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)

Acquired immunodeficiency syndrome (AIDS)-related primary central nervous system lymphoma (PCNSL) is almost always associated with the Epstein-Barr virus (EBV), and EBV-DNA in cerebrospinal fluid (CSF) has been indicated as a useful tumour marker for this HIV-related neoplasm. AIDS lymphomas also show an enhanced production of IL-10 which is generally associated with the presence of EBV in lymphoma cells. We performed a prospective study in 19 HIV seropositive patients with brain mass lesions, and in 21 other AIDS patients with or without other neurological disorders, to assess the in vivo diagnostic value of EBV-DNA and of IL-10 levels in the CSF for primary lymphoma of the central nervous system (CNS). EBV-DNA was detected by a nested polymerase chain reaction (PCR) in the CSF from seven of eight patients with PCNSL, diagnosed by brain biopsy (87.5% sensitivity) and in none of the 11 controls with brain mass lesions (100% specificity) and of the other 21 AIDS patients with or without neurological disorders. The only patient with PCNSL without detectable EBV-DNA in the CSF was also negative for EBV-DNA in the lymphoma tissue, whereas the samples of the other seven brain lymphomas were all positive for EBV-DNA by nested PCR. Therefore 100% of patients with an EBV-positive primary CNS lymphoma had detectable EBV-DNA in the CSF. No patient from the control group without PCNSL with EBV-negative CSF developed a lymphoma after a mean follow-up of 157 +/- 173 d. IL-10 levels in the CSF from the patients with PCNSL were not significantly different from those in the other groups of patients with AIDS. Due to uniformly high levels in the CSF from AIDS patients, IL-10 is not a useful diagnostic marker for AIDS-related brain lymphoma. The detection of EBV-DNA from the CSF by nested PCR is an extremely sensitive and specific diagnostic tool for AIDS-related PCNSL and should be further evaluated as a possible alternative in patients from whom brain biopsy is not advisable.
 ...
PMID:Evaluation of cerebrospinal fluid EBV-DNA and IL-10 as markers for in vivo diagnosis of AIDS-related primary central nervous system lymphoma. 766 63

Complications of human immunodeficiency virus type 1 infection and acquired immunodeficiency syndrome may involve any level of the central or peripheral nervous system. Acute encephalitis, aseptic meningitis and acute demyelinating polyneuropathy may occur early in the course of HIV infection, while dementia, central nervous system-related cancer, opportunistic infections and autonomic neuropathy typically present later. Headache and mental status changes are common early manifestations of central nervous system involvement. Most severe headaches are related to an identifiable cause, including a mass lesion, opportunistic cerebral infection and medication side effect. Memory deficits, concentration difficulties and abnormalities on mental status testing may represent early AIDS dementia complex (HIV encephalopathy), the most common neurologic complication. In patients with AIDs, the differential diagnosis of cerebral mass lesions on computed tomography or magnetic resonance imaging includes cerebral toxoplasmosis, tuberculous or fungal abscess, focal viral encephalitis, metastatic resonance imaging includes cerebral toxoplasmosis, tuberculous or fungal abscess, focal viral encephalitis, metastatic Kaposi's sarcoma and primary CNS lymphoma. Peripheral neuromuscular disease, including distal symmetric polyneuropathy, autonomic neuropathy, and HIV and chronic zidovudine myopathy, affects 15 to 40 percent of all persons with HIV infection or AIDS.
 ...
PMID:Common neurologic complications of HIV-1 infection and AIDS. 784 35

We identified 40 patients with malignant lymphoproliferative diseases (MLD) and HIV infection (seropositive) at a single Spanish university hospital. Thirty-two patients had non-Hodgkin's lymphoma (NHL), 6 primary central nervous system lymphoma (PCL) and 8 patients Hodgkin's disease (HD). Median age at presentation was 32 years. Four histopathological groups had distinct presenting clinical features: in 93% of the Burkitt-type lymphomas, the lymphoma itself was the AIDS defining criterion, while high and intermediate grade NHL other than Burkitt-like tended to have a more advanced HIV infection, demonstrated by antecedent AIDS criteria in 58% of these patients and a median CD4 positive cell count of 291 mm3; HD occurred in some patients without previous opportunistic infections (7/8 patients) but with median CD4 cells of 105 mm3; PCL occurred in a terminal stage of HIV infection, in patients with a low performance status, and frequent antecedent AIDS criteria. Objective response to chemotherapy could be seen in 62% of NHL patients and 100% of HD. Survival was adversely related to an antecedent diagnosis of AIDS, low performance status, and a primary localization in the central nervous system. Overall median survival was 5 months, but patients without the mentioned three adverse prognostic factors had a median survival of 10 months.
 ...
PMID:Malignant lymphoproliferative diseases in HIV-seropositive patients. A study of 40 cases at a single institution in Spain. 786 39

We analyzed the series of 40 malignant lymphoproliferative diseases (MLD) in HIV positive patients, diagnosed between 1986 and 1993 in a University Hospital in Spain. Median age was 32 years. 52% of the patients belonged to the intravenous drug users risk group, and 30% were homosexual. 26 patients were diagnosed of a non-Hodgkin's lymphoma (NHL), 8 of Hodgkin's disease (HD) and 6 of a primary central nervous system lymphoma (PCL). The 6 patients with a PCL (median CD4 of 20 cells/mm3, 80% antecedent AIDS criteria) and 13 NHL with histology of immunoblastic, large cell, plasmablastic, and high grade lymphoma non-otherwise specified (median CD4 of 291, 58% with AIDS criteria) tended to appear in patients with a deteriorated clinical and immunological status due to the underlying HIV infection. However, the 14 small non-cleaved cell NHLs appeared in patients without a previous AIDS-defining condition (93% of the cases, p = 0.065 compared with other NHL histologies). Finally, 8 patients with HD had a low CD4 cell count (median 103 cells/mm3, p = 0.049 compared with median CD4 in NHL patients) without other previous AIDS criteria. In conclusion, The presenting characteristics of HIV positive patients with MLD allows to define four subgroups of patients with a high clinicopathological correlation.
 ...
PMID:[Initial clinicopathological manifestations of malignant lymphoproliferative processes in patients with human immunodeficiency virus seropositivity. Study of 40 cases]. 806 Nov 35

