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

The epidemic of HIV-associated tuberculosis is having a severe impact on tuberculosis control in sub-Saharan Africa, as well as the United States of America, and is expected to spread. Where facilities are limited, the association between HIV and sputum-smear negative tuberculosis hampers diagnosis; trials of anti-tuberculous therapy are indicated in some cases. Standard treatment regimens are effective, but thiacetazone should be avoided because of its association with severe, cutaneous adverse reactions. Treatment may have to be prolonged in HIV positive cases. Measures to maximize compliance with therapy are paramount. These include the use of the shortest possible regimens, of recognized potency, and emphasis on ensuring that the regimen is understood by and readily accessible to the patient.
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PMID:An approach to the management of tuberculosis in HIV endemic areas. 144 Aug 79

Primary care physicians play an important role in identifying and treating bacterial infections in adults infected with the human immunodeficiency virus (HIV). Mycobacterium avium complex and Mycobacterium tuberculosis are pathogens that can cause systemic or local infection in these patients. We review the epidemiology, pathogenesis, clinical presentation, and principles of treatment for these two mycobacterial pathogens. Because M tuberculosis disease is preventable and curable and yet communicable, physicians should maintain a high degree of suspicion for tuberculosis in HIV-infected adults. In comparison, the goal of treating M avium complex in patients with advanced HIV disease is to reduce constitutional symptoms and improve survival.
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PMID:Mycobacterium avium complex and Mycobacterium tuberculosis in patients infected with the human immunodeficiency virus. 144 63

The Eighth International AIDS Symposium in Amsterdam, the Netherlands, provided updated scientific and programmatic information on the human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) to thousands of interested participants. As in the other scientific areas, the amount of information presented in epidemiology and prevention was overwhelming; however, the scientific progress described was steady but incremental. This commentary summarizes progress made in three selected areas that were highlighted during the meeting's scientific session and a fourth that received widespread media attention: (1) the epidemiology of HIV/AIDS in heterosexual women; (2) tuberculosis as an increasing opportunistic pathogen in HIV-infected persons; (3) prevention research, practice, and policy; and (4) preliminary reports of severe immunodeficiency in persons without evident HIV infection. In order to stem HIV transmission worldwide, a safe and effective vaccine is urgently needed. Currently, in the absence of such a vaccine, it is crucial for all of the world's communities to apply the best science-based prevention methods available.
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PMID:Perspectives on HIV/AIDS epidemiology and prevention from the Eighth International Conference on AIDS. 144 93

A prospective study of possible aetiological factors for neuropathy associated with HIV infection was performed in 80 patients and 28 homosexual controls. At entry to the study twelve patients (15 per cent) had evidence of a generalized neuropathy not due to any other cause and a further three patients developed symptomatic neuropathy during a mean (SD) follow-up of 20 (7.5) months. All but two of these neuropathies were of the distal symmetrical sensory type. Electrophysiology was consistent with an axonal pathology and nerve biopsy confirmed this as the major pathological change. Warming threshold was the diagnostic test most frequently abnormal, sometimes in the absence of other electrophysiological abnormalities. No association was seen with opportunistic infection (cytomegalovirus, herpes simplex, Pneumocystis pneumonia, toxoplasmosis, Cryptococcus infection or tuberculosis). HIV proviral DNA could not be detected in paraffin sections of peripheral nerve in six patients with neuropathy. The presence of the neuropathy did not show significant correlation with depression of the number of CD4+ T cells in the blood, impaired T cell function tests, or IgG, IgM, or IgA levels. Immune complexes containing C1q, but not those containing IgG, IgM, IgA or C3c, were significantly more common among neuropathic patients (p = 0.01).
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PMID:A study of neuropathy in HIV infection. 144 48

A retrospective study of drug resistance of Mycobacterium tuberculosis in patients simultaneously affected by tuberculosis (TB) and HIV was conducted in a Spanish university hospital. 39 of the 287 patients (13.6%) were also HIV seropositive. Mycobacterium tuberculosis with primary resistance to at least one of the major antitubercular drugs was isolated in 4 of the 39 (10.3%). The 4 patients (3 males, 1 female) demonstrating primary drug resistance were intravenous drug users aged 23-30 years. 3 were resistant to isoniazid, 1 to rifampin, 1 to streptomycin, and 1 to pyrazinamide. None was resistant to ethambutol. 2 were resistant to one drug and 2 were resistant to 2 drugs. Resistance to streptomycin in 1 patient may have been secondary to treatment with aminoglucosides for endocarditis. It is recommended that diagnostic suspicion of TB be maintained in management of HIV infected patients because of the possibility of drug resistance and of in-hospital transmission. Shortened or simplified treatment regimens should be avoided in seropositive patients.
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PMID:[Isolation of Mycobacterium tuberculosis with primary resistance to chemotherapeutic agents in patients with HIV infection]. 145 Feb 61

