Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019693 (HIV)
 170,526 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Eleven patients with AIDS or AIDS-related complex who developed muscle-related symptoms whilst taking zidovudine were investigated. The clinical details of a further ten patients who did not undergo muscle biopsy are also outlined. The clinical features, quantitative muscle strength testing, electromyographic findings, serial creatine kinase levels, muscle biopsy appearance on light microscopy and the effects of zidovudine withdrawal and rechallenge are described. The spectrum of muscle disease encountered included four cases of frank myopathy diagnosed using clinical, electrophysiological and histological criteria, four patients with mild weakness and myalgia in whom muscle biopsies were normal, three patients with myalgia only and a mild increase in the interstitial cell infiltrate shown by biopsy. The patients presenting with myopathy showed no improvement on withdrawal of zidovudine but responded to immunosuppressive therapy with steroids and, in one case, thalidomide prescribed incidentally. At present, it is not yet possible to clinically define a specific zidovudine-induced myopathy that is distinct from the other effects of HIV infection on muscle structure and function. Our experience suggests that zidovudine may be implicated as a myotoxin in some patients, particularly those with myalgia and mild weakness. In those patients with severe weakness, and with biopsy findings of necrosis and inflammation, the drug effects may be difficult to separate from the primary effects of HIV.
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PMID:Muscle disease, HIV and zidovudine: the spectrum of muscle disease in HIV-infected individuals treated with zidovudine. 826 54

Nemaline-rod myopathy was recently reported in eight young males infected with human immune deficiency virus type 1 (HIV-1). A 41-year-old woman had a 2-year history of progressive proximal-muscle weakness. Muscle biopsy demonstrated the presence of nemaline rods, predominantly in type 1 fibers. She was coinfected with HIV-1 and HTLV-2, as evidenced by positive polymerase chain reaction and serology. There was no lymphopenia or CD4 lymphopenia, despite an abnormal T-cell subset ratio, high CD8 count, skin anergy, and depressed in vitro response to mitogens. This case raises the possibility that dual infection may play a role in the pathogenesis of the rare nemaline-rod myopathies of HIV-infected patients.
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PMID:Progressive nemaline rod myopathy in a woman coinfected with HIV-1 and HTLV-2. 834 53

Human immunodeficiency virus type 1 (HIV-1) is frequently associated with weakness and muscle wasting, referred to as HIV-1 wasting myopathy. This illness, often observed in the advanced stages of acquired immunodeficiency syndrome (AIDS), responds poorly to therapeutic intervention. We describe the cases of three AIDS patients with HIV-1 wasting myopathy who had a favorable response to anabolic steroids as evidenced by an improvement in strength, muscle bulk, body weight, and sense of well-being.
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PMID:Effect of anabolic steroids on HIV-related wasting myopathy. 835 43

Cytomegalovirus (CMV) polyradiculomyelopathy is an uncommon but distinctive clinical syndrome in HIV-infected patients in which ascending motor weakness, areflexia, loss of sphincter control, paresthesias, and varying sensory impairment develop subacutely in association with a polymorphonuclear pleocytosis, increased protein, and hypoglycorrhachia in CSF. Responses to treatment with ganciclovir have varied in reported cases. We report three additional cases: two of these patients responded to treatment and the third was demonstrated to have CMV resistant to ganciclovir. We review other reported cases and identify factors predictive of ganciclovir resistance, which include persistent polymorphonuclear pleocytosis and hypoglycorrhachia on serial CSF studies, and positive CMV cultures from CSF or blood after induction therapy. We conclude that ganciclovir may be an effective therapy for CMV polyradiculomyelopathy, but the presence of these factors, or the development of the syndrome in a patient already being treated with ganciclovir, should prompt consideration of alternative antiviral therapy.
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PMID:Neurologic prognosis of cytomegalovirus polyradiculomyelopathy in AIDS. 823 76

Cerebral lesions in AIDS patients are characterized by a great variety of pathologies, except for HIV infection itself, related to the immunodeficiency context. Due to their frequent association, the interest of imagery (CT and MRI) remains essential today (despite of the underestimation of the lesions due to the weakness of the immune reactions): for the diagnosis detecting intracerebral masses (toxoplasmosis, lymphomas . . . ), white matter lesions, but also meningeal, sub ependymal or vascular lesions to obtain the diagnostic of curable pathologies as soon as possible, but also for the survey during the treatment.
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PMID:[Cerebral imaging and AIDS]. 850 67