Epstein-Barr virus (EBV) is constantly associated with AIDS-related primary lymphomas of the central nervous system (CNS). To assess whether EBV DNA in cerebrospinal fluid (CSF) could be used as a tumour marker, CSF samples that had been taken within 180 days before death from 85 patients with HIV infection and neurological disorders at necropsy were examined retrospectively by nested polymerase chain reaction (PCR) for EBV. Histologically evident primary CNS lymphomas were found in 17 patients, and EBV was shown in tissue by in-situ hybridisation in 16 of the 16 cases examined. All 17 patients with primary CNS lymphoma had EBV DNA in CSF. EBV DNA was found in CSF from 1 of 68 HIV-infected patients without histologically detectable lymphoma at necropsy. PCR for EBV DNA in CSF was 100% sensitive and 98.5% specific for AIDS-associated primary CNS lymphoma, and may be useful as a diagnostic tumour marker.
 ...
PMID:Epstein-Barr virus DNA in cerebrospinal fluid from patients with AIDS-related primary lymphoma of the central nervous system. 810 2

Infection with HIV is associated with an increased risk of systemic and primary central nervous system non-Hodgkin's lymphoma. Patients with systemic non-Hodgkin's lymphoma usually present with high- or intermediate-grade histology and extranodal dissemination. Although the prognosis for such patients is poor, some patients clearly benefit from combination chemotherapy, and several new treatment approaches appear promising. Primary central nervous system lymphoma usually occurs in patients with more profound immunosuppression and is associated with a dismal prognosis. Selected patients with good performance status may benefit from therapy, particularly if opportunistic infections have been few and nondebilitating. Finally, Hodgkin's disease has been reported in patients with HIV infection, particularly in patients with a history of intravenous drug use, and it is more likely to present with advanced-stage disease and unfavorable histology.
 ...
PMID:Treatment of AIDS-related lymphomas. 854 90

Between 1989 and 1993, 22 HIV negative patients with primary central nervous system lymphoma (PCNLS) were treated with three different regimens. In group A, 13 patients received preradiotherapy systemic and intrathecal methotrexate (MTX), radiotherapy (RT) and three courses of post-RT chemotherapy (CT) with thiotepa and procarbazine. In group B, 4 patients received a similar CT only after RT and without intrathecal MTX in 3/4 cases. In group C, 5 elderly patients received CT alone. In group A, 9/13 patients achieved response after pre-RT CT and 12/13 were in complete response (CR) after RT. After a median follow-up of 27 months, 8/13 (62%) patients are alive but 4 have leucoencephalopathy and cognitive dysfunction. In group B, all 4 patients were in CR after RT but the 3 patients who did not receive intrathecal MTX died within 10 months with meningeal recurrence. In group C, 4/5 patients had a response to CT. 2 patients died of recurrent tumour at 5 and 10 months, and 2 are living in CR 11+ and 21+ months after diagnosis, 1 after salvage CT. Combined treatment with RT and CT is useful in PCNSL but adequate treatment of the meninges is required. CT alone is sometimes of value in elderly patients in whom RT is not indicated.
 ...
PMID:Primary central nervous system lymphoma: treatment with chemotherapy and radiotherapy. 856 56

Since 1983, central nervous system (CNS) involvement in acquired immune deficiency syndrome (AIDS) is well recognized. Imaging methods are important in diagnosing AIDS-related primary and secondary CNS processes as HIV-1-associated encephalopathy, cerebral toxoplasmosis, primary CNS lymphoma, cytomegalovirus (CMV) encephalitis, progressive multifocal leukoencephalopathy (PML), and infectious spinal cord granulomas. This paper presents a review of typical AIDS-related CNS findings as seen in morphological radiologic techniques, i.e. cranial computed tomography (CCT) or magnetic resonance imaging (MRI). Furthermore, the paper discusses the value of CCT, MRI and functional (positron emission computed tomography = PET, single-photon emission computed tomography = SPECT, and magnetic resonance spectroscopy) as well as morphometric imaging methods in evaluating subclinical HIV-1-related cerebral deficits and predicting their clinical course.
 ...
PMID:Imaging methods as a diagnostic tool in neuro-AIDS. A review. 865 3

Neurological complications of HIV infection cause considerable morbidity and are often associated with high mortality. These complications include not only the more common opportunistic diseases affecting the brain (cerebral toxoplasmosis, primary central nervous system lymphoma, progressive multifocal leucoencephalopathy, and cryptococcal meningitis) but also the AIDS dementia complex, with its characteristic cognitive and motor dysfunction, which is caused by HIV itself. Additionally, the peripheral nervous system is the target of several disorders, including a common painful neuropathy. Because these and other, less common, central and peripheral nervous system complications of HIV can often be specifically treated or effectively palliated, their accurate and timely diagnosis is important.
 ...
PMID:Neurological complications of HIV infection. 870 86

The prevalence of HIV-related malignant disease is increasing, probably due to more effective management of opportunistic infection. The most frequent tumours are Kaposi's sarcoma, systemic non-Hodgkin's lymphoma and primary central nervous system lymphoma. Management of these conditions must take into account host indicators of immunosuppression and prognostic outcome in order to minimise treatment associated complications.
 ...
PMID:Management of malignancy in HIV infection. 881 35


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