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

Cryptococcus neoformans was found as the causative agent of cryptococcosis in 7 (3.6%) out of 195 HIV-positive persons, most of them being hospitalized. These 7 persons included 6 homosexuals and 1 heroin addict. The examinations were performed at the Mycology Unit of the Robert Koch Institute in Berlin (West) between 1984 and 1986. The brown colour effect (BCE) of the C. neoformans colonies on Guizotia abyssinica creatinine agar (with 0.1% glucose) within 2-5 days at 26 degrees C facilitated the diagnosis of disseminated cryptococcosis. In all 7 cryptococcosis cases, the antigen of C. neoformans was detected in serum and CSF by the latex agglutination test. The initial titres ranged from 1:100,000 to 1:160 in the serum and from 1:1280 to 1:10 in the CSF. In comparison to the progressive stage of the infection with the involvement of the various organs and high antigen titres, the fungus may be detected at an early stage in the respiratory tract only where low antigen titres are observed. All the C. neoformans isolates were found to belong to the variety neoformans. Proposals for an effective control of cryptococcosis are made.
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PMID:The brown colour effect (BCE) of Cryptococcus neoformans in the diagnosis, control and epidemiology of C. neoformans infections in AIDS patients. 332 63

Increased allogeneic activation may account for the observation that pregnancy induces worsening of HIV infection. Urinary neopterin levels were investigated in a 26-year-old woman who had a 10-year history of parenteral drug abuse and anti-HIV seropositivity. First seen at 16 weeks gestation, the patient presented without any AIDS-related signs or symptoms, but her urinary neopterin levels were highly elevated. The pregnancy was normal until week 31, when intrauterine death was diagnosed and delivery was induced. Urinary neopterin levels, elevated in almost all persons with HIV infection, were high throughout the pregnancy, with a mean value of 752 umol neopterin/mol creatinine. This level was almost double that of the 425 umol neopterin/mol creatinine level present before pregnancy. The neopterin level decreased to 500 umol following the delivery, and the patient remained free from AIDS-related symptoms for a further 10 months. The increased neopterin level is indicative of additional activation of the T cell/macrophage axis during pregnancy. Activation of the T cell axis represents the crucial event triggering progressive HIV expression. The neopterin levels found in this HIV-seropositive patient, in the range usually found in acute pulmonary tuberculosis, exemplify the higher degree of T cell activation in HIV seropositives during pregnancy. This could account for the worsening of HIV infection during pregnancy.
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PMID:Allogeneic activation is increased during pregnancy. A risk factor in HIV infection? 350 Jul 40

Fluconazole pharmacokinetics, including absolute bioavailability, were determined for one group of controls (n = 10) and two groups of people with human immunodeficiency virus (HIV) infection (those with CD4+ T-cell counts of less than [n = 4] or greater than [n = 9] 200 cells per mm3). Twenty subjects received four doses of fluconazole; three doses were oral (50, 100, and 400 mg), and one dose was intravenous (either 50, 100, or 400 mg). The other three subjects received one or two doses. The groups were comparable in terms of the weight, body mass index, and estimated creatinine clearance of the subjects, but the people with HIV infection were older. Pharmacokinetic parameters indicated linearity in all subjects; the area under the plasma concentration-time curve and the maximum concentration increased in proportion to the dose. The fraction of an oral dose of fluconazole absorbed approximated unity in all three groups of subjects. The mean (+/- standard deviation) plasma clearance of fluconazole was lowest in the group of subjects with low CD4+ T-cell counts; the value for this group was 0.74 +/- 0.19 liter/h, compared with 0.97 +/- 0.19 liter/h in the group with HIV infection and CD4+ T-cell counts of greater than 200 cells/mm3 and 1.18 +/- 0.23 liter/h in the group of control subjects (P < 0.05). The volume of distribution was lower in those with HIV infection (P = 0.04, corrected for weight). The half-life was longest in people with HIV infection and low CD4+ T-cell counts (P = 0.01). This study has shown that some differences do exist between the pharmacokinetics of fluconazole in people with HIV infection and those in noninfected controls.
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PMID:Pharmacokinetics and bioavailability of fluconazole in two groups of males with human immunodeficiency virus (HIV) infection compared with those in a group of males without HIV infection. 748 28