Since 1985, tuberculosis case counts in the United States have increased, primarily because of the influence of the HIV epidemic. In addition, during this time outbreaks of multidrug-resistant tuberculosis among patients with AIDS or HIV infection have been reported in New York City and Florida. These outbreaks have occurred in hospitals and prisons and have been characterized by high case fatality rates, disease transmission within the institutions, and high infection rates in health care workers. The increase in tuberculosis rates and the outbreaks have raised concern that multidrug-resistant tuberculosis could become a widespread problem in the United States. Dealing with tuberculosis in the 1990s will require reconsideration of our current methods of tuberculosis prevention, diagnosis, treatment, and control.
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PMID:AIDS and multidrug-resistant tuberculosis: an epidemic transforms an old disease. 145 93

Tuberculosis is making a comeback in communities across the nation. Increased rates of the disease, particularly with those having HIV/AIDS, have sounded the alarm that quick and decisive action is needed to halt the spread of TB. Multidrug-resistant TB is becoming a primary concern with public health officials. Specific plans and efforts, instigated by the Centers for Disease Control, have outlined the appropriate steps local public health workers, the medical community, and civic and community organizations should take in order to eliminate TB by the year 2010. With the creation of the Task Force on Drug Resistant Tuberculosis, Louisiana has a vehicle with which to combat its growing TB problem.
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PMID:Attacking today's tuberculosis problem: a multifaceted, coordinated effort. 145 95

In children, as in adults, tuberculosis is much commoner among minority population groups, in Louisiana particularly among blacks. Since 1986 tuberculosis in some states has increased notably; in Louisiana the increase is only now, in 1992, becoming apparent. Eighteen new cases in children under 20 were reported in 1991. Diagnosis in children still depends largely on history of contact and on the Mantoux tuberculin test. Treatment has changed markedly to a more intensive 6 month course including three or four drugs. Preventive treatment of tuberculin positive children is particularly emphasized because it will play an important role in achieving the stated public health goal of elimination of tuberculosis by the year 2010. With the increasing number of children exposed to tuberculosis, the increasing number of HIV-positive children at risk, and the rising number of multiresistant tubercle bacilli, vaccination with BCG must be considered.
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PMID:Tuberculosis in children in 1992. 145 96

A clinical AIDS case definition is needed for surveillance in countries where the CDC case definition is not practical. To derive such a definition, we compared 110 HIV-seropositive and 135 randomly selected HIV-seronegative adult medical-ward inpatients in Brazil. Multivariate analysis of clinical signs and symptoms and simple diagnoses resulted in a discriminant function with sensitivity of 89% and specificity of 96% in predicting for AIDS. These data were the empirical basis for a clinical definition of AIDS in adults drafted in a Caracas, Venezuela, workshop sponsored by the Pan American Health Organization. The revised "Caracas" definition presented here requires a positive HIV serology, the absence of cancer or other cause of immunosuppression, plus > or = 10 cumulative points, as follows: Kaposi's sarcoma (10 points); extrapulmonary/noncavitary pulmonary tuberculosis (10); oral candidiasis or hairy leukoplakia (5); cavitary pulmonary/unspecified tuberculosis (5); herpes zoster < 60 years of age (5); CNS dysfunction (5); diarrhea > or = 1 month (2); fever > or = 1 month (2); cachexia or > 10% weight loss (2); asthenia > or = 1 month (2); persistent dermatitis (2); anemia, lymphopenia, or thrombocytopenia (2); persistent cough or any pneumonia except TB (2); and lymphadenopathy > or = 1 cm at > or = 2 noninguinal sites for > or = 1 month (2). This definition has a sensitivity of 95% and a specificity of 100% (91% without HIV serology) when applied to the Brazilian patients in this study. The Caracas definition has been adopted by Brazil, Honduras, and Surinam, and is in validation elsewhere. The use of a reasonably sensitive and specific case definition commensurate with available diagnostic resources should facilitate AIDS surveillance in developing countries.
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PMID:A simplified surveillance case definition of AIDS derived from empirical clinical data. The Clinical AIDS Study Group, and the Working Group on AIDS case definition. 145 32

The marriage of two scourges, one old (mycobacterial disease) and one new (HIV), has presented an enormous challenge to the medical and public health communities, and has stirred renewed interest in mechanisms for immune control of mycobacterial infection. Virulence of both M. avium and M. tuberculosis appears to be inversely related to the capacity of the microorganisms to induce production of protective cytokines in infected hosts. TNF alpha and IFN gamma are central to this process, and mycobacterial polysaccharides may be their main determinant. Despite these similarities, M. tuberculosis and M. avium cause illnesses at the polar extremes of HIV disease. Tuberculosis, occurring early in the course of HIV disease, may promote HIV replication in otherwise latently infected cells via induction of cytokines. As such, the potential exists for accelerated progression to AIDS due to the mutual synergy of these pathogens.
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PMID:Macrophages, mycobacteria and HIV: the role of cytokines in determining mycobacterial virulence and regulating viral replication. 145 67


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