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

The case of an HIV-seropositive man with gonorrhea, syphilis, genital warts, and chancroid is described. Multiple sexual partners, genital ulcer diseases, and lack of circumcision may have predisposed him to HIV infection. As indicated by his CD4/CD8 ratio of 0.5, his immunological status was not very compromised. Other factors were therefore probably behind these multiple sexually transmitted diseases (STD). This 30-year old man was inadequately treated for a long time for urethral discharge and genital ulcer disease, and ultimately collapsed on the job with a comprised central nervous system. Bacterial infection related to the multiple STDs could certainly have caused this collapse. The time demands of this man's work, the lack of medical facilities to diagnose and treat such conditions, his unprotected sexual behavior with multiple partners, and broader socioeconomic conditions which separate wage- earning males from their families in Africa conspire to produce multiply-afflicted cases such as these.
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PMID:Multiple sexually acquired diseases occurring concurrently in an HIV positive man: case report, diagnosis and management. 150 24

Longitudinal studies of patients infected with HIV-1 reveal a long and variable incubation period between infection and the development of AIDS. Data from a small number of infected patients show temporal changes in the number of genetically distinct strains of the virus throughout the incubation period, with a slow but steady rise in diversity during the progression to disease. A mathematical model of the dynamic interaction between viral diversity and the human immune system suggests the existence of an antigen diversity threshold, below which the immune system is able to regulate viral population growth but above which the virus population induces the collapse of the CD4+ lymphocyte population. The model suggests that antigenic diversity is the cause, not a consequence, of immunodeficiency disease. The model is compared with available data, and is used to assess how the timing of the application of chemotherapy or immunotherapy influences the rate of progress to disease.
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PMID:Antigenic diversity thresholds and the development of AIDS. 194 79

Infection of Human organism by Human Immunodeficiency viruses induces, after a shorter or a longer period, a complex immune Deficiency (ID) that has been named Acquired Immune Deficiency Syndrome (AIDS). Although the designation is not correct, it has been accepted by the scientific community. AIDS includes multiple clinical situations that have in common HIV infection and an almost constant ID, that at the end of natural course of infection manifestated by the presence of opportunistic infections and malignant tumors. HIV-1 and HIV-2 are slow RNA viruses with a common architecture and well known genomic organization. The characteristics that made HIV infectious agent n. 1 in XXth Century are their remarkable heterogeneity, close AA sequence homology between some of their proteins and relevant molecules in human beings: MHC molecules, IL-2, VIP, etc. and a strong affinity of gp 120 to CD4 receptor of T helper lymphocytes (T4), mononuclear phagocytes, natural killer cells, etc. all of them sharing a relevant role in normal immune response (IR). Affected in its cornerstones of cellular defense, human organism starts an immune defense through antibodies, cytotoxic T Lymphocytes (CTL) Natural Killer Cells (NK) antibody dependent cell cytotoxicity (ADCC), that fails. Activating immune system HIV turn that defense strategy to their own profit and enhanced replication. After an apparent latency period--in which the balance seems to favor the host--new viral variants arise due to high rate of HIV mutagenesis, that in turn stimulate immune system, induce new cycles of viral replication and new high virulent mutants, leading to the final collapse of Immune System.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Immunologic aspects of HIV infection]. 180 34

Professors in British Columbia, Canada have devised an autoimmunity model of AIDS (MIAMI model) based on an atypical network theory of regulation of the immune system. It presents different stimuli as cofactors for AIDS: allogenic stimuli in some risk groups and MHC mimicking antigenic stimuli in other risk groups. V regions are on helper T cells that are somewhat anti-self class II MCH. Helper T cell idiotypes interact with both class II MHC and particular suppressor T cell idiotypes, therefore both may be similar. In fact, foreign lymphocytes also can induce an immune response similar to that of MHC image (MI). Hence the MI response is against the anti-self MHC, i.e., foreign idiotypes identify self, particularly self MHC. Further, the HIV envelope protein (gp120) binds to CD4 at a site that overlaps the site where CD4 interacts with class II MHC. Thus recombinant gp120 well as antibodies that recognize the gp120 undying site of CD4 can prevent the interaction of CD4 with class II MHC. Some mutations of CD4 effect the gp120 binding site but not the class II binding site and vice versa and others effect both. This similarity and others HIV can be considered an image of class II MHC, and the anti HIV immune response may be anti MHC image (AMI). MI and AMI responses are against each other and against idiotypic determinants expressed on helper and suppressor T cells respectively. A dual attack on the idiotypes of helper and suppressor T cells accompany these responses thereby causing an imminent collapse of the entire immune system. The model's significant predictive power thereby suggests that we may be able to prevent HIV from causing AIDS by inducing immunological tolerance to HIV components that resemble MHC molecules. This model rejects the 11 paradoxes identified by Duesberg who surmises that HIV is not a cofactor or cause of AIDS.
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PMID:A response to P.H. Duesberg with reference to an idiotypic network model of AIDS immunopathogenesis. 208 29

