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

Two human retroviruses, HIV-1 and HTLV-I, have been associated with myelopathies in addition to other neurologic disorders. We report an American dually infected with HIV-1 and HTLV-I who developed steroid-responsive myeloneuropathy. This 28-year-old bisexual man developed interstitial pneumonitis and a transient midthoracic sensory level followed by the evolution of a slowly progressive spastic paraparesis and sensorimotor neuropathy. Serologic studies demonstrated coinfection with both HIV-1 and HTLV-I. Peripheral blood absolute CD4 count was persistently within the normal range. Cranial MRI was normal and spinal MRI showed T3-T10 atrophy. Serial CSF analyses demonstrated marked intrathecal synthesis of anti-HTLV-I IgG, lymphocytic pleocytosis, elevated protein and immunoglobulin G, and oligoclonal bands. HIV-1 was isolated from CSF but not from peripheral nerve. Lymphoproliferative studies confirmed spontaneous proliferation in both blood and CSF. Soluble interleukin 2 receptor and soluble CD8 were greatly elevated in blood and CSF when compared with patients with HIV-related vacuolar myelopathy and seronegative patients with other causes of myelopathy. Nerve biopsy showed epi- and endoneurial CD8+ lymphocytic infiltration without vasculitis; muscle biopsy showed features of acute and chronic denervation. A 6-week course of prednisone produced sustained improvement in leg strength and walking times. We speculate that the myeloneuropathy was caused by HTLV-I in the setting of coinfection with HIV-1.
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PMID:Steroid-responsive myeloneuropathy in a man dually infected with HIV-1 and HTLV-I. 216 Oct 92

HIV directly affects the CNS, primarily causing subcortical neuropathology. Dementia as the initial presentation is rare, but organic mental changes that mimic many functional disorders can occur during the course of infection. The mental status examination is not adequately sensitive to detect noncognitive dysfunction, and subjective complaints, neurological signs, reduced T4 lymphocytes, CSF abnormalities, diffuse slowing on ECG, mild cerebral atrophy on brain CT, and nonspecific hyperdensities on brain magnetic resonance imaging do not correlate reliably with early and subtle HIV-induced neuropsychological impairment. Zidovudine (AZT) can delay or reverse mental deficits, and psychostimulants can reduce apathetic withdrawal, but high-potency neuroleptics can cause neuroleptic malignant syndrome.
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PMID:Organic mental disorders caused by HIV: update on early diagnosis and treatment. 198 33

The effects of various cytokines were examined in an in vitro model of human immunodeficiency virus type 1 (HIV-1) infection of human peripheral blood monocyte-derived macrophages (MDM). Monocytes were obtained from blood of normal donors by Ficoll/hypaque gradient centrifugation and adherence. These cells were allowed to mature in the presence of varying concentrations of cytokines. After five days in culture, cells were harvested, counted, and inoculated with S5G7, an HTLV-IIIB subclone. The cells were replated in the presence of the same concentrations of cytokines. Culture supernatants were sampled over 28 days for p24 antigen (Ag) as measured by Ag capture assay. In repeat experiments, the following observations were made: 1. MDM from some donors could be infected only in the presence of tumor necrosis factor-alpha (TNF-alpha), granulocyte/macrophage colony-stimulating factor (GM-CSF) or interleukin 4 (IL-4); 2. The effect of GM-CSF was variable; TNF alpha also enhanced HIV replication above controls; 3. IL-4 was the most potent enhancer of HIV-1 replication in MDM of the cytokines tested, inducing p24 Ag levels 75-230 times those seen in control cultures run simultaneously. This effect was dose dependent. Ag production was not observed until Day 14 postinfection in most experiments. Multinucleated giant cell formation was observed only in the presence of IL-4.
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PMID:The effect of interleukin 4 (BSF-1) on infection of peripheral blood monocyte-derived macrophages with HIV-1. 222 44

The record of SSPE cases diagnosed immunochemically and serologically in our laboratory, standing for about 60% of the total new cases reported in our country, shows a significant decrease in the incidence in 1988-89 (from 5.21 new cases per year per million total population in 1987 to 1.82 cases in 1988). In 85% of the patients, SSPE onset occurred at the age of 10 years or more, suggesting the possibility of a primary measles infection before anti-measles immunization became compulsory. High serum and CSF anti-measles antibody titres in recently diagnosed patients show subclinical long-term courses. Further serologic tests for viruses inducing persistent infections (herpes viruses, AgHBs and HIV) do not show any difference when compared to a control group excepting an increased incidence of anti-cytomegalic titres.
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PMID:The continuous decrease in the number of SSPE annual cases ten years after compulsory anti-measles immunization. 222 53

