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

Differences in tuberculosis diagnosis between infected and non-infected HIV patients were described. In Barcelona, tuberculosis is present in 41.6% of 851 patients in whom AIDS was detected between 1981 and the first quarter of 1990. We reviewed the results of the methods used for tuberculosis diagnosis in 270 AIDS patients controlled in our hospital, in whom tuberculosis was detected (33.3%), and we compared these data with the results obtained in HIV carriers with tuberculosis and with tuberculous patients without HIV infection. Statistically significant differences were found between the three groups with respect to sex, age, results of Ziehl-Neelsen stain in pulmonary specimens and skin test reaction; between AIDS patients and the non-HIV infected population differences were observed in tuberculosis site. Positive skin test reaction diminished from tuberculous individuals non-HIV infected (95%), to HIV carriers with tuberculosis (71.8%) and AIDS patients with tuberculosis (21.8%). Acid-fast smears from pulmonary specimens were positive in 35.7%, 23.5% and 43.7% respectively. Statistically significant differences were found in tuberculosis localization between tuberculous patients non-HIV infected and tuberculous patients with AIDS, in the last group tuberculosis lymphadenitis was the most frequent localization (33.3%) of extrapulmonary tuberculosis, followed by abdominal tuberculosis (15.5%). The incidence of HIV infection among tuberculous patients was 4.6 in our study, but could be higher if patients between 19 and 30 years old were always checked for anti-HIV antibodies.
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PMID:Diagnosis of mycobacterial infection in acquired immunodeficiency syndrome (AIDS) patients and HIV carriers. 129 12

Physicians examined the records of 47 adults with visceral leishmaniasis (VL) and HIV-1 infection who were patients at 3 urban teaching hospitals in the Andalucia region in southern Spain between January 1986 and November 1991. They wanted to identify the clinical, biological, and epidemiological features of VL in HIV-1 positive patients. 96% of the cases were diagnosed with both infections during the last 2 years of the study period and 79% between January and November 1991. All the patients had risk factors for HIV infection (65.9% IV drug use, 21.3% sexual contact, and 12.8% blood transfusion). 70% exhibited the classic symptoms of VL (fever, enlarged liver and spleen, and depressed counts of blood cells). Most patients were already very immunocompromised when VL was diagnosed. 87% had a total lymphocyte count of less than 1000 x 1 million/1 and a CD4 lymphocyte count of less than 200 x 1 million/1. In fact, 66% had full blown AIDS prior to diagnosis of VL. VL was the first severe infection in 10 cases. 68% also suffered from opportunistic infections, especially candidiasis, extrapulmonary tuberculosis, and Pneumocystis carinii pneumonia. Microscopic examination of Leishmania amastiogotes in tissue samples led to a diagnosis in 94% of cases, isolation of motile amastigotes in culture of bone marrow aspirate in 2%, and microscopic and culture in 4%. Just 46% completed a full course of treatment (pentavalent antimony, allopurinol, and/or pentamidine). Only 38% had a microbiological response. Immunofluorescence detected sizeable titers (1:40) of antileishmanial antibodies in just 31% of cases. 17% experienced clear clinical improvement. Physicians in endemic areas should consider VL in every HIV-1 infected patient with fever, hepatosplenomegaly, or hematological abnormalities to avoid underdiagnosis of leishmaniasis.
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PMID:Visceral leishmaniasis in HIV-1-infected individuals: a common opportunistic infection in Spain? 136 80

