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

Extensive vascular calcification in an 8-year-old girl with perinatally acquired AIDS is reported. Complicating factors included cardiomyopathy, chronic lung disease, disseminated Mycobacterium avium complex (MAC), and wasting syndrome with total nutrition dependence. Plain abdominal films and CT of the abdomen immediately prior to her death revealed dense calcification of major vessels. Autopsy revealed calcification in the media of most major vessels typical of HIV arteriopathy. A review of the literature failed to reveal a description of similar vascular calcifications in pediatric AIDS.
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PMID:Extensive vascular calcification in a patient with perinatally acquired AIDS. 865 70

From last years eighty's decade the number of women with HIV infection have significantly increased. To know the epidemiological and clinic trades in this group we studied retrospectively 476 HIV infected patients attending in a General Hospital from January 1986 to June 1993. Seventy nine (16.5%) were female and 397 male. The mean female group was 25.8 years, 61.9% were IVDUs and 30.4% heterosexual transmission. This last transmission route was more important between females than males (5%) (p < 0.001) and in 1992 the 55% of women been infected by this way. The mean CD4 count was 643 cel/ml in the female group at the diagnostic time and 21.7% developed antigenaemia without difference with the male group. 59.7% of women were no symptoms at the diagnosis time and 14.3% were AIDS, no differences with men, but more in the female group developed AIDS along following time 39.5% in front of 24.7% in the male group (p < 0.05). Disseminated Tuberculosis (DTB) (29.1%) and Wasting Syndrome (WS) (29.1%) were the more frecuent AIDS defining conditions in the female group. The more frecuent complications were: Oropharynx Candidiasis 39.1%, Esophagus Candidiasis 6.3%, WS 11%, DTB 12.65%, PCP 10.12% and Neoplasias 5.06%. Fourteen women became pregnant during HIV infection, no clinical nor immunological differences were observed in this group with the control. The treatment (66%) and following (46.8%), compliance was better between women than men. The rise of women with HIV infection, the poor development in this group described by some authors, so far gynecological aspect and vertical transmission makes HIV infection in women an major health problem.
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PMID:[Human immunodeficiency virus infection in women]. 867 99

The objective of this study was to describe the epidemiology and clinical presentation of HIV infection among upper middle class patients in Mexico City. A retrospective review of outpatient and hospital records of all HIV-infected patients was accomplished by one of the authors between 1984 and 1990. A total of 115 patients were seen during the study period, 109 men and 6 women. One hundred and seven patients acquired HIV infection through sexual contact, six patients had HIV infection associated with blood transfusion and two were homosexual men who also had a history of intravenous drug use. The mean age of the patients was 36.2 years (range 13 - 65 years). CDC classification at presentation was predominantly stage IV (65%) with the most common AIDS associated diseases at presentation being wasting syndrome in 30 (42.2%), P. carinii pneumonia in 22 (30.9%), cytomegalovirus infection in 11 (15.5%), Cryptosporidium parvum diarrhea in 7 (9.8%), and Kaposi's sarcoma in 6 (8.4%). CD4+ T-lymphocyte cell counts at the time of HIV diagnosis were available in 87 patients (median = 150 cells/microliters; mean = 224 cells/microliters, SD +/- 219). Zidovudine was used in 37 patients after 1988 when it first became available in Mexico, in six patients the drug had to be discontinued because of serious hematologic toxicity. The average follow-up on zidovudine was 8.5 months. Similar age, gender, age distribution, risk categories and CDC classification at presentation was seen compared to other series reported from Mexico. However, the spectrum of opportunistic infections found were similar to that seen in the United States.
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PMID:The spectrum of HIV infection in patients seen at a private hospital in Mexico City: 115 patients seen from 1984 to 1990. 869 65

