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Query: UMLS:C0019693 (
HIV
)
170,526
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Clinical symptoms of the central and peripheral nervous system occur in about 40% of patients wit
HIV infection
. At autopsy, CNS lesions can be demonstrated in even higher percentages. Primary sequelae of
HIV infection
--either due to direct viral effects or the immunopathologic response of the human host--are acute aseptic meningitis or mengingo-encephalitis, HIV encephalopathy, myelopathy, neuropathy, and myositis. Secondary consequences of immunodeficiency in AIDS are opportunistic infections with other viruses, bacteria, fungi, and protozoa, e.g. CMV, HSV and HZV encephalitis, mycobacterial CNS infections, neurosyphilis, cryptococcal meningitis, and last but not least cerebral
toxoplasmosis
. The main secondary malignoma of the CNS is lymphoma. Together these disorders form a complex spectrum of central and peripheral neurological symptoms.
...
PMID:[Neurologic complications of AIDS]. 304 48
Acquired immune deficiency syndrome (AIDS) in children has until recently been under-reported, since the initial Centers for Disease Control definition of AIDS was restrictive. The case definition has now been revised. Most children with AIDS acquired their infection perinatally and have a parent with established AIDS-related complex or AIDS or belong to a high-risk group. Prior to March 1985, children also acquired human immunodeficiency virus from a contaminated blood product transfusion or from factor replacement for hemophilia. In the United States, AIDS in children occurs predominantly in cities with large populations of intravenous drug users. There are a number of differences between the clinical manifestations of
human immunodeficiency virus infection
in children compared with adults. For example, recurrent bacterial infection is more common in children, perhaps reflecting the abnormal B cell function that occurs relatively early in the disease course. Certain opportunistic infections (e.g.,
toxoplasmosis
, cryptococcal meningitis) are less common in children than adults. Lymphocytic interstitial pneumonia does not occur in adults but is found in 30 to 50 percent of children. On the other hand, Kaposi's sarcoma and other malignancies are less common in children. Treatment has consisted largely of general supportive care in hospital or at home; this is dependent on the availability and utilization of resources and financial support. However, as anti-retroviral therapy becomes available, studies in children have been initiated. It is hoped that in the future it may be possible to prevent the disease; in the meantime, earlier diagnosis and better therapy are important goals.
...
PMID:Acquired immune deficiency syndrome in children. Current problems and therapeutic considerations. 304 85
The
HIV
epidemic probably arose in Africa at about the same time as in the West, and there is a significant seroprevalence of
HIV
in the central African region. However, the epidemiology and clinical course of AIDS are different in Africa and in the West. In Africa males are infected as often as females, and the commonest means of transmission is heterosexual intercourse. Many
HIV
-infected people are symptomless, but many others present with or progress to generalized lymphadenopathy, pruritus, herpes zoster, herpes simplex, cellulitis, and oral candidiasis. The World Health Organization developed a clinical case-definition of AIDS in Africa, which was found to have a specificity of 90% and a sensitivity of 59% when tested in Zaire. The Kaposi's sarcoma seen in African AIDS patients is more aggressive than that seen in the West and is often visceral. Gastrointestinal AIDS (the "slim" disease) with weight loss and diarrhea is common in Africa, as are oral and esophageal candidiasis. In Africa Pneumocystis carinii pneumonia is rare, but pulmonary tuberculosis is common. Neurological manifestations include cerebral
toxoplasmosis
, cytomegalovirus infection, headache, and terminal encephalopathy. About 60% of infants born to seropositive women are infected and die within the 1st year of life. Lack of drugs and diagnostic facilities make both diagnosis and treatment of opportunistic infections difficult.
...
PMID:Clinical aspects of HIV infection in developing countries. 305 40
The nervous system is involved in the acquired immunodeficiency syndrome (AIDS) by infections and infestations, by neoplasms, and by several diseases of uncertain pathogenesis. The most common pathological abnormalities are the changes associated with the
HIV
agent itself, the '
HIV
subacute encephalitis'; the most specific change is demyelination with multinucleate giant cells. Cytomegalovirus (CMV) is the most common secondary virus, but progressive multifocal leucoencephalopathy (PML) is more frequently seen at biopsy.
