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)

In this pilot study, 12 patients with chronic delta hepatitis were studied. The diagnosis was based on the presence of antibodies to the hepatitis delta antigen in the serum and hepatitis delta virus RNA and hepatitis delta antigen in the serum and liver. All patients were also positive for hepatitis B surface antigen. The infection was presumed to have been transmitted by intravenous drug abuse in six of the patients, blood transfusion in one and by sexual contact in four (two had antibodies to human immunodeficiency virus in their serum, but did not show signs of acquired immunodeficiency syndrome). In one further patient, the source of infection was unknown. Interferon alfa-2b (INTRON A, Schering-Plough Corporation) was initiated at 5 million units per day subcutaneously for at least 4 months, being reduced by half if side effects occurred. Serum alanine aminotransferase levels, hepatitis delta virus RNA and hepatitis delta antigen were measured at monthly intervals for up to 12 months in some patients. Interferon therapy resulted in decreased serum levels of these three markers. On cessation of therapy, most patients experienced a relapse over 6 months, but alanine amino transferase levels could be normalized once more by restarting interferon therapy. In conclusion, interferon decreased hepatic inflammation by the inhibition of hepatitis delta virus replication, although relapse occurred when interferon was stopped and long-term therapy is required to achieve permanent control of the disease. Care will be required when treating patients with advanced or decompensated liver disease.
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PMID:Therapy of chronic delta hepatitis with interferon alfa-2b. 207 75

Sera from 172 intravenous drug users were tested for the presence of antibodies to hepatitis C virus (anti-HCV). The results were analysed in relation to aspects of the history of drug use and evidence of liver disease. The presence of anti-HCV was strongly associated with duration of intravenous drug use. Two-thirds of patients were anti-HCV seropositive within two years of commencing regular intravenous drug use, and there was 100% seropositivity among people injecting drugs for more than eight years. Seropositivity for hepatitis C virus closely paralleled exposure to hepatitis B virus, which was also endemic in this population. In contrast, only one patient tested positive for antibodies to the human immunodeficiency virus. The presence of anti-HCV correlated poorly with biochemical markers of hepatitis. About half the patients with anti-HCV had normal serum levels of alanine aminotransferase, whereas an abnormal liver biochemistry was frequently observed in anti-HCV seronegative subjects. Previous studies of non-A, non-B hepatitis that have used abnormal liver biochemistry as a marker have underestimated the prevalence of chronic hepatitis among intravenous drug users; the use of a specific screening test reveals that infection with hepatitis C virus is very common in this population.
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PMID:Hepatitis C virus in intravenous drug users. 804 44

We investigated 24 completed pregnancies of 20 healthy, human immunodeficiency virus (HIV)-seropositive sex partners of 20 seropositive hemophilic men. One woman had recurrent herpes simplex type 2 infection; no woman was known to use illicit drugs or to have other purported cofactors for vertical HIV transmission. For 8 offspring, the mothers learned of their partners' serostatus and received counseling against pregnancy prior to the fifth month of gestation; for 9 offspring (37.5%), the mothers learned of their own seropositivity and received counseling prior to the fifth month. Acquired immunodeficiency syndrome developed in 7 (35%) of 20 fathers, 4 of whom died; HIV-related symptoms developed in 4; severe liver disease developed in 2; and 7 (35%) were in good health. In four mothers (20%) HIV-related symptoms developed. Five offspring were breast-fed for 2 days to more than 3 years, two while the mother was known to be seropositive; four of these were seronegative and healthy, and one was seropositive at 30 months of age and had persistent cervical lymphadenopathy at 48 months of age. Infants were born at term; median birth weight was 2.86 kg. Solely on the basis of serologic studies and symptoms for those with more than 15 months of follow-up, the minimum perinatal transmission rate for this group of women without putative transmission cofactors (drug usage, promiscuity, malnutrition, HIV symptoms) was at least 25%, a rate comparable to that reported for women in other risk groups.
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PMID:Pregnancies in human immunodeficiency virus-infected sex partners of hemophilic men. The Hemophilia-AIDS Collaborative Study Group. 232 14

