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

Cutaneous manifestations are common in patients with HIV infection and mainly due to the immunodeficiency. In the initial stage of HIV infection, we frequently observe a rash of macular lesions. During the asymptomatic phase, the patients may typically show the following skin diseases: seborrhoic dermatitis, acneiform folliculitis, persistent herpes simplex, and infections with the human papilloma virus. In ARC and AIDS patients, 3 groups of skin disorders are found: cutaneous infections, skin tumors, and other mixed skin diseases. Herpes simplex and herpes zoster may develop into ulcerating and necrotising forms especially in patients with advanced immunodeficiency. The most frequent skin tumors in AIDS patients are the disseminated Kaposi's sarcoma and non-Hodgkin's lymphoma. More than 50% of the AIDS patients treated with trimethoprim/sulfamethoxazole developed a severe drug eruption. African and Caribbean patients with AIDS frequently suffer from pruritic skin lesions, the pathogenesis of which is not known. Aside from these cutaneous manifestations, a variety of other skin disorders have been reported in patients with HIV infection, ARC, or AIDS; future research will furnish definite proof whether they are correlated with HIV infection.
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PMID:[Skin manifestations in patients with HIV infection]. 220 61

In the course of the infection with the human immunodeficiency virus (HIV), we frequently observe disorders of the mucous membranes and, occasionally, they present the first manifestation of HIV-induced immunodeficiency. Like in other organs, opportunistic infections and malignant tumors prevail as a result of the impaired immune system. Opportunistic infections are characterized by frequency (candidiasis), aggressive expansion, persistence, frequent recurrences, and resistance to therapy (gingivitis, parodontitis, herpes simplex, warts). Oral hairy leucoplakia is considered a specific lesion of HIV infection. Malignant tumors, such as Kaposi's sarcoma, non-Hodgkin's lymphoma, and squamous cell carcinoma, may cause marked morbidity in AIDS patients; occasionally, the clinical picture of Kaposi's sarcoma and non-Hodgkin's lymphoma is rather uncharacteristic. Other manifestations on the mucous membranes may arise in association with systemic reactions, such as drug eruptions, thrombocytopenic purpura, or acute HIV infection. The etiology of still other lesions of the mucous membranes (e.g. chronic recurrent ulcers, xerostomia, disorders of pigmentation) is incompletely understood. The awareness of these disorders of the mucous membranes in HIV infection is of diagnostic, therapeutic and epidemiological importance.
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PMID:[AIDS--mucous membrane manifestations]. 220 62

Therapy of AIDS comprises two aspects: (1) causative therapy, directed against HIV, and (2) symptomatic therapy of opportunistic infections and malignancies. The best results regarding antiretroviral therapy - both in vitro and in vivo - have been obtained, so far, with inhibitors of reverse transcriptase. We discuss the mechanism of action, the efficacy, and the side effects of AZT, a nucleoside analogue, and comment on combined therapies with acyclovir and immunomodulators. We report on the therapy of the most frequent opportunistic infection - i.e. Pneumocystis carinii pneumonia - with sulfamethoxazole/trimethoprim and pentamidine as well as the chemoprophylaxis of this disease. During the last few years, important progress has been made in the field of antiviral chemotherapy (HSV, CMV, VZV) and the therapy of gastrointestinal infections. Moreover, the therapy of Kaposi's sarcoma associated with AIDS and that of non-Hodgkin's lymphoma has been established by now.
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PMID:[AIDS therapy]. 220 64

Fourty-four patients with lymphoid neoplasia 37 males and 7 females aged 15 to 75 years, were seen in the Department of Internal Medicine, Tikur Anbessa (Black Lion) Hospital, Addis Ababa, Ethiopia, between January and December 1988. Twenty-seven (61.4%) had non-Hodgkin's lymphoma, eleven (25%) Hodgkin's disease and six (13.6%) chronic lymphocytic leukaemia. Six (22.2%) of the non-Hodgkin's lymphoma one, (9.1%) of the Hodgkin's disease and none of the chronic lymphocytic leukaemia cases had positive enzyme linked immunosorbent assay (ELISA) and Western Blot tests for human immunodeficiency virus (HIV) infection. Of the 6 non-Hodgkin's lymphoma patients with HIV infection, five had extra-nodal involvement--four of the gastrointestinal tract, including the oropharynx, and one of the cervix uteri. Four of these six had clinically advanced disease at the time of presentation and histologically three patients had intermediate and three high grade malignancy. Two of the patients have died within two months of diagnosis, one is lost to follow up, and three patients are still alive and well 12 to 46 months after diagnosis. The HIV positive patient with Hodgkin's disease had stage IV E disease involving the pancreas with mixed cellularity histology, and died seven months after diagnosis. Diffuse, aggressive non-Hodgkin's lymphoma and possibly atypical aggressive Hodgkin's disease, may be indicator diseases for AIDS in HIV seropositive individuals.
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PMID:Human immunodeficiency virus (HIV) infection in patients with lymphoid neoplasia. 220 77

