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

Toxoplasmic encephalitis was observed early in the acquired immunodeficiency syndrome (AIDS) epidemic and has now been recognized as the major cause of opportunistic infection of the central nervous system after human immunodeficiency virus infection. This complication of AIDS usually represents a reactivation of latent infection. At present, the definitive diagnosis can be made only by demonstrating the protozoan causal agent, Toxoplasma gondii, in brain tissue. Pyrimethamine and sulfadiazine are effective treatments. Nurses are challenged to understand this neurological manifestation of AIDS. Since therapy is life-long, patient education is important in addressing discharge planning concerns and return-to-community issues.
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PMID:Toxoplasmic encephalitis in the AIDS patient. 153 8

This paper deals with the management of pregnant women with HIV infection. The virus is transmitted by the mother to 20-30 percent of the infants, and therapeutic abortion should be offered to women whose pregnancy does not exceed 26 weeks of amenorrhoea. If pregnancy is pursued, the mother must be investigated for sexually transmitted diseases which are particularly frequent in this population and may have repercussions on the newborn. Pneumocystis carinii pneumonia is the most common opportunistic infection in pregnancy. In case of T4-cell depletion chemotherapy with pentamidine must be instituted. Hygienic and dietetic measures should be applied to avoid listeriosis and toxoplasmosis. Serological tests for toxoplasmosis are necessary in all HIV patients, with chemoprophylaxis in case of increased IgG levels. Thrombocytopenia usually responds to human immunoglobulins. At delivery, there is no need to modify the usual obstetrical procedures. During the post-partum period, another pregnancy must be avoided by good compliance with a reliable contraceptive method. As for the preventive treatment of mother-to-child HIV transmission, at the moment only AZT can be considered, but its effectiveness remains to be evaluated in therapeutic trials.
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PMID:[Pregnancy in HIV infected women. Current therapeutic indications]. 153 74

Rhodococcus (Corynebacterium) equi is a well-known Gram positive bacillus which is usually pathogenic in farm animals but rarely causes diseases in humans. Only 30 cases of human infection have been reported in the literature. R. equi has recently been added to the list of opportunistic agents in severe HIV infection. Its most common manifestation in immunocompromised is a slowly progressive pneumonia which may cavitate. R. equi pulmonary infections are difficult to treat: they usually require prolonged parenteral antibiotic therapy and often need surgical treatment. Two cases of cavitary pneumonia in patients with severe HIV infection are reported here. In one case the disease was associated with pulmonary Kaposi sarcoma and pneumocystis pneumonia; the other case was the first opportunistic infection in the course of HIV infection.
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PMID:[Lung abscess caused by Rhodococcus (Corynebacterium) equi in HIV infection. Two cases]. 153 35

A cross-sectional study was undertaken to determine the prevalence of Mycoplasma fermentans infection in patients with human immunodeficiency virus (HIV) infection using polymerase chain reaction methodology. Targeted M. fermentans DNA sequences could be amplified from the DNA extracted from the blood of 6 (11%) of 55 HIV-seropositive patients but from none of 26 HIV-seronegative subjects at low risk for HIV infection (P = .17). There was no correlation between M. fermentans infection and HIV clinical stage. There was a nonsignificant trend toward an association between M. fermentans infection and a history of syphilis. Infection with M. fermentans may occur more commonly in HIV-infected patients; however, a role as a copathogen or opportunistic infection was not established in this study.
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PMID:Association of mycoplasma and human immunodeficiency virus infection: detection of amplified Mycoplasma fermentans DNA in blood. 153 64

Since 1982, voluntary anonymous reports that meet the criteria of the WHO/CDC-AIDS definition are being collected by the Federal Health Office. By December 31st, 1989 a total of 4,306 AIDS cases has been registered. More than 80% of the reported cases are homo- and bisexual men and injection drug-users. The remaining cases are divided between hemophiliacs, persons who get infected by heterosexual contacts, blood transfusion recipients, and children infected pre- or perinatally. In 16% of all cases AIDS was diagnosed only on the basis of a Kaposi's sarcoma (KS) and in another 6% on the basis of KS and an opportunistic infection (OI). KS occurred mostly in homo- and bisexual men. The relative proportion of KS has steadily decreased from 30% up to 1986 to less than 20% in 1989. The overall incidence of KS decreased mainly due to the decrease of KS in homosexual men with AIDS. OI were diagnosed in 70% of the cases. Pneumocystis-carinii-pneumonia is most frequent (47%), followed by candida-oesophagitis (19%) and toxoplasmosis of brain in 9.5%. A malignant lymphoma was diagnosed in 3% of the cases. Furthermore, HIV-encephalopathy was seen in 2.8% and HIV-wasting-syndrome in 1.6% of cases. There is a different spectrum of diseases at the first manifestation of AIDS diagnosed in injecting drug-users. The reasons for this may be due to different life-style in this group.
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PMID:[AIDS in Germany: clinical manifestations of AIDS]. 154 64