This article reviews the clinical aspects and diagnosis of HIV-associated tuberculosis in developing countries, and summaries WHO's recommendations for treatment. According to WHO estimates (early 1992) over 4 million persons worldwide have been infected with HIV and tuberculosis; 95% of them are in the developing countries. Clinical features of HIV-associated pulmonary tuberculosis in adults are frequently atypical, particularly in the late stage of HIV infection, with non-cavitary disease, lower lobe infiltrates, hilar lymphadenopathy, and pleural effusion. More typical post-primary tuberculosis with upper lobe infiltrates and cavitations is seen in the earlier stages of HIV infection. Extrapulmonary tuberculosis is reported more frequently, despite the difficulties in diagnosing it. WHO's recent guidelines recommend 6-month short-course chemotherapy with isoniazid, rifampicin, pyrazinamide, and ethambutol for patients with HIV-associated tuberculosis. The older 12-month regimen without rifampicin is much less effective. Streptomycin should not be used, because of the risk of transmitting blood-borne pathogens through contaminated needles. Thioacetazone should be abandoned, because of severe averse reactions observed among HIV-infected patients. The roles of preventive chemotherapy and BCG vaccination for prevention of tuberculosis are also briefly discussed. (author's)
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PMID:HIV-associated tuberculosis in developing countries: clinical features, diagnosis, and treatment. 139 86

The authors report a connection between a meningitis tuberculosis and a meningoencephalitis with cryptococcus in the case of an african VIH+. The diagnostic of a meningitis tuberculosis was retained on an indirect arguments, this of meningoencephalitis of direct arguments (antigen cryptococcus, cultivation on Sabouraud environment). The pulmonary tuberculosis and/or extrapulmonary tuberculosis is current in Central Africa during HIV infection, as well as the crytococcosis during AIDS. But, any observation on neuromeningitis strike of those two infections have been reported up to now.
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PMID:[Simultaneous association of tubercular meningitis and cryptococcal meningitis in an African with human immunodeficiency virus HIV positive serology. University Hospital Center of Bujumbura,Burundi]. 140 16

Tuberculous infections of the breast are considered rare in the developed world. We describe a case of mammary tuberculosis in a woman who was not initially known to be seropositive for the human immunodeficiency virus (HIV) and who was thought to have a pyogenic breast abscess. This uncommon presentation of extrapulmonary tuberculosis as an AIDS-defining condition highlights the necessity for performing mycobacterial smears and cultures in such cases when patients are at risk for HIV infection.
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PMID:Tuberculosis of the breast as a presenting manifestation of AIDS. 142 Jun 82

We report a case of mesenteric tuberculosis. Two painful abdominal masses and fever were the first manifestation of disease. Diagnosis was obtained by aspirative punction of a mesenteric adenopathy guided by ultrasonography. AIDS risk factors were not recognized by anamnesis but serum HIV antibodies were detected. Thus, extrapulmonary tuberculosis and the finding of HIV-Ab confirmed the diagnosis of AIDS in our patient. It is necessary to assay for HIV-Ab in extrapulmonary tuberculosis, especially when mesenteric tuberculosis is present.
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PMID:[Isolated mesenteric tuberculosis as the first manifestation of AIDS]. 152 May 54

Between 1983 and 1989, we cared for 56 patients with tuberculosis and human immunodeficiency virus (HIV) infection. In 37 patients (66%), tuberculosis occurred before any other AIDS-defining disease (group 1); in 10 (18%) it occurred during the same month as another AIDS-defining disease (group 2); and in 9 (16%), after the diagnosis of AIDS (group 3). Tuberculosis was entirely pulmonary in 14 patients (25%), entirely extrapulmonary in 9 (16%), and both pulmonary and extrapulmonary in 33 (59%). The frequency of extrapulmonary involvement was similar in patients from group 1 and from groups 2 and 3 (combined): 76% versus 74%. Needle biopsy of the liver revealed hepatic involvement in 18 patients (32%). The mean CD4 lymphocyte count was 232/mm3 when tuberculosis was entirely pulmonary, and 243/mm3 when extrapulmonary disease was present (difference not significant). In group 1, the onset of both pulmonary and extrapulmonary tuberculosis occurred at the same stage of HIV infection, 12 and 10 months, respectively, before any other AIDS-defining disease. Treatment, planned to last 1 year, was highly effective, despite frequent side-effects. Among the 32 patients who completed treatment, relapse of tuberculosis occurred in 2 (6%) with a mean follow-up of 16 months (0-53 months) after completion. Our results suggest that pulmonary tuberculosis should be included in the criteria for diagnosis of AIDS.
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PMID:Should pulmonary tuberculosis be an AIDS-defining diagnosis in patients infected with HIV? 152 76

