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

A case of HIV-associated cardiac non-Hodgkin's lymphoma (NHL) is described, and the epidemiologic and clinicopathologic features of 21 cases previously reported in the literature are analyzed. All patients were homosexual males, and the cardiac NHL was the first acquired immune deficiency syndrome-defining condition in the majority. Patients were referred with nonspecific clinical findings including dyspnea and tachycardia, but rapid progression of cardiac dysfunction was frequent after symptoms appeared. Echocardiography constitutes the most useful noninvasive procedure in the diagnosis of cardiac NHL. Most of the patients had disseminated diseased at initial presentation; pathologically, the lymphomas were of B lymphocyte origin and of high-grade subtypes. Prognosis of HIV-associated cardiac NHL is generally poor, although clinical remission has been observed with combination chemotherapy. Cardiac lymphomas in HIV-associated patients are typically high-grade and often disseminate early. Although the prognosis is poor, patients in whom dissemination has not occurred could have longer survival under systemic chemotherapy.
Clin Cardiol 1997 May
PMID:Non-Hodgkin's lymphoma of the heart in patients infected with human immunodeficiency virus. 913 85

Invasion of the heart by HIV has become a clinical problem over the last decade. The objective of the present study was to systematically detect the excess HIV-related cardiac lesions in Kinshasa by performing echocardiography. The study population consisted of 166 HIV-infected patients and 166 HIV-seronegative patients with heart disease (control group). 69% of patients were at stage A of HIV infection and 31% were at stage AIDS C3 according to CDC 1993 criteria. A higher incidence of echocardiographic abnormalities was observed in HIV-seropositive subjects (28.3%) than in control subjects (13%) (p = 0.035). Systolic function was very severely impaired at the stage of AIDS (%R = 21,6 +/- 8.7) showing a highly significant difference (p < 0.01) compared to HIV-seropositive patients at stage A (% R = 29.2 +/- 11.9) and control subjects (%R = 28.9 +/- 5). One patient (0.6%) developed Salmonella enteritidis infectious endocarditis. Echocardiography, a noninvasive technique, contributes to the diagnosis of cardiac lesions associated with HIV infection. HIV has a predominant role in the severity of dilatation and alteration of the left ventricular systolic function in black Africans compared to Caucasian populations.
Ann Cardiol Angeiol (Paris) 1997 Feb
PMID:[The effect of HIV infection on high incidence of heart diseases in Kinshasa (Zaire). Echocardiographic study]. 913 74

A 36-old-woman was admitted with an infectious syndrome, respiratory insufficiency and vasculitis. There was a history of chronic intravenous drug abuse, sexual promiscuity and rheumatic heart disease. She had HIV positive tests. The vasculitis and heart failure worsened and the patient died of stroke. At autopsy it was found histologic evidence of AIDS, rheumatic heart disease with Aschoff nodes, infective endocarditis with cerebral abscesses and thalamic infarction.
Arq Bras Cardiol 1996 Oct
PMID:[Rheumatic heart disease and infective endocarditis in a patient with acquired immunodeficiency syndrome]. 918 24

We evaluated the effect of chronic Pneumocystis carinii pneumonia (PCP) prophylaxis, with a once a month dose of 300 mg of inhalatory pentamidine isethionate, on QT interval duration. We included 22 human immunodeficiency virus (HIV)-infected patients: 11 were on this medication and 11 were not. The two groups were matched for age, sex and HIV infection stage. No patient had any clinical condition or was under any medication known to affect the duration of the QT interval. The heart rate-corrected QT (QTc) was obtained by averaging the observations of three independent observers. QTc duration was similar in both groups. The time separating pentamidine administration and the performance of the ECG did not influence the results, neither did the duration of inhalatory pentamidine therapy. Our results suggest that inhalatory pentamidine does not prolong the QT interval duration and so, as opposed to what has been reported concerning intravenous pentamidine therapy, does not seem to induce an increased risk of torsades de pointes.
Int J Cardiol 1997 May 23
PMID:Inhalatory pentamidine therapy and the duration of the QT interval in HIV-infected patients. 918 45

