Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0021051 (immunodeficiency)
 71,517 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Consecutive gallium-67 scans (n = 237) of 180 human immunodeficiency virus-seropositive patients with suspected pulmonary infections were evaluated for intensity and pattern of gallium distribution. Scan findings were correlated with the history, chest radiographic findings, and clinicopathologic diagnoses. Pneumocystis carinii pneumonia (PCP) occurred significantly more often with heterogeneous diffuse uptake than with homogeneous diffuse uptake. Heterogeneous diffuse uptake had an 87% positive predictive value for PCP, which was higher than that of other patterns. Localized pulmonary uptake was most commonly due to bacterial pneumonia or PCP; ill-defined, perihilar uptake, to cytomegalovirus or PCP; and focal (lymph node) uptake, to tuberculosis or lymphoma. The positive predictive value of any pulmonary uptake for lung pathology was 93%, and the negative predictive value of a negative scan was 96%. These findings confirm the utility of gallium scanning in the detection of lung pathology related to acquired immunodeficiency syndrome, particularly PCP. Furthermore, identification of a diffuse pattern may permit the use of a less invasive test more specifically directed at the confirmation of a diagnosis of PCP.
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PMID:Diagnostic implications of Ga-67 chest-scan patterns in human immunodeficiency virus-seropositive patients. 253 45

Current evidence indicates that the length of survival for patients with the acquired immunodeficiency syndrome (AIDS) is increasing, thereby affording a greater opportunity for strategies designed to prevent the infectious diseases that mark the syndrome. Because these infections may occur at different stages of immunosuppression caused by the human immunodeficiency virus (HIV), effective application of preventive measures depends not only on detection of HIV infection but also on the use of staging indicators. The diseases that serve to define AIDS, such as Pneumocystis carinii pneumonia, tend to occur late in the course of HIV infection and often when the T helper lymphocyte (CD4+ cells) count is less than 0.2 x 10(9)/l. Other infections, such as tuberculosis and pyogenic bacterial pneumonia, may develop at any point after HIV infection has occurred. Given this relation between the degree of immunosuppression and the occurrence of particular pulmonary infections, different preventive interventions should be applied at different times. It is now known that the incidence of several of the pulmonary infections that are common in patients with HIV infection can be reduced by prophylactic measures. Pneumocystis pneumonia is decreased in frequency by any one of several prophylactic agents, the best established being pentamidine administered as an inhaled aerosol. The role of isoniazid in the chemoprophylaxis of tuberculosis in patients not infected with HIV is well established. Although there is little evidence of benefit so far from isoniazid in HIV infected patients with a positive tuberculin skin test response, it is logical to assume that there could be some effect. The use of pneumococcal polysaccharide vaccine may also be of some benefit in reducing the frequency of pneumococcal pneumonia in patients with AIDS. In addition to these specific measures, the antiretroviral agent zidovudine decreases both the frequency and the severity of opportunist infections, at least during the first few months of treatment. A comprehensive strategy for prevention of HIV associated lung infection first requires detection of HIV seropositivity, staging the immunosuppression by the CD4+ cell count, and determining whether tuberculous infection is present by a tuberculin skin test. All seropositive individuals should be given pneumococcal vaccine and those with evidence of tuberculosis infection should be treated with isoniazid for one year. Zidovudine should probably be started when CD4+ cell counts are in the range 0.4-0.5 x 10(9)/l and prophylaxis against pneumocystis infection when CD4+ cell counts are in the range 0.2-0.3 x 10(9)/l.
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PMID:Prevention of lung infections associated with human immunodeficiency virus infection. 257 1

To determine the effects of human immunodeficiency virus (HIV) infection on pregnancy outcomes, we prospectively studied female intravenous drug users in a methadone program in New York City. Of 191 women with HIV status known prior to pregnancy, 17 (24%) of 70 seropositives and 26 (22%) of 121 seronegatives became pregnant during 28 months of follow-up. Including 54 additional women first tested for HIV antibody after becoming pregnant, 125 pregnancies were studied in 97 women (39 seropositive, 58 seronegative). None of the seropositive pregnant women had advanced HIV-related disease at entry, and only one developed symptomatic disease (oral candidiasis) during pregnancy. No differences were observed between groups in the frequency of spontaneous or elective abortion, ectopic pregnancy, preterm delivery, stillbirth, or low-birth-weight births. Among women giving birth to live infants, seropositives were more likely than seronegatives to be hospitalized for bacterial pneumonia during pregnancy and had an increased tendency for breech presentation, although these events were infrequent. There were otherwise no differences between groups in the occurrence of antenatal, intrapartum, or neonatal complications. Results suggest that asymptomatic HIV infection is not associated with a decreased pregnancy rate or an increased risk of adverse pregnancy outcomes in intravenous drug users, and that an acceleration in HIV-disease status during pregnancy is uncommon.
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PMID:Prospective study of human immunodeficiency virus infection and pregnancy outcomes in intravenous drug users. 291 55

