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)

T helper (Th) cells are of central importance in regulating many critical immune effector mechanisms. The profile of cytokines produced by Th cells correlates with the type of effector cells induced during the immune response to foreign antigen. Th1 cells induce the cell-mediated immune response, while Th2 cells drive antibody production. Th cells are the preferential targets of human retroviruses. Infections with human T-cell leukemia virus (HTLV) or human immunodeficiency virus (HIV) result in the expansion of Th cells by the action of HTLV (adult T-cell leukemia) or the progressive loss of T cells by the action of HIV (AIDS). Both retrovirus infections impart a high-level activation state in the host immune cells as well as systemically. However, diverging responses to this activation state have contrasting effects on the Th-cell population. In HIV infection, Th-cell loss has been attributed to several mechanisms, including a selective elimination of cells by apoptosis. The induction of apoptosis in HIV infection is complex, with many different pathways able to induce cell death. In contrast, infection of Th cells with HTLV-1 affords the cell a protective advantage against apoptosis. This advantage may allow the cell to escape immune surveillance, providing the opportunity for the development of Th-cell cancer. In this review, we will discuss the impact of Th-cell activation and general immune activation on human retrovirus expression with a focus upon Th-cell function and the progression to disease.
 ...
PMID:T helper cell activation and human retroviral pathogenesis. 898 61

Infections caused by Chlamydia trachomatis are probably the most common sexually transmitted diseases in the United States. Commonly unrecognized and often inadequately treated, chlamydial infections can ascend the reproductive tract and cause pelvic inflammatory disease, which often results in the devastating consequences of infertility, ectopic pregnancy, or chronic pelvic pain. C. trachomatis infections are also known to increase the risk for human immunodeficiency virus infection. The obligate intracellular life cycle of C. trachomatis has traditionally required laboratory diagnostic tests that are technically demanding, labor-intensive, expensive, and difficult to access. In spite of these historical challenges, however, laboratory diagnosis of C. trachomatis has been a rapidly advancing area in which there is presently a wide array of commercial diagnostic technologies, costs, manufacturers. This review describes and compares the diagnostic methods for C. trachomatis infection that are currently approved for use in the United States, including the newest DNA amplification technologies which are yet to be licensed for commercial use. Issues to consider in selecting a test for purposes of screening versus diagnosis based on prevalence, performance, legal, social, and cost issues are also discussed.
 ...
PMID:Current methods of laboratory diagnosis of Chlamydia trachomatis infections. 945 34

With changes in epidemiology and the application of newer treatment and prophylactic regimens, the types of pulmonary diseases that occur in HIV-infected persons are changing. New ways to assess the progression of HIV disease and new antiretroviral treatments are available. Increased survival is often coupled with worsening immunosuppression. Overall mortality from Pneumocystis carinii pneumonia is declining, but mortality from bacterial pneumonia and mycobacterial disease is increasing. Infections with unusual and resistant organisms are also increasing. Patients with severe immunosuppression are susceptible to fungal, viral, and neoplastic pulmonary disease.
 ...
PMID:Pulmonary complications of HIV infection. 919 62

This article reviews the importance of preventing illness in HIV-infected patients. The indications and medication regimens for preventing several common opportunistic complications are discussed. Infections addressed include pneumocystis pneumonia, Mycobacterium avium complex, toxoplasmosis encephalitis, and tuberculosis, among others. Other preventive interventions such as routine immunizations are addressed briefly as well. Diagnosis and treatment of five of the most common HIV-associated opportunistic infections are reviewed.
 ...
PMID:Prevention and treatment of common HIV-associated opportunistic complications. 927 92

