Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019829 (Hodgkin's disease)
 30,247 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The clinical manifestations of chronic infection with the Human Immunodeficiency Virus (HIV) fall into two broad categories: opportunistic infections and opportunistic malignancies. The initial observation of both occurring in outbreak fashion among young homosexual men led to the early identification of the present pandemic. Conversely, the identification of additional malignancies which occur in excess frequency in the presence of the immunodeficiency of HIV infection can provide insight into the role of viruses in human malignancy. The first report related to the acquired immunodeficiency syndrome (AIDS) epidemic was of a series of 5 cases of Pneumocystic carinii in young homosexual men in Los Angeles and was published in June 1981. This was shortly followed by the report of additional cases of P. carinii as well as Kaposi's sarcoma (KS) occurring among young homosexual men in California and New York City. The increased risk of KS among people with HIV infection has been confirmed since these initial reports, with 1 in 5 AIDS patients in the United States developing KS sometime in their course of disease. However, the proportion of AIDS patients with KS has decreased from 35% before 1983 to 15% in the first half of 1987. Among the recognized risk groups of AIDS patients, the proportion with KS is highest among homosexual men and female intravenous drug abusers, and lowest among children and hemophiliacs. This variation suggests that risk of KS in AIDS parallels that of sexually-transmitted infections. A second family of opportunistic malignancy in AIDS is comprised of the non-Hodgkin's disease lymphomas (NHL). These lymphomas are typically of B-cell origin, immunoblastic or Burkitt's-like in character, and frequently present with extra-nodal involvement such as the central nervous system. These were first recognized somewhat later than KS as being associated with AIDS; together, KS and NHL account for about 95% of all neoplasms seen in AIDS patients. Additional malignancies are currently suspected to occur excessively with HIV infection. These include Hodgkin's disease, anorectal carcinoma, and testicular cancer. Validation of these associations will require extensive epidemiologic surveillance. Since HIV infection leads to progressive loss of cellular immunity, it is probable that these malignancies result from the progressive reactivation or loss of immunologic control of latent oncogenic viruses. The cytomegalovirus has been implicated in the pathogenesis of KS, perhaps with reinfection, and the Epstein-Barr virus in the NHL. The role of papilloma viruses in anorectal carcinoma has also been proposed.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Opportunistic malignancies and the acquired immunodeficiency syndrome. 350 39

Infection with the human immunodeficiency virus (HIV) leads to selective depletion of the helper/inducer lymphocyte subset and a subsequent state of acquired cellular immunodeficiency. Simultaneously, evidence of B-cell hyper-activity may exist. A subset of patients infected with HIV demonstrates a syndrome of persistent generalized lymphadenopathy (PGL). Lymph node biopsies reveal benign reactive changes with a pattern of florid follicular hyperplasia. A polyclonal hypergammaglobulinemia reflects humoral immune dysfunction. Patients with PGL are similar to those with full-blown AIDS with regards to demographics, immune and virologic studies. Our prospective natural history study of PGL patients initiated in November 1981 reveals a 15% rate of evolution to AIDS in the 200 patient cohort. Factors associated with increased risk of transformation to AIDS include severity of constitutional symptoms, shrinking adenopathy, oral candidiasis or viral hairy leukoplakia, peripheral cytopenias, elevated erythrocyte sedimentation rate or an antecedent episode of herpes zoster. Therapeutic interventions to prevent evolution to AIDS in high risk subsets of lymphadenopathy patients have been investigated. In addition to benign B-cell proliferation associated with HIV infection, malignant lymphomas have also been diagnosed in 29 patients in AIDS risk groups in our clinic population. All patients were male; 26 homosexuals, 2 IV drug abusers and 1 multiply transfused sickle cell anemia patient. Seven patients had antecedent PGL. Non-Hodgkin's lymphoma was diagnosed in 19 patients. Histologies were predominantly diffuse undifferentiated or large cell. Eleven patients were Stage IV at diagnosis. Of 10 patients with mixed cellularity Hodgkin's disease, 7 were Stage IV-B at presentation. Extranodal disease was frequent in patients with lymphomas. Fourteen patients lacked peripheral lymphadenopathy. Response to chemotherapy was good, but complicated by prolonged marrow suppression and development of AIDS-related opportunistic infections. Median survival was 7 months. Laboratory studies investigating the possible role of lymphotropic retroviruses in the development of AIDS-related lymphomas revealed that serum from all patients with high grade non-Hodgkin's lymphoma contained antibodies to HIV and that the majority also expressed antibodies to HTLV-I. This degree of seroreactivity to HTLV-I and HIV was characteristic only of lymphoma patients as sera from only 10 - 15% of AIDS and ARC patients in San Francisco had similar findings.
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PMID:AIDS-related benign lymphadenopathy and malignant lymphoma: clinical aspects and virologic interactions. 382 9

