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)

Evidence from many countries suggests an association of human immunodeficiency virus (HIV) infection and tuberculosis of major public health significance. In order to begin assessing the impact of HIV on tuberculosis in Kenya, we have determined the HIV-1 seroprevalence among tuberculosis patients and compared the clinical characteristics of tuberculosis in HIV-positive and HIV-negative patients in two cross-sectional studies at the Infectious Disease Hospital (IDH) and the Ngaira Avenue Chest Clinic (NACC), Nairobi, Kenya. The diagnosis in 92% of all patients with pulmonary tuberculosis was confirmed by culture. The remainder were diagnosed on histological, clinical or radiological grounds. HIV seroprevalence among tuberculosis patients at IDH was 26.5% (52/196) compared to 9.2% (18/195) at NACC (P less than 0.001). There was no association between numbers of streptomycin injections in the previous 5 years and HIV infection. Positive sputum smear rates in HIV-positive patients were slightly lower than in HIV-negative patients at both study sites (71% vs 83% at IDH and 73% vs 82% at NACC) but the difference was not significant. Only Mycobacterium tuberculosis was isolated. Miliary disease was not associated with HIV infection. Persistent diarrhoea, oral candidiasis, generalized itchy rash, herpes zoster and generalized lymphadenopathy were all associated with HIV infection, but 46% (95% CI:38-54%) of all HIV-positive patients had none of the clinical features listed in the WHO Clinical Criteria for the Diagnosis of AIDS, apart from fever, cough and weight loss. Stevens-Johnson Syndrome was reported in 7/52 (13%) patients with HIV infection, and in 4/144 (3%) patients without (RR 4.85, 95% CI: 1.45-15.88).(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Cross-sectional survey of HIV infection among patients with tuberculosis in Nairobi, Kenya. 138 70

We analyze serum samples from 70 patients with pulmonary tuberculosis and 50 healthy individuals. The antigenic activity (IgG) against protein purified antigen (PPD) and antigen 60 (A60) from M. tuberculosis. Thirteen patients were also HIV infected, and three patients had AIDS defined by the presence of disseminated tuberculosis. The test using antigen alone showed a 77% sensitivity and 74% specificity when PPD is used. When A60 was used, both values improved (81% sensitivity, 94% specificity). The use of a combined test (PPD and A60) improves the sensitivity (89%) but reduces the specificity (82%). The HIV infected patients showed similar responses to those of other patients. The combined use of different antigens might be useful for diagnosing tuberculosis.
 ...
PMID:[Antigenic response against PPD and antigen 60 in tubercular patients: single antigen versus the combined test]. 139 Sep 96

A brief note on the status of the AIDS pandemic, from the Amsterdam VIIIth International Conference on AIDS, warns that the course of the epidemic is not being altered by prevention efforts. AIDS occurs in every country, usually spread by heterosexual contact, so that women are equally affected with men. WHO estimates that there are 2 million cases as of mid-1992, and that there will be 15-18 million by 2000. 90% of the expected cases by 2000 will be in developing countries, particularly in Africa. HIV is particularly widespread in central African cities, affecting as many as 38% of young people in Kigali, Rwanda. While the epidemic is spreading, the response to prevention efforts has reached a plateau, with no more evidence of effect from existing prevention programs. Unfortunately AIDS is being followed by an epidemic of tuberculosis. AIDS preferentially attacks the marginalized, stigmatized, and those of lesser status, such as women. In the US there are still 47,500 new cases annually, most in the South, and among blacks and Hispanics. Most Americans do not perceive themselves at risk, and ignore their cumulative lifetime risk.
 ...
PMID:AIDS epidemic grows but response slows. 139 20