Because the risk factors for human immunodeficiency virus (HIV) infection and hepatitis B (HBV) are similar and therefore coinfection is not uncommon, a detailed histological and immunohistochemical study of chronic hepatitis B infection in a group of 20 HIV positive Caucasian males (who did not have AIDS) and 30 HIV negative controls were undertaken. Using both the conventional histological classification and the Knodell histological activity index it was shown that HIV negative patients were more likely to have active disease and also more scarring than HIV positive patients. Hepatitis B surface antigen (HBsAg) expression was not significantly different between the two groups but expression of hepatitis Be antigen (HBeAg) and HBV-DNA polymerase was greater in those who were HIV positive. HIV positive patients are therefore more likely to have immunohistochemical markers of active viral replication, although histologically, liver disease is less severe. These findings have important implications for assessing the biopsy specimens in this group of patients and for treatment strategies aimed at improving their immune function.
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PMID:Histological and immunohistochemical study of hepatitis B virus in human immunodeficiency virus infection. 233 17

The pharmacokinetics of zidovudine (azidothymidine, AZT) was investigated after oral administration (200 mg) in 14 human immunodeficiency virus seronegative patients with liver cirrhosis. They were divided in three groups according to the severity of the liver disease quantitated by the Child-Pugh score. Plasma and urine concentrations of zidovudine and its glucuronidated metabolite (GAZT) were measured simultaneously by HPLC assay. Findings were compared with those previously measured in six healthy volunteers. As a consequence of a marked drop in oral clearance (10 +/- 4 versus 38 +/- 15 ml/min/kg), zidovudine concentrations, half-life, and mean residence time were increased in patients with cirrhosis. No difference could be established between the three groups. The reason for such a decrease in oral clearance of zidovudine was the reduction in the GAZT formation clearance (236 +/- 73 versus 1540 +/- 540 ml/min); this led to a decrease in the AUC ratio of GAZT and zidovudine (1.3 +/- 0.6 versus 4.6 +/- 0.7), which was directly related to the severity of the cirrhosis. In patients, as in volunteers, formation of GAZT rate limits its elimination. To avoid important cumulation of zidovudine after repeated dosing in patients with acquired immunodeficiency syndrome who have hepatic impairment, a dosage adjustment could be proposed.
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PMID:Pharmacokinetics of zidovudine in patients with liver cirrhosis. 235 67

No information is available on the role of non-A, non-B hepatitis in the various hepatic abnormalities described in patients with the acquired immune deficiency syndrome. Of 97 patients referred with suspected non-A, non-B hepatitis, 3 were found to have antibody to the human immunodeficiency virus. These latter 3 patients all developed symptomatic cirrhosis within 3 yr of onset of hepatitis. Such a rapid progression of liver disease was rare in patients with non-A, non-B hepatitis who did not have simultaneous human immunodeficiency infection. These findings suggest that human immunodeficiency virus infection may potentiate the liver injury of chronic non-A, non-B hepatitis.
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PMID:Rapidly progressive non-A, non-B hepatitis in patients with human immunodeficiency virus infection. 251 Oct 56

The frequency of hepatitis C virus (HCV) infection in Spain was assessed by means of a recombinant-based immunoassay for serum anti-HCV antibodies. 836 serum samples were tested from 676 patients selected according to their risk of blood-borne viral infections and presence of liver disease. Among patients at high risk of infection (with or without liver disease) anti-HCV antibodies were found in 85% of prospectively followed patients with post-transfusion non-A, non-B hepatitis, 62% of patients with chronic hepatitis or cirrhosis and a history of blood transfusion, 70% of haemophiliacs receiving replacement therapy, 70% of intravenous drug abusers, and 20% of haemodialysis patients. Only 8% of homosexual men infected with human immunodeficiency virus and 6% of female contacts of drug abusers were positive. Among patients with liver disease and no history of parenteral exposure to blood, anti-HCV antibodies were detected in 38% with cryptogenic, alcoholic, or primary biliary cirrhosis and in 44% with chronic active hepatitis. Among healthy subjects without risk factors for hepatitis the overall prevalence of anti-HCV was 1.2%.
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PMID:Hepatitis C virus antibodies among risk groups in Spain. 256 2