Infections due to Cryptococcus neoformans are common in AIDS patients. We investigated the effect of chloroquine, which raises the pH of phagolysosomes, on the anticryptococcal activity of mononuclear phagocytes. C. neoformans multiplied within monocyte-derived macrophages (MDM) in the absence of chloroquine but were killed with the addition of chloroquine. Ammonium chloride was also beneficial, suggesting that effects were mediated by alkalinizing the phagolysosome. Chloroquine inhibits growth of other intracellular pathogens by limiting iron availability. However, chloroquine-induced augmentation of MDM anticryptococcal activity was unaffected by iron nitriloacetate, demonstrating that chloroquine worked by a mechanism independent of iron deprivation. There was an inverse correlation between growth of C. neoformans in cell-free media and pH, suggesting that some of the effect of chloroquine on the anticryptococcal activity of MDM could be explained by relatively poor growth at higher pH. Chloroquine enhanced MDM anticryptococcal activity against all tested cryptococcal strains except for one large-capsule strain which was not phagocytosed. Positive effects of chloroquine were also seen in monocytes from both HIV-infected and -uninfected donors. Finally, chloroquine was therapeutic in experimental cryptococcosis in outbred and severe combined immunodeficient mice. Thus, chloroquine enhances the activity of mononuclear phagocytes against C. neoformans by iron-independent, pH-dependent mechanisms and is therapeutic in murine models of cryptococcosis. Chloroquine might have clinical utility for the prophylaxis and treatment of human cryptococcosis.
 ...
PMID:Chloroquine induces human mononuclear phagocytes to inhibit and kill Cryptococcus neoformans by a mechanism independent of iron deprivation. 929 33

Infections with organisms of the genus Bartonella, for many years important only in South and Central America, have assumed significance in developing countries, especially in conjunction with the advent of the pandemic of the human immunodeficiency virus infection. New molecular and culture techniques have determined that these organisms cause new diseases such as bacillary angiomatosis as well as diseases the etiology of which have been unknown such as cat scratch disease. In this article, the microbiology, pathogenesis, histopathology and clinical manifestations of diseases caused by these organisms are discussed.
 ...
PMID:Bacillary angiomatosis and other Bartonella species infections. 930 Jun 30

Bacteremia due to non-typhi Salmonella is frequent in human immunodeficiency virus (HIV)-infected patients; however, focal complications rarely have been reported. Ten of 38 HIV-infected patients (26.3%) with salmonellosis documented over a period of 9 years had focal suppurative complications; only 19 (3.9%) of 490 adults without HIV infection who were seen during the same period had focal complications (P = .001). Infections of the urinary tract, lungs, and soft tissue, followed by arthritis, endocarditis, and meningitis were most frequently seen. Although salmonellosis occasionally heralded HIV infection, most patients were severely immunocompromised and had CD4 cell counts of <100/mm3. The mortality rate was 50%, equivalent to that observed among patients with other immunosuppressive disorders (52.6%). Major emphasis must be put on intensive therapy for salmonella bacteremia and prevention of its complications.
 ...
PMID:Focal infections due to non-typhi Salmonella in patients with AIDS: report of 10 cases and review. 931 63

The learning needs of persons with HIV/AIDS continue to grow more complex as new treatments are developed and HIV disease shifts from being a terminal to a chronic illness. Clinicians could use a simple tool to help them to focus on what clients think is important to know about living with HIV/AIDS. This article describes the development of the HIV Educational Needs Assessment Tool (HENAT). HIV+ persons (N = 363) who were receiving health care in a variety of ambulatory and institutional settings participated in this research during 1990 and 1993-1994. Factor analysis was used to shorten the instrument into a form that could be used in any nurse/client interaction. Principal axis factor extraction and varimax rotation deleted 16 items. The remaining 34 items were grouped into six factors: Treatments, Entitlements, Relationships, Preventing Infections, Social Support, and Working. Cronbach's alphas were computed and results ranged from .70 to .88. Two month test-retest correlations for a subset of participants (n = 195) ranged from .54 to .67. HENAT can be used (a) to examine differences in perception of learning needs between clients with HIV disease and their health care providers, (b) to measure shifts in learning needs over time, (c) to relate HIV-specific learning needs to length of time living with HIV disease, (d) to give clients an opportunity to assess their learning needs, and (e) as part of a larger intervention study that evaluates the effectiveness of patient education.
 ...
PMID:Development of an HIV educational needs assessment tool. 935 66