We describe the case of a young man of Calabrian origin, who came to our observation for the appearance of erythematous pustular, intensely itching, lesions on the arms, trunk and, in a less extent, on the face. The blood count revealed a differential cell count of 16.8% eosinophils. Serum IgE levels were elevated (1000 IU/ml), and T cell subsets showed an increase in CD8+ and a decrease in CD4+ with an inversion of CD4+/CD8+ ratio (= 0.78). The result of the following investigations were either normal or negative: anti-(ds)DNA antibody, anti-nuclear antibody, anti-smooth muscle antibody, anti-striated muscle antibody, serological tests for viral, bacterial, fungal and parasitic diseases and cultural examination of the material from lesion. Histopathological examination of a biopsy specimen from the left arm showed the presence of abundant perivascular inflammatory infiltrate in the dermis and inflammatory infiltrate, with numerous eosinophils, around sebaceous glands. Taken together, all these data suggest the diagnosis of eosinophilic pustular folliculitis, a dermatosis of unknown etiology, with a histopathological picture identical to Ofuji's disease. Eosinophilic pustular folliculitis can be associated with HIV infection or haematological diseases (as non-Hodgkin lymphomas, myeloma, etc.); it was also reported in adult immunocompetent healthy individuals and in children. On the basis of our findings, we propose that this case should be classified as an idiopathic form, as we were not able to demonstrate any associated disease.
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PMID:[Eosinophilic pustular folliculitis and Ofuji disease. A case report]. 750 2

A total of 186 specimens of Hodgkin's disease of various histologic types (127 nodular sclerosis, 39 mixed cellularity, 14 lymphocyte predominance, 3 lymphocyte depleted, and 3 unclassified) were evaluated for the presence of latent membrane protein (LMP) and Epstein-Barr virus nuclear antigen-2, two Epstein-Barr virus encoded gene products that appear to play important roles in cell transformation and oncogenesis. Immunoreactivity for LMP was observed in Reed-Sternberg cells and variants of 27/39 (69%) cases of mixed cellularity type, 18/127 (14%) of nodular sclerosis type, 2/3 cases of lymphocyte depleted type, and 1/3 cases of unclassified type. All cases of lymphocyte predominance Hodgkin's disease were nonreactive for LMP. In cases that were reactive for LMP, staining was restricted to Reed-Sternberg cells and variants. Other cells within the proliferation, e.g., lymphocytes, histiocytes, eosinophils, fibroblasts, etc., were nonreactive. The pattern of immunoreactivity for LMP was characterized by strong diffuse cytoplasmic staining, occasionally with membrane accentuation and/or paranuclear staining. Reactivity for LMP was demonstrated in cryostat sections and was also well preserved in paraffin sections of B5- or formalin-fixed tissues. Five of six specimens of Hodgkin's disease (4 mixed cellularity and 2 nodular sclerosis type) that occurred in HIV-positive patients exhibited immunoreactivity for LMP in Reed-Sternberg cells and variants. Cryostat section studies for Epstein-Barr virus nuclear antigen-2 using monoclonal antibody PE-2 failed to reveal staining for 43 cases (26 nodular sclerosis, 12 mixed cellularity, and 5 lymphocyte predominance) after a 2-h incubation with primary antibody.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Immunohistochemical detection of Epstein-Barr virus-encoded latent membrane protein in Reed-Sternberg cells and variants of Hodgkin's disease. 752 May 86

