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

All symptoms and signs of uncomplicated malaria are non-specific, as shared with other febrile conditions, and can occur early or later in the course of the disease. In endemic areas, the presence of hepatosplenomegaly, thrombocytopenia and anaemia is clearly associated with malaria, particularly in children. Fever, cephalgias, fatigue, malaise, and musculoskeletal pain constitute the most frequent clinical features in malaria. Following single exposure to Plasmodium falciparum infection, the patient will either die in the acute attack or survive with the development of some immunity. Elderly individuals are prone to a more severe course of disease. The non-fatal P. vivax and P. ovale cause similar initial illnesses, with bouts of fever relapsing periodically, but irregularly over a period of up to 5 years. Renal involvement of a moderate degree is more common in mild falciparum malaria than initially suspected. The liver is also afflicted in mild disease, but organ damage is limited and fully reversible after parasitological cure. Whereas the cardiotoxic adverse effects of antimalarial chemotherapeutics are well known, clinically relevant cardiac involvement in humans is rare in severe disease and even rarer in uncomplicated falciparum malaria. Co-infection can aggravate malaria. There is a growing body of evidence that there is significant interaction in terms of mutual aggravation of the course of disease between HIV and malaria, particularly in pregnant women. Children with a high level of exposure to P. falciparum have a lower risk of developing atopic disorders.
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PMID:Uncomplicated malaria. 1626 88

A 21-year-old patient with a history of drug addiction presented with generalized, centrally-ulcerated papules and haemorrhagic crusts. Initially, differential diagnostic considerations included pityriasis lichenoides et varioliformis acuta and syphilis. Biopsy and serological testing confirmed the latter diagnosis. Syphilis maligna is a rare form of secondary syphilis; symptoms include a papulonecrotic exanthem and general malaise with fevers and wasting. In the past the disease was described in connection with tuberculosis; today it is most often seen in association with HIV.
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PMID:[Syphilis maligna in an HIV-negative patient]. 1627 33

The human chemokine receptors, CCR5 and CXCR4, are potential host targets for exogenous, small-molecule antagonists for the inhibition of HIV-1 infection. HIV-1 strains can be categorised by co-receptor tropism - their ability to utilise CCR5 (CCR5-tropic), CXCR4 (CXCR4-tropic) or both (dual-tropic) as a co-receptor for entry into susceptible cells. CCR5 may be the more suitable co-receptor target for small-molecule antagonists because a natural deletion in the CCR5 gene preventing its expression on the cell surface is not associated with any obvious phenotype, but can confer resistance to infection by CCR5-tropic strains - the most frequently sexually-transmitted strains. The current leading CCR5 antagonists in clinical development include maraviroc (UK-427,857, Pfizer), aplaviroc (873140, GlaxoSmithKline) and vicriviroc (SCH-D, Schering-Plough), which have demonstrated efficacy and tolerability in HIV-infected patients. Pharmacodynamic data also suggest that these compounds have a long plasma half-life and/or prolonged CCR5 occupancy, which may explain the delay in viral rebound observed following compound withdrawal in short-term monotherapy studies. A switch from CCR5 to CXCR4 tropism occurs spontaneously in approximately 50% of HIV-infected patients and has been associated with, but is not required for, disease progression. The possibility of a co-receptor tropism switch occurring under selection pressure by CCR5 antagonists is discussed. The completion of ongoing Phase lib/Ill studies of maraviroc, aplaviroc and vicriviroc will provide further insight into co-receptor tropism, HIV pathogenesis and the suitability of CCR5 antagonists as a potent new class of antiyirals for the treatment of HIV infection.
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PMID:CCR5 antagonists: host-targeted antivirals for the treatment of HIV infection. 1632 83

We evaluated the safety and maximum tolerated dose of interferon (IFN)-alpha2b in combination with protease inhibitor-based highly active antiretroviral therapy (HAART) in a phase 1 study in 14 patients with AIDS-associated Kaposi sarcoma (KS). Planned IFN dose levels were 0, 1, 5, 10, and 15 million IU administered by daily subcutaneous injection. Dose-limiting toxicities were neutropenia and malaise. The maximum tolerated IFN dose was 5 million IU/d. The median CD4 count increased from 260 cells/muL at baseline to a maximum on-study value of 359 cells/muL. In 6 patients with paired baseline and on-study values, the median HIV RNA level decreased from 20,179 copies/mL to a minimum on-study value of 309 copies/mL. Of 13 patients whose KS response could be evaluated, 5 showed objective tumor regression. Responses occurred in HAART-experienced and HAART-naive subjects. Five patients, including 2 responders, 2 with stable KS, and 1 with progression, had serial measurements of Kaposi sarcoma herpesvirus (KSHV) load. None of these patients, irrespective of treatment arm or KS response, showed durable clearance of KSHV from plasma or peripheral blood mononuclear cells. This study establishes a safe dose of IFN that can be used with HAART and, potentially, with other inhibitors of KS in future clinical trials.
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PMID:Interferon-alpha2b with protease inhibitor-based antiretroviral therapy in patients with AIDS-associated Kaposi sarcoma: an AIDS malignancy consortium phase I trial. 1639 45

