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

Parasitic etiologies of pulmonary symptoms generally represent some degree of immunocompromise or occur as uncommon presentations of common parasitic infections. In regions where HIV infection is more prominent, PCP probably will be the most common parasitic respiratory disease seen. In geographic regions where helminthic infections are more common, patients with respiratory symptoms and eosinophilia probably will be seen more often and require a search for a specific etiology. In more rare circumstances, travel to an endemic area may suggest a more exotic parasitic etiology for respiratory symptoms.
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PMID:Respiratory distress caused by parasites. 780 19

The frequency of PCP among adult Danish AIDS patients notified in 1988-93 was higher among patients tested HIV-positive less than 4 months prior to AIDS than among those known to be positive for > 1 year. Among the latter, the proportion with PCP decreased significantly over the period, from 45.3% in 1988 to 22.0% in 1993, while no such trend was found among patients tested positive for HIV less than 4 months before AIDS was diagnosed. The incidence of PCP as an AIDS-defining disease has decreased, most likely due to the use of PCP prophylaxis.
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PMID:Danish AIDS patients 1988-1993: a recent decline in Pneumocystis carinii pneumonia as AIDS-defining disease related to the period of known HIV positivity. 785 49

Infants generally acquire HIV form mother during gestation, or delivery by contact with maternal blood and body fluids or breast feeding. At Saraburi Hospital, from January 1989 to December 1992, there were 17,766 mothers who gave birth, 80 anti HIV positive mothers were included. Up to now, four cases of PCP have been reported in HIV infants born to anti HIV positive mothers at this hospital. All cases presented with symptoms of pneumonia and bilateral bronchopneumonia by chest X-ray. Diagnosis was confirm with positive organism identification by methenamine silver stain of lung tissues autopsy, lung fluid, tracheal secretion and by toluidine blue O stain of lung percussion fluid. Two infants died before specific treatment was administered. The other two recovered with the specific treatment of trimethoprim and sulfamethoxazole. Conventional treatment was given after the definitive diagnosis was confirmed. Pediatricians should be aware of PCP. Specific treatment should be considered in infants with HIV who fail to respond to antibiotics treatment for lower respiratory infection symptoms.
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PMID:Pneumocystis carinii pneumonia in infants born to anti HIV positive mothers. 796 41

78 consecutive cases of PCP have been analysed: 59 (75.6%) cases were associated with HIV infection and 19 (24.4%) cases were associated with solid tumors and hematologic malignancies at advanced stage of the disease and renal transplantation. It could suggest primary prevention for such patients.
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PMID:[Pulmonary pneumocystosis in immunodepression: apropos of 78 consecutive cases seen at the CHRU of Clermont-Ferrand from 1984 to 1993]. 800 59

The epidemiologic shift in HIV-infected populations from homosexual men to intravenous drug users and their sexual partners, together with the wide application of antipneumocystis prophylaxis and a better understanding of the broad range of HIV-associated illnesses, has changed our concept of the spectrum of lung infections that occur in patients with HIV infection. Bacterial pneumonia, not PCP, is the most common lower respiratory infection. Newer therapies of mild-to-moderate PCP increase the treatment options. The worldwide increase in tuberculosis cases is attributable to coinfection with HIV, and multidrug-resistant tuberculosis is now a serious threat, especially in the inner cities. Fungal pneumonias occur with increased frequency in patients with HIV infection, depending on the geographic factors and the severity of immunodeficiency.
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PMID:Pneumonia in patients with HIV infection. 807 69

Preliminary evidence suggests that a CD4 cell count < 50 cells/mm3 is associated with a particularly poor short-term prognosis, and is both necessary and sufficient for death associated with HIV infection. We sought to validate these findings in a cohort of 1,415 zidovudine (ZDV)-treated patients, with advanced HIV infection, and to examine more closely the profile of CD4 cell decline over the 2 years prior to death. As of December 31, 1991, 432 patients had died. The cumulative 2 year survival of patients once their CD4 cell count fell to < or = 50 cells/mm3 (median survival = 17.3 months) was substantially shorter at 25.7%, than from when their CD4 cell counts first fell within the range 51-100/mm3 (51.4%); 101-150/mm3 (67.3%); or 151-200/mm3 (76.5%). The percent of patients with a CD4 count < 50 cells/mm3, increased from 33% at 24 months prior to death to 58% at 12 months and 86% at 1 month. Patients with a CD4 count > or = 50 cells/mm3 in the month prior to death, were significantly older (p < 0.001) and had higher CD4 cell counts (p < 0.05) at initiation of ZDV compared to those with a CD4 count < 50 cells/mm3. There were no important differences in HIV risk category, duration of ZDV therapy or use of PCP prophylaxis between the two groups. These findings highlight the importance of more intensive monitoring of patients with CD4 counts < 50 cells/mm3, since life-threatening opportunistic infections are more likely to supervene at this stage. A CD4 count < 50 may also be a useful surrogate endpoint for survival in clinical trials.
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PMID:Progressive CD4 cell depletion and death in zidovudine-treated patients. 810 Feb 72

