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

A follow-up study was done in Bissau on 113 HIV-2 seropositive patients and 97 HIV-2 seronegative patients 3-15 months after hospitalization. Follow-up totalled 63.5 person years for seropositive patients and 62 for seronegative patients. The mortality during the follow-up period was 43.3% among the seropositive patients (rate 72/100 person years; p.y.) and 25.8% among the seronegative patients (40/100 p. y.). Among 25 HIV-2 associated AIDS cases the mortality was 80% (rate 117/100 p. y.). The median survival time for the AIDS patients was 8 months. Among 48 HIV-2 seropositive patients who lacked signs or symptoms included in the WHO case definition for AIDS at the time of hospitalization 6 patients (12.5%) developed AIDS related symptoms (ARS) during altogether 31.5 person years of follow-up (rate 19/100 p. y.). Tuberculin anergy was demonstrated in 83.3% (15/18) of HIV-2 seropositive patients with AIDS or ARS, in 14.3% (6/42) of seropositive patients without HIV-related symptoms and in 6.9% (5/72) of seronegative patients. A low CD4 T-lymphocyte count in combination with a low CD4/CD8 T-cell ratio was found significantly more often in HIV-2 seropositive patients with AIDS or ARS (62.5%, 10/16) than in HIV-2 seropositive patients without HIV associated symptoms (6.9%, 2/29) or in seronegative patients (2.7%, 1/37). Thus the mortality among recently hospitalized HIV-2 seropositive patients was high and a high proportion of seropositive patients with HIV-related symptoms had evidence of immunodeficiency.
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PMID:Clinical and immunological follow-up of previously hospitalized HIV-2 seropositive patients in Bissau, Guinea-Bissau. 128 6

Between December 1987 and April 1990, health workers administered a tuberculin test to 26,529 6-to-10-year-old children in 16 districts (Woredas) of Ethiopia to obtain a sample of 47 children who had not received a BCG vaccination earlier. They were able to read the reaction in 99% of the children. 2574 (10.1%) children had a BCG scar and 591 (23%) of them tested positive for tuberculosis. 2503 (10.6%) of the 23,695 children who did not have a BCG scar tested positive for tuberculosis. Tuberculin positivity was highest in Deder Woreda (Harrarghe Region) and lowest in Wuchale Woreda (Shoa Region) (27.9% vs. 2%). In fact, prevalence was higher in urban areas than rural areas, suggesting overcrowding's effect on transmission. The last tuberculin survey in Ethiopia occurred in 1953-1955, at which time the prevalence was much higher than in 1988-1990 (30% vs. 10.6%). In addition, the annual risk of infection was higher (3% vs. 1.4%). Between the 2 surveys the prevalence of tuberculosis fell at a rate of 2.2%/year. Yet, the HIV infection pandemic in Ethiopia threatened that downward trend. The cost of chemoprophylactic drugs and lack of sufficient laboratory facilities posed a problem for Ethiopia's National Tuberculosis Control Programme.
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PMID:Tuberculin survey in Ethiopia. 140 82

The diagnostic and therapeutic implications of human immunodeficiency virus (HIV) infection and tuberculosis in South Africa, where tuberculosis remains a major health problem, are reviewed. Mycobacterium tuberculosis is a high-grade pathogen and is able to establish infection early in immunodeficiency. With HIV infection showing significant entry into the heterosexual population in the RSA, an increasing number of cases with both infections can be expected to occur. The radiological appearance in combined infection is variable, ranging from a formal cavitatory picture to the more common finding of diffuse pulmonary infiltration. Intrathoracic adenopathy is a more specific sign of tuberculosis in HIV infection, since it is not associated with persistent generalised lymphadenopathy and pulmonary opportunistic infections, such as Pneumocystis carinii pneumonia. Intercurrent pneumonic infections and other pulmonary manifestations of HIV disease render the interpretation of new infiltrates on chest radiography problematical. Tuberculin skin testing remains useful in HIV infection and should be performed in all HIV-infected patients. The value of tuberculosis serology still remains questionable. Standard antituberculosis drug regimens are effective, but maintenance treatment must be continued for life and should include isoniazid and rifampicin. BCG vaccination is recommended routinely at birth in infants with HIV infection and for asymptomatic HIV-infected individuals who have not previously been immunised.
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PMID:AIDS and tuberculosis. 223 87

