Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0019693 (HIV)
 170,526 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

HIV infection develops not only to AIDS, but it is also a leading risk factor for the development of many other infectious diseases due to the depletion of T lymphocytes such as the interrelated prevalence of tuberculosis (TB) and AIDS. Surveillance conducted in the 1988-1989 in the US and other recent studies found a serious epidemiological relation. Thailand has an endemic disease, melioidosis, caused by P. pseudomallei living in environmental soil and water. The disease takes various clinical types; localized, systemic, acute, subacute, chronic, and inapparent; presenting symptoms undistinguishable from many other infectious diseases. Pulmonary melioidosis shows a clinical feature similar to lung tuberculosis which occurs more easily in the individuals of impaired immunity, such as diabetes patients. According to available literatures, one case of recurrent melioidosis has been reported in Thailand as a complication of AIDS. The patient was a German homosexual male who had been living in the country for more than 10 years and showed a fatal course with interstitial pneumonitis. Ubon Ratchathani province, Thailand, is an area endemic for both TB and melioidosis, as well as a major supplier of laborers to Bangkok. A preliminary survey was conducted for the prevalence of HIV infections in pulmonary TB and melioidosis patients in Ubon Ratchathani province. TB was found to be prevalent in the province to a greater extent than in most other provinces and melioidosis is endemic. Four individuals were found to be HIV-seropositive amid a total 551 suspected and culture-positive cases of pulmonary TB, while no HIV-seropositive case was found among 121 melioidosis patients. In view of the rapidly expanding HIV-infections in Thailand, careful attention will have to be given to the future epidemiological status of HIV infection in TB patients.
 ...
PMID:A preliminary survey for human immunodeficient virus (HIV) infections in tuberculosis and melioidosis patients in Ubon Ratchathani, Thailand. 130 71

120 AIDS patients (mean age 33 +/- 9 years, 108 males) were evaluated regarding rheumatic manifestations. According to CDC's classification, 18.3% belonged to group II, 28.3% to group III, and 53.4% to group IV. Arthralgia was present in 33 patients (27.5%), and in only 8 could be associated with infections other than HIV (5 cases of tuberculosis, 3 P. carinii, and 1 gonococcal infection). Incidence of arthralgia was equal in either sex. Arthritis was present in 8 patients, 2 of them with Reiter's syndrome. In 6 patients arthralgia was the first symptom (3 with arthritis) before AIDS diagnosis. There was a higher incidence of dry mouth, dry eyes, and muscular complaints in patients with arthralgia than in patients without arthralgia. Antinuclear antibodies and rheumatoid factor were absent in the serum of the patients studied. Arthritic manifestations possibly occur in AIDS, even in patients without other clinical manifestations, as a reactive state to HIV infection.
 ...
PMID:[Rheumatic manifestations of acquired immunodeficiency syndrome (AIDS)]. 130 73

Between January-June 1989, researchers evaluated 473 admissions and 100 deaths at the Pulmonary Medicine Service at the University Hospital in Abidjan, Ivory Coast to determine prevalence of HIV-1 and HIV-2 infections, to look at death rates in relation to HIV status, and to examine the pulmonary pathology associated with these infections compared with deaths in HIV negative patients. HIV-1 seroprevalence was 38%, HIV-2 4%, and dual HIV reactive 14%. The death rate for the entire sample was 21%. It was higher in HIV seropositive patients than HIV seronegative patients (27% vs. 14%; relative risk=1.95 times). HIV seropositive patients regardless of HIV group essentially died from the same diseases: 40% from pulmonary tuberculosis (disseminated nonreactive multibacillary pattern), 34% from nonspecific pneumonia, 8% from Pneumocystis pneumonia, 6% from Kaposi's sarcoma, and 4% from lung cancer. Among only HIV-1 seropositive cases, Pneumocystis carinii was the cause of death in only 95 of cases. The leading causes of death for HIV seronegative patients included lung cancer (64%), nonspecific pneumonia (28%), and pulmonary tuberculosis (4%). Researchers should be pressed to develop more sensitive means to diagnosis tuberculosis as well as prophylaxis against reactivation of tuberculosis among HIV seropositive people in Africa. Since Pneumocystis carinii infection is uncommon among HIV seropositive people in Africa, prophylaxis for it is not needed.
 ...
PMID:Pneumocystis carinii pneumonia. An uncommon cause of death in African patients with acquired immunodeficiency syndrome. 131 14