Hypoalbuminemia is the most powerful predictor of mortality in end-stage renal disease. Since protein-calorie malnutrition can decrease albumin synthesis it is assumed that hypoalbuminemia results principally from malnutrition in these patients, but albumin synthesis may also be decreased as part of the acute-phase response, and hypoalbuminemia can also result from redistribution of albumin pools or from albumin losses. We measured albumin synthesis, fractional catabolic rate, and distribution from the turnover of [125I] human albumin in six hemodialysis patients with plasma albumin less than 35 mg/ml and in six patients with plasma albumin greater than 40 mg/ml. Patients with liver disease, HIV, or other infection were excluded. Both groups were maintained with high-flux polysulfone dialyzers for more than three months. Kt/Vurea and PCR were measured during each dialysis (N = 12 to 18/patient). A four-day calorie and protein intake was determined by dietary history and long-term nutritional status was determined anthropometrically. Measured variables included serum urea, creatinine, transferrin, and the positive acute-phase proteins alpha 2- macroglobulin, C-reactive protein, ferritin, and IGF-1. Albumin synthesis was significantly reduced in the low albumin group. There were no differences in dietary intake, body composition, PCR, BUN, creatinine, or Kt/Vurea. Plasma albumin concentration correlated negatively with ferritin, C-reactive protein and alpha 2-macroglobulin. Albumin synthesis rate correlated negatively with both alpha 2-macroglobulin and Kt/Vurea. Both plasma albumin concentration and synthesis rate correlated positively with IGF-1, and both were independent of PCR and all other nutrition-related variables.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Mechanisms of hypoalbuminemia in hemodialysis patients. 756 20

Human immunodeficiency virus associated nephropathy (Hivan) is a distinct renal disease described in patients infected with the human immunodeficiency virus (HIV). Hivan is characterized by a nephrotic syndrome, enlarged kidneys, a histologic finding of focal and segmental glomerulosclerosis, and a very rapid progression to end-stage renal disease (ESRD). No therapeutic intervention has been shown, in a prospective evaluation, to either alter the course of established Hivan or to influence the emergence of Hivan in HIV-infected patients. We conducted a prospective study on 23 consecutively selected patients seen between 1989 and 1992 who were infected with the HIV, 14 (61%) of whom had significant proteinuria (> or = 2+). Percutaneous kidney biopsy was performed in 5 (36%) of the 14 subjects who had significant proteinuria, and histologic examination of the kidney tissue revealed focal and segmental glomerulosclerosis in all 5 cases. Of the 14 subjects with proteinuria, 8 (57%) also had azotemia (serum creatinine level > or = 1.3 mg/dl). Nine (39%) of 23 subjects admitted intravenous drug use, while 9 (39%) of 23 subjects have had an opportunistic infection before enrollment in the study. The known duration of HIV infection before initiation of zidovudine therapy was 10.3 +/- (SD) 8 months. The mean CD4 count before zidovudine therapy was 195.9 +/- 117 (range 21-654) cells/mm3. The mean dose of zidovudine administered was 543 +/- 117 (range 400-800) mg daily for a period of 20.4 +/- 11 (range 6-38) months.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Zidovudine is beneficial in human immunodeficiency virus associated nephropathy. 761 46

Among a spectrum of renal disorders encountered in patients infected with the human immunodeficiency virus (HIV), the lesion studied most often has been the glomerular disease known as HIV-associated nephropathy. Of the other coincidental renal perturbations reported, the most significant are a heterogenous group encompassing potentially reversible acute renal failure (ARF), primarily acute tubular necrosis. While HIV-associated nephropathy may frequently be seen in asymptomatic HIV-seropositive individuals, acute tubular necrosis almost always is encountered in patients with clinical acquired immunodeficiency syndrome (AIDS). We analyzed our decade's experience in the management of 146 HIV disease patients with ARF (132 AIDS patients and 14 HIV-seropositive patients) and compared it with a contemporaneous group of 306 non-HIV subjects with ARF. All patients evaluated for ARF between January 1984 and December 1993 by the Renal Division at Kings County Hospital Center, Brooklyn, NY, were reviewed. Only those patients with ARF who reached a serum creatinine concentration of 530 mumol/L or higher were included in the analysis. Ninety-one percent of 146 HIV disease patients with ARF were less than 50 years old compared with only 33% of the 306 non-HIV subjects (P < 0.001). Septicemia was directly or indirectly responsible for 75% of patients with ARF in the AIDS group and for 39% in the non-HIV subjects (P < 0.006). Urinary tract obstruction was the cause of ARF in 54 of 306 (17%) non-HIV patients compared with none in the HIV group (P < 0.00001).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Outcome of severe acute renal failure in patients with acquired immunodeficiency syndrome. 787 16

