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)

Benign intracranial hypertension (BICH) is a rare adverse event. We report the case of a 31-year-old female drug addict who had been seropositive for HIV since 1987. She had stage IV C1 AIDS, and was receiving intravenous amphotericin B for generalized cryptococcosis with no neuromeningeal involvement. She developed BICH that regressed when the antifungal drug was withdrawn and treatment for cerebral edema was started. BICH is a clinical entity involving intracranial hypertension with no focal neurological signs or detectable intracranial lesion. The manifestations include headache, transitory or permanent visual disturbances (diplopia, loss of visual acuity) and the perception of intracranial noise. The cerebrospinal fluid is under increased pressure but the composition is normal. The eye fundus examination shows papillary edema, and the neuroradiological workup is normal. BICH can only be diagnosed once an expansive intracranial process, neuromeningeal infection, and non-communicative hydrocephalus have been ruled out. In the majority of cases, no etiology is found. Such cases of idiopathic BICH usually occur in overweight young women, although drugs can be implicated. Amphotericin B has not previously been held responsible for BICH. On the basis of this observation, we present a review of the literature.
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PMID:[Drug-induced benign intracranial hypertension. Apropos of a case with amphotericin B. Review of the literature]. 129 80

Penicilliosis marneffei is a rare deep fungal infection. The endemic area especially located in the Southeast of Asia. In the former literatures till 1990, 29 cases were reported, most of them were diagnosed pathologically from autopsy. Since 1989 there were more reports of P. marneffei in the HIV infected individuals and graft recipient, so far as the increased immunocompromised hosts systemic fungi infection would be a crucial problem. In this report, a case of systemic Penicilliosis marneffei according to biopsy and cultural identification was reported. Amphotericin B was administered in a total dose of 873 mg, and got a good response. The pathogenesis, clinical manifestations and diagnosis were reviewed.
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PMID:[Penicilliosis marneffei. Report of a case and review of literatures]. 133 13

The nucleoside analogue azidothymidine (AZT) and the methyl ester of amphotericin B (AME) were assayed for antiviral effect on HIV infection singly and in combination. Both compounds were effective in inhibiting HIV infection of MT-4 cells. At concentrations where either compound alone had no significant effect on infection, the compounds in combination were potent inhibitors of HIV as evaluated by reduction in HIV antigen production and HIV induced cytopathic effect. These results indicate that a combination therapy employing compounds with different modes of action like AZT and AME may have synergistic antiviral properties. Amphotericin B itself significantly reduced HIV infectivity in vitro and should not be used as an antifungal agent in cultures intended to propagate HIV.
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PMID:Synergistic antiviral effect in vitro of azidothymidine and amphotericin B methyl ester in combination on HIV infection. 158 23

Through a retrospective review, we identified 77 previously unreported cases of coccidioidomycosis during HIV infection. Patients were classified into 1 of 6 categories based on their primary clinical presentation: 20 had focal pulmonary disease (Group 1), 31 had diffuse pulmonary disease (Group 2), 4 had cutaneous coccidioidomycosis (Group 3), 9 had meningitis (Group 4), 7 had extrathoracic lymph node or liver involvement (Group 5), and 6 has positive coccidioidal serology without a clinical focus of infection (Group 6). Coccidioidal serologies were positive on initial testing in 83% of the patients in whom such serologic testing was performed. Sera from 39% of patients were positive for TP antibodies while 74% had CF antibodies. Eleven of 12 seronegative patients had pulmonary disease (Group 1 or 2). Serologic results of other patients sent to a single reference laboratory were similar, with 26% positive for immunodiffusion TP antibodies and 79% positive for immunodiffusion CF antibodies. For the 77 patients in this study, the CD4-lymphocyte count was below 0.250 X 10(9) cells/L in 46 of the 55 patients who had this test performed, and a low CD4 count was significantly associated with mortality (p less than 0.01). At the time of follow-up, 32 of the 77 patients (42%) had died. There were significantly more deaths in those with diffuse pulmonary disease (Group 2) than in other groups (p less than 0.001). Amphotericin B, ketoconazole, fluconazole, and itraconazole were all used as antifungal therapies. Outcome could not be related to the therapy used. Of note, 3 patients developed coccidioidomycosis while receiving ketoconazole for other conditions.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Coccidioidomycosis during human immunodeficiency virus infection. A review of 77 patients. 214 61

Histoplasma capsulatum and Coccidioides immitis are two fungi that are regional in occurrence and cause opportunistic fungal infections in patients with AIDS. Many cases of histoplasmosis have been reported in patients months or years after they have been in an endemic area. These are obviously cases of reactivation of latent infections. With coccidioidomycosis, the cases have been reported from endemic areas, but some also appear to be reactivation infections, and we should anticipate such cases in nonendemic areas just as with histoplasmosis. The clinical presentations may be atypical, even mimicking acute bacterial sepsis. The diagnosis should be sought in any HIV-infected patient with an unexplained infection and residence or travel in an endemic area even in the remote past. Studies should include bone marrow examinations for histoplasmosis as well as skin biopsies with special strains and cultures for fungi for both infections. Sputum or bronchoscopy specimens have often been the source of a diagnosis in coccidioidomycosis. Serologic tests for antibody in both diseases yield inconsistently positive results in AIDS patients. Treatment of the acute infection should be with amphotericin B followed by maintenance suppressive therapy with ketoconazole or Amphotericin B.
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PMID:Fungal infections in AIDS. Histoplasmosis and coccidioidomycosis. 306 May 28

