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

Clostridium difficile is considered the most common cause of nosocomial acquired diarrhoea, with frequencies differing widely from one institution to another. So far, it is a scarcely reported condition in Spain. In the present study 129 episodes of Clostridium difficile associated diarrhoea (CDAD) occurred in 120 patients in a 2,000-bed hospital in 1994 is reported. All cases were diagnosed by demonstrating cytotoxicity on cellular lines (MRC-5) from feces or from the strain isolated from a culture medium (CCFA). The overall incidence was 2.4 episodes every 1,000 admissions. Twenty-eight out of the 120 patients (23%) were HIV-positive patients, that is, an incidence of 30 episodes every 1,000 admissions. No significant differences were observed regarding the presentation and clinical course between HIV-positive and HIV-negative patients, with the exception of the antimicrobial agents used previously. Forty-two percent of patients had undergone surgery and 97% had received antimicrobials in the 8 weeks before the CDAD episode, with an average of 3.3 antibiotics per patient. Out of the 129 episodes, 72.8% were treated correctly. A total of 11.7% of patients responded exclusively to the discontinuation of the antimicrobials that were being administered. Eighty-three patients were treated with specific antibiotics, 59 with oral vancomycin, and 24 with metronidazole. Seventy-six patients (91.5%) responded to the initial therapy, 5 relapsed (6%), and 2 (2.5%) failed. The associated mortality rate was 0.7%. C. difficile can be a relevant cause of nosocomial diarrhoea in our setting, particularly in HIV-positive patients, but also in other patients. Its early diagnosis and appropriate therapy can contribute to decrease a relevant cause of morbidity in inpatients.
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PMID:[Diarrhea associated with Clostridium difficile: one-year experience in a general hospital]. 880 2

During the past five years, researchers from the Medical Research Council and Uganda Virus Research Institute (MRC/UVRI) Programme on AIDS have studied sexual behaviour to better understand the risk and the spread of HIV infection in a rural Ugandan community. This paper aims at a reflective critique of the application of various methods of studying sexual behaviour in a series of six studies within the programme. The objectives of these various studies have been different: ranging from the natural history of HIV-infection to marital instability to household coping. This variety of foci has led to multiple research strategies. Three methodological factors influencing the research and the results were identified: the research model; the meanings of research questions; and personal factors affecting the interview relationship. Although the impact of these factors could not be entirely eliminated, precautions could be taken to diminish these biases. Comparing data obtained through different methods proved useful not only as a validity test but also as a mean to more deeply interpret the data according to culture, linguistics and society. Lessons learned during this piece of work include the importance to the quality of data by inviting local communities to participate in the research process; broadening the field of sexuality from a health-oriented model to reach an anthropological perspective; considering the influence of research organization on the context in which sexual behaviour takes place as a part of the study objectives and promoting an inter-disciplinary dialogue overcoming dogma and prejudices.
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PMID:Rethinking methods for the study of sexual behaviour. 892 31

HIV-2 infection is endemic in Guinea Bissau, with up to 20% of the population, depending upon age, infected. HIV-2 genetic subtypes A-E have been identified, although only subtypes A and B have been associated with clinical disease. Gambia's MRC Laboratories set up a prospective cohort study in 1991 to follow HIV-2-seropositive individuals in a rural village in Guinea Bissau, together with age- and sex-matched controls. Over a two-year mean follow-up period, 5.5% of HIV-2-infected subjects died compared to 1.8% of seronegative controls. The excess mortality among HIV-2 carriers is the result of deaths among infected individuals under age 55 years who have a significantly higher mortality relative to uninfected controls. HIV-2 carriers aged 55-80 years appeared to have mortality similar to that of uninfected controls. Genotyping of viruses from both groups found only subtype A to be circulating.
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PMID:HIV type 2 pathogenicity is not related to subtype in rural Guinea Bissau. 910 Sep 92

