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

Lymphoma is one of the defining manifestations of AIDS. Most of these lymphoproliferations are high-grade B-cell non-Hodgkin's lymphoma. Unlike lymphoproliferations that arise in other settings of immunodeficiency, HIV-related lymphomas have a variable association with Epstein-Barr virus (EBV) and also contain alterations in c-myc and p53. EBV infection appears to precede clonal expansion, and its latent expression pattern (Epstein-Barr nuclear antigen1+/Epstein Barr nuclear antigen 2-/latent membrane protein+) is unique among non-Hodgkin's lymphomas. Both EBV types A and B are present in HIV-related lymphomas. Mutations in c-myc include translocations and point mutations. Other altered loci include ras and bcl-6. Although all of these somatic alterations can be detected in lymphomas arising in the general population, their accumulation in a relatively short period (6 to 8 years) after HIV infection suggests an acceleration of underlying mechanisms.
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PMID:Biologic aspects of AIDS-related lymphoma. 782 54

There is evidence that, in addition to Kaposi's sarcoma, high-grade non-Hodgkin's lymphoma, and invasive cervical carcinoma (the only malignancies diagnostic per se of AIDS), other tumors have been occurring in the HIV setting, often with peculiar clinicopathologic characteristics. Because the survival of patients with HIV infection has improved owing to the better prevention and management of opportunistic infections, it is highly likely that these malignancies will increase in the next few years. The study of these tumors will help us better understand the relationship between the prolonged immunosuppression and the development of tumors.
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PMID:Other cancers in HIV-infected patients. 782 55

A 33 year old patient was admitted to the hospital because of deteriorated general condition, upper abdominal pain and progressive dyspnea. He had a positive HIV-serology associated with i.v. drug abuse. The CDC classification on admission was B1. There was no history of opportunistic infections, the patient had refused all prophylactic treatment. The physical examination showed an elevated central venous pressure, decreased breath-sound and percussible dullness, the liver was enlarged and a tumor was palpable on chest. The x-ray of the thorax confirmed a pleural effusion. Cytology of the effusion revealed blasts of malignant non-Hodgkin's lymphoma of B-cell type. A CT-scan of the thorax and abdomen showed a tumor mass in the right ventricle and superior vena cava, a pleural effusion and multiple lesions in the liver. The patient refused a palliative chemotherapy with vincristine and prednisone and died few days after admission.
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PMID:[Upper influx distension in a patient with HIV; unusual localization of an HIV-associated lymphoma]. 784 32

In HIV-infected patients with AIDS the most frequent malignancies are Kaposi's sarcoma and non-Hodgkin's lymphoma. In these patients, the natural history of these tumors is quite different from those of HIV-negative subjects. These tumors may present atypical clinical aspects, may be very aggressive, and the coexistence of immunosuppression and opportunistic infections may render their treatment more difficult. The aim of this article is to provide updated information on the epidemiology, pathogenesis, natural history, and management of tumors that develop in the oral cavity of patients with AIDS.
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PMID:HIV-related tumors of the oral cavity. 785 81

We identified 40 patients with malignant lymphoproliferative diseases (MLD) and HIV infection (seropositive) at a single Spanish university hospital. Thirty-two patients had non-Hodgkin's lymphoma (NHL), 6 primary central nervous system lymphoma (PCL) and 8 patients Hodgkin's disease (HD). Median age at presentation was 32 years. Four histopathological groups had distinct presenting clinical features: in 93% of the Burkitt-type lymphomas, the lymphoma itself was the AIDS defining criterion, while high and intermediate grade NHL other than Burkitt-like tended to have a more advanced HIV infection, demonstrated by antecedent AIDS criteria in 58% of these patients and a median CD4 positive cell count of 291 mm3; HD occurred in some patients without previous opportunistic infections (7/8 patients) but with median CD4 cells of 105 mm3; PCL occurred in a terminal stage of HIV infection, in patients with a low performance status, and frequent antecedent AIDS criteria. Objective response to chemotherapy could be seen in 62% of NHL patients and 100% of HD. Survival was adversely related to an antecedent diagnosis of AIDS, low performance status, and a primary localization in the central nervous system. Overall median survival was 5 months, but patients without the mentioned three adverse prognostic factors had a median survival of 10 months.
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PMID:Malignant lymphoproliferative diseases in HIV-seropositive patients. A study of 40 cases at a single institution in Spain. 786 39

