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)

In order to describe the clinical features of AIDS, particularly injection drug use (IDU) related AIDS in patients attending the Regional Infectious Diseases Unit in Edinburgh a prospective review of the 680 HIV-positive patients, 30% of whom were women and 68% were infected via IDU was undertaken. The commonest AIDS-related clinical problem in Edinburgh was Pneumocystis carinii pneumonia (PCP). Whilst gender differences were not apparent in terms of clinical problems, differences were observed in risk groups as previously reported; Kaposi's sarcoma (KS), cytomegalovirus (CMV) and toxoplasmosis were commoner in homo/ bisexuals whilst oesophageal candidiasis was commoner in drug users. Extrapulmonary tuberculosis was uncommon unlike cohorts from the USA or Italy. Each patient with AIDS can expect 1-2 AIDS-related clinical events per year of survival. Considerable differences in mortality rates by risk group but not by gender were observed and explanations for this difference need to be considered further. The mortality rates for drug users were however remarkably similar to published rates from Amsterdam and the Bronx, New York.
 ...
PMID:Clinical features of AIDS in the Edinburgh City Hospital cohort. 879 81

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.
 ...
PMID:Cryptococcosis in HIV infection of man: an epidemiological and immunological indicator? 883 78

Women constitute the fastest growing segment of adults with acquired immunodeficiency syndrome (AIDS), representing 18% of all cases in the United States in 1994. Heterosexual transmission is now the dominant route by which women are infected. Recent reports indicate that although certain manifestations may be different in women than in men, the rate of clinical progression is similar when they receive comparable medical treatment. Antiretroviral therapy is equally as effective in women as in men. As in men, Pneumocystis carinii pneumonia is the most frequent AIDS-defining diagnosis in women. Candida esophagitis and ulcers secondary to herpes simplex virus are more common in women. Kaposi's sarcoma is rare. The prevalence of humanpapilloma virus infection and cervical neoplasia is increased in HIV-seropositive women. Vaginitis due to candida, trichomonas, and bacterial vaginosis are common findings among human immunodeficiency virus seropositive women. The clinical course and response to therapy in certain sexually transmitted diseases (syphilis and herpes) may be altered. The use of zidovudine during pregnancy and delivery has been associated with a 67.5% reduction in vertical transmission.
 ...
PMID:Human immunodeficiency virus infection and acquired immunodeficiency syndrome among North American women. 887 94

The efficacy of oral itraconazole and ketoconazole in the treatment of oropharyngeal and/or esophageal candidiasis, and the rate of post-treatment relapse, were compared in a multicenter, prospective, double-blind, double-dummy, randomized, parallel-group trial. A total of 143 adult HIV-positive patients with oropharyngeal and/or esophageal candidiasis were assigned to receive either itraconazole or ketoconazole (200 mg/day). Patients with oropharyngeal and esophageal candidiasis were treated for 2 and 4 weeks, respectively. Patients were evaluated clinically and mycologically after 1, 2 and 4 (for esophageal patients) weeks of therapy, and relapses were compared in a 6-week post-treatment follow-up period. Of 129 evaluable patients, 98 had oropharyngeal candidiasis and 31 esophageal infection. CDC classification, CD4+ cell counts, and number of previous episodes of oropharyngeal or esophageal candidiasis were comparable in both groups. Oropharyngeal infection was cleared clinically at 21 days in 71% of patients receiving itraconazole and 60% receiving ketoconazole, and esophageal candidiasis was cleared at 41 days in 100% of patients receiving itraconazole and 91% receiving ketoconazole. Marginally significant differences were found between itraconazole and ketoconazole in rates of clearing of infection clinically in patients with oropharyngeal and esophageal candidiasis (p = 0.0614 and 0.0781, respectively). Mean rates of infection relapse were not statistically different in the two treatment groups. Adverse events were generally mild and not considered drug related. Itraconazole is marginally more efficacious than ketoconazole in the treatment of oropharyngeal and esophageal candidiasis in HIV-positive patients and both drugs appear safe and well tolerated.
 ...
PMID:Comparison of itraconazole and ketoconazole in HIV-positive patients with oropharyngeal or esophageal candidiasis. Human Immunodeficiency Virus Itraconazole Ketoconazole Project Group. 887 77

