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

The human immunodeficiency virus infected persons frequently have manifestations of central nervous system disfunction. These can be primary involvement or secondary processes such as infections or tumors. The present paper presents a short review of radiologic CNS findings in patients with AIDS as seen on CT and or MRI. The radiologic findings of HIV-1 encephalitis, toxoplasmosis, primary CNS lymphoma, PMLE, cryptococcosis, histoplasmosis, CMV encephalitis, HVS and varicella are presented. We expect this will ultimately help in the management of the AIDS patient.
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PMID:CNS involvement in AIDS patients as seen with CT and MR: a review. 181 9

A 37 year old male developed fever for 20 days, along with headache, anorexia, malaise, sweating, pharyngitis, lymphadenopathy and splenomegaly. At this stage, Ag p24 was positive and anti HIV was negative. The patient recovered fully but 6 months later positive HIV titers were demonstrated by immunofluorescence and Western-blot. A retrospective diagnosis of acute retroviral syndrome was made. The difficult differential diagnosis with infectious mononucleosis, cytomegalovirus, measles, rubella, toxoplasmosis and influenza is discussed. Thus, anti HIV antigenemia should be investigated in any patient with a mononucleosis like syndrome belonging in a high risk group for AIDS, even if Paul-Bunnell-Davidson or IgG anti VCA-EB reactions are positive.
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PMID:[Acute retroviral syndrome]. 182 45

Fifty-two patients at various stages of human immunodeficiency virus (HIV) infection who had one or several epileptic seizures in the course of that disease were retrospectively studied from 1985 to 1990. Thirty-five percent of these patients were in overt clinical AIDS at the time of the seizure(s). AIDS was revealed by a seizure in 2 cases. Generalized seizures were observed in 71 percent of the patients, and partial seizures in 29 percent. Electroencephalograms showed signs of brain irritation in only 19 percent of the cases. The cause of epileptic seizure(s) could be determined in 36 patients: cerebral toxoplasmosis in 23 cases; progressive multifocal leucoencephalitis in 2 cases; HIV encephalopathy in 3 cases; iatrogenic cause in 4 cases; meningoencephalitis in 3 cases and neurosyphilis in 1 case. No cause other than HIV infection was found in 16 patients. These findings confirm those of previous studies. In about one-third of AIDS patients epileptic seizures are the only clinical manifestation of viral central nervous system infection.
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PMID:[Epilepsy seizures in HIV infection. 52 cases]. 183 61

Neuropsychiatric problems have assumed an increasingly prominent role in HIV-infected individuals. Disease occurs at all levels of the central and peripheral nervous systems by a variety of mechanisms. The AIDS dementia complex is the prototypical example of "direct" effects of HIV on the neuraxis, while infections such as toxoplasmosis and cryptococcal meningitis are complications of HIV-induced immunosuppression. Neurologic manifestations vary in frequency depending upon the overall stage of HIV disease; diagnostic difficulties may be encountered because of HIV's effect on cerebrospinal fluid parameters. The uncertainties of management of neurosyphilis in this setting provide and example of these problems. As is the case with other organ systems, the main goal of neurodiagnostic efforts is to find the increasing number of treatable components of neuropsychiatric dysfunction.
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PMID:Neurologic and psychiatric manifestations of HIV disease. 184 9

During a period of 3 years 14 patients with AIDS and CNS focal lesions documented by CT scan were evaluated. All patients received empirical treatment against Toxoplasma. The aim of the study was to determine the prevalence of the different etiologies of the neurologic lesions as well as to evaluate the usefulness of routine cerebral biopsy before establishing empiric antitoxoplasma treatment in a population of AIDS patients with a high incidence of drug addiction. Eleven patients developed histologic and clinical criteria of cerebral toxoplasmosis, one patient presented progressive multifocal leukoencephalopathy, and in the remaining two patients the etiologic diagnosis could not be established. Only one patient presented multiple etiologic lesions and in no cases the presence of mycobacteria or fungi could be demonstrated in the cerebral tissue. The overall percentage of responses to the empiric antitoxoplasma treatment was 42%. This percentage increased to 54% if patients with coma were not included in the analysis. Cumulated mortality of the entire group was 78.5%. It is concluded: 1) the predominance of Toxoplasma gondii as a cause of cerebral lesions in our AIDS population; 2) the acceptable percentage of response to empiric antitoxoplasma treatment in non-comatose patients, and 3) the high overall mortality rate in these patients. It is therefore suggested that routine cerebral biopsies will not be justified as initial diagnostic approach in HIV positive patients with focal CNS lesions.
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PMID:[Brain lesions in patients with acquired immunodeficiency syndrome]. 185 55

