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

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

Infectious molecular clones of the human immunodeficiency virus type 2 (HIV-2) will be valuable tools for the study of regulatory gene functions and the development of an animal model for the human acquired immunodeficiency syndrome (AIDS). To this end, we have cloned and sequenced a novel HIV-2 isolate, HIV-2BEN. One clone, designated MK6, is infectious for various human T-cell lines and for human and macaque peripheral blood lymphocytes (PBL), allowing molecular studies of HIV-2 infection and replication. Since MK6 is highly cytopathic in MT-2 and Molt-4 clone 8 cells, antiviral agents and neutralizing sera may be tested. Cluster analysis of HIV-1, HIV-2, and simian immunodeficiency virus (SIV) env and gag genes revealed that HIV-2BEN yielded the earliest node of phylogenetic divergence for all reported HIV-2 sequences. Noise analysis showed that, with the current data, no specification of any branching order can be made among the four groups of primate lentiviruses, HIV-1, HIV-2/SIVSMM/MAC, SIVAGM, and SIVMND.
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PMID:A novel proviral clone of HIV-2: biological and phylogenetic relationship to other primate immunodeficiency viruses. 235 57

A survey of skeletal muscle pathology in 92 autopsied cases of AIDS revealed microscopic alterations in 64 cases. There were 40 cases of disuse atrophy, 8 of denervation atrophy, 2 of cryptococcal myositis, 1 of Mycobacterium avium intracellulare (MAI) infection and 2 of necrotizing myopathy associated with hyperkalemia. A second group of cases with changes of unknown etiology was found. These were tentatively ascribed to the direct or indirect action of HIV. This category includes 8 cases of inflammatory myopathy, 8 of necrotizing myopathy in absence of a known etiological factor, 3 of extreme atrophy and 4 of "regenerating" myopathy.
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PMID:Skeletal muscle pathology in AIDS: an autopsy study. 236 23

Twenty-one major abdominal operations performed on 20 patients with Acquired Immunodeficiency Syndrome (AIDS) were reviewed. Fourteen operations were for therapeutic indications, eight were emergent. The array of pathology encountered included opportunistic infection with Mycobacterium avium intracellulare, Cytomegalovirus, Cryptosporidium, abdominal tuberculosis, lymphoma, Kaposi's sarcoma, AIDS-related immune thrombocytopenia, perforated appendicitis and colonic pseudo-obstruction. Hospital mortality was 20 per cent. Major morbidity occurred in 15 per cent of patients and was more common following emergency operations. Preoperative demographic, hematologic, or nutritional parameters examined or the presence of single-organ system dysfunction did not predict outcome. Fifty-three per cent of hospital survivors are alive with a nine-month median postoperative follow-up. It is concluded that major abdominal procedures in patients with AIDS should not be withheld due to fear of excessive morbidity or mortality. General surgeons are involved in the evaluation and treatment of increasing numbers of patients with HIV infection. Appropriate management requires recognition of a wide range of surgical pathology and attention to details of safe intraoperative conduct.
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PMID:Major abdominal operations in acquired immunodeficiency syndrome. 236 89

Because of the abnormalities of host defenses caused by the human immunodeficiency virus (HIV), persons with HIV infection are vulnerable to tuberculosis. Inferential data from several parts of the country indicate increases in tuberculosis case rates, probably occurring in patients with HIV infection. In a person infected with both HIV and Mycobacterium tuberculosis, attack rates of tuberculosis seem to be very high. In general, the disease tends to occur earlier in the course of HIV infection than other opportunistic processes that serve to define the acquired immunodeficiency syndrome (AIDS), presumably because M tuberculosis is more pathogenic than Pneumocystis carinii or Mycobacterium avium complex, for example. The clinical features of tuberculosis in this patient population seem to vary depending on the stage of the HIV infection. Late in the process, tuberculosis usually has atypical features with chest films showing diffuse infiltration, no cavities, and intrathoracic adenopathy. Tuberculin skin tests commonly are negative. At earlier stages of HIV infection, the clinical findings are similar to those in HIV-seronegative persons. Response to treatment is generally good; however, it is recommended that the standard duration be at least 9 months, using isoniazid and rifampin usually supplemented by pyrazinamide in the first 2 months. The use of isoniazid for preventive therapy is recommended for all HIV-seropositive persons who have tuberculin skin test reactions greater than or equal to 5 minutes. Those implementing infection-control measures for HIV-infected patients who have pulmonary findings should take tuberculosis into account until the disease is excluded. Medical personnel providing care for patients with tuberculosis should use universal blood and body substance precautions because of the possibility of undetected HIV infection in patients with tuberculosis.
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PMID:Tuberculosis and human immunodeficiency virus infection. 266 35