Serum cryptococcal antigen titres were measured in 828 HIV-infected patients with pyrexia, 69 of whom had meningism. Serum cryptococcal antigen was positive in 17 patients of whom 16 had meningism with cryptococcus isolated from their CSF. The other patient had no meningism, had no evidence of cryptococcal infection on repeated CSF examination and remains well. A positive serum cryptococcal antigen test was therefore valuable in the diagnosis of cryptococcal meningitis, although in all 16 patients meningism was present and a diagnostic lumbar puncture was therefore carried out. In our experience routine screening for serum cryptococcal antigen did not predict patients who subsequently developed cryptococcal meningitis.
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PMID:The value of serum cryptococcal antigen in the diagnosis of cryptococcal infection in patients infected with the human immunodeficiency virus. 223 Jan 76

We studied three patients who were admitted to the hospital because of progressive weakness without other systemic signs or symptoms. All three cases were young males who had been intravenous drug user for many years. Electrophysiologic study showed prolonged distal latencies and marked slowing of motor and sensory conduction velocities, consistent with primary demyelination. Nerve biopsy also showed signs of demyelination. Antibodies against HIV in CSF and blood were detected during the diagnostic evaluation. Clinical and electrophysiological studies improved in two cases after prednisone administration. Patients with predominant motor demyelinating neuropathies and risk factors should be screen for HIV infection.
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PMID:Chronic inflammatory demyelinating polyneuropathy as first manifestation of human immunodeficiency virus infection. 224 15

We report 2 HIV-seropositive patients with neurosyphilis whose initial CSF VDRL tests were negative. The CSF VDRL became positive after 12 days of IV penicillin treatment for syphilitic meningitis in the 1st patient. The 2nd patient developed syphilitic polyradiculopathy and a positive CSF VDRL 3 months after treatment with IV penicillin. Serial CSF VDRL determinations may be required in AIDS patients when a diagnosis of neurosyphilis is suspected.
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PMID:Neurosyphilis in AIDS patients: initial CSF VDRL may be negative. 231

We determined intrathecal synthesis (ITS) of anti-HIV-1 immunoglobulin in 62 CSF samples from 51 HIV-1 seropositive homosexual men using an ELISA technique with paired serum and CSF samples diluted to a concentration of IgG of 10 micrograms/ml. All subjects were neurologically normal and none was taking zidovudine. We estimated duration of HIV-1 infection from semiannual serologic testing during the 3-year period before CSF analysis and detected ITS of anti-HIV-1 immunoglobulin in 2 of 12 (17%) of those with less than 18 months of HIV-1 seropositivity, in 3 of 21 (14%) with 19 to 36 months, and in 13 of 29 (45%) with greater than 36 months of HIV-1 seropositivity (p = 0.037). There was a trend toward an inverse relationship between level of ITS and the peripheral blood T-helper lymphocyte count. This study demonstrates that increasing ITS of anti-HIV-1 IgG is related to duration of HIV-1 infection and suggests an inverse correlation with systemic immune status. The detection of ITS of anti-HIV-1 immunoglobulin is not necessarily a marker of clinically overt neurologic involvement.
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PMID:Intrathecal synthesis of anti-HIV IgG: correlation with increasing duration of HIV-1 infection. 233 Jan 9

The authors describe a simple and available technique for HIV isolation from cerebrospinal fluid and report preliminary results obtained. Exposed data indicate that neurological involvement occurs early in the natural history of HIV infection and that the virus may be recovered in CSF at all stages of the disease, regardless of immunological conditions of patients. Virological evaluation of CSF may be important in understanding pathogenetic aspects of HIV infection and in clinical management of infected patients.
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PMID:[Isolation of the human immunodeficiency virus (HIV) from the cerebro-spinal fluid]. 235 38

Human immunodeficiency virus type 1 (HIV-1) expresses the Vif, Vpr, Vpu, and Env proteins through complex differential splicing of a single full-length RNA precursor. We used HIV-1-specific oligonucleotide primer pairs in a quantitative polymerase chain reaction procedure on RNA from fresh peripheral blood lymphocytes infected with HIV-1JR-CSF to detect and characterize the singly spliced RNA species which might encode these proteins. The nucleotide sequences at the junctions of splice donor and acceptor sites of these RNAs were determined. One of these RNAs, which has not been previously described, appears to be a novel HIV-1 RNA encoding Env and/or Vpu proteins.
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PMID:Characterization and expression of novel singly spliced RNA species of human immunodeficiency virus type 1. 238 24


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