Endocarditis remains a major worldwide problem despite significant advances in diagnostic and therapeutic interventions. This review centers on the recent studies that have been published in the past year concerning the epidemiologic, diagnostic, and therapeutic aspects of infective and noninfective endocarditis in both the general and special high-risk populations (eg, drug users, HIV-infected patients, and elderly patients).
Curr Opin Cardiol 1997 Mar
PMID:Endocarditis. 919 80

The present study summarizes our ten-year (1985-1995) experience with endomyocardial biopsy (EMB) in patients with idiopathic congestive heart failure (CHF), with specific reference to frequency of myocarditis, treatment policy, relative benefits, and follow-up. Of the 601 patients who constituted our series, 38 were clinically suspected of having myocarditis on the bases of a very recent onset of congestive heart failure and/or of arrhythmias and/or of conduction disturbances, and of a close-to-recent history of flu-like febrile illness. Corresponding EMBs showed myocarditis in 16 of the 38 cases (42.1%). A further 10 EMBs, from patients with a recent onset of congestive heart failure without prior infection episodes, showed myocarditis. Therefore, biopsy-proven myocarditis occurred in 26 of the 601 patients (4.3%). Of the 26 cases, 21 were lymphocytic, 1 was necrotizing granulomatous, 1 was eosinophilic and occurred in a patient who later developed overt zoonosis, 1 had some giant cells within endocardial inflammatory infiltrates, and 2 were borderline forms. In active myocarditis, inflammatory cells mostly constituted of T-lymphocytes (CD45RO+) with sparse macrophages (CD68+) and a few B cells (CD20+). B-lymphocytes and macrophages, along with activated T-lymphocytes, all expressed MHC class II HLA DR molecules, which were also expressed "de novo" by activated endothelial calls of capillaries and of small intramural vessels. HLA DR revealed itself as a very useful marker for the detection of activated inflammatory and endothelial cells. We also noted an increase in the number of perivascular and interstitial mast cells. Ultrastructural study was helpful for the characterization of myocyte damage and of interactions between inflammatory cells and myocytes. In 4 cases (1 of whom was later revealed as HIV positive, and subsequently died of AIDS), we found microreticulotubular structures in endothelial cells of small vessel and capillaries; in 7 cases, there were myocyte changes similar to those described in polymyositis; in 1 case, we observed subplasmalemmal buddings, but no viral particles; in 6 cases, there was extensive myocyte damage with myofibrillar lysis and focal adipous metaplasia; the remaining 6 cases showed myocyte damage of differing extent and severity; in the borderline forms, such damage coexisted with interstitial fibrosis. One of the 21 lymphocytic myocardites was not treated because during hospital screening the patient proved to be HIV positive; of the remaining 20 active myocardites, 11 were treated with a 6-month tapered steroid and azathioprine protocol (one was treated for 24 months), while 9 were not treated. The corresponding follow-up was: 6 deaths (congestive heart failure), 2 cardiac transplants and 3 survivals (1 with pace-maker) in the treated group, and 3 deaths (2 of congestive heart failure and 1 of sudden death), 1 cardiac transplant and 5 survivals (1 on the waiting list for transplantation) in the non-treated group. One of the 2 patients with borderline myocarditis died of congestive heart failure, and 1 is alive. Of the 22 patients with clinical diagnosis of myocarditis and negative biopsy, 7 died of congestive heart failure (2 on the waiting list for transplantation), 4 underwent cardiac transplantation, and 11 are alive (1 is awaiting transplantation). Of the 20 patients currently alive, 1 was originally in NYHA class III, 15 were in class II and 4 were in class I. Of the 20 overall patients who died, 12 were originally in NYHA class IV, 6 in class III, 2 in class II; of the 8 patients who underwent transplantation, 6 were originally in NYHA class IV and 2 in class III. Our overall experience shows that the frequency of myocarditis diagnosed according to Dallas criteria is high in patients with clinical diagnosis of myocarditis, while it is extremely low in dilated cardiomyopathy patients. This finding suggests that, although non-specific, recent onset of symptoms and prior febrile infe
G Ital Cardiol 1997 Mar
PMID:Ten-year experience with endomyocardial biopsy in myocarditis presenting with congestive heart failure: frequency, pathologic characteristics, treatment and follow-up. 919 49

