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

Pulmonary immunity has not been studied in children with acquired immunodeficiency syndrome (AIDS) or tuberculosis (TB), even though lungs of both children and adults infected with human immunodeficiency virus (HIV-1) or Mycobacterium tuberculosis are affected frequently and severely. In the present studies, the distributions of T (CD3+, CD4+, CD8+) and B (CD19+) lymphocytes in bronchoalveolar lavage fluid (BALF) and blood of children with AIDS (N = 28) and children with pulmonary TB (N = 18) were determined using direct immunofluorescence (flow microfluorimetry). The distributions of lymphocyte subsets in BALF differed dramatically from those in blood. In pediatric AIDS, reduction of CD4/CD8 ratio was much more pronounced in BALF than in peripheral blood (0.15 +/- 0.04 vs. 0.43 +/- 0.11). This difference was due to selective depletion of BALF CD4+ lymphocytes, rather than to a great influx of CD8+ cells into the lung. In childhood TB, the CD4/CD8 ratio in BALF also was significantly decreased, despite its elevation in blood (1.02 +/- 0.26 vs. 1.96 +/- 0.32). The results show that (1) examination of peripheral blood lymphocytes does not reflect the kind and extent of changes observed in the distribution of pulmonary lymphocyte subsets, and (2) the profound decrease of the CD4/CD8 ratios in BALF of children with AIDS or TB is due to decreased percentages and absolute numbers of BALF CD4+ lymphocytes. The data suggest that analysis of BALF provides a more accurate evaluation of the patient pulmonary immune status than monitoring peripheral blood.
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PMID:Different distributions of lung and blood lymphocyte subsets in pediatric AIDS or tuberculosis. 128 Sep 36

The paper provides an epidemiological characterization of HIV infection spread in a Russia's large region with more than 10 million people. The epidemiological findings show that the significant onset of HIV infection occurred among the population in this region in mid 1988. Homosexuals and bisexuals are prevalent among the HIV-infected, sexual contact is the main mode of HIV transmission. In addition to delivery of HIV infection from foreign countries, there are cases of local transmission. The clinical evidence indicates that most HIV-infected people are asymptomatic. Herpes viruses, Mycobacteria tuberculosis, Toxoplasma and fungi are common among causative agents of AIDS-related infections.
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PMID:[Clinico-epidemiological analysis of the cases of HIV infection in the north-western region of Russia]. 128 9

Concurrent infection with HIV-1 and Mycobacterium tuberculosis (TB) is increasingly common in East Africa. In HIV-infected individuals, pulmonary TB tends to occur before the onset of opportunistic infections. A common treatment regimen in developing countries is two months of intramuscular streptomycin combined with twelve months of isoniazid and thiacetazone. TB control programs have found this approach to be of acceptable efficacy with a low incidence of adverse reactions. Anecdotal reports of increasing cases of Stevens-Johnson syndrome, however, prompted a two-month prospective search for cases of severe cutaneous hypersensitivity reactions at Muhimbili Medical Center in Dar es Salaam, Tanzania. Five such patients were admitted to an hospital ward over the two-month period, four of whom were HIV-seropositive and all of whom were being treated with isoniazid and thiacetazone. Two were also receiving streptomycin. Four had extensive mucosal involvement of the eyelids, lips, and mouth, consistent with Stevens-Johnson syndrome. The remaining patient had bullous skin lesions, without mucosal involvement, consistent with an exfoliative dermatitis. On admission, medications were discontinued and patients underwent routine management, including the administration of steroids. Four patients were discharged from the hospital 3-7 weeks after admission with improved conditions. One patient died suddenly after five weeks of hospitalization due to unknown causes. These patients give extra support to observations that thiacetazone is associated with the increased incidence of severe cutaneous hypersensitivity syndrome in people infected with HIV-1. Further studies are needed to quantify the excess morbidity and mortality resulting from this treatment regimen.
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PMID:Severe cutaneous hypersensitivity reactions during treatment of tuberculosis in patients with HIV infection in Tanzania. 128 79

This article summarises the existing international structures in Europe which collate data produced by surveillance systems in individual countries. The surveillance of influenza, tuberculosis, and other infections in Europe is undertaken by the World Health Organisation (WHO), the European Community (EC), and national and international organisations set up to study specific diseases. The surveillance of foodborne infections, rabies, travel-associated legionellosis and AIDS/HIV is undertaken by WHO collaborating centres or WHO/EC programmes. Research into immunisation and sexually transmitted diseases other than HIV is carried out through EC concerted action programmes. The Maastricht treaty, if ratified, may lead to changes in the way communicable disease surveillance is undertaken in the EC.
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PMID:The surveillance of communicable disease in the European Community. 128 36

