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

Evidence from many countries suggests an association of human immunodeficiency virus (HIV) infection and tuberculosis of major public health significance. In order to begin assessing the impact of HIV on tuberculosis in Kenya, we have determined the HIV-1 seroprevalence among tuberculosis patients and compared the clinical characteristics of tuberculosis in HIV-positive and HIV-negative patients in two cross-sectional studies at the Infectious Disease Hospital (IDH) and the Ngaira Avenue Chest Clinic (NACC), Nairobi, Kenya. The diagnosis in 92% of all patients with pulmonary tuberculosis was confirmed by culture. The remainder were diagnosed on histological, clinical or radiological grounds. HIV seroprevalence among tuberculosis patients at IDH was 26.5% (52/196) compared to 9.2% (18/195) at NACC (P less than 0.001). There was no association between numbers of streptomycin injections in the previous 5 years and HIV infection. Positive sputum smear rates in HIV-positive patients were slightly lower than in HIV-negative patients at both study sites (71% vs 83% at IDH and 73% vs 82% at NACC) but the difference was not significant. Only Mycobacterium tuberculosis was isolated. Miliary disease was not associated with HIV infection. Persistent diarrhoea, oral candidiasis, generalized itchy rash, herpes zoster and generalized lymphadenopathy were all associated with HIV infection, but 46% (95% CI:38-54%) of all HIV-positive patients had none of the clinical features listed in the WHO Clinical Criteria for the Diagnosis of AIDS, apart from fever, cough and weight loss. Stevens-Johnson Syndrome was reported in 7/52 (13%) patients with HIV infection, and in 4/144 (3%) patients without (RR 4.85, 95% CI: 1.45-15.88).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Cross-sectional survey of HIV infection among patients with tuberculosis in Nairobi, Kenya. 138 70

The objective for this work was to describe the transmission mechanisms and the clinical behavior of 60 HIV-infected pediatric patients. We studied children from newborn to 15 years old according to the CDC criteria. From January 1985 to February 1992, were evaluated 60 patients, 40 males and 20 females; 25 with perinatal transmission (23 transplacental and 2 breast-feeding), 22 hemophiliacs, 12 by blood transfusion and 1 by intramuscular injection with contaminated needle. The disease was symptomatic in 50 patients, asymptomatic in 5 and indeterminate in 5 cases. Up to date, 28 children are in phase P2, 10 in P0 and P1, and 22 patients have died. The clinical manifestations in 50 patients were: altered growth and development in 50, generalized lymphadenopathy in 30, severe infections in 23, fever in 15, hepatosplenomegaly in 15, chronic diarrhea in 10, and HIV-encephalopathy in one. It is concluded what at present time perinatal transmission is the main mechanism.
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PMID:[AIDS in children. 8 years experience at La Raza Medical Center Infectology Hospital, Mexican Social Security Institute]. 138 82

A report from Kampala, Uganda, compares the situation in 1991 to the state of chaos 10 years earlier when the regime of Idi Amin had been overthrown by Milton Obote's soldiers with the help of Tanzanian troops. Soldiers went on looting sprees, and 1 victim of their marauding became a 12-year old boy who got shot for refusing to part with his bike. In contrast, in 1991 things were much more peaceful; however, the AIDS epidemic was the new threat. The government radio transmits hourly warnings on HIV. Since President Museveni came to power, economy and security have improved radically. Shops and markets are open until late at night; public transport is reliable, and small scale industry flourished. There would be optimism about the future, if AIDS was not here. There is no doubt that the economy will soon be affected. According to the Kampala blood bank, 40% of the healthy population is already seropositive. In the hospitals the majority of admissions suffer from AIDS with diarrhea and an itching dermatitis; there is more cancer of the cervix and lymphoma; appendicitis is on the increase; and tuberculous lymph nodes are now quite common. Many of these patients have clinical AIDS. The government is frank about the situation and is active in preventive measures and education. Private charities and foreign aid organizations contribute. But the epidemic is so overwhelming, that some Western organizations might soon lose interest owning to meager returns on their efforts. A 6-year-old boy has grossly swollen lymph nodes around his neck, both parotids are painfully swollen, pus pours from the ears. A nonspecific cough and mild diarrhea are also present with an itching and sore herpes zoster on his left chest. the mother is frightened of losing him, and demurs at the hint of AIDS, since for her, AIDS means sexual promiscuity.
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PMID:A tale of one city. 139 51

