Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019693 (HIV)
 170,526 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A series of 320 German i.v. drug abusers (32.2% female, 67.8% male) were tested in a cross-sectional study for antibodies against HIV. Seroprevalence increased from 0 in those who discontinued i.v. drug abuse before 1982 to 37.2% in those who stopped injecting drugs in 1985/1986 or who were still addicted. Antibodies to HIV were significantly associated with lymphadenopathy and clinical symptoms (fever, weight loss, diarrhea, fatigue, night sweat, dermal lesions) and with markers of hepatitis A and hepatitis B virus infection. Participants of the study admitted in 92.5% of cases to "needle sharing" and in 83.1% of cases to sexual contacts among drug abusers. Prostitution and drug abuse in prison were significantly correlated with seropositivity. No antibodies to HIV infection were detected in 131 subjects of a control group of household contacts.
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PMID:Risk factors for HIV infection in German i.v. drug abusers. Clinical, serological and epidemiological features. 349 95

In an ongoing prospective study of homosexual men conducted in Vancouver since November 1982, 87 cases of human immunodeficiency virus (HIV) seroconversion have been documented to date. Comparison of laboratory results obtained a mean of 4.9 months before and 5.4 months after the estimated date of seroconversion revealed that a significant increase in the serum IgG level (from 1149 to 1335 mg/dl on average) and in C1q binding (from 8.8% to 14.2% on average) was associated with early HIV infection (p less than 0.001). A marginally significant decrease in the ratio of helper to suppressor (CD4 to CD8) cells (from 1.55 to 1.29 on average) was also noted (p = 0.025). A marked decrease in absolute number of CD4 cells was not seen with seroconversion, which suggests that profound loss of these cells may be a long-term effect of HIV infection. The occurrence of symptoms (including fatigue, fever, night sweats, unintentional weight loss, diarrhea, joint pains, cough unrelated to smoking, shortness of breath, oral thrush, herpes zoster and rash) did not increase with seroconversion. This finding suggests that most cases of HIV seroconversion may be asymptomatic or associated with relatively minor symptoms. On the other hand, generalized lymphadenopathy was found to develop after HIV seroconversion in about 50% of cases.
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PMID:The Vancouver Lymphadenopathy-AIDS Study: 7. Clinical and laboratory features of 87 cases of primary HIV infection. 364 8

This article provides a clinically-oriented overview of palliative care for patients with AIDS. Indicators of decreased survival time are divided into categories of infections/illnesses, clinical signs and symptoms, immunological and serological markers, and psychosocial factors. Primary symptoms in AIDS are discussed according to etiology and treatment. However, treatments of opportunistic infections per se are not directly addressed in this article. Problems discussed include pain, confusion, depression and anxiety, fatigue, fever, dyspnea, nausea and vomiting, diarrhea, wasting, and dehydration. The article also briefly addresses clinical and ethical questions and challenges presented by AIDS to hospice or palliative care providers, and the various stages of HIV infection.
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PMID:Palliative care for patients with acquired immunodeficiency syndrome. 749 35

The Karnofsky Performance Status (KPS) is the most widely used health status measure in human immunodeficiency virus (HIV) medicine and research. Because there are limited data on KPS metric properties in this setting, we present evidence of the construct validity of the KPS in a sample of HIV-infected persons using data from the AIDS Time-Oriented Health Outcome Study (ATHOS). The sample consisted of 160 primarily white, homosexual/bisexual men with a mean age of 45 years and a mean KPS score of 82 (range, 40-100). Ninety percent were classified in Centers for Disease Control (CDC) clinical category B or C. Pearson's product-moment correlations were strong between the KPS and measures of global health status, physical disability, numbers of symptoms, CDC clinical category, social function, days off work, and energy/fatigue (r = 0.39-0.52, p < 0.0001). Correlations with measures of mental health and cognition were less impressive but statistically significant. Analysis of variance followed by Student Newman-Keuls test showed significant differences among three KPS groupings for global health status but not for physical disability. Regression analysis indicated three significant variables accounting for KPS variance: visual analogue global health status (27%), days off work (10%), and energy/fatigue (1.7%). We conclude that the upper range of the KPS reflects global health status better than physical performance and much better than psychosocial constructs, in persons with HIV infection. Further research examining the ability of the KPS to detect clinically significant change over time is needed.
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PMID:Validity of the Karnofsky Performance Status in an HIV-infected sample. 889 76