In order to study the epidemiological, clinical, and progressive characteristics of TB in HIV-infected individuals, a retrospective study was conducted in nine infectious disease centres of university hospitals located in the southern half of France. Among the 5730 HIV-seropositive in- and out-patients, 123 (2.1 per cent) had TB (121 infections caused by M. tuberculosis, 2 by M. bovis). Tuberculosis was pulmonary in 53 patients (43.1 per cent), extrapulmonary in 36 patients (29.3 per cent), and combined in 34 patients (27.6 per cent). There was no statistically significant difference among these three locations as to the mean CD4 count/mm3 (160 +/- 17), the type of antituberculosis therapy, the length of treatment (10.8 +/- 0.6 months) and the outcome. Fifty-two (45.2 per cent) patients received an initial antituberculosis therapeutic regimen of four drugs: isoniazid, rifampicin, ethambutol, pyrazinamide; 54 (46.9 per cent) were started on three drugs: isoniazid, rifampicin, ethambutol; and nine (7.8 per cent) received a two-drug combination: isoniazid, rifampicin. Fourteen of 75 patients subsequently received secondary preventive therapy. The mean follow-up time was 252 +/- 290 days. Clinical healing was obtained in 57.7 per cent of patients. Forty-six patients died, 33 during treatment: 23 from AIDS and eight from TB (in the first 3 weeks of treatment). Five patients suffered from relapses due to poor treatment compliance. Patients had a good prognosis if tuberculosis was diagnosed early.
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PMID:Tuberculosis in patients infected with human immunodeficiency virus 1. A retrospective multicentre study of 123 cases in France. The Groupe des Infectiologues du Sud de la France. 128 4

The association between tuberculosis and HIV presents an immediate and grave public health and socioeconomic threat, particularly in the developing world. In early 1992 WHO estimated that approximately 4 million people had been infected with both Mycobacterium tuberculosis and HIV since the beginning of the pandemic; 95% of them were in developing countries. The association between tuberculosis and HIV is evident from the high incidence of tuberculosis, estimated at 5-8% per year, among HIV-infected persons, the high HIV seroprevalence among patients with tuberculosis, the high occurrence of tuberculosis among AIDS patients, and the coincidence of increased tuberculosis notifications with the spreading of the HIV epidemic in several African countries. The impact of the two epidemics on resource-poor countries has ominous social and medical implications, and the already overstretched health services now have to face a tremendously increasing tuberculosis problem. HIV infection worsens the tuberculosis situation by increasing reactivation of latent tuberculosis infection in dually infected persons as well as by favouring rapid progression of new infections in the HIV-infected. This also results in an increase of the risk of infection and a subsequent increase of cases in the general population. In order to respond to this urgent problem, the highest priority must be given to strengthening tuberculosis control programmes in the countries where they are poorly developed and where the prevalence of HIV and tuberculosis infections is high. Besides improving the cure rate by early diagnosis and prompt treatment of patients with tuberculosis, two major strategies that need consideration include BCG vaccination and preventive chemotherapy among HIV-infected individuals. The latter strategy is considered as the most critical intervention that would help to limit the expected increase in clinical tuberculosis from the pool of HIV and tuberculosis coinfected individuals. However, a number of issues need to be addressed urgently and before such an intervention can be implemented in the developing countries.
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PMID:HIV-associated tuberculosis in developing countries: epidemiology and strategies for prevention. 816 72

We examined the frequency of serum cross-reactivity on Western blot for HIV1 and HIV2. 661 patients with tuberculosis in Abidjan, and 4,899 asymptomatic persons for HIV1 and HIV2 infections were tested. All specimens positive on ELISA for HIV1 or HIV2 were further characterized by synthetic peptide based tests. Confirmed positive samples were tested by HIV1 and HIV2 specific Western blot criteres utilisis. Dual serologic reactivity on synthetic peptide tests was significantly more frequent in HIV positive patients with tuberculosis than asymptomatic subjects. Positive HIV1 Western blots were seen in 61%-86% of specimens positive for HIV2 only on synthetic peptide tests. [Cross-reactivity, to HIV2 Western blots by HIV1 positive specimens was significantly more frequent in patients with tuberculosis than in asymptomatic subjects.] Using recently recommended criteria for HIV1 and HIV2 Western blot interpretation (presence of 2 env bands) reduced the overall proportion of HIV1 positive specimens having a positive HIV2 Western blot from 39% to 14% and HIV2 positive specimens having a positive HIV1 Western blot from 31% to 8%.
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PMID:[Analysis of new criteria for increasing the specificity of commercial Western blots]. 129 90