The oropharynx is the site of primary infection and further propagation of the Epstein-Barr virus (EBV). From here, virus is shed to saliva and infects peripheral blood lymphocytes. Eight oral Non-Hodgkin lymphomas (NHL) were investigated for the presence of EBV both by immunohistochemistry for the latent membrane protein (LMP) and a PCR-strategy for general and subtype-specific viral sequences. All but one NHL turned out to be negative both by LMP and PCR. EBV general sequences and of the two viral subtypes A and B were found in an HIV-1+ patient. It is concluded that it is not the localisation which predetermines NHLs to EBV-positivity but merely the underlying disease (this study) or the type of tumour (previous studies).
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PMID:[Oral non-Hodgkin lymphomas and Epstein-Barr virus]. 753 5

Incidence of HD varies from about 0.5 per 100,000 person-years in parts of Asia to over 3 in parts of North America. In recent decades, many registries have reported slightly declining age adjusted incidence among men and women. Some lymphomas previously diagnosed as HD now would be classified as NHL, but this shift does not explain all of the decline. When analysed by age group, incidence has decreased substantially at older ages, whereas increases have been reported among young adults in some industrial countries. Less developed countries continue to show high rates in childhood. Hodgkin's disease of the nodular sclerosis subtype has increased over time, whereas HD of mixed cellularity has declined. Improved therapy for HD has led to sharply declining mortality rates, but further understanding of the role of EBV and other possible causal agents should afford opportunities for prevention. Non-Hodgkin's lymphoma stands out from most other malignancies because incidence and mortality rates have risen dramatically, steadily and almost universally during the past few decades. Incidence overall has been rising 3-4% per year. No sudden rise has occurred in specific birth cohorts or calendar year of diagnosis, although incidence rates have increased more steeply at older ages. Diagnosis of NHL has improved with time, perhaps beyond the ways considered herein, but has it improved so much more than diagnosis of other malignancies, and roughly simultaneously around the world? Although it appears that diagnostic improvements are partly responsible for the upward trend, it is likely that aetiological factors are playing an important part. Infections with HIV have started to inflate NHL incidence rates further but cannot account for the striking trend already under way for several decades. Clues should be vigorously pursued to determine the role of other known viruses, immunosuppressive states, herbicides and other chemicals in the environment, and commercial products such as hair dyes. To clarify reasons for the upward trends and to take preventive action will require a better understanding of the origins of the lymphomas through epidemiological research, including interdisciplinary approaches that can identify new viruses, host-environmental interactions and lifestyle and other exposures that alter susceptibility.
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PMID:Hodgkin's and non-Hodgkin's lymphomas. 753 35

Clinical and pathological characteristics as well as outcome of 45 Hodgkin's disease (HD) cases collected by the French registry of HIV-associated tumors between January 1987 and December 1989 (all clinically staged according to the Ann Arbor system) were analyzed and compared with those of a cohort of 407 patients with clinical stages (CS) IA to IVB enrolled between September 1981 and August 1988 in a multicentric clinical trial. The route of HIV infection, initial CD4 cell count at the time of HD diagnosis and CDC class of HIV infection were studied as well as the progression to AIDS onset were recorded. HIV-HD is characterized by a predominance of advanced CS (75%), B symptoms (80%) and mixed cellularity histology (49%), as well as by early bone marrow involvement (24%); a specific feature is the rare occurrence of mediastinal involvement (13% in HIV-HD versus 71% in primary HD). With standard therapies, 79% of the patients achieved a complete remission, but hematological and infectious complications were very frequent. The proportion of intravenous drug abusers (IVDA) in HIV-HD (38%) is higher than in French HIV-infected population as a whole (20.8%). Median CD4 cell count was 306/microliters at the time of HD diagnosis, while only 5 cases (11%) were preceded by an AIDS manifestation; progression to AIDS rate was 94% at 2 years. Overall 2-year survival was 41%, with 71% for patients with an initial CD4 cell count over 300/microliters and 0% for those with CD4 cell count lower than 300/microliters (p < 0.01); opportunistic infections were the most frequent cause of death. HIV-HD seems to occur preferentially in.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Human immunodeficiency virus associated Hodgkin's disease: report of 45 cases from the French Registry of HIV-Associated Tumors. 754 Apr 59

