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

56 cases of pregnant women with a positive HIV serology were reported in 20 months at the Maternity of the Nice Hospital Center. In 10 cases, there were clinical signs of the disease (9 ARC-Syndrome, one case of AIDS). The predisposing factor was most of the time drug addiction, 53 cases (94.5%) and one case occurred after a blood transfusion. In the majority of the cases (52%) the pregnancy was pursued because of the late term or the patient's decision. A therapeutic abortion was performed in 12 instances (25%) and an interruption before 12 weeks of amenorrhea in 15 cases. 24 women delivered. The obstetrical complications were frequent with especially a fetal death in utero, five premature deliveries and fifteen hypotrophies. A severe infectious complication (septicemia, pneumopathy secondary to Pneumocystis carinii) was observed in 9 cases, a marked thrombopenia causing profuse post-partum haemorrhages in one case. Finally, one woman died 35 days after delivery. The study of the consequences on the child is incomplete because of insufficient follow-up: all children were sero-positive at birth and among thirteen children aged between 12 to 20 months, there were one death, one AIDS syndrome, 4 ARC-syndrome, 4 sero-positive and 3 sero-negative. The notion of HIV sero-positivity in a pregnant woman presents serious problems for the obstetrician. Decompensation of the disease during the pregnancy is uncertain but it is now confirmed that the child is affected, and this is a well established fact. These important consequences lead to propose, at this time a therapeutic interruption of pregnancy when possible, depending on the term, and when accepted by the patient.
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PMID:[Positive HIV (human immunodeficiency virus) serology in the pregnant woman: current data on its management. Apropos of a continuous series of 56 cases]. 347 87

After revising literature concerning Pneumocystis Carinii Pneumoniae (PCP), the authors undertook a close examination of the immunological system of the HIVab-positive patients that suffered opportunistic pneumopathy from PCP. Hundred-forty-three cases of HIVab-positive (mean age of 29), prevalently heroin drug-users, were studied. There were 13 AIDS, 26 ARC, 91 LAS cases and 13 patients with only Ab positivity for HIV. Four hundred chest radiographs were examined without previous knowledge of case histories. A small number of hilum and/or mediastinal lymphadenopathies was observed. Moreover, percentage increase in acute lung inflammatory diseases, mainly interstitial, was seen. These data were correlated to the worsening of the HIV infection and to the developing of LAS, ARC and AIDS. In a number of cases there was radiological evidence of progressed inflammatory episodes. The clinical pattern of PCP patients is dramatic and often fatal. Clinical-radiological cases with special reference to acute interstitial disease, caused by opportunistic agents, are presented.
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PMID:[Contribution of chest radiology to the diagnosis of HIV virus infection]. 350 Apr 88

The World Health Organization and the International Union Against Tuberculosis and Lung Disease published two joint statements on tuberculosis (TB). The first statement confirms that HIV infection is the most potent factor promoting the development of TB in people infected with Mycobacterium tuberculosis. The lifetime risk of developing TB is estimated to be at least 50% for co-infected people. TB in this group is thought to result largely from the reactivation of previously acquired infection, but re-infection may be important in populations with a high prevalence of TB. Chemoprophylaxis, usually with isoniazid, prevents the development of TB in all patients infected with M. tuberculosis, whether or not they are also infected with HIV. The second joint statement is aimed at developing countries and follows UK and US guidelines for preventing the transmission of TB in health care settings. Essentially, patients with confirmed or suspected infectious TB should be isolated until they are no longer infectious or the diagnosis is revised; risks should be minimized to patients, health care workers, and laboratory staff during procedures producing aerosols; TB isolation rooms should be safely and effectively ventilated to the outside of buildings; and all immunocompromised patients and health care workers should be protected from exposure to patients with infectious TB.
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PMID:Joint statements on preventing tuberculosis. 751 35

Lung 99mTc DTPA transfer/permeability has been widely used to assess the integrity of the lung alveolar-capillary interface. The use in HIV positive patients to provide a rapid assessment of causes of breathlessness or fever is discussed in this overview. There is I believe a clear role for this technique in this group of patients. It is more sensitive than Gallium-67 scanning in defining lung disease and is capable of distinguishing between alveolitic processes and bacterial infections of Kaposi sarcomatous infiltration. The 99mTc DTPA transfer/permeability can also define the absence of lung involvement in those patients with a fever to allow more suitable investigation to proceed. The 99mTc DTPA transfer/permeability measurement is a rapid, easy method of evaluating patients with HIV disease. Depending on the clinicians philosophy it can be used as a basis to initiate treatment or at the very least point to the next necessary investigation.
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PMID:99mTc DTPA transfer/permeability in patients with HIV disease. 755 46

