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

In order to examine the character and phases of injury to the nervous system in HIV infection, 207 persons were observed. In 100, antibodies to the virus and to its separate proteins were discovered by immunofermentation analysis (IFA) reaction and by Western blot test. In 67, first phases of acute inflammation asymptomatic of persistent generalized lymphadenopathy were registered; and in 33, other ailments were found. In this group, which consisted of 74 men and 26 women aged 18-45, 91 were citizens of the Community of Independent States (15 of whom had served in the military) and 9 were citizens of other countries (4 had seen military duty). 75% of cases contracted the infection via sexual transmission. The control group comprised 65 seropositive people at the first screening confirmed by IFA but negative or doubtful by Western blot. Clinical laboratory and special psychological investigations were carried out using a 16-factor personality questionnaire and standard personality analysis methods. Generalized lymphadenopathy was found in 78%, hepatomegaly in 69%, chronic infection of the upper respiratory tract 67%, dermatological pathologies 33%, acute infections 32% (syphilis, hepatitis B), splenomegaly 20%, diarrhea and loss of more than 10% of body mass 11%. There was significant decrease of T-helper cells in 82.8%, in the correlation of the quality of T helper cells and T suppressor cells in 72.4%. In 67 persons who were in the second stage of HIV infection, there was a high frequency of pathological psychological symptoms. According to the personality scale, 60% had schizoid signs, 50% had depression, 40% had psychopathy, 30% had psychasthenia, and 20% had paranoia. When 33 persons in the second and third phase of the disease were measured, schizoid signs increased to 85.7%, depression to 78.6%, psychopathy to 57.1%, psychasthenia to 71.4%, and paranoia to 64.3%. In the first phases of the disease mainly hypochondria, depression, and hysteria predominated, and as the disease progressed, psychopathy, paranoia, psychasthenia, schizoid signs, and mania rose.
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PMID:[HIV infection: the clinical and expert diagnostic aspects]. 817 5

This report describes the clinical spectrum and outcome of the hemophagocytic syndrome (HS) in 5 HIV infected patients. All 5 patients presented with fever, hepatomegaly and/or splenomegaly, confusion or coma and respiratory symptoms. Severe anemia was associated with thrombocytopenia and with neutropenia in 4 cases. Diffuse intravascular coagulopathy was present in 2 cases. Liver function tests were abnormal in three patients. The diagnosis of HS was made 2 to 12 weeks after the onset of symptoms and required in most patients repeated examinations of the bone-marrow, showing infiltration by histiocytes with prominent phagocytosis of blood cells. In one case this infiltration was not seen in the bone-marrow but only in the liver and the spleen. Varicella, mycobacterium infection, oesophageal candidiasis, Kaposi sarcoma were observed in the evolution of 3 patients. Anaplastic large cell Ki-1 lymphoma was present in one case. Four patients died as a result of complications of HS. The one patient with lymphoma survived.
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PMID:[Hemophagocytic syndrome in HIV infection]. 824 41

A follow-up study of 179 cases of human immunodeficiency virus (HIV) seropositive neonates born from HIV seropositive mothers is reported. At the time of the present study, HIV infection resulting from maternofetal transmission was found in 50 cases, while 108 infants were not infected; HIV infection remained uncertain in 16 cases; 5 infants were lost for follow-up. Out of the 50 infected cases, 20 were less than two-year old, 17 were 2-5 year old and 13 were older than 5 years. Very few remained asymptomatic after the age of 6 months, the most common symptoms being adenopathies and/or hepatomegaly and/or splenomegaly. Twenty-six had an acquired immunodeficiency syndrome (AIDS). Six died, from pneumocystosis (3), cytomegalovirus infection (1) and septicemia (2). Virus culture and polymerase chain reaction were the most efficient laboratory methods for early diagnosis of HIV infection, both being positive in more than 95% of the infected cases after the age of 3 months. A close clinical and biological supervision is recommended in these infants and children because of the permanent threat of infectious diseases in relation to their immunodeficiency. Treatment associates: 1) antiviral therapy with AZT as soon as the HIV infection is diagnosed; 2) primary prophylaxis against pneumocystosis with trimethoprim-sulfamethoxazol; 3) IV immunoglobulins in the case of repeated bacterial infection; 4) regular evaluation of the nutritional status and psychological assistance.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Management of HIV-seropositive newborn infants. Personal experience apropos of 179 cases]. 839 76