Data on 887 AIDS cases in Zimbabwe were collected at the District Hospital in Hurungwe, Zimbabwe, from 1986-89 before the official notification system included this disease. The number of cases increased from 19 in 1986 to 290 in 1987, 433 in 1988, and 145 in the first 3 months of 1989. The female male ratio in adults were 1.4. There were 102 children under 5 with AIDS and the 5 children aged 5-15, who were all female. The presenting signs and symptoms were most often persistent generalized lymphadenopathy, chest infection, herpes zoster, chronic STDs, and chronic diarrhea with weight loss. There were 44 cases of HIV-positive pulmonary tuberculosis; 8 patients being treated for tuberculosis developed Stevens-Johnson syndrome. Of patients, overall, with herpes zoster, 89% were HIV-positive, of those with oral thrush, 83% were HIV-positive, of those with generalized lymphadenopathy, 76% were HIV-positive, and of those with weight loss and chronic diarrhea, 70% were HIV-positive. The Hurungwe District lies along the road from harare to Lusaka, Zambia, where long-distant truck drivers frequently interact with the locally mobile population. The authors suggest that herpes zoster, with its ease of diagnosis, be used as a tool to follow the spread of HIV.
 ...
PMID:Pattern of HIV-infection in Hurungwe district, Mashonaland West, Zimbabwe. 139 93

This article reviews the clinical aspects and diagnosis of HIV-associated tuberculosis in developing countries, and summaries WHO's recommendations for treatment. According to WHO estimates (early 1992) over 4 million persons worldwide have been infected with HIV and tuberculosis; 95% of them are in the developing countries. Clinical features of HIV-associated pulmonary tuberculosis in adults are frequently atypical, particularly in the late stage of HIV infection, with non-cavitary disease, lower lobe infiltrates, hilar lymphadenopathy, and pleural effusion. More typical post-primary tuberculosis with upper lobe infiltrates and cavitations is seen in the earlier stages of HIV infection. Extrapulmonary tuberculosis is reported more frequently, despite the difficulties in diagnosing it. WHO's recent guidelines recommend 6-month short-course chemotherapy with isoniazid, rifampicin, pyrazinamide, and ethambutol for patients with HIV-associated tuberculosis. The older 12-month regimen without rifampicin is much less effective. Streptomycin should not be used, because of the risk of transmitting blood-borne pathogens through contaminated needles. Thioacetazone should be abandoned, because of severe averse reactions observed among HIV-infected patients. The roles of preventive chemotherapy and BCG vaccination for prevention of tuberculosis are also briefly discussed. (author's)
 ...
PMID:HIV-associated tuberculosis in developing countries: clinical features, diagnosis, and treatment. 139 86

The efficacy of bronchoscopy for the diagnosis of tuberculosis in patients infected with human immunodeficiency virus (HIV) has not been systematically evaluated. We therefore compared the diagnostic yield of bronchoscopy in 67 HIV-infected and 45 non-HIV-infected patients with culture-proven pulmonary tuberculosis. In all cases, acid-fast smears of sputum were negative or not obtained prior to bronchoscopy. Prebronchoscopic sputum culture yielded Mycobacterium tuberculosis in 34 (89 percent) of 38 HIV-infected patients and 26 (93 percent) of 28 non-HIV-infected patients from whom specimens were obtained. Bronchoscopy provided an early diagnosis of tuberculosis (positive acid-fast smear or granulomata on biopsy) in 23 (34 percent) of the HIV-infected patients and 20 (44 percent) of the patients without HIV infection. The sensitivities of the acid-fast smear and of mycobacterial culture of bronchoscopic specimens and postbronchoscopic sputum were similar in patients with or without HIV infection. In HIV-infected patients, granulomatous inflammation was noted on transbronchial biopsy in 11 (19 percent) of 59 patients with HIV infection, compared to 16 (43 percent) of 37 patients without HIV infection (p = 0.01). Nevertheless, transbronchial biopsy provided the exclusive means for an early diagnosis of tuberculosis in six (10 percent) of 59 HIV-infected patients. We conclude that the yield of bronchoscopy for the diagnosis of pulmonary tuberculosis in HIV-infected patients is similar to that in patients without HIV infection, and that transbronchial biopsy provides incremental diagnostic information not available from evaluation of sputum or bronchoalveolar lavage fluid.
 ...
PMID:Yield of bronchoscopy for the diagnosis of tuberculosis in patients with human immunodeficiency virus infection. 139 40

