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

A 33-year-old, HIV-1 positive, white, homosexual man was hospitalized in May, 1991, because of fever, cough, skin eruptions, anorexia, and weight loss during the previous 2 months. In October, 1990, he had traveled in Sumatra. On examination he was ill, tachypneic, normotensive with a temperature of 39.1 degrees Celsius. The spleen was substantially enlarged. Laboratory investigations showed: ALAT 72 U/I (normal 23 U/1), LDH 508 U/1 (normal 275 U/1). A bronchoscopy with bronchoalveolar lavage revealed yeast cells. Gastroscopy showed an ulcer in the hypopharynx and an erosion in the stomach. Biopsies of this ulcer demonstrated the presence of Penicillium marneffei. Biopsies of the liver showed the same organism. The patient was treated with amphotericin B induction therapy (1 dd 0.5 mg/kg for 21 days, total dose of 730 mg) in combination with flucytosine (3 dd 2500 mg, total dose 142 g in 19 days). In the following 2 weeks the temperature became normal, and the dyspnea and the skin eruptions disappeared, except for the mollusca contagiosa. The spleen diminished by 50%. LDH and ALAT became normal. Oral maintenance therapy followed with fluconazole (the first 3 months 400 mg daily, followed by 200 mg a day). 24 months later, no recurrence had been observed. Case 2 was a 28-year-old, HIV-infected, homosexual man, born in Suriname, who was hospitalized in October, 1991, with prolonged fever, dyspnea, and a painful throat. In March, 1991, he had traveled in rural Thailand. AIDS was diagnosed on the basis of cerebral toxoplasmosis in August, 1991. A biopsy of the ulcer in the oropharynx showed an active aspecific inflammation and also P. marneffei. Treatment with amphotericin B intravenously (0.5 mg/kg, total dose 1052 mg in 32 days) was commenced. The lesions in the oral cavity and throat, the lymph nodes, and the shortness of breath disappeared within a few days. Ten months later he died from emaciation caused by cryptosporidiosis.
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PMID:Disseminated Penicillium marneffei infection as an imported disease in HIV-1 infected patients. Description of two cases and a review of the literature. 820 1

We investigated the long-term health effects of HIV-1 infection in homosexual men not close to developing AIDS by comparing 916 HIV-1-seropositive (SP) men at least 1.67-3.67 years prior to a clinical AIDS diagnosis to 2,161 HIV-1-seronegative (SN) controls. The SP group reported a higher total of 12 distinct symptoms (fatigue, shortness of breath, night sweats, rash, cough, diarrhea, headache, thrush, skin discoloration, fever, weight loss, and sore throat/mouth) than did the SN group (p < 0.0001), corresponding to at least 5.6 more days/year of such symptoms. The SP group had lower body mass index (p < 0.0001) and lower hemoglobin (p < 0.0001). The SP group was more depressed, as measured by CES-D score (p = 0.047), before knowledge of one's serostatus was likely, and became even further depressed (p = 0.038 for increase in depression) after the HIV-1 serostatus test was accessible to high-risk groups. These associations remained unchanged in multivariate models, incorporating other covariates.
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PMID:Signs and symptoms of "asymptomatic" HIV-1 infection in homosexual men. Multicenter AIDS Cohort Study. 826 59

Atypical pulmonary manifestations of Pneumocystis carinii infection and fair numbers of extrapulmonary and disseminated infections have lately been documented in patients with human immunodeficiency virus infection treated prophylactically with inhalative pentamidine. We report the case of a 32-year-old homosexual patient who was assessed for complaints of night sweats, weight loss, and progressive malaise. The patient denied any respiratory tract symptoms such as cough, sputum production, pleuritic chest pain, or shortness of breath. Chest X-ray revealed two large round noncavitating lesions in the lower lobe of the right lung. Pneumocystomas were diagnosed by fine-needle aspiration. A 3-week course of intravenous high-dose cotrimoxazole resulted in amelioration of symptoms but no change in the radiographic appearance of the pulmonary lesions. Four months later the patient is alive and stable and is being treated with pentamidine inhalation of 300 mg per 2 weeks and two tablets of pyrimethamine sulfadoxine per week.
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PMID:A novel variety of atypical Pneumocystis carinii infection after long-term prophylactic pentamidine inhalation in an AIDS patient: large lower lobe pneumocystoma. 847 17

Cutaneous Kaposi's sarcoma (KS) is a well-known complication of the acquired immunodeficiency syndrome. KS in the internal organs, however, is rare in Japan. We present here a 33-years-old Japanese homosexual man who had AIDS complicated with cytomegalovirus (CMV) infection and KS. He was found to be HIV-seropositive, when he was 31-years-old. He visited our hospital in June 1996 because of high fever. The peripheral blood CD4+ lymphocyte counts were 2 per cubic millimeter, and CMV antigenemia was noted (p65 antigen positive cells; 240/50,000 white blood cells). Thereafter he was successfully treated with parental ganciclovir. On admission, some brown-colored flat nodules were found on the skin, and the diagnosis of KS was made by skin biopsy. We administrated human chorionic gonadotropin (hCG) for the treatment of KS, but had no clinical response. In September 1996, he complained of severe cough, shortness of breath, and vomiting. A chest radiogram showed nodular lesions and pleural effusion in bilateral lungs. A computed tomography of his chest also revealed nodular and linear densities distributed along the bronchovascular bundles. The ultrasonic examination of his abdomen revealed a duodenal nodule. Both nodules in the lungs and duodenum were proved to be KS based on the autopsy findings. Intranuclear inclusionbodies pathognomonic for CMV infections were detected in the stomach and the colon.
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PMID:[An autopsy case of AIDS complicated with cytomegalovirus infection and multiple Kaposi's sarcoma]. 1035 94