Clinically, malnutrition appears as the last stage in pediatric AIDS. It is, however, difficult to determine the causes of malnutrition without diagnostic facilities and in the absence of differentiating clinical criteria. The authors therefore set out to determine the prevalence of HIV in children, to assess the various modes of infection in children, and to define a clinical profile indicative of HIV infection in malnourished children. They found that among children exhibiting severe malnutrition, HIV-seropositive children are distinguished by a high horizontal transmission rate, a high specific clinical profile, and a very poor prognosis. The study population consisted of 433 severely malnourished children of average age 19 months, in the range 4-48 months, admitted to the Sanou Souro National Hospital in Burkina Faso. 63% presented with marasmus, 13%% with kwashiorkor, and 24% with both forms of malnutrition. 13.8% of children older than 12 months were infected with HIV; HIV-1 in 95.8% of these cases. Mother-to-child transmission was proved in 77% of cases; in 10% of the observed pediatric AIDS cases, transmission may have occurred through multi-injections with contaminated equipment. Marasmus was the form of malnutrition most frequently associated with HIV, with its severity exacerbated by HIV infection. Adenopathy, oral candidiasis, skin disorders, and hepatomegaly appeared to be significantly related to HIV infection. Discriminant analysis, however, revealed that the presence of adenopathies was the strongest indicator symptom of HIV infection. Multivariate analysis defined a clinical profile of marasmus, adenopathies, and oral candidiasis as indicative of HIV infection in the population. The short-term clinical prognosis for the infants was poor and usually led to the death of the child when seropositive.
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PMID:HIV infection and severe malnutrition: a clinical and epidemiological study in Burkina Faso. 844 99

Two young human immunodeficiency virus (HIV)-infected patients, a 25-year-old woman and a 26-year-old man, consumed large amounts of germanium lactate citrate 18% as an "immunostimulant" for 9 months. The woman, who had stage II HIV infection, developed severe renal dysfunction (creatinine clearance, 7 mL/min/1.73 m2) and slight proteinuria (0.28 g/d) after ingesting 260 g germanium lactate citrate 18%. Hepatomegaly with liver dysfunction (SGOT, 102 U/L; gamma-glutamyl transferase (GT), 159 U/L) and lactic acidosis (plasma lactate, 7.3 mmol/L) developed simultaneously. Renal biopsy revealed tubulointerstitial nephropathy with vacuolar cell degeneration and periodic acid-Schiff-positive intracellular deposits mainly in distal tubules. Liver biopsy disclosed severe hepatic steatosis; liver function tests returned to normal within 5 weeks. Since renal failure persisted for 2 years after ingestion of germanium (creatinine clearance, 14 mL/min/1.73 m2; proteinuria, 0.84 g/d), a second renal biopsy was performed, which showed marked but focal distal tubular atrophy and slight interstitial fibrosis. The male patient, who had stage III HIV infection, had ingested the same compound; he presented with a creatinine clearance of 43 mL/min/m2 and proteinuria of 0.36 g/d. Renal biopsy disclosed tubulointerstitial changes similar to those found in the female patient. After 9 months off germanium, creatinine clearance remained unchanged. Neutron activation analysis of all biopsy specimens in both cases documented germanium concentrations 10 to 70 times normal in renal tissue and 140 times normal in liver tissue.
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PMID:Tubulointerstitial nephropathy persisting 20 months after discontinuation of chronic intake of germanium lactate citrate. 848 24

A wide range of abnormal findings can be seen at abdominal ultrasonography in patients with HIV infection. The most frequent findings, hepatomegaly, splenomegaly, and enlarged lymph nodes, are nonspecific, however. Increased echogenicity or focal lesions of parenchymal organs, dilated bile ducts, nephromegaly, gut wall thickening or abscesses are uncommon findings. If there is clinical suspicion for a treatable disease, abnormalities seen on ultrasound examination of HIV-infected patients need to be confirmed by guided biopsy.
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PMID:[Ultrasound findings in HIV patients]. 865 99

Peliosis hepatis is an uncommon entity characterized by multiple oval and irregularly shaped blood-filled cystic cavities in the liver parenchyma. The spaces are lined by either hepatocytes or endothelial cells. They communicate with the sinusoids, many of which are dilated. The condition has been associated with cirrhosis, malignancy, infection with tuberculosis and HIV, and medication such as anabolic or androgenic steroids. The etiology is uncertain, but toxic injury to the sinusoidal wall is postulated. The condition may present with hepatomegaly, cirrhosis and portal hypertension, hepatic failure, or shock from hepatic or splenic rupture. The authors report the case of a patient who developed peliosis hepatis while taking oral contraceptives. Abdominal ultrasound performed upon the 35-year-old woman presenting with right upper quadrant abdominal pain identified multiple, well-circumscribed liver lesions of varying size and echogenicity. No blood flow was detected on color duplex ultrasound and the rest of the abdominal examination was normal. Her condition was attributed to oral contraceptive use. Such use was therefore discontinued, and 6 months later the lesions were found to have reduced in size. The patient's pain had reduced considerably and she was clinically well. Follow-up is mandatory in such cases following diagnosis and treatment.
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PMID:Peliosis hepatis associated with oral contraceptive use. 868 55

