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)

A 38-year-old man, HIV-positive for 6 years, developed fever and cough with deterioration in his general state. Chest radiography demonstrated an infiltration in the left upper lobe and computed tomography showed a septated cavity. Three bronchioalveolar lavages over 4 weeks recovered Klebsiella, Candida, Pseudomonas and Staphylococcus in the lavage fluid. Acid-fast rods were not found in any of the microscopic preparations. His clinical condition and the radiological findings deteriorated despite appropriate antibiotic administration. A further cavity occurred in the right upper lobe and the inflammatory infiltrations extended further. Although no acid-fast organism had been demonstrated, tuberculostatic treatment was begun (daily 300 mg isoniazid, 600 mg rifampicin, 900 mg streptomycin, 2 g pyrazinamide). His general condition and the radiological findings rapidly improved. Four weeks after culturing the lavage fluid atypical Mycobacterium xenopi was isolated. This case illustrates the difficulty of diagnosing an atypical mycobacterial infection. It takes time and effort, but it is of great importance because up to 50% of patients with AIDS contract such infection. Early and appropriate treatment will significantly improve quality of life and life expectancy.
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PMID:[Pneumonia due to a rare atypical Mycobacterium in AIDS]. 822 23

A retrospective study was carried out to evaluate the incidence, etiology and role of non-opportunistic bacterial infections in a series of 788 consecutive HIV-infected patients hospitalized during the last 7 years; 71.9% of patients were i.v. drug addicts, 15.6% homo-bisexual men, 7.4% heterosexuals, 2.7% haemophiliacs and 2.4% children with vertically-acquired infection. According to the CDC classification of HIV infection, 71 patients were classified as CDC I-II, 148 as CDC III, and 569 (72.2%) as CDC IV. Diagnosis of bacterial infection was based on signs and symptoms, in association with the isolation of microorganisms consistent with the clinical picture. Two hundred and nineteen patients out of 788 (27.8%) (4 in CDC group I-II, 34 in CDC III and 181 in CDC IV), presented one or more episodes of non-opportunistic bacterial infection. The morbidity of these infections showed a significant correlation with the progression of HIV disease (CDC III vs. CDC I-II [p < 0.003] and CDC IV vs. CDC III [p < 0.05]), but no significant relation was found with age, sex or type of risk for HIV infection. The most frequent clinical picture was sepsis/bacteraemia (33.3%), followed by respiratory tract (23.8%), and genitourinary tract (20.8%) infections. A total of 399 bacterial pathogens were isolated in 303 different episodes of infection: 211 (52.9%) were gram-positive and 188 gram-negative, with Staphylococcus aureus (69 isolations), Staphylococcus epidermidis (50), and Pseudomonas spp. (48) as the major pathogens. Sepsis/bacteraemia was the most frequent clinical picture associated with growth of gram-positive pathogens, while detection of gram-negative bacteria appeared more significantly related with genitourinary or respiratory tract localizations. Bacterial infections in hospitalized HIV-infected patients, even though rarely life-threatening, need particular attention because of the high incidence and recurrence rate, the wide aetiological and clinical spectrum, the frequent microbial associations and the strict relationship with the progression of HIV disease.
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PMID:Sepsis-bacteraemia and other infections due to non-opportunistic bacterial pathogens in a consecutive series of 788 patients hospitalized for HIV infection. 825 61

A large-scale immunoaffinity (IA) purification process was developed for the isolation of recombinant soluble antigen CD4 (sCD4) from Escherichia coli fermentations. The monoclonal antibody used for IA purification of sCD4 recognized a conformation-dependent epitope on the surface of domain 1 of CD4. IA chromatography was used to purify both sCD4-183, consisting of the N-terminal 183 amino acids of human CD4, and sCD4-PE40, a fusion protein consisting of the N-terminal 178 amino acids of CD4 and amino acids 1-3 and 253-613 of Pseudomonas exotoxin A (PE40). sCD4-183 was purified from E. coli cell pellets using cell disruption, protein solubilization, oxidation, Q-Sepharose anion-exchange and IA chromatography steps. sCD4-PE40 was purified from cell pellets using cell disruption, protein solubilization, oxidation, Cu(2+)-immobilized metal-affinity chromatography, anion-exchange and IA chromatography steps. The IA-purified sCD4 analogues demonstrated the correct apparent molecular masses on SDS/PAGE. The immobilized monoclonal antibody appeared to select for correctly folded CD4 protein, since sCD4-183 and sCD4-PE40 purified by the IA method bound human-immunodeficiency-virus glycoprotein gp120 (HIV gp120) in vitro. sCD4-PE40 purified by IA chromatography also inhibited protein synthesis in CV-1 cells expressing HIV gp120/160 at the cell surface. Relatively high recoveries of sCD4-183 and sCD4-PE40 were observed in the IA step of the purification process (71 and 79% recovery respectively). The results demonstrate that immobilized monoclonal antibodies directed against conformational epitopes may be used for rapid purification of gram amounts of correctly folded protein from mixtures of oxidized E. coli proteins.
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PMID:Large-scale immunoaffinity purification of recombinant soluble human antigen CD4 from Escherichia coli cells. 829 11