Many conditions may present as fever of unknown origin in the HIV-infected patient, and their relative frequency is influenced by multiple factors. The history and physical examination may provide some useful clues for the diagnosis. Haematological, biochemical, and conventional radiological tests are rarely diagnostic; even serological and/or microbiological tests have some limitations in these patients. The geographical setting and the local prevalence of diseases are of the utmost importance. Infections that have a world-wide distribution, such as tuberculosis, should be intensively searched for, particularly in areas of high prevalence. The measurement of the CD4+ cell count is essential, as there is a strong association between this count and certain opportunistic diseases that may manifest as fever of unknown origin. Imaging procedures, such as CT and radionuclide scans, are useful for the location of inflammatory and neoplastic lesions. Liver and bone marrow biopsies are helpful in certain subsets of patients and the efficacy of empirical treatments has been clearly documented in certain infections. Some HIV-infected patients with fever of unknown origin remain undiagnosed after a thorough investigation; these individuals should be managed conservatively. Finally, symptomatic treatment is the best option for terminally ill patients in whom benefit from a detailed investigation of the cause of fever is not expected.
 ...
PMID:Fever of unknown origin in the HIV-infected patient: new scenario for an old problem. 936 Feb 45

Progression from seroconversion to the development of AIDS in Africa may be shorter than in industrialized countries, but there are insufficient data to be certain. Although the data are not always directly comparable, survival after an AIDS diagnosis appears to be substantially shorter in African countries and this may be partly because of later diagnosis of AIDS in Africa, but may also be because of environmental factors such as increased exposure to pathogens of high virulence and lack of access to care. Tuberculosis and bacterial infections are the most important causes of morbidity and mortality among hospitalized patients. Bacteraemia is frequent, particularly due to non-typhoid salmonellae and S. pneumoniae. Cryptosporidia and I. belli are the most frequently isolated pathogens in patients with diarrhoea; non-typhoid salmonellae and Shigella species are also commonly isolated when stool cultures are performed. Cerebral toxoplasmosis, and meningitis due to Cryptococcus, tuberculosis and bacterial pathogens are the most frequent neurological infections and cognitive changes are frequently identified when specifically looked for. Infections with atypical mycobacteria and Pneumocystis carinii are rare, as is CMV retinitis. In women, HIV infection is associated with cervical human papillomavirus and with SIL, although there is currently no evidence for an association with invasive cervical cancer. Individuals infected with HIV-2 progress to AIDS and to death more slowly than those infected with HIV-1, but seem to experience the same spectrum of opportunistic disease when they reach the stage of advanced disease. The limited data available suggest that HIV-infected individuals in Africa develop opportunistic disease at broadly the same level of immunosuppression as do individuals in industrialized countries, but death occurs at a higher range of CD4 counts, although still in the range consistent with advanced disease. Data are still lacking concerning the aetiology of common clinical presentations of HIV disease and the relative frequencies of specific opportunistic diseases in different regions, particularly from southern Africa. Tuberculosis is the single most important HIV-related opportunistic infection in African countries, but diagnosis, particularly of extrapulmonary disease, remains difficult. The lack of laboratory facilities makes the diagnosis of bacterial infections difficult in many parts of the continent and, since this situation is unlikely to change in the near future, clinical algorithms for syndromic management need to be evaluated. More information is needed about gynaecological disease in HIV-infected women. The most important research questions concern the development and evaluation of cost-effective regimes for prophylaxis and treatment of opportunistic disease in order to prolong healthy life in HIV-infected individuals.
 ...
PMID:Natural history and spectrum of disease in adults with HIV/AIDS in Africa. 941 66


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