A 19-year-old male intravenous drug abuser, was admitted to hospital with a one-week history of lower limb weakness and urinary retention. He was known to have been HIV-seropositive for 3 years and had been treated for cerebral toxoplasmosis. Neurological examination confirmed flaccid paraparesis with weak ankle jerks and bilateral extensor plantar responses. There was no obvious sensory deficit. Neurological examination was otherwise normal. CSF contained 63 mg/dl protein and 10 leucocytes/mm3. Myelography was normal. He died 1 month later from septic peritonitis. Neuropathological examination showed chronic lesions of toxoplasmosis in brain. Small necrotic foci with myelin loss, proliferation of microglia, macrophages and multinucleated giant cells (MGC) were disseminated in the whole spinal cord, mostly in the white matter, but the brain was spared. Immunohistochemistry demonstrated p24 and p17 HIV antigens in macrophages, MGC and microglial cells. These lesions resemble those of so called 'multifocal giant cell encephalitis'. The present case demonstrates that HIV-related multifocal inflammatory changes may be restricted to the spinal cord and may be a cause of myelopathy in AIDS patients.
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PMID:Multifocal multinucleated giant cell myelitis in an AIDS patient. 185 90

The authors describe a case of toxoplasmosis occurring in a subject who is HIV positive who presented with a cough and an infectious syndrome. Toxoplasma gondii was identified in the broncho-alveolar lavage even though the X-ray, the fibroscopy, blood gases and the broncho-alveolar lavage were normal. The frequency of pulmonary disease in the course of a toxoplasma infection in HIV subjects was underlined. Amongst the non invasive diagnostic methods the authors stress the value of broncho-alveolar lavage with a close search for toxoplasma even in the absence of any suggestive paraclinical anomalies.
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PMID:[Disseminated toxoplasmosis in a patient with HIV infection]. 185 17

Adherent cells from human immunodeficiency virus (HIV)-infected subjects but not from normal blood donors, patients with Gram-positive or -negative bacteremia, active tuberculosis, toxoplasmosis, pulmonary aspergillosis, and cytomegalovirus infection produce spontaneously an activity which inhibits alpha chain of interleukin-2 (Tac) expression and interleukin 2 (IL-2) production by normal activated T cells and IL-2 production by these cells. A similar biologic activity was detected in culture supernatants of in vitro HIV-I-infected normal adherent and leukemic U937 cells. Tac-inhibitory activity is not cytotoxic and it could be detected in serum-free conditioned media. Recombinant granulocyte/macrophage colony-stimulating factor and phorbol myristate acetate stimulation of patients' and normal adherent cells did not enhance specifically the production of the Tac inhibitor. Biologically active conditioned media did not contain infectious virus as well as secreted p24, gp120 viral proteins; the biologic activity could not be abolished by anti-p24, anti-gp120, and anti-nef monoclonal antibodies or human purified polyclonal anti-HIV IgG. Gel filtration of conditioned media followed by anion exchange chromatography resulted in a 1,200-fold degree of purification and revealed that the biologically active molecule was cationic. Sodium dodecyl sulfate polyacrylamide gel electrophoresis of this fraction and gel elution of the proteins showed that the biologic activity was associated with a 29-kD protein which was distinct from alpha- or gamma-interferon, tumor necrosis factor-alpha, and prostaglandin E2. The above findings demonstrate the production of inhibitory factor(s) during HIV infection, which might be involved in the pathogenesis of the patients' immune defect.
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PMID:Biological and biochemical characterization of a factor produced spontaneously by adherent cells of human immunodeficiency virus-infected patients inhibiting interleukin-2 receptor alpha chain (Tac) expression on normal T cells. 190 71

Earlier diagnosis and improved therapies for the opportunistic infections have led to improved quality of life as well as survival time of patients with advanced HIV-related immunodeficiency. Most of the therapies can be administered on an outpatient basis. Outpatient treatment further contributes to improving the quality of life of the patients. Presentation, clinical aspects, treatment and prophylaxis of the five most frequent opportunistic infections in HIV-infected patients with advanced immunodeficiency in our outpatient clinic (oral and esophageal candidiasis, pneumocystis carinii pneumonia, herpes zoster, herpes simplex virus infection and cerebral toxoplasmosis) are discussed with respect to the practical implications.
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PMID:[Ambulatory therapy and prevention of the most frequent HIV-associated opportunistic infections]. 192 48

A retrospective review of the neuroimaging procedures of 84 patients with the diagnosis of AIDS was performed. Both computed tomography (CT) and magnetic resonance imaging (MRI) procedures were evaluated for the presence of atrophy, enhancing lesions and focal non-enhancing lesions. The imaging findings in several infectious conditions (toxoplasmosis, cytomegalovirus, papovavirus, HIV virus, tuberculosis and histoplasmosis) are described. Intracranial lymphoma, another complication of AIDS, also is discussed.
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PMID:Neuroimaging of AIDS. 194 Feb 89


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