In order to detect an association between HIV infection and tuberculosis (TB), 130 TB inpatients were studied one of whom presented a pulmonary disease due to Mycobacterium avium intracellulare. All had advanced TB, 95.4%, with pulmonary localization. Serum anti-HIV antibodies were detected by ELISA and their presence confirmed by immunoblotting in 4 (3.1%) individuals, three males and one female, with different degrees of pulmonary TB. Of the males, 1 was bisexual, 2 were promiscuous, and the female was the sexual partner of a non symptomatic HIV-infected man. No immunological disturbances or other AIDS related alterations were observed. There was one case of miliary TB, but neither atypical X-ray abnormalities nor extrapulmonary involvement were found. Tuberculin reaction was positive in three of the four HIV infected patients. Clinical, radiological and bacteriological evolution were favorable. Adverse drug reaction occurred in two cases, one of them presenting serious toxidermia caused by isoniazid. Of the 130 individuals, 12 presented risk factors for HIV infection so that the prevalence of anti-HIV antibodies presented here, 4 cases out of 12, is consistent with data from previous reports for high risk populations.
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PMID:[Human immunodeficiency virus infection associated with tuberculosis]. 229 8

Because of the abnormalities of host defenses caused by the human immunodeficiency virus (HIV), persons with HIV infection are vulnerable to tuberculosis. Inferential data from several parts of the country indicate increases in tuberculosis case rates, probably occurring in patients with HIV infection. In a person infected with both HIV and Mycobacterium tuberculosis, attack rates of tuberculosis seem to be very high. In general, the disease tends to occur earlier in the course of HIV infection than other opportunistic processes that serve to define the acquired immunodeficiency syndrome (AIDS), presumably because M tuberculosis is more pathogenic than Pneumocystis carinii or Mycobacterium avium complex, for example. The clinical features of tuberculosis in this patient population seem to vary depending on the stage of the HIV infection. Late in the process, tuberculosis usually has atypical features with chest films showing diffuse infiltration, no cavities, and intrathoracic adenopathy. Tuberculin skin tests commonly are negative. At earlier stages of HIV infection, the clinical findings are similar to those in HIV-seronegative persons. Response to treatment is generally good; however, it is recommended that the standard duration be at least 9 months, using isoniazid and rifampin usually supplemented by pyrazinamide in the first 2 months. The use of isoniazid for preventive therapy is recommended for all HIV-seropositive persons who have tuberculin skin test reactions greater than or equal to 5 minutes. Those implementing infection-control measures for HIV-infected patients who have pulmonary findings should take tuberculosis into account until the disease is excluded. Medical personnel providing care for patients with tuberculosis should use universal blood and body substance precautions because of the possibility of undetected HIV infection in patients with tuberculosis.
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PMID:Tuberculosis and human immunodeficiency virus infection. 266 35

To determine the risk of active tuberculosis associated with human immunodeficiency virus (HIV) infection, we prospectively studied 520 intravenous drug users enrolled in a methadone-maintenance program. Tuberculin skin testing and testing for HIV antibody were performed in all subjects. Forty-nine of 217 HIV-seropositive subjects (23 percent) and 62 of 303 HIV-seronegative subjects (20 percent) had a positive response to skin testing with purified protein derivative (PPD) tuberculin before entry into the study. The rates of conversion from a negative to a positive PPD test were similar for seropositive subjects (15 of 131; 11 percent) and seronegative subjects (26 of 202; 13 percent) who were retested during the follow-up period (mean, 22 months). Active tuberculosis developed in eight of the HIV-seropositive subjects (4 percent) and none of the seronegative subjects during the study period (P less than 0.002). Seven of the eight cases of tuberculosis occurred in HIV-seropositive subjects with a prior positive PPD test (7.9 cases per 100 person-years, as compared with 0.3 case per 100 person-years among seropositive subjects without a prior positive PPD test; rate ratio, 24.0; P less than 0.0001). We conclude that, although the prevalence and incidence of tuberculous infection were similar for both HIV-seropositive and HIV-seronegative intravenous drug users, the risk of active tuberculosis was elevated only for seropositive subjects. These data also suggest that in HIV-infected persons tuberculosis most often results from the reactivation of latent tuberculous infection; our results lend support to recommendations for the aggressive use of chemoprophylaxis against tuberculosis in patients with HIV infection and a positive PPD test.
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PMID:A prospective study of the risk of tuberculosis among intravenous drug users with human immunodeficiency virus infection. 279 92