We examined all reports of adult AIDS cases made to the 2 national surveillance centres in the UK for changes in AIDS defining conditions between January 1982 and September 1994. Differences and changes among persons diagnosed since January 1988 who had and had not been aware of their HIV infection prior to their AIDS diagnosis were of particular interest. Pneumocystis carinii pneumonia (PCP) is the AIDS defining disease most often reported at the initial AIDS diagnosis. Its proportion of all AIDS cases has increased significantly between January 1982 and December 1987 and decreased markedly thereafter. Since January 1988 a significant decrease in the proportion of cases diagnosed with cryptosporidial infection was also observed while increases were observed in the proportion of cases diagnosed with: HIV wasting (chi(1)(2) = 5.56) PML (chi(1)(2) = 19.47), mycobacterium avium complex (chi(1)(2) = 35.76) and pulmonary tuberculosis (chi(1)(2) = 144.0). For cases diagnosed between January 1988 and September 1994, PCP was more likely to be diagnosed in patients previously unaware of their HIV infection (P < 0.01) as was extrapulmonary TB (P < 0.01). In contrast, the following diseases were more likely to be diagnosed in patients already aware of their HIV infection prior to the diagnosis of AIDS: oesophageal candidiasis (P < 0.001), HIV wasting (P = 0.07), mycobacterium avium complex (P = 0.0001), cytomegalovirus disease (P < 0.001), HIV encephalopathy (P = 0.0009) and cryptosporidial infection (P = 0.02). Prophylaxis and anti-retroviral therapy appear to have had a significant impact on the temporal changes of the most frequently diagnosed AIDS diseases. While PCP prophylaxis has substantially reduced the likelihood of a PCP diagnosis at AIDS, the corresponding increase in other opportunistic infections suggests that there may be a need for improved prophylaxis for these conditions.
 ...
PMID:AIDS defining diseases in the UK: the impact of PCP prophylaxis and twelve years of change. 887 55

Systemic non-Hodgkin's lymphoma and Kaposi's sarcoma occur in approximately 4% and 30% of patients with HIV infection, respectively. Single-agent or combination chemotherapy is often indicated for such patients. Combination chemotherapy produces a significant decrease in CD4 lymphocytes and significantly increases the risk of opportunistic infection. Supportive care should include prophylaxis against Pneumocystis carinii pneumonia and esophageal candidiasis. Herpes labialis frequently occurs, may be confused with chemotherapy-induced stomatitis, and it requires appropriate treatment and secondary prophylaxis once recognized. Antiretroviral therapy should be continued during chemotherapy, if possible, and should be selected based on the patient's prior antiretroviral exposure, the toxicity profile of the antiretroviral agent, the toxicity of the chemotherapy, and the potential for drug interaction. The use of hematopoietic growth factors as primary prophylaxis may be reasonable for patients at high risk for febrile neutropenia, although the information about their use in this population is limited.
 ...
PMID:Infection prophylaxis and antiretroviral therapy in patients with HIV infection and malignancy. 891 6

Wasting in African AIDS patients is severe, and its aetiology is probably multifactorial: persistent diarrhoea, poverty and tuberculosis may all contribute. We report a cross-sectional study of body composition measured anthropometrically in 75 adult patients with HIV-related persistent diarrhoea in Lusaka, and its relationship to gastrointestinal infection and systemic immune activation assessed using serum neopterin and soluble tumour necrosis factor receptor (sTNF-R55) concentrations. Patients as a group were generally severely wasted (mean body mass index (BMI) 15.8 kg/m2, range 11-22), but the severity of wasting was related neither to oesophageal candidiasis nor to intestinal infection. In men but not women, all measures of nutritional status were negatively related to serum sTNF-R55 concentration (fat-free mass in men, r = -0.64; 95% CI: -0.80, -0.41; p < 0.0001). Some wasted patients had cutaneous features of malnutrition, again associated with higher sTNF55 concentrations, and two had peripheral oedema. The diarrhoea-wasting syndrome in this part of Africa seems to be associated with evidence of high cytokine activity in men, rather than oesophageal candidiasis or any particular intestinal opportunistic infection. This immune activation requires further investigation in the context of the sex difference we have observed.
 ...
PMID:Systemic immune activation as a potential determinant of wasting in Zambians with HIV-related diarrhoea. 897 62

