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

We have measured sIL-2R in 60 haemophiliacs and 20 male control subjects. Haemophiliacs were grouped according to their HIV/HCV antibody status. Group 1 (n = 20) comprised HIV + ve/HCV + ve, group 2 (n = 27) HIV - ve/HCV + ve and group 3 (n = 13) HIV - ve/HCV - ve. Group 4 comprised the normal control subjects. We also examined, retrospectively, the relationship between the severity of chronic liver disease, assessed histologically, and sIL-2R levels in selected patients. There was no significant difference between sIL-2R levels of the group 1 and group 2 patients, and the levels for both were significantly greater than those of either the group 3 patients or the control subjects. sIL-2 levels were also higher in selected patients with cirrhosis than in those with chronic active hepatitis (CAH) or chronic persistent hepatitis (CPH). We conclude that in haemophiliacs, chronic HCV-related liver disease is associated with increased plasma levels of sIL-2R and that the degree of elevation may reflect the severity of the associated chronic liver disease.
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PMID:Increased soluble IL-2 receptor levels in HCV-infected haemophiliacs: a possible indicator of liver disease severity. 794 92

This report describes the case of a 14-yr-old hemophiliac who died of complications of primary pulmonary hypertension. He was infected with the human immunodeficiency virus. The autopsy disclosed that he also had membranoproliferative glomerulonephritis type III and hepatic cirrhosis, both clinically unsuspected. This is the second report describing the association of membranoproliferative glomerulonephritis type III and primary pulmonary hypertension in an HIV-infected patient and the first to consider cirrhosis as a possible additional element of the syndrome.
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PMID:Pulmonary hypertension and HIV infection: new observations and review of the syndrome. 799 28

We have studied morbidity and mortality related to hepatitis C virus infection in haemophilic patients treated at our centre. 11/255 HCV seropositive patients have developed hepatic decompensation. 20 years after first exposure to lyophilized clotting factor concentrate the risk of hepatic decompensation is estimated to be 10.8% (95% CI 3.8-17.8%). There is a significantly increased risk associated with HIV infection, and also with increased age. For HIV seropositive patients the rates of decline in CD4 lymphocyte count and the development of p24 antigenaemia are significant risk factors for hepatic decompensation. Cirrhosis was seen in 9/19 HIV seropositive patients at post mortem. There was an association of cirrhosis with increased age but not with CD4 count, p24 antigenaemia, or AIDS. In conclusion, HCV infection is associated with serious liver disease in haemophilic patients, but so far this has been restricted to a minority of those at risk. HIV co-infection accelerates progression to hepatic decompensation, and we speculate that this is probably due to enhanced HCV replication in the presence of immune deficiency.
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PMID:The progression of HCV-associated liver disease in a cohort of haemophilic patients. 799 96

A 44-year-old man was admitted with symptoms compatible with Addison crisis. Abdominal computer tomography revealed extensive bilateral adrenal abscesses. Histoplasma capsulatum was cultured from a needle aspirate. The patient was HIV-seronegative and had no underlying malignancy. He may have acquired the infection during several stays in endemic areas in the United States, South America and Asia. The case was also remarkable for moderate brain atrophy, thrombosis of the portal and splenic veins and liver cirrhosis caused by alpha-1-antitrypsin deficiency (phenotype MZ). The patient recovered fully under substitution of adrenal hormones and antifungal treatment. He received intravenous amphotericin B (75 mg q24h) for 10 days, followed subsequently by oral treatment with itraconazole (400 mg q24h) over several months. Radiologic follow-up 9 and 18 months later showed a pronounced decrease of the inflammatory adrenal lesions.
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PMID:[Addison crisis due to bilateral adrenal gland histoplasmosis]. 799 62

