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

A psychiatrist/drug abuse specialist reviewed the medical records of 77 HIV-positive patients aged 15-61 at Budhachinaraj Hospital in Phitsanulok, Northern Thailand, during February-July 1994 to determine the HIV disease situation in Phitsanulok and the nearby provinces. (The first HIV-positive IV drug user in Phitsanulok was identified in June 1988.) The sex ratio between male and female was 4.1:1 (i.e., 62 males and 15 females). 55 of the 77 patients were 20-39 years old. All but one HIV-positive patients were Thai. Leading occupations were farmer/gardener (27) and worker (27). 62 had completed primary school. Most of the HIV-positive patients were from Phitsanulok (46), followed by those from Sukothai (10). 52 patients had full-blown AIDS, the leading opportunistic infections being cryptococcal meningitis (23), Pneumocystis carinii pneumonia (13), and pulmonary tuberculosis (10). Seven of nine cases of advanced HIV disease had CD4 cell counts under 50 cells/cubic mm and two had under 150 cells/cu. mm. 15 HIV cases died of opportunistic infections.
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PMID:Clinical study of HIV disease in the lower area of northern Thailand in 1994. 787 66

Murine MoAbs to the Cryptococcus neoformans capsular glucuronoxylomannan (GXM) polysaccharide are protective in mice in vivo and in vitro. The prevalence of protective anti-GXM antibodies in human serum is unknown. To provide further insight into the human antibody response to C. neoformans we determined the prevalence, isotype, and IgG subclass utilization of human anti-GXM antibodies in HIV+ and HIV- sera by a sensitive antigen capture FLISA assay. One hundred and twenty-three sera from the Bronx Municipal Hospital Centre serum bank were studied retrospectively. Seventy were from HIV+ individuals, 10 with a history of cryptococcal meningitis (CM), and 53 were from HIV- individuals. Serum GXM determinations were also performed on 61 HIV+ sera. Our results demonstrated that anti-GXM IgG, IgA, and IgM are ubiquitous in both HIV+ (including those with CM), and HIV- sera. Anti-GXM IgA titres and total serum IgA concentration were elevated in HIV+ sera. Anti-GXM IgG antibodies were almost exclusively isotype-restricted to the IgG2 subclass. Our data also demonstrated elevations of anti-bovine serum albumin (BSA) titres in HIV+ sera. Taken together, our findings confirm hypergammaglobulinaemia and expansion of anti-protein (BSA) antibodies in HIV+ individuals and isotype restriction of human anti-carbohydrate (GXM) antibodies to the IgG2 subclass. Our report of ubiquitous anti-GXM antibodies of the IgG and IgA isotypes suggests that anti-GXM antibodies exist before HIV infection.
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PMID:Antibodies to the Cryptococcus neoformans capsular glucuronoxylomannan are ubiquitous in serum from HIV+ and HIV- individuals. 788 65

A profound and long-lasting reduction in circulating CD4+ T lymphocytes (< 80/microliters) was found in a 37-year-old man (without known risk factors for HIV infection) presenting with recurrent oral candidiasis who subsequently developed cryptococcal meningitis. Infection with HIV was ruled out by serological and virological studies. In vitro and in vivo cell-mediated immunity was severely impaired. Abnormal phenotypic patterns of both CD4+ and CD8+ cells were consistently observed. A systematic family survey revealed in some of his asymptomatic relatives several immunological abnormalities which may point to a genetically based primary immunodeficiency disorder.
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PMID:Profound and possibly primary "idiopathic CD4+ T lymphocytopenia" in a patient with fungal infections. 791 Jan 24

Penicillium marneffei (PM) is the only Penicillium species which is dimorphic and can cause systemic mycosis in human beings; it is endemic in southeast Asia and China. The prevalence of PM infection has increased substantially during the past few years, occurring exclusively among patients infected with HIV. After extrapulmonary tuberculosis and cryptococcal meningitis, disseminated infection with PM is the most common opportunistic infection of HIV disease in northern Thailand. The clinical, microbiological, and therapeutic features of a large series of well-documented cases have not, however, been reported. The authors describe the clinical and laboratory features of 80 HIV-infected adults with disseminated PM infection seen over the period August 1987 - June 1992 at Chiang Mai University Hospital, Thailand. Subjects were of mean age 32.4 years in a range of 18-63. 74 subjects were male and 76 acquired HIV via heterosexual relations. Fever was present in 92%, anemia in 77%, weight loss in 76%, and skin lesions in 71%, while 87% of patients presenting with skin lesions had generalized papules with central umbilication. Most patients who were diagnosed responded initially to amphotericin or itraconazole, while most who were not diagnosed and treated died. More precisely, 40 of the 68 patients treated responded to the therapy. Twelve patients relapsed within six months of cessation of treatment.
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PMID:Disseminated Penicillium marneffei infection in southeast Asia. 791 50

