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

Interferon (IFN) plays an important role in the treatment and pathogenesis of HIV disease. Recent studies show beneficial effects of IFN alpha in the treatment of HIV-associated Kaposi's Sarcoma and early HIV-infection. Moreover, cell culture studies support these beneficial effects. HIV infection of monocytes is blocked by IFN alpha administered at the time of viral challenge. The IFN alpha-treated cells show no evidence of HIV infection. Viral gene products produced in monocytes infected with HIV then treated with IFN alpha gradually decrease to baseline. Large quantities of proviral DNA are seen in the HIV-infected IFN alpha-treated cells with little evidence for viral transcription suggesting true microbiological latency. While most viral infections of cells result in IFN production, HIV is a notable exception. Indeed, HIV does not induce monocytes to produce IFN alpha and blocks its production following poly(I).poly(c) stimulation. This allows HIV yet another mechanism to evade an important host antiviral response. Paradoxically, the appearance of IFN activity in sera of HIV-infected patients is associated with disease progression, not resolution. Recent observations showing that the interaction between HIV-infected monocytes and PBMC results in the production of IFN alpha s with reduced anti-HIV activity may help explain this paradox. Thus, IFN alpha plays an important but complex role in HIV disease. The elucidation of cellular factors that regulate the antiretroviral effects of IFN alpha may lead to the development of novel therapeutic strategies for HIV infection.
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PMID:Interferons in the persistence, pathogenesis, and treatment of HIV infection. 137 92

Duration of the AIDS-free period after HIV-infection and survival time vary to a wide extent. About 50 percent of the patients develop AIDS within 10 years. The most important prognostic factor is the CD4-lymphocyte count. The risk of AIDS increases significantly after CD4-lymphocyte counts drop below 400/microliters. Another prognostic factor is age. In older patients disease progresses more rapidly. AIDS often is preceded by an AIDS-Related-Complex characterized for example by Oral Candidiasis, Hairy Leukoplakia or Zoster of more than one dermatome. AIDS mostly develops 1/2 to 1 year after AIDS-Related-Complex. After AIDS is diagnosed the median survival time is not longer than 1 1/2 years. Single patients live much longer. Prognosis is influenced by the disease defining AIDS. Kaposi's Sarcoma often occurs early in the course of immunodeficiency and median survival is longer than after other opportunistic diseases. Survival also is longer after Pneumocystis Carinii Pneumonia since it is well treatable. A very short survival has been noticed after Non-Hodgkin-Lymphoma. During the last few years survival after HIV-infection and AIDS has been prolonged a little by sufficient prophylaxis of Pneumocystis Carinii Pneumonia which is the most frequent opportunistic disease, by antiretroviral treatment with Zidovudine and by increase of knowledge which makes early diagnosis and treatment of opportunistic diseases possible.
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PMID:[Survival in HIV infection and AIDS]. 162 24

Kaposi's Sarcoma (KS) is a tumor of mesenchymal origin of unclear etiology and pathogenesis. The epidemic form of KS (AIDS-associated) occurs in up to 30% of HIV-1 infected individuals with lesions characterized by mixed cellularity, spindle cells proliferation and neoangiogenesis. The establishment of in vitro and in vivo model systems (AIDS-KS cell cultures and nude mouse) have allowed studies toward the understanding of the pathogenesis of KS. The data presented here support the hypothesis that KS is a cytokine mediated disease and that interactions between mesenchymal cell types and HIV-1 gene products might lead to a composite lesion such as KS. In fact, in vitro and in vivo studies indicate that the HIV-1 Tat protein acts as a growth factor for cells derived from AIDS-KS lesions, thus establishing an experimental link between HIV-1 infection and the development of KS in humans. Human immunodeficiency virus (HIV-1) is implicated in various clinical manifestations associated with AIDS, including KS. KS represents the most frequent tumor arising in infected individuals, particularly homosexual and bisexual men. This form of KS (epidemic or AIDS-KS) is aggressive and often results in dissemination and invasion of lymph nodes and viscera. Histologically, KS is characterized by the proliferation of spindle-shaped cells ("KS cells"), considered to be the tumor element of the lesions, associated with endothelial cells, fibroblasts, inflammatory cells and new blood vessel formation (early stage lesions). In a later stage, the spindle cells tend to coalesce in larger tumor masses, although the slit-like spaces, which are characteristic of the lesion, usually remain evident. The histogenesis of the KS spindle cells, however, is still controversial and both types of mesenchymal cells, endothelial and smooth muscle cells, have been proposed as potential cell progenitors. Although KS is clearly associated with HIV-1 infection, little is known about the molecular events underlying its pathogenesis. Recently, however, two experimental advances (the establishment of long-term cell cultures derived from KS lesions of AIDS patients and the development of animal models) have made the study of the pathogenesis of AIDS-KS possible. Here we discuss results obtained from these new systems suggesting that the induction of the AIDS-KS lesions involves a pathway of events mediated by specific cytokines and that the HIV-1 tat gene product may play a crucial role in the development and/or progression of KS in HIV-1 infected individuals.
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PMID:Molecular mechanisms in the pathogenesis of AIDS-associated Kaposi's sarcoma. 180 71

