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

HIV infection may impair a large portion of the human immune response. Infection of CD4+ T cells results in depletion of this population, leading to dysfunction of T-cell-dependent activities. Numerous other immune functions are directly or indirectly impaired, including the function of CD8+ T cells and decreases in total lymphocytes, IL-2 secretion, IL-2R expression, proliferative response to mitogens, NK activity, ADCC, and several other measures. Immune alterations seen in normal pregnancy include decreases in CD4 and T cells, the proliferative response to mitogen, IL-2 secretion, and NK activity. These changes are largely cellular and usually are not apparent clinically. Normal pregnant women are immunocompetent. When pregnancy is complicated by asymptomatic HIV infection, the obstetric outcome does not seem to be adversely affected. Preliminary studies show that the course of HIV disease may not be adversely affected in these women, but this matter is the subject of intense investigation.
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PMID:The immunology of HIV disease and pregnancy and possible interactions. 197 32

The role of primary care physicians in diagnosis of human immunodeficiency virus (HIV) infection is becoming increasingly important. Given the development of antiretroviral therapy, which can delay the clinical progression of asymptomatic HIV infection, early and accurate identification is invaluable to these patients. Screening begins with the enzyme immunoassay, which, although highly sensitive, lacks specificity. Therefore, the Western blot test should always be used for confirmation. When results of the Western blot test are indeterminate, reassessment for risk factors for HIV infection should be followed by serial Western blot testing and HIV culture or polymerase chain reaction testing.
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PMID:What to do when results of a western blot test are indeterminate. 199 56

The present study attempts to estimate the prevalence of Aids Dementia Complex assessed by neuropsychological testing in Norwegian patients with AIDS using a clinical control group with acute leukemia and an asymptomatic HIV-positive group as reference groups. Newly diagnosed patients with AIDS and not receiving zidovudine or other anti-viral drugs, patients with asymptomatic HIV infection, and newly diagnosed patients with acute leukemia, were studied with a battery of neuropsychological tests. Speeded tests and composite non-verbal measures discriminated significantly between groups. The results indicate higher than 50% prevalence of ADC in newly diagnosed Norwegian patients with AIDS. Our findings indicate that the AIDS population may contain two distinct groups, a subgroup with ADC and a subgroup with persistently normal neuropsychological function. The group with asymptomatic HIV infection showed normal neuropsychological performance.
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PMID:Prevalence of neuropsychological deficit in HIV infection. Incipient signs of AIDS dementia complex in patients with AIDS. 206 51

To assess the effects of human immunodeficiency virus (HIV) for the work of community nursing staff, and to find out how community staff regard their contribution to the prevention of HIV infection, the care of people with AIDS and their preparation for this role was ascertained in a postal survey of one in five field staff carried out in Scotland. The 1,205 respondents represent an 85% response rate. While only 3% of respondents had experience of patients with AIDS, 11% had been involved with known asymptomatic HIV infection and 30% had encountered those they considered to be at high risk of infection. While the workload generated by HIV-infected patients for individual nurses at this time was small, there were variations in the proportions of staff involved according to type of staff and employing health board. Only one-fifth of those who had encountered HIV-positive patients had offered them health education, and fewer had referred patients to their general practitioners or offered counselling. However, community nursing staff do consider that they have a role to play in health education, counselling and terminal care, but feel ill equipped to carry out this role. There is an urgent need for policies which clearly specify the roles that community nursing staff should be playing and for in-service education programmes which assist them to draw on the knowledge and skills that they have to enable them to apply them to help patients with HIV infection.
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PMID:HIV infection and community nursing staff in Scotland--1. Experience, practice and education. 223 98

Cardiac abnormalities are frequently reported in patients with acquired immunodeficiency syndrome (AIDS). Much less is known about the true prevalence of cardiac involvement in patients with human immunodeficiency virus (HIV) infection. We prospectively examined 138 consecutive patients with HIV infection including 41 with AIDS, 49 with AIDS-related complex (ARC), 32 with chronic lymphoadenopathy syndrome (LAS) and 16 with asymptomatic HIV infection. Sixty-one patients had opportunistic infection. The prevalence of cardiac involvement progressively increased from patients with HIV infections or LAS (4%) to ARC (14%) to AIDS (37%). "Major" echocardiographic abnormalities (dilated cardiomyopathy and/or infective endocarditis and/or severe pericardial effusion) were identified in 3 patients (2%), "minor" abnormalities (mild pericardial effusion, hypokinesis of the interventricular septum, mild dilatation of the left ventricle in 21 (15%). Electrocardiographic abnormalities unassociated with echo abnormalities or clinical problems were seen in other 11 patients. End diastolic left ventricular dimension (normalized for body surface area) was higher among AIDS respect to pre-AIDS patients (30.1 +/- 7.1 vs 27.6 +/- 7.5; p less than 0.01) and among patients with respect to patients without opportunistic infections (29.5 +/- 6.5 vs 27.5 +/- 2.4; p less than 0.05). Left ventricular shortening fraction was lower in the subgroup with and absolute CD4 lymphocyte count less than 100/mm3 (31 +/- 7 vs 34 +/- 5; p less than 0.055). In conclusion, in a large, unselected group of patients with HIV infection, echocardiogram discloses cardiac abnormalities in 17% of the cases; their clinical relevance is generally low but in selected patients cardiac tamponade and/or dilated cardiomyopathy (secondary to viral myocarditis) may cause death.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Cardiac involvement in HIV infection: a prospective, multicenter clinical and echocardiographic study]. 224 21