The characteristics of 14 HIV-seropositive patients with NHL consecutively observed between 1984 and 1988 at our Institution are described. Patients belonged to a known population of 1242 HIV-seropositive individuals in whom the incidence of NHL was 1.13%, significantly higher than in age-matched controls (P less than .0001). Within this population, a previous diagnosis of ARC or AIDS, but not of LAS, was the only significant risk factor for the development of NHL (P less than .0001). According to the status of HIV infection at the time of NHL diagnosis, two groups of patients could be clearly identified with different clinicopathological features and prognosis. In fact, NHL developing in 7 patients previously affected by ARC or AIDS, presented as localized, extranodal disease, predominantly in the CNS; large cell histology, peripheral blood cytopenia, severe immunodeficiency and poor prognosis further distinguished this subgroup. Conversely, NHL developing in 7 patients with either asymptomatic HIV-seropositivity or LAS, more often presented as disseminated disease both in nodal and extranodal sites, with Burkitt's-type histology. Cytopenia was uncommon and immunodeficiency was significantly less severe. In this subgroup complete remission (CR) was achieved with aggressive treatment in 6 of 7 patients. No relapses occurred but two opportunistic infection-related deaths were observed. Four patients are alive 6-34 months after CR, two of whom show newly developed opportunistic infections.
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PMID:Incidence and clinicopathological heterogeneity of HIV-related non-Hodgkin's lymphoma. 222 20

The lesions known as lymphocytic vasculitis, polymorphic reticulosis (midline malignant reticulosis, lethal midline granuloma), lymphomatoid granulomatosis, and angiocentric lymphoma form what have been collectively termed the angiocentric immunoproliferative lesions (AIL). Because of recent reports demonstrating clonal rearrangements of the T-cell receptor in these lesions, the AIL are now thought to represent a continuous spectrum of post-thymic T-cell non-Hodgkin's lymphoma (NHL). NHL associated with the acquired immune deficiency syndrome (AIDS) represents intermediate or high-grade B-cell malignancies in HIV-infected patients that may be etiologically related to the Epstein-Barr virus (EBV). There have been reports of EBV-associated T-cell NHL, AIL, and large granular lymphocyte (LGL) proliferations, as well as HIV-associated T-cell neoplasia, LGL/T-cell proliferations, and AIL. We describe a case of polymorphic reticulosis (lethal midline granuloma) arising in an HIV-infected individual, who later progressed to AIDS, and review the literature on HIV-associated and EBV-associated T-cell neoplasia, LGL/T-cell proliferations, and AIL. The etiology of this AIL/T-cell NHL, especially in relation to EBV and HIV, is discussed.
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PMID:Angiocentric immunoproliferative lesion/T-cell non-Hodgkin's lymphoma and the acquired immune deficiency syndrome: a case report and review of the literature. 224 97

Gastrointestinal disease in AIDS is common and is due to opportunistic infections, aggressive malignancy and possible direct HIV enteropathy. Disabling gastrointestinal symptoms are prominent both in patients with established AIDS and in patients with earlier stages of HIV infection. We report the cases of 160 patients with AIDS who underwent gastroenterological investigations at St Vincent's Hospital, Sydney, between November 1983 to October 1987. Of these, 127 had the diagnosis of AIDS established prior to referral and 33 patients had the diagnosis of AIDS established as a result of gastroenterological investigations. Diarrhoea and weight loss (88%) were the most frequent reasons for undertaking gastroenterological investigations. Swallowing disorders (47%), abdominal pain (20%), oral and perianal disease (74%) and evidence of hepatobiliary disease were the other major indications for investigation. In 90% of cases there was evidence of concurrent and active gastrointestinal disease at two or more sites within the alimentary tract. Results from this series reveal a wide range of infectious pathogens: viral (Cytomegalovirus, Herpes simplex), bacterial (Mycobacterium avium intracellulare) and parasitic (Cryptosporidium, Isospora belli). Kaposi's sarcoma and non-Hodgkin's lymphoma were the only malignancies detected in this series. Gastrointestinal disease associated with HIV infection is common, and contributes significantly to its overall morbidity and mortality. Moreover, chronic diarrhoea, weight loss and malnutrition may also contribute to the overall immunodeficiency.
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PMID:The gastrointestinal manifestations of AIDS. 234 18