A retrospective review of 71 children infected with human immunodeficiency virus cared for over a 3.5-year period revealed that 44 of 71 (63%) required a bacterial culture and 27 of 71 (37%) had bacteriologically documented infection. There were 125 episodes in 27 patients. Pneumonia (24 of 125 (19%)), upper respiratory tract syndromes (23 of 125 (19%)), urinary tract infection (24 of 125 (19%)) and wound infection (12 of 125 (10%)) were the most common syndromes identified. Bacteremic infections occurred in 35 of 125 (28%), and in 17 of 125 (14%) no other primary source could be identified. Pneumococci (11 of 35 (31%)) and Salmonella (4 of 35 (11%)) were the most common blood isolates; however, a wide spectrum of Gram-positive and Gram-negative pathogens were recovered. Bacterial pneumonia directly contributed to the death of 4 patients, in whom pneumonia caused by Pneumocystis carinii (2), cytomegalovirus (1) or varicella-zoster virus (1) also coexisted, respectively. Absolute T4 counts less than 400 and depressed lymphocyte-proliferative responses to diphtheria and tetanus toxoids, Candida antigen and pokeweed mitogen correlated with the occurrence of bacterial infection in human immunodeficiency virus-infected children. Although bacterial infections are a frequent cause of morbidity in human immunodeficiency virus-infected children, they are usually treatable.
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PMID:Bacterial infections in human immunodeficiency virus-infected children. 296 48

Hyponatremia has been recognized as a complication in adults with acquired immunodeficiency syndrome (AIDS). We did a retrospective study evaluating the medical records of 86 children (age 4 months to 21 years) with human immunodeficiency virus (HIV-1) infection to determine the frequency and clinical associations of hyponatremia. Twenty-two children (26%) developed hyponatremia (serum sodium < 135 mEq/L; range 104 to 134 mEq/L; mean 130 mEq/L). Fourteen were male; 18 of the 22 patients were black and 4 were white. At the time of hyponatremia, the children frequently had comorbid associations, including 8 (35%) with AIDS encephalopathy; 3 (14%) with cardiomyopathy; 3 (14%) using diuretics; 1 (5%) using pentamidine; 3 (14%) with bacterial pneumonia; 2 (9%) requiring gastric lavage feedings; 2 (9%) with tuberculosis meningitis; 2 (9%) with gastroenteritis; 1 (5%) with infection caused by Mycobacterium avium-intracellulare; 1 (5%) each with brain tumor and tumor metastasis to brain. The cause of hyponatremia was attributed to syndrome of inappropriate antidiuretic hormone in 8 children; poor sodium intake and/or excessive diarrheal losses in 5; and the use of diuretics in 3 patients. Mild hyponatremia with no identifiable cause was found in 5 patients.
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PMID:Hyponatremia in pediatric patients with HIV-1 infection. 748 60

Infection with Cryptococcus neoformans occurs with increased frequency in patients with the human immunodeficiency virus (HIV). Despite the lungs being the portal of entry for the fungus the commonest presentation is with meningitis: Cryptococcal broncho pulmonary infection occurs less commonly. The chest radiographs of fourteen HIV positive patients with cryptococcal pneumonia were reviewed. The commonest radiographic abnormalities were interstitial infiltrates, (nine patients) and focal or widespread alveolar consolidation (seven patients). Ground glass shadowing, not previously described in cryptococcal pneumonia, occurred in six radiographs, miliary nodules in one, lymphadenopathy in four, and small pleural effusions in three. Two patients had a normal chest radiograph. In contrast to previous reports, we found alveolar consolidation and ground glass shadowing to be common and nodules and cavitation to be rare. Cryptococcal pneumonia should be considered in the differential diagnosis of Pneumocystis carinii pneumonia, bacterial pneumonia and miliary tuberculosis in HIV positive patients.
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PMID:Cryptococcal pneumonia in patients with the acquired immunodeficiency syndrome. 748 24