Whether tuberculosis patients received short-course chemotherapy with treatment of isoniazid (INH) and rifampicin (RIF), combined or not with pyrazinamide (PZA) and ethambutol (EMB) or streptomycin (SM), or long term chemotherapy with INH, SM and thiacetazone (Tb1), the rate of sputum culture conversion was similar in HIV-positive and HIV-negative patients. To prevent relapses it was recommended to treat patients for a minimum of 9 months and for at least 6 months after culture conversion, or even to administer INH for life after the end of treatment. However, no difference was observed in the percentage of relapses between HIV-positive and HIV-negative patients. Side-effects were observed in approximately 20% of HIV-positive patients treated with INH + RIF + PZA + EMB (or SM) or with INH + SM + Tb1, Tb1 being responsible for epidermal necrolysis, in some cases fatal. The mean survival of HIV-patients with tuberculosis was from 10 to 18 months after the diagnosis of tuberculosis. Other opportunistic infections could have been the main cause of death. Acquired drug resistance is not a common complication of tuberculosis treatment in HIV-positive patients, but several epidemics of nosocomial transmission of multiple drug-resistant tuberculosis have recently been observed in the USA. Sparfloxacin, a new fluoroquinolone with a long half-life and low MIC (0.25-0.50 mg/l) against Mycobacterium tuberculosis, is a promising drug against tuberculosis.
 ...
PMID:Treatment of tuberculosis in HIV infection. 826 Jun 70

The great number of AIDS cases in children in Romania, together with the high annual risk of Tb infection, created the premises for the occurrence of a relatively great number of disease cases through HIV infection/AIDS + tuberculosis, particularly in the age-group "0-5 years". Serum positive HIV children were considered as AIDS cases when tuberculosis was also associated. Twelve cases in which the infections were concomitant, transmitted through injections, constituted an exception to the point. The 12 children serum positive for HIV showed a primary musculo-cutaneous complex on their thighs, at the very place of injections. A proportion of 50% of them showed a favourable evolution under anti-Tb treatment. Most children developed primary tuberculosis aerogenically acquired, associated with AIDS. A proportion of 59.5% of them evoluted towards severe disseminated forms (milliaria, meningitis), with many deaths, and 37.8% only showed a favorable evolution under anti-tuberculosis treatment. HIV infection in children took place predominantly between 1987-1989. Tuberculosis was associated 1-2 years later, when the switching from bacillary infection into active tuberculosis was facilitated by the progressive immunodepression which is specific for AIDS. The tuberculin test with 2 IU-PPD was positive in less advanced AIDS cases but faded in children in the final stage of the syndrome or in those with severe forms of tuberculosis. Tuberculosis finding out in children with HIV infection/AIDS is however possible; therefore, skin test reaction is compulsory in all children in this category. In children with a tuberculosis cured through specific treatment in their histories, the association of HIV infection reaching AIDS stage can lead to a Tb relapse.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[The association of tuberculosis with HIV/AIDS infection in children in Romania]. 133 97

1. When the sera of patients with tuberculosis were tested for anti-Mycobacterium tuberculosis IgG using an indirect ELISA, the test was positive for 94.1% of the samples from patients not having AIDS (N = 51), but for only 37.5% of the samples from patients with AIDS (N = 16). 2. False-positive results were obtained for 7.3% of patients not infected with HIV (N = 96) and for 4.7% of patients infected with HIV (N = 64). 3. In most serum samples obtained from patients with tuberculosis and AIDS after the beginning of specific treatment there was a reduction of the ELISA absorbance at 490 nm with time. 4. These results indicate that serological tests for the detection of anti-M. tuberculosis IgG in patients with AIDS are of limited value for the diagnosis of tuberculosis, most likely as a consequence of the underlying immune defect of the patients.
 ...
PMID:Reduced anti-Mycobacterium tuberculosis antibody response in tuberculosis patients with acquired immunodeficiency syndrome. 134 37

Worldwide, approximately 1.7 billion persons are infected with M. tuberculosis, and 5 million with HIV. In developing countries, a strong association exists between the 2 pathogens, with 14-30% of AIDS patients having tuberculosis (TB), and 12-60% of TB patients HIV-seropositive (HIV+). TB is one of the most frequent opportunistic infection in AIDS, and is a common way for AIDS to present. Evidence suggests that most TB cases in HIV+ patients are due to the endogenous reactivation of past TB infection instead of from new exogenous infection. Particular cause for concern exists in developing countries where approximately 1/2 of the population aged 20-40 years is infected with TB. While 10% of HIV-individuals may develop TB over their lifetimes, HIV+ individuals are at far greater risk of developing the disease. The paper discusses diagnosis, chemoprophylaxis, and treatment of TB. To help stymie major increases in TB patients as HIV spreads across populations with high prevalence of TB, the authors recommend offering HIV testing and counseling to all patients, including TB in the differential diagnoses of all pulmonary diseases in HIV+ patients, offering BCG vaccination to every nonsymptomatic AIDS newborn in countries with high levels of TB infection, routinely obtaining mycobacterial stains and cultures on specimens from HIV+ patients with respiratory symptoms, making clinicians aware of the many false negative tuberculin tests and atypical radiographic patterns in advanced HIV infection, offering 12 months of isoniazid chemoprophylaxis to those HIV+, treating HIV patients with TB with isoniazid, rifampicin, and 1 or 2 of pyrazinamide, ethambutol, or streptomycin during the 1st 2 months, and making health workers aware of infection risks from doing tuberculin tests and injecting streptomycin.
 ...
PMID:The impact of the HIV epidemic on tuberculosis control programmes in developing countries. 835 44

