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

Insulin resistance is more often seen in hepatitis C than in other liver diseases, including non-alcoholic steatohepatitis. The Homeostasis Model for Assessment [HOMA= fasting insulin (mUI/ml) * fasting glucose (mmol/L) / 22.5] has proved useful in the measurement of insulin sensitivity in euglycemic patients. Cross-sectional and case-cohort studies support a role for hepatitis C as a factor implied in the development of type-2 diabetes in high-risk patients (male patients, older than 40 years, and overweight). In transgenic mice models the HCV core protein has been found to induce insulin resistance via TNF production. Insulin resistance has been associated with steatosis development and fibrosis progression in a genotype-dependent manner. In genotype-1 patients, the mechanisms by which insulin resistance promotes fibrosis progression include: a) steatosis; b) hyperleptinemia; c) increased TNF production; and d) impaired expression of PPARg receptors. Indeed, insulin resistance has been found as a common denominator to the majority of features associated with difficult-to-treat patients. Patients with cirrhosis, obesity, coinfected with HIV, and Afro-American, all of them showed insulin resistance. Insulin resistance strongly influences sustained response rates, at least in genotype-1 patients. Insulin resistance decreases during and after treatment in patients that achieved virus C clearance. Moreover, the incidence of type-2 diabetes seems to be lower in responders than in non-responders. In summary, hepatitis C promotes insulin resistance and insulin resistance induces steatosis, fibrosis, and interferon resistance. The treatment of insulin resistance by decreasing hyperinsulinemia could improve sustained response rates in patients with chronic hepatitis C treated with peginterferon plus ribavirin.
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PMID:Hepatitis C and insulin resistance: steatosis, fibrosis and non-response. 1704 97

Interleukin (IL)-18 is a proinflammatory cytokine that plays an important role in both innate and adaptive immune responses against viruses and intracellular pathogens. Increased levels of circulating IL-18 from HIV-1 infected patients have been reported especially in the advanced and late stages of the disease, whereas in the initial stage serum levels of IL-18 were not increased. In contrast, low production of Il-18 was observed in vitro from peripheral blood mononuclear cells (PBMC) of HIV-1 infected patients, and these results were also observed in macaques infected with simian immunodeficiency virus (SIV). In addition, decreased IL-18 production from PBMC was significantly correlated with low production of IL-2. Furthermore, serum levels of IL-18 significantly decreased after highly active antiretroviral therapy. During the early stage of HIV-1 infection there is a decreased production of gamma interferon (IFN), IL-12 and IL-2 as well as not activation of IL-18 production and this leads to inhibition of Th1 immune response, whereas in the advanced stage of the disease, strong activation of IL-18 production along with persistent decreased production of gamma IFN, IL-12 and IL-2 may promote a Th2 immune response, which leads to persistent viral replication. Several studies have shown increased levels of IL-18 in HIV-seronegative subjects with obesity, insulin resistance and type II diabetes. Metabolic disorders, fat redistribution and cardiovascular manifestations are becoming more frequent in HIV-1 infected patients treated with antiretroviral drugs. Consequently, involvement of IL-18 in these disorders has been postulated and demonstrated in patients with lipodistrophy, or with hypertriglyceridemia. Finally, higher serum levels of IL-18 may represent an useful marker in HIV-1 infected patients with metabolic disorders and fat redistribution, as well as a sensitive predictor of cardiovascular complications in treated patients.
Curr HIV Res 2006 Oct
PMID:Interleukin-18: a proinflammatory cytokine in HIV-1 infection. 1707 17

We performed a cross-sectional analysis of factors associated with negative body image among 550 older men with or at-risk for HIV infection, including demographics, depression, illicit drug use, and antiretroviral therapy adherence. Overall, 31 per cent of participants reported negative body image, which was independently associated with increased BMI, self-rated fair/poor health, depression, and erectile dysfunction, but not HIV status. Screening for and treating depression, sexual dysfunction, and obesity in older men should be considered.
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PMID:Body image in older men with or at-risk for HIV infection. 1736 4

