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

The effects of human interferon-alpha (IFN-alpha) on the release of an antimicrobial interleukin, interleukin-8 (IL-8), from human immunodeficiency virus type 1 (HIV-1)-infected myelomonocytic cell line, U937, were studied in vitro to evaluate the potential of IFN-alpha in the management of acquired immunodeficiency syndrome (AIDS)-associated opportunistic diseases. The latently HIV-1-infected U937 cells (U937/HIV-1(L)) showed a marked reduction of IL-8 secretion as compared to uninfected U937 cells, whereas IL-8 release from productively HIV-1-infected U937 cells was comparable to uninfected cells. The IFN-alpha recovered partially the reduced IL-8 level from U937/HIV-1(L) cells in a dose-dependent manner. Any significant inhibition of IFN-alpha-augmented IL-8 secrement by anti-IL-1 antibody was not observed, suggesting that the enhanced IL-8 secretion occurred without augmenting IL-1 production. The IFN-alpha-augmented IL-8 secretion from latently HIV-1-infected U937 cells may suggest a beneficial potential of IFN-alpha in a treatment of bacterial or fungal infection frequently seen in patients with progressive stages of HIV-1 infection.
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PMID:Effects of interferon-alpha on a reduced release of interleukin-8 from latently HIV-1-infected monocytic cell line U937 cells. 793 Jul 59

A case of cutaneous cryptococcosis in a HIV-positive 46-year-old farmer is presented. The situation could be cured by applying itraconazole 400 mg day-1 for 45 days.
Mycoses
PMID:Cutaneous cryptococcosis in AIDS: successful treatment with itraconazole. 793 78

A 29-year-old female suffering from full-blown AIDS received fluconazole 400 mg day-1 for a long period for treatment of oral candidosis, pseudomembranous type. She had previously received this drug repeatedly for the same reason, yet manifest disease persisted. She was therefore put on parenteral amphotericin B, which led to clinical, but not mycological, cure in the short term. IC30 testing revealed a minimum inhibitory concentration (MIC) > 128 micrograms ml-1 for fluconazole. The isolate, however, was susceptible in vitro to ketoconazole, itraconazole and amphotericin B. The same antimicrobial susceptibility pattern was found with a second isolate obtained later. Resistance to fluconazole might become a major problem in HIV-infected patients receiving this drug for long periods.
Mycoses
PMID:Fluconazole-resistant oral candidosis in a repeatedly treated female AIDS patient. 793 90

Severe fungal infections have become increasingly common over the past 10 years, largely due to the greater number of immunocompromised patients, such as those infected with HIV and those undergoing immunosuppressive therapy for malignancies. Between 60% and 80% of people with AIDS, for example, develop at least one fungal infection. Other predisposing factors for these infections include mechanical defects such as indwelling catheters, surgery, and burns. Candidiasis, aspergillosis, cryptococcoses, coccidioidomycosis, and histoplasmosis are among the fungal infections most commonly encountered in the clinical setting. Diagnosis is often elusive and treatment difficult. Amphotericin B has been the standard therapy for most life-threatening fungal infections for almost three decades but has significant drawbacks, including severe adverse reactions. Other systemic antifungal agents have proved useful in certain situations. Fluconazole, a new broad-spectrum agent, has shown particular promise in the treatment of candidiasis and cryptococcal meningitis.
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PMID:Fungal infections associated with malignancies, treatments, and AIDS. 795 89

Cutaneous fungal infections are a major source of morbidity in HIV-infected patients, and their management poses special challenges. Superficial mycoses, such as tinea pedis, tinea cruris, tinea corporis, and onychomycosis, are no more common in HIV-infected patients than in the HIV-negative population but are of greater severity. Although they respond to topical and systemic antifungal agents, HIV-positive patients are predisposed to frequent recurrences. Unusual types of fungal infections such as Majocchi's granuloma are more likely to develop in HIV-infected patients and respond best to systemic antifungal therapy with imidazoles or triazoles. Infections with Candida albicans develop in virtually all HIV-positive patients. Although mucosal involvement is the most common, patients may also develop superficial cutaneous infections. Topical agents are frequently all that is necessary, but in some, oral medications are required. Although fluconazole is effective, an appreciable number of isolates are resistant. Patients with pityriasis versicolor and seborrheic dermatitis, in which Pityrosporum species are thought to be involved, respond well to short courses of oral ketoconazole. Milder forms of seborrheic dermatitis can also be treated with low-potency topical steroids or topical ketoconazole. The oral triazole fluconazole is not particularly effective in the management of seborrheic dermatitis. Although the cause of eosinophilic pustular folliculitis, a common disorder in immunosuppressed HIV-positive patients, is unknown, some can be cured with high doses of itraconazole, suggesting that fungi are important in the pathogenesis of the disease in some patients.
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PMID:Management of common superficial fungal infections in patients with AIDS. 807 10