We studied the prevalence of anti-HTLV-I/II antibodies in 22 patients with AIDS-related non-Hodgkin lymphoma (NHL), 453 HIV-1-infected patients without lymphoma (194 of whom were diagnosed as having AIDS), and 6 HIV-1-positive and 75 HIV-1-negative patients with Hodgkin lymphoma. The frequency of serological reactivity against HTLV antigens was significantly higher in the AIDS patients with lymphoma than in those without (8 of 22, 36.4% vs. 20 of 194, 10.3%-p = 0.0027). One of the HIV-1-positive and none of the HIV-1-negative patients with Hodgkin lymphoma showed anti-HTLV-I/II reactivity. Four of the eight seropositive NHL patients showed antibodies directed against HTLV-II recombinant antigens when tested for serological discrimination in a Western blot assay. A PCR study of PBMCs from the only patient with NHL still alive at the time of the study showed HTLV-II-specific sequences in the genomic DNA. These data suggest that HTLV-II or a closely homologous retrovirus infects a high proportion of patients with AIDS-associated NHL.
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PMID:Frequent detection of antibodies against HTLV antigens in patients with AIDS-related non-Hodgkin lymphoma. 754 9

The Inter-Company Collaboration for AIDS Drug Development (ICC) represents a collaborative effort among member companies to facilitate the conduct of clinical trials on AIDS drugs. One of the goals of the ICC is to expedite the development of combination antiretroviral therapy through data and compound sharing. Recently, the ICC formed a consensus master protocol to evaluate rapidly the safety and efficacy of triple-drug combinations of antiretroviral therapy for treatment of HIV-infected patients. This concept builds upon historical work with combination chemotherapy that resulted in treatments to successfully control chronic immunosuppressive, infectious or malignant diseases, such as tuberculosis, leprosy, childhood acute lymphoblastic leukemia, and Hodgkin's lymphoma. Because of limitations on potency and the continuing emergence of drug resistance seen with use of currently available antiretroviral agents in monotherapy and two-drug combination regimens, triple-combination regimens should represent a more promising approach to maximize antiviral activity, maintain long-term efficacy, and reduce the incidence of drug resistance. The ICC master protocol is a randomized, controlled, double-blind study with a treatment duration of 52 weeks. Patients eligible to enroll in this study must have documented HIV infection, with CD4 counts between 200 and 500 cells/mm3, and no history of antiretroviral therapy. The first four triple-drug combinations will be evaluated in two trials. These regimens have been selected based on encouraging data from laboratory and clinical studies. Each ICC trial will consist of three arms, with 75 patients per arm. Protocol ICC 001 will include AZT + zalcitabine (ddC) + saquinavir, AZT + ddC + nevirapine, and AZT + ddC as the control arm.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Inter-Company Collaboration Combination Trials. Clinical Trial Subcommittee of the Inter-Company Collaboration for AIDS Drug Development. 755 20

The time from the recognition that AIDS was an infectious disease, to the discovery of HIV as the causative agent and the identification of the first specific antiviral agent that showed some clinical benefit, was impressively short. Over the last few years it would appear that progress against AIDS has slowed down considerably. Neither new treatments nor vaccines have given much grounds for optimism and back to basics has been the main battle cry. However it is easy to overlook the tremendous improvements that have taken place in the management of HIV disease in the absence of a curative treatment. Many of the opportunistic infections that used to kill patients are not only treatable but are able to be treated prophylactically. This has altered the clinical spectrum of disease with many patients surviving several years with virtually no CD4 lymphocytes only to succumb to other HIV related disease such as non Hodgkins lymphoma. This review identifies the major advances that have occurred in our understanding of AIDS and identifies the major problems to be overcome in the next few years at both the clinical and basic levels.
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PMID:AIDS: clinical and scientific issues past, present and future. 755 39


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