Skeletal muscle involvement may occur at all stages of HIV-infection and represents the first manifestation of the disease in some patients. We usually classify muscle involvement in HIV-infected patients in one of the following categories: (1) HIV-associated myopathy, a myopathy that meets the criteria for polymyositis in a majority of patients, and those for acquired nemaline myopathy in some; (2) zidovudine myopathy, a reversible mitochondrial myopathy; (3) the HIV-wasting syndrome and other AIDS-associated cachexias; (4) opportunistic infections and tumoral infiltrations of the skeletal muscle; (5) vasculitic processes and iron pigment deposits; (6) HIV-associated myasthenia gravis and (7) rhabdomyolysis. Immunohistology for major histocompatibility complex class I antigen and histochemical reaction for cytochrome c oxidase are helpful in correct classification of a myopathy as HIV polymyositis or zidovudine myopathy.
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PMID:[Muscular involvement in HIV infection]. 874 23

Cryptococcosis is an epidemiological and immunological indicator due to the absence of Cryptococcus neoformans as a saprophyte in immunocompetent humans and the advantage of specific C. neoformans culture. On this basis, a report is presented on the CD4 lymphocyte count of 36 AIDS patients suffering from cryptococcosis and other concomitant or missing opportunistic AIDS-defining infections. In 26 out of 36 patients, i.e. 72%, a CD4 lymphocyte count of < or = 50/microL (mean value 39.5%) was found. Cryptococcosis as the sole opportunistic infection was diagnosed in 5 cases (13.9%). In 31 cases, various combinations of AIDS-associated diseases were found: Pneumocystis carinii pneumonia (PCP) (n = 19), cytomegalovirus infection (CMV) (n = 10), Kaposi's sarcoma (n = 6), Mycobacterium avium intracellulare infection (MAI) (n = 5), pneumonia (n = 2), toxoplasmosis (n = 2), Candida esophagitis (n = 1), tuberculosis (n = 1), lambliasis (n = 1), salmonellosis (n = 1) and wasting syndrome (n = 5). The conspicuous simultaneous occurrence or succession of pneumocystosis and cryptococcosis and the contrasting absence of aspergillosis and mucormycosis (zygomycosis) are commented. Based on the present observations in HIV-infected persons in Berlin, a CD4 lymphocyte count of < 150/microL may be used as a parameter indicating a predisposition for cryptococcosis as an airborne AIDS-defining infection. Attention is drawn to bird droppings as the sole habitat of C. neoformans and accidental niche of various other microorganisms.
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PMID:Cryptococcosis in HIV infection of man: an epidemiological and immunological indicator? 883 78

Two proviral HIV transgenic mouse models, one bearing wild-type HIV proviral DNA and the other a modified provirus in which the viral LTRs contained the core enhancer of the Moloney murine leukemia virus (MLV), were compared. The MLV/HIV chimeric LTR, in which the MLV enhancer replaced the NF-kappa B-binding motifs, was transcriptionally active in human and murine cells in vitro and virus containing the chimeric LTR was replication competent in human cell cultures. Transgenic mice derived from microinjections of chimeric MLV/HIV proviral DNA transcribed HIV genes at a greater frequency and at higher levels than wild-type HIV proviral transgenic mice. MLV/HIV mice were also more apt to develop disease; wasting, periocular infections, and a degenerative myopathy characterized the most predominant phenotype. The tissue specificities of the wild-type and chimeric LTRs in transgenic mice were remarkably similar, but a significant difference was apparent in lymphoid cells. Basal level and LPS-inducible HIV gene expression occurred in peritoneal and bone marrow-derived macrophages from wild-type HIV transgenic mice. In contrast, HIV gene expression in macrophages from MLV/HIV mice was undetectable, even following LPS induction. However, cultured splenocytes from MLV/HIV mice supported HIV proviral gene transcription better than splenocytes from HIV mice, particularly after induction with LPS or anti-IgD antibody but not with concanavalin A. These data suggest that in transgenic mice, the HIV and MLV/HIV LTRs display a differential tropism for macrophages and B cells, respectively. HIV and MLV/HIV transgenic mice represent alternative models amenable to in vivo studies of HIV gene regulation in lymphoid cells, the induction of HIV-related disease and the evaluation of anti-HIV therapies.
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PMID:Models of HIV type 1 proviral gene expression in wild-type HIV and MLV/HIV transgenic mice. 884 15