It has been debated whether dilated cardiomyopathy seen in patients with acquired immune deficiency syndrome is caused by the virus itself or by the combination of other factors such as presence of opportunistic pathogens and/or severe immunosuppression. This paper describes the first reported case of a patient with human immunodeficiency virus (HIV) infection presenting with dilated cardiomyopathy during his acute seroconversion illness. Presence of cardiac involvement at a very early stage of HIV infection with no evidence of opportunistic infections, or immunosuppression with high CD4 count indicates that HIV may itself be a cardiac pathogen. This case also illustrates the importance of testing for HIV infection as part of the assessment of any patient presenting with myocarditis or dilated cardiomyopathy.
Clin Cardiol 1997 Aug
PMID:Early presentation of dilated cardiomyopathy as a part of seroconversion illness in human immunodeficiency virus infection. 925 70

A great variety of cardiac disorders have been reported in HIV-infected patients: pericarditis, myocarditis, cardiomyopathies, endocarditis, cardiac involvement through malignancies, pulmonary hypertension, arrhythmias and thromboembolic disease. In general, these disorders are asymptomatic and often diagnosed in echocardiographic studies or autopsies. Pericardial involvement is the most common disorder. Pericardial effusions are asymptomatic and non-specific in a great proportion, but in some instances opportunistic infections or malignancies may lead to cardiac tamponade and are associated with an increased risk of mortality. The etiopathogenesis of myocarditis and cardiomyopathies is uncertain. There is controversy about the role of HIV as the primary etiologic agent. Opportunistic infections, cardiotoxic substances, nutritional deficiencies and autoimmune reactions have also been implicated as etiologic agents of myocardial damage. Short-term prognosis worsens as clinical manifestations of heart failure appear. Valvular involvement usually presents as marantic or infectious endocarditis, the latter most frequently in IVDU. This article reviews the main cardiovascular manifestations in AIDS.
Rev Esp Cardiol 1997 Oct
PMID:[Heart pathology of extracardiac origin (I). Cardiac involvement in AIDS]. 941 63

Cardiac involvement with HIV infection has been documented worldwide in various forms among people with AIDS, including myocarditis, cardiomyopathies, pericardial effusions, ventricular tachycardia, neoplastic infiltration, and non-bacterial thrombotic endocarditis. Recent studies in Africa have reported that HIV may exhibit a cardiac tropism. The authors investigated whether clinical features, sex, age at onset, biological or echocardiographic variables influence the survival of African HIV-infected patients and the progression of AIDS. 157 consecutive Black African HIV-seropositive patients of mean age 38 years with neither cardiac lesions nor other AIDS-defining illnesses underwent physical, electrocardiographic, and Doppler echocardiographic examinations at the Heart of Africa Cardiovascular Center, Lomo Medical, Kinshasa, Congo, between July 1987 and July 1994. The sample was comprised of 89 men and 68 women. Cardiac lesions occurred in 87 patients (55%) during the 7-year follow-up. The onset of heart involvement was associated with a protection against opportunistic comorbidity. In the multiple regression model, cardiac mass/volume ratio, body temperature, deceleration time, body mass index, and socioeconomic status were each independently associated with AIDS outcome. The lowest socioeconomic status and pericardial effusion were the independent predictors of death in a multivariate analysis, while higher CD4 count and cardiac lesions outcome were associated with slower progression to AIDS. Dilated cardiomyopathy was associated with longer survival.
Int J Cardiol 1998 Mar 13
PMID:Heart involvement and HIV infection in African patients: determinants of survival. 957 18

Infective endocarditis is a life-threatening infective complication in parenteral drug abusers. The tricuspid valve is the structure most frequently affected and Staphylococcus aureus the predominant microorganism. Fever, multiple pulmonary emboli and sustained bacteremia by S. aureus are signs of clinical alert for right-sided endocarditis in these patients. Echocardiography has developed a significant improvement in diagnosis and the transthoracic mode has a considerable reliability when high suspicion is established. Outcome is usually favourable with mortality less than 10%. Recent studies have made shorter treatments possible in selected patients and oral therapy is also considered. HIV infection, in advanced status, may indicate a worse survival rate.
Rev Esp Cardiol 1998
PMID:[Endocarditis in parenteral drug addicts. Right-sided endocarditis. Influence of HIV infection]. 965 52


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>