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)

Hepatitis C virus (HCV) has an etiological role in post-transfusional Non-A Non-B Hepatitis, cirrhosis, and hepatoma. Studies have revealed an high prevalence of anti-HCV antibodies in hemophiliacs, IV drug users, and other groups at risk for parenterally transmitted infections. The authors report findings from their investigation into the sexual transmission of HCV. The prevalences of antibodies to HCV, the hepatitis B core (HBc) antigen, and to Treponema pallidum were assessed among groups of individuals at high and low risk for sexually transmitted diseases (STD). The population at low risk for STDs was comprised of 2494 volunteer blood donors at the Hospital Universitario Clementino Fraga Filho (HUCFF) over the period July-November 1990. The population at high risk for STDs was comprised of 187 adults consecutively enrolled between September 1990 and January 1991 in a cohort study of the natural history of HIV infection. Sera were screened with a first generation HCV ELISA test, with repeat reactive samples further analyzed using a second generation recombinant immunoblot confirmatory test (RIBA-2). Data on the presence of antibodies to HBc, VRDL, and HIV were abstracted from the Blood Bank records. Antibody testing against Treponema pallidum was conducted among HCV-ELISA positive blood donors and their controls using FTA-ABs. 2.08% of blood donors were infected with HCV, 7.96% of the HIV-infected homosexuals, and 8.02% of the whole group with sexually acquired HIV infection. Anti-HBc antibodies were more frequently present in anti-HCV RIBA-2 confirmed positive blood donors than in controls. 33.3% of the HCV-positive blood donors and 11.04% of controls were found to be anti-HBc positive. 17.6% of HCV-positive donors and 4.9% of controls yielded positive FTA-ABs results. 5.9% of samples from blood donors were both anti-HBc and FTA-ABs positive, while none of the controls reacted in both tests. The association between HCV, hepatitis B infection, and syphilis in individuals at low risk for parenterally transmitted diseases suggests that sexual transmission contributes to the maintenance of the endemicity of HCV in the local population.
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PMID:Prevalence of antibodies to hepatitis C virus in populations at low and high risk for sexually transmitted diseases in Rio de Janeiro. 750 22

Epidemiology of Hepatitis C virus (HCV) infection in Europe is changing very rapidly since the main source of contamination was blood transfusion and the use of surrogate markers allowed to diminish dramatically the number of patients contaminated through HCV post transfusion hepatitis. The recent description of several genotypes with different distributions over Europe and different pathogenicity will allow to explain various evolutive aspects of the disease. At present, groups at risk are drug addicts (70%), hemophiliacs (contaminated with blood products before 1985), hemodialysis patients (20%) and patients with cirrhosis with or without hepatocellular carcinoma. The detection of HCV markers prior to blood transfusion allowed to detect asymptomatic carriers of HCV, some of them with latent chronic hepatitis which can be predicted by the detection of HCV RNA in the serum. Vertical and sexual transmission are rare but possible events observed with certainty in patients co-infected with HIV and controversial in other situations.
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PMID:Epidemiology of hepatitis C virus in Europe. 752 25

It has been suggested that acquired abnormalities of the red cell membrane due to various injuries [azidothymidine (AZT) therapy, immunoglobulin coating of red cells, differentiation abnormalities of erythroid precursors] contribute to the onset of anaemia in HIV-infected patients. In vitro proteolysis of erythrocyte membrane proteins is regarded as a molecular marker of membrane damage induced in vivo by different agents. We therefore investigated in vitro proteolysis of ghosts derived from red blood cells of 30 HIV-infected patients. Considered collectively, there was no significant increase in in vitro proteolysis in ghosts from anaemic HIV patients. However, a significantly higher degree of in vitro self-digestion of RBC membrane proteins was evident in HIV-infected patients with spleen enlargement, but not in splenomegalic patients suffering from liver cirrhosis. Neither AZT therapy nor the presence of a positive direct antiglobulin test seemed to be directly associated with increased in vitro protein breakdown. The results seem to suggest damage of the red cell membrane in HIV infection, induced by injuries on red cells during their prolonged retention inside an enlarged spleen, while it seems unlikely that AZT therapy or immunoglobulin coating of red cells play major roles in red cell damage.
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PMID:In vitro proteolysis of the red cell membrane in patients with HIV infection. 754 74