The experience of 22 Hodgkin's disease (HD) patients with human immunodeficiency virus type I (HIV) antibodies, collected from a cooperative study of six hospitals during 1984-1989 is presented. Young men (average age, 27.6 years) with a high incidence of intravenous drug abuse (86%) were found. The status of the HIV infection at diagnosis of HD was: four patients, acquired immune deficiency syndrome (AIDS); eight patients, persistent generalized lymphadenopathy (PGL); and ten patients, asymptomatic. The natural history of HD was unusual, with a high incidence of B symptoms (81%), advanced Stages III to IV (90%), bone marrow invasion (50%), cytopenias before treatment (45%), opportunistic infections (68%), and aggressive histologies. A decreased response to chemotherapy with poor marrow tolerance and a significant decrease in survival, 18 months, was observed. The AIDS and cytopenias pretreatment were associated with a shorter statistically significant survival, which defines the importance of immunodeficiency in HD prognosis. Complete remission after treatment was a factor that contributed to a longer statistically significant survival. The PGL or asymptomatic patients survived longer but also had a poor course, and five of them had AIDS criteria during evolution. A high incidence of HD in relation to non-Hodgkin's lymphoma (NHL) in patients with HIV infection in the six cooperating hospitals was found. Criteria for considering HD as an AIDS-associated lymphoproliferative disease in our environment are discussed.
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PMID:Hodgkin's disease in patients with antibodies to human immunodeficiency virus. A study of 22 patients. 234 9

The demographic, social and clinical presentation of 100 HIV positive patients hospitalized in Tikur Anbessa Hospital, Addis Ababa, Ethiopia, between 1986 and 1989 are described. The mean age is 38.2 years with a range of 16 to 58. Over 75% of the patients are under 40 years. They came from ten different regions of Ethiopia. Only 82% of the patients fulfil the provisional World Health Organization clinical case definition of AIDS (acquired immunodeficiency syndrome). Tuberculosis is the commonest infection, presenting in unusual and aggressive ways. However, response to chemotherapy is similar to that in HIV-negative patients. It is recommended that all patients with unusual and aggressive tuberculosis should be screened for HIV and Mantoux-positive HIV carriers should receive INH prophylaxis. Also, all non-Hodgkin's lymphoma cases should be tested for HIV. Kaposi's sarcoma was not seen (see Addendum). As HIV infection is spreading rapidly and diagnostic facilities are limited, physicians and other health workers must develop a high index of suspicion to test for HIV among high risk groups, such as prostitutes, individuals having contacts with prostitutes, single, divorced and unemployed women living in towns and truck drivers, when they present with significant weight loss, unexplained and prolonged fever and diarrhoea, lymphadenopathy and oral thrush. Also, facilities and expertise for diagnosing opportunistic infections should be available in hospitals to prolong the lives of patients with AIDS.
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PMID:The demographic, social and clinical presentations of one hundred Ethiopian patients with human immunodeficiency virus (HIV) infection. 236 37

Eleven patients with non-Hodgkin's lymphoma and three patients with Hodgkin's disease were observed among 876 anti-HIV-positive subjects attending the AIDS clinic at the University Hospital, Zurich, Switzerland. Compared to the general population this represents a 50-fold (95% confidence limits: 25-90) increased risk of non-Hodgkin's lymphoma and an 11.4-fold (2.3-33) increased risk for Hodgkin's disease in anti-HIV-positive men. High malignancy, advanced stage of disease at the time of diagnosis, and extranodal localization are characteristic of non-Hodgkin's lymphoma in AIDS patients, which carries a poor prognosis. However, remissions and prolonged disease-free survival are possible in individual cases. Only one opportunistic infection was observed during 92 months of treatment and observation using a mild chemotherapeutic regimen (m-BACOD). Less myelosuppressive chemotherapeutic schedules appear to be more beneficial than aggressive regimens in anti-HIV-positive patients due to the lower incidence of opportunistic infections.
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PMID:[Malignant lymphomas in HIV-infected patients]. 246 Sep 19


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