Polymorphonuclear leukocytes (PMN) are the predominant inflammatory cells recruited in acute lung injury. This study compares the concentration of interleukin-8 (IL-8) to those of GRO alpha, both of which are CXC chemokines, in bronchoalveolar lavage fluid (BALF) in three acute pathologic states: bacterial pneumonia (BPN); adult respiratory distress syndrome (ARDS); and Pneumocystis carinii pneumonia (PCP). Levels of both IL-8 and GRO alpha were below 5 pg/ml in 16 nonsmoking volunteers who served as controls. Despite more than twice as many neutrophils in the BALF of the BPN group (n = 12) than in the group with ARDS (n = 13), both groups had similar levels of IL-8, of 569 +/- 120 pg/ml and 507 +/- 96 pg/ml, respectively. The GRO alpha concentrations in the BPN and ARDS patients were respectively 3.3 and 3.4 times those of IL-8, reaching 1,870 +/- 314 pg/ml for the BPN and 1,699 +/- 377 for the ARDS patients. In the PCP group (n = 48, 45 human immunodeficiency virus [HIV]-positive, 3 HIV-negative), GRO alpha levels (897 +/- 172 pg/ml) were sevenfold higher than IL-8 levels (123 +/- 40 pg/ml). In all pathologic states there was a good correlation between GRO alpha and IL-8 (r = 0.53, p = 0.0001). GRO alpha or IL-8 both correlate with the absolute neutrophil number/ml when all groups were studied together (r = 0.52, p = 0.0001). Only in the PCP and ARDS groups did IL-8 correlate with the PMN number.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:GRO alpha and interleukin-8 in Pneumocystis carinii or bacterial pneumonia and adult respiratory distress syndrome. 758 92

The objective of our study was to evaluate the prevalence of pleural effusions in patients with the acquired immunodeficiency syndrome, to correlate these effusions with any concomitant pulmonary diseases and to evaluate the role of cytologic examination in the diagnosis of the effusions. Twenty-eight of 389 (7.2%) human immunodeficiency virus-infected patients had pleural effusions and 27 of the 28 were suffering from concomitant pulmonary diseases. Those diseases were bacterial pneumonia (9), mycobacterial infection (7), non-Hodgkin's lymphoma (4) and Kaposi's sarcoma (2). Pneumocystis carinii pneumonia was diagnosed in two patients, and cytomegalovirus pneumonitis and pulmonary aspergillosis and small cell carcinoma in one patient each. Cytologic examination of pleural effusions provided conclusive diagnoses of mycobacterial infection in 2 of the 7 patients, of non-Hodgkin's lymphoma in 4 and of P carinii infection in 2.
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PMID:Pleural effusions in human immunodeficiency virus-infected patients. Correlation with concomitant pulmonary diseases. 763 43

Multiple defects in host defense mechanisms produce an increased incidence of community-acquired bacterial pneumonia in individuals infected with the human immunodeficiency virus. Clinical studies suggest that Staphylococcus aureus is an uncommon cause of such infections, though its incidence is increased in the setting of intravenous drug use, indwelling vascular catheter, and coexistent pulmonary Kaposi's sarcoma or pneumonia due to Pneumocystis carinii. The significantly higher incidence of S aureus pneumonia documented in autopsy series suggests that the infection frequently remains undiagnosed ante mortem. The clinical and radiologic presentation of staphylococcal pneumonia in HIV-seropositive patients is similar to that seen in immunocompetent hosts. However, atypical radiographic patterns can occur. We describe a case of S aureus pneumonia manifested as an infiltrate with focal predominance and multiple cavitary lesions. Such a radiologic appearance has not previously been described in this population. Given the likelihood that pneumonia due to S aureus is significantly underdiagnosed ante mortem, a high index of clinical suspicion is warranted.
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PMID:Pneumonia due to Staphylococcus aureus in a patient with AIDS: review of incidence and report of an atypical roentgenographic presentation. 773 54

Our aim was to investigate whether serum neopterin and beta 2-microglobulin have any value in the distinction between Pneumocystis carinii pneumonia (PCP) and pneumonia due to extracellular bacteria. Also, to study whether neopterin and beta 2-microglobulin would correlate with the clinical course of lung infections in human immunodeficiency virus (HIV)-positive and HIV-negative patients. Thirty HIV-positive subjects with PCP, 9 HIV-positive patients with bacterial pneumonia, and 16 HIV-negative patients with bacterial pneumonia were investigated. Thirty eight asymptomatic HIV-positive subjects and 48 healthy blood donors were used as controls. The HIV-positive patients with PCP and the HIV-positive subjects with bacterial pneumonia had significantly and similarly elevated levels of neopterin and beta 2-microglobulin in the acute stage. In the weeks before the acute stage of PCP, neopterin and beta 2-microglobulin had been increasing. After start of treatment, serum neopterin declined significantly, whilst serum beta 2-microglobulin remained elevated. The HIV-negative patients with bacterial pneumonia had significantly increased serum concentrations of both markers in the acute stage, and had decreasing serum concentrations in the weeks after treatment. We conclude that neither neopterin nor beta 2-microglobulin seem to be of value in distinction between PCP and bacterial pneumonia in HIV-positive subjects. In the HIV-positive patients, neopterin may correlate partly with the clinical activity of PCP, whilst serum beta 2-microglobulin may remain elevated after PCP, despite treatment and recovery. The elevated level may, in part, be due to repeated infections and progression to acquired immune deficiency syndrome (AIDS).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Changes in serum neopterin and serum beta 2-microglobulin in subjects with lung infections. 792


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