Changes in mineral metabolism have recently been described in AIDS patients. To determine whether such changes affect bone turnover and bone mass, we studied 16 HIV-seropositive patients, classified according to Centers for Disease Control criteria, and 27 healthy controls. Biochemical markers of bone turnover and bone mineral density were analyzed. Serum concentrations of osteocalcin were abnormally low (0.5 +/- 1.3 ng/ml) in HIV-seropositive patients, in comparison with the control group (2.98 +/- 1.6 ng/ml) (p < 0.05). Urinary calcium/creatinine ratio was also decreased in HIV-positive patients (0.10 +/- 0.09 vs 0.14 +/- 0.09) (p < 0.05). In addition, bone mass was slightly lower in HIV-seropositive patients, although the difference was not statistically significant. The pathogenic mechanism of these alterations and their clinical relevance still remain unclear, and several factors may be implicated.
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PMID:Alterations in bone turnover in HIV-positive patients. 790 Nov 71

GLQ223 is a highly purified single-chain ribosome-inactivating protein with selective effects against a variety of cells, including macrophages infected with human immunodeficiency virus. We evaluated the safety, pharmacokinetics, and immunologic effects of multiple doses of GLQ223 in 22 patients with AIDS or AIDS-related complex; CD4+ T-cell counts were between 100 and 350/mm3. GLQ223 was administered intravenously at doses of 8, 16, 24, 36, and 50 micrograms/kg of body weight; the drug was administered by constant infusion over 3 h to achieve a concentration in serum of 50 ng/ml; this concentration is known to be associated with anti-HIV effects in vitro. All patients reported a flu-like syndrome characterized by muscle and joint aches and an increase in creatinine kinase levels; symptoms were controlled easily. For patients who received 36 and 50 micrograms/kg, target concentrations in serum were achieved and an increase in CD4+ and CD8+ T cells was sustained; this sustained increase persisted for at least 28 days after the last infusion. beta 2-Microglobulin levels increased during the infusions and then declined when the infusions ended. Repeat infusions of GLQ223 were safe and relatively well tolerated. The target concentration of GLQ223 in serum was achieved and sustained. Our results suggest that GLQ223 may have activity in treating patients with human immunodeficiency virus infection.
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PMID:Safety, activity, and pharmacokinetics of GLQ223 in patients with AIDS and AIDS-related complex. 791 Jul 22

The pharmacokinetics of fluconazole after a single 100 mg i.v. dose were studied in 10 healthy subjects (5 M; 5 F) and 10 HIV-positive patients (8 M; 2 F). The mean value of plasma clearance was 25% lower in the patient groups (17 +/- 6 (s.d.) vs 23 +/- 4 ml min-1; 95% CI of difference -11 to -0.7; P < 0.05). This difference may have been related to slightly reduced kidney function in the patient group (mean creatinine clearance -18%) but is unlikely to be clinically significant. Therefore, no adjustment of the dose of intravenously administered fluconazole appears to be necessary in AIDS patients without clinical signs of enteropathy.
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PMID:The pharmacokinetics of fluconazole after a single intravenous dose in AIDS patients. 794 40

This article reports the findings of a study conducted to identify the relationship between HIV infection and cerebral malaria in Burundi. Study subjects were selected from hospital patients diagnosed with cerebral malaria. The Glasgow scale was used for unconscious patients as a measurement for admission into this study. Parasite density was determined with Giemsa-stained thick blood smears. HIV-1 testing was done by enzyme-linked immunosorbent assay (ELISA) techniques and positives were confirmed by Western blot. All patients received 10 mg of quinine per kg of body weight as an initial dose by intravenous infusion. This regimen was followed by a daily dose of 25 mg/kg body weight via intravenous infusion. If after 2 days the patient could take treatment orally, it was switched. This treatment regimen lasted 5-7 days total. Statistical analysis was performed using the Mann-Whitney U test, the Fisher exact test, and the Chi-square test. Of the 31 study patients, 22 were male and 9 were female. 7 (22.6%) died within the first 96 hours. The surviving 24 patients had a mean coma recovery time of 33.7 +or- 25.8 hours. No neurological damage was noted. The mean Glasgow score was 8.3 +or- 2.7 for the whole group of 31 patients. The mean malaria parasitemia was 11,920 (95% CI: 643-221,018) parasites/mcl of blood. Plasma levels of creatinine were higher in fatal cases than in patients who survived (307.2 +or- 261.8 mcmol/L vs. 135.1 +or- 55.3 mcmol/L). Of the 31 patients, 12 (38.7%) had antibodies to HIV-1. No relationship between positive HIV-1 and cerebral malaria was found, and no patient showed any clinical symptoms of acquired immunodeficiency syndrome.
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PMID:Prognostic indicators in adult cerebral malaria: a study in Burundi, an area of high prevalence of HIV infection. 802 53


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