shares several clinical and histopathological features with focal and segmental glomerulosclerosis and HIV-nephropathy; nevertheless, there is enough evidence to support collapsing glomerulopathy as a different entity. It must be mentioned that collapsing glomerulopathy, focal and segmental glomerulosclerosis and HIV-nephropathy may have a similar pathophysiological mechanism of damage to the visceral epithelial cell.
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PMID:[Collapsing glomerulopathy: a new entity associated with nephrotic syndrome and end-stage renal failure]. 1097 63

HIV infection has reached endemic proportions in many African countries. In addition, HIV infection is a significant cause of renal dysfunction in the United States. HIV patients are at higher risk of developing hypertension at a younger age than the general population. Predisposing factors for developing hypertension include vasculitis in small, medium, and large vessels in the form of leukocytoclastic vasculitis, and aneurysms of the large vessels such as the carotid, femoral, and abdominal aorta with impairment of flow to the renal arteries. A syndrome of acquired glucocorticoid resistance has been described in patients with HIV with hypercortisolism and a lower affinity of the glucocorticoid receptors. The syndrome is characterized clinically by weakness, hypertension or hypotension, and skin pigmentation changes. Acute and chronic renal failure is often associated with HIV infection. The associated dysfunction in water and salt handling often induces hypertension. Finally, atherosclerosis has been described in young adults with HIV infection secondary to receiving highly active antiretroviral therapy.
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PMID:Hypertension in the HIV-infected patient. 1099 24

Nontropical pyomyositis is rare and usually associated with immunodeficiency virus (HIV) infection. This study assessed manifestations and response to treatment of nontropical pyomyositis in an area with a high prevalence of HIV seropositivity. We undertook a chart review of eight consecutive patients treated for pyomyositis - primary infection of skeletal muscles - from 1988 through 1998. All patients complained of myalgia; four (50%) had fever and six (75%) had leukocytosis. Muscles involved were deltoid, quadriceps, gluteus, and psoas. Six (75%) patients had identifiable risk factors for pyomyositis: HIV seropositivity (two), history of intravenous drug abuse (one), chronic paraplegia and malnutrition (one), diabetes and chronic renal failure (one), and leukemia (one). One patient had had streptococcal pharyngitis previously but was otherwise healthy; another, a 2-year-old, had no evidence of underlying disease. Staphylococcus aureus was the most common organism isolated (50%). Four patients were treated with incision and drainage plus antibiotics; the remaining four patients were treated with intravenous antibiotics only; all recovered. Nontropical pyomyositis, which is often associated with HIV seropositivity or chronic illness, has a favorable outcome. Treatment can be effective even without surgical intervention.
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PMID:Nontropical pyomyositis: analysis of eight patients in an urban center. 1109 21

Human immunodeficiency virus type 1 (HIV-1)-seropositive patients are at risk for the development of a variety of acute and chronic renal diseases. The most common cause of chronic renal failure in HIV-1-seropositive patients is HIV-associated nephropathy (HIVAN). HIVAN occurs almost exclusively in black patients and the majority of published cases are of patients who present with acquired immunodeficiency syndrome (AIDS). This disease is currently the third leading cause of end-stage renal disease in blacks aged 20-64. Because HIV-1-seropositive patients may develop a wide variety of acute and chronic renal diseases, definitive diagnosis requires renal biopsy. Emerging data suggest a direct role of HIV-1 infection of kidney cells in the pathogenesis of HIVAN. There have been no well-controlled clinical trials in the treatment of HIVAN. The therapeutic agents with the most promise are angiotensin-converting enzyme inhibitors and antiretroviral medications. Long-term renal prognosis may be changing in the setting of improved aggressive antiretroviral therapy. Patient survival is determined primarily by the stage of HIV-1 infection. In this article, we present the case history of a patient who developed HIVAN. We then review the current literature concerning the epidemiology, differential diagnosis, etiology, and treatment of HIVAN.
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PMID:HIV-associated nephropathy: case study and review of the literature. 1111 30

Erythropoietin, a glycoprotein hormone, is synthesized predominantly in the kidney and secreted by renal cortical interstitial cells in response to tissue hypoxia. Erythropoietin is the main regulator of the production of red blood cells. It functions in the recruitment and differentiation of erythroid progenitor cells and aids in their maintenance and survival. Erythropoietin also stimulates the synthesis of hemoglobin. In the last 15 years, the ready availability of recombinant human erythropoietin (r-HuEPO, epoetin alfa) has permitted the clinical investigation and application of this hormone to the treatment of anemia in various patient populations. Epoetin alfa has been shown to accelerate erythropoiesis and reduce allogeneic blood transfusion in major elective, noncardiac, nonvascular surgery and in certain anemic patients with chronic renal failure, nonmyeloid malignancies and human immunodeficiency virus infection. In addition to improving hematologic parameters, epoetin alfa therapy can enhance health-related quality of life in these patients. The success of epoetin alfa in treating anemia in other surgical populations suggests that it may be of benefit in treating the perioperative anemia that is highly prevalent in gynecologic surgery patients. Further investigation of the use of epoetin alfa in patients undergoing gynecologic surgery would increase awareness of its benefits for this patient population.
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PMID:Erythropoietin, the biology of erythropoiesis and epoetin alfa. An overview. 1139 86