Human cytomegalovirus (HCMV) infection is frequently associated with AIDS patients and immunocompromised recipients of organ transplants. The progression of HCMV infection is related to a complex interrelation of virus replication with the host immune system, including soluble and cellular factors. A chemokine, interleukin-8 (IL-8), is essentially involved in neutrophil-mediated tissue injury. Moreover, several chemokine receptors are co-receptor for HIV entry. Hence, we investigated the effects of IL-8 on HCMV replication in human embryonic fibroblasts, MRC-5 cells. IL-8 augmented both infectious virus production and replication of HCMV, with concomitant increases in the levels of both the HCMV pp71 genome and the synthesis of the HCMV late antigen. The enhancing effect of IL-8 was observed at concentration from 0.1 ng to 10 ng of IL-8/ml, showing a dose-response relationship similar to that observed in the neutrophil chemotactic activity of IL-8. IL-8 did not enhance the growth of MRC-5 cells, indicating that IL-8 enhanced HCMV replication and virus production without affecting the proliferation of host cells. We also found that HCMV selectively induced transcripts of CXCR-1 in fibroblasts by RT-PCR, but significant numbers of binding sites could not be detected on HCMV infected cells by using 125I-labeled IL-8. Thus, IL-8 may enhance HCMV replication in fibroblasts through interaction with small number of CXCR-1. Furthermore, HCMV infection induced IL-8 gene transcription in a human monocytic cell line, THP-1, leading to IL-8 secretion. It is unlikely that HCMV infection enhanced IL-8 production indirectly by inducing the production of some soluble factors, because virus-free filtrated HCMV or UV-irradiated HCMV infected supernatants failed to induce IL-8 production. The functional analysis of the IL-8 gene revealed that both AP-1 and NF-kB factor-binding element were involved in conferring the responsiveness to HCMV. Moreover, electrophoretic mobility shift assay demonstrated that the formation of AP-1 and NF-kB complex was observed upon HCMV infection. These results suggest that IL-8 produced upon HCMV infection, may aggravate HCMV infection by enhancing its replication. Thus, IL-8 and CXCR-1 might be a novel target for intervention therapy for opportunistic HCMV infection.
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PMID:[Interrelationship between human cytomegalovirus infection and chemokine]. 946 67

The clinical, laboratory and radiological features of 30 children with clinically diagnosed tuberculous meningitis (TBM) who were HIV-seronegative were compared with those of ten HIV-infected children with TBM. Such comparative data are not currently available in the literature and so are an important addition to our knowledge of the HIV-TB co-infection epidemic. In comparison with the HIV-negative children, those infected with HIV were younger, had a shorter duration of symptoms and were more often Mantoux-negative (HIV-positive 23% vs HIV-negative 70%; p = 0.01). On presentation, all children in both groups were in MRC TBM stages II or III. Clinical features were similar in both groups but computed tomography of the brain showed more ventricular enlargement (HIV-positive 80% vs HIV-negative 63%), gyral enhancement (HIV-positive 60% vs HIV-negative 17%; p = 0.01) and cerebral atrophy (HIV-positive 40% vs HIV-negative 17%). Outcome was considerably worse in the HIV-positive children, of whom 30% died (vs HIV-negative 0/30; p = 0.01) and the remainder were moderately (HIV-positive 30% vs HIV-negative 24%) or severely (HIV-positive 30% vs HIV-negative 19%) handicapped at the end of treatment. While clinical features were not markedly different in HIV-infected and uninfected children with TBM, abnormal radiological findings were more common in the HIV-infected group and outcome was considerably worse. Co-existing HIV encephalopathy and diminished immune competence undoubtedly contributed to the more severe clinical and neuro-radiological features.
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PMID:Tuberculous meningitis and co-infection with HIV. 992 79

A series of 4'alpha-C-branched-chain pyrimidine nucleosides was synthesized from 2'-deoxycytidine or uridine. In the 2'-deoxycytidine series, the substituent at the 4'alpha-position affected cytotoxicity against L1210 mouse leukemic cells in vitro in the order Me (23) > CN (22) > C(symbol)CH (21) > CH=CH(2) (19) > Et (24) > CH=CHCl (20). However, uridine and cytidine derivatives with ethynyl and cyano groups at the 4'alpha-position did not show any cytotoxicity. The antiviral activities of these nucleosides against HSV-1, HSV-2, and HIV-1 in vitro were also examined. Compounds 22 and 23 showed antiviral activities against HSV-1 and HSV-2 without showing significant toxicity to the host cells (MRC-5 cells). Although almost all of the nucleosides showed anti-HIV-1 activities, they were also cytotoxic to the host cells (MT-4).
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PMID:Nucleosides and nucleotides. 185. Synthesis and biological activities of 4'alpha-C-branched-chain sugar pyrimidine nucleosides. 1042 99

This study compares the performance of a line probe assay (LiPA) for the detection of the major mutations associated with reduced sensitivity to nucleoside analogues with a well characterised point mutation assay (PMA). Plasma samples obtained from patients in a trial of four reverse transcriptase inhibitors (MRC Quattro Trial) were tested by both LiPA and PMA at baseline, 32nd and 64th weeks for the presence of drug resistance associated mutations in the reverse transcriptase (RT) gene. HIV-1 RNA was extracted from plasma by the Boom method and amplified by RT-PCR prior to being tested by LiPA or PMA. Assay discrepancies were further investigated by sequencing of the RT gene. Of 275 samples available from 98 trial subjects, 246 samples were successfully amplified by PCR and analysed by LiPA and PMA for six mutations. Of the 1476 individual codons analysed, LiPA successfully assayed 1444 (97.8%) and PMA gave a result with 1418 (96.1%). LiPA failed to give a result for 32 codons from 22 samples and PMA failed with 58 codons from 38 samples. Gross differences between the two assays, in which one scored a codon as wild-type only and the other as mutant only or vice versa, occurred at 28 codons analysed (1.9%) representing 26 samples from 20 subjects. Sequencing of 22 of the 26 samples confirmed the LiPA result in nine cases, the PMA result in 11 and detected a novel variant at codon 215 in four cases. The PMA and LiPA approach to the detection of the major mutations that are genotypically associated with reduced sensitivity to nucleoside analogues can correctly detect mutations in 97% of the cases.
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PMID:Comparison of a point mutation assay with a line probe assay for the detection of the major mutations in the HIV-1 reverse transcriptase gene associated with reduced susceptibility to nucleoside analogues. 1096 Jun 99