The co-occurrence of myasthenia gravis and AIDS in a 38 year old drug addict with HIV-infection is reported. The diagnosis "myasthenia gravis" is based on clinical features with muscle weakness worsening with exercise and depending on the time of day, and secondly on the result of electrophysiological tests, with a typical decrement in repetitive nerve conduction study, and on the presence of antibodies to acetylcholine receptors. A co-existing neurosyphilis was treated intravenously with penicillin G, resulting in good improvement of the associated myopathy. The remaining muscle weakness responded well to treatment with pyridostigmine bromide started after the end of the antibiotic therapy. A tumor in the anterior mediastinum measuring 3 by 2 cm was diagnosed by CT scan and removed, histology showed normal thymus tissue. After operation the patient became asymptomatic on treatment with low dosage pyridostigmine (3 x 30 mg). The association of myasthenia gravis with AIDS may derive from an alteration of the immune system based on changes in the thymus gland. Differential diagnosis in AIDS patients with generalized weakness should include a myasthenic reaction.
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PMID:[Myasthenia gravis in AIDS and neurosyphilis]. 850 18

21 seroconversion HIV-infected subjects have been examined. 16 of them presented with acute symptoms. The disease in the period of seroconversion manifested with fever, weakness, headache, pain in the throat, enlargement of peripheral lymph nodes, polymorphous eruption. Typical mononucleosis-like syndrome occurred in 3 patients only. Half of the patients had subclinical disease, no eruption was seen. Because of clinical indications only 8 of 21 patients were examined for HIV infection. One-third of the patients in seroconversion had moderate thrombocytopenia, probably of autoimmune nature. Autoimmune disorder of the thyroid was registered in 1 patient. The diagnosis of acute HIV infection is not easy in view of rare occurrence of immunodeficiency typical for this infection. Candidiasis of the mucosa was seen in 37.5%, low levels of CD4-lymphocytes in 66.7% of the cases.
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PMID:[The clinical manifestations of HIV infection during seroconversion]. 857 Dec 43

Tumor necrosis factor alpha (TNF-alpha), a cytokine produced during the host defense against infection, is associated with fevers, weakness, and progressive weight loss. Thalidomide inhibits the synthesis of TNF-alpha both in vitro and in vivo and may have clinical usefulness. We therefore initiated a pilot study of thalidomide treatment in patients with human immunodeficiency virus type 1 (HIV-1)-associated wasting with or without concomitant infection with tuberculosis. Thirty-nine patients were randomly allocated to treatment with either thalidomide or placebo in a double-blind manner for 21 days. Thirty-two patients completed the study. In patients with concomitant HIV-1 and tuberculosis infections, thalidomide therapy was associated with a reduction in both plasma TNF-alpha levels and HIV-1 levels. No significant reduction in either TNF-alpha or HIV- 1 levels was observed in patients with HIV-1 infection only. During the study period, patients receiving thalidomide treatment (n=16) showed a significant weight gain (mean +/- SEM: 6.5 +/- 1.2%; p<0.02) relative to placebo-treated patients (n=16). Patients with simultaneous HIV-1 and tuberculosis infections experienced a higher mean weight gain during thalidomide treatment than the group of patients with HIV-1 infection only. The results of this pilot study suggest that thalidomide may have a clinical role in enhancing weight gain and possibly reducing TNF-alpha and HIV-1 levels in patients with HIV-1 and concomitant mycobacterial infections.
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PMID:The effect of thalidomide on the pathogenesis of human immunodeficiency virus type 1 and M. tuberculosis infection. 860 61

We describe a fatal case of varicella-zoster virus myelitis that was preceded by neurological symptoms for 10 months in a patient with human immunodeficiency virus infection and an extremely low CD4 cell count (20/microL). The patient was also receiving chronic acylovir therapy for suppression of herpes complex. Despite chronic unilateral periauricular and facial pain, which was later accompanied by upper- and lower-extremity weakness, a cutaneous eruption never developed. It is hypothesized that a blunted inflammatory response in the spinal cord--possibly related to a very low CD4 cell count--and long-term acylovir administration might have contributed to the atypical manifestation might have contributed to the atypical manifestation of varicella-zoster virus-related neurological disease in this immunocompromised patient.
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PMID:Chronic varicella-zoster virus myelitis without cutaneous eruption in a patient with AIDS: report of a fatal case. 864 52

Psychological and educational data were analyzed for all school-aged males with hemophilia at the Hemophilia Center of Central Pennsylvania (N = 66). Mean IQ (113.5) was higher than normal, and 2.4 times as many boys with hemophilia were enrolled in gifted programming than is the state average for boys. However, there was a disproportionately high prevalence of attention-deficit/hyperactivity disorder (ADHD; 28.3%), learning disability (LD; 15.8%), and graphomotor weakness. These were not significantly associated with HIV status or type and severity of coagulation disorder. School absenteeism was high but was not significantly related to academic achievement, IQ/achievement discrepancy, need for educational intervention, or diagnosis of ADHD or LD.
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PMID:The relationship of HIV status, type of coagulation disorder, and school absenteeism to cognition, educational performance, mood, and behavior of boys with hemophilia. 865 1


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