Because of relatively low efficacy, considerable side effect and high cost, HCV infected patients complicated with the other disease(patients with hematologic dysorders, chronic renal failure on hemodialysis, HIV co-infection and collagen disease) have been excluded from large trials evaluating the efficacy of IFN or in combination with ribabirin. So, little is known about treatment of these patients. We analyzed the medical literature focusing on treatment of HCV infection in these patients, to suggest conclusion about indication based on tolerance and efficacy. In case the other disease is well controlled and long term sevival is expected, treatment should be required based on the evaluation of liver function test including liver pathology for preventing liver disease from developing terminal stage. Further studies are needed to better define HCV therapies in these patients.
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PMID:[Treatment of chronic hepatitis C patients complicated with the other disease]. 1149 37

Renal manifestations are an important component of HIV disease. Renal disease significantly contributes to morbidity and mortality in patients with HIV. Great progress has been made in identifying specific glomerular lesions and its pathogenesis. Newer antiretroviral agents offer great promise in preventing renal disease and also in patients with established HIVAN. Survival of patients with HIV and ESRD (irrespective of cause) who are receiving RRT continues to improve over the years. Acute reversible renal failure, a preventable complication, is also declining in hospitalized HIV patients. More and more physicians, who in the past were reluctant to care for patients with HIV and renal failure because of grim prognosis, are now becoming familiar with the renal sequelae and are encouraged by recent favorable results. As knowledge about viruses is expanding, the proper use of newer highly effective antiretroviral and other agents in complicated patients should further improve both the survival and quality of life in patients with HIV infection and renal disease.
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PMID:Human immunodeficiency virus infection and renal failure. 1157 Jan 44

Viral hepatitis and human immunodeficiency virus (HIV) infection are important causes of mortality and morbidity in patients treated by haemodialysis (HD). Both are further promoted by the characteristic immunological dysfunction that develops in renal failure and interferes with the patient's ability to eliminate these viruses. The hepatotropic viruses A through G remain the causative agents in 60 to 80% of hepatitis. But, as far as HD is concerned, hepatitis B virus (HBV) and hepatitis C virus (HCV) are the two most important organisms responsible for almost all the patients' morbidity. In HD, both patients as well as staff are at a high risk of acquiring hepatitis B infection. The prevalence of HBV in the dialysis population in India is reported to range between 3.4% and 42%. The acute course of the infection is often anicteric and peak transaminase concentration is significantly less than in patients with normal renal function. Up to 60% of dialysis patients with HBV infection develop chronic hepatitis with persistence of hepatitis B surface antigen (HBsAg) and infectivity. The risk of transmission of HBV infection due to blood from one patient to another is mostly because of inadequate precautions taken by the dialysis staff. Combined therapy with interferon (6-10 million units) three times a week and lamivudine (100-300 mg/day) would be more effective in controlling viral replication. The most important modality for prevention of HBV infection is induction of immunity by hepatitis B vaccination. Administration of 40 microg doses at months 0, 1, 2 and 6 is the most rapid immunogenic schedule. The prevalence of HCV in HD patients ranges from 6% in the United Kingdom to 60% in Poland and Eastern Europe, 8-36% in North America. HD patients in different parts of India exhibit high anti-HCV positivity (12.1%, 45.2%, 33.3% and 41.9%) in various studies. The incidence and prevalence of HCV infection among patients on dialysis in developed countries are steadily declining because of (i) reduction in post-transfusion HCV infection, (ii) infection control measures to prevent nosocomial infection. Among HD patients with HCV infection, serum alanine aminotransferase (ALT, SGPT) levels are elevated in only 4 to 67% patients who are positive for anti-HCV, in only 12 to 31% patients with HCV RNA and only in one-third of those with biopsy proven hepatitis. Number of blood transfusion, duration of HD treatment, and mode of dialysis are important risk factors. Patient to patient transmission of HCV occurs in HD units by needle stick injury, breakdown in standard infection control practices, physical proximity to an infected patient, dialysis machines, dialysis membranes and HD ultrafiltrate and reprocessing of dialyser. The prevalence of HIV infection in dialysis populations varies according to different countries and geographic areas, 0% and 13% in 1990 and 1995 respectively. There was no evidence of transmission within the centre transmission, from patient to patient or patient to staff. Antiretroviral therapy is the corner-stone of the HIV infection in end stage renal disease (ESRD). Most commonly, zidovudine (AZT) has been used in these patients. Currently recommended dose of 200 mg three times a day is probably safe in these patients.
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PMID:Hepatitis and HIV infection during haemodialysis. 1166 25

Human immunodeficiency virus-associated nephropathy (HIVAN) is a clinicopathological entity characterised by proteinuria, rapidly developing azotemia and histologically by collapsig variant of focal and segmental glomerulosclerosis with acute tubular necrosis and mild interstitial inflammation. Untreated, it may result in end stage renal disease (ESRD) in as little as four months. The incidence of HIVAN continues to increase and is the single most common cause of chronic renal disease in HIV-1 seropositive patients. It affects predominantly black individuals. Exact pathogenesis is still not clear but a great deal of progress has been made in the recent past by studies on transgenic mouse model, renal cell cultures and from study of human biopsy material. Current considerations revolve around the role of HIV or protein in renal epithelium and the effects of cytokines, including transforming growth factor-beta and basic fibroblast growth factor on renal structures. Different modalities of treatment with corticosteroids, zidovudine or angiotensin converting enzyme inhibitors have been tried with modest success.
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PMID:Human immunodeficiency virus-associated nephropathy. 1183 70


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