The characteristics and consequences of the AIDS/HIV epidemic in New York City are examined, with special attention to its impact on inner-city communities. The high numbers of AIDS cases are the source of increasing stress on public and community treatment and family and neighborhood networks of support. As the epidemic deepens (8 to 10 thousand new cases per year are expected by 1992) these resources, already weakened by years of underfunding, are becoming overwhelmed and are in danger of collapse. The high rates of HIV infection in these communities (5 to 20 percent of adults aged 25 to 45) and their linkage to widespread drug use prefigure the development of endemic levels in several population subgroups, with substantial risk of heterosexual spread. Simultaneously, there is a steady diffusion of infection to adjacent urban areas and, via migration patterns, to localities quite distant from New York City (e.g., Puerto Rico). Some hope can be found in the advent of more effective methods of early intervention for presymptomatic HIV infection. These offer an opportunity for combining clinical care with public health strategies that may restrict the spread of HIV while providing humane care for large numbers of people with AIDS and support for their families.
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PMID:Epidemic in the war zone: AIDS and community survival in New York City. 226 78

Human immunodeficiency virus (HIV) infection can bring about total collapse of the immune system by infecting helper T lymphocytes which express CD4, the molecule which mediates interaction between the cell surface and viral envelope glycoprotein gp120 (refs 3-10). HIV apparently escapes the effects of neutralizing antibodies in vivo by generating new variants which must still interact with CD4 to maintain a cycle of infection. One route to block HIV infection, therefore, could use solubilized CD4 protein to inhibit attachment of the virus to its target cell. We have used recombinant DNA techniques to generate soluble forms of CD4, and show here that these are potent inhibitors of HIV infection in vitro.
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PMID:Soluble CD4 molecules neutralize human immunodeficiency virus type 1. 282 24

Some features of the HIV infection are unique to the developing world (as exemplified by Africa, which is the frontline continent for AIDS). The infection affects all social groups, and since it is spread by heterosexual activity, it affects equal numbers of men and women, and the infection of women has dire consequences for population structure. Opportunistic infections are caused by organisms against which there is no effective treatment. Health budgets, with an average of $10 per capita, cannot buy such drugs as are available. Political instability and poverty create a climate favorable to casual sex and prostitution. Infection is highest among adults in their 20s and 30s, when the men are most productive economically, and the women have begun but not completed their childbearing. In Zaire the mean age at infection is 37 for men and 30 for women, and the mean age at death in Zambia is 35 for men and 26 for women. Seroprevalence is as high as 76% (among barmaids in Uganda), and at least half of the spouses of seropositive persons are infected. The number of new cases at 1 hospital in Kampala was 3-8/day in 1986. Using what is known about AIDS and what is know about the population structure in African countries, it is possible to model the impact of AIDS on a typical developing country with a population of 10 million. If seropositivity were 5%, 20.000 cases of AIDS could be expected each year among 15-50-year olds, with an additional 1500 cases among newborns. At least half of the babies of seropositive women will be seropositive. For every adult death, 20 man- or 40 woman-hours of work will be lost. The deaths of young married women will leave an immense burden of sick and dying orphans on extended families whose kinship ties are no longer close enough to cope, in countries which have no institutional facilities for orphan care. The number of opportunistic infections will increase, and, unless AIDS patients are turned away, health resources will be drained from potentially curable diseases. The number of people willing to practice medicine, nursing, and midwifery will diminish, and the burden of AIDS care will fall on already overcrowded, large urban hospitals. Blood transfusions will become unavailable because no one will want to be tested for HIV seropositivity. Xenophobia will characterize international relations, and governments will collapse, as educated decision-makers and managers die and cannot be replaced. The only bright spots in this otherwise dismal prospect are the increased awareness of young people of the need for chastity and monogamy, with an attendant fall in the level of sexually transmitted diseases generally; an acceleration in the development of health services and diagnostic facilities; the possibility of the development of a vaccine from the more benign HIV-2; a renewal of social life not based on sex; and a return to transcendental values and faith in God.
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PMID:Impact of AIDS in the developing world. 305 46