The case notes of patients with blood cultures positive for enterobacteriaceae were examined retrospectively over a 6-month period in Parirenyatwa Hospital, Harare, Zimbabwe. Speciation was possible for Salmonella typhi and shigellae only. Nontyphoidal salmonellae were serotyped. Salmonella or shigella bacteremia was identified in 51 patients. There were 14 isolates of S. typhi, 32 isolates of nontyphoidal salmonellae, and 5 isolates of shigellae species. The case notes of 38 patients could be identified for review, and of these HIV serology was available for 15 seropositive and 15 seronegative patients. The male to female ratio was approximately 3:1 for both groups and the mean age was 29.7 +or- 21. Nontyphoidal bacteremias as compared with typhoid fever were strongly associated with HIV seropositivity [p 0.01]. 3 out of 8 HIV-negative patients with nontyphoidal bacteremia had another underlying immunosuppressive disease [2 had myeloma and 1 patient had cirrhosis with complicating hepatoma]. 2 patients with nontyphoidal bacteremia whose HIV status was unknown also had another immunosuppressing disease [acute myeloid leukemia and idiopathic pancytopenia]. 13 out of 15 HIV-positive patients showed other signs of HIV infection [oral candida, herpes zoster, persistent generalized lymphadenopathy]. 3 out of 11 patients [27%] with typhoid died, while 11 out of 27 patients [40.7%] with nontyphi bacteremia died. Most strains of S. typhimurium were included in serogroup B, which accounted for 37% of nontyphoidal isolates. Earlier studies identified invasive salmonellosis in patients with other AIDS defining diseases. In Nairobi clinical features of HIV infection were found in 64% of bacteremic HIV-positive patients, but only 28% of patients fulfilled the CDC clinical case definition for AIDS. A more recent study from Nairobi demonstrated that S. typhimurium bacteremia is a common cause of intercurrent infection in HIV-positive tuberculous patients.
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PMID:Salmonella and shigella bacteraemia in Zimbabwe. 813 Nov 97

The risk of HBV and HCV liver infection in kidney graft recipients was evaluated in 35 patients. All were tested for anti-HBc, HBsAg, HBeAg, anti-HBs, Anti-HBe, anti-HCV (c-100-3 and c-100-3, c-22, 33-c), anti-HDV and anti-HIV by ELISA, and for HBV-DNA by hybridization. Liver biopsy, immunostaining for HBcAg and Knodell's hepatic inflammatory index were performed in 18. Mean time elapsing form transplant to inclusion was 20.7 months (range 1-108). HBsAg was the only marker searched for prior to transplant. Twenty six (74.2%) patients presented HBV and/or HCV markers, while 9 (25.8%) had none; 16 (45%) proved anti-HBc+, 6(17.1%) HBsAg+, (3 HBeAg+ and 3 anti-HBe+), 7 (20%) anti-HBs+ and 3 (8.5%) isolated anti-HBc. Anti-HCV (C-100-3) was positive in 9/32 (28.1%), while 2nd. generation anti-HCV was positive in 20/35 (57.1%) cases. No false positives for 1st. generation test were found. Both anti-HDV and anti-HIV were negative in all the sample. Raised aminotransferases were present in 13/30 (43.3%), 7 in anti-HCV+, one in HBsAg+ and 3 in HBsAg+/HCV+ cases, but normal in 17/30 (56.6%). History of Transfusion and Hemodialysis time showed no significant differences between anti-HCV+ and anti-HCV negative cases. Biopsy disclosed 10 chronic persistent hepatitis (CPH), one chronic active hepatitis (CAH) with cirrhosis, one inactive cirrhosis (Ci) 4 minimal lesions (MHL) and 2 normal. Seven CPH, 3 MHL. one normal and both cirrhosis cases proved anti-HCV+. HBsAg was positive in the single CAH, in 2 CPH and in one MHL.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:HBV and HCV infection in kidney transplant recipients. 824 31

C receptor type 1 (CR1, CD35) is present in a soluble form in plasma (sCR1). Soluble CR1 was measured with a specific ELISA assay in normal individuals and in patients with different diseases. The mean serum concentration of sCR1 in 31 normal donors was 31.4 +/- 7.8 ng/ml, and was identical in plasma. An increase in sCR1 was observed in 36 patients with end-stage renal failure on dialysis (54.8 +/- 11.7 ng/ml, p < 0.0001), and in 22 patients with liver cirrhosis (158.3 +/- 49.9 ng/ml, p < 0.0001). The mean sCR1 levels dropped from 181 +/- 62.7 to 52.1 +/- 24.0 ng/ml (p < 0.001) in nine patients who underwent liver transplantation, and was 33.5 +/- 7.3 in 10 patients with functioning renal grafts, indicating that the increase in sCR1 was reversible. Soluble CR1 was elevated in some hematologic malignancies (> 47 ng/ml), which included B cell lymphoma (12/19 patients), Hodgkin's lymphoma (4/4), and chronic myeloproliferative syndromes (4/5). By contrast, no increase was observed in acute myeloid or lymphoblastic leukemia (10) or myeloma (5). In two patients with chronic myeloproliferative syndromes, sCR1 decreased rapidly after chemotherapy. The mean concentration of sCR1 was not significantly modified in 181 HIV-infected patients at various stages of the disease (34.8 +/- 14.4 ng/ml), and in 13 patients with active SLE (38.3 +/- 19.6 ng/ml), although in both groups the number of CR1 was diminished on E. There was a weak but significant correlation between sCR1 and CR1 per E in HIV infection and SLE (r = 0.39, p < 0.0001, and r = 0.60, p < 0.03 respectively). In vitro, monocytes, lymphocytes, and neutrophils were found to release sCR1 into culture supernatants. In vivo, sCR1 was detected in the serum of SCID mice populated with human peripheral blood leukocytes. The sCR1 levels correlated with those of human IgG (r = 0.97, p < 0.0001), suggesting synthesis of sCR1 by the transferred lymphocytes. The mechanisms underlining the increased levels of sCR1 and its biologic consequences remain to be defined.
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PMID:Circulating soluble CR1 (CD35). Serum levels in diseases and evidence for its release by human leukocytes. 833 53