In patients with HIV infection the diagnosis of PCP is relatively simple when patients present late, with advanced pneumonia. The diagnosis becomes more difficult when patients present with minimal symptoms, are receiving specific prophylactic therapy or have had previous AIDS-related pulmonary diseases. A number of non-invasive tests, such as Gallium scanning, exercise-induced hypoxaemia, DTPA scanning and lung function testing have been developed to improve on the diagnostic value of clinical examination and the chest X-ray. Although each has its own particular advantages and disadvantages, the most efficient means of diagnosing PCP, in patients presenting with respiratory symptoms, is to use these investigations as part of a diagnostic algorithm, thereby maximizing resources and defining relative risks for different types of patients.
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PMID:Efficient diagnosis of Pneumocystis carinii pneumonia. 814 19

This Quick Reference Guide for Clinicians contains highlights from the Clinical Practice Guideline on Evaluation and Management of Early HIV Infection, which was developed by a private-sector panel of health care providers and consumers. Selected aspects of evaluating and managing patients, both adults and children, who are in the early stages of human immunodeficiency virus infection are presented. Topics covered include disclosure of HIV status, monitoring of CD4 lymphocyte counts, prevention of Pneumocystis carinii pneumonia and infection with Mycobacterium tuberculosis, initiation of antiretroviral therapy, treatment of syphilis, eye and oral care, performance of Papanicolaou smears, diagnosis of HIV infection in infants and children, preventive therapy for PCP and assessment of neurologic problems in HIV-infected children, pregnancy counseling, and development of a comprehensive case management system. Algorithms are included that show the sequence of events related to evaluating and managing early HIV infection in adults and children, as well as drug dosing tables for antiretroviral, PCP, and M. tuberculosis therapies.
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PMID:Managing early HIV infection. Agency for Health Care Policy and Research. 814 62

Pneumocystis carinii colonization was studied in 90 men using the polymerase chain reaction. These comprised ten heterosexual controls; ten HIV-seronegative homosexual controls; 20 HIV-seropositive homosexuals with blood CD4 count > 400 x 10(6) l-1; 20 HIV-seropositive homosexuals with CD4 < 400 x 10(6) l-1; ten HIV-seropositive homosexuals with CD4 < 60 x 10(6) l-1 receiving PCP chemoprophylaxis; and 20 HIV-seropositive homosexuals with respiratory symptoms but without PCP. Induced sputum was obtained from all but the last group, who had bronchoalveolar lavage, and all specimens were tested for P. carinii using the polymerase chain reaction. The first four groups received no pneumocystis chemoprophylaxis, and all but the last group were asymptomatic. P. carinii colonization did not occur in the two control groups. P. carinii colonization rates were significantly different in the CD4 > 400, CD4 < 400, and CD4 < 60 groups (10%, 20%, and 40% respectively) (P < 0.025). Two patients (one each from CD4 < 400 and CD4 < 60) developed PCP 4-6 weeks after sputum induction, both had previously had high levels of P. carinii on sputum induction. Two patients from the CD4 < 400 group had high levels of P. carinii but did not develop PCP. In the symptomatic group, two subjects had low levels of P. carinii, but did not develop PCP. We have demonstrated P. carinii colonization in HIV-seropositive homosexuals in association with a low peripheral CD4 count. The polymerase chain reaction may be a useful technique for determining the need and efficacy of anti-pneumocystis chemoprophylaxis.
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PMID:DNA amplification by the polymerase chain reaction to detect sub-clinical Pneumocystis carinii colonization in HIV-positive and HIV-negative male homosexuals with and without respiratory symptoms. 826 40

The authors conducted complete histories, physical examinations, blood counts, chest radiograms, sputum examinations for bacterial and fungal pathogens, and bronchoscopy with bronchoalveolar lavage and transbronchial biopsy on 35 HIV-seropositive individuals with respiratory complaints in a study to determine how often and by what means an identifiable pulmonary pathogen can be recognized in HIV-infected patients with respiratory disorders in Brazil, which are the most frequently observed microorganisms, and what impact specific therapy has on the agents. One or more microorganisms were found in 24 subjects, while another three individuals showed nonspecific interstitial pneumonitis. Tuberculosis (TB) found in 41% of cases, P. carinii in 55%, and cytomegalovirus pneumonitis in 8% were the most common respiratory opportunistic diseases among the study subjects. Histologic evaluation was essential to identify the pulmonary pathogens, with clinical, laboratory, and radiographic findings failing to distinguish the specific pathogens. 23 individuals with P. carinii pneumonitis and/or TB received specific therapy; among the patients who could be evaluated, the therapeutic response rates were 79% for PCP and 100% for TB. TB in these individuals displayed clinical and radiographic findings atypical for reactivation disease. The authors note that most of the features observed in HIV-infected patients had been previously described in infection of the normal host.
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PMID:Respiratory complications in Brazilian patients infected with human immunodeficiency virus. 828 97


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