In a controlled prospective study we used peripheral autonomic surface potentials (PASP) and an autonomic test battery (valsalva, 30:15 ratio, deep breathing, sustained handgrip, Schellong test) to evaluate HIV-1 associated autonomic dysfunction (HIVAD) in 38 HIV-seropositive patients. Criteria of exclusion were drug or alcohol abuse, concurrent infections, neoplasms, wasting syndrome and neurotoxic medication. We found increased PASP onset latencies and lower PASP amplitudes even in asymptomatic HIV-infected patients (p < 0.0125, Bonferroni corrected p-value). A mild or marked HIVAD was detected in 21% of the patients each. Heart rate and blood pressure responses were similarly affected. HIVAD was not related to HIV-1 associated changes in sural and tibial nerve conduction parameters. Our data suggest that HIVAD is a frequent complication of HIV-1 infection and that HIV-1 plays a direct role in its pathogenesis. Sympathetic and parasympathetic divisions of the ANS appear to be similarly affected.
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PMID:[HIV-1 associated autonomic dysfunction (HIVAD)]. 885 Dec 96

Women, perinatally-infected infants, and sexually exposed and exploited youths and adolescents have become a major focus of the worldwide HIV/AIDS pandemic. Increased perinatal screening, improvement in early infant diagnosis, and the benefits of primary HIV therapies have increased the numbers identified and longevity of infants and children living with HIV. This increase in survival is associated with HIV/AIDS becoming a chronic multiorgan system disease that requires a multidiscipline comprehensive care approach. The combination of poor oral intake, increased loss, and increased metabolic needs of long-term surviving HIV-infected children are obstacles to both survival and quality of life. HIV-infected children and their families need supportive care services including nutritional as well as primary therapy. Clinical guidelines for effective nutrition interventions must be developed to prevent and treat failure to thrive and wasting syndrome. Gains in survival duration must be linked to enhanced quality of life through supportive care, including comprehensive nutritional services that have their efficacy documented by appropriate clinical trials.
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PMID:Historical perspectives on the evolution in understanding the importance of nutritional care in pediatric HIV infection. 886 23

Microsporidia are emerging as opportunistic pathogens in patients with AIDS. Enterocytozoon bieneusi and Encephalitozoon (Septata) intestinalis have been implicated in enteric infections in AIDS patients with chronic diarrhea, a wasting syndrome, and malabsorption. We used the polymerase chain reaction (PCR) and primers that amplify the conserved regions of the small-subunit rRNA (SSU-rRNA) gene of E. bieneusi and E. intestinalis in tissue specimens from HIV-infected patients with and without diarrhea to examine the association between microsporidia and diarrhea in patients with AIDS. Tissue specimens were obtained from 68 patients with AIDS and diarrhea (mean CD4 lymphocyte count, 21/mm3) and 43 AIDS patients without diarrhea (mean CD4 lymphocyte count, 60/mm3). By means of PCR with use of the SSU-rRNA primers specific for E. bieneusi and E. intestinalis, we found that 44% of patients with diarrhea were infected with microsporidia, whereas only 2.3% of the patients without diarrhea were infected with microsporidia (P < .001). There was a clear association between the presence of microsporidia and diarrhea. In addition, the SSU-rRNA primers proved to be sensitive and specific when used in this clinical setting.
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PMID:Prevalence of microsporidiosis due to Enterocytozoon bieneusi and Encephalitozoon (Septata) intestinalis among patients with AIDS-related diarrhea: determination by polymerase chain reaction to the microsporidian small-subunit rRNA gene. 892 93

