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

The study of the clinical manifestations, progression, and outcome of human immunodeficiency virus (HIV) infection in women has begun in earnest. AIDS-defining diseases that are more common in women than in men include wasting syndrome, esophageal candidiasis, and herpes simplex virus disease, whereas Kaposi's sarcoma is rare. Non-AIDS-defining gynecological conditions such as vaginal candida infections and cervical pathology are prevalent among women at all stages of HIV infection. Associations have been documented between the presence of human papillomavirus, lower genital tract neoplasia, and HIV-related immunosuppression. Pregnancy has not been confirmed to have an effect on the clinical progression of HIV disease in women incremental to the effect of time. Differential access and utilization of therapeutic interventions appear to account for much of the reported gender discrepancy in survival. Well designed epidemiological and clinical studies will help further scientific knowledge leading to early diagnosis, appropriate treatment, and timely prevention of the manifestations of HIV disease in women.
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PMID:HIV disease and AIDS in women: current knowledge and a research agenda. 145 25

In 1990, among pregnant women .1% tested positive for HIV antibodies in Amsterdam compared to 24.5% in Lusaka, Zambia. During 1990 and 1991 data were collected from 231 patients fulfilling the WHO clinical criteria for the diagnosis of AIDS in 3 hospitals of Sesheke, a rural Zambian district. 46.3% of the group was male and 53.7% was female, and the mean age of women was significantly lower than that of men (25.2 vs. 31.1 years, p 0.001). A total of 185 patients could be tested for HIV-1 antibodies using ELISA-Welcozyme and HIVCECK-Du Pont. There were 141 (81.6%) positive results, 19 (10.3%) negative results, and in 15 (8.1%) cases the outcome was not clear. Seroprevalence figures for HIV-1 in the same period were 16% for blood donors and 41% for patients attending the clinic for sexually transmitted diseases. Most patients with AIDS in Sesheke district present with a wasting syndrome, and in these cases, tuberculosis (TB), whose incidence has increased dramatically, has to be excluded. Loss of more than 10% of body weight was the most common symptom followed by chronic cough lasting for more than 1 month, fever persisting for more than 1 month, and chronic diarrhea lasting for more than 1 more. Chronic coughing was more frequent among adults than among children (P 0.001). Weight loss, chronic diarrhea, persistent coughing, generalized lymphadenopathy, generalized dermatitis, and oropharyngeal candidiasis occurred among both adults and children equally often. Only 4 patients (18%) and extrapulmonary TB in 10 patients (4%). In the district there was no registration system for the dead and the follow-up of AIDS patients were not organized well, but as of January 1, 1992, from hospital records it was established that 74 patients out of the 231 studied were decreased. The outlook for the population in Sesheke and Zambia is dim in light of the current high seroprevalence rate.
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PMID:[AIDS in a Zambian district]. 147 Feb 44

High levels of an unusual acid-labile interferon (IFN) alpha in sera of patients with human immunodeficiency virus (HIV) infection are associated with disease progression to acquired immunodeficiency syndrome (AIDS). Since IFNs have been shown to enhance the cytotoxic actions of tumor necrosis factor (TNF), a potent mediator of inflammation and cachexia, a study was undertaken to investigate whether the acid-labile IFN alpha produced in AIDS can regulate TNF receptor expression. The expression of TNF receptors was determined by studying the interaction of [125I]TNF with cellular receptors. The results show the acid-labile IFN alpha present in AIDS sera is capable of inducing the expression of cellular receptors for TNF. The extent of induction of TNF receptors depends on the concentration of the acid-labile IFN alpha in the AIDS sera. There is no significant induction of TNF receptors when the AIDS sera are preneutralized with polyclonal anti-IFN alpha antibodies. It is also shown that the synthesis of TNF by peripheral blood monocytes (PBM) from patients with HIV infection is enhanced during the progression of HIV infection in vivo. Thus, the TNF system is activated in patients with HIV infection. This activation may be a contributing factor to some of the physiological disturbances including the wasting syndrome observed in AIDS.
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PMID:Regulation of tumor necrosis factor receptor expression by acid-labile interferon-alpha from AIDS sera. 165 73

