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Query: UMLS:C0021051 (immunodeficiency)
 71,517 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Vaccine-preventable diseases cause needless sickness and death in adult Americans. Most adults 65 years of age or older have not been immunized against influenza or pneumococcal disease. In addition to an age of 65 years or older, indications for influenza and pneumococcal vaccines include chronic obstructive pulmonary disease, hemodynamically significant cardiac disease and infection with the human immunodeficiency virus. Many adults in the United States also are not sufficiently protected against tetanus, diphtheria, measles, mumps and rubella.
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PMID:Adult immunizations--a practical approach for clinicians: Part I. 788 62

Strong specific T-cell responses to human immunodeficiency virus type 1 (HIV-1) gp160 were induced by immunization with recombinant gp160 (rgp160). It was given as postinfection vaccination to 40 asymptomatic HIV-1 seropositive patients. The participants received 6 doses of 160 micrograms rgp160 administered intramuscularly at 0, 1, 4, 8, 17, and 26 weeks and were monitored for 1 year. Lymphocyte proliferation was performed by cultivating lymphoid cells in vitro with specific antigens and mitogens. After immunization with gp160, specific T-cell proliferative responses were induced in all 40 patients. One week after the sixth immunization at day 180, a substantially increased response was detected in 98% of the patients, with a mean stimulation index value of 195. Furthermore, proliferative responses were also identified, after immunization, against native gp120 and against a peptide representing the V3 region of gp120. In addition to the HIV-specific T-cell responses, increased reactivity to several other non-HIV antigens, including tetanus toxoid, influenza, measles, and cytomegalovirus, were seen after gp160 vaccination. The responses to CMV and measles were interpreted to represent an improved recall antigen response. Such recall antigen responses were few in matched HIV-infected controls immunized with influenza virus only. All patients initially and repeatedly showed a normal capacity of total T-cell activation, evaluated by the mitogen phytohemagglutinin (PHA). The trend in CD4 counts improved in 30 of 40 patients during the year of follow-up. The frequency of increases of proliferative responses to antigens was associated with a better CD4 trend. Addition of zidovudine for 2 weeks after each immunization had no beneficial effects nor did it prevent induction of immune responses. All patients tolerated the immunizations well, and no systemic adverse effects were noted. This is a phase I trial, and no definitive conclusions regarding clinical efficacy can be reached.
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PMID:Improved cell-mediated immune responses in HIV-1-infected asymptomatic individuals after immunization with envelope glycoprotein gp160. 790

The main immunological abnormality in human immunodeficiency virus (HIV)-infected patients, and particularly those with the acquired immune deficiency syndrome (AIDS), is a deficiency in cellular immunity. However, symptomatic HIV-infected children also have evidence of deficiency of specific antibody synthesis, and intravenous immune globulin (IVIG) preparations in doses of 0.2-0.4 g/kg every 2-4 weeks have been shown to reduce the incidence of respiratory infections. IVIG therapy may also reduce the mortality and incidence of bacterial infections in adults but further studies are required. In addition, high-dose IVIG therapy (1-2 g/kg over 2-5 days) produces increased platelet counts in patients with idiopathic thrombocytopenic purpura (ITP) associated with HIV infection. Finally, IVIG therapy may have a role in HIV-infected patients suffering from severe parvovirus B19 or measles infection, or in patients suffering from autoimmune disorders where high-dose IVIG therapy has been shown to be efficacious.
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PMID:Does intravenous immune globulin have a role in HIV-infected patients? 803 37

The relationship between progressive immunodeficiency related to infection with human immunodeficiency virus (HIV) and waning immunity to measles was investigated in this retrospective cohort study. Titers of serum antibodies to measles virus were measured by enzyme immunoassay of stored sera from a cohort of homosexual men who were studied at San Francisco General Hospital. Subjects underwent a baseline and follow-up measure of measles antibodies. High levels of antibodies to measles virus were maintained in the HIV-positive and negative groups. One (2%) of the 50 HIV-negative controls was seronegative for the measles virus, and no controls evidenced seroreversal (decline in antibody to a level at which protection is not provided) during the study. Two (1.4%) of the 145 HIV-positive subjects were measles-seronegative, and two others evidenced seroreversal. Analysis with Spearman's rank correlation revealed no relationship between changes in the CD4 cell count and measles antibody level. Thus we conclude that waning measles immunity is not greatly accelerated in HIV-infected adults despite progressive HIV-related immunodeficiency.
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PMID:Progressive immunodeficiency due to infection with human immunodeficiency virus does not lead to waning immunity to measles in a cohort of homosexual men. 803 24

The human peripheral blood mononuclear cells responsible for IFN-alpha production in response to viral stimuli have been most often described as either monocytes (as typified by the response to Sendai virus) or as a light density, HLA-DR+ population which is negative for most cell surface markers characteristic of mature T cells, B cells, monocytes, or natural killer cells (as typified by the response to Herpes simplex virus (HSV)). The frequency of IFN-alpha-producing cells (IPC) responding to Sendai virus is typically 10-fold or more higher than those responding to HSV. In the current study, we have used ELISpot assays to determine the frequency of IPC responding to DNA and RNA viruses including HSV, Sendai, vesicular stomatitis virus, cytomegalovirus, adenovirus, SV40, influenza, measles, mumps, Newcastle disease virus (NDV) and human immunodeficiency virus (HIV). The enveloped viruses but not the nonenveloped viruses (adenovirus and SV40) elicited an IFN-alpha response. The frequency of IPC for each of the other viruses was more similar to the low frequency HSV-responding population than to the higher frequency Sendai virus response. These included several viruses in the same family as Sendai virus, namely the paramyxo viruses measles, mumps, and NDV. IPC were also tested for sensitivity to the lysosomotropic drug chloroquine, which diminishes IFN-alpha produced in response to HSV but not Sendai virus. With the exception of Sendai virus, chloroquine treatment abrogated the majority of IFN-alpha produced and IPC against each of the viruses. We conclude that low frequency, nonmonocytic NIPC account for the majority of IFN-alpha production in response to different viruses.
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PMID:Viral induction of low frequency interferon-alpha producing cells. 809 44

