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

Neuropathological lesions were studied in a consecutive autopsy series of 206 cases, comprising 61% of all patients who died of Aids in Switzerland between April 1981 and December 1988. Central nervous system involvement was found in 84% of the patients, and 17% showed multiple concomitant intracerebral lesions. Among the non-viral opportunistic infections, cerebral toxoplasmosis was most frequent (24%), whilst among the viral opportunistic infections, cytomegalovirus (CMV) encephalitis was most frequent (7%). A nodular encephalitis consisting of disseminated microglial nodules without morphological or immunocytochemical evidence of CMV occurred in 13.5% of the patients. The majority of these cases showed evidence of extracerebral CMV infection. Progressive multifocal leukoencephalopathy (PML) was observed in 6% of the patients and was associated with widespread tissue destruction and cyst formation. HIV encephalopathy occurred in 38 patients (18%) and showed two characteristic morphological patterns: progressive diffuse leukoencephalopathy (PDL) and multifocal giant cell encephalitis (MGCE). PDL was observed in 22 patients and was characterized by a diffuse demyelination and gliosis of the white matter with little inflammatory infiltrates and scattered multinucleated giant cells which were immunoreactive to HIV antigens. MGCE was found in 16 patients and was characterized by clusters of macrophages, lymphocytes, and HIV-immunoreactive multi-nucleated giant cells. In our view, PDL and MGCE represent two opposite variants of HIV-induced encephalopathies with numerous intermediate manifestations.
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PMID:[Nervous system pathology in AIDS: results of a collaborative autopsy study from Switzerland]. 218 22

This article highlights the clinical and social features of the AIDS epidemic in Uganda. AIDS is already the most common cause of admission and death among hospitalized adults in many parts of the country. 1 million adults out of a country of 17 million people are estimated to be HIV-seropositive. With such a large population of HIV infected people high risks no longer exist and knowing a patient's social history rarely helps in diagnosing AIDS. Tuberculosis is now ubiquitous with a doubling in the number of cases from 1984 to 1987. With few reliable laboratory resources, a patient with AIDS with a pulmonary infiltrate can present a dilemma to a Ugandan health worker. Even though HIV testing is not routinely available in Uganda where resources are being used to repair a damaged economy, the clinical criteria for diagnosing AIDS may actually be more than 92% specific. A benefit to the clinical diagnosis is that many treatable non-HIV-related illnesses, such as diabetes, are frequently undiagnosed as AIDS related syndrome in people who are shown to be HIV seropositive by routine testing. Since AIDS immunosuppresses patients, the local opportunistic infections indicate the common environmental pathogens. In Uganda the highly prevalent infections are: syphilis, 5-30%; cytomegalovirus infection, 100%; toxoplasmosis, 50-75%; and chronic hepatitis B antigenemia, 15%. Unfortunately, there is little a Ugandan physician can do for AIDS patients with limited health resources. Counseling is controversial due to expected social norms and arguments about the situation's futility. A huge infusion of education, money, and personnel will be needed to combat AIDS in Uganda.
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PMID:AIDS in Uganda--clinical and social features. 199 59

Human immunodeficiency virus (HIV) infection in infants and young children differs in a number of ways from that in adults. In most HIV-infected children the infection is acquired perinatally and the course of infection is more accelerated than in adults. Diseases related to B cell defects and dysgammaglobulinemia (e.g., multiple or recurrent bacterial infections) predominate early in the disease, and children can be symptomatic before their CD4+ count decreases. Lymphoid interstitial pneumonitis occurs frequently and almost exclusively in children, and a number of the opportunistic infections (e.g., cryptococcosis, toxoplasmosis) or malignancies (e.g., Kaposi's sarcoma) occur infrequently in children. A major disease manifestation in the pediatric population is HIV encephalopathy, which results in impairment in neurologic development that can lead to loss or lack of developmental milestones and to diminished intellectual function. The methodology and design of clinical trials for the study of pediatric HIV infection should consider these clinical and laboratory manifestations as well as the developmental differences that reflect the disease in infants and young children.
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PMID:Considerations for the evaluation of antiretroviral agents in infants and children infected with human immunodeficiency virus: a perspective from the National Cancer Institute. 220 Oct 73

Computed tomography (CT) is a sensitive noninvasive study used for the diagnosis of cerebral lesions in patients with AIDS. Toxoplasmosis is, by far, the most common opportunistic central nervous system disease (CNS) in this population; accordingly, most groups start empirical antitoxoplasma therapy if the radiological features of the lesion suggest the diagnosis. It is common, however, when CT images do not suggest toxoplasmosis, not to start empirical therapy until the investigation of the lesion with other studies has not been completed. We report a case of cerebral toxoplasmosis in a patient with AIDS which, in our opinion, illustrates that empirical antitoxoplasma therapy should be started in all CNS lesions in patients with HIV infection while etiological investigation is undertaken, independently from the appearance of the lesion in the CT.
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PMID:[Cerebral toxoplasmosis in a patients with the acquired immunodeficiency syndrome. Discussion of the criteria of computerized axial tomography]. 225 May 7