Zidovudine-induced myopathy is characterized by reversible muscle weakness, wasting, myalgia, fatigue, and elevated creatine kinase (CK). Some zidovudine-treated patients with normal muscle strength experience excessive fatigue, myalgia, or transient mild CK elevations that improve when zidovudine is stopped. To determine the cause of these symptoms, we studied 13 physically fit, HIV-infected men who developed fatigue, myalgia, and reduced endurance, while taking zidovudine for a mean period of 20 months (2-39 months), with neurological evaluation and muscle biopsy processed for enzyme histochemistry and electron microscopy (EM). All subjects had normal muscle strength. In 6 of the 13 patients, muscle biopsies were normal by enzyme histochemistry. EM, however, demonstrated proliferation of normal or abnormal mitochondria, and increased amounts of lipid, glycogen, and lipofuscin. Electromyographic (EMG) studies (5/5) and serum CK (6/6) were normal. The other 7 individuals had signs of moderate to severe mitochondrial abnormalities shown by both light microscopy and EM, characterized by severe destruction, vacuolization, and rare paracrystalline inclusions. Most had elevated CK (4 out of 7) and normal EMG (5 out of 7). The severity of morphological abnormalities did not correlate with duration of HIV infection, zidovudine therapy, or zidovudine dosage. We conclude that in zidovudine-treated patients, symptoms of fatigue, myalgia, reduced endurance, and exercise intolerance represent early signs of zidovudine-induced mitochondriotoxicity, which causes an energy shortage within the muscle fibers even when muscle strength is still normal. Zidovudine, a DNA chain terminator, results in overt myopathy when a critical threshold of molecular, histological, and biochemical dysfunction of mitochondria is crossed, which seems to vary between individuals.
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PMID:Early features of zidovudine-associated myopathy: histopathological findings and clinical correlations. 757 71

The first case of disseminated Mycobacterium bovis infection with meningitis in an AIDS patient is reported. A 54-year-old male HIV-positive patient was admitted for evaluation of fever, weight loss, inappetence, fatigue and malaise. Mycobacterium bovis (non-BCG) was isolated from blood, bone marrow, stool, urine, sputum, abdominal lymph nodes and cerebrospinal fluid. Antituberculous therapy using a five-drug regimen plus steroids resulted in complete recovery.
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PMID:A case of disseminated Mycobacterium bovis infection in an AIDS patient. 761 65

Patients on long-term zidovudine (AZT) therapy experience muscle fatigue and weakness attributed to AZT-induced mitochondrial toxicity in skeletal muscle. To determine if the clinico-pathological abnormalities in these patients correspond to abnormal muscle energy metabolism, we used 31P in vivo magnetic resonance spectroscopy to follow phosphorylated metabolites during exercise. We studied 19 normal volunteers, 6 HIV-positive patients never treated with AZT, and 9 HIV-positive patients who had been treated with AZT for a mean period of 33 mo (range 12-48 mo) and had muscle biopsy-proven AZT-myopathy with abnormal mitochondria. Changes in phosphocreatine, ATP, and intracellular pH in the gastrocnemius muscle were followed during a graded steady state exercise protocol, and the recovery of phosphocreatine was followed on cessation of exercise. We found that graded steady state exercise produced a greater depletion of muscle phosphocreatine levels in the AZT-treated patients, compared to either HIV-positive patients who were not treated with AZT or normal controls. No differences in the effects of steady state exercise on muscle phosphocreatine levels were observed between the control group and the HIV-positive patients who had not been treated with AZT. The results suggest that the effect of AZT on muscle energy metabolism is significant, and similar to the effect observed in patients with known mitochondrial myopathies. Using a well-known model for control of mitochondrial metabolism, the observed differences in steady state phosphocreatine levels during exercise suggest that AZT treatment decreases the maximal work output and the maximal rate of muscle ATP synthesis.
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PMID:Metabolic abnormalities in skeletal muscle of patients receiving zidovudine therapy observed by 31P in vivo magnetic resonance spectroscopy. 761 82

