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

Over one million children world-wide are living with HIV infection and respiratory disease is the commonest cause of morbidity and mortality in these children. The initial presentation of respiratory infection is usually in infancy or early childhood. There is enormous potential to prevent childhood HIV infection that is being realised in industrialised countries but not yet elsewhere. Increasingly, therefore, the burden of HIV disease is in children living in or from non-industrialised countries. This review describes and contrasts the pattern of respiratory infection from both regions. This pattern has changed with the implementation of PCP prophylaxis and the availability of potent antiretroviral therapy for children in resource-rich countries, such as the UK. More data are required from resource-poor regions such as tropical Africa, but it is clear that the major differences reflect greater background risk for respiratory infection and very limited management options rather than specific aetiology.
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PMID:HIV disease and respiratory infection in children. 1199 3

This paper investigates the current application of health economic principles to HIV and AIDS therapy and compares prophylaxis in 2 opportunistic infections (Pneumocystic carinii pneumonia or PCP and cytomegalovirus or CMV) as well as therapies for early and advanced HIV. The economic impact of the disease and overall cost of the disease on society (in 1993 Hellinger estimated that the lifetime direct medical costs for persons with HIV was $119,000); most Western government controls on health care expenditure; and recognition of the intangible benefits from therapy such as quality of life have influenced the application of economic principles to health care and AIDS. When measuring economic costs and benefits there are 2 treatments, the alternative regimen and the therapy under investigation. Economic data is collected to compare the impact on health status, increased survival and/or quality of life, as well as effects on productivity or work time lost. The majority of studies with economic data have investigated a single therapy against placebo without any estimation of the influence that this has had on the patient's life. Similarly, very little information exists about whether one therapy has benefits such as quality of life over another. The PCP prophylaxis literature has quite a few studies that compare one active therapy to another rather than to a placebo. Regarding therapies that combat CMV infection, there is a need for studies that actually compare active therapy with active therapy and can incorporate the indirect benefits. For useful decision making either the intangible benefits must be measured and reported separately in the Cost Effectiveness Analysis or, optimally, a Cost Utility Analysis should be performed yielding the Quality Adjusted Life Year.
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PMID:Why isn't increased survival enough? 1231 24

Patients with HIV frequently present at some time in their illness with community-acquired pneumonia (CAP). Early in the prognosis of HIV when CD4 counts are somewhat decreased, HIV patients with CAP are infected with the same pulmonary pathogen as normal hosts plus Legionella, Salmonella or Chlamydia pneumoniae. Later in HIV, when the CD4 counts are markedly reduced, Pneumocystis carinii (PCP), CMV and acid-fast organisms (TB or MAI) are important pulmonary pathogens. This article presents a clinical approach to empiric antibiotics based on chest x-ray appearance and CD4 count. This permits a rational therapeutic approach to avoid excessive coverage commonly employed by clinicians because of the multiplicity of potential pulmonary pathogens in HIV patients with CAP.
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PMID:Community-acquired pneumonia in patients with HIV. 1498 50

Specific interventions to prevent mother-to-child transmission (MTCT) include antiretroviral therapy, elective caesarean section and avoidance of breastfeeding. Rates of MTCT below 1-2% are now achievable in developed country settings. However, although the vast majority of infants born to HIV infected mothers are protected from acquisition of infection, most are exposed to antiretroviral drugs for which there is only limited information on toxicity. Increasing use of complex and potent combinations of antiretroviral drugs in pregnancy, particularly during the period of organogenesis, has raised many questions relating to pregnancy outcome and safety issues for the exposed children, both in the short and longer term. A shorter duration of pregnancy has been reported to be associated with taking protease inhibitors in pregnancy, particularly prolonged and early use, but this has been an inconsistent finding. Risk of congenital abnormalities may be increased with exposure to specific antiretroviral drugs, such as efavirenz, and certain combinations of Pneumonia Pneumocystis Carinii (PCP) prophylaxis and antiretroviral drugs, but there is no evidence of an excess of congenital malformations associated with exposure to zidovudine prophylaxis. Although data from observational studies and follow-up of children enrolled in clinical trials have not shown uninfected, zidovudine-exposed children to be at increased risk of adverse events including cancer in the short- to medium-term, the possibility that they may be at risk of cancer at older ages cannot be excluded. Concerns regarding mitochondrial dysfunction in children with foetal/neonatal exposure to zidovudine have arisen following a report from France of eight uninfected children with mitochondrial dysfunction, of whom two died. However, there is limited additional evidence of clinically evident mitochondrial disease in children exposed to antiretroviral therapy in utero or neonatally, and the absence of any excess mortality in large observational cohort studies of children born to HIV infected women and exposed to antiretroviral drugs is reassuring.
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PMID:Antenatal and neonatal antiretroviral therapy in HIV-infected women and their infants: a review of safety issues. 1501 May 53

Introduction of new antiretroviral agents and development of new prophylaxis schedules against opportunistic microorganisms have allowed increase in survival as well as better quality of life in HIV-infected patients. These new treatment schedules have changed the epidemiology of opportunistic infections that previous to use of highly active antiretroviral therapy (HAART), formerly occurred with high frequency in HIV-infected children. Specifically, pneumonia due to Pneumocystis carinii formerly occurred in 12 to 80% of these patients and was associated with high mortality. Currently, with use of combined antiretroviral therapy (ART) and prophylactic treatments important reduction of PCP has been observed. However, despite these benefits ART is not yet available for many patients from several developing countries who are at risk for opportunistic infections, mainly due to Pneumocystis carinii, which can affect life expectancy. Therefore, the purpose of this paper was a review of epidemiologic, clinical, and therapeutic characteristics of P. carinii pneumonia in HIV-infected children.
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PMID:[Pneumonia due to Pneumocystis carinii in HIV-infected children]. 1502 88