The lung is directly affected by HIV virus early in the disease and is the site of a specific lymphocytic alveolitis. Neoplastic pulmonary disease linked to the virus occurs (Kaposi sarcoma, lymphoma and epidermoid tumour) but it is principally following opportunistic infections that patients with AIDS come under the care of a respiratory physician. Certain of the responsible infectious agents causing opportunistic pneumonia are probably present in a latent fashion before the disease presents and are reactivated by the immuno-depression. They may occur successively such as tuberculosis, toxoplasmosis (in this case pulmonary), infection to CMV and pneumocystis. Other infectious agents are transported by the environment and lead to recurrent bacterial infections, mycotic infections or infections with atypical mycobacteria. The clinical management of these different diseases has advanced greatly from a diagnostic therapeutic prophylactic and curative viewpoint.
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PMID:[Clinical management by the respiratory physician of patients with HIV infections]. 227 Mar 40

Two non-alcoholic homosexual patients with acquired immunodeficiency syndrome (AIDS) are reported who developed acute Wernicke's encephalopathy in the terminal stage of their illness. The first patient presented with vascular congestion, minute haemorrhages, proliferation of microglia and of the vessel walls at the predilection sites of the Wernicke-Korsakoff process. In the second patient only the mamillary bodies were involved. Besides Wernicke's encephalopathy, a primary cerebral immunoblastoma and cerebral toxoplasmosis were found in the first patient, whereas the second showed severe encephalitis with numerous microglial and multinucleated giant cells reacting positively with anti-HIV antibody. Just as in the development of Wernicke's encephalopathy in malignant diseases, the catabolic trend of the metabolism of the immunodeficient patients with consecutive thiamine deficiency must be considered the principal pathogenetic mechanism.
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PMID:Wernicke's encephalopathy in two patients with acquired immunodeficiency syndrome. 227 15

Multiple hyperechoic foci were noted on a head sonogram in the basal ganglia and periventricular white matter of an eleven month old, human immunodeficiency virus (HIV) seropositive male infant. The infant presented with failure to thrive, recurrent viral and bacterial infections, and progressive neurologic impairment. Toxoplasmosis, Cytomegalo-inclusion virus and other "TORCH" infections were excluded. A computed tomography (CT) scan of the brain demonstrated multiple punctate calcifications in the above areas. The literature indicates that these changes might be the result of direct HIV infection of the brain. To our knowledge this is the first reported case of the sonographic findings.
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PMID:Intracranial human immunodeficiency virus infection in an infant: sonographic findings. 228 45

Toxoplasmosis encompasses a variety of clinical conditions. Serious sequelae are seen in congenital toxoplasmosis and in infections of the immunocompromised host. In the former, prevention of maternal acquisition of toxoplasmosis during pregnancy is paramount. Infection in the compromised host often presents with neurologic abnormalities. Unfortunately, the HIV syndrome itself or other opportunistic infections can present in a similar manner. Often, empiric treatment for toxoplasmosis is begun based on clinical findings and an enhancing lesion noted on the head CT. Pyrimethamine and sulfadiazine remain the drugs of choice for toxoplasmosis and are able to penetrate blood-brain barriers. Currently, trials using other agents are in progress.
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PMID:Toxoplasma gondii. 233 5

A black heterosexually HIV-infected woman, initially presented with cryptococcal meningitis (satisfactorily responding to fluconazole treatment), which was soon followed by lethal cerebral toxoplasmosis.
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PMID:Cryptococcal meningitis and toxoplasma encephalitis in an AIDS patient. 233 99

Among 630 patients with human immunodeficiency virus infection, 70 patients with new-onset seizures were studied. Generalized seizures occurred in 66 patients (94%): they occurred as the initial seizure in 56 patients (80%) and during follow-up in another 10 patients (14%). Partial seizures (18 patients), status epilepticus (10 patients), and recurrent seizures (38 patients) were also noted. Identified processes included cerebral toxoplasmosis in 11 patients, cerebral lymphoma in 8, metabolic derangement in 8, cryptococcal meningitis in 7, and vascular infarction in 4. In 32 patients (46%) seizures were not associated with identifiable brain lesions and were believed to result from human immunodeficiency virus cerebral infection. Phenytoin treatment was associated with adverse drug reactions in 16 of 62 patients who received it. Our results suggest that the majority of patients with human immunodeficiency virus and seizures do not have secondary focal brain lesions as the cause of the seizures and that human immunodeficiency virus infection alone can, and often does, cause seizures.
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PMID:Seizures in human immunodeficiency virus infection. 234 90


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