This study categorized the problems of clients with human immunodeficiency syndrome/acquired immune deficiency syndrome (HIV/AIDS), identified on admission to home care, into nursing diagnoses. The study followed a descriptive retrospective record review of adult men and women (n = 244) admitted to a certified home health care agency in New York City. When all problems were clustered into nursing diagnoses, the principle diagnosis in more than 70% of the sample were impaired home maintenance, high risk for ineffective individual coping, altered nutrition:less than body requirements, feeding self-care deficit, and fatigue. The results indicate that the home healthcare needs of persons with HIV/AIDS are multifaceted in nature and extend beyond the signs and symptoms of advancing disease. Nursing diagnoses serve as a basis for capturing all data that contribute to client problems and are the focus of planning nursing care in the home.
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PMID:Nursing research in HIV/AIDS home care, Part 2: Results and implications. 763 57

The objective of this study was to evaluate the reliability and validity of a brief index to measure symptoms in individuals infected with human immunodeficiency virus (HIV). From an ambulatory clinic that specializes in the care of HIV-infected individuals at a university hospital in northeast Ohio, 148 randomly selected outpatients (predominantly homosexual men) with a broad spectrum of HIV disease were enrolled in a prospective, cohort study. In standard interviews, patients rated the frequency of 36 symptoms related to HIV infection on an ordinal scale from zero (never) to three (daily); these interviews were repeated and outcomes determined every 3 months for one year. Clinical data were abstracted from the medical record with a standard chart review. Using specific criteria, 12 symptoms were selected for the HIV Symptom Index: fatigue, fevers, headache, imbalance, paresthesias, memory loss, cough, nausea, diarrhea, sadness, sleep disturbance, and skin problems. The HIV Symptom score (the sum of frequency ratings for the 12 symptoms) ranged from 0 to 31 with a mean of 9.4 (+/- SD 6.6). The test-retest reliability was high (intraclass correlation coefficient = 0.92) as was the internal consistency (Cronbach's alpha = 0.79). The validity of the index was established with three observations. (1) The HIV Symptom Index makes clinical sense and includes a representative spectrum of symptoms of infection. (2) Symptom Index scores were greater in patients with more advanced disease and in patients who were functionally impaired. (3) The Index was responsive to changes in health as the disease progressed.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:An index of symptoms for infection with human immunodeficiency virus: reliability and validity. 773 Aug 79

The aberrant sleep documented in subjects with human immunodeficiency virus (HIV) infection is uniquely important because of the contribution this poor quality sleep makes to the fatigue, disability, and eventual unemployment that befalls these patients. Especially given this importance in clinical care, the research on the prominent sleep changes described in HIV infection remains modest in quantity. The chronic asymptomatic stage of HIV infection is associated with the most intriguing and singular sleep structure changes. Especially robust is the increase in slow wave sleep, particularly in latter portions of the sleep period. This finding is rare in other primary or secondary sleep disorders. The sleep structure alterations are among the most replicable of several pathophysiological sequelae in the brain associated with early HIV infection. It is unlikely that these sleep architecture changes are psychosocial in etiology, and they occur before medical pathology is evident. They are not associated with stress, anxiety, or depression. Evidence is accumulating to support a role for the somnogenic immune peptides tumor necrosis factor (TNF)alpha and interleukin (IL-1 beta) in the sleep changes and fatigue commonly seen in HIV infection. These peptides are elevated in the blood of HIV-infected individuals, and are somnogenic in clinical use and animal models. The peripheral production of these peptides may also have a role in the regulation of normal sleep physiology. The lentivirus family contains both HIV and the feline immunodeficiency virus (FIV). The use of the FIV model of HIV infection may provide a way to further investigate the mechanism of a neurotropic, neurotoxic virus initiating the immune acute phase response and affecting sleep. Neurotropic lentivirus infection is a microbiological probe facilitating neuroimmune investigation.
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PMID:Lentiviral infection, immune response peptides and sleep. 779 94


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