Parenteral drug users have a high prevalence of infection with human immunodeficiency virus (HIV), the etiologic agent of acquired immune deficiency syndrome (AIDS). New York City has had a prolonged and extensive epidemic of HIV infection and AIDS. In this study, we analyze, in relation to antibody to HIV (anti-HIV), available data from sera from parenteral drug users collected in New York City during 1978 through 1983 in the course of studies of liver disease. Among parenteral users of both heroin and cocaine, 30 (52%) of 58 had anti-HIV, compared with six (13%) of 48 injectors of heroin only (P less than 0.0001). Only two (11%) of 18 white patients were HIV-infected, compared with 34 (39%) of 88 black or Hispanic patients (P = 0.03). No other factors studied were linked to anti-HIV. In a multiple logistic regression, anti-HIV was significantly more common in parenteral users of both cocaine and heroin (P less than 0.0001), black patients (P = 0.02), and Hispanic patients (P = 0.049). We conclude that parenteral users of both cocaine and heroin as well as black and Hispanic patients were disproportionately HIV-infected during the early years of the HIV epidemic. Use of cocaine and heroin as well as ethnicity were independently linked to anti-HIV. Measures to prevent or treat drug use, HIV infection, and other medical problems while addressing the specific needs of cocaine users and black and Hispanic patients are urgently needed.
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PMID:Cocaine injection and ethnicity in parenteral drug users during the early years of the human immunodeficiency virus (HIV) epidemic in New York City. 261 98

Infections with the hepatitis B (HBV) and delta (HDV) viruses and with the human immunodeficiency virus (HIV) are very common among intravenous drug addicts. The serum of 80 percent of drug addicts contains one of the HBV markers, and 15 percent of them carry an anti-D antibody. Infections with the hepatitis A and non A-non B viruses are also very common among drug abusers. Some of them may harbour several of these pathogens. This can explain the frequency of liver disease (biological anomalies and histological lesions) observed in drug addicts, as does alcohol consumption associated with drug abuse. Fifty to 60 per cent of intravenous drug addicts are seropositive for HIV. This prevalence varies across studies and countries. The high prevalence of infection by HIV in drug addicts may be explained by the use of a shared syringe. This prevalence exposes drug addicts to an increase in AIDS cases in the near future. The high prevalence of infections by HBV, HDV and HIV in drug addicts represents a risk factor for the spread of HBV, HDV and HIV infections among the general population. Preventing the rapid spread of these viruses among drug addicts is of utmost importance for the future.
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PMID:Prevalence of hepatitis B virus, delta agent and human immunodeficiency virus infections in drug addicts. 268 71

A family is described in which multiple members are afflicted with liver disease and primary biliary cirrhosis (PBC). In the third generation, one member died of PBC, and a second individual has both symptomatic PBC and selective immunoglobulin A (IgA) deficiency, an association not previously reported. By culturing this patient's lymphocytes in vitro it was shown that the IgA deficiency was due to a failure of B cells to secrete IgA. Two other siblings of this patient have multiple serum biochemical and serologic abnormalities that are sometimes associated with PBC, but they do not have histopathologically overt PBC or IgA deficiency. All three surviving family members have a diminished autologous mixed lymphocyte reaction, an immunologic abnormality that has previously been found in patients with PBC, selective IgA deficiency, and several autoimmune diseases. As there is an association between selective IgA deficiency and certain autoimmune diseases, it is possible that this immunodeficiency contributed to the development of PBC in the patient in whom the two diseases coexisted. Furthermore, the occurrence of PBC in a patient with selective IgA deficiency indicates that the pathogenesis of PBC does not require IgA-dependent immune mechanisms.
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PMID:Selective immunoglobulin A deficiency associated with primary biliary cirrhosis in a family with liver disease. 293 89


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