Worldwide, HCV is a major etiologic agent of chronic hepatitis that may lead to the development of liver cirrhosis and hepatocellular carcinoma. Thus, significant morbidity and mortality is caused by HCV infection and effective control measures against the spread of this virus are needed. Originally, the extent of genetic heterogeneity of HCV was not fully appreciated. However, the breadth of the genetic heterogeneity of HCV is great, and this may have important implications in diagnosis, pathogenesis, treatment, and vaccine development. In an infected individual the HCV genome population circulates as a quasispecies distribution of closely related yet heterogeneous RNA sequences centered around one dominant sequence. The dominant sequence, as well as the consensus sequence, changes sequentially during the course of the infection. A hypervariable region (HVR1) within one of the envelope proteins of HCV (E2) evolves very rapidly. Patients infected with HCV mount a humoral immune response to epitopes of HVR1. However, sequential changes in the consensus sequence of HVR1 during infection result in the generation of variants that are not recognized by preexisting antibodies. This might represent a mechanism by which HCV evades host immune surveillance and establishes and maintains persistent infection. It will be important to determine whether HVR1 of HCV, as was found for the V3 loop of HIV, contains epitopes that elicit neutralizing antibodies against HCV. Furthermore, it will be important to determine whether the quasispecies nature of HCV helps the virus evade the cytotoxic T-cell response of the host. Analysis of complete or partial HCV genomic sequences revealed that HCV exists as multiple, distinct genotypes. A total of nine major genetic groups and at least 30 subgroups have been recognized. To evaluate the current classification of HCV genotypes, we performed phylogenetic analyses of complete and partial nucleotide sequences from isolates that represent all published variants of HCV. Analysis of complete HCV sequences, which represent three major genetic groups, supports the currently used genotype classification scheme. However, analysis of the partial genomic regions (ie, C, E1, and NS5b) of HCV isolates that represent all recognized variants of HCV demonstrates that the genetic relatedness among some of the genotypes was not equivalent in the different gene regions. Furthermore, the distinction among isolates, subtypes, and types of HCV was not always clear. This finding might reflect the shortcomings of analyzing only limited gene regions or may reflect the wide spectrum of genetic variation of HCV.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Genetic heterogeneity of hepatitis C virus: quasispecies and genotypes. 759 43

Over the past decade, with the use of plasma-derived factor VIII and factor IX, treated with virucidal methods, as well as with recombinant factor VIII, the replacement therapy of hemophilia has been intensified. In developed countries, a majority of patients are being treated at home, and large groups of children benefit from primary prophylaxis. A serious task in these countries for the coming years is the management of patients infected with HIV. In Poland and less-developed countries, the supply of antihemophilic factor concentrates is inadequate. Patients with inhibitor antibodies should be included in programmes of immune tolerance inducement. Many patients who had been multitransfused with cryoprecipate or received lyophilized concentrates before 1985, have developed chronic hepatitis associated with viral infections. About 15-30% show evidence of cirrhosis. Recombinant technologies should be improved and become more accessible in order to provide patients with safe and cheap antihemophilic factor concentrates. A true break-through in the hemophilia treatment would be a repair of the inherited clotting defect with gene therapy.
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PMID:[Current status and future prospects of hemophilia treatment]. 765 34

Hepatitis C virus (HCV) is a major cause of transfusion-induced chronic liver disease in hemophiliacs, with 70% to 90% being anti-HCV positive. Seroreversion or loss of antibody response to HCV has been observed in a small proportion of human immunodeficiency virus-positive [HIV(+)] anti-HCV(+) hemophilic men. Despite the seroreversion to an anti-HCV-negative state, such patients continue to show serum alanine aminotransferase (ALT) elevations and biopsy evidence of cirrhosis and/or chronic active hepatitis. To determine the cause for the loss of anti-HCV antibody, we compared first- and second-generation anti-HCV enzyme immunosorbent assay (EIA 1.0 and 2.0), second-generation recombinant immunoblot (RIBA 2.0), and HCV-RNA amplification using polymerase chain reaction (PCR) in 19 "seroreverters" before and after seroreversion. There was no difference between 19 seroreverters and 59 persistently anti-HCV-positive hemophiliacs in mean ALT (1.1 +/- 0.1 XUL v 2.0 +/- 0.2 XUL; chi 2 = 1.80, P > .05), in mean CD4 (188 +/- 36/microL v 232 +/- 28/microL; t = 0.965, P > .05), or in the rate of progression to acquired immunodeficiency syndrome (13 of 19 [68.4%] v 30 of 59 [50.9%]; chi 2 = .987, P > .05, respectively). Before seroreversion, all 19 seroreverters (100%) were positive for EIA 1.0 and 2.0 and PCR, and all but 2 of 19 (89.5%) were RIBA 2.0 positive, whereas, after seroreversion, none were positive for EIA 1.0, 15 of 19 (78.9%) were positive for EIA 2.0, 8 of 18 (44.4%) were positive for RIBA 2.0, and 18 of 19 (94.7%) were positive for PCR. There was a lower CD4 lymphocyte number after seroreversion in those who were RIBA 2.0 negative as compared with those who were RIBA 2.0 positive (32 +/- 10/microL v 171 +/- 52/microL; t = 2.638, P > .05). These results indicate that HIV(+) anti-HCV(+) hemophilic men who undergo "HCV seroreversion" are truly infectious and anti-HCV positive by second-generation tests. Anti-HCV detection in immunosuppressed hosts is significantly improved by second-generation EIA and RIBA assays.
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PMID:The presence of hepatitis C virus (HCV) antibody in human immunodeficiency virus-positive hemophilic men undergoing HCV "seroreversion". 768 87

