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

To investigate the development of a reduced DLCO in patients with HIV-related disease, we studied 474 HIV-seropositive patients and performed serial lung function measurements over 18 months. The mean values of DLCO at presentation were lower in patients with more advanced HIV disease compared with asymptomatic HIV-seropositive patients (DLCO 88% of predicted). When compared with the DLCO in asymptomatic HIV-seropositive patients, the DLCO had reduced values in patients with persistent generalized lymphadenopathy (PGL) (82% of predicted, p less than 0.05), acquired deficiency syndrome-related complex (ARC) (73% predicted, p less than 0.001), nonpulmonary Kaposi's sarcoma (KS) (72% of predicted, p less than 0.001), nonpulmonary complications of AIDS excluding KS (73% of predicted, p less than 0.001), pulmonary KS (63% of predicted, p less than 0.001), pulmonary mycobacterial infection (68% of predicted, p less than 0.05), pyogenic infection (70%, p less than 0.05), acute Pneumocystis carinii pneumonia (PCP; 49%, p less than 0.001), and following recovery from PCP (71%, p less than 0.001). Serial lung function measurements over 18 months revealed no change in DLCO within any patient group, and in particular there was no tendency for a gradual decline. Clinical deterioration due to the development of PCP was associated with a reduction in DLCO. Conversely, in patients recovering from PCP, there was a partial improvement in DLCO over 3 months. Zidovudine (AZT) use did not affect DLCO within any diagnostic group or the recovery in DLCO following PCP. However, cigarette smoking was associated with further reductions in DLCO in all patient groups and with an impaired recovery of DLCO following acute PCP.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Pulmonary function in human immunodeficiency virus infection. A prospective 18-month study of serial lung function in 474 patients. 151 57

A 39 years old homosexual male suffering from chronic type B hepatitis superinfected by HDV, and positive for anti-HIV1 was treated with zidovudine associated with high doses of recombinant interferon alpha for onset of an extensive cutaneous Kaposi sarcoma. Other than the long-lasting disappearance of Kaposi's lesions, this therapy was followed by complete recovery from hepatitis B and D. Serological and hepatic clearance of both viruses was marked by two successive cytolytic peaks separated by a 9 month interval. The patient's immunologic status has remained stable at 30 months. To our knowledge, such a success had never been reported in the literature and the clearance of both hepatitis B and D viruses in an AIDS patient stands in sharp contrast with the usual rapidly progressive evolution of those triple coinfections. This phenomenon illustrates the potential benefits of zidovudine in association with high dose of interferon alpha in HIV patients suffering from hepatitis D.
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PMID:[Recovery of chronic hepatitis B- delta infection by zidovudine and recombinant interferon alpha combination therapy in a patient with Kaposi's sarcoma associated with HIV infection]. 152 1

This study correlates the prevalent oral disease findings in 390 patients seropositive for human immunodeficiency virus type 1 (HIV-1) with their level of staging (Walter Reed) and depletion of peripheral helper T lymphocytes (CD4+). Chronic lymphadenopathy of the head and neck was a common finding (59.2%) that occurred early in staging progression and did not correlate with depression of helper T-cell levels. Of the three prevalent oral disease findings (oral hairy leukoplakia (OHL), candidiasis, necrotizing ulcerative gingivitis [NUG]) only OHL and NUG were significantly correlated with helper T-cell depletion. The occurrence of visually detectable OHL and NUG corresponds to depletion of peripheral helper T-lymphocyte values in a range of 157 to 299 cells/mm3. This range may represent a more accurate value for biologically significant lymphocyte depletion than the Walter Reed value of 400 cells/mm3. The presence of OHL showed a weak statistical correlation with staging progression, indicating deteriorating immunoregulation. No cases of Kaposi's sarcoma or other HIV-1-associated oral diseases were observed in the sample population, regardless of the patient's staging category or peripheral helper T-lymphocyte count.
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PMID:Correlation of oral disease with the Walter Reed staging scheme for HIV-1-seropositive patients. 153 56

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

Between 1988/89 1207 HIV-positive patients were registered at the Medical Policlinic of the University Hospital Zurich. In 57 of these patients colonoscopy or rectosigmoidoscopy was performed because of serious symptoms or symptoms refractory to therapy (diarrhea, bloody diarrhea, massive abdominal pain, weight loss). 24/57 (42%) had a negative colonoscopy and in 6/57 patients (10%) Kaposi's sarcoma was found. 14/57 (25%) had unspecific colitis. In 13/57 (23%) cases with colitis, one or multiple bacterial or viral agents were diagnosed: CMV (n = 5), herpes (n = 2), Mycobacterium avium-intracellulare (n = 3), different bacterial agents (n = 5), HIV (n = 1). One patient had a double and one a triple infection. Another had colitis with HIV as the only isolated pathogenic agent in the colon epithelium.
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PMID:[Diagnostic problems in infectious colitis in the framework of an HIV infection]. 153 96