Health workers took blood examples from 130 9-70 year old patients with liver cirrhosis admitted to the Department of Gastroenterology at BYL Nair Hospital in Bombay, India, between January 1990 and February 1992. Since patients with liver cirrhosis tend to undergo many blood transfusions in emergency situations, because of vomiting blood, researchers wanted to determine whether an association exists between HIV infection and liver cirrhosis. Laboratory personnel tested the samples for anti-HIV antibodies using first the ELISA and then confirming positive samples with the Western Blot (WB) test. The ELISA revealed 11 positive samples (5 were WB positive; 4 were WB negative, and 2 had indeterminate results) and the WB confirmed 5 HIV positive cases (all being 20 to 50 year old males). Thus, the HIV seroprevalence was 3.8% among the liver cirrhosis cases. 1 HIV-positive patient had earlier engaged in homosexual intercourse, 2 others had had multiple sexual partners. 4 HIV=positive patients had chronic alcoholism. 1 HIV-positive patient suffered from extensive intra abdominal tuberculosis and died during his hospital stay. None of the HIV-positive patients had earlier undergone a blood transfusion. The researchers called for more studies to confirm a relationship between HIV infection and liver cirrhosis with or without alcoholism.
 ...
PMID:HIV infection in patients of liver cirrhosis. 139 3

Between December 1987 and April 1990, health workers administered a tuberculin test to 26,529 6-to-10-year-old children in 16 districts (Woredas) of Ethiopia to obtain a sample of 47 children who had not received a BCG vaccination earlier. They were able to read the reaction in 99% of the children. 2574 (10.1%) children had a BCG scar and 591 (23%) of them tested positive for tuberculosis. 2503 (10.6%) of the 23,695 children who did not have a BCG scar tested positive for tuberculosis. Tuberculin positivity was highest in Deder Woreda (Harrarghe Region) and lowest in Wuchale Woreda (Shoa Region) (27.9% vs. 2%). In fact, prevalence was higher in urban areas than rural areas, suggesting overcrowding's effect on transmission. The last tuberculin survey in Ethiopia occurred in 1953-1955, at which time the prevalence was much higher than in 1988-1990 (30% vs. 10.6%). In addition, the annual risk of infection was higher (3% vs. 1.4%). Between the 2 surveys the prevalence of tuberculosis fell at a rate of 2.2%/year. Yet, the HIV infection pandemic in Ethiopia threatened that downward trend. The cost of chemoprophylactic drugs and lack of sufficient laboratory facilities posed a problem for Ethiopia's National Tuberculosis Control Programme.
 ...
PMID:Tuberculin survey in Ethiopia. 140 82

The authors report a connection between a meningitis tuberculosis and a meningoencephalitis with cryptococcus in the case of an african VIH+. The diagnostic of a meningitis tuberculosis was retained on an indirect arguments, this of meningoencephalitis of direct arguments (antigen cryptococcus, cultivation on Sabouraud environment). The pulmonary tuberculosis and/or extrapulmonary tuberculosis is current in Central Africa during HIV infection, as well as the crytococcosis during AIDS. But, any observation on neuromeningitis strike of those two infections have been reported up to now.
 ...
PMID:[Simultaneous association of tubercular meningitis and cryptococcal meningitis in an African with human immunodeficiency virus HIV positive serology. University Hospital Center of Bujumbura,Burundi]. 140 16

In order to assess the diagnostic usefulness of the A60 (ANDA Biological, Strassbourg, France) sero-diagnostic enzyme-linked immunosorbent assay (ELISA) kit for tuberculosis in Africa, sera of 53 pulmonary smear-positive tuberculosis (TB) patients, 30 apparently healthy control subjects and 6 AIDS suspects were sampled in Agogo Hospital in the forest area of Ghana. These sera were analyzed for antibodies to HIV-1 and HIV-2, and IgG-antibodies to the A60 BCG-antigen, while the non-HIV individuals were tested for total IgG levels. One healthy control subject, all of 6 AIDS suspects and 7 of the TB patients has HIV infections. In the non-HIV TB group, the sensitivity and specifity of the A60 ELISA was 78% and 86%, respectively, which was much poorer than expected from published reports about the A60 test. The A60 test failed, completely however, to discriminate between TB and non-TB in the HIV-positive group. In the non-HIV groups, total IgG levels were significantly higher in TB patients than in controls. It seems that the usefulness of the A60 ELISA test to diagnose tuberculosis is very limited in this high-incidence area, and that it seems to be of no value in patients infected with HIV.
 ...
PMID:Sero-diagnosis of tuberculosis with A60 antigen enzyme-linked immunosorbent assay: failure in HIV-infected individuals in Ghana. 140 59


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