Bronchiolitis obliterans organizing pneumonia (BOOP) is increasingly recognized as an important cause of diffuse infiltrative lung disease. It is a diagnostic consideration in patients with a febrile flu-like illness of a few weeks' duration and a roentgenogram showing bilateral patchy infiltrates that are not responsive to a typical course of antibiotics. It is defined as granulated tissue plugs within lumens of small airways that extend into alveolar ducts and alveoli. Clinically, a flu-like illness, cough, and crackles are common. Pulmonary function studies of patients show a decreased vital capacity, normal flow rates (except in smokers), and a decreased diffusing capacity. It is generally idiopathic, but it may occur during the resolution of a viral or mycoplasma pneumonia. It is also associated with a variety of systemic illnesses and clinical settings. These include the connective tissue disorders, antineoplastic and other drugs, and immunological disorders, as well as bone marrow and lung transplantation. There are numerous related disorders, including human immunodeficiency virus infection, radiation therapy, thyroiditis, and alcoholic cirrhosis. In idiopathic BOOP, complete resolution occurs in 65% to 85% of patients treated with corticosteroid therapy. This type of therapy is often effective in patients with associated systemic disorders or in other clinical settings, but there may be limited or no response in patients with dermatomyositis, immunosuppression, or interstitial opacities at the lung bases. Respiratory failure leading to death may occur in 5% of patients. It is important to add BOOP to the differential diagnosis of febrile, noninfectious illnesses that are mimics of pneumonia.
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PMID:Bronchiolitis obliterans organizing pneumonia. 756 1

Mycobacterium avium complex infections, common in patients with AIDS as either pulmonary or disseminated disease, are infrequent in patients without AIDS. Participants were 45 HIV-negative patients with lung disease and positive sputum cultures for M avium; 10 had documented immunocompromise, and 24 had preexisting lung disease. Clarithromycin dosage was 500 to 2,000 mg daily (mean +/- SD = 1,633 +/- 432 mg). The drug was administered either alone (n = 14) or in combination with rifampin (n = 8), aminoglycoside (n = 1), quinolone (n = 10), clofazimine (n = 18), isoniazid (n = 5), ethambutol (n = 9), pyrazinamide (n = 1), or minocycline (n = 6). At 3 months, 36 patients among 39 bacteriologically assessed had negative sputum cultures, 3 had positive culture, 3 were dead, and 3 discontinued treatment. At the end of treatment, 32 patients remained negative, 7 were positive. The success rate was 15 of 22 (64%) in patients previously treated with antimycobacterial drugs for M avium disease and 17 of 23 (74%) in new patients. Adverse effects included mild hearing loss (n = 4), increase in liver enzyme levels (n = 5), and gastrointestinal pain (n = 10, two of whom had to stop treatment). Patients stopped treatment after 300 +/- 186 days due to side effects (3), death (4), or the patient's (5) or physician's decision (33). During the follow-up, one patient suffered a relapse with peripheral lymph nodes. A daily dose of 30 mg/kg of clarithromycin in the treatment of M avium infections appears to be effective and safe. Concomitant drug therapy should be assessed for its ability to prevent relapse.
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PMID:Clarithromycin in the treatment of Mycobacterium avium lung infections in patients without AIDS. Clarithromycin Study Group of France. 770 12

HIV infection and its final form as AIDS were ignored by the public opinion in Romania till 1990. Nowadays it is real fact in our country. Out of total number of 2235 AIDS cases declared till March 1st 1993 by the Ministry of Health only 134 were adult persons. The study concerns 65 cases of AIDS in adults in order to find out the lung symptoms proportion as etiologic features, to settle the ways of transmission of HIV infection and to warn the romanian pneumologists on this problem. The study shows that in 56.9% of total cases, lung symptoms were noted and in 49.2% the lung disease revealed the AIDS. Out of the total number of 65 cases, 24.6% showed tuberculosis as a first disease, 12.4% lung pneumocystosis, 7.76 Kaposi syndrome with lung expression and 4.5% other pneumopathies.
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PMID:[The etiological profile of the pulmonary manifestations in AIDS patients (studies of 65 cases recorded in Romania up to 1 March 1993)]. 773 83

