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

We studied renal lesions at biopsy (20 cases) and at autopsy (21 cases) among patients with the acquired immune deficiency syndrome (AIDS). Nephrotic syndrome with concomitant renal insufficiency was most common indication for biopsy. 85 percent of biopsies showed features of HIV associated nephropathy (HIVAN) which include: Focal segmental glomerulosclerosis (FSGS), glomerular collapse and mesangial hyperplasia. These glomerular changes were always accompanied by tubular microcysts and ultrastructurally, tubuloreticular inclusions (TRI) within the glomerular endothelium were often noted. Changes of HIVAN were also seen in two cases who were HIV negative at the time of biopsy but were positive on repeat testing. Minimal change disease, mesangiocapillary glomerulonephritis and diffuse proliferative lupus nephritis were other biopsy lesions. Autopsy findings were HIVAN (33 percent), tubular necrosis and opportunistic infections. We conclude that HIVAN is a distinct clinicopathologic entity that may sometimes be the first manifestation of the underlying disease state.
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PMID:Renal lesions in AIDS: a biopsy and autopsy study. 1042 Jun 84

Idiopathic collapsing glomerulopathy (ICG) is a clinically and pathologically distinct variant of focal segmental glomerulosclerosis, characterized clinically by rapid progression of renal insufficiency, a male and African-American racial predominance, and pathologically by segmental glomerular collapse, visceral epithelial cell hypertrophy and hyperplasia, and the absence of endothelial tubuloreticular inclusions. Pathologically similar lesions have been reported in adult and pediatric patients with human immunodeficiency virus (HIV) infection and/or intravenous (IV) drug abuse. Most patients with ICG who have been reported in the literature are adults. Six children with ICG were retrospectively identified (two from East Carolina University, four from University of North Carolina-Chapel Hill). Clinical data and renal biopsy findings were reviewed for all patients. All six patients were male; five African-American and one Hispanic. Ages ranged from 2 to 17 years (mean 12 years). Steroid-resistant nephrotic syndrome was the presenting clinical finding. Average 24-h urine protein excretion was 6.3 g (range 3.2-15 g). Five patients were serologically negative for HIV infection (one patient not tested) and none had a history of IV drug abuse or known HIV risk factors. Progression to end-stage renal insufficiency in two patients within 1 year of biopsy required renal transplantation, and within 1 month of biopsy one patient required dialysis. We report a series of pediatric patients with ICG, an aggressive variant of focal segmental glomerulosclerosis. ICG in children is similar clinically and pathologically to this disease in adult patients.
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PMID:Idiopathic collapsing glomerulopathy in children. 1068 63

Using a vulnerability and comparative perspective, this paper examines the status of health in southern Africa highlighting the disease complex and some of the factors for the deteriorating health conditions. It is argued that aggregate social and health care indicators for the region such as life expectancy and infant mortality rates often mask regional variations and intra-country inequalities. Furthermore, the optimistic projections of a decade ago about dramatic increases in life expectancy and declines in infant mortality rates seem to have been completely out of line given the current and anticipated devastating effects of the HIV/AIDS pandemic in southern Africa. The central argument is that countries experiencing political and/or economic instability have been more vulnerable to the spread of diseases such HIV/AIDS and the collapse of their health care systems. Similarly, vulnerable social groups such as commercial sex workers and women have been hit hardest by the deteriorating health care conditions and the spread of HIV/AIDS. The paper offers a detailed discussion of several interrelated themes which, through the lense of vulnerability theory, examine the deteriorating health care conditions, disease and mortality, the AIDS/HIV situation and the role of structural adjustment in the provision of health care. The paper concludes by noting that the key to a more equitable and healthy future seems to lie squarely with increased levels of gender empowerment.
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PMID:Health and disease in southern Africa: a comparative and vulnerability perspective. 1071 20

Previous studies have reported that approximately 10% of the patients with human immunodeficiency virus (HIV) infection develop HIV-associated nephropathy (HIVAN). However, over the last decade, morbidity and mortality as a result of HIV-1 infection has remarkably decreased with the availability of potent new antiretroviral drugs. We therefore determined the prevalence of HIVAN from autopsy data of HIV-infected patients in more recent years (1992 to 1997). Autopsy reports of 389 patients were reviewed. In reports suggestive of possible HIVAN, slides of renal tissue were retrieved and reviewed again to ensure appropriate classification. The criteria for the diagnosis of HIVAN were focal segmental glomerulosclerosis with collapse of the glomerular tuft in some glomeruli, extensive tubular ectasia, and significant tubulointerstitial disease. Of 389 autopsy reports, 54% of the patients were black, 35% were white, and 11% were Hispanic. Thirty-three percent of the patients had a history of intravenous drug abuse. The mean CD4 count of the patients was 54 +/- 91/microL (mean +/- SD). In 27 cases, typical features of HIVAN were found based on the criteria used, accounting for an overall HIVAN prevalence of 6.9% (27 of 389 autopsies). Because the overwhelming majority of these patients were black (93%), the prevalence in blacks was 12% (25 of 209 autopsies). We conclude that although mortality and morbidity from HIV infection is decreasing, HIVAN remains an important complication of HIV infection in blacks, even in recent years.
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PMID:Prevalence of HIV-associated nephropathy in autopsies of HIV-infected patients. 1079 23