To study the prevalence of oral manifestations, we examined 217 patients infected with the human immunodeficiency virus (HIV). Most of our patients were intravenous drug abusers (IVDAs) (65%). Other risk categories were represented by IVDAs who were also male homosexuals or bisexuals (11%), male homosexuals and bisexuals (16%), sexual partners of HIV-infected patients (5%), and hemophilic persons and recipients of blood transfusions (3%). Forty-six patients were women and 171 were men, with a median age of 27 years (range, 11 to 65 years). At the time of first examination, 38% of patients had asymptomatic HIV infection, 36% had lymphadenopathy syndrome, 17% had AIDS-related complex, and 9% had AIDS. Oral manifestations were observed in 89 (41%) patients. Of these, 15 had asymptomatic infection, 23 had lymphadenopathy syndrome, 27 had AIDS-related complex, and 24 had AIDS. Increasing severity of disease was significantly associated with higher prevalence of oral lesions (p less than or equal to 0.0001). Candidiasis was the most common oral lesion, followed by hairy leukoplakia. Kaposi's sarcoma, melanotic macules, herpes labialis, condyloma acuminatum, perioral molluscum contagiosum, and bacterial glossitis due to Escherichia coli infection were found in a small number of patients. Results of culture for fungi, available for 203 patients, revealed that 51% of patients with positive Candida cultures had clinical evidence of candidiasis. Our study demonstrates that oral lesions are also important signs of HIV infection among IVDAs. Early diagnosis of these manifestations is becoming increasingly significant in the practice of dentistry.
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PMID:Prevalence of oral lesions among HIV-infected intravenous drug abusers and other risk groups. 230 43

Of 207 homosexual or bisexual patients with the acquired immune deficiency syndrome (AIDS), 24 with the AIDS related complex, and 39 with asymptomatic HIV infection, 32 patients were found to have mycobacterial infection. Mycobacterium tuberculosis was found in 13 patients with AIDS and in two with the AIDS related complex. M avium-intracellulare was found in 15 patients with AIDS and was disseminated in 12. One patient was infected with M kansasii and one with M ulcerans. Invasive procedures were frequently required to obtain positive bacteriological results. Subclinical carriage of M avium-intracellulare and other mycobacteria thought to be nonpathogenic was common in patients seronegative for the human immunodeficiency virus and at all stages of human immunodeficiency virus infection. All but one isolate of M tuberculosis were fully sensitive to standard antimycobacterial antibiotics. Response to treatment was usually rapid. M avium-intracellulare isolates were all resistant to first line agents in vitro, and antibiotics such as ansamycin and amikacin were required to obtain a clinical response.
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PMID:Mycobacterial infection in patients infected with the human immunodeficiency virus. 208 83

To assess the effects of HIV infection on the work of community midwives, a postal survey of 1 in 5 in Scotland and England was carried out. The 907 respondents represent an 83% response rate. While only 1% of respondents had experience of patients with AIDS, 8% had been involved with known asymptomatic HIV infection and 32% had encountered those that they considered to be 'at high risk'. While the workload generated by HIV-infected patients for individual midwives at this time was small, almost all midwives themselves considered that they had a role to play in the prevention of HIV infection through health education and in counselling. While less than a quarter of those who had encountered HIV-positive patients had provided health education, more than half had done so to those worried about HIV infection and almost a quarter had counselled them. However, confidence to provide these aspects of practice was low, even among those who had received in-service education, although higher than among those who had not done so. A minority of community midwives had read policies or guidelines about aspects of practice and service provision, except for infection control where two thirds had read what they considered an adequate policy.
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PMID:HIV infection and community midwives: experience and practice. 232 76

A spectrum of renal abnormalities has been described in patients infected with the human immunodeficiency virus (HIV) with or without signs of the acquired immunodeficiency syndrome (AIDS). In particular, attention has been focused on a nephropathy characterized clinically by nephrotic proteinuria and rapidly advancing renal insufficiency, and histologically by focal and segmental glomerulosclerosis (FSGS). To evaluate the relationship between HIV infection and structural renal disease, we reviewed all consultations between January 1982 and March 1988 to the Division of Nephrology at San Francisco General Hospital (SFGH), a municipal hospital treating approximately one-third of AIDS cases in San Francisco. Seventy-three consultation requests were received during this period regarding patients with AIDS (48), AIDS-Related Complex (23), or asymptomatic HIV infection (2). Of these, 27 gave evidence of structural renal disease (Group I): 14 had chronic renal insufficiency, in 10 of whom nephrotic proteinuria was also present. However, progression of renal insufficiency to end-stage renal disease (ESRD) in this group did not follow the rapid course described for HIV-associated nephropathy. Renal tissue was examined in 11 Group I patients and showed FSGS in four and a variety of acute and chronic glomerular and tubulointerstitial changes in the others. In 46 Group II patients, consultation was requested for acute renal failure or fluid, electrolyte, and acid-base disturbances. We also reviewed 91 consecutive autopsies performed in patients dying with AIDS at SFGH between 1981 and 1986.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Renal involvement in patients infected with HIV: experience at San Francisco General Hospital. 234 28

The progression of infection with Human Immunodeficiency Virus (HIV) is not completely understood with regard to a variety of potentially controllable and uncontrollable factors. The purpose of this article is to present the most common clinical indicators of potential HIV infection and classical indicators of clinical progression of the infection as presently understood. The progression of asymptomatic HIV infection to frank diagnosis of AIDS is discussed with regard to the differences in diagnosis and presentation in women versus men. Special emphasis is placed on the role of nurses in the early recognition, counseling and treatment of women at risk for HIV infection within this article. It should also be stressed that evidence increasingly grows to support the fact that AIDS is and will become increasingly a chronic, manageable condition requiring increasing nursing support as with diabetes.
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PMID:Progression of HIV infection in women: asymptomatic state to frank AIDS. 236 30


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