111-Indium-DTPA-IgG (111In-IgG) is a new radiopharmaceutical that has been evaluated for the detection of infection without the need for in vitro cell labeling. We prospectively studied this agent in 33 patients suspected of having lung infections, most of whom also had HIV infection, and three patients with HIV infection and diarrhea without lung disease. Anterior and posterior lung images in the upright position were obtained within 24 h after intravenous administration of 2 mCi of 111In-IgG and were read in a blinded fashion by two nuclear medicine physicians. Of 29 patients suspected to have Pneumocystis carinii pneumonia (PCP), the diagnosis was confirmed by bronchoalveolar lavage in 18. Diffusely increased lung uptake of 111In-IgG was found in 17 of 18 patients who had PCP and was normal in 10 of 11 patients without PCP. The intensity of 111In-IgG uptake was related to sever gas exchange abnormality. Two patients with apparent bacterial lung infections had focal accumulation of 111In-IgG while two patients with minor radiographic abnormalities had no increased uptake. Normal lung uptake also occurred in two of three HIV-positive patients who had diarrhea and no lung disease. 111In-IgG appears to be useful in the detection of PCP and other pulmonary infections.
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PMID:111-indium-DTPA-IgG lung imaging in patients with pulmonary and HIV infection. 775 Mar 28

Poor management of tuberculosis (TB) control is responsible for resistance to antituberculosis drugs. It leads to treatment failure, relapse, transmission of resistant TB, and multi-drug resistant TB. In developing countries, where resources are already limited, an epidemic of multi-drug resistant TB would jeopardize TB control. The effect of HIV infection is likely to worsen drug resistance-related problems. Specifically, streptomycin injections pose a risk of HIV transmission. It appears that withdrawal of thiacetazone from HIV infected TB patients causes resistance to more powerful drugs. If these 2 antibiotics cannot be used to treat TB patients, the armamentarium available to control TB in high HIV prevalence countries is reduced, which could foster resistance to the fewer remaining antibiotics. Good management and supervision is needed to prevent resistance to antituberculosis drugs. Surveillance of drug resistance is also needed to monitor the current level and characteristics of the drug resistance problem and to identify effective solutions. Specifically, at the national level, a TB surveillance system can assess the TB control program's performance and assess the need to modify the current treatment policy. It can identify districts or health centers with high levels of drug resistance and determine the risk factors for resistance. WHO will assist developing countries in developing their own surveillance systems. WHO and the International Union Against Tuberculosis and Lung Disease plan on setting up a network of supranational reference laboratories to determine the quality control and standardization of susceptibility testing needed for international comparison. WHO also plans on supporting national reference laboratories in developing countries.
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PMID:Surveillance of resistance to antituberculosis drugs in developing countries. 791 5

Our objective was to characterize the population with tuberculosis (TB) and to identify factors predictive of resistance to anti-TB agents in an area of high prevalence of human immunodeficiency virus infection. We reviewed microbiology and clinical records from 1988 to 1991 at Beth Israel Medical Center, New York City, for patients with culture-proved TB and analyzed the frequency of resistance to anti-TB agents with respect to demographic and clinical variables. Of 360 patients with TB, 17.5% had drug-resistant isolates. Of the 333 patients on whom the information was available, 72% reported HIV risk factors, 54% injectable drug use, and nearly one-third homelessness. The majority (56%) had documented HIV infection. Between 1988 and 1991, acquired resistance to isoniazid (INH) alone rose from 5% to 21% and initial resistance to INH alone rose from 0% to 19%. Drug resistance was more likely in previously treated patients; 61% of the previously treated patients admitted noncompliance with therapy. Cavitary lung disease was the strongest predictor of acquired drug resistance. Initial drug resistance was more likely in patients with HIV infection. Among persons with HIV infection, none of the analyzed factors was found to be predictive of drug resistance. Noncompliance with therapy and the HIV epidemic played a major role in the rise of drug resistance in our population. HIV infection confounds the epidemiologic factors that might otherwise allow clinical prediction of resistance.
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PMID:Drug-resistant tuberculosis: factors associated with rise in resistance in an HIV-infected urban population. 796 28


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