AIDS is the leading cause of death among adults in at least two capital cities in Africa: Abidjan, Cote d'Ivoire, and Kinshasa, Zaire. Knowledge of the causes of morbidity and mortality in HIV-positive people in Africa is, however, less than complete due to limited postmortem diagnostic facilities, difficulties in obtaining consent for postmortem examinations, and a general lack of pathologists. Although HIV affects all organs, either directly or by facilitating opportunistic infections and tumors, pulmonary insufficiency, wasting, cerebral lesions compromising vital centers, and overwhelming toxic systemic infection are the major causes of HIV disease. Virtually every pathological lesion described in developed countries has also been seen in Africa. This paper discusses what is known of the major serious pathologies in sub-Saharan Africa. It is clear that more pathological diagnostic and follow-up data are needed before an accurate picture of the patterns and pathogeneses of the various manifestations of HIV infection in Africa can be drawn. Sections consider HIV-1 and HIV-2 infection, Mycobacterium tuberculosis infection, non-tuberculosis pulmonary disease, diarrhea and the wasting syndrome, neuropathology, specific systemic infections, tumors associated with HIV infection, and pediatric AIDS in Africa.
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PMID:The pathology of severe morbidity and mortality caused by HIV infection in Africa. 166 11

Up to June 1991 a total of 6,604 AIDS cases were reported to the central AIDS-registry at the Federal Health Office. As typical for "pattern I" countries most of the AIDS-cases are homo/bisexual men (70%), followed by i.v. drug users (IDU, 13%). However, the proportion of homo/bisexual men is constantly decreasing since 1986 while the proportion of IDU's is increasing. As also observed in other industrialized countries a flattening off in the AIDS incidence curve is seen since 1989. Probable reasons for this observation are a decrease of new infections since 1984/85 (due to early saturation of the populations at highest risk and to the early onset of prevention campaigns in these populations) and improved therapeutic strategies in the prevention of AIDS indicating diseases. However, since about 60,000 people are estimated to be HIV infected in the FRG today AIDS incidence will remain on a stable level for the next years regardless the number of new infections occurring today. Since 1988 major changes in the distribution of AIDS indicating diseases are seen. While Kaposi's sarcoma is constantly decreasing non Hodgkin lymphomas, HIV encephalopathy and wasting syndrome are increasing. Due to the effective primary prophylaxis of pneumocystis carinii pneumonia (PCP) by pentamidine the proportion of PCP as AIDS-indicating opportunistic infection decreased from more than 60% in 1988 to 41% in 1991. The second most frequent opportunistic infection is now toxoplasmosis (19%). The changes in the distribution of AIDS-indicating diseases and the increasing proportion of IDU's have major implications on patient care as well as diagnostic and therapeutic procedures.
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PMID:[The epidemiology and acquired immunodeficiency syndrome--status and trends]. 172 53

In 1988, researchers recruited 18-35 year old women from pediatric and prenatal care clinics at the Centre Hospitalier de Kigali in Rwanda to observe HIV disease progression. They compared probability of survival of the 460 HIV-positive women with that of the 998 HIV-negative women. They used simple clinical and laboratory variables as predictors of mortality from AIDS. The researchers did not use the WHO clinical case definition of AIDS as the outcome measure since 40 and 30 women from each group, respectively, met the criteria for AIDS at entry. Only 66% (25) of the HIV=infected women who died met the criteria for AIDS during the study. After 2 years, mortality among HIV-infected women stood at 7% (39) which was more than 20 times higher than that among women not HIV infected (0.3%; p .001). Mortality was 21% for those who met the WHO criteria for AIDS. The wasting syndrome was the cause of the death in 51% of HIV-infected death cases. The baseline predictors of mortality in HIV-infected women in descending order of prevalence of predictor included an at most body mass index of 21 kg.sq. (48%; relative hazard [RH] 2.3), low income (46%; RH=2.6), mm/hour erythrocyte sedimentation rate (39%; rh = 4.9), chronic diarrhea (10%; RH = 2.6), a history of herpes zoster (9%; RH 5.3), and oral candidiasis (1%; RH 7.3). The erythrocyte sedimentation rate was a better predictor than lymphocyte counts (p .001) and p .11, respectively). Of the 40 HIV-infected women who met the criteria for AIDS, the health of 32 women improved so the physicians no longer considered them to have AIDS. Thus health workers should treat symptomatic HIV-positive cases. AIDS was responsible for 90% of all deaths among reproductive age women living in Kigali. Health workers in Africa can use the simpler erythrocyte sedimentation rate instead of the more costly CD4 counts as a predictor of progression to AIDS.
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PMID:Predictors of mortality among HIV-infected women in Kigali, Rwanda. 173 89