Pneumocystis carinii pneumonia (PCP) is an opportunistic infection that occurs in immunosuppressed populations, primarily patients with advanced human immunodeficiency virus infection. The classic presentation of nonproductive cough, shortness of breath, fever, bilateral interstitial infiltrates and hypoxemia does not always appear. Diagnostic methods of choice include sputum induction and bronchoalveolar lavage. The drug of choice for treatment and prophylaxis is trimethoprim-sulfamethoxazole, but alternatives are often needed because of adverse effects or, less commonly, treatment failure. Adjunctive corticosteroid therapy improves survival in moderate to severe cases. Complications such as pneumothorax and respiratory failure portend poorer survival. Prophylaxis dramatically lowers the risk of disease in susceptible populations. Although PCP has declined in incidence in the developed world as a result of prophylaxis and effective antiretroviral therapy, its diagnosis and treatment remain challenging.
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PMID:Pneumocystis carinii pneumonia: a clinical review. 1105 37

Symptom management for persons living with HIV disease is recognized as an extremely important component of care management. This article reports the validation of a new sign and symptom assessment tool designed to assess the intensity of HIV-related symptoms using two samples (study 1: n=247; study 2: n=686) of people living with HIV disease. Study 1 data were collected between 1994 and 1996 before the initiation of highly active antiretroviral therapy (HAART). Study 2 data were collected between 1997 and 1998 after the wide adoption of HAART therapy. The initial version of the Sign and Symptom Check-List for Persons with HIV Disease (SSC-HIV) included 41 signs and symptoms. This scale was submitted to a principal components factor analysis with a varimax rotation. The final solution reports six factors explaining 68.9% of the variance. The six symptom clusters (factors), the number of items in the factor, and the Cronbach alpha reliability estimates were: malaise/weakness/fatigue (six items, alpha=0.90); confusion/distress (four items, alpha=0.90); fever/chills (four items, alpha=0.85); gastrointestinal discomfort (four items, alpha=0. 81); shortness of breath (three items, alpha=0.79); and nausea/vomiting (three items, alpha=0.77). These six factors have strong reliability estimates and a stable factor structure that supports the construct validity of the 26-item instrument. Additional evidence supports the concurrent validity of the scale as well as its sensitivity to change over time. The final version of the SSC-HIV is a 26-item scale available for use by clinicians and researchers to measure the patient's self-report of HIV-related signs and symptoms.
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PMID:Validation of the Sign and Symptom Check-List for Persons with HIV Disease (SSC-HIV). 1056 2

Combination drug therapy and enhanced patient management techniques result in increased survival for many AIDS patients. This phenomenon has brought the issue of fatigue, a common and difficult side effect of HIV/AIDS treatment, to the forefront. Three-quarters of the AIDS patients surveyed in a recent study indicated that fatigue negatively affects their quality of life and influences their willingness to continue aggressive treatment. New advances for combating fatigue include the use of nutritional therapy, anti-depressants, anti-infectives, medications that boost the production of red blood cells, hormone replacement, exercise, massage, and acupuncture. The most common source of fatigue in HIV-positive patients is anemia, which also causes shortness of breath and dizziness. Anti-HIV medications may inhibit red blood cell production. An alternative treatment, Epoetin alfa, works by increasing low levels of naturally producing erythropoietin, a protein manufactured in the kidneys. Fatigue resulting from low testosterone levels can be treated with anabolic steroids. Poorly functioning adrenal glands can be the cause of fatigue in patients with advanced disease. Taking hydrocortisone pills is often effective. Depression is the fourth most common cause of fatigue. Antidepressants work well without traditional side effects.
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PMID:More awareness needed in treatment of fatigue. 1136 53

Many HIV patients develop Pneumocystis carinii pneumonia (PCP), a lung infection characterized by fever, fatigue, weight loss, dry cough, and shortness of breath. Medicines can help fight PCP by keeping the immune system stronger, preventing the onset of the disease, and preventing recurrent infections. Patients are encouraged to maintain regular health care check-ups, develop a healthy style of living, and follow any PCP treatment or prophylaxis as prescribed to prevent this potentially severe infection.
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PMID:Help yourself defeat the lung infection called PCP. National Institutes of Health. 1136 36

The National Minority AIDS Council (NMAC) and model/actress Daisy Fuentes are launching a national awareness campaign to encourage people with HIV/AIDS to discuss anemia with their doctors. The "Celebrate Life" campaign includes public service announcements, a toll-free hotline, and a web site for further information. Anemia is a common complication of HIV treatment, and is easily diagnosed. Persons with anemia often suffer from symptoms including fatigue, shortness of breath, and loss of appetite and sex drive. The campaign contact information is provided.
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PMID:Anemia awareness campaign. 1136 79

The association between pulmonary hypertension and HIV infection is well established. However, the development and progression of pulmonary hypertension has no relationship with the stage of HIV disease and the history of opportunistic infections. Although the pathogenesis of HIV-associated pulmonary hypertension is not clear, several hypotheses have been proposed. Pulmonary arterial pressures are in the moderate-to-severe range. Plexogenic pulmonary arteriopathy is the most common histopathologic finding. Progressive shortness of breath and pedal edema are the two most common presenting features. Responses to pulmonary vasodilator agents, antiretroviral agents, and anticoagulation therapy are variable. The appearance of unexplained cardiopulmonary symptoms in HIV-infected individuals should suggest pulmonary hypertension. Furthermore, HIV testing is recommended in all patients presenting with unexplained pulmonary hypertension, even when they deny HIV risk behaviors.
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PMID:[HIV-associated pulmonary hypertension]. 1141 Nov 35


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