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

From September 1982 to December 1988 113 cases of AIDS have been autopsied and the brains examined at Montefiore Medical Center. Findings in four areas were presented; 1. Opportunistic infections In approximately one third of cases there were opportunistic infections which were often the cause of death. Cryptococcus, cytomegalovirus and toxoplasma were the three most common infections followed by papovavirus (progressive multifocal leukoencephalopathy) and herpes zoster. Tuberculosis, aspergillosis, histoplasmosis and infection with mycobacterium avium-intracellulare infection were found in only one case each. 2. Malignant lymphoma Both primary and metastatic lymphomas were seen in almost 10% of the cases. 3. HIV encephalitis This conclusion is regarded as the pathological substrate of "AIDS dementia complex" described by the neurologists. In general, it was characterized by cerebral atrophy and diffuse pallor of the white matter with gliosis. The basal ganglia and other areas of the CNS were also often involved. Histologically, there was perivascular infiltration of lymphocytes, macrophages and multinucleated giant cells. Microglial nodules were commonly seen. Electron microscopic and other techniques demonstrates the HIV virus within macrophages and multinucleated cells. 4. Cerebrovascular lesions These lesions are known in AIDS but their high frequency is not generally appreciated unless a careful search for microinfarcts is made. Microinfarcts were found in approximately 1/3 of our cases.
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PMID:[Neuropathology of AIDS: Montefiore experience]. 263 Jan 49

Cytokines play an important role not only for initiation of immune reactivity but also for development of tissue injury. Of 38 patients infected with human immunodeficiency virus type 1 (HIV-1) interleukin-1 beta (IL-1 beta) and interleukin-6 (IL-6) were identified in cerebrospinal fluid (CSF) of 22 (58%) and 16 (42%) patients, respectively. Among the IL-1 beta- and IL-6-positive CSF were eight of 15 HIV-1 patients with no clinical signs of central nervous system involvement and four of five patients with acquired immunodeficiency syndrome (AIDS) dementia complex. The presence of IL-6 was often associated with IL-1 beta and soluble interleukin-2 receptor in CSF as well as with intrathecal IgG synthesis. In none of the CSF samples tumor necrosis factor-alpha or interleukin-2 was detected.
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PMID:Human immunodeficiency virus type 1 (HIV-1) infection of the central nervous system: an evaluation of cytokines in cerebrospinal fluid. 265 53

Zidovudine (Retrovir) is the only drug found to be useful for managing human immunodeficiency virus (HIV) infection in patients with acquired immunodeficiency syndrome (AIDS) and AIDS-related complex. The drug is virostatic, ie, it prevents replication of HIV by inhibiting the enzyme reverse transcriptase. Zidovudine is well tolerated and provides short-term benefits by improving the quality of life and extending survival time. It is expensive and can be toxic, however, so its use requires close supervision. Zidovudine at present is approved only for patients with documented Pneumocystis carinii pneumonia or with a CD4 count below 200/mm3. Other probable indications include HIV wasting syndrome, HIV dementia complex, oral candidiasis, Kaposi's sarcoma, the presence of early markers of HIV infection, and HIV-related symptomatic thrombocytopenia. A stepwise approach to initiating zidovudine therapy should include detailed counseling and close surveillance.
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PMID:Zidovudine for treating AIDS. What physicians need to know. 266 55

A relatively high prevalence of neuropsychological impairment has been reported among individuals within the spectrum of HIV-1 disease. These deficits range from mild motoric slowness to a severe dementia characterized by forgetfulness, psychomotor slowing, impaired performance on "frontal systems" tasks, and frequently, dysphoric affect. This paper reviews the preliminary evidence to date on the prevalence and pattern of neuropsychological deficits within the spectrum of HIV-1 infection. Common methodologic pitfalls in this research arena are reviewed. Finally, implications for clinical practice are discussed, with emphasis on construction of screening and more comprehensive neuropsychological test batteries specifically for this population.
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PMID:The neuropsychological aspects of HIV-1 spectrum disease. 266 6

Human Immunodeficiency Virus (HIV) has neurotropic effects that are independent of the well-known lymphotropism. They have been proved by various techniques, but their pathogenesis is not clear. It is remarkable that the neuropathological features do not correlate with the degree of the clinical symptomatology. HIV antigens and antibodies are demonstrable within the central nervous system by immunological tests. The macrophages transport the virus across the blood-brain barrier and are responsible for its persistence in that location. Different cell types, especially of the subcortical areas, have HIV-receptive CD4 molecules. These markers may be identical with the receptors for endogenous neuropeptides and it is likely that viral proteins are causing a competitive inhibition of these mostly neurotrophic factors. This interference is discussed as one of the main reasons of HIV dementia.
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PMID:[Why does the human immunodeficiency virus (HIV) invade the nervous system?]. 266 43