Although a variety of renal lesions may occur in acquired immune deficiency syndrome (AIDS), a rare but aggressive form of focal and segmental glomerulosclerosis with capillary collapse has been considered a possible component of this disorder. It is manifested by heavy proteinuria and progression to renal failure in a short time. We studied renal biopsies from nine patients with HIV infection and the above clinical features and compared the renal tissues to biopsies from HIV-positive individuals with immune complex glomerulonephritis and to biopsies from patients with heroin abuse nephropathy. The HIV-associated nephropathy was characterized by a combination of lesions: focal and segmental glomerulosclerosis, often in an early stage of evolution and with prominent degenerative changes of visceral epithelium; tubular necrosis without identifiable nephrotoxic or hemodynamic etiology; interstitial edema; large plasma protein-containing tubular casts in all segments of the nephron associated with marked tubular dilatation; and widespread tubuloreticular structures in vascular endothelium. In contrast, neither the sclerosing glomerular changes nor the tubulointerstitial abnormalities were present in HIV-infected patients with immune complex glomerulonephritis. Similarly, the tubular and interstitial changes and widespread tubuloreticular structures were absent in heroin-abuse nephropathy. The lesions of HIV-associated nephropathy occurred in patients with AIDS, AIDS-related complex, and in individuals clinically asymptomatic for HIV infection. Their morphological features in asymptomatic patients are sufficiently specific to allow for accurate diagnosis of HIV infection.
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PMID:HIV-associated nephropathy. A unique combined glomerular, tubular, and interstitial lesion. 307 May 50

The health system in Cuba guarantees accessibility to the entire population, and it is free of charge. Cuba's health figures are on a par with developed countries that have 20 times the budget. Each year around 4000 students start their medical training at 23 different universities. Since 1980 there has been a training course for family doctors. By 1995 22,000 of them have been trained covering 90% of the population. Their main work is preventive: health promotion and offering basic curative care. The family doctors are backed up by 400 polyclinics, where specialists offer their services to about 30,000 people. Life expectancy is 77 years and infant mortality a mere 9 per 1000 live births. Malaria has been eradicated and dengue fever successfully reduced. Leading causes of mortality are cardiovascular diseases, neoplasms, accidents, and homicides. Up to now only 1089 people have been diagnosed as HIV positive. From a mere epidemiological point of view, strict isolation could contain the epidemic in a closed society. In practice, however, the island opened the doors to tourism, with a side effect of increasing prostitution. Condoms or any contraceptives are in short supply. Nevertheless, the number of abortions is low, less than 1 per 100 deliveries. The reason is that all women whose expected menstruation is late by two weeks are offered a microaspiration in the polyclinic. 700 regulations are performed for every 5000 fertile women. Pregnancy tests are not performed as they are not available. The country is experiencing a difficult period because of the collapse and loss of support from the Soviet Union; over 30 years' trade embargo by the United States and the gradual change from a centrally planned economy towards more of a free market system. Family planning and AIDS seem two topics that need further exploration. Even if their system is under strain, health indices do not show a deterioration in health yet.
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PMID:Cuba: plenty of care, few condoms, no corruption. 758 May 57

The decline in CD4/CD8 ratios in lymph nodes (LNs) of SIV macaques and HIV-infected individuals occurs later than that in blood. In a previous study, long-term SIV-infected macaques were delineated into two groups: (1) those whose LNs had normal CD4/CD8 ratios and (2) those whose LNs had low CD4/CD8 ratios. In the present investigation, LNs, spleens, and blood from these groups have been further analyzed to ascertain the cellular and virological events, particularly those involving CD8+ cells, that occur concomitantly with LN CD4% decline. An increase in the percent of CD69-, IL-2R(p75)-, CD45RA1o CD8+ cells was the most constant event observed in lymphoid tissue from mid- to late-stage SIV-infected monkeys. Such cells were sometimes observed in LNs prior to any other immunological or morphological changes. However, decline in LN CD4/CD8 ratios and the associated degeneration of follicular dendritic cells (FDCs) in the germinal centers (GCs) of these nodes were observed only when both CD8+ cell infiltration of GCs and accumulation of viral antigens within the FDC network could be demonstrated. These dramatic changes were also associated with significantly reduced responsiveness to mitogens throughout the lymphoid compartment. In terms of viral burden, immunological and structural collapse of LNs was not always associated with increased viral DNA levels. Despite the CD4+ cell decline in blood during HIV and SIV infections, the immunological and architectural collapse of the lymphoid compartment, which comprises the bulk of the lymphocytes in the body, appears to be a critical event leading to the onset of AIDS. The present findings suggest that increased CD8+ cell activity as well as decrease in CD4+ cell function both contribute to this process.
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PMID:Immunological and virological changes associated with decline in CD4/CD8 ratios in lymphoid organs of SIV-infected macaques. 798 91


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