Over a period of 3 months a human immunodeficiency virus 1 (HIV-1)-infected patient showed a sequence of positive-negative-positive anti-HIV screening test results. During this period the level of HIV p24 antigen declined and the HIV antibody pattern by Western blot gradually became complete, suggesting recent HIV infection. However the patient's weight loss, esophageal candidiasis, and Pneumocystis carinii pneumonia, together with the severely and persistently lowered CD4 cell counts and the absence of an IgM anti-HIV response, suggest late-stage HIV infection. Despite additional and follow-up testing, it was impossible to determine whether the patient suffered from acute, primary HIV infection with severe immunodepression or from advanced HIV infection (AIDS) with hampered HIV antibody production leading to false-negative test results by the anti-HIV enzyme immunoassay and Western blot. This case illustrates that HIV serology does not always follow the rules. The presence of HIV infection should be considered in a patient showing clinical signs of acute or late-stage HIV infection, even if the anti-HIV assay is negative.
 ...
PMID:Temporary seronegativity in a human immunodeficiency virus type 1-infected man. 898 53

The susceptibility of Candida albicans to a new antifungal triazole, voriconazole (UK-109,496), was investigated in 105 isolates obtained from the oral cavities of patients with human immunodeficiency virus (HIV) infection to study this drug's activity against fluconazole-susceptible and -resistant isolates. MICs were determined by a broth microdilution technique according to document M27-T from the National Committee for Clinical Laboratory Standards and by using a broth microdilution technique and a synthetic high-resolution medium. These antifungal susceptibility testing methods showed high levels of agreement (93% for fluconazole and 86% for voriconazole). Data from in vitro studies showed that voriconazole has good activity against fluconazole-susceptible and -resistant C. albicans isolates; the MICs at which 90% of all isolates were inhibited were 0.19 to 0.39 microgram/ml. We found that for isolates for which fluconazole MICs were high, voriconazole MICs were proportionally higher than those for fluconazole-susceptible C.albicans (P < 0.001). Pretreatment isolates from six patients with fluconazole-refractory esophageal candidiasis were included in the study. For these isolates the MICs were < or = 0.39 microgram/ml, and all patients responded to voriconazole. These results suggest that voriconazole is effective even in the treatment of fluconazole-refractory esophageal candidiasis and should be studied further to determine its clinical relevance in patients with HIV infection.
 ...
PMID:In vitro activities of voriconazole (UK-109,496) against fluconazole-susceptible and -resistant Candida albicans isolates from oral cavities of patients with human immunodeficiency virus infection. 905 95

Candidiasis has increased its frequency over the last decade, particularly among hospitalized patients where it is accompanied with high rates of mortality, and in patients with AIDS who are predisposed to oropharyngeal or esophageal candidiasis. The aim of this study was to determine the frequency of appearance of different yeast species and the resistance profile to current antifungal drugs in hospitalized pediatric patients and adult HIV patients from 5 institutions of Buenos Aires City and suburbs, and La Plata City, during the period 1993-1995, in order to obtain local and updated information. Candida albicans was the etiologic agent recovered in 87% of the 214 HIV positive patients with oropharyngeal candidosis, and in 50% of the 209 hospitalized pediatric patients. In the latter group 28% of these infections were due to Candida parapsilosis and 18% to Candida tropicalis, but only 2% and 4% of oral candidosis were caused by these organisms. Detection of Malassezia furfur and Hansenula anomala, responsible of systemic infections, and Trichosporon beigelii, isolated from a burn patient, were considered remarkable since these organisms appear to be emerging pathogens. Azole resistant species as Candida krusei and C. glabrata were mostly recovered from HIV positive patients, exposed to fluconazole treatment. A very low number of amfotericin B "resistant" yeasts (n = 9) were observed in both groups. However, resistance to azole drugs, particularly to fluconazole, was found in pediatric patients (13%) and in HIV infected adults (34%).
 ...
PMID:[Yeast infections: causative agents and their antifungal resistance in hospitalized pediatric patients and HIV-positive adults]. 922 26


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