Collapsing glomerulopathy is an aggressive form of glomerular disease defined for its histopathological features of glomerular collapse, visceral epithelial cell damage and tubulointerstitial changes that are characteristic. Patients with collapsing glomerulopathy present with severe nephrotic syndrome, marked proteinuria, generally more than 10 g/day and rapid progression to chronic renal failure, or death due to complications of nephrotic syndrome, despite any form of treatment. Collapsing glomerulopathy presents as de novo or recurrent disease in the renal allograft. There is slight predominance in males and strong predominance in blacks as renal diseases in general. Collapsing glomerulopathy shares several clinical and histopathological features with focal and segmental glomerulosclerosis and HIV-nephropathy; nevertheless, there is enough evidence to support collapsing glomerulopathy as a different entity. It must be mentioned that collapsing glomerulopathy, focal and segmental glomerulosclerosis and HIV-nephropathy may have a similar pathophysiological mechanism of damage to the visceral epithelial cell.
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PMID:[Collapsing glomerulopathy: a new entity associated with nephrotic syndrome and end-stage renal failure]. 1097 63

The human and simian immunodeficiency viruses (HIV and SIV, respectively) are members of the lentiviridae subgroup of retroviruses that cause a progressive failure of the host immunological functions culminating in the clinical collapse known as AIDS, or acquired immunodeficiency syndrome. In the absence of antiviral therapy, this course is inexorable in spite of an initially vigorous immune response. Two fundamental characteristics of the biology of primate lentiviruses explain this apparent paradox. First, HIV and SIV infect CD4(+)targets such as helper T lymphocytes and macrophages, that is, cells that normally play an essential role in the emergence and maintenance of an effective antiviral response. Second, these viruses have evolved a number of strategies to evade control by the immune system. These include mutational escape, latency, masking of antibody-binding sites on the viral envelope, downmodulation of the class I major histocompatibility complex (MHC-I), and upregulation of the Fas ligand on the surface of infected cells. Examining the mechanisms of these phenomena not only helps to understand how HIV wins its war against the immune system, but it also suggests as yet unexploited avenues to combat the virus through therapies and to develop a vaccine.
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PMID:Living in oblivion: HIV immune evasion. 1128 99

The Alaska Supreme Court has ruled that a woman misdiagnosed with HIV can seek damages against her doctor for causing emotional distress, but said the doctor cannot be held liable for the collapse of the woman's marriage or his breach of her confidentiality. A battery of lab tests, including an HIV-antibody test, were ordered for [name removed] after she went to the hospital in February 1989 for treatment of a persistent bout of pneumonia and gastritis. The initial test, an Elisa screen, indicated the presence of antibodies, but the lab cautioned that further tests would have to be performed to establish an HIV diagnosis. [Name removed], the admitting room physician, informed [name removed]'s husband that she was HIV-positive. After discharge, the couple obtained her medical records, which stated "False positive HIV test." A retest proved [name removed] was HIV-negative. She sued [name removed], alleging that he did not have her informed consent to test her for HIV antibodies. She also charged that [name removed] had violated her confidentiality by informing her husband of the test results before telling her. As a result, she suffered damages, including emotional distress. The judge concluded that in the absence of physical injury, [name removed] could not as a matter of law or policy claim emotional damages. On appeal, the Supreme Court decided that its formulation of assessing emotional distress without physical injury needed reappraisal. The court reversed the lower court's directed verdict. [Name removed] lost on all other claims.
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PMID:Doctor who misdiagnosed HIV must face patient's damage claim. 1136 28

A Federal judge in Louisiana ruled that the wife of a sailor who contracted HIV from contaminated blood and spread the virus to her cannot recover wrongful death damages from the government. The government cannot be held liable under the Federal Tort Claims Act for injuries to a serviceman if those injuries arose in the course of military service. The sailor in question received 13 units of blood after the collapse of a lung. The blood turned out to be tainted with HIV and the sailor tested positive for HIV antibodies. Both the sailor and his wife have since died of AIDS-related causes. Claims brought by the sailor's estate were denied under the Feres Doctrine.
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PMID:Survivor cannot sue Navy for tainted blood transfusion. 1136 20

We report three HIV-negative patients with spontaneous pneumothorax as clinical manifestation of active tuberculosis acute chest pain and dyspnea was the cause of admission. Chest roentgen grams showed lung collapse and parenchymal cavitation in two of therm and hydropneumothorax in the other. Outcome was favorable with antituberculous drug therapy and placement of chest tube. Although spontaneous pneumothorax is frequent in fibrosis pulmonary tuberculosis, it seldom complicated active tuberculosis in spite of increase of its incidence.
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PMID:[Spontaneous pneumothorax and active pulmonary tuberculosis]. 1159 82

Situated in Southeastern Europe, with a surface of 237,500 km2 and a population of over 22 million, Romania was a special case in the evolution of global AIDS crisis. After the first reported case in a homosexual male in 1985, five years elapsed till the epidemiological investigations done in the Institute of Virology, Bucharest (1-4) provided strong evidence for what may represent the world's largest iatrogenic transmission of blood-borne pathogens in children. On the basis of Epidemiological Fact Sheet concerning Romania provided by UNAIDS/WHO Working Group on Global HIV/AIDS and STD Surveillance we offer a couple of graphics which are considered important for informed decision-making and planning at national and regional levels. We emphasize the lack of availability of many specific data both on epidemiological and socio-behavioral indicators. Structural collapse in Eastern Europe sets the scene for the rapid spread of HIV/AIDS among young people and the lack of information may contribute to an unexpected rebound of the epidemic.
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PMID:Romanian HIV-AIDS epidemic after a decade of evolution. 1160 80


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