There was once an idea that the extensive development of antibiotics and vaccines would cause most bacterial and viral infections to fade away someday. However, the occurrence of antibiotic resistant bacteria and variant viruses proved this to be illusion. The spread of HIV infection, since there is no way to cure it so far, is of great concern. The occurrence of methicillin resistant Staphylococcus aureus (MRSA) presents another difficulty in preventing nosocomial infections due to the existence of healthy carriers. The out-break of MRSA in wards is one of the most serious problems in hospital management. HCV is capable of inducing chronic hepatitis, hepatic cirrhosis and hepatoma. HCV is thus a more serious concern today than HBV, since preventive measures against HBV by vaccination and anti-HBV immunoglobulin are fully established. We, doctors, nurses and clinical technologists are apt to be exposed to these hazardous microorganisms and thus should take appropriate precautions during routine work. The present symposium was planned to present recent research on these microorganisms, HIV, MRSA and HCV, so that we can improve our measures to prevent them.
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PMID:[Symposium "infections, recently worth noticing". Introductory address]. 834 53

Although a normal or increased anion gap (AG) is commonly used to help assess acid-base balance, decreased AG has aided in the diagnosis of halogen ingestion and myeloma. Substantially increased levels of IgG cause a decrease in the AG. Patients with polyclonal increases in immunoglobulins, especially hepatic cirrhosis, also exhibit decreased anion gaps. Patients with human immunodeficiency virus (HIV) infection commonly show polyclonal increases in immunoglobulins. A case is reported of a patient with HIV infection who exhibited a decreased AG associated with increased polyclonal IgG (63 g per L). Unlike the electrophoretic profile of patients with hepatic cirrhosis, which commonly shows a beta-gamma-globulin bridge, reflecting a decreased immunoglobulin degradation, the profile of the patient with HIV infection was consistent with an increased immunoglobulin synthesis. Examination of sera from 18 additional HIV positive patients indicated that, in general, the AG of HIV infected patients with normal renal function is significantly higher than in normal persons. The significance of this finding is as yet unclear. Nevertheless, decreased AG was associated with increased IgG. This may complicate the use of the AG in evaluating HIV infected patients because of frequent elevations in IgG. These relationships are now in the process of further investigation. Nevertheless, it is suggested that, with appropriate history and physical, identification of a decreased anion gap in conjunction with a polyclonal increase in gamma-globulin may be reason to consider a work up for infection by HIV.
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PMID:Human immunodeficiency virus infection and anion gap. 837 29

The histological features of chronic viral hepatitis differ according to etiological agent and replicative phases. Thus, in chronic HBV hepatitis with a high level of HBV replication the histological lesion is generally mild. During the seroconversion phase, a lobular lesion is present in the liver biopsy followed by amelioration of the disease. Chronic delta hepatitis is very aggressive histologically, progression to cirrhosis is frequent, and sanded nuclei are often observed in liver biopsies of patients with anti-HIV. In contrast, chronic hepatitis C shows a milder histological picture and immunohistochemical techniques to detect HCV-Ag in the liver tissue should be developed. In summary, the majority of cases of chronic viral hepatitis have distinctive histological features that may be identified in liver biopsies.
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PMID:Liver biopsy and the etiologic diagnosis of chronic hepatitis. 838 84


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