Nervous system opportunistic infections are seen in about one fifth of AIDS cases and account for over 40% of the patients with neurological manifestations. Serious infections are seen in severely immunosuppressed patients, usually with CD4 counts of 200 ml-1 or less. The commonest is CMV, which can produce acute encephalitis, sometimes with focal hemisphere or brain-stem signs, dementia, retinitis, optic neuritis and an ascending radiculomyeloencephalitis. Cryptococcal meningitis is the most frequent fungal disease; a high degree of clinical suspicion is required in patients with fever, malaise, headache or seizures. Only CSF cultures are always positive; both serum and CSF cryptococcal antigen tests are highly sensitive and specific. Treatment with amphotericin B and flucytosine is successful in at least 70% of first episodes but side-effects are common. Without maintenance therapy 50% of patients relapse; fluconazole is recommended. Cerebral toxoplasmosis can present with focal cerebral or spinal cord signs but also as a diffuse encephalopathy; negative T. gondii serology is exceptional but positive serum titres are usually unhelpful. Treatment with sulfadiazine, pyrimethamine and folinic acid achieves good results in 90% of the first episodes, but side-effects are common. Appearances on CT scan or MRI may take several weeks to improve. The value of an empirical approach to treatment is well-established; an initial cerebral biopsy is difficult to justify. Without maintenance therapy a relapse rate of 50% can be expected; therapy with sulfadiazine and pyrimethamine may also prevent pneumocystosis. HIV disease appears to increase the likelihood of neurosyphilis, and the risk of relapse after conventional penicillin doses, in patients with syphilis; at least 3-4 weeks of appropriate therapy are recommended. A number of other diseases caused by viruses, fungi, bacteria and parasites are less common; these include progressive multifocal leukoencephalopathy, herpes simplex and zoster infections and tuberculosis.
 ...
PMID:Central nervous system opportunistic infections in HIV disease: clinical aspects. 134 47

Between December 1991 and May 1992 physicians included all patients who come to Parirenyatwa Hospital or Harare Central Hospital in Zimbabwe with suspected pulmonary, pleural, or pericardial tuberculosis (TB) in their study to determine the utility of fine-needle aspiration of extrathoracic lymph nodes in suspected intrathoracic TB in identifying HIV-related pulmonary, pleural, or pericardial TB. They conducted fine-needle aspiration in 28 patients with suspected TB. Microscopy revealed acid-fast bacilli in 20 patients (71%). 48 hours after hospital admission, 3 of these patients died even though they received anti-TB chemotherapy. The other 17 responded well to anti-TB chemotherapy. 3 of the 8 patients who had negative lymph-node aspirates for acid-fast bacilli responded to anti-TB therapy, indicating that they probably did indeed have TB. Therefore, fine needle extrathoracic lymph node aspiration followed by staining detected TB in 87% of patients actually ill with TB (20/23). Since the study did not include sputum-positive patients, those with penicillin-responsive fever, and those with obvious palatal or cutaneous Kaposi's sarcoma, the study was somewhat biased. Nevertheless, these results indicated that HIV-associated intrathoracic TB was often associated with extrathoracic tuberculous lymphadenitis. Since fine-needle aspiration is simple, rural hospitals and clinics in developing countries could use it to detect sputum-negative TB and then to determine appropriate therapy. Infection with atypical mycobacteria rarely occurs in Zimbabwe and other African countries, so physicians in Africa should use anti-TB chemotherapy to treat patients with a positive aspirate.
 ...
PMID:Fine-needle extrathoracic lymph-node aspiration in HIV-associated sputum-negative tuberculosis. 809 35

HIV infection is characterized by CD4+ lymphocyte depletion manifested through the loss of the immune response capacity. The resulting immunodeficit is expressed by the blocking of immune surveillance mechanisms and, thus, by the establishment of favourable conditions to the development of opportunistic infections and/or malignant processes. In tuberculosis, the immunodeficiency associated with HIV infection makes possible the evolution of a latent infection to a clinically manifest disease. Latent tuberculosis is characterized by the intracellular persistence of some metabolically inactive Tb bacillus forms which are incapable of multiplication. The conversion of these inactive into metabolically active forms capable of multiplication is usually neutralized by immunosurveillance mechanisms. The blocking of such mechanisms in case of CD4+ cell depletion will allow the multiplication of metabolically active Tb bacillus forms, and the development of a clinically manifest tuberculosis. CD4+ lymphocyte depletion is the result of facilitating antibodies and certain cytokines, and of some autoimmune processes which also affect the non-infected CD4+ cells. Therefore, it is necessary that Tb chemoprophylaxis in HIV infected subjects should also be addressed to the processes initiating the immune deficit, which include autoimmune mechanisms as well as those facilitating HIV infection.
 ...
PMID:[AIDS and tuberculosis: the immunopathogenic processes]. 136 59


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>