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)

All referrals made to the liaison psychiatric service for HIV and AIDS patients over one year were reviewed. ICD-9 and CDC diagnoses were applied to each case at presentation. Sixty HIV-positive patients were assessed, of whom 35 had affective disorder, which was significantly associated with CDC group IV disease (AIDS). Adjustment reaction was seen in nine patients, paranoid states in six, dementia in four, personality changes in four and paranoid schizophrenia in two. CT scans of the brain were performed on 23 of the patients: 17 of these showed abnormalities. The proportion of registered AIDS patients who were referred was five times the proportion of HIV patients.
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PMID:Psychiatric illnesses in patients with HIV infection and AIDS referred to the liaison psychiatrist. 195 44

The diagnostic evaluation of dementia is directed toward the identification of treatable causes. It can be facilitated by classification of the dementia into one of four categories: attentional, amnestic, cognitive, and intentional. Intentional dementia reflects dysfunction of frontal lobe systems, components of which include the frontal cortex, basal ganglia, thalamus, limbic structures, and subcortical white matter. Disorders that affect one or more of these components and produce intentional dementia include Binswanger's disease, Parkinson's disease, Huntington's disease, HIV infection, closed head injury, normal pressure hydrocephalus, neoplasms, syphilis, vitamin B12 deficiency, multiple sclerosis, and a number of uncommon degenerative and acquired syndromes. Depression may resemble intentional dementia. Guidelines for diagnosis and management are discussed.
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PMID:Multi-infarct dementia, subcortical dementia, and hydrocephalus. 203 8

Since 1986 the notation Human Immunodeficiency Virus (HIV) is used for the retroviral agent of the Acquired Immunodeficiency Syndrome (AIDS). At the beginning of the therapeutical interest in the immunodeficiency syndrome have been primarily focussed in the internal complications. 1982 one reported for the first time about nervous system manifestations (NS-M) in HIV-patients; according to the latest reports NS-M are diagnosed in 39-63% of these patients. In this review all important aspects of the pathogenesis, clinic and therapy for the HIV-associated peripheric- and central-neurological (like e.g. acute and chronic meningitis/meningoencephalitis, dementia, opportunistic infections, polyneuropathies and myopathies) and psychiatric diseases are described.
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PMID:[HIV and nervous system manifestations: a review]. 205 Mar 14

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

Hallmarks of central nervous system (CNS) disease in AIDS patients are headaches, fever, subtle cognitive changes, abnormal reflexes, and ataxia. Dementia and severe sensory and motor dysfunction characterize more severe disease. Autoimmune-like peripheral neuropathies, cerebrovascular disease, and brain tumors are also observed. Histological changes include inflammation, astrocytosis, microglial nodule formation, and diffuse de- or dysmyelination. Focal demyelination can also be seen. It is clear that AIDS-associated neurological diseases are correlated with greater levels of HIV-1 antigen or genome in tissues. In AIDS dementia, macrophages and microglial cells of the CNS are the predominant cell types infected and producing HIV-1. However, manifestations of the disease make it unlikely that direct infection by HIV-1 is responsible. It seems more likely that the effects are mediated through secretion of viral proteins or viral induction of cytokines that bind to glial cells and neurons. HIV-1 induction of such cytokines as interleukin 1 (IL 1) and tumor necrosis factor-alpha (TNF alpha) may lead to an autocrine feedback loop involving further productive virus replication and induction of other cytokines such as interleukin 6 (IL 6) and granulocyte-macrophage colony-stimulating factor (GMCSF). Interleukin 1 and TNF alpha in combination with IL 6 and GMCSF could account for many clinical and histopathological findings in AIDS nervous system diseases. As HIV-1 infected patients produce elevated levels of IL 1, TNF alpha, and IL 6, it will be important to make a formal connection between the presence of these factors in the CNS, which are all products of activated macrophages, astroglia, and microglia, their in vivo induction directly by virus or indirectly by virus-induced intermediates, and the clinical and pathological conditions seen in the nervous system in this disease.
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PMID:HIV-1, macrophages, glial cells, and cytokines in AIDS nervous system disease. 206 87

