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

We describe the clinical and histologic features of non-Hodgkin's lymphoma in 26 patients with human immunodeficiency virus 1 (HIV) infection. These represent 10 per cent of AIDS cases recorded in the Bordeaux area. Mean age was 42. Contamination was mostly related to homosexuality (50 per cent) and blood transfusion (27 per cent) with 5 female cases. The initial presentation of lymphoma was extranodal (69 per cent). Lymphoma spread was diffuse (65 per cent), involving the bone marrow (38 per cent), lymph nodes (35 per cent), central nervous system (27 per cent), oral and digestive mucosae (23 per cent), liver (19 per cent) and genital tract (12 per cent). Histologic types were of intermediate or high grade malignancy (88 per cent) with 38 per cent large, non cleaved-cell (centroblastic) subtype. Median survival was 4 months. Lymphoma caused death in 65 per cent of patients and opportunistic infection in 18 per cent. Lymphoma was the first manifestation of HIV infection in 10 patients (38 per cent) and was responsible for AIDS in 14 (54 per cent). Diagnosis of lymphoma could be established at an early stage on extranodal biopsy. In these patients a prolonged disease-free survival was obtained after chemotherapy alone or associated with radiotherapy.
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PMID:[Non-Hodgkin's lymphoma associated with human immunodeficiency virus infection. Bordeaux experience with 26 cases]. 213 32

The majority of patients with Aids suffer from diarrhea and weight loss, as well as opportunistic infection and tumors of the gastrointestinal tract; endoscopy is frequently necessary. Often, but not always, it is possible to identify an opportunistic tumor or infection which explains the patient's signs and symptoms. In other cases, HIV may itself be pathogenic. The most important opportunistic pathogens are Candida albicans (stomatitis and esophagitis), cytomegalovirus and herpes simplex virus (esophagus, stomach, biliary system, colon), cryptosporidium (small intestine, biliary system), Isospora belli (small intestine), salmonella, shigella, and campylobacter (small and large intestine, septicemia), and Mycobacterium avium intracellulare (liver, spleen, intestinal submucosa, and bacteremia). Involvement of the gastrointestinal tract is frequent in Kaposi's sarcoma, though it is often asymptomatic. In contrast, gastrointestinal lymphomas are aggressive and rapidly progressive tumors.
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PMID:[AIDS and gastrointestinal tract: a summary for gastroenterologists and surgeons]. 215 57

A female infant born pre-term to a HIV seropositive mother presented at birth with seropositivity for HIV and CMV viruria. At five months of age she developed an AIDS-related complex. Six months later she died from rapidly progressive diffuse encephalopathy. Post mortem examination revealed generalized CMV infection. Neuropathological examination showed a nodular encephalitis with occasional cytomegalic cells containing characteristic CMV inclusion bodies. There was no evidence of HIV encephalitis; immunostaining for HIV antigen (gp 41) was negative. Opportunistic infections in infants with congenital AIDS are the exception. To our knowledge, only one case of CMV encephalitis in an infant with congenital AIDS has been reported previously. In that case, as in the present one, a reactivation of a congenital CMV infection is likely.
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PMID:Cytomegalovirus encephalopathy in an infant with congenital acquired immuno-deficiency syndrome. 217 57

A 42 year old male Spanish patient who presented since one year a symptomatic stage IV C1,C2,D HIV infection (Pneumocystis carinii pneumonia, cerebral toxoplasmosis, esophageal candidiasis, Kaposi's sarcoma) became progressively asthenic with weight loss, diarrhea, fever and complained about bone pain. These symptoms could be attributed to visceral leishmaniasis. This novel opportunistic infection should be considered in the differential diagnosis of fever of unknown origin in HIV+ patients coming from or having travelled in endemic areas.
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PMID:[Visceral leishmaniasis (kala-azar) and HIV infection. Apropos of a case and literature review]. 218 45

In this chapter, we have suggested that neurobehavioral phenomena in HIV-infected individuals can be usefully grouped according to underlying pathogenesis. Neurogenic phenomena are those that result from direct involvement of the brain either by HIV-1 (primary neurogenic disorder) or from opportunistic infection, neoplasia, or side effects of treatment (secondary neurogenic disorder). These phenomena should be distinguished from disturbances resulting from a second pathogenetic mechanism--the psychogenic disorders. We define psychogenic disorders as those that reflect primarily psychological responses to knowledge of HIV infection and/or progression of disease, and resultant of social ramifications. In proposing the neurogenic and psychogenic groupings, we do not intend to harken back to antique "mind-body" distinctions. We recognize fully that diseases of the brain can and do cause disturbances in mood, thought, and behavior, and that preexisting psychogenic disturbances might, in fact, be substantially worsened by onset of such neuropathology. Nevertheless, for the sake of clarity and also of determining appropriate treatment, we feel that the distinction we propose is a heuristically useful one. Challenges that lie ahead include defining more precisely the incidence and natural course of HIV-associated neurogenic disorder. Although there is little doubt that CDC IV individuals have higher prevalence of both subclinical and clinical "organic mental" symptomatology, the time of onset and rate of progression of such changes are not understood. At present, it seems likely that early in the course of HIV infection, the CNS is spared; at some point, however, rate of neuropsychiatric abnormality probably increases, and this may not be directly related to progression of the immunological aspect of the disease. In regard to psychogenic phenomena, it is clear that anxiety syndrome can occur as a direct product of knowledge of HIV serostatus and may be exacerbated by progression of disease. It is possible also that some subgroups of HIV + individuals (e.g., military samples) may be at heightened risk for suicide. These observations pose challenges for focused intervention with these groups. Accumulating data both on neurogenic and psychogenic phenomenology underscore also the importance of conceptualizing HIV infection in neurobehavioral as well as immunologic-virologic terms.
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PMID:Neurogenic and psychogenic behavioral correlates of HIV infection. 218 17