We have tested the ability of Amphotericin B to form ion channels/defects in osmotically stressed large unilamellar vesicles (LUV) using pyranine fluorescence detected ion/H+ exchange. We found that sterol-free LUV exhibit greatly increased sensitivity to AmB channel formation in the soluble oligomer state (> 0.5 microM) under modestly hypoosmotic conditions (< 100 delta mosM). These vesicles are completely insensitive under isoosmotic conditions. The related antibiotics, Amphotericin B methyl ester and Nystatin showed almost no activity under hypoosmotic conditions in the absence of sterol. This difference may be attributable to differences in solution oligomeric states. Experiments with KCl and CaCl2 internal buffers demonstrate that these sterol-free AmB membrane disruptions are highly selective for monovalent cations (K+) over anions (Cl-), ruling out massive lysis or unselective membrane defects caused by osmotic pressure. Thus, AmB seems to be acting as a 'molecular harpoon', an expression coined to describe substances which can selectively target osmotically stressed, strained or highly curved membranes. These results may provide a rationale for AmB's reported anti-HIV activity and reported activity against sterol-free small unilamellar vesicles (highly curved membranes) as well as the reduced activity of liposomal drug delivery systems toward cholesterol-containing and sterol-free membranes (fewer soluble oligomers).
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PMID:Osmotic stress sensitizes sterol-free phospholipid bilayers to the action of Amphotericin B. 754 30

Histoplasma capsulatum histoplasmosis occurs frequently in endemic areas and with the AIDS outbreak, it appears as an opportunistic fungus involved in disseminated disease. We report the clinical, biological and treatment features of seven cases diagnosed in the CISIH of the Eastern part of Paris. Clinically, four patients were suffering from pulmonary symptoms, in three cases digestive disorders and in three cutaneous lesions. In all cases, the mycologic diagnosis was necessary. Amphotericin B and itraconazole were used as treatment for five patients (two died before the diagnosis was completed). Among these five subjects, four died (death was attributed to histoplasmosis in only one case). These observations emphasize the importance of this infection in HIV-infected patients coming from endemic areas.
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PMID:[Histoplasmosis, caused by Histoplasma capsulatum, and AIDS]. 765 22

3'-azido-3'deoxythymidine (AZT), a clinically used anti-HIV compound, was evaluated for antiviral effect on HIV infection in combination with other antiviral compounds in vitro. Interactions were evaluated by the median-effect principle and the isobologram technique. Synergistic effect was obtained by combining many evaluated antiviral agents with AZT. We observed a difference in the degree of synergism depending on the evaluated compound; the results indicate that compounds with the same target in the viral replicative cycle (ddI: 2',3'-dideoxyinosine, didanosine; d4T: 2',3'-dideoxy-2',3'-didehydrothymidine stavodine; TIBO: tetrahydro-imidazole-benzodiazepin) had a synergistic effect at all concentrations, agents that disturb the infectivity of virus (CAS: Castanospermine; AME: Amphotericin B Methyl Ester) exerted a strong synergistic effect at low concentrations, and finally compounds interfering with the adhesion/penetration process of virus (ConA: Concanavalin A; DS: dextran sulfate) were most potent with AZT when used in rather high concentrations. At this moment in the HIV epidemic, these observations suggest that combinations of antiviral compounds should be evaluated in clinical trials, with the major emphasis on nucleoside analogues and compounds influencing the infectivity of the virus.
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PMID:Evaluation of the combination effect of different antiviral compounds against HIV in vitro. 768 46

Mucosal (oropharyngeal, esophageal, and, in women, vaginal) candidiasis is a common infectious complication in HIV-infected patients. There is a wide range of drugs to treat or suppress Candida infections. However, with the increasingly common use of fluconazole as treatment or prophylaxis in patients with relatively advanced HIV disease, mucosal candidiasis that is clinically resistant to fluconazole is increasingly recognized. Susceptibility testing for fluconazole has not been well standardized, and laboratory and clinical correlations often have been difficult to demonstrate. However, the frequency with which Candida strains resistant to fluconazole can be isolated appears to be increasing, particularly in patients with advanced HIV disease. Anecdotal results suggest that patients who fail fluconazole therapy usually do not respond to higher doses of fluconazole, but may occasionally respond to itraconazole or ketoconazole. In vitro susceptibility to these agents does not necessarily ensure clinical efficacy. Amphotericin B is usually effective initially but requires parenteral administration. However, with any therapy, relapses tend to occur and progressively recalcitrant disease often occurs, with increasing morbidity for patients. There is a clear need for studies addressing the incidence of resistance, the risk factors for its development, and more effective therapy.
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PMID:Resistant candidiasis. 781 44

Severe fungal infections have become increasingly common over the past 10 years, largely due to the greater number of immunocompromised patients, such as those infected with HIV and those undergoing immunosuppressive therapy for malignancies. Between 60% and 80% of people with AIDS, for example, develop at least one fungal infection. Other predisposing factors for these infections include mechanical defects such as indwelling catheters, surgery, and burns. Candidiasis, aspergillosis, cryptococcoses, coccidioidomycosis, and histoplasmosis are among the fungal infections most commonly encountered in the clinical setting. Diagnosis is often elusive and treatment difficult. Amphotericin B has been the standard therapy for most life-threatening fungal infections for almost three decades but has significant drawbacks, including severe adverse reactions. Other systemic antifungal agents have proved useful in certain situations. Fluconazole, a new broad-spectrum agent, has shown particular promise in the treatment of candidiasis and cryptococcal meningitis.
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PMID:Fungal infections associated with malignancies, treatments, and AIDS. 795 89


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