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)

The human immunodeficiency virus (HIV) is reportedly transmitted by sexual contact, sharing of infected needles among intravenous drug abusers, blood and blood products, artificial insemination, and kidney transplantation. This study reports on cornea and kidney recipients of two HIV-infected donors. HIV was transmitted to two kidney recipients who developed symptoms of acute HIV infection (i.e., fever, leukopenia, mild thrombopenia, splenomegaly) starting 12 days after transplantation. These signs of acute infection ended with seroconversion of HIV antibodies on approximately the 56th day after transplantation. The three cornea recipients showed no signs of acute infection and no HIV antibodies were detected up to three years after transplantation. The nontransmission observed in our cases, however, may not be representative of cornea transplantations in general. HIV is neurotropic in the later stages of the disease, and transmission of other neurotropic viruses like rabies and Creutzfeldt-Jakob disease by cornea transplantation has been reported. All tissue and organ donors should be tested for anti-HIV prior to donation.
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PMID:Human immunodeficiency virus transmission by organ donation. Outcome in cornea and kidney recipients. 329 18

Coded cadaveric sera from 35 patients with acquired immunodeficiency syndrome (AIDS), from 45 cadavers at high risk of human immunodeficiency virus (HIV) infection, and from 262 cadavers without known signs or risk of AIDS were assessed using three commercially available enzyme-linked immunosorbent assays (ELISA) kits and Western blot analysis. Greater than 94% sensitivity and 99% specificity was achieved with each of the ELISA test kits using cadaveric sera. The Western blot method gave 97.1% sensitivity compared with the autopsy-proven diagnosis of AIDS. Positive results were obtained on sera from AIDS cadavers even if the time of blood draw was delayed 35 hours from death and the time of sera preparation was delayed up to 176 days. False-negative or false-positive ELISA results did not appear to correlate with hemolysis or any parameter of sera preparation. In contrast to the high sensitivity in testing sera, only 16 to 26% of aqueous humor samples from AIDS cadavers were ELISA-positive and 79% were positive by Western blot. These results indicate that three commercially available ELISA test kits are an effective means of screening cadaveric sera for antibodies to HIV, but that aqueous humor cannot be reliably substituted for cadaveric sera to screen potential cornea donors by an ELISA assay.
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PMID:Screening cornea donors for antibodies against human immunodeficiency virus. Efficacy of ELISA testing of cadaveric sera and aqueous humor. 355 92

Routine screening of cornea donors for human immunodeficiency virus type 1 (HIV-1) has been established and has reduced the risk of HIV-1 transmission to a minimum. Screening for HIV-2 is less common. We evaluated 100 cornea donors for HIV-2 and 166 cornea donors for HIV-1 according to our routine screening procedure. Enzyme-linked immunosorbent assays (ELISAs) with high sensitivity were used to detect antibodies in donor blood. HIV-2 seroconversion was not found in any of the 100 cases tested, whereas HIV-1 seroconversion was detected in 4 of 166 cases; consecutive Western-blot analysis showed only 1 positive result. Thus, 1 of 166 cases (0.6%) had to be considered infected with HIV-1. Our findings of HIV-1 seroprevalence are comparable with those obtained in studies carried out in Europe and the United States. Data are lacking for comparison with our results concerning HIV-2 seroprevalence. Because of the epidemiologic situation of HIV-2 in Europe, different seroprevalence rates would be expected. Routine screening of potential cornea donors for HIV-2 in Germany may be necessary only if the seroprevalence rises in the population.
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PMID:Human immunodeficiency virus type 1 and type 2 seroprevalence in cornea donors. 786 30

In this article we develop a calculation or formula for use in determining the potential dilution effect of fluids administered during patient treatment on serologic testing parameters. The formula uses basic principles of (a) fluid distribution over time from administration; (b) ratios of plasma and extravascular fluid volumes to body weight; and (c) common practices of fluid resuscitation. A dilution threshold of 50% was set using data from enzyme-linked immunosorbent assay human immunodeficiency virus antibody determinations performed on in vitro diluted seropositive serum samples. These data respond to issues raised by guidelines from the Centers for Disease Control and the U.S. Food and Drug Administration to achieve recipient safety without unnecessarily restricting the potential donor pool.
Cornea 1994 Jul
PMID:Guidelines for preventing "dilution false negatives" in in vitro laboratory testing of the donor population. 792 26

A 29-year-old female intravenous drug abuser infected with the human immunodeficiency virus suffered recurrent, bilateral corneal infections over an 11-month period. Multiple infectious organisms were responsible, including capnocytophaga species, Candida albicans, Staphylococcus aureus, coagulase-negative staphylococcus, and a-streptococcus. One eye was eviscerated because of corneal perforation and loss of vision; the second eye has maintained good vision. Predisposing factors usually associated with corneal infections were absent. Treatment was complicated by extremely poor patient compliance, ongoing intravenous drug abuse, and concurrent multiple extraocular medical problems.
Cornea 1993 May
PMID:Recurrent corneal infections in a patient with the acquired immunodeficiency syndrome. 850 Mar 41