The impact of the new AIDS definition on tuberculosis in Barcelona is evaluated. In 1988 active epidemiological surveillance demonstrated a tuberculosis incidence rate of 58.31/100,000 and an AIDS incidence rate of 9.93/100,000 according to the old definition, and 14.16/100,000 according to the CDCs' new definition (42.5% increase). The majority of these new cases are HIV-positive drug abusers with extrapulmonary tuberculosis. Pulmonary or extra-pulmonary tuberculosis is also observed more frequently in drug abusers than in homosexuals (odds ratio = 7.4; CL 95%; 3.5-15.5). Up until 1986, 39% of AIDS cases were homosexuals and 36% drug abusers. In 1988, according to the old AIDS definition, 54.2% of AIDS cases were drug abusers and 31.9% were male homosexuals but with the new definition it is even more striking that the high risk group is still drug abusers. Today we must add to the old social problem of tuberculosis the problem of drug abusers, and all the difficulties of compliance with chemotherapy or antituberculous chemoprophylaxis. New strategies will have to be devised to deal with this new problem.
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PMID:Impact of tuberculosis on the new AIDS definition in Barcelona [corrected]. 165 Feb 71

From October 1987 to June 1988, we attempted to determine the prevalence of HIV infection among patients hospitalized with tuberculosis and the extent of immunosuppression among those tuberculosis patients infected with HIV. Of 178 consecutive patients, 18-65 years of age, who were hospitalized with newly diagnosed, previously untreated tuberculosis, 46% (82 out of 178) had clinical or serological evidence of HIV infection, 30% (54 out of 178) were HIV-seronegative, and 24% (42 out of 178) could not be assessed for the presence of HIV infection. Among the HIV-seropositive patients without an AIDS-defining diagnosis by non-tuberculous criteria, the median CD4 lymphocyte (CD4) count was 133 x 10(6) cells/l (range: 11-677 x 10(6]; among the HIV-seronegative patients, the median CD4 count was 613 x 10(6) cells/l (range: 238-1614 x 10(6); P less than 0.001). Among the HIV-seropositive patients, those with disseminated tuberculosis (median CD4 = 79 x 10(6) cells/l) and those with pulmonary tuberculosis who had radiographic evidence of mediastinal or hilar adenopathy (median CD4 = 45 x 10(6) cells/l) had the most severe CD4 depletion, whereas those with localized extrapulmonary tuberculosis (median CD4 = 242 x 10(6) cells/l) and those with pulmonary tuberculosis without adenopathy (median CD4 = 299 x 10(6) cells/l) were less severely immunosuppressed. Of the 178 patients, 6% (11 out of 178) were infected with strains of Mycobacterium tuberculosis resistant to both isoniazid and rifampin.
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PMID:HIV prevalence, immunosuppression, and drug resistance in patients with tuberculosis in an area endemic for AIDS. 167 82

We have described a case of miliary tuberculosis, with symptoms primarily due to hepatic involvement during pregnancy. Liver biopsy showed granulomatous hepatitis, and subsequent cultures of sputum, urine, and gastric aspirate were positive for Mycobacterium tuberculosis. Although this patient was seronegative for HIV, an increased incidence of extrapulmonary and disseminated tuberculous infection has recently been noted in patients with HIV infection. Given the increasing incidence of HIV in the general population, we may therefore anticipate a corresponding rise in the incidence of extrapulmonary tuberculosis. Since an increasing number of gravidas will be immunocompromised by HIV infection, renewal of knowledge regarding diagnosis of miliary tuberculosis in pregnancy is valuable.
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PMID:Miliary tuberculosis: unusual cause of abdominal pain in pregnancy. 173 86


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