Growth during infancy is slightly lower among breastfed infants, but the difference seems to disappear later during childhood. Breastfeeding seems to have a beneficial effect on blood pressure, lipid profile and possible insulin resistance/type-2 diabetes and obesity, but there is no evidence for effects on clinical manifestations of cardiovascular diseases. Potential negative effects include transfer of environmental pollutants and viruses, especially HIV, and the risk of hypernatraemic dehydration during the first weeks after delivery. For the mother, breastfeeding seems to reduce the risk of developing breast cancer.
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PMID:[The effects of breastfeeding II: effects on lifestyle illnesses, mother's health and negative effects]. 1737 29

Metabolic and immune systems are very important for a living organism to survive. Since they play crucial roles in maintaining homeostasis, both systems work interdependently. In metabolic disorders like obesity and related diseases, lot of reports have been published about immune system impairment. In addition, in the case of malnutrition and calorie restriction, immune system is affected through several mechanisms. Different from the current point of view, I propose an unusual way of thinking about the relationship between immune and metabolic systems. The nutrient-based ecosystemic balance; the simple desires and rules like feeding or reproduction underlying very complex relations among species; the beneficial effects of caloric restriction; and the similarities between the pathways contributing obesity and infection made me look from a different perspective. Based on ecology and systems thinking, the present hypotheses suggest that pathologic organisms could be a kind of dietary source for lymphoid cells. If it is true, it will bring new and hopeful insights to all events related to metabolic and immune systems. At first, new mechanisms could be improved to defeat unbeatable organisms like Mycobacterium tuberculosis or HIV. The unphagocytosed organisms could be unknown tastes for our body's defenders. For example, the lymphoid cells could be classified as virovores, bacterivores, or fungivores like herbivores, and carnivores. Secondly, this basic relation could be used to solve huge problems caused by obesity related disorders like diabetes, because insulin would play more important roles for lymphoid cells while regulating the blood glucose level if the hypothesis is true. And the persistence of hyperglycemia would mainly effect lymphoid cells according to the current hypothesis.
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PMID:Could pathogens be nutrients for lymphoid cells? 1744 12

Patterns of future urban growth, combined with advances in the treatment of traditional scourges of communicable diseases, will cause a shift in the burden of disease toward category 2 (noncommunicable) and 3 (injury) conditions over the next 30 years. Communicable diseases, particularly HIV/AIDs, will continue to be the most important killers among the poor. However, new risks will emerge for several reasons. First, the marked sprawl of cities in the developing world will make access to care more difficult. Second, increasing motor vehicles and the likelihood of inadequate infrastructure will make air pollution and accidents in road traffic more common than in the past. Third, impoverished urban populations have already shown a propensity toward undernourishment, and its obverse, obesity, is already emerging as a major risk. Also, the large projected increase in slums suggests that violence and homicide will become a more important burden of health, and very large hazards will be created by fire-prone, insubstantial dwellings that will house nearly two billion people by 2030. In addition, decentralized governance will exacerbate the tensions and discontinuities that have plagued the management of health issues on the urban fringe over the past decade. Accordingly, public health agencies will need to adjust to the regional and country-specific factors to address the changing profile of risk. This analysis suggests that four factors--levels of poverty, speed of city growth, sprawl in cities, and degree of decentralization--will have importance in shaping health strategies. These factors vary in pace and intensity by region, suggesting that health care strategies for Category II and III conditions will need to be differentiated by region of the world. Also, interventions will have to rely increasingly on actors outside the ranks of public health specialists.
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PMID:Emerging disease burdens and the poor in cities of the developing world. 1745 49

Chronic medical conditions can complicate maternal and fetal health during pregnancy, making unintended or mistimed pregnancy problematic. The use of highly effective reversible contraceptives is important for women with health issues, yet sometimes those same illnesses make the contraceptives themselves less effective or less safe. We review the evidence surrounding contraceptive use by women with six common medical conditions: systemic lupus erythematosus, diabetes mellitus, anticonvulsant use for epilepsy or mood disorder, HIV infection, migraine headache, and obesity. In some instances it is not possible to make a risk-free contraceptive choice, yet pregnancy may be even riskier. Good clinical judgment and patient counseling must be exercised.
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PMID:Contraception for women with chronic medical conditions. 1747 68