The composition of human immunodeficiency virus type 1 (HIV-1) clonal populations at different stages of infection and in different compartments was analyzed. Biological HIV-1 clones were obtained by primary isolation from patient peripheral blood mononuclear cells under limiting dilution conditions, with either blood donor peripheral blood lymphocytes or monocyte-derived macrophages (MDM) as target cells, and the biological phenotype of the clones was analyzed. In asymptomatic individuals, low frequencies of HIV-1 clones were observed. These clones were non-syncytium inducing and preferentially monocytotropic. In individuals progressing to disease, a 100-fold increase in frequencies of productively HIV-1-infected cells was observed as a result of a selective expansion of nonmonocytotropic clones. In a person progressing to AIDS within 19 months after infection, only syncytium-inducing clones were detected, shifting from MDM-tropic to non-MDM-tropic over time. From his virus donor, a patient with wasting syndrome, only syncytium-inducing clones, mostly non-MDM-tropic, were recovered. Parallel clonal analysis of HIV-1 populations in cells present in bronchoalveolar lavage fluid and peripheral blood from an AIDS patient revealed a qualitatively and quantitatively more monocytotropic virus population in the lung compartment than in peripheral blood at the same time point. These findings indicate that monocytotropic HIV-1 clones, probably generated in the tissues, are responsible for the persistence of HIV-1 infection and that progression of HIV-1 infection is associated with a selective increase of T-cell-tropic, nonmonocytotropic HIV-1 variants in peripheral blood.
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PMID:Biological phenotype of human immunodeficiency virus type 1 clones at different stages of infection: progression of disease is associated with a shift from monocytotropic to T-cell-tropic virus population. 173 94

Seven young cats were injected with feline leukemia virus (FeLV); six of them became viremic. All of the viremic cats developed AIDS-related symptoms, i.e. lymphopenia, neutropenia, thymic atrophy, and wasting syndrome, along with an altered pituitary and adrenocortical function. These symptoms closely resemble human AIDS induced by HIV. It was discovered that, after 2 weeks of infection, the average amount of plasma adrenocorticotropic hormone (ACTH) detected in the infected cats was reduced by 29% in comparison with that before the infection. In contrast to the second week, the fifth week of infection showed a 94% increase of plasma ACTH which then dropped back down to 38% after the sixth and seventh weeks. This opposing biphasic pattern of change was also observed in the plasma cortisol content of the infected cats. The amount of change in plasma cortisol did not correlate with the detected increase in plasma ACTH, indicating a weak adrenal response to pituitary action.
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PMID:Induction of feline immunodeficiency syndrome by feline leukemia virus: pituitary and adrenocortical dysfunctions. 196 24

AIDS is now worldwide, and the HIV infection is spreading rapidly via the heterosexual route. Among Third World countries, those in sub-Saharan Africa are hardest hit, and it is estimated that 1 in 40 adults is already infected. 1/2 of these victims are women, who will give birth to a large number of infected children. The clinical picture of full-blown AIDs in an African patient is not very different from other locations. However, other AIDS-related conditions seem to be influenced by a variety of endogenic pathogens which might explain the development of the typical wasting syndrome; i.e., "Slim disease". Tuberculosis is the most typical opportunistic infection in Africa, and adds another dimension to the misfortune. The outlook is gloomy in light of the potential for widespread disruption of normal social and economic activities. (author's modified)
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PMID:[AIDS in the Third World. Africa suffers most]. 204 81

The natural course of HIV infection in 205 intravenous drug users (IVDU) presenting at 11 centers in Italy was followed since 1983. Criteria for entering the study were spontaneous attendance at the clinic from January 1983-April 1988; history of IVDU; dated negative HIV test and a positive test not over 18 months later. 13 of the 205 subjects developed AIDS by 30 April 1988, a total of 447.25 person-years, for an overall incidence of AIDS of 2.9% person-years. The clinical presentation was opportunistic infections in 7, wasting syndrome in 5, and encephalopathy in 1. No Kaposi's sarcoma was seen. The incidence of AIDS was 1.5% in the 1st year; 2.9% after 2 years; 9.9% after 3 years and 17.9% after 42-48 months. The risk of AIDS increased significantly 24 months after seroconversion. 11 others developed AIDS-related complex (ARC) in the 4-year period, an incidence of 3.4% person-years. The minor opportunistic infections seen were zona (4 cases), oral candidiasis (2), and hairy leukoplakia (1). 2 subjects had myelopathy. 87 others developed persistent generalized lymphadenopathy (PGL). 45.8% of the group remained asymptomatic. The subjects mean age was 26, and the sex ratio was 4:1 overall, but 12:1 among the AIDS group. The natural history of AIDS in this series closely resembled other reports on male homosexuals.
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PMID:The natural history of HIV infection in intravenous drug users: risk of disease progression in a cohort of seroconverters. 249 24


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