The incidence of cell transplant-transmitted infection is unknown and can only be inferred from prospective studies--that have not yet been performed and reported. The possibility of donor-to-recipient disease transmission through cell transplant therapy can be considered by reviewing the risk associated with other transplanted tissues and organs. Viral, bacterial, and fungal infections have been transmitted via transplantation of organs, tissue allografts such as bone, skin, cornea, and heart valves, and cell such as islets, hematopoietic stem cells, and semen. Several types of protozoan and worm parasites have been transferred via organ transplants. Bone allografts have transmitted hepatitis, tuberculosis, and human immunodeficiency virus (HIV-1). Corneas have transmitted rabies, Creutzfeldt-Jakob disease (CJD), hepatitis B (HBV), cytomegalovirus (CMV), herpes simplex virus (HSV), bacteria, and fungi. Heart valves have been implicated in transmitting tuberculosis and hepatitis B. HIV-1 and CMV seroconversion has been reported in patients receiving skin from seropositive donors. CJD has been transmitted by dura and pericardium transplants. Over the past several years, improvements in donor screening criteria, such as excluding potential donors with infection and those with behaviors risky for HIV-1 and hepatitis infection, and introduction of new donor blood tests have greatly reduced the risk of HIV-1 and hepatitis and may have nearly eliminated the risk of tuberculosis and CJD. Prior to use, many tissues are exposed to antibiotics, disinfectants, and sterilants, which further reduce or remove the risk of transmitted disease. Because organs, cells, and some tissue grafts cannot be subjected to sterilization steps, the risk of infectious disease transmission remains and thorough donor screening and testing is especially important.
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PMID:Infectious disease transmission through cell, tissue, and organ transplantation: reducing the risk through donor selection. 852 Aug 30

We report the development of cytomegalovirus (CMV) keratitis in the penetrating keratoplasty of a 59-year-old human immunodeficiency virus-negative woman after uncomplicated corneal transplantation. Immunosuppression with topical cyclosporine A 2% in corn oil and topical prednisolone acetate 1% suspension was used postoperatively. The 15-month postoperative course was complicated by multiple episodes of endothelial rejection, medically controlled elevated intraocular pressure, polymicrobial bacterial (coagulase-negative staphlococcus and alpha-hemolytic streptococcus) keratitis, and endothelial plaque formation with associated hypopyon and epithelial defect. The graft failed and penetrating keratoplasty was repeated. Cytomegalovirus infection of superficial keratocytes in a region of scarring was identified in histological sections stained with hematoxylin and eosin and confirmed using mouse monoclonal anti-cytomegalovirus antibodies. Excision of the diseased corneal button with no additional treatment appears to have been curative. Low-grade keratitis was the only manifestation of the CMV infection, and it has not recurred 6 months postoperatively.
Cornea 1995 Nov
PMID:Cytomegalovirus keratitis after penetrating keratoplasty. 857 88

Viruses such as human immunodeficiency virus, herpes simplex virus, cytomegalovirus, hepatitis B, hepatitis C, and rabies can be transmitted to the recipient by corneal transplantation. Very few cases of rabies have been reported. Here we report two cases of rabies transmitted by the same donor. Both of the recipients died of rabies.
Cornea 1996 Jul
PMID:Transmission of rabies by corneal graft. 907 42

A 31-year-old man with the acquired immunodeficiency syndrome presented with herpes zoster ophthalmicus on the right. Five days after he began treatment for the zoster pseudodendrites and skin lesions, he developed superficial punctate keratitis, uveitis, and crusting skin lesions in the left eye. After treatment, the ocular lesions resolved in both eyes without incident. The bilateral manifestation of herpes zoster ophthalmicus is a result of the increased severity associated with immunosuppression caused by the human immunodeficiency virus.
Cornea 1996 Nov
PMID:Presumed bilateral herpes zoster ophthalmicus in an AIDS patient: a case report. 889 77

Transmission of infectious agents from a patient to the following one in the medical office may result from infected collyria, from contact to the cornea by infected instruments or simply by the hands of the medical staff if some rules of hygiene are not respected. The prevention comprises the instillation without contact of the collyria, the adequate disinfection of instruments and the frequent hand washing. The disinfection of the tonometers and contact glasses aims particularly the elimination of viruses. If the virus of herpes, hepatitis and acquired immunodeficiency are eliminated by hypochlorite, oxygenated water and alcohol after 10 minutes, the adenovirus which is not coated is on the other hand resistant to alcohol and may survive several days on instruments. Ideally the disinfection would have to be performed between each utilization by soaking in bleach water at 500 ppm, or in chloramine 0.5%, or in hydrogen peroxide 3% (during 10 minutes). The alcohol may damage the glue of diagnostic contact lens. The hypochlorite attacks the metal. In case of possible contact with the blood of the patient, the wear of gloves is counseled (for example for fluorescein angiography) and is of course mandatory for surgical procedures in the office like excision of chalazion or keratotomy. Disposable needles will be thrown in solid wall containers reserved to this aim without being recapped.
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PMID:[Prevention of infections in the ophthalmology office]. 902 12


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