Chronic laryngitis in patients with acquired immunodeficiency syndrome may be due to infections or tumors, such as Kaposi's sarcoma and non-Hodgkin's lymphoma. We present what we believe to be the first proven case of herpes simplex virus chronic laryngitis in a man positive for human immunodeficiency virus. Direct laryngoscopy showed leukoplakic lesions on both vocal cords. Biopsy of the lesions showed squamous epithelial cells with the characteristic features of herpes simplex virus, which was confirmed by immunohistochemical stains. We discuss the differential diagnosis of chronic laryngitis in a human immunodeficiency virus infection. Herpes simplex viral infection of the vocal cords should be considered in patients with acquired immunodeficiency syndrome presenting with chronic hoarseness and leukoplakic lesions on direct laryngoscopy, especially with no evidence of Kaposi's sarcoma, tumor, or cytomegaloviral or fungal infection elsewhere. Treatment should be acyclovir, except in the face of acyclovir resistance.
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PMID:Herpes simplex chronic laryngitis and vocal cord lesions in a patient with acquired immunodeficiency syndrome. 808 35

Skin scrapings from the toe clefts, soles and nail plates of 138 HIV-infected patients at various stages were examined for the presence of dermatophytes using both microscopy and culture. Dermatophytes, in particular Trichophyton rubrum, could be grown in 58 cases (42%). Although cultures were more often positive in late stages of disease, there was no close correlation with the clinical stage or the T4/T8 ratio. Susceptibility to itraconazole, but not to other antimycotics, was correlated with the immune status (P < 0.05). Pedal dermatophyte infection does not seem to be a major problem in HIV infection.
Mycoses
PMID:Dermatophytes on the feet of HIV-infected patients: frequency, species distribution, localization and antimicrobial susceptibility. 811 7

Far and away the most common fungal infection associated with HIV infection is candidiasis. This tends to produce mucosal topical infections and local treatment may be enough to control them. Generally we prefer courses of 1-2 weeks rather than chronic suppression, for fear of eliciting overgrowth of resistant isolates. Fluconazole resistant Candida species may be an increasing problem over the next decade. For cryptococcoses the problem is both simpler and more complicated. Fluconazole is highly effective for chronic suppression, but not very effective for initial therapy. Here a short course of amphotericin B, just 2 weeks in length, is followed by chronic azole suppression. Fluconazole appears excellent, but itraconazole may also be effective. For histoplasmosis itraconazole appears to be the most advantageous drug, with excellent clinical response within 2 weeks. A role for fluconazole is unclear. Coccidioidomycosis is uncommon, but difficult. I cannot offer any suggestions on "ideal" therapy here. Other diseases, such as aspergillosis, are extremely uncommon but still are AIDS associated mycoses. It is my personal fear that as we go along identifying the AIDS virus and its complications, aspergillosis and zygomycosis may establish themselves as the future "black hats" for which we will need to pull something out of the "box". What to pull is not very clear.
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PMID:Treatment of systemic mycoses in patients with AIDS. 811 65

After some general epidemiological data concerning mycoses occurring during the acquired immunodeficiency syndrome (AIDS), the role of the pathologist in the diagnosis of mycotic diseases is reviewed. Histological methods and criteria allowing fungal identification in tissues are described. Changes in the inflammatory reaction in contact with mycoses arising in these immunodeficient hosts are reported. The various mycoses observed in HIV positive patients are then reviewed as well as their morphological features and their various sites.
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PMID:[Histological aspects of mycotic infections in acquired immunodeficiency syndrome (AIDS)]. 813 80

The severe immunosuppression associated with HIV infection increases susceptibility to opportunistic fungi. We describe a primary gangrenous cutaneous infection caused by Rhizopus arrhizus in an HIV-infected intravenous narcotic user. In addition, we review nine reported cases of zygomycosis in HIV-infected patients and discuss the frequency and outcome of zygomycosis in HIV infection. Eight of 10 patients were intravenous drug users. Cutaneous infection occurred in four patients. Another case was associated with drug-induced neutropenia. With treatment, 60% of the patients recovered. HIV-induced immunosuppression rarely predisposes to zygomycosis except in intravenous drug users or persons with other risk factors for this fungal infection.
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PMID:Zygomycosis and HIV infection. 816 72


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