Maternally acquired immunity was studied in 16 pairs of human immunodeficiency virus (HIV)-seropositive women and their newborns, and was compared to 18 control mother-newborn pairs. The HIV-infected women had higher IgG levels than the control subjects, but no difference was observed between newborn samples, presumably due to the limited placental IgG transfer in the HIV group. A poor type 2 poliovirus antibody transfer was also noted in this group. The population of newborns lacking demonstrable measles antibodies was higher in the HIV group than in the control group, probably because many of the HIV-infected mothers lacked measles antibodies also. These results show that maternally acquired immunity may be affected to newborns from HIV-infected women, either because of low maternal serum antibody levels or deficient transplacental transfer. If so, the measles vaccine schedule should be revised for these children and the same should be done for future passive immunization regarding fetus protection in pregnant HIV-seropositive women.
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PMID:Maternally acquired immunity in newborns from women infected by the human immunodeficiency virus. 815 20

Current approaches to the prevention and control of AIDS by vaccines and by chemotherapy have failed to provide satisfactory solutions to this important medical problem and have failed, in addition, to provide definitive guidelines for future research endeavor. Vaccine research must and will continue but it is possible that a safe and effective vaccine may never be developed and it may be timely to explore, in addition, alternative means for immunological intervention in AIDS. Both immunoprophylactic and immunotherapeutic efforts might be assisted by manipulating the T helper 1 (Th1) and T helper 2 (Th2) subsets of CD4+ T helper cells, which is therefore worthy of exploration. Selective control of immune response by the two T helper subsets is by release of different cytokines that promote either cellular or humoral immunity, the latter of which may be associated with inappropriate immune responses and with immune dysfunction. Discovery of the Th1 and Th2 subsets and definition of the cytokines they release provide a new avenue toward possible development of a safe and effective vaccine and an approach, in addition, to correction of immune dysfunction by selective cytokine administration or by cytokine ablation by antagonists or antibodies. AIDS pathogenesis and immune dysfunction are complex and understanding them may be overwhelmed by an excess of possibilities. Simplification of the endeavor might benefit from comparative studies of the pathogenesis of measles, in which there also is immune deficiency but usually with spontaneous viral clearance, reversal of immune dysfunction, and total recovery. In addition, measles presents as a single disease and is caused by antigenically stable virus. Identification of the process whereby measles immunodeficiency is spontaneously reversed might be of importance in attempting to devise means for similar reversal in AIDS.
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PMID:Vaccinology, immunology, and comparative pathogenesis of measles in the quest for a preventative against AIDS. 817 62

This brief editorial argues in favor of making acquired immunodeficiency syndrome (AIDS) a notifiable disease. According to the World Health Organization (WHO), AIDS will cause more deaths in sub-Saharan Africa than anywhere else in the world over the next 3 years. More children will die from AIDS than from malaria or from measles. The number of cases of tuberculosis, in association with human immunodeficiency virus (HIV), will also rise, creating an uncontrollable pandemic under present policies. The argument that notification requirements will drive AIDS underground (Dr. Prozesky of the Medical Research Council at the launch of the AIDS Bulletin) is indefensible. Patients who have contracted syphilis or gonorrhea, with regard to privacy and confidentiality, are questioned about sources of their infection; however, preventive action follows that protects public health. This cannot be left as a personal option (G Stewart, Nursing Times, 1993, Vol 89, No 26). Group rights collide with individual rights; however, groups as well as individuals have human rights. The greater responsibility is to public health, rather than to individual sensitivity.
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PMID:Should AIDS be notifiable? 826 78

The clinical features, chest radiographs and computed tomographic (CT) images were evaluated in 11 cases with serologically proved adult measles complicated with pneumonia (10 were previously healthy and one had sarcoidosis). Pneumonia appeared during the rash period in all cases. Respiratory symptoms were cough (9/11), dyspnea (3/11), and hypoxemia (10/11). Pneumonia manifestations were detected in only 4 cases by chest radiograph; on the other hand, they were seen in all cases by CT scan and consisted of ground-glass opacities (73%), nodular opacities (64%) and consolidation (27%). CT seems to be a useful method to detect measles pneumonia if it is suspected. Measles pneumonia in previously healthy patients had a good prognosis, as the hypoxemia disappeared within 6 days in all cases. The sarcoidosis patient showed prolonged pneumonic shadows and period of hypoxemia. Measles pneumonia occurring in a host with cellular immunodeficiency may have a severe clinical course.
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PMID:[Clinical features of measles pneumonia in adults: usefulness of computed tomography]. 825 23

We have described a patient, immunocompromised from an infection with the human immunodeficiency virus, who had rapidly progressive measles complicated by measles pneumonia and respiratory failure. Rapid improvement in the patient's condition followed therapy with inhaled ribavirin and intravenous immune globulin. Patients who have measles pneumonia associated with respiratory failure may benefit from combination therapy with ribavirin and IV immune globulin.
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PMID:Ribavirin and intravenous immune globulin therapy for measles pneumonia in HIV infection. 827 26


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