Several dideoxynucleosides, including 3'-azido-2',3'-dideoxythymidine (zidovudine, azidothymidine, AZT), 2',3'-dideoxycytidine (ddC), and 2',3'-dideoxyinosine (ddI), have been shown to be potent inhibitors of human immunodeficiency virus (HIV) replication in human T cells and macrophages. These compounds undergo anabolic phosphorylation within target cells to a 3'-triphosphate moiety; as triphosphates, they act at the level of HIV DNA polymerase (reverse transcriptase). AZT has been shown to reduce the morbidity and mortality of patients with severe HIV infection and to at least temporarily ameliorate certain cases of HIV-induced dementia. In phase 1 studies, ddC and ddI have been shown to induce immunologic and virologic improvements in patients with AIDS or related disorders; phase 2 studies of ddC and ddI are underway. The use of these drugs can be associated with toxicity. AZT can cause bone marrow toxicity or myositis with prolonged use, ddC can cause peripheral neuropathy at high doses, and ddI can cause sporadic pancreatitis and peripheral neuropathy at high doses. For each compound, however, a therapeutic window exists in which an anti-HIV effect can be attained without short-term toxicity in most patients. Dose-intensity appears to be an important determinant of the toxicity of dideoxynucleosides. Studies are underway to explore how the therapeutic profiles of these compounds may be enhanced by attention to scheduling or through the use of combination therapy.
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PMID:Initial clinical experience with dideoxynucleosides as single agents and in combination therapy. 207 27

The 43rd World Health Assembly approved the 10th Revision of the International Classification of Diseases (ICD-10) in May 1990 and recommended its implementation by January 1, 1993. The ICD-10 uses a new alpha-numeric code, which provides sufficient code-numbers for all new entities, included in ICD-10 and for further amendments in the future. The extended tabular list of ICD-10 contains HIV-disease (AIDS) and permits separate coding of HIV-disease resulting in various infections, neoplastic and other diseases, such as HIV-dementia complex. Extensions and rearrangements have been made in other groups of diseases, for instance in the chapter on diseases of the genitourinary system. ICD-10 now permits a clear distinction between glomerular and renal tubulointerstitial diseases. The different groups of glomerular diseases can be further characterized by a fourth-digit subdivision of the code-number according to the histopathological findings. Thus, ICD-10 reflects recent developments in medial science. The scientific and practical impact of ICD-coding on mortality statistics, however, largely depends on the use of precise diagnosis and their proper arrangement on the death certificate by the physician, certifying the death. This permits the underlying cause of death to be clearly identified by the coder. The role of the pathologist in this process is stressed. Exact and internationally unified formulation of the diagnosis will be supported in the future by the on-going project developing an International Nomenclature of Diseases (IND). A few volumes of the IND have already been published in English, others are in preparation.
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PMID:[The 10th revision of the International Classification of Diseases]. 208 50

We report five cases of psychosis in patients with antibody to human immunodeficiency virus. All patients was man and intravenous drug abuser. The age range was 22 from 31 years with a mean of 25 years. In all cases acute schizophrenia was the first clinical picture of the HIV. Four patients had opportunistic infections and AIDS-Dementia Complex months later. If there is a genuine biological association between HIV carriage and schizophrenia illness, then HIV infection should be considered in the differential diagnosis of such an illness.
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PMID:[HIV and schizophrenia]. 210 15

The ability of MR to detect CNS lesions in AIDS patients was evaluated by postmortem scanning of 10 formalin-fixed brains. Nine patients had premortem mental status changes and five had focal neurologic deficits. The brains were imaged and sectioned in corresponding planes. MR images showed atrophy in eight of the 10. All grossly identified lesions and areas of MR abnormality were histologically evaluated. Areas of infarction and necrosis associated with cytomegalovirus (CMV) or Toxoplasma gondii were seen as foci of increased signal intensity. Severe ventriculitis and focal gliosis were also visible by MR. Neither CT nor MR was able to detect diffuse CMV- or HIV-associated microglial nodules. Dementia without focal neurologic signs correlated best with the presence of diffuse microglial nodules at pathology. Our results demonstrate the usefulness of correlating postmortem MR imaging with neuropathology, and the relevance of postmortem findings to the interpretation of MR images in living patients.
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PMID:Abnormalities of the brain in AIDS patients: correlation of postmortem MR findings with neuropathology. 212 Sep 95

Trichosanthin, a ribosomal inhibitor protein, blocks HIV replication in lymphocytes and macrophages. This agent was used to treat 51 patients with advanced HIV disease in a dose-escalation study in which three injections were administered over a 9-21-day period in a dose range of 10-30 micrograms/kg per injection. The maximum tolerated dose was estimated to be 30 micrograms/kg. Reversible but severe fatigue and myalgias were the major dose-limiting side-effects; mild leucocytosis and elevations in serum transaminases were noted and were reversible. Non-dose-related reversible mental status changes were seen in six patients and were considered to be associated with the drug. This was usually manifest as dementia, but progressed to coma in two patients. This reversed, but the sequelae resulted in death in one patient. Decreases in serum p24 antigen levels were noted 1 month after the first infusion in 10 of 18 patients who entered the study with elevated levels; one converted to negative. Values usually remained low to the end of the study period (2 months). In those patients with CD4+ cell levels greater than 50 x 10(6) cells/l significant decreases in sedimentation rate and increases in CD4+ cell numbers were also noted. These changes were found at all dose levels but only in patients receiving three infusions.
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PMID:A phase I/II study of trichosanthin treatment of HIV disease. 208 6


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