Between January 1981 and December 1986, 4,178 patients were cultured for mycobacteria at a community teaching hospital in Hartford. The number of patients with positive cultures totaled 278 (6.65%). Mycobacterium other than tuberculosis (MOTT) was isolated from 228 (82%). MOTT isolation increased yearly from 1.5% of the patients in 1981 to 14.5% of the patients in 1986. Mycobacterium avium intracellulare (MAI) was the most common MOTT species isolated (197/228). Fifty-nine patients were under the age of 50, but 23 had predisposing factors for MOTT. Of the 36 who did not have an underlying condition, 25 had the human immunodeficiency virus (HIV). The isolation of MAI preceded the diagnosis of AIDS/ARC in nine patients, in 10 others it coincided with their diagnosis and in six it followed the diagnosis. Isolation of MAI in a patient under the age of 50 with no predisposing factors may suggest concommitant HIV disease.
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PMID:Mycobacterium avium intracellulare as a marker of human immunodeficiency virus disease. 275 31

In a 3 year period from the beginning of January 1985 to the end of December 1987, 474 biopsies obtained from 266 patients with serological evidence of human immunodeficiency virus infection were examined. Most frequent were skin biopsies of which 52% showed Kaposi's sarcoma, and transbronchial lung biopsies of which 40% showed Pneumocystis carinii pneumonia. Other opportunistic infections were much less common; Mycobacterium avium intracellulare was found in six biopsies and Cytomegalovirus in three. Non-Hodgkin's lymphoma was diagnosed in six patients.
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PMID:Biopsy pathology of HIV infection: experience at St Stephen's Hospital, London. 278 82

We compared the clinical features of disease due to tuberculosis and to Mycobacterium avium complex (MAC) in 94 patients with human immunodeficiency virus infection. Tuberculosis preceded the diagnosis of acquired immunodeficiency syndrome in 26 (67%) of 39 cases, compared with none of 55 with MAC infection. Chest roentgenographic findings suggested mycobacterial infection in 24 (83%) of 29 patients with pulmonary tuberculosis, compared with 7 (25%) of 28 with MAC infection. Sputum smears revealed acid-fast bacilli in 19 (83%) of 23 patients with pulmonary tuberculosis, but only 4 (16%) of 25 cases of pulmonary MAC infection. In 39 patients with tuberculosis, lymphadenitis and pleuritis were present in 13 (33%) and 8 (20%), respectively, but occurrence was rare in patients with MAC infection. In contrast, mycobacteremia was more frequent in MAC infection, occurring in 47 (85%) of 55 cases. In 5 patients, tuberculosis was unsuspected and probably contributed to death. These findings suggest that clinical features often distinguish tuberculosis from MAC infection in patients with human immunodeficiency virus infection. In addition, more intensive diagnostic use of sputum acid-fast smears may improve the outcome in patients with tuberculosis.
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PMID:Mycobacterial disease in patients with human immunodeficiency virus infection. 280 87

To establish the indications for splenectomy in patients with human immunodeficiency virus (HIV) infection we retrospectively analyzed 12 patients who underwent splenectomy. Patients with HIV infection who had immune thrombocytopenic purpura (ITP) were excluded as they had no splenomegaly and a definite indication for splenectomy exists in some of these patients. All 12 patients were anemic; 6 were thrombocytopenic and 6 leukopenic. All patients had splenomegaly and all were febrile. At surgery 3 patients were found to have Mycobacterium avium intracellulare (MAI) infection; 2 had splenic abscess due to Salmonella group D; 1 each had cytomegalovirus (CMV) splenitis and localized Kaposi's sarcoma (KS) of the spleen. No definite histopathologic diagnosis could be made in five patients, all of whom had evidence of extramedullary hematopoiesis. The degree of splenic enlargement did not correlate with the outcome. Both clinical and hematologic improvements were achieved in patients with splenic abscess and in patients who had splenomegaly, anemia, and thrombocytopenia. The presence of either of these findings constitutes an indication for splenectomy. Anemia and/or leukopenia without thrombocytopenia failed to improve; the presence of MAI and active CMV infection also resulted in failure. The presence of either of these conditions may be considered a contraindication to splenectomy.
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PMID:Splenectomy in patients with AIDS. 281 11

Mycobacterial infections were confirmed in 629 HIV-infected persons (1.4%). Five patients had a generalized infection with Mycobacterium avium complex (MAC), four an extrapulmonary tuberculosis caused by Mycobacterium tuberculosis (M. tbc). In general, the tuberculosis was the first severe opportunistic infection, while infections with MAC were more frequent in patients with already manifest AIDS. Common to all patients were a septic temperature and definite shift to the left of neutrophil granulocytes. Four of five patients with MAC also had diarrhoea, and three of four with tuberculosis additionally had peripheral lymphomas. The chest x-ray films were normal in six of the nine patients. The diagnosis was made in six patients primarily by the microscopic demonstration of acid-fast bacteria in lymph node tissue or stool, in three patients by culture from blood or liver tissue. Microscopic stool examination was helpful: in three of five patients with MAC and one of two with M. tbc in the stool culture, acid-fast bacteria had already been demonstrated. In an individual case MAC infections could not be distinguished either clinically or morphologically from infections with M. tbc, but only by culture.
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PMID:[Mycobacterioses in patients with HIV infection]. 313 Feb 41


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