The DATTA panelists considered aerosolized pentamidine to be both safe and effective for primary and secondary prophylaxis of PCP. T4 helper cell counts offer guidance as to the best candidates for primary prophylaxis. Patients with a T4 helper cell count of fewer than 200/mm3 are the most appropriate group to receive primary prophylaxis with aerosolized pentamidine. However, T4 helper cell counts are not an exclusive criterion for aerosolized pentamidine prophylaxis. Some DATTA panelists suggested that certain patients, such as those with Kaposi's sarcoma and lymphomas and those with concomitant human T-cell lymphotropic virus type 1 infection, might be considered candidates for aerosolized pentamidine regardless of T4 helper cell counts. There is no current literature to support this, and this opinion is based solely on clinical experience. Perhaps the use of other markers of immune function (beta 2-microglobulin, neopterin) in conjunction with T4 helper cell counts will give a better indication of when to start primary prophylaxis. Aerosolized pentamidine is not the only potential prophylactic regimen for PCP. Other drugs, including pyrimethamine and sulfadoxine, sulfamethoxazole and trimethoprim, and dapsone, are currently being evaluated. Prior diagnosis and therapy for patients with M tuberculosis must occur before initiation of the use of aerosolized pentamidine. This and other appropriate environmental precautions should reduce transmission of M tuberculosis to health care workers and other patients. Whether any prophylactic treatment of an opportunistic infection will prolong survival in HIV-infected individuals has yet to be proved. The assumption is made, however, that a reduction in opportunistic infections should lower mortality and improve the quality of life.
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PMID:Diagnostic and therapeutic technology assessment. Prophylactic treatment for opportunistic infections in HIV-positive patients: aerosolized pentamidine. 218 63

In the late 1980s, HIV seroprevalence in Rwanda stood at 17.8% in urban areas and 1.3% in rural areas. Adult symptoms of AIDS are generally different than those of children. For example, worldwide, the most prevalent symptom (about 50% of patients) of HIV infection among adults is cotton wool spots, fluffy white superficial retinal lesions. In a sample of 110 seropositive children in Rwanda, however, cotton wool spots' prevalence was very low (.9%). Further, 20-40% of all AIDs patients worldwide experience small retinal hemorrhages (.8% for 110 seropositive children in Rwanda), an advanced stage of microvasculopathy, 8% of the children had other microvascular conditions. Researchers have isolated HIV in the aqueous humor of 3 patients in Rwanda with retinal perivasculitis indicating that it may contribute to this disease's etiology. Moreover, 46% of the Rwandan children with AIDs experienced perivasculitis and/or sheathing. HIV has also been found in tears, the conjunctiva, the cornea, the retinal vascular endothelium, and from multiple ocular tissues. Even though cytomegalovirus retinitis is the leading opportunistic infection (26%- 40%) of the eye and the major cause of blindness among AIDS patients in Europe and the US, it only appeared in 5% of AIDS patients in a Rwandan study. Physicians have found herpes simplex keratitis to be more resistant to treatment and recurred more often in AIDS patients than in immunocompetent patients. They have also learned that other infectious diseases of the eyes manifest themselves differently between the 2 groups. Kaposi's sarcoma, B-cell lymphoma, and squamous cell carcinoma are often present in patients with AIDS.
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PMID:Ocular problems in AIDS. 218 17

Overall GM-CSF is a well tolerated intervention in patients with HIV associated disease. As in a number of other clinical settings, it is able to improve myelopoiesis and abrogate the myelotoxicity of chemotherapeutic agents. At present, clinical data is insufficient to indicate an ultimate clinical benefit from the use of GM-CSF in terms of opportunistic infection, mortality or quality of life for HIV infected patients. As phase I and phase II trials are completed however comparative clinical trials addressing these issues are anticipated. Hematopoietic growth factors may permit the use of optimal doses of therapeutics and thereby play an adjunctive role in the combination therapies anticipated for the treatment of HIV related disease.
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PMID:Granulocyte macrophage colony stimulating factor (GM-CSF) in AIDS. 218 38

A mortality of 41 percent has so far been recorded from 2.779 cases on the AIDS register. Surgical problems were found to arise only in the terminal stage, when gastro-intestinal, anorectal, pulmonary, neurological, and haematological manifestations have to be expected. Surgical intervention is indicated in situations of massive bleeding, perforations, and mechanical ileus. Opportunistic infections have proved to give rise to the development of gall-bladder empyema and CMV-induced ulcerations. The risk of infection run by medical personnel as well as prophylaxis against AIDS infection of people in contact with HIV infected individuals are described in great detail.
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PMID:[Surgical problems in AIDS]. 218 78

Oral candidiasis, an opportunistic infection increasingly often met, includes many clinical aspects where oral thrush is the best known. The etiology is often iatrogenic but candidiasis also represents the most frequent opportunistic infection in HIV infection. To avoid recurrences, therapy must begin with elimination of factors which have promoted its development. Imidazoles appear to furnish the most effective antifungal therapy.
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PMID:[Oral candidiasis: epidemiology, diagnosis and treatment]. 219 82


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