Data on 887 AIDS cases in Zimbabwe were collected at the District Hospital in Hurungwe, Zimbabwe, from 1986-89 before the official notification system included this disease. The number of cases increased from 19 in 1986 to 290 in 1987, 433 in 1988, and 145 in the first 3 months of 1989. The female male ratio in adults were 1.4. There were 102 children under 5 with AIDS and the 5 children aged 5-15, who were all female. The presenting signs and symptoms were most often persistent generalized lymphadenopathy, chest infection, herpes zoster, chronic STDs, and chronic diarrhea with weight loss. There were 44 cases of HIV-positive pulmonary tuberculosis; 8 patients being treated for tuberculosis developed Stevens-Johnson syndrome. Of patients, overall, with herpes zoster, 89% were HIV-positive, of those with oral thrush, 83% were HIV-positive, of those with generalized lymphadenopathy, 76% were HIV-positive, and of those with weight loss and chronic diarrhea, 70% were HIV-positive. The Hurungwe District lies along the road from harare to Lusaka, Zambia, where long-distant truck drivers frequently interact with the locally mobile population. The authors suggest that herpes zoster, with its ease of diagnosis, be used as a tool to follow the spread of HIV.
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PMID:Pattern of HIV-infection in Hurungwe district, Mashonaland West, Zimbabwe. 139 93

A prospective case series study was conducted Jan 1991-Oct 1991 on 108 neonates admitted to NICU, Lusaka. 90 patients satisfied inclusion criteria, 45 cases and 45 controls. Symptomatic seropositive babies born to seropositive mothers presented with failure to thrive, fever, persistent or recurrent thrush, severe Sepsis and large liver. Tendency to prematurity among cases was high. Diarrhoea, Sepsis and Haemolytic Anaemia appear to be terminal signs. Neonates suffer the most aggressive form of HIV/AIDS, with symptomatic cases dying 3-4/52 of onset of symptoms. Over one quarter of the mothers were symptomatic. Congenital malformations and Lymphadenopathy were not significantly associated. Microcephaly occurred in association with failure to thrive and was not an isolated finding.
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PMID:Clinical presentation of HIV/AIDS in the high risk neonate in Zambia. 139 42

In the early 1990s, HIV seroprevalence in the rural community in Casamance, Senegal was .8% (age range from 24 to 68 years). 25 people had HIV-2 infection and 2 had HIV-1 infection. Health workers evaluated 22 of the HIV-2 positive adults and compared them with 64 matched controls. The HIV-2 positive adults were 7.25 times more likely to suffer from ill health than the controls (50% vs. 12.5%). Clinical signs of HIV-2 positive status were more common among HIV-2 positive adults than controls (40.9% vs. 7.8%; odds ration [OR] = 8.2), especially chronic cough (OR - 18.5). Presence of diarrhea was insignificant (22% vs. 40%). HIV-2 positive adults had much higher levels of CD8 cells (p = .03), IgG (p = .0001), and beta 2 macroglobulin (p =.001) than the controls. Their CD4/CD8 ratio levels were much lower than those of the HIV-2 negative individuals (1.1 vs. 1.9; p = .0001). Among HIV-2 positive adults, symptomatic adults had significantly lower levels of red blood cells (p = .02), white blood cells (p = .02), lymphocytes (p = .01), T cells (p = .01), and CD4 cells (p = .002) than the healthy adults. Their beta 2 macroglobulin levels were much greater than controls (4.6 mg/vs. 2.9 mg/l, p = .03). 5 HIV-2 cases (22.7%) researchers suffered from immunosuppression (500 CD4 cells/mcl) compared with only 1 control (1.6%) (OR = 18.5). Clinical symptoms were more likely to be present in immunodepressed people than in non immunodepressed people (35.7% of 14 sick adults vs. 1.4% of healthy adults). 1 person who had AIDS as defined by WHO (weight loss, persistent cough, and diarrhea) had 429 CD4 cells/mcl. 1 person suffered from bronchopneumonia (326 CD4 cells/mcl). Another person had chronic diarrhea and bronchopneumonia (350 CD4 cells/mcl). The mean age of HIV-2 infected people who had a respiratory condition was 51 years (42-68 years) while it was 41 years (26-68 years) for asymptomatic HIV-2 infected people indicating a rather long incubation period. These results suggested that HIV-2 can be significant public health problems.
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PMID:HIV-2 infections in a rural Senegalese community. 140 31