Differences in tuberculosis diagnosis between infected and non-infected HIV patients were described. In Barcelona, tuberculosis is present in 41.6% of 851 patients in whom AIDS was detected between 1981 and the first quarter of 1990. We reviewed the results of the methods used for tuberculosis diagnosis in 270 AIDS patients controlled in our hospital, in whom tuberculosis was detected (33.3%), and we compared these data with the results obtained in HIV carriers with tuberculosis and with tuberculous patients without HIV infection. Statistically significant differences were found between the three groups with respect to sex, age, results of Ziehl-Neelsen stain in pulmonary specimens and skin test reaction; between AIDS patients and the non-HIV infected population differences were observed in tuberculosis site. Positive skin test reaction diminished from tuberculous individuals non-HIV infected (95%), to HIV carriers with tuberculosis (71.8%) and AIDS patients with tuberculosis (21.8%). Acid-fast smears from pulmonary specimens were positive in 35.7%, 23.5% and 43.7% respectively. Statistically significant differences were found in tuberculosis localization between tuberculous patients non-HIV infected and tuberculous patients with AIDS, in the last group tuberculosis lymphadenitis was the most frequent localization (33.3%) of extrapulmonary tuberculosis, followed by abdominal tuberculosis (15.5%). The incidence of HIV infection among tuberculous patients was 4.6 in our study, but could be higher if patients between 19 and 30 years old were always checked for anti-HIV antibodies.
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PMID:Diagnosis of mycobacterial infection in acquired immunodeficiency syndrome (AIDS) patients and HIV carriers. 129 12

Clinical and paraclinical experience in HIV infection, though the time elapsed since the first observations is relatively short, begins to get typical outlines. In the case of AIDS, the lung is the main place of opportunistic infections, other inflammatory processes and neoplasia. The present work deals with six clinical cases with positive serum tests for HIV and secondary respiratory phenomena such as: Kaposi sarcoma, pneumonia with Pneumocystis carinii, tuberculosis, candidosis, pneumonia with common germs. Particular aspects of treatment and disease evolution are commented.
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PMID:[The pulmonary manifestations in AIDS]. 129 94

India has launched a liberalization of its economy with restructuring, privatization, and increased imports in order to achieve higher economic performance. This drive also affected the pharmaceutical industry and drug distribution, but in a negative manner. In the 1980s there were 9000 drug manufacturers that together produced up to 60,000 different preparations. In 1992, only 20,000 drugs were produced. The Voluntary Health Organization of India (VHAI) has fought for 10 years for a rational policy on medicines to halt the production of worthless or outright harmful products. For instance, anabolic steroids are sold as nutritional supplements to children, and the banned clioquinol is regularly used against diarrhea despite an international boycott. In recent years unscrupulous manufacturers have sold contaminated water as glucose for infusion bags and anti-D-immunoglobulin which was contaminated with HIV-infected blood. In northern India, a criminal organization bought up used cannulas from hospitals and repacked them for resale as new supplies. While a new medicine policy is formulated, there is a serious shortage of life-saving drugs such as insulin and rifampicin. In the last years, prices have exploded as some products have become six times more expensive. The whole national health system has undergone cost cuts to comply with an ultimatum from the World Bank and the International Monetary Fund; otherwise, sorely needed dollar loans would not be forthcoming. Funds for fighting tuberculosis and malaria have been trimmed, although AIDS and family planning budgets have been increased. One-fourth of the state health expenditures go to combat AIDS, since about 1 million people are infected with HIV. The pharmaceutical industry has also been embroiled in a patent protection wrangle with American drug exporters who claim that Retrovir or AZT (developed by Burroughs Wellcome) was pirated by the Cipla firm, whereas Cipla countered that it was ferreted out from scientific journals.
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PMID:[India: an expensive and dangerous drug]. 130 Jun 63


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