Obesity is common in women and is associated with a number of adverse health outcomes including cardiovascular disease, infectious diseases, and cancer. We explore the relationship between obesity and immune cell counts in women in a longitudinal study of 322 women from 1999 through 2003 enrolled as HIV-negative comparators in the Women's Interagency HIV Study. Body mass index (BMI, kg/m(2)) was categorized as normal weight (BMI 18.5-24.9), overweight (BMI 25-29.9), obese (BMI 30-34.9), and morbidly obese (BMI >/=35). CD4 and CD8 counts and percents and total lymphocyte and white blood cell (WBC) counts were measured annually using standardized techniques. A mixed model repeated measures analysis was performed using an autoregressive correlation matrix. At the index visit, 61% of women were African American; mean age was 35 years, and median BMI was 29 kg/m(2). Immunologic parameters were in the reference range (median CD4 count, 995 cells/mm(3); CD8 count, 488 cells/mm(3); total lymphocyte count, 206 cells/mm(3); median WBC, 6 x 10(3) cells/mm(3)). In multivariate analyses, being overweight, obese, or morbidly obese were independently associated with higher CD4, total lymphocyte, and WBC counts than being normal weight; morbid obesity was associated with a higher CD8 count. The strongest associations between body weight and immune cell counts were demonstrated in the morbidly obese. Increasing body weight is associated with higher CD4, CD8, total lymphocyte, and WBC counts in women. Investigation into the impact of obesity on immune function and long-term adverse outcomes is needed.
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PMID:Obesity and immune cell counts in women. 1757 Feb 64

Lipodystrophy is a common alteration in HIV 1-infected patients under anti-retroviral treatment. This syndrome is usually associated with peripheral lipoatrophy, central adiposity and, in some cases, lipomatosis, as well as systemic insulin resistance and hyperlipidemia. Research on the ethiopathogenesis of the disease revealed novel aspects of adipose tissue biology highly relevant to obesity research: the pivotal role of mitochondria in white adipose tissue function, the role that interference with master transcription factors of adipogenesis may have in human adipose tissue, the capacity of human white adipose tissue to acquire brown fat-like features, as well as the importance of apoptosis and the potential impact of viral infections in adipose tissue. The dramatic difference between subcutaneous adipose depots, prone to lipoatrophy, and the visceral adipose depots, prone to enlargement, has been further evidenced in the study of the lipodystrophy syndrome. The recognition of a local pro-inflammatory environment in lipoatrophic adipose tissue from affected patients, including macrophage infiltration and enhanced expression of chemokines and cytokines, points to events paradoxically similar to those in the hypertrophied adipose tissue in obesity. However, this also potentially provides an explanation for the existence of systemic alterations common to lipodystrophy and obese patients and reminiscent of the metabolic syndrome.
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PMID:Lipodystrophy in HIV 1-infected patients: lessons for obesity research. 1765 62

The mission of the W. Montague Cobb/NMA Health Institute, which was founded in December 2004, is to study and provide solutions for the elimination of health disparities affecting African Americans as well as other underserved populations. The vision of the Cobb Institute is to become the repository of information regarding the health of African Americans, with holdings in statistics, solutions to health disparities, and best practices to prove the efficacy of these solutions. The major diseases on which the Cobb Institute is particularly focused include heart disease, diabetes, obesity, asthma, HIV/AIDS, and cancer (prostate, breast, colorectal). The scientific sections of the National Medical Association form the basis of the research capabilities of the Cobb Institute. Clinical trials performed by these research physicians and their institutions will provide cutting-edge data for the Cobb Institute to review, validate, and publicize in scientific journals and other communication vehicles.
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PMID:Cobb Institute strategies for the elimination of health disparities. 1776 93


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