A patient of ALS-like disorder in an HIV-1 clade-C-infected heterosexual male is being reported. A 37-year-old gentleman presented with subacute, progressive asymmetrical onset of weakness and wasting of upper limbs associated with brisk muscle stretch reflexes and without any sensory or sphincter involvement. While nerve conduction tests were normal, the EMG of proximal and distal limb muscles on both sides revealed evidence of denervation and reinnervation. Routine blood and urine tests and investigations for underlying causes of motor neuron disease were noncontributory. He was HIV-1, subtype clade C seropositive. A diagnosis of HIV-related anterior horn cell disease was considered and zidovudine, lamivudine and nevirapine were started. After 1 month, there was a subjective improvement of 10% and objective improvement in strength of muscles of proximal upper limb on both sides by one grade power on MRC scale. Reports of amyotrophic lateral sclerosis (ALS)-like illness in HIV are sparse. The reversibility of "ALS"-like features in this subgroup of patients might offer an insight into the pathogenesis of amyotrophic lateral sclerosis. This is a first report of ALS-like illness caused by subtype C of HIV-1 strain.
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PMID:HIV-1 clade-C-associated "ALS"-like disorder: first report from India. 1545 Jul 78

Since macrophage activation can now be studied at a global level using modern microarray and proteomic analyses, discovery of novel macrophage activation genes is inevitable and important for understanding HIV-associated dementia (HAD). We isolated two different types of primary human macrophages: microglia and monocyte-derived macrophages (MDM) from brain tissue and whole blood, respectively. The microarray analysis of differentially regulated macrophage activation genes reported here supports our previous assertions that the mixed glia (MIX) cultured in starvation conditions (DMEM alone) are a non-activated, or "quiescent", tissue culture model for studying macrophage activation in the brain. Transcript levels from these quiescent cultures provided a background level of gene expression and allowed for the identification of upregulated macrophage activation genes in the MIX brain cultures upon treatment with an array of soluble activation factors: serum components, cytokines, and growth factors. We found that 914 genes in the MIX cultures and 734 genes in the MDM cultures had a greater than twofold increase in expression. We discovered 180 genes with expression that was increased more than twofold in both culture types. Microarray-specific statistical analyses were performed to complement fold change analysis: significance analysis of microarrays (SAM) and Partek Pro. In the MIX cultures, we detected over a 100-fold increase in IL-1beta and TIMP1 transcription; Caspase 9, S100A8 and 9, MMP12, IL-8, monocyte chemotactic protein 1 (MCP1), MRC-1, and IL-6 were also upregulated. Activation of starved MDM cultures resulted in fewer upregulated genes compared to MIX cultures. Genes upregulated in both MIX and MDM included CCL2 (MCP1), CCL7, CXCL5, TNFSF14, kinases, and phosphatases. These microarray data may provide leads for identifying previously unknown neurotoxins, disease biomarkers, and pathways responsible for the neuronal apoptosis observed in HAD and for the eventual identification of therapeutic targets and treatments.
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PMID:Microarray analysis of activated mixed glial (microglia) and monocyte-derived macrophage gene expression. 1557 77

Production of recombinant proteins with the vaccinia virus expression system in five mammalian cell lines (HeLa, BS-C-1, Vero, MRC-5, and 293) was investigated for protein yield and proper posttranslational modifications. Regulatory acceptance of the host cell line was taken into consideration, where Vero, MRC-5, and 293 were considered more acceptable to the regulatory authorities. Relevant process knowledge for ease of scale-up with the particular cell type was also considered. Two proteins were expressed, enhanced green fluorescent protein (EGFP) in the cytoplasm and gp120, an HIV envelope coat protein that is secreted into the culture medium. HeLa cells produced the most EGFP at 17.2 microg/well with BS-C-1 and 293 following. BS-C-1 produced the most gp120 at 28.2 microg/mL with 293 and Vero following. Therefore, of the three most appropriate cell lines (Vero, MRC-5, and 293) for production processes, the best results were obtained with 293 cells. Although MRC-5 had a very high productivity on a per cell basis, the low cell density and slow growth rate made the overall production insufficient. Because gp120 contained a significant amount of posttranslational modification, this protein, produced by the different cell lines, was further analyzed by PNGase digestion suggesting N-linked glycosylation modifications in all cell lines tested. On the basis of these results and overall process considerations, 293 cells are recommended for further production process optimization in a serum-free suspension system.
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PMID:Vaccinia virus-based expression of gp120 and EGFP: survey of mammalian host cell lines. 1590 57


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