The third in a series reviewing the HIV/AIDS antiretroviral drugs, this report summarizes the interactions between antiretrovirals and common drugs of abuse. In an overview format for primary care physicians and psychiatrists, the metabolism and drug interactions in the context of antiretroviral therapy are presented for the following drugs of abuse: alcohol, benzodiazepines, cocaine, GHB (liquid X), ketamine (special K), LSD (acid), MDMA (Ecstasy), opiates, PCP (angel dust), and THC (marijuana).
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PMID:Med-psych drug-drug interactions update. Antiretrovirals, part III: antiretrovirals and drugs of abuse. 1576 27

To determine the correlation between the immunoreaction against the core structure of human immunodeficiency virus type (HIV-1) transmembrane protein gp41 epitopes and the disease progression, it is essential to evaluate the anti-core structure antibody epitopes and the humoral immunity against the epitopes. For this purpose we evaluated monoclonal antibodies (mAbs) against the gp41 core structure such as mAbs 50.69, 98.6 and T26, by Western blotting (WB) and flow cytometry. WB showed mAbs 50.69 and 98.6 bound to both monomeric and oligomeric gp41, and mAb T26 exclusively bound to oligomeric gp41. We evaluated the sera from Pneumocystis pneumonia patients (PCP; n=7) and long-term survivors (LTS; n=7). Competition assay with sera and mAbs for binding to H9 cells infected with HIV-1 IIIB virus was done using flow cytometry. The results revealed that PCP sera as well as LTS sera inhibited the binding of all the three mAbs, and the PCP sera inhibited mAb T26 binding more efficiently than LTS. Therefore, PCP patients retain competing immunity to antibodies against not only the shared epitopes of the core structure (binding sites of mAbs 50.69 and 98.6) but also against oligomeric gp41 specific epitope (binding site of mAb T26).
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PMID:Properties of anti-gp41 core structure antibodies, which compete with sera of HIV-1-infected patients. 1582 13

We retrospectively reviewed 205 HIV-infected patients, who came at first entry from January 2001 to December 2002 to the Hospital Kuala Lumpur, Kuala Lumpur, Malaysia. The aged range was 21-69 years [mean 37.25 years (+/- SD) 8.1]. Subjects were mainly in the age group 35-44 years. The majority of patients were male (82%), Chinese (55.1%), single (55.6%), resided in Kuala Lumpur (55.1%), and were unemployed (57.1%). The most frequent routes of transmission were sexual contact (78.5%), followed by IDUs (30%), blood transfusion (5%), and unknown (0.5%). Oral candidiasis was the most common mucocutaneous disease and significant co-existence was found with the main opportunistic systemic diseases, such as TB, PCP, toxoplasmic encephalitis, penicillosis, and CMV retinitis (p < 0.05). In this study, the range of CD4 counts was 0-910, with a median of 35 cells/mm3. Significant associations between a CD4 level less than 100 cells/mm3 at the time of diagnosis, and the occurrence of major opportunistic diseases, such as candidiasis, TB, PCP, TE, herpes simplex infection, CMV retinitis, penicillosis, and histoplasmosis were found (p < 0.05) in this study.
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PMID:Spectrum of opportunistic infections among HIV-infected patients in Malaysia. 1590 30

Communities most affected by HIV/AIDS have been instrumental in shaping Australia's responses to the threat of the epidemic. There are recent signs that levels of engagement in communities based around HIV-positivity have changed: a diminished sense of an AIDS crisis, the relative success of highly active antiretroviral therapy (HAART), and an increasing individualization of the HIV experience may be contributing to changes in the way HIV-community is experienced. In this paper, we explore levels of engagement in HIV-positive community among a cohort of people living with HIV/AIDS (PLWHA) and seek to explain why some PLWHA engage in an HIV-positive community while others do not. Using multivariate logistic regression, we found that three factors were independently related to feeling part of an HIV-positive community: having been diagnosed with HIV prior to the advent of HAART; having more recently taken Bactrim or Septrin for PCP; and finding it easier to take 'pills' on time. Taken together, these results suggest that both historical effects, such as the introduction of HAART, and effects related to living with HIV, such as the experience of an AIDS-related illness, help explain HIV-positive community engagement among PLWHA.
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PMID:Trends and predictors of HIV-positive community attachment among PLWHA. 1603 45

Polydrug use is an important public health issue since it has been linked to significant adverse health outcomes. Recently, club drugs, including ketamine and other drugs used in dance/rave scenes, have been identified as key substances in new types of polydrug using patterns. While seemingly a self-explanatory concept, "polydrug" use constitutes multiple drug using practices that may impact upon health risks. Ketamine, a club drug commonly administered intranasally among youth for its disassociative properties, has emerged as a drug increasingly prevalent among a new hidden population of injection drug users (IDUs). Using an ethno-epidemiological methodology, we interviewed 40 young (<25 years old) ketamine injectors in New York during 2000-2002 to describe the potential health risks associated with ketamine and polydrug use. Findings indicate that ketamine was typically injected or sniffed in the context of a polydrug using event. Marijuana, alcohol, PCP, and speed were among the most commonly used drugs during recent ketamine using events. Polydrug using events were often quite variable regarding the sequencing of drug use, the drug combinations consumed, the forms of the drug utilized, and the modes of administrating the drug combinations. Future research should be directed towards developing a more comprehensive description of the risks associated with combining ketamine with other drugs, such as drug overdoses, the transmission of bloodborne pathogens, such as HIV and HCV, the short- and long-term effects of drug combinations on cognitive functioning, and other unanticipated consequences associated with polydrug use.
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PMID:Patterns of polydrug use among ketamine injectors in New York City. 1604 23


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