The nature of the clinical presentation of HIV infection continues to evolve over time. New cutaneous (e.g., seborrheic dermatitis, onychomycosis, and tinea pedis) and systemic (e.g., Aspergillus fumigatus and Penicillium marneffei) opportunistic fungal infections can now be added to the classic clinical markers for progressive HIV infection, such as Kaposi's sarcoma, Pneumocystis carinii pneumonia, Mycobacterium avium intercellulare infections, and cryptococcal meningitis. The fact that the appearance of many of these fungal diseases is directly correlated with the patient's CD4 cell count is a valuable tool for ongoing clinical evaluation. Although systemic manifestations characterize a progression from asymptomatic HIV infection to AIDS, many of the signs of disease progression are cutaneous. Prophylaxis against many of the potentially life-threatening systemic opportunistic infections associated with HIV positivity has had a positive impact on the life expectancy of patients with AIDS.
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PMID:The AIDS epidemic. 791 31

Pneumocystis carinii pneumonia (PCP) is one of the most common AIDS-defining diagnoses. First-line therapy is cotrimoxazole (trimethoprim-sulfamethoxazole), despite a high incidence of toxic effects, and a greater incidence of hypersensitivity reactions among HIV-positive patients compared with the seronegative population. Alternative agents such as intravenous pentamidine, or clindamycin with primaquine, and trimethoprim with dapsone, also have a wide range of serious adverse effects, but remain treatment options. Atovaquone appears promising for the treatment of both PCP and toxoplasmosis, and has a lower reported incidence of toxicity than the alternative agents. The most toxic antifungal drugs are reserved for serious infections, such as cryptococcal meningitis. Liposomal amphotericin B has less renal toxicity than standard formulations, and exemplifies that new formulations of existing drugs, although often expensive, may have a better adverse effect profile. There are 2 different drugs currently available for cytomegalovirus (CMV) infections, ganciclovir and foscarnet. Both have a high incidence of serious adverse effects; ganciclovir mainly causes bone marrow toxicity and foscarnet leads to renal toxicity. The drugs used for mycobacterial infection (including mycobacteria as well as tuberculosis) have a wide range of adverse effects, particularly skin rashes and drug-induced hepatitis. Some of these compounds are quite new, such as rifabutin and clarithromycin, and it is important to be ever vigilant for previously unreported adverse effects.
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PMID:Adverse effects of drugs used in the management of opportunistic infections associated with HIV infection. 791 73

Severe fungal infections have become increasingly common over the past 10 years, largely due to the greater number of immunocompromised patients, such as those infected with HIV and those undergoing immunosuppressive therapy for malignancies. Between 60% and 80% of people with AIDS, for example, develop at least one fungal infection. Other predisposing factors for these infections include mechanical defects such as indwelling catheters, surgery, and burns. Candidiasis, aspergillosis, cryptococcoses, coccidioidomycosis, and histoplasmosis are among the fungal infections most commonly encountered in the clinical setting. Diagnosis is often elusive and treatment difficult. Amphotericin B has been the standard therapy for most life-threatening fungal infections for almost three decades but has significant drawbacks, including severe adverse reactions. Other systemic antifungal agents have proved useful in certain situations. Fluconazole, a new broad-spectrum agent, has shown particular promise in the treatment of candidiasis and cryptococcal meningitis.
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PMID:Fungal infections associated with malignancies, treatments, and AIDS. 795 89

Here we describe a case of unexplained CD4+ T-lymphocyte depletion and cryptococcal meningitis in a patient without evidence of human immunodeficiency virus (HIV) infection. This newly recognized syndrome has been named idiopathic CD4+ lymphopenia (ICL). When HIV infection is suspected in a patient with an opportunistic infection, a CD4+ lymphocyte count should be obtained, even if the patient's HIV test is negative. Patients with persistently low CD4 counts (< 300 cells/microL, or < 20%) who show no evidence of HIV infection, who have no defined immunodeficiency, and who are not receiving therapy associated with CD4 depletion have disease that meets the definition of ICL, and the case should be reported to the Centers for Disease Control.
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PMID:HIV-negative "AIDS" in Kentucky: a case of idiopathic CD4+ lymphopenia and cryptococcal meningitis. 802 11

Case report of a pulmonary nocardiosis associated with a pneumocystosis pneumonia and a cryptococcal meningitis in an African not already known as infected with Human Immunodeficiency Virus. Fever reoccurred when cotrimoxazole was stopped for intolerance. Bronchoalveolar lavage gave diagnosis.
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PMID:[Pulmonary nocardiosis in a HIV positive African patient]. 805 17

The olfactory mucosa, bulbs and tracts were examined for the presence of Cryptococcus neoformans in 3 patients with the acquired immune deficiency syndrome (AIDS) and cryptococcal meningitis. Two of them had antibodies against HIV-1 and one had positive serology for HIV-2. Cryptococci were seen in the subarachnoid space around olfactory tracts and bulbs and in the submucosal olfactory nerve fascicles. In one case, olfactory nerve fascicles from the lamina propria were also affected. Olfactory epithelium and respiratory mucosa were not involved. We suggest that Cryptococcus reached the olfactory nerve fascicles through the olfactory pathways for cerebrospinal fluid drainage which might serve as a source of latent cryptococcal infection.
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PMID:Olfactory pathways in three patients with cryptococcal meningitis and acquired immune deficiency syndrome. 806 14


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