To identify how the spectrum of head and neck complications of HIV disease has altered over the 7-year period between 1984 and 1991, a prospective collection of data on 429 HIV-positive subjects referred since 1984 was undertaken. Information was grouped into three study periods by date of presentation for analysis of trends. There has been a trend towards increased heterosexual acquisition (P < 0.02) and a decrease over time in the proportion of patients presenting with AIDS, as a proportion of HIV-positive patients (20/31 1983-1984; 90/179 1989-1991: P < 0.001). While the occurrence of mucosal candidiasis (P < 0.0001) and Kaposi's sarcoma (P < 0.05) has decreased that of rhinosinusitis (P < 0.0001) and non-Hodgkin's lymphoma (P < 0.05) has increased. Cervical lymphadenopathy has shown a significant decline (P < 0.05), but other conditions have been relatively constant. Otolaryngologists should be aware of current emphasis in the head and neck manifestations of HIV infection, which have important implications for diagnosis and management.
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PMID:Changing patterns of HIV infection in otolaryngology. 789 76

Two cases of invasive oropharyngeal and craniofacial infection caused by fungal and actinomycotic pathogens are described in HIV-infected patients. Two women with a previous diagnosis of AIDS, one with non-Hodgkin's lymphoma and one with Candida oesophagitis, developed a subacute, invasive inflammatory process characterized by ulcerative necrotizing lesions spreading from the oropharynx up to the soft and hard palate, maxillary sinuses and nasal cavity, with extensive soft-tissue necrosis. Although presenting with a very similar clinical picture, infection was due to Actinomyces spp. in the first case, while an apparent dual fungal aetiology (Aspergillus flavus and Candida spp.) was demonstrated in the second patient. Both cases were characterized by remarkable diagnostic difficulties leading to a late final recognition (confirmed by histological examination), and by a partial response to antimicrobial treatment.
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PMID:Invasive mycotic and actinomycotic oropharyngeal and craniofacial infection in two patients with AIDS. 789 19

The goals of this study were to compare the prevalence of oral lesions in women infected with human immunodeficiency virus (HIV) and HIV-negative women, and to determine the association of oral lesions with route of HIV transmission and with level of immunosuppression in infected women. As part of a prospective 4-year study, oral examinations and blood tests were performed, at 6-month intervals, on 176 HIV-infected women and on 117 HIV-negative women at risk for HIV infection. We evaluated participants for the following oral conditions: hairy leukoplakia, candidiasis, ulcers, warts, non-Hodgkin's lymphoma, Kaposi's sarcoma, and parotid enlargement. As previously reported in men, the prevalence of oral lesions was significantly higher among HIV-infected (22%) than HIV-negative women (3%) [odds ratio (OR) = 8.2; 95% confidence interval (CI) 2.8, 23.5], particularly candidiasis (14%) and hairy leukoplakia (10%). Among HIV-infected women with CD4 cell count nadir > or = 200 cells/microliters, the prevalence of hairy leukoplakia was higher among those infected heterosexually than among injection drug users (OR = 5.5; 95% CI: 1.5; 19). The OR for the association between oral lesions and CD4 cell count nadir (< 200 vs. > 500 cells/microliters) was 8.9 (95% CI: 2.6, 30), indicating a strong positive association with level of immunosuppression.
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PMID:HIV-related oral manifestations in two cohorts of women in San Francisco. 791 33

With the aim of comparing the clinical features of Burkitt's like lymphoma (BL) in HIV-infected patients and in the general population, we retrospectively analyzed 35 patients with HIV-positive non-Hodgkin's lymphoma (NHL) and 535 patients with HIV-negative NHL, from 1985 to 1990. A total of 33 patients with BL were diagnosed at our institute: 18 without and 15 with HIV infection; 3.3% and 43% of all HIV-seronegative and HIV-seropositive NHL respectively. No significant differences were found between these two series concerning clinical features, with the exception of peripheral adenopathy that was more common in the HIV infected patients (p = 0.05). In both groups BL was characterized by advanced stage and high incidence of bone marrow and gastrointestinal involvement. Response rate was lower in the HIV-positive patients, but the difference was not significant. No relevant differences in the toxicity after chemotherapy were observed. The median survival in the HIV-infected patients was lower (7 months) than in the other group (14 months), with borderline statistical significance (p = 0.06).
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PMID:Burkitt's like lymphoma in patients with and without HIV infection. A report of 33 patients from north-east Italy. 791 63

Kaposi's sarcoma, non-Hodgkin's lymphoma, and cervical carcinoma are the malignancies most clearly associated with HIV infection. Other malignancies with no established association with immunodeficiency, in particular, lung cancer and germ-cell malignancies, also occur in persons with HIV infection, and there is clear overlap in the demographic characteristics of patients with these tumors and HIV-infected individuals. Compared with lung cancer in the general population, lung cancer in HIV-infected patients presents at a younger age, with more advanced disease, and more commonly with adenocarcinoma. No correlations between degree of immunodeficiency and stage of lung cancer at presentation or duration of survival have been established. Patients with and without HIV infection who develop germ-cell malignancies are similar in presentation and tumor histology. Treatment for germ-cell malignancies is well-tolerated and appropriate for HIV-infected patients.
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PMID:Cancers not associated with immunodeficiency in HIV infected persons. 791 42


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