A fundamental aspect of public health is the accuracy of death certification. Assessing the death registration system is a step toward improving the quality of death reporting. Thailand implemented a more rigorous and informative pilot death registration system in March 2001 in 18 provinces, followed by nationwide implementation in August 2003. Since Thailand is an industrializing nation, its experiences will be of interest to other developing nations planning similar reforms. The causes of all deaths in the 15 provincial pilot projects (of Thailand's 76 provinces) and a random sampling in Bangkok were investigated between July 1997 and December 1999. Health workers interviewed close relatives and three medical doctors reviewed hospital records to verify the causes of death. We were able to interview 78% of the relatives (i.e. 47,632 in number). Three-quarters (76%) of the deceased had sought prior medical care; 41% died in hospital and 54% at home. The overall agreement between the causes of death in our survey vs. that reported on the death certificate was 29%. The highest agreement was for: 'Ill-defined' causes (33%), 'Cancer and Tumors' (17%), 'External Causes' (16%), and 'Infectious Diseases' (10%). Considering the different patterns among age groups and sex, hypertension with stroke, cancer of the liver and bile duct, and HIV infection, were the highest ranking causes among females. Infectious diseases (especially HIV/AIDS), hypertension with stroke and accidents, were the leading causes of deaths among males. External causes were highest among children and young adults.
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PMID:Thailand's national death registration reform: verifying the causes of death between July 1997 and December 1999. 1642 55

Few studies have addressed the issue of domestic violence and health care for HIV-positive women. However, such women are at increased risk of clinical progression when domestic violence prevents access to health care or their ability to take HIV medicines on a consistent basis. To address this issue, 3 focus groups and 50 in-depth interviews were conducted at a public health clinic with HIV-positive women clients who had experienced domestic violence. The results are illustrated in 4 case studies of how domestic violence diminishes women's ability to obtain regular health care. Abused women were reluctant to keep appointments if they were afraid of their partners, if they were depressed, feeling ill or "too worn down," or if they were ashamed of being abused. Abusive partners were sometimes reported to sabotage women's efforts to seek care, keep appointments or take medications. The study concluded that domestic violence is an underrecognized barrier to women's ability to obtain regular medical care for HIV/AIDS. Effective HIV treatment is dependent on consistent HIV care, and domestic violence is a crucial barrier for some women. More research is needed to determine the most effective interventions for domestic violence in relation to HIV-positive women.
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PMID:Domestic violence in barriers to health care for HIV-positive women. 1647 93

Malignant or noduloulcerative syphilis is an infrequent variant of secondary syphilis which appears in HIV+ patients. It is associated with fever, general malaise and skin lesions in the form of pustules or ulcerative scabs. Histology studies on the lesions show a perivascular infiltration of plasma cells and a formation of granuloma of giant and epitheloid cells. Most patients test positive for syphilis. We discuss the case of a 37-yar-old man who attended our service complaining of fever and scabby nodular lesions all over his skin. Blood testing confirmed that he had syphilis and HIV. The patient responded rapidly to penicillin treatment, with remittance of his fever. The skin lesions disappeared after 8 weeks. The rareness of malignant syphilis and its unusual clinical manifestation is a challenge to medical personnel. This diagnosis ought to be considered in HIV+ patients with fever and ulcerative skin lesions. Penicillin is the treatment of choice.
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PMID:[Malignant syphilis in patients with human immunodeficiency virus (HIV)]. 1695 21

A 46-year-old Hispanic male from Ecuador presented with fever, malaise, weight loss, and dyspnea. He was HIV-positive with a CD4+ cell count of 4/microL. He was hospitalized, and therapy for community-acquired pneumonia with broad-spectrum antibiotics was started. Both Histoplasma capsulatum and Cryptococcus neoformans were cultured from bronchial lavage, blood, and bone marrow specimens. Despite aggressive therapy with amphotericin B, the patient died 8 days after admission.
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PMID:Concomitant disseminated histoplasmosis and cryptococcosis in a person with AIDS. 1715 48

Severely Mentally Ill (SMI) adults have disproportionately high HIV seroprevalence rates. Abuse of alcohol and other substances (AOD) and lifetime exposure to trauma by others are particularly potent risk factors, which, in combination with psychiatric disabilities, create triple jeopardy for HIV infection. This study examined the predictive utility of demographic characteristics; history of physical, emotional, or sexual abuse; extent of drug and alcohol abuse; knowledge about HIV/AIDS; sexual self-efficacy; and condom attitudes toward explaining the variance in a composite of HIV high-risk behavior among 188 SMI women and 158 SMI men. History of sexual abuse, engaging in sexual activities while high on substances, and lower cannabis use were the most significant predictors of HIV sexual risk behaviors. Given the triple jeopardy for HIV risk in this population, a triple barreled approach that simultaneously addresses multiple health risks within an integrated treatment setting is warranted.
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PMID:Triple jeopardy for HIV: substance using Severely Mentally Ill Adults. 1729 27

Analysis of time trends in newly diagnosed HIV-1 infected patients in Slovenia over a 10-year period (1996-2005) showed an increase in the number of newly diagnosed HIV-1 infected patients in 2004 and 2005 as well as increase in the number of newly diagnosed patients with primary/early HIV-1 infection. A retrospective analysis was performed in order to evaluate the clinical, epidemiological, laboratory and virological parameters of primary/early HIV-1 infection presenting with or without acute retroviral syndrome (ARS). Primary/early HIV-1 infection was diagnosed in 33 (19.5%) out of 169 newly diagnosed HIV-1 infected patients during the 10-year period. Most patients experienced ARS, the most commonly reported symptoms being fever, malaise and pharyngitis, followed by rash and lymphadenopathy. Median CD4 cell count was 415 cells/mm3, median CD8 cell count was 865 cells/mm3 and median HIV-1 viral load at the time of diagnosis was 5.1 loglo copies/mL. The increase in the number of newly diagnosed HIV-1 infected patients may be in part due to increased awareness among clinicians of the possibility of ARS, and the possibility of increased awareness of symptoms of ARS among persons at high risk of infection.
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PMID:Clinical features and virologic characteristics of primary and early HIV-1 infection in Slovenian patients. 1750 74


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