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)

In February 1991, a 30-year old single, Chinese male, who had not has sexual intercourse with another man but did have it with a woman while in another country 12 months earlier, sought medical care at Tan Tock Seng Hospital in Singapore. He had a productive cough for 3 months, lost 5 kg over 4 months, and had been gasping for breath for 3 days. Upon admission, he had a low grade fever and breathed very rapidly while resting. The apical segment of the right lower lobe of the lung had a 3 x 2 cm cavity which was filling with exudate. A sputum smear did not indicate acid fast bacilli in 2 of 3 samples and blood cultures did not yield aerobic or anaerobic bacteria. The Western blot test revealed HIV antibodies. The absolute CD4 lymphocyte count stood at 80/cu mm compared with more than 500/cm mm in healthy individuals. Physicians used a bronchoscope to do bronchoalveolar lavage (BAL) and transbronchial lung biopsy (TBLB), both of which disclosed cysts of Pneumocystis carinii. Treatment first consisted of trimethoprim/sulfamethoxazole for 7 days and antituberculosis chemotherapy for 2 weeks until the physicians realized he had Pneumocystis carinii. They switched the treatment to iv pentamidine isethionate because he still had a fever after 7 days. This treatment was successful. Physicians then administered Zidovudine (AZT) and aerosolized pentamidine each month. As of mid-1992 he was still healthy. In addition to the BAL/TBLB results indicating Pneumocystis carinii and excluding tuberculosis, other features excluding tuberculosis were a Mantoux reading of O, absence of hilar and/or mediastinal lymphadenopathy, response to pentamidine isethionate, and sputum and blood cultures that did not indicate Mycobacterium species.
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PMID:A case of cavitating pneumonia in AIDS. 141 78

Lymphadenitis is a common extrapulmonary manifestation of mycobacterial disease in persons with human immunodeficiency virus (HIV) infection. We compared the clinical, mycobacterial, and diagnostic characteristics of mycobacterial adenitis in 11 HIV-seropositive and 29 HIV-seronegative patients. Ninety-three percent of the HIV-seronegative patients and 54% of the HIV-seropositive patients were foreign-born. In contrast to the HIV-seronegative patients, seropositive patients were more likely to be febrile and have negative purified protein derivative skin tests and abnormal chest roentgenograms. Sputum samples were rarely diagnostic in either group. Mycobacterium tuberculosis was the most commonly isolated organism in both groups, although United States-born patients with HIV infection were more likely to be infected with nontuberculous mycobacteria. In contrast to results for seronegative patients, fine-needle aspiration was usually diagnostic in the HIV-seropositive population, especially in those at risk for M. tuberculosis infection. Similarly, the rate at which smears were positive for acid-fast bacilli was significantly higher in the HIV-seropositive group, a circumstance suggesting a higher burden of organisms in this population. Finally, although preceding opportunistic infections were uncommon in the HIV-seropositive group, both tuberculous and nontuberculous adenitis were associated with advanced immunosuppression.
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PMID:Comparison of mycobacterial lymphadenitis among persons infected with human immunodeficiency virus and seronegative controls. 142 Jun 73

Chronic diarrhea and wasting are very common manifestations of AIDS in adults in developing countries. Etiologic studies show that protozoa (including Cryptosporidium parvum, Isospora belli, and Enterocytozoon bieniusi) and Mycobacterium avium-intracellulara are the most frequently identified pathogens. Limited data in children suggest that common enteric pathogens are equally as likely in HIV+ and HIV- babies. Preliminary analysis of an ongoing longitudinal study of 469 babies born to mothers with known HIV serostatus in Kinshasa, Zaire, reveals progression of acute to persistent diarrhea is six times greater in HIV+ compared to HIV- babies, and 3.5 times greater in HIV- babies born of HIV+ mothers in comparison to HIV- babies with HIV- mothers. HIV+ babies were also at greater risk than HIV- babies to have recurrent episodes of diarrhea (RR = 2.3). Fifty percent of the deaths were due to acute or persistent diarrhea, and were strongly associated with HIV infection. Efforts to improve child survival in AIDS infected populations will need to address HIV infections in both mothers and infants.
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PMID:Persistent diarrhea associated with AIDS. 142 40