At the end of 1984, there were about 1.5 million children worldwide infected with HIV-1. 75% of these children lived in sub-Saharan Africa and Latin America. The rate of mother-to-child transmission of HIV-1 is estimated to range from 13% to 42%. It is twice as high in Africa as it is in Europe. By the year 2000, 6 million pregnant women and 5-10 million children will be infected with HIV-1. It appears that clearance of HIV-1 infection occurs in 2.7% to 6.4% of infected infants. Possible intervention strategies to reduce perinatal HIV-1 transmission include antiretroviral therapy with zidovudine, recommending breast feeding only in areas where it is clearly necessary, cesarean section, passive immunotherapy with anti-HIV immunoglobulins, and viral envelope subunit vaccines. An accurate diagnosis of HIV-1 infection can occur in non-breast fed infants born to seropositive mothers by the age of 3 months. Most children (80-90%) with HIV-1 infection develop features of HIV-1 infection within the first year of life. Common manifestations in the first year are lymphadenopathy, splenomegaly, and/or hepatomegaly. Young infants, especially those 3-6 months old, are more likely to be diagnosed with Pneumocystis carinii pneumonia (PCP) than older HIV-1 infected children. HIV-1 infected children are more likely to develop PCP, serious bacterial infections, cytomegalovirus infection, lymphoid interstitial pneumonitis, and encephalopathy than adults. They are, however, less likely to develop other opportunistic infections (e.g., toxoplasmosis, tuberculosis, cryptococcoses, and histoplasmosis). Possible underlying mechanisms of disease progression in HIV-1 infected children include presence of rapidly replicating syncytium-inducing HIV-1, high virus burden, persistent neutralizing antibody response, antibody-dependent cellular cytotoxicity against HIV-1, and transplacental passage of maternal neutralizing antibodies.
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PMID:Paediatric HIV infection. 894 23

Progressive disseminated histoplasmosis (PDH), a recognized defining illness of AIDS, is an opportunistic fungal infection caused by Histoplasma capsulatum. The authors report a case of PDH in a HIV-infected African child from a Histoplasma capsulatum non-endemic area. An 8-year-old girl from Kwazulu/Natal, South Africa, was admitted to King Edward VIII hospital with pyrexia and respiratory distress. Pale with generalized lymphadenopathy, she had been sick with general malaise and fever for 3 weeks. A punched-out painless ulcer was present on the child's lower left leg and she had ulcerative lesions on the tip of her tongue and the angle of her mouth. There was a tender hepatomegaly and clinical signs of pneumonia, while a chest roentgenogram showed right upper lobe consolidation with early cavitation. The purified protein derivative tuberculin skin test was negative and no acid-fast bacilli were detected on three sputum samples taken on different days. A Western blot test conducted for antibodies to HIV was positive. Additional laboratory tests were conducted. The patient was treated with parenteral acyclovir for herpesvirus infection, ceftriaxone for severe community-acquired pneumonia, and trimethoprim-sulfamethoxazole because Pneumocystis carinii infection was part of the clinical differential diagnosis. Bone marrow aspirate and trephine biopsy revealed yeast forms of H. capsulatum. The girl died on the second day of hospital admission, before antifungal therapy could be commenced.
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PMID:Disseminated histoplasmosis in a human immunodeficiency virus-infected African child. 910 50

According studies run during four years (1992-1995) in the Pediatric Unit of Libreville Hospital, to determine importance and features of sickle-cell disease in children in Gabon, profit and mode of regular follow-up, data of hospitalisation and management of children with sickle-cell disease were found as follow: Sickle-cell disease is third rank of admission motivations (13% of total admissions), and first after 4 years. Mortality is 8.4% of total mortality. Main causes of hospitalisation were acute anemia, painful crisis, and bacterial infections. Half of children had no medical follow-up, third was regularly checked, the remaining very irregularly, 80% of died children had no medical follow-up. A survey with an ambulatory taking-care which concerned 210 kids regularly checked, shows theses outcomes: the social families background was either medium or disavow. More than half of children were detected before one year, mainly by complication. Third had splenomegaly, 70% hepatomegaly and 40% were icteric. Based on 103 children tested for HIV, only 2 were found positive, but 22% were positive for HBs Ag. Growth, puberty and school retardation is a supplementary social handicap. A comparative with other cohorts must headlight genetic and personal environing matters. Unit of management of sickle-cell disease, annexed to a Pediatric Unit, provided that official acknowledgement, seems to be the best solution, as regards cost/efficiency, in the local context.
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PMID:[The importance of sickle cell anemia in a pediatric environment in Gabon]. 943 15


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