5.4% (108 of 2,000) women have been confirmed for HIV 1 infection in Brazzaville in 1987. 1,172 deliveries have been registered by study, 7.76% have been occurred in HIV+ women. The prevalence of miscarriages was significantly, higher in HIV+ women than in HIV- ones (p less than 0.001). The birth-weight of new-borns was not significantly different among the children born to HIV+ and HIV- mothers. There were the various probable reasons of death of children born to HIV+ mothers. More frequently the respiratory affections with persistent hyperthermia were noticed. During the follow-up, in all groups of age, the fever with failure of thrive were the most frequent signs (50%) with pneumopathy. The clinical picture was completed by diarrhoea after six months of live.
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PMID:[Retrospective study of infection by the human immunodeficiency virus in pregnant women. Future of the child and the mother]. 140 11

Chronic diarrhea and wasting are very common manifestations of AIDS in adults in developing countries. Etiologic studies show that protozoa (including Cryptosporidium parvum, Isospora belli, and Enterocytozoon bieniusi) and Mycobacterium avium-intracellulara are the most frequently identified pathogens. Limited data in children suggest that common enteric pathogens are equally as likely in HIV+ and HIV- babies. Preliminary analysis of an ongoing longitudinal study of 469 babies born to mothers with known HIV serostatus in Kinshasa, Zaire, reveals progression of acute to persistent diarrhea is six times greater in HIV+ compared to HIV- babies, and 3.5 times greater in HIV- babies born of HIV+ mothers in comparison to HIV- babies with HIV- mothers. HIV+ babies were also at greater risk than HIV- babies to have recurrent episodes of diarrhea (RR = 2.3). Fifty percent of the deaths were due to acute or persistent diarrhea, and were strongly associated with HIV infection. Efforts to improve child survival in AIDS infected populations will need to address HIV infections in both mothers and infants.
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PMID:Persistent diarrhea associated with AIDS. 142 40

A 25-year-old homosexual man with a 2-year history of watery diarrhoea and a 20 kg weight loss is described. He had been diagnosed HIV-1 antibody positive 6 years previously. Investigations excluded opportunist pathogens and other known causes of diarrhoea. A range of anti-diarrhoeal medication had been unsuccessful. Plasma levels of gastrointestinal and pancreatic peptides were normal and treatment with the somatostatin analogue, octreotide, which inhibits release of pancreatic/gut peptides, did not provide any benefit. Cardiovascular autonomic function tests revealed blunted pressor responses but no other abnormalities. Gastric emptying studies with a technetium labelled meal indicated rapid gastric emptying time. This was slowed by the anticholinergic drug, atropine. This suggested increased parasympathetic activity to the gut. He was, therefore, treated with the anti-cholinergic agent, propantheline bromide, which reduced the frequency and volume of stools. He put on weight and has remained well since. This case highlights the diagnostic challenge in HIV-associated chronic diarrhoea, the case for investigations of autonomic function, and the need for a therapeutic trial of anticholinergic drugs, when other measures have failed.
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PMID:Increased gut parasympathetic activity and chronic diarrhoea in a patient with the acquired immunodeficiency syndrome. 142 96

There are considerable data suggesting that breast milk and colostrum transmit HIV. The European Collaborative Study shows the risk of transmission of HIV from breast milk to infant to be about 28%. A study in Rwanda indicates that transmission is more likely to take place during viremia which occurs during primary HIV infection and later with progression to AIDS. Postnatal transmission in this study stood at about 60%. Breast feeding protects against diarrhea and respiratory infections. A study in Brazil demonstrates that infants who were not breast fed were at 14.2 and 3.6 higher risk of death from diarrhea and respiratory infections, respectively, than breast-fed infants. These risks are especially great where poverty, inadequate sanitation, and poor hygiene predominate. A study in Malaysia shows that infants living in a household with no piped water and no toilet and were not breast-fed faced a 5-fold risk of death after 1 week of age than breast-fed infants living under the same conditions. This risk continued to be high (2.5) for non-breast-fed infants living in a household with piped water and a toilet. In developed countries, affordable formula, clean water, and adequate facilities for sterilizing bottles allows HIV positive mothers to bottle feed their infants which should reduce the vertical transmission rate. In developing countries, however, bottle feeding is expensive and hazardous. Governments often cannot provide potable water and sanitation services. In addition, mathematical models demonstrate that for HIV positive mothers, the risk of infant death is lower in infants who breast feed than in those who do not. Thus, in those areas of the world where infectious diseases and malnutrition are the leading causes of infant death, health workers should promote breast feeding regardless of HIV status of the mothers.
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PMID:Breast feeding and HIV infection. 148 98


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