Primary care physicians play an important role in identifying and treating bacterial infections in adults infected with the human immunodeficiency virus (HIV). Mycobacterium avium complex and Mycobacterium tuberculosis are pathogens that can cause systemic or local infection in these patients. We review the epidemiology, pathogenesis, clinical presentation, and principles of treatment for these two mycobacterial pathogens. Because M tuberculosis disease is preventable and curable and yet communicable, physicians should maintain a high degree of suspicion for tuberculosis in HIV-infected adults. In comparison, the goal of treating M avium complex in patients with advanced HIV disease is to reduce constitutional symptoms and improve survival.
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PMID:Mycobacterium avium complex and Mycobacterium tuberculosis in patients infected with the human immunodeficiency virus. 144 63

A retrospective study of drug resistance of Mycobacterium tuberculosis in patients simultaneously affected by tuberculosis (TB) and HIV was conducted in a Spanish university hospital. 39 of the 287 patients (13.6%) were also HIV seropositive. Mycobacterium tuberculosis with primary resistance to at least one of the major antitubercular drugs was isolated in 4 of the 39 (10.3%). The 4 patients (3 males, 1 female) demonstrating primary drug resistance were intravenous drug users aged 23-30 years. 3 were resistant to isoniazid, 1 to rifampin, 1 to streptomycin, and 1 to pyrazinamide. None was resistant to ethambutol. 2 were resistant to one drug and 2 were resistant to 2 drugs. Resistance to streptomycin in 1 patient may have been secondary to treatment with aminoglucosides for endocarditis. It is recommended that diagnostic suspicion of TB be maintained in management of HIV infected patients because of the possibility of drug resistance and of in-hospital transmission. Shortened or simplified treatment regimens should be avoided in seropositive patients.
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PMID:[Isolation of Mycobacterium tuberculosis with primary resistance to chemotherapeutic agents in patients with HIV infection]. 145 Feb 61

The marriage of two scourges, one old (mycobacterial disease) and one new (HIV), has presented an enormous challenge to the medical and public health communities, and has stirred renewed interest in mechanisms for immune control of mycobacterial infection. Virulence of both M. avium and M. tuberculosis appears to be inversely related to the capacity of the microorganisms to induce production of protective cytokines in infected hosts. TNF alpha and IFN gamma are central to this process, and mycobacterial polysaccharides may be their main determinant. Despite these similarities, M. tuberculosis and M. avium cause illnesses at the polar extremes of HIV disease. Tuberculosis, occurring early in the course of HIV disease, may promote HIV replication in otherwise latently infected cells via induction of cytokines. As such, the potential exists for accelerated progression to AIDS due to the mutual synergy of these pathogens.
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PMID:Macrophages, mycobacteria and HIV: the role of cytokines in determining mycobacterial virulence and regulating viral replication. 145 67

This study determines the prevalence of Mycobacterium tuberculosis (TB) infection and the incidence among HIV infected and uninfected women in urban Rwanda. The sample population includes 460 HIV-positive women and 998 HIV-negative women who were recruited from pediatric and prenatal care clinics at the Centre Hospitalier de Kigali. The sample is considered representative of childbearing women from the capital city. Initial interviews were conducted in 1988 and followed-up in 1990. HIV-1 diagnosis was determined on the basis of enzyme immunoassay and western blot tests or indirect immunofluorescence that showed reactivity to both a core protein and an envelope protein. A positive tuberculin test was defined as induration of 10 mm or more. Routine visits were made every 6 months. Comparisons were made between women who were HIV positive at their first HIV test (250 women), women who were negative at their first test but seroconverted between the first HIV test and the TB test 3 years later (80 women), and women who were HIV negative at the time of TB testing (687). 55% of HIV-negative women had positive tests with induration of more than 10 mm. 25% of HIV-positive women and 66% of HIV-negative women had TB tests with over 5 mm induration. 31% of HIV-positive women and 70% of HIV-negative women had induration of over 2 mm. 77% of women had TB vaccine scars. Prevalence of a positive test was significantly higher in the HIV-negative vaccinated group than in the nonvaccinated group. The proportion with low white cell counts, low lymphocyte counts, and high sedimentation rates was higher among HIV-positive women than HIV-negative women. During the 2-year follow-up period, 20 of the 401 HIV-positive women and 2 of the 917 HIV-negative women were diagnosed with TB. The risk ratio was 22.9. The incidence of TB was 3 times higher among women who had been infected with HIV at least 18 months than among women who had been infected less than 18 months. Low income and low body mass were associated with an increased risk of TB. 9 out of 17 HIV-infected women with TB had negative TB tests.
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PMID:Two-year incidence of tuberculosis in cohorts of HIV-infected and uninfected urban Rwandan women. 145 59