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

We report on a patient with AIDS who developed erythema nodosum, an association that has not previously been reported. Extensive clinical and laboratory investigations disclosed no obvious origin of erythema nodosum apart from HIV infection with disseminated Kaposi sarcoma.
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PMID:[Erythema nodosum and AIDS]. 154 33

We describe the clinical and epidemiological characteristics of human immunodeficiency virus (HIV) infection in patients greater than 55 years of age at the time of diagnosis and make comparisons with younger HIV-infected patients. Patients were selected by stratification according to age (greater than 55 years and less than 40 years) from a large cohort, and information was obtained by review of charts. Three samples of younger patients were used for general comparison (sample 1), for analysis of progression to acquired immunodeficiency syndrome (AIDS) (sample 2), and for analysis of survival after AIDS (sample 3). We identified 33 patients greater than 55 years of age (30 men and 3 women). The mean age was 60.1 years (range, 55-72). Risk factors included homosexual/bisexual, 22 (67%); blood products, seven (21%); heterosexual, two (6%); and unknown risk, two (6%). HIV encephalopathy tended to be more common in the older group, while Kaposi's sarcoma was more common in younger controls. Older patients more frequently acquired HIV infection via transfusion of blood or blood products (p less than 0.005), were more likely to have AIDS at presentation (p less than 0.001), progressed to AIDS more rapidly (p less than 0.002), and had higher mortality rates (p less than 0.001). Transfusion of blood or blood products is an important mode of acquisition of HIV in patients greater than 55 years of age. HIV infection has a more rapid and aggressive course in older patients.
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PMID:HIV infection in patients over 55 years of age. 154 71

Kaposi's sarcoma (KS) is a pleomorphic spindle cell lesion whose incidence has markedly increased among patients infected with the human immunodeficiency virus (HIV), especially among those whose primary risk factor is homo/bisexual transmission. The question as to whether KS is even a true neoplasm still remains largely unsettled due to the body of epidemiologic and histologic evidence suggesting an infectious etiology of the lesion. Accordingly, very few studies have been published regarding systemic distribution or patterns of metastatic progression of the lesion. In the past, such studies have been primarily hampered by inadequate sampling of different tissue specimens and by the lack of a method whereby the data could be rationally interpreted. In the present study we have reviewed the clinical and pathologic features of 169 autopsied patients with either documented HIV infection or the acquired immunodeficiency syndrome, among whom 28 patients were found to have KS. Using cluster analysis, we constructed a novel data structure, called a "dendrogram," whereby patterns of metastasis could be examined. Our results show at least three patterns of metastasis of the lesions, predominantly involving the skin, upper gastrointestinal tract, or midgastrointestinal tract, within this cohort of autopsied patients. These three patterns suggest that there is no single pathogenetic mechanism in the acquisition and dissemination of HIV-associated KS.
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PMID:Cluster analysis of the metastatic patterns of human immunodeficiency virus-associated Kaposi's sarcoma. 155 40

Human immunodeficiency virus (HIV) infection has been associated with a number of hepatic and biliary tract disorders. Case reports, series of liver biopsies, and postmortem studies that examined the hepatobiliary system were retrieved with a MEDLARS search and form the basis of this review. The liver and biliary tract are frequently involved with opportunistic infections (most commonly mycobacteria and cytomegalovirus) and neoplasms (mainly Kaposi's sarcoma) in patients with HIV infection. The patients are often asymptomatic but may have elevated levels of serum liver enzymes. These abnormalities are nonspecific. Sulfa drugs, pentamidine, and ketoconazole are the medications used in HIV-related infections that are most likely to result in abnormalities on liver tests. Acalculous cholecystitis and sclerosing cholangitis also occur in HIV infection. Cytomegalovirus and Cryptosporidium are the organisms most commonly associated with these conditions. Imaging studies of the liver may detect parenchymal abnormalities and guide liver biopsy. The role of this procedure in the diagnosis of opportunistic infections and neoplasms is controversial because these lesions are generally disseminated at the time liver abnormalities are evident. A liver biopsy is best used when other less invasive procedures have failed to provide a diagnosis. Endoscopic retrograde cholangiopancreatography is a useful diagnostic procedure with therapeutic potential in patients with abdominal pain, fever, or an elevated serum alkaline phosphatase level.
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PMID:Hepatobiliary complications in patients with human immunodeficiency virus infection. 155 86


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