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)

The association between tuberculosis and HIV presents an immediate and grave public health and socioeconomic threat, particularly in the developing world. In early 1992 WHO estimated that approximately 4 million people had been infected with both Mycobacterium tuberculosis and HIV since the beginning of the pandemic; 95% of them were in developing countries. The association between tuberculosis and HIV is evident from the high incidence of tuberculosis, estimated at 5-8% per year, among HIV-infected persons, the high HIV seroprevalence among patients with tuberculosis, the high occurrence of tuberculosis among AIDS patients, and the coincidence of increased tuberculosis notifications with the spreading of the HIV epidemic in several African countries. The impact of the two epidemics on resource-poor countries has ominous social and medical implications, and the already overstretched health services now have to face a tremendously increasing tuberculosis problem. HIV infection worsens the tuberculosis situation by increasing reactivation of latent tuberculosis infection in dually infected persons as well as by favouring rapid progression of new infections in the HIV-infected. This also results in an increase of the risk of infection and a subsequent increase of cases in the general population. In order to respond to this urgent problem, the highest priority must be given to strengthening tuberculosis control programmes in the countries where they are poorly developed and where the prevalence of HIV and tuberculosis infections is high. Besides improving the cure rate by early diagnosis and prompt treatment of patients with tuberculosis, two major strategies that need consideration include BCG vaccination and preventive chemotherapy among HIV-infected individuals. The latter strategy is considered as the most critical intervention that would help to limit the expected increase in clinical tuberculosis from the pool of HIV and tuberculosis coinfected individuals. However, a number of issues need to be addressed urgently and before such an intervention can be implemented in the developing countries.
 ...
PMID:HIV-associated tuberculosis in developing countries: epidemiology and strategies for prevention. 816 72

Worldwide, approximately 1.7 billion persons are infected with M. tuberculosis, and 5 million with HIV. In developing countries, a strong association exists between the 2 pathogens, with 14-30% of AIDS patients having tuberculosis (TB), and 12-60% of TB patients HIV-seropositive (HIV+). TB is one of the most frequent opportunistic infection in AIDS, and is a common way for AIDS to present. Evidence suggests that most TB cases in HIV+ patients are due to the endogenous reactivation of past TB infection instead of from new exogenous infection. Particular cause for concern exists in developing countries where approximately 1/2 of the population aged 20-40 years is infected with TB. While 10% of HIV-individuals may develop TB over their lifetimes, HIV+ individuals are at far greater risk of developing the disease. The paper discusses diagnosis, chemoprophylaxis, and treatment of TB. To help stymie major increases in TB patients as HIV spreads across populations with high prevalence of TB, the authors recommend offering HIV testing and counseling to all patients, including TB in the differential diagnoses of all pulmonary diseases in HIV+ patients, offering BCG vaccination to every nonsymptomatic AIDS newborn in countries with high levels of TB infection, routinely obtaining mycobacterial stains and cultures on specimens from HIV+ patients with respiratory symptoms, making clinicians aware of the many false negative tuberculin tests and atypical radiographic patterns in advanced HIV infection, offering 12 months of isoniazid chemoprophylaxis to those HIV+, treating HIV patients with TB with isoniazid, rifampicin, and 1 or 2 of pyrazinamide, ethambutol, or streptomycin during the 1st 2 months, and making health workers aware of infection risks from doing tuberculin tests and injecting streptomycin.
 ...
PMID:The impact of the HIV epidemic on tuberculosis control programmes in developing countries. 835 44

This article reviews the clinical aspects and diagnosis of HIV-associated tuberculosis in developing countries, and summaries WHO's recommendations for treatment. According to WHO estimates (early 1992) over 4 million persons worldwide have been infected with HIV and tuberculosis; 95% of them are in the developing countries. Clinical features of HIV-associated pulmonary tuberculosis in adults are frequently atypical, particularly in the late stage of HIV infection, with non-cavitary disease, lower lobe infiltrates, hilar lymphadenopathy, and pleural effusion. More typical post-primary tuberculosis with upper lobe infiltrates and cavitations is seen in the earlier stages of HIV infection. Extrapulmonary tuberculosis is reported more frequently, despite the difficulties in diagnosing it. WHO's recent guidelines recommend 6-month short-course chemotherapy with isoniazid, rifampicin, pyrazinamide, and ethambutol for patients with HIV-associated tuberculosis. The older 12-month regimen without rifampicin is much less effective. Streptomycin should not be used, because of the risk of transmitting blood-borne pathogens through contaminated needles. Thioacetazone should be abandoned, because of severe averse reactions observed among HIV-infected patients. The roles of preventive chemotherapy and BCG vaccination for prevention of tuberculosis are also briefly discussed. (author's)
 ...
PMID:HIV-associated tuberculosis in developing countries: clinical features, diagnosis, and treatment. 139 86

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.
 ...
PMID:Tuberculin survey in Ethiopia. 140 82

In order to assess the diagnostic usefulness of the A60 (ANDA Biological, Strassbourg, France) sero-diagnostic enzyme-linked immunosorbent assay (ELISA) kit for tuberculosis in Africa, sera of 53 pulmonary smear-positive tuberculosis (TB) patients, 30 apparently healthy control subjects and 6 AIDS suspects were sampled in Agogo Hospital in the forest area of Ghana. These sera were analyzed for antibodies to HIV-1 and HIV-2, and IgG-antibodies to the A60 BCG-antigen, while the non-HIV individuals were tested for total IgG levels. One healthy control subject, all of 6 AIDS suspects and 7 of the TB patients has HIV infections. In the non-HIV TB group, the sensitivity and specifity of the A60 ELISA was 78% and 86%, respectively, which was much poorer than expected from published reports about the A60 test. The A60 test failed, completely however, to discriminate between TB and non-TB in the HIV-positive group. In the non-HIV groups, total IgG levels were significantly higher in TB patients than in controls. It seems that the usefulness of the A60 ELISA test to diagnose tuberculosis is very limited in this high-incidence area, and that it seems to be of no value in patients infected with HIV.
 ...
PMID:Sero-diagnosis of tuberculosis with A60 antigen enzyme-linked immunosorbent assay: failure in HIV-infected individuals in Ghana. 140 59