Chronic viral hepatitis caused by hepatitis B, C or D may lead to cirrhosis, hepatocellular failure and hepatocellular carcinoma. The morbidity of these diseases has necessitated a prolonged search for effective therapy. Interferon-alpha has been studied widely, and remains the mainstay of treatment. Therapy for hepatitis B has now become possible with the demonstration that alpha-interferons inhibit hepatitis B virus (HBV) replication and that prolonged therapy can lead to a remission in disease. A number of other cytokines, including thymosin, are being evaluated. Currently used nucleoside analogues and anti-retroviral therapies used in human immunodeficiency virus infection have not proven useful in chronic hepatitis B. There are a number of new experimental nucleoside analogues with activity against HBV. Unfortunately, fialuridine has been associated with severe mitochondrial damage and hepatotoxicity. Other stereoisomers may be more active and less toxic, but the potential danger of these drugs indicates that large scale clinical trials should proceed cautiously. Experimental test systems for the preliminary investigation of antiviral compounds in hepatitis B and C will be required. Antisense oligodeoxyribonucleotides may inhibit the expression of the HBV genes. The natural history of hepatitis C is uncertain. Therapeutic trials of interferon-alpha indicated that a proportion of patients may respond to treatment with this agent. There is most information about 3 mU t.i.w. administered for 6 months. It is not yet clear whether this dose is optimal. Multivariate analysis of several pretreatment parameters indicate that patients without cirrhosis are more responsive to interferon. The influence of genotypes of hepatitis C is the subject of considerable interest at present. Patients with diverse circulating quasispecies may be less responsive to therapy than those with a single major species. Improved responses have been observed in patients with lower levels of circulating hepatitis C virus RNA.
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PMID:Treatment and prevention of chronic viral hepatitis. 771 82

The aim of this study was to identify and describe possible alterations of bone histomorphometry in patients with human immunodeficiency virus (HIV-1) infection and to assess the relation between these alterations and disease severity. Forty-four HIV-1-infected patients seen successively at our hospital were evaluated for the study. In an attempt to avoid confounding factors as far as possible, we excluded patients who fulfilled any of the following criteria: age less than 18 or greater than 40 years; recent history of extended bed rest; previous diagnosis of metabolic bone disease, renal insufficiency, or hepatic failure; clinical or echographic signs of liver cirrhosis; diabetes mellitus or previous diagnosis of other endocrine diseases; drug therapy that could act on bone metabolism; and/or moderate to severe nutritional alteration. Twenty-two patients (13 men, 9 women; age: 27.9 +/- 4.1 years, mean +/- standard deviation) were included in the study. Plasma and urine biochemistry and calcium-regulating hormones were determined. Bone mineral content was measured on vertebrae L2 to L4 and on the neck and intertrochanteric areas of the femur by dual-photon absorptiometry. A transiliac bone biopsy was performed after double-tetracycline labelling, with histomorphometric study of undecalcified bone. Serum osteocalcin was found to be lower in patients who, according to the Centers for Disease Control (CDC) classification, had greater disease severity, and showed a positive correlation with the number of CD4+ T lymphocytes. No alterations in bone densitometry were observed.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Bone remodelling in human immunodeficiency virus-1-infected patients. A histomorphometric study. 775 46

Infectious arthritis is mostly caused by hematogenous spread of Gram-positive bacteria, which often infects a previously damaged joint. During the past 20 years there has been a notable increase in joint infections caused Gram-negative bacteria. They develop mostly in patients with systemic diseases, such as malignancy, cirrhosis or HIV infection, which cause an immune deficient state. We present an 84-year old man admitted because of fever and a diagnosis of pneumonia. During hospitalization he complained of pain in his right knee. On physical examination there was evidence of local inflammation. Infection with E. coli originating in the urinary tract was diagnosed, based on synovial fluid, blood and urine cultures. He was treated with antibiotics intravenously, the knee was surgically drained, and he was discharged 4 weeks after admission. There was no underlying systemic disease in this case that could have caused an immune deficient state, which could promote the Gram-negative joint infection. The case is presented to draw attention to the possibility of infectious arthritis in an elderly patient presenting with fever. In such cases the location of the infection may not be obvious if the infected joint is deeply located parts of bones such as those of the hip, shoulder, or vertebrae. In these cases the diagnosis may be overlooked or delayed and irreversible damage to the infected joint may result.
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PMID:[Bacterial arthritis with E. coli in an elderly patient]. 781 26

Twenty-nine patients with severe aplastic anaemia (SAA) were submitted to bone marrow transplantation (BMT) and their immunological recovery analysed. Total lymphocyte counts, estimation of B lymphocytes, T lymphocytes and their subsets, natural-killer (NK) activity were performed. Cells with the CD8+ phenotype and NK activity were the first signs of immunological recovery, whereas the CD4+ subset recovered later in patients who suffered from acute graft versus host disease (GvHD) and infections. Acute and chronic GvHD, cirrhosis, rejection and HIV viral infection contributed to the persistence of the profound immunodeficiency status observed after BMT. Our results did not differ greatly from the others and confirmed that BMT may be performed in underdeveloped countries despite the difficulties it might pose.
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PMID:Immunological recovery after bone marrow transplantation for severe aplastic anaemia: a Brazilian experience. 792 58


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