Toxoplasmosis
is the most common cause of abscess formation, but fungal infections, especially by cryptococcus, are more often the cause of meningitis. Mycobacterial infections and other opportunistic organisms are relatively rarely seen in the CNS. A vacuolar myelopathy of unknown pathogenesis is seen in AIDS; it involves the dorsal and lateral columns and the thoracic spinal cord most prominently. Endarteritis of unknown cause with resultant infarction is seen in children. Primary CNS lymphoma accounts for a major percentage of the lymphomas seen in AIDS; they are high grade tumours, are most often multiple, and are of B-cell origin. Metastatic Kaposi's sarcoma is very rare. Several peripheral neuropathies occur in AIDS, and recently a myopathy with small rod bodies has been reported.
...
PMID:Neuropathology of acquired immunodeficiency syndrome. 305 9
Central Nervous System (CNS) involvement, whether primary by the
Human Immunodeficiency Virus
--
HIV
--itself, or secondary (
toxoplasmosis
or lymphoma) is remarkably frequent in AIDS, in 40 to 70% of cases, depending upon the author. In order to study the natural history of this illness, a cohort of 25 asymptomatic seropositive patients have been established. Every 6 months these patients undergo biological and clinical examinations, as well as Magnetic Resonance brain scans. After two examinations at a 6 month's interval, the first results are reported. Out of these 25 cases, 9 present anomalies: One patient with diffuse cerebral atrophy and 8 others with high signal intensity areas on T2 weighted sequences, like those of the Multiple Sclerosis. No relationship could be demonstrated between the existence of these lesions and various criteria such as age, sex, risk factors and T4 cells count. The nature of these lesions is not clear. They certainly indicate early involvement of the CNS after primary infection by the
HIV
virus. They may either represent scars of the primary infection or early alterations announcing developing encephalopathy.
...
PMID:[Magnetic resonance imaging: early detection of involvement of the central nervous system in acquired immunodeficiency syndrome]. 314 38
Diagnosis of clinical AIDS can be difficult for clinicians in Africa, where there is only limited access to the sophisticated bacteriological diagnostic facilities needed for diagnoses based on the criteria laid down by the Center for Disease Control in the US. The most common presentation of AIDS in Africa is as an enteropathic condition known as 'Slim.' Based on this and other common presentations of the disease in Africa, a group of clinicians in Bangui, Central African Republic, drew up a list of criteria for the diagnosis of AIDS in Africa which are based on patient history and examination and the exclusion of other conditions rather than on serological confirmation of
HIV infection
. The major criteria are 1) unexplained fever for longer than 1 month; 2) unexplained diarrhea for longer than 1 month; and 3) weight loss greater than 10% of previous weight. Minor symptoms are presence of a maculopapular rash, oral candidiasis or thrush, herpes zoster or shingles, aggressive or uncontrollable herpes simplex, unexplained cough for longer than 1 month, or enlarged lymph nodes in more than 1 extrainguinal site. The finding of 2 major symptoms and at least 1 minor one is enough for diagnosis. These criteria have been found to be useful. However, they do not cover all the presentations which have been associated with AIDS. Unusual presentations of
HIV
infected persons which have been seen in Africa include serially developing abscesses in pyomyositis, gall bladder diseases, pericarditis or myocarditis, diseases of the Central Nervous System (cryptococcal meningitis,
toxoplasmosis
, non-specific leuko-encephalitis, atraumatic paraplegia, acute psychosis or chronic deterioration in mental capacity, lymphoma of the brain), prodromal illnesses, swollen lymph nodes, herpes zoster or shingles in young adults, or tumours of the lymphatic system. Differential diagnosis is extremely important.
...