Acquired immunodeficiency syndrome (AIDS), first described in 1981, is produced by infection with a retrovirus of the lentivirus family, now called human immunodeficiency virus (HIV). While, initially, the disease was almost exclusively seen in homosexual men, it has become apparent that numerous other categories of people are at risk, i.e., drug addicts who share dirty needles, hemophiliacs and haitians. In addition, epidemiological data from the industrialized nations clearly indicate that heterosexual contact is becoming an important source of viral transmission, as it has been known to occur in several african nations for many years. Initially, studies on patients with AIDS mainly focused on the immunosuppressive effects of the virus and on the various opportunistic infections and neoplastic complications that followed. Not much attention was given to a possible direct HIV infection of the nervous system. Consequently, patients who presented with neurological findings were simply considered to harbor in the CNS the same complications that occurred in other organs. While this was true in many cases, it has become also apparent that important changes in the central and peripheral nervous systems are due to direct viral involvement of these tissues. The first important step in the understanding of nervous system involvement in AIDS was the demonstration, in 1985, of HIV in the CSF and cerebral tissues of patients with neurological symptoms (47). Further studies have shown that, while opportunistic infections and neoplastic complications certainly contribute to the neurological morbidity of AIDS, the most important neuropathological changes, particularly in the brain, are due to direct HIV infection. The aim of this paper is to review the pathology of HIV-induced encephalitis and to discuss pathogenetic hypotheses regarding mechanisms of HIV-mediated tissue injury and the clinical manifestations that follow, particularly the syndrome now known as AIDS-Dementia-Complex (ADC). First, however, it may be appropriate to quickly review some basic notions on the biology of the virus.
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PMID:AIDS-dementia-complex: pathology, pathogenesis and future directions. 267 Aug 16

Vacuolar myelopathy (VM) is a frequent neurological complication of the acquired immune deficiency syndrome (AIDS). A suspected connection between VM and human immunodeficiency virus (HIV) has been based only on HIV isolation from affected spinal cord tissue. We report here an AIDS patient dying after 14 months of progressive dementia, including 3 months of spinal signs and symptoms. At autopsy, the brain revealed moderate diffuse damage of the white matter compatible with HIV-induced progressive diffuse leukoencephalopathy. The spinal cord showed VM mainly in the lateral and the posterior columns. Mono- and multinucleated macrophages were localized within intramyelinic and periaxonal vacuoles. Light and electron microscopic immunocytochemistry revealed the presence of HIV antigens restricted to mono- and multinucleated macrophages within the spongy lesions. Productive HIV infection is documented for the first time within VM lesions of this case. Therefore, VM should be included among HIV-induced lesions of the central nervous system. The intimate relation of infected macrophages to vacuolar myelinopathy could suggest secretion of a myelinotoxic factor by macrophages productively infected by HIV. Immune electron microscopy appears as promising tool to detect HIV in tissue even when the density of virus may be low.
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PMID:Vacuolar myelopathy with multinucleated giant cells in the acquired immune deficiency syndrome (AIDS). Light and electron microscopic distribution of human immunodeficiency virus (HIV) antigens. 268 61

Neuropathologic features of HIV encephalitis are described in 8 cases selected among 36 autopsies of AIDS patients. From an epidemiologic point of view, the author remarks that parenteral drug addict patients are as prone as male homosexual patients to get HIV encephalitis. The surprisingly low incidence of this illness, recorded in the epidemiologic bulletin of Health Ministry is pointed out. Clinicopathologically, the complex nosologic problem and terminologic confusion of AIDS dementia are discussed, as well as the different neuropathologic criteria used to define HIV encephalitis. The term "panencephalitis with multinucleated cells" is proposed to name the neuropathologic lesions of those patients with HIV dementia and who show multinucleated cells as histopathologic hall mark of HIV encephalitis on brain examination. Physiopathologic interpretation about how the HIV affects the CNS is analyzed. Recent etiopathogenic interpretations of HIV dementia are included.
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PMID:[Neuropathology of HIV encephalitis]. 270 Feb 96

The AIDS dementia complex (ADC) is the SNC complaint that appears most frequently in AIDS patients. ADC is characterized by a subacute onset of dementia accompanied by motor disturbance and changes in behaviour and is considered to be directly caused by HIV-1. Very frequent in advanced stages of AIDS, it can also be the way in which the illness appears. In 90% of the necropsies of these patients a diffuse demyelination of the white substance is observed with multinucleate cells appearing in 40% of the cases. Up to now, the factors triggering this disease are not well understood, nevertheless, the immunosuppression present in these individuals could act as a factor favouring the appearance of ADC. A specific marker does not exist and, therefore, the complementary studies can only help to eliminate other causes of neurological complaints. Successful tests of treatment with zidovudine have been made, although it would be necessary to carry out studies with a larger number of patients to be able to evaluate its long-term efficacity.
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PMID:[AIDS dementia complex]. 270 Feb 97

Involvement of the central nervous system with the human immunodeficiency virus is thought to underlie the clinical and pathologic features of acquired immunodeficiency syndrome (AIDS) encephalopathy. Although morphologic, immunocytochemical, and molecular data point to predominant human immunodeficiency virus infection of multinucleated and mononuclear macrophages, neuroglial and other cells are thought to be involved as well. Electron microscopic studies of biopsy tissue that might further define the neuropathologic changes have been limited. The opportunity to study well-preserved biopsy tissue from a 38-year-old man with the acute onset of dementia and AIDS encephalopathy prompted this report. Human immunodeficiency virus was seen budding from the surface of multinucleated and mononuclear cells with morphologic features of macrophages; a rare astrocyte process showed evidence of viral infection as well. Macrophages were noted within the walls of blood vessels and in intimate contact with lymphocytes within the neuropil. Notably rare were tubuloreticular inclusions, interferon-related cytoplasmic structures commonly found in systemic endothelial cells and lymphocytes in AIDS. Their relative scarcity may signify reduced interferon production in AIDS encephalopathy.
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PMID:The fine structure of acquired immunodeficiency syndrome encephalopathy. 275 85


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