Neuro-cryptococcosis is a common opportunistic infection in AIDS or HIV infected patients. From a series of 10 neuro-cryptococcosis the four of them studied by magnetic resonance (MR) are reported. In AIDS patients a high suspicion of opportunistic infection of the CNS is needed as exemplified by two of the four patients who only presented cephalalgia. The other two patients suffered additional symptoms and signs of meningeal and CNS involvement, such as nuchal rigidity, cranial nerve palsies, papilloedema, gait ataxia and dismetria. Diagnosis was achieved (confirmed) by a positive culture, serology or indian ink test in CSF. CT scan did not contribute to the diagnosis and management of the patients. In contrast MR, showed in three of them a peculiar pattern of small, confluent, high-signal lesions, roughly symmetrically placed in the basal ganglia and the internal capsule. They probably correspond to the dilated Virchow-Robin spaces through which torulae migrate from the subarachnoid space.
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PMID:[Use of magnetic resonance in the diagnosis of neuro-cryptococcosis in the acquired immunodeficiency syndrome: study of 4 patients]. 155 79

An increasing number of AIDS cases occur each year in West Virginia despite its small urban population. From January 1984 to March 1991 at the Marshall University based multispecialty internal medicine group (the University Physicians in Internal Medicine), 66 HIV-infected persons were treated, most of whom are native West Virginians and always resided in the state. The study group consisted of 61 men and 5 women; four-fifths of the men are homosexual/bisexual and one-seventh used intravenous illicit drugs. Four women acquired infection heterosexually and one from transfusion. Twenty-eight patients never had any opportunistic infection (OI) and 38 experienced at least one OI, usually Pneumocystis carinii Pneumonia. About two-fifths of patients had CD4 counts less than 200 cells/cmm at their initial examination. Three-fourths of patients received AZT, six ddI, and most aerosolized pentamidine. Nineteen patients have died, all of whom suffered at least one OI. The mean interval until death from HIV infection and from AIDS was about 27 and 11.5 months, respectively.
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PMID:Characteristics and outcome variables of HIV cases at a university-based medical practice. 155 6

A health practitioner took blood samples from 352 pregnant women who attended the antenatal clinic at either the University College Teaching Hospital or St. May's Catholic Hospital in Ibadan City, Nigeria to determine the prevalence of toxoplasma infection among these women. The practitioner also took 241 samples from both women and newborns just after delivery. The samples were flown to the Toxoplasma Reference Unit of the Public Health Laboratory in Swansea, Wales to be tested by the toxoplasma dye test (DT) and ELISA IgM method. The DTs showed that 78% of the Nigerian women had titres of =or1/16. Further 47% had titres of =or1/128. On the other hand, these corresponding figures for pregnant women in Swansea, Wales were only 22% and 3%. Yet only 1 DT titre positive sample among those from the Nigerian women tested positive using the ELISA IgM method. The infant of the women who had a detectable toxoplasma specific IgM exhibited polydactylism, a common congenital abnormality in Ibadan. The researchers suggested that reinfections or recrudescence may account for the high antibody levels. The inner area of Ibadan, where 98% of these pregnant women lived, was overcrowded with poor environmental sanitation conditions including considerable contamination of cat feces. This situation most likely explains the higher prevalence of toxoplasma infection among pregnant women in Ibadan than among those in Swansea, Wales. This high rate of chronic toxoplasmosis poses a considerable potential risk as HIV spreads in Africa since cerebral toxoplasmosis is an opportunistic infection of AIDS.
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PMID:The prevalence of Toxoplasma infection among pregnant women in Ibadan, Nigeria. 156 Apr 85

Primary prophylaxis against opportunistic infections is a capital advance in the management of HIV-infected patients. In cases with pneumocystosis prophylaxis is recommended when the number of T4 cells reaches 200/mm3 or 15 to 20% and constitutes a major incitation to apply for detection of seropositivity. It can be predicted that other prophylaxis of this type will be available for other main opportunistic infections whose proportion is increasing due to extension of the patient's life expectation (e.g. toxoplasmosis). Research in this field relies on new drugs, on the use of older drugs, and above all on experimental models providing a good preclinical evaluation. The development of combined prophylactic treatments against several opportunistic infections is a priority target. Maintenance treatments are systematically given after a first opportunistic infection.
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PMID:[Prophylaxis and maintenance treatments of opportunistic infections in adults]. 156

Although Pneumocystis carinii pneumonia (PCP) is the most common major opportunistic infection in the acquired immunodeficiency syndrome (AIDS), its immunopathogenesis is not fully understood. It is known that anti-pneumocystis antibodies are present in the sera of individuals with and without PCP. In order to determine whether anti-pneumocystis antibodies are also present in bronchoalveolar lavage fluid (BAL), we looked for them, by immunoreactivity with tissue sections of intra-alveolar P. carinii, in the BAL of (a) HIV-seropositive patients with PCP (n = 18); (b) HIV-seropositive patients without PCP (n = 11); and (c) HIV-seronegative patients with nonpneumocystis lung disease (n = 5). BALs from 19 of 29 HIV-seropositive patients were deficient in at least one isotype (13 with PCP, six without PCP), while only one of five HIV-seronegative patients was deficient. Despite the considerable documentation of atypical presentations of disease caused by P. carinii, little is known concerning the mechanisms involved. To determine whether there is any relationship between BAL anti-pneumocystis antibodies and diverse host responses, we studied antibody binding to P. carinii in different settings. IgG antibodies in BAL bound P. carinii within spleen, liver, skin, and muscle, as well as within pulmonary alveoli and granulomas. However, IgA antibodies in BAL bound intraalveolar and disseminated P. carinii but did not bind to P. carinii within pulmonary granulomas.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Detection of antibodies to Pneumocystis carinii in bronchoalveolar lavage fluid by immunoreactivity to Pneumocystis carinii within alveoli, granulomas, and disseminated sites. 157 87


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