A 27-year old female HIV-positive patient developed septic tuberculosis, with mycobacterium tuberculosis typus humanus repeatedly found not only in sputum, bronchial secretion, blood and faeces but also in biopsy material from the liver. Although standard therapy with Pyrazinamid, Rifampicin and INH had to be replaced at times by Ethambutol or Streptomycin respectively, there was a surprisingly fast clinical and bacteriological improvement. Establishment of the diagnosis AIDS requires not only HIV-infection but also the occurrence of opportunistic infections. The latter include, according to the definition given by CDC, atypical mycobacteriosis, but not tuberculosis. Tuberculosis, however, is increasingly seen in HIV-infected patients. This observation allows us to question whether mycobacterium tuberculosis typus humanus should not be included in the list of opportunistic agents in AIDS. We conclude that in HIV infection the possibility of atypical and typical mycobacteriosis has to be taken into consideration. On the other hand, in tuberculosis patients at risk from AIDS the possibility of infection with HIV has to be considered. Tuberculin reactivity in HIV infected subjects is frequently missing and therefore can not be used for diagnosis. HIV-positive patients may require prophylactic treatment with INH, but BCG vaccination is strictly contraindicated. With early combination therapy continued for at least nine months, the prognosis may be good.
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PMID:[Septicemia due to tuberculosis in HIV infection]. 367 72

Records of patients with concomitant HIV infection and human tuberculosis were analysed. Nine out of 232 AIDS patients (4%) developed human tuberculosis with a preponderance (6/9) of immigrants from sub-Saharan Africa. In three patients the diagnosis was delayed because of atypical manifestations of the disease and lack of typical chest X-ray findings. Tuberculin skin tests were positive in only three patients, and became negative in one patient who developed two episodes of tuberculosis. All the patients who complied with the conventional triple anti-tuberculosis regimen responded well, and no multidrug-resistant tuberculosis was observed.
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PMID:[Tuberculosis among AIDS patients in Ullev]l hospital]. 749 76

We tested 403 clients at an inner-city methadone clinic to determine the rate of positive tuberculin test reactions and to determine how this rate was influenced by race, gender, and infection with the human immunodeficiency virus (HIV). In addition to skin testing, an experimental urine test for antibody to HIV was offered; 73% of the clients provided urine specimens. Positive urine test results were confirmed by serum antibody testing. Of the subjects who returned for follow-up, 33.9% had indurations > or = 10 mm; 49.7% of these subjects were Black, 30% were Hispanic, and 18% were White. Antibodies to HIV were present in 12.5% of urine specimens. Tuberculin reactions of > or = 5 mm were observed for 32.7% of HIV-positive subjects and 48.4% of HIV-negative subjects. Screening of urine for antibodies to HIV proved to be simple, specific, and well accepted by the subjects. Providing prophylaxis for tuberculosis should be a high priority in populations with rates of tuberculin reactions and HIV infection that are comparable to those for clients of our methadone clinic.
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PMID:Tuberculin reactions among attendees at a methadone clinic: relation to infection with the human immunodeficiency virus. 788 40

This prospective randomised study compares 100 each HIV negative und HIV positive patients suffering from pulmonary tuberculosis, under hospital conditions. Both groups are similar in respect of age and sex. Tuberculin anergy exists in 24% of the patients of the HIV positive group. Symptomatology and complaints are analogous. HIV positive patients excrete a greater quantity of tuberculosis bacilli. There is no difference between both groups in respect of sputum conversion. The HIV negative group has a comparatively greater number of tuberculous cavities, whereas the positive group has more infiltrations. Radiological regression is more rapid and marked in the HIV-negative group, and weight increase is also superior, plus a definite regression of the sedimentation reaction and correction of anaemias. Drug tolerance is equally good in both groups. There is a difference in respect of social status and profession.
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PMID:[Clinical findings and follow-up of 100 each HIV-negative and HIV-positive cases of bacillary pulmonary tuberculosis in Rwanda]. 789 54


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