CD4-PE40, a recombinant protein consisting of a portion of human CD4 linked to Pseudomonas aeruginosa exotoxin, was studied in vitro to assess its ability to inhibit the replication of primary isolates of HIV. CD4-PE40 was added to cultures of phytohemagglutin (PHA)-stimulated normal peripheral blood mononuclear cells (PBMCs) infected either with the laboratory strain HIVIIIb or single-passage virus stocks derived from patient PBMCs. Results showed that the replication of HIVIIIb was inhibited by a single pulse of CD4-PE40 and, more significantly, by continuous exposure to the drug. The replication of primary virus isolates, however, was inhibited only by continuous exposure to CD4-PE40. Cultures of freshly isolated PBMCs from HIV-seropositive individuals that were directly treated with CD4-PE40 before culture also required the continuous presence of drug to demonstrate inhibition of HIV replication. These results suggest that continuous administration of CD4-PE40 may be required to produce a significant anti-HIV effect in vivo.
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PMID:Continuous presence of CD4-PE40 is required for antiviral activity against single-passage HIV isolates and infected peripheral blood mononuclear cells. 831 52

Community-acquired sinusitis due to Pseudomonas aeruginosa developed in four patients with advanced human immunodeficiency virus (HIV) infection who had no local predisposing factors or neutropenia. Two persons were bacteremic. Combination antibiotic therapy and surgical drainage were necessary for adequate treatment. Ciprofloxacin-resistant strains were isolated possibly because of the chronic use of the drug as part of a treatment regimen for disseminated infection with Mycobacterium avium complex. Physicians treating patients with HIV infection must have an increased index of suspicion for P. aeruginosa as a causative agent of sinusitis.
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PMID:Sinusitis due to Pseudomonas aeruginosa in patients with human immunodeficiency virus infection. 845 52

Despite the ability of soluble forms of CD4 (sCD4) and related CD4 derivatives to neutralize human immunodeficiency type 1 (HIV-1) infectivity in vitro, these agents have shown little evidence of efficacy in clinical trials with infected individuals. These disappointing findings may be related to recent observations that much higher concentrations of sCD4 are required for in vitro neutralization of primary HIV-1 isolates compared to laboratory-adapted strains. An alternative CD4-based therapeutic strategy exploits CD4 as a targeting agent to direct cytotoxic molecules to selectively kill HIV-infected cells. In this report we demonstrate that CD4-Pseudomonas exotoxin inhibits spreading infection by primary HIV-1 isolates known to be highly refractory to neutralization by soluble CD4; the observed potency is at least as great as for a prototypic sCD4-sensitive, laboratory-adapted HIV-1 strain. Thus, the in vitro efficacy of a CD4-based agent, which acts by targeted killing of infected cells, appears not to be compromised by features which render primary HIV-1 isolates refractory to neutralization by sCD4 derivatives. These results have important conceptual and practical implications for CD4-based therapeutic strategies.
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PMID:Primary HIV-1 isolates refractory to neutralization by soluble CD4 are potently inhibited by CD4-Pseudomonas exotoxin. 851 27