High dose IFN-alpha is an effective treatment for a subset of patients with Kaposi's Sarcoma, that is, those who lack systemic symptoms (e.g. fever, weight loss), and co-existing HIV-associated conditions (e.g. opportunistic infections), and whose cell-mediated immunity system is only mildly or moderately impaired. There is little evidence that the addition of chemotherapeutic agents to IFN-alpha improves treatment outcome. Response rates in excess of 40% have been reported with the addition of AZT to IFN-alpha, and may prove active in patients with more severely impaired T-cell immunity. There is evidence that in responding patients, IFN-alpha also suppresses HIV replication, and in vitro studies indicate synergistic suppression of HIV by the IFN-alpha-AZT combination; evidence for in vitro synergy is being sought.
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PMID:Interferon-alpha therapy in patients with Kaposi's sarcoma and the acquired immunodeficiency syndrome. 182 8

The effect of prolonged exposure to heat on the HIV has had limited exploration. This is the report of a 33-year-old white man with positive tests for HIV and multiple lesions of Kaposi's Sarcoma. The patient was exposed to total body hyperthermia of 42 degrees C for two hours. Three months following hyperthermia the patient feels improved. The lesions of Kaposi's Sarcoma have markedly regressed, and the T4 lymphocyte count has risen from 5 per cc to 330 per cc. HIV cultures (blood) remain negative. These data would indicate this modality of therapy has altered the progression of disease in this patient.
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PMID:Total body hyperthermia in the treatment of Kaposi's sarcoma in an HIV positive patient. 204 82

Patients with Kaposi's Sarcoma (KS) were grouped according to their clinical symptoms into "indolent", "locally aggressive", "endemic generalised aggressive" and "epidemic generalised aggressive" disease. Only the patients in the epidemic generalised aggressive disease group had serum antibodies to HIV. Complete peripheral blood counts, including lymphocyte subsets, and serum IgG assays were performed on all patients before treatment was initiated. In all the aggressive disease groups there was evidence of immune deficiency in that T helper/inducer (T4) cells were reduced leading to reduced T4,T8 (suppresser/cytotoxic) ratio. All patient groups had increased levels of serum IgG. Although immune deficiency and aggressive KS can be explained in the HIV infected patients no underlying cause has been found in the HIV negative patients with aggressive KS.
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PMID:Kaposi's sarcoma in Zimbabwe. II. Peripheral lymphocytes, immunoglobulin G levels and HIV antibody positivity. 325 Oct 44

Kaposi's Sarcoma (KS) in young individuals is unusual and most often associated with cellular immunodeficiency caused by infective or other neoplastic diseases. It has recently been highly associated with the Acquired Immunodeficiency Syndrome (AIDS). We report the case of a heterosexual 29 year aged man with no evidence of underlying malignancy or infectious diseases. Antibodies to the Human Immunodeficiency Virus (HIV) were absent on repeat testing. His immunological profile demonstrated elevated number of CD8+ cells, normal number of CD3+ and CD4+ cells and hypogammaglobulinemia. These data are distinctly different from those described with AIDS associated KS. The development of KS in young individuals of mediterranean origin may reflect mild degree of immune abnormalities in the absence of infection with HIV.
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PMID:Kaposi's sarcoma in a young man in absence of AIDS or other known causes of immune suppression. 343 54

Data suggest that 10-20% of African HIV-infected persons have Kaposi's Sarcoma (KS). African epidemic, AIDS-related KS (EKS) is widespread in the southern African region, with patients often needing treatment because of the disfiguring and stigmatic nature of the disease. Cytotoxic chemotherapy has shown antitumor activity, but it may further compromise the underlying immune deficiency. EKS is, however, very radiosensitive and radiation therapy is considered to be the treatment of choice for palliation, despite the absence of large studies concerning the role of radiation therapy in the southern African variant of EKS reported to date. The authors report findings from a 1982-92 study of radiation therapy among 25 patients with EKS at the Johannesburg General Hospital. Radiation fields were individually tailored to the extent of the disease. Total administered doses ranged 8-12 Gy (single fraction) to 24-30 Gy fractionated over 2-3 weeks to yield 72% and 80% overall response and symptomatic relief rates, respectively. Toxicity was mild and manageable. This retrospective analysis therefore supports the use of radiation therapy for the southern African type of EKS.
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PMID:Radiation therapy in epidemic, AIDS-related Kaposi's sarcoma in southern Africa. 751 2

We report a case of isolated rectal Kaposi's Sarcoma in a homosexual man with active Human Immunodeficiency Virus infection. Although gastrointestinal tract affection is not infrequent, it is usually associated with the existence of skin lesions. A few cases of noncutaneous gastrointestinal Kaposi's Sarcoma have been described, but no one affecting only the rectum. This is a diagnostic possibility in patients with Human Immunodeficiency Virus infection and rectal symptoms.
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PMID:[Isolated rectal Kaposi's sarcoma]. 812 97

We report a case of a 33-year-old man, intravenous drugs abuser, HIV-positive, with peripheral lymphadenopathy, hepato-splenomegaly and fever, in which a ganglionic biopsy showed a histology with morphologic features of multicentric Castleman's-like disease, and minute foci of Kaposi's sarcoma ganglion, without cutaneous lesions. Given the interrelationships between this morphology of angiofollicular lymph node hyperplasia, the development of Kaposi's Sarcoma, and the aggressive clinical course seen in our patient and those in the literature, the use of lymph node biopsy may be an important prognostic tool for the patients with the acquired immunodeficiency syndrome.
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PMID:[Generalized lymphadenopathy with morphologic findings of multicentric angiofollicular ganglionic hyperplasia in a patient with AIDS]. 825 54


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