This paper profiles the epidemiology of tuberculosis in a geographically defined area, the Eastern Health Board. In 1990, 191 new cases of the disease were notified, 15.5/100,000. One hundred and eighty five were from the indigenous population. Fifty four per cent were male. Nearly 50% of all cases occurring in females do so in those under 35 years and for males, 45% occur in those less than 45 years. One hundred and three (54%) had pulmonary tuberculosis alone and only 50 (26%) had a presumptive diagnosis. Although the lower social classes were overrepresented, cases occurred throughout all social classes and a significant proportion were either gainfully employed or in full time education. Data on BCG status was incomplete, however 28 cases were known to have had BCG at some stage of their life. Thirteen cases were also known to be HIV positive. The contact tracing process was responsible for locating 33 (17%) cases. Continuing surveillance both at national and local level is required in order to assist eradication.
 ...
PMID:The epidemiology of tuberculosis in a geographically defined area. Eastern Health Board Tuberculosis Advisory Committee. 142 75

The authors studied the prevalence and risk determinants for human immunodeficiency virus type 1 (HIV-1) and type 2 (HIV-2) in female prostitutes from Dakar (1985-1990), Ziguinchor (1987-1990), and Kaolack (1987-1990), Senegal, West Africa. Each cohort showed a distinct distribution of HIVs: 10.0% HIV-2 and 4.1% HIV-1 in Dakar, 38.1% HIV-2 and 0.4% HIV-1 in Ziguinchor, and 27.4% HIV-2 and 1.3% HIV-1 in Kaolack. In 1,275 female prostitutes from Dakar, increase years of sexual activity and a history of scarification were associated with HIV-2 seropositivity. In contrast, HIV-1 seroprevalence was associated with a shorter duration of prostitution and a history of hospitalization. In 278 female prostitutes from Ziguinchor, HIV-2 seroprevalence was associated with women of Guinea-Bissau nationality and increased years of sexual activity. In 157 female prostitutes from Kaolack, HIV-2 seroprevalence was associated with increased years of sexual activity and a history of never using condoms. The authors also studied the risk determinants for HIV-2 in the 1,280 Senegalese prostitutes pooled from all three sites. Controlling for ethnic group, women from Ziguinchor and Kaolack were more likely to be HIV-2 seropositive as compared with women from the Dakar site. Increased years of sexual activity were associated with HIV-2 seropositivity, while a history of excision and BCG vaccinations decreased the risk of HIV-2 infection.
 ...
PMID:Prevalence and risk determinants of human immunodeficiency virus type 2 (HIV-2) and human immunodeficiency virus type 1 (HIV-1) in west African female prostitutes. 144 55

In children, as in adults, tuberculosis is much commoner among minority population groups, in Louisiana particularly among blacks. Since 1986 tuberculosis in some states has increased notably; in Louisiana the increase is only now, in 1992, becoming apparent. Eighteen new cases in children under 20 were reported in 1991. Diagnosis in children still depends largely on history of contact and on the Mantoux tuberculin test. Treatment has changed markedly to a more intensive 6 month course including three or four drugs. Preventive treatment of tuberculin positive children is particularly emphasized because it will play an important role in achieving the stated public health goal of elimination of tuberculosis by the year 2010. With the increasing number of children exposed to tuberculosis, the increasing number of HIV-positive children at risk, and the rising number of multiresistant tubercle bacilli, vaccination with BCG must be considered.
 ...
PMID:Tuberculosis in children in 1992. 145 96

We present a 28-year-old HIV-infected man with a 2-year delayed complication of BCG immunization. When immunized the man was healthy, with an unknown HIV status, but 2 years later he was diagnosed with AIDS because of a Pneumocystis carinii pneumonia. He was successfully treated and discharged in a state of good health. A few months later he presented with an enlarged lymph node and Mycobacterium bovis, BCG strain, was cultured. No sign of dissemination was found. We discuss the indications for BCG vaccination in adults, especially in areas and in populations with a high prevalence of HIV.
 ...
PMID:Infection with Mycobacterium bovis in a patient with AIDS: a late complication of BCG vaccination. 158 15

A retrospective study of 22 bacteriologically documented cases of tuberculosis associated with HIV1 positivity was carried out in the department of infectious diseases of Marseille, south of France, a high prevalence area for HIV infection. Sixty-seven percent of the patients were intravenous drug abusers. Thirty-two percent were classified as having AIDS prior to the diagnosis of tuberculosis. All but one had M. tuberculosis isolated from bronchopulmonary samples; 5 had no parenchymatous radiological abnormalities, 5 had excavated lesions. Four patients had cervical adenopathies, 4 other patients had asymptomatic extra-pulmonary sites of infection. All patients responded well to chemotherapy; no relapse was observed during or after treatment. Eight died, two of them before treatment (cause of death unknown), 6 from other complications of AIDS within the 2 years following the diagnosis of tuberculosis. The low incidence of extra-thoracic involvement and the high frequency of excavated pulmonary lesions are discordant with most US studies, as is the relatively late onset of tuberculosis in the course of HIV infection. We suggest that different local epidemiological factors and maybe the practice of systematic BCG vaccination during childhood in France could contribute to these differences.
 ...
PMID:[Tuberculosis in human immunodeficiency virus infection. 22 cases]. 183 23


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