The acquired immunodeficiency syndrome (AIDS) wasting syndrome (AWS) is a devastating complication of human immunodeficiency virus infection characterized by a disproportionate decrease in lean body mass. The pathogenesis of the AWS is unknown, but recent data suggest that endogenous secretion of the potent anabolic hormone, testosterone; is decreased in 30-50% of men with AIDS. However, it is unknown whether decreased androgen levels are associated with decreased lean body mass and/or functional decreases in muscle strength and aerobic capacity in hypogonadal men with the AWS. In addition, testosterone is known to have stimulatory effects on GH secretion, and the loss of these effects on the GH-insulin-like growth factor I (IGF-I) axis may be an additional mechanism of decreased lean body mass in this population. Twenty hypogonadal subjects (free-testosterone < 12 pg/mL) with weight loss > 10% of preillness weight or absolute weight < 90% ideal body weight (IBW) were enrolled in the study. None of the subjects were receiving Megace. Lean body mass and fat-free mass were determined by potassium-40 isotope analysis (40K) and dual-energy x-ray absorptiometry, respectively, and analyzed with respect to gonadal function by linear regression analysis. Muscle mass was determined by urinary creatinine excretion, and exercise functional capacity was assessed by a 6-min walk test, a sit-to-stand test, and a timed get-up-and-go test. Results also were compared with gonadal function by regression analysis. IGF-I and mean overnight GH levels, determined from frequent sampling (q20 min from 2000-0800 h), were compared with results obtained from age- and sex-matched normal controls. Subjects were 26-58 yr of age (39 +/- 7 yr, mean +/- SD) with a CD4 cell count of 150 +/- 186 cells/mm3. Serum levels of FSH were elevated in 30% of the subjects. Muscle mass was significantly reduced, compared with expected mass for height (23.3 +/- 5.5 vs. 29.3 +/- 1.7 kg, P = 0.0001) and was decreased disproportionately to weight (77% of expected value for muscle mass vs. 93% of expected value for weight). Free-testosterone levels were correlated with total body potassium (R = 0.45, P < 0.05) and muscle mass (R = 0.45, P < 0.05). Total-testosterone levels were correlated with exercise functional capacity (R = 0.64, P = 0.01 for the sit-to-stand test and R = 0.53, P < 0.05 for the 6-min walk test). Mean GH levels were significantly increased (3.03 +/- 1.76 vs. 0.90 +/- 0.37 ng/mL, P < 0.001) and IGF-I levels decreased (167 +/- 66 vs. 225 +/- 69 ng/mL, P < 0.01), compared with age- and sex-matched eugonadal controls. GH levels were inversely correlated with caloric intake (R = -0.60, P = 0.02) and percent fat mass by dual-energy x-ray absorptiometry (R = 0.58, P = 0.02). Six additional hypogonadal subjects receiving Megace for AIDS wasting were analyzed separately. Nutritional status and parameters of body composition were compared in the Megace and non-Megace-treated subjects. No significant differences in caloric intake, lean body mass, fat mass, or muscle mass were demonstrated. These data demonstrate that changes in body composition, including loss of lean body and muscle mass, and deterioration in exercise functional capacity are highly correlated with androgen levels in hypogonadal men with the AWS. Furthermore, our data demonstrate significantly increased GH levels and decreased IGF-I in association with low weight in this population. These data suggest that androgen deficiency combined with classical GH resistance may contribute to the critical loss of lean body and muscle mass in hypogonadal men with the AWS. These data are the first to link muscle and lean body wasting with progressive gonadal dysfunction among the large percentage of men with AIDS wasting who are hypogonadal. This demonstrates the need for additional studies to determine the efficacy of gonadal steroid replacement to increase lean body mass in this population.
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PMID:Loss of lean body and muscle mass correlates with androgen levels in hypogonadal men with acquired immunodeficiency syndrome and wasting. 892 60


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