PMID:Clinical manifestations of AIDS in tropical countries. 319 42
The central nervous system was examined in 40 AIDS patients who died between August 1982 and 1987. The cases included two children born to intravenous drug abusers and 38 male adults. The brains of eight patients who had no clinical or radiological evidence of central nervous system involvement showed non-specific changes which included microglial nodules, perivascular mononuclear cuffs, mineralization of blood vessels and granular ependymitis. In 32 brains from patients with neurological symptoms,
toxoplasmosis
was the most frequent finding (19 cases) manifested by multifocal, necrotic lesions or a diffuse pseudo-encephalitic process. Other opportunistic infections included cytomegalovirus (eight cases), progressive multifocal leucoencephalopathy (two cases), cryptococcosis (one case), aspergillosis (one case), multiple bacterial microabscesses (one case) and Mycobacterium avium intracellulare (one case). Two patients had cerebral lymphoma. Subacute encephalitis with white matter lesions and multinucleated giant cells characteristic of
HIV infection
was present in 15 cases. Various combinations of all these infections were encountered in the same brain, sometimes in the same area and, occasionally, in the same cell.
...
PMID:Pathology of the central nervous system in 40 cases of acquired immune deficiency syndrome (AIDS). 320 Mar 67
The central nervous system (CNS) of 40 patients who died of acquired immune deficiency syndrome (AIDS) between August 1982 and August 1987 was examined. In 15 cases, multinucleated giant cells (MGC) characteristic of
Human Immunodeficiency Virus
(
HIV
) infection were observed. In 3 cases ultrastructural examination disclosed
HIV
-like viral particles in the cytoplasm of some MGC. All cases with MGC showed, in addition, predominant white matter lesion: diffuse myelin pallor, multiple small, usually subcortical, necrotic foci, vacuolar myelopathy, proliferation of rod-shade microglia and microglial nodules, reactive astrocytosis, mineralization of the vessel walls. These changes, typical of HIV encephalitis, were isolated in 3 cases. In the other cases, they were associated with other AIDS-related CNS lesions, i.e., cerebral
toxoplasmosis
(9 cases), cytomegalovirus infection (5 cases), progressive multifocal leukoencephalitis (1 case), cryptococcosis (1 case) and cerebral lymphoma (1 case). The involvement of MGC with these lesions was remarkable.
...
PMID:[Neuropathologic study of 15 cases of multinucleated giant cell encephalitis in acquired immunodeficiency syndrome (AIDS)]. 321 96
232 sera and 40 cerebrospinal fluid samples of altogether 125 patients in stages III or IV of a
HIV
-infection were tested for circulating antigen of Toxoplasma gondii by means of a three-layer enzyme-linked immunosorbent assay. Circulating antigen was detected in 32 sera of 20 patients (= 16% of all persons investigated). These ELISA results were reexamined by an Immunoblot following a SDS-PAGE and confirmed in most cases. In addition, this test system led to a partial characterization of the circulating antigen; it consists of at least two proteins with atomic mass units of 27 and 57 kd respectively. The antigenemia was correlated with IgG- and IgM-antibody titres, with clinical symptoms, and with pathological findings also. Our results indicate that the detection of circulating antigen in sera offers a rapid and efficient method for the diagnosis of an acute
toxoplasmosis
in AIDS-patients.
...
PMID:Circulating antigen of Toxoplasma gondii in patients with AIDS: significance of detection and structural properties. 322 42
Disorders of the nervous system frequently complicate Acquired Immune Deficiency Syndrome (AIDS). They may be related to the development of opportunistic agents (
toxoplasmosis
, cryptococcossis, cytomegalovirus, JC Virus), or primary CNS lymphoma. There is also a constellation of neurologic disorders which may result from direct
Human Immunodeficiency Virus
(
HIV
) replication in the CNS and
HIV
has been found in brain and CSF of numerous patients suffering from AIDS. The precise cellular localization of
HIV
is not known, but the macrophage seems to be a strong candidate for
HIV
replication in CNS.
...
PMID:[Interactions between HIV virus and the nervous system: recent pathogenic data and hypotheses]. 329 Aug 36
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