Optimum treatment of tuberculosis in persons with human immunodeficiency virus (HIV) infection is still being defined. Tuberculosis treatment failure in an HIV-infected patient is described and 10 similar cases from the medical literature are reviewed to search for common patterns associated with an adverse outcome of therapy in this setting. Six patients were poorly compliant. In nine patients, the subsequent episode of tuberculosis was disseminated or extrapulmonary; in four the central nervous system was involved. In five patients, a problem with rifampin usage was encountered: Three had rifampin-resistant Mycobacterium tuberculosis, one experienced an adverse reaction to rifampin, leading to withdrawal from the regimen after 1 week, and one was receiving a drug that may interfere with rifampin's antimycobacterial effect. This case report and literature review suggest that particular attention should be directed toward ensuring that patients with HIV infection comply with treatment of tuberculosis. For the majority of patients, the already stretched resources available for the treatment of tuberculosis and HIV infection should be devoted to compliance enhancement rather than to more prolonged or intensive drug regimens. However, it should be emphasized that patients with disseminated tuberculosis or central nervous system disease and those who are not able to receive rifampin because of drug resistance or an adverse reaction should be managed individually.
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PMID:Failure of therapy for tuberculosis in human immunodeficiency virus infection. 147 56

The effect of the human immunodeficiency virus (HIV) on mycobacterial antibody production was investigated. Using an enzyme-linked immunosorbent assay (ELISA) for detecting IgG against Mycobacterium tuberculosis PPD, it was observed that individuals at risk of HIV infection show a pattern of humoral response to the tubercle bacillus similar to that previously found in the immunocompetent population not exposed to risk factors: 6 of 12 (50.0%) tuberculosis cases had elevated levels of antibodies to PPD and 27 of 30 (90.0%) asymptomatic individuals had antibody levels within the normal range. In an HIV-seropositive group without AIDS indicator diseases, 8 of 22 (36.4%) tuberculous patients had detectable mycobacterial antibodies whereas 156 of 164 (95.1%) non-tuberculous subjects did not. Among AIDS cases, only 1 of 20 (5.0%) patients with tuberculosis and none of 53 non-tuberculous subjects showed a positive result. The study evidenced an increasing humoral unresponsiveness to PPD in the progression of HIV infection to AIDS. Thus, a serodiagnostic method for detecting tuberculosis such as the ELISA here employed noticeably decreases its utility in the latency stage of the HIV infection, and it is practically useless in clinical AIDS.
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PMID:Humoral response to Mycobacterium tuberculosis in patients with human immunodeficiency virus infection. 147 83

In the past 5 yr, an increased incidence of tuberculosis has been noted in the United States. Simultaneously, the population infected with human immunodeficiency virus-type I (HIV-I) and the number of cases of acquired immunodeficiency syndrome (AIDS) have increased. Selected areas of the United States have also reported increases in the frequency of drug-resistant isolates of Mycobacterium tuberculosis. Because our institution serves a population in which tuberculosis, AIDS, and drug resistant isolates of M. tuberculosis are frequently encountered, we sought to better define interrelationships among these factors by retrospectively reviewing the demographic, clinical, bacteriologic, and radiologic data for all adult patients in whom M. tuberculosis was isolated from a culture of respiratory-tract secretions during a 1-year period (June 1, 1988 to May 31, 1989). Two hundred forty-six patients were thus identified; 66.5% were U.S. born blacks, and 62.6% were 17 to 40 yr of age. Risk factors for HIV infection were present in 106 patients. The overall resistance rate (one or more drugs) = 30.9%, with primary resistance = 22.6% (35 of 155) and secondary resistance = 49.2% (29 of 59). In addition, 12 resistant isolates were found in 32 patients whose prior treatment status was indeterminate. Of the resistant isolates, 56.6% (43 of 76) were multiply resistant. Isoniazid resistance was noted in 90.7% (69 of 76) and rifampin resistance was noted in 50% (38 of 76) of the resistant isolates. No significant differences in the overall frequency of resistance were noted in patients at risk for HIV infection compared with those without these risks.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Drug-resistant tuberculosis in an urban population including patients at risk for human immunodeficiency virus infection. 843 Sep 76


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