There is an increasing population of immunocompromised patients with HIV, IV drug abuse, organ transplantation, and long-term steroid treatment developing spinal infections. Delayed diagnosis because of blunted host immune response and lack of outward signs and symptoms places the treating physician at a disadvantage in the treatment of this type of disease, which presents at a later stage of development. Immunocompromised patients are infected by a different group of pathogens than their healthier cohorts (e.g., Pseudomonas, gram-negative bacteria and fungal infections) because their host defenses are diminished. Osteomyelitis with or with out pyomyositis and epidural abscess may occur. The overriding symptom is back pain. Radiculopathy, myelopathy, and sensory loss may accompany local pain and tenderness. Plain film radiography, CT scan, MR image, and bone scan is invaluable in the diagnosis of these infections. The cornerstone of treatment is identification of the responsible pathogen, appropriate medical therapy, immobilization of the affected segment of the spine, and physical therapy to combat physical deconditioning. Psoas abscesses may require surgical debridement if they cannot be adequately drained by CT-guided percutaneous catheterization. Epidural abscesses with neurologic compromise require surgical drainage. Impingement of the spinal cord or cauda equina by collapsed osteomyelitic vertebral bodies requires surgical debridement by anterior vertebrectomy, with an autologous tricortical iliac crest strut and immobilization of the spine using external bracing or posterior instrumentation as dictated by the disease.
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PMID:Spinal infections in the immunocompromised host. 853 51

Patients with HIV infection are at increased risk for community-acquired bacterial pneumonias, due in part to their defects in B-cell function. Streptococcus pneumoniae is the commonest cause of community-acquired pneumonia, with the second most common bacterial agent being Haemophilus influenzae. These two organisms account for about two-thirds of community-acquired bacterial pneumonias. Frequently bacterial pneumonias appear difficult to distinguish from Pneumocystis carinii pneumonia or other opportunistic lung infections, because of their atypical clinical and radiologic presentations. Community-acquired pneumonias may be recurrent but have low fatality rates. In comparison, nosocomial pneumonias occur primarily in patients with AIDS and are usually due to Staphylococcus aureus, Pseudomonas aeruginosa and other aerobic gram-negative bacilli. Nosocomial pneumonias have high fatality rates. S.aureus is an important cause of morbidity and mortality in patients with AIDS and has emerged as a secondary opportunist in lungs of patients with opportunistic diseases. While appropriate laboratory study is being done, empiric antibiotic therapy should be directed against the microorganisms above described.
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PMID:Bacterial pneumonia in adult patients with HIV infection. 856 41

We here replaced the cell-binding domain in Pseudomonas exotoxin A (PE) with HIV-binding portion of CD4V1V2 molecule and constructed a chimeric gene CD4V1V2-PE40, which can be expressed in E. coli. The hybrid protein displays targeting toxicity toward cells infected by HIV and thus represents a promising novel therapeutic agent for the treatment of AIDS.
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PMID:[Construction and expression of the gene CD4V1V2-PE40, coding for a molecular targeted protein against AIDS]. 857 44

This report describes the epidemiology of Penicillium marneffei infections among HIV infected children who were seen at Chiang Mai University Hospital, Thailand, between April 1989 and January 1995. HIV infections among children 18 months old and older were determined by both enzyme-linked immunosorbent assay and particle agglutination tests. Confirmation of HIV infection was made among younger children by signs and symptoms and repeated reactive serum tests. Diagnosis of P. marneffei infection was determined by isolation of the organism from clinical blood or tissue specimens. Antifungal agents were administered and improvement was recorded. There were 23 cases of P. marneffei among the 362 children diagnosed with HIV infection during the study period. One case was a non-HIV infected girl and another was a thalassemic patient who had received an HIV infected blood transfusion. The remaining 21 children acquired the infection perinatally. All mothers of the 21 children had acquired the HIV infection as prostitutes or from husbands who used prostitutes. All 21 children had clinical cases of HIV infection at the onset of the P. marneffei infection. The median time of presentation was 32 months. Fever was a primary symptom. 67% had skin lesions and most lesions were on the face and extremities. Other laboratory findings are reported. 9 of the 21 children had other HIV-related opportunistic infections diagnosed at the same time as the diagnosis of P. marneffei. There were 4 cases of Salmonella bacteremia, 2 cases of cryptosporidiosis, 1 case of Pseudomonas aeruginosa bacteremia, 1 case of Pneumocystis carinii and cytomegalovirus pneumonia, and 1 case of nontyphoid Salmonella bacteremia and herpes zoster. All 7 culture-proved patients who did not receive antifungal therapy died. 9 culture-proved and 3 other cases responded to antifungal treatment. Findings suggest that P. marneffei infection should be included as another AIDS-defining illness. The case fatality rate of patients with P. marneffei infection was very high, mostly due to late diagnosis.
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PMID:Disseminated Penicillium marneffei infection in human immunodeficiency virus-infected children. 858 58


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